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In the field of innovative cancer treatment strategies, oncolytic vaccinia virus (VV)es have gained traction as promising vectors. In the current study, we inserted the human C-type lectin domain family 2 member A (CLEC2A) gene into VV, creating a replicating therapeutic, oncoVV-CLEC2A. The findings reveal that oncoVV-CLEC2A effectively suppresses colorectal proliferation of mouse xenografts and a range of human cancer cell lines by augmenting viral reproduction capabilities, including the lung cancer H460 cell line, colorectal cancer cell lines (HCT116 and SW620), and hepatocellular carcinoma HuH-7 cell line. Moreover, it is evident that oncoVV-CLEC2A can induce antitumor immunity by boosting cytokine production but not antivirus response, and enhancing calreticulin expression. Further investigation indicates that oncoVV-CLEC2A can enhance antitumor capabilities by activating natural killer cells to produce interferon-γ and induce M1-like macrophage polarization. These findings shed light on the antitumor mechanisms of oncoVV-CLEC2A, provide a theoretical basis for oncolytic therapies, and lay the groundwork for novel strategies for modifying VVs.

The aging timescale of particles is a key parameter in determining their impacts on air quality, human health, and climate. In this study, a one-year simulation of the age distributions of the primary and secondary inorganic fine particulate matter (PM2.5) components was conducted over China using an age-resolved Community Multiscale Air Quality (CMAQ) model. The results indicate that primary PM2.5 (PPM) and ammonium mainly originate from fresh local emissions, with approximately 60%–80% concentrated in 0–24 h age bins in most of China throughout the year. The average age is about 15–25 h in most regions in summer, but increases to 40–50 h in southern region of China and the Sichuan Basin (SCB) in winter. Sulfate is more aged than PPM, indicating an enhanced contribution from regional transport. Aged sulfate with atmospheric age > 48 h account for 30%–50% of total sulfate in most regions and seasons, and the concentrations in the > 96 h age bin can reach up to 15 µg·m−3 in SCB during winter. Dramatic seasonal variations occur in the Yangtze River Delta, Pearl River Delta, and SCB, with highest average age of 60–70 h in winter and lowest of 40–45 h in summer. The average age of nitrate is 20–30 h in summer and increases to 40–50 h in winter. The enhanced deposition rate of nitric acid vapor combined with the faster chemical reaction rate of nitrogen oxides leads to a lower atmospheric age in summer. Additionally, on pollution days, the contributions of old age bins (> 24 h) increase notably for both PPM and secondary inorganic aerosols in most cities and seasons, suggesting that regional transport plays a vital role during haze events. The age information of PM2.5, provided by the age-resolved CMAQ model, can help policymakers design effective emergent emission control measures to eliminate severe haze episodes.

Abstract Particulate 2-methyltetrols (2-MT) and 2-methylglyceric acid (2-MG) are typically used to indicate the abundance of isoprene-derived secondary organic aerosols (SOA). However, their formation and fate are not fully understood. In this study, we showed that particulate 2-MT and 2-MG collected at multiple monitoring sites under a wide range of atmospheric and emission conditions, with concentrations spanning six orders of magnitudes, are well reproduced with an expanded isoprene-SOA scheme implemented into the Community Multiscale Air Quality (CMAQ) model. The scheme considers their three-phase (gas-aqueous-organic phase) partitioning, formation from acid-driven multiphase reactions, and degradation by OH radicals in the gas and aqueous phases. The model results reveal that a non-aqueous formation pathway or direct biogenic emission is needed to supplement the commonly assumed acid-driven multiphase reaction process to explain the observed 2-MT concentrations. This missing pathway contributes to 20–40% of 2-MT in areas with aerosol pH

Abstract Trace metals in fine particulate matter (PM2.5) are of significant concern in environmental chemistry due to their toxicity and catalytic capability. An observation-constrained hybrid model is developed to resolve regional source contributions to trace metals and other primary species in PM2.5. In this method, source contributions to primary PM2.5 (PPM2.5) from the Community Multiscale Air Quality (CMAQ) Model at each monitoring location are improved to align better with the observation data by applying source-specific scaling factors estimated from a unique regression model. The adjusted PPM2.5 predictions and chemical speciation data are then used to generate observation-constrained source profiles of primary species. Finally, spatial distributions of their source contributions are produced by multiplying the improved CMAQ PPM2.5 contributions with the deduced source profiles. The model is applied to the Pearl River Delta (PRD) region, China using daily observation data collected at multiple stations in 2015 to resolve source contributions to 8 trace metals, elemental carbon, primary organic carbon, and 10 other primary species. Compared to three previous methods, the new model predicts 13 species with smaller model errors and 16 species with less model biases in 10-fold cross validation analysis. The source profiles determined in this study also show good agreement with those collected from the literature. The new model shows that during 2015 in the PRD region, Cu is mainly from the area sources (31%), industry sector (27%), and power generation (20%), with an annual average concentration as high as 50 ng m−3 in some districts. Meanwhile, major contributors to Mn are area sources (40%), emission from outside PRD (23%) and power generation (17%), leading to a mean level of around 10 ng m−3. Such information is essential in assessing the epidemiological impacts of trace metals as well as formulating effective control measures to protect public health.

