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Fulltext Glutathione (GSH) improves sperm quality and testicular morphology in streptozotocin-induced diabetic mice

Abdullah F, Khan Nor-Ashikin MN, Agarwal R, Kamsani YS, Abd Malek M, Bakar NS, et al.

Asian J Androl, 2021 1 22;23(3):281-287.
PMID: 33473013 DOI: 10.4103/aja.aja_81_20

Diabetes mellitus (DM) is known to cause reproductive impairment. In men, it has been linked to altered sperm quality and testicular damage. Oxidative stress (OS) plays a pivotal role in the development of DM complications. Glutathione (GSH) is a part of a nonenzymatic antioxidant defense system that protects lipid, protein, and nucleic acids from oxidative damage. However, the protective effects of exogenous GSH on the male reproductive system have not been comprehensively examined. This study determined the impact of GSH supplementation in ameliorating the adverse effect of type 1 DM on sperm quality and the seminiferous tubules of diabetic C57BL/6NTac mice. GSH at the doses of 15 mg kg-1 and 30 mg kg-1 was given intraperitoneally to mice weekly for 6 consecutive weeks. The mice were then weighed, euthanized, and had their reproductive organs excised. The diabetic (D Group) showed significant impairment of sperm quality and testicular histology compared with the nondiabetic (ND Group). Diameters of the seminiferous lumen in diabetic mice treated with 15 mg kg-1 GSH (DGSH15) were decreased compared with the D Group. Sperm motility was also significantly increased in the DGSH15 Group. Improvement in testicular morphology might be an early indication of the protective roles played by the exogenous GSH in protecting sperm quality from effects of untreated type 1 DM or diabetic complications. Further investigation using different doses and different routes of GSH is necessary to confirm this suggestion.
Fulltext Prevalence and Associated Factors of Psychological Distress and Burnout among Medical Students: Findings from Two Campuses

Arif NMNA, Roslan NS, Ismail SB, Nayak RD, Jamian MR, Mohamad Ali Roshidi AS, et al.

Int J Environ Res Public Health, 2021 08 10;18(16).
PMID: 34444193 DOI: 10.3390/ijerph18168446

Medical training is intensive and predisposes students to psychological distress and burnout. Unaddressed burnout in medical training may persist in the internship phase and impact the quality of patient care. While some associations have been established, the link between some individual factors and training characteristics with distress and burnout in medical training remained unclear. In this study, we aim to examine the prevalence of psychological distress and burnout, and its association with gender, training phase, funding status, cumulative grade points average (CGPA), and coping strategies among medical students. The study applied a multicenter cross-sectional study design and convenience sampling on medical students from two medical schools from Malaysia and India. We used a self-reporting instrument that includes demographic details, the 12-item General Health Questionnaire (GHQ), the Copenhagen Burnout Inventory (CBI), and the Brief Coping Orientation to Problems Experienced (Brief COPE). A total of 748 medical students participated in the study. The prevalence of psychological distress, personal-related, work-related, and patient-related burnout were 33.0%, 56.1%, 35.0%, and 26.2%, respectively. Being male, clinical year, self-funded, and having a CGPA of more than 3.50 predicted psychological distress and burnout with mixed results. Maladaptive coping mechanisms consistently predicted the risk of psychological distress and burnout by more than two times. The findings indicate that primary and secondary mental health interventions have a role in medical training. A systematic intervention should incorporate coping skills training alongside institutional-targeted intervention.
Identification of Alkaloid Compounds Arborinine and Graveoline from Ruta angustifolia (L.) Pers for their Antifungal Potential against Isocitrate lyase (ICL1) gene of Candida albicans

Kamal LZM, Adam MAA, Shahpudin SNM, Shuib AN, Sandai R, Hassan NM, et al.

Mycopathologia, 2021 May;186(2):221-236.
PMID: 33550536 DOI: 10.1007/s11046-020-00523-z

