Small and medium enterprises (SMEs) in India are suffering from the long-standing challenges related to asymmetric information, high transaction costs, SMEs’ opacity and limited access to credit. Blockchain technology, which is still in its infancy in terms of adoption in India, can facilitate SMEs to counter these challenges. Fuelled by this motivation, the study aims to investigate the significant barriers to blockchain adoption in supply chain finance practices by Indian SMEs. Using fuzzy-analytic hierarchy process, sensitivity analysis, and fuzzy-decision-making trial and evaluation laboratory this paper identifies the blockchain barriers, prioritises them and examine their cause and effect relationships. The results of the study indicate that technology barriers are the most influential barriers that impede blockchain adoption. The findings will help the policymakers and practitioners to take suitable measures to overcome these barriers and fuel the adoption of blockchain in Indian SMEs. Supply chain finance (SCF) is an approach for two or more supply chain partners and an external service provider to create value by planning, steering, and controlling the flow of financial resources on an inter-organizational level . It is lBlockchain technology can bring new levels of collaboration among the supply chain actors and accelerate the cash flows through the supply chain . It is aTraditional SCF processes suffer from inefficiencies in the financial settlements in the supply chain. Although SMEs have digitised their processes to some extent, the processing of financial transactions remains in traditional paper form in most organisations, leading to delay in payment, greater days of sales outstanding, and ultimately raising the demand for working capital . BlockchThe commercial application projects in this area are already gaining traction. The technology giant IBM has teamed up with one of the largest logistics service providers, Maersk Line, to create a blockchain-based solution to digitise the global, cross-border supply chains. China-based fintech firms Dianrong and FnConn have launched the blockchain-based SCF platform to secure funding for SMEs in China . MoreoveBlockchain technology has good potential to transform the SCF practices in SMEs, but its adoption is still in its infancy . AlthougIdentifying the adoption barriers would help understand the steps for the successful adoption of blockchain in SCF processes by SMEs. Such information will be helpful to the policy-making bodies, supply chain partners, and government to prepare an appropriate strategy for adopting blockchain in SCF by SMEs. The following section presents a review of literature explaining the relevance of blockchain technology in SCF processes. The research methodology is explained in Sect. Blockchain is a decentralised, public database that is shared across a network of computers . This neMaintaining trust among a large number of anonymous members on the blockchain is a challenging task due to its open and decentralised architecture. This is where the consensus algorithm comes into play. A consensus algorithm is a mechanism through which all the members of a blockchain network validate the transactions and ensure its accuracy. In this way, blockchain participants can trust the unknown peers in a distributed network and maintain the integrity and security of the data. When new intended transactions are validated and accepted by the network, it is added to a block. A cryptographic algorithm called hashing provides a unique hash value to each block . These bSuccessful implementation of SCF programs depends on improving software and technology solutions. The automated processes can speed up the cash flows throughout the supply chain. The advent of enterprise resource planning (ERP) systems and the rise of e-invoicing brings a certain level of automation and dematerialisation to B2B processes, enabling faster and more efficient SCF solutions .At present, most supply chain operations rely heavily on centralised and stand-alone information management systems, such as ERP systems . These sAlthough ERP systems partially integrate different layers of supply chain processes into one wide application system, isolated operating units can still exist within the organisation . This leOn the other hand, if the organisations use blockchain as the underlying technology, information can be recorded and broadcast across all the participants while maintaining a single source of truth . Each paBlockchain enhances the automation of SCF processes by bringing fully digital and signed documents which leads to faster invoice approval , 30. EarThe supply chain partners face two key risks in pre-shipment SCF solutions, such as inventory finance and purchase order finance. First, the performance risk of the supplier in fulfilling the purchase order and second, the credit risk of the buyer . CombinaIn order to develop a comprehensive understanding of blockchain adoption barriers, it is imperative to develop the theoretical foundation of the barriers discussed in the study. Previous studies discussing blockchain adoption barriers in supply chains have lacked theoretical background. While popular theories such as the technology acceptance model and institutional theory have been used in the literature to explain the underlying motivations of an organisation to adopt a technology, such theories do not explain how managers develop knowledge of the new technology, which eventually shape their actions . There iMost of the existing literature on technology adoption emphasises the implementation phase of the technology adoption process, focusing less on the pre-adoption phase . AdoptinThe lack of adoption of blockchain technology can also be explained with the help of force field theory . Force fIn pursuit of a higher level of traceability and visibility in supply chain finance transactions, blockchain is a promising technology to drive operational efficiency and competitive advantage. According to Koh et al.  resourceInformation processing theory (IPT) complements the understanding of the effects of blockchain on the SCF processes. The SCF information is used to reduce the firms’ capital and investment risk within the supply chain and improve their financing decisions. The uncertain environment and inadequate management of information processing may jeopardise the integration of the financial supply chains . InformaThe study applies a hybrid methodology combining fuzzy-AHP, sensitivity analysis, and fuzzy- DEMATEL. Fuzzy-AHP is used for ranking the barriers and sub-barriers based on their significance, whereas fuzzy DEMATEL highlights the cause and effect relationships among them. In order to evaluate the ranks of particular barriers by making small changes in their weights, the study employs sensitivity analysis. Sensitivity analysis is a crucial tool to ensure the validity of a developed model . The AHPIn order to collect data, academicians and practitioners knowledgeable in blockchain and supply chains were approached to identify the key barriers, prioritise them and evaluate their cause and effect relationship. A questionnaire-based survey was conducted amongst 58 supply chain professionals to identify the key barriers and sub-barriers to blockchain adoption in supply chain finance. The experts were asked to rank the barriers based on their significance on a five-point rating scale in this survey. The experts were also asked to suggest any new barriers relevant to the study. We shortlisted 22 sub-barriers grouped in 6 categories based on the survey responses. The experts also added three new barriers to the study. Finally, we got 25 sub-barriers categorised under six barrier categories, which are given in Table In the next step, 30 experts in supply chains and blockchains were contacted to know the priority and the relationships between these barriers and sub-barriers. However, 15 experts agreed to participate as decision makers in this task. The group size of experts can affect the results of data analysis in the study. According to Gumus , 5–50 exFuzzy AHP is an advanced analytical method developed from the traditional AHP proposed by Saaty . It is aStep 1 Identifying the key barriers and sub- barriers to the adoption of blockchain in SCF: To identify the key barriers, past studies in this area have been reviewed, and six main barriers and 26 sub-barriers were identified. These barriers were then put for deliberation of practitioners and academicians to add or eliminate any barrier. Finally, the experts shortlisted 22 sub-barriers and added three new barriers, giving us 25 sub-barriers classified into six main categories.Step 2 Employ fuzzy set theory to deal with the imprecision in the experts’ judgments: Fuzzy set theory, proposed by Zadeh  can be represented as follows:by Zadeh , helps sby Zadeh . The fuzStep 3 Build a hierarchical structure of the barriers: In this step, a hierarchical structure of the problem is presented, comprising three levels. Level 1 indicates the goal of the given problem; level 2 shows the major barriers to the adoption of blockchain in SCF, and level 3 describes the sub-barriers categorised within each main barrier. Figure Step 4 Compute the pairwise comparison matrices for the barriers and sub-barriers: Fuzzy pairwise comparison matrices are prepared based on the judgement of the experts through the fuzzy linguistic scale provided in Table ij]mxn where the fuzzy entries in the matrices are represented by aij = . These fuzzy numbers fulfils the following property:Step 5 Calculate the significance weights of the barriers: In this step, the triangular fuzzy numbers of the fuzzy pair-wise comparison matrices are processed to calculate the weights of the barriers’ significance to establish their priority. The calculation requires specific algebraic operations. Therefore, Chang’s extent analysis method is used to calculate the significance weights of the barriers and sub-barriers [barriers , 68, 69.In order to establish the weight vectors for main barriers, the obtained values are normalised. The resultant significance weights of the barriers are shown in Table The sub-barriers were ranked based on their relative weights and global weights in the next level. The global weights of the sub-barriers were obtained by multiplying the relative weights of each sub-barrier with the preference weights of the barriers. The global ranking of the barriers to blockchain adoption in supply chain finance is summarised in Table Sensitivity analysis is an essential tool to check