Socioeconomic characteristics and postoperative outcomes of patients undergoing prenatal vs. postnatal repair of myelomeningoceles.

PURPOSE: To investigate differences in sociodemographic characteristics and short-term outcomes between patients undergoing prenatal versus postnatal myelomeningocele repair. METHODS: Patients who underwent myelomeningocele repair at our institution were stratified based on prenatal or postnatal timing of repair. Baseline characteristics and outcomes were compared. Multivariate analysis was performed to identify whether prenatal repair was a predictor of outcomes independent of socioeconomic measures. RESULTS: 49 patients underwent postnatal repair, and 30 underwent prenatal repair. Patients who underwent prenatal repair were more likely to have private insurance (73.3% vs. 42.9%, p = 0.03) and live farther from the hospital where they received their repair (251.5 ± 447.4 vs. 72.5 ± 205.6 miles, p = 0.02). Patients who underwent prenatal repair had shorter hospital stays (14.3 ± 22.7 days vs. 25.3 ± 20.1 days, p = 0.03), fewer complications (13.8% vs. 42.9%, p = 0.01), fewer 30-day ED visits (0.0% vs. 34.0%, p < 0.001), lower CSF diversion rates (13.8% vs. 38.8%, p = 0.02), and better functional status at 3-months (13.3% vs. 57.1% delayed, p = 0.009), 6-months (20.0% vs. 56.7% delayed, p = 0.03), and 1-year (29.4% vs. 70.6% delayed, p = 0.007). On multivariate analysis, prenatal repair was an independent predictor of inpatient complication (OR(95%CI): 0.19(0.05-0.75), p = 0.02) and 3-month (OR(95%CI): 0.14(0.03-0.80) p = 0.03), 6-month (OR(95%CI): 0.12(0.02-0.73), p = 0.02), and 1-year (OR(95%CI): 0.19(0.05-0.80), p = 0.02) functional status. CONCLUSION: Prenatal repair for myelomeningocele is associated with better outcomes and developmental functional status. However, patients receiving prenatal closure are more likely to have private health insurance and live farther from the hospital, suggesting potential barriers to care.

Evaluating empathy level amongst the dental students using jefferson scale of physician empathy- health professional students.

BACKGROUND: Empathy is described as one's ability to perceive and apprehend another person's feelings, situation, emotions, and problems as their own. Empathetic behavior increases patients' satisfaction, reduces discomfort, and helps with patient's satisfaction. OBJECTIVE: To evaluate the psychometric properties of the Jefferson Empathy Scale and compare the measure of invariance within genders and amongst the public and private sector dental students. METHOD: This cross-sectional study utilized JSE-HPS version for research purpose. An exploratory factor analysis was performed to detect underlying factors. Reliability of the study tool was evaluated using Cronbach alpha test. Mann Whitney U test was used to compare the differences in scores between genders and among public and private university students while Student's t analysis compared the scores according to different domains. The level of significance was ≤ 0.05. RESULTS: Females demonstrated higher empathy levels (88.52 ± 14.19) along with private institute students (88.46 ± 13.98). Perspective taking and compassionate care domain was also scored highest by the females (31.73 ± 6.49 & 29.31 ± 6.22) and among second year students (33.30 ± 7.11 & 30.50 ± 7.16). PCA analysis extracted 4 factors namely (i) Health-care-provider's sense of humor contributed to improved outcome (ii) Health-care provider's understanding of patients' feelings and of their families influences treatment outcomes (iii) Understanding body language is as important as verbal communication and (iv) Patients feel better when their feelings are understood, which accounted for the 59.51% of the total variance. CONCLUSION: The findings revealed that students from private institute and females demonstrated higher empathy score. Moreover, the Jefferson Scale of Empathy (JSE) was found to be a reliable and validated tool for assessment of empathy in our sample population.

Endoscopic sphincterotomy with balloon dilatation versus sphincterotomy alone for common bile duct stones removal: a randomised controlled trial.