Candida albicans has been reported globally as the most widespread pathogenic species contributing candidiasis from superficial to systemic infections in immunocompromised individuals. Their metabolic adaptation depends on glyoxylate cycle to survive in nutrient-limited host. The long term usage of fungistatic drugs and the lack of cidal drugs frequently result in strains that could resist commonly used antifungals and display multidrug resistance (MDR). In search of potential therapeutic intervention and novel fungicidals, we have explored a plant alkaloids, namely arborinine and graveoline for its antifungal potential. Alkaloids belongs to Rutaceae family have been reported with numerous antimicrobial activities. In this study, we aimed to isolate and identify the antifungal active alkaloids of R. angustifolia and assess antifungal effect targeting C. albicans isocitrate lyase (ICL) gene which regulates isocitrate lyase, key enzyme in glyoxylate cycle contributing to the virulence potential of C. albicans. Alkaloids were extracted by bioassay guided isolation technique which further identified by TLC profile and compared with the standard through HPLC and NMR analysis. The antifungal activities of the extracted alkaloids were quantified by means of MIC (Minimum Inhibitory Concentration). The gene expression of the targeted gene upon treatment was analysed using RT-qPCR and western blot. Additionally, this study looked at the drug-likeness and potential toxicity effect of the active alkaloid compounds in silico analysis. Spectroscopic analysis showed that the isolated active alkaloids were characterized as acridone, furoquinoline, 4-quinolone known as arborinine and graveoline. Results showed that each compound significantly inhibited the growth of C. albicans at the dose of 250 to 500 µg/mL which confirm its antifungal activity. Each alkaloid was found to successfully downregulate the expression of both ICL1 gene CaIcl1 protein. Finally, ADMET analysis suggests a good prediction of chemical properties, namely absorption, distribution, metabolism, excretion and toxicity (ADMET) that will contribute in drug discovery and development later on.
Fulltext Impact of natural salt lick on the home range of Panthera tigris at the Royal Belum Rainforest, Malaysia

Lazarus BA, Che-Amat A, Abdul Halim Shah MM, Hamdan A, Abu Hassim H, Mustaffa Kamal F, et al.

Sci Rep, 2021 05 19;11(1):10596.
PMID: 34012045 DOI: 10.1038/s41598-021-89980-0

Natural salt lick (sira) is a strategic localisation for ecological wildlife assemblage to exhibit geophagy which may act as a population dynamic buffer of prey and predators. Undoubtedly, many agree that geophagy at natural licks is linked to nutritional ecology, health and assembly places facilitating social interaction of its users. Overall, natural salt licks not only save energy of obtaining nutrient leading to health maintenance but also forms the basis of population persistence. The Royal Belum Rainforest, Malaysia (Royal Belum) is a typical tropical rainforest in Malaysia rich in wildlife which are mainly concentrated around the natural salt lick. Since this is one of the most stable fauna ecology forest in Malaysia, it is timely to assess its impact on the Malayan tiger (Panthera tigris) home range dynamics. The three-potential home ranges of the Malayan tiger in this rainforest were selected based on animal trails or foot prints surrounding the salt lick viz (e.g. Sira Kuak and Sira Batu; Sira Rambai and Sira Buluh and Sira Papan) as well as previous sightings of a Malayan tiger in the area, whose movement is dependent on the density and distribution of prey. Camera traps were placed at potential animal trails surrounding the salt lick to capture any encountered wildlife species within the area of the camera placements. Results showed that all home ranges of Malayan tiger were of no significance for large bodied prey availability such as sambar deer (Rusa unicolor), and smaller prey such as muntjacs (Muntiacus muntjac) and wild boar (Sus scrofa). Interestingly, all home range harbour the Malayan tiger as the only sole predator. The non-significance of prey availability at each home range is attributed to the decline of the Malayan tiger in the rainforest since tigers are dependant on the movement of its preferred prey surrounding natural salt licks. Thus, the information from this study offers fundamental knowledge on the importance of prey-predator interaction at salt lick which will help in designing strategy in rewilding or rehabilitation programs of the Malayan tiger at the Royal Belum Rainforest.
Antifouling polyethersulfone hemodialysis membranes incorporated with poly (citric acid) polymerized multi-walled carbon nanotubes

Abidin MNZ, Goh PS, Ismail AF, Othman MHD, Hasbullah H, Said N, et al.

Mater Sci Eng C Mater Biol Appl, 2016 Nov 01;68:540-550.
PMID: 27524052 DOI: 10.1016/j.msec.2016.06.039

Poly (citric acid)-grafted-MWCNT (PCA-g-MWCNT) was incorporated as nanofiller in polyethersulfone (PES) to produce hemodialysis mixed matrix membrane (MMM). Citric acid monohydrate was polymerized onto the surface of MWCNTs by polycondensation. Neat PES membrane and PES/MWCNTs MMMs were fabricated by dry-wet spinning technique. The membranes were characterized in terms of morphology, pure water flux (PWF) and bovine serum albumin (BSA) protein rejection. The grafting yield of PCA onto MWCNTs was calculated as 149.2%. The decrease of contact angle from 77.56° to 56.06° for PES/PCA-g-MWCNTs membrane indicated the increase in surface hydrophilicity, which rendered positive impacts on the PWF and BSA rejection of the membrane. The PWF increased from 15.8Lm(-2)h(-1) to 95.36Lm(-2)h(-1) upon the incorporation of PCA-g-MWCNTs due to the attachment of abundant hydrophilic groups that present on the MWCNTs, which have improved the affinity of membrane towards the water molecules. For protein rejection, the PES/PCA-g-MWCNTs MMM rejected 95.2% of BSA whereas neat PES membrane demonstrated protein rejection of 90.2%. Compared to commercial PES hemodialysis membrane, the PES/PCA-g-MWCNTs MMMs showed less flux decline behavior and better PWF recovery ratio, suggesting that the membrane antifouling performance was improved. The incorporation of PCA-g-MWCNTs enhanced the separation features and antifouling capabilities of the PES membrane for hemodialysis application.
Hemocompatibility evaluation of poly(1,8-octanediol citrate) blend polyethersulfone membranes

