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1.
Int Symp Process Syst Eng ; 49: 2149-2154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36790937

RESUMO

Active control strategies play a vital role in modern pharmaceutical manufacturing. Automation and digitalization are revolutionizing the pharmaceutical industry and are particularly important in the shift from batch operations to continuous operation. Active control strategies provide real-time corrective actions when departures from quality targets are detected or even predicted. Under the concept of Quality-by-Control (QbC), a three-level hierarchical control structure can be applied to achieve effective setpoint tracking and disturbance rejection in the tablet manufacturing process through the development and implementation of a moving horizon estimation-based nonlinear model predictive control (MHE-NMPC) framework. When MHE is coupled with NMPC, historical data in the past time window together with real-time data from the sensor network enable model parameter updating and control. The adaptive model in the NMPC strategy compensates for process uncertainties, further reducing plant-model mismatch effects. The frequency and constraints of parameter updating in the MHE window should be determined cautiously to maintain control robustness when sensor measurements are degraded or unavailable. The practical applicability of the proposed MHE-NMPC framework is demonstrated via using a commercial scale tablet press, Natoli NP-400, to control tablet properties, where the nonlinear mechanistic models used in the framework can predict the essential powder properties and provide physical interpretations.

2.
Int Symp Process Syst Eng ; 49: 1543-1548, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36790940

RESUMO

The development of condition monitoring systems often follows a modular scheme where some systems are already embedded in certain equipment by their manufacturers, and some are distributed across various equipment and instruments. This work introduces a framework for guiding the modular development of monitoring systems and integrating them into a comprehensive model that can handle uncertainty of predictions from the constituent modules. Furthermore, this framework improves the robustness of the modular condition monitoring systems as it provides a methodology for maintaining quality assurance and preventing unnecessary shutdowns in the event of some modules going off-line due to condition-based maintenance interventions.

3.
ESCAPE ; 51: 1087-1092, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36790941

RESUMO

Controllers are often tuned during plant commissioning, with a fixed process model. However, over time degradation can occur in the process, the process model and the controller, making it necessary to either re-tune the controller or re-identify the process model. Authors have proposed a variety of approaches to identify plant-model mismatch (PMM) and control performance degradation (CPD). While each approach may have its own advantages and disadvantages, they are generally designed to function on different timescales. The differing timescales result in the need for a multi-level hierarchical approach to monitor, detect, and manage PMM and CPD, as illustrated through a continuous pharmaceutical manufacturing application, i.e., a direct compression tablet manufacturing process. This work also highlights the requirement for index-based metrics, that enable the impact of PMM and CPD to be quantified and assessed from a control performance monitoring perspective, to aid fault diagnosis through root cause analysis to guide maintenance decisions for continuous manufacturing applications.

4.
ESCAPE ; 51: 1081-1086, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36790943

RESUMO

We report progress of an ongoing work to develop a virtual sensor for flowability, which is a critical tool for enabling real time process monitoring in a granulation line. The sensor is based on camera imaging to measure the size and shape distribution of granules produced by wet granulation. Then, statistical methods were used to correlate them with flowability measurements such as ring shear tests, drained angle of repose, dynamic angle of repose, and tapped density. The virtual sensor addresses the issue with these flowability measurements, which are based on off-line characterization methods that can take hours to perform. With a virtual sensor based on real-time measurement methods, the prediction of granule flowability become faster, allowing for timely decisions regarding process control and the supply chain.

