Despite publishing and securing research grants being obligatory in research universities, the literature on the factors influencing academic productivity is relatively scarce. Thus, in this study, we aimed to determine the personal and behavioural-related factors that influence the culture of publishing and securing research grants among academicians with lower research-related performance. This cross-sectional study was conducted among 49 academic staff members of Universiti Kebangsaan Malaysia (UKM). A self-administered questionnaire consisting of personal, attitude and behavioural (barriers, perceived stress scale, work extrinsic and intrinsic motivation scale, psychological well-being scale, and basic needs satisfaction scale) questions were distributed during a workshop and online. Simple linear regression (SLR) analyses were performed for each variable, followed by multiple linear regression (MLR) to identify the associated factors of research output. After adjusting for covariates, having a doctoral degree (β=0.396, 95% CI=0.221-2.146, p<0.05) and integrated regulation (β=0.574, 95% CI=0.036-3.612, p<0.05) were found to be associated with research grant acquisition (R2=0.273). Moreover, increasing age (β=0.426, 95% CI=0.088-0.397, p<0.05), living alone (β=0.331, 95% CI=0.944-6.626, p<0.05), having a doctoral degree (β=0.248, 95% CI=0.174-6.747, p<0.05), environmental mastery (β=0.318, 95% CI=0.013-0.347, p<0.05), self-acceptance (β=0.284, 95% CI=0.010-0.242, p<0.05), satisfaction incompetence (β=0.273, 95% CI=0.001-0.200, p<0.05) and relatedness (β=0.280, 95% CI=0.001-0.116, p<0.05) were found to be the factors that influence the publications produced among participants (R2 =0.423). The findings of this study could be used by management to formulate effective strategies to increase the productivity of academics in their research-related performance.

INTRODUCTION: Glaucoma is a leading cause of permanent blindness, often going undetected in its early, asymptomatic stages, especially in older age groups. In Malaysia, glaucoma is a growing public health issue due to an increase in the ageing population. While screening is essential for early glaucoma detection, the most suitable strategy for Malaysia's healthcare system remains unclear. This study explored the perspectives of eye healthcare professionals on the most suitable glaucoma screening strategies for Malaysia. MATERIAL AND METHODS: This qualitative study used semi-structured interviews with 19 eye health professionals (ophthalmologists, optometrists, nurses, ophthalmic technicians, and assistant medical officers) practicing in the Klang Valley. The interviews were conducted face-to-face in their workplace or via a video conferencing platform. All interviews were recorded, transcribed, and analysed using thematic analysis. RESULTS: Six major themes were identified: types of glaucoma screening programmes, accessible screening locations, target screening population, instruments and use of digital technology, trained personnel, and referral criteria. Opportunistic case finding and population-based programmes were identified as the glaucoma screening programmes in which trained personnel conducted screening at accessible locations. Glaucoma screening for high-risk individuals was recommended, focusing on visual acuity testing, tonometry, anterior chamber angle assessment, funduscopy, perimetry, and retinal nerve fibre assessment. A lack of clear referral criteria due to low awareness and poor implementation of existing guidelines was observed. CONCLUSION: Further investigations are required to identify the best combination of components for glaucoma screening. This will enable policymakers to develop an effective glaucoma screening programme in Malaysia.

ObjectiveMigraine is a leading neurological disorder and the fourth most common cause of years lived with disability worldwide, affecting nearly 116 million individuals. Although pharmacological treatments are available, their efficacy is often limited by side effects and variable response rates. Repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) offers a safe, non-invasive alternative for migraine management. However, the neurophysiological mechanisms, particularly how rTMS modulates local cortical excitability and distributed pain-related circuits, remain poorly understood. Elucidating these mechanisms is essential for optimizing treatment protocols and improving clinical outcomes. MethodsThis study employed concurrent transcranial magnetic stimulation and electroencephalography (TMS-EEG) to investigate neuroplastic and neurocircuitry mechanisms of DLPFC-rTMS in migraine. Study 1 compared 30 migraineurs and 28 healthy controls to identify abnormalities in TMS-evoked potentials (TEPs) and significant current density (SCD) within sensory-discriminative regions including the primary somatosensory cortex (S1) and posterior insula (pINS), cognitive-affective regions including the anterior insula (aINS) and midcingulate cortex (MCC), and a descending modulatory region, the periaqueductal gray (PAG). Study 2 used a single-blind, crossover, sham-controlled design in 34 healthy participants. Each participant received both active (10 Hz, 80% RMT, 1 500 pulses) and sham DLPFC-rTMS in counterbalanced order. TMS-EEG and cold pain tolerance were assessed before and after each session. ResultsIn Study 1, migraineurs showed a significantly less negative N120 amplitude compared to healthy controls (P=0.027, Cohen’s d=0.60), indicating local intracortical disinhibition. No group differences were observed for N40, P60, or P180 components. At the source level, migraineurs exhibited significantly higher SCD in the S1, pINS, aINS, and MCC (allQ<0.05), but not in the ventroposterior thalamus (vpTHAL), mediodorsal thalamus (mdTHAL), or PAG. In Study 2, active rTMS significantly reduced SCD from pre- to post-stimulation in the S1, aINS, and MCC (all Q<0.05). Sham stimulation also reduced SCD in the S1 (Q<0.05) but not in the aINS or MCC. Although no significant group-level analgesic effect was observed between active and sham conditions (P=0.107), correlation analyses revealed that greater SCD reductions in the S1 and MCC were significantly associated with higher post-rTMS pain tolerance (R=-0.487 and -0.495, both Q<0.01) and larger improvements in pain tolerance(R=-0.487 and -0.451, both Q<0.05). No such correlations were found following sham stimulation, suggesting that the behavioural relevance of neural changes is specific to active rTMS. ConclusionThis study provides novel evidence that migraineurs exhibit both local neuroplastic abnormalities (reduced N120 amplitude) and hyperactivity in key pain-processing regions (S1, pINS, aINS, MCC). A single session of DLPFC-rTMS reduced hyperactivity in the aINS, MCC, and S1. Notably, greater reductions in the S1 and MCC were associated with improved pain tolerance. These findings identify distinct cortical circuitries, particularly within the cognitive-affective pain network, that may serve as potential biomarkers for optimizing rTMS treatment in migraine and other chronic pain conditions. Future studies should validate these results in patient populations experiencing spontaneous migraine attacks and explore multi-session or accelerated rTMS protocols.

