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.

BACKGROUND Individualized positive end-expiratory pressure (PEEP) titration is a crucial technique in mechanical ventilation therapy for acute respiratory distress syndrome (ARDS) patients with intra-abdominal hypertension (IAH). This study aimed to evaluate the effectiveness of electrical impedance tomography (EIT)-guided PEEP titration in this population. METHODS: This prospective study enrolled 36 ARDS patients, including 22 patients with IAH and 14 without IAH. All the patients underwent EIT-guided PEEP titration at the intersection point between alveolar overdistension and collapse during a decremental PEEP trial. The changes in pulmonary ventilation distribution, respiratory mechanics and hemodynamics during the titration process were observed. RESULTS: After EIT-guided PEEP titration was performed, the PEEP, peak inspiratory pressure and plateau pressure increased significantly (P<0.05). Furthermore, no significant differences were observed in respiratory system compliance, tidal volume, driving pressure, or the 4*DP+RR index between the two groups (P>0.05). The mechanical power increased in the non-IAH (NIAH) group after PEEP titration (P<0.05). Ventilation in gravity-dependent lung regions significantly increased (P<0.05), and the oxygenation index (PaO2/FiO2) improved significantly (P<0.05) in both groups. However, blood pressure, heart rate, respiratory rate, central venous pressure, and lactate levels did not significantly change. In the IAH group, the PaO2/FiO2 ratio improved less than that in the NIAH group did (P<0.05). CONCLUSION: In our study, individualized PEEP titration guided by EIT improved oxygenation in ARDS patients with concomitant IAH without significantly affecting hemodynamics. The presence of IAH may limit the improvement of oxygenation during EIT-guided PEEP titration.

Objective: To investigate the molecular mechanism of Syk in phagocytosis induced by CD36 antibodies. Methods: In vitro, two CD36 monoclonal antibodies, GZ1 (IgG2a) and GZ4 (IgG1), at different concentrations were co-incubated with platelets from CD36-positive blood donors, and the affinity of the antibodies for platelets was assessed using flow cytometry. CD36 positive platelets from donors were labeled with Red-SE. The GZ1 and GZ4 antibodies were added together with dye-labeled platelets to peripheral blood from blood donors for phagocytosis experiments. The expression of the Spleen Tyrosine Kinase (Syk), P-Syk, P38 MAPK and P-P38 were detected using Western blot(WB). In the in vitro phagocytosis inhibition assay, Fcγ receptor (FcγR) antibodies or Syk inhibitor (R406) were pre-incubated with monocytes prior to performing the phagocytosis experiment. In vivo experiments were performed using female C57BL/6J mice. R406 was administered via intraperitoneal injection, followed by tail vein infusion of GZ1 or GZ4 antibodies. Additionally, a treatment group was set up in which the antibodies were infused first, followed by administration of R406. Changes in platelet counts were analyzed using a blood routine analyzer, and antibody binding to platelets was detected by flow cytometry. Results: GZ1 had higher affinity for CD36positive platelets than GZ4. The phagocytosis rate induced by GZ1 was significantly higher than that of GZ4 [(42.12±2.25)% vs (16.25±6.45)%, P<0.001]. Moreover, GZ1-mediated platelet phagocytosis mainly depends on FcγRⅠ of monocytes, while GZ4-mediated platelet phagocytosis mainly relies on FcγRⅡ of monocytes. WB results showed that the GZ1 group significantly upregulated the expression of Syk and phosphorylated Syk (P-Syk), and induced phosphorylation of the downstream P38 MAPK signaling pathway. Pretreatment of monocytes with R406 inhibited the phagocytosis of antibodyopsonized platelets by monocytes. After injecting GZ1 or GZ4 antibodies into C57BL/6 female mice through the tail vein, GZ1 mAbs had a stronger binding rate to the platelets compared with GZ4 mAbs, leading to a significant decrease in platelet count. After pre-injecting R406 into mice, the platelet count reduction in both the GZ1 and GZ4 groups was alleviated, and the binding rate of antibodies to platelets was also significantly reduced. However, administration of R406 after antibody injection failed to prevent the decrease in platelet counts in mice. Conclusion: This study indicates that Syk plays an important role in the phagocytosis of anti-CD36 opsonized platelets by monocytes/macrophages and is closely associated with the activation of the P38 MAPK signaling pathway.

