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The methodological quality of guidelines for hospital-acquired pneumonia and ventilator-associated pneumonia: A systematic review

Ambaras Khan R, Aziz Z

J Clin Pharm Ther, 2018 Aug;43(4):450-459.
PMID: 29722052 DOI: 10.1111/jcpt.12696

WHAT IS KNOWN AND OBJECTIVES: Clinical practice guidelines serve as a framework for physicians to make decisions and to support best practice for optimizing patient care. However, if the guidelines do not address all the important components of optimal care sufficiently, the quality and validity of the guidelines can be reduced. The objectives of this study were to systematically review current guidelines for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), evaluate their methodological quality and highlight the similarities and differences in their recommendations for empirical antibiotic and antibiotic de-escalation strategies.
METHODS: This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Electronic databases including MEDLINE, CINAHL, PubMed and EMBASE were searched up to September 2017 for relevant guidelines. Other databases such as NICE, Scottish Intercollegiate Guidelines Network (SIGN) and the websites of professional societies were also searched for relevant guidelines. The quality and reporting of included guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) instrument.
RESULTS AND DISCUSSION: Six guidelines were eligible for inclusion in our review. Among 6 domains of AGREE-II, "clarity of presentation" scored the highest (80.6%), whereas "applicability" scored the lowest (11.8%). All the guidelines supported the antibiotic de-escalation strategy, whereas the majority of the guidelines (5 of 6) recommended that empirical antibiotic therapy should be implemented in accordance with local microbiological data. All the guidelines suggested that for early-onset HAP/VAP, therapy should start with a narrow spectrum empirical antibiotic such as penicillin or cephalosporins, whereas for late-onset HAP/VAP, the guidelines recommended the use of a broader spectrum empirical antibiotic such as the penicillin extended spectrum carbapenems and glycopeptides.
WHAT IS NEW AND CONCLUSIONS: Expert guidelines promote the judicious use of antibiotics and prevent antibiotic overuse. The quality and validity of available HAP/VAP guidelines would be enhanced by improving their adherence to accepted best practice for the management of HAP and VAP.
Fulltext Assessment of Malaysia's Large-Scale Solar Projects: Power System Analysis for Solar PV Grid Integration

Khan R, Go Y

Glob Chall, 2020 Feb;4(2):1900060.
PMID: 32042443 DOI: 10.1002/gch2.201900060

Malaysia targets to become the second-largest producer of solar photovoltaic (PV) in the world by increasing the current output from 12% to 20% in 2020. The government also expects to achieve 45% reduction of greenhouse gas emission by 2030 through renewable energy mainly by solar PV. Large-scale solar (LSS) aims to produce 2.5 GW, which contributes to 10% of the nation's electricity demands. The LSS system is held back by the grid-scale integration, transmission, and distribution infrastructure. Thus, power system analysis is crucial to achieve optimization in LSS to power grid integration. This paper investigates various power system analysis models and recommends an optimized configuration based on Malaysia's LSS scenario. In stage 1, an optimal PV sizing is carried out based on real data of LSS installation in different locations. In stage 2, power analysis is carried out using to analyze the potential difference variation when connected to a nine-bus power system. The potential variation at each bus of the system is assessed and hence provides a feasibility statement on the most effective configurations for LSS-grid integration. This paper serves as the reference model for LSS-grid integration in Malaysia and is expected to be replicated in the other countries with similar conditions.
Antibiotic de-escalation in patients with pneumonia in the intensive care unit: A systematic review and meta-analysis

