Currently, 3D printing has emerged in the biomedical implants in fracture fixations as well as artificial organs. Interestingly, 4D bioprinting is a recently developed method or concept that intends to logically create 3D patterned biological matrices from synthetic hydrogel-based inks with the potential to change form upon stimulation. However, the static and fixed structure of 3D printing unable to mimic the complex structures of human tissue which involves contract and relax. In addressing this issue, the additive manufacturing (AM) of four dimensional (4D printing) has taken a place in biomedical application in fabricating highly printable shapes.

Introduction: Swimming pools pose significant public health risks due to chemical and microbiological contaminants. This study focuses on evaluating the prevalence of faecal coliform, Escherichia coli, and Pseudomonas aeruginosa, while also assessing physicochemical parameters in residential swimming pools located in Ampang, Selangor, Malaysia. Materials and methods: Water samples were collected 20cm below the pool surface, preserved in 500ml sterile containers, and transported to the laboratory in iceboxes. Physicochemical analyses, including pH and residual chlorine, were performed. Microbiological examination utilized standard multiple tube fermentation and membrane filtration techniques. Results: Thirty-three swimming pools participated in the study. Physicochemical parameters revealed a mean pH of 5.8±1.2 and residual chlorine of 1.2±1.24/L. Notably, 66.7% of tested pools exhibited pH levels outside the acceptable range (7.0 to 7.9), and 75.7% had residual chlorine values below the standard level (0-0.5mg/L). Microbial analysis indicated a prevalence of 24.2% for faecal coliform, 15.1% for E. coli, and 9.1% for P. aeruginosa. Conclusion: This study highlights prevalent issues in residential swimming pools, including low pH levels, insufficient residual chlorine, and the presence of microbial contaminants. The findings underscore the need for proactive measures to enhance water quality management in domestic pools, ensuring the safety of users. Ongoing vigilance and maintenance practices, particularly monitoring pH and chlorine concentrations, are crucial to mitigate potential health hazards associated with swimming pool water. Implementing stringent protocols and regular inspections by relevant authorities can contribute to maintaining optimal pool conditions and safeguarding public health.

The tunable properties of hydrogels have led to their widespread use in various biomedical applications such as wound treatment, drug delivery, contact lenses, tissue engineering and 3D bioprinting. Among these applications, natural polysaccharide-based hydrogels, which are fabricated from materials like agarose, alginate, chitosan, hyaluronic acid, cellulose, pectin and chondroitin sulfate, stand out as preferred choices due to their biocompatibility and advantageous fabrication characteristics. Despite the inherent biocompatibility, polysaccharide-based hydrogels on their own tend to be weak in physiochemical and mechanical properties. Therefore, further reinforcement in the hydrogel is necessary to enhance its suitability for specific applications, ensuring optimal performance in diverse settings. Integrating nanomaterials into hydrogels has proven effective in improving the overall network and performance of the hydrogel. This approach also addresses the limitations associated with pure hydrogels. Next, an overview of recent trends in the fabrication and applications of hydrogels was presented. The characterization of hydrogels was further discussed, focusing specifically on the reinforcement achieved with various hydrogel materials used so far. Finally, a few challenges associated with hydrogels by using polysaccharide-based nanomaterial were also presented.

Background: Absenteeism amongst pre-school children is often due to illnesses such as hand, foot, and mouth disease, acute gastroenteritis, cold and fu, which are easily spread amongst them. This is because of weak immunity and lack of knowledge on proper hand hygiene. This quasi-experimental study assessed the efcacy of an intervention consisting of a hand hygiene education programme, along with digital tools in bringing about a change in behaviour and health conditions amongst preschool children in Klang Valley, Malaysia. Methods: A total of 377 school children, male and female, aged 5–6 years old, participated and were assigned to either the intervention or a control group. During the 2 months intervention period, children in the test group were trained on proper hand hygiene practices and techniques with the aid of the interactive android-based tablets. The numbers of absent days of all the children were recorded for 2 months before the intervention and during the intervention. Results: In the test group, there was a 25% increase in the total number of absent days from the pre-intervention period to the intervention period, a much lesser increment observed as compared to that of control group in which the increase was much higher at 89%. Results: showed a signifcant diference (P<0·05) between the absenteeism rates for the test and control group during the intervention period. Conclusion: These results suggest that proper education and intervention increase hand hygiene compliance, which may help decrease school absenteeism due to illness; however, a longer study duration may be necessary to evaluate the beneft further.

