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Fulltext Possible Benefits of Zinc supplement in CVD and COVID-19 Comorbidity

Karim MM, Sultana S, Sultana R, Rahman MT

J Infect Public Health, 2021 Nov;14(11):1686-1692.
PMID: 34649043 DOI: 10.1016/j.jiph.2021.09.022

As far as comorbidity is concerned, cardiovascular diseases (CVD) appear to be accounted for the highest prevalence, severity, and fatality among COVID 19 patients. A wide array of causal links connecting CVD and COVID-19 baffle the overall prognosis as well as the efficacy of the given therapeutic interventions. At the centre of this puzzle lies ACE2 that works as a receptor for the SARS-CoV-2, and functional expression of which is also needed to minimize vasoconstriction otherwise would lead to high blood pressure. Furthermore, SARS-CoV-2 infection seems to reduce the functional expression of ACE2. Given these circumstances, it might be advisable to consider a treatment plan for COVID-19 patients with CVD in an approach that would neither aggravate the vasodeleterious arm of the renin-angiotensinogen-aldosterone system (RAAS) nor compromise the vasoprotective arm of RAAS but is effective to minimize or if possible, inhibit the viral replication. Given the immune modulatory role of Zn in both CVD and COVID-19 pathogenesis, zinc supplement to the selective treatment plan for CVD and COVID-19 comorbid conditions, to be decided by the clinicians depending on the cardiovascular conditions of the patients, might greatly improve the therapeutic outcome. Notably, ACE2 is a zinc metalloenzyme and zinc is also known to inhibit viral replication.
Fulltext Specificity of estimating femoral anteversion using linea aspera version for total hip arthroplasty: A three-dimensional computed tomography study

Mohamed Thajudeen MZ, Mahmood Merican A, Hashim MS, Nordin A

Medicine (Baltimore), 2022 Nov 11;101(45):e31398.
PMID: 36397421 DOI: 10.1097/MD.0000000000031398

Femoral anteversion is an important parameter that can prevent complication following total hip arthroplasty (THA) caused by improper positioning of the implant. However, assessing femoral anteversion can be challenging in situation with significant defect of the femoral neck. In this study, linea aspera version was nominated as alternative parameter to femoral anteversion. So, the main objective of this study is to determine whether femoral anteversion correlates with linea aspera version. Cross-sectional study. Three-dimensional images of 100 femora were generated and their femoral anteversion and linea aspera version was measured. Correlation between the parameters was calculated. The mean linea aspera version was 7.27° ± 12.17° (mean ± standard deviation) while the mean femoral anteversion was 11.84° ± 10.06°. The linea aspera version was inversely correlated with the femoral anteversion with a correlation coefficient of -0.85. Linea aspera should be considered as an additional bony landmark to assess proper implant positioning in THA.
Fulltext A hybrid controller method with genetic algorithm optimization to measure position and angular for mobile robot motion control

Razali MR, Mohd Faudzi AA, Shamsudin AU, Mohamaddan S

Front Robot AI, 2022;9:1087371.
PMID: 36714801 DOI: 10.3389/frobt.2022.1087371

Due to the complexity of autonomous mobile robot's requirement and drastic technological changes, the safe and efficient path tracking development is becoming complex and requires intensive knowledge and information, thus the demand for advanced algorithm has rapidly increased. Analyzing unstructured gain data has been a growing interest among researchers, resulting in valuable information in many fields such as path planning and motion control. Among those, motion control is a vital part of a fast, secure operation. Yet, current approaches face problems in managing unstructured gain data and producing accurate local planning due to the lack of formulation in the knowledge on the gain optimization. Therefore, this research aims to design a new gain optimization approach to assist researcher in identifying the value of the gain's product with a qualitative comparative study of the up-to-date controllers. Gains optimization in this context is to classify the near perfect value of the gain's product and processes. For this, a domain controller will be developed based on the attributes of the Fuzzy-PID parameters. The development of the Fuzzy Logic Controller requires information on the PID controller parameters that will be fuzzified and defuzzied based on the resulting 49 fuzzy rules. Furthermore, this fuzzy inference will be optimized for its usability by a genetic algorithm (GA). It is expected that the domain controller will give a positive impact to the path planning position and angular PID controller algorithm that meet the autonomous demand.
Fulltext The impact of COVID-19 on the economic performance of Wuhan, China (2019-2021)

