3-DOF Parallel robotics System for Foot Drop therapy using Arduino

This paper discusses a robotic system used for physical therapy for foot drop case, caused by brain stroke. This device provides most exercises practiced by patient for treatment at any time or any place without going to the rehabilitation center located in hospitals. The robotics system designed according to the mechanism of parallel robot and controlled by computer or microcontroller (Arduino). This robot allows the patient to do the exercise without any need for any knowledge about computer or programing. The developed robot system show a good potential to be developed and distributed for large number of physical therapy clinics with low cost and good reliability. Keywords: 3DOF Robot, Parallel Robot, Foot Drop Physical Therapy, Arduino

Comprehensive Survey Congestion Control Mechanisms in Wireless Sensor Networks:Comprehensive Survey

Wireless sensor network (WSN) occupies the top rank of the widely used networks for gathering different type of information from different averments. WSN has nodes with limited resources so congestion can cause a critical damage to such network where it limited resources can be exhausted. Many approaches has been proposed to deal with this problem. In this paper, different proposed algorithm for congestion detection, notification, mitigation and avoidance has been listed and discussed. These algorithms has been investigated by presenting its advantages and disadvantages. This paper provides a robust background for readers and researches for wireless sensor networks congestion control approaches. Keywords: WSN, Congestion Control, congestion mitigation, congestion detection, sink channel load, buffer load

Effect of Obesity on Dural Puncture Epidural Analgesic Onset in Parturients Scheduled for Normal Vaginal Delivery

Background: Obese parturients are at higher risk for epidural analgesic failure, so the dural puncture epidural (DPE) technique may have particular advantage in this population. DPE has been suggested to improve the efficacy of labor epidural analgesia, potentially by facilitating the translocation of medication from the epidural to intrathecal space.   Objective: We designed this prospective interventional study to explore the influence of obesity on DPE technique regarding labor analgesia onset and quality.   Methods: Design: A prospective interventional study.   Patients: 64 parturients were consented to receive a DPE labor analgesia. Parturients were assigned according to pregestational body mass index groups into normal weight and obese groups. After successful placement of the epidural catheter and puncturing the dura, analgesic regimen was initiated.   Main outcome measure: The primary outcome was median time to onset of sensory block assessed by Kaplan-Meier analysis.   Results: Using Kaplan-Meier curve, we found median time to onset of sensory block 6 min in obese parturients compared with 13 min in non obese. Difference between both groups was statistically significant (Logrank Chi-squared = 56.663, df = 1, p < 0.0001). Incidence rate ratio (95% CI) = 21.0 (9.51, 46.5). No asymmetrical block was noticed in both groups, but a higher incidence of perineal dose supplementation and postoperative nausea were observed in obese group Conclusion: DPE offers a favorable risk–benefit ratio for management of neuraxial analgesia in obese parturient. Further studies comparing different volume, concentration, method of application of DPE local anesthetic are needed

Social-ecological and institutional factors affecting forest and landscape restoration in the Chittagong Hill Tracts of Bangladesh

Bangladesh government has recently pledged to restore 0.75 million ha of degraded forestland as part of its commitment to the Bonn Challenge, however little is known about the potential challenges and opportunities involved in achieving that goal. Using secondary literature complemented by expert consultation and a field survey, we examined the outcomes and limitations of previous restoration programmes and identified key social, ecological and institutional aspects crucial for a successful forest restoration programme in the Chittagong Hill Tracts (CHT) of Bangladesh. The CHT region accounts for over a third of state-owned forests, and it supports a large part of the country's forest-dwelling ethnic populations, although most of the forestland is severely degraded. Our analysis revealed that past programmes had utilised participatory tree planting, horticulture and rubber-based agroforestry to restore degraded forestland and improve community livelihood in the CHT. However, past restoration programmes merely emphasised improving tree cover without considering the ecological functionality, biodiversity and carbon co-benefits of restored forests. The duration of these pro-grammes was also relatively short, and there was no clear plan for engaging local communities in the restoration activities beyond the programme period. Among other things, the local ethnic community's land rights issue remained unresolved and the participant's land ownership influenced their willingness to participate effectively in any restoration programme. Households with secured land rights had a more positive attitude towards participating in forestland restoration than those with unsecured land rights. Suitable acts and policies that would allow people to legally continue to use tree-based land in the regions (i.e. forest and land tenure rights) are also lacking. Future forest and landscape restoration (FLR) programmes may thus need to focus on improving the biodiversity and ecological functionality of those restored forests, resolving local people's forest and land tenure rights and involving them in site-specific restoration interventions. The engagement of local and regional-level multi-stakeholders in such an FLR programme is also essential for realising the restoration's multiple social and ecological benefits

