Pyroptosis and mitochondrial function participated in miR-654-3p-protected against myocardial infarction.

Myocardial infarction (MI) is one of the leading causes of heart failure with highly complicated pathogeneses. miR-654-3p has been recognized as a pivotal regulator of controlling cell survival. However, the function of miR-654-3p in cardiomyocytes and MI has yet to be reported. This study aimed to identify the role of miR-654-3p in the regulation of myocardial infarction. To understand the contribution of miR-654-3p on heart function, we generated cardiac-specific knockdown and overexpression mice using AAV9 technology in MI injury. Mechanically, we combined cellular and molecular techniques, pharmaceutical treatment, RNA sequencing, and functional testing to elucidate the potential pathological mechanisms. We identified that mice subjected to MI decreased the expression of miR-654-3p in the border and infarcted area. Mice lacking miR-654-3p in the heart showed some inflammation infiltration and myocardial fibrosis, resulting in a mild cardiac injury. Furthermore, we found a deficiency of miR-654-3p in cardiomyocytes resulted in pyroptotic cell death but not other programmed cell death. Intriguingly, miR-654-3p deficiency aggravated MI-induced cardiac dysfunction, accompanied by higher myocardial fibrosis and cardiac enzymes and augmented pyroptosis activation. Cardiac elevating miR-654-3p prevented myocardial fibrosis and inflammation infiltration and decreased pyroptosis profile, thereby attenuating MI-induced cardiac damage. Using RNA sequence and molecular biological approaches, we found overexpression of miR-654-3p in the heart promoted the metabolic ability of the cardiomyocytes by promoting mitochondrial metabolism and mitochondrial respiration function. Our finding identified the character of miR-654-3p in protecting against MI damage by mediating pyroptosis and mitochondrial metabolism. These findings provide a new mechanism for miR-654-3p involvement in the pathogenesis of MI and reveal novel therapeutic targets. miR-654-3p expression was decreased after MI. Mice lacking miR-654-3p in the heart showed some inflammation infiltration and myocardial fibrosis, resulting in a mild cardiac injury. The deficiency of miR-654-3p in cardiomyocytes resulted in pyroptotic cell death. miR-654-3p deficiency aggravated MI-induced cardiac dysfunction, accompanied by higher myocardial fibrosis and cardiac enzymes and augmented pyroptosis activation. Overexpression of miR-654-3p prevented myocardial fibrosis and inflammation infiltration and decreased pyroptosis profile, thereby attenuating MI-induced cardiac damage. Overexpression of miR-654-3p in the heart promoted the metabolic ability of the cardiomyocytes by promoting mitochondrial metabolism and mitochondrial respiration function.

The evolving role of social media in enhancing quality of life: a global perspective across 10 countries.

BACKGROUND: Excessive or inappropriate use of social media has been linked to disruptions in regular work, well-being, mental health, and overall reduction of quality of life. However, a limited number of studies documenting the impact of social media on health-related quality of life (HRQoL) are available globally. AIM: This study aimed to explore the perceived social media needs and their impact on the quality of life among the adult population of various selected countries. METHODOLOGY: A cross-sectional, quantitative design and analytical study utilized an online survey disseminated from November to December 2021. RESULTS: A total of 6689 respondents from ten countries participated in the study. The largest number of respondents was from Malaysia (23.9%), followed by Bangladesh (15.5%), Georgia (14.8%), and Turkey (12.2%). The prevalence of social media users was over 90% in Austria, Georgia, Myanmar, Nigeria, and the Philippines. The majority of social media users were from the 18-24 age group. Multiple regression analysis showed that higher education level was positively correlated with all four domains of WHOQoL. In addition, the psychological health domain of quality of life was positively associated in all countries. Predictors among Social Media Needs, Affective Needs (ß = -0.07), and Social Integrative Needs (ß = 0.09) were significantly associated with psychological health. CONCLUSION: The study illuminates the positive correlation between higher education levels and improved life quality among social media users, highlighting an opportunity for policymakers to craft education-focused initiatives that enhance well-being. The findings call for strategic interventions to safeguard the mental health of the global social media populace, particularly those at educational and health disadvantages.

