Relationship of nutritional and metabolic factors to non-invasive indices of macrovascular disease in diabetes

Factors which may account for the high frequency of macrovascular disease in diabetics are age, sex, cigarette smoking, hypertension, obesity, lack of exercise, diet, hyperglycaemia, hyperinsulinaeroia, hypercholesterolaemia, hypertriglyceridaemia, low HDL-cholesterol concentration, elevated free fatty acid concentration and enhanced platelet aggregation. Twenty seven (13 men and 14 women) non-insulin-dependent diabetics and thirty eight age, height and weight matched healthy subjects (10 men and 28 women) were studied. None of the subjects were smokers, or hypertensive. No subject had any clinical evidence of peripheral arterial disease, coronary heart disease or cerebrovascular disease. All had apparently normal peripheral pulses and normal ankle/arm blood pressure indices. Methods for determining arterial compliance in the segment between the left subclavian artery and each common femoral artery, and proximal resistance at the common femoral artery and posterior tibial artery, have been reviewed and developed. An appropriate food intake methodology for deriving food indices from food records was developed. Biochemical determinants have been made of glucose tolerance, glycosylated haemoglobin, serum total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, plasma free fatty acid and insulin. A significant decrease in the arterial compliance, and a significant increase in the arterial proximal resistance at the common femoral artery and posterior tibial artery in non-insulin-dependent diabetics, compared with their healthy controls, have been found. Significant negative correlation between arterial compliance and proximal resistance and, a significant positive correlation between the arterial proximal resistance of common femoral artery and posterior tibial artery were found. Differences between control (healthy subjects) and non-insulin-dependent diabetic groups indicate that preclinical peripheral arterial disease can be recognised even in mild diabetics by non-invasive measurement of arterial compliance or proximal resistance. There were significant and negative correlations between arterial compliance and each of blood glucose, blood glycosylated haemoglobin (HbAlC), plasma free fatty acid and plasma insulin concentration. There were significant and positive correlations between arterial proximal resistance of common femoral artery and posterior tibial artery and each of blood glucose, glycosylated haemoglobin and plasma free fatty acid concentration. Multivariate analysis to examine each of the biochemical factors Including blood glucose, blood glycosylated haemoglobin (HbAlC), plasma free fatty acid, plasma Insulin and lipids, showed that the factor which most influenced the arterial compliance and the proximal resistance of posterior tibial artery was the glucose level in the fasting state or the glucose response after a glucose load. In addition, the factors which most influenced proximal resistance of the common femoral artery were free fatty acid -level in the fasting state or glucose response after a glucose load. The factors which most influenced arterial compliance were glucose level in men, and the insulin level in the fasting state or the plasma free fatty acid response after a glucose load in women. These findings indicate that blood glucose, plasma free fatty acid and plasma insulin are risk factors for changes in arterial wall characteristic at a stage when no clinical evidence of macrovascular disease is apparent. Arterial compliance was decreased and the proximal resistance of posterior tibial artery was increased in those with a low intake of protective foods compared with those with a high intake whether healthy subjects or non-insulin-dependent diabetics. Arterial compliance was decreased in non-fish eaters compared with the fish eaters whether healthy subjects or non-insulin-dependent diabetics. Proximal resistance of the posterior tibia! artery in non-fish eaters was increased compared with fish eaters in healthy subjects. Overall, food variety, a protective food score consumption and fish consumption emerge as importance determinants of arterial wall characteristics at a stage when no clinical evidence of macrovascular disease is apparent

The bactericidal activity of moxifloxacin in patients with pulmonary tuberculosis

