Pre-implementation guidelines for infectious disease point-of-care testing in medical institutions

Infectious disease point-of-care test (ID-POCT) devices are becoming widely available, and in this respect, international quality standards and guidelines are available for consultation once ID-POCT has been implemented into medical institutions. However, specific guidelines for consultation during the initial pre-implementation decision-making process are currently lacking. Further, there exist pre-implementation issues specific to ID-POCT. Here we present pre-implementation guidelines for consultation when considering the implementation of ID-POCT in medical institutions

Development of Sustainable Masonry Brick

Implementation of environmentally-friendly and cost-effective building designs has been a persistent challenge to the civil engineering community. The current study aims to develop innovative masonry bricks which could open up the prospects in the future for inexpensive construction. It is also envisioned that if adopted, the proposed process of the brick fabrication could benefit the brick manufacturing industry by curtailing the carbon dioxide foot-print and firing energy levels without compromising the prescribed mechanical and physical properties of the resulting product. The research explores the potential of incorporating HBS-polymer which is a biologically-inert product produced after various treatment processes in the Environmental Laboratory of Lassonde, and Incinerated Sewage Sludge Ash (ISSA) obtained from biological treatment facilities as alternative raw materials in manufacturing low cost and environmentally-friendly masonry bricks. The development of geopolymer masonry bricks, that ensures minimum of 40% reuse of waste glass by weight per brick is an another actively pursued area of the current research. The geo-polymerization process was done using quarried shale, Recycled Crushed Glass (RCG) and sodium silicate. In contrast to the conventional masonry bricks fired exclusively over 1000 degree Celsius for no less than 24 hours, the geopolymer bricks were made at a firing temperature of 400 degree Celsius for four hours. In both cases the materials considered are used in partial replacement of shale, which in turn makes the geopolymer bricks and the Incinerated Sewage Sludge Ash bricks a potentially sustainable construction material in the sense that it uses wastes to replace the use of irreplaceable natural resources. The resulting hybrid bricks will be tested for the effect in compressive strength, flexural strength, split tensile strength, ultrasonic pulse velocity, cold as well as hot water absorption, saturation coefficient, efflorescence, freeze thaw damage, and resonant frequency, all being part of the established quality control procedures in this industry. For the HBS-polymer bricks, the findings indicate that, while the compressive strength, hot as well as cold water absorption and resistance to freeze-thaw damage of hybrid bricks was on par with the control brick without any shale replacement, HBS polymer bricks were much lighter (apparently owing to a better distribution of fine pores and without a commensurate increase in water absorption capacity). The results from the study of the Geo-polymer bricks, Bio-polymer bricks and SSA bricks suggest that they can be a promising solution for the long debated economical building construction with a reduced carbon footprint and firing energy while offering an alternative to landfill disposal of waste

Hypoxia induces dilated cardiomyopathy in the chick embryo: mechanism, intervention, and long-term consequences

Background: Intrauterine growth restriction is associated with an increased future risk for developing cardiovascular diseases. Hypoxia in utero is a common clinical cause of fetal growth restriction. We have previously shown that chronic hypoxia alters cardiovascular development in chick embryos. The aim of this study was to further characterize cardiac disease in hypoxic chick embryos. Methods: Chick embryos were exposed to hypoxia and cardiac structure was examined by histological methods one day prior to hatching (E20) and at adulthood. Cardiac function was assessed in vivo by echocardiography and ex vivo by contractility measurements in isolated heart muscle bundles and isolated cardiomyocytes. Chick embryos were exposed to vascular endothelial growth factor (VEGF) and its scavenger soluble VEGF receptor-1 (sFlt-1) to investigate the potential role of this hypoxia-regulated cytokine. Principal Findings: Growth restricted hypoxic chick embryos showed cardiomyopathy as evidenced by left ventricular (LV) dilatation, reduced ventricular wall mass and increased apoptosis. Hypoxic hearts displayed pump dysfunction with decreased LV ejection fractions, accompanied by signs of diastolic dysfunction. Cardiomyopathy caused by hypoxia persisted into adulthood. Hypoxic embryonic hearts showed increases in VEGF expression. Systemic administration of rhVEGF165 to normoxic chick embryos resulted in LV dilatation and a dose-dependent loss of LV wall mass. Lowering VEGF levels in hypoxic embryonic chick hearts by systemic administration of sFlt-1 yielded an almost complete normalization of the phenotype. Conclusions/Significance: Our data show that hypoxia causes a decreased cardiac performance and cardiomyopathy in chick embryos, involving a significant VEGF-mediated component. This cardiomyopathy persists into adulthood

