Prevalence and predictors of social anxiety disorders among Malaysian secondary school students during the COVID-19 pandemic: Exploring the influence of internet gaming disorder and impulsivity.

This study aimed to investigate the prevalence of social anxiety disorder (SAD) among Malaysian secondary school students during the COVID-19 pandemic and to explore its correlations with demographic variables, impulsivity behavior, and internet gaming disorder (IGD). A total of 1574 participants from 12 government secondary schools across five Malaysian states, comprising 569 males and 1005 females, completed an online questionnaire containing validated Malay versions of the Social Interaction Anxiety Scale, Barratt Impulsiveness Scale, and Internet Gaming Disorder Scale - Short Form. The findings revealed a notable SAD prevalence rate of 40.53% among Malaysian adolescents. Logistic regression analysis unveiled significant associations between SAD and factors such as attention impulsiveness (OR = 2.58, p < .001), motor impulsiveness (OR = 1.47, p = .03), female gender (OR = 2, p < .001), Malay ethnicity, and IGD (OR = 1.08, p < .001). In conclusion, this study provides valuable insights into the extent of social anxiety experienced by Malaysian secondary school students during the pandemic, shedding light on the demographic and psychosocial factors linked to its emergence. Furthermore, the research underscores a robust link between IGD and SAD, emphasizing the need for comprehensive interventions addressing both issues concurrently. By recognizing the multifaceted nature of these associations, future interventions can be tailored to provide holistic support for adolescents' mental well-being.

Prevention and inhibition of nasopharyngeal carcinoma growth by attenuated salmonella SGN1 / 中国药理学通报

Aim To study the inhibitory effect of attenuated salmonella SGN1, overexpressing methioninase, on nasopharyngeal carcinoma (NPC) and the underlying mechanism. Methods The cell proliferation, cell cycle, cell apoptosis, clony formation and migration a-bility of 5-8F, HNE-2, CNE-2 cells were measured u-sing flow cytometry assay, clone formation assay, and wound assay after the methionine restriction treatment. 5-8F, HNE-2, CNE-2 cells were infected with SGN1 at the multiplicity of infection (MOI) of 1: 100 for 5 hours, followed with the measurement of cell growth. A xenograft model was constructed by subcutaneous injection of 5-8F cells in mice to observe the inhibitory effect of SGN1 on nasopharyngeal carcinoma. Results Compared with the control group, methionine restriction significantly inhibited the proliferation, migration ability, and clone formation of nasopharyngeal carcinoma cells and blocked the G

Progress on development and application of the diet-related inflammatory index in cancer epidemiological studies / 中华流行病学杂志

Cancer is a major public health problem worldwide, causing an more serious burden of disease. Inflammation is considered a predisposing factor for cancer with close relationship with its incidence. In recent years, the public and epidemiologists has paid more attention to the association between nutrition and cancer and other chronic diseases in the perspective of inflammation. This paper summarizes the development and application of the diet-related inflammatory index in cancer epidemiological studies based on the literature retrieval of common diet-related inflammatory index. Firstly, we highlight the common diet-related inflammatory indices and their construction methods, such as the Dietary Inflammatory Index, a literature-derived diet-related inflammatory index, and the Empirical Dietary Inflammatory Index, an empirically derived diet-related inflammatory index, and so on. Secondly, the epidemiological research progress on the commonly used diet-related inflammatory indices is briefly introduced. Finally, the advantages and disadvantages of the two types of this inflammatory indices are also briefly described for the purpose of providing reference for nutrition epidemiological studies of cancer and other chronic diseases in China.

Dynamic Grafting of Carboxylates onto Poly(Vinyl Alcohol) Polymers for Supramolecularly-Crosslinked Hydrogel Formation.

Supramolecular hydrogels have attracted considerable interest due to their unique stimuli-responsive and self-healing properties. However, these hydrogel systems are usually achieved by covalent grafting of supramolecular units onto the polymer backbone, which in turn limits their reprocessability. Herein, we prepared a supramolecular hydrogel system by forming dynamic covalent crosslinks between 4-carboxyphenylboronic acid (CPBA) and polyvinyl alcohol (PVA). The system was then further crosslinked with either calcium ions or branched polyethylenimine (PEI) to generate hydrogels with distinctly different properties. Incorporation of calcium ions resulted in the formation of hydrogels with higher storage modulus of 7290 Pa but without self-healing properties. On the other hand, PEI-crosslinked hydrogel (PVA-CPBA-PEI) exhibited >2000% critical strain value, demonstrated high stability over 52 days and showed sustained antibacterial effect. A combination of supramolecular interactions and dynamic covalent crosslinks can be an alternate strategy to fabricate next-generation hydrogel materials.

