CASE PRESENTATION: A child with diabetes diagnosed at age 8 years, harbored a PAX4 variant, c.890G>A (p.Gly297Asp), initially classified as variant of uncertain significance. Eleven family members (7 adults and 4 children) with and without diabetes across 3 generations were genotyped. The variant co-segregated with diabetes or prediabetes across 3 generations of the family. The variant is reclassified as likely pathogenic according to standard guidelines.
CONCLUSIONS: Genetic testing is essential to confirm PAX4-MODY as the presentation is variable even within the same family. PAX4 mutation needs to be considered in MODY genetic testing in Asian patients.
OBJECTIVE: The aim of this study is to report an alternative cerebrospinal fluid (CSF)-diversion method using image-guided ipsilateral trigonal ventriculostomy.
METHODS: Single-center retro- and prospective cohort study of n = 62 patients undergoing above-mentioned technique. Prior durotomy, CSF-diversion was performed to the point where the posterior fossa dura was visibly pulsatile. Outcome assessment consisted of the surgeon's intra- and postoperative clinical observations, and postoperative radiological imaging.
RESULTS: Fifty-two out of n = 62 (84%) cases were eligible for analysis. The surgeons consistently reported successful ventricular puncture and a pulsatile dura prior durotomy without cerebellar contusion, swelling or herniation through the dural incision in n = 51/52 (98%) cases. Forty-nine out of n = 52 (94%) catheters were placed correctly within the first attempt, with the majority of catheter tips (n = 50, 96%) located intraventricularly (grade 1 or 2). In n = 4/52 (8%) patients, postoperative imaging revealed evidence of a ventriculostomy-related hemorrhage (VRH) associated with an intracerebral hemorrhage [n = 2/52 (4%)] or an isolated intraventricular hemorrhage [n = 2/52 (4%)]. However, these hemorrhagic complications were not associated with neurological symptoms, surgical interventions or postoperative hydrocephalus. None of the evaluated patients demonstrated radiological signs of upward transtentorial herniation.
CONCLUSION: The method described above efficiently allows CSF-diversion prior durotomy to reduce cerebellar pressure during retrosigmoid approach for CPA tumors. However, there is an inherent risk of subclinical supratentorial hemorrhagic complications.
METHODS: We used pre-COVID-19 pulmonary tuberculosis (PTB) data (2007-2018) to fit SARIMA, Prophet, and LSTM models, assessing their ability to predict PTB incidence trends. These models were then applied to compare the predicted PTB incidence patterns with actual reported cases during the COVID-19 pandemic (2020-2023), using deviations between predicted and actual values to reflect the impact of COVID-19 countermeasures on PTB incidence.
RESULTS: Prior to the COVID-19 outbreak, PTB incidence in China exhibited a steady decline with strong seasonal fluctuations, characterized by two annual peaks-one in March and another in December. These seasonal trends persisted until 2019. During the COVID-19 pandemic, there was a significant reduction in PTB cases, with actual reported cases falling below the predicted values. The disruption in PTB incidence appears to be temporary, as 2023 data indicate a gradual return to pre-pandemic trends, though the incidence rate remains slightly lower than pre-COVID levels. Additionally, we compared the fitting and forecasting performance of the SARIMA, Prophet, and LSTM models using RMSE (root mean squared error), MAE (mean absolute error), and MAPE (mean absolute percentage error) indexes prior to the COVID-19 outbreak. We found that the Prophet model had the lowest values for all three indexes, demonstrating the best fitting and prediction performance.
CONCLUSIONS: The COVID-19 pandemic has had a temporary but significant impact on PTB incidence in China, leading to a reduction in reported cases during the pandemic. However, as pandemic control measures relax and the healthcare system stabilizes, PTB incidence patterns are expected to return to pre-COVID-19 levels. The Prophet model demonstrated the best predictive performance and proves to be a valuable tool for analyzing PTB trends and guiding public health planning in the post-pandemic era.
OBJECTIVE: This study aimed to evaluate the ergonomic risk factors contributing to MSDs among traffic police in Putrajaya.
METHODS: A questionnaire encompassing socio-demographic variables, work tasks, ergonomic hazards, and the Body Symptom Survey (BOSS) was administered to 40 traffic police officers stationed at the Putrajaya District Police Headquarters. Data analysis was conducted using Statistical Package for the Social Sciences (SPSS) software.
RESULTS: Results revealed a predominantly male (87.5%), Malay (90%) population, aged between 31 and 40, with a majority serving as corporals (42.5%) within operational task units (82.5%). Primary duties among the respondents were traffic control (45%) and police escort (30%). Extreme temperatures emerged as the most prevalent ergonomic risk factor (82.5%), with the neck being the most affected body part (50%). Significant correlations were found between MSDs and various ergonomic risk factors, including awkward posture (p ≤ 0.001), static motion (p
OBJECTIVE: This study aims to investigate the expression level of HSP70 in response to indoor heat exposure among vulnerable populations in both urban and rural settings.
METHODS: A comparative cross-sectional was conducted among 108 participants from urban and rural areas in Klang Valley, Malaysia. The study included face-to-face interviews, indoor heat exposure monitoring, and thermal stress classification using the Universal Thermal Climate Index (UTCI). HSP70 gene and protein expressions were analyzed using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) and HSP70 High Sensitivity Enzyme-linked Immunosorbent Assay (ELISA), respectively.
RESULTS: Urban areas experienced signficantly higher UTCI heat exposure levels than rural areas (p
CONTENT: A scoping review examined the impact of heat and existing mitigation and adaptation responses for vulnerable populations in temperate regions, with a focus on A|NZ. Additionally, temperature trend analysis was conducted for current and projected trends using Climate CHIP for six major heat-affected cities in A|NZ to assess the recognition of heat as a societal concern.
SUMMARY AND OUTLOOK: The review identified mitigation and adaptation strategies for existing vulnerable groups and discovered other potential vulnerable groups in A|NZ, including Indigenous people (Māori), Pacific communities, low-income groups, migrants, and visitors. Temperature trends show an increasing pattern, suggesting heightened future heat-related impacts on these populations. This review reveals A|NZ's growing vulnerability to rising temperatures, particularly among high-risk groups, and calls for stronger mitigation and adaptation strategies to address future heat-health risks.