Search results for: cognitive control
10505 Early Childhood Care and Education in the North-West of Nigeria: Trends and Challenges
Authors: Muhammad Adamu Kwankwaso
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Early childhood is a critical period of rapid physical, cognitive and psycho-social development of a child. The quality of care and Education which a child receives at this crucial age will determine to a great extent the level of his/her physical and cognitive development in the future. In Nigeria, Early Childhood Care and Education (ECCE) is a fundamental aspect or form of Education for children between the age of 3-6. It was started after independence as pre-primary Education or early child development as contained in the 1977 National Policy on Education. The trends towards ECCE in Nigeria and the northwestern part of the country in particular keep up changing as in the case of other part of the world. The current trends are now towards expansions, inclusiveness, redefinition, early literacy, increased government participation and the unprecedented societal response and awareness towards the Education of the younger children. While all hands are on deck to ensure successful implementation of the ECCE programme, it is unfortunate that, ECCE is facing some challenges. This paper therefore, examines the trends in Early Childhood Care and Education and the major challenges in the north west of Nigeria. Some of the major challenges include, inadequate trained ECCE teachers, lack of unified curriculum, teacher pupil’s ratio, and the medium of instructions and inadequate infrastructural and teaching facilities respectively. To improve the situation the paper offered the following recommendations; establishment of more ECCE classes, enforcement for the use of mothers’ tongue or the languages of the immediate community as a medium of instructions, and adequate provision of infrastructural facilities and the unified curriculum across the northwestern States of Nigeria.Keywords: early childhood care, education, trends, challenges
Procedia PDF Downloads 47510504 Real-Time Hybrid Simulation for a Tuned Liquid Column Damper Implementation
Authors: Carlos Riascos, Peter Thomson
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Real-time hybrid simulation (RTHS) is a modern cyber-physical technique used for the experimental evaluation of complex systems, that treats the system components with predictable behavior as a numerical substructure and the components that are difficult to model as an experimental substructure. Therefore it is an attractive method for evaluation of the response of civil structures under earthquake, wind and anthropic loads. Another practical application of RTHS is the evaluation of control systems, as these devices are often nonlinear and their characterization is an important step in the design of controllers with the desired performance. In this paper, the response of three-story shear frame controlled by a tuned liquid column damper (TLCD) and subject to base excitation is considered. Both passive and semi-active control strategies were implemented and are compared. While the passive TLCD achieved a reduction of 50% in the acceleration response of the main structure in comparison with the structure without control, the semi-active TLCD achieved a reduction of 70%, and was robust to variations in the dynamic properties of the main structure. In addition, a RTHS was implemented with the main structure modeled as a linear, time-invariant (LTI) system through a state space representation and the TLCD, with both control strategies, was evaluated on a shake table that reproduced the displacement of the virtual structure. Current assessment measures for RTHS were used to quantify the performance with parameters such as generalized amplitude, equivalent time delay between the target and measured displacement of the shake table, and energy error using the measured force, and prove that the RTHS described in this paper is an accurate method for the experimental evaluation of structural control systems.Keywords: structural control, hybrid simulation, tuned liquid column damper, semi-active sontrol strategy
Procedia PDF Downloads 29810503 Numerical Investigation of Turbulent Flow Control by Suction and Injection on a Subsonic NACA23012 Airfoil by Proper Orthogonal Decomposition Analysis and Perturbed Reynolds Averaged Navier‐Stokes Equations
Authors: Azam Zare
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Separation flow control for performance enhancement over airfoils at high incidence angle has become an increasingly important topic. This work details the characteristics of an efficient feedback control of the turbulent subsonic flow over NACA23012 airfoil using forced reduced‐order model based on the proper orthogonal decomposition/Galerkin projection and perturbation method on the compressible Reynolds Averaged Navier‐Stokes equations. The forced reduced‐order model is used in the optimal control of the turbulent separated flow over a NACA23012 airfoil at Mach number of 0.2, Reynolds number of 5×106, and high incidence angle of 24° using blowing/suction controlling jets. The Spallart-Almaras turbulence model is implemented for high Reynolds number calculations. The main shortcoming of the POD/Galerkin projection on flow equations for controlling purposes is that the blowing/suction controlling jet velocity does not show up explicitly in the resulting reduced order model. Combining perturbation method and POD/Galerkin projection on flow equations introduce a forced reduced‐order model that can predict the time-varying influence of the blowing/suction controlling jet velocity. An optimal control theory based on forced reduced‐order system is used to design a control law for a nonlinear reduced‐order model, which attempts to minimize the vorticity content in the turbulent flow field over NACA23012 airfoil. Numerical simulations were performed to help understand the behavior of the controlled suction jet at 12% to 18% chord from leading edge and a pair of blowing/suction jets at 15% to 18% and 24% to 30% chord from leading edge, respectively. Analysis of streamline profiles indicates that the blowing/suction jets are efficient in removing separation bubbles and increasing the lift coefficient up to 22%, while the perturbation method can predict the flow field in an accurate Manner.Keywords: flow control, POD, Galerkin projection, separation
Procedia PDF Downloads 15010502 Safety of Implementation the Gluten - Free Diet in Children with Autism Spectrum Disorder
Authors: J. Jessa
