Browse publications by year: 2023

  1. Mahmood A, Srivastava HM, Abbas M, Abdullah FA, Othman Mohammed P, Baleanu D, et al.
    Heliyon, 2023 Oct;9(10):e20852.
    PMID: 37916109 DOI: 10.1016/j.heliyon.2023.e20852
    The analytical soliton solutions place a lot of value on birefringent fibres. The major goal of this study is to generate novel forms of soliton solutions for the Radhakrishnan-Kundu-Lakshmanan equation, which depicts unstable optical solitons that arise from optical propagations using birefringent fibres. The (presumably new) extended direct algebraic (EDA) technique is used here to extract a large number of solutions for RKLE. It gives soliton solutions up to thirty-seven, which essentially correspond to all soliton families. This method's ability to determine many sorts of solutions through a single process is one of its key advantages. Additionally, it is simple to infer that the technique employed in this study is really straightforward yet one of the quite effective approaches to solving nonlinear partial differential equations so, this novel extended direct algebraic (EDA) technique may be regarded as a comprehensive procedure. The resulting solutions are found to be hyperbolic, periodic, trigonometric, bright and dark, combined bright-dark, and W-shaped soliton, and these solutions are visually represented by means of 2D, 3D, and density plots. The present study can be extended to investigate several other nonlinear systems to understand the physical insights of the optical propagations through birefringent fibre.
  2. Li S, Nor NM, Kaliappan SR
    SSM Popul Health, 2023 Dec;24:101533.
    PMID: 37916186 DOI: 10.1016/j.ssmph.2023.101533
    Research on the impact of childhood nutrition on adult health and human capital has been extensively studied in developed countries, but research in China on this topic is limited. Nowadays, for children's nutritional status, while significant progress has been made in addressing childhood undernutrition in China, regional disparities persist, conversely, the prevalence of childhood overweight continues to rise. For adults' health human capital, the burden of chronic non-communicable diseases among Chinese residents is gradually increasing, over 50% of Chinese residents are overweight or obese, with obesity being one of the risk factors for other chronic diseases. Therefore, this study uses national representative data from 1991 to 2015 China Health and Nutrition Survey (CHNS), matched with individual information from their childhood, to examine the relationship between childhood nutrition and adult health human capital. Based on the two-way fixed effects models and logit models, the study finds that childhood nutrition status measured by height-for-age z score (HAZ) significantly and continuously has been influencing adult health human capital measured by height, BMI, self-rated health (SRH), whether have been sick in last four weeks (SH). BMI-for-age z score (BMIZ) significantly and continuously influence adult health human capital measured by BMI, blood pressure, and perceived stress (PS). Among that, this study places special emphasis on the long-lasting effects of late childhood and adolescence (ages exceeding 6) on the progressive height accumulation and sustained presence of elevated blood pressure. In conclusion, reducing childhood overweight and promoting linear growth and development throughout the whole childhood can reduce the future burden of disease on the nation.
  3. Julius A, Syahida-Emiza S, Utteridge TMA
    PhytoKeys, 2023;234:181-188.
    PMID: 37916213 DOI: 10.3897/phytokeys.234.106829
    Ardisiakrauensis, a new species of Primulaceae from Peninsular Malaysia, is described and illustrated. The new species is assignable into subgenus (§) Pyrgus on account of specialised lateral reproductive branches bearing a terminal inflorescence subtended by foliose bracts. Morphologically, the new species mostly resembles Ardisiarigida in having elliptic leaves. However, the new species can be distinguished by the combination of its lateral veins number, the inflorescence branching pattern, the rachis and flower colour, and the stigma shape. Ardisiakrauensis is found in an entirely protected habitat, thus, it is assessed as Least Concern (LC).
  4. Dong L, Zhang Y, Li Y, Liu Y, Chen Q, Liu L, et al.
    Food Funct, 2023 Nov 13;14(22):10221-10231.
    PMID: 37916290 DOI: 10.1039/d3fo02474a
