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Fulltext A study of computer-related upper limb discomfort and computer vision syndrome

Sen A, Richardson S

J Hum Ergol (Tokyo), 2007 Dec;36(2):45-50.
PMID: 18572794 DOI: 10.11183/jhe1972.36.2_45

Personal computers are one of the commonest office tools in Malaysia today. Their usage, even for three hours per day, leads to a health risk of developing Occupational Overuse Syndrome (OOS), Computer Vision Syndrome (CVS), low back pain, tension headaches and psychosocial stress. The study was conducted to investigate how a multiethnic society in Malaysia is coping with these problems that are increasing at a phenomenal rate in the west. This study investigated computer usage, awareness of ergonomic modifications of computer furniture and peripherals, symptoms of CVS and risk of developing OOS. A cross-sectional questionnaire study of 136 computer users was conducted on a sample population of university students and office staff. A 'Modified Rapid Upper Limb Assessment (RULA) for office work' technique was used for evaluation of OOS. The prevalence of CVS was surveyed incorporating a 10-point scoring system for each of its various symptoms. It was found that many were using standard keyboard and mouse without any ergonomic modifications. Around 50% of those with some low back pain did not have an adjustable backrest. Many users had higher RULA scores of the wrist and neck suggesting increased risk of developing OOS, which needed further intervention. Many (64%) were using refractive corrections and still had high scores of CVS commonly including eye fatigue, headache and burning sensation. The increase of CVS scores (suggesting more subjective symptoms) correlated with increase in computer usage spells. It was concluded that further onsite studies are needed, to follow up this survey to decrease the risks of developing CVS and OOS amongst young computer users.
Indian cat (Felis indica) as a host to subperiodic Malaysian strain of human Brugia malayi

Murthy PK, Chowdhury TK, Sen AB

J Commun Dis, 1983 Jun;15(2):100-5.
PMID: 6630983
Revolutionizing Nipah virus vaccinology: insights into subunit vaccine development strategies and immunological advances

Das T, Datta S, Sen A

In Silico Pharmacol, 2024;12(2):69.
PMID: 39070666 DOI: 10.1007/s40203-024-00246-9

The Nipah virus (NiV), a zoonotic virus in the Henipavirus genus of the Paramyxoviridae family, emerged in Malaysia in 1998 and later spread globally. Diseased patients may have a 40- 70% chance of fatality depending on the severity and early medication. The recent outbreak of NiV was reported in Kerala (India) by a new strain of MCL-19-H-1134 isolate. Currently, no vaccines are available, highlighting the critical need for a conclusive remedy. Our study aims to develop a subunit vaccine against the NiV by analyzing its proteome. NiV genome and proteome sequences were obtained from the NCBI database. A phylogenetic tree was constructed based on genome alignment. T-cell, helper T-cell, and B-cell epitopes were predicted from the protein sequences using NetCTL-1.2, NetMHCIIPan-4.1, and IEDB servers, respectively. High-affinity epitopes for human receptors were selected to construct a multi-epitope vaccine (MEV). These epitopes' antigenicity, toxicity, and allergenicity were evaluated using VaxiJen, AllergenFP-v.1.0, and AllergenFP algorithms. Molecular interactions with specific receptors were analyzed using PyRx and ClusPro. Amino acid interactions were visualized and analyzed using PyMOL and LigPlot. Immuno-simulation was conducted using C-ImmSim to assess the immune response elicited by the MEV. Finally, the vaccine cDNA was inserted into the pET28a(+) expression vector using SnapGene tool for in silico cloning in an E. coli host. The potential for an imminent outbreak cannot be overlooked. A subunit vaccine is more cost-effective and time-efficient. With additional in vitro and in vivo validation, this vaccine could become a superior preventive measure against NiV disease.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40203-024-00246-9.
Fulltext Evaluating the Potential and Pitfalls of AI-Powered Conversational Agents as Humanlike Virtual Health Carers in the Remote Management of Noncommunicable Diseases: Scoping Review

