A series of comprehensive focus group discussions with active firefighters revealed that inconsistencies in incorporating a rigorous physical training program during work hours contributed significantly to the challenges of maintaining functional fitness, particularly strength. This article outlines a process for identifying the specific exercises required to enhance strength, drawing on the expertise and experience of physical trainers. Modified nominal group technique (mNGT) sessions were conducted to identify and rank exercises for five functional strengths (i.e., pushing, pulling, lifting, carrying, and dragging). A total of six physical trainers from the firefighter academy were interviewed to 1) identify the skeletal muscles involved in the functional movements using a visual aid; 2) generate ideas for exercises via brainstorming; 3) privately rank the displayed list of exercises for each muscle group involved in each functional movement; and 4) design a physical training programme for beginner, intermediate and advanced levels by manipulating loads. Males dominated the expert group (66.7%) and had a mean of 11.50 (SD 5.20) years of experience in physical training. The mNGTs yielded three top-ranking exercises for each functional strength: 1) Pushing: the push-up, sit-up, and jumping jack; 2) pulling: the push-up, jumping jack, and sit-up; 3) lifting: the jumping jack, push-up, and jumping squat; 4) carrying: the push-up, plank, and sit -up; and 5) dragging: the jumping jack, sit-up, and jumping squat. Then each exercise was designed for the beginner, intermediate, and advanced levels by manipulating loads (i.e. additional weight or number of repetitions). This study demonstrated that mNGT is an effective tool for identifying the three top-ranking exercises that address firefighter recruits’ functional strength. The experts chose multi-joint exercises targeting agonist and antagonist skeletal muscle groups and mimicking movements of daily work life. The exercises, corroborated by previous empirical evidence, provide opportunities for common skeletal muscle groupings to be targeted simultaneously to increase cardiovascular adaptations over a shorter period. The physical exercise is now ready to be implemented for piloting purposes among firefighter recruits.

Menawan Gunung Kinabalu: Penyakit Altitud Tinggi dan Langkah-Langkah Pencegahan PengenalanGunung Kinabalu, puncak tertinggi di Malaysia dengan ketinggian 4095 meter, merupakan destinasi popular bagi pendaki tetapi boleh mendatangkan risiko penyakit berkaitan altitud kepada para pendaki. Artikel ini bertujuan untuk membincangkan penyakit altitud tinggi dan langkah-langkah pencegahan yang boleh diambil oleh pendaki sebelum, semasa dan selepas pendakian dari segi perubahan mekanisme fisiologi.MetodologiSatu kajian literatur secara komprehensif telah dijalankan, dengan fokus kepada simptom, gejala, dan pencegahan penyakit altitud dalam kalangan pendaki. Maklumat dikumpulkan dari jurnal yang disemak oleh rakan sejawat, laporan teknikal pendakian, dan kajian lapangan berkaitan dengan Gunung Kinabalu dan pendakian di altitud tinggi.Hasil KajianPenyakit altitud tinggi seperti penyakit ketinggian akut, high-altitude cerebral oedema, high-altitude pulmonary oedema, dan beberapa penyakit lain dikupas dengan lebih mendalam. Selain itu, faktor risiko penyakit altitud tinggi turut dikenal pasti. Strategi pencegahan yang dibahagikan kepada sebelum, semasa, dan selepas pendakian kemudian dibincangkan. Antara langkah pencegahan yang berkesan termasuk persediaan fizikal badan, konsultasi dan penilaian kesihatan komprehensif pra-pendakian, aklimatisasi secara beransur-ansur, mengekalkan hidrasi, dan penggunaan ubat profilaksis seperti acetazolamide dan dexamethasone..KesimpulanSetiap pendaki yang ingin menawan gunung altitud tinggi seperti Gunung Kinabalu perlu fahami risiko penyakit altitud tinggi. Langkah pencegahan yang bersesuaian dan mencukupi bukan sahaja mampu mengurangkan risiko penyakit altitud tinggi, tetapi berjaya menawan puncak Gunung Kinabalu dan pulang dengan selamat.

