Voltage-gated sodium channels (VGSCs) play pivotal roles in cancer progression and have emerged as promising therapeutic targets and biomarkers. VGSCs comprise multiple subtypes with distinct tissue distributions, influencing tumour characteristics in different ways. Among these, the tetrodotoxin-sensitive α-subunits and the β1 subunit, commonly found in breast cancer, have been implicated in metastasis and tumour aggressiveness. The NaV1.5 channel and its neonatal variant (nNaV1.5) are overexpressed in aggressive cancers such as breast, prostate, colorectal, and lung cancers, thereby enhancing their invasive capacity. nNaV1.5 is particularly significant due to its tumour-specific expression and strong association with poor prognosis, especially in breast cancer, where it regulates cell proliferation, invasion, and tumour microenvironment remodelling. This review highlights nNaV1.5 as a critical ion channel that drives metastasis through ion regulation, extracellular acidification, and cytoskeletal remodelling. We further evaluate current therapeutic strategies, including siRNA, monoclonal antibodies, and small-molecule inhibitors, while addressing translational challenges such as tumour heterogeneity, drug delivery limitations, and off-target cardiotoxicity due to its similarity with the adult isoform. In addition, we explore the potential of nNaV1.5 as a biomarker subject to epigenetic regulations by factors including RE1-silencing transcription factor (REST) and histone deacetylase 2 (HDAC2), which may facilitate patient stratification and treatment optimization. By integrating mechanistic insights, therapeutic opportunities, and translational challenges, this review goes beyond descriptive summaries to provide a framework for advancing nNaV1.5 research from preclinical studies toward clinical application in cancer therapy.

Background: s/Aims: Portal vein embolization (PVE) and Yttrium-90 (Y-90) radioembolization are used to induce liver hypertrophy, increasing future liver remnant volume and reducing the risk of post-resection liver failure. This systematic review compares the effectiveness of PVE and Y-90 radioembolization in promoting liver hypertrophy in patients undergoing liver resection. Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, Cochrane, and Web of Science were searched for studies published between January 2000 and August 2023. Studies comparing PVE and Y-90 radioembolization with respect to liver hypertrophy were included. Risk of bias was assessed using the Newcastle–Ottawa Scale. Pooled mean differences were calculated using an inverse-variance random-effects model. Results: Of 1,965 studies identified, three retrospective cohort studies met inclusion criteria, comprising 125 patients. Among these, 67.3% underwent PVE and 32.7% received Y-90 radioembolization. Hepatocellular carcinoma was the most common diagnosis (55.9%), followed by metastatic disease (32.3%) and cholangiocarcinoma (11.8%). PVE was more commonly used as a preoperative strategy for liver resection, while Y-90 radioembolization was primarily employed for palliative intent. One study reported greater hypertrophy with Y-90 compared to PVE (63% vs. 36%); however, hypertrophy was assessed over a longer interval (150 vs. 30 days). In pooled analysis, PVE was associated with significantly greater hypertrophy (mean difference 23.75%; 95% CI 12.02–35.48; p < 0.0001; I 2 = 48%). Conclusions Evidence directly comparing PVE and Y-90 radioembolization for liver hypertrophy remains limited. While pooled results favor PVE, procedure selection should be individualized based on clinical context.

The rising rates of type 2 diabetes mellitus (T2DM) pose a major health challenge, especially for adults at high risk of developing the disease. Without early intervention, a substantial proportion of these individuals will eventually develop the disease, diminishing their quality of life, leading to limitations in daily activities and elevated psychological distress. Mobile health (mHealth) interventions such as the MyDiPP application have been proposed as a potential tool to support diabetes prevention; however, evidence on their effects on HRQoL in high-risk populations remains limited. This study aimed to evaluate the effect of the MyDiPP mobile application intervention on the HRQoL among adults at high risk of developing T2DM. This randomised controlled trial (RCT) involved 112 high-risk adults from Kuala Terengganu, Terengganu, Malaysia. They were randomly assigned to either the MyDiPP mobile application intervention group (n=56) or a control group (n=56) receiving standard health education. Changes in HRQoL at 6 and 12 months were analysed using repeated measures ANCOVA with an intention-to-treat (ITT) approach. Findings showed limited improvements across HRQoL domains following the MyDiPP intervention, particularly in role emotional (RE) and the mental component summary (MCS), reflecting a mild but encouraging influence on HRQoL. Therefore, further research is required to determine whether largerscale studies can yield more substantial outcomes.

Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare autosomal recessive neurometabolic synthesis disease with sympathetic autoregulation deficiency. Perioperative management of AADCD presents unique challenges due to autonomic dysfunction, impaired sympathetic regulation of heart rate, and potential airway complications. Herein, we report the successful anesthetic management of a 14-year-old male patient with AADCD under total intravenous anesthesia during extensive dental procedures. We applied the rapid sequence induction and intubation method with cricoid pressure to minimize the risk of pulmonary aspiration due to the potential difficulty in mask ventilation and intubation, limited mouth opening, microcephaly, micrognathia, and poor cooperation. Intubation was performed without any complications. Due to the autonomic dysfunction, potential airway complications, and developmental, mental, and motor delays in this disorder, perioperative management requires a multidisciplinary approach with comprehensive preoperative evaluation.

Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare autosomal recessive neurometabolic synthesis disease with sympathetic autoregulation deficiency. Perioperative management of AADCD presents unique challenges due to autonomic dysfunction, impaired sympathetic regulation of heart rate, and potential airway complications. Herein, we report the successful anesthetic management of a 14-year-old male patient with AADCD under total intravenous anesthesia during extensive dental procedures. We applied the rapid sequence induction and intubation method with cricoid pressure to minimize the risk of pulmonary aspiration due to the potential difficulty in mask ventilation and intubation, limited mouth opening, microcephaly, micrognathia, and poor cooperation. Intubation was performed without any complications. Due to the autonomic dysfunction, potential airway complications, and developmental, mental, and motor delays in this disorder, perioperative management requires a multidisciplinary approach with comprehensive preoperative evaluation.

Aromatic L-amino acid decarboxylase deficiency (AADCD) is a rare autosomal recessive neurometabolic synthesis disease with sympathetic autoregulation deficiency. Perioperative management of AADCD presents unique challenges due to autonomic dysfunction, impaired sympathetic regulation of heart rate, and potential airway complications. Herein, we report the successful anesthetic management of a 14-year-old male patient with AADCD under total intravenous anesthesia during extensive dental procedures. We applied the rapid sequence induction and intubation method with cricoid pressure to minimize the risk of pulmonary aspiration due to the potential difficulty in mask ventilation and intubation, limited mouth opening, microcephaly, micrognathia, and poor cooperation. Intubation was performed without any complications. Due to the autonomic dysfunction, potential airway complications, and developmental, mental, and motor delays in this disorder, perioperative management requires a multidisciplinary approach with comprehensive preoperative evaluation.

Introduction: The Theory of Planned Behavior (TPB) construct is recommended by the World Health Organization to assess intention for vaccination; however, there is yet a validated instrument in the context of booster dose Covid-19 vaccination in Malaysia. The purpose of the present study is to translate and investigate the factorial validity and internal reliability of the TPB construct for booster dose Covid-19 vaccination (TPB-BDV) questionnaire in Malaysia. Materials and methods: In the pre-testing of the study, five experts and 40 Malaysian adults respectively rated the content and validity index of all 11 items of the translated questionnaire in Malay version. Next, 160 Malaysian adults completed the Malay version of Theory of Planned Behavior- Booster Dose Vaccination (TPB-BDV) questionnaire via online. Results: In the pre-testing phase, Content Validity and Face Validity Index for 10 items in Malay version of TPB-BDV achieved cutoff mean score >3.0 for relevancy, clarity, ambiguity, and simplicity. Meanwhile, Item 8 scored low on relevancy. In the main study, exploratory factor analysis suggested three factors consisting of a final 10 items (without Item 8) which accounted for 74.0% of the total variance. The three factors were Attitude (5 items), Subjective Norms (3 items), and Perceived Behavioral Control (2 items). The internal reliability ranged from a = 0.83 to a = 0.93, with an overall value of a = 0.90. Conclusion: The findings suggest that the 10-items Malay version of TPB-BDV is valid and reliable to measure the individual decision in taking the Covid-19 booster-dose vaccine among Malaysian adult population.

