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Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

Seow SR, Mat S, Lam OHH, Maktar JF, Rajab NF, Ismail IS, et al.

J Vis Exp, 2025 Mar 07.
PMID: 40127005 DOI: 10.3791/67521

This study explores hyperglycemia's influence on knee osteoarthritis (KOA) related symptoms, physical performance, physical activity level, radiographic severity, and inflammation in older adults. Prolonged hyperglycemic states contribute to advanced glycation end-product (AGE) formation, which worsens KOA symptoms. Capillary blood glucose (CBG) and glycated hemoglobin A1C (HbA1C) levels are commonly used in laboratory tests for glycemic assessment, offering distinct advantages and limitations. Participants were divided into good and poor glycemic control groups based on their CBG and HbA1C levels. KOA clinical severity and physical activity were measured using the knee injury and osteoarthritis outcome score (KOOS) and international physical activity questionnaire. Physical performance was measured with hand grip strength, gait speed, time-up-and-go (TUG), and 5 times sit-to-stand (5STST). Knee X-rays were performed, and serum enzyme-linked immunosorbent assay (ELISA) analysis was conducted for IL-1β, IL-4, CRP, NF-κB, and AGE. Three hundred recruited participants (mean age [SD] = 66.40 years (5.938) with CBG, of fasting blood sugar > 7.0 mmol/L and random blood sugar > 11.1 mmol/L, (N = 254) were compared with KOOS pain (p=0.008) and symptoms (p=0.017) and 5STST (p=0.015); while HbA1c > 6.3% (N = 93) was compared with 5STST (p=0.002), and AGEs (p=0.022) based on Mann Whitney U test. Logistic regression revealed significant associations between glycemic control and lower limb muscle strength, radiological severity, laboratory markers, and between glycemic status and KOOS pain and symptoms. However, these associations did not remain significant after adjusting for BMI. Poor glycemic status alone was associated with better function in sport and recreation domains after antidiabetic medication adjustment, suggesting anti-inflammatory and analgesic effects that masked the effect of high blood sugar. Future studies could explore the predictive ability of glycemic assessment for poor knee function and physical performance while accounting for the effects of the medication.
Fulltext About Falls Efficacy: A commentary on "World guidelines for falls prevention and management for older adults: a global initiative"

Soh SLH, McCrum C, Okubo Y, Farlie M, Soh SE, Tan MP, et al.

J Frailty Sarcopenia Falls, 2024 Dec;9(4):281-285.
PMID: 39635562 DOI: 10.22540/JFSF-09-281
Fulltext Gendered narratives and cultural shifts: A qualitative study on decadal changes in community alcohol consumption

Tan MG, Wider W, Pang NTP, Lasimbang HB, Shoesmith WD, Tangau CRM, et al.

PLoS One, 2024;19(12):e0309378.
PMID: 39621663 DOI: 10.1371/journal.pone.0309378

Alcohol consumption has been a central practice in Sabah, Malaysia. However, this region has witnessed a nuanced shift in drinking habits over the last decade, raising concerns about the health, economic, and social implications of alcohol use within the community in Sabah. This study explores the impact of gender narratives and cultural transformations on alcohol consumption within Sabah over the last decade. The objectives of this research include 1) assessing the shifts in alcohol consumption patterns over the last 10 years, 2) understand the role of gender differences in shaping these patterns, and 3) identify the economic consequences resulting from the changes. Employing a qualitative approach, we conducted focus group interviews with members of the native community, each group consisting of up to 7 participants. Thematic analysis was used to identify key themes pertaining to gender roles, cultural practices, and socioeconomic influences of alcohol consumption. The data were then contextualized using Bronfenbrenner's social-ecological model and social role theory. The study reveals a significant shift in drinking habits. Historically, alcohol was mostly consumed by men, but now more women are drinking, changing long-standing gender roles related to alcohol use. Children often copy their parents' drinking behaviors, and with alcohol being more easily available, more people are drinking than before. Our findings also expose the complex consequences of alcohol use, which extend to health concerns, familial tension, and economic hardship. Despite the entrenched cultural status of alcohol, these negative outcomes are exacerbated by a lack of supportive healthcare services. In light of these insights, the study suggests the need for intervention plans that respect the cultural background of Sabah and account for gender dynamics while tackling the current issues of alcohol misuse. The research adds to the wider conversation about managing alcohol in different cultural settings and also recommended strategies based on the findings, such as cultural and gender sensitive community programs, youth centered programs, community-based healthcare services, employment support and training and development of laws and policies.
Fulltext Polyethylene glycol-phospholipid functionalized single-walled carbon nanotubes for enhanced siRNA systemic delivery

Tan YF, Hii LW, Lim WM, Cheong SK, Leong CO, Yee MS, et al.

