Displaying publications 4681 - 4700 of 57217 in total

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  1. Ji L, Luo Y, Bee YM, Xia J, Nguyen KT, Zhao W, et al.
    J Diabetes, 2023 Jun;15(6):474-487.
    PMID: 37088916 DOI: 10.1111/1753-0407.13392
    The objective of this study was to provide recommendations regarding effectiveness, safety, optimal starting dose, optimal maintenance dose range, and target fasting plasma glucose of five basal insulins (glargine U-300, degludec U-100, glargine U-100, detemir, and insulin protamine Hagedorn) in insulin-naïve adult patients with type 2 diabetes in the Asia-Pacific region. Based on evidence from a systematic review, we developed an Asia-Pacific clinical practice guideline through comprehensive internal review and external review processes. We set up and used clinical thresholds of trivial, small, moderate, and large effects for different critical and important outcomes in the overall certainty of evidence assessment and balancing the magnitude of intervention effects when making recommendations, following GRADE methods (Grading of Recommendations, Assessment, Development, and Evaluation). The AGREE (Appraisal of Guidelines, Research and Evaluation) and RIGHT (Reporting Items for practice Guidelines in HealThcare) guideline reporting checklists were complied with. After the second-round vote by the working group members, all the recommendations and qualifying statements reached over 75% agreement rates. Among 44 contacted external reviewers, we received 33 clinicians' and one patient's comments. The overall response rate was 77%. To solve the four research questions, we made two strong recommendations, six conditional recommendations, and two qualifying statements. Although the intended users of this guideline focused on clinicians in the Asia-Pacific region, the eligible evidence was based on recent English publications. We believe that the recommendations and the clinical thresholds set up in the guideline can be references for clinicians who take care of patients with type 2 diabetes worldwide.
    Matched MeSH terms: Humans
  2. Ang SP, Chia JE, Jaiswal V, Bandyopadhyay D, Iglesias J, Mohan GVK, et al.
    Curr Probl Cardiol, 2023 Aug;48(8):101719.
    PMID: 36967069 DOI: 10.1016/j.cpcardiol.2023.101719
    While subclinical hypothyroidism (SCH) was reportedly associated with an increased risk of cardiovascular mortality, the relationship between SCH and clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) is uncertain. The aim of this study was to assess the association of SCH and cardiovascular outcomes in patients undergoing PCI. We searched PubMed, Embase, Scopus, and CENTRAL databases from its inception until April 1, 2022 for studies comparing the outcomes between SCH and euthyroid patients undergoing PCI. Outcomes of interest include cardiovascular mortality, all-cause mortality, myocardial infarction (MI), major adverse cardiovascular and cerebrovascular events (MACCE), repeat revascularization and heart failure. Outcomes were pooled using the DerSimonian and Laird random-effects model and reported as risk ratios (RR) and 95% confidence intervals (CI). A total of 7 studies involving 1132 patients with SCH and 11,753 euthyroid patients were included in the analysis. Compared with euthyroid patients, patients with SCH had significantly higher risk of cardiovascular mortality (RR 2.16, 95% CI: 1.38-3.38, P < 0.001), all-cause mortality (RR 1.68, 95% CI: 1.23-2.29, P = 0.001) and repeat revascularization (RR 1.96, 95% CI: 1.08-3.58, P = 0.03). However, there were no differences between both groups in terms of incidence of MI (RR 1.81, 95% CI: 0.97-3.37, P = 0.06), MACCE (RR 2.24, 95% CI: 0.55-9.08, P = 0.26) and heart failure (RR 5.38, 95% CI: 0.28-102.35, P = 0.26). Our analysis suggests among patients undergoing PCI, SCH was associated with increased risk of cardiovascular mortality, all-cause mortality and repeat revascularization compared to euthyroid patients.
    Matched MeSH terms: Humans
  3. Roslee NF, Kamil NAFM, Alias S, Senthil Kumar P, Alkhadher S, Muthusamy G, et al.
    Chemosphere, 2023 Sep;334:139037.
    PMID: 37244559 DOI: 10.1016/j.chemosphere.2023.139037
    Palm oil fuel ash (POFA) has limited use as a fertilizer, while contribute effectively to the environmental contamination and health risks. Petroleum sludge poses a serious effect on the ecological environment and human health. The present work aimed to present a novel encapsulation process with POFA binder for treating petroleum sludge. Among 16 polycyclic aromatic hydrocarbons, four compounds were selected for the optimization of encapsulation process due to their high risk as carcinogenic substrates. Percentage PS (10-50%) and curing days (7-28 days) factors were used in the optimization process. The leaching test of PAHs was assessed using a GC-MS. The best operating parameters to minimize PAHs leaching from solidified cubes with OPC and10% POFA were recorded with 10% PS and after 28 days, at which PAH leaching was 4.255 and 0.388 ppm with R2 is 0.90%. Sensitivity analysis of the actual and predicted results for both the control and the test (OPC and 10% POFA) revealed that the actual results of the 10% POFA experiments have a high consistency with the predicted data (R2 0.9881) while R2 in the cement experiments was 0.8009. These differences were explained based on the responses of PAH leaching toward percentage of PS and days of cure. In the OPC encapsulation process, the main role was belonged to PS% (94.22%), while with 10% POFA, PS% contributed by 32.36 and cure day contributed by 66.91%.
    Matched MeSH terms: Humans
  4. Chang XL, Chee PS, Lim EH
    Sci Rep, 2023 Jun 15;13(1):9678.
    PMID: 37322083 DOI: 10.1038/s41598-023-36335-6
    This paper presents a 35.0 × 35.0 × 2.7 mm3 compact, low-profile, and lightweight wearable antenna for on-body wireless power transfer. The proposed antenna can be easily printed on a piece of flexible tattoo paper and transformed onto a PDMS substrate, making the entire antenna structure conform to the human body for achieving a better user experience. Here, a layer of frequency selective surface (FSS) is inserted in between the antenna and human tissue, which has successfully reduced the loading effects of the tissue, with 13.8 dB improvement on the antenna gain. Also, the operating frequency of the rectenna is not affected much by deformation. To maximize the RF-DC conversion efficiency, a matching loop, a matching stub, and two coupled lines are integrated with the antenna for tuning the rectenna so that a wide bandwidth (~ 24%) can be achieved without the use of any external matching networks. Measurement results show that the proposed rectenna can achieve a maximum conversion efficiency of 59.0% with an input power of 5.75 μW/cm2 and can even exceed 40% for a low input power of 1.0 μW/cm2 with a 20 kΩ resistive load, while many other reported rectennas can only achieve a high PCE at a high power density level, which is not always practical for a wearable antenna.
    Matched MeSH terms: Humans
  5. Dalawi I, Isa MR, Chen XW, Azhar ZI, Aimran N
    BMC Public Health, 2023 Jun 13;23(1):1131.
    PMID: 37312175 DOI: 10.1186/s12889-023-16044-5
    OBJECTIVE: This study aimed to assess the content and face validity index of the development of the understanding, attitude, practice and health literacy questionnaire on COVID-19 (MUAPHQ C-19) in the Malay language.