This study addresses the application of rough set theory in English hierarchical teaching and explores how to optimize the teaching mode and improve the teaching quality and learning effect through this theory. This paper adopts a literature analysis and questionnaire survey method to study rough set theory’s knowledge expression and systematic decision-making mechanism. It applies it to the design of the curriculum system and the innovation of the teaching mode in the English platform of special-purpose universities. The optimized English hierarchical teaching mode using rough set theory significantly improved students’ learning interest and learning effect, in which 87.53% of the students believed it could improve their mastery of knowledge. The average score of 90.3 was 23.4 points higher than that of the control group, which was statistically significant (P

Topological lasers often suffer from low directionality, and/or complex design requirements hindering operation at small wavelengths. Here, by using a few monolayers of perovskite quantum dots, the authors demonstrate a lithography-free, vertical-emitting, single-mode laser emitting in the green.

Background: Studies suggest associations between long-term ambient air pollution exposure and outcomes related to Alzheimer’s disease (AD). Whether a link exists between pollutants and brain amyloid accumulation, a biomarker of AD, is unclear. We assessed whether long-term air pollutant exposures are associated with late-life brain amyloid deposition in Atherosclerosis Risk in Communities (ARIC) study participants. Methods: We used a chemical transport model with data fusion to estimate ambient concentrations of PM2.5 and its components, NO2, NOx, O3 (24-hour and 8-hour), CO, and airborne trace metals. We linked concentrations to geocoded participant addresses and calculated 10-year mean exposures (2002 to 2011). Brain amyloid deposition was measured using florbetapir amyloid positron emission tomography (PET) scans in 346 participants without dementia in 2012–2014, and we defined amyloid positivity as a global cortical standardized uptake value ratio ≥ the sample median of 1.2. We used logistic regression models to quantify the association between amyloid positivity and each air pollutant, adjusting for putative confounders. In sensitivity analyses, we considered whether use of alternate air pollution estimation approaches impacted findings for PM2.5, NO2, NOx, and 24-hour O3. Results: At PET imaging, eligible participants (N = 318) had a mean age of 78 years, 56% were female, 43% were Black, and 27% had mild cognitive impairment. We did not find evidence of associations between long-term exposure to any pollutant and brain amyloid positivity in adjusted models. Findings were materially unchanged in sensitivity analyses using alternate air pollution estimation approaches for PM2.5, NO2, NOx, and 24-hour O3. Conclusions: Air pollution may impact cognition and dementia independent of amyloid accumulation, though whether air pollution influences AD pathogenesis later in the disease course or at higher exposure levels deserves further consideration.

Introduction: Myelofibrosis is a rare disease. There is currently no published data reporting the demographics and outcome of myelofibrosis patients in Malaysia. We aimed to study the demographics, clinical characteristics, and outcome of our patients in Sarawak. Materials and methods : This non-interventional, retrospective, and multi-center study was conducted on secondary data of medical records collected at four Sarawak Public Hospitals. All adult myelofibrosis patients diagnosed between January 2001 and December 2021 were included. Results : A total of 63 patients (male 31) with myelofibrosis were included—47 (74.6%) primary and 16 (25.4%) secondary myelofibrosis. Eleven had antecedent polycythaemia vera, whereas five transformed from essential thrombocythaemia. The combined annual incidence rate was 0.182 per 100,000 population. The period prevalence per 100,000 population over the entire study duration was 2.502. The median age was 59.0 years (33.0–93.0). Majority had high-risk (34/63(54.0%)) and intermediate-2 risk disease (19/63(30.2%)). JAK2V617F mutation was identified in 52 patients (82.5%), followed by CALR mutation in 6 (9.5%) and negative for both mutations in 5 (7.9%). Hydroxyurea was used as first-line therapy in 41/63 (65.1%), followed by interferon (8/63(12.7%)) and ruxolitinib (4/63(6.3%)). Out of 46 patients who received second-line therapy, 18 (39.1%) were switched to ruxolitinib and 9 (19.6%) to interferon. The median age of survival for overall patients was 6.8 years. The use of ruxolitinib in myelofibrosis patients showed a better overall 5-year survival compared to the no ruxolitinib arm, despite no statistical significance ( p = 0.34). Patients who had good performance status had lower hazard of death than patients who had poor performance status (high-risk (95% confidence intervals): 0.06(0.013–0.239), p