Ruiz Estrada MA, Koutronas E, Park D, Khan A, Tahir M

Qual Quant, 2023;57(1):847-862.
PMID: 35431342 DOI: 10.1007/s11135-022-01392-y

This paper attempts to evaluate the impact of massive infectious and contagious diseases and its final impact on the economic performance anywhere and anytime. We are considering to evaluate the case of Wuhan, China. We are taking in consideration the case of COVID-19 to be evaluated under a domestic, national, and international level impact. In this paper, we also propose a new simulator to evaluate the impact of massive infections and contagious diseases on the economic performance subsequently. This simulator is entitled "The Impact of Pandemics on the Economic Performance Simulator (IPEP-Simulator)" Hence, this simulator tries to show a macro and micro analysis with different possible scenarios simultaneously. Finally, the IPEP-Simulator was applied to the case of Wuhan-China respectively.
Fulltext Herpes Zoster Following COVID-19 Vaccine Booster

Shahrudin MS, Mohamed-Yassin MS, Nik Mohd Nasir NM

Am J Case Rep, 2023 Jan 18;24:e938667.
PMID: 36650730 DOI: 10.12659/AJCR.938667

BACKGROUND Herpes zoster is a condition in which there is reactivation of varicella zoster virus (VZV), which is usually seen in the elderly and those with immunocompromised states. Recently, however, there have been many reports of herpes zoster after administration of COVID-19 vaccines, although initial trials showed that these vaccines have good safety and immunogenicity profiles. At the time of writing, about 5 billion people worldwide had received their full course of COVID-19 vaccination. This case report describes an elderly man who developed herpes zoster after receiving a booster dose of the Pfizer-BioNTech (BNT162b2) vaccine, with no adverse effects after the first and second dose. CASE REPORT An 82-year-old man with underlying type 2 diabetes mellitus, hypertension, dyslipidemia, and cerebrovascular disease presented with left-sided chest and upper back pain. The pain was intermittent, burning in nature, and disturbed his sleep. A week prior to his presentation, he received a COVID-19 vaccine (BNT162b2) booster dose. Examination revealed multiple vesicles along his anterior and posterior T3 dermatome. He was diagnosed with herpes zoster and treated with a course of oral acyclovir. Upon review 7 days later, he had recovered well, with resolution of his vesicles and pain. CONCLUSIONS COVID-19 vaccination remains an important measure to prevent transmission of infection and to reduce the mortality and morbidity caused by it. However, healthcare practitioners should be aware of the possible association between COVID-19 vaccination and herpes zoster. Appropriate explanation and safety advice on the possible adverse events following COVID-19 vaccination, including herpes zoster infection, should be given to patients. This will facilitate early recognition and treatment of this condition.
Fulltext Psychological Distress Related to the COVID-19 Pandemic: The Protective Role of Hope

Flesia L, Adeeb M, Waseem A, Helmy M, Monaro M

Eur J Investig Health Psychol Educ, 2023 Jan 03;13(1):67-80.
PMID: 36661755 DOI: 10.3390/ejihpe13010005