    METHODS: The development of the MUAPHQ C-19 was conducted in two stages. Stage I resulted in the generation of the instrument's items (development), and stage II resulted in the performance of the instrument's items (judgement and quantification). Six-panel experts related to the study field and ten general public participated to evaluate the validity of the MUAPHQ C-19. The content validity index (CVI), content validity ratio (CVR) and face validity index (FVI) were analysed using Microsoft Excel.

    RESULTS: There were 54 items and four domains, namely the understanding, attitude, practice and health literacy towards COVID-19, identified in the MUAPHQ C-19 (Version 1.0). The scale-level CVI (S-CVI/Ave) for every domain was above 0.9, which is considered acceptable. The CVR for all items was above 0.7, except for one item in the health literacy domain. Ten items were revised to improve the item's clarity, and two items were deleted due to the low CVR value and redundancy, respectively. The I-FVI exceeded the cut-off value of 0.83 except for five items from the attitude domain and four from the practice domains. Thus, seven of these items were revised to increase the clarity of items, while another two were deleted due to low I-FVI scores. Otherwise, the S-FVI/Ave for every domain exceeded the cut-off point of 0.9, which is considered acceptable. Thus, 50-item MUAPHQ C-19 (Version 3.0) was generated following the content and face validity analysis.

    CONCLUSIONS: The questionnaire development, content validity, and face validity process are lengthy and iterative. The assessment of the instruments' items by the content experts and the respondents is essential to guarantee the instrument's validity. Our content and face validity study has finalised the MUAPHQ C-19 version that is ready for the next phase of questionnaire validation, using Exploratory and Confirmatory Factor Analysis.