Objective: To investigate the value of combined monitoring of hemolytic reaction indicators in the efficacy assessment of lymphomaassociated hemophagocytic lymphohistiocytosis (LAHLH) secondary to Evans syndrome (ES). Methods: One patient with LAHLH secondary to ES complicated by hemolytic crisis was enrolled. Under the premise that necessary red blood cell transfusions were administered due to severe anemia, combined dynamic monitoring was performed for the following hemolytic reaction indicators: posttransfusion hemoglobin increment, reticulocyte percentage (RET%), total bilirubin(TBil), lactate dehydrogenase (LDH), and direct antiglobulin test (DAT). Furthermore, based on the literature of the past five years, we analyzed the relationship between the dynamic changes of the these indicators and the response to immunosuppressive therapy. Results: During the hemolytic crisis period, the 24 hour posttransfusion hemoglobin increments were both <10 g/L after two consecutive red blood cell transfusions, indicating ineffective transfusion. After intensified immunosuppressive therapy, the hemoglobin increments reached +14 g/L and +15 g/L, respectively, after two subsequent transfusions, converting to effective transfusion. Concurrently, RET% decreased from a peak of 29.32% to 12.71%, and LDH and bilirubin improved synchronously. The combined interpretation of hemoglobin increment, dynamic RET% trends, and DAT results facilitated the distinction of the relative contributions of immune hemolysis, hemophagocytosis, and bone marrow failure to anemia. Conclusion: Under the strict premise that transfusion indications are adhered to and patient safety is ensured, combined dynamic monitoring of hemolytic reaction indicators can provide realtime, objective bedside auxiliary information for the efficacy assessment of LAHLH secondary to ES, and has certain clinical value in optimizing the timing of treatment adjustments.

Intra-abdominal Hernia with Bowel Obstruction Triggering Multi-organ Failure: The Role of Preoperative Enteritis This report details the clinical course of a 41-year-old male who developed fulminant multiple organ dysfunction syndrome following emergency surgery for a strangulated intra-abdominal hernia. Preoperative manifestations, including diarrhea and marked leukocytosis, pointed towards an underlying infectious enteritis. We posited that surgical release of the obstructed, ischemic bowel segment precipitated a massive systemic influx of endotoxins and inflammatory mediators, triggering septic shock and rapid sequential organ failure. This case underscored the critical need to suspect concomitant gastrointestinal infection in patients presenting with mechanical bowel obstruction accompanied by infectious signs. Aggressive perioperative sepsis management encompassing early empiric antimicrobial therapy, vigilant hemodynamic monitoring, and preparedness for advanced organ support is essential to mitigate this severe complication.

Objective The study aimed to elucidate the population composition and seasonal distribution characteristics of mosquitoes in Laoshan District, Qingdao City, providing a scientific basis for the prevention and control of mosquito-borne infectious diseases. Methods Mosquito surveillance was conducted in Laoshan District in Qingdao City using light traps from April to November 2020-2022. Dominant mosquito species were identified using the Berger-Parker dominance index(I)and mosquito density was compared using the Kruskal-Wallis H test. The seasonal distribution characteristics of adult mosquitoes were analyzed using concentration and circular distribution method. Spearman rank correlation analysis was used to study the relationship between mosquito populations and meteorological factors with mean monthly temperature, mean monthly relative humidity, and mean monthly rainfall. Results The mean mosquito density for the trapping period was 9.771 females/(trap·night)in 2020,9.771 in 2021, and 9.427 in 2022. There was no statistically significant difference in mosquito density between different years(H = 0.095, P = 0.954). In total, 2 781 adult female mosquitoes comprising five species from four genera were captured over three years. Culex pipiens(I = 0.654), Aedes albopictus(I = 0.202), and Aedes aegypti(I = 0.118)were identified as dominant species. Seasonal fluctuations in the adult mosquitoes were unimodal, and primarily concentrated from June to September. The peak period of adult mosquito varied between years with statistical significance. (F = 3.838, P ＜ 0.05). Mosquito density was highly correlated with mean monthly temperature, mean monthly relative humidity and mean monthly precipitation(P＜ 0.05). Conclusions Cx. pipiens pallens, Ae. albopictus, and Ar. inamoratus are the dominant mosquito species in the Laoshan District of Qingdao City. The activity of adult mosquitoes is seasonal, and primarily concentrated in summer and autumn, during which the risk of mosquito-borne diseases such as dengue fever is increased.

We report a case of a female farmer from the Yichang suburb, aged 68 years, who had been suffering from the infection for 3 years and had a history of seeking medical treatment at a community hospital and receiving blood transfusions. Her hemoglobin was as low as 28 g/L during this visit, and she had been ill for a long time with severe anemia. Routine stool examination revealed hookworm eggs. After active treatment, the patient recovered and was discharged from the hospital.