Abstract Systematic quantification of phosphoprotein within cell signaling networks in solid tissues remains challenging and precise quantification in large scale samples has great potential for biomarker identification and validation. We developed a reverse phase protein array (RPPA) based phosphor-antibody characterization approach by taking advantage of the lysis buffer compatible with alkaline phosphatase (AP) treatment that differs from the conventional RPPA antibody validation procedure and applied it onto fresh frozen (FF) and formalin-fixed and paraffin-embedded tissue (FFPE) to test its applicability. By screening 106 phospho-antibodies using RPPA, we demonstrated that AP treatment could serve as an independent factor to be adopted for rapid phospho-antibody selection. We also showed desirable reproducibility and specificity in clincical specimens indicating its potential for tissue-based phospho-protein profiling. Of further clinical significance, using the same approach, based on melanoma and lung cancer FFPE samples, we showed great interexperimental reproducibility and significant correlation with pathological markers in both tissues generating meaningful data that match clinical features. Our findings set a benchmark of an efficient workflow for phospho-antibody characterization that is compatible with high-plex clinical proteomics in precison oncology.

Abstract Strict emission control policies implemented in two megacities of New York City (NYC) and Beijing show impacts on the non-linear relationship of their ozone (O3) and fine particulate matter (PM2.5) during summertime. Here we show these non-linear O3-PM2.5 relationships including a positive linear part reflecting the O3/PM2.5 co-occurrence and a negative power function part reflecting the O3 formation suppression by PM2.5 based on the multiyear surface observations. The control policies targeting sulfur dioxide and PM2.5, then volatile organic compounds and nitrogen oxides, changed the PM2.5 chemical composition which resulted in an increased linear slope that indicates a weaker O3 control effect than occurred for PM2.5. These policies also enhanced the relative PM2.5 suppression effect as shown by an increase in the power function coefficient. Model simulations suggest that regional equal percentage emission reductions for Beijing and other Chinese megacities will be necessary to avoid further increase in the O3/PM2.5 linear slope and continuing occurrences of high levels of ozone.

Background: Male infertility is an emerging health issue in the world today. Surgical interventions for the treatment of male infertility are available but are quite expensive. Herbal interventions pose a popular alternative for the treatment of infertility. However, much has to be learned regarding their safety and efficacy.Objective: The aim of the study was to investigate the efficacy of herbal interventions in male infertility and also assess the possibility of these interventions as complementary and alternative medicine (CAM) in the future.Method: From inception until 16 December 2021, all articles emphasizing the efficacy of herbal interventions in the treatment of male infertility are included in this review. Seven databases are searched. The literature obtained is screened and extracted. Semen parameters, hormonal concentration, and conception are the outcomes of interest.Results: A total of 19 articles were included in this review. Herbal interventions might improve semen parameters in males with infertility. Among all the interventions, Hochu-ekki-to and W. somnifera have shown the most promising results and should be studied further in a larger sample size.Conclusion: This systematic review has demonstrated the efficacy of herbal interventions, especially Hochu-ekki-to and W. somnifera, in treating male infertility.

Abstract Background The development of novel and effective drugs for targeted human hepatocellular carcinoma still remains a great challenge. The alkaloid nitidine chloride (NC), a component of a traditional Chinese medicine, has been shown to have anticancer properties, but doses at therapeutic levels have unacceptable side effects. Here we investigate folic acid modified D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS-FA) as a potential carrier for controlled delivery of the drug. Methods Synthesized TPGS-FA was characterized by FTIR, UV-visible and 1H NMR spectroscopy, and TPGS loaded with NC was evaluated for its ability to induce apoptosis in Huh7 cells by Annexin V/PI and MTT assays, and observed by laser scanning confocal microscopy and inverted phase contrast microscopy. Results TPGS-FA/NC complexes were prepared successfully, and were homogenious with a uniform size of ~ 14 nm diameter. NC was released from the TPGS-FA/NC complexes in a controlled and sustained manner under physiological conditions (pH 7.4). Furthermore, its cytotoxicity to hepatocarcinoma cells was greater than that of free NC. Conclusions TPGS-FA is shown to be useful carrier for drugs such as NC, and TPGS-FA/NC could potentially be a potent and safe drug for the treatment of hepatocellular carcinoma.