Sci Rep, 2024 Dec 03;14(1):30098.
PMID: 39627280 DOI: 10.1038/s41598-024-80646-1

Small interfering RNAs (siRNA) technology has emerged as a promising therapeutic tool for human health conditions like cancer due to its ability to regulate gene silencing. Despite FDA-approved, their delivery remains localized and limiting their systemic use. This study used single-walled carbon nanotubes (SWNTs) functionalized with polyethylene glycolated (PEGylated) phospholipids (PL-PEG) derivatives for systemic siRNA delivery. We developed an siRNA systemic delivery vehicle (SWNT-siRNA) by conjugating SWNT functionalized with PL-PEG containing either amine (PA) or maleimide (MA). The functionalized SWNT with a lower molecular weight of PA produced the SWNT-siRNA conjugate system with the highest stability and high siRNA loading quantity. The system delivered siRNA to a panel of tumour cell lines of different organs (i.e. HeLa, H1299 and MCF-7) and a non-cancerous human embryonic kidney 293 cells (HEK293T) with high biocompatibility and low toxicity. The cellular uptake of SWNT-siRNA conjugates by epithelial cells was found to be energy dependent. Importantly, the presence of P-glycoprotein, a marker for drug resistance, did not inhibit SWNT-mediated siRNA delivery. Mouse xenograft model further confirmed the potential of SWNT-siRNA conjugates with a significant gene knock-down without signs of acute toxicity. These findings pave the way for potential gene therapy applications using SWNTs as delivery vehicles.
Artificial intelligence-assisted point-of-care devices for lung cancer

Ng XJK, Mohd Khairuddin AS, Liu HC, Loh TC, Tan JL, Khor SM, et al.

Clin Chim Acta, 2025 Feb 11;570:120191.
PMID: 39947574 DOI: 10.1016/j.cca.2025.120191

Lung cancer is the leading cause of cancer-related deaths worldwide, primarily due to late-stage detection, which limits treatment options. Early detection and screening can increase survival rates, but traditional medical imaging methods are costly and inconvenient. Point-of-care biosensors present a promising alternative, being user-friendly, less labor-intensive, and minimally invasive. With high sensitivity and selectivity, these biosensors detect lung cancer-associated biomarkers, including protein and nucleic acid, in biological fluids such as serum, urine, and saliva. Integrating artificial intelligence (AI) with biosensors has further improved their performance. AI algorithms can analyze complex data, differentiate lung cancer patients from healthy individuals, and even predict the risk of cancer metastasis. Despite these advancements, a comprehensive review of AI-coupled biosensors for lung cancer screening and detection has not yet been conducted. The clinical translation of these biosensors is challenged by a lack of standardization in biomarker selection, the number of biomarkers tested, and the determination of clinical cut-off values. This review focuses on recent advances in biosensors for lung cancer screening and detection, the challenges in their clinical application, and the role of AI in improving biosensor performance. Additionally, it explores future perspectives on the evolution of AI-assisted biosensors into comprehensive health monitoring systems, aiming to bridge the gap between technological innovation and practical clinical use.
Fulltext The Association Between Medication Adherence, Internalized Stigma and Social Support Among Outpatients with Major Depressive Disorder in a Malaysian Hospital: A Cross-Sectional Study

Halim R, Kaur M, Syed Mokhtar SS, Chemi N, Sajatovic M, Tan YK, et al.

