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  1. Yap AU, Ong JE, Yahya NA
    J Mech Behav Biomed Mater, 2021 01;113:104120.
    PMID: 33086137 DOI: 10.1016/j.jmbbm.2020.104120
    OBJECTIVES: This study determined the effects of self-adhesive resin coatings on viscoelastic properties of highly viscous glass ionomer cements (HVGICs) using dynamic mechanical analysis.

    MATERIALS AND METHODS: The HVGICs evaluated were Zirconomer [ZR] (Shofu), Equia Forte [EQ] (GC) and Riva [RV] (SDI). Sixty specimens (12mm x 2mm x 2mm) of each material were fabricated using customized Teflon molds. After initial set, the specimens were removed from their molds, finished, measured and randomly divided into 3 groups of 20. Half the specimens in each group were left uncoated while the remaining half was covered with the respective manufacturers' resin coating. The specimens were subsequently conditioned in distilled water, artificial saliva or citric acid at 37°C for 7 days. The uncoated and coated specimens (n=10) were then subjected to dynamic mechanical testing in flexure mode at 37°C with a frequency of 0.1 to 10Hz. Storage modulus, loss modulus and loss tangent data were subjected to normality testing and statistical analysis using one-way ANOVA/Scheffe's post-hoc test and Ttest at significance level p<0.05.

    RESULTS: Mean storage modulus ranged from 1.39 ± 0.36 to 10.80 ± 0.86 GPa while mean loss modulus varied from 0.13 ± 0.03 to 0.70 ± 0.14 GPa after conditioning in the different mediums. Values for loss tangent ranged from 39.4 ± 7.75 to 213.2 ± 20.11 (x10 -3 ). Significant differences in visco-elastic properties were observed between mediums and materials. When conditioned in distilled water and artificial saliva,storage modulus was significantly improved when ZR, EQ and RV were uncoated. Significantly higher values were, however, observed with resin coating when the materials were exposed to citric acid.

    CONCLUSION: The visco-elastic properties of HVGICs were influenced by both resin coating and chemical environment.

  2. Ibrahim H, Aziz AA, Yahya NA, Yap AU
    Oper Dent, 2024 Mar 01;49(2):178-188.
    PMID: 38196082 DOI: 10.2341/23-038-L
    This study examined the influence of cariogenic environments on the surface roughness of ion-releasing restorative materials (IRMs). Custom-made stainless steel molds with holes of 5 mm × 2mm were used to fabricate 60 disc-shaped specimens of each of the following materials: Activa Bioactive (AV), Beautifil Bulk Restorative (BB), Cention N (Bulk-fill) (CN), and Filtek Z350XT (FZ) (Control). Baseline surface roughness (Ra) measurements were obtained using an optical 3D measurement machine (Alicona Imaging GmbH, Graz, Austria). The specimens were then randomly divided into five subgroups (n=12) and exposed to 10 ml of the following mediums at 37°C: distilled water (DW), demineralization solution (DM), remineralization solution (RM), pH cycling (PC) and air (AR) (control). Ra measurements were again recorded after one week and one month, followed by statistical evaluations with two-way analysis of variance (ANOVA) to determine interactions between materials and mediums. One-way ANOVA and post hoc Games Howell tests were performed for intergroup comparisons at a significance level of 0.05. Mean Ra values ranged from 0.085 ± 0.004 (µm) to 0.198 ± 0.001 µm for the various material-medium combinations. All IRMs showed significant differences in Ra values after exposure to the aqueous mediums. The smoothest surfaces were observed in the AR for all materials. When comparing materials, AV presented the roughest surfaces for all mediums. All IRM materials showed increased surface roughness over time in all cariogenic environments but were below the threshold value for bacterial adhesion, except for AV 1-month post immersion with pH cycling. Therefore, besides AV, the surface roughness of IRMs did not deteriorate to an extent that it is clinically relevant.
  3. Ong J, Yap AU, Abdul Aziz A, Yahya NA
    Oper Dent, 2023 Jan 01;48(1):90-97.
    PMID: 36445974 DOI: 10.2341/21-202-L
    This study investigated the effects of environmental pH on the flexural properties of ion-releasing restorative materials (IRMs), including giomer (Beautifil-Bulk Restorative - BB), alkasite (Cention N - CN), bioactive composite (Activa - AB) and resin-modified glass ionomer (Riva Light Cure -RV) restoratives. A bio-inert resin-based composite (Filtek Bulk-fill Posterior - FB) served as the control. Stainless steel molds were used to fabricate 40 beam-shaped specimens (12mm × 2mm × 2mm) for each material. The specimens were finished, measured, and randomly distributed into four groups (n=10) and immersed in aqueous solutions of pH 3.0, pH 5.0, pH 6.8, and pH 10.0 at 37°C for 28 days. Specimens were then subjected to a uniaxial three-point bending flexural test with a load cell of 5 KN and a fixed deformation rate of 0.5 mm/min until fracture occurred. Flexural modulus and strength were statistically analyzed using analysis of variance/Dunnet T3's test (p=0.05). Mean flexural modulus varied from (2.40±0.41 to 9.65±1.21 GPa), while mean flexural strength ranged from (21.56±2.78 to 163.86±13.13 MPa). Significant differences in flexural properties were observed among the various pH values and materials. All materials immersed in artificial saliva (pH 6.8) presented the highest flexural properties, except AB. The flexural strength of AB was significantly better when exposed to acidic environments. FB had better flexural properties than IRMs after exposure to a range of environmental pH values.
  4. Ramli N, Yap A, Muridan R, Seow P, Rahmat K, Fong CY, et al.
    Clin Radiol, 2020 01;75(1):77.e15-77.e22.
    PMID: 31668796 DOI: 10.1016/j.crad.2019.09.134
    AIM: To evaluate the microstructural abnormalities of the white matter tracts (WMT) using diffusion tensor imaging (DTI) in children with global developmental delay (GDD).