BACKGROUND: Mesenchymal stem cells (MSCs) have undergone extensive investigation for their potential therapeutic applications, primarily attributed to their paracrine activity. Recently, researchers have been exploring the therapeutic potential of extracellular vesicles (EVs) released by MSCs. METHODS: MEDLINE/PubMed and Google scholar databases were used for the selection of literature. The keywords used were mesenchymal stem cells, extracellular vesicles, clinical application of EVs and challenges EVs production. RESULTS: These EVs have demonstrated robust capabilities in transporting intracellular cargo, playing a critical role in facilitating cell-to-cell communication by carrying functional molecules, including proteins, RNA species, DNAs, and lipids. Utilizing EVs as an alternative to stem cells offers several benefits, such as improved safety, reduced immunogenicity, and the ability to traverse biological barriers. Consequently, EVs have emerged as an increasingly attractive option for clinical use. CONCLUSION From this perspective, this review delves into the advantages and challenges associated with employing MSC–EVs in clinical settings, with a specific focus on their potential in treating conditions like lung diseases, cancer, and autoimmune disorders.

The coronavirus disease 2019 pandemic has fundamentally reshaped anatomy education, offering invaluable insights to guide the future of anatomy pedagogy. As we transition into a post-pandemic era, it is crucial to integrate the lessons learned to create a more resilient, flexible, and effective educational environment. This paper examines the transformative strategies implemented at Universiti Sains Malaysia during the pandemic, focusing on the empowerment of blended learning, technology-enhanced tools, student-centered learning practical sessions, and enhancement of formative assessment. These strategies include integrating digital learning resources, such as the Virtual Anatomy Museum and online histology quizzes, with in-person instruction, fostering a supportive and interactive learning environment. Additionally, practical sessions were redesigned to emphasize collaborative learning, peer teaching, and developing critical thinking and communication skills. Formative assessments were integrated to provide continuous feedback and support ongoing learning. This comprehensive approach not only enhanced students’ understanding of anatomical concepts but also improved their emotional well-being and overall learning experience. The lessons learned from the pandemic have paved the way for a more innovative and adaptive anatomy education that is well-prepared for future challenges.

The coronavirus disease 2019 pandemic has fundamentally reshaped anatomy education, offering invaluable insights to guide the future of anatomy pedagogy. As we transition into a post-pandemic era, it is crucial to integrate the lessons learned to create a more resilient, flexible, and effective educational environment. This paper examines the transformative strategies implemented at Universiti Sains Malaysia during the pandemic, focusing on the empowerment of blended learning, technology-enhanced tools, student-centered learning practical sessions, and enhancement of formative assessment. These strategies include integrating digital learning resources, such as the Virtual Anatomy Museum and online histology quizzes, with in-person instruction, fostering a supportive and interactive learning environment. Additionally, practical sessions were redesigned to emphasize collaborative learning, peer teaching, and developing critical thinking and communication skills. Formative assessments were integrated to provide continuous feedback and support ongoing learning. This comprehensive approach not only enhanced students’ understanding of anatomical concepts but also improved their emotional well-being and overall learning experience. The lessons learned from the pandemic have paved the way for a more innovative and adaptive anatomy education that is well-prepared for future challenges.

The coronavirus disease 2019 pandemic has fundamentally reshaped anatomy education, offering invaluable insights to guide the future of anatomy pedagogy. As we transition into a post-pandemic era, it is crucial to integrate the lessons learned to create a more resilient, flexible, and effective educational environment. This paper examines the transformative strategies implemented at Universiti Sains Malaysia during the pandemic, focusing on the empowerment of blended learning, technology-enhanced tools, student-centered learning practical sessions, and enhancement of formative assessment. These strategies include integrating digital learning resources, such as the Virtual Anatomy Museum and online histology quizzes, with in-person instruction, fostering a supportive and interactive learning environment. Additionally, practical sessions were redesigned to emphasize collaborative learning, peer teaching, and developing critical thinking and communication skills. Formative assessments were integrated to provide continuous feedback and support ongoing learning. This comprehensive approach not only enhanced students’ understanding of anatomical concepts but also improved their emotional well-being and overall learning experience. The lessons learned from the pandemic have paved the way for a more innovative and adaptive anatomy education that is well-prepared for future challenges.