    Heat sterilization of dairy products can promote the formation of advanced glycation end products (AGEs), protein oxidation products (POPs) and α-dicarbonyl compounds, which have a significant influence on health due to the close association of these products with diabetes complications. In this study, eight oat phenolic acids were first analyzed for their inhibitory effect against AGEs formation. Due to their strong inhibitory effects and structural differences, caffeic acid (CA) and gallic acid (GA) were further selected to assess their anti-glycosylation mechanisms using spectroscopy, chromatography and molecular docking. CA/GA reduced the production of total AGEs and POPs in various bovine milk simulation models and protected whey proteins from structural modifications, oxidation, and cross-linking. Comparative analyses showed a structure-effect relationship between CA/GA and AGEs inhibition. Oat phenolic acids against AGEs and POPs might be related to the unique bonding of key amino acid residues in whey proteins, the inhibitory role of early fructosamine and the trapping of reactive α-dicarbonyl groups to form adducts. In conclusion, oat phenolic acids might present a promising dietary strategy to alleviate AGEs production and glycation of proteins in dairy products upon storage.
    MeSH terms: Whey Proteins/analysis; Chromatography; Spectrum Analysis; Molecular Docking Simulation
  5. Alrashdan MS, Arzmi MH, Ahmad Kamil WN, Al Kawas S, Leao JC
    Ital J Dermatol Venerol, 2023 Oct;158(5):408-418.
    PMID: 37916401 DOI: 10.23736/S2784-8671.23.07676-4
    The oral mucosa can be involved in a wide variety of mucocutaneous conditions that may present primarily in the mouth or affect other cutaneous or mucosal sites. Many of these conditions are immune mediated and typically present as inflammatory mucosal pathology. Patients experiencing such conditions usually seek medical evaluation and treatment due to the associated pain and discomfort and occasionally taste disturbance or dysphagia and the overall deterioration in the oral health-related quality of life. These conditions share some common features and there could be some overlapping in their clinical presentation, which can lead to delays in diagnosis and proper management of patients. Clinicians dealing with such disorders, including dermatologists, need to be aware of the oral manifestations of mucocutaneous conditions, their clinical features, underlying mechanisms, diagnostic approaches, and treatment options, as well as the recent advances in the research on these conditions. This review provides a comprehensive, evidence-based reference for clinicians, with updated insights into a group of immune mediated conditions known to cause oral mucosal pathology. Part one will cover oral lichen planus, erythema multiforme and systemic lupus erythematosus, while part two will cover pemphigus vulgaris and mucous membrane pemphigoid, recurrent aphthous stomatitis, in addition to the less common disorders linear IgA disease, dermatitis herpetiformis and epidermolysis bullosa.
    MeSH terms: Humans; Mouth Mucosa/pathology; Quality of Life
  6. Hameed MM, Razali SFM, Mohtar WHMW, Rahman NA, Yaseen ZM
    PLoS One, 2023;18(10):e0290891.
    PMID: 37906556 DOI: 10.1371/journal.pone.0290891
    The Great Lakes are critical freshwater sources, supporting millions of people, agriculture, and ecosystems. However, climate change has worsened droughts, leading to significant economic and social consequences. Accurate multi-month drought forecasting is, therefore, essential for effective water management and mitigating these impacts. This study introduces the Multivariate Standardized Lake Water Level Index (MSWI), a modified drought index that utilizes water level data collected from 1920 to 2020. Four hybrid models are developed: Support Vector Regression with Beluga whale optimization (SVR-BWO), Random Forest with Beluga whale optimization (RF-BWO), Extreme Learning Machine with Beluga whale optimization (ELM-BWO), and Regularized ELM with Beluga whale optimization (RELM-BWO). The models forecast droughts up to six months ahead for Lake Superior and Lake Michigan-Huron. The best-performing model is then selected to forecast droughts for the remaining three lakes, which have not experienced severe droughts in the past 50 years. The results show that incorporating the BWO improves the accuracy of all classical models, particularly in forecasting drought turning and critical points. Among the hybrid models, the RELM-BWO model achieves the highest level of accuracy, surpassing both classical and hybrid models by a significant margin (7.21 to 76.74%). Furthermore, Monte-Carlo simulation is employed to analyze uncertainties and ensure the reliability of the forecasts. Accordingly, the RELM-BWO model reliably forecasts droughts for all lakes, with a lead time ranging from 2 to 6 months. The study's findings offer valuable insights for policymakers, water managers, and other stakeholders to better prepare drought mitigation strategies.
