Search results for: national health systems
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 20000

Search results for: national health systems

8720 A Web Service Based Sensor Data Management System

Authors: Rose A. Yemson, Ping Jiang, Oyedeji L. Inumoh

Abstract:

The deployment of wireless sensor network has rapidly increased, however with the increased capacity and diversity of sensors, and applications ranging from biological, environmental, military etc. generates tremendous volume of data’s where more attention is placed on the distributed sensing and little on how to manage, analyze, retrieve and understand the data generated. This makes it more quite difficult to process live sensor data, run concurrent control and update because sensor data are either heavyweight, complex, and slow. This work will focus on developing a web service platform for automatic detection of sensors, acquisition of sensor data, storage of sensor data into a database, processing of sensor data using reconfigurable software components. This work will also create a web service based sensor data management system to monitor physical movement of an individual wearing wireless network sensor technology (SunSPOT). The sensor will detect movement of that individual by sensing the acceleration in the direction of X, Y and Z axes accordingly and then send the sensed reading to a database that will be interfaced with an internet platform. The collected sensed data will determine the posture of the person such as standing, sitting and lying down. The system is designed using the Unified Modeling Language (UML) and implemented using Java, JavaScript, html and MySQL. This system allows real time monitoring an individual closely and obtain their physical activity details without been physically presence for in-situ measurement which enables you to work remotely instead of the time consuming check of an individual. These details can help in evaluating an individual’s physical activity and generate feedback on medication. It can also help in keeping track of any mandatory physical activities required to be done by the individuals. These evaluations and feedback can help in maintaining a better health status of the individual and providing improved health care.

Keywords: HTML, java, javascript, MySQL, sunspot, UML, web-based, wireless network sensor

Procedia PDF Downloads 199
8719 Effect of Variable Fluxes on Optimal Flux Distribution in a Metabolic Network

Authors: Ehsan Motamedian

Abstract:

Finding all optimal flux distributions of a metabolic model is an important challenge in systems biology. In this paper, a new algorithm is introduced to identify all alternate optimal solutions of a large scale metabolic network. The algorithm reduces the model to decrease computations for finding optimal solutions. The algorithm was implemented on the Escherichia coli metabolic model to find all optimal solutions for lactate and acetate production. There were more optimal flux distributions when acetate production was optimized. The model was reduced from 1076 to 80 variable fluxes for lactate while it was reduced to 91 variable fluxes for acetate. These 11 more variable fluxes resulted in about three times more optimal flux distributions. Variable fluxes were from 12 various metabolic pathways and most of them belonged to nucleotide salvage and extra cellular transport pathways.

Keywords: flux variability, metabolic network, mixed-integer linear programming, multiple optimal solutions

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8718 Evaluating Social Sustainability in Historical City Center in Turkey: Case Study of Bursa

Authors: Şeyda Akçalı

Abstract:

This study explores the concept of social sustainability and its characteristics in terms of neighborhood (mahalle) which is a social phenomenon in Turkish urban life. As social sustainability indicators that moving away traditional themes toward multi-dimensional measures, the solutions for urban strategies may be achieved through learning lessons from historical precedents. It considers the inherent values of traditional urban forms contribute to the evolution of the city as well as the social functions of it. The study aims to measure non-tangible issues in order to evaluate social sustainability in historic urban environments and how they could contribute to the current urban planning strategies. The concept of neighborhood (mahalle) refers to a way of living that represents the organization of Turkish social and communal life rather than defining an administrative unit for the city. The distinctive physical and social features of neighborhood illustrate the link between social sustainability and historic urban environment. Instead of having a nostalgic view of past, it identifies both the failures and successes and extract lessons of traditional urban environments and adopt them to modern context. First, the study determines the aspects of social sustainability which are issued as the key themes in the literature. Then, it develops a model by describing the social features of mahalle which show consistency within the social sustainability agenda. The model is used to analyze the performance of traditional housing area in the historical city center of Bursa, Turkey whether it meets the residents’ social needs and contribute collective functioning of the community. Through a questionnaire survey exercised in the historic neighborhoods, the residents are evaluated according to social sustainability criteria of neighborhood. The results derived from the factor analysis indicate that social aspects of neighborhood are social infrastructure, identity, attachment, neighborliness, safety and wellbeing. Qualitative evaluation shows the relationship between key aspects of social sustainability and demographic and socio-economic factors. The outcomes support that inherent values of neighborhood retain its importance for the sustainability of community although there must be some local arrangements for few factors with great attention not to compromise the others. The concept of neighborhood should be considered as a potential tool to support social sustainability in national political agenda and urban policies. The performance of underlying factors in historic urban environment proposes a basis for both examining and improving traditional urban areas and how it may contribute to the overall city.

Keywords: historical city center, mahalle, neighborhood, social sustainability, traditional urban environment, Turkey

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8717 Safety Considerations of Furanics for Sustainable Applications in Advanced Biorefineries

Authors: Anitha Muralidhara, Victor Engelen, Christophe Len, Pascal Pandard, Guy Marlair

Abstract:

Production of bio-based chemicals and materials from lignocellulosic biomass is gaining tremendous importance in advanced bio-refineries while aiming towards progressive replacement of petroleum based chemicals in transportation fuels and commodity polymers. One such attempt has resulted in the production of key furan derivatives (FD) such as furfural, HMF, MMF etc., via acid catalyzed dehydration (ACD) of C6 and C5 sugars, which are further converted into key chemicals or intermediates (such as Furandicarboxylic acid, Furfuryl alcohol etc.,). In subsequent processes, many high potential FD are produced, that can be converted into high added value polymers or high energy density biofuels. During ACD, an unavoidable polyfuranic byproduct is generated which is called humins. The family of FD is very large with varying chemical structures and diverse physicochemical properties. Accordingly, the associated risk profiles may largely vary. Hazardous Material (Haz-mat) classification systems such as GHS (CLP in the EU) and the UN TDG Model Regulations for transport of dangerous goods are one of the preliminary requirements for all chemicals for their appropriate classification, labelling, packaging, safe storage, and transportation. Considering the growing application routes of FD, it becomes important to notice the limited access to safety related information (safety data sheets available only for famous compounds such as HMF, furfural etc.,) in these internationally recognized haz-mat classification systems. However, these classifications do not necessarily provide information about the extent of risk involved when the chemical is used in any specific application. Factors such as thermal stability, speed of combustion, chemical incompatibilities, etc., can equally influence the safety profile of a compound, that are clearly out of the scope of any haz-mat classification system. Irrespective of the bio-based origin, FD has so far received inconsistent remarks concerning their toxicity profiles. With such inconsistencies, there is a fear that, a large family of FD may also follow extreme judgmental scenarios like ionic liquids, by ranking some compounds as extremely thermally stable, non-flammable, etc., Unless clarified, these messages could lead to misleading judgements while ranking the chemical based on its hazard rating. Safety is a key aspect in any sustainable biorefinery operation/facility, which is often underscored or neglected. To fill up these existing data gaps and to address ambiguities and discrepancies, the current study focuses on giving preliminary insights on safety assessment of FD and their potential targeted by-products. With the available information in the literature and obtained experimental results, physicochemical safety, environmental safety as well as (a scenario based) fire safety profiles of key FD, as well as side streams such as humins and levulinic acid, will be considered. With this, the study focuses on defining patterns and trends that gives coherent safety related information for existing and newly synthesized FD in the market for better functionality and sustainable applications.

Keywords: furanics, humins, safety, thermal and fire hazard, toxicity

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8716 Simulation Research of Diesel Aircraft Engine

Authors: Łukasz Grabowski, Michał Gęca, Mirosław Wendeker

Abstract:

This paper presents the simulation results of a new opposed piston diesel engine to power a light aircraft. Created in the AVL Boost, the model covers the entire charge passage, from the inlet up to the outlet. The model shows fuel injection into cylinders and combustion in cylinders. The calculation uses the module for two-stroke engines. The model was created using sub-models available in this software that structure the model. Each of the sub-models is complemented with parameters in line with the design premise. Since engine weight resulting from geometric dimensions is fundamental in aircraft engines, two configurations of stroke were studied. For each of the values, there were calculated selected operating conditions defined by crankshaft speed. The required power was achieved by changing air fuel ratio (AFR). There was also studied brake specific fuel consumption (BSFC). For stroke S1, the BSFC was lowest at all of the three operating points. This difference is approximately 1-2%, which means higher overall engine efficiency but the amount of fuel injected into cylinders is larger by several mg for S1. The cylinder maximum pressure is lower for S2 due to the fact that compressor gear driving remained the same and boost pressure was identical in the both cases. Calculations for various values of boost pressure were the next stage of the study. In each of the calculation case, the amount of fuel was changed to achieve the required engine power. In the former case, the intake system dimensions were modified, i.e. the duct connecting the compressor and the air cooler, so its diameter D = 40 mm was equal to the diameter of the compressor outlet duct. The impact of duct length was also examined to be able to reduce the flow pulsation during the operating cycle. For the so selected geometry of the intake system, there were calculations for various values of boost pressure. The boost pressure was changed by modifying the gear driving the compressor. To reach the required level of cruising power N = 68 kW. Due to the mechanical power consumed by the compressor, high pressure ratio results in a worsened overall engine efficiency. The figure on the change in BSFC from 210 g/kWh to nearly 270 g/kWh shows this correlation and the overall engine efficiency is reduced by about 8%. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: aircraft, diesel, engine, simulation

Procedia PDF Downloads 197
8715 Multilevel Regression Model - Evaluate Relationship Between Early Years’ Activities of Daily Living and Alzheimer’s Disease Onset Accounting for Influence of Key Sociodemographic Factors Using a Longitudinal Household Survey Data

Authors: Linyi Fan, C.J. Schumaker

Abstract:

Background: Biomedical efforts to treat Alzheimer’s disease (AD) have typically produced mixed to poor results, while more lifestyle-focused treatments such as exercise may fare better than existing biomedical treatments. A few promising studies have indicated that activities of daily life (ADL) may be a useful way of predicting AD. However, the existing cross-sectional studies fail to show how functional-related issues such as ADL in early years predict AD and how social factors influence health either in addition to or in interaction with individual risk factors. This study would helpbetterscreening and early treatments for the elderly population and healthcare practice. The findings have significance academically and practically in terms of creating positive social change. Methodology: The purpose of this quantitative historical, correlational study was to examine the relationship between early years’ ADL and the development of AD in later years. The studyincluded 4,526participantsderived fromRAND HRS dataset. The Health and Retirement Study (HRS) is a longitudinal household survey data set that is available forresearchof retirement and health among the elderly in the United States. The sample was selected by the completion of survey questionnaire about AD and dementia. The variablethat indicates whether the participant has been diagnosed with AD was the dependent variable. The ADL indices and changes in ADL were the independent variables. A four-step multilevel regression model approach was utilized to address the research questions. Results: Amongst 4,526 patients who completed the AD and dementia questionnaire, 144 (3.1%) were diagnosed with AD. Of the 4,526 participants, 3,465 (76.6%) have high school and upper education degrees,4,074 (90.0%) were above poverty threshold. The model evaluatedthe effect of ADL and change in ADL on onset of AD in late years while allowing the intercept of the model to vary by level of education. The results suggested that the only significant predictor of the onset of AD was changes in early years’ ADL (b = 20.253, z = 2.761, p < .05). However, the result of the sensitivity analysis (b = 7.562, z = 1.900, p =.058), which included more control variables and increased the observation period of ADL, are not supported this finding. The model also estimated whether the variances of random effect vary by Level-2 variables. The results suggested that the variances associated with random slopes were approximately zero, suggesting that the relationship between early years’ ADL were not influenced bysociodemographic factors. Conclusion: The finding indicated that an increase in changes in ADL leads to an increase in the probability of onset AD in the future. However, this finding is not support in a broad observation period model. The study also failed to reject the hypothesis that the sociodemographic factors explained significant amounts of variance in random effect. Recommendations were then made for future research and practice based on these limitations and the significance of the findings.