the validity and robustness of the proposed framework , 69. It The DEMATEL technique helps analyse complex cause and effect relationships among factors in multi-criteria decision-making problems , 70. It Step 1 Collect inputs from the experts on the effect of one barrier on others: The responses from the experts are collected through a fuzzy-DEMATEL questionnaire. The experts made pairwise comparisons among the barriers, recorded their responses using the fuzzy linguistic scale  using Eq.  is calculated using Eq. I represents the identity matrix.In the total relationship matrix, the sum of all rows (represented by R) and all columns (represented by C) has been calculated using Eq. The results of fuzzy-AHP reveal that technology barriers (TB) obtain the first rank, and therefore, occupy the highest priority among all the barriers. This category includes the barriers stemming from the limitations of blockchain technology. It incorporates the technical capability, difficulty, complexity, and availability of blockchain technology . There aOrganisational barriers come second in the priority list and play a critical role in the adoption of blockchain technology. This category identifies the barriers stemming from the internal activities of organisations and supply chain partners’ relationships. On an inter-organisation level, its challenging to manage the relationships between supply chain partners when adopting innovative technologies . This caSecurity barriers (SB) occupy third place in the priority list. In terms of security and scalability, blockchain is still considered an immature technology . TherefoExternal barriers occupy fifth rank. This barrier category presents the challenges stemming from external stakeholders, institutions, industries, and governments. In this category, ‘Legal and regulatory challenges’ (EB2) hold the highest priority. ‘Market competition and uncertainty about using blockchain’ (EB1) are ranked next to EB2 followed by ‘lack of qualified blockchain developers’ (EB3). Financial barriers hold the last place on the priority list and play a crucial role in adopting blockchain technology. It suggests that implementing blockchain technology is very costly for SMEs, and a lack of funds impedes its adoption. There are four specific barriers in this category. Among them, ‘Huge initial capital investment for infrastructure and energy resources’ (FB1) got the highest priority. ‘Lack of financial resources’ (FB2) comes next in this category followed by ‘Complex tax implications around digital assets’ (FB3) and ‘Audit concerns’ (FB4).DEMATEL traces the cause and effect relationships between the barriers. Table Blockchain has the potential to transform the functioning of SMEs. The technology can overcome SMEs’ long-standing constraints in accessing credit. However, blockchain is in the nascent stage; its adoption rate in SMEs is meagre. The study results reveal that technology and organisational barriers are the most significant barriers of blockchain adoption in SMEs’ SCF practices. Moreover, the findings of the study are in line with the two government reports on blockchain by NITI ayog (the policy think tank of the government of India) and by the ministry of electronics and information technology. Additionally, the survey conducted on blockchain by Deloitte in the year 2020 also confirms the study’s findings. Blockchain is one of the top five strategic priorities for the majority of the survey respondents. Globally, there was a substantial jump in blockchain production in 2020 . The finThis paper presents the key barriers to blockchain adoption by Indian SMEs in SCF. Managers can use the knowledge of key barriers in developing a strategy to overcome the barriers and eventually adopt blockchain in SCF practices.The fuzzy-AHP prioritises the barriers that help the managers to target the most critical barriers. Technology barriers got the highest weightage implying that SMEs’ managers should focus the most on improving the technology infrastructure of their firms.The DEMATEL-based tagging of the barriers into cause and effect groups helps the managers to control the cause group barriers to mitigate their effect for the successful implementation of blockchain technology.In India, a national-level blockchain framework can facilitate in scaling the blockchain applications and introduce shared infrastructure for the organizations . TherefoThe government needs to promote research and development in blockchain, along with skilling workforce and students . FundingSMEs need to be convinced of the advantages of blockchain technology, and the resistance to adopt this technology should be eliminated. SMEs and their supply chain partners are sceptical about the use of blockchain platforms due to the issues related to privacy, security, interoperability, and automation of invoices. Therefore, the blockchain developer community should resolve these issues to facilitate the user experience which will eventually fuel the adoption rate of blockchain in SMEs.Blockchain technology has the potential to help SMEs overcome long-standing challenges by reducing transaction costs and information asymmetry and facilitating trade and access to credit. SMEs in India face numerous barriers to adopting blockchain technology in SCF practices. Therefore, the study investigates the prominent barriers to adopting blockchain technology in SCF in Indian SMEs. Through extensive literature search and the opinion of the domain experts from academia and industry, 25 sub-barriers were identified under six main barriers. As a methodological contribution, the study employs an integrated approach of Fuzzy-AHP, Sensitivity analysis, and Fuzzy DEMATEL. Fuzzy AHP illustrates the significance of the barriers; sensitivity analysis validates the developed model, and fuzzy-DEMATEL examines the cause and effect relationship between the identified barriers.Findings of this research reveal that technology barriers have the highest priority, followed by organisational barriers and security barriers. This brings light to the fact that SCF and blockchain practitioners should work on these barriers on a priority basis so that the adoption of blockchain technology can be accelerated to enhance the efficiency of SMEs. Moreover, SMEs should reshape their organisational culture to facilitate the blockchain adoption. Additionally, by implementing the fuzzy-DEMATEL methodology, four barriers have been categorised into cause groups: organisational barriers, knowledge barriers, security barriers, and financial barriers. At the same time, technology barriers and external barriers have been identified as the effect group barriers. The categorisation of these barriers would aid the managers of SMEs to control the barriers in the cause group and reshaping them to implement blockchain technology in SCF practices successfully. In the end, the developed model is tested for its robustness by implementing sensitivity analysis.The novelty of the research is twofold; first and foremost, this is the first study investigating the blockchain adoption barriers in SCF practices in the Indian context. The second aspect lies in the integrated research methodology used in the study. The three methods complement each other and comprehensively analyse the identified barriers.The present study bears some limitations, which open the prospects for future research. First, the study has been conducted concerning SMEs in India. The research implications may vary to a certain extent in the context of SMEs in developed nations. Therefore, future researchers may investigate the barriers faced by SMEs of developed nations and compare the results with this study. Second, it is a qualitative study based on experts’ opinions. The researchers may undertake empirical research and validate this research in the future. Third, although the study identifies the most comprehensive set of barriers, in the future, additional barriers may appear, and some of the existing barriers may also become obsolete with rapidly changing technology. Therefore, future researchers have an opportunity to identify new barriers that affect the adoption of blockchain by Indian SMEs in SCF.


Compared to native starch, the granular size and shape and the X-ray diffraction pattern of γ-HPS are not very different. For low-substituted γ-HPS, the implications may be less evident. Thermal stability measurements by means of thermogravimetric analyses and differential scanning calorimetry (TGA-DSC) proved that thermal stability was reduced and water retaining capacity was increased after hydroxypropylation. Furthermore, the findings also showed that the solubility, light transmittance, and retrogradation of γ-HPS pastes could be improved by etherification. The greater the MS of the γ-HPS, the more its freeze–thaw stability and acid resistivity increased. In this study, we provide relevant information for the application of γ-HPS in food and non-food industries.A new type of hydroxyalkyl starch, γ-hydroxypropyl starch (γ-HPS), was prepared by etherification of alkali-activated starch with 3-chloropropanol. The reaction efficiency, morphological change, thermodynamic and apparent viscosity properties, and other physicochemical characteristics were described. The molar substitution (MS) of modified whole starch was determined to be 0.008, 0.017, 0.053, 0.106, and 0.178, with a ratio of 5%, 15%, 25%, 35%, and 45% 3-chloropropanol to starch ( As an important polysaccharide, starch has received considerable attention in recent years ,2. HowevCorn starch, NaOH, alcohol, isopropanol, and 3-chloropropanol were purchased from Aladdin Reagent Co., Ltd., . All other reagents used in this work were of analytical grade.Hydoxypropylated starch, with varying MSs, was prepared by producing a reaction between native corn starch and 3-chloropropanol, according to the procedure of Han  and Liu 3H6O; WP is the equivalent propyl oxide amount in 100 mg starch.MS was determined using Equation (1), as described by Liu , and theThe X-ray diffraction patterns of native corn starch (NCS) and γ-hydroxypropyl starch were tested with a Bruker X-ray diffractometer  and a CuKα radiation detector  under the following conditions: 40 kV, 30 mA, and 1.5 s time counts. The diffractograms were registered at the Bragg angle (2θ) = 20°–80°.The granule morphologies of NCS and γ-HPS were observed with a JSM-6510LV ultra-scanning electron microscope , following the reported literature .The thermal stability of the native and etherified starches was measured using an