Knowledge, skills, and attitudes of faculty members and residents-in-training of the Department of Rehabilitation Medicine of the Philippine General Hospital towards virtual learning: A cross-sectional study

Background and Objectives@#Virtual learning has been utilized in residency programs to continue training amid the COVID-19 pandemic. This study aimed to determine the knowledge, skills, and attitudes of faculty members and residents of the Department of Rehabilitation Medicine of the Philippine General Hospital towards virtual learning. @*Method@#This is a descriptive cross-sectional study. Respectively, residents and faculty members answered the Online Learning Readiness Scale (OLRS) and Faculty Readiness to Teach Online (FRTO) through Google Forms. @*Results@#Twenty (20) residents and 19 faculty members participated in the study. The majority of the residents preferred asynchronous learning (50%), while faculty members preferred the hybrid mode (74%). Residents’ readiness for online learning was generally high, though problems with easy distractibility (60%) and time management (40%) were revealed. Female residents had higher online communication self-efficacy compared to males (p = 0.0367). Faculty members’ perceived attitude was significantly higher than ability in course design (p = 0.00102), time management (p = 0.00159), and technical competence (p < 0.0001). Males had higher perceived ability in course design (p = 0.0320). Older age groups had lower perceived abilities in course design (p = 0.0301) and technical competence (p = 0.0371). @*Conclusion@#This study revealed the levels of readiness of residents and faculty for virtual learning. Finding indicate the need to address both issues by developing programs to enhance faculty’s online teaching abilities and observing best practices to minimize problems such as distractibility. Large-scale studies with longer time frames are also recommended.

Statistical methods for relative risk estimation and applications in case-cohort study / 中华流行病学杂志

Objective: To systematically introduce the design of case-cohort study and the statistical methods of relative risk estimation and their application in the design. Methods: First, we introduced the basic principles of case-cohort study design. Secondly, Prentice's method, Self-Prentice method and Barlow method were described in the weighted Cox proportional hazard regression models in detail, finally, the data from the Shanghai Women's Health Study were used as an example to analyze the association between obesity and liver cancer incidence in the full cohort and case-cohort sample, and the results of parameters from each method were compared. Results: Significant association was observed between obesity and risk for liver cancer incidence in women in both the full cohort and the case-cohort sample. In the Cox proportional hazard regression model, the partial regression coefficients of the full cohort and the case-cohort sample fluctuated with the adjustment of confounding factors, but the hazard ratio estimates of them were close. There was a difference in the standard error of the partial regression coefficient between the full cohort and the case-cohort sample. The standard error of the partial regression coefficient of the case-cohort sample was larger than that of the full cohort, resulting in a wider 95% confidence interval of the relative risk. In the weighted Cox proportional hazard regression model, the standard error of the partial regression coefficient of Prentice's method was closer to the parameter estimates from full cohort than Self-Prentice method and Barlow method, and the 95% confidence interval of hazard ratio was closer to that of the full cohort. Conclusions: Case-cohort design could yield parameter results closer to the full cohort by collecting and analyzing data from sub-cohort members and patients with the disease, and reduce sample size and improve research efficiency. The results suggested that Prentice's method would be preferred in case-cohort design.

