88 research outputs found

    Effectiveness of Antibiotic Prophylaxis for Leptospirosis among Adults: A Systematic Review

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    Leptospirosis is one of the most widespread re-emerging zoonoses in the world. Malaysia is known to be an endemic country for human leptospirosis, with a case fatality rate of 2.11%, and an average annual incidence rate of 7.80 cases per 100,000 individuals. This systematic review is conducted to determine the effectiveness of antibiotic prophylaxis for leptospirosis among the adult populations who are highly at risk of getting infected. A systematic search was performed for the relevant titles, abstracts and keywords on PubMed, Scopus, Cochrane and Google Scholar from inception to November 2017 based on the PICO strategy; which returned 126 studies. Screening of abstracts had shortlisted 19 studies and data extraction was conducted for 8 studies which had been accepted after review of the full text. For the evaluation of antibiotics prophylaxis effectiveness against leptospirosis, only trials and cohort studies with risk ratio (RR) were selected. The articles were analyzed from the viewpoint of the dosage, adverse effects, study settings and effectiveness of the antibiotic prophylaxis. Using fixed effects model, pooled RR showed protective association between antibiotic prophylaxis use against the incidence of leptospirosis (RR = 0.31; 95% CI: 0.20, 0.48). Antibiotic prophylaxis for leptospirosis had been shown to be effective in preventing the incidence of the disease among high-risk populations and carries minimal adverse effects. It is recommended that the practice of antibiotic prophylaxis for leptospirosis is included in the standard protocol for leptospirosis prevention among people at high-risk, including disaster response teams and patrons of eco-sports tourism activities; with the drug of choice being doxycycline, either as a single 200 mg dose or weekly dose of 200 mg for the duration of exposure, based on the setting, duration of event and resources available

    International Veterinary Epilepsy Task Force recommendations for a veterinary epilepsy-specific MRI protocol

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    Epilepsy is one of the most common chronic neurological diseases in veterinary practice. Magnetic resonance imaging (MRI) is regarded as an important diagnostic test to reach the diagnosis of idiopathic epilepsy. However, given that the diagnosis requires the exclusion of other differentials for seizures, the parameters for MRI examination should allow the detection of subtle lesions which may not be obvious with existing techniques. In addition, there are several differentials for idiopathic epilepsy in humans, for example some focal cortical dysplasias, which may only apparent with special sequences, imaging planes and/or particular techniques used in performing the MRI scan. As a result, there is a need to standardize MRI examination in veterinary patients with techniques that reliably diagnose subtle lesions, identify post-seizure changes, and which will allow for future identification of underlying causes of seizures not yet apparent in the veterinary literature. There is a need for a standardized veterinary epilepsy-specific MRI protocol which will facilitate more detailed examination of areas susceptible to generating and perpetuating seizures, is cost efficient, simple to perform and can be adapted for both low and high field scanners. Standardisation of imaging will improve clinical communication and uniformity of case definition between research studies. A 6–7 sequence epilepsy-specific MRI protocol for veterinary patients is proposed and further advanced MR and functional imaging is reviewed

    Material selection for optimum design of MEMS pressure sensors

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    Choice of the most suitable material out of the universe of engineering materials available to the designers is a complex task. It often requires a compromise, involving conflicts between different design objectives. Materials selection for optimum design of a Micro-Electro-Mechanical-Systems (MEMS) pressure sensor is one such case. For optimum performance, simultaneous maximization of deflection of a MEMS pressure sensor diaphragm and maximization of its resonance frequency are two key but totally conflicting requirements. Another limitation in material selection of MEMS/Microsystems is the lack of availability of data containing accurate micro-scale properties of MEMS materials. This paper therefore, presents a material selection case study addressing these two challenges in optimum design of MEMS pressure sensors, individually as well as simultaneously, using Ashby’s method. First, data pertaining to micro-scale properties of MEMS materials has been consolidated and then the Performance and Material Indices that address the MEMS pressure sensor’s conflicting design requirements are formulated. Subsequently, by using the micro-scale materials properties data, candidate materials for optimum performance of MEMS pressure sensors have been determined. Manufacturability of pressure sensor diaphragm using the candidate materials, pointed out by this study, has been discussed with reference to the reported devices. Supported by the previous literature, our analysis re-emphasizes that silicon with 110 crystal orientation [Si (110)], which has been extensively used in a number of micro-scale devices and applications, is also a promising material for MEMS pressure sensor diaphragm. This paper hence identifies an unexplored opportunity to use Si (110) diaphragm to improve the performance of diaphragm based MEMS pressure sensors

