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The vast development of the technology of embedded systems has had a great impact on the healthcare field. Using low-cost, robust parts, this research proposes an innovative technology and design that enables paralyzed patients or elderly individuals to have a smart room with a voice recognition control unit that works like a joystick for various purposes. The aim is to create an environment that meets their needs and increases their independence, thereby improving their quality of life. The research will show the design of the control unit and present the various applications that can be programmed using voice commands, such as a wheelchair, bed, temperature, lights, TV, and alarm. The voice recognition module will be trained using the patient's voice, for example, to change the movement direction of a wheelchair. The system is based on training the Voice Recognition Module v3 with the use of Arduino and Node MCU. The results of the commendable accuracy of the English word response in a quiet environment ranged between 90% and 100% at the 0.2-meter distance and 50% and 100% at the 0.5-meter distance. While in a noisy environment, it ranged between 40% and 100% at the 0.2-meter distance and 10%–90% at the 0.5-meter distance. As for the Arabic-pronounced words, they ranged between 60% and 100% at the 0.2-meter distance and 30% and 100% at the 0.5-meter distance in a quiet environment. And, in a noisy environment, it ranged between 30% and 100% at the 0.2-meter distance and 10% and 100% at the 0.5-meter distance.

Everything you need to know about the most important trend in the history of the world Within most people's lifetimes, the developments in the biotechnology sector will allow us to live increasingly long and healthy lives, as well as provide us with technological innovations that will transform the way we live. But these innovations offer more than just hope for a better life, but hope for better returns too. Financial returns of incredible magnitude await savvy investors and businesspeople who can see the massive changes on the horizon. This book details these fast-moving trends and innovati

"Everything you need to know about the most important trend in the history of the world. Within most people's lifetimes, the developments in the biotechnology sector will allow us to live increasingly long and healthy lives, as well as provide us with technological innovations that will transform the way we live. But these innovations offer more than just hope for a better life, but hope for better returns too. Financial returns of incredible magnitude await savvy investors and businesspeople who can see the massive changes on the horizon. This book details these fast-moving trends and innovations and offers extensive advice on how to profit from them in business and investing"--Provided by publisher.

Forty-four bottles of drinking water were collected from the local markets of Basra City and stored in the laboratory refrigerator at 4ºC until the physical, chemical and biological measurements were carried out. The results showed a discrepancy in the compatibility of the specifications written on the drinking water bottle label with the sample measurements as well as the variation in the results with the Iraqi standards for bottled water. The percentage of bottled water that is not safe for drinking was 88.5% of the total samples of the study. This value is high and an indication of lack of control over marketing from the imported or produced in the local labs, so it is a danger to the health of the consumer. Results showed that the PH ranged 6.5–8 and did not exceed the values on the information sheet of the potable drinking water as well as the TDS, chloride, magnesium; nitrate and potassium which were within the permissible limits. In addition, the results showed that calcium, total hardness, fluoride and bacterial growth values exceeded the permissible limits, and there are different significations between factors in samples.