SDT-Q600. Thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) were combined. The sample (10 mg) was heated from 25 to 600 °C at a rate of 10 °C/min under the protection of ultra-pure nitrogen. The thermogravimetric curve and differential scanning calorimetry (DSC) curve were drawn by a computer.The paste clarities of NCS and γ-HPS were determined according to the reported literature ,21. The w/v), which was heated in a boiling water bath for 30 min, then centrifuged (3000 r/min) for 20 min. The supernatant was dried and evaporated in a vacuum oven at 105 °C for 12 h. The solubility is expressed as a percentage, which we determined using the weight of starch contained within the supernatant and the total weight of the sample as follows:The solubility of native and modified starch was measured by using 50 mL of the corresponding starch emulsion solution . Subsequently, we heated it in a boiling water bath under constant agitation for 20 min, and then cooled it down to room temperature. We poured the solution into a 100 mL measuring cylinder, diluted it with laboratory-pure water to another volume, mixed it, and let it stand for a certain amount of time. We recorded the volume of the supernatant every 12 h. Retrogradation was determined by the percentage of volume of supernatant over time.To analyze retrogradation, we first measured 100 mL of aqueous suspension of starch  was heated, in order to gelatinize, in a boiling water bath under constant agitation for 20 min, using a beaker with a scale. It was then cooled down and diluted to another volume with laboratory-pure water. Finally, it was poured into a centrifuge tube, covered with a lid, and put in a fridge. An alternating freeze–thaw cycle was conducted, freezing for 20 h at −18 °C and thawing for 4 h at 25 °C. The centrifuged water was separated and measured as a baseline for freeze–thaw stability.The freeze–thaw stability of NCS and γ-HPS was measured by following the method outlined in the literature , with a w/v) was transferred to a proper beaker. The viscometer measured the viscosity change of an aqueous suspension sample with different MSs and pHs. We measured three times and calculated the mean value.The apparent viscosity of the cooked starch and γ-HPS samples was determined using a rotational viscometer . The right amount of well-gelatinized starch solution , respectively  and differential scanning calorimetry (DSC) were combined to investigate the thermal stability of NCS and γ-HPS. The curves of TGA experiments for the whole series of starch derivatives are presented in 2CH2CH2-OH) should increase steric hindrance, prevent the accumulation and crystallization of amyloid chains, and effectively weaken the strength of inter-chain hydrogen bonds.The light transmittance of native starch and γ-HPS was investigated. The results indicated that hydroxypropylation can improve paste clarity. Furthermore, the higher MS of hydroxypropyl starches can increase paste clarity. All of them are listed below: 2.3% (native), 7.6% (MS 0.008), 18.7% (MS 0.017), 30.3% (MS 0.053), 56.4% (MS 0.106), and 67.8% (MS 0.178). These results are in line with hydroxypropyl potato, corn, and amaranth starch ,34. Thus2CH2CH2-OH). Solubility is proportional to the increased MS of γ-HPS. In the present study, γ-HPS with an MS of about 0.178 was not particularly soluble in normal temperature water. Meanwhile, hydroxypropyl starch showed a significant increase in solubility above 75 °C. Temperature is also a favorable factor. High temperatures resulted in an increase in solubility. The gelatinization temperature and higher MSs are crucial for improving solubility. Similar observations for hydroxypropylated sago starch [The solubility of NCS and γ-HPS was affected by factors such as temperature and modification extent . Just aso starch  were repThere is an apparent difference in 2CH2CH2-OH), all of which can directly affect starch retrogradation.The apparent viscosity of native and γ-HPS was measured at different concentrations and pH levels . The decIn this study, γ-HPS was successfully prepared with different levels of MS, ranging from 0.01 to 0.2, and the influence of MS on γ-HPS physicochemical properties was examined. After γ-hydroxypropylation, the functional parameters underwent significant changes, particularly the solubility and paste clarity, as well as the freeze–thaw and retrogradation stability. Some of these relevant functional parameters indicate what is needed to make starch derivatives useful in various industries. The low-substituted etherified γ-HPSs were tailored within the confines of the limits allowed by the appropriate regulation agencies regarding food application. Generally, the physicochemical characteristics enhance as the level of modification increases. Apart from the food sector, starch derivatives may also be relevant in other applications such as hydrogels and composite coating. Further investigations into the effectiveness of such applications of γ-HPS with a high degree of substitution are currently underway in our laboratory.


Osteoarthritis (OA) is a multifactorial disease with various risk factors, resulting in the degeneration of articular cartilage and whole joints. However, to date, no effective disease-modifying therapy for OA has been developed. Oxymatrine (OMT) is associated with many pharmacological effects, including anti-inflammatory, antiapoptotic, and antioxidative properties. However, the role of OMT in OA remains unclear. β-induced chondrocyte model and anterior cruciate ligament transection (ACLT)-induced murine model of OA were constructed. The effect of OMT on chondrocyte viability was assessed using the CCK-8 assay. The protein level was assessed by Western blot analysis, and the apoptosis rate was assessed by flow cytometry in vitro and TUNEL staining in OA model mice. The effect of OMT on the degradation of articular cartilage in ACLT-induced OA mice was assessed by histological analysis.  An IL-1β-triggered apoptosis, upregulated MMP13, MMP9, and Col X, and upregulated Col II in chondrocytes in vitro. OMT represses the NF-κB signaling cascade in IL-1β-triggered chondrocytes in vitro. In an in vivo study, OMT decreased the apoptosis rate of chondrocytes and exerted a protective effect against the degradation of articular cartilage in ACLT-triggered OA mice.  OMT at 0–2 mg/mL showed no conspicuous cytotoxicity on chondrocytes after 24 hours of incubation. OMT at 0.5, 1, and 2 mg/mL inhibited IL-1β in vitro or ACLT in vivo. OMT may play a role in chondrocytes during OA by inhibiting NF-κB signaling by decreasing the phosphorylation of p65 and IκB. OMT treatment may be a promising chondroprotective approach to delay OA cartilage progression. OMT plays a protective role against chondrocyte injury induced by IL-1 There ipoptosis . Moreovess of OA . Additioartilage , 13. TheκB signaling by blocking IκB kinase-triggered IκB phosphorylation, as well as by preventing IκB degradation, thereby downregulating proinflammatory cytokines [κB signaling pathway to upregulate levels of the antiapoptotic protein BCL-2 and suppress cell apoptosis, thereby promoting functional recovery after spinal cord injury in adult rats [Oxymatrine (OMT), a natural alkaloid of tetracyclic quinolizidines, is extracted and purified from Sophora flavescens . In factytokines –22. Otheytokines . Recentlult rats . Based oβ-triggered chondrocytes and ACLT-induced OA. In addition, we investigated the effect of OMT on the NF-κB signaling pathway to elucidate the underlying mechanisms.To test this hypothesis, we used a mouse model to explore the effects of OMT on IL-1β-actin , Bax , type II collagen , Bcl-2 , type X collagen , cleaved-caspase-3 , cleaved-caspase-9 , IκBα , p-IκBα , p65 , p-p65 , MMP-13 , and MMP-9  were used in this study. Male SPF C57BL/6 mice aged 3 months, were purchased from Jiangsu Aniphe Biolaboratory Inc. Finally, C57BL/6 suckling mice aged 3 days, were provided by the Animal Experimental Center of Xinjiang Medical University, Xinjiang, China.Oxymatrine was provided by Shanghai Macklin Biochemical Co., Ltd. , whereas PBS, FBS, penicillin-streptomycin, trypsin, and DMEM/F12 were acquired from Gibco Life Technologies. The CCK-8 kit was supplied by Beijing Solarbio Technology Co. Ltd. Antibodies specific for 2. The cells were then subcultured to 90% confluence. Expression levels of collagen type II and collagen type X mRNAs were analyzed via quantitative real-time PCR (qRT-PCR), and relative expression was computed using the comparative Ct approach to evaluate chondrocyte differentiation.Primary chondrocytes were isolated from 3-day-old C57BL/6 suckling mice using type II collagenase  according to a standard protocol . The iso3 cells/well and then cultured with or without OMT  for 24 hours. Subsequently, 10 μL of CCK‐8 solution was added to each well, followed by a 1 hour incubation at 37°C. The absorbance in each well was measured using a Multiskan™ GO microplate reader  at 450 nm.Cell viability was assessed using a CCK-8 assay kit , as described by the manufacturer. Briefly, cells were plated in 96-well plates at a seeding density of 4 × 10Suspended cells were labeled with Annexin V-APC and 7-AAD using the Annexin V-APC/7-AAD Apoptosis detection kit  and incubated at room temperature (RT) for 15 minutes. The rate of apoptosis was analyzed within 1 hour using a flow cytometer .