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To investigate the seroconversion following first and second COVID-19 vaccination in people with type 1 and type 2 diabetes in relation to glycaemic control prior to vaccination and to analyse the response in comparison to individuals without diabetes.This prospective, multicentre cohort study analysed people with type 1 and type 2 diabetes and a glycated haemoglobin level ≤58 mmol/mol (7.5%) or58 mmol/mol (7.5%), respectively, and healthy controls. Roche's Elecsys anti-SARS-CoV-2 S immunoassay targeting the receptor-binding domain was used to quantify anti-spike protein antibodies 7 to 14 days after the first and 14 to 21 days after the second vaccination.A total of 86 healthy controls were enrolled in the study, as well as 161 participants with diabetes, of whom 150 (75 with type 1 diabetes and 75 with type 2 diabetes) were eligible for the analysis. After the first vaccination, only 52.7% of participants in the type 1 diabetes group and 48.0% of those in the type 2 diabetes group showed antibody levels above the cut-off for positivity. Antibody levels after the second vaccination were similar in participants with type 1 diabetes, participants with type 2 diabetes and healthy controls after adjusting for age, sex and multiple testing (P 0.05). Age (r = -0.45, P 0.001) and glomerular filtration rate (r = 0.28, P = 0.001) were significantly associated with antibody response.Anti-SARS-CoV-2 S receptor-binding domain antibody levels after the second vaccination were comparable in healthy controls and in participants with type 1 and type 2 diabetes, irrespective of glycaemic control. Age and renal function correlated significantly with the extent of antibody levels.

A Swimming performance underlies the biomechanical properties and functional morphology of fish fins. In this article, design and realization of a swimming robot propelled by a pair of pectoral fin is implemented. The suggested shape of the pectoral fins is concave; this type of fin provides a simple approach in generating effective hydrodynamic thrust force through only one degree of freedom (1-DOF). Next, we show the effect of varying fin oscillation speed in two phases, the first phase is the power stroke one, where the fins start to push toward the backward of the body, and the recovery phase, where the fins return toward the frontal part of the body. The detailed steps of the robot design are presented and the thrust force exerted by pectoral fins has been evaluated. The robot is consisting of a rigid-body with an elliptical cross-sectional area, which helps in minimizing the water resistance during the thrusting process. Since pectoral fins provide a vital role in the propulsion mechanism of Labridae fish, the proposed model is driven by a pair of concave-shaped fin to simulate labriform mode swimming mechanism. For motion control, we have suggested to use PID controller in order to improve the system performance. The kinematic and dynamic model of a swimming robot has been derived based on Newton-Euler equations, while an evaluation of the total hydrodynamic forces that are exerted on the swimming robot's body is studied via the computational fluid dynamics (CFD) method. The proposed design has been validated theoretically via Solidworks{\textregistered} platform and examined experimentally. The results of the simulation and practical experiments showed the validity and agility of Labriform swimming robot.

The aim of this study is to develop a swimming robot with good steering performance, in which the steering behavior is achieved by one degree of freedom (1-DOF) represented by a two concave-shaped pectoral fins. The steering mechanism adopted here based on differential drive principle. This principle is carried out by varying the right/left fins velocities. Different radii have been achieved with four different cases of velocities. The proposed design has been validated theoretically via Solidworks{\textregistered} platform and proved practically in a physical swimming pool. A minimum turning radius achieved is 0.40 of body length (BL).

Studies have proven that the blockage that may occur in the blood vessels is a direct cause of cardiac arrest and myocardial arrest, so it is necessary to use the results of the application of radiological examination methods of the heart and large blood vessels - X-ray images, ultrasound, MRI. Therefore, the paper proposed a segmentation method based on a new approach to calculating a continuous and accurate membership function using the (Heaviside and Polynomials) function, in order to extract distinct regions in the images, making the analysis process effective and obtaining an accurate diagnosis, as the results proved that the proposed method highlights the important parts of the cardiovascular images more clearly compared to by traditional methods.