Background Riluzole is the only drug to prolong survival for amyotrophic lateral sclerosis (ALS) and, at a dose of 100 mg, was associated with a 35% reduction in mortality in a clinical trial. A key question is whether the survival benefit occurs at an early stage of disease, late stage, or is spread throughout the course of the disease. To address this question, we used the King's clinical staging system to do a retrospective analysis of data from the original dose-ranging clinical trial of riluzole. Methods In the original dose-ranging trial, patients were enrolled between December, 1992, and November, 1993, in Belgium, France, Germany, Spain, Canada, the USA, and the UK if they had probable or definite ALS as defined by the El Escorial criteria. The censor date for the riluzole survival data was set as the original study end date of Dec 31, 1994. For this analysis, King's clinical ALS stage was estimated from the electronic case record data of the modified Norris scale, UK Medical Research Council score for muscle strength, El Escorial category, vital capacity, and gastrostomy insertion data. The lowest allocated stage was 2 because the original trial only included patients with probable or definite ALS. We used a χ2 test to assess the independence of stage at trial enrolment and treatment group, Kaplan-Meier product limit distribution to test the transition from each stage to subsequent stages, and Cox regression to confirm an effect of treatment group on time in stage, controlling for covariates. We did sensitivity analyses by combining treatment groups, using alternative strategies to stage, stratifying by stage at trial enrolment, and using multistate outcome analysis of treatments (MOAT). Findings We analysed the case records of all 959 participants from the original dose-ranging trial, 237 assigned to 50 mg/day riluzole, 236 to 100 mg/day, 244 to 200 mg/day, and 242 to daily placebo. Clinical stage at enrolment did not significantly differ between treatment groups (p=0·22). Time in stage 4 was longer for patients receiving 100 mg/day riluzole than for those receiving placebo (hazard ratio [HR] 0·55, 95% CI 0·36–0·83; log-rank p=0·037). Combining treatment groups and stratifying by stage at enrolment showed a similar result (HR 0·638, 95% CI 0·464–0·878; p=0·006), as did analysis with MOAT where the mean number of days spent in stage 4 was numerically higher for patients given riluzole at higher doses compared with patients receiving placebo. Time from stages 2 or 3 to subsequent stages or death did not differ between riluzole treatment groups and placebo (p=0·83 for stage 2 and 0·88 for stage 3). Interpretation We showed that riluzole prolongs survival in the last clinical stage of ALS; this finding needs to be confirmed in a prospective study, and treatment effects at stage 1 still need to be analysed. The ALS stage at which benefit occurs is important for counselling of patients before starting treatment. Staging should be used in future ALS clinical trials to assess the stage at which survival benefit occurs, and a similar approach could be used for other neurodegenerative diseases. Funding NIHR Maudsley Biomedical Research Centre, The European Union Joint Programme on Neurodegeneration, and the King's Summer Undergraduate Studentship.

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease. The current status of the epidemiology, challenges to its study, and novel study design options are discussed in this paper. We focus on recent results from large-scale population based prospective studies, case-control studies and population based registries, risk factors, and neuropathologic findings in chronic traumatic encephalomyelopathy. We identify areas of interest for future research, including time-trends in the incidence and prevalence of ALS; the meaning of lifetime risk; the phenotypic description of ALS; the definition of familial versus sporadic ALS, syndromic aspects of ALS; specific risk factors such as military service, life style factors such as smoking, the use of statins, and the presence of β-N-methylamino-L-alanine (BMAA), an excitotoxic amino acid derivative possibly produced by cyanobacteria found in almost every terrestrial and aquatic habitat; the emergence and disappearance of an endemic ALS in areas of the Pacific; and gene-environment interactions in the etiology of ALS. To move the epidemiology forward, we suggest using well-characterized cohorts of newly diagnosed ALS patients to identify risk and prognostic factors; storing biological material for future studies; building on the National ALS Registry as a resource of future studies; working in multidisciplinary consortia; and addressing the possible early life etiology of ALS.

Chalabi, F.: Gulf-Asia energy interdependence. - S. 13-21. Mitchell, J.: Energy ties and "policy gaps". - S. 23-36. Yang Guang: China's stabilizing role. - S. 39-46. Dutta, S.: Indo-Gulf relations: dimensions of security. - S. 47-51. Suetsugu, K.: Energy market forces and power politics. - S. 53-60. Ghorban, N.: Regional cooperation: untapped potential. - S. 63-69. Chalabi, I. al-: Market myths and political realities. - S. 71-76. Kemp, G.: Opportunities and challenges. - S. 79-86. Cronin, P.: Worst cases and best choices. - S. 87-90. Lukman, R.: Gulf-Asia energy ties. - S. 93-100

