Browse publications by year: 2024

  1. Singh VA, Ong BK, Yasin NF
    Musculoskelet Surg, 2024 Dec;108(4):483-489.
    PMID: 38848000 DOI: 10.1007/s12306-024-00840-2
    BACKGROUND: Major musculoskeletal oncology procedures often result in perioperative bleeding. This exposes patients to allogeneic red blood cell transfusion and its potential complications, thus increasing the risk of surgical wound infection and prolonged hospital stay. This study aimed to investigate the efficacy of oxidised cellulose, a topical haemostatic agent, in reducing postoperative blood loss and its subsequent risks.

    METHODS: In this randomised controlled trial, 40 patients undergoing major musculoskeletal oncology procedures were assigned to control and intervention groups. Oxidised cellulose was inserted into the surgical wound after the resection's conclusion before the wound's closure to reduce postoperative bleeding for patients in the intervention group. Postoperative closed suction drain system (Redivac TM) volume, drop in haemoglobin level, allogeneic red blood cell transfusion rate, duration of surgery, and length of hospital stay were compared between the two groups.

    RESULTS: The postoperative Redivac volume (Control: 432 MLS vs. Intervention: 431.75 MLS), drop in haemoglobin level (Control: 3.12 g/dL vs. Intervention: 3.06 g/dL), duration of surgery (Control: 134 vs. Intervention: 156 min), and allogeneic red blood cell transfusion were lower in the intervention group (Control: 204 MLS vs. Intervention: 170 MLS), but they were not statistically significant (p > 0.05) (Control: 134 vs. Intervention: 156 min). Mean hospital stay was similar in both groups (Control: 5.45 days vs. Intervention: 5.85 days).

    CONCLUSION: Oxidised cellulose use does not significantly affect postoperative blood loss, the rate of allogeneic blood transfusion, and hospital stay. However, we believe its use contributes positively but not considerably towards lower postoperative blood loss in musculoskeletal oncology surgeries.