Psychol Res Behav Manag, 2025;18:209-223.
PMID: 39931525 DOI: 10.2147/PRBM.S485333

BACKGROUND: Internalized stigma and medication non-adherence pose significant challenges for treating major depressive disorder (MDD), leading to disability, increased suicide risk, and morbidity. Limited data exists on modifiable factors associated with adherence in lower-resourced settings like Malaysia. This study aimed to investigate poor adherence prevalence and the demographic and clinical factors associated with poor medication adherence among patients with MDD.
METHODS: This cross-sectional survey recruited participants using universal sampling from a major hospital in Selangor, Malaysia. Participants answered questionnaires consisting of demographic and clinical information (medical history, duration of anti-depressant treatment for MDD, psychiatric ward admission history, and any medication side effects experienced), the Internalized Stigma of Mental Illness Scale (comprising alienation, stereotype, perceived discrimination, and social withdrawal), the Multidimensional Scale of Perceived Social Support (comprising family, friend, and significant other support), and the Malaysia Medication Adherence Assessment Tool. Simple and multiple logistic regression and mediation analyses were conducted.
RESULTS: Of the 268 participants (69% female), 57.1% were suboptimally or moderately adherent to their medication. Buddhists (adjusted odds ratio [aOR] = 0.280, 95% CI [0.115, 0.679], p = 0.005), higher family support (aOR = 0.753, 95% CI [0.591, 0.960], p = 0.022), a history of ward admissions (aOR = 3.523, 95% CI [1.537, 8.072], p = 0.003), and higher internalized stigma (aOR = 2.828, 95% CI [1.497, 5.344], p = 0.001) were significantly associated with low/moderate medication adherence. The effect of internalized stigma subdomains (alienation, perceived discrimination, and social withdrawal) on medication adherence were partially mediated by family support.
CONCLUSION: More than half of the participants demonstrated low to moderate medication adherence. Those with higher internalized stigma demonstrated higher odds of low/moderate medication adherence, but this effect was attenuated by family support. Therefore, internalized stigma and family support are important points of consideration when assessing patients with MDD in Malaysia.
A novel classical machine learning framework for early sepsis prediction using electronic health record data from ICU patients

Prithula J, Islam KR, Kumar J, Tan TL, Reaz MBI, Rahman T, et al.

Comput Biol Med, 2025 Jan;184:109284.
PMID: 39579661 DOI: 10.1016/j.compbiomed.2024.109284

Sepsis, a life-threatening condition triggered by the body's response to infection, remains a significant global health challenge, annually affecting millions in the United States alone with substantial mortality and healthcare costs. Early prediction of sepsis is critical for timely intervention and improved patient outcomes. This study introduces an innovative predictive model leveraging machine learning techniques and a specific data-splitting approach on highly imbalanced electronic health records (EHRs). Using PhysioNet/CinC Challenge 2019 data from 40,336 patients, including vital signs, lab values, and demographics. Preliminary assessments using classical and stacked ML models with Synthetic Minority Oversampling Technique (SMOTE) augmentation were conducted, showing improved performance. It is found that stacking ML models enhances overall accuracy but faces limitations in precision, recall, and F1 score for positive class prediction. A novel data-splitting approach with 5-fold cross-validation and SMOTE and COPULA augmentation techniques demonstrated promise, with F1 scores ranging from 93 % to 94 % using the COPULA technique. COPULA excelled at predictions for different hours' onsets compared to the SMOTE technique. The proposed model outperformed existing studies, suggesting clinical viability for early sepsis prediction.
Fulltext Pertussis in Southeast Asia: country-level burden and recommendations from the Global Pertussis Initiative

Nguyen PNT, Heininger U, Muloiwa R, von König CHW, Hozbor D, Ong-Lim A, et al.

IJID Reg, 2025 Mar;14:100559.
PMID: 39906191 DOI: 10.1016/j.ijregi.2024.100559

The Global Pertussis Initiative met in March 2024 to discuss the burden of pertussis and prevention efforts in six Southeast Asian countries: Cambodia, Indonesia, Malaysia, Singapore, Thailand, and Vietnam. Except for Cambodia, pertussis is a notifiable disease; data accuracy varies within and between countries. Most cases in the region are diagnosed based on clinical suspicion. Whole-cell and acellular pertussis combination vaccines are available, but the composition differs between countries. Immunization against pertussis is well-established, but policies regarding boosting vary. Vaccination in pregnancy represents a still-neglected opportunity to protect infants. The Global Pertussis Initiative recommends enacting vaccination in pregnancy in countries without and increasing coverage in countries with policies already in place. There is a need to correct the misperception that pertussis affects children exclusively and that childhood vaccines provide lifelong protection. Education is key to widespread understanding of the threat of pertussis and removing barriers to vaccination in Southeast Asia.
Remote sensing research on plastics in marine and inland water: Development, opportunities and challenge

Chen Z, Si W, Johnson VC, Oke SA, Wang S, Lv X, et al.

