Introduction
Diabetes mellitus (DM) is a significant and common risk factor for the development of peripheral vascular disease (PVD). Peripheral vascular disease is the atherosclerotic narrowing of ...peripheral arteries and has a high prevalence among patients with diabetes.
Material and methods
A cross-sectional study was conducted in the Department of Medicine of Ayub Teaching Hospital, Abbottabad. A total of 271 diagnosed diabetic patients aged 40 years or above were included in the study. Ankle-brachial pressure index (ABPI) was measured using a hand-held Doppler device and sphygmomanometer. An ABPI < 0.9 was taken to be abnormal. The risk factors were noted through history taking, physical examination, and appropriate investigations.
Results
Our study sample included 271 patients. A hundred and forty-five (53.5%) of them were males, and 126 (46.5%) were females. Fifty-three (19.9%) out of 271 patients had peripheral vascular disease. The prevalence of peripheral vascular disease was stratified among smoking (p=0.00), hypertension (p=0.00), obesity (p=0.004), and hypercholesterolemia (p=0.005) to determine if there was any association between these and peripheral vascular disease. A p-value less than 0.05 was taken to be significant.
Conclusion
This study showed a significant association between PVD and smoking, hypertension, hypercholesterolemia, and obesity.
Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and ...treatment delay in private sector health care facilities in Pakistan.
This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment.
One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days).
Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.
•Aspen Plus model to produce syngas and bio-hydrogen by varying the composition of the feed stock material for steam gasification process.•Various simulation models were developed with different ...compositions of biomass feed, including leather and municipal solid waste.•Economic analysis showed that the CAPEX and OPEX of the proposed system is USD 1.42×106 and 2.99×105/yr respectively.
This study investigates the potential use of a blend of different types of biomass for sustainable bio-hydrogen production through steam gasification. Simulation models were developed and optimized using Aspen Plus V.11 to achieve optimal bio-hydrogen production while minimizing carbon monoxide production and maintaining a set amount of carbon dioxide concentration in the syngas. The effects of varying the composition of the feedstock material and steam to biomass ratio on hydrogen yield were investigated for five different blends, including leather and municipal solid waste. The study found that the composition of the feedstock played a crucial role in gasification, with higher calorific values for blends containing higher leather content. Additionally, the study showed that specific energy consumption decreased with an increase in total heat duty for four out of the five blends, with Case V having the lowest specific energy consumption of 39.28 kW/kmol of bio H2. The economic analysis further established the potential for the effective utilization of hybrid biomass for renewable bio-hydrogen production. The optimal case V provides total capital cost of USD 1.42 × 106 and the operating cost of the proposed system accounts to USD 2.99 × 105/yr. The unit production cost involved for the optimal case is USD 0.66/kg of H2. Overall, this study provides a basis for further investigation of hybrid biomass blends as a source of renewable energy.
Extensive uses of silica nanoparticles (SiNPs) in biomedical and industrial fields have increased the risk of exposure, resulting concerns about their safety. We focussed on some of the safety ...aspects by studying neurobehavioural impairment, oxidative stress (OS), neurochemical and ultrastructural changes in corpus striatum (CS) of male Wistar rats exposed to 80-nm SiNPs. Moreover, its role in inducing mitochondrial and endoplasmic reticulum (ER) stress-mediated neuronal apoptosis was also investigated. The results demonstrated impairment in neurobehavioural indices, and a significant increase in lipid peroxide levels (LPO), hydrogen peroxide (H
2
O
2
), superoxide (O
2
-
) and protein carbonyl content, whereas there was a significant decrease in the activities of the enzymes, manganese superoxide dismutase (Mn SOD), glutathione peroxidase (GPx), catalase (CAT) and reduced glutathione (GSH) content, suggesting impaired antioxidant defence system. Protein (cytochrome
c
, Bcl-2, Bax, p53, caspase-3, caspase 12 and CHOP/Gadd153) and mRNA (Bcl-2, Bax, p53 and CHOP/Gadd153, cytochrome
c
) expression studies of mitochondrial and ER stress-related apoptotic factors suggested that both the cell organelles were involved in OS-mediated apoptosis in treated rat brain CS. Moreover, electron microscopic studies clearly showed mitochondrial and ER dysfunction. In conclusion, the result of the study suggested that subchronic SiNPs’ exposure has the potential to alter the behavioural activity and also to bring about changes in biochemical, neurochemical and ultrastructural profiles in CS region of rat brain. Furthermore, we also report SiNPs-induced apoptosis in CS, through mitochondrial and ER stress-mediated signalling.