    MeSH terms: Machine Learning; Animals; Forecasting; Humans; Water; Reproducibility of Results; Ecosystem; Beluga Whale*; Droughts; Lakes*
  7. Tumasyan A, Adam W, Andrejkovic JW, Bergauer T, Chatterjee S, Damanakis K, et al.
    Eur Phys J C Part Fields, 2023;83(10):963.
    PMID: 37906635 DOI: 10.1140/epjc/s10052-023-12050-4
    The mass of the top quark is measured in 36.3fb-1 of LHC proton-proton collision data collected with the CMS detector at s=13TeV. The measurement uses a sample of top quark pair candidate events containing one isolated electron or muon and at least four jets in the final state. For each event, the mass is reconstructed from a kinematic fit of the decay products to a top quark pair hypothesis. A profile likelihood method is applied using up to four observables per event to extract the top quark mass. The top quark mass is measured to be 171.77±0.37GeV. This approach significantly improves the precision over previous measurements.
  8. Adhikaree J, Shrestha R, Bomjan P, Shrestha A, Pokharel S, Acharya R, et al.
    Post Reprod Health, 2023 Dec;29(4):195-200.
    PMID: 37907067 DOI: 10.1177/20533691231213301
    Background: The ovarian follicular cell's degradation and subsequent decrease in the synthesis of estrogen results in the decreased cardiovascular protection. As a result, the incidence of cardiovascular disease (CVD) increases in postmenopausal women and is characterized by change in lipid profile. This study sought to ascertain the extent of the impact that menstrual status might have on lipid profiles among premenopausal and postmenopausal women. Methods: A cross-sectional study was conducted with 260 premenopausal and postmenopausal women (1: 1) and serum lipid component concentrations (high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and total cholesterol (TC)) were measured. A comparison between two groups was made between premenopausal and postmenopausal women, and regression was carried out to estimate the effect of menstrual status on lipid components. Results: Compared with premenopausal women, the concentrations of the lipid components (HDL-C, LDL-C, TG, and TC) were found to be significantly higher in postmenopausal women. Using the linear regression, menstruation status was able to predict 11.7%-13.3% of the lipid components (TG and TC) when age and weight were adjusted. Conclusion: The difference in lipid components between premenopausal women and postmenopausal women exists, with menstrual status explaining 11.7%-13.3% variance for the observed lipid level. The factors influencing the lipid profile beside the menstrual status should also be explored. External intervention such as estrogen replacement therapy is also recommended in case of deviation of lipid profile from the suggested normal clinical range.
    MeSH terms: Cross-Sectional Studies; Female; Humans; Cholesterol, HDL; Cholesterol, LDL; Nepal/epidemiology; Postmenopause*; Tertiary Care Centers
  9. Aljunid SM, Mad Tahir NS, Ismail A, Abdul Aziz AF, Azzeri A, Zafirah SA, et al.
    Sci Rep, 2023 Oct 31;13(1):18771.
    PMID: 37907537 DOI: 10.1038/s41598-023-46079-y
    The economic burden of influenza is a significant issue within healthcare system, related to higher medical costs particularly among the elderly. Yet, influenza vaccination rates in the elderly in Malaysia were considerably low as it is not part of Malaysia's national immunization program, with substantial mortality and morbidity consequences. Therefore, we conducted a cost-effectiveness analysis of quadrivalent influenza vaccine (QIV) for the elderly in Malaysia compared with the current no-vaccination policy. A static cost-utility model, with a lifetime horizon based on age, was used for the analysis to assess the cost-effectiveness and health outcomes associated with QIV. Univariate and probabilistic sensitivity analyses were performed to test the effects of variations in the parameters. The use of QIV in Malaysia's