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Background: Autism is a pervasive developmental disorder, the incidence of which has significantly increased in recent years. Children with autism have impairments in social skills, communication, and imagination. Children with autism has more common than healthy children feeding problems: food selectivity, problems with gastrointestinal tract: diarrhea, constipations, abdominal pain, reflux and others. Many parents of autistic children report that after implementation of gluten-, casein- and sugar free diet those symptoms disappear and even cognitive functions become better. Some children begin to understand speech and to communicate with parents, regain eye contact, become more calm, sleep better and has better concentration. Probably at the root of this phenomenon lies elimination from the diet peptides construction of which is similar to opiates. Enhanced permeability of gut causes absorption of not fully digested opioid-like peptides from food, like gluten and casein and probably others (proteins from soy and corn) which impact on brain of autistic children. Aim of the study: The aim of the study is to assess the safety of gluten-free diet in children with autism, aged 2,5-7. Methods: Participants of the study (n=70) – children aged 2,5-7 with autism are divided into 3 groups. The first group (research group) are patients whose parents want to implement a gluten-free diet. The second group are patients who have been recommended to eliminate from the diet artificial substances, such as preservatives, artificial colors and flavors, and others (control group 1). The third group (control group 2) are children whose parents did not agree for implementation of the diet. Caregivers of children on the diet are educated about the specifics of the diet and how to avoid malnutrition. At the start of the study we exclude celiac disease. Before the implementation of the diet we performe a blood test for patients (morphology, ferritin, total cholesterol, dry peripheral blood drops to detect some genetic metabolic diseases), plasma aminogram) and urine tests (excretion of ions: Mg, Na, Ca, the profile of organic acids in urine), which assess nutritional status as well as the psychological test assessing the degree of the child's psychological functioning (PEP-R). All of these tests will be repeated after one year from the implementation of the diet. Results: To the present moment we examined 42 children with autism. 12 of children are on gluten- free diet. Our preliminary results are promising. Parents of 9 of them report that, there is a big improvement in child behavior, concentration, less aggression incidents, better eye contact and better verbal skills. Conclusion: Our preliminary results suggest that dietary intervention may positively affect developmental outcome for some children diagnosed with ASD.Keywords: gluten free diet, autism spectrum disorder, autism, blood test
Procedia PDF Downloads 32310501 Efficacy and Safety of Inhaled Nebulized Chemotherapy in Treatment of Patients with Newly Diagnosed Pulmonary Tuberculosis in Comparison to Standard Antimycobacterial Therapy
Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian
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Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis
Procedia PDF Downloads 19710500 Fuzzy Control of Thermally Isolated Greenhouse Building by Utilizing Underground Heat Exchanger and Outside Weather Conditions
Authors: Raghad Alhusari, Farag Omar, Moustafa Fadel
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A traditional greenhouse is a metal frame agricultural building used for cultivation plants in a controlled environment isolated from external climatic changes. Using greenhouses in agriculture is an efficient way to reduce the water consumption, where agriculture field is considered the biggest water consumer world widely. Controlling greenhouse environment yields better productivity of plants but demands an increase of electric power. Although various control approaches have been used towards greenhouse automation, most of them are applied to traditional greenhouses with ventilation fans and/or evaporation cooling system. Such approaches are still demanding high energy and water consumption. The aim of this research is to develop a fuzzy control system that minimizes water and energy consumption by utilizing outside weather conditions and underground heat exchanger to maintain the optimum climate of the greenhouse. The proposed control system is implemented on an experimental model of thermally isolated greenhouse structure with dimensions of 6x5x2.8 meters. It uses fans for extracting heat from the ground heat exchanger system, motors for automatic open/close of the greenhouse windows and LED as lighting system. The controller is integrated also with environmental condition sensors. It was found that using the air-to-air horizontal ground heat exchanger with 90 mm diameter and 2 mm thickness placed 2.5 m below the ground surface results in decreasing the greenhouse temperature of 3.28 ˚C which saves around 3 kW of consumed energy. It also eliminated the water consumption needed in evaporation cooling systems which are traditionally used for cooling the greenhouse environment.Keywords: automation, earth-to-air heat exchangers, fuzzy control, greenhouse, sustainable buildings
Procedia PDF Downloads 12910499 Analysis of DC\DC Converter of Photovoltaic System with MPPT Algorithms Comparison
Authors: Badr M. Alshammari, Mohamed A. Khlifi
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This paper presents the analysis of DC/DC converter including a comparative study of control methods to extract the maximum power and to track the maximum power point (MPP) from photovoltaic (PV) systems under changeable environmental conditions. This paper proposes two methods of maximum power point tracking algorithm for photovoltaic systems, based on the first hand on P&O control and the other hand on the first order IC. The MPPT system ensures that solar cells can deliver the maximum power possible to the load. Different algorithms are used to design it. Here we compare them and simulate the photovoltaic system with two algorithms. The algorithms are used to control the duty cycle of a DC-DC converter in order to boost the output voltage of the PV generator and guarantee the operation of the solar panels in the Maximum Power Point (MPP). Simulation and experimental results show that the proposed algorithms can effectively improve the efficiency of a photovoltaic array output.Keywords: solar cell, DC/DC boost converter, MPPT, photovoltaic system
Procedia PDF Downloads 20210498 Identification and Control the Yaw Motion Dynamics of Open Frame Underwater Vehicle
Authors: Mirza Mohibulla Baig, Imil Hamda Imran, Tri Bagus Susilo, Sami El Ferik
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The paper deals with system identification and control a nonlinear model of semi-autonomous underwater vehicle (UUV). The input-output data is first generated using the experimental values of the model parameters and then this data is used to compute the estimated parameter values. In this study, we use the semi-autonomous UUV LAURS model, which is developed by the Sensors and Actuators Laboratory in University of Sao Paolo. We applied three methods to identify the parameters: integral method, which is a classical least square method, recursive least square, and weighted recursive least square. In this paper, we also apply three different inputs (step input, sine wave input and random input) to each identification method. After the identification stage, we investigate the control performance of yaw motion of nonlinear semi-autonomous Unmanned Underwater Vehicle (UUV) using feedback linearization-based controller. In addition, we compare the performance of the control with an integral and a non-integral part along with state feedback. Finally, disturbance rejection and resilience of the controller is tested. The results demonstrate the ability of the system to recover from such fault.Keywords: system identification, underwater vehicle, integral method, recursive least square, weighted recursive least square, feedback linearization, integral error