Zailani MZ, Ismail AF, Sheikh Abdul Kadir SH, Othman MH, Goh PS, Hasbullah H, et al.

J Biomed Mater Res A, 2017 05;105(5):1510-1520.
PMID: 28000366 DOI: 10.1002/jbm.a.35986

In this study, poly (1,8-octanediol citrate) (POC) was used to modify polyethersulfone (PES)-based membrane to enhance its hemocompatibility. Different compositions of POC (0-3%) were added into the polyethersulfone (PES) dope solutions and polyvinylpyrrolidone (PVP) was used as pore forming agent. The hemocompatible POC modified PES membranes were fabricated through phase-inversion technique. The prepared membranes were characterized using attenuated total reflectance-Fourier transform infrared (ATR-FTIR), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), Atomic-force microscopy (AFM), contact angle, Zeta-potential, membrane porosity and pore size and pure water flux (PWF) and BSA rejection. The hemocompatibility of the modified PES membranes was evaluated by human serum fibrinogen (FBG) protein adsorption, platelet adhesion, activated partial thromboplastin time (APTT) and prothrombin time (PT), and thrombin-antithrombin III (TAT), complement (C3a and C5a) activation and Ca2+ absorption on membrane. Results showed that by increasing POC concentration, FBG adsorption was reduced, less platelets adhesion, prolonged APTT and PT, lower TAT, C5a and C3a activation and absorb more Ca2+ ion. These results indicated that modification of PES with POC has rendered improved hemocompatibility properties for potential application in the field of blood purification, especially in hemodialysis. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1510-1520, 2017.
Development of biocompatible and safe polyethersulfone hemodialysis membrane incorporated with functionalized multi-walled carbon nanotubes

Abidin MNZ, Goh PS, Ismail AF, Othman MHD, Hasbullah H, Said N, et al.

Mater Sci Eng C Mater Biol Appl, 2017 Aug 01;77:572-582.
PMID: 28532067 DOI: 10.1016/j.msec.2017.03.273

A novel approach in the design of a safe, high performance hemodialysis membrane is of great demand. Despite many advantages, the employment of prodigious nanomaterials in hemodialysis membrane is often restricted by their potential threat to health. Hence, this work focusses on designing a biocompatible polyethersulfone (PES) hemodialysis membrane embedded with poly (citric acid)-grafted-multi walled carbon nanotubes (PCA-g-MWCNTs). Two important elements which could assure the safety of the nanocomposite membrane, i.e. (i) dispersion stability and (ii) leaching of MWCNTs were observed. The results showed the improved dispersion stability of MWCNTs in water and organic solvent due to the enriched ratio of oxygen-rich groups which subsequently enhanced membrane separation features. It was revealed that only 0.17% of MWCNTs was leached out during the membrane fabrication process (phase inversion) while no leaching was detected during permeation. In terms of biocompatibility, PES/PCA-g-MWCNT nanocomposite membrane exhibited lesser C3 and C5 activation (189.13 and 5.29ng/mL) and proteins adsorption (bovine serum albumin=4.5μg/cm2, fibrinogen=15.95μg/cm2) as compared to the neat PES membrane, while keeping a normal blood coagulation time. Hence, the PES/PCA-g-MWCNT nanocomposite membrane is proven to have the prospect of becoming a safe and high performance hemodialysis membrane.
Highly adsorptive oxidized starch nanoparticles for efficient urea removal

Abidin MNZ, Goh PS, Ismail AF, Said N, Othman MHD, Hasbullah H, et al.