INTRODUCTION: Endoscopic sphincterotomy (EST) plus endoscopic papillary large balloon dilatation (EPLBD) has been reported as a valid alternative to EST alone in removing common bile duct (CBD) stone. The aim of this study is to compare efficacy, and safety of these two groups of patients in removing CBD stone in Hospital Universiti Sains Malaysia (HUSM). MATERIALS AND METHODS: This is a prospective single centre randomised single blinded comparative study conducted in HUSM. The primary endpoints for this study are the overall complete stone clearance rate and complication rate, while the secondary outcome for this study are duration of procedure and rate of usage of adjunct methods. Objective data analysis is conducted using independent sample t-test and chi-squared test. RESULTS: A total of 66 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis which is CBD stone. 34 patients were allocated to EST plus EPLBD arm (n=34), and 32 patients were in EST alone arm (n=32) using randomisation method. For intention to treat, patients from EST alone arm that unable to achieve complete stone clearance will be switched to EST plus EPLBD arm. The overall complete stone removal rate for both groups were comparable (EST plus EPLDB: 100% versus EST alone: 93.8%; p= 0.139). The two patients from EST alone group (6.2%) that unable to achieve complete stone clearance were converted to EST plus EPLBD group for intention to treat and able to achieve complete stone clearance by EST plus EPLBD. For procedural time, both arms are comparable as well (EST plus EPLDB: 15.8 minutes vs EST alone: 15.5 minutes; p= 0.860). Complications such as pancreatitis occurred in one patient in EST plus EPLBD arm (EST plus EPLDB: 2.9 % vs EST alone: 0 %; p= 0.328), and bleeding occurred in one patient in EST alone arm (EST plus EPLDB: 0 % vs EST alone: 3.1 %; p= 0.299) , but it is not statistically significant. No perforation or cholangitis complication occurred in both groups. No adjunct usage was observed in both groups. CONCLUSION: In this study with limited sample size, both EST plus EPLBD and EST alone are effective and has comparable procedural time in removing CBD stone. Even though both methods are equally effective, EPLBD plus EST is an alternative solution if complete stone clearance is unable to achieve via EST alone.

Liver-related mortality among people with hepatitis B and C: Evaluation of definitions based on linked healthcare administrative datasets.

Routinely collected and linked healthcare administrative datasets could be used to monitor mortality among people with hepatitis B (HBV) and C (HCV). This study aimed to evaluate the concordance in records of liver-related mortality among people with an HBV or HCV notification, between data on hospitalization for end-stage liver disease (ESLD) and death certificates. In New South Wales, Australia, HBV and HCV notifications (1993-2017) were linked to hospital admissions (2001-2018), all-cause mortality (1993-2018) and cause-specific mortality (1993-2016) datasets. Hospitalization for ESLD was defined as a first-time hospital admission due to decompensated cirrhosis (DC) or hepatocellular carcinoma (HCC). Consistency of liver death definition of mortality following hospitalization for ESLD was compared with two death certificate-based definitions of liver deaths coded among primary and secondary cause-specific mortality data, including ESLD-related (deaths due to DC and HCC) and all-liver deaths (ESLD-related and other liver-related causes). Of 63,292 and 107,430 individuals with an HBV and HCV notification, there were 4478 (2.6%) post-ESLD hospitalization deaths, 5572 (3.3%) death certificate liver disease deaths and 2910 (1.7%) death certificate ESLD deaths. Between 2001 and 2016, among HBV post-ESLD hospitalization deaths (n = 891), 63% (562) had death certificate ESLD recorded, and 83% (741) had death certificate liver disease recorded. Between 2001 and 2016, among HCV post-ESLD hospitalization deaths (n = 3587), 58% (2082) had death certificate ESLD recorded, and 87% (3135) had death certificate liver disease recorded. At least one-third of death certificates with DC and HCC as cause of death had no mention of HBV, HCV or viral hepatitis. Our study identified limitations in estimating and tracking HBV and HCV liver disease mortality using death certificate-based data only. The optimum data for this purpose is either ESLD hospitalisations with vital status information or a combination of these with cause-specific death certificate data.