Iron overload in anaemia with underlying haemoglobin constant spring in an antenatal mother in primary care.

This is the case of a gravida 3 para 1 woman in her late 20s with underlying haemoglobin constant spring who visited a healthcare clinic for an antenatal check-up. Towards the end of her second trimester, she experienced lethargy. During her antenatal booking, she was diagnosed with mild asymptomatic anaemia, high serum ferritin, T saturation of 88% and abnormal liver function tests. She was referred to a hospital where an MRI scan revealed over 2 g of iron deposits in her liver, leading to a revised diagnosis of iron overload. Treatment included deferoxamine and expectant management throughout her antenatal period, and her delivery was uncomplicated. While iron deficiency anaemia is common in pregnancy, it is crucial not to overlook iron deposition and the distinction from acute fatty liver during pregnancy to prevent treatment delays.

Glia-derived adenosine in the ventral hippocampus drives pain-related anxiodepression in a mouse model resembling trigeminal neuralgia.

Glial activation and dysregulation of adenosine triphosphate (ATP)/adenosine are involved in the neuropathology of several neuropsychiatric illnesses. The ventral hippocampus (vHPC) has attracted considerable attention in relation to its role in emotional regulation. However, it is not yet clear how vHPC glia and their derived adenosine regulate the anxiodepressive-like consequences of chronic pain. Here, we report that chronic cheek pain elevates vHPC extracellular ATP/adenosine in a mouse model resembling trigeminal neuralgia (rTN), which mediates pain-related anxiodepression, through a mechanism that involves synergistic effects of astrocytes and microglia. We found that rTN resulted in robust activation of astrocytes and microglia in the CA1 area of the vHPC (vCA1). Genetic or pharmacological inhibition of astrocytes and connexin 43, a hemichannel mainly distributed in astrocytes, completely attenuated rTN-induced extracellular ATP/adenosine elevation and anxiodepressive-like behaviors. Moreover, inhibiting microglia and CD39, an enzyme primarily expressed in microglia that degrades ATP into adenosine, significantly suppressed the increase in extracellular adenosine and anxiodepressive-like behaviors. Blockade of the adenosine A2A receptor (A2AR) alleviated rTN-induced anxiodepressive-like behaviors. Furthermore, interleukin (IL)-17A, a pro-inflammatory cytokine probably released by activated microglia, markedly increased intracellular calcium in vCA1 astrocytes and triggered ATP/adenosine release. The astrocytic metabolic inhibitor fluorocitrate and the CD39 inhibitor ARL 67156, attenuated IL-17A-induced increases in extracellular ATP and adenosine, respectively. In addition, astrocytes, microglia, CD39, and A2AR inhibitors all reversed rTN-induced hyperexcitability of pyramidal neurons in the vCA1. Taken together, these findings suggest that activation of astrocytes and microglia in the vCA1 increases extracellular adenosine, which leads to pain-related anxiodepression via A2AR activation. Approaches targeting astrocytes, microglia, and adenosine signaling may serve as novel therapies for pain-related anxiety and depression.

Minimally invasive percutaneous screw internal fixation under robot navigation for the treatment of a hamate bone fracture.

PURPOSE: Hamate fractures are rare fractures of the wrist and there is still no consensus on the optimal treatment for these fractures, especially hook of hamate fractures. Herein, the authors present a case study of a series of patients who were treated with closed reduction and minimally invasive percutaneous fixation under robot navigation. METHODS: This retrospective study reviewed 14 patients who had nondisplaced or minimally displaced hamate fractures on computerized tomography images and were treated using the treatment in our centre from November 1, 2019, to October 31, 2022. At the final follow-up, the flexion-extension and radial-ulnar range of motion of the wrist were measured, and the grip strength and pinch strength were measured. The pain of the wrist was assessed using the visual analogue scale (VAS). The Mayo wrist score reflected the recovery of the wrist. RESULTS: The mean total operative duration was 40.1 min. All the fractures showed union at a mean of 3.0 months. At a mean follow-up of 23.3 months (range 6-36 months), the mean VAS score was 0.7, the average Mayo wrist score was 95, and the mean pinch strength and grip strength were 11.3 and 38.7 kg, respectively. The flexion-extension arc was 138.3°, the mean radial and ulnar deviation arc was 63.8°, and the mean pronation-supination arc was 172.3°. And the time of return to the original occupation was mean 4 months (3~6 months). There were no complications, such as infection or nerve paralysis. CONCLUSIONS: This study suggests that nondisplaced or minimally displaced hamate hook fractures can be successfully treated by closed reduction and internal fixation with a headless compression screw with the assistance of robot navigation, and the small fragment of fracture can be accurately fixed with minimal iatrogenic injury.

