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  1. Ge P, Li Q, Dong M, Niu Y, Han X, Xiong P, et al.
    Front Public Health, 2022;10:1074559.
    PMID: 36620260 DOI: 10.3389/fpubh.2022.1074559
    OBJECTIVE: To investigate the status of Chinese residents' self-medication behavior and the important factors to consider when purchasing OTC drugs, and to explore the related factors of the possibility that Chinese residents take medical staff's suggestions as important factors to consider when purchasing OTC drugs.

    STUDY DESIGN: A cross-sectional survey.

    METHODS: A questionnaire was developed for exploring the sociodemographic characteristics of the respondents, their self-medication status, and important considerations. The questionnaire includes several scales including Health Literacy Scale-Short Form (HLS-SF), EQ-5D Visual Analog Scale (EQ-5D-VAS), Big Five Inventary-10 Items (BFI-10), and New General Self Efficacy Scale (NGSES). After carrying out a multi-stage sampling method, the questionnaire was conducted nationwide from July 10 to September 15, 2021. Next, descriptive statistics were conducted to analyze the general features. Logistic regression was then used to analyze the related factors of the possibility that the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs.

    RESULTS: Nine thousand two hundred fifty-six qualified questionnaires were received. 99.06% of Chinese adults had self-medication behaviors. The types of OTC drugs purchased most by the respondents were NSAIDs (5,421/9,256 people, 58.57%) and vitamins/minerals (4,851/9,256 people, 52.41%). 86.2% of the respondents took the suggestions of medical staff as an important consideration when purchasing OTC drugs. The results of multi-factor logistic regression showed that women, those living in the central and western regions of China, those suffering from chronic diseases, those with high agreeableness, high conscientiousness, high neuroticism and openness, high health literacy, high EQ-5D-VAS, and those with high self-efficacy are more likely to take medical staff's suggestions as important factors to consider.

    CONCLUSION: The vast majority of Chinese adults have self-medication behavior. Important considerations when purchasing OTC drugs include medical staff's suggestions, drug safety and drug efficacy. Whether residents take the suggestions of medical staff as an important consideration is related to their sociological characteristics, agreeableness, conscientiousness, neuroticism, openness, health literacy, self-assessment health status, and self-efficacy. When purchasing and using OTC drugs, residents should carefully listen to the suggestions from medical staff. They should also carefully consider their own conditions before buying OTC drugs.

    Matched MeSH terms: Female
  2. Krishnasamy S, Lomer MCE, Marciani L, Hoad CL, Pritchard SE, Paul J, et al.
    J Nutr, 2020 Nov 19;150(11):2890-2899.
    PMID: 32805050 DOI: 10.1093/jn/nxaa191
    BACKGROUND: Whole apples produce greater satiety than processed apples, but the underlying mechanisms remain unclear.

    OBJECTIVE: Our aim was to assess the intragastric processing of apple preparations and the associated small and large bowel contents using MRI.

    METHODS: An open label, 3-way crossover, randomized, controlled trial. Eighteen healthy adults (mean ± SD age, 25 ± 4 y; BMI, 22.7 ± 3.5 kg/m2) underwent serial MRI scans on 3 occasions separated by 7 d, after consumption of isocaloric (178 kcal) portions of either whole apples, apple puree, or apple juice. Gastric emptying, small bowel water content (SBWC; primary endpoint), were measured at baseline and at 45 min intervals (0-270 min) postmeal ingestion. Fullness and satiety were also assessed at each time point. Treatment effects between groups were analyzed using ANOVA.

    RESULTS: Gastric emptying half-time (GE t50) was greater (P < 0.0001) after participants consumed whole apple (mean ± SEM), 65 (3.3) min compared with when they consumed apple puree (41 [2.8] min) or apple juice (38 [2.9] min), times that did not differ. Postprandial area under the curve (AUC) (135-270 min) SBWC was also greater for whole apples than puree (P = 0.025) and juice (P = 0.0004) but juice and puree did not differ. AUC for fullness and satiety (0-270 min) postingestion was also greater (P = 0.002 and 0.004, respectively) for whole apple compared with juice but juice and puree did not differ.

