BACKGROUND: Acute decompensated heart failure (ADHF) is one of the leading causes of mortality, highlighting the importance of early identification of high-risk patients. The fibrosis-5 (FIB-5) index, traditionally used to evaluate hepatic fibrosis, may hold prognostic value in ADHF patients by reflecting systemic congestion, inflammation, and organ dysfunction. The hypothesis of this study is that the FIB-5 index is an independent predictor of 1-month mortality in patients with ADHF. METHODS: This retrospective study included 155 patients diagnosed with ADHF between 2020 and 2024. Patients were divided into two groups based on their left ventricular ejection fraction (LVEF ≤ 40% or LVEF > 50%). Survival was monitored for one month, and clinical, biochemical, and echocardiographic parameters were compared between survivors and death. Logistic regression and receiver operating characteristic curve analyses were performed to assess the prognostic value of the FIB-5 index. RESULTS: During the 1-month follow-up, 66 patients (42.6%) died. The mean FIB-5 index was significantly lower in non-survivors (-10.46 ± 6.93) compared to survivors (-8.10 ± 6.67) (P = 0.03). Multivariate regression analysis identified the FIB-5 index as an independent predictor of 1-month mortality (OR = 1.089, 95% CI: 1.022-1.160, P = 0.009). The receiver operating characteristic curve analysis demonstrated an area under the curve of 0.609 (95% CI: 0.51-0.699) with sensitivity of 59.6% and specificity of 63.4%. Kaplan-Meier survival analysis revealed significantly higher mortality rates among patients with lower FIB-5 values (log-rank: 7.887, P = 0.005). CONCLUSIONS The FIB-5 index is an independent predictor of 1-month mortality in ADHF patients. Its low cost, non-invasive nature, and ability to reflect systemic inflammation and congestion make it a promising tool for risk stratification. Prospective studies are needed to validate its utility in clinical practice and evaluate its role in guiding therapeutic decisions.

Introduction: Food security and dietary diversity are critical in ensuring the nutritional and dietary adequacy of mothers. However, since the COVID-19 outbreak, it has become more challenging for mothers to maintain a healthy and varied diet, as more households are reported to be food insecure. Thus, this study aimed to assess food insecurity and its determinants, as well as to determine how it relates to dietary diversity. Methods: A cross-sectional study comprising 200 of B40 mothers with children under the age of two who resided in metropolitan regions of Selangor was conducted. Household Food Insecurity Access Scale (HFIAS) and Minimum Dietary Diversity for Women (MDDW) questionnaires were used to measure food insecurity and dietary diversity, respectively. Results: About 67% of mothers experienced food insecurity and 29.5% experienced dietary monotony. Less than 12 years of education (AOR=4.89, 95% CI=1.87-12.83) and living in a family with six or more people (AOR=3.48, 95% CI=1.20-11.20) were significantly associated with food insecurity. Besides, mothers with a monotonous diet were eight times more likely to be food insecure (AOR=8.03, 95% CI=2.67-24.05). Higher odds of dietary monotony were associated with less than 12 years of education (AOR=2.46, 95% CI=1.13-5.35) and household income contributor of not more than one person (AOR=3.78, 95% CI=1.66-8.60). Conclusion: Food insecurity was associated with an increased chance of dietary monotony among low-socioeconomic women residing in urban community. Therefore, identifying and addressing issues related to poor dietary diversity may allow for preventive and proactive measures to improve their nutritional status and well-being.

Introduction: Race estimation of unknown individual is essential in forensic investigation. The resiliency of frontal sinus makes it a potential tool for biological profiling, particularly in cases where fragmented skeleton persists. Geometric morphometrics is an efficient way to characterise shape. However, the use of frontal sinus to identify race of Malaysians is yet to be investigated. This research employed a two-dimensional (2D) geometric morphometric to examine the morphological differences of the frontal sinus among the major races in Malaysia. Methods: Lateral skull radiographs which comprising of 453 adult Malaysian (151 Malays, Chinese and Indian respectively) were used. The 2D landmarks of eight were placed on the digitalized radiographs and 2D geometric morphometric analysis was performed using MorphoJ software. Results: Procrustes ANOVA revealed a significantly different frontal sinus shape (p-value < 0.05) between races. Canonical variate analysis showed significantly different frontal sinus morphology (p-value < 0.05) between Malay and Indian as well as Chinese and Indian. Discriminant function analysis with cross-validation demonstrated a 57.4% accuracy rate. Conclusion: This population-specific study based on frontal sinus of Malaysians using the 2D geometric morphometric, though less reliable, sheds new light on the potential applicability of this method for race estimation purpose.