Cascade of care among people with hepatitis B in New South Wales, Australia.

Hepatitis B virus (HBV) care cascade characterisation is important for monitoring HBV elimination progress. This study evaluated care cascade and factors associated with HBV DNA testing and treatment in New South Wales, Australia. HBV care cascade were determined through linkage of HBV notifications (1993-2017) to Medicare and pharmaceutical benefits schemes (2010-2018). Timely HBV DNA testing was within 4 weeks of HBV notification. Multivariate Cox proportional hazards regression evaluated factors associated with HBV DNA testing and treatment. Among 15,202 people with HBV notification, 10,479 (69%) were tested for HBV DNA. A total of 3179 (21%) initiated HBV treatment. HBV DNA testing was more likely among age ≥45 years (adjusted hazard ratio [aHR] 1.07, 95% CI: 1.02, 1.12), hepatocellular carcinoma (HCC) (aHR 1.23, 95% CI: 1.01, 1.50), coinfection (aHR 1.61, 95% CI: 1.23, 2.09), later notification (2014-2017) (aHR 1.21, 95% CI: 1.16, 1.26) and less likely among females (aHR 0.95, 95% CI: 0.91, 0.99), history of alcohol use disorder (AUD) (aHR 0.77, 95% CI: 0.66, 0.89), HCV coinfection (aHR .62, 95% CI: 0.55, 0.70) and Indigenous peoples (aHR 0.84, 95% CI: 0.71, 0.98). HBV treatment was associated with age ≥45 years (aHR 1.35, 95% CI: 1.24, 1.48), decompensated cirrhosis (aHR 2.07, 95% CI: 1.62, 2.65), HCC (aHR 2.96, 95% CI: 2.35, 3.74), HIV coinfection (aHR 4.27, 95% CI: 3.43, 5.31) and later notification (2014-2017) (aHR 1.37, 95% CI: 1.26, 1.47). HBV treatment was less likely among females (aHR 0.68, 95% CI: 0.63, 0.73) and Indigenous peoples (aHR 0.58, 95% CI: 0.42, 0.80). HBV DNA testing and treatment coverage have increased, but remain sub-optimal among some key populations.

Efficacy of anti-CD3 monoclonal antibodies in delaying the progression of recent-onset type 1 diabetes mellitus: A systematic review, meta-analyses and meta-regression.

AIM: Type 1 diabetes mellitus is widely recognized as a chronic autoimmune disease characterized by the pathogenic destruction of beta cells, resulting in the loss of endogenous insulin production. Insulin administration remains the primary therapy for symptomatic treatment. Recent studies showed that disease-modifying agents, such as anti-CD3 monoclonal antibodies, have shown promising outcomes in improving the management of the disease. In late 2022, teplizumab received approval from the US Food and Drug Administration (FDA) as the first disease-modifying agent for the treatment of type 1 diabetes. This review aims to evaluate the clinical evidence regarding the efficacy of anti-CD3 monoclonal antibodies in the prevention and treatment of type 1 diabetes. METHODS: A comprehensive search of PubMed, Google Scholar, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) was conducted up to December 2022 to identify relevant randomized controlled trials. Meta-analysis was performed using a random-effects model, and odds ratios with 95% confidence intervals (CIs) were calculated to quantify the effects. The Cochrane risk of bias tool was employed for quality assessment. RESULTS: In total, 11 randomized controlled trials involving 1397 participants (908 participants in the intervention arm, 489 participants in the control arm) were included in this review. The mean age of participants was 15 years, and the mean follow-up time was 2.04 years. Teplizumab was the most commonly studied intervention. Compared with placebo, anti-CD3 monoclonal antibody treatment significantly increased the C-peptide concentration in the area under the curve at shorter timeframes (mean difference = 0.114, 95% CI: 0.069 to 0.159, p = .000). Furthermore, anti-CD3 monoclonal antibodies significantly reduced the patients' insulin intake across all timeframes (mean difference = -0.123, 95% CI: -0.151 to -0.094, p < .001). However, no significant effect on glycated haemoglobin concentration was observed. CONCLUSION: The findings of this review suggest that anti-CD3 monoclonal antibody treatment increases endogenous insulin production and improves the lifestyle of patients by reducing insulin dosage. Future studies should consider the limitations, including sample size, heterogeneity and duration of follow-up, to validate the generalizability of these findings further.