Carbohydr Polym, 2018 Dec 01;201:257-263.
PMID: 30241818 DOI: 10.1016/j.carbpol.2018.08.069

Portable dialysis is a need to implement daily and nocturnal hemodialysis. To realize portable dialysis, a dialysate regeneration system comprising superior adsorbents is required to regenerate the used dialysate. This study aims to develop a nano-adsorbent, derived from corn starch for urea removal. Oxidized starch nanoparticles (oxy-SNPs) were prepared via liquid phase oxidation, followed by chemical dissolution and non-solvent precipitation. The oxy-SNPs possessed Z-average size of 177.7 nm with carbonyl and carboxyl contents of 0.068 and 0.048 per 100 glucose units, respectively. The urea adsorption achieved the equilibrium after 4 h with 95% removal. The adsorption mechanism fitted Langmuir isotherm while the adsorption kinetics obeyed pseudo-second-order model. This new material has a maximum adsorption capacity of 185.2 mg/g with a rate constant of 0.04 g/mg.h. Moreover, the oxy-SNPs exhibited the urea uptake recovery of 91.6%. Oxy-SNPs can become a promising adsorbent for dialysate regeneration system to remove urea.
Fulltext Feasibility of Patient Navigation to Improve Breast Cancer Care in Malaysia

Yeoh ZY, Jaganathan M, Rajaram N, Rawat S, Tajudeen NA, Rahim N, et al.

J Glob Oncol, 2018 11;4:1-13.
PMID: 30398950 DOI: 10.1200/JGO.17.00229

PURPOSE: Late stage at presentation and poor adherence to treatment remain major contributors to poor survival in low- and middle-income countries (LMICs). Patient navigation (PN) programs in the United States have led to improvement in diagnostic or treatment timeliness, particularly for women in lower socioeconomic classes or minority groups. To date, studies of PN in Asia have been limited. We aimed to assess the feasibility of PN in a state-run hospital in an LMIC and to report the impact on diagnostic and treatment timeliness for patients in its first year of implementation.
METHODS: We established PN in a dedicated breast clinic of a Malaysian state-run hospital. We compared diagnostic and treatment timeliness between navigated patients (n = 135) and patients diagnosed in the prior year (n = 148), and described factors associated with timeliness.
RESULTS: Women with PN received timely mammography compared with patients in the prior year (96.4% v 74.4%; P < .001), biopsy (92.5% v 76.1%; P = .003), and communication of news (80.0% v 58.5%; P < .001). PN reduced treatment default rates (4.4% v 11.5%; P = .048). Among navigated patients, late stage at presentation was independently associated with having emotional and language barriers ( P = .01). Finally, the main reason reported for delay, default, or refusal of treatment was the preference for alternative therapy.
CONCLUSION: PN is feasible for addressing barriers to cancer care when integrated with a state-run breast clinic of an LMIC. Its implementation resulted in improved diagnostic timeliness and reduced treatment default. Wider adoption of PN could be a key element of cancer control in LMICs.
Synthesis and characterisation of composite sulphonated polyurethane/polyethersulphone membrane for blood purification application

Mansur S, Othman MHD, Ismail AF, Kadir SHSA, Goh PS, Hasbullah H, et al.

Mater Sci Eng C Mater Biol Appl, 2019 Jun;99:491-504.
PMID: 30889724 DOI: 10.1016/j.msec.2019.01.092

Polyurethane (PU) with three different functional groups: carboxyl, hydroxyl and sulphonyl group on its molecular structure were synthesised in this work. The synthesised material suppresses blood clotting and exhibits anticoagulant characteristics due to the presence of the important anionic groups. The synthesised PU was blended with polyethersulphone (PES) and fabricated into flat-sheet membrane to study the physico-chemical and biocompatibility properties of the PES membrane for blood purification application. PES-PU flat-sheet membranes were fabricated via the dry-wet phase separation technique. Different loading of PU (0, 1, 2, 3, 4, and 5%) blended with PES was studied and compared. Based on the in-vitro biocompatibility analysis of the membrane, it can be suggested that the membrane incorporated with PU has better anticoagulant properties compared to the pristine PES membrane. PU incorporation prolonged the clotting time, decreased the formation of thrombin, decreased soluble complement component 3a (C3a) generation and suppressed platelet adhesion and aggregation. The anionic groups on the membrane surface might bind to coagulation factors (antithrombin) and the calcium ions, Ca2+ and thus improve anticoagulant ability. Based on both physico-chemical and in-vitro studied, 4% loading of PU is the optimum loading for incorporation with PES membrane. These results suggested that the blended PES-PU membranes with good haemocompatibility allowed practical application in the field of blood purification.
Fulltext Azelaic acid and Melaleuca alternifolia essential oil co-loaded vesicular carrier for combinational therapy of acne

Bisht A, Hemrajani C, Upadhyay N, Nidhi P, Rolta R, Rathore C, et al.