    MATERIALS AND METHODS: Sixteen children with GDD underwent magnetic resonance imaging (MRI) and cross-sectional DTI. Formal developmental assessment of all GDD patients was performed using the Mullen Scales of Early Learning. An automated processing pipeline for the WMT assessment was implemented. The DTI-derived metrics of the children with GDD were compared to healthy children with normal development (ND).

    RESULTS: Only two out of the 17 WMT demonstrated significant differences (p<0.05) in DTI parameters between the GDD and ND group. In the uncinate fasciculus (UF), the GDD group had lower mean values for fractional anisotropy (FA; 0.40 versus 0.44), higher values for mean diffusivity (0.96 versus 0.91×10-3 mm2/s) and radial diffusivity (0.75 versus 0.68×10-3 mm2/s) compared to the ND group. In the superior cerebellar peduncle (SCP), mean FA values were lower for the GDD group (0.38 versus 0.40). Normal myelination pattern of DTI parameters was deviated against age for GDD group for UF and SCP.

    CONCLUSION: The UF and SCP WMT showed microstructural changes suggestive of compromised white matter maturation in children with GDD. The DTI metrics have potential as imaging markers for inadequate white matter maturation in GDD children.

  5. Gan YN, Zaki R, Hafidzar SA, Koh KC, Ahmad Nizaruddin M, Mohd Noh R, et al.
    PLoS One, 2025;20(8):e0328713.
    PMID: 40824910 DOI: 10.1371/journal.pone.0328713
    INTRODUCTION: Expanding HIV pre-exposure prophylaxis (PrEP) through pharmacies may improve access for key populations. As part of the preparation phase of the EPIS (Exploration-Preparation-Implementation-Sustainment) framework, we developed and evaluated an online, self-paced PrEP training program for community pharmacists to prepare for a pilot, pharmacy-led PrEP service in Malaysia.

    MATERIALS AND METHODS: In May 2023, a PrEP training committee developed an online training program covering PrEP efficacy, safety, eligibility, baseline assessments, laboratory testing, prescribing, and special circumstances, and pre-/post-training knowledge tests. In June 2023, 18 community pharmacists asynchronously completed the training. Effectiveness was evaluated using a 20-question pre-/post-training knowledge test, with responses calculated into percentage scores, alongside participant feedback. Paired t-tests assessed knowledge score differences (p 

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