Ambaras Khan R, Aziz Z

Int J Clin Pract, 2018 Oct;72(10):e13245.
PMID: 30144239 DOI: 10.1111/ijcp.13245

OBJECTIVES OF THE REVIEW: Antibiotic de-escalation is part of an antibiotic stewardship strategy to achieve adequate therapy for infections while avoiding the prolonged use of broad-spectrum antibiotics. However, there is a paucity of clinical evidence on the clinical impact of this strategy in pneumonia patients in the intensive care unit (ICU). This review aimed to evaluate the impact of antibiotic de-escalation therapy for adult patients diagnosed with pneumonia in the ICU.
METHODS USED TO CONDUCT THE REVIEW: This review was conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology (MOOSE) recommendation. Electronic databases including MEDLINE, CINAHL, PubMed, Embase, Cochrane Databases and Cochrane Central Register of Controlled Trials were searched up to March 2017 for relevant trials. The methodological quality of included trials was assessed by using a modified version of the Newcastle-Ottawa Quality Assessment Scale for Case-Control and Cohort Studies. A meta-analysis was conducted using the random-effect model to combine the rate of mortality and length of stay outcomes.
FINDINGS OF THE REVIEW: Nine observational trials involving 2128 patients were considered eligible for inclusion. Although based on low quality evidence, there was a statistically significant difference in favour of the impact of de-escalation on hospital stay but not mortality (MD -5.96 days; 95% CI -8.39 to -3.52).
INTERPRETATIONS AND IMPLICATIONS OF THE FINDINGS: This review highlights the need for more rigorous studies to be carried out before a firm conclusion on the benefit of de-escalation therapy is supported.
Fulltext Autobiographical memory and hierarchical search strategies in depressed and non-depressed participants

Haque S, Juliana E, Khan R, Hasking P

BMC Psychiatry, 2014;14:310.
PMID: 25403551 DOI: 10.1186/s12888-014-0310-z

There is a growing body of literature showing individuals with depression and other trauma-related disorders (e.g., posttraumatic stress disorder) recall more overgeneral and less specific autobiographical memories compared to normal participants. Although the mechanisms underlying overgeneral memory are quite clear, the search strategy operated within the autobiographical knowledge base, at time of recollection, requires further exploration. The current study aimed to examine the hierarchical search sequence used to recall autobiographical memories in depressed and non-depressed participants, with a view to determining whether depressed participants exhibited truncated search strategies.
Appropriate Antibiotic Administration in Critically Ill Patients with Pneumonia

Khan RA, Bakry MM, Islahudin F

Indian J Pharm Sci, 2015 7 17;77(3):299-305.
PMID: 26180275

Inappropriate initial antibiotics for pneumonia infection are usually linked to extended intensive care unit stay and are associated with an increased risk of mortality. This study evaluates the impact of inappropriate initial antibiotics on the length of intensive care unit stay, risk of mortality and the co-predictors that influences these outcomes. This retrospective study was conducted in an intensive care unit of a teaching hospital. The types of pneumonia investigated were hospital-acquired pneumonia and ventilator-associated pneumonia. Three different time points were defined as the initiation of appropriate antibiotics at 24 h, between 24 to 48 h and at more than 48 h after obtaining a culture. Patients had either hospital-acquired pneumonia (59.1%) or ventilator-associated pneumonia (40.9%). The length of intensive care unit stay ranged from 1 to 52 days (mean; 9.78±10.02 days). Patients who received appropriate antibiotic agent at 24 h had a significantly shorter length of intensive care unit stay (5.62 d, P<0.001). The co-predictors that contributed to an extended intensive care unit stay were the time of availability of susceptibility results and concomitant diseases, namely cancer and sepsis. The only predictor of intensive care unit death was cancer. The results support the need for early appropriate initial antibiotic therapy in hospital-acquired pneumonia and ventilator-associated pneumonia infections.
Fulltext A comprehensive review of mycotoxins: Toxicology, detection, and effective mitigation approaches

Khan R, Anwar F, Ghazali FM

Heliyon, 2024 Apr 30;10(8):e28361.
PMID: 38628751 DOI: 10.1016/j.heliyon.2024.e28361

Mycotoxins, harmful compounds produced by fungal pathogens, pose a severe threat to food safety and consumer health. Some commonly produced mycotoxins such as aflatoxins, ochratoxin A, fumonisins, trichothecenes, zearalenone, and patulin have serious health implications in humans and animals. Mycotoxin contamination is particularly concerning in regions heavily reliant on staple foods like grains, cereals, and nuts. Preventing mycotoxin contamination is crucial for a sustainable food supply. Chromatographic methods like thin layer chromatography (TLC), gas chromatography (GC), high-performance liquid chromatography (HPLC), and liquid chromatography coupled with a mass spectrometer (LC/MS), are commonly used to detect mycotoxins; however, there is a need for on-site, rapid, and cost-effective detection methods. Currently, enzyme-linked immunosorbent assays (ELISA), lateral flow assays (LFAs), and biosensors are becoming popular analytical tools for rapid detection. Meanwhile, preventing mycotoxin contamination is crucial for food safety and a sustainable food supply. Physical, chemical, and biological approaches have been used to inhibit fungal growth and mycotoxin production. However, new strains resistant to conventional methods have led to the exploration of novel strategies like cold atmospheric plasma (CAP) technology, polyphenols and flavonoids, magnetic materials and nanoparticles, and natural essential oils (NEOs). This paper reviews recent scientific research on mycotoxin toxicity, explores advancements in detecting mycotoxins in various foods, and evaluates the effectiveness of innovative mitigation strategies for controlling and detoxifying mycotoxins.
Anti-gay "Honor" Abuse: A Multinational Attitudinal Study of Collectivist- Versus Individualist-Orientated Populations in Asia and England