Ther Deliv, 2022 Jan;13(1):13-29.
PMID: 34842461 DOI: 10.4155/tde-2021-0059

Aim: Azelaic acid (AzA), a comedolytic, antibacterial, anti-inflammatory anti-melanogenic agent, prescribed against acne vulgaris is safe on skin. Its combination with another widely used anti-acne agent, tea tree oil (EO) whose delivery is limited by volatility, instability and lipophilicity constraints was attempted. Method: Solvent injection was used to prepare AzA-EO integrated ethosomes. Result: Ethosomes were transformed into carbopol hydrogel, which exhibited pseudo-plastic properties with appreciable firmness, work of shear, stickiness and work of adhesion. The hydrogel showed better permeation and retention characteristics vis-a-vis commercial formulation (AzidermTM), when evaluated in Wistar rat skin. Further, ethosome hydrogel composite was better tolerated with no side effects. Conclusion: The findings suggests that the aforementioned strategy could be a potential treatment used for acne management.
Fulltext Mechanical and Imaging Properties of a Clinical-Grade Kidney Phantom Based on Polydimethylsiloxane and Elastomer

Kamal I, Razak HRA, Abdul Karim MK, Mashohor S, Liew JYC, Low YJ, et al.

Polymers (Basel), 2022 Jan 28;14(3).
PMID: 35160523 DOI: 10.3390/polym14030535

Medical imaging phantoms are considered critical in mimicking the properties of human tissue for calibration, training, surgical planning, and simulation purposes. Hence, the stability and accuracy of the imaging phantom play a significant role in diagnostic imaging. This study aimed to evaluate the influence of hydrogen silicone (HS) and water (H2O) on the compression strength, radiation attenuation properties, and computed tomography (CT) number of the blended Polydimethylsiloxane (PDMS) samples, and to verify the best material to simulate kidney tissue. Four samples with different compositions were studied, including samples S1, S2, S3, and S4, which consisted of PDMS 100%, HS/PDMS 20:80, H2O/PDMS 20:80, and HS/H2O/PDMS 20:40:40, respectively. The stability of the samples was assessed using compression testing, and the attenuation properties of sample S2 were evaluated. The effective atomic number of S2 showed a similar pattern to the human kidney tissue at 1.50 × 10-1 to 1 MeV. With the use of a 120 kVp X-ray beam, the CT number quantified for S2, as well measured 40 HU, and had the highest contrast-to-noise ratio (CNR) value. Therefore, the S2 sample formulation exhibited the potential to mimic the human kidney, as it has a similar dynamic and is higher in terms of stability as a medical phantom.
The occurrence of non-steroidal anti-inflammatory drugs (NSAIDs) in Malaysian urban domestic wastewater

Mohd Hanafiah Z, Wan Mohtar WHM, Abd Manan TSB, Bachi' NA, Abdullah NA, Abd Hamid HH, et al.

Chemosphere, 2022 Jan;287(Pt 2):132134.
PMID: 34517236 DOI: 10.1016/j.chemosphere.2021.132134

The water stream has been reported to contain non-steroidal anti-inflammatory drugs (NSAIDs), released from households and premises through discharge from Sewage Treatment Plant (STP). This research identifies commonly consumed NSAIDs namely ibuprofen (IBU), diclofenac (DIC), ketoprofen (KET) and naproxen (NAP) in the influent wastewater from two urban catchments (i.e. 2 STPs). We expand our focus to assess the efficiency of monomer (C18) and dimer (HLB) types of sorbents in the solid phase extraction method followed by gas chromatography mass spectrometry (GCMS) analysis and optimize model prediction of NSAIDs in the influent wastewater using I-Optimal design. The ecological risk assessment of the NSAIDs was evaluated. The HLB produced reliable analysis for all NSAIDs under study (STP1: 6.7 × 10-3 mg L-1 to 2.21 × 10-1 mg L-1, STP2: 1.40 × 10-4 mg L-1 to 9.72 × 10-2 mg L-1). The C18 however, selective to NAP. Based on the Pearson proximity matrices, the DICHLB can be a good indicator for IBUHLB (0.565), NAPC18 (0.721), NAPHLB (0.566), and KETHLB (0.747). The optimized model prediction for KET and NAP based on DIC are successfully validated. The risk quotients (RQ) values of NSAIDs were classified as high (RQ > 1), medium (RQ, 0.1-1) and low (RQ, 0.01-0.1) risks. The optimized models are beneficial for major NSAIDs (KET and NAP) monitoring in the influent wastewater of urban domestic area. An upgrade on the existing wastewater treatment infrastructure is recommended to counteract current water security situation.
Epidemiology and clinical profiles of cutaneous graft versus host disease in allogeneic peripheral blood stem cell transplantation

Kamal Rodin NS, Ismail NA, Abdul Wahid SF, Jamil A, Syed Zakaria SZ, Syed Abd Kadir SS, et al.

