Displaying publications 81 - 100 of 222 in total

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  1. Thangarajah P, Hajissa K, Wong WK, Abdullah MA, Ismail N, Mohamed Z
    BMC Infect Dis, 2019 Feb 28;19(1):202.
    PMID: 30819141 DOI: 10.1186/s12879-019-3830-9
    BACKGROUND: Accurate diagnosis of Toxoplasma gondii (T. gondii) infection remains elusive and requires a comprehensive assessment through laboratory and clinical investigation. In this study, a diagnostic algorithm based on paired serum samples and clinical data was developed and evaluated.

    METHODS: A total of 1267 suspected cases of Toxoplasma infection were enrolled in this study from January 2016 to December 2016. The cases were screened for anti-Toxoplasma IgM and IgG by electrochemiluminiscence immunoassay (ECLIA) method. Based on the serological profiles, all cases with first seropositive serum samples were considered as suggestive cases of Toxoplasma infection. Thus, second serum samples were obtained after an interval of 2 weeks. The diagnosis was made based on laboratory results and clinical data.

    RESULTS: A total of 482 T. gondii seroreactive cases were selected. The patient's records were traced and the data were analysed. Accordingly, 152 cases were diagnosed as clinically confirmed cases; 198 cases were clinically asymptomatic and 132 cases were newborn babies or infants who did not have toxoplasmosis and only acquired passive immunity from their mothers. The paired serum algorithm allowed classifying the seroreactive cases as follows: early (0.6%), acute (1.9%), reactivation (13.5%), recent (1.5%), passive immunity from mother (27.3%) and possible congenital infections (1.2%). In addition, cases of reactivated toxoplasmosis were detected among the pregnant mothers (13/82; 15.8%), children aged above 1 year (2/8; 25.0%) and immunocompetent mothers (5/135; 3.7%). Furthermore, the application of the paired serum analysis resulted in remarkably improved treatment initiation.

    CONCLUSIONS: Toxoplasmosis diagnosis and treatment can be improved through the use of paired serum diagnostic algorithm.