J Environ Manage, 2025 Jan;373:123815.
PMID: 39721385 DOI: 10.1016/j.jenvman.2024.123815

The accumulation of plastic waste from various sources into marine and inland water is considered a global problem due to its serious impacts on aquatic ecosystems and human health. In the past decade, remote sensing has played an important role in monitoring of plastic pollution in marine and inland water sources and has achieved a series of research results in this field. In this study, a comprehensive review was conducted on the development, opportunities, and challenges of datasets and methods in Marine and Inland Water Plastics Remote Sensing (MIWPRS) monitoring over the past decade, based on the Web of Science (WOS) core database. The results indicated that compared with traditional methods, remote sensing has attracted the attention of scholars due to its advantages. Since 2014, the number of related publications has been increasing year by year, especially in China and the United States, which have achieved tremendous development. The MIWPRS research focus mostly on the use of different satellite remote sensing data and related algorithms to obtain the distribution of plastics in marine and inland water. However, it faces the challenge of lacking subsequent systematic impact assessment models and key pollution prevention measures. In terms of data acquisition, there is a lack of continuous observation models due to the fluidity of marine and inland water. Therefore, MIWPRS has great development opportunities in developing specialized sensors and combining multi-source data with interdisciplinary knowledge such as artificial intelligence (AI) and GIS. It is necessary for us to improve the seasonal migration model of plastics in water and promote the development of MIWPRS towards broader and deeper fields.
New host record and redescription of Amblyomma cordiferum nymphs and larvae infesting Malaysian house rats (Rattus rattus diardii) in Peninsular Malaysia, with molecular evidence of Rickettsia, Borrelia, and Bartonella

Kazim AR, Nasir DM, Tan TK, Yin VW, Noh AAM, Heo CC, et al.

Acta Trop, 2025 Jan;261:107496.
PMID: 39667694 DOI: 10.1016/j.actatropica.2024.107496

Nymphal and larval Amblyomma cordiferum ticks, a relatively rare species, were collected from the Malaysian house rat (Rattus rattus diardii) in Peninsular Malaysia. Redescription and molecular analysis of nymphs and larvae, based on the 12S rRNA, 16S rRNA, and COI genes, revealed divergence from A. cordiferum in Taiwan, suggesting that the Taiwanese tick specimens may represent a different taxon. Molecular analysis of the pathogens in these specimens revealed three sequences of Rickettsia closely related or identical to Rickettsia raoultii (99.71-100%), two sequences of relapsing fever Borrelia identical to Borrelia theileri, and four sequences of Bartonella identical to Bartonella phoceensis. This study also identifies a new host record for A. cordiferum in R. r. diardii and reports the first detection of Rickettsia, Borrelia, and Bartonella in this tick species.
Broadly cross-reactive immune responses in chickens immunized with chimeric virus-like particles of nodavirus displaying the M2e originated from avian and human influenza A viruses

Thian BYZ, Fatimah MNN, Wong CL, Ong HK, Mariatulqabtiah AR, Ho KL, et al.

Dev Comp Immunol, 2025 Jan;162:105275.
PMID: 39341478 DOI: 10.1016/j.dci.2024.105275

Avian influenza A viruses (IAVs) pose a persistent threat to poultry industry worldwide, despite the presence of vaccines. Additionally, reverse-zoonosis transmission potentially introduces human-originated IAVs into poultry and complicates the efforts to control the spread of influenza. Current avian influenza vaccines are primarily based upon the rapidly mutating hemagglutinin (HA) and neuraminidase (NA) glycoproteins, which limit their efficacy against diverse strains of IAVs. Hence, the highly conserved ectodomains of matrix 2 protein (M2e) of IAVs are widely studied as alternatives to the HA and NA. However, the differences in the M2e amino acid sequences between avian and human IAVs generate antibodies that do not cross-react reciprocally with IAVs from other origins. To broaden and enhance the immunogenicity of M2e, we fused two copies each of the M2e derived from avian and human IAVs at the C-terminal end of the Macrobrachium rosenbergii nodavirus (MrNV) capsid protein (NvC). Transmission electron microscopic and dynamic light scattering analyses revealed that the chimeric protein self-assembled into virus-like particles (VLPs). Immunization of chickens with the chimeric VLPs demonstrated a robust induction of broadly reactive immune responses against both the M2e of avian and human IAVs. Additionally, the chimeric VLPs elicited the production of cytotoxic T lymphocytes (CTL), macrophages, as well as a well-balanced Th1 and Th2 population, indicating their potential in activating cell-mediated immune responses in chickens. Furthermore, the chimeric VLPs triggered the production of both Th1- and Th2-cytokines, attesting their potential in mounting a robust and balanced immune response in avian species. This study demonstrated the potential of these chimeric VLPs in stimulating and broadening cross-reactive immune responses in chickens against both avian and human IAVs.
Fungicide resistance in Fusarium species: exploring environmental impacts and sustainable management strategies