The COVID-19 outbreak and the worldwide lockdown measures had an impact on the global mental health and psychological well-being of the general population. Several studies attempted to investigate the protective and risk factors for psychological distress related to the pandemic. However, to date, little is known about the role of hope in this context. The aim of this study was to determine the relationship between hope and psychological distress related to the COVID-19 outbreak in the general population. The sample consisted of 504 Pakistani people who completed cross-sectionally the COVID-19 Peritraumatic Distress Index (CPDI) and the Adult Hope Scale (AHS). Bivariate Pearson correlation analysis was run to measure the relationship between hope and psychological distress; hierarchical regression analysis was run to investigate the association between demographics and hope with psychological distress. Higher levels of hope predicted lower levels of psychological distress. Being female, being older, lower level of education, urban residence, being married and living in nuclear family systems were associated with higher levels of psychological distress. The study highlights the protective role of hope on psychological distress related to COVID-19, contributing to knowledge on factors promoting positive mental health during emergency times and providing useful information for implementing effective public health policies and programmes.
Fulltext New Paradigm in Diabetic Foot Ulcer Grafting Techniques Using 3D-Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue (3D-AMHAT) with Fibrin Gel Acting as a Biodegradable Scaffold

Bajuri MY, Kim J, Yu Y, Shahul Hameed MS

Gels, 2023 Jan 13;9(1).
PMID: 36661832 DOI: 10.3390/gels9010066

Adipose tissue is an abundant source of extracellular substances that support the tissue repair process. This pilot study was carried out to determine the efficacy of 3D-bioprinted autologous adipose tissue grafts on diabetic foot ulcers (DFUs), with fibrin gel used to stabilise the graft. This was a single-arm pilot study in a tertiary hospital that provides diabetic wound care services. A total of 10 patients with a DFU were enrolled, and the primary endpoint was complete healing within 12 weeks. The secondary endpoints were wound size reduction, time to healing, and adverse events. Seven out of ten patients showed complete healing of their DFU within 12 weeks (at 2, 4, 5, 10, and 12 weeks, respectively). The wound size reduction rate was significantly and progressively reduced over time. According to our data, autologous adipose tissue grafting using a 3D bioprinter, with the addition of fibrin gel that acts as a scaffold, promotes wound healing with high-quality skin reconstruction. Throughout this study period, no adverse events were observed.
Does good governance promote sustainable tourism? A systematic review of PESTEL analysis

Bhuiyan MA, Zhang Q, Xuan W, Rahman MK, Khare V

SN Bus Econ, 2023;3(1):33.
PMID: 36684689 DOI: 10.1007/s43546-022-00408-x

This paper aims to analyze the articles regarding the role of good governance in sustainable tourism for China. Following the PRISMA guidelines, a systematic literature review approach has been conducted in this paper. A total number of 100 peer-reviewed journal papers have been critically evaluated. Our review analysis shows that taking necessary steps under good governance can promote sustainable tourism development in China. Few policy recommendations and future research aspects have also been included in the paper.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43546-022-00408-x.
Fulltext The efficacy of okra fruit extract on the expression of transforming growth factor beta 1 in the tooth socket of diabetic Wistar rats

Luthfi M, Yuliati, Wijayanti EH, Abdul Razak FB, Irmalia WR

Dent Res J (Isfahan), 2021;18:91.
PMID: 35003556 DOI: 10.4103/1735-3327.330872

Background: Patients with diabetes mellitus suffer from an additional macrophage dysfunction in the secretion of growth factor, which later decreases transforming growth factor beta 1 (TGF-β1). This condition disrupts proliferation and angiogenesis. Extract of okra fruit (Abelmoschus esculentus) contains flavonoid, an active substance which acts as antioxidant, anti-inflammation, and antidiabetes. The purpose of this study is to analyze the difference in TGF-β1 expression in wound-healing process after tooth extraction of diabetic Wistar rats.
Materials and Methods: This is a laboratory experimental study using pretest and posttest on 24 Wistar rats which are divided into two groups: control group (treated with streptozotocin induction but without administration of okra fruit extract) and treatment group (treated with streptozotocin induction and oral administration of 250 mg/kg okra fruit extract once a day). Extractions of the rats' mandibular left incisors were performed using a pair of modified forceps and an elevator. The tooth sockets were then irrigated using saline solution. Four rats in each group were sacrificed on day 3 (KO1, PO1), 5 (KO2, PO2), and 7 (KO3, PO3). The socket tissues from the rats were then immunohistochemically analyzed. Data were analyzed at level significance of 0.05.
Results: The average level of TGF-β1 expression in the treatment groups was higher compared to the control group: PO1 (11.59 ± 0.58), PO2 (15.15 ± 1.07), and PO3 (18.75 ± 2.73) as compared to KO1 (5.32 ± 1.69), KO2 (8.47 ± 0.60), and KO3 (9.28 ± 1.16) with P = 0.001.
Conclusion: The administration of okra fruit extract can increase the level of TGF-β1 in wounds after tooth extraction of diabetic Wistar rats.
Fulltext Triglyceride to high-density lipoprotein cholesterol ratio is an independent predictor of liver fibrosis among pediatrics non-alcoholic fatty liver disease

