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Experimental investigation of the flow of bile in patient specific cystic duct models

Al-Atabi M, Chin SB, Luo XY

J Biomech Eng, 2010 Apr;132(4):041003.
PMID: 20387966 DOI: 10.1115/1.4001043

Three-dimensional scaled-up transparent models of three human cystic ducts were prepared on the basis of anatomical specimens. The measurement of pressure drop across the cystic duct models and visualization of the flow structures within these ducts were performed at conditions replicating the physiological state. The flow visualization study confirmed the laminar nature of the flow of bile inside the cystic duct and values of pressure drop coefficient (Cp) decreased as the Reynolds number (Re) increased. The three tested models showed comparable behavior for the curve of Reynolds number versus the pressure drop coefficient. The results show that the tested cystic ducts have both increased pressure drop and complicated flow structures when compared with straight conduits. High resistance in a cystic duct may indicate that the gallbladder has to exert large force in expelling bile to the cystic duct. For patients with diseased gallbladder, and even in healthy persons, gallbladder is known to stiffen with age and it may lose its compliance or flexibility. A high resistance cystic duct coupled with a stiffened gallbladder may result in prolonged stasis of bile in the gallbladder, which is assumed to encourage the formation of gallstones.
Fulltext Uncovering Physical and Attitudinal Barriers to Adherence to Precautions for Preventing the Transmission of COVID-19 and Anxiety Level of People in Wuhan: 2 Months After the Lockdown

Lin Y, Alias H, Luo X, Hu Z, Wong LP

J Acad Consult Liaison Psychiatry, 2020 09 22;62(2):201-210.
PMID: 33183846 DOI: 10.1016/j.psym.2020.09.005

BACKGROUND: Wuhan, the epicenter of the coronavirus disease 2019 outbreak, was locked down on January 23, 2020. We aimed to investigate the barriers to the physical prevention, negative attitudes, and anxiety levels.
METHODS: A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020.
RESULTS: Of a total of 2411 complete responses, the mean and standard deviation for the total physical prevention barriers score was 19.73 (standard deviation ± 5.3; range 12-45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory score, 79.9% (95% confidence interval [CI]: 78.2-81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak, and 51.3% (95% CI 49.2-53.3) reported moderate to severe anxiety after the peak of coronavirus disease 2019 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95% CI 56.5-60.5) recorded a decreased anxiety. Females reported a higher likelihood of having decreased levels of anxiety than males (odds ratio = 1.78, 95% CI 1.48-2.14). Low negative attitudes score were associated with a higher decrease in anxiety (odds ratio = 1.59, 95% CI 1.33-1.89).
CONCLUSIONS: The attitudinal barriers to prevention of transmission of coronavirus disease 2019 are more prominent than physical prevention barriers after the peak of coronavirus disease 2019. High anxiety levels even after the peak warrant serious attention.
Computational analysis of the flow of bile in human cystic duct

Al-Atabi M, Ooi RC, Luo XY, Chin SB, Bird NC

Med Eng Phys, 2012 Oct;34(8):1177-83.
PMID: 22217515 DOI: 10.1016/j.medengphy.2011.12.006

Computational fluid dynamic (CFD) simulations of the three-dimensional flow structures in realistic cystic ducts have been performed to obtain quantitative readings of the flow parameters to compare with clinical measurements. Resin casts of real patients' cystic ducts lumen that possess representative anatomical features were scanned to obtain three-dimensional flow domains that were used in the numerical analysis. The convoluting nature of the studied cystic ducts resulted in strong secondary flow that contributed towards a dimensionless pressure drop that is four times higher than those of a straight circular tube of an equivalent length and average diameter. The numerical pressure drop results across the cystic duct compared very well with those obtained from clinical observations which indicate that CFD is an appropriate tool to investigate the flow and functions of the biliary system. From the hydrodynamic point of view, the cystic duct lumen seems to serve as a passive resistor that strives to provide a constant amount of resistance to control the flow of bile out of the gallbladder. This is mainly achieved by the coupling of the secondary flow effects and bile rheology to provide flow resistance.
Fulltext Deep Neural Network-Based Fusion Localization Using Smartphones