Comparative efficacy and safety of lemborexant 5 mg versus 10 mg for the treatment of insomnia: a systematic review.

INTRODUCTION: Insomnia is a common condition that may be caused by or coexist with other medical or psychological illnesses. Nearly a quarter of a billion people across the globe suffer from insomnia frequently. Lemborexant, a dual orexin receptor antagonist, is a recently authorized hypnotic-based medication for insomnia. The purpose of this systematic review is to further investigate its efficacy and safety profile, with the primary goal of comparing the effects of two FDA-approved doses of lemborexant, 5 mg and 10 mg (LEM5 and LEM10, respectively). MATERIALS AND METHODS: PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Central were searched for relevant literature, and studies were considered if they compared the efficacy and safety of lemborexant 5 mg to lemborexant 10 mg. This study comprised clinical trials. RESULTS: A total of 6 studies were evaluated for efficacy and safety of lemborexant therapy. They reported a significant betterment in values pertaining to sleep efficacy, sleep onset latency, wake after sleep onset, total sleep time, sleep quality, ISI score, and morning alertness. The results presented a dose-dependent pattern and showed slight variation with the different dosages. The most prevalent side effects noted were somnolence, headaches, and dizziness, with infections like UTIs and upper respiratory tract infections also being commonly reported. The incidence is rather ambiguous and not sincerely dose-dependent. The differences between results for LEM5 and LEM10 do not exhibit a wide variation, although slight dose-dependent alterations are noted. CONCLUSION: Lemborexant is well integrated with the amelioration of sleep disturbances in insomniac patients, as shown by a decrease in eSOL and sWASO and a rise in sSE, sTST, quality of sleep, and morning alertness. Effects last 12 months after therapy.

Cranial pilomatricoma: a diagnosis to consider.

Pilomatricomas are benign tumors of the hair follicle that occur frequently in the scalp region. They occur most often in children. We describe a case of pilomatricoma in a teenager, referred to neurosurgery for excision. This diagnosis should be considered in the workup of scalp lesions, and this case report should serve to draw attention to this entity.

Biomechanical Comparison of 3 Medial Patellofemoral Complex Reconstruction Techniques Shows Medial Overconstraint but No Significant Difference in Patella Lateralization and Contact Pressure.

PURPOSE: The purpose of this study was to investigate biomechanical differences of medial patellofemoral ligament (MPFL) reconstruction, medial quadriceps tendon femoral ligament (MQTFL) reconstruction, and a combination of these techniques to restore lateral patellar constraint and contact pressures. METHODS: Eight fresh frozen cadaver knees were mounted to a custom jig with physiological quadriceps tendon loading. Flexion angles and contact pressure (CP) were dynamically measured using Tekscan® pressure sensors and Polhemus® Liberty 6 degree of freedom (6DOF) positioning sensors in the following conditions: 1) intact 2) MPFL and MQTFL deficient, 3) MPFL reconstructed, 4) Combined MPFL + MQTFL reconstructed, and 5) MQTFL reconstructed. Lateral patellar translation was tested using horizontally directed 30 N force applied at 30° of knee flexion. The knees were flexed in dynamic fashion, and CP values were recorded for 10°, 20°, 30°, 50°, 70°, and 90° degrees of flexion. Group differences were assessed with ANOVA's followed by pairwise comparisons with Bonferroni correction. RESULTS: MPFL (P = .002) and combined MPFL/MQTFL (P = .034) reconstruction significantly reduced patellar lateralization from +19.28% (9.78%, 28.78%) in the deficient condition to -17.57% (-27.84%, -7.29%) and -15.56% (-33.61%, 2.30%), respectively. MPFL reconstruction was most restrictive and MQTFL reconstruction the least -7.29% (-22.01%, 7.45%). No significant differences were found between the three reconstruction techniques. Differences in CP between the three reconstruction techniques were not significant (<.02 MPa) at all flexion angles. CONCLUSION: The present study found no significant difference for patellar lateralization and patellofemoral CP between MPFL, combined MPFL/MQTFL, and MQTFL reconstruction. All 3 techniques resulted in stronger lateral patellar constraint compared to the native state, while the MQTFL reconstruction emulated the intact state the closest. CLINICAL RELEVANCE: Various surgical techniques for medial patellofemoral complex reconstruction can restore patellar stability with similar patellofemoral articular pressures.