Patients in whom acid-fast bacilli smear-positive pulmonary tuberculosis was newly diagnosed were randomized to receive 400 mg moxifloxacin, 300 mg isonaizid, or 600 mg rifampin daily for 5 days. Sixteen-hour overnight sputa collections were made for the 2 days before and for 5 days of monotherapy. Bactericidal activity was estimated by the time taken to kill 50% of viable bacilli (vt(50)) and the fall in sputum viable count during the first 2 days designated as the early bactericidal activity (EBA). The mean vt(50) of moxifloxacin was 0.88 days (95% confidence interval [Cl], 0.43-1.33 days) and the mean EBA was 0.53 (95% CI 0.28-0.79). For the isoniazid group, the mean vt(50) was 0.46 days (95% Cl, 0.31-0.61 days) and the mean EBA was 0.77 (95% Cl, 0.54-1.00). For rifampin, the mean vt(50) was 0.71 days (95% Cl, 0.48-0.95 days) and the mean EBA was 0.28 (95% Cl, 0.15-0.41). Using the EBA method, isoniazid was significantly more active than rifampin (p < 0.01) but not moxifloxacin. Using the vt(50) method, isoniazid was more active than both rifampin and moxifloxacin (p = 0.03). Moxifloxacin has an activity similar to rifampin in human subjects with pulmonary tuberculosis, suggesting that it should undergo further assessment as part of a short course regimen for the treatment of drug-susceptible tuberculosis

Articulated Robot Hand

The purpose of this project is to create a robotic hand that articulates and grips objects like a human hand. The robotic hand includes a single miniature servo for each finger joint, as shown in Figures 2 through 4, allowing full and independent articulation of the nine different primary joints in the hand. The motion of each servo, and therefore each finger joint, is governed by a PIC microcontroller. Use of a microcontroller-based control scheme, as opposed to PC-based control, allows for a more portable, versatile design. A buzzer-based warning system notifies the user of any major irregularities in the operation of the robotic hand. The force exerted by the hand on an object being gripped, will be monitored by touch sensors mounted to the end joints of each digit. A small LCD will display information relating to the operational mode of the hand, as well as any relevant user warnings. A set of potentiometers allow the user to manually control the rotational position and reaction speed of each joint. A 4x4 keypad enables the user to navigate an operational menu displayed on the LCD, and to select a preset position in the automatic operating mode

Can social inclusion be evaluated? Investigating the psychometric properties of the social inclusion intervention scale

The present study aims to validate a newly developed Social Inclusion Intervention Scale (SIIS) using Exploratory Factor Analysis and Confirmatory Factor Analysis. The participants were 128 children aged 45-84 month-old from local integrated preschools in Hong Kong. The factor structure of the SIIS fit the data well (RMSEA = .08, NFI = .92, and TLI = .95, CFI = .96, SRMR = .04), with good convergent validity (all CR values > .92, all AVE values > .61). The internal consistency was good across items (all α values > .91) and factors (all CR values > .92). Hence, the sample obtained from the clinical trials of this study showed a good model fit, which suggested that the SIIS is adequate in measuring social inclusion among preschool children in social inclusion intervention programmes. The implications of the two emerged themes of social inclusion from the findings, Relationships and Acceptance, are further discussed to ascertain how they shed light on the design of social inclusion intervention

Force Characterization and Manufacturing of a Dynamic Unilateral Clubfoot Brace

Clubfoot is a musculoskeletal birth defect characterized by an inward twisting of an infant’s feet. Currently, a series of casts are used to correct the clubfoot, and a boots-and-bar brace is used to maintain the correction. However, this method has concerns with compliance, comfort, and social stigma. Hope Walks and their clinic in Kijabe, Kenya are interested in implementing a new maintenance brace that addresses these concerns. Mr. Jerald Cunningham, CPO, designed and is utilizing a unilateral clubfoot maintenance brace called the Cunningham Clubfoot Brace. He asserts his brace reduces treatment time, lessens social stigma, and increases child mobility. However, to date, there is not enough published research on its biomechanics and patient success rates to confirm his findings. The Cunningham Clubfoot Brace Collaboratory project seeks to validate the effectiveness of the Cunningham design through biomedical testing and increase brace availability through sustainable manufacturing. To do this, the team is measuring the biomechanical forces applied by the brace with multiple force sensor systems and an infant foot model. The team is assisting Mr. Cunningham in his plans to use injection molding to increase brace production by scanning and creating CAD files of the brace. The team is also completing a failure and reuse analysis of the Cunningham Brace for the clinic in Kijabe. Furthermore, the ongoing clinical study at CURE International\u27s hospital in Kijabe, Kenya, and Dr. Emily Farrar’s research paper will provide greater insight into the effectiveness of the Cunningham Brace. These collaborative efforts will allow for further understanding of the effectiveness of the Cunningham Brace and its acceptance as an alternative clubfoot maintenance brace.https://mosaic.messiah.edu/engr2021/1001/thumbnail.jp