    CONCLUSIONS: Gastric emptying is slower after whole apple consumption causing a greater sensation of fullness and satiety than puree or juice in healthy adults. Whole apples increased small bowel and colonic contents during the later phase of the study which may be relevant for subsequent food consumption.This study was registered at clinicaltrials.gov as NCT03714464.

    Matched MeSH terms: Female
  3. Teah MK, Liew EHR, Wong MTF, Yeap TB
    BMJ Case Rep, 2021 Feb 19;14(2).
    PMID: 33608338 DOI: 10.1136/bcr-2020-238600
    Awake fibreoptic intubation (AFOI) is an established modality in patients with anticipated difficulty with tracheal intubation. This case demonstrates that with careful and meticulous preparations, AFOI can lead to improved airway management and excellent patient outcomes. A 38-year-old woman presented with severe trismus secondary to odentogenous abscess was identified preoperatively as having a potential difficult airway. AFOI was performed successfully using combined Spray-As-You-Go and dexmedetomidine technique.
    Matched MeSH terms: Female
  4. Sharif Nia H, She L, Froelicher ES, Marôco J, Moshtagh M, Hejazi S
    BMC Psychiatry, 2023 Feb 07;23(1):92.
    PMID: 36747165 DOI: 10.1186/s12888-023-04580-8
    BACKGROUND: The resilience construct is considered a personal trait composed of multiple aspects. Connor-Davidson Resilience Scale is a standard tool composed of five factors and 25 items. This study aimed to determine the psychometric properties of this scale.

    METHODS: In this cross-sectional study, after the scale translation, the factorial structural validity was assessed via the confirmatory factor analysis with 70 180 samples. Internal consistency, composite reliability, convergent validity were assessed by calculating Cronbach's alpha, composite reliability, maximum reliability, and Average Variance Extracted. The discriminant validity was assessed using Heterotrait-monotrait ratio of correlations matrix and also, measure invariance was evaluated.

    RESULTS: The original five-factor model had good model fit indices but due to low factor loading of item 2 and 20, the model was modified. The Cronbach's alpha and composite reliability for four factors were above 0.7 (except for factor 5). The convergent validity for all five factors were achieved. Between factors 1 with 2 and 4, 2 with 3 and 4 discriminant validity was not established (correlations > 0.9) and the results suggested that there might be a second-order latent construct behind these factors. Therefore, a second-order assessment was performed. The results of the second-order latent construct assessment showed a good goodness-of fit and strong measurement invariance for both men and women.

    CONCLUSION: The 23-item version of Connor-Davidson Resilience Scale is a reliable and valid scale to measure resilience as a complex construct in the Iran context.

