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Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well- differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.

INTRODUCTION: Flexor tendon repair is challenging mainly due to the need to balance between a strong repair technique, ease of tendon gliding and early mobilisation to prevent adhesions while preventing tendon rupture. While different countries have different preferences in repair techniques, core sutures and suture types, there is still no study in Malaysia regarding our preference and whether we are following the current evidence. MATERIALS AND METHODS: We performed a survey with a standard questionnaire distributed during our annual national orthopaedic meeting in 2019. The standard questionnaire consisted of 24-objective multiple-choice questions concerning the treatment of flexor tendon injury were distributed with consent. A total of 290 questionnaires that were filled out correctly were included in this study. RESULTS: The majority of respondents preferred the Modified Kessler technique (n=96, 33.1%) followed by the Adelaide technique (n=81, 27.9%) and Double Modified Kessler (n=45, 15.5%). However, for the number of core strands in the repair, the majority utilised the 4-strand (n=203, 70%), followed by 2-strand (n=34, 11.7%) and 6-strand (n=21, 7.2%). The majority utilised Prolene sutures (n=259, 89.3%) with a suture size of 4/0 (n=157, 54.1%). For rehabilitation, 56.9% (n=165) preferred early passive motion, 27.6% (n=80) early active motion and 14.8% (n=43) would strictly immobilise. CONCLUSION: There is still no consensus as to the best technique; however, the aim of tendon repairs is still the same around the world. It would be helpful to know our preferences to improve our current practice and outcomes following these common flexor tendon injuries in hand.

Chae Hong Lim,1 Sang Eun Yoon,2 Won Seog Kim,2 Kyung-Han Lee,3,4 Seok Jin Kim2,4 1Department of Nuclear Medicine, Soonchunhyang University College of Medicine, Seoul, Korea; 2Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 3Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 4Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, KoreaCorrespondence: Seok Jin KimDivision of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, KoreaTel +82-2-3410-1766Fax +82-2-3410-1754Email kstwoh@skku.eduKyung-Han LeeDepartment of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, KoreaTel +82-2-3410-2630Fax + 82-2-3410-2638Email khnm.lee@samsung.comPurpose: The clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in intravascular large B-cell lymphoma (IVLBCL) is unknown. This study investigated the association between PET/CT features and prognosis in IVLBCL patients.Patients and Methods: Subjects were 30 newly diagnosed Asian variant IVLBCL patients at a single institution. Baseline PET/CT was analyzed for the distribution and intensity of FDG lesions, and PET/CT pattern groups were compared for the outcome.Results: Eight patients had hypermetabolic lymph node (LN) lesions (Nodal group). The remaining 22 patients with extranodal (EN) involvement were categorized into Deauville score 3– 4 (EN/DS3-4; n = 14) and DS5 groups (EN/DS5; n = 8). First-line therapy resulted in a complete or partial response in 75.0%, 64.3%, and 100% of the respective groups. Treatment-related deaths occurred in one nodal group and three EN/DS3-4 group cases, but none among the EN/DS5 group. During 56 months of follow-up, disease progression or relapse occurred in five, four, and one case of respective groups. Cancer-related death occurred more frequently in the Nodal (n = 6) and EN/DS3-4 groups (n = 7) than the EN/DS5 group (n = 1; P = 0.041). Nodal and EN/DS3-4 groups had worse 5-year event-free survival (EFS; 25.0% and 49.0%, respectively, P = 0.010 and 0.076) and overall survival (OS; 33.3% and 48.2%, P = 0.010 and 0.068) compared to the EN/DS5 group (87.5% EFS and 87.5% OS).Conclusion: In patients with Asian variant IVLBCL, the distribution and intensity of FDG uptake lesions on PET/CT can be useful for predicting treatment outcomes and survival.Keywords: intravascular lymphoma, 18F-fluorodeoxyglucose, PET/CT, prognosis

