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Fulltext Assessing malnutrition in patients with nasopharyngeal carcinoma: Diagnostic protocol for the development and validation of a new nutritional assessment tool

Wang P, Soh KL, Japar SB, Khazaai HB, Liao J, Ying Y, et al.

PLoS One, 2024;19(3):e0300067.
PMID: 38527072 DOI: 10.1371/journal.pone.0300067

INTRODUCTION: There is currently no gold standard or specific nutritional assessment tool to assess malnutrition in patients with nasopharyngeal carcinoma (NPC). Our study aims to develop a new nutritional assessment tool for NPC patients.
METHODS AND ANALYSIS: NPC patients will be required to complete a risk factor questionnaire after obtaining their informed consent. The risk factor questionnaire will be used to collect potential risk factors for malnutrition. Univariate and multivariate logistic regression analyses will be used to identify risk factors for malnutrition. A new nutritional assessment tool will be developed based on risk factors. The new tool's performance will be assessed by calibration and discrimination. The bootstrapping will be used for internal validation of the new tool. In addition, external validation will be performed by recruiting NPC patients from another hospital.
DISCUSSION: If the new tool is validated to be effective, it will potentially save medical staff time in assessing malnutrition and improve their work efficiency. Additionally, it may reduce the incidence of malnutrition and its adverse consequences.
STRENGTHS AND LIMITATIONS OF THIS STUDY: The study will comprehensively analyze demographic data, disease status, physical examination, and blood sampling to identify risk factors for malnutrition. Furthermore, the new tool will be systematically evaluated, and validated to determine their effectiveness. However, the restricted geographical range may limit the generalizability of the results to other ethnicities. Additionally, the study does not analyze subjective indicators such as psychology.
ETHICS AND DISSEMINATION: The ethical approval was granted by the Ethical Committee of the First Affiliated Hospital of Guangxi Medical University (NO. 2022-KT-GUI WEI-005) and the Second Affiliated Hospital of Guangxi Medical University (NO. 2022-KY-0752).
CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR2300071550.
Fulltext Effects of UV Irradiation and Storage on the Performance of Inverted Red Quantum-Dot Light-Emitting Diodes

Luo Y, Wang J, Wang P, Mai C, Wang J, Yap BK, et al.

Nanomaterials (Basel), 2021 Jun 18;11(6).
PMID: 34207371 DOI: 10.3390/nano11061606

We report the effects of ultraviolet (UV) irradiation and storage on the performance of ZnO-based inverted quantum-dot light-emitting diodes (QLEDs). The effects of UV irradiation on the electrical properties of ZnO nanoparticles (NPs) were investigated. We demonstrate that the charge balance was enhanced by improving the electron injection. The maximum external quantum efficiency (EQE) and power efficiency (PE) of QLEDs were increased by 26% and 143% after UV irradiation for 15 min. In addition, we investigated the storage stabilities of the inverted QLEDs. During the storage period, the electron current from ZnO gradually decreased, causing a reduction in the device current. However, the QLEDs demonstrated improvements in maximum EQE by 20.7% after two days of storage. Our analysis indicates that the suppression of exciton quenching at the interface of ZnO and quantum dots (QDs) during the storage period could result in the enhancement of EQE. This study provides a comprehension of the generally neglected factors, which could be conducive to the realization of high-efficiency and highly storage-stable practical applications.
Mini Nutritional Assessment for Adult Cancer Patients: A Systematic Review and Meta-Analysis

Wang P, Jiang L, Soh KL, Ying Y, Liu Y, Huang X, et al.

Nutr Cancer, 2023;75(1):61-72.
PMID: 35903897 DOI: 10.1080/01635581.2022.2104877

Early assessment of malnutrition in cancer patients is very important. The Mini Nutritional Assessment (MNA) is often used to assess malnutrition in adult cancer patients. However, the diagnostic values of MNA are controversial. We aimed to analyze the diagnostic values of MNA in assessing malnutrition in adult cancer patients. A systematic search was performed using Embase, Web of Science, PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (VIP). Studies comparing MNA with other tools or criteria in cancer patients were included. The quality of the included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The pooled sensitivity, specificity, the area under the receiver-operating characteristic curve (AUC), and the diagnostic odds ratio (DOR) were calculated using Stata 17.0 and Meta-DiSc1.4. In addition, sensitivity, subgroup, meta-regression, and publication bias analyses were conducted. In total, 11 studies involving 1367 patients involving MNA were included. The pooled sensitivity, specificity, ROC, and DOR were 0.84 (95% CI: 0.81-0.87), 0.66 (95% CI: 0.63-0.69), 0.84 (95% CI: 0.81-0.87), and 16.11 (95% CI: 7.16-36.27), respectively. In the assessment of malnutrition in adult cancer patients, MNA has high sensitivity and moderate specificity.
The Experiences and Needs of Hospice Care Nurses Facing Burnout: A Scoping Review

