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Two pairs of enantiomeric diarylheptanoid-phenylpropanoid adducts bearing a cyclohexenone core, (±)-saccardianones A and B (1 and 2), an alkaloidal diarylheptanoid-phenylpropanoid adduct bearing a 4-piperidone core, (±)-saccardianine A (3), a pair of enantiomeric dimeric diarylheptanoid alkaloids bearing a tetrahydropyridine core, (±)-saccardianine B (4), and a suspected degradation product, saccardianine C (5), in addition to a known diarylheptanoid, platyphyllenone (6), were isolated from the leaves of Pellacalyx saccardianus. Their chemical structures were elucidated based on detailed analyses of the NMR and MS data. The structure of (±)-(1) was also confirmed by X-ray diffraction analysis. Compounds (±)-2 and 6 exhibited selective cytotoxicity towards the AsPC-1 and PANC-1 pancreatic cancer cell lines, respectively.

Ventilator associated pneumonia (VAP) rates in Asia are several times above those of US. The objective of this study is to identify VAP risk factors.We conducted a prospective cohort study, between March 27, 2004 and November 2, 2022, in 279 ICUs of 95 hospitals in 44 cities in 9 Asian countries (China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, Vietnam).153,717 patients, followed during 892,996 patient-days, acquired 3,369 VAPs. We analyzed 10 independent variables. Using multiple logistic regression we identified following independent VAP RFs= Age, rising VAP risk 1% per year (aOR=1.01; 95%CI=1.00-1.01, P.0001); male gender (OR=1.17; 95%CI=1.08-1.26, P.0001); length of stay, rising VAP risk 7% daily (aOR=1.07; 95%CI=1.06-1.07, P.0001); mechanical ventilation (MV) device utilization (DU) ratio (OR=1.43; 95%CI=1.36-1.51; p.0001); tracheostomy connected to a MV (OR=11.17; 95%CI=9.55-14.27; p.0001); public (OR=1.84; 95%CI=1.49-2.26, P.0001), and private (OR=1.57; 95%CI=1.29-1.91, P.0001) compared with teaching hospitals; upper-middle income country (OR=1.86; 95%CI=1.63-2.14, P.0001). Regarding ICUs, Medical-Surgical (OR=4.61; 95%CI=3.43-6.17; P.0001), Neurologic (OR=3.76; 95%CI=2.43-5.82; P.0001), Medical (OR=2.78; 95%CI=2.04-3.79; P.0001), and Neuro-Surgical (OR=2.33; 95%CI=1.61-3.92; P.0001) showed the highest risk.Some identified VAP RFs are unlikely to change= age, gender, ICU type, facility ownership, country income level. Based on our results, we recommend limit use of tracheostomy, reducing LOS, reducing the MV/DU ratio, and implementing an evidence-based set of VAP prevention recommendations.

The role of microbiota in gut-brain communication has led to the development of probiotics promoting brain health. Here we report a genomic study of a Lactobacillus fermentum PS150 and its patented bioactive protein, elongation factor Tu (EF-Tu), which is associated with cognitive improvement in rats. The L. fermentum PS150 circular chromosome is 2,238,401 bp and it consists of 2281 genes. Chromosome comparisons with other L. fermentum strains highlighted a cluster of glycosyltransferases as potential candidate probiotic factors besides EF-Tu. Molecular evolutionary analyses on EF-Tu genes (tuf) in 235 bacteria species revealed one to three copies of the gene per genome. Seven tuf pseudogenes were found and three species only possessed pseudogenes, which is an unprecedented finding. Protein variability analysis of EF-Tu showed five highly variable residues (40 K, 41G, 42 L, 44 K, and 46E) on the protein surface, which warrant further investigation regarding their potential roles as binding sites.

Providing optimal rehabilitation services to the broad public is one of the greatest challenges in the healthcare sector due to the shortage of rehabilitation physicians and facilities. Recent advances in digitalization and sophisticated data analytics offers new innovative ways in delivering rehabilitation services to enhance the quality of life of people with disabilities. Currently, the development of data-driven solutions for rehabilitation in Malaysia is limited due to multiple factors: medical and rehabilitation data is not digitally stored; the knowledge for the interpretation of clinical data is distributed; in particular, there is a lack of expertise in the field of medical data science. Thus, a data science platform is proposed so that medical expertise can be made available through digital services and is not dependent on human resource, location, time or financial ability. This platform is applied for the smart diagnosis of upper limb spasticity in compliance with clinical practice, and extensible for the other smart rehabilitation applications. By collaborating with the prestigious Fraunhofer Society, their knowhow in industrial data science can be brought to Malaysia towards improved health care in the country. The smart diagnosis system provides advice in classifying the severity level of upper limb spasticity based on the Modified Ashworth Scale and the Modified Tardieu scale. The basis is a measurement system for muscle signal, muscle tone and elbow motion. Users of the smart diagnosis application include rehabilitation physicians, doctors from other specialities, nurses, psychologists, physiotherapists and occupational therapists. The tools provided by the data science platform is deployed to store and analyze the clinical data. Further, the expertise of a rehabilitation physician is emulated in the form of an expert system to determine the severity level of upper limb spasticity. The digital clinical database helps medical researchers in secondary analysis towards knowledge discovery for the betterment of intervention and treatment of spasticity.