[Separation, characterization, and antiviral activity of colloidal phase state of Maxing Shigan Decoction].

This study focused on the separation, characterization, content determination, and antiviral efficacy research on colloidal particles with different sizes in Maxing Shigan Decoction(MXSG). The mixed colloidal phase of MXSG was initially separated into small colloidal particle segment(S), medium colloidal particle segment(M), and big colloidal particle segment(B) using ultrafiltration. Further fine separation was performed using size-exclusion chromatography. Dynamic light scattering(DLS) and transmission electron microscopy(TEM) were employed to characterize the size and morphology of the separated colloidal particles. UPLC-MS/MS was used to determine the content of ephedrine, amygdalin, glycyrrhizic acid, and the EDTA complexometric titration was used to measure the calcium(Ca~(2+)) content in different colloidal phases. Finally, a respiratory syncytial virus(RSV) infection mouse model was established using intranasal administration. The experimental groups included a blank group, a model group, a ribavirin group, an MXSG group, an S group, an M group, and a B group. Oral administration was given for treatment, and pathological changes in mouse lung tissue and organ indices were evaluated. The results of the study showed that the distribution of ephedrine, amygdalin, glycyrrhizic acid, and Ca~(2+) content was not uniform among different colloidal segments. Among them, the B segment had the highest proportions of the three components, except for Ca~(2+), accounting for 46.35%, 53.72%, and 92.36%, respectively. Size-exclusion chromatography separated colloidal particles with uniform morphology in the size range of 100-500 nm. Compared to the S and M segments, the B segment showed an increased lung index inhibition rate(38.31%), spleen index, and thymus index in RSV-infected mice, and it improved the infiltration of inflammatory cells and lung injury in the lung tissue of mice. The complex components in MXSG form colloidal particles of various sizes and morphologies through heating, and small-molecule active components such as ephedrine, amygdalin, glycyrrhizic acid, and Ca~(2+) participate in the assembly to varying degrees. The main material basis for the antiviral effect of MXSG is the colloidal particles with certain particle sizes formed by the assembly of active components during the heating process.

Factors influencing parents' hesitancy to vaccinate their children aged 5-11 years old against COVID-19: results from a cross-sectional study in Malaysia.