5.
Horm Behav ; 136: 105072, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34628291

RESUMO

Reproduction is a critical part of an animal's life history, but one which incurs significant costs to survival and future reproductive potential. These physiological consequences are likely to be influenced by context - for example, if an individual is subject to environmental stressors, physiological and behavioral changes associated with reproduction may be altered. Glucocorticoids, hormones produced as part of the physiological response to stressors, may alter how reproduction affects female physiology and behavior, and therefore the outcomes of reproductive trade-offs. Glucocorticoids prioritize immediate survival over reproduction, for example through changes in immune function, metabolic rate, and foraging, which may reduce energy expenditure or increase energy gain. However, we previously found that female eastern fence lizards (Sceloporus undulatus) experiencing elevated glucocorticoid levels during gestation were nevertheless able to maintain reproductive output and body condition. Here we investigate compensatory mechanisms by which eastern fence lizard females may maintain reproduction under experimental increases in a glucocorticoid, corticosterone (CORT). We found that, although CORT-treated females had similar immune function and behavior, they had reduced metabolic rates 3-5 days post-parturition compared to control females. Given that CORT-treated females spent a similar time basking and had equal food intake compared to control females, we suggest that the reduced metabolic rate is a mechanism by which CORT-treated females maintain their energy balance and reduce the energetic costs of gestation during periods of stress. This study suggests that physiological responses to reproduction may be context-dependent and could act to minimize costs of reproduction in situations where CORT is elevated (such as during periods of environmental stress).


Assuntos
Glucocorticoides , Lagartos , Animais , Corticosterona/metabolismo , Corticosterona/farmacologia , Feminino , Glucocorticoides/metabolismo , Glucocorticoides/farmacologia , Número de Gestações , Lagartos/fisiologia , Parto , Gravidez
6.
Artigo em Inglês | MEDLINE | ID: mdl-36776491

RESUMO

The transition from batch to continuous processes in the pharmaceutical industry has been driven by the potential improvement in process controllability, product quality homogeneity, and reduction of material inventory. A quality-by-control (QbC) approach has been implemented in a variety of pharmaceutical product manufacturing modalities to increase product quality through a three-level hierarchical control structure. In the implementation of the QbC approach it is common practice to simplify control algorithms by utilizing linearized models with constant model parameters. Nonlinear model predictive control (NMPC) can effectively deliver control functionality for highly sensitive variations and nonlinear multiple-input-multiple-output (MIMO) systems, which is essential for the highly regulated pharmaceutical manufacturing industry. This work focuses on developing and implementing NMPC in continuous manufacturing of solid dosage forms. To mitigate control degradation caused by plant-model mismatch, careful monitoring and continuous improvement strategies are studied. When moving horizon estimation (MHE) is integrated with NMPC, historical data in the past time window together with real-time data from the sensor network enable state estimation and accurate tracking of the highly sensitive model parameters. The adaptive model used in the NMPC strategy can compensate for process uncertainties, further reducing plant-model mismatch effects. The nonlinear mechanistic model used in both MHE and NMPC can predict the essential but complex powder properties and provide physical interpretation of abnormal events. The adaptive NMPC implementation and its real-time control performance analysis and practical applicability are demonstrated through a series of illustrative examples that highlight the effectiveness of the proposed approach for different scenarios of plant-model mismatch, while also incorporating glidant effects.

7.
Gen Comp Endocrinol ; 297: 113553, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32687935

RESUMO

Territoriality is a common behavioural adaptation, widespread among ungulates. Here, we tested the hypothesis that territorial individuals have higher glucocorticoid concentrations than non-territorial bachelors, in wild impala (Aepyceros melampus) in the Serengeti ecosystem. We also investigated how the relationship between territoriality and glucocorticoid levels is influenced by environmental context, specifically, food quality, population density (i.e., territory defence intensity), and herd size (i.e., mate defence effort). We collected 139 faecal samples over 4 years and analysed these for faecal glucocorticoid metabolites (FGMs). We used Normalised Difference Vegetation Index (NDVI) as a proxy for food quality, and population density was based on aerial surveys. Territorial males had, on average, higher FGM concentrations than bachelors. Increased food quality did not affect FGM levels in territorial males, but decreased FGM levels in bachelors by 78%. Greater population density increased FGM levels by 47%, but this effect was not different between territorial and bachelor males. Herd size did not affect FGM levels in territorial males. While elevated GC levels are often suggested to be repercussions of being territorial, our findings support the hypothesis that elevated GC levels may be beneficial and act as a facilitator of a male's reproductive potential. The elevated GC levels may increase the ability of territorial males to maintain a territory by increasing energy mobilisation and metabolic rate, ultimately increasing their reproductive fitness. Appreciating that long-term increases in GC levels are not simply costly but may have an adaptive, potentially facilitating role in an animal's life history is key to understanding HPA-axis reactivity and its potential in eco-physiological studies.