    MeSH terms: Adult; Aged; Bone Neoplasms/surgery; Female; Hemoglobins/analysis; Hemostatics/therapeutic use; Humans; Length of Stay; Male; Middle Aged; Erythrocyte Transfusion; Operative Time
  2. Munawar K, Mukhtar F, Roy M, Majeed N, Jalaludin MY
    Psychol Health Med, 2024 Dec;29(10):1705-1752.
    PMID: 39467823 DOI: 10.1080/13548506.2024.2421461
    This systematic review evaluates studies focusing on parenting and feeding practices, children's feeding behavior, and growth stunting in Asian countries. Eight electronic databases were searched to screen studies published between Jan 2015 and May 2021. There were contradictory findings related to gender differences in growth stunting and factors that reinforce/facilitate or inhibit acquisition of optimum growth in children. Theme of parenting practices showed that time spent on childcare, traditional beliefs about child-care feeding and responsive feeding were also contributing factors. Amidst economic improvement, political, social changes, and worldwide execution of various nutritional programs, stunting continues to be relentlessly persistent and widespread in Asia. Undernutrition disturbs areas of the mind involved in reasoning, reminiscence, locomotor skills and also an adverse influence on the physical and psychological growth of children and ensuing learning capabilities. Stunted children have more anxiety and depression and lower self-esteem than non-stunted children. A public health strategy is required to: (i) properly examine stunting with time through collaborated efforts of community members and various sectors, (ii) tackle malnutrition with steps to enhance maternal nutrition during pregnancy, infant feeding practices and (iii) involvement of effective multi-sectoral partnership programs for management of stunting.
    MeSH terms: Asia; Child; Child, Preschool; Female; Humans; Infant; Male
  3. van der Laan L, Silva A, Kleinendorst L, Rooney K, Haghshenas S, Lauffer P, et al.
    HGG Adv, 2024 Nov 04;6(1):100380.
    PMID: 39501558 DOI: 10.1016/j.xhgg.2024.100380
    Neurodevelopmental disorder with or without autism or seizures (NEDAUS) is a neurodevelopmental disorder characterized by global developmental delay, speech delay, seizures, autistic features, and/or behavior abnormalities. It is caused by CUL3 (Cullin-3 ubiquitin ligase) haploinsufficiency. We collected clinical and molecular data from 26 individuals carrying pathogenic variants and variants of uncertain significance (VUS) in the CUL3 gene, including 20 previously unreported cases. By comparing their DNA methylation (DNAm) classifiers with those of healthy controls and other neurodevelopmental disorders characterized by established episignatures, we aimed to create a diagnostic biomarker (episignature) and gain more knowledge of the molecular pathophysiology. We discovered a sensitive and specific DNAm episignature for patients with pathogenic variants in CUL3 and utilized it to reclassify patients carrying a VUS in the CUL3 gene. Comparative epigenomic analysis revealed similarities between NEDAUS and several other rare genetic neurodevelopmental disorders with previously identified episignatures, highlighting the broader implication of our findings. In addition, we performed genotype-phenotype correlation studies to explain the variety in clinical presentation between the cases. We discovered a highly accurate DNAm episignature serving as a robust diagnostic biomarker for NEDAUS. Furthermore, we broadened the phenotypic spectrum by identifying 20 new individuals and confirming five previously reported cases of NEDAUS.
  4. Mohamed Tahir AR, Haw VJ, Zaid WSW, Nizaruddin MA, Abd Razak FS, Ludin AFM
    Turk J Pharm Sci, 2024 Nov 21;21(5):413-420.
    PMID: 39569669 DOI: 10.4274/tjps.galenos.2023.23428
    OBJECTIVES: To promote a holistic approach to healthcare, the University of Cyberjaya introduced a unique elective course called sports pharmacy, which incorporates components of lifestyle interventions. Customers increasingly seek guidance about lifestyle factors that impact their health. Pharmacists with expertise in sports and exercise can meet this need. However, there is a lack of studies on the impact of non-pharmacological approaches (NPAs) on health parameters among healthcare professionals and pharmacy students in Malaysia. The objectives of this study were to compare students' health parameters based on NPAs and identify the factors that motivate students to maintain their health.

    MATERIALS AND METHODS: The study comprised 47 Year 4 pharmacy students in the pre- and post-practical phases (September 2018 and November 2018), followed by the post-resting phase (May 2019). The data collection form in the Sport Pharmacy course was used for the data collection.

    RESULTS: Nearly half of the students initially displayed a normal body mass index (BMI). However, after the post-resting period, there was a noticeable increase in the number of students categorized as obese and those with elevated total cholesterol (TC) and fasting blood glucose (FBG) levels. Specifically, in the pre-study phase, out of 47 participants, 22 were within the normal BMI (47%), six underweight (13%), nine overweight (19%), and ten obese (21%). The intervention phase showed a slight reduction in the overweight category, while the obese category showed an increase. For TC, the pre-phase had 70% of participants within the normal range, with 26% borderline high and 4% high. Post-study, showed an improvement, likely influenced by controlled dietary intake and physical activity. In the post-resting phase, however, there was a regression as the majority did not adhere to the non-pharmacological regimen. FBG demonstrated significant changes after the intervention, particularly within the normal range (≤ 6.0 mmol/L), showing the only statistically significant change across parameters. While the post-resting phase saw a minor increase, it remained below baseline. Approximately 23% continued diet control, while 32% maintained physical activity. Key motivations included health improvement, visible results, and improved well-being, while lack of motivation, time, and study schedules were primary discontinuation factors.

    CONCLUSION: The 10-week intervention significantly impacted FBG but had limited influence on BMI and TC. Post-resting outcomes highlight that only a small fraction maintained the non-pharmacological approach, resulting in no marked changes in any parameters. Recommendations include further long-term studies to confirm the sustained benefits and the role of educational institutions in supporting such interventions.

