METHOD: A cross-sectional study was conducted among patients aged >18 years attending Klinik Kesihatan Putrajaya Presint 9 with a high risk of contracting COVID-19 recruited via systematic random sampling. Data were collected using a self-administered questionnaire. A multiple logistic regression analysis was performed to identify the associated factors.
RESULTS: The response rate for this study was 97.4% (N=489). The median patient age was 55 years. Approximately 51.7% were men, and 90.4% were Malays. Approximately 81.2% were willing to receive a COVID-19 booster vaccine. The patients who perceived COVID-19 as a serious illness (Adjusted Odd Ratio, AOR=2.414), those who perceived COVID-19 booster vaccines as beneficial (AOR=7.796), those who disagreed that COVID-19 booster vaccines have many side effects (AOR=3.266), those who had no doubt about the content of COVID-19 vaccines (AOR=2.649) and those who were employed (AOR=2.559) and retired (AOR=2.937) were more likely to be willing to receive a booster vaccine than those who were unemployed and those who did not have close friends or family members who contracted severe COVID-19 (AOR=2.006).
CONCLUSION: The majority of the participants were willing to receive a COVID-19 booster vaccine. Healthcare authorities should take initiatives to design targeted public intervention programmes to increase the willingness for COVID-19 booster vaccination.
MATERIALS AND METHODS: This cross-sectional study was conducted in three Malaysian public hospitals using a multilevel sampling technique to recruit 630 respondents. A validated self-developed four-domain questionnaire which includes one domain for health insurance was used to collect the relevant data.
RESULTS: Approximately 31.7% of the respondents owned PHI. The PHI usage was significantly higher among male respondents (p=0.035), those aged 18-40 years old (p<0.001), Indian and Chinese ethnicities (p=0.002), with tertiary education level (p<0.001), employed (p<0.001), working in the private sector (p<0.001), high household income (T20) (p<0.001), home near to the hospital (p=0.001) and medium household size (p<0.001). The significant predictive factors were age 18-40 years aOR 3.01 (95% CI: 1.67-5.41), age 41-60 years aOR 2.22 (95% CI 1.41-3.49), medium (M40) income aOR 2.90 (95% CI: 1.92-4.39) and high (T20) income aOR 3.86 (95% CI: 1.68-18.91), home near to the hospital aOR 1.68 (95% CI: 1.10-2.55), medium household size aOR 2.20 (95% CI: 1.30-3.72) and female head of household aOR 1.79 (95% CI: 1.01-3.16). The type of cancer treatment, the location of treatment, prior treatment in private healthcare facilities and existence of financial coping mechanisms also were significant factors in determining PHI usage among cancer patients in this study.
CONCLUSION: Several factors are significantly associated with PHI usage in cancer patients. The outcome of this study can guide policymakers to identify high-risk groups which need supplementary health insurance to bear the cost for their cancer treatment so that a better pre-payment health financing system such as a national health insurance can be formulated to cater for these groups.
EXPERIMENTAL APPROACH: The leaves of three F. deltoidea varieties, namely Ficus deltoidea var. angustifolia, Ficus deltoidea var. trengganuensis and Ficus deltoidea var. kunstleri, were subjected to water extraction. The resulting crude extracts were fractionated using water and ethyl acetate. Palmitic acid was used to induce lipid accumulation (steatosis) in human liver (WRL68) cells, before all the samples were tested for their lipid-reducing activity. Several proteomic approaches were incorporated. The changes in protein expression were determined using 2-dimensional gel electrophoresis separation, whereas identification of our protein spots of interest was carried out via matrix-assisted laser desorption/ionization time-of-flight.
RESULTS AND CONCLUSIONS: Ficus deltoidea var. kunstleri alone demonstrated the ability to reduce lipids at the highest tested concentration (200 µg/mL) and was, therefore, used for subsequent experiments. Treatment with Ficus deltoidea var. kunstleri was found to restore redox status by increasing superoxide dismutase and glutathione peroxidase amounts and decreasing malondialdehyde formation. Six proteins were successfully identified; these were heat shock protein beta-1 (HSPB1), proteasome subunit alpha type 1 (PSMA1), glutathione S-transferase omega 1 (GSTO1), peroxiredoxin-1 (PRDX1), histone H2B (HIST1H2BD) and ubiquitin c-terminal hydrolase L3 (UCHL3). Through bioinformatics analysis, it was found that these proteins were significantly involved in specific pathways such as oxidative stress (PRDX1 and GSTO1), protein homeostasis (HSPB1) and degradation (UCHL3 and PSMA1).
NOVELTY AND SCIENTIFIC CONTRIBUTION: F. deltoidea pretreatment was shown to reduce lipid accumulation, thus improving the redox status and protein homeostasis. This suggests the role of F. deltoidea as a preventive mechanism in non-alcohol fatty liver disease.
METHODS: Seventy patients (20-76 aged) with MRI imaging (pre- and post-RT (6 months-1 year)) and complete cognitive assessments were recruited. Hippocampus, temporal lobes (TLs), and cerebellum were delineated and dosimetry parameters were extracted. Assessments were given post-RT via telephone (Telephone Interview Cognitive Status (TICS), Telephone Montreal Cognitive Assessment (T-MoCA), Telephone Mini Addenbrooke's Cognitive Examination (Tele-MACE), and QLQ-H&N 43). Regression and deep neural network (DNN) models were used to predict post-RT cognition using anatomical and treatment dose features.