Keywords: alzheimer’s disease, epidemiology, moderation, multilevel modeling

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8714 Lane Detection Using Labeling Based RANSAC Algorithm

Authors: Yeongyu Choi, Ju H. Park, Ho-Youl Jung

Abstract:

In this paper, we propose labeling based RANSAC algorithm for lane detection. Advanced driver assistance systems (ADAS) have been widely researched to avoid unexpected accidents. Lane detection is a necessary system to assist keeping lane and lane departure prevention. The proposed vision based lane detection method applies Canny edge detection, inverse perspective mapping (IPM), K-means algorithm, mathematical morphology operations and 8 connected-component labeling. Next, random samples are selected from each labeling region for RANSAC. The sampling method selects the points of lane with a high probability. Finally, lane parameters of straight line or curve equations are estimated. Through the simulations tested on video recorded at daytime and nighttime, we show that the proposed method has better performance than the existing RANSAC algorithm in various environments.

Keywords: Canny edge detection, k-means algorithm, RANSAC, inverse perspective mapping

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8713 The Europeanization of Indigenous Tradition: Inventing Classical Wise Men in Prehispanic Mexico

Authors: Jongsoo Lee

Abstract:

From the beginning of the conquest, the Spanish missionaries promoted indigenous intellectuality to prove that indigenous people were capable of receiving Christian doctrine. To prove indigenous intellectuality, Spanish missionaries focused on the highly advanced and complex level of indigenous political, religious, moral, artistic, and cultural practices. In this context, they frequently compared the Aztecs with European gentiles such as Greeks and Romans. In the chronicles of the Spanish missionaries such as Bernardino de Sahagún, indigenous wise men (tlamatinime) appear as clear evidence of indigenous civility and capability. As the pagan Greek and Roman philosophers, orators, rhetoricians, theologians, and physicians known as wise men in European history were responsible for the advanced level of social systems, some Spanish missionaries tried to identify those types of people, tlamatinime, in Aztec society. This paper examines how the Spanish colonizers invented European-style wise men in Prehispanic Mexico.

Keywords: Aztec, indigenous tradition, prehispanic Mexico, wise men

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8712 Modeling the Cyclic Behavior of High Damping Rubber Bearings

Authors: Donatello Cardone

Abstract:

Bilinear hysteresis models are usually used to describe the cyclic behavior of high damping rubber bearings. However, they neglect a number of phenomena (such as the interaction between axial load and shear force, buckling and post-buckling behavior, cavitation, scragging effects, etc.) that can significantly influence the dynamic behavior of such isolation devices. In this work, an advanced hysteresis model is examined and properly calibrated using consolidated procedures. Results of preliminary numerical analyses, performed in OpenSees, are shown and compared with the results of experimental tests on high damping rubber bearings and simulation analyses using alternative nonlinear models. The findings of this study can provide an useful tool for the accurate evaluation of the seismic response of structures with rubber-based isolation systems.

Keywords: seismic isolation, high damping rubber bearings, numerical modeling, axial-shear force interaction

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8711 Opinion Mining and Sentiment Analysis on DEFT

Authors: Najiba Ouled Omar, Azza Harbaoui, Henda Ben Ghezala

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Current research practices sentiment analysis with a focus on social networks, DEfi Fouille de Texte (DEFT) (Text Mining Challenge) evaluation campaign focuses on opinion mining and sentiment analysis on social networks, especially social network Twitter. It aims to confront the systems produced by several teams from public and private research laboratories. DEFT offers participants the opportunity to work on regularly renewed themes and proposes to work on opinion mining in several editions. The purpose of this article is to scrutinize and analyze the works relating to opinions mining and sentiment analysis in the Twitter social network realized by DEFT. It examines the tasks proposed by the organizers of the challenge and the methods used by the participants.

Keywords: opinion mining, sentiment analysis, emotion, polarity, annotation, OSEE, figurative language, DEFT, Twitter, Tweet

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8710 Core Number Optimization Based Scheduler to Order/Mapp Simulink Application

Authors: Asma Rebaya, Imen Amari, Kaouther Gasmi, Salem Hasnaoui

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Over these last years, the number of cores witnessed a spectacular increase in digital signal and general use processors. Concurrently, significant researches are done to get benefit from the high degree of parallelism. Indeed, these researches are focused to provide an efficient scheduling from hardware/software systems to multicores architecture. The scheduling process consists on statically choose one core to execute one task and to specify an execution order for the application tasks. In this paper, we describe an efficient scheduler that calculates the optimal number of cores required to schedule an application, gives a heuristic scheduling solution and evaluates its cost. Our proposal results are evaluated and compared with Preesm scheduler results and we prove that ours allows better scheduling in terms of latency, computation time and number of cores.