Ting YW, Jalaludin MY, Zaini AA, Mohamed R

Front Endocrinol (Lausanne), 2022;13:1071350.
PMID: 36589844 DOI: 10.3389/fendo.2022.1071350

BACKGROUND: Insulin resistance (IR), one of the key components of the metabolic syndrome, is recognized as the pathophysiological hallmark of non-alcoholic fatty liver disease (NAFLD). This study aims to investigate the relationship between surrogate markers of IR and the severity of NAFLD among overweight or obese children.
METHODOLOGY: A total of 56 consecutive children aged 6 to 18 years old were recruited from the pediatric obesity and type 2 diabetes mellitus (T2DM) clinic in University Malaya Medical Centre (UMMC) from 2016 to 2019. Data on anthropometric measurements, clinical components of metabolic syndrome and fasting serum insulin were collected. Triglyceride to high-density lipoprotein cholesterol ratio (TG: HDL-C), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Single Point Insulin Sensitivity Estimator (SPISE) were calculated. Transient elastography was performed with hepatic steatosis and liver fibrosis assessed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively.
RESULTS: A total of 44 children (78.6%) had liver steatosis and 35.7% had presence of significant liver fibrosis (stage F≥2). Majority (89.3%) are obese and 24 children (42.9%) were diagnosed with metabolic syndrome. Higher number of children with T2DM and significant liver fibrosis were associated with higher tertiles of TG: HDL-C ratio (p<0.05). Top tertile of TG: HDL-C ratio was an independent predictor of liver fibrosis (OR=8.14, 95%CI: 1.24-53.36, p=0.029). ROC analysis showed that the area under the curve (AUC) of HOMA-IR (0.77) and TG: HDL-C ratio (0.71) were greater than that of metabolic syndrome (0.70), T2DM (0.62) and SPISE (0.22). The optimal cut-off values of HOMA-IR and TG: HDL-C ratio for detecting liver fibrosis among children with NAFLD are 5.20 and 1.58, respectively.
CONCLUSION: Children with NAFLD and higher TG: HDL-C ratio are more likely to have liver fibrosis. TG: HDL-C ratio is a promising tool to risk stratify those with NAFLD who are at risk of developing advanced liver disease.
Fulltext An SEM-ANN approach to evaluate public awareness about COVID, A pathway toward adaptation effective strategies for sustainable development

Sohail MT, Yang M, Maresova P, Mustafa S

Front Public Health, 2022;10:1046780.
PMID: 36339186 DOI: 10.3389/fpubh.2022.1046780