A swimming performance underlies the biomechanical properties and functional morphology of fish fins. Recently, one of the major fields of robotics researchers' interest, is how to resolve some of the difficulties associated with the different water environments like ponds, lagoons, rivers, and deep water or even shallow, sometimes, exploration and searching in many of these environments tend to be dangerous or inaccessible to man. Thus, it is important to develop an efficient technology with direct applications as a solution to the problems appointed such as the use of swimming robots. In this research, design and realization of a swimming robot propelled by a pair of pectoral fin are implemented. The complete design of the swimming robot body is presented. Next, the effect of varying fin oscillation speed in two phases will be observed, the first phase is the power stroke one, where the fins start to push toward the backward of the body, and the recovery phase, where the fins return toward the frontal part of the body. The detailed steps of the robot design are presented and the thrust force exerted by pectoral fins has been evaluated. The suggested swimming robot is a rigid-body with an elliptical cross-sectional area, which helps in minimizing the water resistance during the thrusting process. To improve the system performance, the kinematic and dynamic model of a swimming robot has been derived based on Newton–Euler equations, while an evaluation of the total hydrodynamic forces that are exerted on the swimming robot’s body is studied via the computational fluid dynamics method. Further, a proportional integral derivative controller has been suggested for motion controlling. The proposed design has been validated theoretically via SOLIDWORKS® platform and examined experimentally by several experiments. The results of the simulation and practical experiments showed the validity of the proposed system as a labriform swimming robot.

To investigate differences in heart rate variability (HRV) during oral glucose tolerance tests (OGTTs) in response to the rate of change in glucose and to different glycaemic ranges in individuals with type 1 diabetes. This was a single‐centre, prospective, secondary outcome analysis in 17 individuals with type 1 diabetes (glycated haemoglobin 53 ± 6.3 mmol/L), who underwent two OGTTs (after 12 and 36 hours of fasting) investigating differences in HRV in response to rapid glucose increases/decreases and different glycaemic ranges during OGTT. Based on the rate of change in glucose level, the variables heart rate (P 50 ms difference (P

The weakness of sperm motility arouses the interest of many researchers due to its effect on the success of fertilization cases in couples. In recent years, this has led to the emergence of new technologies such as controllable micro-motor systems which still under evolution. The previous works that concerned with the design of micro-motors in assisting of sperm for moving or change their direction, were not autonomous-based systems. Further, it is worth noting, designing an autonomous micro-robot that emulates sperm in size and behavior is a difficult challenge. Therefore, this paper presents the first step in designing this micro-robot, by drawing the physical structure of micro-robot based on figuring the biological structure of sperm and its behavior to complete the fertilization process. While the main objective is to design a Micro-actuator system, based on the piezoelectric technique for generating a forward thrust force of the micro-robot. The simulation of the proposed design has been conducted by the Solidworks platform and MATLAB, to examine the performance of the micro-actuator system, in which the results describe the requirement for achieving an actuation system.

Swimming performance underlies the biomechanical properties and functional morphology of fish fins. In this article, a pair of concave fin has been suggested, which is inspired from Labriform-mode Swimming fish. First, three concave fins with different sizes are proposed in order to choose the optimum size. All three fins have the same length but with different surface areas, such that each fin has an aspect ratio different from the others. Next, the complete design of the robot is suggested, the complete design of the body and pectoral fins were subjected to computational fluid dynamics (CFD) analysis to show the validity of the proposed model. Finally, the physical model is suggested and provided with 3D printer of Polylactic Acid (PLA) with a density of 1240 kg/ m3. The swimming robot fins have been examined by CFD analysis provided by Solidworks® to evaluate the highest thrust and lowest drag forces. The result showed that the optimum fin is the one with the lowest aspect ratio fin produces the highest drag, whereas the highest aspect ratio fin gives the lowest drag and thrust, therefore; a value of aspect ratio in between these two cases is chosen. While other types of examinations are based on motion analysis of the 3D design, the required motor torque is calculated in order to select a suitable servomotor for this purpose, which a HS-5086WP waterproof servomotor can achieve the calculated torque.

