Musculoskeletal modelling to analyse and treat anterior cruciate ligament deficiency

Anterior cruciate ligament (ACL) deficiency results in knee instability that includes an increase in internal tibial rotation and anterior tibial translation (ATT) as ACL is the primary restraint to anterior shear and internal rotation. Clinically, ACL deficient (ACLD) patients undergo surgery or/and rehabilitation programmes depending on their ability to cope or otherwise. However, the ACL reconstructed (ACLR) knees may still have residual instability in ATT and tibial internal rotation. Functional electrical stimulation (FES) has been used in conventional physiotherapy for ACL deficiency, including strengthening the muscles around the knee. The rehabilitation treatment focuses on strengthening the quadriceps muscle because it gets weakened after ACL injury or ACL reconstruction. However, stimulating the hamstrings, especially the biceps femoris long head (BFLH) with its insertion on the fibular head is a candidate to reduce the knee instability of ACLD and ACLR by applying a posterior pull and external rotation to the tibia. This thesis proposes that knee instability in ACLD subjects can be reduced by stimulating the BFLH muscle with FES. Here, a musculoskeletal modelling approach was used to simulate the function of FES. A new optimisation method was developed which allowed the inclusion of FES. There are three main studies present in this thesis. First, a pilot study was conducted in which healthy control subjects walked with and without FES of BFLH. It was found that selective activation of the BFLH can reduce the anterior tibial shear and tibial internal rotation torque at the knee in healthy subjects. Second, a validation study for the algorithm used in the musculoskeletal model was conducted in which the effect of FES stimulation of the BFLH on gluteus maximus activations was tested using electromyography (EMG). This study concluded that there were statistical correlations between peak and impulse of gluteus maximus activation between FES activation level and muscle activity of gluteus maximus as quantified by both EMG and the musculoskeletal model. In the final study, the validated model was used to compare the internal rotation torque, anterior shear force, speed and gluteus medius and gluteus maximus muscle activation between control, ACLD and ACLR groups during stance phase with and without FES stimulated on BFLH. This study found that the activation of BFLH with FES during stance phase was able to reduce the knee instability of the patient groups and triggered the compensatory mechanism for each patient group to react differently. Therefore, besides quadriceps, the rehabilitation treatment should focus on appropriate timed activation of the BFLH to improve the quality of life of patients.Open Acces

Quantiferon-TB gold in-tube performance for diagnosing active and latent tuberculosis in Malaysian population

Halting the progression of active tuberculosis (TB) involves the detection ofTB from a latent stage. Currently, in-vitro interferon-gamma assays (!GRAs) are being used to detect for active TB as well as latent TB besides Tuberculin Skin Test (TST). One of IGRA used to diagnose for Latent Tuberculosis Infection (LTBI) is the QuantiFERONTB (QFT) Gold assay which measures the levels of interferon gamma stimulated by QFT peptides (CFP-10, ESAT 6 and TB7.7) in patient plasma. However, the information regarding the performance of this kit especially in Malaysian population is limited. Therefore this study aims to test for the sensitivity and specificity of the QFT kit in Malaysian population. Whole blood samples were collected from 47 confirmed TB patients, 28 high-risk TB individuals (healthy contacts) and 24 BCG vaccinated low-risk TB individuals (non-TB) and stimulated with TB antigens prior to ELISA for QFT. Specificity and sensitivity of the QFT was analysed based on known TB patients and non-TB individuals. The specificity of QFT was determined as 79.16 % among low-risk patients and the sensitivity of QFT for Malaysian population was 68.08% among confirmed TB patients. Meanwhile, the percentage of positivity for latent TB detected among high-risk TB patients was 46.42%. Our study showed comparable results to the studies conducted at other neighbouring regions such as Singapore and India. Our findings revealed that the QFT is also suitable to be used as a diagnostic kit for the detection ofTB and latent TB

Patient Experience and Perspective towards Optometry Students during Eye Examination and Consultation in UiTM Vision Care Clinic