Staphylococcus aureus is a common bacterial pathogen known to cause various kinds of infections due to its repertoire of virulence factors. This study aimed to investigate the distribution of 19 types of virulence genes among clinical isolates of methicillin-susceptible S. aureus (MSSA) using the polymerase chain reaction. A total of 109 MSSA isolates, i.e., 63 hospital-associated (HA) and 46 community-associated (CA) were collected from Hospital Sultanah Nur Zahirah, the main tertiary hospital in Terengganu, Malaysia, from July 2016 to June 2017. The most frequent virulence genes detected were hla (78.9%, n=86) and hld (78.0%, n=85) encoding hemolysins, lukED (56.9%, n=62) encoding leukotoxin ED, followed by seb (26.6%, n=29) and sea (24.8%, n=27) encoding enterotoxins. Among 34 (31.2%) isolates carrying six or more virulence genes, only five were multidrug resistant (MDR) while the remaining isolates were susceptible. Significant associations were discovered between the hld gene with CA-MSSA (p=0.016) and the seo gene with HA-MSSA (p=0.023). However, there is no significant association between virulence genes among the different types of infection. The clinical MSSA isolates in Terengganu showed high prevalence and high diversity of virulence gene carriage.

Aims: This study was aimed to investigate the effects of methanol extracts from various parts of the Pereskia bleo Kuhn plant on Acanthamoeba sp. The antioxidant levels of each extract from different plant parts were measured after the extraction process. These extracts were then exposed to Acanthamoeba sp. to assess dose-response, IC50 values, changes in cell morphology, internal cell activity and apoptosis based on alterations in phospholipids. Methodology and results: The total phenolic content, carotenoid estimation and antioxidant activity of the leaves, flowers and fruits of P. bleo were measured based on 1,1-diphenyl-2-picrylhydrazyl radicals (DPPH) assay. Its anti-amoebic properties were tested using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay for the IC50 determination. The morphological and biochemical changes in the Acanthamoeba sp. were observed under light and fluorescence microscopy using the acridine orange and propidium iodide double staining (AO/PI). The IC50 values of P. bleo leaves, flowers and fruits methanolic extracts were 5.884%, 0.1646% and 20.69%, respectively. Morphological observation displayed shortened acanthapodia with darkened cytoplasms. AO/PI-stained Acanthamoeba sp. cells appear with orange-fluorescent organelles in their green cytoplasm, indicating autophagic cell deaths. Apoptotic and necrotic Acanthamoeba sp. cells were absent based on Annexin V labelling. Conclusion, significance and impact of study: This study confirmed that the methanolic crude extracts of P. bleo exhibit high cytotoxic potential towards Acanthamoeba sp. trophozoites by inducing an autophagic mode of cell death.

The oyster mushroom(Pleurotus spp.)is one of the most widely cultivated mushroom species globally.The present study investigated the effect of synbiotics on the growth and quality of Pleurotus ostreatus and Pleurotus pulmonarius.Different synbiotics formulations were applied by spraying mushroom samples daily and measuring their growth parameters,yield,biological efficiency,proximate composition,mineral content,total phenolic content(TPC),and diphenyl-1-picryl-hydrazyl(DPPH)radical scavenging activity.Results demonstrated that the most significant yield of oyster mushrooms was harvested from synbiotics sprayed with inulin and Lactobacillus casei(56.92 g).Likewise,the highest biological efficiency obtained with a similar synbiotic was 12.65%.Combining inulin and L.casei was the most effective method of improving the mushrooms'growth performance and nutrient content in both samples.Furthermore,synbiotics that combined inulin and L.casei resulted in the highest TPC(20.550 mg gallic acid equivalent(GAE)/g dry extract(DE))in white oyster mushrooms(P.ostreatus).In comparison,in grey mushroom(P.pulmonarius)the highest TPC was yielded by L.casei(1.098 mg GAE/g DE)followed by inulin and L.casei(1.079 mg GAE/g DE).The DPPH results indicated that the oyster mushroom could be an efficient antioxidant.The results revealed that applying synbiotics improved the mushrooms'quality by increasing their antioxidant capacity with higher amounts of phenolic compounds and offering better health benefits with the increased levels of mineral elements.Together,these studies demonstrated the potential of using synbiotics as a biofertilizer,which is helpful for mushroom cultivation;therefore,it might solve the challenge of inconsistent quality mushroom growers face.