    Material selection for Micro-Electro-Mechanical-Systems (MEMS) using Ashby's approach

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    A key aspect in design optimization of a product or a system is the selection of materials that best meet the design needs, ensuring maximum performance and minimum cost. Ashby's approach, originally introduced for macro-systems and products, has been very successfully employed for Micro-Electro-Mechanical-Systems (MEMS)/micromachined sensors, actuators and devices. This paper presents a comprehensive review and critical analysis of MEMS material selection studies using Ashby's approach reported in the literature during the last two decades. Performance and Material Indices derived for various microsystems and MEMS devices have been summarized. Moreover, all MEMS materials reported in the literature and the most suitable materials proposed for a variety of MEMS systems and devices have also been consolidated. A material selection case study utilizing micro-scale properties of 51 MEMS compatible materials has been presented to demonstrate that the use of different materials' bulk properties is not the best choice for MEMS materials selection. This paper will serve as a reference guide and useful resource for researchers and engineers engaged in the design and fabrication of various microsystems and MEMS sensors, actuators and devices

    Sensitivity enhancement of silicon-on-insulator CMOS MEMS thermal hot-film flow sensors by minimizing membrane conductive heat losses

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    Minimizing conductive heat losses in Micro-Electro-Mechanical-Systems (MEMS) thermal (hot-film) flow sensors is the key to minimize the sensors’ power consumption and maximize their sensitivity. Through a comprehensive review of literature on MEMS thermal (calorimetric, time of flight, hot-film/hot-film) flow sensors published during the last two decades, we establish that for curtailing conductive heat losses in the sensors, researchers have either used low thermal conductivity substrate materials or, as a more effective solution, created low thermal conductivity membranes under the heaters/hot-films. However, no systematic experimental study exists that investigates the effect of membrane shape, membrane size, heater/hot-film length and (size) to (hot-film length) Ratio (MHR) on sensors’ conductive heat losses. Therefore, in this paper we have provided experimental evidence of dependence of conductive heat losses in membrane based MEMS hot-film flow sensors on MHR by using eight MEMS hot-film flow sensors, fabricated in a 1 ”m silicon-on-insulator (SOI) CMOS foundry, that are thermally isolated by square and circular membranes. Experimental results demonstrate that: (a) thermal resistance of both square and circular membrane hot-film sensors increases with increasing MHR, and (b) conduction losses in square membrane based hot-film flow sensors are lower than the sensors having circular membrane. The difference (or gain) in thermal resistance of square membrane hot-film flow sensors viz-a-viz the sensors on circular membrane, however, decreases with increasing MHR. At MHR = 2, this difference is 5.2%, which reduces to 3.0% and 2.6% at MHR = 3 and MHR = 4, respectively. The study establishes that for membrane based SOI CMOS MEMS hot-film sensors, the optimum MHR is 3.35 for square membranes and 3.30 for circular membranes, beyond which the gain in sensors’ thermal efficiency (thermal resistance) is not economical due to the associated sharp increase in the sensors’ (membrane) size, which makes sensors more expensive as well as fragile. This paper hence, provides a key guideline to MEMS researchers for designing the square and circular membranes-supported micro-machined thermal (hot-film) flow sensors that are thermally most-efficient, mechanically robust and economically viable
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