Possible Sarcopenia and Its Association with Nutritional Status, Dietary Intakes, Physical Activity and Health-Related Quality of Life among Older Stroke Survivors

Hui Jie Wong,Sakinah Harith,Pei Lin Lua,Khairul Azmi Ibrahim 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.2

Background: Screening for sarcopenia in the stroke population is an emerging concept in research and clinical practice. Therefore, this cross-sectional study aimed to assess the prevalence of possible sarcopenia and its associated factors among older stroke survivors who visited the neurology and rehabilitation departments of three public hospitals in Malaysia. Methods: We acquired data on sociodemographic characteristics, clinical profiles, malnutrition risk, dietary intake, physical activity level, and health-related quality of life. Possible sarcopenia was diagnosed in individuals with decreased calf circumference and low handgrip strength, as proposed by the Asia Working Group for Sarcopenia (2019). Finally, we performed descriptive analysis and binary logistic regression. Results: Among 196 older adults with stroke (mean± standard deviation of age: 67.60 ± 5.70 years), 42.3% had possible sarcopenia, with a higher prevalence in the more advanced age group (≥70 years). In univariable analysis, possible sarcopenia was significantly associated with anthropometric indices, malnutrition risk, nutrient intake, physical activity level, and health-related quality of life. In multivariable analysis, body mass index (adjusted odds ratio [AOR]=0.57; 95% confidence interval [CI], 0.43–0.75) was the only factor associated with possible sarcopenia among individuals aged ≥70 years. Recurrent stroke (AOR=3.48; 95% CI, 1.02–11.92), body mass index (AOR=0.64; 95% CI, 0.54–0.76), and EQ-5D index (AOR=0.15; 95% CI, 0.03–0.78) were significantly associated with possible sarcopenia in the 60–69-year age group. Conclusion: The prevalence of possible sarcopenia among community-dwelling older stroke survivors was high. Therefore, we recommend routine screening for possible sarcopenia to ensure early nutritional and exercise intervention.

Voltage Balance Control of Cascaded H-Bridge Rectifier-Based Solid-State Transformer with Vector Refactoring Technology in αβ Frame

Hui Wong,Wendong Huang,Li Yin 전력전자학회 2019 JOURNAL OF POWER ELECTRONICS Vol.19 No.2

For a solid-state transformer (SST), some factors, such as signal delay, switching loss and differences in the system parameters, lead to unbalanced DC-link voltages among the cascaded H-bridges (CHB). With a control method implemented in the αβ frame, the DC-link voltages are balanced, and the reactive power is equally distributed among all of the H-bridges. Based on the αβ frame control, the system can achieve independent active current and reactive current control. In addition, the control method of the high-voltage stage is easy to implement without decoupling or a phase-locked loop. Furthermore, the method can eliminate additional current delays during transients and get the dynamic response rapidly without an imaginary current component. In order to carry out the controller design, the vector refactoring relations that are used to balance DC-link voltages are derived. Different strategies are discussed and simulated under the unbalanced load condition. Finally, a three-cell CHB rectifier is constructed to conduct further research, and the steady and transient experimental results verify the effectiveness and correctness of the proposed method.

Voltage Balance Control of Cascaded H-Bridge Rectifier-Based Solid-State Transformer with Vector Refactoring Technology in αβ Frame

Wong, Hui,Huang, Wendong,Yin, Li The Korean Institute of Power Electronics 2019 JOURNAL OF POWER ELECTRONICS Vol.19 No.2

For a solid-state transformer (SST), some factors, such as signal delay, switching loss and differences in the system parameters, lead to unbalanced DC-link voltages among the cascaded H-bridges (CHB). With a control method implemented in the ${\alpha}{\beta}$ frame, the DC-link voltages are balanced, and the reactive power is equally distributed among all of the H-bridges. Based on the ${\alpha}{\beta}$ frame control, the system can achieve independent active current and reactive current control. In addition, the control method of the high-voltage stage is easy to implement without decoupling or a phase-locked loop. Furthermore, the method can eliminate additional current delays during transients and get the dynamic response rapidly without an imaginary current component. In order to carry out the controller design, the vector refactoring relations that are used to balance DC-link voltages are derived. Different strategies are discussed and simulated under the unbalanced load condition. Finally, a three-cell CHB rectifier is constructed to conduct further research, and the steady and transient experimental results verify the effectiveness and correctness of the proposed method.

