Search results for: managed intake

Authors: Shuaibu Umar Abdul

Abstract:

This paper examines Nigeria’s foreign policy in the age of global terrorism. It worth saying that the threat of ‘terrorism’ is not peculiar to Western and Middle Eastern countries alone, its tentacles are now spreading all over, Africa inclusive. The issue of domestic terrorism in Nigeria has become pervasive since the return of democratic rule in 1999. This development has never been a witness in any form throughout the year of statehood in Nigeria, the issues of banditry, armed robbery, ritual killing, and criminal activities like kidnapping and pipeline vandalization, the breakdown of law and order, poorly managed infrastructural facilities and corruption remain synonymous to Nigeria. These acts of terrorism no doubt have constituted a challenge that necessitates the paradigm shift in Nigeria’s foreign policy. The study employed the conceptual framework of analysis to lead interrogation; secondary sources were used to generate data while descriptive and content analysis were considered for data presentation and interpretation. In view of the interrogation and discussion on the subject matter, the paper revealed that Nigerian government underrated and underestimated the strength of terrorism within and outside her policy hence, it becomes difficult to address. As a response to the findings and conclusion of the study, the paper recommends among others that Nigeria’s foreign policy has to be rethought, reshaped and remodeled in cognizance to the rising global terrorism for peace, growth and development in the country.

Keywords: foreign policy, globe, Nigeria, rethinking, terrorism

Procedia PDF Downloads 355

Authors: Xiao Luo, Jayashree Arcot, Timothy P. Gill, Jimmy C. Louie, Anna M. Rangan

Abstract:

Excessive consumption of added sugar is negatively associated with many health outcomes such as lower diet quality, dental diseases and other non-communicable diseases. Sugar-sweetened baked goods are popular discretionary foods that contribute significant amounts of added sugar to people’s diets worldwide. Food reformulation is of the most effective methods to reduce consumption of added sugar without significantly altering individual's diet pattern. However, sucrose, as the major sugar in baked goods, plays several vital functional roles such as providing sweetness and bulking, and suitable substitutes must be able to address these. The review examines the literature on sugar-reduced baked goods to summarise the feasible reformulations of low/no added sugar baked goods, and indicates the future directions for healthier baked goods reformulation. Based on this review, polyols and non-nutritive sweeteners (NNS) are suitable for alternative sweeteners to partially or fully replace sucrose in baked goods. Low-calorie carbohydrates such as oligofructose, polydextrose, maltodextrins are the mostly used bulking agents to compensate the loss of bulk due to the removal of sucrose. This review found that maltitol seems the most suitable sole sucrose substitution at present, while diverse mixtures of NNS( stevia, sucralose, acesulfame-K), other polyols and inulins can also deliver the functionalities of sucrose in baked products.

Keywords: alternative sweeteners, baked goods, reformulation, sugar reduction

Procedia PDF Downloads 266

Authors: Arianne V. Julian, Michael R. Umagat, Renato G. Reyes

Abstract:

Pleurotus ostreatus, which is one of the most widely cultivated mushrooms, is an excellent source of protein and other minerals but inherently contains low calcium level. Calcium plays several vital functions in human health; therefore, adequate daily intake is necessary. Supplementation of growth substrate is a significant approach in mushroom production to improve nutritional content and yield. This study focused on the influence of varying concentrations of Ca supplementation derived from natural sources including agricultural lime, eggshell and oyster shell in rice straw-based formulation for the production of P. ostreatus. The effect of Ca supplementation on the total yield and Ca content were obtained. Results revealed that these natural sources increased both the yield and Ca of P. ostreatus. Mushroom grown in substrate with 8-10% agricultural lime and 6% eggshell powder produced the highest yields while using oyster shell powder did not vary with the control. Meanwhile, substrate supplementation using agricultural lime and eggshell powder in all concentrations have increased Ca in fruiting bodies. However, Ca was not absorbed in the oyster shell powder-supplemented substrate. These findings imply the potential of agricultural lime and eggshell powder in the production of Ca-enriched mushrooms resulting in higher yield.