    Matched MeSH terms: Humans
  6. Ong CY, Wai Ching Deanna L
    Glob Health Promot, 2023 Jun;30(2):28-34.
    PMID: 36052969 DOI: 10.1177/17579759221118256
    OBJECTIVES: To assess art initiatives and programmes communicating health messages and during the COVID-19 pandemic in Malaysia from 2020 to 2021.

    STUDY DESIGN: Qualitative narrative study.

    METHODS: Grey literature on COVID-19 art initiatives and programmes in Malaysia was reviewed.

    RESULTS: The art initiatives and efforts in Malaysia to promote health and wellness during the COVID-19 pandemic were compelling and notable. These initiatives can be classified into five major categories, namely performing arts, visual arts, culture, literature and digital art. The main health messages conveyed through these initiatives included public education regarding COVID-19, health precautionary steps recommended for the public, and solidarity in the fight against COVID-19. These art initiatives cultivated positive responses from the public and increased their awareness of COVID-19.

    CONCLUSION: From the public health perspective, the use of arts to educate and create awareness of COVID-19 in Malaysia were encouraging. The public is made more informed and prepared to face the challenges ahead.

    Matched MeSH terms: Humans
  7. Krisdiyanto, Bin Raja Ghazilla RA, Azuddin M, Bin Ahmad Hairuddin MKF, Risdiana N
    Medicine (Baltimore), 2023 Jun 09;102(23):e33983.
    PMID: 37335669 DOI: 10.1097/MD.0000000000033983
    In the market, there are many types and shapes of syringes. One of the groupings of syringe types is based on barrel volume. The shape of the product design affects performance and user perception. The aim of this study is to investigate the effect of barrel volume on its performance and user perception. We performed analysis following international organization for standardization 7886 procedures on syringe with 1 mL, 3 mL, 5 mL, and 10 mL volume. In addition, a user perception test was conducted on 29 respondents using a questionnaire with the Likert chart method. This study indicates that the bigger the syringe volume, the larger the dead space and the force to operate the piston are. A larger syringe volume also raises the volume that changes due to the plunger position increase. Meanwhile, the barrel volume does not affect water and water leakage, as we did not observe any leak during the syringe tests in our experiment. In addition, the user perception test shows that the barrel's length influences the ease of device control during the injection. The volume of the barrel negatively correlated with its effect to the environment. The safety features of all syringes are similar except for the 3 mL syringe, which has a value of 0.1 points difference to other syringes.
    Matched MeSH terms: Humans
  8. Aftab H, Kemp M, Stensvold CR, Nielsen HV, Jakobsen MM, Porskrog A, et al.
    Travel Med Infect Dis, 2023;53:102580.
    PMID: 37088361 DOI: 10.1016/j.tmaid.2023.102580
    Plasmodium knowlesi has been reported as an emerging infection throughout the Southeast Asian region, especially in the Malaysian state of Sabah, where it accounts for the majority of the malaria cases reported. This is in contrast to Europe, where imported P. knowlesi is a rarely reported infection. We present a case of P. knowlesi infection in a Danish woman returning from a short trip to Malaysian Borneo. Microscopy of blood smears revealed 0.8% infected erythrocytes, but due to the atypical morphological presentation, a conclusive species identification was made by molecular methods. Plasmodium knowlesi is a potentially fatal infection and taking the increasing travel activity into consideration after the coronavirus disease 2019 (COVID-19) pandemic, P. knowlesi should be a differential diagnosis in patients with travel-associated illness returning from highly endemic Southeast Asian areas.
    Matched MeSH terms: Humans
  9. Dutta S, Singhal S, Shah RB, Haque M
    Crit Rev Oncog, 2022;27(4):23-37.
    PMID: 37199300 DOI: 10.1615/CritRevOncog.2022046361