    Matched MeSH terms: Female
  5. Hsin YK, Thangarajoo T, Choudhury H, Pandey M, Meng LW, Gorain B
    J Pharm Sci, 2023 Feb;112(2):562-572.
    PMID: 36096286 DOI: 10.1016/j.xphs.2022.09.002
    Vaginal candidiasis is a common form of infection in women caused by Candida species. Due to several drawbacks of conventional treatments, the current research is attempted to formulate and optimize a miconazole nitrate-loaded in situ spray gel for vaginal candidiasis. The stimuli-responsive (pH and thermo-responsive) polymers selected for the in situ gel were chitosan and poloxamer 407, respectively, whereas hydroxypropyl methylcellulose (HPMC) was introduced in the formulation to further improve the mucoadhesive property. The dispersion of each polymer was carried out using the cold method, whereas the optimization of the formulation was achieved using Box-Behnken statistical design considering viscosity and gelation temperature as dependent variables. Present design achieved the optimized outcome with HPMC, poloxamer and chitosan at 0.52% (w/v), 18.68% (w/v) and 0.41% (w/v), respectively. Evaluation of drug-excipients compatibility was performed using differential scanning calorimetry, Fourier transform infrared spectroscopy, and thermogravimetric analysis where the results showed the absence of any chemical interaction between the polymers and drug component. The optimized formulation showed gelation temperature at 31°C allowing in situ phase transition in a vaginal environment; pH of 4.21 is suitable for use in the vaginal cavity, and appropriate viscosity (290 cP) at storage temperature (below 30°C) would allow spraying at ease, whereas strong mucoadhesive force (22.4±0.513 g) would prevent leaking of the formulation after application. The drug release profile showed sustained release up to 24 h with a cumulative drug release of 81.72%, which is significantly better than the marketed miconazole nitrate cream. In addition, an improved antifungal activity could be correlated to the sustained release of the drug from the formulation. Finally, the safety of the formulation was established while tested on HaCaT cell lines. Based on our findings, it could be concluded that the in situ hydrogel formulation using stimuli-responsive polymers could be a viable alternative to the conventional dosage form that can help to reduce the frequency of administration with ease of application to the site of infection, thus will provide better patient compliance.
    Matched MeSH terms: Female
  6. Rordorf R, Scazzuso F, Chun KRJ, Khelae SK, Kueffer FJ, Braegelmann KM, et al.
    J Am Heart Assoc, 2021 Dec 21;10(24):e021323.
    PMID: 34889108 DOI: 10.1161/JAHA.121.021323
    Background Heart failure (HF) and atrial fibrillation (AF) often coexist; yet, outcomes of ablation in patients with AF and concomitant HF are limited. This analysis assessed outcomes of cryoablation in patients with AF and HF. Methods and Results The Cryo AF Global Registry is a prospective, multicenter registry of patients with AF who were treated with cryoballoon ablation according to routine practice at 56 sites in 26 countries. Patients with baseline New York Heart Association class I to III (HF cohort) were compared with patients without HF. Freedom from atrial arrhythmia recurrence ≥30 seconds, safety, and health care utilization over 12-month follow-up were analyzed. A total of 1303 patients (318 HF) were included. Patients with HF commonly had preserved left ventricular ejection fraction (81.6%), were more often women (45.6% versus 33.6%) with persistent AF (25.8% versus 14.3%), and had a larger left atrial diameter (4.4±0.9 versus 4.0±0.7 cm). Serious procedure-related complications occurred in 4.1% of patients with HF and 2.6% of patients without HF (P=0.188). Freedom from atrial arrhythmia recurrence was not different between cohorts with either paroxysmal AF (84.2% [95% CI, 78.6-88.4] versus 86.8% [95% CI, 84.2-89.0]) or persistent AF (69.6% [95% CI, 58.1-78.5] versus 71.8% [95% CI, 63.2-78.7]) (P=0.319). After ablation, a reduction in AF-related symptoms and antiarrhythmic drug use was observed in both cohorts (HF and no-HF), and freedom from repeat ablation was not different between cohorts. Persistent AF and HF predicted a post-ablation cardiovascular rehospitalization (P=0.032 and P=0.001, respectively). Conclusions Cryoablation to treat patients with AF is similarly effective at 12 months in patients with and without HF. Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02752737.
    Matched MeSH terms: Female
  7. Rahilah AS, Murizah MZ
    Med J Malaysia, 2023 Jan;78(1):14-19.
    PMID: 36715185
    INTRODUCTION: Assisted reproductive technology may result in various outcomes, causing a significant stress both physically and emotionally to the patients. This study aims to determine the level of serum human chorionic gonadotrophin (hCG) following embryo transfer in predicting successful live births in in vitro fertilisation (IVF) cycles.

    MATERIALS AND METHODS: This is a retrospective analysis of 407 IVF pregnancies in Hospital Sultanah Bahiyah Kedah from 2014 to 2019. Serum hCG was withdrawn on either (i) day 16 post-oocyte retrieval for fresh IVF cycle or (ii) day 16 from the addition of progesterone in frozen embryo cycles. Outcomes of IVF pregnancies were analysed in relation to the level of serum hCG.

    RESULTS: The overall median hCG level in singleton live birth was 304.7 IU/L, 547.10 IU/L for multiple live births, and early pregnancy loss level was 77 IU/L. When the ROC graphs were plotted, serum hCG level of 152.85 IU/L predicted singleton livebirth with a sensitivity of 81.3%. Serum hCG of 322.40 IU/L predicted multiple live births with sensitivity of 78.6% and a specificity of 64.3%. In the subgroup analysis comparing prediction hCG level in singleton live birth; the cut-off point in frozen cycle was found to be higher as compared to fresh cycle, 277.05 IU/L vs 117.5 IU/L. Blastocyst pregnancies recorded overall higher predictor hCG level as compared to cleavage state in all the outcomes measured; singleton live birth (372.30 IU/L), early pregnancy loss (107.60 IU/L), and multiple pregnancies (711.40 IU/L).