Discovery of Eurytrema Eggs in Sediment from a Colonial Period Latrine in Taiwan

Hui-Yuan Yeh,Chieh-fu Jeff Cheng,ChingJung Huang,Xiaoya Zhan,Weng Kin Wong,Piers D. Mitchell 대한기생충학열대의학회 2019 The Korean Journal of Parasitology Vol.57 No.6

In this study we take a closer look at the diseases that afflicted Japanese police officers who were stationed in a remote mountainous region of Taiwan from 1921 to 1944. Samples were taken from the latrine at the Huabanuo police outpost, and analyzed for the eggs of intestinal parasites, using microscopy and ELISA. The eggs of Eurytrema sp., (possibly E. pancreaticum), whipworm and roundworm were shown to be present. True infection with Eurytrema would indicate that the policemen ate uncooked grasshoppers and crickets infected with the parasite. However, false parasitism might also occur if the policemen ate the uncooked intestines of infected cattle, and the Eurytrema eggs passed through the human intestines. These findings provide an insight into the diet and health of the Japanese colonists in Taiwan nearly a century ago.

Nipple Reconstruction with Rolled Dermal Graft Support

Hui-Ling Chia,Manzhi Wong,Bien-Keem Tan 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.2

Background: Loss of nipple projection is a common problem following nipple reconstruction. The aim of this study was to demonstrate that the use of a tightly rolled dermal graft is effective in the long-term maintenance of nipple projection. Methods: Nipple reconstruction was performed using the C–V flap technique. A dermal graft was harvested from the dog-ear portion of previous scars. The graft was rolled tightly into a compact cylinder and used to augment the nipple reconstruction. Postoperatively, stacked Allevyn dressing was used for protecting the nipple from compression for a minimum of two months. Nipple projection was measured at the time of surgery and at 12 months postoperatively. Results: Forty nipple reconstructions were performed using this technique. There were 19 transverse rectus abdominis musculocutaneous (TRAM) flaps, 10 latissimus dorsi (LD) flaps, and 11 tissue-expanded breast mounds. At one year, the mean projection was 0.80 cm (range, 0.62−1.22 cm). The twelve-month average maintenance of nipple projection was 70.2% for the TRAM flap group, 76.3% for the LD flap group, and 61.8% for the tissue-expanded group. In two patients with previous irradiation of the reconstructed breasts, relatively poor maintenance of nipple projection was noted (45.7%). No complications were noted, and all of the donor sites healed well primarily. Conclusions: Our results demonstrated that the use of a C–V flap with a tightly rolled dermal graft for nipple reconstruction improves the long-term maintenance of nipple projection. Its advantages include reproducibility, technical simplicity, cost-effectiveness, and minimal donor site morbidity.

Quality assurance in education: perception of undergraduate health professions students in a Malaysian university

Hui Meng Er,Vishna Devi Nadarajah,Sook Han Ng,Ann Nee Wong 한국의학교육학회 2020 Korean journal of medical education Vol.32 No.3

Purpose: Direct student involvement in quality processes in education has been suggested to encourage shared responsibilities among faculty and students. The objectives of this study were to explore undergraduate health professions students’ understanding of quality assurance (QA) in education, and identify the challenges and enablers for student involvement in an Asian context. Methods: Twenty semi-structured interviews were conducted among medical, dentistry, and pharmacy students in a Malaysian University. The interviews were audio-recorded, transcribed verbatim, and thematically analyzed to understand the students’ perspectives of QA in education. Results: The participants recognized the importance of QA towards ensuring the quality of their training, which will consequently impact their work readiness, employability, and quality of healthcare services. Academic governance, curriculum structure, content and delivery, faculty and student quality, teaching facilities, and learning resources were indicated as the QA areas. The challenges for students’ involvement included students’ attitude, maturity, and cultural barrier. To enhance their buy-in, clear objectives and impact, efficient QA mechanism, and recognition of students’ contribution had been suggested. Conclusion: The findings of this study support student-faculty partnership in QA processes and decision making.

