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Abstract Background Teriparatide, a recombinant parathyroid hormone, is pivotal in osteoporosis treatment, particularly in post-surgical recovery for hip fractures. This study investigates its efficacy in functional recovery post-hip fracture surgery in elderly patients, a demographic particularly susceptible to osteoporotic fractures. Methods In this retrospective cohort study, 150 elderly patients with proximal femoral fractures undergoing open reduction and internal fixation were enrolled. They were categorized into two groups: receiving 20 µg of daily teriparatide injections for 18 months and receiving standard antiresorptive medications during a 24-month follow-up. Detailed records of patient demographics, Fracture Risk Assessment Tool scores, and comorbidities were kept. Key outcomes, including bone mineral density (BMD) and functional scores (Barthel Index and Visual Analog Scale for hip pain), were evaluated at 3 and 24 months post-surgery. Results Out of the original cohort, 126 patients (20 men and 106 women with an average age of 85.5 ± 9.3 years) completed the study. The teriparatide group exhibited significant enhancements in both functional scores and BMD when compared to the control group. Notably, functional improvements were less pronounced in male patients compared to female patients. Additionally, the incidence of new fractures was markedly lower in the teriparatide group. Conclusion Administering teriparatide daily for 18 months post-surgery for proximal femoral fractures significantly benefits very elderly patients by improving functionality and bone density, with observed differences in recovery between genders. These results reinforce the efficacy of teriparatide as a potent option for treating osteoporosis-related fractures in the elderly and highlight the importance of considering gender-specific treatment and rehabilitation strategies.

This research endeavors to examine the influence of sustainable operational practices on sustainable operational performance, incorporating the moderating influence of green technology adoption within the Saudi Arabian textile industry. Through the utilization of a self-administered questionnaire, data were acquired from a sample of 250 employees affiliated with textile companies in Saudi Arabia. Employing a cross-sectional study design and quantitative methodology, this investigation employed Partial Least Square (PLS)-Structural Equation Modelling (SEM) for statistical analysis. The outcomes of this analysis revealed that internal lean practices, quality management, customer and supplier integration, and internal business processes exerted positive and statistically significant effects on operational performance. Furthermore, the study disclosed that green technology adoption functioned as a substantive moderator, amplifying the impact of sustainable practices on operational performance. The theoretical contributions of this study lie in its emphasis on the pivotal role of technology in advancing sustainability practices within the Saudi Arabian textile industry. Moreover, the practical implications extend to managerial and stakeholder considerations, advocating for the strategic utilization of technology to enhance operational efficiency while mitigating environmental impact. The research also underscores essential directions for future investigations, proposing a broader industry inclusion for comparative analyses and endorsing a mixed-method approach to deepen insights into technology adoption and sustainability practices across diverse business landscapes.

The higher discharge of carbon emissions in environment is endangering human life as well as eco system. With the emergence of digital technology, crypto trading and blockchain technologies are also causing the paradigm shift in technological needs, however, in parallel, creating unresolved environmental problems especially in the top 10 crypto-friendly Asian economies due to the higher percentage of poisonous emissions. Thereby, the study attempts to scrutinize the nexus among crypto-trading, environmental degradation, economic growth and energy usage. CO2 emissions are taken as a proxy of environmental degradation in the context of crypto friendly Asian economies. The data extracted from WDI and coin market cap covering the period from 2012-2020. The article applied CS-ARDL technique in order to find the association between variables in short and long run. Granger Causality test is also applied to find out the causality among constructs. Findings expose that bi-directional causality exists between crypto trading and carbon emission and crypto trading and energy usage, hence, disturbing environmental sustainability due to high emissions. The paper suggests policy makers and other institutional officers to de-socialize those block chain technologies which consumes high energy and use green technology as their substitute. This helps in the reduction of environmental damages.

Five electron transport models for drain current equations of symmetric 10 nm Silicon-based (Si-based) double-gate (DG) nano-MOSFET have been numerically investigated in this paper. All these models are based on ballistic transport flow. The first model, named full ballistic model, assumed no backscattering to the source and produced an on-state drain current of 1.137x103 μA/μm. The second model, named electrostatic model which based on electrostatic, included scattering and produced on-state drain current of 2.182x103 μA/μm. Whereas the third model, named flux-theory model, and fourth model, named flux-theory corrected model, were analyzed using flux-theory concept of electron flow and then two different drain current equations were obtained. However, both models producing almost the same value of on-state drain current 2.548x103 μA/μm numerically. Finally, the fifth model, named space charge model, utilized the concept of subband and electron charge distribution on k-space, producing on-state current of 2.241x103 μA/μm. All these models treat electron flow quantum mechanically. Thus, all five computed on-state currents were benchmarked against an on-state current simulated using online device simulator nanoMOS which outputted Si-based ultra-thin channel nano-MOSFET norminal on-state drain current of 2.500x103 μA/μm. The flux-theory models are found to be the most compatible to simulation result because flux-theory model can be generalized for multi-subband, various materials and arbitrary wafer orientations. On the other hand, the first model without backscattering consideration exhibited the least accurate result due to the fact that scattering cannot be ignored in formulating quantum ballistic transport models. The accuracy of this benchmarking evaluation showed that highly sophisticated electron transport numerical models must incorporated ballistic quantum nature effects as well as scattering effects when developing commercial device simulation tools such as TCAD.