    CONCLUSION: A single reading of serum hCG taken at day 16 post-oocyte retrieval or day 16 from the addition of progesterone in a frozen cycle will help to determine the outcomes of IVF pregnancies and direct the physicians during counselling sessions and plan for further follow-up of the patients.

    Matched MeSH terms: Female
  8. Chiu CL, Chan YK
    Int J Obstet Anesth, 2000 Oct;9(4):273-5.
    PMID: 15321079 DOI: 10.1054/ijoa.2000.0397
    We present a case of headache following epidural anaesthesia for caesarean section. The patient did not exhibit the classical features of post dural puncture headache and the cause was uncertain. The headache was complicated by post partum seizure and a history of pregnancy-induced hypertension. A diagnostic lumbar puncture had to be done to exclude meningitis as she had a raised white blood count. An epidural blood patch performed 12 days post partum resolved the headache immediately.
    Matched MeSH terms: Female
  9. Tham LK, Osman NA, Lim KS, Pingguan-Murphy B, Abas WA, Zain NM
    Med Eng Phys, 2011 May;33(4):407-10.
    PMID: 21146440 DOI: 10.1016/j.medengphy.2010.11.002
    The investigation of patellar tendon reflex involves development of a reflex hammer holder, kinematic data collection and analysis of patellar reflex responses using motion analysis techniques. The main aim of this research is to explore alternative means of assessing reflexes as a part of routine clinical diagnosis. The motion analysis system was applied to provide quantitative data which is a more objective measure of the patellar tendon reflex. Kinematic data was collected from 28 males and 22 females whilst subjected to a knee jerk test. Further analysis of kinematic data was performed to predict relationships which might affect the patellar tendon reflex. All subjects were seated on a high stool with their legs hanging freely within the capture volume of the motion analysis system. Knee jerk tests were applied to all subjects, on both sides of the leg, by eliciting hypo, hyper, and normal reflexes. An additional reinforcement technique called the Jendrassik manoeuvre was also performed under the same conditions to elicit a normal patellar tendon reflex. The comparison of reflex response between genders showed that female subjects generally had a greater response compared to males. However, the difference in reflex response between the left leg and the right leg was not significant. Tapping strength to elicit a hyper-reflex produced greater knee-jerk compared to the normal clinical tapping strength. All results were in agreement with clinical findings and results found by some early researchers.
    Matched MeSH terms: Female
  10. Henry Basil J, Premakumar CM, Mhd Ali A, Mohd Tahir NA, Seman Z, Mohamed Shah N
    BMJ Paediatr Open, 2023 Feb;7(1).
    PMID: 36754439 DOI: 10.1136/bmjpo-2022-001765
    INTRODUCTION: Medication administration errors (MAEs) are the most common type of medication error. Furthermore, they are more common among neonates as compared with adults. MAEs can result in severe patient harm, subsequently causing a significant economic burden to the healthcare system. Targeting and prioritising neonates at high risk of MAEs is crucial in reducing MAEs. To the best of our knowledge, there is no predictive risk score available for the identification of neonates at risk of MAEs. Therefore, this study aims to develop and validate a risk prediction model to identify neonates at risk of MAEs.

    METHODS AND ANALYSIS: This is a prospective direct observational study that will be conducted in five neonatal intensive care units. A minimum sample size of 820 drug preparations and administrations will be observed. Data including patient characteristics, drug preparation-related and administration-related information and other procedures will be recorded. After each round of observation, the observers will compare his/her observations with the prescriber's medication order, hospital policies and manufacturer's recommendations to determine whether MAE has occurred. To ensure reliability, the error identification will be independently performed by two clinical pharmacists after the completion of data collection for all study sites. Any disagreements will be discussed with the research team for consensus. To reduce overfitting and improve the quality of risk predictions, we have prespecified a priori the analytical plan, that is, prespecifying the candidate predictor variables, handling missing data and validation of the developed model. The model's performance will also be assessed. Finally, various modes of presentation formats such as a simplified scoring tool or web-based electronic risk calculators will be considered.

