Neurological Manifestations in Patients with HIV Infection in the Era of Combined Antiretroviral Therapy

Neurological disorders are the most debilitating of manifestations seen in patients infected with HIV. The clinical profile of neurological manifestations in HIV patients has undergone a shift in recent years with opportunistic infections being controlled with combination anti-retroviral therapy and the advent of drugs which have higher central nervous system penetrability. The aim of this paper is to study the clinical, investigation profile and various neurological disorders in HIV patients on anti‐retroviral therapy. Fifty HIV patients with neurological manifestations were studied. A complete neurological examination including neurocognitive functioning using Montreal Cognitive Assessment and HIV Dementia scale were assessed. Apart from relevant investigations, CD4 count, cerebrovascular fluid analysis, computed tomography (CT) and magnetic resonance imaging (MRI) of brain were done whenever required. Neurocognitive disorders formed the largest group with 42% suffering from HIV associated Neurocognitive Disorders. Among them, asymptomatic neurocognitive impairment was seen in 28%; mild neurocognitive disorder in 12%, and 2% had HIV‐associated dementia. Opportunistic infections of the nervous system accounted for 32%, with meningitis being the most common. Four patients had space occupying lesions of central nervous system; four tuberculomas, and one toxoplasmosis. With the advent of highly active retroviral therapy, HIV patients have longer life spans with suppression of viral load leading to decrease in opportunistic infections of the nervous system. Neurocognitive disorders are now the most common neurological dysfunction seen and thus neurocognitive assessment must be done in all patients with HIV.

Investigating Polynomial Interpolation Functions for Zooming Low Resolution Digital Medical Images

Medical digital images usually have low resolution because of nature of their acquisition. Therefore, this paper focuses on zooming these images to obtain better level of information, required for the purpose of medical diagnosis. For this purpose, a strategy for selecting pixels in zooming operation is proposed. It is based on the principle of analog clock and utilizes a combination of point and neighborhood image processing. In this approach, the hour hand of clock covers the portion of image to be processed. For alignment, the center of clock points at middle pixel of the selected portion of image. The minute hand is longer in length, and is used to gain information about pixels of the surrounding area. This area is called neighborhood pixels region. This information is used to zoom the selected portion of the image. The proposed algorithm is implemented and its performance is evaluated for many medical images obtained from various sources such as X-ray, Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI). However, for illustration and simplicity, the results obtained from a CT scanned image of head is presented. The performance of algorithm is evaluated in comparison to various traditional algorithms in terms of Peak signal-to-noise ratio (PSNR), maximum error, SSIM index, mutual information and processing time. From the results, the proposed algorithm is found to give better performance than traditional algorithms.

Tuning for a Small Engine with a Supercharger

The formula project of Kinki University has been involved in the student Formula SAE of Japan (JSAE) since the second year the competition was held. The vehicle developed in the project uses a ZX-6R engine, which has been manufactured by Kawasaki Heavy Industries for the JSAE competition for the eighth time. The limited performance of the concept vehicle was improved through the development of a power train. The supercharger loading, engine dry sump, and engine cooling management of the vehicle were also enhanced. The supercharger loading enabled the vehicle to achieve a maximum output of 59.6 kW (80.6 PS)/9000 rpm and a maximum torque of 70.6 Nm (7.2 kgf m)/8000 rpm. We successfully achieved 90% of the engine’s torque band (4000–10000 rpm) with 50% of the revolutions in regular engine use (2000–12000 rpm). Using a dry sump system, we periodically managed hydraulic pressure during engine operation. A system that controls engine stoppage when hydraulic pressure falls was also constructed. Using the dry sump system at 80 mm reduced the required engine load and the vehicle’s center of gravity. Even when engine motion was suspended by the electromotive force exerted by the water pump, the circulation of cooling water was still possible. These findings enabled us to create a cooling system in accordance with the requirements of the competition.

