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  1. Jiang X, Muthusamy K, Fang X
    Front Public Health, 2024;12:1409254.
    PMID: 39005987 DOI: 10.3389/fpubh.2024.1409254
    BACKGROUND: Fatigue poses risks to occupational health and safety, affecting individuals' work efficiency, physical health, and social security, as well as human wellbeing and quality of life. Olfactory interventions, due to their low interference, are considered promising strategies for mitigating fatigue and reducing occupational health hazards.

    OBJECTIVE: The objective of this review is to bridge the current gaps in the literature by conducting a scoping review of olfactory interventions on human alertness. It aims to explore their application in various occupational settings and to provide comprehensive and practical guidance for the practical application of olfactory interventions in mitigating fatigue and reducing occupational risks.

    METHODS: The literature research was conducted in English using electronic databases such as Web of Science. Keywords related to scent and fatigue and the review followed PRISMA Extension for Scoping Reviews and PICO framework.

    RESULTS: 28 studies were included in this work. Participant characteristics, fatigue measurement methods, and scent intervention methods, such as types of scents, intervention strategies, and scent presentation systems, are thoroughly investigated and discussed. Additionally, the study places a specific emphasis on the applications and research within the field of scent interventions for fatigue driving. Olfactory interventions have been applied to populations in various occupational fields, demonstrating beneficial effects on both physiological and psychological fatigue.

    CONCLUSIONS: Olfactory intervention is effective and promising for enhancing alertness and improving the occupational environment. To provide detailed and practical guidance for the actual application of olfactory intervention in fatigue relief and reducing occupational health and safety hazards, further research into the potential mechanisms, applications, and efficacy assessment systems of fatigue-related olfactory interventions is necessary.

  2. Castro-Aguirre E, Iñiguez-Franco F, Samsudin H, Fang X, Auras R
    Adv Drug Deliv Rev, 2016 12 15;107:333-366.
    PMID: 27046295 DOI: 10.1016/j.addr.2016.03.010
    Global awareness of material sustainability has increased the demand for bio-based polymers like poly(lactic acid) (PLA), which are seen as a desirable alternative to fossil-based polymers because they have less environmental impact. PLA is an aliphatic polyester, primarily produced by industrial polycondensation of lactic acid and/or ring-opening polymerization of lactide. Melt processing is the main technique used for mass production of PLA products for the medical, textile, plasticulture, and packaging industries. To fulfill additional desirable product properties and extend product use, PLA has been blended with other resins or compounded with different fillers such as fibers, and micro- and nanoparticles. This paper presents a review of the current status of PLA mass production, processing techniques and current applications, and also covers the methods to tailor PLA properties, the main PLA degradation reactions, PLA products' end-of-life scenarios and the environmental footprint of this unique polymer.
  3. Liu J, Long J, Zhang S, Fang X, Luo Y
    J Pediatr (Rio J), 2013 07 11;89(5):434-43.
    PMID: 23850112 DOI: 10.1016/j.jped.2013.01.008
    OBJECTIVE: To determine whether three variants (388 G>A, 521 T>C, and 463 C>A) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) are associated with neonatal hyperbilirubinemia.

    DATA SOURCE: The China National Knowledge Infrastructure and MEDLINE databases were searched. The systematic review with meta-analysis included genetic studies which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. Data selection and extraction were performed independently by two reviewers.

    SUMMARY OF THE FINDINGS: Ten articles were included in the study. The results revealed that SLCO1B1 388 G>A is associated with an increased risk of neonatal hyperbilirubinemia (OR, 1.39; 95% CI, 1.07-1.82) in Chinese neonates, but not in white, Thai, Latin American, or Malaysian neonates. The SLCO1B1 521 T>C mutation showed a low risk of neonatal hyperbilirubinemia in Chinese neonates, while no significant associations were found in Brazilian, white, Asian, Thai, and Malaysian neonates. There were no significant differences in SLCO1B1 463 C>A between the hyperbilirubinemia and the control group.

    CONCLUSION: This study demonstrated that the 388 G>A mutation of the SLCO1B1 gene is a risk factor for developing neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations; the SLCO1B1 521 T>C mutation provides protection for neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations.