Novel transdermal device for delivery of triamcinolone for nail psoriasis treatment

INTRODUCTION@#Nail psoriasis treatment is challenging due to difficult drug delivery and systemic therapy toxicities. Self-dissolvable microneedle patches embedded with corticosteroids offers a potentially rapid, minimally invasive drug delivery platform with good efficacy and minimal adverse side effects.@*METHODS@#We conducted a 4-month prospective randomised controlled trial. Subjects with psoriatic nails were randomised to receive microneedle device delivered topical steroids on one hand and control treatment (topical Daivobet gel) on the other. Two independent dermatologists blinded to the treatment assignment scored their Nail Psoriasis Severity Index (NAPSI) during visits at baseline, 2 and 4 months. All treatment was discontinued after 2 months. Average NAPSI score on each hand was analysed.@*RESULTS@#A total of 25 participants were recruited, aged 22 to 73 years. Majority were Chinese (72%), followed by Indian and Malay. There was equal randomisation of treatment to the left and right nail. While there was a rapid significant improvement in average NAPSI score for the control arm at 2 months, the treatment arm had a greater, more sustained improvement of the NAPSI score at 4 months. The average NAPSI score improved for both treatment and control group at 4 months compared to baseline. However, only the NAPSI value improvement in the controls at 2 months compared to baseline was statistically significant (P=0.0039). No severe adverse effects were reported.@*CONCLUSION@#To the best of our knowledge, this is the first prospective randomised control trial comparing microneedle technology against conventional topical steroids in nail psoriasis treatment. Our findings demonstrate microneedle technology is as efficacious as topical therapy.

Feasibility & Efficacy of Deprescribing rounds in a Singapore rehabilitative hospital- a randomised controlled trial.

BACKGROUND: Deprescribing is effective and safe in reducing polypharmacy among the elderly. However, the impact of deprescribing rounds remain unclear in Asian settings. Hence, we conducted this study. METHODS: An open label randomised controlled trial was conducted on patients of 65 years and above, under rehabilitation or subacute care and with prespecified medications from a Singapore rehabilitation hospital. They were randomised using a computer generated sequence. The intervention consisted of weekly multidisciplinary team-led deprescribing rounds (using five steps of deprescribing) and usual care. The control had only usual care. The primary outcome is the percentage change in total daily dose (TDD) from baseline upon discharge, while the secondary outcomes are the total number of medicine, total daily cost and TDD up to day 28 postdischarge, overall side-effect rates, rounding time and the challenges. Efficacy outcomes were analysed using intention-to-treat while other outcomes were analysed as per protocol. RESULTS: 260 patients were randomised and 253 were analysed after excluding dropouts (female: 57.3%; median age: 76 years). Baseline characteristics were largely similar in both groups. The intervention arm (n = 126) experienced a greater reduction of TDD on discharge [Median (IQR): - 19.62% (- 34.38, 0.00%) versus 0.00% (- 12.00, 6.82%); p < 0.001], more constipation (OR: 3.75, 95% CI:1.75-8.06, p < 0.001) and laxative re-prescriptions (OR: 2.82, 95% CI:1.30-6.12, p = 0.009) though death and hospitalisation rates were similar. The median rounding time was 7.09 min per patient and challenges include the inconvenience in assembling the multidisciplinary team. CONCLUSION: Deprescribing rounds can safely reduce TDD of medicine upon discharge compared to usual care in a Singaporean rehabilitation hospital. TRIAL REGISTRATION: This study is first registered at Clinicaltrials.gov (protocol number: NCT03713112 ) on 19/10/2018 and the protocol can be accessed on https://www.clinicaltrials.gov .

Patterns of Suffering in Palliative Care: A Descriptive Study.

Suffering experiences are common phenomena in palliative care. In this study, we aim to explore the different patterns of suffering in palliative care. Adult palliative care patients were recruited from the University of Malaya Medical Centre. Suffering scores were charted 3 times a day for a week. The characteristics of the suffering charts were analyzed using SPSS. The patterns of suffering were analyzed using structural pattern recognition. A total of 53 patients participated. The overall trends of suffering were downward (64%), upward (19%), and stable (17%). Median minimum and maximum suffering scores were 2/10 and 6/10, with an average of 3.6/10. Nine patterns of suffering were recognized from categorizing two key characteristics of suffering (intensity and fluctuation)-named S1 to S9. Understanding the different patterns of suffering may lead to better suffering management.