Vaccination and potentially related side effects might impact glucose management in people with diabetes. In this study, we investigated effects of COVID-19 vaccination on glycemia assessed by continuous glucose monitoring (CGM) in people with type 1 and type 2 diabetes. 74 participants of the ongoing multicenter prospective COVAC-DM-study, investigating the immune response to COVID-19 vaccines in people with diabetes, were willing to participate in this CGM sub-study. Time spent in glycemic ranges (time in range [TIR] 70-180 mg/dL; time below range [TBR] 180 mg/dL) was assessed daily from two days prior to three days after the first COVID-19 vaccination. Participants were asked to document side effects in response to vaccination, insulin injections, and carbohydrate intake. 58 participants with type 1 (27 female, mean age 39.5 years, HbA1c 57 ± 12 mmol/mol) and 16 with type 2 diabetes (9 females, mean age 60.6 years, HbA1c 63 ± 11mmol/mol) were included in this study. The mean TIR did not change on the day of the vaccination and the following 3 days (p>0.05). In people with type 1 diabetes, the TIR (p=0.033) and the TAR (p= 0.043) deteriorated on days with side effects as compared to those without. Side effects occurring after COVID-19 vaccination significantly reduce the TIR and increase the TAR in people with type 1 diabetes, while no impact was observed in people with type 2 diabetes.

AimsImmune response to COVID-19 vaccination and a potential impact of glycaemia on antibody levels in people with diabetes remains unclear. We investigated the seroconversion following first and second COVID-19 vaccination in people with type 1 and type 2 diabetes in relation to glycaemic control prior to vaccination and analysed the response in comparison to individuals without diabetes.Materials and MethodsThis prospective, multicenter cohort study analysed people with type 1 and type 2 diabetes, well (HbA1cResults86 healthy controls and 161 participants with diabetes were enrolled, 150 (75 with type 1 diabetes and 75 with type 2 diabetes) were eligible for the analysis. After the first vaccination, only 52.7% in the type 1 diabetes group and 48.0% in the type 2 diabetes group showed antibody levels above the cut-off for positivity. Antibody levels after the second vaccination were similar in people with type1, type 2 diabetes and healthy controls if adjusted for age, sex and multiple testing (p>0.05). Age (r=−0.45, pConclusionsAnti-SARS-CoV-2 S antibody levels after the second vaccination were comparable in healthy controls, people with type 1 and type 2 diabetes, irrespective of glycaemic control. Age and renal function correlated significantly with the extent of antibody levels.

The ability of fish to change the swimming direction is directly related with maneuvering performance. One of the maneuvering aspects is the steering process. Maneuverability can be defined as the ability to turn in a confined area and it is measured as the turning radius trajectory in terms of the body length (R/BL, where R is defined as the turning radius and BL defined as the total body length). This paper aims to develop a swimming robot of labriform swimming mode with good steering performance. The steering process is achieved by one degree of freedom (1-DOF) represented by two concave-shaped pectoral fins. The steering mechanism adopted in this work is based on the differential drive principle. This principle is carried out by varying the right/left fins velocities. Different radii have been observed with four different cases of velocities. Diving underwater, is another aspect that has been taking into account during this work. The designed robot uses a mass sliding mechanism to change its center of gravity, and consequently, controlling the pitch angle and hence the depth of the robot. The designed glider robot is able to achieve about 40° of pitch angle and swims for a depth of approximately 30 cm underwater. The results of these experiments showed the success of the proposed robot to steer and dive efficiently.