Keywords: computation time, hardware/software system, latency, optimization, multi-cores platform, scheduling

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8709 Maternal Risk Factors Associated with Low Birth Weight Neonates in Pokhara, Nepal: A Hospital Based Case Control Study

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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8708 Site-based Internship Experiences: From Research to Implementation and Community Collaboration

Authors: Jamie Sundvall, Lisa Jennings

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Site based field internship learning (SBL) is an educational approach within a Master’s of Social Work (MSW) university field placement department that promotes a more streamlined approach to the integration of theory and evidence based practices for social work students. The SBL model is founded on research in the field, consideration of current work force needs, United States national trends of MSW graduate skill and knowledge deficits, educational trends in students pursing a master’s degree in social work, and current social problems that require unique problem solving skills. This study explores the use of site-based learning in a hybrid social work program. In this setting, site based learning pairs online education courses and social work field education to create training opportunities for social work students within their own community and cultural context. Students engage in coursework in an online setting with both synchronous and asynchronous features that facilitate development of core competencies for MSW students. Through the SBL model, students are then partnered with faculty in a virtual course room and a university vetted site within their community. The study explores how this model of learning creates community partnerships, through which students engage in a learning loop to develop social work skills, while preparing students to address current community, social, and global issues with the engagement of technology. The goal of SBL is to more effectively equip social work students for practice according to current workforce demands, provide access to education and care to populations who have limited access, and create self-sustainable partnerships. Further, the model helps students learn integration of evidence based practices and helps instructors more effectively teach integration of ethics into practice. The study found that the SBL model increases the influence and professional relevance of the social work profession, and ultimately facilitates stronger approaches to integrating theory into practice. Current implementation of the practice in the United States will be presented in the study. dditionally, future research conceptualization of SBL models will be presented, in order to collaborate on advancing best approaches of translating theory into practice, according to the current needs of the profession and needs of social work students.

Keywords: collaboration, fieldwork, research, site-based learning, technology

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8707 In vitro Antimicrobial Resistance Pattern of Bovine Mastitis Bacteria in Ethiopia

Authors: Befekadu Urga Wakayo

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Introduction: Bacterial infections represent major human and animal health problems in Ethiopia. In the face of poor antibiotic regulatory mechanisms, development of antimicrobial resistance (AMR) to commonly used drugs has become a growing health and livelihood threat in the country. Monitoring and control of AMR demand close coloration between human and veterinary services as well as other relevant stakeholders. However, risk of AMR transfer from animal to human population’s remains poorly explored in Ethiopia. This systematic research literature review attempted to give an overview on AMR challenges of bovine mastitis bacteria in Ethiopia. Methodology: A web based research literature search and analysis strategy was used. Databases are considered including; PubMed, Google Scholar, Ethiopian Veterinary Association (EVA) and Ethiopian Society of Animal Production (ESAP). The key search terms and phrases were; Ethiopia, dairy, cattle, mastitis, bacteria isolation, antibiotic sensitivity and antimicrobial resistance. Ultimately, 15 research reports were used for the current analysis. Data extraction was performed using a structured Microsoft Excel format. Frequency AMR prevalence (%) was registered directly or calculated from reported values. Statistical analysis was performed on SPSS – 16. Variables were summarized by giving frequencies (n or %), Mean ± SE and demonstrative box plots. One way ANOVA and independent t test were used to evaluate variations in AMR prevalence estimates (Ln transformed). Statistical significance was determined at p < 0.050). Results: AMR in bovine mastitis bacteria was investigated in a total of 592 in vitro antibiotic sensitivity trials involving 12 different mastitis bacteria (including 1126 Gram positive and 77 Gram negative isolates) and 14 antibiotics. Bovine mastitis bacteria exhibited AMR to most of the antibiotics tested. Gentamycin had the lowest average AMR in both Gram positive (2%) and negative (1.8%) bacteria. Gram negative mastitis bacteria showed higher mean in vitro resistance levels to; Erythromycin (72.6%), Tetracycline (56.65%), Amoxicillin (49.6%), Ampicillin (47.6%), Clindamycin (47.2%) and Penicillin (40.6%). Among Gram positive mastitis bacteria higher mean in vitro resistance was observed in; Ampicillin (32.8%), Amoxicillin (32.6%), Penicillin (24.9%), Streptomycin (20.2%), Penicillinase Resistant Penicillin’s (15.4%) and Tetracycline (14.9%). More specifically, S. aurues exhibited high mean AMR against Penicillin (76.3%) and Ampicillin (70.3%) followed by Amoxicillin (45%), Streptomycin (40.6%), Tetracycline (24.5%) and Clindamycin (23.5%). E. coli showed high mean AMR to Erythromycin (78.7%), Tetracycline (51.5%), Ampicillin (49.25%), Amoxicillin (43.3%), Clindamycin (38.4%) and Penicillin (33.8%). Streptococcus spp. demonstrated higher (p =0.005) mean AMR against Kanamycin (> 20%) and full sensitivity (100%) to Clindamycin. Overall, mean Tetracycline (p = 0.013), Gentamycin (p = 0.001), Polymixin (p = 0.034), Erythromycin (p = 0.011) and Ampicillin (p = 0.009) resistance increased from the 2010’s than the 2000’s. Conclusion; the review indicated a rising AMR challenge among bovine mastitis bacteria in Ethiopia. Corresponding, public health implications demand a deeper, integrated investigation.

Keywords: antimicrobial resistance, dairy cattle, Ethiopia, Mastitis bacteria

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8706 A Look into Surgical Site Infections: Impact of Collective Interventions

Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

Abstract:

Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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8705 The Effect of Enzymatic Keratin Hydrolysate on the Susceptibility of Cellulosic-Elastomeric Material to Biodecomposition

Authors: Y. H. Tshela Ntumba, A. Przepiórkowska, M. Prochoń

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Polymeric materials have become an integral part of every aspect of today's industry. They have wide applications, inter alia, in areas such as medicine, food industry and agriculture. In agriculture, for example, they are used for the production of pots, irrigation systems and for soil mulching. The aim of this study was the attempt to produce a biodecomposable agricultural mat, by coating cotton fabric with a blend of carboxylated styrene-butadiene latex (LBSK) containing the enzymatic hydrolyzate of keratin from cattle hair, which would serve as a material for mulching. The production of such material allows the beneficial management of burdensome tannery waste constituted by keratin from cattle hair and at the same time, the production of agricultural mats that much faster undergo decomposition than commonly used polyethylene mats.