Malays J Pathol, 2021 Dec;43(3):361-373.
PMID: 34958057

INTRODUCTION: The epidemiology of cutaneous graft versus host disease (GVHD) in allogeneic peripheral blood stem cell transplantation (PBSCT) in Malaysia has not been described.
MATERIALS AND METHODS: We retrospectively analysed 691 allogeneic PBSCT patients between 2010-2017 in two centers.
RESULTS: The prevalence of cutaneous GVHD was 31.4% (217/691). No associations were detected with race, age or gender of donor and recipients. Cutaneous GVHD was associated with host cytomegalovirus (CMV) seropositivity (p<0.01), conditioning (p<0.01), GVHD prophylaxis (p=0.046) and survival (p<0.01). Majority developed the acute form (58.1%;126/217). Biopsies in 20.7% (45/217) showed 55.6% positivity for GVHD. Overall, involvement was non-severe. A majority demonstrated complete response (CR) to first-line corticosteroids (70.0%;152/217). Secondline therapies (extracorporeal phototherapy (ECP), psolaren ultraviolet A (PUVA), mycophenolate, tumour necrosis factor (TNF) inhibitors, interleukins inhibitors, or CD20 monoclonal antibodies) were required in 65/217, with 38.5% CR. Second-line therapy was associated with gender (p=0.042), extra-cutaneous GVHD (p=0.021), treatment outcomes (p=0.026) and survival (p=0.048). Mortality in cutaneous GVHD was 24.0% with severe sepsis being the leading cause at Day 100 (7.8%) and 5-years (7.8%), and relapsed disease at 2-years (32.7%). In steroid refractoriness, severe GVHD caused 30.8% mortality. In cutaneous GVHD, survival at Day 100 was 95.4%; 80.2% at 2-years and 73.1% at 5-years. The median survival in cutaneous GVHD was significantly shorter at 55 months, compared to those without GVHD at 69 months (p=0.001).
CONCLUSION: Cutaneous involvement is the commonest clinical manifestation of GVHD. A larger national study is warranted to further analyse severity and outcome of multiorgan GVHD, and factors associated with steroid refractoriness.
Cost-utility analysis of antiviral use under pandemic influenza using a novel approach - linking pharmacology, epidemiology and heath economics

Wu DBC, Chaiyakunapruk N, Pratoomsoot C, Lee KKC, Chong HY, Nelson RE, et al.

Epidemiol Infect, 2018 03;146(4):496-507.
PMID: 29446343 DOI: 10.1017/S0950268818000158

Simulation models are used widely in pharmacology, epidemiology and health economics (HEs). However, there have been no attempts to incorporate models from these disciplines into a single integrated model. Accordingly, we explored this linkage to evaluate the epidemiological and economic impact of oseltamivir dose optimisation in supporting pandemic influenza planning in the USA. An HE decision analytic model was linked to a pharmacokinetic/pharmacodynamics (PK/PD) - dynamic transmission model simulating the impact of pandemic influenza with low virulence and low transmissibility and, high virulence and high transmissibility. The cost-utility analysis was from the payer and societal perspectives, comparing oseltamivir 75 and 150 mg twice daily (BID) to no treatment over a 1-year time horizon. Model parameters were derived from published studies. Outcomes were measured as cost per quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to examine the integrated model's robustness. Under both pandemic scenarios, compared to no treatment, the use of oseltamivir 75 or 150 mg BID led to a significant reduction of influenza episodes and influenza-related deaths, translating to substantial savings of QALYs. Overall drug costs were offset by the reduction of both direct and indirect costs, making these two interventions cost-saving from both perspectives. The results were sensitive to the proportion of inpatient presentation at the emergency visit and patients' quality of life. Integrating PK/PD-EPI/HE models is achievable. Whilst further refinement of this novel linkage model to more closely mimic the reality is needed, the current study has generated useful insights to support influenza pandemic planning.
Fulltext The impact factor of an open access journal does not contribute to an article's citations

Chua SK, Qureshi AM, Krishnan V, Pai DR, Kamal LB, Gunasegaran S, et al.