β and OMT, as described by the manufacturer, and quantified using a nanodrop spectrophotometer. Samples with an A260/A280 ratio of ≥1.8 were used. cDNA was generated from 1 μg of total RNA using the PrimeScript RT Master Mix kit , followed by qRT-PCR analysis with the SYBR FAST qPCR Master Mix , targeting specific genes whose primer sequences are listed in Isolation of total RNA was performed using TRIzol reagent  from cultured chondrocytes after 24 hours incubation with IL-1β and OMT, rinsed thrice in cold PBS, and pelleted by centrifugation at 1000 rpm for 5 minutes. Isolation of total RNA from the pellet was performed using RIPA buffer. Thereafter, protein quantitation was performed using a BCA assay. Equal quantities of protein samples were fractionated by SDS-PAGE and blotted onto polyvinylidene fluoride (PVDF) membranes (Merck Millipore). Membranes were blocked with 5% nonfat milk at RT for one-hour, and incubated overnight with diluted primary antibodies  at 4°C. Thereafter, the membranes were rinsed in TBST and then incubated for two-hours with secondary antibodies  diluted in TBST at RT. Finally, the immunoreactive bands were visualized with enhanced chemiluminescence (ECL) reagents .Cells were collected after 24 hours of incubation with IL-1n = 5): sham, vehicle, or various OMT concentrations . Preliminary experiments showed that 80 mg/kg OMT generated the best chondroprotective effect, while lower concentrations  had a weaker effect. ACLT-induced OA mice in the OMT group were intraperitoneally inoculated with 80 mg/kg OMT for 8 weeks. Mice in the sham and ACLT-induced OA mice in vehicle groups were inoculated with a similar volume of saline. All mice in each group were sacrificed using an overdose of sodium pentobarbital 8 weeks after surgery.All animal experimental protocols were approved by the Xinjiang Medical University Institutional Animal Care and Use Committee (protocol no. IACUC-20200924-27). Male SPF C57BL/6 mice aged 3 months were selected. All animals were housed in normal mouse cages, in a pathogen-free environment, with a 12 hour light-dark cycle. Access to food and water was unlimited. Prior to the study, all mice were acclimated to a new feeding environment for 3–4 days. Mice were sedated with pentobarbital (40 mg/kg) intraperitoneally and subjected to anterior cruciate ligament transection (ACLT) or sham surgery. Briefly, the right knee joint was exposed via an anterior incision of the knee joint, and the joint capsule was opened using the medial parapatellar method. Next, the patella was laterally dislocated, and the knee joint was fully flexed to expose the anterior cruciate ligament (ACL). Transection of the ACL was performed under a microscope and the procedure was completed with layer-by-layer suturing. The knee joint was initially exposed via a medial capsular incision and the surgical skin incision was closed with sutures for the sham procedure. After a 4-week preliminary experiment to determine the optimal OMT dosage, the mice were randomly allocated to one of six groups  or safranin O/fast green (SF) and examined under a light microscope . Based on the results of SF staining, the Osteoarthritis Research Society International (OARSI) score of articular cartilage was calculated for each group to assess the state of the articular cartilage and proteoglycan level [Tissues from each animals' right knee joint were extracted and preserved for 24 hours in 10% buffered formalin, then decalcified for three weeks in 10% EDTA in 0.1 M phosphate buffer (pH = 7.4). The tissues were subsequently fixed in paraffin and cut into 4 an level . Based oan level . ImmunohThe rate of apoptosis of articular chondrocytes was assessed using the TUNEL cell apoptosis detection kit , as described by the manufacturer. The specimens were viewed under a fluorescence microscope , and the number of apoptotic articular chondrocytes was quantified in relation to the overall cell count.t-test to compare significant differences. All immunoblots were performed in triplicate and one representative experiment is shown. Statistical significance was set at P < 0.05.All statistical analyses were implemented in SPSS v 22.0 . Data are presented as mean ± standard deviation (SD). Differences among groups were determined using the The results of the CCK-8 cell viability assay revealed that OMT at 0–2 mg/mL had no conspicuous cytotoxicity on chondrocytes after 24 hours of incubation . OMT at β induced chondrocytes. The data showed that IL-1β stimulation mediated a significant upregulation of mRNA and protein expression of MMP13, MMP9, and Col X, but downregulated those of Col II in cultured chondrocytes (β-triggered expression of MMP13, MMP9, and Col X in chondrocytes (Figures β-induced imbalance in extracellular matrix metabolism.Next, we evaluated the effect of OMT on genes involved in extracellular matrix metabolism in IL-1drocytes . However Figures . These rβ treatment markedly upregulated synthesis of cellular apoptosis-related proteins including, cleaved-caspase-3 and Bax. Moreover, synthesis of Bcl-2 was downregulated, whilst OMT treatment reversed this effect in a dose-dependent manner (To investigate the effect of OMT on the mitochondrial pathway of apoptosis, apoptosis-linked factors and proapoptosis factors, specifically cleaved-caspase 3 and Bax, and the antiapoptotic factor Bcl-2, were quantified using western blots. Western blot results demonstrated that IL-1t manner .β-triggered apoptosis in chondrocytes was studied using flow cytometry. Results showed that IL-1β treatment markedly increased the number of apoptotic cells relative to that of the control groups, whilst OMT treatment remarkably reduced apoptosis of IL-1β-triggered chondrocytes in a dose-dependent manner (β-triggered chondrocytes, and thus may have a protective role in OA development.The effect of OMT on IL-1t manner . Taken tκB signaling cascade in IL-1β-triggered chondrocytes. Results showed IL-1β markedly enhanced phosphorylation of p65, while OMT remarkably attenuated phosphorylation of p65 triggered by IL-1β (β markedly upregulated the phosphorylation and degradation of Iκβα, which was reversed by OMT in a dose-dependent manner (β-triggered NF-κB signaling activation in chondrocytes in vitro.Western blotting was used to evaluate the influence of OMT on the activation of the NF-by IL-1β . Furthert manner . Collectβ-triggered reduction of HC thickness (β-triggered enhancement of HC thickness (β-triggered downregulation of BCL-2 levels (β-triggered upregulation of Bax levels (H&E  and SF  staininghickness  and decrhickness  and OARShickness . TUNEL shickness . Howeverhickness . Moreove2 levels  and decrx levels . In summβ, inhibit the synthesis of aggrecan in chondrocytes and promote the expression of matrix metalloproteinases, thereby causing the articular cartilage to lose its normal structure and degrade the cartilage matrix [β is often used to induce chondrocyte injury in vitro [β-triggered extracellular matrix metabolism and cellular apoptosis in chondrocytes. The results from our in vivo experiments showed that OMT exerted a chondroprotective effect in ACLT-triggered OA mice. Previous studies [in vitro OA models to investigate the effect of OMT on chondrocytes. Although the cell models are different, the results of a previous study [During the inflammatory response in OA, proinflammatory cytokines, such as IL-1e matrix . Therefoin vitro . In this studies  have useus study  and our β can induce the expression of MMP-9, type X collagen, and MMP-13 in chondrocytes [β, thereby promoting metabolic homeostasis.Homeostasis in the articular cartilage is pivotal to joint health . Previoudrocytes , 38. Morα and IL-1β levels [β upregulates proapoptotic cytokines such as Bax, but downregulates antiapoptotic cytokines such as Bcl-2 [β and upregulated by Bcl-2. Taken together, these findings indicate that OMT exhibits antiapoptotic properties through the mitochondrial apoptotic pathway. These results were partially confirmed by the in vivo experiments of this study. Specifically, articular chondrocytes from vehicle-treated mice exhibited markedly increased levels of cellular apoptosis than those of the sham group. However, OMT treatment markedly suppressed apoptosis of articular chondrocytes and degeneration of articular cartilage. Collectively, these results indicated that OMT can effectively delay OA progression in ACLT-induced OA mouse models.Previous studies have associated OA pathogenesis with apoptosis-triggered chondrocyte death . Notablyβ levels . Previouas Bcl-2 . Consequas Bcl-2 , 42. Theas Bcl-2 , illustrκB signaling cascade plays an indispensable role in stress and inflammatory responses as well as cell survival, especially during OA development [κB can effectively downregulate the expression of catabolic-related cytokines, which are triggered by IL-1β in chondrocytes. Results from in vivo experiments showed markedly lower levels of cartilage degeneration in the p65 knockout OA mouse model relative to the wild-type. Moreover, mounting evidence has revealed that NF-κB can be activated in chondrocytes by various stimuli, including mechanical stress and injury-triggered inflammatory cytokines, increasing phosphorylation of p65 and IκB, promoting catabolic changes and cellular apoptosis [β promoted cellular apoptosis and catabolic activities in chondrocytes by activating the NF-κB signaling cascade. Notably, OMT intervention effectively inhibited the expression of the IL-1β-triggered NF-κB signaling cascade by suppressing phosphorylation of p65 and IκB, findings which are consistent with those of previous studies [κB signaling cascade. Other signals may also be involved in the action of OMT. Since we did not add an NF-κB activator to block the action of OMT, we could not confirm this, though this could be a direction for future work.The NF-elopment , 44. Prepoptosis –47. The  studies –22. We tβ-induced apoptosis and ECM metabolic imbalance in chondrocytes in vitro, exerting a protective effect on the degradation of articular cartilage in ACLT-triggered OA mice. These results suggest OMT is a protective factor against chondrocyte injury during OA. OMT may also play a role in chondrocytes during OA through inhibition of NF-κB signaling through the reduction of phosphorylation of p65 and IκB. Thus, OMT may be a potential chondroprotective agent for delaying OA progression.Taken together, OMT can decrease IL-1