Yu J, Soh KL, He L, Wang P, Soh KG, Cao Y

Am J Hosp Palliat Care, 2023 Sep;40(9):1029-1039.
PMID: 36400563 DOI: 10.1177/10499091221141063

AIM: Explore the existing literature on the experience and needs of palliative nurses facing job burnout.
BACKGROUND: On a global scale, with the increase of aging, the number of people in need of palliative care has increased significantly, which has a huge impact on the professional pressure of palliative nurses. Existing literature focuses on examining palliative care from the perspective of patients, but palliative nurses also face the threats to physical and mental health caused by job burnout.
EVALUATION: A systematic literature search has been carried out in the following databases as of October 2021:PubMed, EMBASE, CINAHL, Web of Science, and Scopus. The Cochrane Library and Joanna Briggs Institute Library were also searched to confirm if there are any available systematic reviews on the subject. Manually searched the reference list of included papers.
KEY ISSUES: Seventeen studies were included in this review. Five key issues in the palliative care nurse's experience: (1) psychological harm, (2) physical symptoms, (3) negative emotions, (4) Burnout caused by communication barriers, and (5) Lack of experience. Two key issues in the needs of palliative care nurses: (1) social support, and (2) training and education.
CONCLUSION: The pressure of facing death for a long time and controlling the symptoms of patients has a very important impact on the mental and physical health of palliative nurses. Nursing staff have needed to be satisfied, and it is essential to provide support and help relieve the pressure on palliative nurses.
Risk factors for malnutrition in patients with nasopharyngeal carcinoma

Wang P, Soh KL, Ying Y, Liao J, Huang X, Zhao H, et al.

Support Care Cancer, 2023 Nov 27;31(12):723.
PMID: 38008866 DOI: 10.1007/s00520-023-08166-8

BACKGROUND: Malnutrition is a common complication in patients with nasopharyngeal carcinoma (NPC). However, there are few studies on risk factors for malnutrition in NPC patients. Our aims were to identify the risk factors for malnutrition in NPC patients.
METHODS: NPC patients were recruited in this cross-sectional study, and they were divided into well-nourished and malnourished groups according to the Global Leadership Initiative on Malnutrition (GLIM). Potential risk factors were initially screened using univariate analysis (p p p p p = 0.011), and low PA (OR = 0.993, 95% CI 0.988-0.998, p = 0.008) were risk factors for malnutrition in NPC patients.
CONCLUSIONS: The low BMI, the high total radiation dose received, appetite loss, and low prealbumin were risk factors for malnutrition in NPC patients.
Systematic Review of Malnutrition Risk Factors to Identify Nutritionally At-Risk Patients With Head and Neck Cancer

Wang P, Lam Soh K, Geok Soh K, Xue L, Ning C, Tan Y, et al.

Clin J Oncol Nurs, 2024 Mar 15;28(2):197-208.
PMID: 38511915 DOI: 10.1188/24.CJON.197-208

BACKGROUND: Patients with head and neck cancer are prone to malnutrition, which can lead to adverse health outcomes. A review of the literature revealed a lack of systematic reviews addressing risk factors for malnutrition in this population.
OBJECTIVES: This study aimed to fill the knowledge gap by identifying risk factors for malnutrition in patients with head and neck cancer.
METHODS: A comprehensive search was conducted in PubMed®, Web of Science, Embase®, and Cochrane Library databases, spanning from their inception until June 2023. Three researchers critically evaluated the inclusion and exclusion criteria. Two investigators independently screened the literature and extracted data, resolving any discrepancies through consensus.
FINDINGS: This systematic review includes 18 studies. The results indicated that risk factors for malnutrition in patients with head and neck cancer encompass disease-related, genetic, lifestyle, nutritional health, physiologic, psychological, and treatment-related factors.
Fulltext ING2 (inhibitor of growth protein-2) plays a crucial role in preimplantation development