F1000Res, 2017;6:208.
PMID: 28649365 DOI: 10.12688/f1000research.10892.1

Background Citations of papers are positively influenced by the journal's impact factor (IF). For non-open access (non-OA) journals, this influence may be due to the fact that high-IF journals are more often purchased by libraries, and are therefore more often available to researchers, than low-IF journals. This positive influence has not, however, been shown specifically for papers published in open access (OA) journals, which are universally accessible, and do not need library purchase. It is therefore important to ascertain if the IF influences citations in OA journals too. Methods 203 randomized controlled trials (102 OA and 101 non-OA) published in January 2011 were included in the study. Five-year citations for papers published in OA journals were compared to those for non-OA journals. Source papers were derived from PubMed. Citations were retrieved from Web of Science, Scopus, and Google Scholar databases. The Thompson-Reuter's IF was used. Results OA journals were found to have significantly more citations overall compared to non-OA journals (median 15.5 vs 12, p=0.039). The IF did not correlate with citations for OA journals (Spearman's rho =0.187, p=0.60). The increase in the citations with increasing IF was minimal for OA journals (beta coefficient = 3.346, 95% CI -0.464, 7.156, p=0.084). In contrast, the IF did show moderate correlation with citations for articles published in non-OA journals (Spearman's rho=0.514, p<0.001). The increase in the number of citations was also significant (beta coefficient = 4.347, 95% CI 2.42, 6.274, p<0.001). Conclusion It is better to publish in an OA journal for more citations. It may not be worth paying high publishing fees for higher IF journals, because there is minimal gain in terms of increased number of citations. On the other hand, if one wishes to publish in a non-OA journal, it is better to choose one with a high IF.
Fulltext Psychometric Properties of Malay Obsessive-compulsive Inventory-child Version (OCI-CV) in Malaysian Perspectives

Fitri Sarnin E, Sharip S, Badilla Idris I, Mohd Hashim S, Salwina Wan Ismail W, Nazri Abdul Rahman F, et al.

Scand J Child Adolesc Psychiatr Psychol, 2022 Jan;10(1):114-122.
PMID: 36514488 DOI: 10.2478/sjcapp-2022-0012

BACKGROUND: This study aimed to examine the psychometric properties of reliability and validity of OCI-CV in a non-clinical sample of Malaysian children and adolescents.
METHOD: Participants of school-age and adolescent students from Klang Valley School completed the 21-item Malay OCI-CV using Google Form. OCI-CV English version was translated backward and forward to the Malay language. Face validity was conducted first before distributing the questionnaire to the participants. Exploratory Factor analysis (EFA) and Confirmatory Factor Analysis (CFA) was conducted to evaluate the psychometric properties of OCI-CV.
RESULTS: A total of 102 school-age children and adolescents with a mean age of 15.96 years (male: 41.2%, female: 58.8%) participated in the study. The Malay OCI-CV showed high internal consistency, with Cronbach Alpha values of 0.90 for the whole scale. EFA showed multifactorial components. Five factors were labelled as "Washing / Ordering, Doubting, Obsessions, Checking, and Hoarding,". In the CFA, the five-factor model indicates adequate fit indices of (χ2/df = 1.51, RMSEA = .071, GFI = .824, AGFI = .769, NFI = .724, CFI = .880).
CONCLUSION: The Malay OCI-CV has good psychometric properties and is suitable for use in the Malaysian context. Further validation studies should be conducted among a clinical population to enhance the generalization of this finding.
Fulltext Exogenous L-Glutathione Improves Vitrification Outcomes in Murine Preimplantation Embryos

Abdul Rahman NS, Mohamed Noor Khan NA, Eshak Z, Sarbandi MS, Mohammad Kamal AA, Abd Malek M, et al.

Antioxidants (Basel), 2022 Oct 25;11(11).
PMID: 36358471 DOI: 10.3390/antiox11112100

Vitrification is an important tool to store surplus embryos in assisted reproductive technology (ART). However, vitrification increases oxidative damage and results in decreased viability. Studies have reported that L-glutathione (GSH) supplementation improves the preimplantation development of murine embryos. Glutathione constitutes the major non-protein sulphydryl compound in mammalian cells, which confers protection against oxidative damage. However, the effect of GSH supplementation on embryonic vitrification outcomes has yet to be reported. This study aims to determine whether GSH supplementation in culture media improves in vitro culture and vitrification outcomes, as observed through embryo morphology and preimplantation development. Female BALB/c mice aged 6−8 weeks were superovulated through an intraperitoneal injection of 10 IU of pregnant mare serum gonadotrophin (PMSG), followed by 10 IU of human chorionic gonadotrophin (hCG) 48 h later. The mated mice were euthanized by cervical dislocation 48 h after hCG to harvest embryos. Two-cell embryos were randomly assigned to be cultured in either Group 1 (GSH-free medium), Group 2 (GSH-free medium with vitrification), Group 3 (0.01 mM GSH-supplemented medium), or Group 4 (0.01 mM GSH-supplemented medium with vitrification). Non-vitrified (Groups 1 and 3) and vitrified (Groups 2 and 4) embryos were observed for morphological quality and preimplantation development at 24, 48, 72, and 96 h. In the non-vitrified groups, there were significant increases in the number of Grade-1 blastocysts in GSH cultures (p < 0.05). Similarly, in the vitrified groups, GSH supplementation was also seen to significantly increase blastocyst formation. Exogenous GSH supplementation resulted in a significant increase in intracellular GSH, a release of cytochrome c from mitochondria, and a parallel decrease in intracellular reactive oxygen species (ROS) levels in vitrified eight-cell embryos (p < 0.05). GSH supplementation was shown to upregulate Bcl2 expression and downregulate Bax expression in the vitrified preimplantation embryo group. The action of exogenous GSH was concomitant with an increase in the relative abundance of Gpx1 and Sod1. In conclusion, our study demonstrated the novel use and practical applicability of GSH supplementation for improving embryonic cryotolerance via a decrease in ROS levels and the inhibition of apoptotic events by improvement in oxidative status.
Fulltext Sequential graph convolutional network and DeepRNN based hybrid framework for epileptic seizure detection from EEG signal