Naqvi SAH, Farhan M, Ahmad M, Kiran R, Shahbaz M, Abbas A, et al.

Arch Microbiol, 2025 Jan 10;207(2):31.
PMID: 39792175 DOI: 10.1007/s00203-024-04219-6

The agricultural productivity and world-wide food security is affected by different phytopathogens, in which Fusarium is more destructive affecting more than 150 crops, now got resistance against many fungicides that possess harmful effects on environment such as soil health, air pollution, and human health. Fusarium fungicide resistance is an increasing concern in agricultural and environmental contexts, requiring a thorough understanding of its causes, implications, and management approaches. The mechanisms of fungicide resistance in Fusarium spp., are reviewed in this article, including increased efflux pump activity, target-site mutations, and metabolic detoxification pathways. Fusarium is naturally resistant to some of the fungicides, on the other hand; it speedily develops resistance against the other fungicides groups. Most of the important plant pathogenic Fusarium species including F. oxysporum, F. psedogramanium, F. graminearium and Fusarium solani, which have shown resistance to major groups of fungicides including triazoles, phenylpyrole and benzimedazoles in various regions of the world. The review also covers a range of management techniques, including fungicide rotation, resistant cultivars, cultural methods, and biological control agents, to lessen fungicide resistance. By shedding light on the current state of knowledge concerning fungicide resistance in Fusarium spp., this review provides valuable information to researchers, policymakers, and practitioners to design long-term effective disease management approaches, as well as fungal menace control to preserve fungicides' effectiveness in agriculture and conservancy activities.
Effects of Different Stretching Modalities on the Antagonist and Agonist Muscles on Isokinetic Strength and Vertical Jump Performance in Young Men

Montalvo S, Gonzalez MP, Dietze-Hermosa MS, Martinez A, Rodriguez S, Gomez M, et al.

J Strength Cond Res, 2025 Feb 01;39(2):173-183.
PMID: 39446677 DOI: 10.1519/JSC.0000000000004937

Montalvo, S, Gonzalez, MP, Dietze-Hermosa, MS, Martinez, A, Rodriguez, S, Gomez, M, Ibarra-Mejia, G, Tan, E, and Dorgo, S. Effects of different stretching modalities on the antagonist and agonist muscles on isokinetic strength and vertical jump performance in young men. J Strength Cond Res 39(2): 173-183, 2025-Exercise warm-up may include static or dynamic stretching, impacting performance differently. This study investigated the effects of various stretching protocols on isokinetic strength, muscular activity, and vertical jump performance. Sixteen subjects, divided evenly between trained and untrained groups, underwent 8 distinct stretching conditions in random order. Outcomes measured included isokinetic knee extension and flexion torque and power, muscular activity (vastus lateralis, vastus medialis, and biceps femoris), and jump performance (jump height and modified reactive strength index [RSImod]). Responses to the stretching conditions were analyzed using a mixed-methods approach. For isokinetic knee extension, dynamic stretching of both agonist and antagonist (DY-AG-ANT) and combined dynamic agonist with static antagonist stretching (DY-AG ST-ANT) produced significant improvements. Dynamic stretching of both agonist and antagonist increased peak torque by 12.72% and average torque by 30.80%, while DY-AG ST-ANT increased peak torque by 15.61% and average torque by 41.06%. Muscular activity also improved significantly; DY-AG ST-ANT increased EMG activity of the vastus lateralis by 29.43% and vastus medialis by 70.75%. Biceps femoris saw a 33.18% increase with DY-AG and a 22.15% increase with ST-AG. Countermovement jump height improved with DY-AG-ANT (12.6%) and static antagonist (ST-ANT) conditions (11.3%) ( p < 0.05). Dynamic stretching of both agonist and antagonist also enhanced average power knee extension by 32.41%, while ST-AG DY-ANT improved it by 31.09% ( p < 0.05). Dynamic stretching, especially when combined with static stretching, optimizes isokinetic strength, muscular activity, and jump height. Coaches should incorporate dynamic stretching, alone or with static antagonist stretching, to maximize performance.
Fulltext Critical updates on oral insulin drug delivery systems for type 2 diabetes mellitus