    Matched MeSH terms: Female
  11. AlSahow A, AlQallaf A, AlYousef A, Bahbahani H, Bahbahani Y, AlHelal B, et al.
    Int Urol Nephrol, 2023 Mar;55(3):721-727.
    PMID: 36136260 DOI: 10.1007/s11255-022-03368-1
    INTRODUCTION: Hemodialysis (HD) patients are at increased risk of severe COVID-19 infection but infection rates vary. Our objectives are to describe COVID-19 positive HD patients' characteristics, infection rates, and factors associated with mortality in HD COVID-19 cases in Kuwait.

    METHODS: Data on demographics, comorbidities, and treatments received, as well as mortality for HD patients admitted to hospitals for COVID-19, from 1/March to 31/July 2020, prospectively collected and analyzed.

    RESULTS: A total of 141 infected HD patients were admitted (Mean age 58 ± 16.1; Males 56%), representing 7% of the total HD population and 0.2% of all COVID-19 cases during the study period. Of those 141 infected HD patients, 27 (19%) died, and this represents 6% of total COVID-19-related mortality and 27% of the total HD mortality. In contrast, total covid-19-related mortality of all positive cases was only 0.7%, and total HD mortality during the study period was only 5%. COVID-19-positive HD patients who died were older and 59% were males. However, the differences were not statistically significant. Of the 61 infected HD patients who needed to be switched to continuous kidney replacement therapy (CKRT), 34% died, and of the 29 infected HD patients who needed admission to intensive care, 65% died.

    CONCLUSION: HD population represents a small fraction of the total population; however, positive HD COVID-19 cases represent a sizable proportion of COVID-19 cases and a significant percentage of total COVID-19-related mortality, and total HD mortality.