At present, aerogel is one of the most interesting materials globally. The network of aerogel consists of pores with nanometer widths, which leads to a variety of functional properties and broad applications. Aerogel is categorized as inorganic, organic, carbon, and biopolymers, and can be modified by the addition of advanced materials and nanofillers. Herein, this review critically discusses the basic preparation of aerogel from the sol–gel reaction with derivation and modification of a standard method to produce various aerogels for diverse functionalities. In addition, the biocompatibility of various types of aerogels were elaborated. Then, biomedical applications of aerogel were focused on this review as a drug delivery carrier, wound healing agent, antioxidant, anti-toxicity, bone regenerative, cartilage tissue activities and in dental fields. The clinical status of aerogel in the biomedical sector is shown to be similarly far from adequate. Moreover, due to their remarkable properties, aerogels are found to be preferably used as tissue scaffolds and drug delivery systems. The advanced studies in areas including self-healing, additive manufacturing (AM) technology, toxicity, and fluorescent-based aerogel are crucially important and are further addressed.

Evidence of gut microbiota involvement in regulating glucose metabolism and type 2 diabetes mellitus (T2DM) progression is accumulating. The understanding of microbial dysbiosis and specific alterations of gut microbiota composition that occur during the early stages of glucose intolerance, unperturbed by anti-diabetic medications, is especially essential. Hence, this systematic review was conducted to summarise the existing evidence related to microbiota composition and diversity in individuals with prediabetes (preDM) and individuals newly diagnosed with T2DM (newDM) in comparison to individuals with normal glucose tolerance (nonDM). A systematic search of the PubMed, MEDLINE and CINAHL databases were conducted from inception to February 2021 supplemented with manual searches of the list of references. The primary keywords of “type 2 diabetes”, “prediabetes”, “newly-diagnosed” and “gut microbiota” were used. Observational studies that conducted analysis of the gut microbiota of respondents with preDM and newDM were included. The quality of the studies was assessed using the modified Newcastle-Ottawa scale by independent reviewers. A total of 18 studies (5,489 participants) were included. Low gut microbial diversity was generally observed in preDM and newDM when compared to nonDM. Differences in gut microbiota composition between the disease groups and nonDM were inconsistent across the included studies. Four out of the 18 studies found increased abundance of phylum Firmicutes along with decreased abundance of Bacteroidetes in newDM. At the genus/species levels, decreased abundance of Faecalibacterium prausnitzii, Roseburia, Dialister, Flavonifractor, Alistipes, Haemophilus and Akkermansia muciniphila and increased abundance of Lactobacillus, Streptococcus, Escherichia, Veillonella and Collinsella were observed in the disease groups in at least two studies. Lactobacillus was also found to positively correlate with fasting plasma glucose (FPG), HbA1c and/or homeostatic assessment of insulin resistance (HOMA-IR) in four studies. This renders a need for further investigations on the species/strain-specific role of endogenously present Lactobacillus in glucose regulation mechanism and T2DM disease progression. Differences in dietary intake caused significant variation in specific bacterial abundances. More studies are needed to establish more consistent associations, between clinical biomarkers or dietary intake and specific gut bacterial composition in prediabetes and early T2DM.

Herpes simplex virus type-1 (HSV-1) encephalitis (HSE) is the most commonly diagnosed cause of viral encephalitis in western countries. Despite antiviral treatment, HSE remains a devastating disease with high morbidity and mortality. Improved understanding of pathogenesis may lead to more effective therapies. Mitochondrial damage has been reported during HSV infection in vitro. However, whether it occurs in the human brain and whether this contributes to the pathogenesis has not been fully explored. Minocycline, an antibiotic, has been reported to protect mitochondria and limit brain damage. Minocycline has not been studied in HSV infection. In the first genome-wide transcriptomic study of post-mortem human HSE brain tissue, we demonstrated a highly preferential reduction in mitochondrial genome (MtDNA) encoded transcripts in HSE cases (n = 3) compared to controls (n = 5). Brain tissue exhibited a significant inverse correlation for immunostaining between cytochrome c oxidase subunit 1 (CO1), a MtDNA encoded enzyme subunit, and HSV-1; with lower abundance for mitochondrial protein in regions where HSV-1 was abundant. Preferential loss of mitochondrial function, among MtDNA encoded components, was confirmed using an in vitro primary human astrocyte HSV-1 infection model. Dysfunction of cytochrome c oxidase (CO), a mitochondrial enzyme composed predominantly of MtDNA encoded subunits, preceded that of succinate dehydrogenase (composed entirely of nuclear encoded subunits). Minocycline treated astrocytes exhibited higher CO1 transcript abundance, sustained CO activity and cell viability compared to non-treated astrocytes. Based on observations from HSE patient tissue, this study highlights mitochondrial damage as a critical and early event during HSV-1 infection. We demonstrate minocycline preserves mitochondrial function and cell viability during HSV-1 infection. Minocycline, and mitochondrial protection, offers a novel adjunctive therapeutic approach for limiting brain cell damage and potentially improving outcome among HSE patients.