The agency of international students has long been neglected and undertheorised, though recent literature indicates that this has started to change. This paper systematically reviews 51 studies that address student agency in international higher education. Focusing on research published in the last two decades (2000–2020), the review draws on studies that foreground student voices, or international students’ perspectives, rather than the perspectives of teachers, administrators or policymakers. A detailed discussion of how international student agency is positioned in the literature found that agency appears as either: a research object, as part of a theoretical or conceptual framework, or an emergent finding. Furthermore, our analysis suggests that the term “agency” is often used as a buzzword rather than as a fleshed-out concept. Thus, drawing on this initial analysis, the review synthesises varying but overlapping conceptualisations of international student agency in the literature into an integrative framework. Implications for future research are drawn, based on our findings about the understudied populations and methodological limitations in the literature.The online version contains supplementary material available at 10.1007/s10734-022-00952-3. Higher education has long had a cross-border element Altbach, , which cGiven the relevance of the international student population in higher education policy and development, an understanding of student experiences is important in furthering higher education research. We recognise that both structural forces and student agency are important and shape international student experiences Oldac, ; howeverThe call for greater attention to agency in IHE is not new  to pursue a higher education degree OECD, . In lineQ1: How is agency positioned in the literature on student voices in international higher education?Q2: How can the literature on international student agency be conceptually synthesised?We used the following questions to guide this study:These questions emerged from the inductive initial review of the selected papers as will be explained in the following sections.(TITLE-ABS-KEY (agency OR agent*) AND TITLE-ABS-KEY  AND TITLE-ABS-KEY (“higher education” OR “tertiary education” OR college OR university) AND TITLE-ABS-KEY (student* OR undergraduate* OR post*graduate* OR graduate* OR doctora* OR phd* OR master*))The literature search was conducted using SCOPUS, Web of Science, ProQuest Social Science, Eric and PsycINFO. We used a combination of keywords selected to capture studies focused on agency of international students at the undergraduate and postgraduate levels. See below for the search string.The search operating terms differed slightly for each database. Results were limited to peer-reviewed journal articles and book chapters published between 2000 and 2020 in English. English was chosen, as it is the lingua franca of the researchers. All database searches were conducted on February 8, 2021, and 5237 results were imported into Mendeley.The titles were filtered and entries on irrelevant topics, for instance, medical studies, political studies and studies on secondary education, were deleted. Any editorials and commentaries were also deleted. A total of 4286 items were removed in the title filter process, resulting in 951 papers. Abstracts were read, and the inclusion/exclusion criteria , while five papers used mixed methods (9.8%). None of the papers included in our sample used purely quantitative research designs, suggesting that agency is not easily studied through quantitative methods.The 51 papers in our final sample were primarily qualitative  or PhD students (n = 12), while seven papers focused on master’s students, four on general “postgraduates”, four on pre-sessional undergraduate students and six involved a mix of students from different program levels.The papers in our sample included participants from various education levels. For instance, the majority of papers focused on either undergraduates , of the studies which focused on samples of participants from a single country, there was a clear emphasis on Chinese students, followed by Thailand , Vietnam  and Saudi Arabia , reflecting an East and Southeast Asian focus  focused on students from China and/or Taiwan. While the majority of papers included participants from various countries , USA , UK , New Zealand  and Canada . This finding aligns with the comprehensive UNESCO data (2022) in that these Anglophone countries have the largest share of international students. In addition, having a few East Asian host societies (e.g. China) among the reviewed studies suggests that East Asia is also attracting researcher attention in this regard.The papers in our sample focused primarily on Anglophone host countries Fig. : AustralOur analysis suggests that agency inhabits different positions in the literature based on the purpose of the study. Namely, agency has appeared in five areas: agency-as-research-object (the research focus), agency-in-conceptual/theoretical-framework, agency-emergent-in-research-findings, agency-as-given (largely undefined) and agency-in-passing . See Table Agency-as-research-object referred to instances in which student agency was identified as the research topic or as a focus in the research question(s). In total, fifteen papers were categorised as agency-as-research-object.In cases where agency was the research object of a study, the concept of agency was used to explore international students’ agency within a particular situation or context. Most papers (9) included in this category examined agency as exercised and developed within the educational degree programme, based on the participants’ experiences as international students. For instance, Baxter  focused Other, more specific, contexts in which international student agency has been examined included supervision settings  threefold notion of space Baxter, ; pedagogThus, agency is used as a research object by the literature on student experiences in IHE. According to the shared notion in the definitions of agency identified here, researchers often use agency when investigating international students’ intentional action on/interaction with structure in IHE. They were particularly interested in the varying extent and manifestation of such tendency (agency) in adapting to their new environments.theoretical framework refers to cases in which researchers draw on existing theory to conceptualise the research. In contrast, a conceptual framework is what researchers formulate themselves for their own research purposes, because existing models cannot sufficiently explain the researched phenomena. Eighteen papers were placed into this category, with two of them double-coded with agency-as-given  to understand international students’ experiences. Researchers using existing definitions of agency drew on a range of theorists including Ahearn ; Biesta Although different frameworks were used and developed to investigate various aspects of student experience in IHE, the reviewed papers seem to understand agency in fundamentally similar ways. What agency enables is students’ ability to actively negotiate social structure towards the construction of the self and environment. On the one hand, agency is a capacity to “creatively interact with” Weber, , to explBy including agency in theoretical and conceptual frameworks, researchers built their studies on the assumption that students are agents. This means that students are presumed to be able to engage in reciprocal interaction with their environments, through which both student and context undergoes transformation. Given that these papers provided meaningful elaborations about their research topics based on this assumption, the use of agency-in-framework offers deductively drawn evidence about the critical role of agency in adaptation and personal development of international students.The papers in the agency-as-finding category did not include agency in their main focus or research questions, but instead discussed agency as an emergent finding. Fourteen papers fell into this category. Of these 14 papers, three discussed agency as a finding and provided a definition, while the other 11 also arrived at agency in the findings but treated the concept as a given, not providing a definition.self-agency, other-agency and joint-agency) denoting to “whom agency is principally attributed” (p. 248) in international students’ daily encounters in which they had to use English for communication. Their findings empirically confirmed the sociocultural aspect of agentic practices, which are influenced by language that can enhance or reduce international students’ “capacity to act” . This suggests that research on student voices in IHE arrived at the concept of agency inductively. That is, even when the aim was not initially focused on agency, empirical findings pointed to agency. Agency as an emergent finding confirms the deductively assumed (by frameworks or as research objects) role of student agency in IHE.We initially conceived of agency-as-given as a separate category during the early phases of our analysis. As explained earlier, agency-as-given means that we could not locate a definition or conceptualisation of agency in these papers. Later stages of the analysis indicated that this category is mostly a subset of other categories, with only one paper marked solely as agency-as-given  appear differently.We inductively developed a framework that incorporates the overlapping or contrasting conceptions of agency. While researchers seem to implicitly agree on a similar When researchers define agency in their studies, they often conceptualise it in relation to structure. This is because most of the original theories of agency to which these studies referred originated in sociology. Thus, to develop a comprehensive understanding of agency, it is necessary to clarify how agency interacts with structure in various situations. According to this review, international students’ agency is expressed in how students actively negotiate social structures such as general learning environments  and tools for interaction  in IHE were frequently studied contexts aimed at producing data about student agency.The final section synthesises construct, functions and mediators of agency to elaborate on the outcomes of enacting agency in IHE. By using self-reflexive and self-regulative functions of agency, international students achieve personal growth and identity development  were all or mostly Chinese students, while only six of the total papers (11.77%) collected data from students in non-Anglo-American countries . This can be problematic because it is not the direction of mobility that determines students’ agency; international students studying in less popular destinations also possess and practice agency. As this gap in the literature was also pointed out by previous researchers  did not discuss what agency is or how it is conceptualised although they included it in their studies. This could be because, firstly, researchers may not know what it means or find it challenging to provide an explicit definition of agency; or because of an implicit assumption that agency is so commonly discussed that everyone understands the same meaning from it, which is not true as the next paragraph explains.The papers that specified what agency is adopted a range of different frameworks, implying a lack of shared understanding of agency and that researchers rarely build upon each other’s work. This might be a necessary phase for an embryonic field that has to experience unintegrated and multiple, separate drivers until a few emerge as dominant and more acknowledged frameworks. The present review, therefore, contributes a significant step towards the next phase of the field by synthesising the burgeoning discussions about international students’ agency.Supplementary file1 (DOCX 55 KB)Below is the link to the electronic supplementary material.