Force Characterization and Manufacturing of a Dynamic Unilateral Clubfoot Brace

Clubfoot is a musculoskeletal birth defect characterized by an inward twisting of an infant’s feet. Currently, a series of casts are used to correct clubfoot and the Steenbeek brace is used to maintain the correction. However, this method has issues with compliance, comfort, and social stigma. Mr. Jerald Cunningham, CPO, designed and is utilizing a unilateral clubfoot maintenance brace called the Cunningham Clubfoot Brace. He expects his brace to reduce treatment time, lessen social stigma, and increase child mobility. Hope Walks, in Kijabe, Kenya, is interested in implementing this new maintenance brace at their clinics. However, there is not enough published research on its biomechanics and patient success rates to confirm Mr. Cunningham’s findings. The Cunningham Clubfoot Brace Collaboratory project seeks to validate the effectiveness of this design through biomedical testing and increase brace accessibility through sustainable manufacturing. The team is measuring the biomechanical forces applied by the brace with multiple force sensors on the Cunningham and Steenbeek braces. Mr. Cunningham plans to use injection molding to increase brace production. The team is completing Finite Element Analysis to determine how the brace’s properties change with injection molding. The team is also completing fatigue analysis with the Cunningham Brace to quantify its reusability. Furthermore, the clinical study in Kenya and Dr. Emily Farrar’s retrospective research paper will contribute to the published research on the Cunningham Brace. The collaborative efforts of the team will increase further understanding of the Cunningham Brace and its acceptance as an alternative clubfoot maintenance brace.https://mosaic.messiah.edu/engr2022/1002/thumbnail.jp

Developing a ‘defamilisation framework’ to examine the strategies for promoting the adult worker model and women’s welfare in eight European countries

This article is intended to explore the link between the study of defamilisation and that of the adult worker model. To meet this purpose, a defamilisation framework for studying issues concerning the adult worker model and defamilisation is developed. To show the empirical significance of these issues, evidence is drawn from a childcare gap typology covering eight European countries. Conducting these analytical tasks provides insights into the development of social work practices for enhancing women’s welfare

Government strategies for supporting the adult worker model in European countries: mixed implications for defamilisation

Purpose – This article explores the link between defamilisation studies and studies of the adult worker model and discusses the mixed implications that government strategies for supporting the adult worker model have for defamilisation. The adult worker model emphasizes that all adult men and women ought to engage in formal employment; defamilisation studies stress the importance of enhancing women’s chances of choosing (not) to perform important family roles such as the receiver of financial support and the care provider. Design/methodology/approach – Two new strategies (‘condition building’ and ‘rewarding/penalizing’) for promoting the adult worker model are identified based on literature review; their empirical significance is explored through an examination of comparative data concerning early childhood education and care policies (ECEC) and reforms in pension age in fourteen countries. Findings – The evidence shows that promoting the adult worker model does not necessarily benefit all women. While the fourteen countries provide ECEC to varying extents, the increase in pension age in most countries shows that governments adopt a ‘rewarding/penalizing’ strategy for promoting the adult worker model by allocating major welfare based on people’s labour force participation. These pension reforms may generate a negative impact on women’s chances of attaining financial autonomy. Originality/value – This study presents two new strategies for promoting the adult worker model and shows the empirical significance of these strategies based on comparative data. It also highlights the importance of searching for alternative concepts, namely economic defamilisation, for guiding pension reforms