Introduction: Vaccination programs have been rolled out across the globe to contain and mitigate the spread of the COVID-19 infection. Until recently, such programs were limited to adults and the older population, thereby limiting children from getting vaccinated. Recently, the Malaysian government rolled out vaccination for children aged 5-11 years. However, there are certain factors that might affect vaccination uptake among children. This study explores factors influencing parents' hesitancy to vaccinate children in Malaysia. Method: A nationwide online cross-sectional convenience sampling survey from April 21, 2022 to June 3, 2022 was conducted. The study used descriptive statistics to inform about vaccine hesitancy among parents. Cross-tabulation was performed to calculate the frequency and percentage of vaccine hesitancy, quality of life, e-health literacy, and the 5C psychological antecedents of vaccination among parents with children 5-11 years in Malaysia. Graphical methods were used to portray the levels of e-health literacy and levels of 5C psychological antecedents of vaccination. The study used both bi-variate and multivariate analysis to understand the relationship between vaccine hesitancy and the socio-demo-economic factors, quality of life, e-health literacy and 5C psychological antecedents. Results: Of 382 participants, almost one-third (33%) of participants reported vaccine hesitancy for their children. For 5C's psychological antecedents of vaccination, around one quarter (26.96%) reported disagreement for confidence in vaccination, almost half (52.36%) reported disagreement for vaccination complacency, three-fifths (60.99%) reported vaccination constraint, one quarter (25.92%) reported calculation antecedent, and almost one-third reported disagreement over collective responsibility antecedent (25.92%). Chi-square test revealed that gender, employment status, and parents' COVID-19 vaccination status were significantly associated (p<0.05) with vaccine hesitancy among parents. Assessing the influence of transactional e-health literacy, only the communication component contained a significant association (p<0.05). Among the 5C psychological antecedents, confidence, calculation, and collective responsibility were significantly associated (p<0.05) with vaccine hesitancy. Parents with secondary [OR: 8.80; CI: 2.44-31.79, (p<0.05)], post-secondary [OR: 5.21; CI: 2.10-13.41, (p<0.05)], and tertiary education [OR: 6.77; CI: 2.25-20.35, (p<0.05)] had significantly higher likelihood of vaccine hesitancy than those with primary education. Conclusion: Highly educated parents are more skeptical and are more likely to perceive the vaccine as unsafe and ineffective for their children. It is critical to disseminate the required information about the vaccine safety to the educated group.

Prognostic significance of TMEM131L in glioma and establishment of oxidative stress prognostic model.

Gliomas are the most aggressive of all brain tumors. In this study, it was found that there is a significant expression of transmembrane-like 131 (TMEM131L) in glioma tissues. The relevance of TMEM131L in the diagnosis and clinical prognosis of GBM and LGG was verified by additional clinical correlation and survival analysis. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve reflected the diagnostic effect of TMEM131L on the clinicopathologic features of glioma. As a unique molecular marker for the poor prognosis of overall survival (OS), PFI, and DSS in patients with GCB and LGG, TMEM131L might be employed, according to time-dependent ROC curves and Kaplan-Meier survival analysis at 1, 3, and 5 years. The potential methylation sites of TMEM131L were selected by correlation analysis between TMEM131L and DNA methylation sites. Meanwhile, TMEM131L was significantly correlated with matrix, immunity, and estimated scores of GBM and LGG. The CIBERSORT analysis revealed a significant correlation between immune checkpoint and infiltration of 22 different kinds of immune cells. Coexpression genes of TMEM131L associated with oxidative stress phenotype were screened by the LASSO logistic regression analysis. Nomogram and calibration curves further confirmed that the prognostic model composed of SYT1, CREB3L3, ITPR1, RASGRF2, PDX1, and RASGRF1 has good stability and potential application value for poor prognosis in patients with glioma.

The incremental significance of heart rate recovery as a predictor during exercise-stress myocardial perfusion SPECT imaging in individuals with suspected coronary artery disease.

Background: Major adverse cardiac events (MACE) are more likely to occur when abnormal heart rate recovery (HRR). This study aimed to assess the incremental predictive significance of HRR over exercise stress myocardial perfusion single-photon emission computed tomography (MPS) results for MACE in individuals with suspected coronary artery disease (CAD). Methods: Between January 2014 and December 2017, we continually gathered data on 595 patients with suspected CAD who received cycling exercise stress MPS. HRR at 1, 2, 3, and 4 min were used as study variables to obtain the optimal cut-off values of HRR for MACE. The difference between the peak heart rate achieved during exercise and the heart rate at 1, 2, 3, and 4 min was used to calculate the HRR, as shown in HRR3. Heart rate variations between two locations in time, such as HRR2 min-1 min, were used to establish the slope of HRR. All patients were followed for a minimum of 4 years, with MACE as the follow-up goal. The associations between HRR and MACE were assessed using Cox proportional hazards analyses. Results: Patients with MACE were older (P = 0.001), and they also had higher rates of hypertension, dyslipidemia, diabetes, abnormal MPS findings (SSS ≥ 5%), medication history (all P < 0.001), and lower HRR values (all P < 0.01). Patients with and without MACE did not significantly vary in their HRR4 min-3 min. The optimal cut-off of HRR1, 2, and 3 combined with SSS can stratify the risk of MACE in people with suspected CAD (all P < 0.001). HRR 1, 2, and 3 and its slope were linked to MACE in multivariate analysis, where HRR3 was the most significant risk predictor. With a global X2 increase from 101 to 126 (P < 0.0001), HRR3 demonstrated the greatest improvement in the model's predictive capacity, incorporating clinical data and MPS outcomes. Conclusions: HRR at 3 min has a more excellent incremental prognostic value for predicting MACE in patients with suspected CAD following cycling exercise stress MPS. Therefore, incorporating HRR at 3 min into known predictive models may further improve the risk stratification of the patients.