elderly population would prevent 66,326 potential influenza cases and 888 potential deaths among the elderly, leading to 10,048 potential quality-adjusted life years (QALYs) gained. The QIV would also save over USD 4.4 million currently spent on influenza-related hospitalizations and reduce productivity losses by approximately USD 21.6 million. The ICER per QALY gained from a third-party payer's perspective would be USD 2216, which is lower than the country's gross domestic product per capita. A QIV-based vaccination program in the elderly was found to be highly cost-effective, therefore would reduce the financial burden of managing influenza and reduce pre-mature death related to this disease.
    MeSH terms: Aged; Cost-Benefit Analysis; Humans; Influenza Vaccines*; Malaysia/epidemiology; Vaccination
  10. Kumar DSRS, Puthiran SH, Selvaraju GD, Matthew PA, Senthilkumar P, Kuppusamy S, et al.
    Mol Biotechnol, 2023 Oct 31.
    PMID: 37907811 DOI: 10.1007/s12033-023-00903-y
    The present study focused on preparing and characterizing magnetite-polyvinyl alcohol (PVA) hybrid nanoparticles using Acanthophora spicifera marine algae extract as a reducing agent. Various analytical techniques, including UV-Visible spectrometry, Fourier-transform infrared (FTIR) analysis, energy-dispersive X-ray (EDX), scanning electron microscopy (SEM), and X-ray diffraction (XRD) analysis, were used to characterize the nanoparticles. The results showed the successful synthesis of nanoparticles with a characteristic color change and absorption peak at 400 nm in UV-Visible spectrometry. FTIR analysis indicated an interaction between the carboxyl group and magnetite-polyvinyl alcohol hybrid ions. SEM analysis revealed spherical nanoparticles with sizes ranging from 20 to 100 nm. EDX analysis confirmed the presence of strong magnetite peaks in Acanthophora spicifera, validating successful preparation. XRD analysis indicated the crystalline nature of the nanoparticles. Furthermore, the antimicrobial potential of As-PVA-MNPs was evaluated, demonstrating a significant zone of inhibition against tested bacterial and fungal samples at a concentration of 100 µg. These findings suggest the promising antimicrobial activity of the synthesized nanoparticles for potential applications in combating pathogenic microorganisms.
  11. Goh Q, Low Y, Abd Rani NHB, Tong C
    JCEM Case Rep, 2023 Mar;1(2):luad016.
    PMID: 37908485 DOI: 10.1210/jcemcr/luad016
    A 31-year-old gentleman presented with clinical hyperthyroidism, goiter, bitemporal hemianopia, and discordant thyroid function test. The high α-subunit and absence of throtropin (thyroid-stimulating hormone; TSH) response to thyrotropin-releasing hormone stimulation indicated a TSH-secreting pituitary tumor. Elevation in prolactin and growth hormone as well as secondary hypogonadism were also observed. A sellar-suprasellar mass displacing the optic chiasm was revealed upon magnetic resonance imaging. The patient was rendered euthyroid with carbimazole and Lugol's iodine before undergoing endoscopic transsphenoidal surgery. Due to the incomplete tumor excision during surgery, patient experienced recurrence of symptoms and rising thyroxine (T4) with nonsuppressed TSH. The histopathology examination demonstrated a plurihormonal tumor with positive immunohistochemical stain for TSH, growth hormone, and prolactin, with invasive and proliferative features. Subsequently he was initiated with a long-acting somatostatin analogue and underwent stereotactic radiosurgery. To date, his symptoms have improved, with a reduction of insulin-like growth factor 1 and normalization of other pituitary hormones as well as a slightly reduced size of the pituitary tumor.
  12. Mesleh A, Ehtewish H, Lennard K, Abdesselem HB, Al-Shaban F, Decock J, et al.
    Front Mol Neurosci, 2023;16:1222506.
    PMID: 37908488 DOI: 10.3389/fnmol.2023.1222506
    INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by defects in two core domains, social/communication skills and restricted/repetitive behaviors or interests. There is no approved biomarker for ASD diagnosis, and the current diagnostic method is based on clinical manifestation, which tends to vary vastly between the affected individuals due to the heterogeneous nature of ASD. There is emerging evidence that supports the implication of the immune system in ASD, specifically autoimmunity; however, the role of autoantibodies in ASD children is not yet fully understood.