Yan S, Su Y, Xiao J, Luo X, Ji Y, Ghazali KHB

Sensors (Basel), 2023 Oct 24;23(21).
PMID: 37960380 DOI: 10.3390/s23218680

Indoor location-based services (LBS) have tremendous practical and social value in intelligent life due to the pervasiveness of smartphones. The magnetic field-based localization method has been an interesting research hotspot because of its temporal stability, ubiquitousness, infrastructure-free nature, and good compatibility with smartphones. However, utilizing discrete magnetic signals may result in ambiguous localization features caused by random noise and similar magnetic signals in complex symmetric and large-scale indoor environments. To address this issue, we propose a deep neural network-based fusion indoor localization system that integrates magnetic and pedestrian dead reckoning (PDR). In this system, we first propose a ResNet-GRU-LSTM neural network model to achieve magnetic localization more accurately. Afterward, we put forward a multifeatured-driven step length estimation. A hierarchy GRU (H-GRU) neural network model is proposed, and a multidimensional dataset using acceleration and a gyroscope is constructed to extract more valid characteristics. Finally, more reliable and accurate pedestrian localization can be achieved under the particle filter framework. Experiments were conducted at two trial sites with two pedestrians and four smartphones. Results demonstrate that the proposed system achieves better accuracy and robustness than other traditional localization algorithms. Moreover, the proposed system exhibits good generality and practicality in real-time localization with low cost and low computational complexity.
Fulltext Long-Term Retrogradation Properties and In Vitro Digestibility of Waxy Rice Starch Modified with Pectin

Zhai Y, Zhang H, Xing J, Sang S, Zhan X, Liu Y, et al.

Foods, 2023 Oct 31;12(21).
PMID: 37959100 DOI: 10.3390/foods12213981

In recent years, the blending of hydrocolloids and natural starch to improve the properties of natural starch has become a research hotspot. In this study, the effects of pectin (PEC) on the retrogradation properties and in vitro digestibility of waxy rice starch (WRS) were investigated. The results showed that PEC could significantly (p < 0.05) reduce the retrogradation enthalpy and reduce the hardness of WRS gel. X-ray diffraction results indicated that PEC could reduce the relative crystallinity of the composite system, and the higher the PEC content, the lower the relative crystallinity. When the PEC content was 10%, the relative crystallinity of the composite system was only 10.6% after 21 d of cold storage. Fourier transform infrared spectroscopy results proved that the interaction between PEC and WRS was mainly a hydrogen bond interaction. Furthermore, after 21 d of cold storage, the T23 free water signal appeared in the natural WRS paste, while only a small free water signal appeared in the compound system with 2% PEC addition. Moreover, addition of PEC could reduce the starch digestion rate and digestibility. When the content of PEC increased from 0% to 10%, the digestibility decreased from 82.31% to 71.84%. This study provides a theoretical basis for the further application of hydrocolloids in starch-based foods.
UPLC/Q-TOF-MS-based Metabolomics Study of the Antiosteoporosis Effects of Vaccarin in Ovariectomized Mice

Song F, Xie T, Liu X, Chin B, Luo X, Liao S, et al.

Planta Med, 2023 Feb;89(2):218-230.
PMID: 36100252 DOI: 10.1055/a-1942-5428

Osteoporosis is a systemic and metabolic bone disease that usually occurs in postmenopausal women, which mainly manifests as bone loss and increased bone fragility that both facilitate fracture. However, few drugs for osteoporosis have shown good efficacy and limited side effects. Vaccarin has demonstrated its antiosteoporosis effects by inhibiting the formation and osteolytic activities of osteoclasts in our previous investigation. In this study, multivariate statistical analysis and ultrahigh-performance liquid chromatography and quadrupole time-of-flight tandem mass spectrometry were used to analyze the serum metabolites of ovariectomized mice treated with or without vaccarin. As a result, 9 serum metabolites were identified as biomarkers. The metabolic levels of 3 crucial biomarkers, namely, lysophosphatidylcholine [22 : 6, (4Z, 7Z, 10Z, 13Z, 16Z, 19Z)], 1-linoleoylglycerophosphocholine and 1-palmitoyl-Sn-glycero-3-phosphocholine, that were correlated with glycerophospholipid metabolism increased and then decreased significantly after vaccarin treatment. Molecular docking analysis and osteoclasts differentiation experiment further revealed that vaccarin may bind with phospholipase A2 and downregulated its activity to reduce the osteoclastogenesis. Therefore, the occurrence of osteoporosis is closely related with glycerophospholipid metabolism disorders, and vaccarin exerts antiosteoporosis effects by reducing the levels of glycerophospholipid metabolites.
Fulltext A non-printed integrated-circuit textile for wireless theranostics

Yang Y, Wei X, Zhang N, Zheng J, Chen X, Wen Q, et al.