This study was conducted to evaluate public awareness about COVID with aimed to check public strategies against COVID-19. A semi structured questionnaire was collected and the data was analyzed using some statistical tools (PLS-SEM) and artificial neural networks (ANN). We started by looking at the known causal linkages between the different variables to see if they matched up with the hypotheses that had been proposed. Next, for this reason, we ran a 5,000-sample bootstrapping test to assess how strongly our findings corroborated the null hypothesis. PLS-SEM direct path analysis revealed HRP -> PA-COVID, HI -> PA-COVID, MU -> PA-COVID, PM -> PA-COVID, SD -> PA-COVID. These findings provide credence to the acceptance of hypotheses H1, H3, and H5, but reject hypothesis H2. We have also examined control factors such as respondents' age, gender, and level of education. Age was found to have a positive correlation with PA-COVID, while mean gender and education level were found to not correlate at all with PA-COVID. However, age can be a useful control variable, as a more seasoned individual is likely to have a better understanding of COVID and its effects on independent variables. Study results revealed a small moderation effect in the relationships between understudy independent and dependent variables. Education significantly moderates the relationship of PA-COVID associated with MU, PH, SD, RP, PM, PA-COVID, depicts the moderation role of education on the relationship between MU*Education->PA-COVID, HI*Education->PA.COVID, SD*Education->PA.COVID, HRP*Education->PA.COVID, PM*Education -> PA.COVID. The artificial neural network (ANN) model we've developed for spreading information about COVID-19 (PA-COVID) follows in the footsteps of previous studies. The root means the square of the errors (RMSE). Validity measures how well a model can predict a certain result. With RMSE values of 0.424 for training and 0.394 for testing, we observed that our ANN model for public awareness of COVID-19 (PA-COVID) had a strong predictive ability. Based on the sensitivity analysis results, we determined that PA. COVID had the highest relative normalized relevance for our sample (100%). These factors were then followed by MU (54.6%), HI (11.1%), SD (100.0%), HRP (28.5%), and PM (64.6%) were likewise shown to be the least important factors for consumers in developing countries struggling with diseases caused by contaminated water. In addition, a specific approach was used to construct a goodness-of-fit coefficient to evaluate the performance of the ANN models. The study will aid in the implementation of effective monitoring and public policies to promote the health of local people.
A new implicit high-order iterative scheme for the numerical simulation of the two-dimensional time fractional Cable equation

Khan MA, Alias N, Khan I, Salama FM, Eldin SM

Sci Rep, 2023 Jan 27;13(1):1549.
PMID: 36707653 DOI: 10.1038/s41598-023-28741-7

In this article, we developed a new higher-order implicit finite difference iterative scheme (FDIS) for the solution of the two dimension (2-D) time fractional Cable equation (FCE). In the new proposed FDIS, the time fractional and space derivatives are discretized using the Caputo fractional derivative and fourth-order implicit scheme, respectively. Moreover, the proposed scheme theoretical analysis (convergence and stability) is also discussed using the Fourier analysis method. Finally, some numerical test problems are presented to show the effectiveness of the proposed method.
The robotic learning curve for a newly appointed colorectal surgeon

Saqib SU, Raza MZ, Evans C, Bajwa AA

J Robot Surg, 2023 Feb;17(1):73-78.
PMID: 35325433 DOI: 10.1007/s11701-022-01400-1

Robotic colorectal surgery allows for better ergonomics, superior retraction, and fine movements in the narrow anatomy of the pelvis. Recent years have seen the uptake of robotic surgery in all pelvic surgeries specifically in low rectal malignancies. However, the learning curve of robotic surgery in this cohort is unclear as established training pathways are not formalized. This study looks at the experience and learning curve of a single laparoscopic trained surgeon in performing safe and effective resections, mainly for low rectal and anal malignancies using the da Vinci robotic system by evaluating metrics related to surgical process and patient outcome. A serial retrospective review of the robotic colorectal surgery database, in the University Hospital Coventry and Warwickshire (UHCW), was undertaken. All 48 consecutive cases, performed by a recently qualified colorectal surgeon, were included in our study. The surgical process was evaluated using both console and total operative time recorded in each case along with the adequacy of resections performed; in addition, patient-related outcomes including intraoperative and postoperative complications were analyzed to assess differences in the learning curve. Forty eight sequential recto-sigmoid resections were included in the study performed by a single surgeon. The cases were divided into four cohorts in chronological order with comparable demographics, tumour stage, location, and complexity of the operation (mean age 65, male 79%, and female 29%). The results showed that the mean console time dropped from 3 to 2.5 h, while total operative time dropped from 6 h to 5.5 h as the surgeon became more experienced; however, this was not found to be statistically significant. In addition, no significant difference in pathological staging was seen over the study period. No major intra-op and post-op complications were observed and no 30-day mortality was recorded. Moreover, after 30 cases, the learning curve developed the plateau phase, suggesting the gain of maximum proficiency of skills required for robotic colorectal resections. The learning curve in robotic rectal surgery is short and flattens early; complication rates are low during the learning curve and continue to decrease with time. This shows that with proper training and proctoring, new colorectal surgeons can be trained in a short time to perform elective colorectal pelvic resections.
Finite element analysis of three commonly used external fixation devices for treating Type III pilon fractures

