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Elucidating the role of MCP-1/VCAM-1 during re-endothelialisation of circulating progenitor cells in denuded human umbilical artery

Wed, 05 Aug 2026 00:00:00 GMT

Title: Elucidating the role of MCP-1/VCAM-1 during re-endothelialisation of circulating progenitor cells in denuded human umbilical artery Authors: Siti Sarah Azman Abstract: Endothelial denudation is a key-initiating event in the pathophysiology of cardiovascular disease and the development of intimal hyperplasia (IH), yet human ex vivo platforms that enable controlled investigation of early endothelial repair responses remain limited. In particular, the mechanisms governing chemokine-mediated recruitment of circulating cells to denuded vascular surfaces are not fully defined. This study aimed to establish a reproducible human umbilical artery (HUA) ex vivo model and used it as a platform to investigate the role of monocyte chemoattractant protein-1 (MCP-1) in peripheral blood mononuclear cells (PBMC) recruitment and adhesion-associated intracellular signalling following endothelial injury. An optimised enzymatic protocol was developed to generate consistent endothelial removal while preserving extracellular matrix integrity, validated by histology, immunofluorescence and glycosaminoglycan (GAG) assessment. Using this denuded HUA platform under dynamic rocking conditions, the effect of MCP-1 supplementation (20 ng/mL) on PBMC recruitment was examined. Although MCP-1-treated samples exhibited numerically higher PBMC recruitment, particularly at 2 hours post-incubation, these differences were not statistically significant under the experimental conditions tested. To explore the intracellular signalling context associated with MCP-1-mediated recruitment and adhesion stabilisation, smooth muscle cells (SMC)-PBMC in vitro co-culture experiments were performed and phosphorylation of focal adhesion kinase (FAK) at Tyr397 was assessed as a marker of integrin-associated adhesion signalling. Vascular cell adhesion molecule-1 (VCAM- 1) inhibition attenuated recruitment-associated responses and altered pFAK (Tyr397) levels. This suggests a potential involvement of adhesion-associated signalling during cellular recruitment following endothelial injury. Furthermore, denuded HUA segments were maintained in prolonged culture for up to 21 days to model ex vivo IH development. However, the vessels demonstrated modest, non-progressive intima-media thickening with limited proliferative activity, indicating adaptive remodelling rather than aggressive IH progression. In summary, this thesis establishes a human ex vivo vascular platform for investigating cellular responses to endothelial injury and vascular repair. Collectively, the findings provide insight into PBMC recruitment dynamics following endothelial denudation and support further investigation of chemokine-mediated recruitment strategies for promoting re-endothelialisation following vascular intervention.

Exploring the link between Vitamin D deficiency and prediabetes in the Ibb Governorate, Yemen: the prevalence and impact of high-dose Vitamin D supplementation

Thu, 27 Aug 2026 00:00:00 GMT

Title: Exploring the link between Vitamin D deficiency and prediabetes in the Ibb Governorate, Yemen: the prevalence and impact of high-dose Vitamin D supplementation Authors: Mohammed Abdo Mohammed Yaseen Al-Hetar Abstract: Prediabetes and vitamin D deficiency are interrelated public health concems, especially in low-resource regions with high metabolic risk. This study aimed to determine the prevalence of prediabetes among adults in Ibb governorate, Yemen, assess vitamin D status in ADA-defined prediabetic individuals, and evaluate the effects of high-dose vitamin D supplementation on glycaemic parameters, insulin resistance, B-cell function, inflammatory markers, lipid profile, and endothelial function. This two-phase study, conducted from July 2024 to May 2025, included a community-based cross-sectional study followed by a randomized controlled trial involving 1,045 adults aged 18-60 years. Prediabetes was defined using American Diabetes Association criteria based on fasting blood glucose (FBG), 2-hour postprandial plasma glucose (2HPP), or glycated hemoglobin (HbA1c). Of 266 adults with ADA-defined prediabetes, 151 who had vitamin D deficiency were randomised to receive weekly oral cholecalciferol 50,000 IU or placebo for 16 weeks. Vitamin D status was categorized as deficient (<20 ng/mL), insufficient (20-30 ng/mL), or sufficient (>30 ng/mL). Primary outcomes were prediabetes prevalence, vitamin D deficiency among prediabetics, and changes in glycaemic parameters and insulin indices (FBG, 2HPP, HbA1c, HOMA-IR, and HOMA-ẞ). Secondary outcomes included hs-CRP, IL-6, lipid profile, and endothelial function measured by flow-mediated dilation (FMD). Prediabetes prevalence was 23.4% (n=245) (FBG), 14.7% (n=154) (2HPP), and 26.4% (n=276) (HbA1c). Among 266 prediabetics, 74.1% (n=197) were vitamin D deficient, 19.2% (n=51) insufficient, and 6.7% (n=18) sufficient. Post-intervention, 25(OH)D level increased significantly in the vitamin D group compared with placebo (31.13 ± 6.42 vs. 10.64 ± 4.87 ng/mL; p<0.001). Vitamin D supplementation significantly reduced FBG (94 ± 8.1 vs. 100 ± 9.3 mg/dL; p<0.001), improved B-cell function (HOMA-ẞ: 94.79 ± 22.6 vs. 72.16 ± 19.4; p=0.028) and endothelial function (FMD: 15.47 ± 3.2% vs. 2.72 ± 1.1%; p<0.001) compared with placebo. No significant differences were observed for HbA1c, 2HPP, HOMA-IR IL-6, hs-CRP, or lipid parameters between groups. In conclusion, prediabetes and vitamin D deficiency are highly prevalent in Ibb governorate. High- dose vitamin D supplementation improves fasting glycemia, B-cell function, and endothelial function, supporting its potential role as an adjunct strategy for early metabolic and vascular risk modification in vitamin D-deficient prediabetics.