Keywords: calcium fortification, mushroom production, natural sources, Pleurotus ostreatus

Procedia PDF Downloads 183

Authors: Nafiseh Mollaei, Reihaneh Kardehi Moghaddam

Abstract:

In case of Diabetes Mellitus the controlling of insulin is very difficult. This illness is an incurable disease affecting millions of people worldwide. Glucose is a sugar which provides energy to the cells. Insulin is a hormone which supports the absorption of glucose. Fuzzy control strategy is attractive for glucose control because it mimics the first and second phase responses that the pancreas beta cells use to control glucose. We propose two control algorithms a type-1 fuzzy controller and an interval type-2 fuzzy method for the insulin infusion. The closed loop system has been simulated for different patients with different parameters, in present of the food intake disturbance and it has been shown that the blood glucose concentrations at a normoglycemic level of 110 mg/dl in the reasonable amount of time. This paper deals with type 1 diabetes as a nonlinear model, which has been simulated in MATLAB-SIMULINK environment. The novel model, termed the Augmented Minimal Model is used in the simulations. There are some uncertainties in this model due to factors such as blood glucose, daily meals or sudden stress. In addition to eliminate the effects of uncertainty, different control methods may be utilized. In this article, fuzzy controller performance were assessed in terms of its ability to track a normoglycemic set point (110 mg/dl) in response to a [0-10] g meal disturbance. Finally, the development reported in this paper is supposed to simplify the insulin delivery, so increasing the quality of life of the patient.

Keywords: interval type-2, fuzzy controller, minimal augmented model, uncertainty

Procedia PDF Downloads 426

Authors: Giuseppe Timperio, Robert de Souza

Abstract:

Logistics operations in the context of disaster response are characterized by a high degree of complexity due to the combined effect of a large number of stakeholders involved, time pressure, uncertainties at various levels, massive deployment of goods and personnel, and gigantic financial flow to be managed. It also involves several autonomous parties such as government agencies, militaries, NGOs, UN agencies, private sector to name few, to have a highly collaborative approach especially in the critical phase of the immediate response. This is particularly true in the context of L3 emergencies that are the most severe, large-scale humanitarian crises. Decision-making processes in disaster management are thus extremely difficult due to the presence of multiple decision-makers involved, and the complexity of the tasks being tackled. Hence, in this paper, we look at applying ICT based solutions to enable a speedy and effective decision making in the golden window of humanitarian operations. A high-level view of ICT based solutions in the context of logistics operations for humanitarian response in Southeast Asia is presented, and their viability in a real-life case about logistics network design is explored.

Keywords: decision support, disaster preparedness, humanitarian logistics, network design

Procedia PDF Downloads 161

Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

Abstract:

Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

Procedia PDF Downloads 118

Authors: Divya Pathak, James Sloane

Abstract:

Surgical treatment of midface fractures should ideally occur within two weeks of injury, after which bony healing and consolidation make the repair more difficult for the operating surgeon. The oral and maxillofacial unit at the Royal Surrey Hospital is the tertiary referral center for maxillofacial trauma from five regional hospitals. This is a complete audit cycle of midface trauma referrals managed over a one year period. The standard set was that clinical assessment of the midface fracture would take place in a consultant led outpatient clinic within 7 days, and when indicated, surgical fixation would occur within 10 days of referral. Retrospective data was collected over one year (01/11/2018 - 31/12/2019). Three key changes were implemented: an IT referral mailbox, standardization of an on-call trauma table, and creation of a trauma theatre list. Re-audit was carried out over six months completing the cycle. 283 midface fracture referrals were received, of which 22 patients needed surgical fixation. The average time from referral to outpatient follow-up improved from 14.5 days to 8.3 days, and time from referral to surgery improved from 21.5 days to 11.6 days. Changes implemented in this audit significantly improved patient prioritization to appropriate outpatient clinics and shortened time to surgical intervention.