Exosuits have been broadly researched owing to their benefits from soft and deformable nature. However, compared to exoskeletons, the exosuits have disadvantages in that the deformation of suit and human tissue can cause dissipation, leading to low force transfer efficiency. In this study, we explore the force capability and human-suit stiffness depending on the anchor point positions of the exosuit, introducing a better understanding of exosuit design. We found the relationships between the anchor point position and the force capability, and the anchor point position and the human-suit stiffness by conducting human subject experiments. When the distance between the anchor point of the waist belt and the anchor point of the thigh brace increased, the force capability increased, whereas the human-suit stiffness decreased. Also, statistical analyses are implemented to verify significant differences according to the anchor point position with a 5% significance level. Moreover, we discuss why the capability of force transmission and the human-suit stiffness differ depending on the anchor point positions. The force capability differed with anchor point positions because of the change in the effective cable stroke. Additionally, the force capability changes nonlinearly owing to the body curve as the condition level of the anchor points changes. The human-suit stiffness is affected by the interference of the body when the assistive force is transmitted through the cable. Characteristics of the force capability and human-suit stiffness model can be used to optimize the performance of existing exosuit or to serve a valuable guide of design a new exosuit when the exosuit needs to maximize the force capability or stiffness. Exosuits, a form of wearable robots, have drawn significant attention from researchers owing to their high utility –8. An exAlthough exosuits exhibit several advantages, which are necessary for wearable robots, they also have some limitations. For instance, it is difficult to obtain sufficient stiffness to transmit force to the user because the soft fabric comprising the exosuit deforms when a force acts on the suit. Because of this limitation, it is challenging to deliver a strong force to the user. Even though the force is delivered, it is accompanied by latency because structural deformation of the suit occurs . MoreoveSeveral researchers have attempted to overcome these limitations of exosuits. Several studies have presented a design of exosuits to enhance structural stiffness. Wehner et al. attained the structural stiffness of an exosuit by introducing the concept of a key anchor, which supports the assistive force, and a virtual anchor, which redirects the force from the actuator to the key anchor through the surface path on the body . HoweverTo advance the endeavors to overcome structural limitations of the exosuits, our group focuses on characterizing the force capability and human-suit stiffness corresponding anchor point positions for a conventional exosuit design. The force capability indicates the maximum value of the force transmitted through the exosuit and the human-suit stiffness indicates the series stiffness of human body and textiles of exosuits. First, we analyzed and identified the trend of the performance of the hip-assisting exosuit corresponding to changes in the anchor point position. The anchor points for transmitting the assistive force must exist on the exosuit. In the case of the exosuit for hip assist, the anchor points are at the waist belt and thigh brace. The anchor points on the waist belt are located at the back of the hip, and those on the thigh brace are located at the back of the thigh. The position of the anchor points is highly related to the capability of force transmission and the human-suit stiffness. Thus, we aimed to determine the correlation between the position of the anchor points and the capability of force transmission and human-suit stiffness.We hypothesized that a greater distance between anchor points leads to a higher force capability owing to the wider permissible deformation range of the exosuit. However, we did not have a strong hypothesis regarding the trend of the human-suit stiffness corresponding to the anchoring points. A waist belt and thigh braces with three different anchor points positioned vertically were produced to verify the hypothesis and to characterize performance. By modifying the position of the anchor point, we searched for changes in the capability to transmit assistive force as the position changes. The assistive force transmission capability changed nonlinearly as the condition level of the anchor points changed. Furthermore, the human-suit stiffness model according to each anchor point position was obtained by measuring the cable position and transmitted force. The force capability and human-suit stiffness were changed in the opposite direction according to the variation of the anchor point position. Finally, we discussed the relationship between the anchor point position and the force capability, and the anchor point position and the human-suit stiffness, suggesting a design guide for exosuits based on this discussion.An exosuit comprises actuators that generate an assistive force, a suit made of textile that delivers the assistive force, and cables that transmit the force to the suit. The suit is divided into a waist belt and thigh braces, depending on the part where it is worn. To effectively transmit the assistive force generated from the actuator to the user, anchor points are required where the cable can be fastened to the exosuit comprising the textile. In the case of the exosuit that assists hip extension muscles, which we set as the target of analysis, four anchor points exist, with two points at the waist belt and two points at the thigh brace for each left and right. The conventional anchor points were designed based on the drawings presented in . The oveTo determine the changes in the force capability and human-suit stiffness model corresponding to the anchor point positions, three different positions for the experiment were set at the waist belt and thigh braces. One of the three positions is identical to that of the conventional anchor point. The new anchor points for the waist belt were located 1 in (2.54 cm) from the conventional anchor points in the upward and downward directions. In contrast, the new anchor points for the thigh brace were located 0.5 in (1.27 cm) and 1 in (2.54 cm) from the conventional position in the downward direction, because no space for positioning the new anchor points was available in the upward direction. In addition, the anchor points for the thigh brace were separated by 0.5 in (1.27 cm) because the current design pattern for the thigh brace did not allow the new anchor points to be separated by 1 in (2.54 cm). The new anchor points of the waist belt and thigh brace were divided into three levels. The anchor point at the uppermost position was Level 1, that at the mid position was Level 2, and that at the undermost position was Level 3. Experiments were conducted under nine conditions resulting from the combination of three different anchor point conditions for the waist belt and thigh brace. The force capability and human-suit stiffness model were measured for eight subjects . To prevent alteration of the exosuit position depending on the subject, the position of the suit was regulated to align the upper end of the waist belt with the pelvis and to locate the lower end of the thigh brace 3 cm above the knee. Experiments under nine different conditions were repeatedly executed ten times each for subject. This study was approved by the Chung-ang University Institutional Review Board, and all procedures were conducted in accordance with the approved study protocol. All participants provided written informed consent before participation, and the nature and possible consequences of the study were explained to them.The experimental procedure was identical for every condition as follows: The subjects wearing the exosuit on the designated position of the body were asked to assume a posture that spread their feet 50 cm apart. This posture was similar to that at 13% gait cycle, which is close to when assistive force was maximally applied based on previous studies , 23. WhiThe force capability and human-suit stiffness model were measured to evaluate the effect of changes in the anchor point position. Force capability refers to the range of maximal assistive force that can be applied under the corresponding anchor point condition. Force capability can be represented by the peak force measured after the cable is pulled to the safety limit. For the evaluation index, the average value of the repeatedly measured peak force was used for each of the nine anchor point conditions. The force capability is expected to change according to the cable stroke, which differs in response to the combination of anchor points of the waist and thigh braces.x is the length of the pulled cable from the point where the force is measured by the load cell; F is the force measured by the load cell; and C1, C2 are the coefficients of the model. The effect of the coefficients in the equation is explained in the Discussion.The human-suit stiffness model was obtained by fitting the measured data based on the stiffness model provided in . The datA statistical analysis was performed to analyze the effect of the anchor point condition change on the force capability and human-suit stiffness using MATLAB . The mean of the force capability and the standard error of the mean for each of the nine conditions were used for the analysis of the force capability. The coefficients of the stiffness model were used to analyze the human-suit stiffness. The normality of the respective evaluation indices was tested for every anchor point condition using the Jarque–Bera test. Different analysis methods were selected depending on the test results. When normality was satisfied, a two-way ANOVA was adopted to test whether a significant difference was observed when the anchor point condition changed. If a significant difference existed, a post-hoc analysis was conducted using Tukey’s HSD test. In contrast, the Scheirer–Ray–Hare test was conducted to verify whether a significant difference was observed when normality was not satisfied. If a difference existed, a post-hoc analysis using the Dunn–Sidák method was executed. The significance level was set at 5% for all statistical analyses.N, 240.6 ± 13.9 N, and 214.6 ± 12.5 N, respectively. Meanwhile, a statistically significant difference was observed only between Level 1 and 3 conditions for the thigh brace. Respective force capabilities were measured as 234.4 ± 14.3 N, 247.1 ± 15.2 N, and 290.2 ± 18.7 N for Level 1, Level 2, and Level 3 conditions, respectively.To perform statistical analyses, normality tests were conducted for force capability of each anchor point condition. Because all the data were satisfied the normality, the two-way ANOVA was conducted to identify whether a significant difference exists. The results of the two-way ANOVA revealed that the force capability had a significant difference for both changes in the waist belt and thigh brace . To ascertain which experimental conditions had statistically significant differences, a post-hoc analysis was implemented. For the waist belt, differences were observed between Level 1 and 2 conditions and between Level 1 and 3 conditions. The force capabilities for Level 1, Level 2, and Level 3 conditions were measured as 316.4 ± 16.4 Note that the force capability changes nonlinearly depending on the level of the anchor points at the waist belt and thigh braces. Figs C1 decreased, whereas coefficient C2 increased. In contrast, coefficient C1 increased while coefficient C2 decreased as the condition level of the anchor point at the thigh brace changed from Level 1 to Level 3.To analyze the obtained stiffness model, the change in the stiffness model coefficients according to the anchor point conditions was identified. The coefficients of the stiffness model for each subject are listed in C1 coefficient satisfied the normality for every condition, while the C2 coefficient did not satisfy the normality for a combination in which the waist belt anchor point and thigh brace anchor point had condition levels of three and one, respectively. A two-way ANOVA was implemented for the coefficient C1 because it was normally distributed for every condition. Therefore, a significant difference was identified for the conditions of the anchor point at the waist belt and the thigh brace (p < 0.001 for waist belt level and thigh brace level). The Tukey HSD test was used to confirm which conditions had significant differences between each other. In the case of the waist belt, differences were shown between condition Level 1 and condition Level 3 and between