Thirteen indole alkaloids comprising six vobasine/sarpagine, one vincamine, two voaphylline, two tacaman, one iboga, and one corynantheine alkaloid, were isolated from the leaf extract of Tabernaemontana corymbosa (sample from Taiping, Perak, Malaysia). The structures of these alkaloids were determined based on analysis of the spectroscopic data (NMR and MS), and in the case of vincarudine, the absolute configuration was established by ECD and X-ray diffraction analysis. Vobasidine E represents the first vobasine-type alkaloid characterized by a contracted ring C and loss of the ethylidene/ethyl side chain. A possible biogenetic pathway from a perivine precursor, which was also present in the leaf extract, is presented. Differences in the new alkaloid content between the present and previous sample of the same plant (occurring in a different location) are discussed.

In order to investigate novel probiotics for brain health improvement, the psychotropic potential of Lactobacillus fermentum PS150 (PS150) was evaluated using a 4-week chronic mild stress (CMS) model in rats. Rats fed with PS150 showed less anxious and depressive behaviour in EPM, OFT and FST compared with negative control rats (P

Background Neonates and infants undergoing general anaesthesia for hernia surgery are at risk of perioperative cardiorespiratory adverse events. The use of regional anaesthesia with dexmedetomidine preserves airway tone and may potentially avoid these complications. This study compares the perioperative conditions and adverse events between dexmedetomidine sedation with caudal block and general anaesthesia with caudal block for inguinal hernia surgery in infants. Methods A randomised controlled trial was conducted in a tertiary hospital in Singapore involving 104 infants younger than 3 months, who were randomised to receive either dexmedetomidine sedation (DEX) with caudal block or general sevoflurane anaesthesia with tracheal intubation and caudal block (GA) for inguinal hernia surgery. Perioperative conditions, haemodynamics and adverse events were compared between groups. Results Fifty-one infants received DEX and 48 infants received GA. In the DEX group, 46 infants (90.2%) had their operations completed solely under this technique, two (3.9%) were converted to general anaesthesia with intubation, and three (5.9%) required brief administration of nitrous oxide or low-dose sevoflurane. Overall, 96.1% of infants in the DEX group did not require intubation. Perioperative conditions were similar in both groups. The DEX group had significantly lower heart rates and higher mean arterial pressures intraoperatively. Two infants in the DEX group (3.9%) required postoperative intensive care admission compared with six infants (12.5%) in the GA group. Conclusions Dexmedetomidine sedation with caudal block provides a feasible alternative to general anaesthesia in infants undergoing hernia surgery. This technique avoids the need for tracheal intubation, which may be beneficial in neonates. Clinical trial registration NCT02559102.

Phytochemical investigations on the whole plant of Hippobroma longiflora (L.) G. Don have resulted in the isolation and elucidation of three new diphenethylpiperidine alkaloids, hippofoline A (1), hippofoline B (2), and (−)-cis-2′,2′′-diphenyllobelidiol N-oxide (5), alongside two known alkaloids, (−)-lobeline (3) and (−)-cis-2′,2′′-diphenyllobelidiol (4). The absolute configurations of alkaloids 1 and 2 were deduced based on experimental and calculated ECD data as well as biogenetic consideration, while the absolute configurations of alkaloids 3 and 4 in their free base form were confirmed by Cu Kα radiation X-ray diffraction analyses. Alkaloids 2–4 were shown to induce concentration-dependent relaxation effects on rat isolated tracheal rings that were pre-contracted with carbachol.

Conventional lighting systems, such as the incandescent light bulbs used on the offshore oil rigs are becoming obsolete due to high energy consumption, poor life span and additional costs of waste treatment and disposal. Furthermore, they are susceptible to fire when exposed to an oxygen rich environment, posing a threat to the oil rig workers. Recent advances have led to the development of polymer light emitting diodes (PLEDs) as substitutes to these prevailing light sources. The PLEDs have advantages over the incandescent bulbs, for being durable, low energy consumption and environmental friendly. Consequently, the increasing research collaborations among the academic researchers and industrial stakeholders are gaining momentum in ensuring the advancements of PLEDs in terms of economic value and performance. This paper is aimed at reviewing the recent advances in the field of current innovation and performance of PLEDs materials. The paper focuses on the important experiments on the PLEDs materials towards the upgrading and modification of anode and holes injection/transporting layer and the influence of doping effect. In spite of that, this paper discovered that synthetic materials, such as synthetic silicates are the commonly used materials in the current PLEDs, and recommends the incorporation of cost effective inorganic clay-polymer nanocomposite-based LEDs as a way forward to reducing the material costs and provide more environmental friendly PLEDs materials.