Experimental Study and Modelling of Fresh Behaviours of Basalt Fibre-Reinforced Mortar Based on Average Water Film Thickness and Fibre Factor.

Though previous studies have indicated that the fresh behaviours of plain mortar/concrete are mainly governed by the average water film thickness (AWFT), whether the concept of AWFT is also applicable to fibrous mortar/concrete still needs to be explored. Furthermore, for fibrous mortar/concrete, it is obvious that the fibres added also have certain effects on the fresh behaviours. In two previous studies on basalt fibre-reinforced mortar (BFRM), the integral effects of the AWFT and fibre dosage as well as the integral effects of the AWFT and fibre length were individually investigated. In this study, a fibre factor (FF) defined as the fibre volume multiplied by the fibre aspect ratio was employed and 24 extra mortar groups were tested. A total of 68 mortar groups were applied in numerical analysis. The results of the regression analysis yielded good correlations of the workability, fluidity, cohesiveness, and adhesiveness of BFRM with the AWFT and FF, suggesting that the AWFT and FF are together the governing parameters controlling the fresh behaviours of BFRM. Hence, the AWFT and FF may be used to develop a model for the fresh properties of BFRM.

Implementation of peer-support services in Asia: A scoping review.

WHAT IS KNOWN ON THE SUBJECT: Peer-support services was started in the 1970s psychiatric survivor movement in the United States of America (USA) due to the lack of transitional support for deinstitutionalized psychiatric patients. Delivered by peer-support workers (PSWs) with lived experiences of mental health conditions, peer-support workers use their experiential knowledge to help others with similar conditions. The paradigm shifts in mental health recovery has led to an increase in interest on peer-support services among the Asia countries. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The diversity political and cultural differences in Asia makes it a unique for people to understand the mental health ecosystem that exist within. This review is timely as it provides the insights into the current state of peer-support services for mental health consumers in Asia and the future research on them. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: First, this review provided a broad overview on the current types of peer-support services and their implementation in Asia. Second, emphasized the importance and value of peer-support services for individuals with mental health conditions in their journey towards recovery. Third, important to build a more positive image for peer-support workers by assigning more clarity to their roles and systematizing training to hone their skills in providing peer support. ABSTRACT: Introduction The increasing recognition and need for recovery-oriented services led to the heightened interests of peer-support services globally, including Asia. However, little is known about the peer-support services in Asia as compared to the West, where peer-support services primarily originated from and are well established. Aim To examine available evidence on the implementation of peer-support services for such consumers in Asia. Method This scoping review was based on the Arksey & O'Malley's framework. A comprehensive search was performed across seven electronic databases. The grey literature was also searched through Open Grey and ProQuest Dissertation and Theses, alongside hand searching of the reference of the studies. Articles searched was from January 2000 to December 2021. Results Three main themes were identified to provide an overview on peer-support services for mental health consumers in Asia: the delivery of such services in Asia; Asian consumers' perceptions of them; and factors affecting their implementation. Discussion Given their relative novelty in Asia, findings from this review represent useful insights for organizations and policy administrators when formulating such services. Implications for Practice Future research should also focus on evaluating the effectiveness of such services in Asia and comparing their outcomes with other regions.

Population pharmacokinetic analysis, renal safety, and dosing optimization of polymyxin B in lung transplant recipients with pneumonia: A prospective study.