Novel Classification and Prediction of Heart Disease using CDMA Algorithm

Chronic illness is a long-term condition that lasts a lifetime. In most cases, immunizations and medications cannot heal them, or they do not work.  The most common chronic illnesses are heart disease. The first step in stopping the progression of these disorders is patient diagnosis and prognosis. The identification of individuals with heart disease may be made easier with the machine learning (ML) and deep learning (DL). Finding people who is at risk for these well-known illnesses is often influenced by a variety of circumstances. High precision is provided by deep learning. Machine learning, however, provides less precision. Deep learning also needs a lot of data. However, machine learning can be trained on less data. By doing so, we may determine that one technique's flaw is fixed by another. To classify and forecast heart disease, this research developed an algorithm by combining ML and DL algorithm that is Combination of Machine Learning and Deep Learning Algorithm (CMDA). The data set for the work was taken from UCI data repository. The CMDA algorithm uses the Dl4jMlpClassifier and the Support Vector Machine (SVM). The technique like stacking classifier is used to integrate above two algorithms in the CMDA. The classification method utilized Naive Bayes as a meta-classifier in the CMDA algorithm, uses a stacking classifier strategy for final prediction. After prediction finally, the CMDA method utilizes the Min-Max normalization approach to determine risk factor. According to the experimental findings, the proposed CMDA algorithm effectively classifies and forecasts heart disease and produce high results while comparing with existing methods. &nbsp

Comparision of Different Classifiers for Prediction of Breast Cancer

The cell formed in the  breast are known as breast cancer. It occurs mainly in women and it may occur rarely in men also. It is considered as the most common ailment that can lead to large number of death in females every year. In spite of the factuality that cancer is treatable and can be relieve if treated at its early stages; many patients are screened for cancer only at a very late stage. Data mining technique such as classifications provides an efficient technique to classify data, where these methods are commonly used for diagnostic decision making. The Machine learning techniques propound various methods such as statistical and probabilistic methods which allow system to learn from past experiences to distinguish and identify patterns from a standard dataset. The research work presents a review of machine learning techniques which can be used in breast cancer disease detection by applying algorithms on breast cancer Wisconsin data set.  Algorithms such as Navies Bayes, Random Forest, Support Vector Machine, Adaboost and Decision Trees were used. The result outcome shows that Random Forest performs better than other techniques

Global solar energy estimation using improved greedy based genetic algorithm with deep convolutional neural network

Demand for solar energy increases and it is required to manage the supply of energy effectively. Accurate detection on patterns of energy consumed assist in taking appropriate decisions on generating energy. Even though many traditional techniques have predicted the consumption rate, still improvement is needed in prediction accuracy. The pre-processing is performed initially for handling missing values. The feature selection is accomplished using improved greedy based genetic algorithm (GGA) to extract best features to enhance the performance of the model. Output from feature-selection is passed as input to the classification phase using proposed deep convolutional neural network (CNN) in which future solar energy patterns are classified and predicted timely basis power consumption and it optimize the model by minimize the error. The prediction accuracy is estimated through evaluation metrics such as mean square error (MSE), mean absolute percentage error (MAPE) and root mean square error (RMSE) 0.423, 0.652, and 0.215, respectively. The outcomes achieved in terms of accuracy at 99.75, precision at 99.28, sensitivity, and recall at 100 revealed the efficiency of the proposed classification model. As a result, the proposed future prediction of solar energy was considered efficient since it achieved reduced error values than other prediction algorithms. It assists in maintaining stability in solar-energy based systems