Low CY, Gan WL, Lai SJ, Tam RS, Tan JF, Dietl S, et al.

J Nanobiotechnology, 2025 Jan 15;23(1):16.
PMID: 39815320 DOI: 10.1186/s12951-024-03062-7

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by insulin resistance, leading to elevated blood sugar levels. Exogenous insulin can counteract the diminished response to insulin and effectively controlling blood glucose levels, thereby minimizing diabetes-related complications. However, given the injectable nature of exogenous insulin, apprehensions regarding its safety and the difficulties associated with its administration have hindered its widespread and prompt utilization. In this context, advanced oral insulin formulations can improve medication adherence in patients with diabetes and enhance their quality of life. Over the last 20 years, sophisticated pharmaceutical technologies have been utilized to provide insulin through oral formulations. Despite the limited absorption of oral insulin, these studies have demonstrated encouraging outcomes in translating clinical discoveries into commercialization. This review examines the advancements of several oral insulin formulations in preclinical and clinical trials, their effectiveness and safety characteristics, and potential implications for future treatment options.
Influence of psychosocial and health-seeking behaviour on the risk of falling among persons living with type 2 diabetes in the Malaysian Elders Longitudinal Research (MELoR) cohort

Goh SSL, Moy FM, Mat S, Ali SM, Hoo ZX, Apparoo SGR, et al.

Aging Clin Exp Res, 2025 Mar 11;37(1):75.
PMID: 40067536 DOI: 10.1007/s40520-025-02961-5

BACKGROUND: Older persons with diabetes have an increased falls risk that could lead to serious complications including death.
AIM: To determine the influence of psychosocial factors and health-seeking behaviour on the risk of falling among individuals with type 2 diabetes.
METHODS: This prospective study included community-dwelling adults aged ≥55 years selected through stratified random sampling from three neighbouring parliamentary constituencies. Data was collected at baseline in 2013-2015 with computer-assisted home-based interviews and follow-up in 2019 via telephone interviews.
RESULTS: Data on diabetes status and falls were available for 908 participants at baseline and follow-up. Diabetes was present in 42.2% of included participants at follow-up, of whom 22.8% at baseline and 25.3% at 5-year follow-up had at least one fall within the last 12 months. Diabetics had a higher risk of falls at baseline (OR: 1.484; 95% CI: 1.060-2.077) and follow-up (OR: 1.424; 95% Cl: 1.038-1.954) than non-diabetics. It was found that female gender, arthritis, alcohol and presence of depression anxiety or stress were associated with increased risk of falls in diabetics. The presence of any depression, anxiety or stress remained significantly associated with falls in diabetics (OR: 1.947; 95% Cl: 1.115-3.402) after adjustments for age, gender, ethnicity, and education but this relationship was attenuated after additional adjustment for arthritis (OR: 1.763; 95% CI: 0.996-3.122).
CONCLUSION: Our findings suggest that psychological issues are significantly associated with increased risk of falls at five-year follow-up in individuals aged 55 years and over with diabetes. These findings highlight the potential importance of psychosocial support among diabetics to reduce the risk of falls, improve patient outcomes and quality of life.
Intraspecific genetic diversity with unrestricted gene flow in the domoic acid-producing diatom Nitzschia navis-varingica (Bacillariophyceae) from the Western Pacific

Tan SN, Kotaki Y, Teng ST, Lim HC, Gao C, Lundholm N, et al.