Myong Ki Baeg, Myung-Gyu Choi, Sun-Hye Ko, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Young-Seok Cho, Bo-In Lee, In-Seok LeeDepartment of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of KoreaBackground: Sarcopenia is associated with adverse outcomes such as physical disability, poorer quality of life, and death. Helicobacter pylori (HP) eradication increases ghrelin secretion, which may be a possible treatment for sarcopenia. We investigated whether HP eradication reduces the risk of low muscle mass (LMM), which is an integral component of sarcopenia.Materials and methods: Healthy, asymptomatic women aged ≥60 years who participated in a health screening program were enrolled. Subjects with a history of HP eradication were compared with those who were HP IgG+, but had not received HP-eradicating therapy. Body composition was measured by multifrequency bioelectrical impedance analysis. LMM was defined as body muscle mass 2 standard deviations below the mean muscle mass of healthy women aged 20–39 years from the same program. Multivariable analysis was used to identify sarcopenia risk factors.Results: Three hundred seventy-two women had received HP eradication, while 689 HP IgG+ women had not. The prevalence of LMM was significantly lower in those who received HP eradication (13.7% vs 21.6%, P=0.002). Multivariable analysis identified risk factors for LMM as age, white blood cell count, serum total protein concentration, and the metabolic syndrome. HP eradication (odds ratio: 0.632, 95% confidence interval: 0.440–0.824, P=0.013) was a significant preventive factor, and exercise (odds ratio: 0.710, 95% confidence interval: 0.504–1.002, P=0.051) had a preventive tendency.Conclusion: HP eradication might reduce LMM risk. This finding should be confirmed in prospective longitudinal studies to determine the long-term effects of HP eradication on sarcopenia.Keywords: sarcopenia, Helicobacter pylori, eradication, bioelectrical impedance analysis

The study of the cementitious material activity of industrial solid wastes is a key issue in the comprehensive utilization of its green building materials. In this study, mechanical activation was used to prepare cementitious materials from vanadium-titanium iron ore tailings (VTIOT) as the main raw materials, and the effects of grinding time, the key parameter, on the grinding characteristics of VTIOT, the mechanical properties of the VTIOT cementitious material, and the hydration mechanism were investigated by means of surface area analysis, particle size analysis, X-ray diffraction (XRD), scanning electron microscopy (SEM), alkali leaching, mechanical testing, hydration heat analysis, and thermogravimetric analysis (TGA). The results show that: the grinding time and specific surface area of VTIOT exhibit a linear correlation. Prolonging the grinding time, the fractal dimension of the particles gradually increases. The activity of Si4+ and Al3+ elements increases rapidly, reaching a Si4+ and Al3+ content of 96 mg·L−1 at 90 min of grinding. With a VTIOT mixing amount of 30 %, a mortar paste ratio of 1:3, and a water cement ratio of 0.5, the 50 min ground VTIOT mortar demonstrates 7 d and 28 d compressive strengths of 29 MPa and 38.7 MPa, corresponding to the highest values of the activity index, measured at 71.4 % and 75.2 %, respectively. Under standard curing conditions, the hydration products of cementitious materials at 7 d are ettringite (AFt), calcium silicate hydrate (C-S-H), alumina, ferric oxide, monsulfate (AFm), calcium hydroxide (Ca(OH)2), and calcium silica (CS). In the hydration process of 7 d, the exothermic peak and exothermic amount of the 50 min VTIOT cementitious materials are greater than those observed for other grinding times, but lower than those of pure reference cement.

Abstract Background The prospective phase III multi-centre L-MOCA trial (NCT03534453) has demonstrated the encouraging efficacy and manageable safety profile of olaparib maintenance therapy in the Asian (mainly Chinese) patients with platinum-sensitive relapsed ovarian cancer (PSROC). In this study, we report the preplanned exploratory biomarker analysis of the L-MOCA trial, which investigated the effects of homologous recombination deficiency (HRD) and programmed cell death ligand 1 (PD-L1) expression on olaparib efficacy. Methods HRD status was determined using the ACTHRD assay, an enrichment-based targeted next-generation sequencing assay. PD-L1 expression was assessed by SP263 immunohistochemistry assay. PD-L1 expression positivity was defined by the PD-L1 expression on ≥ 1% of immune cells. Kaplan–Meier method was utilised to analyse progression-free survival (PFS). Results This exploratory biomarker analysis included 225 patients and tested HRD status [N = 190; positive, N = 125 (65.8%)], PD-L1 expression [N = 196; positive, N = 56 (28.6%)], and BRCA1/2 mutation status (N = 219). The HRD-positive patients displayed greater median PFS than the HRD-negative patients [17.9 months (95% CI: 14.5–22.1) versus 9.2 months (95% CI: 7.5–13.8)]. PD-L1 was predominantly expressed on immune cells. Positive PD-L1 expression on immune cells was associated with shortened median PFS in the patients with germline BRCA1/2 mutations [14.5 months (95% CI: 7.4–18.2) versus 22.2 months (95% CI: 18.3–NA)]. Conversely, positive PD-L1 expression on immune cells was associated with prolonged median PFS in the patients with wild-type BRCA1/2 [20.9 months (95% CI: 13.9–NA) versus 8.3 months (95% CI: 6.7–13.8)]. Conclusions HRD remained an effective biomarker for enhanced olaparib efficacy in the Asian patients with PSROC. Positive PD-L1 expression was associated with decreased olaparib efficacy in the patients with germline BRCA1/2 mutations but associated with improved olaparib efficacy in the patients with wild-type BRCA1/2. Trial registration NCT03534453. Registered at May 23, 2018.