Nat Commun, 2021 08 12;12(1):4876.
PMID: 34385436 DOI: 10.1038/s41467-021-25075-8

While the printed circuit board (PCB) has been widely considered as the building block of integrated electronics, the world is switching to pursue new ways of merging integrated electronic circuits with textiles to create flexible and wearable devices. Herein, as an alternative for PCB, we described a non-printed integrated-circuit textile (NIT) for biomedical and theranostic application via a weaving method. All the devices are built as fibers or interlaced nodes and woven into a deformable textile integrated circuit. Built on an electrochemical gating principle, the fiber-woven-type transistors exhibit superior bending or stretching robustness, and were woven as a textile logical computing module to distinguish different emergencies. A fiber-type sweat sensor was woven with strain and light sensors fibers for simultaneously monitoring body health and the environment. With a photo-rechargeable energy textile based on a detailed power consumption analysis, the woven circuit textile is completely self-powered and capable of both wireless biomedical monitoring and early warning. The NIT could be used as a 24/7 private AI "nurse" for routine healthcare, diabetes monitoring, or emergencies such as hypoglycemia, metabolic alkalosis, and even COVID-19 patient care, a potential future on-body AI hardware and possibly a forerunner to fabric-like computers.
Asia-Pacific survey on green endoscopy

Ho JCL, Lui RN, Ho SH, Hock NTC, Luo X, Tang RSY, et al.

J Gastroenterol Hepatol, 2024 Jan;39(1):133-140.
PMID: 37967819 DOI: 10.1111/jgh.16409

BACKGROUND AND AIM: Greenhouse gas emissions are the fundamental cause of global warming, with CO2 being the most contributive. Carbon reduction has been widely advocated to mitigate the climate crisis. The endoscopy unit is the third highest waste-generating department in a hospital. The awareness and acceptance of the practice of green endoscopy among healthcare workers is unclear.
METHOD: An online survey was conducted over a 5-week period from July to August 2023 in the Asia-Pacific region, which targeted endoscopists, nurses, and other healthcare professionals of the endoscopy unit. The primary outcome was the agreement to adopt green endoscopy. The secondary outcomes included views on sustainable practices, factors associated with increased acceptance of green endoscopy, the acceptance of different carbon reduction measures, and the perceived barriers to implementation.
RESULTS: A total of 259 valid responses were received. Overall, 79.5% of participants agreed to incorporate green endoscopy into their practice. Nevertheless, existing green policies were only reported by 12.7% of respondents. The level of understanding of green endoscopy is the only significant factor associated with its acceptance (odds ratio 3.10, P
Epidemiology and characteristics of the dengue outbreak in Guangdong, Southern China, in 2014

Huang L, Luo X, Shao J, Yan H, Qiu Y, Ke P, et al.

Eur J Clin Microbiol Infect Dis, 2016 Feb;35(2):269-77.
PMID: 26700953 DOI: 10.1007/s10096-015-2540-5