An Improved Approach for Hybrid Rocket Injection System Design

Hybrid propulsion combines beneficial properties of both solid and liquid rockets, such as multiple restarts, throttability as well as simplicity and reduced costs. A nitrous oxide (N2O)/paraffin-based hybrid rocket engine demonstrator is currently under development at the Italian Aerospace Research Center (CIRA) within the national research program HYPROB, funded by the Italian Ministry of Research. Nitrous oxide belongs to the class of self-pressurizing propellants that exhibit a high vapor pressure at standard ambient temperature. This peculiar feature makes those fluids very attractive for space rocket applications because it avoids the use of complex pressurization systems, leading to great benefits in terms of weight savings and reliability. To avoid feed-system-coupled instabilities, the phase change is required to occur through the injectors. In this regard, the oxidizer is stored in liquid condition while target chamber pressures are designed to lie below vapor pressure. The consequent cavitation and flash vaporization constitute a remarkably complex phenomenology that arises great modelling challenges. Thus, it is clear that the design of the injection system is fundamental for the full exploitation of hybrid rocket engine throttability. The Analytical Hierarchy Process has been used to select the injection architecture as best compromise among different design criteria such as functionality, technology innovation and cost. The impossibility to use engineering simplified relations for the dimensioning of the injectors led to the needs of applying a numerical approach based on OpenFOAM®. The numerical tool has been validated with selected experimental data from literature. Quantitative, as well as qualitative comparisons are performed in terms of mass flow rate and pressure drop across the injector for several operating conditions. The results show satisfactory agreement with the experimental data. Modeling assumptions, together with their impact on numerical predictions are discussed in the paper. Once assessed the reliability of the numerical tool, the injection plate has been designed and sized to guarantee the required amount of oxidizer in the combustion chamber and therefore to assure high combustion efficiency. To this purpose, the plate has been designed with multiple injectors whose number and diameter have been selected in order to reach the requested mass flow rate for the two operating conditions of maximum and minimum thrust. The overall design has been finally verified through three-dimensional computations in cavitating non-reacting conditions and it has been verified that the proposed design solution is able to guarantee the requested values of mass flow rates.

The Development of an Integrity Cultivating Module in School-Based Assessment among Malaysian Teachers: A Research Methodology

The competency and integrity required for better understanding and practice of School-based Assessment (PBS) comes not only from the process, but also in providing the support or ‘scaffolding’ for teachers to recognize the student as a learner, improve their self-assessment skills, understanding of the daily teaching plan and its constructive alignment of the curriculum, pedagogy and assessment. The cultivation of integrity in PBS among the teachers is geared towards encouraging them to become committed and dedicated in implementing assessments in a serious, efficient manner, thus moving away from the usual teacher-focused approach to the student-focused approach. The teachers show their integrity via their professional commitment, responsibility and actions. The module based on the cultivation of integrity in PBS among Malaysian teachers aims to broaden the guidance support for teachers (embedded in the training), which consists of various domains to enable better evaluation of complex assessment tasks and the construction of suitable instrument for measuring the relevant cognitive, affective and psychomotor domains to describe the students’ achievement. The instrument for integrity cultivation in PBS has been developed and validated for measuring the effectiveness of the module constructed. This module is targeted towards assisting the staff in the Education Ministry, especially the principal trainers, teachers, headmasters and education officers to acquire effective intervention for improving the PBS assessors’ integrity and competency.

Four Phase Methodology for Developing Secure Software

A simple and robust approach for developing secure software. A Four Phase methodology consists in developing the non-secure software in phase one, and for the next three phases, one phase for each of the secure developing types (i.e. self-protected software, secure code transformation, and the secure shield). Our methodology requires first the determination and understanding of the type of security level needed for the software. The methodology proposes the use of several teams to accomplish this task. One Software Engineering Developing Team, a Compiler Team, a Specification and Requirements Testing Team, and for each of the secure software developing types: three teams of Secure Software Developing, three teams of Code Breakers, and three teams of Intrusion Analysis. These teams will interact among each other and make decisions to provide a secure software code protected against a required level of intruder.

Promoting Biofuels in India: Assessing Land Use Shifts Using Econometric Acreage Response Models

Acreage response function are modeled taking account of expected harvest prices, weather related variables and other non-price variables allowing for partial adjustment possibility. At the outset, based on the literature on price expectation formation, we explored suitable formulations for estimating the farmer’s expected prices. Assuming that farmers form expectations rationally, the prices of food and biofuel crops are modeled using time-series methods for possible ARCH/GARCH effects to account for volatility. The prices projected on the basis of the models are then inserted to proxy for the expected prices in the acreage response functions. Food crop acreages in different growing states are found sensitive to their prices relative to those of one or more of the biofuel crops considered. The required percentage improvement in food crop yields is worked to offset the acreage loss.

X-Corner Detection for Camera Calibration Using Saddle Points

This paper discusses a corner detection algorithm for camera calibration. Calibration is a necessary step in many computer vision and image processing applications. Robust corner detection for an image of a checkerboard is required to determine intrinsic and extrinsic parameters. In this paper, an algorithm for fully automatic and robust X-corner detection is presented. Checkerboard corner points are automatically found in each image without user interaction or any prior information regarding the number of rows or columns. The approach represents each X-corner with a quadratic fitting function. Using the fact that the X-corners are saddle points, the coefficients in the fitting function are used to identify each corner location. The automation of this process greatly simplifies calibration. Our method is robust against noise and different camera orientations. Experimental analysis shows the accuracy of our method using actual images acquired at different camera locations and orientations.