Assuntos
Antílopes/fisiologia , Glucocorticoides/metabolismo , Estresse Fisiológico , Territorialidade , Animais , Masculino , Metaboloma , Modelos Biológicos , Densidade Demográfica , Reprodução/fisiologia
8.
Conserv Physiol ; 8(1): coz117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32477568

RESUMO

In East Africa, climate change is predicted to reduce vegetation quality, and pervasive human disturbance has already resulted in significant declines in biodiversity. We studied the combined effects of reduced forage quality and human disturbance on faecal glucocorticoid metabolite (FGM) concentrations. We predicted that decreasing nutritional quality and increasing human disturbance would have an additive positive effect on FGM levels in wild impala (Aepyceros melampus). Employing a space-for-time approach, we used normalized difference vegetation index (NDVI) as a measure of forage quality, combined with spatially explicit proxies of human disturbance across areas of different protection management strategies in the Serengeti ecosystem. We collected 639 faecal samples, spread over 4 years, including both wet and dry seasons. Impala FGM levels increased significantly with declining NDVI and, to a lesser extent, with increasing proxies for human disturbance. However, we found no interaction between the two, such that impala had elevated FGM levels with low NDVI and low FGM levels with high NDVI regardless of human disturbance levels. This implies that impala will have high FGM levels if forage quality is poor, even with significant protection and reduced human disturbance. Understanding how animals respond to and cope with changes in forage quality and human land use across different protected areas is important for conservationists and managers to better protect species at risk and predict population viability.

9.
BMC Endocr Disord ; 19(1): 11, 2019 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-30670002

RESUMO

BACKGROUND: Fasting plasma glucose (FPG) is the most commonly used screening tool for diabetes in Sri Lanka. Cut-off values from American Diabetes Association recommendations are adopted in the absence of local data. We aimed to establish FPG cut offs for Sri Lankans to screen for diabetes and pre-diabetes. METHODS: Data on FPG and diabetes/pre-diabetes status were obtained from Sri Lanka Diabetes and Cardiovascular Study (SLDCS), a community based island wide observational study conducted in 2005-6. Sensitivity specificity and area under the ROC curve were calculated for different FPG values. RESULTS: Study included 4014 community dwelling people after excluding people already on treatment for diabetes or pre-diabetes. Mean age was 45.3 (± 15) years and 60.4% were females. FPG cut off of 5.3 mmol/L showed better sensitivity and specificity than 5.6 mmol/L in detecting diabetes (87.8% and 84.4% Vs 80.8% and 92.1%) and pre-diabetes (54.7% and 87.0% Vs 43.8% and 94.2%). CONCLUSIONS: A lower FPG cut off of 5.3 mmol/L has a better sensitivity and acceptable specificity in screening for diabetes and pre-diabetes in Sri Lankan adults.


Assuntos
Biomarcadores/sangue , Glicemia/análise , Diabetes Mellitus/diagnóstico , Jejum , Teste de Tolerância a Glucose/métodos , Programas de Rastreamento , Estado Pré-Diabético/diagnóstico , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Intolerância à Glucose , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Estado Pré-Diabético/epidemiologia , Prognóstico , Curva ROC , Fatores de Risco , Sri Lanka/epidemiologia
10.
Actas urol. esp ; 42(6): 396-405, jul.-ago. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-174743