Keywords: agricultural mat, biodecomposition, biodegradation, carboxylated butadiene-styrene latex, cellulosic-elastomeric material, keratin hydrolyzate, mulching, protein hydrolyzate

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8704 Restoration and Conservation of Historical Textiles Using Covalently Immobilized Enzymes on Nanoparticles

Authors: Mohamed Elbehery

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Historical textiles in the burial environment or in museums are exposed to many types of stains and dirt that are associated with historical textiles by multiple chemical bonds that cause damage to historical textiles. The cleaning process must be carried out with great care, with no irreversible damage, and sediments removed without affecting the original material of the surface being cleaned. Science and technology continue to provide innovative systems in the bio-cleaning process (using pure enzymes) of historical textiles and artistic surfaces. Lipase and α-amylase were immobilized on nanoparticles of alginate/κ-carrageenan nanoparticle complex and used in historical textiles cleaning. Preparation of nanoparticles, activation, and enzymes immobilization were characterized. Optimization of loading time and units of the two enzymes were done. It was found that, the optimum time and units of amylase were 4 hrs and 25U, respectively. While, the optimum time and units of lipase were 3 hrs and 15U, respectively. The methods used to examine the fibers using a scanning electron microscope equipped with an X-ray energy dispersal unit: SEM with EDX unit.

Keywords: nanoparticles, enzymes, immobilization, textiles

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8703 Optimal Power Exchange of Multi-Microgrids with Hierarchical Coordination

Authors: Beom-Ryeol Choi, Won-Poong Lee, Jin-Young Choi, Young-Hak Shin, Dong-Jun Won

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A Microgrid (MG) has a major role in power system. There are numerous benefits, such as ability to reduce environmental impact and enhance the reliability of a power system. Hence, Multi-MG (MMG) consisted of multiple MGs is being studied intensively. This paper proposes the optimal power exchange of MMG with hierarchical coordination. The whole system architecture consists of two layers: 1) upper layer including MG of MG Center (MoMC) which is in charge of the overall management and coordination and 2) lower layer comprised of several Microgrid-Energy Management Systems (MG-EMSs) which make a decision for own schedule. In order to accomplish the optimal power exchange, the proposed coordination algorithm is applied to MMG system. The objective of this process is to achieve optimal operation for improving economics under the grid-connected operation. The simulation results show how the output of each MG can be changed through coordination algorithm.

Keywords: microgrids, multi-microgrids, power exchange, hierarchical coordination

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8702 Knowledge Level of Mothers in Wet Nursery and Breast Milk Banking

Authors: Seyda Can, Meryem Unulu

Abstract:

Objective: Breast milk is the most fundamental nutritional element for the healthy growth and development of newborns as they supply all the necessary components. Various obstacles such as diseases of mother and child, allergies of the baby, and insufficient breastmilk affect breast-feeding adversely. The wet nursery or breast milk banking is the most important source in providing the nutrients closest to the ideal for the newborn. Despite increasing opinions about its benefits, breast milk banking practice is controversial because of reasons such as ethical problems, traditional beliefs and attitudes, security concerns of families and lack of knowledge. It is thought that the results of this study will create the data for studies to raise the awareness of the society regarding wet nursery, and milk banks. Method: The study was planned and performed in descriptive type. The population of the study consists of mothers that gave birth between October-November 2017 in a public hospital in Turkey, and the sample consisted of 205 mothers chosen by improbable sampling method from the population and accepted to participate in the study. While gathering data, a survey consisting of 33 questions designed to determine the socio-demographic characteristics and their views on wet nursery and breast milk banking. Written ethical committee and institution permit was taken. Before the interview, participants were informed about the purpose and content of the study and oral permit was taken. Result: When the distribution of 205 mothers according to their individual characteristics, it was detected that their age average was 28,16±5,23 and 63,4 of mothers (n=130) had normal delivery. It was determined that clear majority of mothers, 75,6% (n=155) had no breast-feeding problems and 75,1% (n=154) fed the baby only with breast milk. It was detected that 18,5% (n=38) would accept a stranger to be a wet nurse and 60% (n=123) would donate milk if there is a breast milk bank. It was detected 33,2 % (n=68) of participant mothers want to make use of breast milk bank if there is a situation that prevents breast feeding, 38,5 % (n=79) of mothers think breast milk bank would be problematic religiously. Statistical difference was detected between the educational status of women and the rate of wanting breast milk bank practice. As the educational status of mothers increased, their rate of wanting breast milk bank practice increased. Conclusion: It is essential that every baby is breastfed by its mother primarily. However, when this is not possible, in order to implement wet nursery and breast milk banking as an extension of national breast-feeding policy, regulations need to be made and worries should be eased. Also, organizing training programs are also really important to raise awareness of the society and mothers.