condition Level 2 and condition Level 3. Meanwhile, for the thigh brace, differences were shown between condition Level 1 and condition Level 2, and between condition Level 1 and condition Level 3. In contrast, the Scheirer–Ray–Hare test was executed for coefficient C2 because it did not satisfy normality. Statistically significant differences were observed only for the change in the waist belt anchor point . The differences were shown between condition Level 1 and condition Level 3, and condition Level 2 and condition Level 3, as a result of the post-hoc analysis.Normality tests were conducted to perform statistical analyses for the two coefficients. The kAvg is the average stiffness of the range, which is divided according to the magnitude of the force; Fe and Fi are the values of the measured force at the endpoint and the initial point of the range, respectively; and xe and xi are the traveled length of the cable at the endpoint and the initial point of the range, respectively.Owing to the nonlinearity of the stiffness model, the coefficients of the model represent only this tendency. Hence, for a more practical analysis, we divided the section according to the magnitude of the force. The upper limit of the force for the analysis was set to 200 N, considering that the minimum force capability of the subjects was 190 N. The entire range was divided into every 50 N, such that it was divided into four sections. The average stiffness of each section was calculated using the following equation:Tables For the range of 0–50 N, a significant difference was revealed only for the waist belt level . The difference was identified between condition Levels 2 and 3 as a result of the post-hoc analysis.In contrast, for the range of 50–100 N, significant differences were shown for both the waist belt level and thigh brace level . In the case of the waist belt, condition Levels 1 and 3 showed a difference. For the thigh brace, differences existed between condition Levels 1 and 2, and Levels 1 and 3.The range of 100–150 N also showed significant differences in the level change of both waist belt and thigh brace conditions (p < 0.001 for waist belt level and thigh brace level). For the waist belt, significant differences were observed between condition Levels 1 and 3, and Levels 2 and 3. For the thigh brace, differences were observed between condition Levels 1 and 2, and Levels 1 and 3.Similarly, the average stiffness was significantly different according to the condition level of both the waist belt and thigh braces in the range of 150–200 N (p < 0.001 for the waist belt level and thigh brace level). The result of the post-hoc analysis was identical to that of the 100–150 N range. Significant differences were observed between condition Levels 1 and 3 and Levels 2 and 3 of the waist belt. In the case of the thigh brace, differences were revealed between condition Levels 1 and 2 and Levels 1 and 3.Overall, except for the range of 0–50 N, the stiffness increased when the condition level of the waist belt was higher and that of the thigh brace was lower. In other words, the closer the two anchor points of the waist belt and thigh brace, the higher the human-suit stiffness.This study aimed to explore the characteristics of the force transmitted to the user of a soft-type wearable robot and the stiffness that changes according to the position of the anchor points of the robot system. To investigate the effect of the anchor point, we observed the change in the maximum assistive force capability and human-suit stiffness according to the anchor point positions.The force capability showed a high correlation with the cable stroke. The greater the length of the cable stroke, the greater is the force capability. The maximum value of the force capability was shown when the condition levels of the waist belt and thigh brace were 1 and 3, respectively, for all the subjects.Meanwhile, the average force capability for all subjects changed nonlinearly, as the level of the anchor points at the waist belt and thigh braces changed. This is because the effective cable stroke changed nonlinearly owing to the body curve when the positions of the anchor points were changed. The anchor point position of the waist belt and thigh brace changed by 1 in (2.54 cm) and 0.5 in (1.27 cm), respectively, as the condition levels were changed. Because the cable can deform along the surface curvature of the soft exosuit, the initial cable stroke differs linearly, depending on the anchor point level. However, when cable tension was applied while delivering assistive force to the wearer, the effective cable path became a straight line connecting the anchor points of the waist belt and the thigh brace because the exosuit and the human body easily deformed under the force.x in θ is the angle between two connecting lines that connect point A and the anchor point of the waist belt, and point A and the anchor point of the thigh brace; r is the distance between point A and the anchor point of the waist belt; and l is the distance between point A and the anchor point of the thigh brace.In this situation, the effective cable stroke can be approximated as the direct distance between two anchor points, which is indicated as r is constant, and the values of l and θ change nonlinearly according to the levels of the anchor points of the waist belt and thigh brace. This shows that the effective cable path x, which indicates the distance between the anchor points, changes nonlinearly as the anchor point positions change. Consequently, the force capability exhibits a nonlinear change with the change in the anchor point position.In this equation, the value of In addition, the nonlinear characteristic of the force capability can be affected by the nonlinear stiffness of the human-exosuit system. The magnitude of the transmitted force is decided by the travel length of the cable and the stiffness of the system. Therefore, even if the cable stroke is identical, the force transmitted to the human body appears nonlinearly owing to the nonlinear stiffness. However, the relationship between the stiffness and the force capability could not be revealed through the experiment results. The experiment to obtain the data of force capability under the same condition of the cable stroke and different stiffness was not conducted. Further exploration of the relationship between the stiffness and the force capability would be required.Based on the analysis of the average stiffness in four divided sections according to the magnitude of the force, the closer the two anchor points of the waist belt and thigh brace, the higher the human-suit stiffness, which is in contrast to the effects on the force capability. We investigated the reasons for this trend as follows:The stiffness of the human-suit system is calculated by the force that is measured from the load cell and the cable travel length, which is measured from the encoder at the actuator. Consequently, the stiffness is affected by the cable travel length and force transmitted from the actuator to the user. Each factor changes depending on the positions of the anchor points located at the waist belt and the thigh brace.The force measured by the load cell is related to the degree to which the human body and suit intervene between the two anchor points at the waist belt and thigh brace. A partial loss of force generated by the actuator is induced by the interference of the body during the force-transmitting process from the actuator to the user. The majority of the loss is caused by friction between the cable and human-suit system. Therefore, the lost force increases when the contact between the cable and the user body or suit with the intervention of the human-suit system in the middle of the two anchor points.Accordingly, the force measured by the load cell decreases because a smaller force is transmitted to the user for the same travel length of the cable. In other words, a smaller applied force for an identical travel length of the cable implies that the stiffness decreases. In summary, the stiffness is measured to be higher for the anchor point level that can avoid the interference of the human-suit system between the anchor points of the waist belt and thigh brace. C1 decreased as the condition level of the anchor point at the waist belt changed from Level 1 to Level 3 and the condition level of the anchor point at the thigh brace changed from Level 3 to Level 1. In contrast, the coefficient C2 increased as the condition level of the anchor point at the waist belt changed from Level 1 to Level 3 and the condition level of the anchor point at the thigh brace changed from Level 3 to Level 1. To summarize, the two coefficients C1 and C2 changed in the opposite direction for an identical condition level change of the anchor points. According to C1 and C2 values represent a higher stiffness because the travel length of the cable becomes shorter for the same magnitude of the force. Furthermore, C1 has a larger impact on the travel length of the cable than C2 because the value of C2 is reduced by the logarithm. Consequently, a change in the coefficients of the human-suit stiffness model indicates that the stiffness increases as the anchor point of the waist belt and the anchor point of the thigh brace become closer.Additionally, the relationship between the position of the anchor points and the human-suit stiffness model coefficients can be observed despite of the nonlinearity of the stiffness model. The coefficient We propose a guide for exosuit design by exploiting the characteristics of the force capability and human-suit stiffness that were identified through the experiments as follows. First, the cable stroke should be considered prior to obtaining a sufficient force capability to generate the torque required for assistance. In other words, designing the anchor point position to include the required force within the force-capability range is recommended. For example, an exosuit used to strengthen the body function should have a sufficient force-capability range . Note thIn the case of the exosuit, which aims to transmit low force effectively and not to obtain a high assistive force, designing the anchor point to increase stiffness is more appropriate than maximizing the force capability. In this manner, the exosuit can deliver the target assistive force to the wearer more effectively while minimizing loss. For example, an exosuit used for the rehabilitation of patient or that used to assist elderly people in performing physical activities needs to transmit a small assistive force effectively , 26. TheC1, C2 exhibit a linear correlation as the anchor point levels change. Through this relationship, the new coefficients for the stiffness model with new anchor point positions can be estimated for the new exosuit design.If the anchor points on the waist belt and thigh brace of the exosuit must have a different position than the explored ones in this study, the trend of the stiffness model coefficients derived from the experiment in this study can be used. The stiffness model coefficients This study aims to determine the effect of the anchor point position of soft wearable robots and provide design criteria for setting proper anchor points. First, we experimentally identified the change in force capability and human-suit stiffness model depending on the anchor point position. The force capability differs when the anchor point position changes because the cable stroke changes according to the anchor point positions. In addition, the shape of the human-suit stiffness model is affected by the anchor point position because the degree of user body interference changes with the anchor point. The coefficients of the human-suit stiffness model showed a tendency depending on the anchor point condition. Understanding the nature of components, such as soft textiles or the human body, would provide more insight into the deformable characteristics of soft wearable robots. For example, the information on force capability and human-suit stiffness that we provided can be used when other groups make an exosuit simulator or design a new exosuit.Although the changing trend of the force capability and the human-suit stiffness model according to the anchor point position level were identified, this study is limited in that the degree of the condition change in the waist belt and thigh brace were not treated identically because of the practical issue of designing the proper suit pattern for the anchoring points. Owing to these non-uniform condition changes, the factors that are more effective could not be determined. In future work, we need to further explore the characteristics of the anchoring points, such as which is the major factor in changing the system characteristics, such as the force capability or human-suit stiffness model.S1 Table(PDF)Click here for additional data file.