A Comparative Study of Teneligliptin Versus Other Standard Gliptins Used in Type Ii Diabetes Mellitus Patients

AIM AND OBJECTIVES:To determine the therapeutic efficacy and safety of Teneligliptin when compared with other standard gliptin molecules such as sitagliptin and vildagliptin. OBJECTIVES: Whether this drug used as primary, secondary or add on therapy as third molecule. To find out whether it could be used as a monotherapy in special patients with metformin side effect. Find out the usefulness of the teneligliptin and since it is low cost therapy to be recommended more than the other standard gliptins since it may quite useful in developing country like India. DISCUSSION: The study was designed to compare safety, efficacy and cost effectiveness of teneligliptin, sitagliptin and vildagliptin in type II diabetes mellitus patients. The study was started with 155 patients. Each gliptin were compared with metformin and add on therapy of metformin plus glimepiride. In this study the patients were categorized based on their gender. There were 31 males and 19 females in teneligliptin group, 29 males and 21 females in sitagliptin group and vildagliptin group. The results shows the higher predominance in male for type II diabetes mellitus. This was similar to the previous studies conducted by Bennett et al., and Howteerakul et al., which showed higher prevalence of type II DM in men than women. In this study population was categorized in to 5 groups on the basis of age. Among the 5 groups more number of patients were came under the category of 51-60 and less in 71-80 category. Type II DM is commonly seen in middle-aged individuals, especially after 50 years of age. The mean age in this study was 51-60 years, this fact is supported by the study conducted by Miyako Kishimoto et al., . Among the study population, more number of patients (58%, 54% and54% in group A, B and C respectively) were known to have no family history of type II diabetes mellitus. In this study, 40% patients had a positive family history indicating either one or both the parents had type II DM, which was at one stage or the other transferred from one generation to another. Also this was accordance with larger prospective study conducted by Bennett et al., . Study population was categorized into two groups on the basis of duration of the disease in years. More number of patients were came under category 0-5 years and less in 6-10 years. The average duration of DM in this study was found to be 0- 5 years, which was in line with a previous study conducted by Jeon et al., where the mean duration was 5.89 years.The glycemic efficacy was assessed by analyzing the mean change in the value of Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), and Glycated hemoglobin (HbA1C) from the start of the therapy to the end of 3 months study period in each group. Teneligliptin has been demonstrated to improve glycemic control when monotherapy and added to glimepiride, metformin, in patients with type II diabetes. It is confirmed that the combination of Teneligliptin, metformin and glimepiride significantly improved glycemic control. However, in this study, the reduction in HbA1C with teneligliptin monotherapy was greater than those in teneligliptin metformin group and teneligliptin with metformin and glimepiride group. In this study shows at the end of 3 months of dual therapy mean HbA1C, FPB, and PPBS were significantly (p value-≤0.0001) reduced by 7.1±0.5% 123.62±9.31mg/d L and 164.16±35.15mg/d L respectively. At the end of 3 months combination therapy the following results were noted (p value ≤ 0.0001) reduction in HbA1C, FPG, PPG by 7.49±0.48% 121.5±22.69mg/d L and 183.44±19.84mg/d L respectively. The result of this study perfectly complies with the former study conducted by, Kim et al., studied in combination of teneligliptin with metformin in known type II diabetic Korean patients whose glycemic status were not under controlled with metformin monotherapy, this shows teneligliptin add on metformin plus glimepiride therapy shows the significant reduction of glycemic parameter. Another study conducted by in Ghosh et al., (TREAT-INDIA), there was statistically significant improvement in mean HbA1c, FPG, and PPG with teneligliptin therapy. Means changes in HbA1c, FPG, and PPG were 1.37%±1.15%, 51.29±35.41 mg/dL, and 80.89±54.27 mg/dL, respectively. Subgroup analysis revealed that HbA1c (%) reduction with teneligliptin when used as monotherapy, add-on to metformin or add-on to metformin plus combination, was 0.98±0.53, 