Ramlee MH, Kadir MR, Murali MR, Kamarul T

Med Eng Phys, 2014 Oct;36(10):1322-30.
PMID: 25127377 DOI: 10.1016/j.medengphy.2014.05.015

Pilon fractures are commonly caused by high energy trauma and can result in long-term immobilization of patients. The use of an external fixator i.e. the (1) Delta, (2) Mitkovic or (3) Unilateral frame for treating type III pilon fractures is generally recommended by many experts owing to the stability provided by these constructs. This allows this type of fracture to heal quickly whilst permitting early mobilization. However, the stability of one fixator over the other has not been previously demonstrated. This study was conducted to determine the biomechanical stability of these external fixators in type III pilon fractures using finite element modelling. Three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones were reconstructed from previously obtained CT datasets. Bones were assigned with isotropic material properties, while the cartilage was assigned as hyperelastic springs with Mooney-Rivlin properties. Axial loads of 350 N and 70 N were applied at the tibia to simulate the stance and the swing phase of a gait cycle. To prevent rigid body motion, the calcaneus and metatarsals were fixed distally in all degrees of freedom. The results indicate that the model with the Delta frame produced the lowest relative micromovement (0.03 mm) compared to the Mitkovic (0.05 mm) and Unilateral (0.42 mm) fixators during the stance phase. The highest stress concentrations were found at the pin of the Unilateral external fixator (509.2 MPa) compared to the Mitkovic (286.0 MPa) and the Delta (266.7 MPa) frames. In conclusion, the Delta external fixator was found to be the most stable external fixator for treating type III pilon fractures.
Biomechanical evaluation of two commonly used external fixators in the treatment of open subtalar dislocation--a finite element analysis

Ramlee MH, Kadir MR, Murali MR, Kamarul T

Med Eng Phys, 2014 Oct;36(10):1358-66.
PMID: 25092623 DOI: 10.1016/j.medengphy.2014.07.001

Subtalar dislocation is a rare injury caused by high-energy trauma. Current treatment strategies include leg casts, internal fixation and external fixation. Among these, external fixators are the most commonly used as this method is believed to provide better stabilization. However, the biomechanical stability provided by these fixators has not been demonstrated. This biomechanical study compares two commonly used external fixators, i.e. Mitkovic and Delta. CT imaging data were used to reconstruct three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones. The 3D models of the bones and cartilages were then converted into four-noded linear tetrahedral elements, whilst the ligaments were modelled with linear spring elements. Bones and cartilage were idealized as homogeneous, isotropic and linear. To simulate loading during walking, axial loading (70 N during the swing and 350 N during the stance phase) was applied at the end of diaphyseal tibia. The results demonstrate that the Mitkovic fixator produced greater displacement (peak 3.0mm and 15.6mm) compared to the Delta fixator (peak 0.8mm and 3.9 mm), in both the swing and stance phase, respectively. This study demonstrates that the Delta external fixator provides superior stability over the Mitkovic fixator. The Delta fixator may be more effective in treating subtalar dislocation.
Can green finance, green technologies, and environmental policy stringency leverage sustainability in China: evidence from quantile-ARDL estimation

Afshan S, Yaqoob T, Meo MS, Hamid B

Environ Sci Pollut Res Int, 2023 Mar 18.
PMID: 36934184 DOI: 10.1007/s11356-023-26346-1

