Studies on mechanisms of enterocutaneous fistula healing

This thesis reviewed and investigated several aspects of the management of enterocutaneous fistula (ECF). The best management of ECF, particularly complex fistulas, is in specialist units where there is a multidisciplinary structured approach. Surgical management of ECF at St. Mark’s National Intestinal Failure Unit is safe and improving over time. The highest incidence of ECF development occurs following abdominal surgery particularly in the presence of Crohn’s disease. The audit confirmed this in our unit. A retrospective audit of our unit revealed the majority of patients underwent definitive surgery. There were improved overall healing rates following both surgery and conservative management in the current cohort, with also improvement in the 30 day post fistula resection mortality compared with a previous series at our unit. Multivariate analysis revealed co-morbidity, source of referral and aetiology had significant associations with ECF healing. This thesis has included the first study and design of a scoring system for predicting ECF healing. The scoring systems devised were both validated. They can provide further information to aid clinical management and decision making for the multidisciplinary team and predict the possible long term outcome for patients at external institutions. Meta-analyses of randomised control trials has revealed somatostatin and octreotide increase the likelihood of fistula closure, reducing the time to fistula closure, and neither has an effect on mortality. 5 Immunological studies revealed an increased on-going production of cytokines, in particular TNF-α, in non-IBD ECF compared with control terminal ileum tissue. The data may provide evidence for the potential use of anti-TNF-α agents in the treatment of non-IBD ECF. A future pilot study has been designed with the aim to identify a potential novel therapy for patients with persistent enterocutaneous fistula not associated with inflammatory bowel disease. Any positive findings would equate to a major medical advance with a new use for anti-TNF-α agents.Open Acces

A reconfigurable wheelchair for mobility and rehabilitation:Design and development

This paper presents the design and development of a prototype of a reconfigurable wheelchair for rehabilitation and self-assistance to fit the size of a seven years old child (average 35 kg weight). Though the developed prototype is developed at this stage to fit a child, it can be resized, after considering variations in weight and size, to fit an older adult. The developed prototype has a mechanism that enables the user to transform from sit-to-stand (STS) posture and vice versa. With the help of the developed wheelchair, the user will also be able to adjust the posture of his upper body using an adjustable back support using two linear actuators. This configuration will allow the user to use the wheelchair as a mobility device as well as for rehabilitation purposes without the need of external support. The availability of STS and back adjustment mechanisms will allow the user to do regular exercising which will enhance blood circulation as sitting for long periods inflates lower limbs disability. The proposed configuration will help in enhancing the functional capabilities of end-users allowing for increased independence and ultimately quality of life

Female Education As A Determinant Of Economic Growth: The Case Study Of Pakistan

The contribution of female education has been very important in the GDP growth of the country, but this very sector has been ignored by the Government. This paper focuses on the importance of female education and highlights its significance for national development. It also brings out some impediments, obstacles and barriers confronting female education, especially the low level of the investment on the sector in the rural areas of Pakistan. The study further identifies the effects of female contribution in labor force participation. The study explores the opportunities to encourage the role of female in the developmental activities

Lean model-based definition framework for product life cycle

Poster presented at Cranfield University’s 2019 Manufacturing Doctoral Community event

Personal care robots for children: state of the art

In the last decades, the application of robots in variety of industries has remarkably been increased. Self-governing robots have been employed in various fields of human life, particularly in that of old and very young people. It is assumed that in the succeeding years, personal care robots will be in an intimate relation with human beings. But, what caring responsibilities will the future robots have before children at home? This is directly related to the kinds of robots as well as those aspects of getting old that are the matter of question. Among the topics that are germane to robot carers, Child-care is the least discussed one. In this article the duties of care robots in the life of youth is investigated. It studies the benefits of the application of robots in daily life along with the negative points, perils, and anxieties that rise from the application. In this article, we examine the benefits of the usage of robots in the child life. Besides, we will discuss the disadvantages, dangers and fears that are related to child-robot connections. In the end, we will recommend some useful points

Personal care robots for older adults: an overview

In recent decades, the usages of robots in variety of industries have been increased. Self-directed robots have appeared in human lives, specifically, in the areas related to the lives of elderly. The population of old people is significantly growing worldwide. Therefore, there the demand for personal care robots is increasing. The aim of this demand is to enhance the opportunity of mobility and promote independence. In the future, robots care will be in very near contact with people lives. But, what caring roles will robots have at home in the future before old persons? It depends not only on the kinds of robots but also those facets of ageing which are discussed in the paper. This article probes the part and function of robots care in the lifecycle of older adults. It contemplates on the advantages and disadvantages of robots application in human life