  5. Darbandi A, Koupaei M, Kiani P, Ghanavati R, Najafi P, Hosseini J, et al.
    Immun Inflamm Dis, 2024 Nov;12(11):e70076.
    PMID: 39570098 DOI: 10.1002/iid3.70076
    BACKGROUND: Despite the advent of vaccines against COVID-19, there is considerable variation in the acceptance and hesitancy towards the vaccination program across different countries. The objective of this study was to ascertain the prevalence of hesitancy and acceptance regarding the use of the vaccine against the novel coronavirus, also known as COVID-19, and to identify the factors that influence these attitudes.

    MATERIALS AND METHODS: All the cross-sectional studies were retrieved from the PubMed databases, the Web of Science ISI, Scopus, and the Cochrane Library. Papers published in English between 2 November 2019 and 23 May 2023 were subjected to further assessment based on their title, abstract, and main text, with a view to ensuring their relevance to the present study.

    RESULTS: Following an exhaustive investigation, 59 studies were selected for screening in this systematic review. The most frequently employed method of data collection was the online survey. The study sample comprised 59.12% women and 40.88% men, with ages ranging from 16 to 78 years. The proportion of individuals accepting the vaccine ranged from 13% to 96%, while the proportion of those exhibiting hesitancy ranged from 0% to 57.5%. The primary reasons for accepting the COIVD-19 vaccine were a heightened perception of risk associated with the virus and a general trust in the healthcare system. The most frequently cited reasons for vaccine hesitancy in the context of the ongoing pandemic include concerns about the potential dangers of the vaccines, the rapid pace of their development, the possibility of adverse effects (such as infertility or death), and the assumption that they have been designed to inject microchips.

    DISCUSSION: A variety of socio-demographic factors are implicated in determining the rate of vaccine acceptance. A number of socio-demographic factors have been identified as influencing vaccine acceptance. These include high income, male gender, older age, marriage, the presence of older children who have been vaccinated and do not have chronic diseases, high education, and health insurance coverage.

    CONCLUSION: Eliminating vaccine hesitancy or increasing vaccine acceptance is a crucial factor that should be addressed through various means and in collaboration with regulatory and healthcare organizations.

    MeSH terms: Adolescent; Adult; Aged; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice; Male; Middle Aged; Young Adult
  6. Borazon EQ, Magracia MR, Ong GR, Gillott BK, Mackay S, Swinburn B, et al.
    Glob Health Action, 2024 Dec 31;17(1):2427445.
    PMID: 39570293 DOI: 10.1080/16549716.2024.2427445
    BACKGROUND: This study conducted an exploratory content analysis of TV food advertisements on the top three most popular channels for Filipino children aged two to 17 during school and non-school days.

    METHODS: Data were collected by manually recording of aired advertisements from 16 non-school days (July to September 2020) and 16 school days (January to April 2021). Descriptive and inferential statistical analyses were used to assess children's rates of exposure to food advertisements (mean ± SD of advertisements aired per channel per hour), the healthiness of promoted foods (as permitted (healthier) or not permitted (unhealthy) according to nutrient profiling models from the World Health Organization), and persuasive techniques used in food advertisements, including promotional characters and premium offers.

    RESULTS: The results show that the rates of exposure to food advertisements were higher during school days (14.6 ± 14.8) than on non-school days (11.9 ± 12.0) (p 