Objectives: This study aims to characterize the population pharmacokinetics of polymyxin B in lung transplant recipients and optimize its dosage regimens. Patients and methods: This prospective study involved carbapenem-resistant organisms-infected patients treated with polymyxin B. The population pharmacokinetic model was developed using the NONMEM program. The clinical outcomes including clinical treatment efficacy, microbiological efficacy, nephrotoxicity, and hyperpigmentation were assessed. Monte Carlo simulation was performed to calculate the probability of target attainment in patients with normal or decreased renal function. Results: A total of 34 hospitalized adult patients were included. 29 (85.29%) patients were considered of clinical cure or improvement; 14 (41.18%) patients had successful bacteria elimination at the end of the treatment. Meanwhile, 5 (14.71%) patients developed polymyxin B-induced nephrotoxicity; 19 (55.88%) patients developed skin hyperpigmentation. A total of 164 concentrations with a range of 0.56-11.66 mg/L were obtained for pharmacokinetic modeling. The pharmacokinetic characteristic of polymyxin B was well described by a 1-compartment model with linear elimination, and only creatinine clearance was identified as a covariate on the clearance of polymyxin B. Monte Carlo simulations indicated an adjusted dosage regimen might be needed in patients with renal insufficiency and the currently recommended dose regimens by the label sheet of polymyxin B may likely generate a subtherapeutic exposure for MIC = 2 mg/L. Conclusion: Renal function has a significant effect on the clearance of polymyxin B in lung transplant recipients, and an adjustment of dosage was needed in patients with renal impairments.

Shugan Jieyu capsule improve sleep and emotional disorder in coronavirus disease 2019 convalescence patients: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To evaluate the efficacy of the Shugan Jieyu capsule on improving sleep and emotional disorder during Coronavirus disease 2019 (COVID-19) convalescence. METHODS: We conducted a randomized, double-blind, placebo-controlled trial, and recruit 200 COVID-19 convalescence patients and then divide the subjects into two groups respectively: the experimental group ( 100) and the control group ( 100). Patients in the control group were given doses as a placebo, while those in the experimental group were given Shugan Jieyu capsule. The investigators mainly observed the differences between the two groups before and after treatment in terms of the rate of reduction and the rate of efficiency in Hamilton Depression Scale (HAMD-17) total scores from baseline, and recorded the scores of Hamilton Anxiety Scale (HAMA), Patient Health Questionnaire-15 (PHQ-15), Insomnia Severity Index (ISI) and Treatment Emergent Symptom Scale at 2 week, the 4 week and the 6 week respectively after treatment, and compared the differences between the groups. And the occurrence of adverse events was recorded. RESULTS: After 6-week treatment, there were statistically significant differences in the rate of reduction as well as efficiency in HAMD-17 scores, HAMA Total Scores, PHQ-15 Score, ISI Score from baseline in the experimental group and control group (< 0.05). There were 4 adverse events in the experimental group and 1 in the control group. CONCLUSION: Shugan Jieyu capsule could significantly improve sleep and emotional disorder in patients during COVID-19 convalescence.

Treatment of the hook of hamate fracture with robot navigation: A note on technique.

OBJECTIVE: The aim of this study was to demonstrate a new robotic technique for the fixation of the fracture of the hook of hamate. METHODS: In this retrospective study, six patients who had undergone treatment of the hook of hamate fracture with a new technique using robot navigation were included. Patients were evaluated postoperatively with flexion - extension and radial-ulnar range of wrist motion, and were measured using a goniometer. Grip strength and pinch strength were measured and compared with the contralateral wrist at the final follow-up. The Visual Analog Scale (VAS) and the Mayo Wrist Score were used to evaluate and record the recovery outcome of the wrist. RESULTS: Primarily, healing was achieved at 12.3 weeks postoperatively. At the final follow-up (5-22 months, average 13.1 months) the VAS score of the wrist was an average of 0.3 (0-2); the mean radial-ulnar deviation was 64.7°; the average of the flexion and extension range of motion was 141.9°; the average grip strength was 40.9 Kg; the average pinch strength was 11.8 Kg and the average Mayo Wrist Score was 95.8. CONCLUSION: This study has shown us that treatment of nondisplaced or minimal displaced fractures of the hook of the hamate with robot navigation is a viable technique with satisfactory clinical and radiological results.