(...) Yamani, Ahmed Zaki: Arab oil and the diminishing political power. - S. 21-32. Chalabi, Issam al-: An-Naft al-'arabi. - S. 33-53. Ghanem, Shokri: The role and impact of OPEC's share in the market. - S. 55-74. Chalabi, Fadhil: Weak oil prices and Gulf oil. - S. 77-89. Lababidi, Mohammad Mukhtar al-: Oil and gas industry in the Arab world. - S. 91-109. Khatib, Hisham: Oil and regional Arab development. - S. 111-117. Anbari, A. Amir al-: The elimination of weapons of mass destruction. The politics and practices of the United Nations Special Commission (UNSCOM) in Iraq. - S. 121-155. Murphy, Richard: Sanctions. - S. 157- 162. Rouleau, Eric: Sanctions. A European point of view. - S. 163-166. Ali, Wijdan: The impact of oil on Arab social and political cultures. - S. 169-182. Jefferson, Michael: Oil and the environment. - S. 183-202. Alaini, Mohsin: Oil and the failure of diplomacy. - S. 205-209. Hourani, Mohammad Saleh: Arab oil and diplomacy. A future perspective. - S. 211-217. Shafiq, Tariq: Diplomacy and the oil industry. - S. 219-229

Since amyotrophic lateral sclerosis cases exhibit significant heterogeneity, we aim to investigate the association of lipid composition of plasma and CSF with amyotrophic lateral sclerosis diagnosis, its progression and clinical characteristics. Lipidome analyses would help to stratify patients on a molecular basis. For this reason, we have analysed the lipid composition of paired plasma and CSF samples from amyotrophic lateral sclerosis cases and age-matched non-amyotrophic lateral sclerosis individuals (controls) by comprehensive liquid chromatography coupled to mass spectrometry. The concentrations of neurofilament light chain—an index of neuronal damage—were also quantified in CSF samples and plasma. Amyotrophic lateral sclerosis versus control comparison, in a moderate stringency mode, showed that plasma from cases contains more differential lipids (n = 122 for raw P < 0.05; n = 27 for P < 0.01) than CSF (n = 17 for raw P < 0.05; n = 4 for P < 0.01), with almost no overlapping differential species, mainly characterized by an increased content of triacylglyceride species in plasma and decreased in CSF. Of note, false discovery rate correction indicated that one of the CSF lipids (monoacylglycerol 18:0) had high statistic robustness (false discovery rate-P < 0.01). Plasma lipidomes also varied significantly with the main involvement at onset (bulbar, spinal or respiratory). Notably, faster progression cases showed particular lipidome fingerprints, featured by decreased triacylclycerides and specific phospholipids in plasma, with 11 lipids with false discovery rate-P < 0.1 (n = 56 lipids in plasma for raw P < 0.01). Lipid species associated with progression rate clustered in a relatively low number of metabolic pathways, mainly triacylglyceride metabolism and glycerophospholipid and sphingolipid biosynthesis. A specific triacylglyceride (68:12), correlated with neurofilament content (r = 0.8, P < 0.008). Thus, the present findings suggest that systemic hypermetabolism—potentially sustained by increased triacylglyceride content—and CNS alterations of specific lipid pathways could be associated as modifiers of disease progression. Furthermore, these results confirm biochemical lipid heterogeneity in amyotrophic lateral sclerosis with different presentations and progression, suggesting the use of specific lipid species as potential disease classifiers. ; We acknowledge funding from the Spanish Ministry of Economy and Competitiveness, Institute of Health Carlos III (PI 17-00134, PI20-0155) to M.P-O; from the Spanish Ministry of Science, Innovation, and Universities (RTI2018-099200-B-I00), and the Generalitat of Catalonia [Agency for Management of University and Research Grants (2017SGR696) and Department of Health (SLT002/16/00250)] to R.P. P.T. is a predoctoral fellow from the Ministerio de Educacion (FPU16/01446). Support was also received in the form of a Fundación Española para el Fomento de la Investigación de la Esclerosis Lateral Amiotrófica (FUNDELA) Grant, RedELA-Plataforma Investigación, and the Fundació Miquel Valls (Jack Van den Hoek donation). M.J. is a professor under the Serra Hunter program (Generalitat de Catalunya). Dr W.S. was funded by the Motor Neurone Disease Association (grant application Al-Chalabi/Apr15/844-791). This study has been co-financed by FEDER funds from the European Union ('A way to build Europe'). IRBLleida is funded by a Centres de Recerca de Catalunya (CERCA) Programme/Generalitat of Catalonia.