Procedia PDF Downloads 53610497 Assessment of Trace Metal Concentration of Soils Contaminated with Carbide in Abraka, Delta State, Nigeria
Authors: O.M. Agbogidi, I.M. Onochie
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An investigation was carried out on trace metal concentration of soils contaminated with carbide in Abraka, Delta State, Nigeria in 2014 with a view to providing baseline formation on their status relative to the control plants and to the tolerable limits recommended by World standard bodies including WHO and FAO. The metals were analyzed using the Atomic Absorption Spectrophotometer which showed an elevated level when compared with the control plots. High level of metals including Fe, Pb, Zn, Cu, Cd, Ni, Cr and arsenic were recorded and these values were significantly different (P<0.05) from values obtained from the control plots. These results are indicative of the fact that carbide polluted soil had higher level of trace metals and because these metals are non-biodegradable elements in the ecosystem, a rise to their lethal levels in food chains is envisaged due to the interdependency of plants and animals stemming from soil-water organisms interrelationship.Keywords: bio-concentration, carbide contaminated soils, heavy metals, trace metals
Procedia PDF Downloads 27510496 An Experimental Study of Self-Regulated Learning with High School Gifted Pupils
Authors: Prakash Singh
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Research studies affirm the view that gifted pupils are endowed with unique personality traits, enabling them to study at higher levels of thinking, at a faster pace, and with a greater degree of autonomy than their average counterparts. The focus of this study was whether high school gifted pupils are capable of studying an advanced level curriculum on their own by employing self-regulated learning (SRL) strategies. To be self-regulated, pupils are required to be metacognitively, motivationally, and behaviourally active participants in their own learning processes so that they are able to initiate and direct their personal curriculum efforts to acquire cognitive skills and knowledge, instead of being solely reliant on their teachers. Researchers working with gifted populations concede that limited studies have been conducted thus far to examine gifted pupils’ expertise in using SRL strategies to assume ownership of their learning. In order to conduct this investigation, an enriched module in Accounting for specifically gifted grade eleven pupils was developed, incorporating advanced level content, and use was made of the Post-test-Only Control Group Design to accomplish this research objective. The results emanating from this empirical study strongly suggest that SRL strategies can be employed to overcome a narrow, rigid approach that limits the education of gifted pupils in the regular classroom of the high school. SRL can meaningfully offer an alternative way to implement an advanced level curriculum for the gifted in the mainstream of education. This can be achieved despite the limitations of differentiation in the regular classroom.Keywords: advanced level curriculum, high school gifted pupils, self-regulated learning, teachers’ professional competencies
Procedia PDF Downloads 40210495 Neuromuscular Control and Performance during Sudden Acceleration in Subjects with and without Unilateral Acute Ankle Sprains
Authors: M. Qorbani
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Neuromuscular control of posture as understood through studies of responses to mechanical sudden acceleration automatically has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of acute condition has not been previously explored specially in a sudden acceleration. The aim of this study was to determine neuromuscular control pattern in those with and without unilateral acute ankle sprains. Design: Case - control. Setting: University research laboratory. The sinker–card protocol with surface translation was be used as a sudden acceleration protocol with study of EMG upon 4 posture stabilizer muscles in two sides of the body in response to sudden acceleration in forward and backward directions. 20 young adult women in two groups (10 LAS; 23.9 ± 2.03 yrs and 10 normal; 26.4 ± 3.2 yrs). The data of EMG were assessed by using multivariate test and one-way repeated measures 2×2×4 ANOVA (P< 0.05). The results showed a significant muscle by direction interaction. Higher TA activity of left and right side in LAS group than normal group in forward direction significantly be showed. Higher MGR activity in normal group than LAS group in backward direction significantly showed. These findings suggest that compared two sides of the body in two directions for 4 muscles EMG activities between and within group for neuromuscular control of posture in avoiding fall. EMG activations of two sides of the body in lateral ankle sprain (LAS) patients were symmetric significantly. Acute ankle instability following once ankle sprains caused to coordinated temporal spatial patterns and strategy selection.Keywords: neuromuscular response, sEMG, lateral ankle sprain, posture.
Procedia PDF Downloads 48210494 Adverse Childhood Experiences and the Sense of Effectiveness and Coping with Emotions among Adolescents Taking Drugs
Authors: Monika Szpringer, Aneta Pawlinska
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Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs
Procedia PDF Downloads 10210493 Effects of Clozapine and Risperidone Antipsychotic Drugs on the Expression of CACNA1C and Behavioral Changes in Rat ‘Ketamine Model of Schizophrenia
Authors: Mehrnoosh Azimi Sanavi, Hamed Ghazvini, Mehryar Zargari, Hossein Ghalehnoei, Zahra Hosseini-khah
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Objectives: Calcium Voltage-Gated Channel Subunit Alpha1 C (CACNA1C) is one of the most important genes associated with schizophrenia. Methods: 45 male Wistar rats were divided into 5 groups: saline, control, ketamine, clozapine, and risperidone. Animals in ketamine, risperidone, and clozapine groups received ketamine (30 mg/ kg-i.p.) for 10 days. After the last injection of ketamine, we started injecting clozapine (7.5 mg/kg-i.p.) risperidone (1 mg/kg-i.p.) for up to 28 days. Twenty-four hours after the last injection, open field, social interaction, and elevated plus-maze tests, and gene expression in the hippocampus were performed. Results: The results of the social interaction test revealed a significant decrease in cumulative time with ketamine compared with the saline group and an increase with clozapine and risperidone compared with the ketamine group. Moreover, results from the elevated plus-maze test demonstrated a critical decrease in open-arm time and an increase in close-arm time with ketamine compared with saline, as well as an increase in open-arm time with risperidone compared with ketamine. Further results revealed a significant increase in rearing and grooming with ketamine compared to saline, as well as a decrease with risperidone and clozapine compared to ketamine. There were no significant differences in CACNA1C gene expression between groups in the rat hippocampus. In brief, the results of this study indicated that clozapine and risperidone could partially improve cognitive impairments in the rat. However, our findings demonstrated that this treatment is not related to CACNA1C gene expression.Keywords: schizophrenia, ketamine, clozapine, risperidone