Keywords: maxillofacial trauma, midface trauma, oral and maxillofacial surgery, surgery fixation

Procedia PDF Downloads 138

Authors: O. I. Papagianni, P. Potsaki, K. Almpounioti, D. Chatzicharalampous, A. Voutsa, O. Katira, A. Michalaki, H. C. Karantonis, A. E. Koutelidakis

Abstract:

High intakes of carbohydrates and fats have been associated with an increased risk of chronic diseases due to the role of postprandial oxidative stress. This pilot nutritional intervention aimed to examine the acute effect of consuming two different types of breadsticks prepared from durum wheat flour mixtures differing in total phenolic content on postprandial inflammatory and oxidant responses in healthy volunteers. A cross-over, controlled, and single-blind clinical trial was designed, and two isocaloric high-fat and high-carbohydrate meals were tested. Serum total, HDL- and LDL-cholesterol, triglycerides, glucose, CRP, uric acid, plasma total antioxidant capacity, and antiplatelet activity were determined in fasting and 30, 60, and 120 min after consumption. The results showed a better postprandial HDL-cholesterol and total antioxidant activity response in the intervention group. The choice of durum wheat flours with higher phenolic content and antioxidant activity is presented as promising for human health, and clinical studies will expand to draw safer conclusions.

Keywords: breadsticks, durum wheat flours, postprandial inflammation, postprandial oxidative stress, ex vivo antiplatelet activity

Procedia PDF Downloads 71

Authors: Joseph Carl Macalintal, Erlinda Armovit

Abstract:

Magnesium sulfate has been a mainstay in the management of preeclampsia and is associated with a decreased incidence of morbidity and mortality. The syndrome has an unpredictable course, sometimes rapidly evolving to full-blown disease. In patients with deteriorating status, it is indicated to terminate the pregnancy via cesarean section. The anesthesiologists would prefer to have the procedure done under regional anesthesia; however, there may be cases when neuraxial anesthesia is contraindicated, or a general anesthesia would permit prompt delivery of the fetus. A patient with severe preeclampsia was given magnesium sulfate intrapartum, wherein a primary cesarean section was indicated for arrest in cervical dilatation, and was performed under general anesthesia. The patient developed acute respiratory failure and the causes of this occurrence were investigated in this report. It was later found out that neither the hypermagnesemia nor the muscle relaxant alone caused the patient’s condition but the interaction between the two. The patient was managed expectantly at the intensive care unit (ICU) and was eventually extubated during the 1st post-operative day. Knowledge of this drug interaction would allow obstetricians to advise their patients and their family about the possibility of prolonged intubation and ICU admission. This would also bring to the anesthesiologists’ attention the need to decrease the dose of muscle relaxant and to prepare drugs for immediate decurarisation.

Keywords: eclampsia, magnesium sulfate, preeclampsia, rocuronium bromide

Procedia PDF Downloads 289

Authors: Robert C. Pritchett, Elizabeth Broad, Kelly L. Pritchett

Abstract:

Individuals a with spinal cord injuries have been suggested to be at risk for a 25(OH)D insufficiency. However, little is known regarding the relationship between seasonal Vitamin D status and performance in a spinally injured athletic population. Purpose: The purpose of this study was: 1) to examine the seasonal change in 25(OH)D concentrations and 2) to determine whether 25(OH)D status impacts athletic performance in US Paralympic athletes. Methods: 25 (OH)D concentrations were measured in 11 outdoor track athletes ( 5 men/6 females), between fall (October/November) and winter(February). Dietary intake and lifestyle habits were assessed via questionnaire, and performance measurements were assessed using a 20meter sprint test. 25(OH)D concentrations were assessed using a blood spot method (ZRT Laboratory). Results: There was no significant change in 25 (OH) D concentrations across seasons (P=0.505; 31 + 6.35 ng/mL, 29 + 8.72 ng/mL (mean + SD) for Fall and Winter, respectively. In the Fall,42% of the athletes had sufficient levels (>32ng/mL), and 58% were insufficient. (20ng/mL -31ng/mL) where as the winter levels dropped with 33% being sufficient and 58% being insufficient and 1% being deficient (<20ng/mL). There was a weak but significant correlation between a change in 25(OH)D concentrations, and change in 20m sprint time (p<0.05; r=0.408). Conclusion: A substantial proportion of elite athletes with an SCI have low vitamin D status. However, results suggest there was little seasonal variation in 25(OH)D status in elite track athletes with an SCI. Furthermore, any change that was observed demonstrated a very weak relationship with a change in performance.

