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Background: Functional disability, defined as acquired difficulty in performing basic daily tasks or more complex tasks needed for independent living. Functional assessment among community dwelling elderly is critical due to the changes taking place during the normal aging process, acute illness, worsening chronic illness, and hospitalization which compromises their performances necessary to live independently. Measuring their functional ability can provide objective data to assist with targeting individualized care plan for older adults being the highest consumers of medications due to greater burden of medical conditions in addition to being vulnerable to the effects of medications. It is crucial for the pharmacists to be aware of the geriatric functional disability as pharmacies are often the first point-of-care this elderly group may encounter in community settings. Methods: This study was conducted to estimate the prevalence of functional disability and the common difficulties in the daily task performance among elderly from a state in the Northern region of Malaysia. Besides, the differences in terms of functional disability in both genders were also explored. Among a total of 266 elderly participants. Results: Around 42 % was estimated to face at least one difficulty with Activities of Daily Living while more than half, 57 %, had at least one difficulty with Instrumental Activities of Daily Living. The most common difficulties reported with Activities of Daily Living and Instrumental Activities of Daily Living were transferring (22 %) and transportation (33 %), respectively. Conclusion: In order to deliver effective pharmaceutical care plan emphatically, both senior-friendly pharmacy curricula and pharmacy settings are imperative to address the most common difficulties faced by this vulnerable group.

Glycation is the non-enzymatic reaction of glucose or its metabolites to proteins, causing irreversible changes. Methylglyoxal, a dicarbonyl, affects the structure and function of physiologically important proteins. Being a major circulatory protein, hemoglobin is highly prone to glycation. Current research focuses on identifying potent glycation inhibitors to prevent glycation and their impact on protein structure and function. The present study investigates the Advanced Glycation Endproducts (AGEs) inhibitory effects of 2-methoxy-4-formylphenol (Vanillin) against methylglyoxal mediated glycation of hemoglobin. The hemoglobin-vanillin glycation model exhibited inhibition of AGE formation, amyloid fibrils, aggregates and reduction in esterase activity. The fluorescence spectroscopic technique revealed efficient binding of vanillin and hemoglobin, with Stern Volmer plot indicating the presence of static quenching. The conformational stability of the vanillin and hemoglobin interaction was also evident from the molecular docking and dynamics studies. The proximal orientation of residues (H2 and K82 associated in esterase activity) of hemoglobin β1 chain and vanillin, supports the noted effect of reduced esterase activity in the presence of vanillin in glycated hemoglobin and the inhibition of the overall formation of AGE of hemoglobin in the presence of vanillin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Mycobacterium abscessus complex is responsible for 2.6-13.0% of all non-tuberculous mycobacterial pulmonary infections and these are notoriously difficult to treat due to the complex regimens required, drug resistance and adverse effects. Hence, bacteriophages have been considered in clinical practice as an additional treatment option. Here, we evaluated antibiotic and phage susceptibility profiles of M. abscessus clinical isolates. Whole-genome sequencing (WGS) revealed the phylogenetic relationships, dominant circulating clones (DCCs), the likelihood of patient-to-patient transmission and the presence of prophages., Methods: Antibiotic susceptibility testing was performed using CLSI breakpoints (n = 95), and plaque assays were used for phage susceptibility testing (subset of n = 88, 35 rough and 53 smooth morphology). WGS was completed using the Illumina platform and analysed using Snippy/snp-dists and Discovery and Extraction of Phages Tool (DEPhT)., Results: Amikacin and Tigecycline were the most active drugs (with 2 strains resistant to amikacin, and one strain with Tigecycline MIC of 4 μg/mL). Most strains were resistant to all other drugs tested, with Linezolid and Imipenem showing the least resistance, at 38% (36/95) and 55% (52/95), respectively. Rough colony morphotype strains were more phage-susceptible than smooth strains (77%-27/35 versus 48%-25/53 in the plaque assays, but smooth strains are not killed efficiently by those phages in liquid infection assay). We have also identified 100 resident prophages, some of which were propagated lytically. DCC1 (20%-18/90) and DCC4 (22%-20/90) were observed to be the major clones and WGS identified 6 events of possible patient-to-patient transmission., Discussion: Many strains of M. abscessus complex are intrinsically resistant to available antibiotics and bacteriophages represent an alternative therapeutic option, but only for strains with rough morphology. Further studies are needed to elucidate the role of hospital-borne M. abscessus transmission., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Significant adjustments to maternity care in response to the COVID-19 pandemic and the direct impacts of COVID-19 can compromise the quality of maternal and newborn care., Aim: To explore how the COVID-19 pandemic negatively affected frontline health workers' ability to provide respectful maternity care globally., Methods: We conducted a global online survey of health workers