Objective To explore TCM syndrome distribution law in patients with overlapping non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)gastrointestinal symptoms.Methods A multi-center,cross-sectional study was conducted to investigate the general information of 800 patients with overlapping NERD and EPS gastrointestinal symptoms in four hospitals,such as gender,age,body mass index(BMI)and four diagnostic information of TCM.Descriptive frequency analysis,factor analysis and clustering analysis were used to summarize the TCM syndrome types and distribution characteristics.Results The average age of 800 patients with overlapping NERD and EPS gastrointestinal symptoms was(44.50±14.43)years old,the average BMI was(23.17±4.80)kg/m2,and the male to female ratio was 3:5.Frequency of 95 TCM symptoms/signs≥20%.18 common factor variables were obtained based on factor analysis,and the cumulative contribution rate was 67.11%.The first three syndrome elements of disease location were liver,stomach and spleen,and the disease nature syndrome elements were qi stagnation,qi deficiency and yin deficiency.Based on the clustering analysis of 18 common factor variables,combined with expert discussion,four main TCM syndrome types were obtained,which were liver-stomach stagnation heat syndrome(213 cases,26.63%),spleen-stomach damp heat syndrome(209 cases,26.13%),spleen-stomach deficiency and cold qi stagnation syndrome(190 cases,23.75%)and qi-phlegm stagnation syndrome(188 cases,23.50%).There was no significant difference in the distribution of TCM syndrome types among patients with different genders,ages and BMI values(P>0.05).Patients with a course of disease≥2 years and those residing long-term north of the Qinling-Huaihe Line showed a significantly higher prevalence of spleen-stomach dampness-heat syndrome(P<0.05).Conclusion The syndrome elements of disease location of overlapping NERD and EPS gastrointestinal symptoms are mainly liver,stomach and spleen.The TCM syndrome types are liver-stomach stagnation heat syndrome,spleen-stomach damp heat syndrome,spleen-stomach deficiency cold qi stagnation syndrome and qi-phlegm stagnation syndrome.The course of disease and the regional differences between north and south may be the influencing factors of the distribution of syndrome types.

Objective To investigate the potential mechanism of Jianpi Qinghua Granules in treating gastroesophageal reflux disease(GERD)with spleen deficiency and damp heat syndrome.Methods Six of 50 SPF male SD rats were randomly selected as the sham-operation group,the other 44 rats were treated with modified esophagoduodenostomy+abnormal hunger and satiety+internal and external damp heat intervention to establish GERD model of spleen deficiency and damp heat syndrome.The modeled rats were randomly divided into model group,omeprazole group,sodium cromoglicate group and Jianpi Qinghua Granules low-,medium-and high-dosage group,with 6 rats in each group.Each group was intervened with corresponding measures.Pathological changes in esophageal tissue were observed,ELISA was used to detect serum and esophageal mucosal tissue contents of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),IL-6 and IL-10.Western blot was used to detect protein expressions of nuclear factor-κB(NF-κB)p65,mast cell tryptase(MCT),proteinase-activated receptor 2(PAR2),Toll-like receptor 4(TLR4),TNF receptor-associated factor 6(TRAF6)and transforming growth factor β-activated kinase 1(TAK1)in esophageal mucosal tissue,RT-qPCR was used to detect mRNA expressions of MCT,PAR2,TLR4 and TRAF6 in esophageal mucosal tissue.Results Compared with the sham-operation group,the esophageal mucosal epithelium in the model group was thickened,basal cells proliferated,cell gaps widened,tissue edema and inflammatory cells infiltration were observed;the contents of IL-1β,TNF-α and IL-6 in serum and esophageal mucosa significantly increased,while the content of IL-10 significantly decreased(P<0.01);the expressions of NF-κB p65,MCT,PAR2,TLR4,TRAF6,TAK1 protein and MCT,PAR2,TLR4,TRAF6 mRNA in esophageal mucosa significantly increased(P<0.01).Compared with the model group,the injury of esophageal mucosa in each treatment group was alleviated in varying degrees;the contents of IL-1β,TNF-α and IL-6 in serum and esophageal mucosa increased,while the content of IL-10 decreased,the expressions of NF-κB p65,MCT,PAR2,TLR4,TRAF6 and TAK1 protein in esophageal mucosa decreased,the mRNA expressions of MCT,PAR2,TLR4 and TRAF6 decreased,and the differences were statistically significant in Jianpi Qinghua Granules high-dosage group(P<0.01).Conclusion Jianpi Qinghua Granules can reduce the esophageal mucosal injury and inflammatory reaction in GERD rats with spleen deficiency and damp heat syndrome,and its mechanism may be related to the inhibition of TLR4/NF-κB pathway activation induced by LPS.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.