Shared and specific biological signalling pathways for diabetic retinopathy, peripheral neuropathy and nephropathy by high-throughput sequencing analysis.

OBJECTIVES: We aimed to explore the shared and specific signalling pathways involved in diabetic retinopathy (DR), diabetic peripheral neuropathy (DPN) and diabetic nephropathy (DN). METHODS: Differentially expressed mRNAs and lncRNAs were identified by high-throughput sequencing. Subsequently, functional enrichment analysis, protein-protein interaction (PPI) analysis and lncRNAs-mRNAs networks were conducted to determine the pathogenic mechanisms underlying DR, DPN and DN. RESULTS: Twenty-six biological pathways were shared among DR, DPN and DN groups compared to the type 2 diabetes mellitus (T2DM) group without complications, and most of the shared pathways and core proteins were involved in immune and inflammatory responses of microvascular damage. Cytokine‒cytokine receptor interactions and chemokine signalling pathway were the most significant and specific pathways for DR, and the lncRNA‒mRNA regulatory networks affected DR by targeting these pathways. Sphingolipid metabolism and neuroactive ligand-receptor pathways were found to be specific for the pathogenesis of DPN. Moreover, multiple amino acid metabolic pathways were involved in the occurrence and progression of DN. CONCLUSIONS: Diabetic retinopathy, DPN and DN exhibited commonality and heterogeneity simultaneously. The shared pathologic mechanisms underlying these diabetic complications are involved in diabetic microvascular damage via immune and inflammatory pathways. Our findings predict several biomarkers and therapeutic targets for these diabetic complications.

Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia.

Introduction: This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. Methods: The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. Results: A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents' ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (0R=16.60, 95% CI=2.54-108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (0R=0.13, 95% CI=0.08-0.24). Conclusion: Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.

Epidemiological retrospective analysis in major burn patients: single centre medical records from 2009 to 2019.

Burns cause a loss of skin barrier function, rendering it prone to infection. The prevention of infection comprises a focus on the treatment of patients with burns. Therefore, we analysed the results of microbiological tests of patients with severe and extremely severe burns to provide a basis for the prevention and treatment of infection in patients with burns. The results of microbiological tests of patients with severe and extremely severe burns admitted to our burn centre between 2009 and 2019 were retrospectively reviewed. The overall positive rate of microbial detection was 40.67% and did not significantly decline over the 10-year study period. The most common positive sites were wounds, sputum, and urine. The most common bacterial species causing the infections were Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Furthermore, the predictors of a positive detection, overall and at various sites, mainly included the burn area and depth, inhalation injury, and length of the hospital stay. Positive detection was an important predictor of the prognosis. In particular, a positive blood culture and Klebsiella pneumoniae had better predictive strength for mortality than other sites and strains. This study analysed the microbiological testing results at a single burn centre over a period of 10 years. The results provide information regarding the predictors of a positive detection and the influence of a positive detection on prognosis, and can be used as a basis for the development of clinical infection prevention and treatment strategies, as well as the selection of treatment measures.

Characterization of Bacterial Community Structure Dynamics in a Rat Burn Wound Model Using 16S rRNA Gene Sequencing.

Burns destroy the skin barrier and alter the resident bacterial community, thereby facilitating bacterial infection. To treat a wound infection, it is necessary to understand the changes in the wound bacterial community structure. However, traditional bacterial cultures allow the identification of only readily growing or purposely cultured bacterial species and lack the capacity to detect changes in the bacterial community. In this study, 16S rRNA gene sequencing was used to detect alterations in the bacterial community structure in deep partial-thickness burn wounds on the back of Sprague-Dawley rats. These results were then compared with those obtained from the bacterial culture. Bacterial samples were collected prior to wounding and 1, 7, 14, and 21 days after wounding. The 16S rRNA gene sequence analysis showed that the number of resident bacterial species decreased after the burn. Both resident bacterial richness and diversity, which were significantly reduced after the burn, recovered following wound healing. The dominant resident strains also changed, but the inhibition of bacterial community structure was in a nonvolatile equilibrium state, even in the early stage after healing. Furthermore, the correlation between wound and environmental bacteria increased with the occurrence of burns. Hence, the 16S rRNA gene sequence analysis reflected the bacterial condition of the wounds better than the bacterial culture. 16S rRNA sequencing in the Sprague-Dawley rat burn model can provide more information for the prevention and treatment of burn infections in clinical settings and promote further development in this field.