    MeSH terms: Adolescent; Child; Child, Preschool; Female; Food; Humans; Male; Philippines; Schools; Television*; Marketing/methods
  7. Lee ZH, Tung WS, Santhiran KAJ, Shahzad H, Giribabu N, Salleh N
    Pflugers Arch, 2024 Nov 21.
    PMID: 39570400 DOI: 10.1007/s00424-024-03032-w
    This study aims to investigate the effect of estrogen hindrance, i.e., menopause in women for instance with rheumatoid arthritis on the brain hippocampal region by using collagen-induced arthritis (CIA) female rat model (RA). CIA was induced in female rats by injecting bovine type II collagen and incomplete Freund's adjuvant. Estrogen receptor antagonist, fulvestrant (Ful), was given to RA rats to create estrogen hindrance. Control (C) and RA rats were injected with saline and DMSO, respectively, while RA + Ful rats received a 7-day fulvestrant injection. Following experiment completion, rats were sacrificed, and brains were harvested. Brains were stained with H&E and cresyl violet staining and morphological changes in the hippocampus were identified. Additionally, oxidative stress, inflammatory, and apoptosis markers' levels in the hippocampus were analyzed by qPCR, ELISA, and immunohistochemistry techniques. RA + Ful rats showed neuronal atrophy and reduced neurogenesis in the hippocampal regions. NOX4, NF-κB, IL-1β, IL-6, TNF-α, IKK-β, and Bax protein expression levels in the hippocampus were increased, whereas hippocampal Bcl-2, caspase-3, caspase-9, and IGF-1R protein expression levels were decreased. Furthermore, RA + Ful rats had lower levels of antioxidants PON-1 and catalase in the hippocampal regions. The changes in these molecular markers were statistically significant when compared to RA rats without Ful treatment (p 
  8. Gul N, Rehman IU, Shah Y, Ali AM, Ali Z, Shehzad O, et al.
    PLoS One, 2024;19(11):e0311435.
    PMID: 39570934 DOI: 10.1371/journal.pone.0311435
    INTRODUCTION: Type II Diabetes mellitus (T2DM) patients often do not achieve glycemic control with oral hypoglycemic agents (OHAs). There are two main approaches to address this challenge: transitioning to a triple OHA regimen, or adding Insulin to the existing dual OHA regimen.

    AIM: This study aimed to compare the efficacy of adding Insulin to dual OHAs (Sitagliptin + Metformin) against adding a third OHA to Sitagliptin + Metformin in achieving glycemic control among patients with uncontrolled T2DM.

    METHOD: A pre-post study was conducted between 21 September 2023 and 21 December 2023 at Services Hospital Peshawar, Pakistan. Patients with uncontrolled T2DM with >7% HbA1c were divided into group 1 (Sitagliptin + Metformin plus a third OHA), and group 2 (Sitagliptin + Metformin plus pre-mixed Insulin 70/30). Glycemic control based on HbA1c values, fasting and random blood sugar levels, lipid profile, and body weight were evaluated after 3 months of therapy. The pre- and post- effect was compared by using a paired t-test.

    RESULTS: The study included n = 80 patients with T2DM. Between groups 1 and 2, no significant difference was found in HbA1c values (9.1 vs. 9, with p = 0.724). However, BMI, cholesterol, and LDL significantly decreased in group 1 compared to group 2 (p<0.001 vs. p = 0.131, p = 0.023 vs. p = 0.896, and p = 0.003 vs. p = 0.395, respectively). Additionally, the incidence of hypoglycemic episodes was significantly lower in group 1 (7.5%) than in group 2 (47.5%, p = 0.004). No significant difference was observed between the triple OHA and dual OHA plus Insulin regimens in achieving glycemic control.

    CONCLUSION: The triple OHA regimen improved BMI, cholesterol, and LDL levels, and reduced hypoglycemic episodes more effectively than dual OHA plus Insulin, despite similar HbA1c outcomes, suggesting it may be preferable for uncontrolled T2DM.