Anisha SA, Sen A, Bain C

J Med Internet Res, 2024 Jul 16;26:e56114.
PMID: 39012688 DOI: 10.2196/56114

BACKGROUND: The rising prevalence of noncommunicable diseases (NCDs) worldwide and the high recent mortality rates (74.4%) associated with them, especially in low- and middle-income countries, is causing a substantial global burden of disease, necessitating innovative and sustainable long-term care solutions.
OBJECTIVE: This scoping review aims to investigate the impact of artificial intelligence (AI)-based conversational agents (CAs)-including chatbots, voicebots, and anthropomorphic digital avatars-as human-like health caregivers in the remote management of NCDs as well as identify critical areas for future research and provide insights into how these technologies might be used effectively in health care to personalize NCD management strategies.
METHODS: A broad literature search was conducted in July 2023 in 6 electronic databases-Ovid MEDLINE, Embase, PsycINFO, PubMed, CINAHL, and Web of Science-using the search terms "conversational agents," "artificial intelligence," and "noncommunicable diseases," including their associated synonyms. We also manually searched gray literature using sources such as ProQuest Central, ResearchGate, ACM Digital Library, and Google Scholar. We included empirical studies published in English from January 2010 to July 2023 focusing solely on health care-oriented applications of CAs used for remote management of NCDs. The narrative synthesis approach was used to collate and summarize the relevant information extracted from the included studies.
RESULTS: The literature search yielded a total of 43 studies that matched the inclusion criteria. Our review unveiled four significant findings: (1) higher user acceptance and compliance with anthropomorphic and avatar-based CAs for remote care; (2) an existing gap in the development of personalized, empathetic, and contextually aware CAs for effective emotional and social interaction with users, along with limited consideration of ethical concerns such as data privacy and patient safety; (3) inadequate evidence of the efficacy of CAs in NCD self-management despite a moderate to high level of optimism among health care professionals regarding CAs' potential in remote health care; and (4) CAs primarily being used for supporting nonpharmacological interventions such as behavioral or lifestyle modifications and patient education for the self-management of NCDs.
CONCLUSIONS: This review makes a unique contribution to the field by not only providing a quantifiable impact analysis but also identifying the areas requiring imminent scholarly attention for the ethical, empathetic, and efficacious implementation of AI in NCD care. This serves as an academic cornerstone for future research in AI-assisted health care for NCD management.
TRIAL REGISTRATION: Open Science Framework; https://doi.org/10.17605/OSF.IO/GU5PX.
Exploring Acceptance of Digital Health Technologies for Managing Non-Communicable Diseases Among Older Adults: A Systematic Scoping Review

Anisha SA, Sen A, Ahmad B, Bain C

J Med Syst, 2025 Mar 11;49(1):35.
PMID: 40067482 DOI: 10.1007/s10916-025-02166-3

This review explores the acceptance of digital health (DH) technologies for managing non-communicable diseases (NCDs) among older adults (≥ 50 years), with an extended focus on artificial intelligence (AI)-powered conversational agents (CAs) as an emerging notable subset of DH. A systematic literature search was conducted in June 2024 using PubMed, Web of Science, Scopus, and ACM Digital Library. Eligible studies were empirical and published in English between January 2010 and May 2024. Covidence software facilitated screening and data extraction, adhering to PRISMA-ScR guidelines. The screening process finally yielded 20 studies. Extracted data from these selected studies included interventions, participant demographics, technology types, sample sizes, study designs and locations, technology acceptance measures, key outcomes, and methodological limitations. A narrative synthesis approach was used for analysis, revealing four key findings: (1) overall positive attitudes of older adults towards DH acceptance; (2) the Technology Acceptance Model (TAM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) are the most frequently used standard frameworks for evaluating technology acceptance; (3) the key facilitators of technology acceptance include perceived usefulness, ease of use, social influence, and digital or e-health literacy, while barriers involve technical challenges, usability issues, and privacy concerns; (4) the acceptance of AI-based CAs for NCD management among older adults remains inadequately evaluated, possibly due to limited adaptation of established frameworks to specific healthcare contexts and technology innovations. This review significantly contributes to the DH field by providing a comprehensive analysis of technology acceptance for NCD management among older adults, extending beyond feasibility and usability. The findings offer stakeholders valuable insights into how to better integrate these technologies to improve health outcomes and quality of life for older adults. Protocol Registration: PROSPERO (Registration ID: CRD42024540035).
Fulltext Comprehensive Review on Low-Level Laser Therapy in Dentistry

Singh S, Chakraborty A, Saju AR, Singh R, Sen A, Shrinivas S, et al.

J Pharm Bioallied Sci, 2024 Dec;16(Suppl 4):S3047-S3049.
PMID: 39926956 DOI: 10.4103/jpbs.jpbs_1261_24

Low-level laser therapy (LLLT) has broad applications in dentistry, enhancing patient outcomes through its anti-inflammatory, analgesic, and biostimulatory effects. It is used for reducing pain and swelling, accelerating wound healing, and promoting tissue regeneration. LLLT is effective in managing conditions, such as temporomandibular disorders (TMDs), oral mucositis, and postoperative discomfort. Additionally, it aids in orthodontics by accelerating tooth movement and mitigating associated pain. This non-invasive treatment offers a safe, efficient, and clinically proven approach, integrating well into various dental procedures to improve overall patient care and recovery.
Prioritizing questions and topics for the development of guidelines and consensus-based recommendations supported by ILAE: A scoping review and proposal of prioritization criteria

Lin K, Eyal S, Demarchi IG, Ben-Shushan T, Auvin S, Khoo CS, et al.