Prevalence and determinants of medications non-adherence among patients with uncontrolled hypertension in primary care setting in Sarawak, Malaysia: A cross-sectional study.

Introduction: Non-adherence to antihypertensive medications is a leading cause of uncontrolled hypertension and its complications. However, data on the factors associated with non-adherence to antihypertensive medications in the communities of Sarawak, Malaysia, are limited. This study aimed to examine the prevalence and determinants of medication non-adherence among patients with uncontrolled hypertension. Method: A cross-sectional study was conducted using the systematic sampling method in four government primary healthcare clinics in Sarawak. A self-administered questionnaire was used to obtain socio-demographic data and evaluate non-adherence. Blood pressure was measured, and relevant clinical variables were collected from medical records. Multivariate logistic regression was used to determine the determinants of medication non-adherence. Results: A total of 488 patients with uncontrolled hypertension were enrolled in this study. The prevalence of medication non-adherence was 39.3%. There were four predictors of medication non-adherence among the patients with uncontrolled hypertension: tertiary educational level (odds ratio [OR]=4.21, 95% confidence interval [CI] = 1.67-10.61, P=0.010), complementary alternative medication (0R=2.03, 95% CI=1.12-3.69, P=0.020), non-usage of calcium channel blockers (0R=1.57, 95% CI=1.02-2.41, P=0.039) and 1 mmHg increase in the systolic blood pressure (0R=1.03, 95% CI=1.00-1.05, P=0.006). Conclusion: Because of the high prevalence of medication non-adherence among patients with uncontrolled hypertension, primary care physicians should be more vigilant in identifying those at risk of being non-adherent. Early intervention should be conducted to address non-adherence for blood pressure control.

Demographic and work-related factors associated with burnout, resilience, and quality of life among healthcare workers during the COVID-19 pandemic: A cross sectional study from Malaysia.

Introduction: The healthcare setting is a stressful and demanding work environment, and healthcare workers face a continuous expansion of their job roles and responsibilities. Past studies have shown that factors affecting burnout, resilience, and quality of life among healthcare workers merit further research, as there were inconsistent findings, especially with regards to the influence of demographic and work-related factors. Therefore, this study aims to determine whether demographic and work-related factors are associated with burnout, resilience, and quality of life among healthcare workers. Method: This cross-sectional study was conducted between February 15, 2022 and March 15, 2022, among 394 healthcare workers from Putrajaya and Selangor hospitals, Malaysia. Maslach Burnout Inventory, World Health Organization Quality of Life-BREF 26 inventory, and Brief Resilience Scale were utilized to capture information on burnout, quality of life, and resilience, respectively. Results: The mean score of physical health of participants who work more than 10 h (11.38) is lower than participants who work from 8 to 10 h (13.00) and participants who work 7 h daily (13.03), p-value < 0.001. Similarly, the mean score of psychological health of participants who work more than 10 h (12.35) is lower than participants who work from 8 to 10 h (13.72) and participants who work 7 h daily (13.68), p-value = 0.001. Higher income levels were associated with high resilience and quality of life. Conclusion: It is imperative that healthcare practitioners and policy makers adopt and implement interventions to promote a healthy workplace environment, address ethical concerns, and prevent burnout among healthcare workers during the COVID-19 pandemic. Managing the issue of long working hours could possibly result in improved resilience, burnout, and quality of life among healthcare workers. Despite this study able to tickle out some policy specific areas where interventions are needed, identifying effective solutions and evaluating their efficiency will require larger and interventional studies.