Aims: Shelf-life estimation, determination and validation of frozen food are essential in hazard analysis and critical control points (HACCP) and can be done by adopting an accelerated shelf-life (ASL) study to reduce the time and cost of a long-lasting experiment. This study aims to determine the microbial shelf-life of frozen crispy chicken curry puffs (FCCCP). Methodology and results: An ASL study was performed at varying temperatures of -18 °C, -8 °C, 2 °C and 12 °C for 12 weeks. Samples were also maintained at -18 °C for 12 months for the shelf-life study. Along the studies, microbiological growth (total plate count, yeast and mould count, Salmonella), pH and moisture content were analysed periodically. Findings from the ASL study indicated that storage at 2 °C and 12 °C led to an increase in microbiological growth. Yeast and mold count (YMC) had the highest correlation and was used to estimate the shelf-life using the Arrhenius equation. The estimated shelf-life of FCCCP was 30.5 months at -18 °C, 6.86 months at -8 °C, 1.72 months at 2 °C and 0.47 months at 12 °C. The Q10 was 4.45, 3.99 and 3.62 at -18 °C to -8 °C, -8 °C to 2 °C and 2 °C to 12 °C, respectively. All samples were within the microbiological limit throughout the storage period in the actual shelf-life study. Salmonella was not detected in any of the studies. Conclusion, significance and impact of study These findings provide valuable data for frozen food small and medium enterprises (SMEs) to verify product shelf-life during HACCP application. It can serve as a reference in the shelf-life determination of frozen foods under inappropriate temperature conditions along the cold chain.

Introduction: The use of the lean approach in healthcare has rapidly gained popularity globally, although this approach was more routinely used in the manufacturing sector as opposed to health. Besides, recent studies confirm the suitability of the lean approach applications for improving the quality of medical care. This study aimed to determine the Lean approach’s capacity to improve the waiting time in outpatient clinics in hospitals. Methods: The systematic review approach was employed to help in the research procedures. Search databases used included Ovid, Google scholar, PubMed, MEDLINE, and archive. Besides, search terminologies such as the Lean approach, Hospital-implementation, waiting time, and patient flow were used to help identify sources that best suited the investigation process. Results: The review revealed that the lean approach is suitable for the reduction of waiting times as well as for improving efficiency in the clinic. The outcomes provide a basis for reducing the average waiting time within the hospital. Conclusion: This study recommended that healthcare facilities and departments should take a keen interest in implementing the Lean approaches, as they are crucial for reducing waiting time.

Background: Tirzepatide is a novel dual glucose-dependent insulinotropic peptide (GIP)-glucagon-like peptide 1 (GLP-1) receptor agonist being evaluated for the treatment of various metabolic disorders. We performed a meta-analysis of randomized data on the effects of tirzepatide on serum lipid levels. Methods: We systematically searched the PubMed and ClinicalTrials.gov databases for relevant data from randomized controlled clinical trials. All articles were screened, reviewed, and extracted by at least two independent authors, with conflicts resolved by consensus. Four hundred and thirty-three records were identified in the initial literature search; 18 of them were identified for full-text review, and 14 of those were systematically reviewed and included in the analysis. The meta-analysis was performed using an inverse variance random-effects model. Results: Fourteen articles that reported data from 13 randomized controlled clinical trials were included in the review. Nine trials had a low risk of bias, two had a moderate risk, and two had a high risk of bias. The pooled analysis showed that tirzepatide was efficacious at improving all lipid markers, including cholesterol and triglycerides.Moreover, a clear dose response trend was visible across results from groups taking 5, 10, and 15 mg of tirzepatide. Conclusion There is growing evidence to support the use of tirzepatide in patients with metabolic diseases such as type 2 diabetes mellitus, metabolic syndrome, and obesity. Our results demonstrate that tirzepatide significantly improves all aspects of patient metabolism and might be superior in this regard to conventional agents such as insulin formulations or traditional GLP-1 agonists.