91 research outputs found

    Analysis of the biceps brachii muscle by varying the arm movement level and load resistance band

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    Biceps brachii muscle illness is one of the common physical disabilities that requires rehabilitation exercises in order to build up the strength of the muscle after surgery. It is also important to monitor the condition of the muscle during the rehabilitation exercise through electromyography (EMG) signals. The purpose of this study was to analyse and investigate the selection of the best mother wavelet (MWT) function and depth of the decomposition level in the wavelet denoising EMG signals through the discrete wavelet transform (DWT) method at each decomposition level. In this experimental work, six healthy subjects comprised of males and females (26 ± 3.0 years and BMI of 22 ± 2.0) were selected as a reference for persons with the illness. The experiment was conducted for three sets of resistance band loads, namely, 5 kg, 9 kg, and 16 kg, as a force during the biceps brachii muscle contraction. Each subject was required to perform three levels of the arm angle positions (30°, 90°, and 150°) for each set of resistance band load. The experimental results showed that the Daubechies5 (db5) was the most appropriate DWT method together with a 6-level decomposition with a soft heursure threshold for the biceps brachii EMG signal analysis

    Bayesian signaling game based efficient security model for MANETs

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    Game Theory acts as a suitable tool offering promising solutions to security-related concerns in Mobile Ad Hoc Networks (i.e., MANETs). In MANETs, security forms a prominent concern as it includes nodes which are usually portable and require significant coordination between them. Further, the absence of physical organisation makes such networks susceptible to security breaches, hindering secure routing and execution among nodes. Game Theory approach has been manipulated in the current study to achieve an analytical view while addressing the security concerns in MANETs. This paper offers a Bayesian-Signaling game model capable of analysing the behaviour associated with regular as well as malicious nodes. In the proposed model, the utility of normal nodes has been increased while reducing the utility linked to malicious nodes. Moreover, the system employs a reputation system capable of stimulating best cooperation between the nodes. The regular nodes record incessantly to examine their corresponding nodes’ behaviours by using the belief system of Bayes-rules. On its comparison with existing schemes, it was revealed that the presented algorithm provides better identification of malicious nodes and attacks while delivering improved throughput and reduced false positive rate

    Efek induksi proliferasi sel osteoblas tulang trabekular mencit jantan oleh ekstrak etanol 96% daun Semanggi (Marsilea crenata Presl.)

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    Osteoporosis adalah kondisi penurunan kepadatan mineral tulang dan berisiko patah tulang yang disebabkan oleh defisiensi estrogen. Fitoestrogen adalah senyawa pada tanaman yang memiliki kemampuan berikatan dengan reseptor estrogen untuk menggantikan fungsi estrogen. Daun M. crenata Presl. diketahui mengandung senyawa fitoestrogen. Tujuan penelitian ini adalah untuk membuktikan ekstrak etanol 96% daun M. crenata Presl. dapat meningkatkan jumlah sel osteoblas tulang trabekular femur dan vertebra pada mencit yang mengalami osteoporosis. Penelitian ini dilakukan dengan pemberian ekstrak etanol 96% daun M. crenata Presl. dosis 1,2; 2,4; 4,8; dan 9,6/20 g BB mencit/hari. Analisis dilakukan dengan cara pemeriksaan histomorfometri menggunakan pewarnaan HE, dan pengamatan sel osteoblas menggunakan mikroskop cahaya Olympus dengan software optilab. Data dianalisis menggunakan metode one way ANOVA. Hasil yang didapat yaitu kelompok PIV dengan dosis 9,6/20g BB mencit/hari dapat meningkatkan jumlah rerata sel osteoblas dengan nilai tertinggi yaitu 224,60 pada tulang trabekular femur dan 540,11 pada trabekular vertebra. Nilai perhitungan ED50 ekstrak etanol 96% daun M. crenata Presl. yaitu 1,908 mg pada tulang trabekular femur dan 2,878 mg pada tulang trabekular vertebra

    Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

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    Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone

    Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

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    Outcomes of WHO-conforming, longer, all-oral multidrug-resistant TB regimens and analysis implications