Keywords: 25(oh)d, performance, spinal cord injuries, elite, sprint, concentration

Procedia PDF Downloads 550

Authors: Awais Ali, Hesham Ali

Abstract:

The absence of teeth through either premature loss or developmental absence is a common condition with potentially severe impact on affected individuals. Management of these cases presents a clinical challenge which may be difficult to resolve given the effects of tooth loss or hypodontia over the course of a patient’s lifetime. Treatment of such cases is often best provided by a multi-disciplinary team, where the patient’s expectations and care delivery can be optimally managed. Orthodontic treatment is often used to prepare the dentition in advance of restorative replacement of missing teeth. Conversely, the placement of implants may precede the delivery of orthodontic treatment and indeed may function as an adjunctive orthodontic procedure. We discuss the use of both approaches here and illustrate their clinical implementation with two case reports. The first case demonstrates the use of fixed appliances to prepare the mouth for an opposing implant-retained complete denture. A second case demonstrates the use of implant-retained crowns to provide orthodontic anchorage in a partially dentate patient. We propose that complex cases such as these should always be planned and treated by a multi-disciplinary team in order to optimise the delivery of care, patient experience, and treatment outcome. The presented cases add to the body of evidence in this area.

Keywords: orthodontics, dental implantology, hypodontia, multi-disciplinary

Procedia PDF Downloads 125

Authors: Adam Reilly

Abstract:

The major claim of this paper is that both the English and Canadian branches of the common law have been ill-served by the 'institutional'/'remedial' taxonomy of constructive trusts; what shall be termed the 'orthodox taxonomy'.  The orthodox taxonomy is found both within the case law and the attendant academic commentary.  In truth, the orthodox taxonomy is especially dangerous because it contains a kernel of truth together with a misconception; the interplay of both has caused more harm than the misconception alone would have managed.  The kernel of truth is that some trusts arise automatically when the necessary facts occur ('institutional') and other trusts arise only by way of court order ('remedial').  The misconception is that these two labels represent an exhaustive nomenclature of two distinct 'kinds' of constructive trust such that any particular constructive trust must necessarily be 'institutional' if it is not 'remedial' and vice versa.  The central difficulty is that our understanding of 'remedial' trusts is relatively poor, with the result that anyone using the orthodox taxonomy shall be led astray in one of three ways: (i) by rejecting it wholesale; (ii) by adopting one ‘type’ of trust to the exclusion of the other (as in English law); or (iii) by applying it as an analytical device with sub-optimal results which are difficult to defend.  This paper shall seek to resolve these difficulties by clarifying the criteria for identifying and distinguishing true 'remedial' constructive trusts.  It shall then provide some working examples of how English and Canadian private law at present misunderstand constructive trusts and how that misunderstanding might be resolved once we distinguish the orthodox taxonomy's kernel of truth from the misconception outlined above.

Keywords: comparative law, constructive trusts, equitable remedies, remedial constructive trusts

Procedia PDF Downloads 140

Authors: Ahsan Abdullah, Ahmed A. S. Bakshwain

Abstract:

Livestock is one of the fastest-growing sectors in agriculture. If carefully managed, have potential opportunities for economic growth, food sovereignty and food security. In this study we mainly analyse and compare long-term i.e. for year 2030 climate variability impact on predicted productivity of meat i.e. beef, mutton and poultry for the Kingdom of Saudi Arabia w.r.t three factors i.e. i) climatic-change vulnerability ii) CO2 fertilization and iii) water scarcity and compare the results with two countries of the region i.e. Iraq and Yemen. We do the analysis using data from diverse sources, which was extracted, transformed and integrated before usage. The collective impact of the three factors had an overall negative effect on the production of meat for all the three countries, with adverse impact on Iraq. High similarity was found between CO2 fertilization (effecting animal fodder) and water scarcity i.e. higher than that between production of beef and mutton for the three countries considered. Overall, the three factors do not seem to be favorable for the three Middle-East countries considered. This points to possibility of a vegetarian year 2030 based on dependency on indigenous live-stock population.