The limited market share and growth of Bumiputera entrepreneurs in domestic furniture and wood product industry in Malaysia remains a long-standing challenge. Therefore, a study to examine the market factors that contribute to the failure to thrive among Bumiputera entrepreneurs, registered with the Malaysian Timber Industry Board, was conducted. The results revealed that most of the respondents were micro- and small-sized enterprises, with sales focused on the domestic and contract markets. They were mostly producing sofa and kitchen cabinets, made to order, and sold in domestic markets within the vicinity. The respondents also indicated that the major challenges that impeded their ability to penetrate and capture market share include the limited production volume, lack of product diversity, limited government contract, and inter-ethnicity business collaboration. The Chi-square and Pearson Product Moment Correlation tests found that the significant challenges were only the limited production volume due to small company size, lack of product diversity, and the limited inter-ethnicity business collaboration among Bumiputera entrepreneurs. Therefore, policymakers should take heed that despite the many years of targeted and affirmative assistance to expand the domestic market share of Bumiputera entrepreneurs, the results remain poor, and inevitably, a new approach to Bumiputera entrepreneurs’ development must be adopted.

Background/Purpose: To develop a prediction model for emergency medical technicians (EMTs) to identify trauma patients at high risk of deterioration to emergency medical service (EMS)-witnessed traumatic cardiac arrest (TCA) on the scene or en route. Methods: We developed a prediction model using the classical cross-validation method from the Pan-Asia Trauma Outcomes Study (PATOS) database from 1 January 2015 to 31 December 2020. Eligible patients aged ≥18 years were transported to the hospital by the EMS. The primary outcome (EMS-witnessed TCA) was defined based on changes in vital signs measured on the scene or en route. We included variables that were immediately measurable as potential predictors when EMTs arrived. An integer point value system was built using multivariable logistic regression. The area under the receiver operating characteristic (AUROC) curve and Hosmer-Lemeshow (HL) test were used to examine discrimination and calibration in the derivation and validation cohorts. Results: In total, 74,844 patients were eligible for database review. The model comprised five prehospital predictors: age 20/minute, pulse oximetry

Solar energy is seen as a good option to replace fossil fuels in electricity generation. However, PV panels produce unnecessary heat energy during power generation which increases the temperature and affects the efficiency of PV cells. This article investigates the performance of PV modules using aluminum heat sinks and forced air cooling techniques. A cooling circuit configuration connecting a 6-inch pipe plenum with 5 T-shaped pipes is installed under the solar cell to provide better cold air distribution to the PV panels. The study was conducted on-site and in real-time conditions in a public hospital with high energy consumption as it operates continuously throughout the year. The combination of the two methods has optimized the performance of solar panels in terms of efficiency and electrical energy output. The average electrical efficiency of the studied PV panels is 17% and is very close to the PV module efficiency of 19.38% under standard test conditions (STC). The actual energy yield recorded for the installed PV panel is 12.35% higher than the estimated solar energy output under nominal operating cell temperature (NOCT) conditions. The results of the study show that solar energy generation can be optimized by considering the design, use of materials and proper cooling methods even when using the same solar panel.