Dengue is a rapidly spreading mosquito-borne disease caused by the dengue virus (DENV) and has emerged as a severe public health problem around the world. Guangdong, one of the southern Chinese provinces, experienced a serious outbreak of dengue in 2014, which was believed to be the worst dengue epidemic in China over the last 20 years. To better understand the epidemic, we collected the epidemiological data of the outbreak and analyzed 14,594 clinically suspected dengue patients from 25 hospitals in Guangdong. Dengue cases were then laboratory-confirmed by the detection of DENV non-structural protein 1 (NS1) antigen and/or DENV RNA. Afterwards, clinical manifestations of dengue patients were analyzed and 93 laboratory-positive serum specimens were chosen for the DENV serotyping and molecular analysis. Our data showed that the 2014 dengue outbreak in Guangdong had spread to 20 cities and more than 45 thousand people suffered from dengue fever. Of 14,594 participants, 11,387 were definitively diagnosed. Most manifested with a typical non-severe clinical course, and 1.96 % developed to severe dengue. The strains isolated successfully from the serum samples were identified as DENV-1. Genetic analyses revealed that the strains were classified into genotypes I and V of DENV-1, and the dengue epidemic of Guangdong in 2014 was caused by indigenous cases and imported cases from the neighboring Southeast Asian countries of Malaysia and Singapore. Overall, our study is informative and significant to the 2014 dengue outbreak in Guangdong and will provide crucial implications for dengue prevention and control in China and elsewhere.
Fulltext Asia-Pacific Consensus Recommendations on X-Linked Hypophosphatemia: Diagnosis, Multidisciplinary Management, and Transition From Pediatric to Adult Care

Munns CF, Yoo HW, Jalaludin MY, Vasanwala R, Chandran M, Rhee Y, et al.

JBMR Plus, 2023 Jun;7(6):e10744.
PMID: 37283655 DOI: 10.1002/jbm4.10744

X-linked hypophosphatemia (XLH) is a rare, inherited, multisystem disorder characterized by hypophosphatemia that occurs secondary to renal phosphate wasting. Mutations in PHEX gene (located at Xp22.1) in XLH alter bone mineral metabolism, resulting in diverse skeletal, dental, and other extraskeletal abnormalities that become evident in early childhood and persist into adolescence and adult life. XLH impacts physical function, mobility, and quality of life, and is associated with substantial socioeconomic burden and health care resource utilization. As the burden of illness varies with age, an appropriate transition of care from childhood and adolescence to adulthood is necessary to meet growth-related changes and minimize long-term sequelae of the condition. Previous XLH guidelines that encompassed transition of care have focused on Western experience. Regional differences in resource availability warrant tailoring of recommendations to the Asia-Pacific (APAC) context. Hence, a core expert panel of 15 pediatric and adult endocrinologists from nine countries/regions across APAC convened to formulate evidence-based recommendations for optimizing XLH care. A comprehensive literature search on PubMed using MeSH and free-text terms relevant to predetermined clinical questions on diagnosis, multidisciplinary management, and transition of care of XLH revealed 2171 abstracts. The abstracts were reviewed independently by two authors to shortlist a final of 164 articles. A total of 92 full-text articles were finally selected for data extraction and drafting the consensus statements. Sixteen guiding statements were developed based on review of evidence and real-world clinical experience. The GRADE criteria were used to appraise the quality of evidence supporting the statements. Subsequently, a Delphi technique was utilized to rate the agreement on statements; 38 XLH experts (15 core, 20 additional, 3 international) from 15 countries/regions (12 APAC, 3 EU) participated in the Delphi voting to further refine the statements. Statements 1-3 cover the screening and diagnosis of pediatric and adult XLH; we have defined the clinical, imaging, biochemical, and genetic criteria and raised red flags for the presumptive and confirmatory diagnosis of XLH. Statements 4-12 tackle elements of multidisciplinary management in XLH such as therapeutic goals and options, composition of the multidisciplinary team, follow-up assessments, required monitoring schedules, and the role of telemedicine. Treatment with active vitamin D, oral phosphate, and burosumab is discussed in terms of applicability to APAC settings. We also expound on multidisciplinary care for different age groups (children, adolescents, adults) and pregnant or lactating women. Statements 13-15 address facets of the transition from pediatric to adult care: targets and timelines, roles and responsibilities of stakeholders, and process flow. We explain the use of validated questionnaires, desirable characteristics of a transition care clinic, and important components of a transfer letter. Lastly, strategies to improve XLH education to the medical community are also elaborated in statement 16. Overall, optimized care for XLH patients requires prompt diagnosis, timely multidisciplinary care, and a seamless transfer of care through the coordinated effort of pediatric and adult health care providers, nurse practitioners, parents or caregivers, and patients. To achieve this end, we provide specific guidance for clinical practice in APAC settings. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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