    MATERIALS AND METHODS: In this study, we screened serum samples from 93 cases with ASD and 28 healthy controls utilizing high-throughput KoRectly Expressed (KREX) i-Ome protein-array technology. Our goal was to identify autoantibodies with differential expressions in ASD and to gain insights into the biological significance of these autoantibodies in the context of ASD pathogenesis.

    RESULT: Our autoantibody expression analysis identified 29 differential autoantibodies in ASD, 4 of which were upregulated and 25 downregulated. Subsequently, gene ontology (GO) and network analysis showed that the proteins of these autoantibodies are expressed in the brain and involved in axonal guidance, chromatin binding, and multiple metabolic pathways. Correlation analysis revealed that these autoantibodies negatively correlate with the age of ASD subjects.

    CONCLUSION: This study explored autoantibody reactivity against self-antigens in ASD individuals' serum using a high-throughput assay. The identified autoantibodies were reactive against proteins involved in axonal guidance, synaptic function, amino acid metabolism, fatty acid metabolism, and chromatin binding.

  13. Leung AK, Barankin B, Lam JM, Leong KF
    Drugs Context, 2023;12.
    PMID: 37908643 DOI: 10.7573/dic.2023-8-2
    BACKGROUND: Guttate psoriasis is common and affects 0.5-2% of individuals in the paediatric age group. This review aims to familiarize physicians with the clinical manifestations, evaluation, diagnosis and proper management of guttate psoriasis.

    METHODS: A search was conducted in July 2023 in PubMed Clinical Queries using the key term "guttate psoriasis". The search strategy included all observational studies, clinical trials and reviews published within the past 10 years. The information retrieved from the search was used in the compilation of the present article.

    RESULTS: Guttate psoriasis typically presents with an abrupt onset of numerous, small, scattered, tear-drop-shaped, scaly, erythematous, pruritic papules and plaques. Sites of predilection include the trunk and proximal extremities. There may be a history of preceding streptococcal infection. Koebner phenomenon is characteristic. Guttate psoriasis may spontaneously remit within 3-4 months with no residual scarring, may intermittently recur and, in 40-50% of cases, may persist and progress to chronic plaque psoriasis. Given the possibility for spontaneous remission within several months, active treatment may not be necessary except for cosmetic purposes or because of pruritus. On the other hand, given the high rates of persistence of guttate psoriasis and progression to chronic plaque psoriasis, some authors suggest active treatment of this condition.

    CONCLUSION: Various treatment options are available for guttate psoriasis. Triggering and exacerbating factors should be avoided if possible. Topical corticosteroids alone or in combination with other topical agents (e.g. tazarotene and vitamin D analogues) are the most rapid and efficient treatment for guttate psoriasis and are therefore the first-line treatment for mild cases. Other topical therapies include vitamin D analogues, calcineurin inhibitors, anthralin, coal tar and tazarotene. Ultraviolet phototherapy is the first-line therapy for moderate-to-severe guttate psoriasis, as it is more practical than topical therapy when treating widespread or numerous small lesions. Systemic immunosuppressive and immunomodulatory therapies (e.g. methotrexate, cyclosporine, retinoids, fumaric acid esters and biologics) may be considered for patients with moderate-to-severe guttate psoriasis who fail to respond to phototherapy and topical therapies.

  14. Mansor N, Awang H, Amuthavalli Thiyagarajan J, Mikton C, Diaz T
    Age Ageing, 2023 Oct 28;52(Suppl 4):iv118-iv132.
    PMID: 37902520 DOI: 10.1093/ageing/afad101
    OBJECTIVE: this study aims to conduct a systematic review on available instruments for measuring older persons' ability to learn, grow and make decisions and to critically review the measurement properties of the identified instruments.

    METHODS: we searched six electronic databases, which include PubMed, Embase, PsycINFO, SciELO, ERIC and AgeLine, between January 2000 and April 2022. Reference lists of the included papers were also manually searched. The COSMIN (CONsensus-based Standards for the selection of health Measurement Instruments) guidelines were used to evaluate the measurement properties and the quality of evidence for each instrument.