Lowe M, Khan R, Thanzami V, Barzy M, Karmaliani R

J Interpers Violence, 2021 08;36(15-16):7866-7885.
PMID: 30924715 DOI: 10.1177/0886260519838493

Cultural collectivism, a core feature of honor cultures, is associated with the acceptance of aggression if it is used in the name of so-called "honor." Currently overlooked in the research literature, this study explored perceptions of antigay "honor" abuse in collectivist-orientated honor cultures, where homosexuality, in particular, is considered to be dishonorable. To conduct exploratory and comparative analysis, this study recruited 922 students in four Asian countries (India, Iran, Malaysia, and Pakistan), as well as Asian British and White British students in England. All participants read a brief vignette depicting a man whose relatives verbally abuse him and threaten him with life-threatening violence, after suspecting that he is gay and has joined an online dating website to meet men. Participants then completed a short questionnaire that assessed the extent to which they thought the man's actions had damaged his family's honor and their approval of the antigay "honor" abuse depicted in the scenario. Broadly in line with predictions, data analyses revealed attitudes more supportive of antigay "honor" abuse in all five collectivist-orientated populations than the sample of individualistic-orientated counterparts in England. Notably, however, a series of one-way analyses of variance (ANOVAs) demonstrated that these results varied depending on country of residence, gender, religious denomination, educational status, and age. The findings show that individual and demographic differences influence perceptions toward homophobic "honor" abuse in collectivist cultures. These differences are useful indices of the psychosocial factors that underpin hostile attitudes toward gay males in cultures where homosexuality is denounced.
Fulltext Aflatoxin Biosynthesis, Genetic Regulation, Toxicity, and Control Strategies: A Review

Khan R, Ghazali FM, Mahyudin NA, Samsudin NIP

J Fungi (Basel), 2021 Jul 27;7(8).
PMID: 34436145 DOI: 10.3390/jof7080606

Aflatoxins (AFs) are highly toxic and cancer-causing compounds, predominantly synthesized by the Aspergillus species. AFs biosynthesis is a lengthy process that requires as minimum as 30 genes grouped inside 75 kilobytes (kB) of gene clusters, which are regulated by specific transcription factors, including aflR, aflS, and some general transcription factors. This paper summarizes the status of research on characterizing structural and regulatory genes associated with AF production and their roles in aflatoxigenic fungi, particularly Aspergillus flavus and A. parasiticus, and enhances the current understanding of AFs that adversely affect humans and animals with a great emphasis on toxicity and preventive methods.
Fulltext Bacterial polysaccharides-A big source for prebiotics and therapeutics

Khan R, Shah MD, Shah L, Lee PC, Khan I

Front Nutr, 2022;9:1031935.
PMID: 36407542 DOI: 10.3389/fnut.2022.1031935

Bacterial polysaccharides are unique due to their higher purity, hydrophilic nature, and a finer three-dimensional fibrous structure. Primarily, these polymers provide protection, support, and energy to the microorganism, however, more recently several auxiliary properties of these biopolymers have been unmasked. Microbial polysaccharides have shown therapeutic abilities against various illnesses, augmented the healing abilities of the herbal and Western medicines, improved overall health of the host, and have exerted positive impact on the growth of gut dwelling beneficial bacteria. Specifically, the review is discussing the mechanism through which bacterial polysaccharides exert anti-inflammatory, antioxidant, anti-cancer, and anti-microbial properties. In addition, they are holding promising application in the 3D printing. The review is also discussing a perspective about the metagenome-based screening of polysaccharides, their integration with other cutting-edge tools, and synthetic microbiome base intervention of polysaccharides as a strategy for prebiotic intervention. This review has collected interesting information about the bacterial polysaccharides from Google Scholar, PubMed, Scopus, and Web of Science databases. Up to our knowledge, this is the first of its kind review article that is summarizing therapeutic, prebiotics, and commercial application of bacterial polysaccharides.
Community Safety Behavior in Response to Coronavirus Pandemic