A Novel Markov Model-Based Traffic Density Estimation Technique for Intelligent Transportation System.

An intelligent transportation system (ITS) aims to improve traffic efficiency by integrating innovative sensing, control, and communications technologies. The industrial Internet of things (IIoT) and Industrial Revolution 4.0 recently merged to design the industrial Internet of things-intelligent transportation system (IIoT-ITS). IIoT sensing technologies play a significant role in acquiring raw data. The application continuously performs the complex task of managing traffic flows effectively based on several parameters, including the number of vehicles in the system, their location, and time. Traffic density estimation (TDE) is another important derived parameter desirable to keep track of the dynamic state of traffic volume. The expanding number of vehicles based on wireless connectivity provides new potential to predict traffic density more accurately and in real time as previously used methodologies. We explore the topic of assessing traffic density by using only a few simple metrics, such as the number of surrounding vehicles and disseminating beacons to roadside units and vice versa. This research paper investigates TDE techniques and presents a novel Markov model-based TDE technique for ITS. Finally, an OMNET++-based approach with an implementation of a significant modification of a traffic model combined with mathematical modeling of the Markov model is presented. It is intended for the study of real-world traffic traces, the identification of model parameters, and the development of simulated traffic.

Machine Learning-Based Anomaly Detection in NFV: A Comprehensive Survey.

Network function virtualization (NFV) is a rapidly growing technology that enables the virtualization of traditional network hardware components, offering benefits such as cost reduction, increased flexibility, and efficient resource utilization. Moreover, NFV plays a crucial role in sensor and IoT networks by ensuring optimal resource usage and effective network management. However, adopting NFV in these networks also brings security challenges that must promptly and effectively address. This survey paper focuses on exploring the security challenges associated with NFV. It proposes the utilization of anomaly detection techniques as a means to mitigate the potential risks of cyber attacks. The research evaluates the strengths and weaknesses of various machine learning-based algorithms for detecting network-based anomalies in NFV networks. By providing insights into the most efficient algorithm for timely and effective anomaly detection in NFV networks, this study aims to assist network administrators and security professionals in enhancing the security of NFV deployments, thus safeguarding the integrity and performance of sensors and IoT systems.

Emerging Methods in Biosensing of Immunoglobin G-A Review.

Human antibodies are produced due to the activation of immune system components upon exposure to an external agent or antigen. Human antibody G, or immunoglobin G (IgG), accounts for 75% of total serum antibody content. IgG controls several infections by eradicating disease-causing pathogens from the body through complementary interactions with toxins. Additionally, IgG is an important diagnostic tool for certain pathological conditions, such as autoimmune hepatitis, hepatitis B virus (HBV), chickenpox and MMR (measles, mumps, and rubella), and coronavirus-induced disease 19 (COVID-19). As an important biomarker, IgG has sparked interest in conducting research to produce robust, sensitive, selective, and economical biosensors for its detection. To date, researchers have used different strategies and explored various materials from macro- to nanoscale to be used in IgG biosensing. In this review, emerging biosensors for IgG detection have been reviewed along with their detection limits, especially electrochemical biosensors that, when coupled with nanomaterials, can help to achieve the characteristics of a reliable IgG biosensor. Furthermore, this review can assist scientists in developing strategies for future research not only for IgG biosensors but also for the development of other biosensing systems for diverse targets.