Environmental sustainability is an umbrella approach depending on various climatic and economic policies. In doing so, the current study empirically evaluates the role of green finance, eco-innovation, and environmental policy stringency on the ecological footprint in China. To meet the objectives, the novel quantile autoregressive distributed lag (QARDL) approach was employed from 2000 to 2017. The outcomes reveal heterogeneous associations between the proposed variables. Manifestly, the QARDL estimation results demonstrate a positive impact between eco-innovation, green finance, and environmental policy stringency with the ecological footprints of China; however, the extent of the relationship is quantile dependent. The outcomes are further validated through the Wald test of parameter constancy. The bi-direction causality is observed among all variables at several quantiles. The current study offers policymakers helpful suggestions on enhancing the positive effects of environmentally supported innovation, green finance, and stringent environmental policies on the ecosystem.
Fulltext A fuzzy controller for lower limb exoskeletons during sit-to-stand and stand-to-sit movement using wearable sensors

Reza SM, Ahmad N, Choudhury IA, Ghazilla RA

Sensors (Basel), 2014 Mar 04;14(3):4342-63.
PMID: 24599193 DOI: 10.3390/s140304342

Human motion is a daily and rhythmic activity. The exoskeleton concept is a very positive scientific approach for human rehabilitation in case of lower limb impairment. Although the exoskeleton shows potential, it is not yet applied extensively in clinical rehabilitation. In this research, a fuzzy based control algorithm is proposed for lower limb exoskeletons during sit-to-stand and stand-to-sit movements. Surface electromyograms (EMGs) are acquired from the vastus lateralis muscle using a wearable EMG sensor. The resultant acceleration angle along the z-axis is determined from a kinematics sensor. Twenty volunteers were chosen to perform the experiments. The whole experiment was accomplished in two phases. In the first phase, acceleration angles and EMG data were acquired from the volunteers during both sit-to-stand and stand-to-sit motions. During sit-to-stand movements, the average acceleration angle at activation was 11°-48° and the EMG varied from -0.19 mV to +0.19 mV. On the other hand, during stand-to-sit movements, the average acceleration angle was found to be 57.5°-108° at the activation point and the EMG varied from -0.32 mV to +0.32 mV. In the second phase, a fuzzy controller was designed from the experimental data. The controller was tested and validated with both offline and real time data using LabVIEW.
Fulltext Social entrepreneurial intention among working adults: An emerging country context

Yang Q, Al Mamun A, Jingzu G, Siyu L, Masud MM

Front Psychol, 2023;14:1123198.
PMID: 36860787 DOI: 10.3389/fpsyg.2023.1123198

Under the premise of the value-belief-norm (VBN) model, this study examined the influence of values, beliefs and norms on social entrepreneurial intention of working adults in China. The cross-sectional design was employed, and an online survey, which involved 1,075 working adults, was conducted. All data were analyzed using partial least squares-structural equation modeling (PLS-SEM). The obtained results showed the significant and positive influence of self-enhancement, openness to change, and self-transcendence on the sense of meaning and purpose. Moreover, the sense of meaning and purpose exhibited significant and positive influence on problem awareness, and problem awareness was found to have positive effect on outcome efficacy. Besides that, the sense of meaning and purpose, problem awareness, outcome efficacy, and injunctive social norms were found to exhibit significant and positive on personal norms. Finally, personal norms and injunctive social norms exhibited statistically significant and positive influence on social entrepreneurial intention. The results of effect size confirmed the considerable influence of personal norms and injunctive social norms on social entrepreneurial intention. Therefore, policy development aimed at promoting socioeconomic and environmental sustainability through social entrepreneurship should comprehensively consider the influence of personal norms and injunctive social norms. Increasing the sense of meaning and purpose of the working population, prompting an increased problem consequence and outcome self-efficacy, as well as instilling personal norms and injunctive social norms through various social and environmental incentives are recommended.
A new upper limit for effective dose in patient administered with 18F-FDG for PET/CT whole-body imaging with diagnostic CT parameters