    Matched MeSH terms: Female
  12. Muhammad R, Ismail WNDRAW, Firdus S, Abdul Hamid SB, Mohd Asmawi UM, Md Nor N
    Nutrients, 2023 Feb 08;15(4).
    PMID: 36839227 DOI: 10.3390/nu15040869
    Despite the significance of dietary knowledge interventions, there is a lack of established studies on intuitive eating behaviour among young Malay adults in Malaysia. This cross-sectional study aimed to determine the intuitive eating score, identify the intuitive eating factors, and determine the association of intuitive eating with weight-control behaviours and binge eating. A total of 367 respondents completed self-administered questionnaires on sociodemographic characteristics, namely the Intuitive Eating Scale (IES-2) and The Diabetes Eating Problems Survey (DEPS). The findings reported IES-2 mean scores of 3.52 ± 0.32 and 3.47 ± 0.35 for both men and women. No difference in total IES-2 scores was found between genders for Unconditional Permission to Eat (UPE) and Reliance on Hunger and Satiety Cue (RHSC) subscales (p > 0.05). However, among all four subscales of IES-2, there was a gender difference in the mean EPR and B-FCC subscale scores (p < 0.05). A statistically significant difference was found in intuitive eating, which refers to a belief in one's body's ability to tell one how much to eat, in women across living areas (p < 0.05). The result shows that there is a relationship between weight-control behaviour and binge eating and dieting, with the coefficient of the relationship (R2) of 0.34. As a result, intuitive eating throughout young adulthood is likely to be related to a decreased prevalence of obesity, dieting, poor weight-management behaviours, and binge eating.
    Matched MeSH terms: Female
  13. Kalinichenko LS, Smaga I, Filip M, Lenz B, Kornhuber J, Müller CP
    Behav Brain Res, 2023 Feb 15;439:114225.
    PMID: 36435218 DOI: 10.1016/j.bbr.2022.114225
    Prenatal stress is a critical life event often resulting in mental illnesses in the offspring. The critical developmental processes, which might trigger a cascade of molecular events resulting in mental disorders in adulthood, are still to be elucidated. Here we proposed that sex hormones, particularly testosterone, might determine the "developmental programming" of long-term consequences of prenatal stress in foetuses of both sexes. We observed that severe prenatal stress in the model of repeated corticosterone injections enhanced brain levels of corticosterone and testosterone in male foetuses. The expression of GluN1 and GluN2A, but not GluN2B NMDA receptor subunits were significantly reduced in the brain of stressed male foetuses. However, female foetuses were protected against stress effects on the brain corticosterone and testosterone levels. More moderate types of stress, such as repeated restraint stress and chronic unpredictable stress, did not induce an increase in brain corticosterone in dams and testosterone concentrations in foetuses of both sexes. Moreover, chronic unpredictable stress reduced brain testosterone concentration in male foetuses. Altogether, changes in brain testosterone level might be one of the crucial mechanisms determining the development of long-term consequences of severe prenatal stress in male, but not in female foetuses. Targeting this mechanism might allow to develop principally new prediction and therapeutic approaches for prenatal stress-associated psychiatric disorders.
    Matched MeSH terms: Female
  14. Mat NH, Bakar SNS, Murugaiyah V, Chawarski MC, Hassan Z
    Behav Brain Res, 2023 Feb 15;439:114251.
    PMID: 36503042 DOI: 10.1016/j.bbr.2022.114251
    Mitragynine exerts its analgesic effect mainly via opioid receptors activation. Additionally, the effect may be mediated via mitragynine's anti-inflammatory property and non-opioid receptor pain pathways, namely through the TRPV1 receptor. No studies identify hitherto, hence, the current study aimed to investigate the mitragynine's analgesic effect via the anti-inflammatory property, non-opioid receptor (TRPV1) and the effective dose (ED) to alleviate pain. Male and female Sprague Dawley rats were pre-treated intraperitoneally with either mitragynine (1, 5, 10, 13, 15 or 30 mg/kg), vehicle, or indomethacin (1 mg/kg) 30 min before inducing inflammatory pain using acetic acid. The writhes and pain-related withdrawal behaviour occurrence were counted within a 1-h duration. Percentage of writhes inhibition, pain-related withdrawal behaviour aggregate, ED50 and ED95 were determined. The body temperature was recorded and TRPV1 expression in the rats' brains was measured. Mitragynine (except 1 mg/kg) significantly reduced the number of writhes compared with the vehicle administered group. Mitragynine (30 mg/kg) demonstrated 99.5% inhibition of writhing behaviour and low withdrawal behaviour score compared with vehicle and indomethacin and successfully blocked the hypothermia induced by acetic acid. The overall ED50 and ED95 values of mitragynine were 3.62 and 20.84 mg/kg, respectively. The percentage of writhing inhibition and withdrawal behaviour were similar in both genders. Mitragynine (15 and 30 mg/kg) significantly reduced the TRPV1 expression in the brain of the rats. Mitragynine alleviated pain-like behaviour and showed analgesic effects via anti-inflammatory and non-opioid receptor pathways. The findings also suggest that mitragynine might regulate some physiological functions of the rat.
    Matched MeSH terms: Female
  15. Li C, Yang M, Zhang Y, Lai KW
    Int J Environ Res Public Health, 2022 Nov 14;19(22).
    PMID: 36429697 DOI: 10.3390/ijerph192214976
    PURPOSE: Mental health assessments that combine patients' facial expressions and behaviors have been proven effective, but screening large-scale student populations for mental health problems is time-consuming and labor-intensive. This study aims to provide an efficient and accurate intelligent method for further psychological diagnosis and treatment, which combines artificial intelligence technologies to assist in evaluating the mental health problems of college students.

    MATERIALS AND METHODS: We propose a mixed-method study of mental health assessment that combines psychological questionnaires with facial emotion analysis to comprehensively evaluate the mental health of students on a large scale. The Depression Anxiety and Stress Scale-21(DASS-21) is used for the psychological questionnaire. The facial emotion recognition model is implemented by transfer learning based on neural networks, and the model is pre-trained using FER2013 and CFEE datasets. Among them, the FER2013 dataset consists of 48 × 48-pixel face gray images, a total of 35,887 face images. The CFEE dataset contains 950,000 facial images with annotated action units (au). Using a random sampling strategy, we sent online questionnaires to 400 college students and received 374 responses, and the response rate was 93.5%. After pre-processing, 350 results were available, including 187 male and 153 female students. First, the facial emotion data of students were collected in an online questionnaire test. Then, a pre-trained model was used for emotion recognition. Finally, the online psychological questionnaire scores and the facial emotion recognition model scores were collated to give a comprehensive psychological evaluation score.