Procedia PDF Downloads 6310492 Quality Control of 99mTc-Labeled Radiopharmaceuticals Using the Chromatography Strips
Authors: Yasuyuki Takahashi, Akemi Yoshida, Hirotaka Shimada
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99mTc-2-methoxy-isobutyl-isonitrile (MIBI) and 99mTcmercaptoacetylgylcylglycyl-glycine (MAG3 ) are heat to 368-372K and are labeled with 99mTc-pertechnetate. Quality control (QC) of 99mTc-labeled radiopharmaceuticals is performed at hospitals, using liquid chromatography, which is difficult to perform in general hospitals. We used chromatography strips to simplify QC and investigated the effects of the test procedures on quality control. In this study is 99mTc- MAG3. Solvent using chloroform + acetone + tetrahydrofuran, and the gamma counter was ARC-380CL. The changed conditions are as follows; heating temperature, resting time after labeled, and expiration year for use: which were 293, 313, 333, 353 and 372K; 15 min (293K and 372K) and 1 hour (293K); and 2011, 2012, 2013, 2014 and 2015 respectively were tested. Measurement time using the gamma counter was one minute. A nuclear medical clinician decided the quality of the preparation in judging the usability of the retest agent. Two people conducted the test procedure twice, in order to compare reproducibility. The percentage of radiochemical purity (% RCP) was approximately 50% under insufficient heat treatment, which improved as the temperature and heating time increased. Moreover, the % RCP improved with time even under low temperatures. Furthermore, there was no deterioration with time after the expiration date. The objective of these tests was to determine soluble 99mTc impurities, including 99mTc-pertechnetate and the hydrolyzed-reduced 99mTc. Therefore, we assumed that insufficient heating and heating to operational errors in the labeling. It is concluded that quality control is a necessary procedure in nuclear medicine to ensure safe scanning. It is suggested that labeling is necessary to identify specifications.Keywords: quality control, tc-99m labeled radio-pharmaceutical, chromatography strip, nuclear medicine
Procedia PDF Downloads 32210491 Comparison of Whole-Body Vibration and Plyometric Exercises on Explosive Power in Non-Athlete Girl Students
Authors: Fereshteh Zarei, Mahdi Kohandel
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The aim of this study was investigate and compare plyometric and vibration exercises on muscle explosive power in non-athlete female students. For this purpose, 45 female students from non-athletes selected target then divided in to the three groups, two experimental and one control groups. From all groups were getting pre-tested. Experimental A did whole-body vibration exercises involved standing on one of machine vibration with frequency 30 Hz, amplitude 10 mm and in 5 different postures. Training for each position was 40 seconds with 60 seconds rest between it, and each season 5 seconds was added to duration of each body condition, until time up to 2 minutes for each postures. Exercises were done three times a week for 2 month. Experimental group B did plyometric exercises that include jumping, such as horizontal, vertical, and skipping .They included 10 times repeat for 5 set in each season. Intensity with increasing repetitions and sets were added. At this time, asked from control group that keep a daily activity and avoided strength training, explosive power and. after do exercises by groups we measured factors again. One-way analysis of variance and paired t statistical methods were used to analyze the data. There was significant difference in the amount of explosive power between the control and vibration groups (p=0/048) there was significant difference between the control and plyometric groups (019/0 = p). But between vibration and plyometric groups didn't observe significant difference in the amount of explosive power.Keywords: vibration, plyometric, exercises, explosive power, non-athlete
Procedia PDF Downloads 45310490 Design, Synthesis and Evaluation of 4-(Phenylsulfonamido)Benzamide Derivatives as Selective Butyrylcholinesterase Inhibitors
Authors: Sushil Kumar Singh, Ashok Kumar, Ankit Ganeshpurkar, Ravi Singh, Devendra Kumar
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In spectrum of neurodegenerative diseases, Alzheimer’s disease (AD) is characterized by the presence of amyloid β plaques and neurofibrillary tangles in the brain. It results in cognitive and memory impairment due to loss of cholinergic neurons, which is considered to be one of the contributing factors. Donepezil, an acetylcholinesterase (AChE) inhibitor which also inhibits butyrylcholinesterase (BuChE) and improves the memory and brain’s cognitive functions, is the most successful and prescribed drug to treat the symptoms of AD. The present work is based on designing of the selective BuChE inhibitors using computational techniques. In this work, machine learning models were trained using classification algorithms followed by screening of diverse chemical library of compounds. The various molecular modelling and simulation techniques were used to obtain the virtual hits. The amide derivatives of 4-(phenylsulfonamido) benzoic acid were synthesized and characterized using 1H & 13C NMR, FTIR and mass spectrometry. The enzyme inhibition assays were performed on equine plasma BuChE and electric eel’s AChE by method developed by Ellman et al. Compounds 31, 34, 37, 42, 49, 52 and 54 were found to be active against equine BuChE. N-(2-chlorophenyl)-4-(phenylsulfonamido)benzamide and N-(2-bromophenyl)-4-(phenylsulfonamido)benzamide (compounds 34 and 37) displayed IC50 of 61.32 ± 7.21 and 42.64 ± 2.17 nM against equine plasma BuChE. Ortho-substituted derivatives were more active against BuChE. Further, the ortho-halogen and ortho-alkyl substituted derivatives were found to be most active among all with minimal AChE inhibition. The compounds were selective toward BuChE.Keywords: Alzheimer disease, butyrylcholinesterase, machine learning, sulfonamides
Procedia PDF Downloads 13910489 The Amorphousness of the Exposure Sphere
Authors: Nipun Ansal