  2. Ahmad MH, Ibrahim MI, Mohamed Z, Ismail N, Abdullah MA, Shueb RH, et al.
    PMID: 30999608 DOI: 10.3390/ijerph16081380
    Thank you for the comments received on the article "The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and its Associated Factors" [...].
  3. Zahri KNM, Zulkharnain A, Sabri S, Gomez-Fuentes C, Ahmad SA
    PMID: 33669826 DOI: 10.3390/ijerph18042050
    In the present age, environmental pollution is multiplying due to various anthropogenic activities. Pollution from waste cooking oil is one of the main issues facing the current human population. Scientists and researchers are seriously concerned about the oils released from various activities, including the blockage of the urban drainage system and odor issues. In addition, cooking oil is known to be harmful and may have a carcinogenic effect. It was found that current research studies and publications are growing on these topics due to environmental problems. A bibliometric analysis of studies published from 2001 to 2021 on cooking oil degradation was carried out using the Scopus database. Primarily, this analysis identified the reliability of the topic for the present-day and explored the past and present progresses of publications on various aspects, including the contributing countries, journals and keywords co-occurrence. The links and interactions between the selected subjects (journals and keywords) were further visualised using the VOSviewer software. The analysis showed that the productivity of the publications is still developing, with the most contributing country being the United States, followed by China and India with 635, 359 and 320 publications, respectively. From a total of 1915 publications, 85 publications were published in the Journal of Agricultural and Food Chemistry. Meanwhile, the second and third of the most influential journals were Bioresource Technology and Industrial Crops and Products with 76 and 70 total publications, respectively. Most importantly, the co-occurrence of the author's keywords revealed "biodegradation", "bioremediation", "vegetable oil" and "Antarctic" as the popular topics in this study area, especially from 2011 to 2015. In conclusion, this bibliometric analysis on the degradation of cooking oil may serve as guide for future avenues of research in this area of research.
  4. Suwardi SA, Lee SM, Lo KM, Jotani MM, Tiekink ER
    Acta Crystallogr E Crystallogr Commun, 2017 Mar 01;73(Pt 3):429-433.
    PMID: 28316825 DOI: 10.1107/S2056989017002705
    The title compound, [Cd2(C8H8NS2)4], is a centrosymmetric dimer with both chelating and μ2-tridentate di-thio-carbamate ligands. The resulting S5 donor set defines a Cd(II) coordination geometry inter-mediate between square-pyramidal and trigonal-bipyramidal, but tending towards the former. The packing features C-H⋯S and C-H⋯π inter-actions, which generate a three-dimensional network. The influence of these inter-actions, along with intra-dimer π-π inter-actions between chelate rings, has been investigated by an analysis of the Hirshfeld surface.
  5. Ismail N, Nazri NK, Abdullah AA, Wan Nik WMN, Wright LJ
    Data Brief, 2021 Feb;34:106738.
    PMID: 33521179 DOI: 10.1016/j.dib.2021.106738
    Polychloropolymethylstyrene (PCMS) polymers were synthesized with clay Cloisite and without clay Cloisite and chloromethylstyrene (CMS) combine with styrene (1:1) v/v or known as copolymer and clay Cloisite by the polymerization process. The attenuated total reflection-Fourier transform infrared (ATR-FTIR) spectra of each polymer synthesized are reported. The spectra of IR shows the different value of the wavenumber and intensity for each set of different sample. The spectra can be as a reference for others to use in synthesizing this polymer and clay Cloisite for different type of application.