Zhou L, Wang P, Zhang J, Heng BC, Tong GQ

Zygote, 2016 Feb;24(1):89-97.
PMID: 25672483 DOI: 10.1017/S0967199414000768

ING2 (inhibitor of growth protein-2) is a member of the ING-gene family and participates in diverse cellular processes involving tumor suppression, DNA repair, cell cycle regulation, and cellular senescence. As a subunit of the Sin3 histone deacetylase complex co-repressor complex, ING2 binds to H3K4me3 to regulate chromatin modification and gene expression. Additionally, ING2 recruits histone methyltransferase (HMT) activity for gene repression, which is independent of the HDAC class I or II pathway. However, the physiological function of ING2 in mouse preimplantation embryo development has not yet been characterized previously. The expression, localization and function of ING2 during preimplantation development were investigated in this study. We showed increasing expression of ING2 within the nucleus from the 4-cell embryo stage onwards; and that down-regulation of ING2 expression by endoribonuclease-prepared small interfering RNA (esiRNA) microinjection results in developmental arrest during the morula to blastocyst transition. Embryonic cells microinjected with ING2-specific esiRNA exhibited decreased blastulation rate compared to the negative control. Further investigation of the underlying mechanism indicated that down-regulation of ING2 significantly increased expression of p21, whilst decreasing expression of HDAC1. These results suggest that ING2 may play a crucial role in the process of preimplantation embryo development through chromatin regulation.
Sustainable complete remission in recurrence yolk sac tumor patient treated with tandem high-dose chemotherapy and autologous stem cell

Abdullah NA, Wang PN, Huang KG, Adlan AS, Casanova J

Eur. J. Gynaecol. Oncol., 2013;34(2):183-5.
PMID: 23781595

A 21-year-old lady diagnosed with Stage 3 ovarian yolk sac tumor (YST) underwent primary cytoreductive fertility sparing surgery, followed by conventional courses of platinum-based chemotherapy and etoposide. Recurrence at cul-da-sac was noted after a short period of remission and secondary debulking performed followed by four cycles of conventional chemotherapy. The patient's disease progressed despite courses of treatments. A joint team management including a hematologist was commenced following the failure of conventional chemotherapies. Two cycles of high-dose chemotherapy (HDCT) with ifosfamide/cisplatin/etoposide (ICE) regimen, followed by autologous stem cell transplantation (ASCT) were given. With this salvage treatment, she remained in complete remission and disease-free for more than 30 months, while maintaining her reproductive function. These approaches appear to be effective as a salvage treatment in selected cases of patients with ovarian germ cell tumor, especially those who failed primary conventional chemotherapy.
Fulltext Validation of Brunei's Malay EQ-5D Questionnaire in Patients with Type 2 Diabetes

Koh D, Abdullah AM, Wang P, Lin N, Luo N

PLoS One, 2016;11(11):e0165555.
PMID: 27835652 DOI: 10.1371/journal.pone.0165555

BACKGROUND: The Malay spoken in Brunei a South East Asian country where Malay is the national language is distinctive and different from Malay spoken in Malaysia, Singapore and Indonesia. This study aimed to develop a Brunei Malay version of the 5-level EQ-5D questionnaire (EQ-5D-5L) and to assess its psychometric properties among patients with type 2 diabetes mellitus (T2DM).
METHODS: The Brunei Malay EQ-5D-5L was developed by culturally adapting two existing Malay versions. A total of 154 Bruneians with T2DM completed the questionnaire in two different points of time with one week apart. Known-groups validity of the utility-based EQ-5D-5L index and visual analogue scale (EQ-VAS) was evaluated by comparing subgroups of patients known to differ in health status. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC) or Cohen's kappa.
RESULTS: As hypothesized, patients known to have 'better' health had higher EQ-5D-5L index scores than those having 'worse' health in all 7 known-groups comparisons. The hypothesized difference in the EQ-VAS scores was observed in only 4 of the 7 known-groups comparisons. Kappa values ranged from 0.206 to 0.446 for the EQ-5D-5L items; the ICC value for the EQ-5D-5L index and EQ-VAS was 0.626 and 0.521, respectively.
CONCLUSIONS: The utility-based EQ-5D-5L index appears to be valid and reliable for measuring the health of Brunei patients with T2DM. The validity of the EQ-VAS in Brunei requires further investigation.
Development of a short-term nutritional risk prediction model for hepatocellular carcinoma patients: a retrospective cohort study