Keywords: prediction, animal-source foods, pastures, CO2 fertilization, climatic-change vulnerability, water scarcity

Procedia PDF Downloads 316

Authors: A. Zarei, M. Porkhalili, B. Gholamhosseini

Abstract:

In this experiment, sixty Hy-Line (W-36) laying hens were selected in 40weeks of age. Experimental diets were consumed for 12 weeks duration by them. The experimental design was completely randomized block included four treatments and each of them with five replications and three sample in each replicate. Treatments were as follow: Basal diet+probiotic, basal diet + prebiotic and basal diet+probiotic+ prebiotic. Performance traits were measured such as: hen production, egg weight, feed intake, feed conversion ratio ,shell thickness, shell strength, shell weight, hough unit, yolk color, and yolk cholesterol. Blood parameters like; Ca, cholesterol, triglyceride, VLDL and antibody titer and so morphological of intestine were determined. At the end of experimental period, after sampling from end of cecum, bacterial colony count was measured. Results showed; shell weight was significantly greater than other treatments in probiotic treatment.Yolk weight in prebiotic treatment was significantly greater than other treatments. The ratio of height of villi to dept of crypt cells in duodenum, jejunum, ileum and secum in prebiotic treatment were significantly greater. Results from the other traits were not significant between treatments, however there were totally good results in other traits with simultaneous usage of probiotic and prebiotic.

Keywords: probiotic, prebiotic, laying hens, performance, blood parameters, intestine morphology

Procedia PDF Downloads 319

Authors: Gupta Amit, Kumar Ramesh, P. C. Tewari

Abstract:

Globalization is putting enormous pressure on the business organizations specially manufacturing one to rethink the supply chain in innovative manners. Inventory consumes major portion of total sale revenue. Effective and efficient inventory management plays a vital role for the successful functioning of any organization. Selection of inventory policy is one of the important purchasing activities. This paper focuses on selection and ranking of alternative inventory policies. A deterministic quantitative model-based on Distance Based Approach (DBA) method has been developed for evaluation and ranking of inventory policies. We have employed this concept first time for this type of the selection problem. Four inventory policies Economic Order Quantity (EOQ), Just in Time (JIT), Vendor Managed Inventory (VMI) and monthly policy are considered. Improper selection could affect a company’s competitiveness in terms of the productivity of its facilities and quality of its products. The ranking of inventory policies is a multi-criteria problem. There is a need to first identify the selection criteria and then processes the information with reference to relative importance of attributes for comparison. Criteria values for each inventory policy can be obtained either analytically or by using a simulation technique or they are linguistic subjective judgments defined by fuzzy sets, like, for example, the values of criteria. A methodology is developed and applied to rank the inventory policies.

Keywords: inventory policy, ranking, DBA, selection criteria

Procedia PDF Downloads 383

Authors: Mahshid Rezaei, Zahra Tajari, Zahra Esmaeily, Atefeh Eyvazkhani, Shahrzad Daei, Marjan Mansouri Dara, Mohaddesh Rezaei, Abolghassem Djazayeri, Ahmadreza Dorosti Motlagh

Abstract:

Background: Musculoskeletal pain is one of the most prevalent symptoms in elderly age. Nutrition and diet are considered important underlying factors that could affect chronic musculoskeletal pain. The purpose of this study was to identify the relationship between empirical dietary inflammatory patterns (EDII) and musculoskeletal pain. Method: In this cross-sectional study, 213 elderly individuals were selected from several health centers. The usual dietary intake was evaluated by a valid and reliable 147-items food frequency questionnaire (FFQ). To measure the intensity of pain, Visual Analogue Scale (VAS) was used. Multiple Linear Regression was applied to assess the association between EDII and musculoskeletal pain. Results: The results of multiple linear regression analysis indicate that a higher EDII score was associated with higher musculoskeletal pain (β= 0.21: 95% CI: 0.24-1.87: P= 0.003). These results stayed significant even after adjusting for covariates such as sex, marital status, height, family number, sleep, BMI, physical activity duration, waist circumference, protector, and medication use (β= 0.16: 95% CI: 0.11-1.04: P= 0.02). Conclusion: Study findings indicated that higher inflammation of diet might have a direct association with musculoskeletal pains in elderlies. However, further investigations are required to confirm these findings.