to assess the provision of maternal and newborn healthcare during the COVID-19 pandemic. We collected qualitative data between July and December 2020 among a subset of respondents and conducted a qualitative content analysis to explore open-ended responses., Findings: Health workers (n = 1127) from 71 countries participated; and 120 participants from 33 countries provided qualitative data. The COVID-19 pandemic negatively affected the provision of respectful maternity care in multiple ways. Six central themes were identified: less family involvement, reduced emotional and physical support for women, compromised standards of care, increased exposure to medically unjustified caesarean section, and staff overwhelmed by rapidly changing guidelines and enhanced infection prevention measures. Further, respectful care provided to women and newborns with suspected or confirmed COVID-19 infection was severely affected due to health workers' fear of getting infected and measures taken to minimise COVID-19 transmission., Discussion: Multidimensional and contextually-adapted actions are urgently needed to mitigate the impacts of the COVID-19 pandemic on the provision and continued promotion of respectful maternity care globally in the long-term., Conclusions: The measures taken during the COVID-19 pandemic had the capacity to disrupt the provision of respectful maternity care and therefore the quality of maternity care., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This paper characterize microplastics (MPs) in the heavily urbanized, brackish water Vembanad Lake (India), focussing on some commercially important bottom-feeding fishes and shellfish (Arius maculatus, Etroplus suratensis, E. maculatus and Villorita sp.). The average abundance of MPs was higher in the water column (872 ± 573 nos./m 3 ) than in finfishes (15 ± 13 particles per fish) and shellfish (23 ± 20 nos./ind.). Fibre was the most abundant MP type in the water and the organisms examined. The size of MPs obtained from finfishes ranged between 0.04 and 4.73 mm (4 ± 3 mm), with a majority of particles being <4 mm. No correlation was found between biological features (e.g. gut length, mouth size) of fishes and the size of MPs in their gut. In Villorita sp., the abundance of MPs was positively correlated with the size of the individuals. Raman spectroscopy confirmed the presence of chlorinated polyvinyl chloride, polyethylene, polypropylene and polyester in the samples., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: The Changing Childbirth in British Columbia study explored women's preferences and experiences of maternity care, including women's role in decision-making., Methods: Following content validation by community members, we administered a cross-sectional online survey exploring novel topics, including drivers for interventions, and experiences of autonomy, respect, or mistreatment during maternity care. Using the Mothers Autonomy in Decision-Making (MADM) scale as an outcome measure in a mixed-effects analysis, we examined differential experiences by socio-demographic and prenatal risk profile, type of care provider, interventions received, and nature of communication with care providers., Results: A geographically representative sample of Canadian women (n = 2051) reported on 3400 pregnancies. Most women (95.2%) preferred to be the lead decision-maker during care. Patients of physicians had significantly lower autonomy (MADM) scores than midwifery clients as did women who felt pressured to accept interventions. Women who had a difference in opinion with their provider, and those who felt their provider seemed rushed reported the lowest MADM scores., Conclusion: Women's autonomy is significantly altered by model of maternity care, the nature of interactions with care providers, and women's ability for self-determination., Practice Implications: If health professionals acquire skills in person-centred decision-making experience of autonomy among pregnant women may improve., (Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: The vagus nerve is involved in regulating immunity and resolving inflammation. Current strategies aimed at modulating neuroinflammation and cognitive decline, in many cases, are limited and ineffective., Objective: We sought to develop a minimally invasive, targeted, vagus nerve stimulation approach (pVNS), and we tested its efficacy with respect to microglial activation and amelioration of cognitive dysfunction following lipopolysaccharide (LPS) endotoxemia in mice., Methods: We stimulated the cervical vagus nerve in mice using an ultrasound-guided needle electrode under sevoflurane anesthesia. The concentric bipolar needle electrode was percutaneously placed adjacent to the carotid sheath and stimulation was verified in real-time using bradycardia as a biomarker. Activation of vagal fibers was confirmed with immunostaining in relevant brainstem structures, including the dorsal motor nucleus and nucleus tractus solitarius. Efficacy of pVNS was evaluated following administration of LPS and analyses of changes in inflammation and behavior., Results: pVNS enabled stimulation of the vagus nerve as demonstrated by changes in bradycardia and histological evaluation of c-Fos and choline acetyltransferase expression in brainstem nuclei. Following LPS administration, pVNS significantly reduced plasma levels of tumor necrosis factor-α at 3 h post-injection. pVNS prevented LPS-induced hippocampal microglial activation as analyzed by changes in Iba-1 immunoreactivity, including cell body enlargement and shortened ramifications. Cognitive dysfunction following endotoxemia was also restored by pVNS., Conclusion: Targeted cervical VNS using this novel percutaneous approach reduced LPS-induced systemic