RESUMO

Introducción: La nefrectomía radical laparoscópica (NRL) es un pilar en el tratamiento del cáncer renal y las pequeñas masas renales. El entrenamiento quirúrgico del siglo XXI enfrenta desafíos, por lo tanto debe ser eficiente y seguro para que los cirujanos logren habilidades relevantes, protegiendo a los pacientes y los resultados operativos. Este estudio tuvo como objetivo desarrollar sistemáticamente una herramienta para capacitación y evaluación en NRL y validar la herramienta desarrollada para su uso por los urólogos en formación. Métodos: Este estudio prospectivo, longitudinal y multiinstitucional se realizó entre septiembre de 2014 y junio de 2015. Se utilizó el Análisis Modal de Fallos y Efectos de Salud para el desarrollo y luego se validó, donde la herramienta de evaluación se distribuyó a cinco especialistas para aumentar la validez del contenido. Cuatro expertos fueron observados como un enfoque multiinstitucional. Se consideraron los abordajes asistidos por la mano, transperitoneales y retroperitoneales. Resultados: La herramienta de evaluación NRL constó de cuatro fases, 17 procesos, 41 subprocesos. Se observaron cuatro cirujanos y equipos operativos en cuatro hospitales durante 19,5 h (5,75 h asistidas por la mano, 8,75 h transperitoneales, 5 h retroperitoneales). Después del análisis de riesgos, se construyeron tres listas de verificación. Las de NRL asistida manualmente y NRL transperitoneal contenían cuatro fases, 20 procesos, 33 subprocesos y la de NRL retroperitoneal contenía cuatro fases, 20 procesos, 30 subprocesos. Estos se fusionaron para formar una herramienta de evaluación. El resultado final fue una herramienta de evaluación de NRL de cuatro fases con 17 procesos, 41 subprocesos. Todos los participantes estuvieron de acuerdo en que la herramienta final de evaluación de NRL incluía los pasos pertinentes. Conclusiones: La herramienta de evaluación de NRL se desarrolló utilizando el análisis de riesgos Análisis Modal de Fallos y Efectos de Salud para garantizar que se incluyan los subpasos de procedimientos peligrosos. La validación aseguró que los procesos importantes no fueron pasados por alto. Se debe llevar a cabo una aplicación completa a través de un estudio piloto


Introduction: Laparoscopic radical nephrectomy(LRN) is a cornerstone in managing renal cancer and small renal masses. Twenty-first century surgical training faces challenges, thus must be efficient and safe so surgeons attain relevant skills, protecting patients and operative outcomes. This study aimed to systematically develop a tool for training and assessment in LRN and validate the developed tool for use by trainee urologists. Methods: This prospective, longitudinal, multi-institutional study was undertaken from September 2014 - June 2015. Healthcare Failure Mode and Effect Analysis was utilised for development and followed by validation where the assessment tool was distributed to five specialists to increase content validity. Four experts were observed as a multi-institutional approach. Hand-assisted, transperitoneal and retroperitoneal approaches were considered. Results: The LRN Assessment Tool comprised four phases, 17 processes, 41 sub-processes. Four surgeons and operating teams were observed across four hospitals for 19.5 hours (5.75 h hand-assisted, 8.75 h trans-peritoneal, 5 h retro-peritoneal). After hazard analysis, three checklists were constructed. Those for hand-assisted LRN and transperitoneal LRN contained four phases, 20 processes, 33 sub-processes and that for retroperitoneal LRN contained four phases, 20 processes, 30 sub-processes. These were merged to form one assessment tool. The final result was a four phase LRN Assessment Tool with 17 processes, 41 sub-processes. All participants agreed the final LRN Assessment Tool included pertinent steps. Conclusions: The LRN Assessment Tool was developed using Healthcare Failure Mode and Effect Analysis risk analysis to ensure hazardous procedural sub-steps were included. Validation ascertained important processes were not overlooked. Full application through a pilot study must be undertaken


Assuntos
Humanos , 34600/métodos , Nefrectomia/educação , Laparoscopia/educação , Urologia/educação , Procedimentos Cirúrgicos Urológicos/educação , Estudos Prospectivos , Estudos Longitudinais
11.
Gen Comp Endocrinol ; 268: 1-6, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30016628