Objective: This study assesses the quantity and quality of reliability of both conventional and cone-beam computed tomography (CBCT) in evaluating external root resorption (ERR) and proximity of inferior alveolar canal (IAC) around impacted mandibular third molars and also the practicability to advise CBCT as the first radiographic examination in every patient with above pathology. Methodology: A prospective cross-sectional study was conducted with a sample of 73 individuals, aged between 18 and 40 years, irrespective of their sex. Digital panoramic radiograph (PAN) and CBCT were carried out for individuals with mandibular impacted third molars, which were evaluated by three observers independently for ERR and relation of impacted teeth with inferior alveolar nerve (IAN) canal (resorption of IAN cortical plate, impingement, and approximation). The data was analyzed by Kappa test and the PAN and CBCT findings were compared using Wilcoxon signed-rank test. Results: Out of 73 subjects, 13 subjects showed resorption of the IAN cortical plate in CBCT, among which only five were confirmed in PAN. Forty-three cases showed impingement of the third molar on the IAN in PAN, which was completely absent in CBCT. Among 14 subjects who presented contact or approximation of the third molar with the canal in PAN, only seven were confirmed in CBCT. Twenty-five cases actually showed ERR in CBCT, whereas PAN confirmed only eight cases. Pathologies seen on PAN were considerably very less in comparison with CBCT. Conclusion: Thus, we conclude that two-dimensional (2D) radiographs are the first choice of diagnostic radiographs, even though the CBCT is accurate in displaying the pathology; however, the decision to advise CBCT image should depend on whether the information from CBCT changes the surgeon's diagnosis and treatment planning.

IntroductionThe incidence of type 2 diabetes mellitus is increasing worldwide. The literature suggests that acupuncture is a possible complementary therapy for type 2 diabetes mellitus. This study aims to determine the effectiveness of acupuncture as an adjunctive therapy on homeostasis model assessment-insulin resistance (HOMA-IR), and health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus.Materials and methodsThis randomized, double-blind, placebo controlled, and parallel design trial will be carried out in a public university teaching hospitals in Malaysia. Eligible type 2 diabetes mellitus subjects will be randomly assigned to receive either acupuncture (n = 30) or a placebo (n = 30). The intervention is carried out using press needle or press placebo on abdomen area (10 sessions of treatment). Both groups will continue with their routine diabetes care. Primary outcome of HOMA-IR will be measured at the time of recruitment (-week 0), and after completion of 10 sessions (week 7) of the treatment. Additionally, secondary outcome of HRQoL will be measured at the time of recruitment (-week 0), after completion of 5 sessions (week 3/4), and 10 sessions (week 7) of the treatment. Any adverse event will be recorded at every visit.DiscussionThe findings of this study will provide important clinical evidence for the effect of acupuncture as adjunctive therapy on HOMA-IR, adiposity and HRQoL of type 2 diabetes mellitus.Trial registration numberNCT04829045.

Non-equilibrium Green’s function (NEGF) is a popular method for simulation and modelling of non-equilibrium electron quantum ballistic transport in open mesoscopic system, which is double-gate (DG) nano-MOSFET in this paper, with self-energy scattering effects. In this paper, on-line device simulator nanoMOS using NEGF with finite difference method (FDM) discretization is used to obtain current-voltage (I-V) graph. The simulated on-state current is compared with the calculated and plotted using freeware Scilab code without including NEGF with FDM method to demonstrate the flexibility and accuracy of NEGF with FDM method. Accuracy of 92% is achieved. The difference in due to output resistance at saturation region of I-V curve. Also, this quantum transport model is compared with two others electron transport models derived through Boltzmann statistics along with Einstein relationship, one with high drain bias while other with traditional MOSFET model with ballistic mobility. After analysis, these two approximated equations show 0.87 and 8.8 times, respectively, matches against simulated value. Obviously, nano-MOSFET under high drain bias is closely matched with the quantum model. The traditional MOSFET with ballistic mobility is suitable for very-short-channel length devices (like DG nano-MOSFET) and III-V channel materials with very high-real mobility devices.

Abstract Background Spinal epidural hematomas usually occur under certain conditions; they rarely occur spontaneously. The prevalence of spontaneous spinal epidural hematoma is ~ 0.1 per 100,000, and the male-to-female ratio is approximately 1.4 to 1. Herein, we describe a rare case of spontaneous spinal epidural hematoma. Case presentation A 63-year-old Taiwanese woman, with underlying hypertension, anemia, and a history of cardiovascular accident without sequela, was admitted to our emergency department with a chief complaint of sudden bilateral weakness in the lower limbs. Magnetic resonance imaging revealed a spontaneous epidural hematoma. The patient underwent emergency surgery to remove the epidural hematoma and laminectomy for decompression. The bilateral lower limb weakness was alleviated immediately after the surgery. Conclusion In patients with no risk factors related to spinal epidural hematoma, symptoms of bilateral lower limb weakness must be investigated carefully because this condition may occur spontaneously.