Khan R, Fatima T, Ramayah T, Awan TM, Kayani ZK

Illn Crises Loss, 2023 Jan;31(1):73-99.
PMID: 36605779 DOI: 10.1177/10541373211033962

The purpose of this study is to explore the behavior and lifestyle of individuals in response to the coronavirus that the safety behavior of people in the coronavirus disease of 2019 pandemic. Hence, the study integrates the theory of planned behavior and the health belief model to understand the behavioral change in response to the coronavirus pandemic. The current study is qualitative therefore, a survey-based online questionnaire was used for data collection from university students and staff (faculty and nonfaculty) residing in top-tier cities of Pakistan, nonprobability convenient sampling was used to approach the audience. A two-stage approach was used to test the model using partial least square (variance-based structural equation modeling). The reliability and validity of the measurement model indicate that the data is reliable and valid. Outcomes prove all the relationships as proposed by the study, except for the impact of perceived barriers on intention and individual safety behavior. Perceived barriers act as obstacles that abstain individuals from following the standard operating procedures. The research agenda provides new insights into the fields of marketing, health care, consumer behavior, and behavioral studies. It contributes to the existing literature in the field of social marketing by studying the behavior and changes in the behavior of people in the global pandemic.
Current status of coronary risk factors among rural Malays in Malaysia

Nawawi HM, Nor IM, Noor IM, Karim NA, Arshad F, Khan R, et al.

J Cardiovasc Risk, 2002 Feb;9(1):17-23.
PMID: 11984213

Coronary heart disease (CHD) is the leading cause of death in Malaysia, despite its status as a developing country. The rural population is thought to be at low risk.
Fulltext Pseudo-Ductility, Morphology and Fractography Resulting from the Synergistic Effect of CaCO3 and Bentonite in HDPE Polymer Nano Composite

Ahmed T, Ya HH, Khan R, Hidayat Syah Lubis AM, Mahadzir S

Materials (Basel), 2020 Jul 27;13(15).
PMID: 32726965 DOI: 10.3390/ma13153333

Polymeric materials such as High density polyethylene(HDPE) are ductile in nature, having very low strength. In order to improve strength by non-treated rigid fillers, polymeric materials become extremely brittle. Therefore, this work focuses on achieving pseudo-ductility (high strength and ductility) by using a combination of rigid filler particles (CaCO3 and bentonite) instead of a single non-treated rigid filler particle. The results of all tensile-tested (D638 type i) samples signify that the microstructural features and surface properties of rigid nano fillers can render the required pseudo-ductility. The maximum value of tensile strength achieved is 120% of the virgin HDPE, and the value of elongation is retained by 100%. Furthermore, the morphological and fractographic analysis revealed that surfactants are not always going to obtain polymer-filler bonding, but the synergistic effect of filler particles can carry out sufficient bonding for stress transfer. Moreover, pseudo-ductility was achieved by a combination of rigid fillers (bentonite and CaCO3) when the content of bentonite dominated as compared to CaCO3. Thus, the achievement of pseudo-ductility by the synergistic effect of rigid particles is the significance of this study. Secondly, this combination of filler particles acted as an alternative for the application of surfactant and compatibilizer so that adverse effect on mechanical properties can be avoided.
Appropriateness of antimicrobial prescribing in the high-burden emergency department of a tertiary hospital in Malaysia

Koh HP, Ambaras Khan R, Tay SL, Gill MK, Wong JY, Zainuddin MK

Int J Clin Pharm, 2021 Oct;43(5):1337-1344.
PMID: 33677792 DOI: 10.1007/s11096-021-01255-w