  4. Saad JM, Soepadamo E, Fang XP, McLaughlin JL, Fanwick PE
    J Nat Prod, 1991 11 1;54(6):1681-3.
    PMID: 1812217
    The known lignan (-)-grandisin [1] has been isolated from Cryptocarya crassinervia by using the brine shrimp lethality test to direct the isolation; its structure and relative stereochemistry have been determined by ir, 1H nmr, ms, and X-ray crystallography as an all-trans alpha, alpha'-diaryl-beta, beta'-dimethyltetrahydrofuran. Compound 1 is not significantly cytotoxic in our panel of human tumor cells.
  5. Tan AKG, Yen ST, Fang X, Chiang FS
    Int Health, 2019 03 01;11(2):150-158.
    PMID: 30321364 DOI: 10.1093/inthealth/ihy072
    BACKGROUND: This study examined the factors associated with body mass index (BMI) categories of Malaysian adolescents by physical activity (PA) status.

    METHODS: Data were obtained from the 2012 Malaysia Global School-based Student Health Survey. Generalized ordered logit regression analysis was conducted on 24 339 adolescents by PA status.

    RESULTS: Early- (ages 11-13) and middle-stage (ages 14-16) adolescents were associated with higher overweight and obesity risks than their older peers (ages 17-18). Male adolescents faced higher underweight and obesity likelihoods than females. Hunger due to food shortage at home was associated with higher likelihoods of underweight and normal weight BMI categories. Smokers were more likely to be underweight or normal weight than non-smokers. Segmented-sample analysis by PA status indicated that, while the direction of associations was parallel across PA status, the magnitudes of association between age, hunger and smoking status with BMI status were greater among active than inactive adolescents.

    CONCLUSIONS: Male adolescents faced a dual burden of underweight and obesity. Other sociodemographic and dietary-lifestyle factors were associated with adolescent BMI categories. Segmented-sample analysis by PA status uncovered varying associations between factors that would otherwise be masked in pooled sample analysis. Public health authorities should take these factors into consideration when deliberating programs to ensure healthy adolescent body weight.

  6. Liang Z, Fang X, Liang Z, Xiong J, Deng F, Nyamasvisva TE
    iScience, 2024 Nov 15;27(11):111037.
    PMID: 39524329 DOI: 10.1016/j.isci.2024.111037
    Urban flooding significantly impacts city planning and resident safety. Traditional flood risk models, divided into physical and data-driven types, face challenges like data requirements and limited scalability. To overcome these, this study developed a model combining graph convolutional network (GCN) and spiking neural network (SNN), enabling the extraction of both spatial and temporal features from diverse data sources. We built a comprehensive flood risk dataset by integrating social media reports with weather and geographical data from six Chinese cities. The proposed Graph SNN model demonstrated superior performance compared to GCN and LSTM models, achieving high accuracy (85.3%), precision (0.811), recall (0.832), and F1 score (0.821). It also exhibited higher energy efficiency, making it scalable for real-time flood prediction in various urban environments. This research advances flood risk assessment by efficiently processing heterogeneous data while reducing energy consumption, offering a sustainable solution for urban flood management.
  7. Wang M, Han L, Liu S, Zhao X, Yang J, Loh SK, et al.
    Biotechnol J, 2015 Sep;10(9):1424-33.
    PMID: 26121186 DOI: 10.1002/biot.201400723
    Renewable energy from lignocellulosic biomass has been deemed an alternative to depleting fossil fuels. In order to improve this technology, we aim to develop robust mathematical models for the enzymatic lignocellulose degradation process. By analyzing 96 groups of previously published and newly obtained lignocellulose saccharification results and fitting them to Weibull distribution, we discovered Weibull statistics can accurately predict lignocellulose saccharification data, regardless of the type of substrates, enzymes and saccharification conditions. A mathematical model for enzymatic lignocellulose degradation was subsequently constructed based on Weibull statistics. Further analysis of the mathematical structure of the model and experimental saccharification data showed the significance of the two parameters in this model. In particular, the λ value, defined the characteristic time, represents the overall performance of the saccharification system. This suggestion was further supported by statistical analysis of experimental saccharification data and analysis of the glucose production levels when λ and n values change. In conclusion, the constructed Weibull statistics-based model can accurately predict lignocellulose hydrolysis behavior and we can use the λ parameter to assess the overall performance of enzymatic lignocellulose degradation. Advantages and potential applications of the model and the λ value in saccharification performance assessment were discussed.
  8. Fang X, Chiong MC, Jiang X, Yu LJ, Chen X, Muhieldeen MW, et al.
    Environ Sci Pollut Res Int, 2023 Sep;30(45):101223-101233.
    PMID: 37648923 DOI: 10.1007/s11356-023-29521-6
    In light of the adverse environmental impact of the R134a refrigerant, replacing it with a more environmentally friendly refrigerant has become imperative than ever. This study presents an experimental investigation into the utilization of R152a and R134a refrigerants in a vapor compression refrigeration system employing a variable displacement oil-free linear compressor. The potential for the replacement of R134a with R152a was examined based on energy, environmental, and economic performance analyses. The outcomes indicated that R152a exhibited a higher coefficient of performance (COP) in comparison to R134a under identical operating conditions. Specifically, when the pressure ratio was 2.0 and the piston stroke was 11 mm, R152a's COP was 13.0% higher than R134a. It was also discovered that reducing the operating stroke and increasing the pressure ratio could effectively lower CO2 emissions and total costs. Under the 2.0 pressure ratio and 9-mm piston stroke, R134a produced 1082.4 kg more CO2 emissions than R152a, representing a 209% increase. In addition, the R152a and R134a total cost was reduced by 8.3% with the 2.5 pressure ratio and 11-mm piston stroke. Notably, the results of the current study demonstrated that R152a outperformed R134a in energy consumption, environmental friendliness, and economy in oil-free linear compressor refrigeration systems. R152a used less electric power, generated fewer CO2 emissions, and naturally reduced predicted running costs in order to maintain the same COP.
  9. Fairlie T, Shah A, Wong RK, Fang X, Ghoshal UC, Kashyap PC, et al.
    PMID: 39005136 DOI: 10.1111/nmo.14866
    BACKGROUND: Disorders of gut-brain interaction (DGBI) are characterized by debilitating symptoms not explained by structural or biochemical abnormalities. While functional conditions present with complex, likely heterogeneous pathophysiology, we aimed to investigate if proxy measures of sociocultural and environmental factors are associated with the prevalence of various DGBI in populations across the world.