ObjectiveThe study aims to investigate if a relationship exists between vaginal doses and vaginal stenosis (VS) using posterior–inferior border of symphysis (PIBS) points and the International Commission on Radiation Units-Rectum (ICRU-R) point evaluation system for definitive radio(chemo)therapy in locally advanced cervical cancer.Methods and MaterialsFrom a vaginal dose study in China, 351 patients were prospectively assessed. For every reference point of the PIBS system and ICRU-R point was calculated for all BT and summed with EBRT. Pearson’s chi-square test and Student’s unpaired t-test compared variables with and without vaginal stenosis (VS) G ≥2. The risk factors were assessed for VS G ≥2 in multi- and univariate analyses through Cox proportional hazards model followed by a dose–effect curve construction. The VS morbidity rate was compared via the log-rank test using the median vaginal reference length (VRL).ResultsThe patients (38-month median follow-up) had 21.3% three-year actuarial estimate for VS G ≥2. Compared to G 4.6 cm, the 3-year actuarial estimate was 12.8% vs. 29.6% for VRL ≤4.6 cm. According to the model curve, the risks were 21, 30, and 39% at 75, 85, and 95 Gy, respectively (ICRU-R point dose).ConclusionsPIBS system point doses correlated with late vaginal toxicity. VRL combined with both EBRT and BT dose to the ICRU-R point contribute to VS risk.

During vascular remodeling after intimal injury, circulating platelets are activated by exposed collagen and release platelet-derived microvesicles (PMVs), which may contribute to the injury-induced apoptosis of vascular smooth muscle cells (VSMCs). However, the mechanisms in this process are still unclear. Using a rat balloon injury model, platelet adhesion at the injured site was detected, and promoted medial VSMC apoptosis was revealed with dT-mediated dUTP nick-end labeling (TUNEL) in vivo. VSMC apoptosis was promoted by coincubation with PMVs in vitro. Transcriptomics analysis indicated the abound expression of the microRNA-30 (miR-30) family in platelets, and the expression of the miR-30 family in platelets and PMVs was confirmed with qPCR. Ingenuity Pathway Analysis (IPA) software identified transcription factor 2 (RUNX2) as a pivotal molecule linking miR-30 and cellular apoptosis. In vitro, PMVs delivered miR-30e, an important member of the miR-30 family, into VSMCs and increased cell apoptosis. A dual-luciferase assay was adopted to verify the interaction of miR-30e with RUNX2, and fluorescence in situ hybridization (FISH) proved the cytoplasmic localization of miR-30e in VSMCs. The apoptotic effect on VSMCs was further confirmed by using miR-30e mimics and RUNX2 siRNA. Furthermore, RUNX2 siRNA altered the expression of its downstream genes, Tnfrsf11b, Smad6 and Mmp13, which may participate in apoptosis, as suggested by IPA. Our results indicated that PMVs play important roles in the interactions between circulating elements and VSMCs by delivering miR-30e to VSMCs and then promoting apoptosis. PMVs and potential intercellular messages may be novel therapeutic targets for preventing pathological vascular remodeling after intimal injury.

Our previous studies demonstrated that arming vaccinia viruses with marine lectins enhanced the antitumor efficacy in several cancer cells. This study aims to compare the efficacy of oncolytic vaccinia viruses harboring Tachypleus tridentatus lectin (oncoVV-TTL), Aphrocallistes vastus lectin (oncoVV-AVL), white-spotted charr lectin (oncoVV-WCL), and Asterina pectinifera lectin (oncoVV-APL) in breast cancer cells (BC). These results indicated that oncoVV-AVL elicited the highest anti-tumor effect, followed by oncoVV-APL, while oncoVV-TTL and oncoVV-WCL had lower effects in BC. Further studies showed that apoptosis and replication may work together to enhance the cytotoxicity of oncoVV-lectins in a cell-type dependent manner. TTL/AVL/APL/WCL may mediate multiple pathways, including ERK, JNK, Hippo, and PI3K pathways, to promote oncoVV replication in MDA-MB-231 cells. In contrast, these pathways did not affect oncoVV-TTL/AVL/APL/WCL replication in MCF-7 cells, suggesting that the mechanisms of recombinant viruses in MCF-7 (ER+, PR+) and MDA-MB-231 (TNBC) cells were significantly different. Based on this study, we hypothesized that ER or PR may be responsible for the differences in promoting viral replication and inducing apoptosis between MCF-7 and MDA-MB-231 cells, but the specific mechanism needs to be further explored. In addition, small-molecule drugs targeting key cellular signaling pathways, including MAPK, PI3K/Akt, and Hippo, could be conjunction with oncoVV-AVL to promote breast cancer therapy, and key pathway factors in the JNK and PI3K pathways may be related to the efficacy of oncoVV-APL/TTL/WCL. This study provides a basis for applying oncolytic vaccinia virus in breast carcinoma.