Background Appropriate antimicrobial prescribing in the emergency department (ED) is a challenge due to diagnostic uncertainty, time pressure, and clinical inertia. Objective To assess the appropriateness of antimicrobial prescribing in the ED. Setting This study was conducted in the inpatient ED of a tertiary hospital in Malaysia. Method We conducted a 6-month retrospective antimicrobial prescriptions analysis among ED patients who received intravenous antimicrobial. Antimicrobial prescriptions of conveniently selected adult patients were evaluated with the medication appropriateness index. Main outcome measure Appropriateness of antimicrobial prescribing was the primary outcome measure. Results We analysed 310 patients with 326 antimicrobial prescriptions. Ceftriaxone (41.1%, n = 134) and amoxicillin-clavulanate (36.5%, n = 119) were the most common antimicrobials prescribed. Respiratory infections (71.5%, n = 233) was the main indication for antimicrobial therapy in the ED. All antimicrobials prescribed were indicated as per the Malaysian antimicrobial guidelines. The overall rate of inappropriate antimicrobial prescribing was 53.1% (n = 173). Thirty-two (9.8%) antimicrobials were prescribed with inappropriate doses; the majority was related to beta-lactam/beta-lactamase dose (p = 0.002). One hundred and forty-three (43.9%) antimicrobials prescribed had alternatives with similar efficacy but were less costly; which referring to ceftriaxone usage (p
Curve Fitting for Damage Evolution through Regression Analysis for the Kachanov-Rabotnov Model to the Norton-Bailey Creep Law of SS-316 Material

Sattar M, Othman AR, Akhtar M, Kamaruddin S, Khan R, Masood F, et al.

Materials (Basel), 2021 Sep 23;14(19).
PMID: 34639910 DOI: 10.3390/ma14195518

In a number of circumstances, the Kachanov-Rabotnov isotropic creep damage constitutive model has been utilized to assess the creep deformation of high-temperature components. Secondary creep behavior is usually studied using analytical methods, whereas tertiary creep damage constants are determined by the combination of experiments and numerical optimization. To obtain the tertiary creep damage constants, these methods necessitate extensive computational effort and time to determine the tertiary creep damage constants. In this study, a curve-fitting technique was proposed for applying the Kachanov-Rabotnov model into the built-in Norton-Bailey model in Abaqus. It extrapolates the creep behaviour by fitting the Kachanov-Rabotnov model to the limited creep data obtained from the Omega-Norton-Bailey regression model and then simulates beyond the available data points. Through the Omega creep model, several creep strain rates for SS-316 were calculated using API-579/ASME FFS-1 standards. These are dependent on the type of the material, the flow stress, and the temperature. In the present work, FEA creep assessment was carried out on the SS-316 dog bone specimen, which was used as a material coupon to forecast time-dependent permanent plastic deformation as well as creep behavior at elevated temperatures and under uniform stress. The model was validated with the help of published experimental creep test data, and data optimization for sensitivity study was conducted by applying response surface methodology (RSM) and ANOVA techniques. The results showed that the specimen underwent secondary creep deformation for most of the analysis period. Hence, the method is useful in predicting the complete creep behavior of the material and in generating a creep curve.
Fulltext Deep Learning in Cancer Diagnosis and Prognosis Prediction: A Minireview on Challenges, Recent Trends, and Future Directions

Tufail AB, Ma YK, Kaabar MKA, Martínez F, Junejo AR, Ullah I, et al.

Comput Math Methods Med, 2021;2021:9025470.
PMID: 34754327 DOI: 10.1155/2021/9025470

Deep learning (DL) is a branch of machine learning and artificial intelligence that has been applied to many areas in different domains such as health care and drug design. Cancer prognosis estimates the ultimate fate of a cancer subject and provides survival estimation of the subjects. An accurate and timely diagnostic and prognostic decision will greatly benefit cancer subjects. DL has emerged as a technology of choice due to the availability of high computational resources. The main components in a standard computer-aided design (CAD) system are preprocessing, feature recognition, extraction and selection, categorization, and performance assessment. Reduction of costs associated with sequencing systems offers a myriad of opportunities for building precise models for cancer diagnosis and prognosis prediction. In this survey, we provided a summary of current works where DL has helped to determine the best models for the cancer diagnosis and prognosis prediction tasks. DL is a generic model requiring minimal data manipulations and achieves better results while working with enormous volumes of data. Aims are to scrutinize the influence of DL systems using histopathology images, present a summary of state-of-the-art DL methods, and give directions to future researchers to refine the existing methods.
Fulltext LCSS-Based Algorithm for Computing Multivariate Data Set Similarity: A Case Study of Real-Time WSN Data

Khan R, Ali I, Altowaijri SM, Zakarya M, Ur Rahman A, Ahmedy I, et al.