RESULTS: Remote cognitive assessments were inter-correlated (r > 0.9). TLs showed significance in pre- and post-RT volume differences and cognitive deficits, that are correlated with RT-associated volume atrophy and dose distribution. Good classification accuracy based on DNN area under receiver operating curve (AUROC) for cognitive prediction (T-MoCA AUROC = 0.878, TICS AUROC = 0.89, Tele-MACE AUROC = 0.919).
CONCLUSION: DL-based prediction models assessed using remote assessments can assist in predicting cognitive deficit following NPC RT. Comparable results of remote assessments in assessing cognition suggest its possibility in replacing standard assessments.
IMPLICATIONS FOR CANCER SURVIVORS: Application of prediction models in individual patient enables tailored interventions to be provided in managing cognitive changes following NPC RT.
MATERIALS AND METHODS: An exploratory qualitative study was conducted using videoconferencing. Fourteen medical officers working in public primary healthcare clinics from various regions of Malaysia were chosen using purposive sampling process, and participants underwent a total of seven paired in-depth interview (IDI) sessions. IDIs were video recorded, transcribed and subjected to interpretive thematic analysis.
RESULTS: The two main themes which emerged were the benefits and challenges of NCD teleconsultation service. Various categories relating to benefits of teleconsultation for NCD care are as follows: (1) Improved efficiency for patient care delivery (improved effectiveness, convenient, improved safety, better disease monitoring, patient empowerment) and (2) Benefits for Health Care Providers (improved healthcare and service delivery). Main challenges identified were as follows: (1) Challenges for Delivery of Care (Patients' adaptation in using teleconsultation service, Patients abusing the system, Poor digital literacy, No proper disease monitoring record), (2) Challenges for Health Care Providers (Lack of dedicated team and training, Higher workload and time-consuming) and (3) Challenges for Health Care System (Institutional policy, legal and regulatory weakness, Medical record documentation and prescription updates).
CONCLUSION: Optimisation of NCD patient healthcare delivery via teleconsultation is beneficial during and after pandemic. Targeted improvements to address current challenges are crucial to optimise its use beyond the pandemic period in the Malaysian public healthcare system.
METHODS: A systematic search was performed in the PubMed, Scopus, and Web of Science (WoS) databases in June 2022. Patients with head and neck cancer treated with radiotherapy and periodic rs-fMRI assessments were included. A meta-analysis was performed to determine the potential of rs-fMRI for detecting brain changes.
RESULTS: Ten studies with a total of 513 subjects (head and neck cancer patients, n = 437; healthy controls, n = 76) were included. A significance of rs-fMRI for detecting brain changes in the temporal and frontal lobes, cingulate cortex, and cuneus was demonstrated in most studies. These changes were reported to be associated with dose (6/10 studies) and latency (4/10 studies). A strong effect size (r = 0.71, p
PATIENTS: A young girl who complained of pulsatile tinnitus and an elderly man who presented with ear bleeding. Otoendoscopy examination revealed a pulsatile reddish mass protruding through the tympanic membrane in both patients.
INTERVENTIONS: A combination of clinical assessments and imaging supported the diagnosis of aberrant ICA in the middle ear. Transcanal endoscopic reinforcement of the artery was performed; tragal cartilage was used as a shield to strengthen the carotid canal defect.
RESULTS: Assisted by fine endoscopic instruments, the protruding arteries were separated without damage to the surrounding structures and reinforced using tragal cartilage. Both patients' symptoms improved postoperatively; they reported tinnitus relief and hearing improvement.
CONCLUSION: To prevent catastrophic events, diagnosis of aberrant ICA is important before any surgical intervention. With appropriate management, surgical intervention using transcanal endoscopic ear surgery offers a clear view of the surgical field and is an excellent choice for management of aberrant ICA.
METHODS: A systematic search of the MEDLINE (PubMed) database using "COVID-19," "vaccine" and "acceptance" to obtain original research articles published between 2020 and July 2021. Only studies with full text and that were published in English were included. The Joanna Briggs Institute meta-analysis was used to assess the data quality. The meta-analysis was performed using generic inverse variance with a random-effects model using the Review Manager software.
RESULTS: A total of 172 studies across 50 countries worldwide were included. Subgroup analyses were performed with regard to vaccine acceptance, regions, population, gender, vaccine effectiveness, and survey time. The pooled proportion of COVID-19 vaccine acceptance was 61% (95% CI: 59, 64). It was higher in Southeast Asia, among healthcare workers, in males, for vaccines with 95% effectiveness, and during the first survey.
CONCLUSION: COVID-19 vaccine acceptance needs to be increased to achieve herd immunity to protect the population from the disease. It is crucial to enhance public awareness of COVID-19 vaccination and improve access to vaccines.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2021, identifier CRD42021268645.
METHODS: Fish were injected with 100 μg/g of MPTP intraperitoneally once or twice and then assessed on days 1 to 30 post-injection.
RESULTS: Between one-time and two-time injections, there was no significant difference in most locomotor parameters, expressions of tyrosine hydroxylase-2 (th2) and dopamine transporter (dat) genes, and dopaminergic neurons (tyrosine hydroxylase positive, TH+ cells) counts. However, caspase-3 levels significantly differed between one- and two-time injections on the day 1 assessment.
DISCUSSION: Over a 30-day period, the parameters showed significant differences in swimming speed, total distance traveled, tyrosine hydroxylase-1 (th1) and dat gene expressions, caspase-3 and glutathione protein levels, and TH+ cell counts. Days 3 and 5 showed the most changes compared to the control. In conclusion, a one-time injection of MPTP with delayed assessment on days 3 to 5 is a good PD model for animal studies.