An Internet of Things based bed-egress alerting paradigm using wearable sensors in elderly care environment

The lack of healthcare staff and increasing proportions of elderly population is alarming. The traditional means to look after elderly has resulted in 255,000 reported falls (only within UK). This not only resulted in extensive aftercare needs and surgeries (summing up to £4.4 billion) but also in added suffering and increased mortality. In such circumstances, the technology can greatly assist by offering automated solutions for the problem at hand. The proposed work offers an Internet of things (IoT) based patient bed-exit monitoring system in clinical settings, capable of generating a timely response to alert the healthcare workers and elderly by analyzing the wireless data streams, acquired through wearable sensors. This work analyzes two different datasets obtained from divergent families of sensing technologies, i.e., smartphone-based accelerometer and radio frequency identification (RFID) based accelerometer. The findings of the proposed system show good efficacy in monitoring the bed-exit and discriminate other ambulating activities. Furthermore, the proposed work manages to keep the average end-to-end system delay (i.e., communications of sensed data to Data Sink (DS)/Control Center (CC) + machine-based feature extraction and class identification + feedback communications to a relevant healthcare worker/elderly) below 1 10 th of a second

Bacterial Cr (VI) Reduction and Its Impact in Bioremediation

Chromium is hazardous pollutant for ecosystem caused chromium especially inhexavalent form is very toxic, has high solubility and mobility, teratogenicity, mutagenicity andcarcinogenicity to living system related with its oxiding power. Remediation of soilcontaminated of heavy metals was important caused soil as medium for food producing.Conventional methods for heavy metals remediation consist of physical and chemical processbut these applications were costly and less effective. One of the remediation technologies is theusing living organisms such as microorganisms, because they have ability to reduce Cr(VI) intonon toxic form, Cr(III). The aims of this research were to evaluate the reduction activity ofrhizobacterial isolate and to identify the isolate which take a role in reducing chromiumabsorption by plant. The results showed that Isolate 39 was able to grow on LB mediumcontaining 200 ppm Cr(VI). Isolate 39 reduced Cr(VI) up to 15 ppm concentration level inminimal medium. Isolate 39 has ability to reduce Cr(VI) both at growing cells and resting cellsconditions up to 100% and 51% within 18 hours, respectively. Isolate 39 increased thephytostabilization ability of chromium by Zea mays at 30 days after seeding 3.8 timescompared than control. Based on physiological characteristics and partial sequencing of 16SrRNA gene, Isolate 39 was identified as Agrobacterium sp

Echocardiography role in syncope Patients

Methods: We did a retrospective chart review of 138 patients admitted to observation floor with diagnosis of syncope.https://jdc.jefferson.edu/patientsafetyposters/1054/thumbnail.jp

Tafsir Konstitusional Pelanggaran Pemilukada Yang Bersifat Sistematis, Terstruktur Dan Masif

The Constitutional Court has created a legal breakthrough in handling the local head election dispute, in order to uphold the democracy and break away from habitual practice of systematic, structured, and massive (STM) violations. The Court does not simply calculate the results of vote count but also have to seek the justice and prosecute results counting rate that were disputed. As the juridical normative research, the research uses a statutory, case, historical approach and the sociology of law. The research shows that throughout 2008-2011 Court has granted the dispute for as many as thirty-two cases. Of that amount of cases, those with the STM violations are as many as 21 (twenty one) cases. Whereas the nature of TSM were divided into two kinds namely cumulative and alternative which both may cancel local head election results. There are three types of local head election violations, first, violation in the process that does not affect the results of the election. Second, the breach in the process that affect the election results, thirdly, violation of the terms of conditions to be a candidate which are principal in nature and can be measured. The systematic, structured and massive violation of the local head general election is violations committed by the structural apparatus, both government officials and election organizers, collectively; not an individual action, well-planned (by design) and the impact of such offencesis extensive rather than sporadic

Design of a novel passive Binary-Controlled Variable Stiffness Joint (BpVSJ) towards passive haptic interface application

In this paper we present the design, development and experimental validation of a novel Binary-Controlled Variable Stiffness Joint (BpVSJ) towards haptic teleoperation and human interaction manipulators applications. The proposed actuator is a proof of concept of a passive revolute joint, where the working principle is based on the recruitment of series-parallel elastic elements. The novelty of the system lies in its design topology, including the capability to involve an (n) number of series-parallel elastic elements to achieve (2n) levels of stiffness, as compared to current approaches. Accordingly, the level of stiffness can be altered at any position without the need to revert to the initial equilibrium position. The BpVSJ has low energy consumption and short switching time, and is able to rotate freely at zero stiffness without limitations. Further smart features include scalability and relative compactness. This paper details the mathematical stiffness modeling of the proposed actuator mechanism, as well as the experimentally measured performance characteristics. The experimental results matched well with the physical-based modeling in terms of stiffness variation levels. Moreover, Psychophysical experiments were also conducted using (20) healthy subjects in order to evaluate the capability of the BpVSJ to display three different levels of stiffness that are cognitively realized by the users. The participants performed two tasks: a relative cognitive task and an absolute cognitive task. The results show that the BpVSJ is capable of rendering stiffness with high average relative accuracy (Relative Cognitive Task relative accuracy is 97.3%, and Absolute Cognitive Task relative accuracy is 83%)