    METHODS: We performed an ecological study utilizing peer-reviewed published datasets reporting for 26 countries prevalence rates of DGBI (Rome Foundation Global Epidemiology Study, RFGES), with six independent variables: Helicobacter pylori prevalence and household size as proxy measures for orofecal infections, gross domestic product per capita (GDP), and median age as a proxy measures for socioeconomic development, density of fast food outlets (FFO) per 100,000 population as proxy measure for processed food exposure, and suicide mortality rate per 100,000 people, and world happiness scores were used as a proxy for psychological stress. The data were retrieved from publicly accessible datasets (United Nations, CIA World Factbook, World Bank, World Happiness Report, commercial/financial reports of a global FFO chain). We used linear regression to assess variables in univariate and multivariate analysis and report standardized β coefficients with 95% confidence intervals (CI).

    KEY RESULTS: The regression model revealed that the overall prevalence of DGBI was inversely associated with both GDP per capita (β = -0.57, 95% CI: -0.92, -0.22, p = 0.002) and happiness scores (β = -0.433 95% CI: 0.821, -0.065, p = 0.023), while being positively associated with H. pylori prevalence (β = 0.40, 95% CI: 0.008, 0.81, p = 0.046). The prevalence of functional constipation (FC) was also inversely associated with GDP per capita (β = -0.50, 95% CI: -0.86, -0.13, p = 0.01) and happiness scores (β = -0.497, 95% CI: -0.863, -0.132, p = 0.01), while being positively associated with H. pylori prevalence (β = 0.53, 95% CI: 0.16, 0.91, p = 0.007). The Multivariate model analysis revealed that combining the factors of H. pylori prevalence, suicide rate, household size and happiness scores showed statistically significant association with FC (p = 0.039). Household size (β = -0.43, 95% CI: -0.82, 0.038, p = 0.033) and suicide rates (β = 0.55, 95% CI: 0.19, 0.90, p = 0.004) were statistically significantly associated with functional diarrhea. Irritable bowel syndrome (IBS) was associated with GDP per capita (β = -0.40, 95% CI: -0.79, -0.014, p = 0.043) and happiness scores (β = -0.390, 95% CI: -0.778, -0.003, p = 0.049).