A series of strategies and clinical practice for prevention and control of COVID-19 in COVID-19-designated hospitals / 西安交通大学学报(医学版)

Since the outbreak of COVID-19, the epidemic has been spreading rapidly. As an important base to combat the epidemic, the hospital infection prevention and control work is facing great challenges. In particular, as one of the first COVID-19 designated hospitals in a province and a large general hospital at the same time, how to prevent and control nosocomial infection among patients and medical staff during the epidemic period of COVID-19 is of paramount importance. Our strategies start with the three key elements of infectious disease management, namely, "controlling the source of infection, cutting off the route of transmission, and protecting the susceptible population." The in-patients in pre-examination and triage, fever clinic, isolation ward and common ward were inspected from fever screening, pre-examination and triage, personal protection, in-patient management, emergency treatment, accompanying care management, and environmental disinfection. A series of interventions were carried out to effectively cut off the transmission of COVID-19 in hospitals. After effective screening and rational pre-examination and triage for outpatients, emergency patients and inpatients, medical personnel received a series of training, scientific protection, and accompanying personnel were effectively managed and controlled, there was not a single case of nosocomial infection during the epidemic of COVID-19. This series of intervention strategies provides some reference for other medical institutions to carry out effective prevention and control of the epidemic.

Clinical implications of prompt ascitic drain removal in cirrhosis with refractory ascites

INTRODUCTION@#Large-volume paracentesis (LVP) is the first-line treatment for decompensated cirrhosis with refractory ascites. While ascitic drain removal (ADR) within 72 hours of the procedure was once considered safe, it was uncertain whether ADR within 24 hours could further reduce the risk of ascitic drain-related bacterial peritonitis (AdBP). This study aimed to investigate the association between the timing of ADR and the presence of AdBP.@*METHODS@#All patients with cirrhosis with refractory ascites who underwent LVP in our institution from 2014 to 2017 were studied. AdBP was diagnosed based on an ascitic fluid neutrophil count ≥ 250 cells/mm@*RESULTS@#A total of 131 patients who underwent LVP were followed up for 1,806 patient-months. Their mean age was 68.3 ± 11.6 years, and 65.6% were male. Their mean Model for End-Stage Liver Disease score was 15.2. The overall incidence of AdBP was 5.3%. ADR beyond 24 hours was significantly associated with a longer median length of stay (five days vs. three days, p < 0.001), higher risk of AdBP (0% vs. 8.9%, p = 0.042) and acute kidney injury (AKI) following LVP (odds ratio 20.0, 95% confidence interval 2.4-164.2, p = 0.021). The overall survival was similar in patients who underwent ADR within and beyond 24 hours of LVP.@*CONCLUSION@#ADR within 24 hours of LVP is associated with a reduced risk of AdBP and AKI. As AdBP is associated with resistant organisms and AKI, we recommend prompt ADR within 24 hours, especially in patients who have Child-Pugh class C alcoholic cirrhosis.

The Accuracy of Healthcare Worker versus Self Collected (2-in-1) Oropharyngeal and Bilateral Mid-Turbinate (OPMT) Swabs and Saliva Samples for SARS-CoV-2

Background Self-sampling for SARS-CoV-2 would significantly raise testing capacity and reduce healthcare worker (HCW) exposure to infectious droplets personal, and protective equipment (PPE) use. Methods We conducted a diagnostic accuracy study where subjects with a confirmed diagnosis of COVID-19 (n=401) and healthy volunteers (n=100) were asked to self-swab from their oropharynx and mid-turbinate (OPMT), and self-collect saliva. The results of these samples were compared to an OPMT performed by a HCW in the same patient at the same session. Results In subjects confirmed to have COVID-19, the detection rates of the HCW-swab, self-swab, saliva, and combined self-swab plus saliva samples were 82.8%, 75.1%, 74.3% and 86.5% respectively. All samples obtained from healthy volunteers were tested negative. Compared to HCW-swab, the detection rates of a self-swab sample and saliva sample were inferior by 8.7% (95%CI: 2.4% to 15.0%, p=0.006) and 9.5% (95%CI: 3.1% to 15.8%, p=0.003) respectively. The combined detection rate of self-swab and saliva had a higher detection rate of 2.7% (95%CI: -2.6% to 8.0%, p=0.321). The sensitivity of both the self-collection methods are higher when the Ct value of the HCW swab is less than 30. The negative correctness of both the self-swab and saliva testing was 100% (95% CI 96.4% to 100%). Conclusion Our study provides evidence that detection rates of self-collected OPMT swab and saliva samples were inferior to a HCW swab, but they could still be useful testing tools in the appropriate clinical settings.