Background and aims: Low grade dysplasia (LGD) is believed to predispose to colorectal cancer (CRC), and proctocolectomy has been advocated when this is identified. Between 1978 and 1990, 160 patients [...]

The primary goal of current study is to formulate a novel mathematical model employing the Prabhakar fractional operator, aimed at examining the dynamic behaviour of Jeffrey fluid flow and heat transfer phenomena under ramped wall temperature conditions. Our investigation entails a meticulous investigation of magnetohydrodynamic (MHD) natural convective flow within Jeffrey fluids, where we derive precise analytical solutions utilizing the Prabhakar fractional derivative, characterized by a non-singular type kernel. Furthermore, our study integrates fundamental principles such as Fick’s and Fourier’s laws into the model, leveraging a multi-parameter Mittag-Leffler kernel associated with the fractional operator. We delve into the intricacies of fluid flow near an infinitely vertical plate, considering characteristics such as velocity u0. To address the complexities of the problem, we express it in context the of partial differential equations along side generalized boundary conditions, employing a set of appropriate variables to transform these equations into a dimensionless form. Utilizing Laplace transform, we analyse the equations of fractional system, presenting outcomes both in the form of series and through specialized functions. We systematically explore the influence of key parameters α, Pr, β, Gm, Sc, γ, Gr on fluid flow dynamics, unveiling significant insights. Our comparative analysis reveals the superior performance of the Prabhakar-like non-integer approach over existing operators, substantiated by graphical representations of the results. Additionally, we extend our investigation to various limiting cases, including Newtonian fluids and second-grade, in both fractionalized and classical forms, thus highlighting the versatility and applicability of our proposed model within fluid dynamics research.

BackgroundDengue is a mosquito-borne disease caused by four distinct, closely related dengue viruses (DENV). Global dengue incidence has markedly increased in the past decades. The World Health Organization reported that cases increased from 505,430 in 2000 to 5.2 million in 2019. Similarly, the total dengue cases in Malaysia increased from 7,103 in 2000 to a peak of 130,101 in 2019. Knowledge, attitude, and practice (KAP) remain the most effective dengue prevention and control tools. Furthermore, school-based health education is key to enhancing knowledge and raising awareness of the seriousness of dengue among schoolchildren and transferring knowledge and practice from classrooms to homes. Thus, it is necessary to plan an integrated module for the primary prevention of dengue infection, specifically among schoolchildren.AimsThe present study intends to develop, implement, and evaluate the effectiveness of a theory-based integrated dengue education and learning (iDEAL) module in improving the KAP, environmental cleanliness index, and dengue index among schoolchildren in Selangor and Kuala Lumpur.MethodsThis study is a single-blinded, cluster randomised controlled trial to be conducted from 1 September 2023 to 31 August 2025. The study will involve 20 primary and 20 secondary schools in Selangor and Kuala Lumpur. The 1600 participants will be randomly allocated to intervention and control groups based on selected clusters to avoid contamination. A cluster is a comparable school that fulfils the inclusion and exclusion criteria. The intervention group will receive the iDEAL module, while the control group will receive standard education. The iDEAL module will be developed following a systematic procedure and delivered in-person by trained researchers to the participants. The outcome will be measured using validated, self-administered questionnaires at baseline (T0), immediately (T1), one month (T2), and three months (T3) post-intervention to measure the intervention module effectiveness. The data will be analysed using IBM Statistical Package for Social Science (SPSS) version 28 and descriptive and inferential statistics. Within-group changes over time will be compared using one-way repeated measure analysis of variance for continuous and normally distributed variables. Within-group analysis of categorical data will use Cochran's Q test. The main effect and interaction between and within the intervention and control groups at T0, T1, T2, and T3 will be tested using the generalised linear mixed model (GLMM). Hypothetically, the KAP, environmental cleanliness index, and dengue index among the intervention group will be significantly improved compared to the control group. The hypothesis will be tested using a significance level with a p-value of 0.05 and a confidence interval of 95%.ConclusionsThe study protocol outlines developing and testing an iDEAL module for schoolchildren in Selangor and Kuala Lumpur, with no socio-demographic differences expected. The intervention aims to improve KAP, environmental cleanliness index, and dengue index, potentially reducing dengue risk. Results could inform public health policies, emphasizing school-based interventions' importance in combating diseases like dengue.