Background: To enhance perioperative outcomes, a perioperative registry that integrates high-quality real-world data throughout the perioperative period is essential. Singapore General Hospital established the Perioperative and Anesthesia Subject Area Registry (PASAR) to unify data from the preoperative, intraoperative, and postoperative stages. This study presents the methodology employed to create this database. Methods: Since 2016, data from surgical patients have been collected from the hospital electronic medical record systems, de-identified, and stored securely in compliance with privacy and data protection laws. As a representative sample, data from initiation in 2016 to December 2022 were collected. Results: As of December 2022, PASAR data comprise 26 tables, encompassing 153,312 patient admissions and 168,977 operation sessions. For this period, the median age of the patients was 60.0 years, sex distribution was balanced, and the majority were Chinese. Hypertension and cardiovascular comorbidities were also prevalent. Information including operation type and time, intensive care unit (ICU) length of stay, and 30-day and 1-year mortality rates were collected. Emergency surgeries resulted in longer ICU stays, but shorter operation times than elective surgeries. Conclusions The PASAR provides a comprehensive and automated approach to gathering high-quality perioperative patient data.

Introduction: There is an increasing demand for additional techniques to diagnose and treat cancer including CRC or colorectal cancer effectively. Utilizing antibodies as biomarker could contribute to accurate diagnosis of cancer due to its high specificity and sensitivity. One of the etiologies of CRC progression was proposed as the alterations of hexosamine biosynthetic pathway which could subsequently influence the rate-limiting enzyme, glutamine-fructose-6-phosphate aminotransferase (GFAT1). These increased enzymatic activities resulted in an elevation of glucose uptake that provides nutrients facilitating the progression of cancer cells. Therefore, we attempted to determine the potential of GFAT1 as the biomarker for CRC by correlating its expression with clinicopathological features of the patients. Methods: A total of 132 10% formalin-fixed paraffin embedded tissue were retrieved. Immunohistochemistry (IHC) was performed on the tissue sections and digital images were subsequently acquired. All the images were automatedly analyzed using IHC Profiler. GFAT1 immunoreactivity in colorectal tissues was calculated using an adapted H-score formula. Clinicopathological features of the patients were statistically correlated with the status of GFAT1. Results: Colorectal adenocarcinoma tissues had the significantly highest GFAT1 H-scores with the mean of 103.18 compared to adenoma and non-tumor tissues. There have been no significant associations between clinicopathological characteristics of the patients and the status of GFAT1 except for tumor size. Conclusion: Immunoreactivity of GFAT1 was significantly different between non-tumorous tissues and adenocarcinoma as well as between adenoma and adenocarcinoma tissues. GFAT1 could serve as one of the prognostic biomarkers or useful targets.

Introduction: Globally, commuting accident risks are always neglected in an organisation. There is a need to assess the impact of commuting accidents based on sociodemographic, human, vehicle, road, and environmental factors and to find suitable and effective mitigation strategies to alleviate the associated undesirable outcomes. Methods: This research was designed to develop a mobile application to assess commuting accident risk levels using artificial intelligence principles, as we are now in the 21st-century technology era. A total of 216 respondents from private and government industries participated in this study. Besides, to prove the developed application’s effectiveness, the study evaluated the effectiveness of the identified risk factor in determining the level of commuting risks predicted by respondents with the risk level calculated by the mobile application. Results: A major contribution of this paper is the effectiveness and accuracy of a mobile application known as CommuRisk. The app was developed using Android Studio and natively uses Java. There was a significant difference between with and without mobile applications in determining the level of commuting risks, and the effectiveness was proven with a (p-value = 0.001) at a 95% confidence interval with large sample size. Conclusion: Thus, this paper proved the effectiveness and accuracy of a mobile application in calculating risk levels exposed by commuters compared to risk levels predicted by commuters.