The diathermy scratch pad: A cheap and efficient tool for chemical and explosion-related burns

Wong, Allen Wei-Jiat,Hong, Qi En,Hui, Cheryl Li Yu,Chong, Si Jack Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.1

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.

Dynamic Reconstruction of Anal Sphincter with Camera Shutter Style Double-Opposing Gracilis Flaps

Wong Allen Wei-Jiat,Tan Grace Hui-Min,Koh Frederick Hong-Xiang,Chew Min Hoe 대한성형외과학회 2023 Archives of Plastic Surgery Vol.50 No.5

Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction.We demonstrate a new method of camera shutter style double-opposing gracilis muscle flaps that allows dynamic sphincteric function without the need for electrostimulation. The bilateral gracilis muscles are inset in a fashion that allows orthograde contraction of the muscle to narrow and collapse the neoanal opening. With biofeedback training, the patient is able to regain dynamic continence and return to function without a stoma. There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. The patient was able to reverse his stoma 14 months after the initial insult and reconstruction with biofeedback training without the use of electrostimulation.

Men’s Health Index: A Pragmatic Approach to Stratifying and Optimizing Men’s Health

Hui Meng Tan,Wei Phin Tan,Jun Hoe Wong,Christopher Chee Kong Ho,Chin Hai Teo,Chirk Jenn Ng 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.11

Purpose: The proposed Men’s Health Index (MHI) aims to provide a practical and systematicframework for comprehensively assessing and stratifying older men with theintention of optimising their health and functional status. Materials and Methods: A literature search was conducted using PubMed from 1980to 2012. We specifically looked for instruments which: assess men’s health, frailty andfitness; predict life expectancy, mortality and morbidities. The instruments were assessedby the researchers who then agreed on the tools to be included in the MHI. Whenthere was disagreements, the researchers discussed and reached a consensus guidedby the principle that the MHI could be used in the primary care setting targetting menaged 55-65 years. Results: The instruments chosen include the Charlson’s Combined Comorbidity-AgeIndex; the International Index of Erectile Function-5; the International ProstateSymptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageingand Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the SeniorFitness Test; the Fitness Assessment Score; and the Depression Anxiety StressScale-21. A pilot test on eight men was carried out and showed that the men’s healthindex is viable. Conclusions: The concept of assessing, stratifying, and optimizing men’s health shouldbe incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic positionto engage men at the peri-retirement age in a conversation about their life goalsbased on their current and predicted health status.

Optimization Design of the Electromagnetic Torque for Surface-Mounted PMSM Using GA and Finite Element Analysis for Electric Vehicle

Wong Edric Wee Ming,Mohd-Shafri Syauqina Akmar,Tiang Tow Leong,Tan Choo Jun,Ishak Dahaman,Ahmad Mohd Saufi,Leong Jenn Hwai,Ong Hui Lin 대한전기학회 2022 Journal of Electrical Engineering & Technology Vol.17 No.5

This research off ers an optimization design for a three-phase surface-mounted permanent magnet synchronous machine (SMPMSM) by employing the computer framework consists of fi nite element analysis (FEA) and genetic algorithm (GA) utilized in the applications of electric vehicles. This framework aims to evaluate and determine the optimal setting of SMPMSMs, which require maximum average electromagnetic torque ( T em_avg ) and minimum its ripple ( T em_rip ). Several motor performances, such as magnetic fi eld distribution across the motor, magnetic fl ux density distribution in the mid air gap, phase back-EMF, electromagnetic torque, and its ripple, are investigated for the initial and optimal designs of PM machines during open-circuit and on-load conditions by using FEA. The important parameter of PM machines, i.e. the magnet pole-arc and slot opening angle are taken into account. In order to determine the objective function of the GA framework, the T em_avg and the T em_rip are used to formulate the computing equations where the fi tness value provided by the computing framework is further assessed. The GA framework is used to assess the comparison of parameters and motor performance between the initial and optimal designs of 12s/8p PM motors in terms of electromagnetic torque under BLAC operation. Consequently, the framework of FEA and GA has been proven in the design of SMPMSM, which is very viable for electric cars by reducing the magnet materials and electromagnetic torque ripple.