Velo P, Ismail MI, Mohandas KK, Kasilingam L

J Med Imaging Radiat Sci, 2023 Mar;54(1):43-50.
PMID: 36402716 DOI: 10.1016/j.jmir.2022.09.010

INTRODUCTION: The aim of present study is to estimate effective dose in patient undergoing 18F-FDG for whole body PET/CT imaging with diagnostic CT parameters and identify the lowest achievable total effective dose.
METHOD: A total of 2247 PET/CT patients with normal glucose level underwent 18F-FDG-whole body imaging procedures. The 18F-FDG dose of 3.7MBq per kg of patient weight administered via intravenous infusion. For CT parameters, kilovoltage of 140keV and current of 40 mAs were used for all studies. All the acquired images collected retrospectively and the effective dose was calculated for each patient using algorithm adapted from ICRP Publication 106, modified for patient weight and patient blood volume. The estimated effective doses were evaluated for patients' body weight and BMI.
RESULTS: The mean of total effective dose and standard deviation is approximately 15.08(4.52) mSv using ICRP algorithm. 56% of total patient has normal BMI and their average total effective dose is 13.6mSv. Underweight patients' effective dose can be as low as 9.6mSv even using diagnostic CT protocols.
CONCLUSION: The effective dose of PET/CT procedure in present study is one of the lowest although using diagnostic parameters for CT acquisition compared to published data worldwide. This is due to the improved sensitivity of PET and complex reconstruction technique that maintains the image quality. A significant association between body weight, BMI and effective dose is reported in present study. Therefore, it is suggested that attention must be given for underweight and ideal BMI patients while prescribing FDG activity and CT imaging parameters in order to minimize the effective dose. The effective dose reported in present study can be considered as an upper limit for effective dose in PET/CT patients with normal BMI. This upper limit can be treated as a standard limit when optimizing imaging parameters, developing algorithm for image reconstruction and prescribing activity for patients. This practice could fulfill ALARA principle that could reduce cancer risk.
Fulltext Utility of PIVKA-II and AFP in Differentiating Hepatocellular Carcinoma from Non-Malignant High-Risk Patients

Hadi H, Wan Shuaib WMA, Raja Ali RA, Othman H

Medicina (Kaunas), 2022 Jul 28;58(8).
PMID: 36013482 DOI: 10.3390/medicina58081015

Background and Objectives: We aim to compare the diagnostic performance of Protein induced by vitamin K absence-II (PIVKA-II), a biomarker for hepatocellular carcinoma (HCC), and alpha-fetoprotein (AFP) in differentiating HCC and non-malignant high-risk (NMHR) groups and to determine their cut-off values. Materials and Methods: A total of 163 patients, including 40 with HCC and 123 with NMHR (100 with liver cirrhosis and 23 with non-cirrhotic high-risk patients) were prospectively enrolled. The levels of AFP and PIVKA-II were measured, and their cut-off values were determined. We calculated and compared the areas under the receiver operating characteristic (AUROC) curves of PIVKA-II, AFP, and their combination. Results: The levels of PIVKA-II and AFP were found to be significantly higher in the HCC compared to NMHR patients (p < 0.0001). For the differentiation of HCC from NMHR, the optimal cutoff values for PIVKA-II and AFP were 36.7 mAU/mL (90% sensitivity; 82.1% specificity) and 14.2 ng/mL (75% sensitivity; 93.5% specificity), respectively. The AUROC of PIVKA-II (0.905, p < 0.0001) was higher compared to AFP (0.869, p < 0.0001), but the combination of PIVKA−II and AFP gave the highest AUROC value (0.911, p < 0.0001). However, their differences were not statistically significant (AFP vs. PIVKA; p = 0.4775, AFP vs. Combination; p = 0.3808, PIVKA vs. Combination; p = 0.2268). Conclusions: PIVKA-II and AFP showed equal performance in detecting HCC in high-risk patients. AFP as a screening marker for HCC may be adequate, and replacing or adding the PIVKA-II test in current clinical practice may be of little value.

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