Yu J, Lam SK, He L, Wang P, Cao Y

Sci Rep, 2024 Feb 16;14(1):3921.
PMID: 38365922 DOI: 10.1038/s41598-024-54456-4

Malnutrition in patients is associated with reduced tolerance to treatment-related side effects and higher risks of complications, directly impacting patient prognosis. Consequently, a pressing requirement exists for the development of uncomplicated yet efficient screening methods to detect patients at heightened nutritional risk. The aim of this study was to formulate a concise nutritional risk prediction model for prompt assessment by oncology medical personnel, facilitating the effective identification of hepatocellular carcinoma patients at an elevated nutritional risk. Retrospective cohort data were collected from hepatocellular carcinoma patients who met the study's inclusion and exclusion criteria between March 2021 and April 2022. The patients were categorized into two groups: a normal nutrition group and a malnutrition group based on body composition assessments. Subsequently, the collected data were analyzed, and predictive models were constructed, followed by simplification. A total of 220 hepatocellular carcinoma patients were included in this study, and the final model incorporated four predictive factors: age, tumor diameter, TNM stage, and anemia. The area under the ROC curve for the short-term nutritional risk prediction model was 0.990 [95% CI (0.966-0.998)]. Further simplification of the scoring rule resulted in an area under the ROC curve of 0.986 [95% CI (0.961, 0.997)]. The developed model provides a rapid and efficient approach to assess the short-term nutritional risk of hepatocellular carcinoma patients. With easily accessible and swift indicators, the model can identify patients with potential nutritional risk more effectively and timely.
Fulltext Synthesis of gold nanoparticles with Solanum xanthocarpum extract and their in vitro anticancer potential on nasopharyngeal carcinoma cells

Zhang P, Wang P, Yan L, Liu L

Int J Nanomedicine, 2018;13:7047-7059.
PMID: 30464458 DOI: 10.2147/IJN.S180138

BACKGROUND: Nasopharyngeal cancer (NPC) is one of the subtypes of head and neck cancers. It occurs rarely, and its prevalence depends mainly on geographical location. Modern-day research is focused on coupling nanotechnology and traditional medicine for combating cancers. Gold nanoparticles (AuNPs) were synthesized from Solanum xanthocarpum (Sx) leaf extract using reduction method.
METHODS: Characterization of the synthesized AuNPs was done by different techniques such as ultraviolet-visible spectrum absorption, X-ray diffraction, dynamic light scattering, Fourier transform infrared spectroscopy, transmission electron microscopy, and energy-dispersive X-ray analysis.
RESULTS: All the results showed the successful green synthesis of AuNPs from Sx, which induced apoptosis of C666-1 cell line (NPC cell line). There was a decline in both cell viability and colony formation in C666-1 cells upon treatment with Sx-AuNPs. The cell death was proved to be caused by autophagy and mitochondrial-dependent apoptotic pathway.
CONCLUSION: Thus, due to their anticancer potential, these nanoparticles coupled with Sx can be used for in vivo applications and clinical research in future.
Fulltext Exploration on the Core Elements of Value Co-creation Driven by AI-Measurement of Consumer Cognitive Attitude Based on Q-Methodology

Zhu Y, Wang P, Duan W

Front Psychol, 2022;13:791167.
PMID: 35432076 DOI: 10.3389/fpsyg.2022.791167

Value co-creation (VCC) goes through the stage of co-production, customer experience, service-dominant logic, and service ecosystem. The integration of science and technology has become a key factor to the process of VCC. The rise and application of artificial intelligence (AI) technology has added a new driving force to VCC and began to affect its original practical logic. Based on the consumer perspective, this study uses Q-methodology to measure consumer cognitive attitude toward the use of AI technology in VCC, aiming to explore the key factors that affect VCC. The study found that content quality, information security, efficiency concern, and degree of manipulation have become the important concerns of consumers for VCC under AI integration. Moreover, their different statements have their specific focus and direction. The study demonstrates and analyzes the importance of the four factors and proposes the combination of human and non-human actors (technology and system) to shape the new model of VCC in the future, which is worth further deepening and exploring for academia and enterprises.
The pattern of Ki-67 and bcl-2 expression in lymphoid malignancies

Wang PL, Peh SC

Malays J Pathol, 1997 Jun;19(1):59-64.
PMID: 10879243

The International Working Formulation divides non-Hodgkin's lymphoma (NHL) into three grades: low, intermediate and high. This grading system implies rate of tumour growth and hence prognosis. Ki-67 antigen is a proliferation-related nuclear antigen and bcl-2 oncogene product is known to inhibit apoptosis. This study aimed to determine the pattern of expression of Ki-67 antigen and bcl-2 oncoprotein in various grades of NHL. Paraffin-embedded tissues from 42 cases of NHL (7 low, 15 intermediate, 20 high grade) were retrieved from the files of the Department of Pathology, University of Malaya. Ki-67 antigen and bcl-2 oncoprotein were detected using immunohistochemistry. The percentage of positively stained neoplastic cells was determined by semi-quantitative estimation and given scores ranging from 0 to 6. Partition chi square test demonstrated the association of Ki-67 antigen expression and histological grade (p = 0.007). There was no significant difference in Ki-67 antigen expression between intermediate and high grade malignant lymphomas (p = 0.28), whereas significant difference was demonstrated between low and intermediate/high grade tumours (p = 0.003). Bcl-2 oncoprotein expression in the neoplastic cells varied widely within the three histological grades. Statistical analysis showed no association between the expression of bcl-2 oncoprotein and histological grade (p = 0.25). Ki-67 immunostaining is therefore a useful adjunct to histological grading of NHL.

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