Keywords: musculoskeletal pain, empirical dietary inflammatory pattern, elderlies, dietary pattern

Procedia PDF Downloads 205

Authors: Rupamoni Thakur, Madhusmita Dehingia, Narayan C. Talukdar, Mojibur R. Khan

Abstract:

The human gut is an extremely active fermentation site and is inhabited by diverse bacterial species. Consumption of alcoholic beverages has been shown to substantially modulate the human gut bacterial profile (GBP) of an individual. Assam, a major north-eastern state of India, is home to a number of tribal populations of which the tea-tribes form a major community. These tea-tribal communities are known to prepare and consume a locally-prepared alcoholic beverage from fermented jaggery, whose chemical composition is unknown. In this study, we demonstrate the effect of daily intake of the locally-prepared alcoholic beverage on the GBP of the tea-tribal communities and correlate it with the changes in the biochemical biomarkers of the population. The fecal bacterial diversity of 40 drinkers and 35 non-drinking healthy individuals were analyzed by polymerase chain reaction (PCR)–denaturing gradient gel electrophoresis (DGGE). The results suggested that the GBP was significantly modulated in the fermented-beverage consuming subjects. Significant difference was also observed in the serum biochemical parameters such as triglyceride, total cholesterol and the liver marker enzymes (ASAT/ALAT and GGT). Further studies to identify the GBP of drinkers vs non-drinkers through Next-generation Sequencing (NGS) analysis and to correlate the changes with the biochemical biomarkers of the population is underway.

Keywords: alcoholic beverage, gut bacterial profile, PCR-DGGE analysis, tea-tribes of India

Procedia PDF Downloads 320

Authors: Karina Marie G. Nicolas, Kimberly M. Visaya, Emmanuel R. Cauinian

Abstract:

A comparative study on the antihyperglycemic activity of aqueous extracts of Serpentina (Andrographis paniculata) and Papait (Mollugo oppositifolia linn) administered at 400mg/kg body weight per orem twice daily for 14 days was investigated using 24 alloxan-induced diabetic male, 6-8 weeks old ICR mice and Metformin as standard control. The blood glucose levels of all the animals in the treatment groups were not reduced to < 200mg/dl so as to consider them as non-diabetic but Papait showed a consistent blood glucose lowering effect from day 0 to 14 causing 36.07% reduction as compared to Serpentina which was observed to cause a fluctuating effect on blood glucose levels and a reduction of only 22.53% while the Metformin treated animals exhibited the highest reduction at 45.29%. The blood glucose levels at day 14 of animals treated with Papait (322.93 mg/dl) had comparable blood glucose levels (p<0.05) with the Metformin treated groups (284.50 mg/dl). Also, all the animals in the three treatment groups were still hypercholesterolemic with an observed consistent weight loss and a decrease in feed intake except for Serpentina which recorded a slight increase. Results of the study showed a superior antihyperglycemic activity of Papait compared with Serpentina.

Keywords: antihyperglycemic, diabetes, hypercholesterolemic, papait, serpentina

Procedia PDF Downloads 355

Authors: Harry Burton, Alexios Dimitrios Iliadis, Neil Jones, Aaron Saini, Nicola Bystrzonowski, Alexandros Vris, Georgios Pafitanis

Abstract:

This article portrays the authors’ experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of “spares parts” in reconstructive microsurgery. This case describes a successful use of the osteocutaneous distal tibia turn-over fillet flap that allowed ‘lowering the level of the amputation’ from a through knee to the conventional level of a below-knee amputation to preserve the knee joint function. This case demonstrates the value of ‘spare-parts’ surgery principles and how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-over fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

Keywords: osteocutaneous flap, fillet flap, spare-parts surgery, Below knee amputation

Procedia PDF Downloads 161

Authors: Nicolas Koslover, Tamara Levene

Abstract:

Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

Procedia PDF Downloads 162

Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

Abstract:

Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

Procedia PDF Downloads 94

Authors: Majed Ahmadi

Abstract:

In recent years, the high penetration of different types of renewable energy sources (RESs) has affected most of the available strategies. The main motivations behind the high penetration of RESs are clean energy, modular system and easy installation. Among different types of RESs, wind turbine (WT) is an interesting choice referring to the availability of wind in almost any area. The new technologies of WT can provide energy from residential applications to wide grid connected applications. Regarding the WT, advantages such as reducing the dependence on fossil fuels and enhancing the independence and flexibility of large power grid are the most prominent. Nevertheless, the high volatile nature of wind speed injects much uncertainty in the grid that if not managed optimally can put the analyses far from the reality.the aim of this project is scrutiny and to offer proper ways for renewing distribution networks with envisage the effects of wind power plants and uncertainties related to distribution systems including wind power generating plants output rate and consumers consuming rate and also decrease the incidents of the whole network losses, amount of pollution, voltage refraction and cost extent.to solve this problem we use dual point estimate method.And algorithm used in this paper is reformed bat algorithm, which will be under exact research furthermore the results.