and brain inflammation and significantly improved cognitive responses. These results provide a novel therapeutic approach using bioelectronic medicine to modulate neuro-immune interactions that affect cognition., (Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background and Purpose: Malaysian National Quit Smoking Program had proposed to integrate smoking cessation counseling skills into all relevant healthcare curricula as one of its strategies to increase the number of Malaysians giving up smoking. More effective implementation of the curricula can be facilitated by further understanding the factors influencing students' intention in terms of providing smoking cessation counseling. This study, guided by Integrated Behavior Model (IBM), aimed to explore the factors which influenced pharmacy undergraduates in providing smoking cessation counseling., Educational Activity and Setting: Following the elicitation study, the IBM-guided questionnaire was developed and distributed to students from two pharmacy schools which agreed to participate, each representing public and private institutions., Findings: A total of 387 pharmacy students participated yielding a 83% response rate. Multiple regression analysis revealed that all three, namely, attitude (23%), perceived norm (16%), and personal agency (16%) were significant predictors of students' intention. Further analysis revealed 'experiential attitude', a component of attitude as the strongest predictor. In other words, students who felt more comfortable had higher intention to provide smoking cessation counseling., Summary: An implication of this study is that tobacco-related curricula with an emphasis to enhance students' comfort level in providing counseling would be of value for these future pharmacists in terms of their intention as well as actual provision of smoking cessation counseling through the mediation of "experiential attitude" and personal agency., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Canine ocular onchocerciasis has a worldwide distribution and has been associated in Europe with Onchocerca lupi based on morphologic and molecular analysis. In the United States, canine ocular onchocerciasis is reportedly associated with Onchocerca lienalis. This association is based solely on histopathologic examination of ocular tissues. The purpose of this study was to use molecular analysis of formalin-fixed, paraffin-embedded canine ocular tissue to determine the genetic identity of Onchocerca associated with canine ocular onchocerciasis in the United States. PCR and DNA sequencing of the mitochondrial cytochrome oxidase I (cox1) and NADH hydrogenase 5 (nd5) genes demonstrated >99% similarity between the sequences obtained from canine ocular tissues previously diagnosed with onchocerciasis. The obtained sequences were most similar to O. lupi (>99% similarity). This report confirms for the first time that O. lupi is associated with canine ocular onchocerciasis in the United States, contrary to previously published reports., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Computational design of sequences for a given structure is generally studied by exhaustively enumerating the sequence space or by searching in such a large space, which is prohibitively expensive. However, we point out that the protein topology has a wealth of information, which can be exploited to design sequences for a chosen structure. In this paper, we present a computationally efficient method for ranking the residue sites in a given native-state structure, which enables us to design sequences for a chosen structure. The premise for the method is that the topology of the graph representing the energetically interacting neighbours in a protein plays an important role in the inverse-folding problem. While our previous work (which was also based on topology) used eigenspectral analysis of the adjacency matrix of interactions for ranking the residue sites in a given chain, here we use a simple but effective way of assigning weights to the nodes on the basis of secondary connections, along with primary connections. This indirectly accounts for the edge weight in the graph and removes degeneracy in the degree. The new scheme needs only a few multiplications and additions to compute the preferred ranking of the residue sites even for structures of real proteins of sizes of a few hundred amino acid residues. We use HP lattice model examples (for which exhaustive enumeration of sequences is practical) to validate our ranking approach in obtaining sequences of lowest energy for any H-P residue composition for a given native-state structure. Some examples of native structures of real proteins are also included. Quantitative comparison of the efficacy of the new scheme with the earlier schemes is made. The new scheme consistently performs better and with much lower computational cost. An optimization procedure is added to work with the new scheme in a few rare cases wherein the new scheme fails to provide the best sequence, an optimization procedure is added to work with the new scheme.

Diabetes mellitus is a disease, which virtually affects all the systems in the body including the immune system. Bacterial infections are important causes of increased morbidity and mortality in diabetic patients. In the present study, we assessed the effect of molybdate on immune responses of diabetic rats. The phagocytic potency and nitroblue tetrazolium dye reduction capacity were found to be considerably lowered whereas soluble immune complex formation enhanced significantly in diabetic rats when compared with control rats. From our findings, it is suggested that dietary intake of molybdate may have a vital role in enhancing immune functions during diabetic mellitus.