RESUMO

Organisms are continuously encountering both predictable and unpredictable ecological stressors within their environment. The activation of the hypothalamic-pituitaryadrenal (stress) axis is a fundamental process allowing animals to cope with and respond to such encounters. A main consequence of HPA axis activation is the release of glucocorticoid hormones. Although short-term glucocorticoid elevations lead to changes in physiological and behavioral processes that are often adaptive, our understanding of fitness consequences of repeated acute elevations in glucocorticoid hormones over a longer time period is largely lacking. This is of particular current importance as animals are facing a significant increase in exposure to stressors including those associated with human-induced rapid environmental change. Here, we test fitness-relevant consequences of repeated exposure to glucocorticoids in the absence of natural challenges, by treating wild-caught gravid female eastern fence lizards (Sceloporus undulatus) with a daily transdermal dose of a glucocorticoid hormone until laying. This treatment causes an increase in plasma glucocorticoids that mimics the natural response lizards have when they encounter a stressor in the wild, without confounding effects associated with the encounter itself. This treatment reduced females' reproductive success (hatching success) and survival. Further, glucocorticoid-induced reductions in reproductive success were greater when females had experienced higher temperatures the previous winter. This demonstrates the potential significant consequences of repeated exposure to acute elevations in glucocorticoid hormones. Additionally, the costs of repeated glucocorticoid elevation may be further exaggerated by an individual's previous experience, such as the potential compounding effects of winter warming increasing animals' vulnerability to increased glucocorticoid levels during spring breeding.


Assuntos
Corticosterona/sangue , Glucocorticoides/sangue , Reprodução/fisiologia , Animais , Animais Selvagens , Taxa de Sobrevida
12.
J Exp Zool A Ecol Integr Physiol ; 329(6-7): 317-322, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29992777

RESUMO

Multigenerational effects can have important and sex-dependent effects on offspring. Sex allocation theory predicts that females should differentially invest in sons and daughters depending on sex-specific fitness returns and costs of investment. Maternal stress-relevant (glucocorticoid) hormones may be one mechanism driving this effect. We investigated how maternal stress hormones differentially affected sons and daughters by manipulating levels of the glucocorticoid, corticosterone (CORT), in gravid female eastern fence lizards (Sceloporus undulatus) and quantifying reproductive investment and sex ratio of resulting clutches, and the mass, snout-vent length, and body condition of sons versus daughters at hatching. We found no effect of maternal CORT-treatment on the number or size of eggs laid or on the sex ratio of resulting offspring, but sons of CORT-treated mothers were shorter, lighter, and of poorer body condition at hatching than were sons of control mothers. We found no difference in size or condition of daughters with maternal treatment. Our results suggest that maternal stress, mediated by elevations in maternal CORT concentrations, can have sex-specific effects on offspring manifesting as lower investment in sons.


Assuntos
Lagartos/fisiologia , Razão de Masculinidade , Estresse Fisiológico , Animais , Animais Recém-Nascidos , Tamanho Corporal/fisiologia , Tamanho da Ninhada/efeitos dos fármacos , Corticosterona/administração & dosagem , Corticosterona/farmacologia , Feminino , Masculino , Reprodução/fisiologia
13.
Actas Urol Esp (Engl Ed) ; 42(6): 396-405, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29609827

RESUMO

INTRODUCTION: Laparoscopic radical nephrectomy(LRN) is a cornerstone in managing renal cancer and small renal masses. Twenty-first century surgical training faces challenges, thus must be efficient and safe so surgeons attain relevant skills, protecting patients and operative outcomes. This study aimed to systematically develop a tool for training and assessment in LRN and validate the developed tool for use by trainee urologists. METHODS: This prospective, longitudinal, multi-institutional study was undertaken from September 2014 - June 2015. Healthcare Failure Mode and Effect Analysis was utilised for development and followed by validation where the assessment tool was distributed to five specialists to increase content validity. Four experts were observed as a multi-institutional approach. Hand-assisted, transperitoneal and retroperitoneal approaches were considered. RESULTS: The LRN Assessment Tool comprised four phases, 17 processes, 41 sub-processes. Four surgeons and operating teams were observed across four hospitals for 19.5hours (5.75h hand-assisted, 8.75h trans-peritoneal, 5h retro-peritoneal). After hazard analysis, three checklists were constructed. Those for hand-assisted LRN and transperitoneal LRN contained four phases, 20 processes, 33 sub-processes and that for retroperitoneal LRN contained four phases, 20 processes, 30 sub-processes. These were merged to form one assessment tool. The final result was a four phase LRN Assessment Tool with 17 processes, 41 sub-processes. All participants agreed the final LRN Assessment Tool included pertinent steps. CONCLUSIONS: The LRN Assessment Tool was developed using Healthcare Failure Mode and Effect Analysis risk analysis to ensure hazardous procedural sub-steps were included. Validation ascertained important processes were not overlooked. Full application through a pilot study must be undertaken.