  6. Abdul Halim Chong FH, Md Salleh SN, Abu Bakar N, Ismail IN
    Singapore Dent J, 2019 12;39(1):41-52.
    PMID: 32910746 DOI: 10.1142/S2214607519500044
    Aim: This study evaluates perception toward facial appearance in dentofacial deformity and the need for orthognathic surgery among the public with and without dental backgrounds. Materials and Methods: A questionnaire consisting of 12 facial photographs of cases with dentofacial deformity or malocclusion in varying severity was used. A hundred individuals were selected to answer the questionnaire. The perception of facial appearance (FAS), treatment need score (TNS), and knowledge regarding dentofacial deformity were used for the evaluation. Results: Significant differences were found between dental and non-dental when the respondents' knowledge in all the questionnaire items ([Formula: see text].05) was assessed. However, no significant difference was found in the mean of FAS and TNS in all the presented cases (normal, borderline, severe). Pearson correlation between perceived FAS and TNS was statistically negative for severe and normal cases, whereby a decrease in FAS for severe cases showed an increase in TNS, and an increase in FAS for normal cases showed a decrease in TNS. Conclusion: Respondents with dental background had sound knowledge of dentofacial deformity. A poorly attractive respondent with dentofacial deformity showed a greater need for orthognathic surgery.
  7. Chai A, Wong YS, Ong SA, Aminah Lutpi N, Sam ST, Kee WC, et al.
    Bioresour Technol, 2021 Sep;336:125319.
    PMID: 34049168 DOI: 10.1016/j.biortech.2021.125319
    A pilot scale anaerobic degradation of sugarcane vinasse was carried out at various hydraulic retention time (HRT) in the Anaerobic Suspended Growth Closed Bioreactor (ASGCB) under thermophilic temperature. The performance and kinetics were evaluated through the Haldane-Andrews model to investigate the substrate inhibition potential of sugarcane vinasse. All parameters show great performance between HRT 35 and 25 days: chemical oxygen demand (COD) reduction efficiency (81.6 to 86.8%), volatile fatty acids (VFA) reduction efficiency (92.4 to 98.5%), maximum methane yield (70%) and maximum biogas production (19.35 L/day). Furthermore, steady state values from various HRT were obtained in the kinetic evaluation for: rXmax (1.20 /day), Ks (19.95 gCOD/L), Ki (7.00 gCOD/L) and [Formula: see text] (0.33 LCH4/gCOD reduction). This study shows that anaerobic degradation of sugarcane vinasse through ASGCB could perform well at high HRT and provides a low degree of substrate inhibition as compared to existing studies from literature.
  8. Ranganathan H, Singh DKA, Kumar S, Sharma S, Chua SK, Ahmad NB, et al.
    BMC Med Educ, 2021 Jul 10;21(1):376.
    PMID: 34246264 DOI: 10.1186/s12909-021-02803-8
    BACKGROUND: Online learning is an attractive option for educators, especially as means of overcoming the challenges posed by the global pandemic. Although it is best to evaluate student readiness prior to commencement of an online course, to ensure successful development and delivery of student-centric teaching and learning strategies, readiness towards online learning among physiotherapy undergraduates is unknown. The main aim of this study was to examine physiotherapy undergraduates' readiness towards online learning.

