Wan Abu Bakar Wan Abas

Impact of Low Oxygen Tension on Stemness, Proliferation and Differentiation Potential of Human Adipose-derived Stem Cells.

Adipose-derived stem cells (ASCs) have been found adapted to a specific niche with low oxygen tension (hypoxia) in the body. As an important component of this niche, oxygen tension has been known to play a critical role in the maintenance of stem cell characteristics. However, the effect of O2 tension on their functional properties has not been well determined. In this study, we investigated the effects of O2 tension on ASCs stemness, differentiation and proliferation ability. Human ASCs were cultured under normoxia (21% O2) and hypoxia (2% O2). We found that hypoxia increased ASC stemness marker expression and proliferation rate without altering their morphology and surface markers. Low oxygen tension further enhances the chondrogenic differentiation ability, but reduces both adipogenic and osteogenic differentiation potential. These results might be correlated with the increased expression of HIF-1α under hypoxia. Taken together, we suggest that growing ASCs under 2% O2 tension may be important in expanding ASCs effectively while maintaining their functional properties for clinical therapy, particularly for the treatment of cartilage defects.

Paper-based sample-to-answer molecular diagnostic platform for point-of-care diagnostics

Nucleic acid testing (NAT), as a molecular diagnostic technique, including nucleic acid extraction, amplification and detection, plays a fundamental role in medical diagnosis for timely medical treatment. However, current NAT technologies require relatively high-end instrumentation, skilled personnel, and are time-consuming. These drawbacks mean conventional NAT becomes impractical in many resource-limited disease-endemic settings, leading to an urgent need to develop a fast and portable NAT diagnostic tool. Paper-based devices are typically robust, cost-effective and user-friendly, holding a great potential for NAT at the point of care. In view of the escalating demand for the low cost diagnostic devices, we highlight the beneficial use of paper as a platform for NAT, the current state of its development, and the existing challenges preventing its widespread use. We suggest a strategy involving integrating all three steps of NAT into one single paper-based sample-to-answer diagnostic device for rapid medical diagnostics in the near future.

Evaluation of new suspension system for limb prosthetics

BackgroundGood prosthetic suspension system secures the residual limb inside the prosthetic socket and enables easy donning and doffing. This study aimed to introduce, evaluate and compare a newly designed prosthetic suspension system (HOLO) with the current suspension systems (suction, pin/lock and magnetic systems).MethodsAll the suspension systems were tested (tensile testing machine) in terms of the degree of the shear strength and the patient’s comfort. Nine transtibial amputees participated in this study. The patients were asked to use four different suspension systems. Afterwards, each participant completed a questionnaire for each system to evaluate their comfort. Furthermore, the systems were compared in terms of the cost.ResultsThe maximum tensile load that the new system could bear was 490 N (SD, 5.5) before the system failed. Pin/lock, magnetic and suction suspension systems could tolerate loads of580 N (SD, 8.5), 350.9 (SD, 7) and 310 N (SD, 8.4), respectively. Our subjects were satisfied with the new hook and loop system, particularly in terms of easy donning and doffing. Furthermore, the new system is considerably cheaper (35 times) than the current locking systems in the market.ConclusionsThe new suspension system could successfully retain the prosthesis on the residual limb as a good alternative for lower limb amputees. In addition, the new system addresses some problems of the existing systems and is more cost effective than its counterparts.

Phenotypic and Functional Characterization of Long-Term Cryopreserved Human Adipose-derived Stem Cells