Recently, sustainable development goals (SDGs) have been the requirement of every organization around the globe that requires researchers and regulators' focus. Hence, the present study examines the impact of corporate social responsibilities (CSR) in addressing the SDGs of manufacturing companies in Malaysia. The current article also examines the mediating impact of organizational effectiveness among the linkage of CSR and SDGs achievement. The researchers have used the survey method and taken the questionnaires for data collection. The current article has also applied the smart-PLS to analyze the data collected from selected respondents. The results indicated that CSRs have a positive linkage with the SDG’s achievement. The findings also exposed that organizational effectiveness significantly mediates among the linkage of CSR and SDGs achievement in manufacturing companies of Malaysia. The article has guided the policymakers regarding developing the regulations related to the SDG’s achievement through CSR and organizational effectiveness.

Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention ( n = 35) and control ( n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (−1.34% point, p < 0.001), fasting blood glucose (−1.30 mmol/L, p < 0.001), and systolic blood pressure (−1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle–brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.

Simulation study on silicon-based nano-MOSFETs logic circuits is needed to add more knowledge on the nanoscale circuit performance. Therefore, in this paper, simulation study is carried out on three inputs complex logic gate transistor circuits with four different logic families, namely (i) nano-CMOS complex gate, (ii) nano-MOSFET loaded n-type nano-MOSFET complex gate, (iii) resistive loaded 733.8 Ω nano-MOSFET complex gate, and (iv) pseudo n-type nano-MOSFET complex gate. NanoMOS is used to perform device simulation whereas WinSpice is used to perform circuit simulation. The difficulty faced during downscaling of nano-MOSFET is the realisation of low power high speed nano-MOSFET logic circuits design. Simulation output timing waveforms are used to analyse the timing characteristics of these complex logic circuits with Boolean expression (x(y+z)) ̅. Transient analysis on nano-MOSFET loaded n-type nano-MOSFET complex gate shows that theoretical modelling calculation of propagation delay and simulated propagation delay is 80% matched. With 10 nm nano-MOSFET complex logic circuits design, dynamic power reduction of 498 times and propagation delay improvement of 20 times are achieved when compared with a typical 120 nm MOSFET logic circuit.

Malaysian government provides tax incentives to firms that involve in digital economy to increase digital economy activities in the country. This, however, can enlarge the country’s tax gap. This study, therefore, attempts to investigate the effects of firms’ digital economy involvement on book-tax differences (BTD), and its components, comprising permanent, temporary and statutory tax rates differences. A total of 846 firm-year data of Malaysian-listed firms from 2013 to 2018 were analysed. The relationships between digital economy involvement and temporary differences, and statutory tax rates differences were found positive and significant. This suggests that firms, through temporary differences, are leveraging on the usage of ICT to enjoy the incentives provided by the Government. The firms are also benefiting from cross-border businesses to secure tax benefits from differences of tax rules between jurisdictions. This study contributes to literature by providing further empirical evidence to support theory of tax incentives within the context of technology acceptance model. This study also contributes to the authority by providing insights on the extent the digital economy-related incentives can affect the country’s tax gap. Firms can also be benefited from this study in their attempts to gauge the effects of digital economy activities on their tax position.

There are two objectives of this study, first,it is to examine and compare the accounting quality in pre-and post-implementations IFRS from the viewpoint of investors. Second ,is to identify the differences in the accounting quality between the shariah compliant and non-shariah compliant companies in pre-and post-implementations of IFRS. Using 2169 firm-year observations from firms listed on the Bursa Kuala Lumpur Stock Exchange over the period of 2008 to 2016, the result shows that the implementation of MFRS have reduced the firms’ earnings management. However, this study provides new arguments that Shariah-complaints firms in Malaysia do not necessary have greater incentives to report high-quality reporting based on the investor perspectives. Our evidence thus help to explains the different impact on IFRS adoption on accounting quality in Malaysia and shariah complaint compnaies.

The ongoing COVID-19 pandemic has resulted in a new era in the efficacy of the food supply chain, while the consequences of this new era on humanity, the economy, and the food sector are still under examination. For example, food security is one vital aspect of food systems which is directly affected. This review summarizes food security during epidemics and pandemics before moving on to panic buying, food shortages, and price spikes observed during the current crisis. The importance of food resilience, together with the need for addressing issues related to food loss and food waste, is underlined in the review towards food security and sustainable development. As a result, the pandemic has shown that our food systems are fragile. Since the global population and urbanization will grow in the coming decades, pandemics will likely occur more often, and climate change will intensify. Consequently, there is a need to ensure that our food systems become more sustainable and resilient. To that end, we have highlighted the need to develop contingency plans and mitigation strategies that would allow a more rapid response to extreme events (e.g., disasters from climate change) and transform the food sector by making it more resilient.

The transition phase is a critical moment to students who have completed their secondary school education and are proceeding to pre-university education in Malaysia. The long duration of exposure to rote-learning and examination oriented education systems at school has somehow shaped these students’ perceptions about teaching and learning. Thus, this paper aims to examine the quality of first year students’ experiences in constructing their knowledge and skills throughout the Foundation in Engineering (FIE) programme. This experience refers to metacognitive awareness, namely students’ learning experience from one mode of thinking to the other to construct meaningful knowledge and skills. The researchers used the Metacognitive Awareness Inventory (MAI) (Schraw and Dennison, 1994) as a rating tool to trace the students’ baseline in metacognition and access their successive levels of metacognitive awareness throughout their first semester in the FIE program. The students showed improvements in a number of metacognitive sub-processes. The findings provided the details of the quality of the program’s efficacy and served as a benchmark for future development of effectiveness of teaching and learning approaches.