Patients with anorectal malformation (ARM) and Hirschsprung's disease (HD) face long-term disturbance in bowel function even after definitive surgery. This study evaluates the quality of life (QOL) of patients with ARM and HD, and compares them to healthy controls using self-report questionnaires.A prospective study was performed recruiting patients with ARM or HD from September 2013 to December 2014 who had primary surgery done in our institution at least 2 years prior to participation. Age-matched and gender-matched controls were enrolled from our patients with minor outpatient complaints. All participants completed the following PedsQL™ scales (maximum score 100): 4.0 Generic Core Scales, 3.0 General Well-Being (GWB) Scale and 2.0 Family Impact (FI) Module. All were also scored on bowel function (BFS), with a maximum score 20. Appropriate statistical analysis was performed, with significance level0.05.There were 193 participants: 87 controls, 62 ARM, 44 HD. When comparing Core, GWB and FI scores, there were no significant differences between groups although controls had best scores indicating best QOL and general wellbeing, with least impact of the child's health on the family. BFS was significantly different with controls having best and ARM worst scores. There were no significant differences in scores between parent and child indicating intradyad consistency. There was significant positive correlation between BFS and Core (p0.0001), and between BFS and GWB scores (p0.005); and significant negative correlation between BFS and FI scores (p0.0001).Bowel function impacts quality of life. Those with ARM and HD can achieve good quality of life comparable to controls, based on patient and caregiver self-reported outcomes.Prospective comparative study LEVEL OF EVIDENCE: Level II.

Introduction Duodenal duplication cysts are rare congenital foregut anomalies, accounting for 2%–12% of all gastrointestinal tract duplications. Surgical excision entails risk of injury to the pancreaticobiliary structures due to proximity or communication with the cyst. We present a case of duodenal duplication cyst in a 3 year-old boy who successfully underwent endoscopic decompression. Case report AT is a young boy who first presented at 15 months of age with abdominal pain. There was one subsequent episode of pancreatitis. Ultrasonography showed the typical double wall sign of a duplication cyst and magnetic resonance cholangio-pancreatography showed a large 5 cm cyst postero-medial to the second part of the duodenum, communicating with the pancreaticobiliary system and causing dilatation of the proximal duodenum. He subsequently underwent successful endoscopic ultrasound guided decompression at 3 years of age under general anesthesia, and had an uneventful postoperative recovery. Conclusion Endoscopic ultrasound guided assessment and treatment of gastrointestinal duplication cysts is increasingly reported in adults. To the best of our knowledge, only one case of endoscopic treatment of duodenal duplication cyst, in an older child, has been reported thus far in the paediatric literature. In this paper, we review the current literature and discuss the therapeutic options of this rare condition.

From the leaves of Elaeocarpus tectorius (Lour.) Poir. four previously undescribed phenethylamine-containing alkaloids were isolated, namely, tectoricine, possessing an unprecedented isoquinuclidinone ring system incorporating a phenethylamine moiety, tectoraline, representing a rare alkamide incorporating two phenethylamine moieties, and tectoramidines A and B, representing the first naturally occurring trimeric and dimeric phenethylamine alkaloids incorporating an amidine function. The structures of these alkaloids were established by detailed spectroscopic analysis. The absolute configuration of tectoricine was determined by comparison of the experimental and calculated ECD spectra. Plausible biosynthetic pathways to the four alkaloids are proposed.

Smart Health means innovation of the health sector through digitization. This leads to many possibilities regarding to an effective home-based, self-managed physical rehabilitation. With an innovative Product-Service-System (PSS), patients will have a better access, availability, and affordability of physical rehabilitation. In this contribution we present generic approaches of upgrading existent systems from a technological perspective. Furthermore, we introduce a framework for the agile development of innovative PSS, which could be adapted to other fields. The initial situation is an existing PSS for physical rehabilitation. The framework covers four phases. The planning phase consists of methods from the value based idea creation to Systems Engineering (SE) approaches, which focus on the conception of a Minimum Viable Product (MVP). The second phase describes a fast prototyping of the previously defined MVP, which addresses the PSS concept and the business model. Based on that, the next phase consists of the validation of the developed prototype and business model by real customers. The result is analyzed in the fourth stage. The learnings are interpreted regarding to the real market demand for the developed PSS. The developed PSS will be improved or completely changed through multiple iterations.

Industry 4.0 is changing design and manufacturing methodologies because future production lines will manufacture customized products for the mass market. As for that, Automated machines and systems in such a production line need to communicate with each other. In this context, data exchange takes place between different kind of systems or platforms. Therefore a system level approach clarifying the interactions between the manufacturing devices in heterogeneous environments addressing highly dynamic and often loosely coupled production processes is required. This paper describes a model-based systems engineering approach of which the system integration of a smart factory is systematically managed right from the conception design phase. During the conception phase, the communication flows between the system elements is specified using CONSENS (Conceptual Design Specification Technique for the Engineering of Complex Systems). Based on the system level design specifications, a working prototype of a mini production line deploying Supervisory Control and Data Acquisition (SCADA) technology has been developed. The SCADA software acts as a human-machine interface and provides a gateway to access data of the production line either locally or through the internet. Multi-role users could access the system locally or remotely for monitoring, controlling, analyzing and ordering using SCADA as the interface.