Keywords: breast feeding, breast milk, milk banks, wet nursery

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8701 Improving Student Retention: Enhancing the First Year Experience through Group Work, Research and Presentation Workshops

Authors: Eric Bates

Abstract:

Higher education is recognised as being of critical importance in Ireland and has been linked as a vital factor to national well-being. Statistics show that Ireland has one of the highest rates of higher education participation in Europe. However, student retention and progression, especially in Institutes of Technology, is becoming an issue as rates on non-completion rise. Both within Ireland and across Europe student retention is seen as a key performance indicator for higher education and with these increasing rates the Irish higher education system needs to be flexible and adapt to the situation it now faces. The author is a Programme Chair on a Level 6 full time undergraduate programme and experience to date has shown that the first year undergraduate students take some time to identify themselves as a group within the setting of a higher education institute. Despite being part of a distinct class on a specific programme some individuals can feel isolated as he or she take the first step into higher education. Such feelings can contribute to students eventually dropping out. This paper reports on an ongoing initiative that aims to accelerate the bonding experience of a distinct group of first year undergraduates on a programme which has a high rate of non-completion. This research sought to engage the students in dynamic interactions with their peers to quickly evolve a group sense of coherence. Two separate modules – a Research Module and a Communications module - delivered by the researcher were linked across two semesters. Students were allocated into random groups and each group was given a topic to be researched. There were six topics – essentially the six sub-headings on the DIT Graduate Attribute Statement. The research took place in a computer lab and students also used the library. The output from this was a document that formed part of the submission for the Research Module. In the second semester the groups then had to make a presentation of their findings where each student spoke for a minimum amount of time. Presentation workshops formed part of that module and students were given the opportunity to practice their presentation skills. These presentations were video recorded to enable feedback to be given. Although this was a small scale study preliminary results found a strong sense of coherence among this particular cohort and feedback from the students was very positive. Other findings indicate that spreading the initiative across two semesters may have been an inhibitor. Future challenges include spreading such Initiatives College wide and indeed sector wide.

Keywords: first year experience, student retention, group work, presentation workshops

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8700 Arbutin-loaded Butylglyceryl Dextran Nanoparticles for Topical Delivery

Authors: Mohammad F. Bostanudin, Tan S. Fei, Azwan M. Lazim

Abstract:

Toward the development of colloidal systems that are able to enhance permeation across the skin, a material combining the non-toxic and non-immunogenic of dextran with alkylglycerols permeation enhancing property has been designed. To this purpose, a range of butylglyceryl dextrans (DEX-OX4) were synthesized via functionalization with n-butylglycidyl ether and the successful functionalization was confirmed by NMR and FT-IR spectroscopies, along with GPC with a degree of modification in the range 6.3–35.7 %. A reduced viscosity and an increased molecular weight of DEX-OX4 were also recorded when compared to that of the native dextran. DEX-OX4 was further formulated into nanocarriers and loaded with α-arbutin prior to be investigated for their particle size, morphology, stability, loading ability, and release profiles. The resulting nanoparticles were found to be close-to-spherical and relatively stable at pH 5 and 7, with size 180–220 nm (ζ-potential -22 to -25 mV), and a loading degree of 11.7 %. Lack of toxicity at application-relevant concentrations and increased permeation across skin biological membrane model were demonstrated by nanoparticles in-vitro results against immortalized skin human keratinocytes cells (HaCaT).

Keywords: butylglycerols, dextran, nanoparticles, transdermal

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8699 Characterizing Compressive Strength of Compressed Stabilized Earth Blocks as a Function of Mix Design

Authors: Robert K. Hillyard, Jonathan Thomas, Brett A. Story

Abstract:

Compressed Stabilized Earth Blocks (CSEB) are masonry units that combine soil, sand, stabilizer, and water under pressure to form an earth block. These CSEB’s offer a cost-effective building solution for remote construction, using local resources and labor to minimize transportation and material costs. However, CSEB’s, and earthen construction generally have not been widely adopted as standardized construction materials. One shortcoming is the difficulty in standardizing strength values of CSEB units and systems due to the inherent variations in mix design, including production compression. This research presents findings on compressive strengths of full-scale CSEB’s from 60 different mix designs as a function of the amount of cement, sand, soil, and water added to the mixture. The full-scale results are compared with CSEB cylinder cores.

Keywords: CSEB, compressive strength, earth construction, mix design

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8698 Numerical Analysis and Design of Dielectric to Plasmonic Waveguides Couplers

Authors: Emanuela Paranhos Lima, Vitaly Félix Rodríguez Esquerre

Abstract:

In this work, efficient directional coupler composed of dielectric waveguides and metallic film has been analyzed in details by simulations using finite element method (FEM). The structure consists of a step-index fiber with dielectric core, silica cladding, and a metal nanowire parallel to the core. The results show that an efficient conversion of optical dielectric modes to long range plasmonic is possible. Low insertion losses in conjunction with short coupling length and a broadband operation can be achieved under certain conditions. This kind of couplers has potential applications for the design of photonic integrated circuits for signal routing between dielectric/plasmonic waveguides, sensing, lithography, and optical storage systems. A high efficient focusing of light in a very small region can be obtained.

Keywords: directional coupler, finite element method, metallic nanowire, plasmonic, surface plasmon polariton, superfocusing

Procedia PDF Downloads 259
8697 Investigating the Dynamics of Knowledge Acquisition in Undergraduate Mathematics Students Using Differential Equations

Authors: Gilbert Makanda

Abstract:

The problem of the teaching of mathematics is studied using differential equations. A mathematical model for knowledge acquisition in mathematics is developed. In this study we adopt the mathematical model that is normally used for disease modelling in the teaching of mathematics. It is assumed that teaching is 'infecting' students with knowledge thereby spreading this knowledge to the students. It is also assumed that students who gain this knowledge spread it to other students making disease model appropriate to adopt for this problem. The results of this study show that increasing recruitment rates, learning contact with teachers and learning materials improves the number of knowledgeable students. High dropout rates and forgetting taught concepts also negatively affect the number of knowledgeable students. The developed model is then solved using Matlab ODE45 and \verb"lsqnonlin" to estimate parameters for the actual data.