Agro-industrial waste is a largely untapped natural resource of bioactive compounds including carotenoids and pectin. However, conventional solvent extraction involves the excessive use of organic solvents, costly equipment, and tedious operation. These limitations of conventional extraction methods could be prospectively overcome by the carotenoid–pectin hydrocolloidal complexation. The complexation of lycopene and pectin was efficiently promoted in an aqueous environment, resulting in the colloidal complexes that can be subsequently recovered by sedimentation or centrifugation. In this study, the potential of carotenoid–pectin complexation on tomato pomace containing carotenoids and pectin was evaluated. Tomato pomace is a rich source of lycopene, β-carotene as well as pectin, making it suitable as the raw material for the carotenoid extraction. The extraction of carotenoid and pectin from tomato pomace was optimized using response surface methodology. The maximum recovery was 9.43 mg carotenoid fractions/100 g tomato pomace, while the purity of carotenoid-rich fractions was 92%. The antioxidant capacity of carotenoids extracted from the complexation method was found to be higher than that from the solvent extraction method. Moreover, extraction yield and antioxidant capacity of carotenoid obtained from the carotenoid–pectin complexation were comparable to that from solvent extraction. The carotenoid–pectin complexation is a promising green approach to valorize agro by-products for the extraction of valuable carotenoids.

There are two objectives of this study, first, it is to determine the impact of exchange rate volatility on Malaysian natural rubber (NR) prices of (SMR20 and RSS4); second, it is to forecast a short-term exchange rate (ERP) of Malaysian Ringgit (RM per USD) and NR prices strongly represented in the Malaysian NR market. The granger causality test is first analyzed using the vector error correction model (VECM) with the more efficient Engle-Granger causality procedure. Both short-term ERP and NR prices ex-ante forecasts are tested using Pindyck and Rubinfeld's procedures. The result shows the RSS4 NR price Granger-causes the SMR20 NR price and also ERP with unidirectional causality relationship. Both ERP and NR prices forecasts would be on a slightly increasing trend from January to June 2016. It was due to government and traders changing their behaviour by increasing domestic consumptions for the stabilization of the NR supply-demand balance. Keywords: Exchange Rate Volatility, Forecasting, Malaysian Natural Rubber Price JEL Classifications: C1, C2, D4, F31, F37

Nenering Formation is essentially made up of semi-consolidated sediments, which are divided into basal conglomerate beds, conglomeratic sandstone, cross-bedded sandstone, and siltstone to muddy layers facies. It is overlie unconformable to the Berapit Formation, but conformable to the Kroh and Grik Formations. The stratigraphy of Nenering Formation is a fining upwards sequence where the thickness of conglomerate beds become thinner upwards and become thicker for conglomeratic sandstone. The thickness varies from 0.5 m to tenths of meters. The more sandy in the upper portion (cross-bedded sandstone) overlie with thin siltstone and mudstone facies. The clast and grain composition suggested that the material making up the sedimentary sequence were derived predominantly from the erosion of granitoid rocks and sedimentary and metamorphic rocks constitute a minor provenance. Imbrications and the trend sizes of clasts indicate that the palaeo-current flow toward northeast. Cross bedding that was found in conglomerate and sandstone indicates the main channel depositional environment. The sequence stratigraphy of this area match with the Saskatchewan fluvial braided channel model.

Industrial practise typically applies pre-set original equipment manufacturers (OEMs) limits to turbomachinery online condition monitoring. However, aforementioned technique which considers sensor readings within range as normal state often get overlooked in the developments of degradation process. Thus, turbomachinery application in dire need of a responsive monitoring analysis in order to avoid machine breakdown before leading to a more disastrous event. A feasible machine learning algorithm consists of k-means and Gaussian Mixture Model (GMM) is proposed to observe the existence of signal trend or anomaly over machine active period. The aim of the unsupervised k-means is to determine the number of clusters, k according to the total trend detected from the processed dataset. Next, the designated k is input into the supervised GMM algorithm to initialize the number of components. Experiment results showed that the k-means-GMM model set up not only capable of statistically define machine state conditions, but also yield a time-dependent clustering image in reflecting degradation severity, as a mean to achieve predictive maintenance.

Betulinic acid (BA) is a pentacyclic triterpene found in several botanical sources that has been shown to cause apoptosis in a number of cell lines. This study was undertaken to determine the in vitro cytotoxic properties of BA towards the human mammary carcinoma cell line MDA-MB-231 and the human promyelocytic leukaemia cell line HL-60 and the mode of the induced cell death. The cytotoxicity and mode of cell death of BA were determined using the MTT assay and DNAfragmentation analysis, respectively. In our study, the compound was found to be cytotoxic to MDA-MB-231 and HL-60 cells with IC50 values of 58 μg/mL and 134 μg/mL, respectively. Cells treated with high concentrations of BA exhibited features characteristic of apoptosis such as blebbing, shrinking and a number of small cytoplasm body masses when viewed under an inverted light microscope after 24 h. The incidence of apoptosis in MDA-MB-231 was further confirmed bythe DNA fragmentation analysis, with the formation of DNA fragments of oligonucleosomal size (180-200 base pairs), giving a ladder-like pattern on agarose gel electrophoresis. BA was more cytotoxic towards MDA-MB-231 than HL-60 cells, and induced apoptosis in MDA-MB-231 cells.