Cryopreservation represents an effective technique to maintain the functional properties of human adipose-derived stem cells (ASCs) and allows pooling of cells via long-term storage for clinical applications, e.g., cell-based therapies. It is crucial to reduce freezing injury during the cryopreservation process by loading the ASCs with the optimum concentration of suitable cryoprotective agents (CPAs). In this study, human ASCs were preserved for 3 months in different combinations of CPAs, including 1) 0.25 M trehalose; 2) 5% dimethylsulfoxide (DMSO); 3) 10% DMSO; 4) 5% DMSO + 20% fetal bovine serum (FBS); 5) 10% DMSO + 20% FBS; 6) 10% DMSO + 90% FBS. Interestingly, even with a reduction of DMSO to 5% and without FBS, cryopreserved ASCs maintained high cell viability comparable with standard cryomedium (10% DMSO + 90% FBS), with normal cell phenotype and proliferation rate. Cryopreserved ASCs also maintained their differentiation capability (e.g., to adipocytes, osteocytes and chondrocytes) and showed an enhanced expression level of stemness markers (e.g., NANOG, OCT-4, SOX-2 and REX-1). Our findings suggest that 5% DMSO without FBS may be an ideal CPA for an efficient long-term cryopreservation of human ASCs. These results aid in establishing standardized xeno-free long-term cryopreservation of human ASCs for clinical applications.

Biomechanical evaluation of the relationship between postural control and body mass index.

Postural stability is crucial in maintaining body balance during quiet standing, locomotion, and any activities that require a high degree of balance performance, such as participating in sports and dancing. Research has shown that there is a relationship between stability and body mass. The aims of this study were to examine the impact that two variables had on static postural control: body mass index (BMI) and gender. Eighty healthy young adults (age=21.7±1.8 yr; height=1.65±0.09 m; mass=67.5±19.0 kg) participated in the study and the static postural control was assessed using the Biodex Balance System, with a 20 Hz sampling rate in the bipedic stance (BLS) and unipedic stance (ULS) for 30s. Five test evaluations were performed for each balance test. Postural control was found to be negatively correlated with increased adiposity, as the obese BMI group performed significantly poorer than the underweight, normal weight and overweight groups during BLS and ULS tests. The underweight, normal weight and overweight groups exhibited greater anterior-posterior stability in postural control during quiet stance. In addition, female displayed a trend of having a greater postural sway than male young adults, although it was evidenced in only some BMI groups. This study revealed that BMI do have an impact on postural control during both BLS and ULS. As such, BMI and gender-specific effects should be taken into consideration when selecting individuals for different types of sporting activities, especially those that require quiet standing.

Transtibial prosthetic socket pistoning: Static evaluation of Seal-In ® X5 and Dermo ® Liner using motion analysis system

BACKGROUND The method of attachment of prosthesis to the residual limb (suspension) and socket fitting is a critical issue in the process of providing an amputee with prosthesis. Different suspension methods try to minimize the pistoning movement inside the socket. The Seal-In(®) X5 and Dermo(®) Liner by Ossur are new suspension liners that intend to reduce pistoning between the socket and liner. Since the effects of these new liners on suspension are unclear, the objective of this study was to compare the pistoning effect of Seal-In(®) X5 and Dermo(®) Liner by using Vicon Motion System. METHODS Six transtibial amputees, using both the Iceross Seal-In(®) X5 and the Iceross Dermo(®) Liner, participated in the study. The vertical displacement (pistoning) was measured between the liner and socket in single limb support on the prosthetic limb (full-weight bearing), double limb support (semi-weight bearing), and non-weight bearing on the prosthetic limb, and also under three static vertical loading conditions (30 N, 60 N, and 90 N). FINDINGS The results demonstrated that the pistoning within the socket when Seal-In(®) X5 was used, decreased by 71% in comparison to the Iceross Dermo(®) Liner. In addition, a significant difference between the two liners under different static conditions was found (p<0.05). INTERPRETATION Participants needed to put in extra effort for donning and doffing the prosthesis with Seal-In(®) X5; however, this type of liner provided less pistoning. The new approach that uses the motion analysis system in this study might be an alternative for measuring the pistoning effect in the prosthetic socket.