    MeSH terms: Administration, Oral; Adult; Aged; Blood Glucose; Drug Therapy, Combination*; Female; Humans; Male; Middle Aged; Pilot Projects
  9. Selvavinayagam ST, Sankar S, Yong YK, Anshad AR, Chandramathi S, Somasundaram A, et al.
    PLOS Glob Public Health, 2024;4(11):e0003608.
    PMID: 39570962 DOI: 10.1371/journal.pgph.0003608
    The decline in dengue incidence and/or prevalence during the COVID-19 pandemic (2020-22) appears to be attributed to reduced treatment-seeking rates, under-reporting, misdiagnosis, disrupted health services and reduced exposure to mosquito vectors due to prevailing lockdowns. There is limited scientific data on dengue virus (DENV) disease during the COVID-19 pandemic. Here, we conducted a community-based, cross-sectional, cluster-randomized survey to assess anti-DENV and anti-SARS-CoV-2 seroprevalence, and also estimated the spatial distribution of DENV-positive aedine mosquito vectors during the COVID-19 pandemic across all the 38 districts of Tamil Nadu, India. Using real-time PCR, the prevalence of DENV in mosquito pools during 2021 was analyzed and compared with the previous and following years of vector surveillance, and correlated with anti-DENV IgM and IgG levels in the population. Results implicate that both anti-DENV IgM and IgG seroprevalence and DENV positivity in mosquito pools were reduced across all the districts. A total of 13464 mosquito pools and 5577 human serum samples from 186 clusters were collected. Of these, 3.76% of the mosquito pools were positive for DENV. In the human sera, 4.12% were positive for anti-DENV IgM and 6.4% for anti-DENV IgG. While the anti-SARS-CoV-2 levels significantly correlated with overall DENV seropositivity, COVID-19 vaccination status significantly correlated with anti-DENV IgM levels. The study indicates a profound impact of anti-SARS-CoV-2 levels on DENV-positive mosquito pools and seropositivity. Continuous monitoring of anti-DENV antibody levels, especially with the evolving variants of SARS-CoV-2 and the surge in COVID-19 cases will shed light on the distribution, transmission and therapeutic attributes of DENV infection.
  10. Iswanto AH, Hua LS, Hussin MH, Hamidon TS, Hajibeygi M, Manurung H, et al.
    Int J Biol Macromol, 2024 Nov 19.
    PMID: 39571852 DOI: 10.1016/j.ijbiomac.2024.137714
    The rising environmental concerns and the growing demand for renewable materials have surged across various industries. In this context, lignin, being a plentiful natural aromatic compound that possesses advantageous functional groups suitable for utilization in biocomposite systems, has gained notable attention as a promising and sustainable alternative to fossil-derived materials. It can be obtained from lignocellulosic biomass through extraction via various techniques, which may cause variability in its thermal, mechanical, and physical properties. Due to its excellent biocompatibility, eco-friendliness, and low toxicity, lignin has been extensively researched for the development of high-value materials including lignin-based biocomposites. Its aromatic properties also allow it to successfully substitute phenol in the production of phenolic resin adhesives, resulting in decreased formaldehyde emission. This review investigated and evaluated the role of lignin as a green filler in lignin-based lignocellulosic composites, aimed at enhancing their fire retardancy and decreasing formaldehyde emission. In addition, relevant composite properties, such as thermal properties, were investigated in this study. Markedly, technical challenges, including compatibility with other matrix polymers that are influenced by limited reactivity, remain. Some impurities in lignin and various sources of lignin also affect the performance of composites. While lignin utilization can address certain environmental issues, its large-scale use is limited by both process costs and market factors. Therefore, the exact mechanism by which lignin enhances flame retardancy, reduces formaldehyde emissions, and improves the long-term durability of lignocellulosic composites under various environmental conditions remains unclear and requires thorough investigation. Life cycle analysis and techno-economic analysis of lignin-based composites may contribute to understanding the overall influence of systems not only at the laboratory scale but also at a larger industrial scale.
  11. Ngadimon IW, Shaikh MF, Mohan D, Cheong WL, Khoo CS
    Drug Discov Today, 2024 Nov 19.
    PMID: 39571887 DOI: 10.1016/j.drudis.2024.104247
    Epilepsy, a complex global neurological disorder, has spurred extensive research efforts focused on enhancing diagnostic and therapeutic strategies, with a growing emphasis on the identification of biomarkers. This bibliometric study examines 1,774 publications from 2000 to 2023, revealing a notable increase in research activity, particularly in the past decade. The US, China, and the UK lead contributions, with Asian countries exhibiting growing potential. Keyword co-occurrence analysis reveals a shift towards investigations of neuroinflammatory and genetic biomarkers, as well as emerging areas such as artificial intelligence and epigenetics. Content analysis links specific epilepsy aetiologies to biomarkers, offering promising possibilities for personalised diagnostics and treatments. These findings yield valuable insights into current trends, guiding future research and informing the development of targeted approaches for the diagnosis and treatment of epilepsy.
  12. Tan TW, Tan HL, Chung YC
    PMID: 39572015 DOI: 10.1111/wvn.12756
    BACKGROUND: Breast cancer patients undergoing chemotherapy experience body composition changes impacting treatment outcomes. The role of resistance training in mitigating chemotherapy-induced sarcopenia in breast cancer patients is not well defined.