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People guard their beliefs and opinions with their lives. Beliefs that they’ve formed over a period of time, and can go to any lengths to defy, desist from, resist and negate any outward stimulus that has the potential to shake them. Cognitive dissonance is term used to describe it in theory. And every human being, in order to defend himself from cognitive dissonance applies 4 rings of defense viz. Selective Exposure, Selective Perception, Selective Attention, and Selective Retention. This paper is a discursive analysis on how the onslaught of social media, complete with its intrusive weaponry, has amorphized the external ring of defense: the selective exposure. The stimulus-response model of communication is one of the most inherent model that encompasses communication behaviours of children and elderly, individual and masses, humans and animals alike. The paper deliberates on how information bombardment through the uncontrollable channels of the social media, Facebook and Twitter in particular, have dismantled our outer sphere of exposure, leading users online to a state of constant dissonance, and thus feeding impulsive action-taking. It applies case study method citing an example to corroborate how knowledge generation has given in to the information overload and the effect it has on decision making. With stimulus increasing in number of encounters, opinion formation precedes knowledge because of the increased demand of participation and decrease in time for the information to permeate from the outer sphere of exposure to the sphere of retention, which of course, is through perception and attention. This paper discusses the challenge posed by this fleeting, stimulus rich, peer-dominated media on the traditional models of communication and meaning-generation.Keywords: communication, discretion, exposure, social media, stimulus
Procedia PDF Downloads 40810488 Tibial Plateau Fractures During Covid-19 In A Trauma Unit. Impact of Lockdown and The Pressures on the Healthcare Provider
Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi
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The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.Keywords: Covid-19, knee, tibial plateau fracture, trauma
Procedia PDF Downloads 12510487 The Contemporary Format of E-Learning in Teaching Foreign Languages
Authors: Nataliya G. Olkhovik
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Nowadays in the system of Russian higher medical education there have been undertaken initiatives that resulted in focusing on the resources of e-learning in teaching foreign languages. Obviously, the face-to-face communication in foreign languages bears much more advantages in terms of effectiveness in comparison with the potential of e-learning. Thus, we’ve faced the necessity of strengthening the capacity of e-learning via integration of active methods into the process of teaching foreign languages, such as project activity of students. Successful project activity of students should involve the following components: monitoring, control, methods of organizing the student’s activity in foreign languages, stimulating their interest in the chosen project, approaches to self-assessment and methods of raising their self-esteem. The contemporary methodology assumes the project as a specific method, which activates potential of a student’s cognitive function, emotional reaction, ability to work in the team, commitment, skills of cooperation and, consequently, their readiness to verbalize ideas, thoughts and attitudes. Verbal activity in the foreign language is a complex conception that consolidates both cognitive (involving speech) capacity and individual traits and attitudes such as initiative, empathy, devotion, responsibility etc. Once we organize the project activity by the means of e-learning within the ‘Foreign language’ discipline we have to take into consideration all mentioned above characteristics and work out an effective way to implement it into the teaching practice to boost its educational potential. We have integrated into the e-platform Moodle the module of project activity consisting of the following blocks of tasks that lead students to research, cooperate, strive to leadership, chase the goal and finally verbalize their intentions. Firstly, we introduce the project through activating self-activity of students by the tasks of the phase ‘Preparation of the project’: choose the topic and justify it; find out the problematic situation and its components; set the goals; create your team, choose the leader, distribute the roles in your team; make a written report on grounding the validity of your choices. Secondly, in the ‘Planning the project’ phase we ask students to represent the analysis of the problem in terms of reasons, ways and methods of solution and define the structure of their project (here students may choose oral or written presentation by drawing up the claim in the e-platform about their wish, whereas the teacher decides what form of presentation to prefer). Thirdly, the students have to design the visual aids, speech samples (functional phrases, introductory words, keywords, synonyms, opposites, attributive constructions) and then after checking, discussing and correcting with a teacher via the means of Moodle present it in front of the audience. And finally, we introduce the phase of self-reflection that aims to awake the inner desire of students to improve their verbal activity in a foreign language. As a result, by implementing the project activity into the e-platform and project activity, we try to widen the frameworks of a traditional lesson of foreign languages through tapping the potential of personal traits and attitudes of students.Keywords: active methods, e-learning, improving verbal activity in foreign languages, personal traits and attitudes
Procedia PDF Downloads 10510486 Investigating the Insecticidal Effects of the Hexanic Extracts of Thymus spp. and Eucalyptus spp. on Cotton Bollworm, Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae)
Authors: Reza Sadeghi, Maryam Nazarahari
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Considering the effectiveness of plant pesticides in pest control, this group of pesticides can provide an efficient way to reduce the damage caused by pests in agriculture and maintain environmental health. Plant pesticides allow farmers to cultivate their crops by lowering the use of chemical pesticides and help improve the quality of agricultural products. In this research, various plant compounds were extracted from two different sources, thyme and eucalyptus, by using n-hexane solvent and investigated to control cotton bollworm in laboratory conditions. The mortality rates of cotton bollworm (Helicoverpa armigera) caused by different concentrations of hexanic extract formulations were evaluated. The results showed that the varied concentrations of the hexanic extract formulations of thyme and eucalyptus had significant effects on the mortality rates of cotton bollworm larvae during a 24-h exposure period. The hexanic extract of thyme as a plant pesticide can be an effective alternative in agriculture and plant pest control. The use of pesticides in agriculture can help the environment and reduce the problems related to chemical toxins. Also, this research revealed that the types and compounds of plant pesticides can be effective in pest control and help to develop more efficient agricultural strategies.Keywords: cotton bollworm, thyme, eucalyptus, extract formulation, toxicity
Procedia PDF Downloads 9110485 Designing Space through Narratives: The Role of the Tour Description in the Architectural Design Process
Authors: A. Papadopoulou