A comparative study of early functional outcomes in undisplaced neck of femur fracture treated with partially threaded and fully threaded cannulated screw fixation in patients above 60 years age.

Objective: To compare the partially threaded versus fully threaded cannulated screw fixation methods in stable neck of femur fracture in terms of early functional outcomes in patients of age 60 and above. Methods: A randomized controlled trial was conducted at Orthopedic Unit-II, Mayo Hospital Lahore, Pakistan from July 2021 to July 2022. A total of 82 (41 in each group) patients of both genders, aged 60 or above were included. All patients had garden Type-I or II and were mobile before they fractured the femoral neck were included. In Group-A, cannulated screw fixation (cancellous screws 6 mm) was done using partially threaded screws while fully threaded screws (cancellous screws 6 mm) were used in Group-B. Patients were followed up at six weeks, three months and six months interval for "Radiographic Union Scale for Hip (RUSH)" and "Harris Hip score". Results: In a total of 82 (41 in each group) patients, 66 (80.5%) we male. At 6th week (p=0540) and 3rd month (p=0.653) postoperatively, no significant differences were seen between groups for Hip Harris score. However, at 6th month, functional outcome of Group-B patients was significantly better as compared to Group-A (p=0.038). Mean RUSH score in Group-A and in Group-B at 6th month postoperative was 25.45±2.73 and 30.52±2.39 (p<0.001). Conclusion: Fully threaded cannulated screw fixation is better in treating undisplaced neck of femur fracture as compared to partially threaded cannulated screw fixation in terms of early functional outcomes among the age group of 60 years and above.RCT Registration number: NCT05587660.

Comparing Low Volume Versus Conventional Volume of Polyethylene Glycol for Bowel Preparation during Colonoscopy: A Randomised Controlled Trial.

Background: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration. Methods: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups. Results: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039). Conclusion: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.

Impact of Molybdenum Dichalcogenides on the Active and Hole-Transport Layers for Perovskite Solar Cells, X-Ray Detectors, and Photodetectors.

The interface architectures of inorganic-organic halide perovskite-based devices play key roles in achieving high performances with these devices. Indeed, the perovskite layer is essential for synergistic interactions with the other practical modules of these devices, such as the hole-/electron-transfer layers. In this work, a heterostructure geometry comprising transition-metal dichalcogenides (TMDs) of molybdenum dichalcogenides (MoX2  = MoS2 , MoSe2 , and MoTe2 ) and perovskite- or hole-transfer layers is prepared to achieve improved device characteristics of perovskite solar cells (PSCs), X-ray detectors, and photodetectors. A superior efficiency of 11.36% is realized for the active layer with MoTe2 in the PSC device. Moreover, X-ray detectors using modulated MoTe2 nanostructures in the active layers achieve 296 nA cm-2 , 3.12 mA (Gy cm2 )-1 and 3.32 × 10-4 cm2 V-1 s-1 of collected current density, sensitivity, and mobility, respectively. The fabricated photodetector produces a high photoresponsivity of 956 mA W-1 for a visible light source, with an excellent external quantum efficiency of 160% for the perovskite layer containing MoSe2 nanostructures. Density functional theory calculations are made for pure and MoX2 doped perovskites' geometrical, density of states and optical properties variations evidently. Thus, the present study paves the way for using perovskite-based devices modified by TMDs to develop highly efficient semiconductor devices.

Contrariwise obesity through organic food consumption in Malaysia: a signaling theory perspective.

