RESULTS: In this study, several genetically modified sub-genotype B4 EV-A71 mutants were constructed by site-directed mutations at positions 158, 475, 486, 487 and 5262 or through partial deletion of the 5'-NTR region (∆ 11 bp from nt 475 to 486) to generate a deletion mutant (PD). EV-A71 mutants 475 and PD caused minimal cytopathic effects, produced lowest viral RNA copy number, viral particles as well as minimal amount of viral protein (VP1) in RD cells when compared to mutants 158, 486, 487 and 5262.
CONCLUSIONS: The molecular determinants of virulent phenotypes of EV-A71 sub-genotype B4 strain 41 (5865/Sin/000009) were found to differ from the C158 molecular determinant reported for the fatal EV-A71 sub-genotype B1 strain (clinical isolate 237). The site-directed mutations (SDM) introduced at various sites of the cDNA affected growth of the various mutants when compared to the wild type. Lowest viral RNA copy number, minimal number of plaques formed, higher infectious doses required for 50% lethality of RD cells and much reduced VP1 of the EV-A71 sub-genotype B4 strain 41 genome was attained in mutants carrying SDM at position 475 and through partial deletion of 11 bp at the 5'-NTR region.
METHOD: A parallel randomized controlled trial was conducted with 73 hypertensive patients (intervention group = 35, control group = 38) at Hospital Kulim, Malaysia, for 7 months.
RESULTS: The intervention group demonstrated a significant improvement in medication possession ratio (p
METHODS: This study used a survey to collect data from 200 nursing staff, i.e., nurses and medical assistants, employed by a large private hospital and a public hospital in Malaysia. Respondents were asked to answer 5-point Likert scale questions regarding transformational leadership, employee empowerment, and job satisfaction. Partial least squares-structural equation modeling (PLS-SEM) was used to analyze the measurement models and to estimate parameters in a path model. Statistical analysis was performed to examine whether empowerment mediated the relationship between transformational leadership and job satisfaction.
RESULTS: This analysis showed that empowerment mediated the effect of transformational leadership on the job satisfaction in nursing staff. Employee empowerment not only is indispensable for enhancing job satisfaction but also mediates the relationship between transformational leadership and job satisfaction among nursing staff.
CONCLUSIONS: The results of this research contribute to the literature on job satisfaction in healthcare industries by enhancing the understanding of the influences of empowerment and transformational leadership on job satisfaction among nursing staff. This study offers important policy insight for healthcare managers who seek to increase job satisfaction among their nursing staff.
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
OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.
METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.
RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.
CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.
OBJECTIVE: To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.
METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.
RESULTS: Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.
CONCLUSION: Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.
STUDY REGISTRATION: PROSPERO (registration number: CRD42016046484).
PURPOSE: The present study aims to look at the association between CH and severity of OSAS, and whether CH could be another link between OSAS and the development of glaucoma.
METHODS: This was a cross-sectional, observational study at the University Malaya Medical Centre, Kuala Lumpur. Patients undergoing polysomnography for assessment of OSAS were recruited. We measured central corneal thickness (CCT) using optical biometry, and CH using ocular response analysis. Intraocular pressure (IOP) and Humphrey visual field (HVF) indices were also measured. The Apnea Hypopnea Index (AHI) divided patients into normal, mild, moderate, and severe OSAS categories. The normal and mild categories (47.9%) were then collectively called group 1, and the moderate and severe categories (52.1%) were called group 2. T tests, Pearson correlation tests, and general linear model analysis were performed, with P .05). CH correlated negatively with AHI (r = -0.229, P = .013) and positively with lowest oxygen saturation (r = 0.213, P = .022).
CONCLUSIONS: CH is lower in moderate/severe OSAS than in normal/mild cases. This may be another link between OSAS and the development of glaucoma; further studies are indicated to determine the significance of this connection.
METHODS: Secondary data for 9,850 participants were obtained from the Social Security Organisation Return To Work database. The dependent variable was the Return To Work programme outcome, successful return to employment (same employer or different employer) or unsuccessful return. Logistic regression analysis with weighted sum contrasts was performed to assess the odds ratios with 95% confidence interval (95% CI) for successful return to employment across the various subgroups of participants.
RESULTS: Overall, 65.5% of participants successfully returned to employment, either with their former employers or with new employers. Successful return to employment was found to be significantly higher than the overall proportion among those participants who had had commuting accidents, followed by those who had had workplace accidents. Successful return to employment was also associated with injuries of the upper and lower limbs, employers who were interested in hiring disabled workers, motivation to participate in the programme, an intervention period of 3 months or less, age 29 years or younger, and male participants.
CONCLUSION: A structured multidisciplinary intervention programme provides a positive outcome in terms of returning to work. Related factors have various impacts on successful return to work.