In Brain-Computer Interfaces (BCI), data sets need consistency factor to train good filters and classifiers. If there is lack of pattern in the data sets, it will affect the classification accuracy of the results. Consistency in extracted data-epoch requires precise markers to be embedded along the continuous Electroencephalography (EEG) data collection process. This study suggests placing the markers on actual movement through Electromyography (EMG) data classifications during isometric finger flexion and extension. An EMG-based marker system is applied to generate marker in EEG signal during data measurement in real time. EEGLAB software is used for pre-processing. The data loaded into the BCILAB interface for chosen feature extraction and classification. Spectrally weighted Common Spatial Pattern (Spec-CSP) used as feature extraction method and Linear Discriminant Analysis (LDA) is implemented for classification process. Results show that EMG-based marker approach shows higher potential success rate, at 73.6% compared to visual cue-based marker at 71.1%. It is suggested that EMG-based marker approach is applicable in finding pattern recognition of EEG data in isometric finger flexion and extension.

Alstobrogaline ( 1 ), an unusual monoterpenoid indole alkaloid incorporating a third N atom and possessing two aldimine functions, with one being in the form of N -oxide, was isolated from the leaves of Alstonia scholaris . Its structure and relative configuration were determined by extensive NMR spectroscopic analysis, while its absolute configuration was established by X-ray diffraction analysis. A possible biogenetic pathway to 1 was proposed. Compound 1 displayed weak cytotoxic effects against MDA-MB-231 and MCF7 breast cancer cells.

In this study, hypercholesterolemic mice fed with Lactobacillus fermentum FTDC 8312 after a seven-week feeding trial showed a reduction in serum total cholesterol (TC) levels, accompanied by a decrease in serum low-density lipoprotein cholesterol (LDL-C) levels, an increase in serum high-density lipoprotein cholesterol (HDL-C) levels, and a decreased ratio of apoB100:apoA1 when compared to those fed with control or a type strain, L. fermentum JCM 1173. These have contributed to a decrease in atherogenic indices (TC/HDL-C) of mice on the FTDC 8312 diet. Serum triglyceride (TG) levels of mice fed with FTDC 8312 and JCM 1173 were comparable to those of the controls. A decreased ratio of cholesterol and phospholipids (C/P) was also observed for mice fed with FTDC 8312, leading to a decreased number of spur red blood cells (RBC) formation in mice. Additionally, there was an increase in fecal TC, TG, and total bile acid levels in mice on FTDC 8312 diet compared to those with JCM 1173 and controls. The administration of FTDC 8312 also altered the gut microbiota population such as an increase in the members of genera Akkermansia and Oscillospira, affecting lipid metabolism and fecal bile excretion in the mice. Overall, we demonstrated that FTDC 8312 exerted a cholesterol lowering effect that may be attributed to gut microbiota modulation.

Prosthetic hand acts as a tool that enables the amputee to perform daily tasks. Instead of passive devices which are aesthetically pleasing, current devices come with improved functionality utilizing robotic technology. There are various ways to control a prosthetic hand. One of it includes Brain Computer Interface (BCI) which has advanced technologies and creates new possibilities in providing healthcare solutions for people with severe motor impairment. Generally, Electroencephalography (EEG) is dominated by BCI researchers as it provides non-invasive, inexpensive equipment, good resolution, ease of use, portability and no implantation approaches. EEG signals were recorded from healthy subjects through brain waves at specific locations on the scalp using Emotiv EEG Headset. This device can capture brain waves that include artifacts such as movement of a limb, respiration, speech, heartbeat and many more. Most artifacts will disturb the data, but artifacts can also be used for researchers to control the prosthetic hand. This paper shows that this technology is still undergoing a maturing process. In this work, the state-of-the-art is reviewed and a conceptual design for a non-invasive approach for controlling a prosthesis hand using Emotiv EEG Headset integrated with Graphical User Interface (GUI) is presented and designed using LabVIEW. This project is designed for applying cost-effective prosthetic hands controlled using signal artifacts. This device can be used and controlled by paralyzed individuals with limited communication ability using simple GUI.

The application of a high-fidelity part-task trainer for clinical education on upper limb disorders allows students to carry out recurring practices, gain skills and build up their confidence prior to engaging with real patients. The standardization of the symptoms assessment assists in the improvement of clinical findings which are not just limited to spasticity, but also leadpipe rigidity and cogwheel rigidity. The deployment of the Beckhoff PC-based control technology enables high precision in simulating spasticity characteristics thus increasing trainee proficiency. With the growing number of medical schools and therapy training centers, it solves the dilemma of patient unavailability and the difficulty of obtaining patient assistance for the preparation of apprenticeship training.

We report a dual-stage photocrosslinked polymer network based on sequential ultraviolet (UV)-triggered radical polymerization and thermally activated etherification, applicable to the fabrication of tailorable and programmable high-resolution structures. The first stage involves photoinitiated polymerization of monomer and crosslinker to obtain an intermediate polymer network. As such, sophisticated two-dimensional (2D) and micro-scale three-dimensional (3D) structures can be made by using UV-based advanced manufacturing technologies. These complex structures can then be readily programmed into other desired, permanent shapes, in the second stage, via thermally triggered etherification which results in a highly crosslinked, robust polymer network. The intermediate network (Stage I) is characterized to have a Young’s modulus ranging from 342 to 1146 MPa and a glass transition temperature from 52 °C to 83 °C, depending on the concentration of crosslinker. The same material attains a glass transition temperature ranging from 67 °C to ~105 °C and a Young’s modulus of up to 1607 MPa after the subsequent heating process (Stage II). Originally 3D printed 2D structures can be further programmed into rigid, permanent 2.5/3D ones. Micropatterns fabricated from intrinsically hydrophilic dual-stage crosslinked photopolymers through soft lithography show superhydrophobicity, and can subsequently be molded with different curvatures for practical applications.

