Cosmos caudatus (CC) contains high flavonoids and might be beneficial in neuroprotection. It has the potential to prevent neurodegenerative diseases. Therefore, we aimed to investigate the effects of 12 weeks of Cosmos caudatus supplement on cognitive function, mood status, blood biochemical profiles and biomarkers among older adults with mild cognitive impairment (MCI) through a double-blind, placebo-controlled trial. The subjects were randomized into CC supplement (n = 24) and placebo group (n = 24). Each of them consumed one capsule of CC supplement (250 mg of CC/capsule) or placebo (500 mg maltodextrin/capsule) twice daily for 12 weeks. Cognitive function and mood status were assessed at baseline, 6th week, and 12th week using validated neuropsychological tests. Blood biochemical profiles and biomarkers were measured at baseline and 12th week. Two-way mixed analysis of variance (ANOVA) analysis showed significant improvements in mini mental state examination (MMSE) (partial η² = 0.150, p = 0.049), tension (partial η² = 0.191, p = 0.018), total mood disturbance (partial η² = 0.171, p = 0.028) and malondialdehyde (MDA) (partial η² = 0.097, p = 0.047) following CC supplementation. In conclusion, 12 weeks CC supplementation potentially improved global cognition, tension, total mood disturbance, and oxidative stress among older adults with MCI. Larger sample size and longer period of intervention with incorporation of metabolomic approach should be conducted to further investigate the underlying mechanism of CC supplementation in neuroprotection.

Objective: This study aims to investigate the public pattern in seeking breast cancer screening information inMalaysia using Google Trends. Methods: The Google Trends database was evaluated for the relative Internet searchpopularity of breast cancer and screening-related search terms from 2007 to 2018. Results: Result showed downwardtrends in breast cancer search, whereas mammogram and tomosynthesis search fluctuated consistently. A significantincrement was found during Pink October month. Breast cancer search term achieved the highest popularity in the eastcoast of Malaysia with [x2 (5, N=661) = 110.93, P<0.05], whereas mammogram attained the highest search volume incentral Malaysia [x2 (4, N=67) = 18.90, P<0.05]. The cross-correlation for breast cancer was moderate among northernMalaysia, Sabah, and Sarawak (0.3 ≤ rs ≤ 0.7). Conclusion: Public interest trend in breast cancer screening is stronglycorrelated with the breast cancer awareness campaign, Pink October. Breast cancer screening should be promoted inthe rural areas in Malaysia.

Background: Persicaria minorextract exhibits antioxidant and anti-inflammatory properties and has potential effects on cognitive function and mood. However, the effects ofP.minoron brain activation and biomarkers have not been studied among older adults. This multicentre, randomized, double-blinded, placebo-controlled study aimed to investigate the effect of 6 monthsP.minorextract supplement (Biokesum®) on cognition, mood, biomarkers, and brain activation among older adults with Mild Cognitive Impairment (MCI).Method: A total of 36 Malaysian community-dwelling older adults with MCI (60–75-year-old) were randomized into Biokesum® (n = 18) and placebo group (n = 18). Each subject consumed one capsule of Biokesum® (250 mg/capsule) or placebo (maltodextrin, 280 mg/capsule) twice daily for 6 months. Cognitive function and mood were assessed at baseline, 3rd, and 6th-month using neuropsychological tests (MMSE, Digit Span, RAVLT, Digit Symbol, and Visual Reproduction) and Profile of Mood State (POMS) questionnaire. Blood lipid profile, fasting blood glucose, and biomarkers (MDA, LPO, COX-2, iNOS, and BDNF) were measured at baseline and 6th month. By the end of the intervention, there were 30 compliers (Biokesum®:N = 15; Placebo: N = 15) and 6 dropouts. For brain activation assessment, 15 subsamples (Biokesum®:N = 8; Placebo:N = 7) completed N-back and Stroop tasks during fMRI scanning at baseline and 6th month. The dorsolateral prefrontal cortex (Brodmann’s area 9 and 46) was identified as a region of interest (ROI) for brain activation analysis using SPM software.Results: Two-way mixed ANOVA analysis showed significant improvements in Visual Reproduction II (p = 0.012, partial η² = 0.470), tension (p = 0.042, partial η² = 0.147), anger (p = 0.010, partial η² = 0.207), confusion (p = 0.041, partial η² = 0.148), total negative subscales (p = 0.043, partial η² = 0.145), BDNF (p = 0.020, partial η² = 0.179) and triglyceride (p = 0.029, partial η² = 0.237) following 6 months of Biokesum® supplementation. Preliminary finding also demonstrated significant improvement at 0-back task-induced right DLPFC activation (p = 0.028, partial η² = 0.652) among subsamples in Biokesum® group. No adverse events were reported at the end of the study.Conclusion: Six months Biokesum® supplementation potentially improved visual memory, negative mood, BDNF, and triglyceride levels among older adults with MCI. Significant findings on brain activation at the right DPLFC must be considered as preliminary.Trial registration: Retrospectively registered on 30th August 2019 [ISRC TN12417552].

To investigate the knowledge of diagnostic reference levels (DRLs), image quality, radiation dose and protocol parameters among Jordanian medical imaging professionals (MIPs) involved in PET/CT and CT scan procedures. A questionnaire was designed and distributed to MIPs in Jordan. The survey comprised four sections: demographic data, MIP knowledge on dose/protocol parameters, image quality, and DRLs. Statistical analyses were performed utilizing Pearson's correlation, t-tests, ANOVA, and linear regression, with a significance level of 95 % and a p-value threshold of <0.05. The study involved 147 participants. Most respondents were male (76.2 %), and most were aged 26–35 years (44.2 %). Approximately 51 % held a bachelor's degree, and the most common range of experience was 3–5 years (28.6 %). Participants showed a moderate level of knowledge regarding dose and protocol parameters, with a mean score of 61.8 %. The mean scores for knowledge of image quality and DRLs were 45.2 % and 44.8 %, respectively. The age group of the MIPs and the total experience were found to have a significant impact on the knowledge of the dose and protocol parameters, as well as the DRLs. Additionally, experience was found to have a significant influence on knowledge of the dose and protocol parameters. The study revealed a positive and significant effect of MIPs' knowledge of dose/protocol parameters and image quality on their knowledge of DRLs. This study indicates that professionals across five specialties who are engaged in PET/CT and CT imaging possess a moderate understanding of dosage and protocol parameters. However, there is a notable gap in knowledge regarding DRLs and image quality. To address this issue, it is recommended that MIPs actively engage in educational programs emphasizing exposure parameters and their impact on image quality. Additionally, access to comprehensive education and training programs will enable MIPs to grasp the complexities of DRLs and their implications, facilitating their implementation in clinical practice.