The unstable environment of hotel industry which is driven by the fluctuation of tourism demand has motivated this study to look into the best diversification strategy for firm performance betterment. 42 hotel firms are investigated across 4 Asian economies, from year 2001 to 2012. Our results suggest that unrelated industrial diversification is the only alternative to improve hotel firm performance. Unrelated international diversification instead has a significant negative effect towards firm performance. Our results further show that board of directors implies a significant link to the relationship between diversification and firm performance, only in a crisis period.

Abstract Background Feature selection plays an undeniably important role in classification problems involving high dimensional datasets such as microarray datasets. For filter-based feature selection, two well-known criteria used in forming predictor sets are relevance and redundancy. However, there is a third criterion which is at least as important as the other two in affecting the efficacy of the resulting predictor sets. This criterion is the degree of differential prioritization (DDP), which varies the emphases on relevance and redundancy depending on the value of the DDP. Previous empirical works on publicly available microarray datasets have confirmed the effectiveness of the DDP in molecular classification. We now propose to establish the fundamental strengths and merits of the DDP-based feature selection technique. This is to be done through a simulation study which involves vigorous analyses of the characteristics of predictor sets found using different values of the DDP from toy datasets designed to mimic real-life microarray datasets. Results A simulation study employing analytical measures such as the distance between classes before and after transformation using principal component analysis is implemented on toy datasets. From these analyses, the necessity of adjusting the differential prioritization based on the dataset of interest is established. This conclusion is supported by comparisons against both simplistic rank-based selection and state-of-the-art equal-priorities scoring methods, which demonstrates the superiority of the DDP-based feature selection technique. Reapplying similar analyses to real-life multiclass microarray datasets provides further confirmation of our findings and of the significance of the DDP for practical applications. Conclusion The findings have been achieved based on analytical evaluations, not empirical evaluation involving classifiers, thus providing further basis for the usefulness of the DDP and validating the need for unequal priorities on relevance and redundancy during feature selection for microarray datasets, especially highly multiclass datasets.

Abstract Background Due to the large number of genes in a typical microarray dataset, feature selection looks set to play an important role in reducing noise and computational cost in gene expression-based tissue classification while improving accuracy at the same time. Surprisingly, this does not appear to be the case for all multiclass microarray datasets. The reason is that many feature selection techniques applied on microarray datasets are either rank-based and hence do not take into account correlations between genes, or are wrapper-based, which require high computational cost, and often yield difficult-to-reproduce results. In studies where correlations between genes are considered, attempts to establish the merit of the proposed techniques are hampered by evaluation procedures which are less than meticulous, resulting in overly optimistic estimates of accuracy. Results We present two realistically evaluated correlation-based feature selection techniques which incorporate, in addition to the two existing criteria involved in forming a predictor set (relevance and redundancy), a third criterion called the degree of differential prioritization (DDP). DDP functions as a parameter to strike the balance between relevance and redundancy, providing our techniques with the novel ability to differentially prioritize the optimization of relevance against redundancy (and vice versa). This ability proves useful in producing optimal classification accuracy while using reasonably small predictor set sizes for nine well-known multiclass microarray datasets. Conclusion For multiclass microarray datasets, especially the GCM and NCI60 datasets, DDP enables our filter-based techniques to produce accuracies better than those reported in previous studies which employed similarly realistic evaluation procedures.

Micro elastofluidics is an emerging research field that encompasses characteristics of conventional microfluidics and fluid-structure interactions. Micro elastofluidics is expected to enable practical applications, for instance, where direct contact between biological samples and fluid handling systems is required. Besides design optimization, choosing a proper material is critical to the practical use of micro elastofluidics upon interaction with biological interface and after its functional lifetime. Biodegradable polymers are one of the most studied materials for this purpose. Micro elastofluidic devices made of biodegradable polymers possess exceptional mechanical elasticity, excellent bio compatibility, and structural degradability into non-toxic products. This article provides an insightful and systematic review of the utilization of biodegradable polymers in digital and continuous-flow micro elastofluidics., (© 2023 The Authors. Small published by Wiley‐VCH GmbH.)