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When people are asked to provide an oral description of a space they usually provide a Tour description, which is a dynamic type of spatial narrative centered on the narrator’s body, rather than a Map description, which is a static type of spatial narrative focused on the organization of the space as seen from above. Also, subjects with training in the architecture discipline tend to adopt a Tour perspective of space when the narrative refers to a space they have actually experienced but tend to adopt a Map perspective when the narrative refers to a space they have merely imagined. This pilot study aims to investigate whether the Tour description, which is the most common mode in the oral descriptions of experienced space, is a cognitive perspective taken in the process of designing a space. The study investigates whether a spatial description provided by a subject with architecture training in the type of a Tour description would be accurately translated into a spatial layout by other subjects with architecture training. The subjects were given the Tour description in written form and were asked to make a plan drawing of the described space. The results demonstrate that when we conceive and design space we do not adopt the same rules and cognitive patterns that we adopt when we reconstruct space from our memory. As shown by the results of this pilot study, the rules that underlie the Tour description were not detected in the translation from narratives to drawings. In a different phase, the study also investigates how would subjects with architecture training describe space when forced to take a Tour perspective in their oral description of a space. The results of this second phase demonstrate that if intentionally taken, the Tour perspective leads to descriptions of space that are more detailed and focused on experiential aspects.Keywords: architecture, design process, embodied cognition, map description, oral narratives, tour description
Procedia PDF Downloads 15810484 Streamlining Cybersecurity Risk Assessment for Industrial Control and Automation Systems: Leveraging the National Institute of Standard and Technology’s Risk Management Framework (RMF) Using Model-Based System Engineering (MBSE)
Authors: Gampel Alexander, Mazzuchi Thomas, Sarkani Shahram
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The cybersecurity landscape is constantly evolving, and organizations must adapt to the changing threat environment to protect their assets. The implementation of the NIST Risk Management Framework (RMF) has become critical in ensuring the security and safety of industrial control and automation systems. However, cybersecurity professionals are facing challenges in implementing RMF, leading to systems operating without authorization and being non-compliant with regulations. The current approach to RMF implementation based on business practices is limited and insufficient, leaving organizations vulnerable to cyberattacks resulting in the loss of personal consumer data and critical infrastructure details. To address these challenges, this research proposes a Model-Based Systems Engineering (MBSE) approach to implementing cybersecurity controls and assessing risk through the RMF process. The study emphasizes the need to shift to a modeling approach, which can streamline the RMF process and eliminate bloated structures that make it difficult to receive an Authorization-To-Operate (ATO). The study focuses on the practical application of MBSE in industrial control and automation systems to improve the security and safety of operations. It is concluded that MBSE can be used to solve the implementation challenges of the NIST RMF process and improve the security of industrial control and automation systems. The research suggests that MBSE provides a more effective and efficient method for implementing cybersecurity controls and assessing risk through the RMF process. The future work for this research involves exploring the broader applicability of MBSE in different industries and domains. The study suggests that the MBSE approach can be applied to other domains beyond industrial control and automation systems.Keywords: authorization-to-operate (ATO), industrial control systems (ICS), model-based system’s engineering (MBSE), risk management framework (RMF)
Procedia PDF Downloads 9510483 Effect of Whey Protein-Rice Bran Oil Incorporated Zataria multiflora Extract Edible Coating on Chemical, Physical and Microbial Quality of Chicken Egg
Authors: Majid Javanmard
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In this study, the effects of coating with whey protein concentrate (7.5% w/v) alone and/or in combination with rice bran oil (0.2, 0.4, 0.6 g in 100 ml coating solution) and Zataria multiflora extract (1 and 2 μL in 100 ml coating solution) on the quality attributes and egg shelf life were carefully observed and analyzed. Weight loss, Haugh index, yolk index, pH, air cell depth, shell strength and the impact of this coating on the microbial load of the eggs surface were studied at the end of each week (during the 4 weeks of storage in a room environment temperature and humidity). After 4 weeks of storage, it was observed that the weight loss in all of the treated eggs with whey protein concentrate and 0.2 gr of rice bran oil (experimental group) was significantly lower than that of the control group(P < 0/05). With regard to Haugh index and yolk index, egg shelf life increased about 4 weeks compared with the control samples. Haugh Index changes revealed that the coated samples remained at grade A after 3 weeks of storage, while the control samples were relegated from grade AA to B after one week. Haugh and yolk Indices in all coated eggs were more than those of the control group. In the coated groups, Haugh and yolk indices of the coated samples with whey protein concentrate and 0.2 g rice bran oil and with whey protein concentrate and 0.2g of rice bran oil and 1 micro liter of Zataria multiflora extract were more than those of the other coated eggs and the control group eggs. PH values of the control group were higher than those of the coated groups during the storage of the eggs. The shell strength of the coated group was more than that of the control group (uncoated) and in coated samples, whey protein concentrate and 0.2 gr of rice bran oil coated samples had high shell strength. In the other treatments, no significant differences were observed. The depth of the air cell of the coated groups was determined to be less than that of the control group during the storage period. The minimum inhibitory concentration was 1 μL of Zataria multiflora extract. The results showed that 1 μL concentration of Zataria multiflora extract reduces the microbial load of the egg shell surface to 87% and 2 μL reduced total bacterial load to zero. In sensory evaluation, from evaluator point of view, the coated eggs had more overall acceptance than the uncoated group (control), and in the treatment group coated eggs, those containing a low percentage of rice bran oil had higher overall acceptability. In conclusion, coating as a practical and cost effective method can maintain the quality parameters of eggs and lead to durability of supply conditions in addition to the product marketability.Keywords: edible coating, chicken egg, whey protein concentrate, rice bran oil, Zataria multiflora extract, shelf life
Procedia PDF Downloads 30210482 Egg Yolk and Serum Cholesterol Reducing Effect of Garlic and Natural Cocoa Powder Using Laying Birds as Model
Authors: Onyimonyi Anselm Ego, Obi-Keguna Christy, Dim Emmanuel Chinonso, Ugwuanyi Evelyn, Uzochukwu Ifeanyi Emmanuel