Aphrocallistes vastus lectin (AVL) is a C-type marine lectin derived from sponges. Our previous study demonstrated that oncolytic vaccinia virus carrying AVL (oncoVV-AVL) significantly enhanced the cytotoxicity of oncoVV in cervical cancer, colorectal cancer and hepatocellular carcinoma through the activation of Ras/ERK, MAPK/ERK and PI3K/Akt signaling pathways. In this study, the inflammatory response induced by oncoVV-AVL in a hepatocellular carcinoma cell (HCC) model was investigated. The results showed that oncoVV-AVL increased the levels of inflammatory cytokines including IL-6, IL-8 and TNF-α through activating the AP-1 signaling pathway in HCC. This study provides novel insights into the utilization of lectin AVL in the field of cancer therapy.

Background. Infertility is an emerging health issue for men. Comparative efficacy of different pharmacological interventions on male infertility is not clear. The aim of this review is to investigate the efficacy of various pharmacological interventions among men with idiopathic male infertility. All randomized control trials evaluating the effectuality of interventions on male infertility were included for network meta-analysis (NMA) from inception to 31 April 2020, systematically performed using STATA through the random effect model. The protocol was registered at PROSPERO (CRD42020152891).Results. The outcomes of interest were semen and hormonal parameters. Treatment effects (p < 0.05) were estimated through WMD at the confidence interval of 95%. Upon applying exclusion criteria, n=28 RCTs were found eligible for NMA. Results from NMA indicated that consumption of supplements increases sperm concentration levels [6.26, 95% CI 3.32, 9.21] in comparison to SERMs [4.97, 95% CI 1.61, 8.32], hormones [4.14, 95% CI 1.83, 6.46], and vitamins [0.15, 95% CI −20.86, 21.15)] with placebo, whereas the use of SERMs increased percentage sperm motility [6.69, 95% CI 2.38, 10.99] in comparison to supplements [6.46, 95% CI 2.57, 10.06], hormones [3.47, 95% CI 0.40, 6.54], and vitamins [−1.24, 95% CI −11.84, 9.43] with placebo. Consumption of hormones increased the sperm morphology [3.71, 95% CI, 1.34, 6.07] in contrast to supplements [2.22, 95% CI 0.12, 4.55], SERMs [2.21, 95% CI −0.78, 5.20], and vitamins [0.51, 95% CI −3.60, 4.62] with placebo. Supplements boosted the total testosterone levels [2.70, 95% CI 1.34, 4.07] in comparison to SERMs [1.83, 95% CI 1.16, 2.50], hormones [0.40, 95% CI −0.49, 1.29], and vitamins [−0.70, 95% CI −6.71, 5.31] with placebo. SERMs increase the serum FSH levels [3.63, 95% CI 1.48, 5.79] better than hormones [1.29, 95% CI −0.79, 3.36], vitamins [0.03, 95% CI −2.69, 2.76], and supplements [−4.45, 95% CI −7.15, −1.76] in comparison with placebo.Conclusion. This review establishes that all interventions had a significantly positive effect on male infertility. Statistically significant increased sperm parameters were noted in combinations of zinc sulfate (220 mg BID), clomiphene citrate (50 mg BID), and testosterone undecanoate and CoQ10; tamoxifen citrate and FSH were shown to improve the hormonal profile in infertile males.