Viability of Eggshells Ash Affecting the Setting Time of Cement

This research paper reports on the feasibility and viability of eggshells ash and its effects on the water content and setting time of cement. An experiment was carried out to determine the quantity of water required in order to follow standard cement paste of normal consistency in accordance with MS EN 196-3:2007. The eggshells ash passing the 90µm sieve was used in the investigation. Eggshells ash with percentage of 0%, 0.1%, 0.5%, 1.0%, 1.5% and 2.0% were constituted to replace the cement. Chemical properties of both eggshells ash and cement are compared. From the results obtained, both eggshells ash and cement have the same chemical composition and primary composition which is the calcium compounds. Results from the setting time show that by adding the eggshells ash to the cement, the setting time of the cement decreases. In short, the higher amount of eggshells ash, the faster the rate of setting and apply to all percentage of eggshells ash that were used in this investigation. Both initial and final setting times fulfill the setting time requirements by Malaysian Standard. Hence, it is suggested that eggshells ash can be used as an admixture in concrete mix.

Preparation, Characterisation, and Measurement of the in vitro Cytotoxicity of Mesoporous Silica Nanoparticles Loaded with Cytotoxic Pt(II) Oxadiazoline Complexes

Cytotoxic platinum compounds play a major role in the chemotherapy of a large number of human cancers. However, due to the severe side effects for the patient and other problems associated with their use, there is a need for the development of more efficient drugs and new methods for their selective delivery to the tumours. One way to achieve the latter could be in the use of nanoparticular substrates that can adsorb or chemically bind the drug. In the cell, the drug is supposed to be slowly released, either by physical desorption or by dissolution of the particle framework. Ideally, the cytotoxic properties of the platinum drug unfold only then, in the cancer cell and over a longer period of time due to the gradual release. In this paper, we report on our first steps in this direction. The binding properties of a series of cytotoxic Pt(II) oxadiazoline compounds to mesoporous silica particles has been studied by NMR and UV/vis spectroscopy. High loadings were achieved when the Pt(II) compound was relatively polar, and has been dissolved in a relatively nonpolar solvent before the silica was added. Typically, 6-10 hours were required for complete equilibration, suggesting the adsorption did not only occur to the outer surface but also to the interior of the pores. The untreated and Pt(II) loaded particles were characterised by C, H, N combustion analysis, BET/BJH nitrogen sorption, electron microscopy (REM and TEM) and EDX. With the latter methods we were able to demonstrate the homogenous distribution of the Pt(II) compound on and in the silica particles, and no Pt(II) bulk precipitate had formed. The in vitro cytotoxicity in a human cancer cell line (HeLa) has been determined for one of the new platinum compounds adsorbed to mesoporous silica particles of different size, and compared with the corresponding compound in solution. The IC50 data are similar in all cases, suggesting that the release of the Pt(II) compound was relatively fast and possibly occurred before the particles reached the cells. Overall, the platinum drug is chemically stable on silica and retained its activity upon prolonged storage.

Passive Non-Prehensile Manipulation on Helix Path Based on Mechanical Intelligence

Object manipulation techniques in robotics can be categorized in two major groups including manipulation with grasp and manipulation without grasp. The original aim of this paper is to develop an object manipulation method where in addition to being grasp-less, the manipulation task is done in a passive approach. In this method, linear and angular positions of the object are changed and its manipulation path is controlled. The manipulation path is a helix track with constant radius and incline. The method presented in this paper proposes a system which has not the actuator and the active controller. So this system requires a passive mechanical intelligence to convey the object from the status of the source along the specified path to the goal state. This intelligent is created based on utilizing the geometry of the system components. A general set up for the components of the system is considered to satisfy the required conditions. Then after kinematical analysis, detailed dimensions and geometry of the mechanism is obtained. The kinematical results are verified by simulation in ADAMS.

Design of a Pulse Generator Based on a Programmable System-on-Chip (PSoC) for Ultrasonic Applications

This paper describes the design of a pulse generator based on the Programmable System-on-Chip (PSoC) module. In this module, using programmable logic is possible to implement different pulses which are required for ultrasonic applications, either in a single channel or multiple channels. This module can operate with programmable frequencies from 3-74 MHz; its programming may be versatile covering a wide range of ultrasonic applications. It is ideal for low-power ultrasonic applications where PZT or PVDF transducers are used.