Keywords: order renewal, wind turbines, bat algorithm, outspread production, uncertainty

Procedia PDF Downloads 280

Authors: M. Card

Abstract:

Working with anorexia patients can be a challenging experience for mental and health care professionals. The reasons for not wanting to work with this patient population stems from the numerous concerns surrounding the patient’s health – physically and mentally. Many health care professionals reported having strong negative feelings, such as; anger, hopelessness and helplessness when working with anorexia patients. These feelings often impaired their judgement to treatment and affected how they related to the patient. This research focused on psychotherapists who preferred to work with anorexia patients; what countertransference feelings were evoked in them during sessions with patients and most importantly, how they managed the feelings. The research used interpretative phenomenological analysis (IPA) as the theoretical framework and data analysis method. Semi-structured interviews were used with ten experienced psychotherapists to obtain their countertransference experiences with anorexia patients and how they manage it. There were three main themes discovered; (1) the use of supervision, (2) their own personal therapy and finally (3) experience and evolution. The research unearthed that experienced psychotherapists also experienced strong countertransference feelings towards their patients; some positive and some negative. However, these feelings could actually be interpreted as co-transference with their anorexia patients. The psychotherapists were able to own their part in the evocative unconscious nature of a relational therapeutic space, where their personal issues may be entangled in their anorexia patient’s symptomatology.

Keywords: anorexia nervosa, countertransference, co-transference, psychotherapy, relational psychotherapy

Procedia PDF Downloads 164

Authors: Alice W. Theuri, Anselimo O. Makokha, Florence M. Kyallo

Abstract:

Type 2 diabetes mellitus (T2DM) is a serious metabolic disorder whose prevalence among adults has been increasing in the last decade. It is estimated that by 2030, the number of cases in Africa will almost double. Diet and lifestyle modifications are considered the cornerstone for the treatment and management of T2DM. Despite this, there is minimum literature assessing the dietary practices and glycemic control in a semi arid region context in Kenya. The objective of this study was to determine the dietary practices of adult T2DM patients attending Kitui out patient clinic in Kitui County. This was a cross sectional study design where every consenting second patient attending diabetic clinic was interviewed. A total of 138 T2DM patients were interviewed using a structured interview guide on socio-economic and dietary practices administered. The study was carried out in April and May 2017. There were more female (64%) than male (36%) in this study with majority being unemployed (38.4%). Forty seven percent (47.6%) had elevated HbA1c. Majority took three meals per day while DDS was 4.3 ± 1.09. The mean energy intake for men and women was 2823.8 ± 82.45 and 2766.3.30 ± 76.74 respectively. There was a non significant positive relationship (r= 131; P value = 0.124) between amount energy consumed and glycemic control. There were suboptimal dietary practices leading to poor glycemic control among T2DM patients attending diabetic clinic at Kitui District Hospital.

Keywords: adults, dietary practices, semi arid region, T2DM

Procedia PDF Downloads 146

Authors: Liu Wei-Hsien, Chuang Hsiao-Li, Huang Yen-Te, Wu Chien-Chen, Chou Geng-Ting, Tsai Ying-Chieh

Abstract:

Intestinal microflora play an important role in communication along the gut-brain axis. Probiotics, defined as live bacteria or bacterial products, confer a significant health benefit to the host. Here we administered Lactobacillus plantarum PS128 (PS128) to the germ-free (GF) mouse to investigate the impact of the gut-brain axis on emotional behavior. Administration of live PS128 significantly increased the total distance traveled in the open field test; it decreased the time spent in the closed arm and increased the time spent and total entries into the open arm in the elevated plus maze. In contrast, heat-killed PS128 caused no significant changes in the GF mice. Treatment with live PS128 significantly increased levels of both serotonin and dopamine in the striatum, but not in the prefrontal cortex or hippocampus. However, live PS128 did not alter pro- or anti-inflammatory cytokine production by mitogen-stimulated splenocytes. The above data indicate that the normalization of emotional behavior correlated with monoamine neurotransmission, but not with immune activity. Our findings suggest that daily intake of the probiotic PS128 could ameliorate neuropsychiatric disorders such as anxiety and excessive psychological stress.