    METHODS: In this cross-sectional study, participants were selected through a combination of total population and convenience sampling. The Student Online Learning Readiness questionnaire was distributed among physiotherapy undergraduates from two public and two private universities in Malaysia to investigate their technical, social and communication competencies. Information about device characteristics were obtained to evaluate their equipment readiness. Descriptive and group comparisons were conducted using independent t-test, and analysis of variance with p  80% possessed smartphones and laptop) level of equipment readiness. Institution and gender had no significant effect on the level of readiness (p > 0.05). Year 1 and 2 had significantly higher levels of social competencies with instructor compared to final year physiotherapy undergraduates (p 

  9. Ismail NF, Mohd Radzuan NA, Sulong AB, Muhamad N, Che Haron CH
    Polymers (Basel), 2021 Jun 19;13(12).
    PMID: 34205236 DOI: 10.3390/polym13122005
    The use of kenaf fiber as a reinforcement material for polymer composites is gaining popularity, especially in the production of automotive components. The main objective of this current work is to relate the effect of alkali treatment on the single fiber itself and the composite material simultaneously. The effect of temperature condition during mechanical testing is also investigated. Composite materials with discontinuous natural kenaf fibers and epoxy resin were fabricated using a compression moulding process. The epoxy composites were reinforced with 50 wt% untreated and treated kenaf fibers. The kenaf fiber was treated with NaOH solution (6% by weight) for 24 h at room temperature. Kenaf fiber treated with NaOH treatment had a clean surface and no impurities. For the first time we can see that alkali treatment had a damaging effect on the mechanical properties of kenaf fibers itself and the treated kenaf/epoxy composites. The composite reinforced with untreated kenaf fiber and treated kenaf fiber showed increased tensile strength (72.85% and 12.97%, respectively) compared to the neat epoxy. Reinforcement of the composite with treated kenaf fiber decreased the tensile strength due to the fiber pull out and the formation of voids which weakens the adhesion between the fibers and matrix. The temperature conditions also play an important role in composites with a significant impact on the deterioration of composite materials. Treated kenaf fiber has thermal stability and is not sensitive to temperature and as a result reinforcement with treated kenaf gives a lower loss value of 76%.
  10. Wong JL, Siti Azrin AH, Narizan MI, Norliah Y, Noraida M, Amanina A, et al.
    Trop Biomed, 2014 Sep;31(3):534-9.
    PMID: 25382481 MyJurnal
    Hands of Health Care Personnel (HCP) are one of the most common vehicles for the transmission of infection. Microorganisms can survive well on the hands of HCP for a certain duration. Therefore, the purpose of this study is to bring awareness to HCP that their hands can actually be contaminated with many microorganisms. These microbes on the hands of HCP can potentially infect their patients if they do not comply with the proper hand hygiene practice. This cross-sectional study was conducted at a randomly selected Intensive Care Unit (ICU) and general ward in a hospital. Twenty five HCP from each ward were randomly selected and their hands were imprinted on blood culture plates. Microorganism growth were quantified and identified. Data were analyzed and presented as descriptive analysis. One hundred blood agar plates were processed and analyzed. Majority (71%) of the samples had more than 50 colony-forming units (CFU) and only 17% of the samples had less than 25 CFU. Microorganisms identified include Staphylococcus spp., Acinetobacter spp., Enterobacteriaceae, Pseudomonas spp., Moraxella, Delftiaacidovorans and fungi. All isolated microorganisms were antibiotic sensitive strain. This study showed that the hands of HCP were contaminated with many microorganisms. Therefore, it is imperative that HCP must practice proper hand hygiene when taking care of their patients in the wards.
  11. Gurdeep Singh HK, Yusup S, Abdullah B, Cheah KW, Azmee FN, Lam HL
    J Environ Manage, 2017 Apr 28.
    PMID: 28460799 DOI: 10.1016/j.jenvman.2017.04.021
    Crude rubber seed oil is a potential source for biofuel production. However it contains undesirable impurities such as peroxides and high oxidative components that not only affect the oil stability, colour and shelf-life but promote insoluble gums formation with time that could cause deposition in the combustion engines. Therefore to overcome these problems the crude rubber seed oil is refined by undergoing degumming and bleaching process. The effect of bleaching earth dosage (15-40 wt %), phosphoric acid dosage (0.5-1.0 wt %) and reaction time (20-40 min) were studied over the reduction of the peroxide value in a refined crude rubber seed oil. The analysis of variance shows that bleaching earth dosage was the most influencing factor followed by reaction time and phosphoric acid dosage. A minimum peroxide value of 0.1 milliequivalents/gram was achieved under optimized conditions of 40 wt % of bleaching earth dosage, 1.0 wt % of phosphoric acid dosage and 20 min of reaction time using Response Surface Methodology design.
  12. Daud A, Fuzi NMHM, Arshad MM, Kamarudin S, Mohammad WMZW, Amran F, et al.
    Vet World, 2018 Jun;11(6):840-844.
    PMID: 30034179 DOI: 10.14202/vetworld.2018.840-844
    Background: Leptospirosis is a zoonotic disease that infects human and livestock which causes economic losses to the farmers. It has been reported as one of the causes of reproductive failure in cattle and other ruminants, determining abortions, stillbirth, weak newborns, and decrease in their growth rate and milk production.