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    BACKGROUND: Evidence of the effectiveness of the WHO-recommended design of longer individualized regimens for multidrug- or rifampicin-resistant TB (MDR/RR-TB) is limited.OBJECTIVES: To report end-of-treatment outcomes for MDR/RR-TB patients from a 2015-2018 multi-country cohort that received a regimen consistent with current 2022 WHO updated recommendations and describe the complexities of comparing regimens.METHODS: We analyzed a subset of participants from the endTB Observational Study who initiated a longer MDR/RR-TB regimen that was consistent with subsequent 2022 WHO guidance on regimen design for longer treatments. We excluded individuals who received an injectable agent or who received fewer than four likely effective drugs.RESULTS: Of the 759 participants analyzed, 607 (80.0%, 95% CI 77.0-82.7) experienced successful end-of-treatment outcomes. The frequency of success was high across groups, whether stratified on number of Group A drugs or fluoroquinolone resistance, and ranged from 72.1% to 90.0%. Regimens were highly variable regarding composition and the duration of individual drugs.CONCLUSIONS: Longer, all-oral, individualized regimens that were consistent with 2022 WHO guidance on regimen design had high frequencies of treatment success. Heterogeneous regimen compositions and drug durations precluded meaningful comparisons. Future research should examine which combinations of drugs maximize safety/tolerability and effectiveness

    Effect of priming interval on reactogenicity, peak immunological response, and waning after homologous and heterologous COVID-19 vaccine schedules: exploratory analyses of Com-COV, a randomised control trial

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    Background: Priming COVID-19 vaccine schedules have been deployed at variable intervals globally, which might influence immune persistence and the relative importance of third-dose booster programmes. Here, we report exploratory analyses from the Com-COV trial, assessing the effect of 4-week versus 12-week priming intervals on reactogenicity and the persistence of immune response up to 6 months after homologous and heterologous priming schedules using the vaccines BNT162b2 (tozinameran, Pfizer/BioNTech) and ChAdOx1 nCoV-19 (AstraZeneca). Methods: Com-COV was a participant-masked, randomised immunogenicity trial. For these exploratory analyses, we used the trial's general cohort, in which adults aged 50 years or older were randomly assigned to four homologous and four heterologous vaccine schedules using BNT162b2 and ChAdOx1 nCoV-19 with 4-week or 12-week priming intervals (eight groups in total). Immunogenicity analyses were done on the intention-to-treat (ITT) population, comprising participants with no evidence of SARS-CoV-2 infection at baseline or for the trial duration, to assess the effect of priming interval on humoral and cellular immune response 28 days and 6 months post-second dose, in addition to the effects on reactogenicity and safety. The Com-COV trial is registered with the ISRCTN registry, 69254139 (EudraCT 2020–005085–33). Findings: Between Feb 11 and 26, 2021, 730 participants were randomly assigned in the general cohort, with 77–89 per group in the ITT analysis. At 28 days and 6 months post-second dose, the geometric mean concentration of anti-SARS-CoV-2 spike IgG was significantly higher in the 12-week interval groups than in the 4-week groups for homologous schedules. In heterologous schedule groups, we observed a significant difference between intervals only for the BNT162b2–ChAdOx1 nCoV-19 group at 28 days. Pseudotyped virus neutralisation titres were significantly higher in all 12-week interval groups versus 4-week groups, 28 days post-second dose, with geometric mean ratios of 1·4 (95% CI 1·1–1·8) for homologous BNT162b2, 1·5 (1·2–1·9) for ChAdOx1 nCoV-19–BNT162b2, 1·6 (1·3–2·1) for BNT162b2–ChAdOx1 nCoV-19, and 2·4 (1·7–3·2) for homologous ChAdOx1 nCoV-19. At 6 months post-second dose, anti-spike IgG geometric mean concentrations fell to 0·17–0·24 of the 28-day post-second dose value across all eight study groups, with only homologous BNT162b2 showing a slightly slower decay for the 12-week versus 4-week interval in the adjusted analysis. The rank order of schedules by humoral response was unaffected by interval, with homologous BNT162b2 remaining the most immunogenic by antibody response. T-cell responses were reduced in all 12-week priming intervals compared with their 4-week counterparts. 12-week schedules for homologous BNT162b2 and ChAdOx1 nCoV-19–BNT162b2 were up to 80% less reactogenic than 4-week schedules. Interpretation: These data support flexibility in priming interval in all studied COVID-19 vaccine schedules. Longer priming intervals might result in lower reactogenicity in schedules with BNT162b2 as a second dose and higher humoral immunogenicity in homologous schedules, but overall lower T-cell responses across all schedules. Future vaccines using these novel platforms might benefit from schedules with long intervals. Funding: UK Vaccine Taskforce and National Institute for Health and Care Research

    The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

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    Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe
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