Keywords: dopamine, hypothalamic-pituitary-adrenal axis, intestinal microflora, serotonin

Procedia PDF Downloads 412

Authors: Mohamed Aniss El-Gamal

Abstract:

For decades, the Global South has been facing many challenges in the fields of heritage conservation and local development. These challenges continue to increase due to rapid urbanization in historical cities, thus resulting in complicated juxtaposed contexts of heritage resources and deteriorated dwellings, where slum areas are dotted with heritage structures. While the majority of cases show the incapacity of national and local governments to deal with such contexts, few others managed to demonstrate how different levels of government can play complementary roles in the cooperation with local and international institutions as well as involving local community to achieve an integrated strategy and overcome the challenge. This paper discusses heritage conservation and local development strategies in reference to a number of case studies in cities of the Global south, i.e. Porto Alegre, Agra, Cairo and Mumbai. It further investigates main key aspects of success and failure through cross case studies analysis (Matrix). This study could help create a delineation of an integrated strategy for undertaking future interventions in similar contexts. Integrated strategies are needed to overcome the gap between heritage conservation and local development, maintaining the value of heritage structures and ensuring the quality of life for communities residing in its surroundings.

Keywords: heritage conservation, local development, the global south, regional development

Procedia PDF Downloads 315

Authors: Abdikarim Barqadle Igale

Abstract:

The main objective of this study is to find out the indicators of excellent supply chain management based on game theory. The study employed a survey design to collect data. A total of 268 respondents participated in this research. The results indicate that both companies (Coca-cola & Yousran International) managed to effectively use the physical and information flows but were different from the focus on the items in the two key areas. The Coca-cola, for instance, sustained to utilize the flows of excellent planning, starting from row materials, timing, transformation, transportation, and storage of goods to reach consumer’s hands on one side and solid linkage to strategic partners to plan and work together for long-term control of better day-to-day supply chains of goods and materials down to customers’ consumption on the other. Meanwhile, the Yousran International heavily concentrated on the physical side with moderate rapports with strategic partners for long-term improvement on supply chain. The study proposes that strong combination of effective use of both physical and information flows are good indicators of better supply chain management in today’s emerging companies.

Keywords: game theory, physical flow, supply chain management, indicators

Procedia PDF Downloads 281

Authors: Zabeehullah, Fahim Arif, Yawar Abbas

Abstract:

Software Defined Network (SDN) is a next genera-tion networking model which simplifies the traditional network complexities and improve the utilization of constrained resources. Currently, most of the SDN based Internet of Things(IoT) environments use traditional network routing strategies which work on the basis of max or min metric value. However, IoT network heterogeneity, dynamic traffic flow and complexity demands intelligent and self-adaptive routing algorithms because traditional routing algorithms lack the self-adaptions, intelligence and efficient utilization of resources. To some extent, SDN, due its flexibility, and centralized control has managed the IoT complexity and heterogeneity but still Software Defined IoT (SDIoT) lacks intelligence. To address this challenge, we proposed a model called Deep Routing Strategy (DRS) which uses Deep Learning algorithm to perform routing in SDIoT intelligently and efficiently. Our model uses real-time traffic for training and learning. Results demonstrate that proposed model has achieved high accuracy and low packet loss rate during path selection. Proposed model has also outperformed benchmark routing algorithm (OSPF). Moreover, proposed model provided encouraging results during high dynamic traffic flow.

Keywords: SDN, IoT, DL, ML, DRS

Procedia PDF Downloads 108

Authors: Ryan J. Trefethen, Vincent H. Smith

Abstract:

This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

Procedia PDF Downloads 251

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

Procedia PDF Downloads 55