Epilepsia, 2025 Jan 29.
PMID: 39878760 DOI: 10.1111/epi.18286

Clinical practice guidelines (CPGs) and consensus-based recommendations (CBRs) require considerable effort, collaboration, and time-all within the constraints of finite resources. Professional societies, such as the International League Against Epilepsy (ILAE), must prioritize what topics and questions to address. Implementing evidence-based care remains a crucial challenge in clinical practice. Using rigorous processes to ensure that the best available research evidence informs health care recommendations is of the utmost importance. We aimed to develop a structured and transparent process for prioritizing future CPGs and CBRs supported by the ILAE. A multidisciplinary group of researchers and experts from the ILAE Prioritization Task Force conducted a scoping review to identify prioritization approaches for CPG and CBR development. This scoping review was reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Cochrane recommendations. A Problem/population, Concept, and Context (PCC) strategy was applied to the literature search and selection of the studies. We searched Medline/PubMed, Embase, Web of Science, and Scopus without time or language limits. The findings were synthesized qualitatively. A consensus-based process was followed to develop a prioritization scoring tool for CPGs and another for CBRs. Thirty-nine participants, including clinicians, experts in the field, methodologists, and other relevant stakeholders, contributed to developing the final instrument (based on a 5-point Likert scale). Of 721 unique citations, 8 papers reporting prioritization approaches for guideline development were included. Based on these, we developed an initial tool with 10 criteria. It was iteratively optimized and revised by the ILAE Standards and Best Practice Council, which unanimously approved the instrument. The ILAE Executive Committee subsequently approved its final version. The ILAE Prioritization Tool is intended to standardize the prioritization processes and optimize the ILAE's use of resources to select CPGs and CBRs for endorsement.
Fulltext Baseline and lifetime alcohol consumption and risk of differentiated thyroid carcinoma in the EPIC study

Sen A, Tsilidis KK, Allen NE, Rinaldi S, Appleby PN, Almquist M, et al.

Br J Cancer, 2015 Sep 01;113(5):840-7.
PMID: 26313664 DOI: 10.1038/bjc.2015.280

BACKGROUND: Results from several cohort and case-control studies suggest a protective association between current alcohol intake and risk of thyroid carcinoma, but the epidemiological evidence is not completely consistent and several questions remain unanswered.
METHODS: The association between alcohol consumption at recruitment and over the lifetime and risk of differentiated thyroid carcinoma was examined in the European Prospective Investigation into Cancer and Nutrition. Among 477 263 eligible participants (70% women), 556 (90% women) were diagnosed with differentiated thyroid carcinoma over a mean follow-up of 11 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models.
RESULTS: Compared with participants consuming 0.1-4.9 g of alcohol per day at recruitment, participants consuming 15 or more grams (approximately 1-1.5 drinks) had a 23% lower risk of differentiated thyroid carcinoma (HR=0.77; 95% CI=0.60-0.98). These findings did not differ greatly when analyses were conducted for lifetime alcohol consumption, although the risk estimates were attenuated and not statistically significant anymore. Similar results were observed by type of alcoholic beverage, by differentiated thyroid carcinoma histology or according to age, sex, smoking status, body mass index and diabetes.
CONCLUSIONS: Our study provides some support to the hypothesis that moderate alcohol consumption may be associated with a lower risk of papillary and follicular thyroid carcinomas.
Fulltext Coffee and tea consumption and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition

Sen A, Papadimitriou N, Lagiou P, Perez-Cornago A, Travis RC, Key TJ, et al.

Int J Cancer, 2019 Jan 15;144(2):240-250.
PMID: 29943826 DOI: 10.1002/ijc.31634

The epidemiological evidence regarding the association of coffee and tea consumption with prostate cancer risk is inconclusive, and few cohort studies have assessed these associations by disease stage and grade. We examined the associations of coffee (total, caffeinated and decaffeinated) and tea intake with prostate cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 142,196 men, 7,036 incident prostate cancer cases were diagnosed over 14 years of follow-up. Data on coffee and tea consumption were collected through validated country-specific food questionnaires at baseline. We used Cox proportional hazards regression models to compute hazard ratios (HRs) and 95% confidence intervals (CI). Models were stratified by center and age, and adjusted for anthropometric, lifestyle and dietary factors. Median coffee and tea intake were 375 and 106 mL/day, respectively, but large variations existed by country. Comparing the highest (median of 855 mL/day) versus lowest (median of 103 mL/day) consumers of coffee and tea (450 vs. 12 mL/day) the HRs were 1.02 (95% CI, 0.94-1.09) and 0.98 (95% CI, 0.90-1.07) for risk of total prostate cancer and 0.97 (95% CI, 0.79-1.21) and 0.89 (95% CI, 0.70-1.13) for risk of fatal disease, respectively. No evidence of association was seen for consumption of total, caffeinated or decaffeinated coffee or tea and risk of total prostate cancer or cancer by stage, grade or fatality in this large cohort. Further investigations are needed to clarify whether an association exists by different preparations or by concentrations and constituents of these beverages.