Jibon FA, Jamil Chowdhury AR, Miraz MH, Jin HH, Khandaker MU, Sultana S, et al.

Digit Health, 2024;10:20552076241249874.
PMID: 38726217 DOI: 10.1177/20552076241249874

Automated epileptic seizure detection from ectroencephalogram (EEG) signals has attracted significant attention in the recent health informatics field. The serious brain condition known as epilepsy, which is characterized by recurrent seizures, is typically described as a sudden change in behavior caused by a momentary shift in the excessive electrical discharges in a group of brain cells, and EEG signal is primarily used in most cases to identify seizure to revitalize the close loop brain. The development of various deep learning (DL) algorithms for epileptic seizure diagnosis has been driven by the EEG's non-invasiveness and capacity to provide repetitive patterns of seizure-related electrophysiological information. Existing DL models, especially in clinical contexts where irregular and unordered structures of physiological recordings make it difficult to think of them as a matrix; this has been a key disadvantage to producing a consistent and appropriate diagnosis outcome due to EEG's low amplitude and nonstationary nature. Graph neural networks have drawn significant improvement by exploiting implicit information that is present in a brain anatomical system, whereas inter-acting nodes are connected by edges whose weights can be determined by either temporal associations or anatomical connections. Considering all these aspects, a novel hybrid framework is proposed for epileptic seizure detection by combined with a sequential graph convolutional network (SGCN) and deep recurrent neural network (DeepRNN). Here, DepRNN is developed by fusing a gated recurrent unit (GRU) with a traditional RNN; its key benefit is that it solves the vanishing gradient problem and achieve this hybrid framework greater sophistication. The line length feature, auto-covariance, auto-correlation, and periodogram are applied as a feature from the raw EEG signal and then grouped the resulting matrix into time-frequency domain as inputs for the SGCN to use for seizure classification. This model extracts both spatial and temporal information, resulting in improved accuracy, precision, and recall for seizure detection. Extensive experiments conducted on the CHB-MIT and TUH datasets showed that the SGCN-DeepRNN model outperforms other deep learning models for seizure detection, achieving an accuracy of 99.007%, with high sensitivity and specificity.
Fulltext Perceptions of risk and coping strategies during the COVID-19 pandemic among women and older adults

Ke GN, Gow A, Wong RMM, Raman S, Mohammad Z, De-Lima N, et al.

PLoS One, 2024;19(4):e0301009.
PMID: 38630742 DOI: 10.1371/journal.pone.0301009

The world's health, economic, and social systems have been adversely impacted by the COVID-19 pandemic. With lockdown measures being a common response strategy in most countries, many individuals were faced with financial and mental health challenges. The current study explored the effect of the COVID-19 pandemic on the psychological well-being, perception of risk factors and coping strategies of two vulnerable groups in Malaysia, namely women and older adults from low-income households (USD592). A purposive sample of 30 women and 30 older adults was interviewed via telephone during Malaysia's Movement Control Order (MCO) regarding the challenges they faced throughout the pandemic. Thematic analysis was subsequently conducted to identify key themes. The themes identified from the thematic analysis indicated a degree of overlap between both groups. For women, seven themes emerged: 1) Psychological challenges due to COVID-19 pandemic, 2) Family violence, 3) Finance and employment related stress and anxiety, 4) Women's inequality and prejudice, 5) Coping strategies, 6) Professional support, and 7) Women's empowerment. Similarly, there were six themes for the older adults: 1) Adverse emotional experiences from COVID-19, 2) Threats to health security, 3) Loss of social connections, 4) Government aid to improve older adults' psychological well-being, 5) Psychological support from family members and pets, and 6) Self-reliance, religion, and spirituality. The findings provide valuable information on the specific burdens faced by these groups, and support psychological interventions and mitigations that would be appropriate to improve well-being during the recovery phase.

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