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  1. Cellulase-Xylanase-Treated Guava Purée by-Products as Prebiotics Ingredients in Yogurt
    Hui CY, Lee KC, Chang YP
    Plant Foods Hum Nutr, 2022 Jun;77(2):299-306.
    PMID: 35661961 DOI: 10.1007/s11130-022-00981-4
    Fruit processing by-products may be re-utilized as prebiotic ingredients to minimize the environmental impact of solid wastes generated from food industries. This study investigated the effects of enzymatic-induced hydrolysis on two types of guava purée by-products, particularly the prebiotic activity after its inclusion in yogurt-making. Commercial cellulase and xylanase were applied together or separately on refiner (the seed-rich fraction), and decanter (the pulp-rich fraction); labelled as 150 XY (xylanase); 150 CE (cellulase), 150 CX (combined cellulase-xylanase), and CT (control, untreated). The hydrolysis extents followed the order of 150 XY 
  2. Fulltext Mapping national information and communication technology (ICT) infrastructure to the requirements of potential digital health interventions in low- and middle-income countries
    Hui CY, Abdulla A, Ahmed Z, Goel H, Monsur Habib GM, Teck Hock T, et al.
    J Glob Health, 2022 Dec 29;12:04094.
    PMID: 36579436 DOI: 10.7189/jogh.12.04094
    BACKGROUND: Digital health can support health care in low- and middle-income countries (LMICs) by overcoming problems of distance, poor infrastructure and the need to provide community practitioners with specialist support. We used five RESPIRE countries as exemplars (Bangladesh, India, Indonesia, Malaysia, Pakistan) to identify the digital health solutions that are valuable in their local setting, worked together with local clinicians and researchers to explore digital health policy, electricity/ICT infrastructure, and socio-cultural factors influencing users' ability to access, adopt and utilise digital health.

    METHODS: We adopted the Joanna Briggs Institute's scoping review protocol and followed the Cochrane Rapid Review method to accelerate the review process, using the Implementation and Operation of Mobile Health projects framework and The Extended Technology Acceptance Model of Mobile Telephony to categorise the results. We conducted the review in four stages: (1) establishing value, (2) identifying digital health policy, (3) searching for evidence of infrastructure, design, and end-user adoption, (4) local input to interpret relevance and adoption factors. We used open-source national/international statistics such as the World Health Organization, International Telecommunication Union, Groupe Speciale Mobile, and local news/articles/government statistics to scope the current status, and systematically searched five databases for locally relevant exemplars.

    RESULTS: We found 118 studies (2015-2021) and 114 supplementary online news articles and national statistics. Digital health policy was available in all countries, but scarce skilled labour, lack of legislation/interoperability support, and interrupted electricity and internet services were limitations. Older patients, women and those living in rural areas were least likely to have access to ICT infrastructure. Renewable energy has potential in enabling digital health care. Low usage mobile data and voice service packages are relatively affordable options for mHealth in the five countries.

    CONCLUSIONS: Effective implementation of digital health technologies requires a supportive policy, stable electricity infrastructures, affordable mobile internet service, and good understanding of the socio-economic context in order to tailor the intervention such that it functional, accessible, feasible, user-friendly and trusted by the target users. We suggest a checklist of contextual factors that developers of digital health initiatives in LMICs should consider at an early stage in the development process.

  3. Fulltext Implementing digital respiratory technologies for people with respiratory conditions: A protocol for a scoping review
    Hui CY, Condon K, Kolekar S, Roberts N, Sreter KB, Simons SO, et al.
    PLoS One, 2024;19(12):e0314914.
    PMID: 39729438 DOI: 10.1371/journal.pone.0314914
    The value of 'data-enabled', digital healthcare is evolving rapidly, as demonstrated in the COVID-19 pandemic, and its successful implementation remains complex and challenging. Harmonisation (within/between healthcare systems) of infrastructure and implementation strategies has the potential to promote safe, equitable and accessible digital healthcare, but guidance for implementation is lacking. Using respiratory technologies as an example, our scoping review process will capture and review the published research between 12th December 2013 to 12th December 2023. Following standard methodology (Arksey and O'Malley), we will search for studies published in ten databases: MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, Scopus, IEEE Xplore, CABI Global Health, and WHO Medicus. Our search strategy will use the terms: digital health, respiratory conditions, and implementation. Using Covidence, screening of abstracts and full texts will be undertaken by two independent reviewers, with conflicts resolved by a third reviewer. Data will be extracted into a pilot-tested data extraction table for charting, summarising and reporting the results. We will conduct stakeholder meetings throughout to discuss the themes emerging from implementation studies and support interpretation of findings in the light of their experience within their own networks and organisations. The findings will inform the future work within the ERS CONNECT clinical research collaboration and contribute to policy statements to promote a harmonised framework for digital transformation of respiratory healthcare.
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