Ultrasound Therapy: Amplitude Modulation Technique for Tissue Ablation by Acoustic Cavitation

In recent years, non-invasive Focused Ultrasound (FU) has been utilized for generating bubbles (cavities) to ablate target tissue by mechanical fractionation. Intensities >10 kW/cm2 are required to generate the inertial cavities. The generation, rapid growth, and collapse of these inertial cavities cause tissue fractionation and the process is called Histotripsy. The ability to fractionate tissue from outside the body has many clinical applications including the destruction of the tumor mass. The process of tissue fractionation leaves a void at the treated site, where all the affected tissue is liquefied to particles at sub-micron size. The liquefied tissue will eventually be absorbed by the body. Histotripsy is a promising non-invasive treatment modality. This paper presents a technique for generating inertial cavities at lower intensities (< 1 kW/cm2). The technique (patent pending) is based on amplitude modulation (AM), whereby a low frequency signal modulates the amplitude of a higher frequency FU wave. Cavitation threshold is lower at low frequencies; the intensity required to generate cavitation in water at 10 kHz is two orders of magnitude lower than the intensity at 1 MHz. The Amplitude Modulation technique can operate in both continuous wave (CW) and pulse wave (PW) modes, and the percentage modulation (modulation index) can be varied from 0 % (thermal effect) to 100 % (cavitation effect), thus allowing a range of ablating effects from Hyperthermia to Histotripsy. Furthermore, changing the frequency of the modulating signal allows controlling the size of the generated cavities. Results from in vitro work demonstrate the efficacy of the new technique in fractionating soft tissue and solid calcium carbonate (Chalk) material. The technique, when combined with MR or Ultrasound imaging, will present a precise treatment modality for ablating diseased tissue without affecting the surrounding healthy tissue.

Economic Loss due to Ganoderma Disease in Oil Palm

Oil palm or Elaeis guineensis is considered as the golden crop in Malaysia. But oil palm industry in this country is now facing with the most devastating disease called as Ganoderma Basal Stem Rot disease. The objective of this paper is to analyze the economic loss due to this disease. There were three commercial oil palm sites selected for collecting the required data for economic analysis. Yield parameter used to measure the loss was the total weight of fresh fruit bunch in six months. The predictors include disease severity, change in disease severity, number of infected neighbor palms, age of palm, planting generation, topography, and first order interaction variables. The estimation model of yield loss was identified by using backward elimination based regression method. Diagnostic checking was conducted on the residual of the best yield loss model. The value of mean absolute percentage error (MAPE) was used to measure the forecast performance of the model. The best yield loss model was then used to estimate the economic loss by using the current monthly price of fresh fruit bunch at mill gate.

Outcomes of Pregnancy in Women with TPO Positive Status after Appropriate Dose Adjustments of Thyroxin: A Prospective Cohort Study

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Affine Combination of Splitting Type Integrators, Implemented with Parallel Computing Methods

In this work we present a family of new convergent type methods splitting high order no negative steps feature that allows your application to irreversible problems. Performing affine combinations consist of results obtained with Trotter Lie integrators of different steps. Some examples where applied symplectic compared with methods, in particular a pair of differential equations semilinear. The number of basic integrations required is comparable with integrators symplectic, but this technique allows the ability to do the math in parallel thus reducing the times of which exemplify exhibiting some implementations with simple schemes for its modularity and scalability process.

Simulation Modeling and Analysis of In-Plant Logistics at a Cement Manufacturing Plant in India

This paper presents the findings of successful implementation of Business Process Reengineering (BPR) of cement dispatch activities in a cement manufacturing plant located in India. Simulation model was developed for the purpose of identifying and analyzing the areas for improvement. The company was facing a problem of low throughput rate and subsequent forced stoppages of the plant leading to a high production loss of 15000MT per month. It was found from the study that the present systems and procedures related to the in-plant logistics plant required significant changes. The major recommendations included process improvement at the entry gate, reducing the cycle time at the security gate and installation of an additional weigh bridge. This paper demonstrates how BPR can be implemented for improving the in-plant logistics process. Various recommendations helped the plant to increase its throughput by 14%.

Neighborhood Sustainability Assessment Tools: A Conceptual Framework for Their Use in Building Adaptive Capacity to Climate Change

Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

3D Shape Knitting: Loop Alignment on a Surface with Positive Gaussian Curvature

This paper aims at manipulating loop alignment in knitting a three-dimensional (3D) shape by its geometry. Two loop alignment methods are introduced to handle a surface with positive Gaussian curvature. As weft knitting is a two-dimensional (2D) knitting mechanism that the knitting cam carrying the feeders moves in two directions only, left and right, the knitted fabric generated grows in width and length but not in depth. Therefore, a 3D shape is required to be flattened to a 2D plane with surface area preserved for knitting. On this flattened plane, dimensional measurements are taken for loop alignment. The way these measurements being taken derived two different loop alignment methods. In this paper, only plain knitted structure was considered. Each knitted loop was taken as a basic unit for loop alignment in order to achieve the required geometric dimensions, without the inclusion of other stitches which give textural dimensions to the fabric. Two loop alignment methods were experimented and compared. Only one of these two can successfully preserve the dimensions of the shape.