Objective To analyze the incidence rate and risk factors of atrial fibrillation (AF) in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 392 patients with COPD in the hospital were selected from December 2020 to December 2024. Patients' data (medical history, echocardiographic data, etc.) were recorded. The incidence rate of AF in patients was recorded and the patients were grouped according to whether or not they developed AF. The differences were compared between the two groups, and the risk factors of AF occurrence in elderly patients with COPD were analyzed. Results Among the 392 patients with COPD, 127 cases (32.40%) met the diagnostic criteria of AF. There were statistically significant differences in age, pulmonary infection, heart failure, diabetes, smoking history, disease duration, LAD, severe renal insufficiency and coronary heart disease between the AF group and the non-AF group (P<0.05). Multivariate logistic regression analysis suggested that age, pulmonary infection, heart failure, diabetes mellitus, smoking history, disease course, LAD, severe renal insufficiency and coronary heart disease were all risk factors for elderly patients with COPD (OR=1.129, 4.246, 3.955, 4.125, 2.038, 1.112, 1.102, 4.397, and 3.865, P<0.05). Conclusion The incidence rate of AF is high in elderly patients with COPD. Age, pulmonary infection, heart failure, diabetes mellitus, smoking history, course of disease, LAD, severe renal insufficiency, and coronary heart disease are all risk factors for AF.

[摘 要] 目的：探讨β-catenin/CREB结合蛋白（CBP）通路抑制剂PRI-724联合伊马替尼对BCR-ABL1阳性慢性髓系白血病（CML）细胞及荷瘤模型的抗肿瘤作用及其潜在机制。方法：体外实验采用人K562细胞、能够稳定表达野生型BCR-ABL1（32D-WT）和T315I突变型BCR-ABL1（32D-T315I）的鼠源32D髓系细胞。采用CCK-8法检测伊马替尼、PRI-724单药及联合处理对细胞存活能力的影响，并计算半数抑制浓度（IC50）和联合指数（CI）；采用SA-β-gal染色检测细胞衰老相关表型；采用免疫共沉淀（Co-IP）法检测PRI-724对β-catenin与CBP/p300相互作用的影响。体内实验采用K562、32D-WT和32D-T315I细胞建立裸鼠皮下荷瘤模型，分别设未治疗组、伊马替尼组、PRI-724组及伊马替尼+PRI-724组，并给予相应处理，观察瘤体生长变化，并基于肿瘤生长抑制率（TGI）计算体内CI。采用WB法检测瘤组织中PI3K/AKT信号通路相关蛋白、核内β-catenin/CBP及下游效应因子c-Myc、Cyclin D1的表达。结果：伊马替尼和PRI-724对K562、32D-WT和32D-T315I细胞均呈浓度依赖性抑制作用。伊马替尼对K562、32D-WT和32D-T315I细胞的IC50分别为0.860、0.594和1.646 μmol/L；PRI-724对上述3种细胞的IC50分别为1.120、0.761和0.756 μmol/L。与32D-WT细胞相比，32D-T315I细胞对伊马替尼的敏感性降低，而对PRI-724的敏感性未见明显下降。K562、32D-WT和32D-T315I细胞中伊马替尼 + PRI-724联合处理的CI分别为0.635、0.780和0.689，提示两药在体外具有协同抑制作用。SA-β-gal染色显示，与伊马替尼单药组相比，PRI-724单药组3种CML细胞β-gal阳性细胞比例均升高，联合伊马替尼后进一步升高。Co-IP结果显示，PRI-724处理后β-catenin免疫沉淀复合物中CBP共沉淀水平降低，而p300共沉淀水平升高。体内实验显示，与伊马替尼单药组相比，伊马替尼 + PRI-724联合组瘤体体积和瘤体质量进一步降低；但基于TGI计算的K562、32D-WT和32D-T315I荷瘤模型体内CI均 > 1，提示在当前剂量和给药方案下，两药体内联合效应未达到理论相加预期，可能存在拮抗趋势。WB结果显示，与伊马替尼单药组相比，联合治疗组瘤体组织中p-PI3K/PI3K、p-AKT/AKT比值降低，核内β-catenin、CBP、c-Myc和Cyclin D1表达水平均降低。结论：PRI-724联合伊马替尼在体外具有协同抑制作用，并可在体内较伊马替尼单药进一步抑制瘤体生长。其机制可能与调节β-catenin/CBP/p300复合物、抑制PI3K/AKT信号通路及下调c-Myc、Cyclin D1表达有关。