BACKGROUND: THE CONTEXT AND PURPOSE OF THE STUDY: Unhealthy food consumption has raised an alarming situation of obesity among Asian nations and posing serious threats to human health. Recent studies have acknowledged that organic food consumption has been contrariwise associated with obesity. The consumption of healthy food has received research attention in social marketing and several antecedents and consequences have been identified. However, to date, there is a void in literature that how social, individual, and marketing elements together tradeoff in predicting a healthy lifestyle. Thus, the current investigation unfolds the antecedents of healthy foods' adoption in Asia by integrating the brand signaling and theory of planned behavior. METHODS: The data of 241 respondents were collected from selected social media Facebook communities through a survey using assessed 42 questions. For this purpose, participants' Facebook accounts were selected from the online healthy communities such as 'Diet Suku Suku Separuh' (469,000 followers), 'Hiking, and Camping around Malaysia' (351,200 followers), and 'Healthy Malaysia' (332 followers). The enumerator also engaged with the online community by liking posts and following health accounts. RESULTS: The data was analyzed using PLS (SEM) approach, the outcomes of hypotheses revealed interesting information that health consciousness not significantly predicts the purchase intention of healthy food. All antecedents were significant contributors to the prediction of foods' purchase intentions in this study. However, the findings indicated that no positive relationship exists between brand image identifications and brand credibility identifications, and healthy foods' purchase intentions identifications. The findings also indicated that no positive relationship exists between health consciousness identifications and healthy foods' purchase intentions identifications. Owing to the perilous increase in obesity among the general public in Asia. This study reinforced the factor that can help in the adoption of a healthy lifestyle. The study validated that a healthy lifestyle is reliant on the consumers' health consciousness, environmental concern, and innovativeness through motivating the consumers' healthy foods' purchase intentions. Surprisingly, the results highlighted that respondents have not identified brand image and credibility as an antecedent of purchase intention. Given that organic food brands are somewhat new in Asian markets and therefore, brands must endure crisis marketing practices to improve their brand recognition. Therefore, policymakers must facilitate the food promotional activities that are critical to enhancing the perceived benefits of organic food to combat issues like obesity. This paper offers a foundation for future empirical investigations in Asia and various stakeholders on how to promote a healthy lifestyle in Asia. Specifically, the results will help policymakers to offer positive policies and procedures for the improvement of a healthy lifestyle through the understanding of the antecedents and consequences of health-conscious consumers' healthy foods' purchase intentions.

Data gaps and opportunities for comparative and conservation biology.

Biodiversity loss is a major challenge. Over the past century, the average rate of vertebrate extinction has been about 100-fold higher than the estimated background rate and population declines continue to increase globally. Birth and death rates determine the pace of population increase or decline, thus driving the expansion or extinction of a species. Design of species conservation policies hence depends on demographic data (e.g., for extinction risk assessments or estimation of harvesting quotas). However, an overview of the accessible data, even for better known taxa, is lacking. Here, we present the Demographic Species Knowledge Index, which classifies the available information for 32,144 (97%) of extant described mammals, birds, reptiles, and amphibians. We show that only 1.3% of the tetrapod species have comprehensive information on birth and death rates. We found no demographic measures, not even crude ones such as maximum life span or typical litter/clutch size, for 65% of threatened tetrapods. More field studies are needed; however, some progress can be made by digitalizing existing knowledge, by imputing data from related species with similar life histories, and by using information from captive populations. We show that data from zoos and aquariums in the Species360 network can significantly improve knowledge for an almost eightfold gain. Assessing the landscape of limited demographic knowledge is essential to prioritize ways to fill data gaps. Such information is urgently needed to implement management strategies to conserve at-risk taxa and to discover new unifying concepts and evolutionary relationships across thousands of tetrapod species.

Postoperative cardiac troponin I as an indicator of surgical outcomes: A systematic review.