    RESULTS: 13 instruments from 29 studies were included for evaluation of their measurement properties. Of the 13 reviewed, 6 were on the ability to learn, 3 were on the ability to grow and 4 were on the ability to make decisions. The review found no single instrument that measured all three constructs in unidimensional or multidimensional scales. Many of the instruments were found to have sufficient overall rating on content validity, structural validity, internal consistency and cross-cultural validity. The quality of evidence was rated as low due to a limited number of related validation studies.

    CONCLUSION: a few existing instruments to assess the ability to learn, grow and make decisions of older people can be identified in the literature. Further research is needed in validating them against functional, real-world outcomes.

    MeSH terms: Aged; Aged, 80 and over; Humans; Learning*; Databases, Factual; Consensus
  15. Mokhtar SMA, Derrick-Roberts ALK, Evans DR, Strudwick XL
    ACS Appl Bio Mater, 2023 Nov 20;6(11):4662-4671.
    PMID: 37902811 DOI: 10.1021/acsabm.3c00416
    Recently, transdermal monitoring and drug delivery have gained much interest, owing to the introduction of the minimally invasive microneedle (MN) device. The advancement of electroactive MNs electrically assisted in the capture of biomarkers or the triggering of drug release. Recent works have combined conducting polymers (CPs) onto MNs owing to the soft nature of the polymers and their tunable ionic and electronic conductivity. Though CPs are reported to work safely in the body, their biocompatibility in the skin has been insufficiently investigated. Furthermore, during electrical biasing of CPs, they undergo reduction or oxidation, which in practical terms leads to release/exchange of ions, which could pose biological risks. This work investigates the viability and proliferation of skin cells upon exposure to an electrochemically biased MN pair comprising two differently doped poly(3,4-ethylenedioxy-thiophene) (PEDOT) polymers that have been designed for skin sampling use. The impact of biasing on human keratinocytes and dermal fibroblasts was determined at different initial cell seeding densities and incubation periods. Indirect testing was employed, whereby the culture media was first exposed to PEDOTs prior to the addition of this extract to cells. In all conditions, both unbiased and biased PEDOT extracts showed no cytotoxicity, but the viability and proliferation of cells cultured at a low cell seeding density were lower than those of the control after 48 h of incubation.
    MeSH terms: Cell Survival; Humans; Polymers*; Skin; Keratinocytes*
  16. Reidpath D, Khosla R, Gruskin S, Dakessian A, Allotey P
    BMJ Glob Health, 2023 Oct;8(10).
    PMID: 37903566 DOI: 10.1136/bmjgh-2023-013274
    MeSH terms: Health Equity*; Humans; Social Justice*
  17. Kow CS, Ramachandram DS, Hasan SS
    Ann Endocrinol (Paris), 2023 Dec;84(6):792.
    PMID: 37903668 DOI: 10.1016/j.ando.2023.09.004
    MeSH terms: Humans; Hypoglycemic Agents/therapeutic use
  18. Zakaria MI, Suhaimi S, Pin TM, Mokhtar MAM, Zahedi AZA
    Ann Geriatr Med Res, 2023 Dec;27(4):324-328.
    PMID: 37903753 DOI: 10.4235/agmr.23.0150
    BACKGROUND: The practice of safe emergency medicine requires accurate and adequate assessments. However, screening for cognitive deficits is not performed regularly in the emergency department (ED). This study aimed to determine factors influencing the frequency of cognitive testing by ED doctors.

    METHODS: This study included all doctors working in the EDs of three teaching hospitals. A 17-item online survey instrument that collected information on sex, experience, perceived prevalence, perception, and practice of cognitive assessment was distributed through electronic mail and data messaging services.

    RESULTS: Of the 210 participants, 72 were male. The estimated mean with standard deviation prevalence of cognitive impairment in older patients in the ED was 39.5%±19.7%. Among the participating ED doctors, 75.8% performed cognitive testing up to 10% of the time. Moreover, the participants ranked cognitive impairment the lowest compared to the other four chronic conditions in terms of its impact on hospitalization outcomes. Multiple linear regression revealed that the doctors' perceptions of the responsible personnel and the importance of cognitive testing, as well as their lack of expertise, were independently associated with the frequency of testing.