Keywords: differential equations, knowledge acquisition, least squares, dynamical systems

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8696 Linear Array Geometry Synthesis with Minimum Sidelobe Level and Null Control Using Taguchi Method

Authors: Amara Prakasa Rao, N. V. S. N. Sarma

Abstract:

This paper describes the synthesis of linear array geometry with minimum sidelobe level and null control using the Taguchi method. Based on the concept of the orthogonal array, Taguchi method effectively reduces the number of tests required in an optimization process. Taguchi method has been successfully applied in many fields such as mechanical, chemical engineering, power electronics, etc. Compared to other evolutionary methods such as genetic algorithms, simulated annealing and particle swarm optimization, the Taguchi method is much easier to understand and implement. It requires less computational/iteration processing to optimize the problem. Different cases are considered to illustrate the performance of this technique. Simulation results show that this method outperforms the other evolution algorithms (like GA, PSO) for smart antenna systems design.

Keywords: array factor, beamforming, null placement, optimization method, orthogonal array, Taguchi method, smart antenna system

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8695 Patients' Out-Of-Pocket Expenses-Effectiveness Analysis of Presurgical Teledermatology

Authors: Felipa De Mello-Sampayo

Abstract:

Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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8694 Enhancement to Green Building Rating Systems for Industrial Facilities by Including the Assessment of Impact on the Landscape

Authors: Lia Marchi, Ernesto Antonini

Abstract:

The impact of industrial sites on people’s living environment both involves detrimental effects on the ecosystem and perceptual-aesthetic interferences with the scenery. These, in turn, affect the economic and social value of the landscape, as well as the wellbeing of workers and local communities. Given the diffusion of the phenomenon and the relevance of its effects, it emerges the need for a joint approach to assess and thus mitigate the impact of factories on the landscape –being this latest assumed as the result of the action and interaction of natural and human factors. However, the impact assessment tools suitable for the purpose are quite heterogeneous and mostly monodisciplinary. On the one hand, green building rating systems (GBRSs) are increasingly used to evaluate the performance of manufacturing sites, mainly by quantitative indicators focused on environmental issues. On the other hand, methods to detect the visual and social impact of factories on the landscape are gradually emerging in the literature, but they generally adopt only qualitative gauges. The research addresses the integration of the environmental impact assessment and the perceptual-aesthetic interferences of factories on the landscape. The GBRSs model is assumed as a reference since it is adequate to simultaneously investigate different topics which affect sustainability, returning a global score. A critical analysis of GBRSs relevant to industrial facilities has led to select the U.S. GBC LEED protocol as the most suitable to the scope. A revision of LEED v4 Building Design+Construction has then been provided by including specific indicators to measure the interferences of manufacturing sites with the perceptual-aesthetic and social aspects of the territory. To this end, a new impact category was defined, namely ‘PA - Perceptual-aesthetic aspects’, comprising eight new credits which are specifically designed to assess how much the buildings are in harmony with their surroundings: these investigate, for example the morphological and chromatic harmonization of the facility with the scenery or the site receptiveness and attractiveness. The credits weighting table was consequently revised, according to the LEED points allocation system. As all LEED credits, each new PA credit is thoroughly described in a sheet setting its aim, requirements, and the available options to gauge the interference and get a score. Lastly, each credit is related to mitigation tactics, which are drawn from a catalogue of exemplary case studies, it also developed by the research. The result is a modified LEED scheme which includes compatibility with the landscape within the sustainability assessment of the industrial sites. The whole system consists of 10 evaluation categories, which contain in total 62 credits. Lastly, a test of the tool on an Italian factory was performed, allowing the comparison of three mitigation scenarios with increasing compatibility level. The study proposes a holistic and viable approach to the environmental impact assessment of factories by a tool which integrates the multiple involved aspects within a worldwide recognized rating protocol.

Keywords: environmental impact, GBRS, landscape, LEED, sustainable factory

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8693 Rhizobium leguminosarum: Selecting Strain and Exploring Delivery Systems for White Clover

Authors: Laura Villamizar, David Wright, Claudia Baena, Marie Foxwell, Maureen O'Callaghan

Abstract:

Leguminous crops can be self-sufficient for their nitrogen requirements when their roots are nodulated with an effective Rhizobium strain and for this reason seed or soil inoculation is practiced worldwide to ensure nodulation and nitrogen fixation in grain and forage legumes. The most widely used method of applying commercially available inoculants is using peat cultures which are coated onto seeds prior to sowing. In general, rhizobia survive well in peat, but some species die rapidly after inoculation onto seeds. The development of improved formulation methodology is essential to achieve extended persistence of rhizobia on seeds, and improved efficacy. Formulations could be solid or liquid. Most popular solid formulations or delivery systems are: wettable powders (WP), water dispersible granules (WG), and granules (DG). Liquid formulation generally are: suspension concentrates (SC) or emulsifiable concentrates (EC). In New Zealand, R. leguminosarum bv. trifolii strain TA1 has been used as a commercial inoculant for white clover over wide areas for many years. Seeds inoculation is carried out by mixing the seeds with inoculated peat, some adherents and lime, but rhizobial populations on stored seeds decline over several weeks due to a number of factors including desiccation and antibacterial compounds produced by the seeds. In order to develop a more stable and suitable delivery system to incorporate rhizobia in pastures, two strains of R. leguminosarum (TA1 and CC275e) and several formulations and processes were explored (peat granules, self-sticky peat for seed coating, emulsions and a powder containing spray dried microcapsules). Emulsions prepared with fresh broth of strain TA1 were very unstable under storage and after seed inoculation. Formulations where inoculated peat was used as the active ingredient were significantly more stable than those prepared with fresh broth. The strain CC275e was more tolerant to stress conditions generated during formulation and seed storage. Peat granules and peat inoculated seeds using strain CC275e maintained an acceptable loading of 108 CFU/g of granules or 105 CFU/g of seeds respectively, during six months of storage at room temperature. Strain CC275e inoculated on peat was also microencapsulated with a natural biopolymer by spray drying and after optimizing operational conditions, microparticles containing 107 CFU/g and a mean particle size between 10 and 30 micrometers were obtained. Survival of rhizobia during storage of the microcapsules is being assessed. The development of a stable product depends on selecting an active ingredient (microorganism), robust enough to tolerate some adverse conditions generated during formulation, storage, and commercialization and after its use in the field. However, the design and development of an adequate formulation, using compatible ingredients, optimization of the formulation process and selecting the appropriate delivery system, is possibly the best tool to overcome the poor survival of rhizobia and provide farmers with better quality inoculants to use.