Importance: Juvenile amyotrophic lateral sclerosis (ALS) is a rare form of ALS characterized by age of symptom onset less than 25 years and a variable presentation. Objective: To identify the genetic variants associated with juvenile ALS. Design, Setting, and Participants: In this multicenter family-based genetic study, trio whole-exome sequencing was performed to identify the disease-associated gene in a case series of unrelated patients diagnosed with juvenile ALS and severe growth retardation. The patients and their family members were enrolled at academic hospitals and a government research facility between March 1, 2016, and March 13, 2020, and were observed until October 1, 2020. Whole-exome sequencing was also performed in a series of patients with juvenile ALS. A total of 66 patients with juvenile ALS and 6258 adult patients with ALS participated in the study. Patients were selected for the study based on their diagnosis, and all eligible participants were enrolled in the study. None of the participants had a family history of neurological disorders, suggesting de novo variants as the underlying genetic mechanism. Main Outcomes and Measures: De novo variants present only in the index case and not in unaffected family members. Results: Trio whole-exome sequencing was performed in 3 patients diagnosed with juvenile ALS and their parents. An additional 63 patients with juvenile ALS and 6258 adult patients with ALS were subsequently screened for variants in the SPTLC1 gene. De novo variants in SPTLC1 (p.Ala20Ser in 2 patients and p.Ser331Tyr in 1 patient) were identified in 3 unrelated patients diagnosed with juvenile ALS and failure to thrive. A fourth variant (p.Leu39del) was identified in a patient with juvenile ALS where parental DNA was unavailable. Variants in this gene have been previously shown to be associated with autosomal-dominant hereditary sensory autonomic neuropathy, type 1A, by disrupting an essential enzyme complex in the sphingolipid synthesis pathway. Conclusions and Relevance: These data broaden the phenotype associated with SPTLC1 and suggest that patients presenting with juvenile ALS should be screened for variants in this gene.

International audience ; Importance: Juvenile amyotrophic lateral sclerosis (ALS) is a rare form of ALS characterized by age of symptom onset less than 25 years and a variable presentation.Objective: To identify the genetic variants associated with juvenile ALS.Design, setting, and participants: In this multicenter family-based genetic study, trio whole-exome sequencing was performed to identify the disease-associated gene in a case series of unrelated patients diagnosed with juvenile ALS and severe growth retardation. The patients and their family members were enrolled at academic hospitals and a government research facility between March 1, 2016, and March 13, 2020, and were observed until October 1, 2020. Whole-exome sequencing was also performed in a series of patients with juvenile ALS. A total of 66 patients with juvenile ALS and 6258 adult patients with ALS participated in the study. Patients were selected for the study based on their diagnosis, and all eligible participants were enrolled in the study. None of the participants had a family history of neurological disorders, suggesting de novo variants as the underlying genetic mechanism.Main outcomes and measures: De novo variants present only in the index case and not in unaffected family members.Results: Trio whole-exome sequencing was performed in 3 patients diagnosed with juvenile ALS and their parents. An additional 63 patients with juvenile ALS and 6258 adult patients with ALS were subsequently screened for variants in the SPTLC1 gene. De novo variants in SPTLC1 (p.Ala20Ser in 2 patients and p.Ser331Tyr in 1 patient) were identified in 3 unrelated patients diagnosed with juvenile ALS and failure to thrive. A fourth variant (p.Leu39del) was identified in a patient with juvenile ALS where parental DNA was unavailable. Variants in this gene have been previously shown to be associated with autosomal-dominant hereditary sensory autonomic neuropathy, type 1A, by disrupting an essential enzyme complex in the sphingolipid synthesis pathway.Conclusions and ...