INTRODUCTION: Cardiac surgeries are generally associated with high morbidity and mortality. To prevent any adverse outcomes, it is crucial to identify patients at risk of developing postoperative complications and initiate relevant therapeutic interventions. Several biomarkers are used to determine postoperative myocardial injury but they either lack sensitivity and specificity or are elevated for a short time. In this systematic review, we evaluate postoperative troponin I as a predictor of postoperative myocardial infarction, mortality, and hospital and Intensive Care Unit stay. METHODS: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A thorough literature search was conducted over PubMed, clinicaltrials. gov, and the Cochrane library from inception till May 24, 2022 using relevant keywords, and only articles that met the pre-defined criteria were recruited. RESULTS: Following a comprehensive literature search, a total of 359 articles were obtained. Following a rigid screening and full-length review, only 13 studies met our inclusion criteria and were included. The recruited studies evaluated data from a total of 12,483 individuals and assessed troponin I as a predictor of at least one outcome. CONCLUSION: Troponin I has the potential to be used as a stand-alone predictor of surgical outcomes following coronary artery bypass grafting and valvular surgeries. However, supplementing it with other markers and scores offers the best chance at timely diagnosing any complications.

Thalassemia in Malaysia.

Malaysia is a multi-ethnic nation, comprising of Malays and other indigenous groups (67.4%), Chinese (24.6%), Indians (7.3%) and others (0.7%). Thalassemia, which includes α- and ß-thalassemia (α- and ß-thal), is one of the most common genetic disease in Malaysia. Between 4.5 and 5.0% of the Malaysian population were reported to be carriers of this disease and 3.0-40.0% were Hb E (c.79G>A) carriers. In 2013, the Malaysian Thalassaemia Registry reported a total of 5712 registered thalassemia patients, of which 1847 had Hb E/ß-thal and 2329 had ß-thal major (ß-TM). Out of the total number of registered thalassemia patients, Malays comprise 62.0%, Chinese 13.0% and Kadazan-Dusun 13.0%. There were eight common deletions and mutations of the α-thal gene, including three double gene deletions, two single gene deletions, and three nondeletional mutations. The five types of ß-thal mutations generally found in the Malay ethnic group were codon 19 (A>G) (or Hb Malay (HBB: c.59A>G), IVS-I-1 (G>T) (HBB: c0.92+1G>T), IVS-I-5 (G>C) (HBB: 92+5 G>C), and polyadenylated signal (polyA) (AATAAA>AATAGA) (HBB: c.*112A>G). The structural variant, Hb E, accounted for 76.0% of the ß-thal mutations. Malaysia was positioned among the top countries in terms of having the best healthcare in the world in 2019 and this includes free access to three iron chelation agents for the treatment of thalassemia. The Malaysian National Programme for Thalassemia Prevention and Control was launched in 2004 and consisted of mass public education campaigns, public awareness and health education, Malaysian Thalassaemia Registry, population screening, laboratory diagnosis and comprehensive patient management.

Graphene-Oxide-Based Fluoro- and Chromo-Genic Materials and Their Applications.

Composite materials and their applications constitute a hot field of research nowadays due to the fact that they comprise a combination of the unique properties of each component of which they consist. Very often, they exhibit better performance and properties compared to their combined building blocks. Graphene oxide (GO), as the most widely used derivative of graphene, has attracted widespread attention because of its excellent properties. Abundant oxygen-containing functional groups on GO can provide various reactive sites for chemical modification or functionalization of GO, which in turn can be used to develop novel GO-based composites. This review outlines the most recent advances in the field of novel dyes and pigments encompassing GO as a key ingredient or as an important cofactor. The interactions of graphene with other materials/compounds are highlighted. The special structure and unique properties of GO have a great effect on the performance of fabricated hybrid dyes and pigments by enhancing the color performance of dyes, the anticorrosion properties of pigments, the viscosity and rheology of inks, etc., which further expands the applications of dyes and pigments in dyeing, optical elements, solar-thermal energy storage, sensing, coatings, and microelectronics devices. Finally, challenges in the current development as well as the future prospects of GO-based dyes and pigments are also discussed. This review provides a reference for the further exploration of novel dyes and pigments.