The global financial crisis increased corporate world uncertainties. Therefore, to meet these challenges, firms take a more proactive approach to tackling various corporate governance and firm value initiatives and policies. This study aims to explore the moderating effect of capital adequacy on the relationship between board characteristics and the firm value of listed banks in Pakistan. To obtain a more robust empirical model and results, this study incorporates moderator and control variables. This study is based on half-yearly secondary data of 560 sample observations from 2009 to 2021. Multiple regression and panel data estimation techniques were employed for the analysis. The study used firm value as a dependent variable, proxied by Tobin’s Q, along with five independent variables, one moderating variable, and two control variables. The results of this study indicate that a higher capital adequacy ratio (CAR) increases firm value and has a moderating effect on board characteristics and firm value. Low proportions of women and independent directors on board affect firm value. The presence of risk management and audit committees in listed Pakistani banks, on the other hand, increases firm value. The banks in Pakistan have no problem with CEO duality. The study also found that bank size has a positive relationship with firm value, while bank age has a negative relationship with firm value.

Indoor environmental quality has a profound effect on human health and productivity. In this respect, this study evaluates indoor air quality in terms of its various parameters in sustainably built homes in three different locations. A supplementary study to examine the formaldehyde emission levels from furniture with three different finishes was also undertaken. A questionnaire-based survey was then conducted to evaluate the general public perception of the prevailing indoor air quality in the three locations. The results revealed that temperature, relative humidity, indoor air speed, particulate matter (PM10), CO2, NO2, and total volatile organic compounds (TVOC) and formaldehyde (HCHO) readings were not significantly different between the three locations and were below the existing limit allowed for indoor environmental quality. However, the HCHO emission was the highest from furniture with the two-layer coatings, followed by single layer coating, and finally the furniture with the veneer overlay. It was noteworthy that the general public’s awareness and knowledge of indoor air quality was relatively poor, except for the tertiary level educated respondents. In this regard, policymakers need to increase the awareness and knowledge of indoor environmental quality among the general public, if non-compliance is to be detected and promptly addressed.

The study of firm value and financial risks became more important after the global financial crisis of 2007–2008, as the required risk was mismanaged, resulting in a deterioration in firm value. It is important to study the relationship between financial risks and firm value. This study aims to examine the moderating effect of capital adequacy on the relationship between financial risks and the firm value of listed banks in Pakistan. This study is based on half-yearly secondary data of 560 sample observations from 2009 to 2021. Multiple regression and panel data estimation techniques were employed for the analysis. The study used firm value as a dependent variable, proxied by Tobin’s Q, along with five independent variables and one moderating variable. The results of this study indicate that a higher capital adequacy ratio (CAR) increases firm value and has a moderating effect on financial risks and firm value. Nonperforming loans, net interest margin, and cost income ratio are found to have a significant negative relationship with firm value. The study concludes that the stock prices of listed banks in Pakistan are declining persistently, which causes the stock’s worth to shift from being inflated to being undervalued.

As the world intensifies efforts to mitigate the effect of global climate change, an on-line survey was carried out involving 1,081 wood products and furniture manufacturers in Malaysia. The main objective was to evaluate the level of awareness, extent of adoption, and challenges faced by these manufacturers in adopting environmental, social, and governance (ESG) practices. The survey found that large-sized companies were more receptive to adopting ESG practices, as opposed to the medium-, small-, and micro-sized companies. Respondents were apparently more responsive to environmental requirements, followed by governance, and finally the social factors. Within the environmental sphere, compliance with using certified and legal wood and wood products, waste management, and conformance to emission standards were well received among respondents. The survey revealed that market forces and legislative requirements were the two most important factors that enticed respondents to comply with the ESG practices; among those respondents who did not comply with ESG requirements, the primary deterrent factors include lack of awareness, no direct benefit from adopting ESG, and the high cost involved. The ESG compliance may transform the wood products and furniture industries into a more sustainable industry, offering equitable wages and green jobs while producing high value-added products.

Abstract Background More than half of the world’s population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data. Methods The DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2021 and Apr 2024 were included. Initially, all clusters will apply “usual care” according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED. Conclusions This study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.