    Aim: The objectives of this study were to determine the leptospirosis seroprevalence and to identify the predominant infecting serovars among cattle.

    Materials and Methods: A cross-sectional study involving 420 cattle from six randomly selected districts in Kelantan was conducted. A serological test using the microscopic agglutination test was conducted in the Institute of Medical Research with a cutoff titer for seropositivity of ≥1:100.

    Results: The overall prevalence of leptospirosis seropositivity among cattle in this study was 81.7% (95% confidence interval: 63.5, 80.1). The most common reaction obtained with the sera tested was from the serovar Sarawak with 78.8%.

    Conclusion: A high seroprevalence of leptospiral antibodies was found among cattle in Northeastern Malaysia. These findings urge that more studies are required to determine the reasons for the high seroprevalence among the cattle along with its transmission and pathogenicity of the local serovar Sarawak.

  13. Habib MA, Yuen GC, Othman F, Zainudin NN, Latiff AA, Ismail MN
    Biochem. Cell Biol., 2017 04;95(2):232-242.
    PMID: 28177774 DOI: 10.1139/bcb-2016-0144
    The natural rubber latex extracted from the bark of Hevea brasiliensis plays various important roles in today's modern society. Following ultracentrifugation, the latex can be separated into 3 layers: C-serum, lutoids, and rubber particles. Previous studies have shown that a large number of proteins are present in these 3 layers. However, a complete proteome for this important plant is still unavailable. Protein sequences have been recently translated from the completed draft genome database of H. brasiliensis, leading to the creation of annotated protein databases of the following H. brasiliensis biosynthetic pathways: photosynthesis, latex allergens, rubberwood formation, latex biosynthesis, and disease resistance. This research was conducted to identify the proteins contained within the latex by way of de novo sequencing from mass spectral data obtained from the 3 layers of the latex. Peptides from these proteins were fragmented using collision-induced dissociation, higher-energy collisional dissociation, and electron-transfer dissociation activation methods. A large percentage of proteins from the biosynthetic pathways (63% to 100%) were successfully identified. In addition, a total of 1839 unique proteins were identified from the whole translated draft genome database (AnnHBM).
  14. Ahmad MH, Ibrahim MI, Mohamed Z, Ismail N, Abdullah MA, Shueb RH, et al.
    PMID: 30223572 DOI: 10.3390/ijerph15092018
    Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
  15. Khoo JJ, Ishak SN, Lim FS, Mohd-Taib FS, Khor CS, Loong SK, et al.
    J Med Entomol, 2018 10 25;55(6):1642-1647.
    PMID: 30137379 DOI: 10.1093/jme/tjy122
    The Borrelia genus consists of spirochete bacteria known to cause Lyme disease (LD) and relapsing fever in humans. Borrelia pathogens are commonly transmitted via arthropod vectors such as ticks, mites, or lice. Here, we report the molecular screening of LD group Borrelia sp. from ticks (Acari: Ixodidae) collected from rodents trapped in recreational forests and a semiurban residential area in the Selangor state in Malaysia. Of 156 adult ticks surveyed, 72 ticks were determined as positive for Borrelia sp. by polymerase chain reaction (PCR). All Borrelia PCR-positive ticks belonged to the Ixodes granulatus Supino species. Borrelia sp. was not detected in other tick species examined, including Dermacentor sp. and Amblyomma sp. ticks. Thirteen Borrelia PCR-positive tick samples were selected for further sequence analyses. Phylogenetic analyses of partial flaB gene sequences revealed that the Borrelia sp. were closely related to the LD group borreliae, Borrelia yangtzensis; a novel Borrelia genospecies reported in East Asian countries including Japan, Taiwan, and China. To our knowledge, this is the first report of Borrelia sp. related to Borrelia yangtzensis detected in Malaysia and Southeast Asia. The zoonotic potential of the Borrelia sp. reported here merits further investigation, as it may explain the previously reported serological evidence for borrelial infections in Malaysia.
  16. Yusufzai SK, Khan MS, Sulaiman O, Osman H, Lamjin DN
    Chem Cent J, 2018 Dec 04;12(1):128.
    PMID: 30515636 DOI: 10.1186/s13065-018-0497-z
    Coumarins are the phytochemicals, which belong to the family of benzopyrone, that display interesting pharmacological properties. Several natural, synthetic and semisynthetic coumarin derivatives have been discovered in decades for their applicability as lead structures as drugs. Coumarin based conjugates have been described as potential AChE, BuChE, MAO and β-amyloid inhibitors. Therefore, the objective of this review is to focus on the construction of these pharmacologically important coumarin analogues with anti-Alzheimer's activities, highlight their docking studies and structure-activity relationships based on their substitution pattern with respect to the selected positions on the chromen ring by emphasising on the research reports conducted in between year 1968 to 2017.
  17. Zaman R, Islam RA, Ibnat N, Othman I, Zaini A, Lee CY, et al.
    J Control Release, 2019 05 10;301:176-189.
    PMID: 30849445 DOI: 10.1016/j.jconrel.2019.02.016