Calcium alginate elastic capsules with a core-shell structure are versatile spherical solid beads that can be produced in large quantities using various techniques. This type of capsule is a promising platform for cell culture applications, owing to its mechanical elasticity and transparency. This paper reports the production of calcium alginate capsules with high consistency, and for the first time, demonstrates the feasibility of the capsules for microalgal cultivation. Cell growth analysis reveals that the vibrationally-shaken calcium alginate elastic capsule platform yielded a higher maximum cell number (4.86 × 10 8 cells per mL) during the cultivation period than the control solution platforms. Aquafeed and food supplements for humans are the targeted applications of this novel platform., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Objective: This study aimed to determine the epidemiology of uterine cancer in Sarawak, Malaysia, using data from a population-based cancer registry., Methods: The study population included all women diagnosed with uterine cancer in Sarawak, Malaysia between January 1996 and December 2015. Data on demographic and clinical characteristics were obtained from the Sarawak Cancer Registry. The crude incidence rate, age-standardized incidence rate (ASR), and incidence risk ratios (IRR) were calculated. Joinpoint regression analyses were performed to assess trends in incidence rates., Results: A total of 811 women were diagnosed with primary uterine cancer during the study period. The overall crude incidence rate for uterine cancer in Sarawak for the period 1996-2015 was 3.7 per 100,000. The ASR was 4.4 per 100,000 with a 95% CI (4.1-4.8). The ASR in 2011-2015 is 1.6 times higher than the ASR of uterine cancer in 1996-2000. Higher incidence rates were observed in women aged 40-59 years and those aged 60 years and above. Chinese women had the highest ASR, followed by Malay and Iban women. Joinpoint regression analyses showed a significant increase in cases of uterine cancer among all ethnic groups and age groups., Conclusion: The incidence of primary uterine cancer in Sarawak, Malaysia, has increased over the past 20 years, with higher incidence rates observed in older age groups and among Chinese women. The findings suggest the need for continued efforts to improve the prevention, early detection, and treatment of uterine cancer in Sarawak.

Effective immunotherapies activate natural antitumor immune responses in patients undergoing treatment. The ability to monitor immune activation in response to immunotherapy is critical in measuring treatment efficacy over time and across patient cohorts. Protein arrays are systematically arranged, large collections of annotated proteins on planar surfaces, which can be used for the characterization of disease-specific and treatment-induced antibody repertoires in individuals undergoing immunotherapy. However, the absence of appropriate image analysis and data processing software presents a substantial hurdle, limiting the uptake of this approach in immunotherapy research. We developed a first, automated semiquantitative open-source software package for the analysis of widely used protein macroarrays. The software allows accurate single array and inter-array comparative studies through the tackling of intra-array inconsistencies arising from experimental disparities. The innovative and automated image analysis process includes adaptive positioning, background identification and subtraction, removal of null signals, robust statistical analysis, and protein pair validation. The normalized values allow a convenient semiquantitative data analysis of different samples or timepoints. Enabling accurate characterization of sample series to identify disease-specific immune profiles or their relative changes in response to treatment may serve as a diagnostic or predictive tool of disease., Competing Interests: The authors declare no competing financial interest., (© 2023 Author(s).)

Objectives: This analysis provides an epidemiological update for nasopharyngeal carcinomas the state of Sarawak and an analysis of the trend over a 20 years period., Method: Data between 1996 to 2015 from a population-based cancer registry in Sarawak Malaysia was analyzed. Crude incidence rates and age-standardized rates (ASR) were calculated and compared between ethnic groups and locations (administrative division) and Joinpoint regression analysis was done to analyze trends., Result: A total of 3643 cases of NPC were recorded with male to female ratio of 2.5:1. Annualised age-standardized incidence rates able 2) for men is 13.2 cases per 100,000 population (95% CI: 12.6, 13.7) and for women is 5.3 cases per 100,000 population (95% CI: 5.0, 5.6). The highest incidence rates were reported among the Bidayuh population and it ranks among the highest in the world. Trend analysis noted an overall reduction of cases, with a significant decrease between 1996 and 2003 (annual percentage reduction of incidence by 3.9%). Analysis of individual ethnic groups also shows a general reduction with exception of Iban males showing an average 5.48 per cent case increase between 2009 to 2015, though not statistically significant., Conclusion: Comparing the incidences with other registries, the Bidayuh population in Sarawak remained among the highest in the world and warrants close attention for early screening and prevention strategies.

Cellular response to mechanical stimuli is a crucial factor for maintaining cell homeostasis. The interaction between the extracellular matrix and mechanical stress plays a significant role in organizing the cytoskeleton and aligning cells. Tools that apply mechanical forces to cells and tissues, as well as those capable of measuring the mechanical properties of biological cells, have greatly contributed to our understanding of fundamental mechanobiology. These tools have been extensively employed to unveil the substantial influence of mechanical cues on the development and progression of various diseases. In this report, we present an economical and high-performance uniaxial cell stretching device. This paper reports the detailed operation concept of the device, experimental design, and characterization. The device was tested with MDA-MB-231 breast cancer cells. The experimental results agree well with previously documented morphological changes resulting from stretching forces on cancer cells. Remarkably, our new device demonstrates comparable cellular changes within 30 min compared with the previous 2 h stretching duration. This third-generation device significantly improved the stretching capabilities compared with its previous counterparts, resulting in a remarkable reduction in stretching time and a substantial increase in overall efficiency. Moreover, the device design incorporates an open-source software interface, facilitating convenient parameter adjustments such as strain, stretching speed, frequency, and duration. Its versatility enables seamless integration with various optical microscopes, thereby yielding novel insights into the realm of mechanobiology.