Design and application of quality standard of Dao-di herbs / 中国中药杂志

Dao-di herbs, which are widely recognized as medicinal materials with a high quality and good efficacy in clinic, are now facing the dilemma of absence of standard. This study focused on a pivotal scientific problem of design and application of quality standard of Dao-di herbs, and systematically illustrated the general rules for the quality standard of Dao-di herbs involving "four rules, six core contents, and three key methods". The quality standard of Dao-di herbs shall be fully based on literatures as well as habitat, planting/breeding, processing, characters, chemical-pharmacological/toxic data. The common requirements for the quality standard of Dao-di herbs contain "clear source, explicit origin, rational indicator, gradable quality, and multiple detection methods". Notably, traditional experiences and modern techniques, quality tracing management system, "quality determination by distinguishing characters" method, rapid detection technology, effective/toxic substances control method, were comprehensively applied in this standard to purse the objectification, automation, and intellectualization of detection technology. Appearance characters, chemical components, and bioactive parameters, unified effective/toxic indicators, quality markers, and pharmacopeial control indicators and reasonable ranges were included in rigorous quality standards for Dao-di herbs. Besides, simple grading method shall be developed to guide the implementation of "high quality-high price" policy. Eventually, the new quality standards for Dao-di herbs will lead international standards and promote the high-quality development of Dao-di herbs.

Structural characterization and anti-complement activity of polysaccharides from Glechomae Herba / 中草药

Objective: To isolate and purify the homogeneous polysaccharides from Glechomae Herba through the guidance of anti-complement activity, and study their structures. Methods: Crude polysaccharides from Glechomae Herba were extracted by water extraction and alcohol precipitation, then homogeneous polysaccharides were separated by DEAE-52 and Sephadex G-100 column chromatography. The structures of homogeneous polysaccharides were characterized by HPGPC, IR, GC, methylation and NMR, and their anti-complement activities were also determined. Results: Two homogeneous polysaccharides GLP-1 and GLP-2 were obtained with the molecular weight of 5 370 and 20 040. They were both heteropolysaccharides composed of arabinose and galactose with the ratio of 1:6.3 and 1:4.9, respectively. Conclusion: The structures of GLP-1 and GLP-2 further elucidate the pharmacodynamic basis of their anti-complement activities and provide basis for screening natural complement inhibitors.

Limitation standard of toxic aconitines in proprietary Chinese medicines using on-line extraction electrospray ionization mass spectrometry

Development of rapid analytical methods and establishment of toxic component limitation standards are of great importance in quality control of traditional Chinese medicine. Herein, an on-line extraction electrospray ionization mass spectrometry (oEESI-MS) coupled with a novel whole process integral quantification strategy was developed and applied to direct determination of nine key aconitine-type alkaloids in 20 proprietary Chinese medicines (APCMs). Multi-type dosage forms (, tablets, capsules, pills, granules, and liquid preparation) of APCM could be determined directly with excellent versatility. The strategy has the characteristics of high throughput, good tolerance of matrix interference, small amount of sample (∼0.5 mg) and reagent (∼240 μL) consumption, and short analysis time for single sample (<15 min). The results were proved to be credible by high performance liquid chromatography-mass spectrometry (LC-MS) and electrospray ionization mass spectrometry, respectively. Moreover, the limitation standard for the toxic aconitines in 20 APCMs was established based on the holistic weight toxicity (HWT) evaluation and the severally, and turned out that HWT-based toxicity evaluation results were closer to the real clinical applications. Hence, a more accurate and reliable APCM toxicity limitation was established and expected to play an important guiding role in clinics. The current study extended the power of ambient MS as a method for the direct quantification of molecules in complex samples, which is commonly required in pharmaceutical analysis, food safety control, public security, and many other disciplines.

Thoughts on the construction of military medical training system in the new era / 医学研究生学报

To adapt to the situation of medical support in the new era, we need to further improve the military medical training system. This paper reviews the course of military medical development, and puts forward some suggestions for the construction of the military medical training system of our army for reference，based on the characteristics of our army and the practical needs of military struggle preparation in the new era.