    CONCLUSION: Lack of expertise, perception of the importance of cognitive testing, and lack of consensus on which discipline is responsible for performing cognitive testing in older patients in the ED were the limiting factors in performing cognitive testing in the ED. Improving perception and awareness of the importance of cognitive assessment as a screening tool could improve the detection and overall management of older patients.

  19. Lee RE, Chan PY
    Sci Rep, 2023 Oct 30;13(1):18622.
    PMID: 37903843 DOI: 10.1038/s41598-023-45802-z
    The distinction between Parkinson's disease (PD) and essential tremor (ET) tremors is subtle, posing challenges in differentiation. To accurately classify the PD and ET, BiLSTM-based recurrent neural networks are employed to classify between normal patients (N), PD patients, and ET patients using accelerometry data on their lower arm (L), hand (H), and upper arm (U) as inputs. The trained recurrent neural network (RNN) has reached 80% accuracy. The neural network is analyzed using layer-wise relevance propagation (LRP) to understand the internal workings of the neural network. A novel explainable AI method, called LRP-based approximate linear weights (ALW), is introduced to identify the similarities in relevance when assigning the class scores in the neural network. The ALW functions as a 2D kernel that linearly transforms the input data directly into the class scores, which significantly reduces the complexity of analyzing the neural network. This new classification method reconstructs the neural network's original function, achieving a 73% PD and ET tremor classification accuracy. By analyzing the ALWs, the correlation between each input and the class can also be determined. Then, the differentiating features can be subsequently identified. Since the input is preprocessed using short-time Fourier transform (STFT), the differences between the magnitude of tremor frequencies ranging from 3 to 30 Hz in the mean N, PD, and ET subjects are successfully identified. Aside from matching the current medical knowledge on frequency content in the tremors, the differentiating features also provide insights about frequency contents in the tremors in other frequency bands and body parts.
    MeSH terms: Artificial Intelligence; Birth Weight; Humans; Parkinson Disease*; Tremor; Neural Networks (Computer); Essential Tremor*
  20. Ong MF, Soh KL, Saimon R, Tiong IK, Saidi HI, Mortell M
    BMC Geriatr, 2023 Oct 31;23(1):703.
    PMID: 37904086 DOI: 10.1186/s12877-023-04372-5
    BACKGROUND: Protection Motivation Theory could be another potential and good framework that addresses essential elements in a behavioural change leading to positive fall protective behaviours. The positive behavioural change could reduce the risk of falls and improve the quality of life of the older community. The study aims to evaluate the reliability and validity of the culturally adapted Protection Motivation Theory scale for older adults' fall protection motivation or protective behaviours to reduce fall risk.

    METHODS: A cross-sectional study was conducted to establish a psychometric instrument validation. A total of 389 participants aged 55 years and above were included. The study was conducted in Sarawak, Malaysia, from November 2021 to January 2022 in two phases, translation of the PMT Scale, cross-cultural adaptation, face validation and pre-testing of the PMT Scale. The participants were selected using multistage random sampling in a primary healthcare clinic. Data entry and statistical analysis were performed using IBM SPSS version 26 for exploratory factor analysis and SmartPLS version 3.3.7 for confirmatory factor analysis using partial least square structural equation modelling.

    RESULTS: The Kaiser-Meyer-Olkin value was 0.760, Bartlett's sphericity test was significant and the total variance explained was 61%. It identified 31 items within eight dimensions of the Protection Motivation Theory scale. The Higher Order Constructs' measurement model indicates that the convergent and discriminant validity were established (Cronbach's alpha and composite reliability: ≥ 0.740; average variance extracted: 0.619 to 0.935 and Henseler's Heterotrait-Monotrait criterion for all constructs' discriminant validity: 

    MeSH terms: Aged; Cross-Sectional Studies; Humans; Motivation*; Psychometrics; Quality of Life*; Surveys and Questionnaires; Reproducibility of Results
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