    AIMS: This study aims to assess the efficacy of resistance training in preventing sarcopenia among breast cancer patients undergoing chemotherapy.

    METHODS: A systematic search was conducted across PubMed, EMBASE, Medline, the Cochrane Library, and CINAHL until May 5, 2023. Selected literature focused on the effects of resistance training on body fat, muscle mass, muscle strength, and physical performance in breast cancer patients undergoing chemotherapy. Cochrane Risk of Bias tool version 2.0 was employed for quality assessment, and data were analyzed using Comprehensive Meta-Analysis version 2.0.

    RESULTS: Eleven randomized controlled trials (RCTs) showed that resistance training had a significant positive impact on reducing body fat (SMD = -0.250, 95% CI [-0.450, -0.050]), increasing lean body mass (SMD = 0.374, 95% CI [0.178, 0.571]), and enhancing handgrip strength at both the affected site (SMD = 0.326, 95% CI [0.108, 0.543]) and the nonaffected site (SMD = 0.276, 95% CI [0.059, 0.492]). Additionally, significant improvements were observed in leg press strength (SMD = 0.598, 95% CI [0.401, 0.796]) and overall physical performance (SMD = 0.671, 95% CI [0.419, 0.923]).

    LINKING EVIDENCE TO ACTION: Resistance training is a recommended intervention for reducing body fat, increasing muscle mass, muscle strength, and enhancing physical performance in breast cancer patients undergoing chemotherapy. Ideal low-intensity resistance training programs span 8-24 weeks, with 20-to-90-min sessions 2-4 times weekly. Regimens generally entail 8-12 repetitions at 40%-90% of one-repetition maximum test, with free-weight resistance training targeting major muscle groups yielding substantial benefits. Further research should explore outcomes across different chemotherapy phases and investigate long-term resistance training effects for a comprehensive view.

  13. Abbasi MA, Siddiqui SZ, Nazir M, Muhammad S, Raza H, Shah SAA, et al.
    Chem Biodivers, 2024 Nov 21.
    PMID: 39572384 DOI: 10.1002/cbdv.202401806
    Biological screening combined with the synthesis of heterocyclic compounds with numerous functions is the most effective approach available for pharmacological assessment. In the  under taken research that is presented here,  4-(1H-indol-3-yl)butanoic acid was sequentially converted into 4-(1H-indol-3-yl)butanoate, 4-(1H-indol-3-yl)butanohydrazide and 5-[3-(1H-indol-3-yl)propyl]-1,2,4-triazole-2-thiol  as a nucleophile. The structural confirmation of all the synthesized compounds was done by IR, 1H-NMR, 13C-NMR and CHN analysis data. The enzyme inhibitory effects of these bi-heterocyclic propanamides were evaluated against elastase, and Oleanolic acid with IC50 value 13.453 ± 0.015 µM was used as a standard.  The kinetics mechanism was ascribed by Lineweaver-Burk plots, which revealed that compound 9d inhibited elastase competitively. The inhibition constant Ki calculated from Dixon plots for this compound was 0.51 μM. Compound 9d's activity (IC50 = 0.142 ± 0.014 µM) significantly increased when a slightly bulky ethyl group was replaced for the solitary methyl group in 9c at the para position. However, compound 9e's activity was significantly lower (IC50 = 38.338 ± 0.993µM). These molecules also exhibited mild cytotoxicity. So, these molecules might be deliberated as nontoxic medicinal scaffolds for dealing with the elastase related ailments such as lungs diseases, cyclic neutropenia, pruritic skin disease and liver infection.
  14. Abdullah R, Maamor N, Zakaria MN, Nik Othman NA, Othman BF, Abdul Wahab NA
    PMID: 39572413 DOI: 10.1007/s00405-024-09080-3
    PURPOSE: To compare the intersubject reliability of cortical auditory evoked potential (CAEP) elicited by acoustic and electrical stimulations in pediatric cochlear implant (CI) recipients.