Like the polar bear beleaguered by global warming, artificial intelligence (AI) serves as the charismatic megafauna of an entangled set of local and global histories of science, technology and ...economics. This Themes issue develops a new perspective on AI that moves beyond conventional origin myths – AI was invented at Dartmouth in the summer of 1956, or by Alan Turing in 1950 – and reframes contemporary critique by establishing plural genealogies that situate AI within deeper histories and broader geographies. ChatGPT and art produced by AI are described as generative but are better understood as forms of pastiche based upon the use of existing infrastructures, often in ways that reflect stereotypes. The power of these tools is predicated on the fact that the Internet was first imagined and framed as a ‘commons’ when actually it has created a stockpile for centralized control over (or the extraction and exploitation of) recursive, iterative and creative work. As with most computer technologies, the ‘freedom’ and ‘flexibility’ that these tools promise also depends on a loss of agency, control and freedom for many, in this case the artists, writers and researchers who have made their work accessible in this way. Thus, rather than fixate on the latest promissory technology or focus on a relatively small set of elite academic pursuits born out of a marriage between logic, statistics and modern digital computing, we explore AI as a diffuse set of technologies and systems of epistemic and political power that participate in broader historical trajectories than are traditionally offered, expanding the scope of what ‘history of AI’ is a history of.
The study of dye-surfactant interaction is very important in achieving an optimal dyeing process in textile industries. Conductivity measurements of the cationic surfactant cetylpyridinium chloride ...(CPC) in the presence of bromocresol green dye (BCG) in various solvents were performed, in order to provide insight into the interaction between BCG and CPC. Three critical micelle concentrations (cmc) were observed over the studied CPC concentration range. The observed cmc values of the BCG + CPC system were found to change significantly as a function of BCG concentration. The cmc values of the BCG + CPC system showed U-shaped variation, with increasing temperature in aqueous and propanol media, while decreasing monotonically in ethanol media. The concentration of additives (ethanol, propanol, and propylene glycol) also affected the cmc values significantly. The values of counterion binding (β) were also found to be dependent on the temperature and concentration of additives. Different thermodynamic parameters, e.g. Gibbs free energy (
), enthalpy (
), and entropy (
) changes, as well as their transfer properties associated with micellization of the BCG + CPC system, were determined. The ΔH
o
m
and ΔS
o
m
values reveal the presence of hydrophobic, ion-dipole, or dipole-diploe interactions amongst employed constituents.
The concepts of lean manufacturing operations and sustainability are congruent in nature, marked by the facet of improving organizational efficiency. However, only difference lies in the definition ...of waste. This definition is given a new dimension by sustainability by incorporating the extensive scope of reductions in the environmental consequences in the form of 6R (reduce, reuse, recycle, recover, redesign and remanufacture); which requires a consolidated integrated approach. Therefore, as to affirm the requirement, a systematic literature review has been carried out which scrutinized previous researches in view of their originality, methodology, objectives and limitations. Based on this literature study, 25 most related approaches (lean and sustainable integrated approaches) were selected and their originality was investigated. Investigation revealed that few research articles are integrating lean and sustainable approaches. This study identifies the gap of the integration of lean practices with 6Rs and a framework was developed which implemented on the case study that carries ability to attain 6R based sustainable lean production systems. Because of more social and environmentally friendly atmosphere achieved through 6R based implementation, the results achieved are 50% decrease in heating cost by redesigning furnaces (from oil furnaces to gas furnaces), 36.33% improvement in value added time, 40.14% in lead-time and 22% reduction in labour utilization. This improvement indicates that use of proposed integrated framework is highly beneficial for any kind of manufacturing sector.
Culture and ethnicity influence how people communicate about their pain. This makes it challenging to develop pain self-report tools that are acceptable across ethnic groups.
We aimed to inform the ...development of cross-culturally acceptable digital pain self-report tools by better understanding the similarities and differences between ethnic groups in pain experiences and self-reporting needs.
Three web-based workshops consisting of a focus group and a user requirement exercise with people who self-identified as being of Black African (n=6), South Asian (n=10), or White British (n=7) ethnicity were conducted.
Across ethnic groups, participants shared similar lived experiences and challenges in communicating their pain to health care professionals. However, there were differences in beliefs about the causes of pain, attitudes toward pain medication, and experiences of how stigma and gender norms influenced pain-reporting behavior. Despite these differences, they agreed on important aspects for pain self-report, but participants from non-White backgrounds had additional language requirements such as culturally appropriate pain terminologies to reduce self-reporting barriers.
To improve the cross-cultural acceptability and equity of digital pain self-report tools, future developments should address the differences among ethnic groups on pain perceptions and beliefs, factors influencing pain reporting behavior, and language requirements.
Tuberculosis- (TB) associated stigma is a well-documented phenomenon with various factors, both individual and societal, manifesting its role in shaping health-seeking behavior and contributing to ...suboptimal TB care in Pakistan. The objective of this study was to assess TB-related knowledge and perceived stigma among community members. This was a cross-sectional survey using a convenience sample of 183 individuals recruited between October and December 2017. A validated stigma measurement tool developed by Van Rie et al. was adapted. Data was analyzed using SPSS version 20.0. A clear majority was aware that TB is curable disease and that it is transmitted by coughing. However, respondents also thought that TB spread through contaminated food, sharing meals, sharing utensils, and by having sexual intercourse with a TB patient. In addition, females, unemployed, and persons having less than six years of education were also more likely to associate stigma with TB. We found an association between the lack of knowledge about TB and perceived stigma. This study highlights the need for improved TB-related education among communities.
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