Qu (FQ) could efficiently produce enzymatically modified starch at a low cost. However, it is poorly understood that how FQ influences the waxy maize starch (WMS) structure and the digestion behavior. In this study, WMS was fermented by Qu at different time and starches were isolated at each time point, and its physico-chemical properties and structural parameters were determined. Results showed that the resistant starch (RS), amylose content (AC), the average particle size [D] the ratio of peaks at 1,022/995 cm–1, and the onset temperature of gelatinization (To) were increased significantly after 36 h. Conversely, the crystallinity, the values of peak viscosity (PV), breakdown (BD), gelatinization enthalpy (ΔH), and the phase transition temperature range (ΔT) were declined significantly after 36 h. It is noteworthy that smaller starch granules were appeared at 36 h, with wrinkles on the surface, and the particle size distribution was also changed from one sharp peak to bimodal. We suggested that the formation of smaller rearranged starch granules was the main reason for the pronounced increase of RS during the FQ process.The fermentation of  This di120 min) . The in diseases . Starch diseases . TherefoThere are many methods to modify the digestibility of starch, such as physical, chemical, and enzymatic methods. The physical methods change the multi-scale structure of starch through hydrothermal treatment, high temperature, or high pressure, which causes the rearrangement of the starch structure and reduces the digestibility of starch . HoweverQu has been widely used to produce wine at a low cost (Qu (FQ) is a process in which a large number of glucoamylases and amylases are produced, and starches are degraded into glucose . The GOPOD Kit was purchased from Megazyme . All other chemical reagents were analytical grade.Waxy maize starch  was obtained from Maize Genetic Breeding Laboratory at Northwest A&F University in China. Pancreatin  and amyloglucosidase  were obtained from Sigma . Qu in a sealed tank. Maize flour, water, and Qu were in the proportion of 250:75:1 according to the instructions of the manufacturer, and the suspension was fermented at a 30°C constant temperature incubator for 12, 24, 36, 48, and 60 h, respectively. Maize vinasse at each time point was collected to extract starch (The maize flour (100 g) was mixed evenly with both water and t starch .Starch was isolated according to the previous methods with some modifications . Maize v2) (0.2 g) were dissolved in 100 ml of deionized water to obtain iodine solution. Starch (10 mg) was dispersed in 100 μl of ethanol. Sodium hydroxide solution  and deionized water (8.9 ml) were added to the suspension to form Solution A. Then, Solution A (200 μl), 0.1 M HCl (200 μl), iodine solution (200 μl), and deionized water (9.4 ml) were mixed evenly. The absorbance of this solution at 510 and 620 nm was detected by UV spectrophotometry . The AC was calculated according to the following formula:The measurement of amylose content (AC) was conducted according to the dual wavelength method . PotassiThe morphology of starch granules was observed by SEM  at a voltage of 5 kV. Samples were sprayed with gold before observation .The particle size distributions of starch granules were analyzed by Laser diffraction particle size (LDPS) analyzer  with a resolution of 0.1–1,000 μm .Crystal patterns of starch granules were analyzed by X-ray diffraction (XRD) . The X-ray beam was set to 40 mA and 40 kV, the diffraction angle range (2θ) was 3–40°, and the scanning speed was 4°/min. The relative crystallinity (RC) was calculated by MDI JADE 6.0 software .–1 was applied, and OMNIC software  was used for deconvolution. The peak width was 70.4 cm–1, and the resolution enhancement factor was 2.0 (The short-range ordered structure of starch was determined by Fourier transform infrared (FTIR) spectroscopy . The wavelength range of 800–1,200 cm was 2.0 .o), peak temperature (Tp), conclusion temperature (Tc), and gelatinization enthalpy (ΔH) were determined . Starch (3 mg) and deionized water (9 μl) were mixed evenly in a sealed aluminum container and incubated overnight to achieve hydration. Moreover, a blank aluminum container was used as a blank control. The scanning range was 30–120°C, and the scanning speed was 10°C/min. The onset gelatinization temperature . Starch (3 g) was dissolved in 25 ml of deionized water. The starch suspension was first heated at 50°C for 1 min, heated to 95°C for 2.5 min at a rate of 12°C/min, and finally cooled to 50°C for 2 min at the same rate. The peak viscosity (PV), trough viscosity (TV), final viscosity (FV), breakdown (BD), and setback (SB) values were measured .The digestibility of starch was evaluated according to the Englyst method  with slip < 0.05) to determine whether there were significant differences among the results.All experiments were conducted with three biological replicates. The data are expressed as the mean ± standard deviation (SD). SPSS 22 was used to perform a one-way analysis of variance (ANOVA) and least significant difference (LSD) tests  was obtained at 60 h. In contrast, the content of RS was increased during the process of fermentation, and the predominant increase happened after 36 h, the maximum value (65.6%) was obtained at 60 h. As for SDS, it did not change within 24 h and then decreased significantly, and the minimum value (22.0%) was also obtained at 60 h . These rThe AC of WMS was increased with the increasing fermentation time, and it significantly increased after 36 h . A possiThe shape of native WMS was irregular polygon, consistent with previous research results . During The fermentation did not change the average granular size  of WMS within 24 h and was significantly increased after 24 h . This maThe native WMS had strong diffraction peaks at 15, 17, 18, and 23° , which i–1 are representative of the crystalline and amorphous regions, respectively  of starch did not change within 36 h. However, it increased pronouncedly after 36 h. The peak gelatinization temperature (Tp) showed a similar trend, which was increased significantly after 36 h, and the change within 36 h can be ignored. As for the conclusion gelatinization temperature (Tc), it was raised within 24 h and then dropped, and the maximum value was obtained at 24 h. Both the gelatinization enthalpy (ΔH) and the transition temperature range (ΔT) showed a similar trend, which did not change within 36 h and then was decreased significantly  and the pronounced narrowing of ΔT after 36 h (Our data also demonstrated this, the value of BD was also decreased seriously at this time point, indicating the enhanced intermolecular force of starch. Meanwhile, the significant increase in gelatinization onset temperature (Tter 36 h  also demter 36 h . TherefoIn conclusion, the effects of FQ on WMS may have two processes. Firstly, the “weak points” were hydrolyzed, which made the crystal structure become more perfect and the RS increased slightly . Then, tThe RS content of WMS could be increased significantly by the FQ, which may be due to the crystal structure changed under the action of enzymes during fermentation. There may undergo two processes. Firstly, the “weak points” of the crystal structure were hydrolyzed preferentially, which made the crystal structure become more perfect and RS content increased slightly. In the second process, the crystal structure was almost destroyed completely, and the broken starch could be rearranged to form smaller starch granules, which was the main reason for the pronounced increase of RS during fermentation. Therefore, by controlling fermentation time, it could produce the WMS with higher RS content at a low cost, and it also could be applied to the functional food area on a large-scale in the future.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.WW: conceptualization, visualization, investigation, writing-original draft, preparation, and writing-review and editing. XZ, NL, and XL: writing-review and editing. JQ: software. RX, CZ, and HL: investigation. YZ: conceptualization and writing-review and editing. DG: conceptualization, funding acquisition, and writing-review and editing. All authors contributed to the article and approved the submitted version.