Three new bisindole alkaloids, arbolodinines A−C, comprising aspidofractinine-aspidofractinine, aspidofractinine-strychnan, and kopsine-strychnan alkaloids, respectively, were isolated from the stem bark extract of the Malayan Kopsia arborea. The structures of the alkaloids were elucidated based on analysis of the spectroscopic data while the absolute configurations were established based on experimental and calculated ECD data. Arbolodinine A is characterized by the union of two aspidofractinine halves with rare and unusual branching from C-5′ of an iminium/carboxylate zwitterion of one aspidofractinine half to the olefinic C-14 of the other aspidofractinine half, while arbolodinines B and C represent first examples of aspidofractinine-strychnan and kopsine-strychnan bisindoles, respectively. Arbolodinine B displayed pronounced cytotoxic effects against an array of human cancer cell lines, including KB, vincristine-resistant KB, PC-3, HCT 116, HT-29, MDA-MB-231, MCF7 and A549 cells with IC50 values ranging from 1.3 to 9.6 μM.

Aim The role of ischemia in the pathogenesis of necrotizing enterocolitis (NEC) remains unclear. We used immunohistochemical markers of hypoxia to identify presence/absence of ischemia in NEC and spontaneous intestinal perforation (SIP) with clinical correlation. Methods Immunohistochemical staining was performed on 24 NEC and 13 SIP intestinal resection specimens using 2 hypoxia markers, hypoxia inducible factor 1α (HIF-1α) and glucose transporter 1 (GLUT1) and inflammatory markers, leukocyte common antigen (LCA) and myeloperoxidase. Ischemic score (0-6) from the sum of the HIF-1α and GLUT1 staining intensity grades was devised (positive ≥3). Inflammation was graded from the sum of LCA and myeloperoxidase grading. Relevant clinical information was obtained from hospital case records. Results Fourteen NEC specimens had positive ischemic score (4.6±1.2). The remaining 10 NEC (ischemic score 0.7±0.8) and all 13 SIP samples (ischemic score 0.5±0.5) were ischemic-negative. The ischemic-positive cases had classic NEC with multiple areas of bowel necrosis; were associated with later onset, enteral feeding and pneumatosis. In contrast, all ischemic-negative NEC were short-segment NEC with perforation. Their clinical profile was similar to the SIP cases with younger gestational age at birth, early onset, association with ibuprofen/indomethacin usage but not with feeding and pneumatosis. Ischemic scores are correlated with inflammation scores in mucosa but not submucosa. Conclusions Ischemia as assessed with immunohistochemical markers HIF-1α and GLUT1, has a primary role in pathogenesis of classic NEC only, not in SIP or short-segment NEC with perforation. Better categorization of the different types of NEC can direct appropriate prevention and treatment strategies.

Two new septicine-type alkaloids, fistulopsines A and B (1 and 2), together with four known phenanthroindolizidine alkaloids ((+)-septicine, (+)-tylophorine, (+)-tylocrebrine, and (–)-3,6-didemethylisotylocrebrine) and (+)-(6S,9S)-vomifoliol, were isolated from the bark and leaves of Ficus fistulosa. The structures of these compounds were established by spectroscopic analysis. Fistulopsines A and B (1 and 2) showed in vitro growth inhibitory activities in HCT 116 and MCF7 cell lines with GI50 ranging between 2–7μM. Furthermore, both compounds 1 and 2 were found to predominantly arrest cells in G1 phase of the cell cycle without induction of apoptosis. HCT 116 cell cycle perturbation by both compounds was found to be transient (< 72h).

The use of body-powered prostheses can be tiring and lead to further problems with compliance and prosthetic restoration. Brain-Computer-Interfaces (BCI) offers a mean of controlling prostheses for patients that otherwise are unable to operate such devices due to physical limitations. An issue with BCIs is that they tend to either require invasive recording methods, posing a surgical risk, or work by generating control signals from not task related brain activity patterns such as right vs. left hand, hand vs. leg or visual stimulation and therefore are not intuitive in their control. This research aims to test the possibility of controlling the grasp and release of an upper limb prosthetic terminal device by classifying Electroencephalogram (EEG) data from real hand grasping and releasing movement. Data from five healthy subjects were recorded using a consumer grade non-invasive Emotiv EPOC headset. During the measurement the subjects were asked to perform isometric finger extension and flexion of their right hand. In order to bring the EEG data into correlation with the executed movement a simultaneous electromyogram (EMG) recording is proposed as an alternative method to recordings of visual cued movement. Classified EMG data was used to generate markers in the EEG data and to epoch the data. In order to increase the signal to noise ratio and allow better classification, the EEG data was filtered and spectrally weighted common spatial patterns (spec-CSP) were used for feature extraction. Using linear discriminant analysis a classification rate of up to 73.2% between grasp and release was achieved. In this work, a novel EMG-assisted approach has been developed for classification of EEG data from hand grasp and release movements. It shows feasibility for a more intuitive control of upper limb prosthetic terminal device using low-cost BCI without the risk associated with invasive measurement.