Emissions from power plants in China and India contain a myriad of fine particulate matter (PM2.5, PM ≤ 2.5 μm in diameter) precursors, posing significant health risks among large, densely settled populations. Studies isolating the contributions of various source classes and geographic regions are limited in China and India, but such information could be helpful for policy makers attempting to identify efficient mitigation strategies. We quantified the impact of power generation emissions on annual mean PM2.5 concentrations using the state-of-the-art atmospheric chemistry model WRF-Chem (Weather Research Forecasting model coupled with Chemistry) in China and India. Evaluations using nationwide surface measurements show the model performs reasonably well. We calculated province-specific annual changes in mortality and life expectancy due to power generation emissions generated PM2.5 using the Integrated Exposure Response (IER) model, recently updated IER parameters from Global Burden of Disease (GBD) 2015, population data, and the World Health Organization (WHO) life tables for China and India. We estimate that 15 million (95% Confidence Interval (CI): 10 to 21 million) years of life lost can be avoided in China each year and 11 million (95% CI: 7 to 15 million) in India by eliminating power generation emissions. Priorities in upgrading existing power generating technologies should be given to Shandong, Henan, and Sichuan provinces in China, and Uttar Pradesh state in India due to their dominant contributions to the current health risks. Keywords: Air quality modeling, Power generation, China, India, WRF-Chem

Correct folding of nascent peptides occurs in the endoplasmic reticulum (ER). It is a complicate process primarily accomplished by the coordination of multiple redox proteins including members of the protein disulfide isomerase (PDI) family. As a critical member of the PDI family, thioredoxin domain containing protein 5 (TXNDC5) assists the folding of newly synthesized peptides to their mature form through series of disulfide bond exchange reactions. Interestingly, TXNDC5 is frequently found overexpressed in specimens of many human diseases including various types of cancer. In this review, we summarized the biochemical function of TXNDC5 in mammalian cells and the recent progress on the understanding of its role and molecular mechanisms in cancer development. Findings of TXNDC5 in the activation of intracellular signaling pathways, stimulation of cell growth & proliferation, facilitation of cell survival and modulation of extracellular matrix to affect cancer cell invasion and metastasis are reviewed. These published studies suggest that strategies of targeting TXNDC5 can be developed as potentially valuable methods for the treatment of certain types of cancer in patients. Keywords: Cancer, Cell signal, Protein disulfide isomerase, Protein folding, Receptor modulation

Spin–orbit torque (SOT) is a promising approach to manipulate the magnetization for high-performance spintronic applications. In conventional SOT heterostructures with heavy metal (HM)/ferromagnet layers, the SOT efficiency is determined by the charge-to-spin conversion, characterized by the spin Hall angle θSH of the HM layer. Researchers have investigated various HMs with different θSH to enhance the SOT efficiency while it is still limited because of the HM’s intrinsic properties. In this study, we employ a rare-earth holmium (Ho) layer on top of a ferromagnetic Co layer (Pt/Co/Ho) to enhance the SOT efficiency. An increased damping-like SOT efficiency up to 200% is achieved at an optimized thickness of 2-nm Ho, corresponding to a lower switching current density, which is 60% less compared to the sample without a Ho layer. The damping-like torque efficiency per current density is estimated at around 0.256 for Pt/Co/Ho heterostructures. Our results, herein, demonstrate that inserting a rare-earth metal affords an additional spin current and/or improves the spin transparency to enhance the SOT efficiency, providing a route for energy-efficient spintronic devices.

Aims: Facial candling is one of the traditional treatments that is claimed to be able to help in curing or reducing various allergy and inflammation conditions such as allergic rhinitis. We aimed to explore the perceptions of participants with allergic rhinitis toward their disease conditions and facial candling treatment. Materials and Methods: The study used a qualitative exploratory design, comprising 12 in-depth interviews. A semi-structured topic guide was used to explore all relevant aspects of the topic, which were audio recorded, transcribed verbatim. All the interviews were conducted in a few beauty salons in purposively selected city areas in the state of Kedah, Malaysia. Results: Of the 12 patients, seven (58%) reported a positive experience of facial candling treatment, with improvement in the condition of their allergic rhinitis. Specific themes about the experience of facial candling treatment that were identified within the transcript data included knowledge about facial candling, options for disease treatment, effectiveness of facial candling, sources of information, comparison, application of treatment, treatment budget, and safety. The major strength lies in the fact that reasons for using facial candling were uncovered from the perspectives of people with allergic rhinitis through the in-depth interviews. Conclusions: The motives of these participants for using facial candling are mainly due to cultural influence and its low cost of treatment. There were mixed responses from the participants about the usefulness of facial candling. Most of the respondents had not assessed the safety of prolonged use of facial candling and regarded it as a safe procedure as this has been practiced for generations.