    Macromolecular protein and peptide therapeutics have been proven to be effective in treating critical human diseases precisely. Thanks to biotechnological advancement, a huge number of proteins and peptide therapeutics were made their way to pharmaceutical market in past few decades. However, one of the biggest challenges to be addressed for protein therapeutics during clinical application is their fast degradation in serum and quick elimination owing to enzymatic degradation, renal clearance, liver metabolism and immunogenicity, attributing to the short half-lives. Size and hydrophobicity of protein molecules make them prone to kidney filtration and liver metabolism. On the other hand, proteasomes responsible for protein destruction possess the capability of specifically recognizing almost all kinds of foreign proteins while avoiding any unwanted destruction of cellular components. At present almost all protein-based drug formulations available in market are administered intravenously (IV) or subcutaneously (SC) with high dosing at frequent interval, eventually creating dose-fluctuation-related complications and reducing patient compliance vastly. Therefore, artificially increasing the therapeutic half-life of a protein by attaching to it a molecule that increases the overall size (eg, PEG) or helps with receptor mediated recycling (eg, albumin), or manipulating amino acid chain in a way that makes it more prone towards aggregate formation, are some of the revolutionary approaches to avoid the fast degradation in vivo. Half-life extension technologies that are capable of dramatically enhancing half-lives of proteins in circulation (2-100 folds) and thus improving their overall pharmacokinetic (PK) parameters have been successfully applied on a wide range of protein therapeutics from hormones and enzymes, growth factor, clotting factor to interferon. The focus of the review is to assess the technological advancements made so far in enhancing circulatory half-lives and improving therapeutic potency of proteins.
  18. Nurul Najian AB, Foo PC, Ismail N, Kim-Fatt L, Yean CY
    Mol Cell Probes, 2019 04;44:63-68.
    PMID: 30876924 DOI: 10.1016/j.mcp.2019.03.001
    This study highlighted the performance of the developed integrated loop-mediated isothermal amplification (LAMP) coupled with a colorimetric DNA-based magnetogenosensor. The biosensor operates through a DNA hybridization system in which a specific designed probe captures the target LAMP amplicons. We demonstrated the magnetogenosensor assay by detecting pathogenic Leptospira, which causes leptospirosis. The color change of the assay from brown to blue indicated a positive result, whereas a negative result was indicated by the assay maintaining its brown color. The DNA biosensor was able to detect DNA at a concentration as low as 200 fg/μl, which is equivalent to 80 genomes/reaction. The specificity of the biosensor assay was 100% when it was evaluated with 172 bacterial strains. An integrated LAMP and probe-specific magnetogenosensor was successfully developed, promising simple and rapid visual detection in clinical diagnostics and service as a point-of-care device.
  19. Ashaie MA, Islam RA, Kamaruzman NI, Ibnat N, Tha KK, Chowdhury EH
    Pharmaceutics, 2019 Jul 02;11(7).
    PMID: 31269666 DOI: 10.3390/pharmaceutics11070309
    While several treatment strategies are applied to cure breast cancer, it still remains one of the leading causes of female deaths worldwide. Since chemotherapeutic drugs have severe side effects and are responsible for development of drug resistance in cancer cells, gene therapy is now considered as one of the promising options to address the current treatment limitations. Identification of the over-expressed genes accounting for constitutive activation of certain pathways, and their subsequent knockdown with specific small interfering RNAs (siRNAs), could be a powerful tool in inhibiting proliferation and survival of cancer cells. In this study, we delivered siRNAs against mRNA transcripts of over-regulated cell adhesion molecules such as catenin alpha 1 (CTNNA1), catenin beta 1 (CTNNB1), talin-1 (TLN1), vinculin (VCL), paxillin (PXN), and actinin-1 (ACTN1) in human (MCF-7 and MDA-MB-231) and murine (4T1) cell lines as well as in the murine female Balb/c mice model. In order to overcome the barriers of cell permeability and nuclease-mediated degradation, the pH-sensitive carbonate apatite (CA) nanocarrier was used as a delivery vehicle. While targeting CTNNA1, CTNNB1, TLN1, VCL, PXN, and ACTN1 resulted in a reduction of cell viability in MCF-7 and MDA-MB-231 cells, delivery of all these siRNAs via carbonate apatite (CA) nanoparticles successfully reduced the cell viability in 4T1 cells. In 4T1 cells, delivery of CTNNA1, CTNNB1, TLN1, VCL, PXN, and ACTN1 siRNAs with CA caused significant reduction in phosphorylated and total AKT levels. Furthermore, reduced band intensity was observed for phosphorylated and total MAPK upon transfection of 4T1 cells with CTNNA1, CTNNB1, and VCL siRNAs. Intravenous delivery of CTNNA1 siRNA with CA nanoparticles significantly reduced tumor volume in the initial phase of the study, while siRNAs targeting CTNNB1, TLN1, VCL, PXN, and ACTN1 genes significantly decreased the tumor burden at all time points. The tumor weights at the end of the treatments were also notably smaller compared to CA. This successfully demonstrates that targeting these dysregulated genes via RNAi and by using a suitable delivery vehicle such as CA could serve as a promising therapeutic treatment modality for breast cancers.
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