1.07±0.83, 1.46±1.33, respectively.CONCLUSION: Out of 150 patients, the prevalence of type 2 diabetes mellitus was higher in males than females in age group of 51-60 years and most of the patients were observed in the duration was 0-5 years. From this study it was observed that only female patients having the comorbid conditions were thyroid and rheumatoid arthritis. This study provides an evidence of safety and efficacy of teneligliptin as a monotherapy or in combination therapies with a Metformin and Glimepiride in patients with type II Diabetes mellitus. The results pointed out that all the group of patients showed an improvement in their glycemic parameters such as FBS, PPBS, and HbA1c during the study period and from the group comparison study it was observed that the patients receiving combination therapy of teneligliptin have better glycemic control than combination therapy of vildagliptin. The study demonstrated the effectiveness of teneligliptin combination and sitagliptin combination therapy in type II diabetes mellitus patients. Both the combinations on comparison reveled similar efficacy in glycemic parameter, there by failing to prove the superiority in over each other. There was no significance difference was found in SrCr and SGPT level for the follow-up of 3 months therapy with teneligliptin combinations, sitagliptin combinations and vildagliptin combinations. No severe ADR were reported in the 3 groups. All the ADR reported during the study were mild. However the incidence of ADR were numerically more in vildagliptin combination therapy and the incidence of hypoglycemia is more in sitagliptin combination therapy. The teneligliptin combination shows lesser side effects than the other two combinations. Vildagliptin group shows ADR like GI irritation, Hypoglycemia, Headache and Dizziness. In that occurrence of hypoglycemia were high and other ADRs were mild. Sitagliptin groups shows ADRs like GI irritation, head ache, nausea and diarrhea, in that the major ADR was GI irritation. Compare to the other two groups of combination drugs, teneligliptin has less ADRs like GI irritation, Hypoglycemia and Diarrhea. There was no incidence of renal and hepatic toxicity with all the three combination drugs. The cost effective analysis of teneligliptin, sitagliptin, and vildagliptin monotherapy and their combination with metformin was done , the results shows that teneligliptin alone and its combination with metformin was found to be more cost effective than the other groups of drugs. The teneligplin has more advantages than the other two gliptins in type II diabetes mellitus patients. Teneligliptin with metformin and sulfonyl urea treatment was effective and well tolerated in patients with type II diabetes and it has long halflife of 26.9 hours with unique pharmacokinetic advantage which allows convenient once daily administration irrespective of food. It has dual mode of elimination via renal and hepatic, hence it can be administered safely in renal impairment patients. No dosage adjustment is required in mild to moderate hepatic impairment. The appropriate approach towards managing diabetes should be not only glycemic control but also preservation of islet cell function early and to delay the progression of a disease. In conclusion teneligliptin significantly improves glycemic parameters in Indian T2DM patients with mild ADRs when prescribed as monotherapy or as add-on to Metformin and Sulfonyl ureas and it also cost effective than the other gliptins

Challenges of Parents with Two Intellectually Disabled Children

This study was conducted to assess the psycho-social problems faced by parents with more than one intellectually disabled child in Mangalapuram Panchayath of Trivandrum District, Kerala. The psycho-social elements considered for this qualitative study includes emotional adaptability of parents, the role of support systems and the precautions taken by the family after the birth of the first child. Data were collected from 5 cases selected from the 15 cases identified in Mangalapuram panchayath. The cases were purposively selected from parents having minimum two disabled children. Data were collected using a semi-structured interview guide as a tool. The difficulty faced by the families with two disabled children reveals multiple levels of stress when compared to families with typically developing children. Such families face problems ranging from financial aspects to the physical, psychological and social aspects, which in turn affect their quality of life