15.
J Biol Dyn ; 11(1): 480-503, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28976297

RESUMO

A simple mathematical model for the growth of tumour with discrete time delay in the immune system is considered. The dynamical behaviour of our system by analysing the existence and stability of our system at various equilibria is discussed elaborately. We set up an optimal control problem relative to the model so as to minimize the number of tumour cells and the chemo-immunotherapeutic drug administration. Sensitivity analysis of tumour model reveals that parameter value has a major impact on the model dynamics. We numerically illustrate how does these delay can change the stability region of the immune-control equilibrium and display the different impacts to the control of tumour. Finally, epidemiological implications of our analytical findings are addressed critically.


Assuntos
Evasão da Resposta Imune , Imunoterapia , Modelos Imunológicos , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Simulação por Computador , Humanos , Análise Numérica Assistida por Computador
16.
Asian Pac J Cancer Prev ; 17(2): 807-13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26925684

RESUMO

Triple-negative breast cancers constitute about 15% of all cases, but despite their higher response to neoadjuvant chemotherapy, the tumors are very aggressive and associated with a poor prognosis as well as a higher risk of early recurrence. This study was retrospectively performed on 101 patients with stage II and III invasive breast cancer who received 6-8 cycles of neo-adjuvant chemotherapy. Out of the total, 23 were in the triple negative breast cancer subgroup. Nuclear Ki-67 expression in both the large cohort group (n=101) and triple negative breast cancer subgroup (n=23) and its relation to the pathological response were evaluated. The purpose of the study was to identify the predictive value of nuclear protein Ki-67 expression among patients with invasive breast cancers, involving the triple negative breast cancer subgroup, treated with neoadjuvant chemotherapy in correlation to the rate of pathological complete response. The proliferation marker Ki-67 expression was highest in the triple negative breast cancer subgroup. No appreciable difference in the rate of Ki-67 expression in triple negative breast cancer subgroup using either a cutoff of 14% or 35%. Triple negative breast cancer subgroup showed lower rates of pathological complete response. Achievement of pathological complete response was significantly correlated with smaller tumor size and higher Ki-67 expression. The majority of triple negative breast cancer cases achieved pathological partial response. The study concluded that Ki-67 is a useful tool to predict chemosensitivity in the setting of neoadjuvant chemotherapy for invasive breast cancer but not for the triple negative breast cancer subgroup.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/metabolismo , Antígeno Ki-67/metabolismo , Terapia Neoadjuvante , Neoplasias de Mama Triplo Negativas/patologia , Adulto , Quimioterapia Adjuvante , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/metabolismo
17.
Clin Exp Hypertens ; 36(7): 484-91, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24433043

RESUMO

We studied the community prevalence, patterns and predictors of hypertension in a large sub-population of South Asian adults with a view of identifying differential risk factors. Data were collected between years 2005-2006 and 5000 adults were invited for the study. The sample size was 4485, and about 39.5% were males. Mean systolic and diastolic blood pressures were 127.1 ± 19.8 mmHg and 75.4 ± 11.3 mmHg, respectively. Age-adjusted prevalence in all adults, males and females was 23.7%, 23.4% and 23.8%, respectively. Urban adults had a significantly higher prevalence of hypertension than rural adults. In the binary logistic-regression analysis, male gender (OR: 1.2), increasing age, Sri Lankan Moor ethnicity (OR: 1.6), physical inactivity (OR: 1.7), presence of diabetes (OR: 2.2) and central obesity (OR: 2.3) all were significantly associated with hypertension. In conclusion, nearly one-third of the Sri Lankan adult population is hypertensive. Hence, public health initiatives should encourage healthier lifestyles with emphasis on preventing obesity and increasing physical activity.


