OBJECTIVE

This review article aims to determine the properties, uses, toxicity, and other side effects of crosslinking agents in tissue scaffolds when applied in vitro and in vivo.

A literature search was performed using the PubMed-NCBI (MEDLINE) database (https://pubmed.ncbi.nlm. nih.gov/) with keywords: crosslinking reagent, collagen, hydroxyapatite, and bone regeneration. GRADE criteria were used to assess the quality of evidence.

A total of six articles were included in the study. Improved mechanical properties of collagen-hydroxyapatite scaffolds with high porosity can be achieved by employing crosslinking methods, including physical dehydrothermal (DHT) treatment, chemical treatment with glutaraldehyde (GA), Microbial Transglutaminase (mTGase), 1‐ethyl‐3‐(3‐ dimethylaminopropyl) carbodiimide (EDAC), or a combination of both DHT and EDAC. Furthermore, the crosslinking of EDAC and DHT can lead to forming ester bonds between activated carboxyl groups and hydroxyl groups.

The combination of DHT and EDAC crosslinking can increase mechanical strength, make the pore size appropriate, make the scaffold more stable, and support cell adhesion so that new cells can grow, and the process of osteogenesis can run more optimally.

WAGR syndrome is a rare congenital disorder, occurring in approximately 1 in 500,000 to 1,000,000 individuals, often presenting with ocular malformations such as aniridia. Glaucoma frequently develops when the iris and angle structures are affected, posing a significant risk of vision loss. We report a one-year and seven-month-old patient who presented with corneal opacity of the left eye. Examination revealed corneal opacity, aniridia, and markedly elevated intraocular pressure of 65 mmHg, while the fellow eye, also with aniridia, was normotensive. The patient underwent immediate combined trabeculectomy-trabeculotomy. Postoperative follow-up and timely management of complications allowed acceptable pressure control over one year, though visual prognosis remained guarded. This case highlights the challenges of managing glaucoma in WAGR syndrome, particularly in resource-limited settings. Medical therapy alone is often insufficient, making surgical intervention essential. Combined trabeculectomytrabeculotomy proved effective in maintaining pressure control when glaucoma drainage devices were not feasible. Multiple interventions and close monitoring are frequently required due to the risk of scarring and postoperative complications. Our experience emphasizes the need for a multidisciplinary ophthalmology approach to optimize outcomes. Despite pressure control, visual outcomes often remain poor due to structural anomalies and the challenges inherent to pediatric patients with this rare syndrome.

OBJECTIVE

To discuss the clinical presentation and management of idiopathic hypertrophic pachymeningitis that presented with multiple cranial neuropathies.

This is a case report.

A 37-year-old female presented with right-sided headache and ipsilateral cranial nerve (CN) I, II, III, IV, and V deficits which improved with nonsteroidal anti-inflammatory drugs (NSAIDs). Six months later she developed bilateral blurring of vision with pain on eye movement, which progressed to severe bilateral affectation that prompted admission and treatment with high-dose methylprednisolone therapy followed by prolonged oral steroid treatment which was gradually tapered. Recurrence was treated with oral steroids and azathioprine. Diagnostic modalities included an initial cranial contrast computed tomography (CT) scan which was inconclusive; contrast magnetic resonance imaging (MRI) clinched the diagnosis, as well as demonstrated thickening of the optic nerve perineurium. Visual field analysis 30-2 as well as optic nerve head optical coherence tomography (OCT) were used to support the diagnosis and document optic nerve affectation. Biologic testing was used to rule out tuberculosis, syphilis, fungal infection, granulomatosis with polyangiitis, polyarteritis nodosa, and rheumatoid arthritis. The patient had complete vision recovery in the left eye but only partial vision recovery in the right eye.

Pachymeningitis should be a diagnostic consideration in patients with headache and multiple cranial neuropathies. Clinicians should always perform independent evaluation of diagnostic modalities with the patient’s clinical presentation in mind. Pachymeningitis can involve the perineurium through contiguous spread of the lesion and present as optic perineuritis as well, with more insidious progression and lasting deficits than isolated optic perineuritis.

Environmental and Health Impacts of Pesticide-Based Malaria Control in Low- and Middle-Income Countries: A Scoping Review Introduction Malaria remains a major public health challenge in tropical and subtropical regions, necessitating effective vector control strategies. This scoping review aims to evaluate the environmental and health impacts of pesticide-based malaria control in low-and middle-income countries (LMICs). Methods A comprehensive search was conducted across Scopus, Web of Science and PubMed for studies published between 2004 and 2024, using a predefined search string based on the PEO framework. Inclusion criteria focused on studies addressing malaria control programmes and their effects on the environment and human health. Data extraction followed PRISMA 2020 guidelines. Results 12 studies were included, most of which focused on indoor residual spraying (IRS) and insecticide-treated nets (ITNs). The review identified significant direct and indirect impacts. While effective in reducing malaria transmission, IRS and ITNs pose substantial risks. Direct health effects included acute poisoning and long-term neurodevelopmental issues linked to pesticide exposure, with residues detected in breast milk. Environmental impacts included soil and water contamination, biodiversity loss and ecological disruption. The overlap of pesticide use in malaria control and agriculture was found to exacerbate insecticide resistance in mosquito populations. Conclusions Pesticide-based malaria control, while crucial, carries significant unintended consequences for human health and the environment. The findings underscore the urgent need for Integrated Vector Management (IVM) strategies that reduce reliance on chemical pesticides, mitigate resistance, and ensure environmental sustainability and public health safety.