Purslane: A Perspective Plant Source Of Nutrition And Antioxidant

Purslane (Portulaca oleracea) is a leafy vegetable that most likely originated in the Mediterranean region. It is a rich source of potassium, magnesium and possesses the potential to be used as vegetable source of omega-3 fatty acid and recently has been recognized as the richest source of a-linolenic acid, essential omega-3 and 6 fatty acids, ascorbic acid, glutathione, atocopherol and b-carotene. The stems and leaves also have high energy values which is 303.9 Kcal/100g dry weight. Mineral contents (mg/100gm DM) were K (14.71), Na (7.17), Ca (18.71), Fe (0.48) and Zn (3.02). P. oleracea has higher total phenolic and antioxidant content than plants at immature stages. The antioxidant content and nutritional value of purslane are important for human consumption. It revealed tremendous nutritional potential and has indicated the potential use of this herb for the future

Development and validation of a high-performance thin-layer chromatographic method for the quantitative analysis of vitexin in Passiflora foetida herbal formulations

© 2019 Dehon et al. Introduction: Formative evaluations of clinical teaching for emergency medicine (EM) faculty are limited. The goal of this study was to develop a behaviorally-based tool for evaluating and providing feedback to EM faculty based on their clinical teaching skills during a shift. Methods: We used a three-phase structured development process. Phase 1 used the nominal group technique with a group of faculty first and then with residents to generate potential evaluation items. Phase 2 included separate focus groups and used a modified Delphi technique with faculty and residents, as well as a group of experts to evaluate the items generated in Phase 1. Following this, residents classified the items into novice, intermediate, and advanced educator skills. Once items were determined for inclusion and subsequently ranked they were built into the tool by the investigators (Phase 3). Results: The final instrument, the Faculty Shift Card, is a behaviorally-anchored evaluation and feedback tool used to facilitate feedback to EM faculty about their teaching skills during a shift. The tool has four domains: teaching clinical decision-making; teaching interpersonal skills; teaching procedural skills; and general teaching strategies. Each domain contains novice, intermediate, and advanced sections with 2-5 concrete examples for each level of performance. Conclusion: This structured process resulted in a well-grounded and systematically developed evaluation tool for EM faculty that can provide real-time actionable feedback to faculty and support improved clinical teaching

Management of hepatitis C virus genotype 4: recommendations of an international expert panel.

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections

COVID-19 Vaccination Among Diverse Population Groups in the Northern Governorates of Iraq

Objectives: The present study was carried out to investigate COVID-19 vaccination coverage among populations of internally displaced persons (IDPs), refugees, and host communities in northern Iraq and the related underlying factors.Methods: Through a cross-sectional study conducted in five governorates in April–May 2022, 4,564 individuals were surveyed. Data were collected through an adapted questionnaire designed to gather data on participants.Results: 4,564 subjects were included (59.55% were 19–45 years old; 54.51% male). 50.48% of the participants (51.49% of host communities, 48.83% of IDPs, and 45.87% of refugees) had been vaccinated with at least one dose of COVID-19 vaccine. 40.84% of participants (42.28% of host communities, 35.75% of IDPs, and 36.14% of refugees) had been vaccinated by two doses, and 1.56% (1.65% of host communities, 0.93% of IDPs, and 1.46% of refugees) were vaccinated with three doses.Conclusion: Sociodemographic factors including age, gender, education, occupation, and nationality could affect vaccination coverage. Moreover, higher acceptance rate of vaccination is associated with belief in vaccine safety and effectiveness and trust in the ability of the vaccine to prevent complications

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London