Harmful Algae, 2025 Jan;141:102769.
PMID: 39645396 DOI: 10.1016/j.hal.2024.102769

The benthic pennate diatom Nitzschia navis-varingica, known for producing domoic acid (DA) and its isomers, is widely distributed in the Western Pacific (WP) region. To investigate the genetic differentiation and gene flow patterns among the populations in the WP, the genetic diversity of 354 strains of N. navis-varingica was analysed using two nuclear-encoded rDNA loci: the large subunit rDNA (LSU rDNA) and the internal transcribed spacer 2 (ITS2). Frustule morphology of each strain was examined by TEM. The LSU rDNA phylogeny revealed a monophyletic lineage encompassing all strains, with sequence divergences of <0.9 %. Phylogenetic and population genetic analyses of ITS2 identified eight distinct clades (designated as Groups A to H) with moderate to high genetic heterogeneity (0.5-19.7 %). The low genetic differentiations between the geographically separated populations (pairwise FST of <0.03) suggested high gene flow and lack of spatial genetic structuring. Molecular clock analysis of the ITS2 phylogeny traced the evolutionary history of N. navis-varingica to the Eocene Epoch, and the split between clades likely occurred from the mid-Miocene to Pleistocene Epochs (10.8-1.2 Ma). The population dispersal in the WP were likely influenced by historical events like the Quarternary glacial cycles during the period, contributing to its homogenous distributions in the region.
Transforming care: Optimizing ERAS pathway in breast cancer surgery with latissimus dorsi flap

Lai LL, Teh MS, Beh ZY, Lim WL, Lim SM, Soh WQ, et al.

World J Surg, 2024 Dec;48(12):2799-2810.
PMID: 39444164 DOI: 10.1002/wjs.12364

INTRODUCTION: This study aims to establish, execute, and assess the effectiveness of a perioperative enhanced recovery after surgery (ERAS) clinical care pathway in breast reconstruction patients with LD flap breast cancer treatment. The goal is to improve early recovery outcomes, reduce hospitalization time, and enhance patient satisfaction by implementing a standardized approach to postoperative care.
METHODS: This study was conducted at the University of Malaya Medical Center. The outcomes of 21 breast cancer patients who underwent autologous reconstructive breast surgery with the latissimus dorsi (LD) flap within six months before the implementation of the ERAS pathway (pre-ERAS) were compared with 26 patients who underwent the same surgery with the ultrasound-guided erector spinae plane (ESP) block for the (ERAS protocol implementation) cohort. The study was conducted from November 2019 to October 2020. The length of hospital stay, amount of analgesic usage, and incidence of postoperative nausea vomiting (PONV) were recorded.
RESULTS: The implementation of the ERAS clinical care pathway resulted in shorter hospital stays compared with the preceding care. On average, ERAS patients were mostly discharged on Day 2 post-surgery, whereas pre-ERAS patients were mostly discharged on Day 7. ERAS patients had a lower incidence of PONV from Days 1 to 5, starting with 88.5% not experiencing the condition on Days 1 and 2 and increasing to 100% on Day 5. All pre-ERAS patients experienced PONV in the first 5 days post-surgery. Fewer ERAS patients required antiemetics post-surgery (88.5%) compared with pre-ERAS patients (42.9%).
CONCLUSION: The implementation of the ERAS protocol as part of clinical care in autologous reconstructive breast surgery with the LD flap can improve recovery by shortening hospital stay, decreasing the use of analgesia, and alleviating PONV.
Determining the computed tomography perfusion changes in patients presenting with acute seizures of different etiologies - A case-control study

Rapai Kasini NA, Payus AO, Khoo CS, Tan HJ, Mohamed Mukari SA, Mohd Mustapha AM, et al.

Epilepsy Behav, 2025 Feb 19;165:110309.
PMID: 39978077 DOI: 10.1016/j.yebeh.2025.110309