Objectives: Hypertension, commonly known as high blood pressure, is a prevalent and serious condition affecting a significant portion of the adult population globally. It is a chronic medical issue that, if left unaddressed, can lead to severe health complications, including kidney problems, heart disease, and stroke. This study aims to develop a feature selection model using the XGBoost algorithm to identify specific single nucleotide polymorphisms (SNPs) as biomarkers for detecting hypertension risk. Methods: We propose using the high dimensionality of genetic variations (i.e., SNPs) to build a classifier model for prediction. In this study, SNPs were used as markers for hypertension in patients. We utilized the OpenSNP dataset, which includes 19,697 SNPs from 2,052 samples. Extreme gradient boosting (XGBoost) is an ensemble machine learning method employed here for feature selection, which incrementally adjusts weights in a series of steps. Results: The experimental results identified 292 SNPs that exhibited high performance, with an F1-score of 98.55%, precision of 98.73%, recall of 98.38%, and overall accuracy of 98%. This study provides compelling evidence that the XGBoost feature selection method outperforms other representative feature selection methods, such as genetic algorithms, analysis of variance, chi-square, and principal component analysis, in predicting hypertension risk, demonstrating its effectiveness. Conclusions We developed a model for predicting hypertension using the SNPs dataset. The high dimensionality of SNP data was effectively managed to identify significant features as biomarkers using the XGBoost feature selection method. The results indicate high performance in predicting the risk of hypertension.

Objectives: Hypertension, commonly known as high blood pressure, is a prevalent and serious condition affecting a significant portion of the adult population globally. It is a chronic medical issue that, if left unaddressed, can lead to severe health complications, including kidney problems, heart disease, and stroke. This study aims to develop a feature selection model using the XGBoost algorithm to identify specific single nucleotide polymorphisms (SNPs) as biomarkers for detecting hypertension risk. Methods: We propose using the high dimensionality of genetic variations (i.e., SNPs) to build a classifier model for prediction. In this study, SNPs were used as markers for hypertension in patients. We utilized the OpenSNP dataset, which includes 19,697 SNPs from 2,052 samples. Extreme gradient boosting (XGBoost) is an ensemble machine learning method employed here for feature selection, which incrementally adjusts weights in a series of steps. Results: The experimental results identified 292 SNPs that exhibited high performance, with an F1-score of 98.55%, precision of 98.73%, recall of 98.38%, and overall accuracy of 98%. This study provides compelling evidence that the XGBoost feature selection method outperforms other representative feature selection methods, such as genetic algorithms, analysis of variance, chi-square, and principal component analysis, in predicting hypertension risk, demonstrating its effectiveness. Conclusions We developed a model for predicting hypertension using the SNPs dataset. The high dimensionality of SNP data was effectively managed to identify significant features as biomarkers using the XGBoost feature selection method. The results indicate high performance in predicting the risk of hypertension.

Objectives: Hypertension, commonly known as high blood pressure, is a prevalent and serious condition affecting a significant portion of the adult population globally. It is a chronic medical issue that, if left unaddressed, can lead to severe health complications, including kidney problems, heart disease, and stroke. This study aims to develop a feature selection model using the XGBoost algorithm to identify specific single nucleotide polymorphisms (SNPs) as biomarkers for detecting hypertension risk. Methods: We propose using the high dimensionality of genetic variations (i.e., SNPs) to build a classifier model for prediction. In this study, SNPs were used as markers for hypertension in patients. We utilized the OpenSNP dataset, which includes 19,697 SNPs from 2,052 samples. Extreme gradient boosting (XGBoost) is an ensemble machine learning method employed here for feature selection, which incrementally adjusts weights in a series of steps. Results: The experimental results identified 292 SNPs that exhibited high performance, with an F1-score of 98.55%, precision of 98.73%, recall of 98.38%, and overall accuracy of 98%. This study provides compelling evidence that the XGBoost feature selection method outperforms other representative feature selection methods, such as genetic algorithms, analysis of variance, chi-square, and principal component analysis, in predicting hypertension risk, demonstrating its effectiveness. Conclusions We developed a model for predicting hypertension using the SNPs dataset. The high dimensionality of SNP data was effectively managed to identify significant features as biomarkers using the XGBoost feature selection method. The results indicate high performance in predicting the risk of hypertension.