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A total of 144 Shaver Brown Layers in their sixteenth week of lay were used in a twelve weeks study to evaluate the egg yolk and serum cholesterol of the birds when fed varying dietary combinations of garlic and natural cocoa powder. The birds were randomly assigned into nine dietary treatments with 16 birds per treatment. Each bird was housed separately in a cage measuring 45 cm x 35 cm in an open sided battery cage house typical of the tropics. A standard poultry mash diet with 16.5% CP and 2800 KcalME/kg was formulated as the basal ration which also served as the control diet. Garlic and natural cocoa powder were incorporated in varying combinations (50 g or 100 g/100 kg of feed) in the remaining eight treatments. Weekly data of egg weight, egg length, egg diameter, yolk weight, albumen weight and hen day egg production were kept. Egg yolk and serum cholesterol levels were determined using a Randox kit. Results showed that birds receiving garlic and natural cocoa powder had significantly (P<0.05) reduced egg and albumen weight as compared to control birds. Hen day production of the birds was also significantly higher than control birds. Egg yolk and serum cholesterol of birds receiving the garlic and natural cocoa powder were significantly (P<0.05) lower than the control. Serum cholesterol levels showed decline in the birds receiving garlic and natural cocoa powder. The least yolk cholesterol level of 160 mg/dl was observed in birds receiving 50g garlic and 50 g natural cocoa powder (Treatment 5). Control birds had an egg cholesterol level of 245.45 mg/dl. It was concluded that incorporating garlic and natural cocoa powder in the diets of laying hens can result in a significant reduction in the egg and serum cholesterol levels.Keywords: egg, serum, cholesterol, garlic
Procedia PDF Downloads 76710481 Effects of Turkish Classical Music on Cognitive Function, Depression and Quality of Life in Elderly
Authors: Rukiye Pinar Boluktas
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According to 2015 statistics, in Turkey, 46% of older people live alone in their homes, 55% have poor health perceptions, 18% face poverty, and 43% are unhappy. Prevalence of depression is between 14% and 20%. In 2013, rate of suicide was 6.5. However, the most of older people prefer to live in their community although they are lonely, they face poverty, and face limitations as a result of chronic diseases and disabilities. Community based care for older people is also encouraged by Ministry of Health as it is more cost-effective. Music therapy is a simple, effective, safe, and nonpharmacologic intervention that may be used to decrease depression and to improve cognition, and health related quality of life (HRQOL). In Turkish culture, music is typically described as ‘food for soul’. This study aimed to investigate the effect of Turkish classical music songs in 32 community dwelling older people. Participants were received interventions two or three times per week, 50-60 min per session, for 8 weeks at a day health center. Each intervention session started listening music for 15-20 min to get remember songs, then followed singing songs as a group. Participants were assessed at baseline (week 0), and two follow-up at month 1 and month 2. Compared to baseline, at two follow-up, we observed that cognition improved, depression decreased, and SF-36 scores, including 8 domains and two summary scores increased. We conclude that an intervention comprising listening and singing Turkish classical music improve cognition, depression and HRQOL in older people.Keywords: cognitive function, depression, elderly, quality of life, Turkish classical music
Procedia PDF Downloads 16510480 Study on Capability of the Octocopter Configurations in Finite Element Analysis Simulation Environment
Authors: Jeet Shende, Leonid Shpanin, Misko Abramiuk, Mattew Goodwin, Nicholas Pickett
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Energy harvesting on board the Unmanned Ariel Vehicle (UAV) is one of the most rapidly growing emerging technologies and consists of the collection of small amounts of energy, for different applications, from unconventional sources that are incidental to the operation of the parent system or device. Different energy harvesting techniques have already been investigated in the multirotor drones, where the energy collected comes from the systems surrounding ambient environment and typically involves the conversion of solar, kinetic, or thermal energies into electrical energy. The energy harvesting from the vibrated propeller using the piezoelectric components inside the propeller has also been proven to be feasible. However, the impact on the UAV flight performance using this technology has not been investigated. In this contribution the impact on the multirotor drone operation has been investigated at different flight control configurations which support the efficient performance of the propeller vibration energy harvesting. The industrially made MANTIS X8-PRO octocopter frame kit was used to explore the octocopter operation which was modelled using SolidWorks 3D CAD package for simulation studies. The octocopter flight control strategy is developed through integration of the SolidWorks 3D CAD software and MATLAB/Simulink simulation environment for evaluation of the octocopter behaviour under different simulated flight modes and octocopter geometries. Analysis of the two modelled octocopter geometries and their flight performance is presented via graphical representation of simulated parameters. The possibility of not using the landing gear in octocopter geometry is demonstrated. The conducted study evaluates the octocopter’s flight control technique and its impact on the energy harvesting mechanism developed on board the octocopter. Finite Element Analysis (FEA) simulation results of the modelled octocopter in operation are presented exploring the performance of the octocopter flight control and structural configurations. Applications of both octocopter structures and their flight control strategy are discussed.Keywords: energy harvesting, flight control modelling, object modeling, unmanned aerial vehicle
Procedia PDF Downloads 7710479 Perceptions of Cognitive Behavioural Therapy in Physiotherapy Management for Chronic Low Back Pain: A Qualitative Exploration of Stakeholder Views
Authors: Latifa Alenezi, Liz Croot, Janet Harris