INTRODUCTION: It can be challenging at times to clinically differentiate between acute seizure and acute stroke. This study aimed to compare the computed tomography perfusion (CTP) changes in patients presenting with acute seizures of different etiologies to those with acute cortical stroke.
METHODS: We conducted a single-center cross-sectional case-control study on the CTP changes of 31 patients presenting with acute seizures of different etiologies, and compared them with 31 patients of acute cortical stroke patients (n = 31) as the control.
RESULTS: 58.1% had increased time to peak (TTP) in the seizure group. None of the patients with acute stroke had reduced TTP compared to 25.8% in the seizure group. The majority of patients in the seizure group had normal to reduced relative cerebral blood flow (rCBF) (38.7% and 35.5%, respectively). 35.5% and 38.7% of the patients presenting with acute seizures had normal and reduced relative cerebral blood volume (rCBV), respectively. The association between the perfusion parameters and etiology of seizures, presence of underlying epilepsy, or presence of postictal neurological deficits was not statistically significant. The seizure group had cortical ribbon (51.6%), holo-hemispheric (32.3%), multi-lobar (9.7%), and normal (6.5%) CT perfusion patterns. In conclusion, our study shows that the majority of the patients of the acute seizure group had normal to hypoperfusion patterns. Seizure-related perfusion changes did not conform to expected vascular territories, and cortical ribbon pattern was found to be predominant in our study.
SIGNIFICANCE: There is cerebral hypoperfusion or normal perfusion in most patients presenting with acute seizures. Seizure-related perfusion changes are not limited to arterial vascular territories.
Prevalence and associated factors of caregiving burden among caregivers of adults with epilepsy in Malaysia - A cross-sectional study

Mohd Ismail I, Khoo CS, Ibrahim L, Ong MJY, Tan HJ, Hod R, et al.

Epilepsy Behav, 2025 Feb;163:110244.
PMID: 39740259 DOI: 10.1016/j.yebeh.2024.110244

BACKGROUND: There are still insufficient data on caregiver burden among caregivers of adult people with epilepsy (PWE), particularly in Malaysia. This study aims to explore the level of perceived caregiver burden among the informal caregivers caring for PWE, its predicting factors associated with caregiver burden, and the impact of this caregiver burden on their psychological health.
METHODS: In this cross-sectional study, caregivers of adult PWE attending the neurology outpatient clinic at Hospital Canselor Tuanku Muhriz (HCTM) completed a comprehensive questionnaire comprising demographic data of participants and care recipients (adult PWE). Epilepsy-related data were obtained from the interview and medical records. Affiliate stigma among caregivers was assessed using Affiliate Stigma Scale (ASS), and psychological impacts were evaluated using Depression Anxiety Stress Scale 21 (DASS-21). The level of caregiver burden was evaluated with Zarit Burden Interview (ZBI).
RESULTS: A total of 119 caregivers participated in the study, and 35.2 % of them reported mild to moderate burden. The factors most strongly associated with higher caregiver burden were female caregivers, needs for assistance in activities of daily living (ADL), frequent seizures, polypharmacy, and affiliate stigma among caregivers. A statistically significant positive correlation was seen between caregiver burden and psychological impacts of depression (r 0.522, p
Fulltext Optimization of instant sweet osmanthus white tea: formulation, sensory evaluation, and antioxidant properties

Yang Y, Fan L, Lin Y, Huang Y, Zhang J, Li S, et al.

Front Nutr, 2025;12:1538848.
PMID: 40046756 DOI: 10.3389/fnut.2025.1538848

OBJECTIVE: This study aims to optimize the formulation of instant sweet osmanthus white tea (IOWT) and evaluate its antioxidant activities through in vitro assays.
METHODS: Single-factor and orthogonal experiments were conducted to investigate the impacts of sweet osmanthus-to-white tea ratio and the concentrations of β-cyclodextrin, erythritol, and citric acid on sensory properties and total flavonoids content (TFC) of IOWT. Mixtures of the dried ingredients were spray-dried to produce IOWT.
RESULTS AND DISCUSSION: The optimal formulation of IOWT was as follows: sweet osmanthus-towhite tea ratio of 1:5, 4% β-cyclodextrin, 6% erythritol, and 0.5% citric acid. This optimized IOWT formulation obtained the highest sensory score of 89.5 and a TFC of 25.76%. Using ascorbic acid as a positive control, the in vitro antioxidant activities of the optimized IOWT formulation were assessed by measuring its ability to scavenge DPPH radicals, hydroxyl radicals, superoxide anion radicals, and ABTS radicals. At a concentration of 1.0 mg/mL, the optimized IOWT formulation exhibited scavenging rates of 88.01, 94.99, 97.57, and 99.11% against DPPH, hydroxyl radicals, superoxide anion radicals, and ABTS radicals, respectively, indicating strong in vitro antioxidant activities of IOWT. This study demonstrated promising potential for the development of novel white tea-based products.

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