Clinical training for optometry students is a gateway for exposure in eye care management. Understanding patient experience and satisfaction of being examined by students is essential to improve clinical competency and education. A survey was done to determine patient experience and perspective among 228 adults who had eye examinations at the UiTM Vision Care clinic. Overall, the majority of the patients rated the care as good (96%) and believed it is vital for students to examine patients (93%). Patients of the fourth-year students were reportedly more happy for future student involvement. Concerns on lengthy examination recommend necessary measures.Keywords: patient experience; optometry; students; clinical educationeISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.193

Parameters estimation of holt-winter smoothing method using genetic algorithm

A powerful technique based on adaptive heuristic namely Genetic Algorithm is widely used in many fields. This technique is very popular for solving global optimization problems. In this thesis, the Genetic Algorithm approach is used to estimate the parameters of Holt-Winter Exponential Smoothing method. The value of a combination of three parameters to be optimized, namely �, � and must lie between 0 and 1 by minimizing the one-step ahead forecasting accuracy of Mean Absolute Percentage Error (MAPE). Moreover, the difference of the initialization method, population size and crossover probability were also used, so that the comparative study of minimum value of MAPE can be done. The overall results of the Genetic Algorithm are compared with the conventional methods. From this study, it was found that the genetic algorithm outperformed the conventional method by giving the lowest value of MAPE. Hence, this proved that the genetic algorithm is effective for estimating Holt-Winter parameters. The data used in this study are monthly data set for the total number of tourist arrivals to Langkawi from 2002 until 2011. This investigation is done using computer simulations programmed by Microsoft Visual Studio 2010

Perbezaan perspektif pengguna di Pusat Kesihatan Universiti Awam dan Swasta

University Health Center is one of the most important supporting facilities to ensure the function of a university can be effectively delivered to the students. Within a limited budget, public universities’ health centers seems to be able to maintain their excellent service and performance. The study conducted at UTM as a public university and AIMST University as a private university. This research aims to measure the different of performance of both health center through Post Occupancy Evaluation (POE) approach to enable its performance to be maintained. The difference in performance of public university and private university health centers is identified to determine improvement that can be applied in both universities. Literature review is conducted to determine the criteria of performance measurement involved. Performance measurement criteria used in this study are health, safety, function, social needs, aesthetics, psychology, comfort, and circulation. All eight criteria were then adopted in the questionnaire on both universities. Results of the respondents were analyzed using mean score analysis and frequency analysis. The results of the analysis showed that AIMST's health center had 17 items that perform better than UTM’s health center, which is air circulation, lighting condition, and also aesthetics. However, UTM's health center performance also led AIMST health center score in the 12 items studied. The parameter is size of waiting room, facilities for disabled user, and also safety equipment like hand sanitizer to avoid infection. The results of this study have found a room of improvements that can be made and items to be prioritized in planning asset replacement and maintenance programs, so that budget allocations can be optimally used. This study is expected to assist the management team to make their decisions efficiently

Tourists’ Shopping Expectation, Perceived Value and Shopping Satisfaction in Malaysia / Anis Liyana Buliah ... [et al.]

The tourism industry is one of the most important industries to help a country in improving its economy. With the arrival of every foreign tourist, a country’s total receipts will simultaneously increase due to a tourist’s needs and want which are translated through the spreading of various economic activities. Among favorite economic activities during vacation is shopping. This study will explore the relationship between shopping expectation and perceived value, the relationship between shopping expectation, perceived value and disconfirmation, the relationship between perceived value, disconfirmation and shopping satisfaction and, the relationship between disconfirmation and shopping satisfaction. The Expectation-Confirmation Theory (ECT) involves three main antecedents which are the expectation, disconfirmation and perceived performance. For this study, ECT was used to formulate a proposed model for this study which will enhance Malaysia’s position as a shopping hub