In children with haemophilia (CwH), central venous access devices (CVADs) are frequently placed to aid in the delivery of factor concentrates. In those who develop inhibitors, CVADs also allow for easy venous access and facilitation of immune tolerance therapy.

This research briefly investigates and compares three different and distinct methods of assessing the pozzolanic reactivity of a cementitious replacement material, Spent Bleaching Earth Ash (SBEA). SBEA is waste by-product of the edible oils refining industry and has some pozzolanic properties that could possibly be enhanced through calcination. Many methods have been developed to assess the reactivity of pozzolans and three of the most common ones were employed in this research; namely the Strength Activity Index (SAI), Frattini Test and X-Ray Diffraction (XRD) methods. These three methods were chosen as they measured reactivity based on fundamentally different methods; the SAI method relies on the mechanical strength of mortar cubes, XRD based it on the morphology of the material whilst the Frattini test looks into consumption of artificially-introduced calcium hydroxide by the pozzolan. This investigation allows correlation to be drawn between the three methods and at the same time, the effectiveness of calcination on SBEA can also be evaluated. The calcined SBEA was obtained through a 700°C heating process in the furnace at the for 4 hours. Both the SAI and Frattini tests were in good agreement and showed that the calcined SBEA consistently under-performed compared to uncalcined SBEA at both testing ages. This was, however, disputed by the XRD result which showed that SBEA benefitted from the calcination process as it lost over 7 % in crystallinity, hence making it more reactive. This outcome tells us that the selection of testing methods for pozzolanic reactivity must be done carefully and ideally several methods be used concurrently in order to correlate the results.

Abstract Background and aim Endoscopic sleeve gastroplasty (ESG) is an effective treatment for obesity. Recently, a novel single‐channel endoscopic suturing device has been made available to overcome the need for a double‐channel endoscope. However, there is limited evidence evaluating its utility for ESG. In this multicenter study, we aim to assess the efficacy and safety of the single‐channel suturing device for ESG. Methods We reviewed the records of 18 patients who underwent ESG using the novel device at the Singapore General Hospital, Singapore, and Siriraj Hospital, Bangkok, between 2020–2021. We adopted a “U” suture pattern. Our primary outcome was to assess technical feasibility and safety. The secondary outcome was to determine the percentage of total body weight loss at 1 year. Results The mean ± SD age and body mass index were 42 ± 8.5 years and 34.9 ± 4.4 kg/m2, respectively. The majority were female (61%). ESG was technically successful in 94% (n = 17) of patients. Device dislodgement occurred in one patient. We used an average of five sutures (range, 4–8), and the mean ± SD procedure time was 96.5 ± 43.8 min. No complications occurred. The mean ± SD length of stay was 2.3 ± 1.5 days. The mean ± SD percentage of total body weight loss at 6 and 12 months were 16 ± 5.2% and 13.1 ± 5.8%, respectively. We found that >5%, >10%, and >15% total body weight loss was observed in 83.3%, 72.2%, and 56%, respectively. Conclusion ESG using the single‐channel endoscopic suturing system is safe and effective for inducing weight loss at 1 year in patients with obesity.

The human leukocyte antigen (HLA) system is a complex of genes on chromosome 6 in humans that encodes cell surface proteins responsible for regulating the immune system. Viral peptides presented to cancer cell surfaces by the HLA trigger the immune system to kill the cells, creating antibody–peptide epitopes (APE). This study proposes an in silico approach to identify patient-specific APEs by applying complex networks diagnostics on a novel multiplex data structure as an input for a deep learning model. The proposed analytical model identifies patient- and tumor-specific APEs with as few as 20 labeled data points. In addition, the proposed data structure employs complex network theory and other statistical approaches that can better explain and reduce the black box effect of deep learning. The proposed approach achieves an F1-score of 80% and 93% on patients one and two, respectively, and above 90% on tumor-specific tasks. In addition, it minimizes the required training time and the number of parameters.