Multi-material fused filament printing (FFP) of conductive and dielectric materials has tremendous potential in the co-fabrication of embedded electronics, allowing for increasing freedoms in part design while seamlessly integrating electrical components to mechanical structures. However, co-fabrication of 3D embedded conductive structures have proven challenging, due to poor electrical conductivity of printed conductive structures, and geometrical restrictions of printed conductive structures bound by material properties. Here, we introduce a highly conductive low density polyethylene (LDPE) composite filled with copper particles and Sn95Ag4Cu1. At metal filler content of 35 % vol, the electrical conductivity of the composite achieves 3.3 × 104 S/m with a Young’s modulus of 7.2 GPa. Through a combination of inert and reducing gas environment, thermo-oxidation of the conductive composite has been minimized. Additionally, the electrical conductivity of the printed composite has been correlated to the morphology of the print. Under optimized printing parameters, the fuse-filament printed conductive structure retained 55 % (of 1.05 × 104 S/m) of its electrical conductivity after printing. A series of mechanically stable suspended bridge structure has been printed using the LDPE-Cu-Sn95Ag4Cu1 composite. We further demonstrate compressive sensing of two types of embedded and suspended structures: toroidal disk and interdigitated fingers. These designs have been printed without using support structure. This work shows the potential in co-fabrication of electrically functional components in a dielectric structure with high degree of geometrical freedom.

Fourteen previously undescribed alkaloids comprising two N-1-hydroxymethylmacroline alkaloids, one talpinine-type oxindole acetal, a pair of equilibrating talpinine-type oxindole hemiacetals, eight oxidized derivatives of sarpagine- and akuammiline-type indole alkaloids, in addition to alstochalotine a diastereomer of gelsochalotine recently isolated from Gelsemium elegans, were isolated from the leaf and stem-bark extracts of Alstonia penangiana. The structures and relative configurations of these alkaloids were established using NMR, MS, and in one instance, confirmed by X-ray diffraction analysis. An NMR-based method is described as a useful chemotaxonomic tool for differentiating between A. penangiana and A. macrophylla. Several of the alkaloids isolated showed appreciable growth inhibitory effects when tested against a number of human cancer cell lines.

Reduced graphene oxide (rGO) has been fabricated into a microelectrode array (MEA) using a modified nanoimprint lithography (NIL) technique. Through a modified NIL process, the rGO MEA was fabricated by a self-alignment of conducting Indium Tin Oxide (ITO) and rGO layer without etching of the rGO layer. The rGO MEA consists of an array of 10μm circular disks and microelectrode signature has been found at a pitch spacing of 60μm. The rGO MEA shows a sensitivity of 1.91nAμm(-1) to dopamine (DA) without the use of mediators or functionalization of the reduced graphene oxide (rGO) active layer. The performance of rGO MEA remains stable when tested under highly resistive media using a continuous flow set up, as well as when subjecting it to mechanical stress. The successful demonstration of NIL for fabricating rGO microelectrodes on flexible substrate presents a route for the large scale fabrication of highly sensitive, flexible and thin biosensing platform.

Friction stir welding (FSW) is a relatively new solid-state joining process which is considered energy efficient, eco-friendly and versatile. High stress and strain occur at the rotating tool, consisting of a pin (probe) and a shoulder, during the friction stir process. The geometrical design of the tool has some impact in terms of stress and strain once static load is applied against the tool. In this work, specific stress can be found on the tool due to the plunging and travel process that is analysed using finite element method. In the present work, a steady state finite element stress analysis of friction stir welding was carried out using CATIA V5 software. The critical points of the FSW tool are located mainly on the edge between the shoulder and the pin, where a large amount of stress is found and further leads to failure or tool defects. This critical stress and strain can be reduced by enlarging the diameter size of the pin and increasing tool life.

The applicability of shape memory alloy as an actuator for robotic hands is tested. A parallel arrangement of SMA wires along the forearm is implemented into a hand model after consideration of different designs. The activation of the SMA is achieved using a joule heating approach. The arrangement is tested for its controllability using open and closed loop control. An adaptive PID controller shows best results for the full range of motion.

To reproduce a complex and functional tissue, it is crucial to provide a biomimetic cellular microenvironment that not only incorporates biochemical cues, but also physical features including the nano-topographical patterning, for cell/matrix interaction. We developed spatially-controlled nano-topography in the form of nano-pillar, nano-hole and nano-grill on polycaprolactone surface via thermal nanoimprinting. The effects of chondroitin sulfate-coated nano-topographies on cell characteristics and chondrogenic differentiation of human mesenchymal stem cell (MSC) were investigated. Our results show that various nano-topographical patterns triggered changes in MSC morphology and cytoskeletal structure, affecting cell aggregation and differentiation. Compared to non-patterned surface, nano-pillar and nano-hole topography enhanced MSC chondrogenesis and facilitated hyaline cartilage formation. MSCs experienced delayed chondrogenesis on nano-grill topography and were induced to fibro/superficial zone cartilage formation. This study demonstrates the sensitivity of MSC differentiation to surface nano-topography and highlights the importance of incorporating topographical design in scaffolds for cartilage tissue engineering. From the clinical editor: These authors have developed spatially-controlled nano-topography in the form of nano-pillar, nano-hole and nano-grill on polycaprolactone surface via thermal nanoimprinting, and the effects of chondroitin sulfate-coated nano-topographies on cell characteristics and chondrogenic differentiation of human mesenchymal stem cells (MSC) were investigated. It has been concluded that MSC differentiation is sensitive to surface nano-topography, and certain nano-imprinted surfaces are more useful than others for cartilage tissue engineering.