Digital droplet reactors have become a valuable tool for the analysis of single cells, organisms, or molecules by discretising reagents into picolitre or nanolitre volumes. However, DNA-based assays typically require processing of samples on the scale of tens of microlitres, with the detection of as few as one or as many as a hundred thousand fragments. Through the present work, we introduce a flow-focusing microfluidic device that produces 120 picolitre core-shell beads, which are assembled into a monolayer in a Petri dish for visualization and analysis. The bead assembly is subjected to polymerase chain reaction (PCR) amplification and fluorescence detection to digitally quantify the DNA concentration of the sample. We use a low-cost 21-megapixel digital camera and macro lens to capture wide-field fluorescence images with a 10-30 mm 2 field-of-view at magnifications ranging from 5× to 2.5×. A customised Python script analysed the acquired images. Our study demonstrates the ability to perform digital PCR analysis of the entire bead assembly through end-point imaging and compare the results with those obtained through RT-qPCR.

Background: Published epidemiological studies of haematological cancers are few. Hereby we present a 20-year epidemiological data of haematological cancers in Sarawak from a population-based cancer registry., Methods: Haematological cancer cases with ICD-10 coded C81-C96 and ICD-O coded /3 diagnosed from 1996 to 2015 were retrieved from Sarawak Cancer Registry. Adult was defined as those 15 years and above. Incidence rate (IR) was calculated based on yearly Sarawak citizen population stratified to age, gender, and ethnic groups. Age-standardised IR (ASR) was calculated using Segi World Standard Population., Results: A total of 3,947 cases were retrieved and analysed. ASR was 10 and male predominance (IR ratio 1.32, 95%CI 1.24,1.41). Haematological cancers generally had a U-shaped distribution with lowest IR at age 10-14 years and exponential increment from age 40 years onwards, except acute lymphoblastic leukaemia (ALL) with highest IR in paediatric 2.8 versus adult 0.5. There was a significant difference in ethnic and specific categories of haematological cancers, of which, in general, Bidayuh (IR ratio 1.13, 95%CI 1.00, 1.27) and Melanau (IR ratio 0.54, 95%CI 0.45, 0.65) had the highest and lowest ethnic-specific IR, respectively, in comparison to Malay. The ASR (non-Hodgkin lymphoma, acute myeloid leukaemia, ALL, chronic myeloid leukaemia, and plasma cell neoplasm) showed a decreasing trend over the 20 years, -2.09 in general, while Hodgkin lymphoma showed an increasing trend of + 2.80. There was crude rate difference between the 11 administrative divisions of Sarawak., Conclusions: This study provided the IR and ASR of haematological cancers in Sarawak for comparison to other regions of the world. Ethnic diversity in Sarawak resulted in significant differences in IR and ASR., (© 2023. The Author(s).)

Objectives: Malaysia has achieved the status of zero indigenous human malaria cases. Nevertheless, imported human malaria has increasingly been reported in Sarawak, Malaysian Borneo. As zoonotic malaria caused by Plasmodium knowlesi remains a major public health problem in Sarawak, the threat of imported malaria must be addressed as it can cause human malaria reintroduction, sustain transmission, and lead to complications. The objectives of this study were to investigate the epidemiological characteristics of imported malaria cases reported in Sarawak and to underline the challenge posed by imported malaria towards malaria elimination efforts., Methods: Imported malaria cases reported in Sarawak from 2011 to 2019 were collected from Sarawak State Health Department and analysed in this longitudinal retrospective study., Results: A total of 2058 imported malaria cases were registered in all districts in Sarawak. Highest number of cases were reported in Kapit (n = 559; 27.16%), followed by Sibu (n = 424; 20.6%), and Miri (n = 166; 8.07%). Based on the demographic profile, most of the patients constituted of either male sex (98.49%), age group of 40-49 years (39.6%), Iban ethnic (57.92%), worked in logging industry (88.58%), Malaysian nationals (91.84%), contracted malaria in Papua New Guinea (46.11%), uncomplicated disease (77.89%), or hospitalised cases (97.86%). The most prominent Plasmodium species diagnosed were P. vivax (52.67%) and P. falciparum (35.81%)., Conclusions: Surveillance, disease detection, and medical follow-up must be carried out thoroughly for individuals who returned from malaria-endemic countries. It is also necessary to promote pre-travel preventive education as well as chemoprophylaxis to travellers heading to endemic areas., (© 2023 John Wiley & Sons Ltd.)

Core-shell particles are micro- or nanoparticles with solid, liquid, or gas cores encapsulated by protective solid shells. The unique composition of core and shell materials imparts smart properties on the particles. Core-shell particles are gaining increasing attention as tuneable and versatile carriers for pharmaceutical and biomedical applications including targeted drug delivery, controlled drug release, and biosensing. This review provides an overview of fabrication methods for core-shell particles followed by a brief discussion of their application and a detailed analysis of their manipulation including assembly, sorting, and triggered release. We compile current methodologies employed for manipulation of core-shell particles and demonstrate how existing methods of assembly and sorting micro/nanospheres can be adopted or modified for core-shell particles. Various triggered release approaches for diagnostics and drug delivery are also discussed in detail.