Mitochondrial retrograde signaling (MRS) supports photosynthetic function under a variety of conditions. Induction of mitochondrial dysfunction with myxothiazol (a specific inhibitor of the mitochondrial bc1 complex) or antimycin A (an inhibitor of the mitochondrial bc1 complex and cyclic electron transport in the chloroplast under light conditions) in the light and dark revealed diurnal control of MRS. This was evidenced by (1) significantly enhanced binding of ANAC017 to promoters in the light compared with the dark in Arabidopsis plants treated with myxothiazol (but not antimycin A), (2) overlap in the experimentally determined binding sites for ANAC017 and circadian clock regulators in the promoters of ANAC013 and AOX1a, (3) a diurnal expression pattern for ANAC017 and transcription factors it regulates, (4) altered expression of ANAC017-regulated genes in circadian clock mutants with and without myxothiazol treatment, and (5) a decrease in the magnitude of LHY and CCA1 expression in an ANAC017-overexpressing line and protein–protein interaction between ANAC017 and PIF4. This study also shows a large difference in transcriptome responses to antimycin A and myxothiazol in the dark: these responses are ANAC017 independent, observed in shoots and roots, similar to biotic challenge and salicylic acid responses, and involve ERF and ZAT transcription factors. This suggests that antimycin A treatment stimulates a second MRS pathway that is mediated or converges with salicylic acid signaling and provides a merging point with chloroplast retrograde signaling.

Government authorities have encouraged the public to use the contactless payment method in accordance with the new norm practised during the COVID-19 pandemic outbreak. Malaysians will receive RM50 in mobile wallet credit as part of a Penjana Economic Recovery Plan initiative in July 2020 to encourage safe and contact-free payment. Hence, this paper aimed to study the factors influencing consumer adoption of mobile wallets during the COVID-19 outbreak. The independent variables included in this study are perceived usefulness, perceived ease of use, perceived social influence and perceived security. A total of 250 Malaysians from three states of Malaysia are given a set of self-administered questionnaires to be answered. The response rate is 94%, with 235 sets of completed questionnaires used for analysis. The Partial Least Squares Structural Equation Modelling (PLS-SEM 3.3.3) is used to analyse the model. The hypothesis testing results concluded that perceived usefulness, social influence and perceived security have a significant relationship with mobile wallet adoption during the COVID-19 outbreak. Nonetheless, this research is useful for mobile wallet developers and other researchers. Lastly, the findings of this study provide some managerial implications for mobile wallet developers, which can help developers produce a better mobile wallet in the marketplace.

Abstract The contextual suggestion systems are emerging as modified recommendation systems integrated with information retrieval techniques to search within large databases with the purpose to provide a user with a list of suggestions based on context i.e. location, time of the day, any day of the week (weekdays or weekend). The goal of this research is to conduct a systematic review in the field of contextual suggestion and recommendation systems incorporate with smart cities as the repositories of large datasets. This paper highlights the concerns linked with approaches being used in the contextual suggestion system and discussing various approaches which are being utilized in the contextual suggestion system. The keywords for query searching include; “contextual suggestion”, “recommendation system” and “smart city” which identified 191 papers published from 2012 to 2020. Four major article repositories were considered for searching (i) Science Direct, (ii) Scopus, (iii) IEEE, and (iv) Web of Science. The review was conducted under the protocols of four phases (i) Query searching in major article’s repositories, (ii) remove duplicates, (iii) scan title and abstract, and (iv) complete article reading. To identify the gaps in ongoing research a taxonomy analysis was exemplified into categories which further divided into subcategories, the main categories are highlighted as (i) review articles, (ii) model/framework and, (iii) smart city and applications. The critical analysis highlighted the limitations of approaches being used in the field and discussed the challenges. The review also reveals that most researches utilized approaches based on content-based filtering, collaborative filtering, preference-based product ranking, language modelling, evaluation measures were precision, normalized discounted cumulative, mean reciprocal rank, and the test collection comprised of internet resources.

This study aims to examine the interaction effect of country of manufacture and brand awareness, packaging and price impact on the purchase intention of toothpaste among young adults in Malaysia. As previous studies show, the country of origin should not be taken as a single clue, as it exaggerates the country of origin effect. This study evaluates the effect of the country of origin effect on the low-involvement good (toothpaste). The Cue Utilization Theory was used to explain how the consumer uses product cues to rate a product before making a purchase decision. Study data are analysed using SmartPLS. The results of this study showed that all variables influence consumer purchase intention for toothpaste. IPMA analysis showed that the interaction effect of the country of manufacture and brand awareness are important factors.