Large size and high quality graphene grown by chemical vapour deposition (CVD) has been fabricated into an array of discrete graphene sheets with well-defined sizes and shapes. A fabrication process based on nanoimprint lithography has been developed to achieve shape tunability with sizes ranging from micrometer to nanometer. The technique preserves the quality of the CVD grown graphene and offers the versatility of transferring the graphene array onto any rigid or flexible substrate. The process is then expanded to fabricating a graphene based microelectrode array whose performance is demonstrated in the real time sensing of peroxidase excreted by breast cancer cells. The device displayed a linear working range of 0.01–25 mM and a sensitivity of 8.8 mA mol−1.

A total of seventeen alkaloids, comprising six macroline (including alstofolinine A, a macroline indole incorporating a butyrolactone ring-E), two ajmaline, one sarpagine, and eight akuammiline alkaloids, were isolated from the stem-bark and leaf extracts of the Malayan Alstonia macrophylla. The structure and relative configurations of these alkaloids were established using NMR, MS and in several instances, confirmed by X-ray diffraction analysis. Six of these alkaloids were effective in reversing multidrug-resistance (MDR) in vincristine-resistant KB cells.

Upper limb spasticity is commonly seen in conditions of upper motor neuron pathology, of which includes traumatic brain injury, stroke, high cervical spinal cord injury and Cerebral Palsy. Trained physicians, physiotherapists and occupational therapists are needed for the rehabilitation of such patients. To obtain skills in addressing spasticity, current practice in training of students utilizes patients as primary learning subjects. Novices without the required skills put the patient safety at stake. Further, physicians and therapists evaluate spasticity using the Tardieu, Ashworth, and Modified Ashworth Scale which can vary dependent on experience. Variability in rater scores suggest that training can be improved. To tackle this issue, an upper limb part-task trainer that is capable of consistently emulating spasticity symptoms is proposed for pre-clinical training of physicians, therapists and medical students. In order to obtain clinical data for the emulation of upper limb spasticity symptoms, a non-invasive evaluation procedure has been designed deploying a goniometer and a manual muscle tester. The goniometer measures the angle of elbow joint of the patient while the manual muscle tester measures the force applied by the rehabilitation physician on the patient's forearm. The elbow joint angle and its resistance force are recorded in real time via a data acquisition interface and NI LabVIEW software. The evaluation procedure was carried out by a rehabilitation physician during a routine rehabilitation session to the patients with symptoms of upper limb spasticity.

Stroke is a major cause of long-term disability among adults in many countries. Post stroke rehabilitation consumes a huge amount of health care resources in terms of costs related to hospital and home assistance. Recently, robot-assisted rehabilitation has been introduced to support physiotherapists in providing high-intensity and repetitive rehabilitation sessions. It has been observed that robotics offers an objective and reliable tool to monitor patient's progress and to accurately assess their motor function. This paper presents a novel finger rehabilitation approach for acute paralyzed stroke survivors using a wearable device for hand motor function restoration. After analyzing four main working mechanisms for hand assistance and rehabilitation, i.e. pneumatic cylinders, artificial rubber muscles, linkage mechanism and cable-driven mechanism, a new device called Pneumatic Actuated Finger Exoskeleton (PAFEx) has been designed. The prototype development was carried out in four stages involving simulation of the assisted structure of the MCP joint and the PIP joint, algorithm development, design and fabrication of prototype as well as product function evaluation. Offering ease of use and affordability, the device has great potential to be deployed for individualized rehabilitation session for patients who have to undergo therapy in their home.

A computational model of human motor control for a nonlinear 2 degrees-of-freedom (DOF) robot arm to mimic humanlike behavior is developed and presented in this paper. The model is based on a simple mathematical model of a 2-segment compound pendulum which mimics the human upper arm and forearm. Using the Lagrangian and Euler-Lagrange equations, the 2-DOF dynamic equations were successfully derived and solved using Euler's method. Two types of controllers; a feedback Proportional-Derivative (PD) controller and a feedforward controller, were combined into the model. The algorithm exhibited learning of the necessary torque required in performing the desired Position Control via Specific Trajectory (PCST) rehabilitative task via feedback control and using it as the feedforward torque in subsequent trial motions. After 30 trials, the mean absolute error with respect to the desired motion of the upper arm, showed a decrease from 0.09533 to 0.005859, and the forearm motion from 0.3526 to 0.006138. This decrement trend in mean absolute errorwith increase in number of trials is consistent with the adaptive control strategy of the human arm known as the Feedback Error Learning (FEL) strategy.

