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Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c
Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance
The Effects of Triggering Mechanisms on the Energy Absorption Capability of Circular Jute/Epoxy Composite Tubes under Quasi-Static Axial Loading
The usage of composite materials have been improving over the years due to its
superior mechanical properties such as high tensile strength, high energy absorption capability,
and corrosion resistance. In this present study, the energy absorption capability of circular jute/
epoxy composite tubes were tested and evaluated. To induce the progressive crushing of the
composite tubes, four different types of triggering mechanisms were used which were the nontrigger, single chamfered trigger, double chamfered trigger and tulip trigger. Quasi-static axial
loading test was carried out to understand the deformation patterns and the load-displacement
characteristics for each composite tube. Besides that, the influence of energy absorption, crush
force efficiency, peak load, mean load and load-displacement history were examined and
discussed. The primary results displayed a significant influence on the energy absorption
capability provided that stable progressive crushing occurred mostly in the triggered tubes
compared to the non-triggered tubes. Overall, the tulip trigger configuration attributed the
highest energy absorptio