Septic pulmonary embolism (SPE) secondary to infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) is rare in extensive burn cases. MRSA is a highly pathogenic bacteria and IE is very difficult to treat. The best therapy for serious MRSA infection remains controversial. Herein, we reported a patient with SPE secondary to IE caused by MRSA, who was treated with teicoplanin (1000 mg twice daily as the loading dose and 1000 mg daily as the maintenance dose, based on the severity and body weight 95 kg, 12 mg/kg) and daptomycin 500 mg daily. The patient was successfully cured with slight liver function impairment. So high-dose (>800 mg) teicoplanin is a potential option to treat serious SPE and IE caused by MRSA. Keywords: Teicoplanin, Daptomycin, Septic pulmonary embolism, Infective endocarditis, Methicillin-resistant Staphylococcus aureus

Background: Incomplete childhood immunization against communicable diseases is a major concern and vaccine hesitancy remains a hurdle to overcome in primary vaccination programs. This study was to examine the parents’ vaccine knowledge, awareness and hesitancy in relation to their children’s immunization status. Methods: A cross-sectional questionnaire study design was used. The parents who brought their children for immunization visit or follow-up at four public health clinics located in Sandakan district were invited to participate in this survey. Informed consent was obtained before each participant completed a hard copy of self-administered questionnaire in either English or Malay versions. Results: Of 405 parents responded, they generally had good knowledge and awareness of vaccines, only a small percentage (6.8%) of parents were found vaccine hesitant. There were significant differences in vaccine knowledge and awareness in those from different education levels and employment status; similarly, these two factors also significantly affected the vaccine hesitancy among the parents. The parents’ knowledge score was found to be moderately associated with their awareness (r = 0.551, p < 0.01) and inversely correlated to vaccine hesitancy (r = −0.397, p < 0.01). Most of the children (n = 376, 92.8%) in the study were immunized. The children’s immunization status was significantly associated with the parents’ education level (p = 0.025). There was also a significant difference in the total vaccine knowledge scores between the groups of parents with different child immunization status (p = 0.05). Conclusion: This study revealed that parents with higher education had a better knowledge of vaccinations, were less vaccine hesitant and were more likely to ensure that their children complete the recommended course of immunization. It is crucial to ensure parents are well-informed about the safety and efficacy of vaccines so that the children are protected from communicable diseases by the child vaccination program.

Background: The emergence of new technologies in the area of health information and communication helps pharmacists to check the safety of medications used via electronic prescribing. Objectives: The study aimed to identify the rate and types of problems with electronic prescriptions (e-prescriptions) that required pharmacist intervention at an inpatient pharmacy, and to evaluate prescribers’ acceptance of these interventions. Methods: A retrospective cross-sectional study on the interventions of e-prescriptions documented by pharmacists was conducted in a public hospital inpatient pharmacy. Data were collected for descriptive analysis using a collection form, including the e-prescription interventions, types of wards, drugs involved, and acceptance of intervention by prescribers. A chi-square test was used to evaluate the association between ward pharmacist availability and the rate of interventions. Results: A total number of 11,922 (3.3%) pharmacist interventions were proposed for 357,760 e-prescriptions ordered in the 12 month study period. Of the total number of proposed interventions, 11,381 (95.5%) were accepted by prescribers. The interventions on e-prescriptions were from surgical wards (11.7%) followed by intensive care (5.6%), paediatric (3.5%) and medical specialty wards (2.9%). Anti-infective agents (33.8%) and cardiovascular medicines (27.0%) were among the drugs with the highest rate of interventions. The most common type of intervention was revising the drug regimen (58.4%), especially with anti-infective agents (33.8%). Prescribers in surgical wards showed the highest level of acceptance of pharmacist interventions, which was 97.37%. The presence of ward pharmacists showed a higher number of interventions (6.2 vs. 1.0%, p < 0.001) than wards without pharmacists, as well as a higher percentage of acceptance (96.4 vs. 91.1%, p < 0.001) towards e-prescription intervention. Conclusion: In e-prescribing, errors can be prevented by pharmacists’ interventions on e-prescriptions. This helps to prevent medication errors and thus optimise rational pharmacotherapy in patients. The role of ward pharmacists in pharmaceutical care is highly accepted by prescribers.