    METHODS: Twenty-two MED-EL CI recipients (aged 13-93 months) participated in this study. The acoustic CAEP (aCAEP) waveforms were elicited using four speech stimuli (/ba/, /m/, /g/, and /t/) presented at 65 dB SPL in a free-field condition. The electrical CAEP (eCAEP) responses were obtained by presenting electrical pulses through apical, medial, and basal electrodes. The aCAEP and eCAEP data (n = 28 ears) were analyzed using coefficient of variation (CV) and other appropriate statistics.

    RESULTS: P1, N1, and P2 peaks were observed in most of the children (92.9% response rate). The CV values were smaller for the latency metric (13.6-34.2%) relative to the amplitude metric (51.3-92.4%), and the differences were statistically significant (p 

  15. Hasani WSR, Musa KI, Chen XW, Cheng KY
    Sci Rep, 2024 Nov 21;14(1):28849.
    PMID: 39572630 DOI: 10.1038/s41598-024-80091-0
    Cardiovascular disease (CVD) is a major global cause of premature mortality. While multiple studies propose CVD mortality prediction models based on regression frameworks, incorporating causal understanding through causal inference approaches can enhance accuracy. This paper demonstrates a methodology combining evidence synthesis and expert knowledge to construct a causal model for premature CVD mortality using Directed Acyclic Graphs (DAGs). The process involves three phases: (1) initial DAG development based on the Evidence Synthesis for Constructing Directed Acyclic Graphs (ESC-DAGs) framework, (2) validation and consensus-building with 12 experts using the Fuzzy Delphi method (FDM), and (3) application to data analysis using population-based survey data linked with death records. Expert input refined the initial DAG model, achieving consensus on 45 causal paths. The revised model guided selection of confounding variables for adjustment. For example, to estimate the total effect of diabetes on premature CVD mortality, the suggested adjustment set included age, dietary pattern, genetic/family history, sex hormones, and physical activity. Testing different DAG models showed agreement between expert ratings and data accuracy from regression models. This systematic approach contributes to DAG methodology, offering a transparent process for constructing causal pathways for premature CVD mortality.
    MeSH terms: Female; Humans; Male; Middle Aged; Causality; Mortality, Premature*
  16. Yang H, Li J, Hao M, Zhang W, He H, Sangaiah AK
    Sci Rep, 2024 Nov 21;14(1):28877.
    PMID: 39572631 DOI: 10.1038/s41598-024-80048-3
    In order to address the problem of data heterogeneity, in recent years, personalized federated learning has tailored models to individual user data to enhance model performance on clients with diverse data distributions. However, the existing personalized federated learning methods do not adequately address the problem of data heterogeneity, and lack the processing of system heterogeneity. Consequently, these issues lead to diminished training efficiency and suboptimal model performance of personalized federated learning in heterogeneous environments. In response to these challenges, we propose FedPRL, a novel approach to personalized federated learning designed specifically for heterogeneous environments. Our method tackles data heterogeneity by implementing a personalized strategy centered on local data storage, enabling the accurate extraction of features tailored to the data distribution of individual clients. This personalized approach enhances the performance of federated learning models when dealing with non-IID data. To overcome system heterogeneity, we design a client selection mechanism grounded in reinforcement learning and user quality evaluation. This mechanism optimizes the selection of clients based on data quality and training time, thereby boosting the efficiency of the training process and