A long-term goal of agricultural automation is to deploy intelligentrobots to facilitate labor-intensive tasks such as crop care or selective harvesting with minimum human supervision. To achieve this goal, the agricultural robots must be able to adapt themselves in response to various terrain conditions. The reason is that the terrain characteristics can jeopardize the performance of a robotin carrying out a taskor even causing it being trapped in the field. The aim of this work is to evaluate the effectiveness of using an intelligent algorithm, i.e. support vector machine (SVM) in recognizing various terrain conditions in an agricultural field. For this purpose, asmall tracked-driven mobile robot together witha terrain test bed has been developed. The terrain test bed emulates three types of terrain conditions, i.e. sand, gravel and vegetation. The tracked-driven robot is embedded with a low power MEMS accelerometer for measuring vibration signals resulted from the track-terrain interaction. An experimental study was conducted usinga SVMtrained with three different kernel functions, i.e. linear function, polynomial function and radial basis function (RBF). The results showed that the SVM can recognize different terrain conditions effectively. This work contributes to devising a self-adaptive agricultural robot in coping with changing terrain conditions.

Smart solutions for energy generationare required for a sustainable future. Many studiesand researches are in the pipeline to forge new reliable and affordable techniques for electricity generation from natural sources, particularly in low power generation due to mass consumption of small and portable electronic devices. In this context, piezoelectric material is seen as a potential candidate for energy generation since it has an outstanding property of converting kinetic energy into electricity. In this study, a prototype termed as Vibration Energy Harvester (VEnH) is developed to assess its performance in generating electricity from a vibration source. The prototype consists of a cantilever beam with a piezoceramic attached at half-length of the cantilever beam, a DC motor for emulationof the vibration produced by human footsteps and a microcontroller. Whena continuous force is applied to the VEnH, the cantilever beam experiencesdeformations and thus induces electricity. Two tests were conducted, namely the input force magnitude variation (1 mm – 18 mm) tests and the input frequency increment (0 Hz – 10 Hz) tests. The results showed that the output voltage was consistently increased proportional to the applied input displacement until it reacheda saturationpoint. In an optimal condition, about 5.4 Volts was generated before it reached the saturation point. Nonetheless the saturation point varies according to the input excitation frequency and it is discovered that the optimal input excitation frequency is of4.2 Hz. The results have potently showed the energy generation via VEnH isreliable and consistent, and thus upholds the positive prospective for its applications to harvest energy from human activities.

Medullary Thyroid Carcinoma (MTC) is the most common cause of death in MEN patients. It is curative by prophylactic total thyroidectomy, but controversies remain as to the optimal timing for prophylactic thyroidectomy. The current recommendation is for prophylactic total thyroidectomy before age 5, but a recent study suggested that in the ethnic Chinese, even "high risk" mutations did not result in early malignant change, and it was suggested that prophylactic thyroidectomy may be performed at a later age. We report a case of an ethnic Chinese girl with MEN2A codon 634 (C634R) mutation, whose operative specimen at prophylactic thyroidectomy at 4 years 8 months showed MTC. We advocate that management of MEN2A patients should be codon-directed, regardless of ethnicity.

Efficient derivation of neural cells from human embryonic stem cells (hESCs) remains an unmet need for the treatment of neurological disorders. The limiting factors for current methods include being labor-intensive, time-consuming and expensive. In this study, we hypothesize that the substrate topography, with optimal geometry and dimension, can modulate the neural fate of hESCs and enhance the efficiency of differentiation. A multi-architectural chip (MARC) containing fields of topographies varying in geometry and dimension was developed to facilitate high-throughput analysis of topography-induced neural differentiation in vitro. The hESCs were subjected to "direct differentiation", in which small clumps of undifferentiated hESCs were cultured directly without going through the stage of embryoid body formation, on the MARC with N2 and B27 supplements for 7 days. The gene and protein expression analysis indicated that the anisotropic patterns like gratings promoted neuronal differentiation of hESCs while the isotropic patterns like pillars and wells promoted the glial differentiation of hESCs. This study showed that optimal combination of topography and biochemical cues could shorten the differentiation period and allowed derivation of neurons bearing longer neurites that were aligned along the grating axis. The MARC platform would enable high-throughput screening of topographical substrates that could maximize the efficiency of neuronal differentiation from pluripotent stem cells.

Objective To improve understanding of the implications of testicular microlithiasis (TM) in paediatric patients diagnosed incidentally on scrotal ultrasonography (US). Patients and methods 31 boys aged 4–14 years diagnosed with TM based on US between February 2000 and September 2007 were retrospectively reviewed. Demographic data, indications for US, associated inguino-scrotal pathologies and follow-up data were collated. Results A total of 59 testes were evaluated. Fifty-four had TM at US. The most common indication for US was scrotal swelling ( n = 17). Twenty patients (65%) had at least one associated inguino-scrotal pathology related to patent processus vaginalis, with cryptorchidism being the most frequently observed (39%). On follow up (mean 39.6 months), 6 patients documented decrease or resolution of TM, while 2 showed increase in TM density. No testicular malignancy was observed during follow up. Conclusions TM is commonly diagnosed incidentally on US in paediatric patients. A literature review revealed few case reports on its association with testicular malignancy and a prevalence of 4.2% among asymptomatic boys. The spontaneous resolution of TM supports degeneration of seminiferous tubules as the possible cause and further questions its malignant implication. An appropriate surveillance scheme would require involvement of a well-informed patient and parent with good compliance on testicular self-examination.