Environmental health (EH) is the study of environment and environmental factors affecting the health of human. Identifying the most relevant and up-to-date and updated teaching topics of EH programs is vital to ensure competent practitioners are nurtured. Thus, this study aimed to attain the view of current content of EH programs for EH professionals and intended to recommend topics necessary for education and practice. The level of importance of current and newly proposed topics for EH courses at diploma and bachelor’s level was assessed using a cross-sectional survey design. Practicing EH programs graduates were invited via social media and e-mails to participate in the survey. The respondents were asked to rank the importance of different EH topics based on 5-point Likert-type scale. Descriptive statistics were employed to report the importance of EH curricula at Malaysian tertiary institutions. It was found that between diploma’s and bachelor’s level, the bachelor’s graduates were expected to have high exposure in existing topics such as vector control management, legislation for EH and safety, health and safety risk assessment, as well as newly proposed topics including critical literature evaluation and innovation in creating awareness activities. The findings from this survey could serve as a guide to improvise EH curricula to ensure the EH programs continue to produce students with the necessary skills, knowledge, and competencies.

Long-term air pollution data with high temporal and spatial resolutions are needed to support the research of physical and chemical processes that affect the air quality, and the corresponding health risks. However, such datasets were not available in China until recently. For the first time, this study examines the spatial and temporal variations of PM2.5, PM10, CO, SO2, NO2, and 8 h O3 in 31 capital cities in China between March 2013 and February 2014 using hourly data released by the Ministry of Environmental Protection (MEP) of China. The annual mean concentrations of PM2.5 and PM10 exceeded the Chinese Ambient Air Quality Standards (CAAQS), Grade I standards (15 and 40 μg/m3 for PM2.5 and PM10, respectively) for all cities, and only Haikou, Fuzhou and Lasa met the CAAQS Grade II standards (35 and 70 μg/m3 for PM2.5 and PM10, respectively). Observed PM2.5, PM10, CO and SO2 concentrations were higher in cities located in the North region than those in the West and the South-East regions. The number of non-attainment days was highest in the winter, but high pollution days were also frequently observed in the South-East region during the fall and in the West region during the spring. PM2.5 was the largest contributor to the air pollution in China based on the number of non-attainment days, followed by PM10, and O3. Strong correlation was found between different pollutants except for O3. These results suggest great impacts of coal combustion and biomass burning in the winter, long range transport of windblown dust in the spring, and secondary aerosol formation throughout the year. Current air pollution in China is caused by multiple pollutants, with great variations among different regions and different seasons. Future studies should focus on improving the understanding of the associations between air quality and meteorological conditions, variations of emissions in different regions, and transport and transformation of pollutants in both intra- and inter-regional contexts. Keywords: Spatial variation, Temporal variation, Criteria pollutants, PM2.5, Provincial capital cities, China

Diabetes self-management offers an opportunity to patients to be actively involved in managing their conditions and modifying lifestyle behaviors to attain positive health outcomes. With the unprecedented growth of mobile technology, smartphone plays a role in supporting diabetes self-management. Nonetheless, selecting appropriate mobile applications (apps) is challenging for patients. Thus, this study aimed to evaluate and compare the contents and features of mobile medical apps for diabetes self-management. Of 346 commercial apps, 16 (16%) and 19 (7.72%) of the diabetes apps found in Apple and Google Play stores, respectively, were included based on the selection criteria and individually scored for the availability of 8 main features of diabetes self-management. The apps supported self-management by offering features such as free installation, less than 50 MB space used, offline use, automated data entry, data export and sharing, educational tool, and advice. Of the 8 evaluated features, only 11 (31.4%) apps had a score of 5 whereas 7 (20%) apps scored the lowest, with a score of 3. The majority of apps were free, required no Internet connectivity to use and were less than 50 MB in size. Our findings showed that the design of diabetes mobile apps focused on reporting and setting reminders, rather than providing personalized education or therapeutic support. In the future, the design of apps could be improved to integrate patients’ needs, usability for disease management, and lifestyle modifications.

Ciprofloxacin, a second generation broad spectrum fluoroquinolone, is active against both Gram-positive and Gram-negative bacteria. Ciprofloxacin has a high oral bioavailability and a large volume of distribution. It is used for the treatment of a wide range of infections including urinary tract infections caused by susceptible bacteria. However, the availability and use of substandard and spurious quality of oral ciprofloxacin formulations in the developing countries has been thought to have contributed toward increased risk of treatment failure and bacterial resistance. Therefore, quality control and bioequivalence studies of the commercially available oral ciprofloxacin formulations should be monitored. Appropriate actions should be taken against offending manufacturers in order to prevent the sale of substandard and spurious quality of ciprofloxacin formulations.