Sensors (Basel), 2019 Jan 04;19(1).
PMID: 30621241 DOI: 10.3390/s19010166

Multivariate data sets are common in various application areas, such as wireless sensor networks (WSNs) and DNA analysis. A robust mechanism is required to compute their similarity indexes regardless of the environment and problem domain. This study describes the usefulness of a non-metric-based approach (i.e., longest common subsequence) in computing similarity indexes. Several non-metric-based algorithms are available in the literature, the most robust and reliable one is the dynamic programming-based technique. However, dynamic programming-based techniques are considered inefficient, particularly in the context of multivariate data sets. Furthermore, the classical approaches are not powerful enough in scenarios with multivariate data sets, sensor data or when the similarity indexes are extremely high or low. To address this issue, we propose an efficient algorithm to measure the similarity indexes of multivariate data sets using a non-metric-based methodology. The proposed algorithm performs exceptionally well on numerous multivariate data sets compared with the classical dynamic programming-based algorithms. The performance of the algorithms is evaluated on the basis of several benchmark data sets and a dynamic multivariate data set, which is obtained from a WSN deployed in the Ghulam Ishaq Khan (GIK) Institute of Engineering Sciences and Technology. Our evaluation suggests that the proposed algorithm can be approximately 39.9% more efficient than its counterparts for various data sets in terms of computational time.
Fulltext A Neighborhood and Machine Learning-Enabled Information Fusion Approach for the WSNs and Internet of Medical Things

Khan ZA, Naz S, Khan R, Teo J, Ghani A, Almaiah MA

Comput Intell Neurosci, 2022;2022:5112375.
PMID: 35449734 DOI: 10.1155/2022/5112375

Data redundancy or fusion is one of the common issues associated with the resource-constrained networks such as Wireless Sensor Networks (WSNs) and Internet of Things (IoTs). To resolve this issue, numerous data aggregation or fusion schemes have been presented in the literature. Generally, it is used to decrease the size of the collected data and, thus, improve the performance of the underlined IoTs in terms of congestion control, data accuracy, and lifetime. However, these approaches do not consider neighborhood information of the devices (cluster head in this case) in the data refinement phase. In this paper, a smart and intelligent neighborhood-enabled data aggregation scheme is presented where every device (cluster head) is bounded to refine the collected data before sending it to the concerned server module. For this purpose, the proposed data aggregation scheme is divided into two phases: (i) identification of neighboring nodes, which is based on the MAC address and location, and (ii) data aggregation using k-mean clustering algorithm and Support Vector Machine (SVM). Furthermore, every CH is smart enough to compare data sets of neighboring nodes only; that is, data of nonneighbor is not compared at all. These algorithms were implemented in Network Simulator 2 (NS-2) and were evaluated in terms of various performance metrics, such as the ratio of data redundancy, lifetime, and energy efficiency. Simulation results have verified that the proposed scheme performance is better than the existing approaches.
Fabrication of amine-functionalized and multi-layered PAN-(TiO2)-gelatin nanofibrous wound dressing: In-vitro evaluation

Khan R, Haider S, Khan MUA, Haider A, Razak SIA, Hasan A, et al.

Int J Biol Macromol, 2023 Dec 31;253(Pt 5):127169.
PMID: 37783243 DOI: 10.1016/j.ijbiomac.2023.127169

The development of advanced multifunctional wound dressings remains a major challenge. Herein, a novel multilayer (ML) electrospun nanofibers (NFs) wound dressing based on diethylenetriamine (DETA) functionalized polyacrylonitrile (PAN), TiO2 nanoparticles (NPs) coating (Ct), and bioderived gelatin (Gel) was developed for potential applications in wound healing. The ML PAN-DETA-Ct-Gel membrane was developed by combining electrospinning, chemical functionalization, synthesis, and electrospray techniques, using a layer-by-layer method. The ML PAN-DETA-Ct-Gel membrane is comprised of an outer layer of PAN-DETA as a barrier to external microorganisms and structural support, an interlayer TiO2 NPs (Ct) as antibacterial function, and a contact layer (Gel) to improve biocompatibility and cell viability. The NFs membranes were characterized by scanning electron microscopy (SEM), surface profilometry, BET analysis, and water contact angle techniques to investigate their morphology, surface roughness, porosity, and wettability. The ML PAN-DETA-Ct-Gel wound dressing exhibited good surface roughness, porosity, and better wettability. Cell morphology, proliferation, and viability were determined using fibroblasts (3T3), and antibacterial assays were performed against six pathogens. The ML PAN-DETA-Ct-Gel NFs membrane showed good cell morphology, proliferation, viability, and antibacterial activity compared with other membranes. This new class of ML NFs membranes offers a multifunctional architecture with adequate biocompatibility, cell viability, and antibacterial activity.
Fulltext Fabrication of Bilayer Nanofibrous-Hydrogel Scaffold from Bacterial Cellulose, PVA, and Gelatin as Advanced Dressing for Wound Healing and Soft Tissue Engineering