Prevalence and risk factors of fear of childbirth among pregnant women: A mixed-method study in Hebei Province, China

Sat, 22 Aug 2026 00:00:00 GMT

Title: Prevalence and risk factors of fear of childbirth among pregnant women: A mixed-method study in Hebei Province, China Authors: Chen Chunning Abstract: Fear of childbirth (FOC) significantly impacts women's health and fertility intentions, contributing to adverse outcomes such as increased caesarean section rates and postpartum anxiety or depression. In China, declining fertility rates and high caesarean section rates are partly attributed to childbirth fear. However, current studies on FOC in China are limited, as most examine only specific populations or areas. The purpose of this study was to determine the psychometric properties of the simplified Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire Version A (W- DEQ-A) in the general pregnant women population and to further investigate the prevalence and risk factors of FOC in a mixed-methods approach. Performed at a tertiary Chinese hospital in 2024, the study had two phases. In Phase 1, a cross-sectional survey was conducted to analyse the psychometric properties of the Chinese version of the W-DEQ-A using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency reliability was also assessed, and the instrument was revised based on the results of the study. The resulting 19-item, five-factor version of the W-DEQ-A was found to be a reliable and valid measure of FOC for Mandarin- speaking groups. Phase 2 adopted an explanatory sequential design, surveying 314 pregnant women and conducting in-depth phenomenological interviews with 16 participants exhibiting severe FOC. The findings indicated a prevalence of 14.9%, which was related to age, gestational ,and parity. Risk factors were categorised as physiological (pre-pregnancy BMI, poor health or pregnancy complications, and unexpected foetal conditions), psychological (stress, self-doubt and low confidence, and previous negative childbirth experiences), and social (unmet social support needs, low household income and increased postpartum financial stress, horror stories from family or friends, negative information from the media, and excessive risk reminders from medical staff). These findings have important implications for clinical practice and policy. Integrating the validated W-DEQ-A into routine antenatal screening could help to identify at-risk women early on. Healthcare providers should receive training in culturally sensitive and empathetic risk communication. Furthermore, supportive social policies that address economic assistance and family pressures are essential to reducing FOC and enhancing maternal well-being across China. Keywords Fear of childbirth; Mixed-method; Pregnancy; Prevalence; Risk factors

Development and evaluation of teleglaucoma programme in a teaching hospital in Kuala Lumpur for the prevention of future blindness in Malaysia

Wed, 19 Aug 2026 00:00:00 GMT

Title: Development and evaluation of teleglaucoma programme in a teaching hospital in Kuala Lumpur for the prevention of future blindness in Malaysia Authors: Wee, Xiao Hui Abstract: Glaucoma, a leading cause of irreversible blindness, necessitates timely diagnosis as disease is asymptomatic. Undetected glaucoma remains a challenging issue even in developed countries, revealing limitations in current case detection. Significant economic and productivity losses due to blindness caused by glaucoma demand a better detection of glaucoma cases. Teleglaucoma, a telemedicine for glaucoma, offers a promising solution to overcome these challenges. The aim of this study was to explore the role of a teleglaucoma programme in improving the detection rate of cases with glaucoma and probable glaucoma in the Malaysian population. This study comprised of five study phases which were (1) identify strategies for implementation of teleglaucoma programme and (2) components of its training programme using systematic reviews and qualitative interviews, (3) development, validation and evaluation of training programme for glaucoma screeners, (4) usability and functionality of a local teleglaucoma system and (5) comparison of detection rate of glaucoma or probable glaucoma between teleglaucoma pathway at Primer Clinic and opportunistic case finding pathway at Sentul Health Clinic. Components for implementation of teleglaucoma programme include high-risk individuals of glaucoma, glaucoma screening examinations including history taking, visual acuity test, tonometry, fundus photography and perimetry, accessible screening locations, well- connected teleglaucoma system, skilled personnel, and a clear referral guideline. The training module were developed in Malay and English languages with good content and face validity by both experts and targeted participants. The training module increased the glaucoma screeners' knowledge (p=0.02) and skills (100% pass) in glaucoma screening. The local teleglaucoma system was found to be user-friendly and functionable. The detection rate of glaucoma and probable glaucoma using teleglaucoma sys (6%) was higher compared to the opportunistic case finding (1.4%). This study is the first in Malaysia that explored the feasibility of implementing a teleglaucoma screening programme using a local system. Teleglaucoma programme can transform the standard glaucoma practice, leading to early identification and prevent blindness. Future study should include evaluation of cost-effectiveness in implementation of teleglaucoma in Malaysia.