Structural Optimization of Adaptive Soft Fin Ray Fingers with Variable Stiffening Capability

Soft and adaptable grippers are desired for their ability to operate effectively in unstructured or dynamically changing environments, especially when interacting with delicate or deformable targets. However, utilizing soft bodies often comes at the expense of reduced carrying payload and limited performance in high-force applications. Hence, methods for achieving variable stiffness soft actuators are being investigated to broaden the applications of soft grippers. This paper investigates the structural optimization of adaptive soft fingers based on the Fin Ray® effect (Soft Fin Ray), featuring a passive stiffening mechanism that is enabled via layer jamming between deforming flexible ribs. A finite element model of the proposed Soft Fin Ray structure is developed and experimentally validated, with the aim of enhancing the layer jamming behavior for better grasping performance. The results showed that through structural optimization, initial contact forces before jamming can be minimized and final contact forces after jamming can be significantly enhanced, without downgrading the desired passive adaptation to objects. Thus, applications for Soft Fin Ray fingers can range from adaptive delicate grasping to high-force manipulation tasks

Towards ethical framework for personal care robots:Review and reflection

In recent decades, robots have been used noticeably at various industries. Autonomous robots have been embedded in human lives especially in elderly and disabled lives. Elderly population is growing worldwide significantly; therefore there is an increased need of personal care robots to enhance mobility and to promote independence. A great number of aging and disabled hold appeals for using robots in daily routine tasks as well as for various healthcare matters. It is essential to follow a proper framework in ethics of robot design to fulfill individual needs, whilst considering potential harmful effects of robots. This paper primarily focuses on the existing issues in robot ethics including general ethics theories and ethics frameworks for robots. Consequentialism ethics will be recommended to be applied in robot ethics frameworks

Wheat cultivars exposed to high temperature at onset of anthesis for yield and yield traits analysis

Received: April 16th, 2021 ; Accepted: July 26th, 2021 ; Published: August 16th, 2021 ; Correspondence: [email protected] fluxes at some critical growth stages adversely affect the crop yield. Heat stress (HS) of limited duration shows mild to marked effects on crop yield. The study focused on evaluating HS of limited durations on wheat crop effective from anthesis. Four wheat cultivars (Pirsabak-2005, Pakhtunkhwa-2015, Pakistan-2013, and DN-84) and three advanced lines (P-2, P-12, and P-18) were subjected to HS for 48, 72, and 96 h evaluating changes in the yield and yield contributing traits. The experiment was conducted in a randomized complete block design during 2017–18 and 2018–19 at Agronomy Research Farm, the University of Agriculture Peshawar Pakistan. At the onset of anthesis, plants were exposed to HS in the plastic tunnel for limited durations. The temperature inside and outside tents was recorded periodically. The mean across the years showed a significant effect on yield traits by HS imposition at anthesis stage. The mean data across the two years showed a significant effect of HS on yield and yield contributing traits. In comparison with control, spike weight (g) reduced by 29, 40, and 49% under limited HS of 48, 72, and 96 h, respectively. Grains per spike were decreased by 45, 61, and 69% and grain weight by 29, 36, and 45% from control to imposed HS of 48, 72, and 96 h, respectively. Overall grain yield decreased by 44, 61, and 70% upon exposed to 48, 72, and 96 h of HS, respectively. The differences among the cultivars for yield and yield contributing traits were different under various HS conditions. The study concluded that HS effective from anthesis has an adverse effect on grain weight and number and hence the grain yield. Among the cultivars, Pakistan-2013 showed better resistance to HS of limited duration when exposed at the anthesis stage of the crop growth

The Delta variant mutations in the receptor binding domain of SARS-CoV-2 show enhanced electrostatic interactions with the ACE2

The mutations in the receptor binding domain (RBD) of the SARS-CoV-2 are shown to enhance its replication, transmissibility, and binding to host cells. Recently, a new strain is reported in India that includes mutations (T478K, and L452R) in the RBD, which are possibly increasing the infection rate. Here, using Molecular Mechanics (MM) and Monte Carlo (MC) sampling, we show that the mutations in the RBD of the Delta variant of SARS-CoV-2 induced conformational changes in ACE2-E37, which enhanced the electrostatic interactions by the formation of a salt-bridge with SARS-CoV-2-R403. In addition, we observed that these mutations altered the electrostatic interactions of the salt-bridge formed between the RBD-T500 and the ACE2-D355, which reduced by more than 70% compared the to the WT