    RESULTS: The experimental results of the facial emotion recognition model proposed to show that its classification results are broadly consistent with the mental health survey results. This model can be used to improve efficiency. In particular, the accuracy of the facial emotion recognition model proposed in this paper is higher than that of the general mental health model, which only uses the traditional single questionnaire. Furthermore, the absolute errors of this study in the three symptoms of depression, anxiety, and stress are lower than other mental health survey results and are only 0.8%, 8.1%, 3.5%, and 1.8%, respectively.

    CONCLUSION: The mixed method combining intelligent methods and scales for mental health assessment has high recognition accuracy. Therefore, it can support efficient large-scale screening of students' psychological problems.

    Matched MeSH terms: Female
  16. Chong SE, Chang F, Chuah KH, Sthaneshwar P, Nik Mustapha NR, Mahadeva S, et al.
    Ann Hepatol, 2023;28(2):100888.
    PMID: 36586588 DOI: 10.1016/j.aohep.2022.100888
    INTRODUCTION AND OBJECTIVES: The Hepamet fibrosis score was introduced for the diagnosis of advanced liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). To date, external validation is limited, and its utility in combination with liver stiffness measurement (LSM) has not been explored.

    MATERIAL AND METHODS: This is a cross-sectional study on NAFLD patients who had a liver biopsy and LSM on the same day. The diagnostic performance of the Hepamet fibrosis score was evaluated using the area under the receiver operating characteristic curve (AUROC).

    RESULTS: The data for 196 patients were analyzed (mean age 50 ± 11 years old, 50% men, 56.6% Malay, 27.6% Chinese, 15.8% Indian, 67.9% NASH, 15.8% advanced liver fibrosis). The AUROC of Hepamet fibrosis score for the diagnosis of advanced liver fibrosis was 0.85 (95% CI, 0.80 - 0.91). Using the <0.12 and ≥0.47 cut-offs from the original study, the sensitivity, specificity, positive predictive value, negative predictive value, the proportion of indeterminate results and misclassification rate were 81.8%, 91.8%, 47.4%, 98.2%, 32.1% and 6.1%, respectively. Using LSM <10 kPa and ≥15 kPa for the diagnosis of absence and presence of advanced liver fibrosis, respectively, in patients with Hepamet fibrosis score ≥0.47 (i.e., the two-step approach) reduced indeterminate results and misclassification to 16.1% and 3.6%, respectively.

    CONCLUSIONS: We found the Hepamet fibrosis score to have good diagnostic accuracy in a population that was largely unrepresented in earlier work and demonstrated its utility in a two-step approach with LSM for the diagnosis of advanced liver fibrosis.