    Oral cancers (OCs), being one of the frequent malignancies in the head and neck region, need prompt diagnosis and treatment. Apart from basic therapeutic modalities, immunotherapy has now been utilized as a novel approach to combat the disease. With the comprehension of the strategies adopted by cancer cells to evade the immune elimination by the body's immune system, targeted immunotherapies have now become the core area of research. The immune expression of epidermal growth factor receptor (EGFR), programmed cell death protein ligand-1 (PDL-1), etc., are enhanced in OC and have been associated with evasion of the immune system. Targeted immunotherapies now include monoclonal antibodies targeting EGFR like cetuximab and panitumumab, programmed cell death-1 (PD-1) inhibitors like pembrolizumab, cemiplimab, and nivolumab, and PD-L1 inhibitors like atezolizumab, avelumab, and durvalumab. Targeted immunotherapies like chimeric antigen receptor T-cell treatment and small molecule inhibitors are in several clinical trials tried as monotherapy and adjuvant immunotherapy and have shown promising results. Other immunothera-peutic approaches such as cytokines like interferons or interleukins, vaccines, and gene therapy have also been an area of research for the management of OC. However, the cautious selection of appropriate patients with specific immune characteristics as a candidate for immunotherapeutic agents is a crucial component of targeted immunotherapy. This article elaborates on the immune contexture of oral cancer cells, the mechanism of immune evasion by cancer cells, targets for immunotherapies, existent immunotherapeutic agents, and prospects in the field of immunotherapy.
    Matched MeSH terms: Humans
  10. Balakumar P, Venkatesan K, Abdulla Khan N, Raghavendra NM, Venugopal V, Bharathi DR, et al.
    Drug Discov Today, 2023 Jul;28(7):103627.
    PMID: 37224995 DOI: 10.1016/j.drudis.2023.103627
    The past couple of decades in particular have seen a rapid increase in the prevalence of type 2 diabetes mellitus (T2DM), a debilitating metabolic disorder characterised by insulin resistance. The insufficient efficacy of current management strategies for insulin resistance calls for additional therapeutic options. The preponderance of evidence suggests potential beneficial effects of curcumin on insulin resistance, while modern science provides a scientific basis for its potential applications against the disease. Curcumin combats insulin resistance by increasing the levels of circulating irisin and adiponectin, activating PPARγ, suppressing Notch1 signalling, and regulating SREBP target genes, among others. In this review, we bring together the diverse areas pertaining to our current understanding of the potential benefits of curcumin on insulin resistance, associated mechanistic insights, and new therapeutic possibilities.
    Matched MeSH terms: Humans
  11. Nurkolis F, Taslim NA, Hardinsyah H
    Clin Nutr ESPEN, 2023 Aug;56:81-82.
    PMID: 37344087 DOI: 10.1016/j.clnesp.2023.05.008
    Potential studies and evidence regarding nutrient nanoencapsulation combined with emulsion-based delivery systems are relatively limited. Therefore, for the importance issue of health vision, with this critical opinion to the editor is scientifically important to invite worldwide researchers to raise their concern for clinical research and the development of plant-based lutein nanoencapsulation in staple foods in alleviating nutritional problems for the eyes, which has not been reported before. This is in line with the WHO World Report which aimed to overcome the challenge regarding vision and galvanizing action, one of which is through innovation and research. With the hypothesis that, through this opinion will increase the awareness of scientists to improve clinical studies on the stability and bioaccessibility of lutein for health vision concern. As our hypothesis and objectives, we hope that this critical short opinion to the editor will assist efforts to reduce the burden of eye conditions and vision loss to achieve the Sustainable Development Goals (SDGs), particularly SDG 3.8 on universal health coverage through lutein-plant based nanoencapsulation clinical studies by worldwide researchers. Finally, it is very important and needed an effort to improve clinical studies focus on the stability and bioaccessibility of lutein for health vision via lutein-plant based nanoencapsulation approaches. Moreover, the benefit of lutein supplementation for the health vision might be limited by its bioaccessibility and bioavailability. Future studies and approaches should employ strategies that could overcome the foregoing limitations, of which is through nanoencapsulation approach. Something new has been synthesized in this work, "Because, every human eye, is the eye of the world".
    Matched MeSH terms: Humans
  12. Mohandas S, Shete A, Sarkale P, Kumar A, Mote C, Yadav P
    Virulence, 2023 Dec;14(1):2224642.
    PMID: 37312405 DOI: 10.1080/21505594.2023.2224642