elevating the overall performance of personalized models. Moreover, we devise a local training method that utilizes global knowledge distillation of non-target classes, which combined with traditional federated learning can effectively address the issue of catastrophic forgetting during global model updates. This approach enhances the generalization capability of the global model and further improves the performance of personalized models. Extensive experiments on both standard and real-world datasets demonstrate that FedPRL effectively resolves the challenges of data and system heterogeneity, enhancing the efficiency and model performance of personalized federated learning methods in heterogeneous environments, and outperforming state-of-the-art methods in terms of model accuracy and training efficiency.
  17. Chew EG, Liu Z, Li Z, Chung SJ, Lian MM, Tandiono M, et al.
    Nat Aging, 2024 Nov 21.
    PMID: 39572736 DOI: 10.1038/s43587-024-00760-7
    Parkinson's disease (PD) is an incurable, progressive and common movement disorder that is increasing in incidence globally because of population aging. We hypothesized that the landscape of rare, protein-altering variants could provide further insights into disease pathogenesis. Here we performed whole-exome sequencing followed by gene-based tests on 4,298 PD cases and 5,512 controls of Asian ancestry. We showed that GBA1 and SMPD1 were significantly associated with PD risk, with replication in a further 5,585 PD cases and 5,642 controls. We further refined variant classification using in vitro assays and showed that SMPD1 variants with reduced enzymatic activity display the strongest association (<44% activity, odds ratio (OR) = 2.24, P = 1.25 × 10-15) with PD risk. Moreover, 80.5% of SMPD1 carriers harbored the Asian-specific p.Pro332Arg variant (OR = 2.16; P = 4.47 × 10-8). Our findings highlight the utility of performing exome sequencing in diverse ancestry groups to identify rare protein-altering variants in genes previously unassociated with disease.
  18. Dai L, Md Johar MG, Alkawaz MH
    Sci Rep, 2024 Nov 21;14(1):28885.
    PMID: 39572780 DOI: 10.1038/s41598-024-80441-y
    This work is to investigate the diagnostic value of a deep learning-based magnetic resonance imaging (MRI) image segmentation (IS) technique for shoulder joint injuries (SJIs) in swimmers. A novel multi-scale feature fusion network (MSFFN) is developed by optimizing and integrating the AlexNet and U-Net algorithms for the segmentation of MRI images of the shoulder joint. The model is evaluated using metrics such as the Dice similarity coefficient (DSC), positive predictive value (PPV), and sensitivity (SE). A cohort of 52 swimmers with SJIs from Guangzhou Hospital serve as the subjects for this study, wherein the accuracy of the developed shoulder joint MRI IS model in diagnosing swimmers' SJIs is analyzed. The results reveal that the DSC for segmenting joint bones in MRI images based on the MSFFN algorithm is 92.65%, with PPV of 95.83% and SE of 96.30%. Similarly, the DSC for segmenting humerus bones in MRI images is 92.93%, with PPV of 95.56% and SE of 92.78%. The MRI IS algorithm exhibits an accuracy of 86.54% in diagnosing types of SJIs in swimmers, surpassing the conventional diagnostic accuracy of 71.15%. The consistency between the diagnostic results of complete tear, superior surface tear, inferior surface tear, and intratendinous tear of SJIs in swimmers and arthroscopic diagnostic results yield a Kappa value of 0.785 and an accuracy of 87.89%. These findings underscore the significant diagnostic value and potential of the MRI IS technique based on the MSFFN algorithm in diagnosing SJIs in swimmers.
    MeSH terms: Adolescent; Adult; Algorithms; Female; Humans; Image Processing, Computer-Assisted/methods; Male; Young Adult
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