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Chronic Low Back Pain (CLBP) is one of the most common and recurrent musculoskeletal problems that causes patients to access health care services frequently. The Bio-psychosocial Model emphasises that psychological, behavioural and social factors contribute to the development and persistence of CLBP. Cognitive behavioural therapy (CBT) is a psychological pain management strategy that can be used by physiotherapists treating chronic low back pain. However, evidence of the effectiveness of CBT for CLBP varies between different studies. The proposed study was preceded by a mixed methods systematic review that found that CBT has a beneficial effect for CLBP patients when compared to waiting list or other treatments; however, there is variation in effectiveness across different settings. Little is known about how CBT is applied by physiotherapists in physiotherapy settings. The interest of this study is directed towards generating an explanation and understanding of why, when, and how some physiotherapists make decisions and choose to apply CBT for CLBP patients, whereas others do not. Also, how and for what type of CLBP patients does CBT work, and for whom might CBT not work? Therefore, the study will take a qualitative approach to explore CLBP patients’, physiotherapists’ and managers’ perceptions of CBT and how it is used in physiotherapy to enable a deeper understanding and richer explanation of CBT effectiveness and help to inform research and practice. The study will use grounded theory approach to generate an explanatory theory of the clinical application of CBT for CLBP in physiotherapy settings. Physiotherapists, patients and managers of physiotherapy services will be interviewed. Grounded theory techniques will be used to analyse the data. The presentation will describe findings from the interviews and the emerging theory. This research will help to further inform RCTs about the effectiveness of CBT for CLBP in physiotherapy.Keywords: CBT, CLBP, perception, physiotherapy, theory
Procedia PDF Downloads 23310478 Evaluation of Inceptor Design for Manned Multicopter
Authors: Jędrzej Minda
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In aviation, a very narrow spectrum of control inceptors exists, namely centre sticks, side-sticks, pedals, and yokes. However, new types of aircraft are emerging, and with them, a need for new inceptors. A manned multicopter created at AGH University of Science and Technology is an aircraft in which the pilot takes a specific orientation in which classical inceptors may be impractical to use. In this paper, a unique kind of control inceptor is described, which aims to provide a handling quality not unlike standard solutions, and provide a firm grip point for the pilot without the risk of involuntary stick movement. Simulations of the pilot-inceptor model were performed in order to compare the dynamic amplification factors of the design described in this paper with the classical one. A functional prototype is built on which drone pilots carry out a comfort-of-use evaluation. This paper provides a general overview of the project, including a literature review, reasoning behind components selection, and mechanism design finalized by conclusions.Keywords: mechanisms, mechatronics, embedded control, serious gaming for training rescue missions, rescue robotics
Procedia PDF Downloads 8210477 Anticipating Asthma with Control Environmental Factors and Food
Authors: Destin Kurniawati
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Asthma is one of the deadly diseases in the world. According to the World Health Organization in 2012, 300 million people suffer from asthma of different races and classes. An estimated 250,000 people die because of asthma annually.As well as more than 57% of children and 51% of adults with asthma. There two risk factors for asthma. That risk factors are the host and environmental. One of the environmental factors that can bring asthma is allergens. When an allergen enters the body, the allergen binds to IgE and cause cell granulat- issued several mediators such as histamine, leukotrienes, bradykinin or something like that. This will cause localized edema effect on bronchial walls of small, thick mucous secretions in the bronchioles, and bronchial smooth muscle spasm. Then there will be inflammation of the airways. Methodology this research is by literature. Therefore, to anticipate and cope with asthma is to control environmental factors that serve to minimize allergens and controlling one's intake in the form of antioxidant-rich foods. Foods rich in antioxidants serve to improve lung function and decrease symptoms of the disease of the respiratory tract.Keywords: asthma, deadly disease, allergen, environmental and food control
Procedia PDF Downloads 26110476 The Effect of Fish and Krill Oil on Warfarin Control
Authors: Rebecca Pryce, Nijole Bernaitis, Andrew K. Davey, Shailendra Anoopkumar-Dukie
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Background: Warfarin is an oral anticoagulant widely used in the prevention of strokes in patients with atrial fibrillation (AF) and in the treatment and prevention of deep vein thrombosis (DVT). Regular monitoring of Internationalised Normalised Ratio (INR) is required to ensure therapeutic benefit with time in therapeutic range (TTR) used to measure warfarin control. A number of factors influence TTR including diet, concurrent illness, and drug interactions. Extensive literature exists regarding the effect of conventional medicines on warfarin control, but documented interactions relating to complementary medicines are limited. It has been postulated that fish oil and krill oil supplementation may affect warfarin due to their association with bleeding events. However, to date little is known as to whether fish and krill oil significantly alter the incidence of bleeding with warfarin or impact on warfarin control. Aim:To assess the influence of fish oil and krill oil supplementation on warfarin control in AF and DVT patients by determining the influence of these supplements on TTR and bleeding events. Methods:A retrospective cohort analysis was conducted utilising patient information from a large private pathology practice in Queensland. AF and DVT patients receiving warfarin management by the pathology practice were identified and their TTR calculated using the Rosendaal method. Concurrent medications were analysed and patients taking no other interacting medicines were identified and divided according to users of fish oil and krill oil supplements and those taking no supplements. Study variables included TTR and the incidence of bleeding with exclusion criteria being less than 30 days of treatment with warfarin. Subject characteristics were reported as the mean and standard deviation for continuous data and number and percentages for nominal or categorical data. Data was analysed using GraphPad InStat Version 3 with a p value of <0.05 considered to be statistically significant. Results:Of the 2081 patients assessed for inclusion into this study, a total of 573 warfarin users met the inclusion criteria. Of these, 416 (72.6%) patients were AF patients and 157 (27.4%) DVT patients and overall there were 316 (55.1%) male and 257 (44.9%) female patients. 145 patients were included in the fish oil/krill oil group (supplement) and 428 were included in the control group. The mean TTR of supplement users was 86.9% and for the control group 84.7% with no significant difference between these groups. Control patients experienced 1.6 times the number of minor bleeds per person compared to supplement patients and 1.2 times the number of major bleeds per person. However, this was not statistically significant nor was the comparison between thrombotic events. Conclusion: No significant difference was found between supplement and control patients in terms of mean TTR, the number of bleeds and thrombotic events. Fish oil and krill oil supplements when used concurrently with warfarin do not significantly affect warfarin control as measured by TTR and bleeding incidence.Keywords: atrial fibrillation, deep vein thormbosis, fish oil, krill oil, warfarin
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