Biosynthesis of phyto-functionalized silver nanoparticles using olive fruit extract and evaluation of their antibacterial and antioxidant properties

The green synthesis of nanomaterials is of utmost interest as it offers an eco-friendly approach over chemical synthetic routes. However, the reported biosynthesis methods are often time-consuming and require heating or mechanical stirring. The current study reports a facile one-pot biosynthesis of silver nanoparticles (AgNPs) mediated by olive fruit extract (OFE) and sunlight irradiation of only 20 s. OFE acts as both a reducing and a capping agent for the formation of OFE-capped AgNPs (AgNPs@OFE). The as-synthesized NPs were systematically characterized by UV-vis spectrometry, Fourier transform infrared (FTIR) spectroscopy, scanning electrochemical microscopy with energy-dispersive X-ray (SEM-EDX), X-ray diffraction (XRD), dynamic light scattering (DLS), and cyclic voltammetry. SEM images confirmed the successful formation of monodispersed spherical AgNPs@OFE of approximately 77 nm. FTIR spectroscopy suggested the involvement of functional groups of phytochemicals from the OFE in the capping and reduction of Ag+ to Ag. The particles revealed excellent colloidal stability as evidenced from the high zeta potential (ZP) value (−40 mV). Interestingly, using the disk diffusion method, AgNPs@OFE revealed higher inhibition efficiency against Gram-negative bacteria (Escherichia coli, Klebsiella oxytoca, and extensively drug-resistant (XDR) Salmonella typhi) than Gram-positive bacteria (Staphylococcus aureus), with Escherichia coli showing the highest inhibition zone of 27 mm. In addition, AgNPs@OFE exhibited maximum potent antioxidant scavenging potential against H2O2, followed by DPPH, O2−, and OH− free radicals. Overall, OFE can be considered an effective source for the sustainable production of stable AgNPs with potential antioxidant and antibacterial activities for biomedical applications

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Genotyping and drug resistance patterns of M. tuberculosis strains in Pakistan

<p>Abstract</p> <p>Background</p> <p>The incidence of tuberculosis in Pakistan is 181/100,000 population. However, information about transmission and geographical prevalence of <it>Mycobacterium tuberculosis </it>strains and their evolutionary genetics as well as drug resistance remains limited. Our objective was to determine the clonal composition, evolutionary genetics and drug resistance of <it>M. tuberculosis </it>isolates from different regions of the country.</p> <p>Methods</p> <p><it>M. tuberculosis </it>strains isolated (2003–2005) from specimens submitted to the laboratory through collection units nationwide were included. Drug susceptibility was performed and strains were spoligotyped.</p> <p>Results</p> <p>Of 926 <it>M. tuberculosis </it>strains studied, 721(78%) were grouped into 59 "shared types", while 205 (22%) were identified as "Orphan" spoligotypes. Amongst the predominant genotypes 61% were Central Asian strains (CAS ; including CAS1, CAS sub-families and Orphan Pak clusters), 4% East African-Indian (EAI), 3% Beijing, 2% poorly defined TB strains (T), 2% Haarlem and LAM (0.2). Also TbD1 analysis (<it>M. tuberculosis </it>specific deletion 1) confirmed that CAS1 was of "modern" origin while EAI isolates belonged to "ancestral" strain types.</p> <p>Prevalence of CAS1 clade was significantly higher in Punjab (P < 0.01, Pearsons Chi-square test) as compared with Sindh, North West Frontier Province and Balochistan provinces. Forty six percent of isolates were sensitive to five first line antibiotics tested, 45% were Rifampicin resistant, 50% isoniazid resistant. MDR was significantly associated with Beijing strains (P = 0.01, Pearsons Chi-square test) and EAI (P = 0.001, Pearsons Chi-square test), but not with CAS family.</p> <p>Conclusion</p> <p>Our results show variation of prevalent <it>M. tuberculosis </it>strain with greater association of CAS1 with the Punjab province. The fact that the prevalent CAS genotype was not associated with drug resistance is encouraging. It further suggests a more effective treatment and control programme should be successful in reducing the tuberculosis burden in Pakistan.</p

Global trends of hand and wrist trauma : a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

Background As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. Results The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. Conclusions Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.Peer reviewe