Sensitive biomolecule detection in lateral flow assay with a portable temperature–humidity control device

Lateral flow assays (LFAs) have currently attracted broad interest for point-of-care (POC) diagnostics, but their application has been restricted by poor quantification and limited sensitivity. While the former has been currently solved to some extent by the development of handheld or smartphone-based readers, the latter has not been addressed fully, particularly the potential influences of environmental conditions (e.g., temperature and relative humidity (RH)), which have not yet received serious attention. The present study reports the use of a portable temperature-humidity control device to provide an optimum environmental requirement for sensitivity improvement in LFAs, followed by quantification by using a smartphone. We found that a RH beyond 60% with temperatures of 55-60°C and 37-40°C produced optimum nucleic acid hybridization and antigen-antibody interaction in LFAs, respectively representing a 10-fold and 3-fold signal enhancement over ambient conditions (25°C, 60% RH). We envision that in the future the portable device could be coupled with a fully integrated paper-based sample-to-answer biosensor for sensitive detection of various target analytes in POC settings.

Balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis.

Balance is essential for mobility and performing activities of daily living. People with knee osteoarthritis display impairment in knee joint proprioception. Thus, the aim of this study was to evaluate balance and risk of fall in individuals with bilateral mild and moderate knee osteoarthritis. Sixty subjects aged between 50 and 70 years volunteered in this study. They were categorized into three groups which were healthy (n = 20), mild (n = 20) and moderate (n = 20) bilateral knee osteoarthritis groups. Dynamic and static balance and risk of fall were assessed using Biodex Stability System. In addition, Timed Up and Go test was used as a clinical test for balance. Results of this study illustrated that there were significant differences in balance (dynamic and static) and risk of fall between three groups. In addition, the main (most significant) difference was found to be between healthy group and moderate group. Furthermore, on clinical scoring of balance, the “Timed Up and Go” test, all three groups showed significant difference. In conclusion, bilateral knee osteoarthritis impaired the balance and increased the risk of fall, particularly in people with moderate knee osteoarthritis.

A novel dengue fever (DF) and dengue haemorrhagic fever (DHF) analysis using artificial neural network (ANN)

Dengue fever (DF) is an acute febrile viral disease frequently presented with headache, bone or joint and muscular pains, and rash. A significant percentage of DF patients develop a more severe form of disease, known as dengue haemorrhagic fever (DHF). DHF is the complication of DF. The main pathophysiology of DHF is the development of plasma leakage from the capillary, resulting in haemoconcentration, ascites, and pleural effusion that may lead to shock following defervescence of fever. Therefore, accurate prediction of the day of defervescence of fever is critical for clinician to decide on patient management strategy. To date, no known literature describes of any attempt to predict the day of defervescence of fever in DF patients. This paper describes a non-invasive prediction system for predicting the day of defervescence of fever in dengue patients using artificial neural network. The developed system bases its prediction solely on the clinical symptoms and signs and uses the multilayer feed-forward neural networks (MFNN). The results show that the proposed system is able to predict the day of defervescence in dengue patients with 90% prediction accuracy.

Clinical investigation of the interface pressure in the trans-tibial socket with Dermo and Seal-In X5 liner during walking and their effect on patient satisfaction

BACKGROUND The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputees satisfaction and comfort. Liners provide a comfortable interface by adding a soft cushion between the residual limb and the socket. The Dermo and the Seal-In X5 liner are two new interface systems and, due to their relative infancy, very little are known about their effect on patient satisfaction. The aim of this study was to compare the interface pressure with these two liners and their effect on patient satisfaction. METHODS Nine unilateral transtibial amputees participated in the study. Two prostheses were fabricated for each amputee, one with the Seal-In liner and one with the Dermo liner. Interface pressure was measured at the anterior, posterior, medial and lateral regions during walking on the level ground. Each subject filled in a Prosthetic Evaluation Questionnaire (PEQ) regarding the satisfaction with the two liners. Findings The mean peak pressures with the Seal-In liner was 34.0% higher at the anterior, 24.0% higher at the posterior and 7.0% higher at the medial regions of the socket (P=0.008, P=0.046, P=0.025) than it was with the Dermo Liner. There were no significant differences in the mean peak pressures between the two liners at the lateral regions. In addition, significant difference was found between the two liners both for satisfaction and problems (P<0.05). Interpretation There was less interface pressure between the socket and the residual limb with the Dermo liner. The results indicated that the Dermo liner provides more comfort in the socket than the Seal-In liner.