Keywords: formulation, Rhizobium leguminosarum, storage stability, white clover

Procedia PDF Downloads 139
8692 An Observational Study Assessing the Baseline Communication Behaviors among Healthcare Professionals in an Inpatient Setting in Singapore

Authors: Pin Yu Chen, Puay Chuan Lee, Yu Jen Loo, Ju Xia Zhang, Deborah Teo, Jack Wei Chieh Tan, Biauw Chi Ong

Abstract:

Background: Synchronous communication, such as telephone calls, remains the standard communication method between nurses and other healthcare professionals in Singapore public hospitals despite advances in asynchronous technological platforms, such as instant messaging. Although miscommunication is one of the most common causes of lapses in patient care, there is a scarcity of research characterizing baseline inter-professional healthcare communications in a hospital setting due to logistic difficulties. Objective: This study aims to characterize the frequency and patterns of communication behaviours among healthcare professionals. Methods: The one-week observational study was conducted on Monday through Sunday at the nursing station of a cardiovascular medicine and cardiothoracic surgery inpatient ward at the National Heart Centre Singapore. Subjects were shadowed by two physicians for sixteen hours or consecutive morning and afternoon nursing shifts. Communications were logged and characterized by type, duration, caller, and recipient. Results: A total of 1,023 communication events involving the attempted use of the common telephones at the nursing station were logged over a period of one week, corresponding to a frequency of one event every 5.45 minutes (SD 6.98, range 0-56 minutes). Nurses initiated the highest proportion of outbound calls (38.7%) via the nursing station common phone. A total of 179 face-to-face communications (17.5%), 362 inbound calls (35.39%), 481 outbound calls (47.02%), and 1 emergency alert (0.10%) were captured. Average response time for task-oriented communications was 159 minutes (SD 387.6, range 86-231). Approximately 1 in 3 communications captured aimed to clarify patient-related information. The total duration of time spent on synchronous communication events over one week, calculated from total inbound and outbound calls, was estimated to be a total of 7 hours. Conclusion: The results of our study showed that there is a significant amount of time spent on inter-professional healthcare communications via synchronous channels. Integration of patient-related information and use of asynchronous communication channels may help to reduce the redundancy of communications and clarifications. Future studies should explore the use of asynchronous mobile platforms to address the inefficiencies observed in healthcare communications.

Keywords: healthcare communication, healthcare management, nursing, qualitative observational study

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8691 A 4-Month Low-carb Nutrition Intervention Study Aimed to Demonstrate the Significance of Addressing Insulin Resistance in 2 Subjects with Type-2 Diabetes for Better Management

Authors: Shashikant Iyengar, Jasmeet Kaur, Anup Singh, Arun Kumar, Ira Sahay

Abstract:

Insulin resistance (IR) is a condition that occurs when cells in the body become less responsive to insulin, leading to higher levels of both insulin and glucose in the blood. This condition is linked to metabolic syndromes, including diabetes. It is crucial to address IR promptly after diagnosis to prevent long-term complications associated with high insulin and high blood glucose. This four-month case study highlights the importance of treating the underlying condition to manage diabetes effectively. Insulin is essential for regulating blood sugar levels by facilitating the uptake of glucose into cells for energy or storage. In IR individuals, cells are less efficient at taking up glucose from the blood resulting in elevated blood glucose levels. As a result of IR, beta cells produce more insulin to make up for the body's inability to use insulin effectively. This leads to high insulin levels, a condition known as hyperinsulinemia, which further impairs glucose metabolism and can contribute to various chronic diseases. In addition to regulating blood glucose, insulin has anti-catabolic effects, preventing the breakdown of molecules in the body, such as inhibiting glycogen breakdown in the liver, inhibiting gluconeogenesis, and inhibiting lipolysis. If a person is insulin-sensitive or metabolically healthy, an optimal level of insulin prevents fat cells from releasing fat and promotes the storage of glucose and fat in the body. Thus optimal insulin levels are crucial for maintaining energy balance and plays a key role in metabolic processes. During the four-month study, researchers looked at the impact of a low-carb dietary (LCD) intervention on two male individuals (A & B) who had Type-2 diabetes. Althoughvneither of these individuals were obese, they were both slightly overweight and had abdominal fat deposits. Before the trial began, important markers such as fasting blood glucose (FBG), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, and Hba1c were measured. These markers are essential in defining metabolic health, their individual values and variability are integral in deciphering metabolic health. The ratio of TG to HDL is used as a surrogate marker for IR. This ratio has a high correlation with the prevalence of metabolic syndrome and with IR itself. It is a convenient measure because it can be calculated from a standard lipid profile and does not require more complex tests. In this four-month trial, an improvement in insulin sensitivity was observed through the ratio of TG/HDL, which, in turn, improves fasting blood glucose levels and HbA1c. For subject A, HbA1c dropped from 13 to 6.28, and for subject B, it dropped from 9.4 to 5.7. During the trial, neither of the subjects were taking any diabetic medications. The significant improvements in their health markers, such as better glucose control, along with an increase in energy levels, demonstrate that incorporating LCD interventions can effectively manage diabetes.

Keywords: metabolic disorder, insulin resistance, type-2 diabetes, low-carb nutrition

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