The coronavirus disease 2019 pandemic has fundamentally reshaped anatomy education, offering invaluable insights to guide the future of anatomy pedagogy. As we transition into a post-pandemic era, it is crucial to integrate the lessons learned to create a more resilient, flexible, and effective educational environment. This paper examines the transformative strategies implemented at Universiti Sains Malaysia during the pandemic, focusing on the empowerment of blended learning, technology-enhanced tools, student-centered learning practical sessions, and enhancement of formative assessment. These strategies include integrating digital learning resources, such as the Virtual Anatomy Museum and online histology quizzes, with in-person instruction, fostering a supportive and interactive learning environment. Additionally, practical sessions were redesigned to emphasize collaborative learning, peer teaching, and developing critical thinking and communication skills. Formative assessments were integrated to provide continuous feedback and support ongoing learning. This comprehensive approach not only enhanced students’ understanding of anatomical concepts but also improved their emotional well-being and overall learning experience. The lessons learned from the pandemic have paved the way for a more innovative and adaptive anatomy education that is well-prepared for future challenges.

Medication review is an intervention with the potential to reduce drug-related problems (DRPs) in the elderly. This study aimed to determine the effect of pharmacists’ medication reviews on geriatric patients. This study accessed two online databases, MEDLINE Complete and Scopus, and examined all studies published in English between 2019 and 2023, except for reviews. The studies included (1) participants over 65 years of age and (2) medication reviews conducted by pharmacists. The titles, abstracts, and full texts were reviewed for data extraction to determine whether the studies satisfied the inclusion and exclusion criteria. Forty-four of the initial 709 articles were included in this study. The articles included discussions on the incidence rates of DRPs and potentially inappropriate medications (PIMs) (n=21), hospitalization (n=14), medication adherence (n=9), quality of life (QoL) (n=8), and falls (n=7). Pharmacist medication reviews were associated with a reduced incidence of DRPs and PIMs, and improved adherence to medications. Patients’ overall QoL is also increasing. However, pharmacist medication reviews were not strongly associated with decreased hospitalization or falls. A pharmacist’s medication review may be a feasible intervention for reducing the incidence rates of DRPs and PIMs, regardless of whether it is performed as a sole intervention or supplemented with other interventions. The intervention was also effective in increasing medication adherence and QoL.

Objective: To determine the effects of lower limb muscle fatigue on spatiotemporal gait parameters and turning difficulty characteristics during the extended Timed Up and Go (extended TUG) test in individuals with different severity stages of Parkinson’s disease (PD). Methods: Forty individuals with PD, classified as Hoehn and Yahr (H&Y) stages 2 and 3 participated in this pre- and post-experimental study design. The participants performed a continuous sit-to-stand task from a chair based on 30 cycles/min set-up to induce lower limb muscle fatigue. They performed extended TUG test immediately before and after completing the fatigue protocol. Spatiotemporal gait parameters and turning difficulty characteristics were recorded using two GoPro® Hero 4 Silver cameras. Data were subjected to a repeated-measure ANOVA. Results: Individuals with PD experience significant changes in spatiotemporal gait parameters, specifically stride velocity and length, under conditions of lower limb muscle fatigue (p=0.001). These changes were more pronounced in individuals with PD in the H&Y stage 3 group. Additionally, both PD groups exhibited difficulty with turning, requiring more than five steps to complete a 180° turn and taking more than 3 seconds to accomplish it. Conclusion These findings highlight the impact of muscle fatigue on gait performance in PD and suggest that individuals in later stages of the disease may be particularly affected. Further research is needed to explore interventions that can mitigate these gait impairments and improve mobility in individuals with PD.