    Nipah virus (NiV) is a high-risk pathogen which can cause fatal infections in humans. The Indian isolate from the 2018 outbreak in the Kerala state of India showed ~ 4% nucleotide and amino acid difference in comparison to the Bangladesh strains of NiV and the substitutions observed were mostly not present in the region of any functional significance except for the phosphoprotein gene. The differential expression of viral genes was observed following infection in Vero (ATCC® CCL-81™) and BHK-21 cells. Intraperitoneal infection in the 10-12-week-old, Syrian hamster model induced dose dependant multisystemic disease characterized by prominent vascular lesions in lungs, brain, kidney and extra vascular lesions in brain and lungs. Congestion, haemorrhages, inflammatory cell infiltration, thrombosis and rarely endothelial syncitial cell formation were seen in the blood vessels. Intranasal infection resulted in respiratory tract infection characterised by pneumonia. The model showed disease characteristics resembling the human NiV infection except that of myocarditis similar to that reported by NiV-Malaysia and NiV-Bangladesh isolates in hamster model. The variation observed in the genome of the Indian isolate at the amino acid levels should be explored further for any functional significance.
    Matched MeSH terms: Humans
  13. Adikusuma W, Zakaria ZA, Irham LM, Nopitasari BL, Pradiningsih A, Firdayani F, et al.
    Sci Rep, 2023 Jun 20;13(1):10032.
    PMID: 37340026 DOI: 10.1038/s41598-023-37120-1
    Diabetic foot ulcers (DFUs) are a common complication of diabetes and can lead to severe disability and even amputation. Despite advances in treatment, there is currently no cure for DFUs and available drugs for treatment are limited. This study aimed to identify new candidate drugs and repurpose existing drugs to treat DFUs based on transcriptomics analysis. A total of 31 differentially expressed genes (DEGs) were identified and used to prioritize the biological risk genes for DFUs. Further investigation using the database DGIdb revealed 12 druggable target genes among 50 biological DFU risk genes, corresponding to 31 drugs. Interestingly, we highlighted that two drugs (urokinase and lidocaine) are under clinical investigation for DFU and 29 drugs are potential candidates to be repurposed for DFU therapy. The top 5 potential biomarkers for DFU from our findings are IL6ST, CXCL9, IL1R1, CXCR2, and IL10. This study highlights IL1R1 as a highly promising biomarker for DFU due to its high systemic score in functional annotations, that can be targeted with an existing drug, Anakinra. Our study proposed that the integration of transcriptomic and bioinformatic-based approaches has the potential to drive drug repurposing for DFUs. Further research will further examine the mechanisms by which targeting IL1R1 can be used to treat DFU.
    Matched MeSH terms: Humans
  14. Rengarajoo J, Harun RH, Royan SJ, Kohir S, Mamat MR
    Ann R Coll Surg Engl, 2022 Jul;104(7):556.
    PMID: 35174718 DOI: 10.1308/rcsann.2021.0299
    Matched MeSH terms: Humans
  15. Yap LS, Lee WL, Ting ASY
    Prep Biochem Biotechnol, 2023;53(6):653-671.
    PMID: 36137173 DOI: 10.1080/10826068.2022.2122064
    L-asparaginase is an enzyme commonly used to treat acute lymphoblastic leukemia. Commercialized bacterial L-asparaginase has been reported to cause several life-threatening complications during treatment, hence the need to seek alternative sources of L-asparaginase. In this study, the novelty of upstream and downstream bioprocessing of L-asparaginase from a fungal endophyte, Colletotrichum gloeosporioides, and the cytotoxicity evaluation was demonstrated. Six variables (carbon source and concentration, nitrogen source and concentration, incubation period, temperature, pH and agitation rate) known to influence L-asparaginase production were studied using One-Factor-At-A-Time (OFAT) approach, with four significant variables further optimized using Response Surface Methodology (RSM). The crude extract produced using optimized condition was purified, characterized and examined for its anticancer effect. Purification of fungal L-asparaginase was performed via ultrafiltration and size exclusion chromatography, which are less common techniques. The protein profile and monomeric weight of L-asparaginase were determined using SDS-PAGE and Western blot. Cytotoxicity of purified L-asparaginase on leukemic Jurkat E6 and oral carcinoma cells were studied using MTS assay for 24 h and 48 h. OFAT results from optimization showed that glucose and L-asparagine concentrations, incubation period and temperature, were significant factors affecting L-asparaginase production by C. gloeosporioides. RSM analysis further evidence the significant interaction between glucose and L-asparagine concentrations in inducing L-asparaginase production. Purified L-asparaginase was profiled with specific activity of 255.02 IU/mg protein, purification fold of 6.12, and 34.63% of enzyme recovery. SDS and Western blot revealed that the purified L-asparaginase might be a tetramer with monomeric units of 25 kDa. Purified L-asparaginase was discovered to be more efficient against Jurkat leukemic cells than against H103 oral carcinoma cells, as lower IC50 value was observed for Jurkat cell lines (46 .36 ± 1.52 µg/mL for Jurkat and 125.56 ± 7.28 µg/mL for H103). In short, purified L-asparaginase derived from endophytic C. gloeosporioides showed high purity and significant anticancer effect toward cancer cells. This study therefore demonstrated the potential of fungal L-asparaginase as alternative chemotherapy drug in the future.