DO CURRENT AWARENESS AND EDUCATIONAL PROGRAM TOWARDS UNREGISTERED DRUGS EFFECTIVE FOR PUBLIC? PHARMACISTS' PERCEPTIVE

Objective: Awareness and educational programme are one of the solutions to reduce unregistered drugs usage. In Malaysia, an agency called Pharmaceutical Services Division (PSD) and Pharmacy Enforcement Division (PED) are highly active in yielding many awareness programmes throughout the country as well as in its website. The goal of this research was to explore the pharmacist views or perceptions on the current awareness and educational programme on registered drugs.Methods: These findings emerged from one-on-one semi-structured interview guided with sixteen pharmacists in Klang Valley who have represented the voice from the pharmacists throughout Malaysia.Results: Six themes identified: ‘Consumer utility', ‘low health literacy', ‘social and education influenced', ‘equitable access to information', ‘promotion' and ‘persistent'. These themes emphasise the current awareness to improve and provide the programme to everyone in Malaysia to get the same information regardless they're staying. Pharmacists also expressed their concern about the current consumer who only cares about their benefit such as fast effect; cheap and easy to get by ignoring the bad impact if they consume the unregistered products. The pharmacists also believed that the health literacy, the social and educational level also influenced the purchase behaviour amongst consumer.Conclusion: The findings indicate that the management of unregistered drugs needs to involve every organisation. Future research could develop a particular measure and score on awareness and knowledge amongst public on this issue. This test can be used as the indicator to evaluate the outcome of the future knowledge programmed.Keywords: Unregistered drugs, Awareness and educational programme, Pharmacist, Public, Perspective

Calicivirus VP2 forms a portal-like assembly following receptor engagement

To initiate infection, many viruses enter their host cells by triggering endocytosis following receptor engagement. However, the mechanisms by which non-enveloped viruses escape the endosome are poorly understood. Here we present near-atomic-resolution cryo-electron microscopy structures for feline calicivirus both undecorated and labelled with a soluble fragment of its cellular receptor, feline junctional adhesion molecule A. We show that VP2, a minor capsid protein encoded by all caliciviruses1,2, forms a large portal-like assembly at a unique three-fold axis of symmetry, following receptor engagement. This assembly—which was not detected in undecorated virions—is formed of twelve copies of VP2, arranged with their hydrophobic N termini pointing away from the virion surface. Local rearrangement at the portal site leads to the opening of a pore in the capsid shell. We hypothesize that the portal-like assembly functions as a channel for the delivery of the calicivirus genome, through the endosomal membrane, into the cytoplasm of a host cell, thereby initiating infection. VP2 was previously known to be critical for the production of infectious virus3; our findings provide insights into its structure and function that advance our understanding of the Caliciviridae

MILP model for integrated line balancing and model sequencing problems for Mixed-Model Two-Sided Assembly Line

This research explores two interrelated problems in Mixed-Model Two-Sided Assembly Line (MMTSAL), which are line balancing and model sequencing. These two problems are solved simultaneously using Mixed Integer Linear Programming (MILP) with the objectives of minimizing total utility work and idle time by considering various practical constraints. The problem is analyzed using small-size to large-sized test cases using General Algebraic Modelling System (GAMS) with the solver CPLEX. Experimental results indicate that integrating the problems help to minimize the proposed objective function. Also, it is found that the feasible solution for model sequence with the assignment of tasks to assembly line is optimal

Aldehyde-alcohol dehydrogenase forms a high-order spirosome architecture critical for its activity

Aldehyde-alcohol dehydrogenase (AdhE) is a key enzyme in bacterial fermentation, converting acetyl-CoA to ethanol, via two consecutive catalytic reactions. Here, we present a 3.5 Å resolution cryo-EM structure of full-length AdhE revealing a high-order spirosome architecture. The structure shows that the aldehyde dehydrogenase (ALDH) and alcohol dehydrogenase (ADH) active sites reside at the outer surface and the inner surface of the spirosome respectively, thus topologically separating these two activities. Furthermore, mutations disrupting the helical structure abrogate enzymatic activity, implying that formation of the spirosome structure is critical for AdhE activity. In addition, we show that this spirosome structure undergoes conformational change in the presence of cofactors. This work presents the atomic resolution structure of AdhE and suggests that the high-order helical structure regulates its enzymatic activity