Plasmodium knowlesi is a simian malaria parasite that causes significant zoonotic infections in Southeast Asia, particularly in Malaysia. The Plasmodium thrombospondin-related apical merozoite protein (TRAMP) plays an essential role in the invasion of the parasite into its host erythrocyte. The present study investigated the genetic polymorphism and natural selection of the full length PkTRAMP from P. knowlesi clinical isolates from Malaysia. Blood samples (n = 40) were collected from P. knowlesi malaria patients from Peninsular Malaysia and Malaysian Borneo. The PkTRAMP gene was amplified using PCR, followed by cloning into a plasmid vector and sequenced. Results showed that the nucleotide diversity of PkTRAMP was low (π: 0.009). Z-test results indicated negative (purifying) selection of PkTRAMP. The alignment of the deduced amino acid sequences of PkTRAMP of Peninsular Malaysia and Malaysian Borneo revealed 38 dimorphic sites. A total of 27 haplotypes were identified from the amino acid sequence alignment. Haplotype analysis revealed that there was no clustering of PkTRAMP from Peninsular Malaysia and Malaysian Borneo., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The Plasmodium knowlesi secreted protein with an altered thrombospondin repeat (PkSPATR) is an important protein that helps in the parasite's invasion into the host cell. This protein has been regarded as one of the potential vaccine candidates against P. knowlesi infection. This study investigates the genetic diversity and natural selection of PkSPATR gene of P. knowlesi clinical isolates from Malaysia. PCR amplification of the full length PkSPATR gene was performed on 60 blood samples of infected P. knowlesi patients from Peninsular Malaysia and Malaysian Borneo. The amplified PCR products were cloned and sequenced. Sequence analysis of PkSPATR from Malaysia showed higher nucleotide diversity (CDS p: 0.01462) than previously reported Plasmodium vivax PvSPATR (p = 0.0003). PkSPATR from Peninsular Malaysia was observed to have slightly higher diversity (CDS p: 0.01307) than those from Malaysian Borneo (CDS p: 0.01212). Natural selection analysis on PkSPATR indicated significant purifying selection. Multiple amino acid sequence alignment revealed 69 polymorphic sites. The phylogenetic tree and haplotype network did not show any distinct clustering of PkSPATR. The low genetic diversity level, natural selection and absence of clustering implied functional constrains of the PkSPATR protein.

We investigated experimentally, analytically, and numerically the formation process of double emulsion formations under a dripping regime in a tri-axial co-flow capillary device. The results show that mismatches of core and shell droplets under a given flow condition can be captured both experimentally and numerically. We propose a semi-analytical model using the match ratio between the pinch-off length of the shell droplet and the product of the core growth rate and its pinch-off time. The mismatch issue can be avoided if the match ratio is lower than unity. We considered a model with the wall effect to predict the size of the matched double emulsion. The model shows slight deviations with experimental data if the Reynolds number of the continuous phase is lower than 0.06 but asymptotically approaches good agreement if the Reynolds number increases from 0.06 to 0.14. The numerical simulation generally agrees with the experiments under various flow conditions.

Objectives: To characterise the state-wide epidemiology of indigenous knowlesi malaria in Sarawak from 2011 to 2019., Methods: Longitudinal retrospective study was conducted based on Sarawak knowlesi malaria surveillance data recorded from 2011-2019. Only indigenous cases were included and information extracted for analysis comprised age, sex, occupation, ethnicity, case severity, hospital admission and parasite density., Results: Over the 9 years, 8473 indigenous knowlesi malaria cases were recorded. Age group 40-49 years, males, plantation workers and Iban communities recorded the highest percentage of cases in each demographic variable. Most of the cases were uncomplicated (n = 7292; 86.1%) and 89.6% (n = 7589) of the total cases were reported with ≤20 000 parasites/μl of blood. Age group and ethnic group are associated with the severity of knowlesi malaria in Sarawak. Multivariable logistic regression indicated that the age group 60+ years had the highest odds of developing severe knowlesi malaria compared with other age groups (AOR 2.48; 95% CI 1.22, 5.02; p = 0.012). Bidayuh patients were more likely to develop severe knowlesi malaria than Ibans, the largest ethnic group among knowlesi malaria patients (AOR 1.97; 95% CI 1.31, 2.97; p = 0.001)., Conclusions: Identification of risk groups is important for the implementation of prevention programs and treatments targeting at specific group to combat knowlesi malaria effectively., (© 2022 John Wiley & Sons Ltd.)

Objective: Anticholinergic burden refers to the cumulative effects of taking multiple medications with anticholinergic effects. This study was carried out in a public hospital in Singapore, aimed to improve and achieve a 100% comprehensive identification and review of measured, anticholinergic burden in a geriatric psychiatry liaison service to geriatric wards. We evaluated changes in pre-to post-assessment anticholinergic burden scores and trainee feedback., Method: Plan Do Study Act methodology was employed, and Anticholinergic Effect on Cognition scale (AEC) was implemented as the study intervention. A survey instrument evaluated trainee feedback., Results: There was no measured anticholinergic burden in a baseline of 170 assessments. 75 liaison psychiatry assessments were conducted between June and November 2021 in two cycles. 94.7% of pre-assessments (at the time of assessment) and 71.1% of post-assessments (following assessment) had a record of AEC scores in clinical documentation in cycle one, improving in the second cycle to 100%, 94.6%, respectively. A high post-assessment AEC score of 3 and over reduced from 15.8% in cycle one to 5.4% in cycle two. The trainee feedback suggested an enriching educational experience., Conclusions: Using the AEC scale, the findings support the feasibility of comprehensive identification and review of measured anticholinergic burden in older people with neurocognitive disorders.