Khan R, Aslam Khan MU, Stojanović GM, Javed A, Haider S, Abd Razak SI

ACS Omega, 2024 Feb 13;9(6):6527-6536.
PMID: 38371763 DOI: 10.1021/acsomega.3c06613

Tissue engineering is currently one of the fastest-growing areas of engineering, requiring the fabrication of advanced and multifunctional materials that can be used as scaffolds or dressings for tissue regeneration. In this work, we report a bilayer material prepared by electrospinning a hybrid material of poly(vinyl alcohol) (PVA) and bacterial cellulose (BC NFs) (top layer) over a highly interconnected porous 3D gelatin-PVA hydrogel obtained by a freeze-drying process (bottom layer). The techniques were combined to produce an advanced material with synergistic effects on the physical and biological properties of the two materials. The bilayer material was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and a water contact measurement system (WCMS). Studies on swelling, degradability, porosity, drug release, cellular and antibacterial activities were performed using standardized procedures and assays. FTIR confirmed cross-linking of both the top and bottom layers, and SEM showed porous structure for the bottom layer, random deposition of NFs on the surface, and aligned NFs in the cross section. The water contact angle (WCA) showed a hydrophilic surface for the bilayer material. Swelling analysis showed high swelling, and degradation analysis showed good stability. The bilayer material released Ag-sulfadiazine in a sustained and controlled manner and showed good antibacterial activities against severe disease-causing gram + ive and -ive (Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa) bacterial strains. In vitro biological studies were performed on fibroblasts (3T3) and human embryonic kidneys (HEK-293), which showed desirable cell viability, proliferation, and adhesion to the bilayer. Thus, the synergistic effect of NFs and the hydrogel resulted in a potential wound dressing material for wound healing and soft tissue engineering.
Fulltext An Industrial IoT-Based Blockchain-Enabled Secure Searchable Encryption Approach for Healthcare Systems Using Neural Network

Ali A, Almaiah MA, Hajjej F, Pasha MF, Fang OH, Khan R, et al.

Sensors (Basel), 2022 Jan 12;22(2).
PMID: 35062530 DOI: 10.3390/s22020572

The IoT refers to the interconnection of things to the physical network that is embedded with software, sensors, and other devices to exchange information from one device to the other. The interconnection of devices means there is the possibility of challenges such as security, trustworthiness, reliability, confidentiality, and so on. To address these issues, we have proposed a novel group theory (GT)-based binary spring search (BSS) algorithm which consists of a hybrid deep neural network approach. The proposed approach effectively detects the intrusion within the IoT network. Initially, the privacy-preserving technology was implemented using a blockchain-based methodology. Security of patient health records (PHR) is the most critical aspect of cryptography over the Internet due to its value and importance, preferably in the Internet of Medical Things (IoMT). Search keywords access mechanism is one of the typical approaches used to access PHR from a database, but it is susceptible to various security vulnerabilities. Although blockchain-enabled healthcare systems provide security, it may lead to some loopholes in the existing state of the art. In literature, blockchain-enabled frameworks have been presented to resolve those issues. However, these methods have primarily focused on data storage and blockchain is used as a database. In this paper, blockchain as a distributed database is proposed with a homomorphic encryption technique to ensure a secure search and keywords-based access to the database. Additionally, the proposed approach provides a secure key revocation mechanism and updates various policies accordingly. As a result, a secure patient healthcare data access scheme is devised, which integrates blockchain and trust chain to fulfill the efficiency and security issues in the current schemes for sharing both types of digital healthcare data. Hence, our proposed approach provides more security, efficiency, and transparency with cost-effectiveness. We performed our simulations based on the blockchain-based tool Hyperledger Fabric and OrigionLab for analysis and evaluation. We compared our proposed results with the benchmark models, respectively. Our comparative analysis justifies that our proposed framework provides better security and searchable mechanism for the healthcare system.

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