    Matched MeSH terms: Humans
  16. Im SA, Gennari A, Park YH, Kim JH, Jiang ZF, Gupta S, et al.
    ESMO Open, 2023 Jun;8(3):101541.
    PMID: 37178669 DOI: 10.1016/j.esmoop.2023.101541
    The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer (MBC) was published in 2021. A special, hybrid guidelines meeting was convened by ESMO and the Korean Society of Medical Oncology (KSMO) in collaboration with nine other Asian national oncology societies in May 2022 in order to adapt the ESMO 2021 guidelines to take into account the differences associated with the treatment of MBC in Asia. These guidelines represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with MBC representing the oncological societies of China (CSCO), India (ISMPO), Indonesia (ISHMO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO). The voting was based on the best available scientific evidence and was independent of drug access or practice restrictions in the different Asian countries. The latter were discussed when appropriate. The aim of these guidelines is to provide guidance for the harmonisation of the management of patients with MBC across the different regions of Asia, drawing from data provided by global and Asian trials whilst at the same time integrating the differences in genetics, demographics and scientific evidence, together with restricted access to certain therapeutic strategies.
    Matched MeSH terms: Humans
  17. Blaauw M, Ridikas D, Baytelesov S, Salas PS, Chakrova Y, Eun-Ha C, et al.
    J Radioanal Nucl Chem, 2017;311(1):409-418.
    PMID: 28111485 DOI: 10.1007/s10967-016-5036-6
    Molybdenum-99 is one of the most important radionuclides for medical diagnostics. In 2015, the International Atomic Energy Agency organized a round-robin exercise where the participants measured and calculated specific saturation activities achievable for the (98)Mo(n,γ)(99)Mo reaction. This reaction is of interest as a means to locally, and on a small scale, produce (99)Mo from natural molybdenum. The current paper summarises a set of experimental results and reviews the methodology for calculating the corresponding saturation activities. Activation by epithermal neutrons and also epithermal neutron self-shielding are found to be of high importance in this case.
    Matched MeSH terms: Humans
  18. Khan PA, Johl SK, Kumar A, Luthra S
    Environ Sci Pollut Res Int, 2023 Apr;30(19):55237-55254.
    PMID: 36882655 DOI: 10.1007/s11356-023-26262-4
    The current production and conception have impacted the environmental hazards. Green innovation (GI) is the ideal solution for sustainable production, consumption, and ecological conservation. The objective of the study is to compare comprehensive green innovation (green product, process, service, and organization) impact on firm financial performance in Malaysia and Indonesia, along with the first study to measure the moderation role of the corporate governance index. This study has addressed the gap by developing the green innovation and corporate governance index. Collected panel data from the top 188 publicly listed firms for 3 years and analyzed it using the general least square method. The empirical evidence demonstrates that the green innovation practice is better in Malaysia, and the outcome also shows that the significance level is higher in Indonesia. This study also provides empirical evidence that board composition has a positive moderation relationship betwixt GI and business performance in Malaysia but is insignificant in Indonesia. This comparative study provides new insights to the policymakers and practitioners of both countries to monitor and manage green innovation practices.
    Matched MeSH terms: Humans
  19. Inoue K, Chieh JTW, Yeh LC, Chiang SJ, Phrommintikul A, Suwanasom P, et al.
    Trials, 2022 Dec 07;23(1):986.
    PMID: 36476401 DOI: 10.1186/s13063-022-06907-4
    BACKGROUND: More than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data.

    METHODS: The DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2022 and Apr 2024 were included. Initially, all clusters will apply "usual care" according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED.

    CONCLUSIONS: This study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.

    Matched MeSH terms: Humans
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