Problem: In September 2024, an illegal toxic waste dumping incident along the Tebrau River in Johor State, Malaysia, raised widespread health concerns in Johor Bahru and Kulai districts. The pollution released a strong, unpleasant odour, resulting in acute symptoms among exposed individuals, including sore throat, dizziness and coughing. Context: The Tebrau River is a vital waterway supporting urban populations in Johor. This was not the first chemical pollution event in the region, as previous incidents, including the Kim Kim River crisis in 2019, highlighted the region’s vulnerability to such events. The involvement of multiple districts and agencies during the response presented challenges in coordination and data sharing. Action: The Johor Bahru District Health Office promptly deployed a rapid assessment team to assess the affected areas and implement both active and passive case detection. Community engagement targeted vulnerable populations, such as schoolchildren, to minimize exposure risks. Additional dumping sites identified along the Tebrau River prompted expanded surveillance and a state-level response to coordinate efforts across districts and all health-care facilities. Outcome: A total of 484 individuals were exposed to the pollution, 334 of whom developed symptoms related to chemical exposure. Timely public health actions consisted of actions to mitigate the impact. Health facilities were placed on high alert and community trust was maintained through proactive engagement. However, gaps in cross-district coordination and challenges accessing environmental data underscored areas for improvement. Discussion: This incident highlighted the importance of rapid assessment, cross-sector collaboration, community engagement and integrated data systems. It also showed that effective public health action is possible despite environmental data limitations. The strengthening of communication, standardized protocols and real-time data sharing will be critical to improving future chemical pollution events.

BACKGROUND

Intraoperative transfusion for gynecologic surgery, when appropriately used, can improve patient outcomes. However, when utilized incorrectly, blood transfusion can worsen patient outcomes and increase patient cost. This study aimed to evaluate the blood transfusion practices of tertiary hospitals in the Philippines.

The study utilized a cross-sectional design wherein prospective data were gathered through multiple sources across seven tertiary-level hospitals. Women admitted to undergo gynecologic surgery were recruited based on a set of criteria. A chart review was conducted, and blood utilization indices were calculated. Outcomes were compared between public versus private facilities and transfused versus nontransfused patients.

Among 514 patients, 79.7% underwent cross-matching and 75.1% received transfusions. Adverse events were rare, with no transfusion-related deaths. The overall crossmatch-to-transfusion ratio (C/T ratio) was 2.8, exceeding the 2.5 optimal benchmark; all public hospitals recorded a C/T ratio >2.5, whereas private centers had more efficient usage. Six hospitals met acceptable benchmarks for transfusion probability and transfusion index. Open abdominal procedures, particularly hysterectomy, accounted for the most blood used. Transfused patients had longer operative times, greater blood loss, lower preoperative hemoglobin, and more frequently involved resident physicians in training. Public hospitals recorded higher cross-match and transfusion rates, greater resident physician participation, and broader use of general anesthesia.

Results of the study highlight the importance of monitoring blood transfusion parameters to optimize blood utilization. The observed differences between public and private institutions in the country highlight the urgent need for standardized and evidence-based practice to ensure efficient transfusion protocols nationwide.

OBJECTIVE

This study assessed the correlation of macular pigment optical density (MPOD) and varying levels of exposure to video display terminals (VDT) among young adult Filipinos.

This cross-sectional, analytical, single-center study compared the MPOD, measured using the Zeiss VISUCAM 500, between two groups of individuals aged 20 to 35 years old with differing VDT exposure. The more exposed group consisted of individuals who spent at least 8 hours per day on VDTs for the past 1 year, while the less exposed group spent less than 6 hours per day. Student’s t-test and chi-square test were used to compare the two groups, while Pearson's r coefficient was utilized to determine the relationship between MPOD and VDT exposure.

A total of 80 individuals (40 in each group) were included in the study. Both groups had similar profiles, except for refractive errors, which were significantly higher in the prolonged VDT exposure group (p = 0.02). The prolonged exposure group averaged 10 hours of VDT use per day, compared to 3 hours in the low VDT exposure group. The MPOD level, particularly the maximum optical density (Max OD), was significantly lower in the prolonged VDT exposure group (0.2034 DU) compared to the low VDT exposure group (0.2467 DU) (p = 0.0051). A negative weak correlation was observed between the VDT exposure hours and MPOD levels (Max OD r = –0.387, p = 0.0005).

This study found a weak but significant negative correlation between prolonged VDT exposure and lower MPOD levels, suggesting that extended screen time may contribute to reduced macular pigment density. While the correlation was weak (r = –0.387), these findings underscore the potential risk of diminished macular health with increased VDT use. The results highlight the importance of promoting protective strategies, such as reducing screen time and encouraging dietary or lifestyle changes that support eye health, especially among individuals with high VDT exposure.