Medical doctors’ work to prevent, diagnose, treat diseases, disorders, and injuries as well as prescribing medication. Many people are attracted to this profession because it gives them the opportunity to help others. Doctors’ improve quality of life by providing advice, healing physical ailments and performing complex surgeries. Medicine is a profession in which dedication to the wellbeing of others is of paramount importance. Balancing the requirements of work and personal life can be a struggle as the demand of work as a doctors’ is great. Perception and expectation of medical students regarding the lifestyle of doctors’ is important to ensure that they had made the right career choice. Thus, the aim of this study is to assess the perception of pre-clinical students regarding doctors’ lifestyle. This study is a cross-sectional study involving all third-year pre-clinical medical students at University Sains Islam Malaysia. A total of 81 students participated in this study. Participants were given a set of questionnaire consisting of demographic data, open-ended questions on their perception on doctors’ lifestyle of working environment, salary expectation and family life. Thematic analysis were used to analyse the data. The participants comprised 69% female and their age range was between 20-21 years old. Majority of them were from middle income families. Majority of the students perceived that the doctors’ lifestyle would be busy (72%). Approximately 30% of them expected that the time schedule will be unpredictable, 21% mentioned that sacrifice is required and 16% perceived it as a tiring job. Other themes emerged were ‘requiring high commitment’ (6%), challenging (7%) and risky (4%). With regards to salary expectation, 48% expected reasonable salary, 33% high salary and 12% described it as 'not worth compared to the workload'. Majority of them perceived that their family life will be restricted (62%) and time management is important (33%). Only 15% mentioned that family members have to sacrifice and spousal understanding is important (7%). About 10% of them perceived that their family will not be affected by their profession. Majority of the medical students perceived a busy doctors’ lifestyle, reasonable salary and restricted family life. However, there was a significant proportion of them who required counselling for better preparation of their future lifestyle.

The emergence of nanocellulose from various natural resources as a promising nanomaterial has been gaining interest for a wide range application. Nanocellulose serves as an excellent candidate since it contributes numerous superior properties and functionalities. In this review, details of the three main nanocellulose categorised: cellulose nanocrystal (CNC), cellulose nanofibril (CNF), and bacterial nanocellulose (BNC) have been described. We focused on the preparation and isolation techniques to produce nanocellulose including alkaline pre-treatment, acid hydrolysis, TEMPO-mediated oxidation, and enzymatic hydrolysis. The surface modification of nanocellulose through esterification, silylation, amidation, phosphorylation, and carboxymethylation to improve the diverse applications has also been reviewed. Some invigorating perspectives on the applications, challenges, and future directions on the relevant issues regarding nanocellulose are also presented.

Recently, additive manufacturing (AM), being part of IR4.0, received great attention for the fabrication of customized implants with outstanding quality, which are used in hard tissue replacement. For an orthopedic application, the titanium alloy implants, especially those that use Ti-6Al-4V manufactured by selective laser melting (SLM), should facilitate maximum osteointegration between the implant and corresponding bone. However, the superior mechanical characteristics, poor surface integration, antibacterial performance, and readiness of SLM Ti6Al-4V for use in advanced implants are still not comparable to those of anatomical bone. This review focused on the current issue of stress-shielding limitations in SLM Ti-6Al-4V owing to failures in load-bearing applications. The surface treatment and modification strategy that might improve the osseointegration of the implant were discussed. The corrosion resistance of SLM Ti-6Al-4V which could significantly affect antibacterial capability, improve cell adherence and apatite formation on the bone remodeling surface was also addressed. Finally, the current challenges, prospects and applications for SLM Ti-6Al-4V development were presented.