    Matched MeSH terms: Female
  17. Yip YY, Hwong WY, McCarthy SA, Hassan Chin AA, Woon YL
    J Palliat Care, 2023 Apr;38(2):111-125.
    PMID: 36464769 DOI: 10.1177/08258597221143195
    Background: Addressing timely community palliative care integration is prioritized due to the increased burden of noncommunicable diseases. Objectives: To compare referral-to-death duration among palliative cancer and noncancer patients and to determine its associated factors in a Malaysian community palliative care center. Methods: This retrospective cohort study included decedents referred to a Malaysian community palliative care center between January 2017 and December 2019. Referral-to-death is the interval between the date of community palliative care referral and to date of death. Besides descriptive analyses, negative binomial regression analyses were conducted to identify factors associated with referral-to-death among both groups. Results: Of 4346 patients referred, 86.7% (n  =  3766) and 13.3% (n  =  580) had primary diagnoses of cancer and noncancer respectively. Median referral-to-death was 32 days (interquartile range [IQR]: 12-81) among cancer patients and 19 days (IQR: 7-78) among noncancer patients. The shortest referral-to-death among cancer patients was for liver cancer (median: 22 days; IQR: 8-58.5). Noncancer patients with dementia, heart failure, and multisystem organ failure had the shortest referral-to-death at 14 days. Among cancer patients, longer referral-to-death was associated with women compared to men (IRR: 1.26; 95% CI: 1.16-1.36) and patients 80 to 94 years old compared to those below 50 years old (IRR: 1.19; 95% CI: 1.02-1.38). Cancer patients with analgesics prescribed before or upon referral had 29% fewer palliative care days compared to no prescribing analgesics. In contrast, noncancer patients 50 to 64 years old had shorter referral-to-death compared to those below 50 years old (IRR: 0.51; 95% CI: 0.28-0.91). Conclusion: Shorter referral-to-death among noncancer patients indicated possible access inequities with delayed community palliative care integration. Factors associated with referral-to-death are considered in developing targeted approaches ensuring timely and equitable community palliative care.
    Matched MeSH terms: Female
  18. Mohamad N, Jayalakshmi P, Rhodes A, Liam CK, Tan JL, Yousoof S, et al.
    Br J Biomed Sci, 2017 Oct;74(4):176-180.
    PMID: 28705139 DOI: 10.1080/09674845.2017.1331520
    BACKGROUND: Non-small cell lung cancer (NSCLC) is a major cause of cancer-related death. Approximately 2-16% of NSCLC patients with wild-type epidermal growth factor receptor (EGFR) harbour anaplastic lymphoma kinase (ALK) mutations. Both EGFR and ALK mutations occur most commonly in Asian patients with NSCLC. As targeted therapy is available for NSCLC patients with these mutations, it is important to establish reliable assays and testing strategies to identify those most likely to benefit from this therapy.

    MATERIALS AND METHODS: Patients diagnosed with adenocarcinoma of the lung between 2010 and 2014 were tested for EGFR mutations. Of these, 92 cases were identified as EGFR wild type and suitable candidates for ALK testing utilising immunohistochemistry and the rabbit monoclonal antibody D5F3. The reliability of the IHC was confirmed by validating the results against those achieved by fluorescence in situ hybridisation (FISH) to detect ALK gene rearrangements.

    RESULTS: Twelve (13%) cases were positive for ALK expression using immunohistochemistry. Of the 18 evaluable cases tested by FISH, there was 100% agreement with respect to ALK rearrangement/ALK expression between the assays, with 11 cases ALK negative and 7 cases ALK positive by both assays. ALK tumour expression was significantly more common in female compared to male patients (29.6% vs. 6.2%, P 

    Matched MeSH terms: Female
  19. Ho PJ, Khng AJ, Tan BK, Tan EY, Tan SM, Tan VKM, et al.
    Breast Cancer, 2022 Sep;29(5):869-879.
    PMID: 35543923 DOI: 10.1007/s12282-022-01366-w
    BACKGROUND: Human leukocyte antigen (HLA) genes play critical roles in immune surveillance, an important defence against tumors. Imputing HLA genotypes from existing single-nucleotide polymorphism datasets is low-cost and efficient. We investigate the relevance of the major histocompatibility complex region in breast cancer susceptibility, using imputed class I and II HLA alleles, in 25,484 women of Asian ancestry.

    METHODS: A total of 12,901 breast cancer cases and 12,583 controls from 12 case-control studies were included in our pooled analysis. HLA imputation was performed using SNP2HLA on 10,886 quality-controlled variants within the 15-55 Mb region on chromosome 6. HLA alleles (n = 175) with info scores greater than 0.8 and frequencies greater than 0.01 were included (resolution at two-digit level: 71; four-digit level: 104). We studied the associations between HLA alleles and breast cancer risk using logistic regression, adjusting for population structure and age. Associations between HLA alleles and the risk of subtypes of breast cancer (ER-positive, ER-negative, HER2-positive, HER2-negative, early-stage, and late-stage) were examined.

    RESULTS: We did not observe associations between any HLA allele and breast cancer risk at P 

    Matched MeSH terms: Female
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