    CONCLUSIONS & INFERENCES: Utilizing publicly available data, the prevalence of DGBI across diverse countries is linked to various socio-cultural and environmental factors. Collectively, the data suggests that the prevalence of DGBI is increased in less prosperous regions of the world.

  10. Kulin D, Shah A, Fairlie T, Wong RK, Fang X, Ghoshal UC, et al.
    PMID: 39056447 DOI: 10.1111/nmo.14878
    BACKGROUND: This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes.

    METHODS: Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI.

    KEY RESULTS: Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries.

    CONCLUSIONS & INFERENCES: This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.

  11. Gwee KA, Gonlachanvit S, Ghoshal UC, Chua ASB, Miwa H, Wu J, et al.
    J Neurogastroenterol Motil, 2019 Jul 01;25(3):343-362.
    PMID: 31327218 DOI: 10.5056/jnm19041
    Background/Aims: There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus.

    Methods: Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method.

    Results: Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy.

    Conclusions: Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.

  12. Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J, et al.
    Gastroenterology, 2021 01;160(1):99-114.e3.
    PMID: 32294476 DOI: 10.1053/j.gastro.2020.04.014
    BACKGROUND & AIMS: Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents.

    METHODS: Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately.

    RESULTS: Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval [CI], 39.9-40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2-21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6-1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3-1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%).

    CONCLUSIONS: In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.

  13. Sperber AD, Bor S, Fang X, Bangdiwala SI, Drossman DA, Ghoshal UC, et al.
    PMID: 37018412 DOI: 10.1111/nmo.14583
    BACKGROUND AND AIMS: The Rome Foundation Global Epidemiology Study (RFGES) assessed the prevalence, burden, and associated factors of Disorders of Gut-Brain Interaction (DGBI) in 33 countries around the world. Achieving worldwide sampling necessitated use of two different surveying methods: In-person household interviews (9 countries) and Internet surveys (26 countries). Two countries, China and Turkey, were surveyed with both methods. This paper examines the differences in the survey results with the two methods, as well as likely reasons for those differences.

    METHODS: The two RFGES survey methods are described in detail, and differences in DGBI findings summarized for household versus Internet surveys globally, and in more detail for China and Turkey. Logistic regression analysis was used to elucidate factors contributing to these differences.

    RESULTS: Overall, DGBI were only half as prevalent when assessed with household vs Internet surveys. Similar patterns of methodology-related DGBI differences were seen within both China and Turkey, but prevalence differences between the survey methods were dramatically larger in Turkey. No clear reasons for outcome differences by survey method were identified, although greater relative reduction in bowel and anorectal versus upper gastrointestinal disorders when household versus Internet surveying was used suggests an inhibiting influence of social sensitivity.

    CONCLUSIONS: The findings strongly indicate that besides affecting data quality, manpower needs and data collection time and costs, the choice of survey method is a substantial determinant of symptom reporting and DGBI prevalence outcomes. This has important implications for future DGBI research and epidemiological research more broadly.

  14. Eriksson K, Strimling P, Gelfand M, Wu J, Abernathy J, Akotia CS, et al.
    Nat Commun, 2021 Apr 26;12(1):2483.
    PMID: 33903599 DOI: 10.1038/s41467-021-22955-x
  15. Eriksson K, Strimling P, Gelfand M, Wu J, Abernathy J, Akotia CS, et al.
    Nat Commun, 2021 03 05;12(1):1481.
    PMID: 33674587 DOI: 10.1038/s41467-021-21602-9
    Norm enforcement may be important for resolving conflicts and promoting cooperation. However, little is known about how preferred responses to norm violations vary across cultures and across domains. In a preregistered study of 57 countries (using convenience samples of 22,863 students and non-students), we measured perceptions of the appropriateness of various responses to a violation of a cooperative norm and to atypical social behaviors. Our findings highlight both cultural universals and cultural variation. We find a universal negative relation between appropriateness ratings of norm violations and appropriateness ratings of responses in the form of confrontation, social ostracism and gossip. Moreover, we find the country variation in the appropriateness of sanctions to be consistent across different norm violations but not across different sanctions. Specifically, in those countries where use of physical confrontation and social ostracism is rated as less appropriate, gossip is rated as more appropriate.
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