Clinical Features and Risk Factors of Systemic Lupus Erythematosus Complicated with Cytomegalovirus Infection / 中国医学科学院学报

Objective To explore the clinical characteristics and risk factors of systemic lupus erythematosus(SLE)complicated with cytomegalovirus infection(CMV). Methods The medical records of patients diagnosed with SLE at discharge in the Department of Immunology at Peking Union Medical College Hospital between July 1,2017 and April 1,2019 were retrospectively reviewed,and the clinical and laboratory data related to CMV infection were analyzed. Results Of the 231 patients with SLE,115(49.8%)had CMV infection.Among them,78(67.8%)were asymptomatic CMV infection and 37(32.2%)were diagnosed with CMV disease.Univariate analysis showed the number of organs involved(

Quality evaluation of musk based on the biological potency of its anti-thrombin activty / 中国中药杂志

This study attempts to establish a method for the anti-thrombin activty bioassay of musk, explore the impact of species and producing areas on the anti-thrombin activty of musk, and provide scientific basis for its biological quality evaluation. Anti-thrombin activty of musk was analyzed by thrombin titration, and the influence factors such as musk solution concentration, fibrinogen concentration, thrombin concentration and titration interval were optimized to evaluate the effect of different species and producing areas on anti-thrombin activty of musk. As a result, there was a good linear relationship between musk solution concentration and thrombin consumption volume within the range of 0.01-0.02 g·mL⁻¹ (=0.991 4) under the experimental condition as follows: fibrinogen concentration was 0.5%, the thrombin concentration was 10 U·mL⁻¹； titration time interval was once every minute, and each titration volume was 2 μL. The average anti-thrombin activty potency of Moschus berezovskii from different producing areas was (105.0±10.4) U·g⁻¹, (102.4±5.5) U·g⁻¹ for M. sifanicus from different producing areas, (97.7±6.6) U·g⁻¹ for M. moschiferus from Anhui province, and (58.6±6.4) U·g⁻¹ for artificial musk. The results indicated that this anti-thrombin activty bioassay method could be applied to evaluate the anti-thrombin activty of musk quickly, conveniently, sensitively and exactly. It was also suggested that different species and producing areas had effects on the anti-thrombin activty of musk, so it is necessary to pay attention to species and producing areas in the process of musk domestication; meanwhile, the artificial musk and natural musk also showed great differences in anti-thrombin activty, suggesting that ratio in artificial musk prescription needs to be further optimized.

In vivo metabolism of three coumarins from Chimonanthi Radix based on UHPLC-QTOF-MS/MS / 中国中药杂志

Scopolin (SC-1), scopoletin (SC-2) and isofraxidin (IS-1) are the main active constituents in Chimonanthi Radix. However, the in vivo metabolism of SC-1, SC-2 and IS-1 have not been comprehensively clarified. In this study, the in vivo metabolic profiles of these three coumarins in the rat plasma, urine and feces were analyzed. Ultra-high performance liquid chromatography-quadrupole time of flight mass spectrometry (UHPLC-QTOF-MS/MS) method was applied to characterize the prototypes and metabolites of SC-1, SC-2 and IS-1 in rat feces, urine, and plasma after intravenous administration. A total of 11 metabolites of the three parent compounds were tentatively identified. The main metabolic pathways were analyzed by identification of metabolites, and it was found that these three coumarins underwent multiple in vivo metabolic reactions including glucuronidation, sulfonation, isomerism and reduction. In this study, the analysis of metabolites of three coumarins basically demonstrated their in vivo metabolic process, providing basis for the further pharmacokinetics and pharmacological evaluations of SC-1, SC-2 and IS-1.

Design and application of medical war storage materials management platform based on context awareness / 医疗卫生装备

Objective To realize intelligent and refined management of medical war storage materials by designing a management platform based on context awareness.Methods The conditions of medical war storage materials and its storage environment were monitored dynamically,and technologies of context awareness,radio frequency identification,temperature and humidity sensing and etc were used to establish the platform.Results The platform improved the traditional medical war storage materials management system in intelligence and refinement,and implemented auto update and intelligent alarm for the information on medical war storage materials.Conlusion The platform fulfills automatic and intelligent medical war storage materials management,and thus has practical values for medical service support.