Assuntos
Hipertensão/epidemiologia , Adulto , Idoso , Pressão Sanguínea , Comorbidade , Estudos Transversais , Países em Desenvolvimento , Complicações do Diabetes/epidemiologia , Feminino , Promoção da Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/fisiopatologia , Hipertensão/prevenção & controle , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , População Rural , Sri Lanka/epidemiologia , População Urbana
18.
Case Rep Pathol ; 2013: 687427, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23533895

RESUMO

Primary thyroid-like follicular carcinoma of the kidney is a rare but newly emerging histological variant of renal cell carcinoma RCC, with only nine cases reported in the literature to date. We present a further case of this unique condition, discuss the workup and typical histological findings, and review the literature regarding this rare histological variant.

19.
Diabetes Res Clin Pract ; 99(3): 292-9, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23298662

RESUMO

AIMS: Obesity associated metabolic diseases have reached epidemic levels in many South Asian countries. Conventional anthropometric indices have poor sensitivity and specificity for detecting people with increased metabolic risks. The aim of this study was to investigate and compare WHtR (Waist to Height Ratio) as a marker of diabetes and cardio-metabolic risks with existing classical anthropometric indices such as; Body Mass Index (BMI), Waist Circumference (WC) and Waist to Hip Ratio (WHR) in a large sub-population of ethnic South Asians. METHODS: A total of 5000 subjects recruited from a nationally representative community-based sample using multi-stage random cluster-sampling method. Anthropometric, biochemical and clinical parameters were measured. Receiver-operating characteristic (ROC) curves were performed and area under the curve (AUC) was calculated for each anthropometric index. RESULTS: Sample size was 4485. The mean WHtR in all adults was 0.496 (±0.077), males (0.477±0.065) had a significant lower WHtR than females (0.508±0.081) (p<0.001). WHtR had the highest correlation with metabolic parameters. In all adults, males and females the AUC of WHtR was significantly higher than that of BMI, WC and WHR in diabetes mellitus, pre-diabetes, hypertension, metabolic syndrome and hypercholesterolemia. Mean age, fasting blood glucose, 2-h post prandial blood Glucose, total cholesterol, LDL cholesterol, triglycerides, systolic blood pressure and diastolic blood pressure were all significantly higher among all adults, males and females with WHtR≥0.5. CONCLUSIONS: WHtR is a simple and effective anthropometric index to identify obesity associated metabolic risks among Sri Lankan adults.


Assuntos
Antropometria , Estatura , Doenças Metabólicas/etiologia , Obesidade/complicações , Circunferência da Cintura , Adulto , Idoso , Área Sob a Curva , Povo Asiático , Biomarcadores , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estado Pré-Diabético , Fatores de Risco , Sri Lanka/epidemiologia
20.
J Environ Biol ; 34(2): 273-5, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24620591

RESUMO

The Adyar estuary was once known for its unique ecology and endemic flora and fauna, has lost its pristine condition due to urbanization, discharge of untreated domestic wastes, industrial effluents and encroachments. Zooplankton were monitored for a period of one year from July 2009 to June 2010, following standard methods to evaluate the seasonal variations in diversity and density in relation to environmental parameters like temperature (28.6-33.6 degrees C), salinity (23.3-30.3 per thousand), pH (7.3-7.8) and DO (4.4-7.1 mg l(-1)). Highest diversity was observed during post-monsoon (20 species) and pre-monsoon (19 species), followed by summer (9 species) and monsoon (9 species). The zooplankton density was maximum during summer (1887167 m(-3)) followed by pre-monsoon (1843832 m(-3)), post-monsoon (1153333 m(-3)) and monsoon (182334 m(-3)). Zooplankton community structure and dynamics showed a differential pattern with dominance of harpacticoids and rotifers in pre-monsoon; cyclopoids and rotifers during post-monsoon and summer. The significance of monitoring zooplankton biodiversity as a base-line study for future investigations on environmental changes in this area is discussed.


Assuntos
Estuários , Zooplâncton/classificação , Zooplâncton/fisiologia , Animais , Biodiversidade , Índia
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