Magnesium (Mg) has attracted great attention as a possible biomedical implant due to its appropriate mechanical property, good biocompatibility, and lightweight. However, fast and uneven degradation has been a significant problem of pure Mg. The goal of this review was to investigate the current state of the art in the corrosion resistance and load-bearing capacities of osteopromotive biomaterials created by altering Mg surface coating with Hydroxyapatite (HA) ceramics. Initially, the osteopromotive characteristics of magnesium and also the magnesium corrosion behaviour in the human body’s microenvironment were discussed. Following that, the different HA sol-gel coating methods in modifying the surface and corrosion behaviour of Mg were established. It was proposed that the optimal HA coating is about 5 to 6 µm as a corrosion barrier, which may also be improved by heat treatment at temperatures ranging from 300°C to 450°C. Finally, the strategies of HA sol-gel surface modification to improve the apatite formed and their degradation issue to promote healing in orthopaedic high load-bearing skeletal sites were elucidated.

Choosing a career is one of the most important decisions in our life. A right career leads a person to grow with that career and achieve success through the decision. Thus, career suitability assessment is important to help individuals to understand how a variety of personal attributes can impact their potential success and satisfaction with different career options and work environments. Some career needs specific personality trait that relates to attributes of job requirements and commitments. For medicine, being caring, approachable, inquisitive, able to listen and understand patients’ pain, anxiety and sorrow are important. The aim of this study was to evaluate the career suitability of pre-clinical students. This was a cross sectional study conducted among pre-clinical medical students in Universiti Sains Islam Malaysia. 'Sidek Career Interest Inventory’ was used to assess the students’ suitability for the course. This instrument had been validated locally to suit the local social and cultural context. It assessed the students’ personality trait based on Holland’s theory and their interests. For students to pursue in the medical course, two main personality trait are believed to be essential namely investigative and social trait personalities. Some of the characteristics of investigative trait are analytical, rational, intellectual and curious, while the characteristics of social trait personality include empathy, friendly, understanding and accommodating. The score for each personality trait were categorized as low (0-3.99), moderate (4-6.99) and high (7-10). A total of 81 pre-clinical medical students were included in this study. About two third (93.8%) of them were female and all of them are from 20 to 21 of age. Approximately, half of the students (47.5%) scored high and another 46.3% scored moderate for investigative trait. For social trait, only 13.8% scored high while 31.3% scored moderate. Only 12.5% (10) students had high scores for both investigative and social traits. Most of the pre-clinical medical students scored high in the investigative sections, however their social values were inadequate (low scores). For them to become good medical doctors, they should be good in both investigative and social skills to enhance their suitability for this career. Therefore, there is a need to nurture these medical students with appropriate social values and soft skills.

Clinical training may expose medical and nursing students to workplace hazards comparable to those encountered by healthcare workers (HCWs). This study was designed to investigate the prevalence of latent tuberculosis infection (LTBI) and associated risk factors among medical and nursing students. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, a systematic review was conducted utilising four electronic databases to appraise and synthesise the literature on LTBI which used the tuberculin skin test (TST) and the blood interferon-gamma release assay (IGRA). Results: Original articles published in the English language between 2010 and 2020 were included, yielding 14 relevant articles. The average prevalence of LTBI in high-burden countries was 38.2% for TST and 20.6% for the IGRA test. According to TST and IGRA findings, the average prevalence of LTBI in nations with an intermediate burden was 16.7% and 4.7 %, respectively. The average prevalence was 2.8% and 1.1% from the TST and IGRA tests for low-burden countries, respectively. A greater risk of LTBI was shown to be related with an increase in age among postgraduate medical school students, a history of Bacillus Calmette-Guerin (BCG) vaccination, origin from high-risk tuberculosis (TB) countries, increased hours of hospital exposure, a history of contact with TB cases, a high body mass index, older age group students, and a lower TB knowledge score. Conclusion: The available evidence from this review emphasised the importance of developing and implementing efficient and cost-effective TB infection-control programmes, particularly in high-burden countries and amongst students at risk.