METHODS: All patients with traumatic brain injury (mild, moderate, and severe) who were admitted to Queen Elizabeth Hospital from November 1, 2017, to January 31, 2019, were prospectively analyzed through a data collection sheet. The discriminatory power of the models was assessed as area under the receiver operating characteristic curve and calibration was assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test and Cox calibration regression analysis.
RESULTS: We analyzed 281 patients with significant TBI treated in a single neurosurgical center in Malaysia over a 2-year period. The overall observed 14-day mortality was 9.6%, a 6-month unfavorable outcome of 23.5%, and a 6-month mortality of 13.2%. Overall, both the CRASH and IMPACT models showed good discrimination with AUCs ranging from 0.88 to 0.94 and both models calibrating satisfactorily H-L GoF P>0.05 and calibration slopes >1.0 although IMPACT seemed to be slightly more superior compared to the CRASH model.
CONCLUSIONS: The CRASH and IMPACT prognostic models displayed satisfactory overall performance in our cohort of TBI patients, but further investigations on factors contributing to TBI outcomes and continuous updating on both models remain crucial.
METHODS: A software-assisted method using E-Prime 2.0 was used to create an experiment. The participants were Malay adolescents aged 13 years old-15 years old. The conventional method was compared with the software-assisted method to assess the participants' comprehension and production performance. Data on reaction time (RT), scoring and no response (NR) were obtained from the adolescents.
RESULTS: Based on the two methods, the findings on the selection of participants for the SLI and TD groups was different. The two methods produced similar results in terms of the selection of TD group and most participants in the syntactic SLI group except for two participants who failed in the conventional method but passed the test in the software-assisted method.
CONCLUSION: The descriptive evaluation of the findings suggested selecting software-assisted method as the alternative source because the provided information was detailed and this information enabled the researcher to identify the SLI group.
METHODS: This is single centre cross-sectional study involved 105 traumatic head injury patients under the Neurosurgical Department Hospital Sultanah Aminah, Johor Bahru, Malaysia. The primary investigator will do an interview and the patients will be asked question to complete a questioner from SF-36 (36 questions). Subsequently, consent for participation will be taken and blood sampling will be done.
RESULTS: Thirty-three patients were noted to have anterior pituitary dysfunction. The mean age was 36.97 ± 12.96 years old. Twenty-seven patients (32.5%) were male and six patients were female (27.3%). Chronic anterior pituitary dysfunction in patients with a severe traumatic head injury around 47.1% (23 patients), as compared to a moderate head injury (8 patients, 38.1%) and 2 sustained mild head injury (5.6%). The mean duration after the onset of trauma was 10.3 ± 1.79 months. All patient with anterior pituitary dysfunction had positive CT brain findings with 22 had subarachnoid haemorrhage (SAH) at the basal cistern and 27 patients had a base of skull fracture, where 52.1% of the patient underwent surgical intervention, 84.8% involved one axis and another 5 patients had two axes involved. Severity of the head injury (P < 0.001), prolonged duration of hospital stay (P = 0.014), radiological findings of a base of skull fracture (P < 0.001) and presence of SAH at basal cistern (P < 0.001) was significantly associated with pituitary dysfunction. The patient with anterior pituitary dysfunction has the lower 36-item Short Form Survey (SF-36) marks 56.3 ± 10.3.
CONCLUSION: The prevalence of hypopituitarism was 31%. Indicators are increased TBI severity, prolonged hospitalisation and positive finding in radiological assessment. Post-traumatic chronic anterior pituitary dysfunction also related with poor quality of life as showed by low SF-36 marks.
OBJECTIVE: This study aimed to translate and validate the CAFU instrument into the Malay language and test the validity and reliability of the CAFU among informal stroke caregivers in Malaysia.
METHODS: A standard forward-backward translation method was employed to translate CAFU. Subsequently, 10 expert panels were included in the validation process, and thereafter reliability testing was conducted among 51 stroke caregivers. The validation of the instrument was determined by computing the content validity indices (CVIs), and we used the Cronbach's alpha method to explore the internal consistency of the overall score and subscales scores of the Malay-CAFU. Finally, the explanatory factor analysis used principal component extraction and a varimax rotation to examine construct validity.
RESULTS: All items of the Malay-CAFU had satisfactory item-level CVI (I-CVI), with values greater than 0.80, and the scale-level CVI (S-CVI) was 0.95. These results indicate that the Malay-CAFU had good relevancy. The internal consistency for the reliability test showed a Cronbach's alpha value of 0.95 for the overall score. The eigenvalues and scree plot supported a two-factor structural model of the instrument. From the explanatory factor analysis, the factor loadings ranged from 0.82 to 0.90 and 0.56 to 0.83, respectively.
CONCLUSION: The Malay-CAFU questionnaire is a valid and reliable instrument to assess the dependence level of stroke survivors and the upset level of informal stroke caregivers in Malaysia.
Method: Total RNA was isolated from MSCs and MSCs-derived NPCs followed by cDNA library construction for transcriptomic analysis. Sample libraries that passed the quality and quantity assessments were subjected to high throughput mRNA sequencing using NextSeq®500. Differential gene expression analysis was performed using the DESeq2 R package with MSC samples being a reference group. The expression of eight differentially regulated genes was counter validated using real-time PCR.
Results: In total, of the 3,252 differentially regulated genes between MSCs and NPCs with two or more folds, 1,771 were upregulated genes, whereas 1,481 were downregulated in NPCs. Amongst these differential genes, 104 transcription factors were upregulated, and 45 were downregulated in NPCs. Neurogenesis related genes were upregulated in NPCs and the main non-redundant gene ontology (GO) terms enriched in NPCs were the autonomic nervous system, cell surface receptor signalling pathways), extracellular structure organisation, and programmed cell death. The main non-redundant GO terms enriched in MSCs included cytoskeleton organisation cytoskeleton structural constituent, mitotic cell cycle), and the mitotic cell cycle process Gene set enrichment analysis also confirmed cell cycle regulated pathways as well as Biocarta integrin pathway were upregulated in MSCs. Transcription factors enrichment analysis by ChEA3 revealed Foxs1 and HEYL, amongst the top five transcription factors, inhibits and enhances, respectively, the NPCs differentiation of MSCs.
Conclusions: The vast differences in the transcriptomic profiles between NPCs and MSCs revealed a set of markers that can identify the differentiation stage of NPCs as well as provide new targets to enhance MSCs differentiation into NPCs.