In urban-traffic scenarios, massive mobile terminals can provide more comprehensive and accurate environmental sensing data with various built-in sensors. Humans can also collect environmental information as task executors. Therefore, facing different sensing requirements from environmental monitoring, intelligent transportation, urban management, and other fields, if we make good use of the sensing abilities of mobile terminals and humans, we can provide more supporting data for them. This paper proposes a multitasking-oriented participant-recruitment algorithm for vehicular crowd sensing based on the Combine-S algorithm that could merge-common sensing requirements in the time and space dimensions to solve the problem of overlapping requirements among multiple tasks. Combine-S could also be integrated with a greedy recruitment algorithm to improve the sensing effect and reduce sensing costs. We used the OMNet++ simulators that are used for simulating urban transportation and IoTKeywords-Genetic Algorithm, NSL-KDD, Intrusion Detection system, Fast Learning Network.

Most cases of poor fertilization suffered by men due to the abnormal shape of sperm, weak sperm activity, few numbers of sperm, or the high viscosity of semen. In this paper, an autonomous micro-robot like sperm has been designed that helps the couple to complete the fertility process which, the physical structure of the proposed micro-robot has been described. Micro-Robot mathematical model has been derived based on observation of sperm motion to evaluate the required thrust force produced by the micro-robot tail. The piezoelectric system has been used for implementing the motion generation of robots. The proposed robot is simulated by Solidworks software, which the simulation results indicated to the success of the proposed design and ability to generate thrust force for the robot.

The use of digital technologies in agriculture has become very important to ensure the protection of trees from disease and limit their development, which leads to increased production, so the paper proposes a modified analytical model to analyze the data and graphical parts of the leaves of fruit trees using priority fuzzy C-means (PFCM). Based on the proposed distance scale to obtain a clustering with a less error rate and fairly close to accuracy for the purpose of monitoring the development of diseases of fruit trees, by classifying the diseases and medications needed for each disease, a database was created containing large samples of data and images, where the results of Analysis of previous studies that analyzes of large amounts of data give accurate results. The proposed method was used in smart gardens with large areas and we got the desired results.

The pectoral fin shape, size, and speed are the three main parameters for the proposed design. The influence of the geometrical shape of pectoral fin in labriform‐mode swimming mechanism is evaluated with the aid of computational fluid dynamics (CFD) method, which could be considered as a first step before building the complete robot prototype. The simulated results obtained are then validated experimentally. Two concave‐shape fins were designed with high precision, and each one of them is attached to a servomotor arm, which is, in turn, connected to a servomotor that is sliding on a pair of parallel shafts fixed at the center of a pool. The mathematical model of the proposed design is derived and then simulated by SolidWorks software. A different number of fin oscillating angles are tested with different power‐to‐recovery ratios. The generated thrust and drag force components under different working conditions are investigated, and hence, the drag coefficient is obtained experimentally. Body velocity and motor torque are calculated and compared with theoretical analysis. The results indicate that for each angle of rotation, there exists an optimal ratio that produces a maximum thrust during power stroke and maintains a minimum drag during recovery stroke.

Objective The aim of this study was to evaluate the use of neoadjuvant chemotherapy (NACT) and primary debulking surgery (PDS) before and after results from a randomized trial were published and showed non-inferiority between NACT and PDS in the management of advanced-stage ovarian carcinoma. Methods We evaluated consecutive patients with advanced-stage ovarian cancer treated at our institution from 1/1/08–5/1/13, which encompassed 32months before and 32months after the randomized trial results were published. We included all newly diagnosed patients with high-grade histology and stage III/IV disease. Associations between the use of NACT and clinical variables over time were evaluated. Results Our study included 586 patients. Median age was 62years (range, 30–90); 406 patients (69%) had stage III disease, and 570 (97%) had disease of serous histology. Twenty-six percent (154/586) were treated with NACT and 74% (432/586) with PDS. NACT use increased significantly from 22% (56/256) before 2010 (at which point the results of the randomized trial were published) to 30% (98/330) after 2010 (p=0.037). Although patients who underwent PDS were more likely to experience grade 3/4 surgical complications than those who underwent NACT, those selected for PDS had a median OS of 71.7months (CI, 59.8-not reached) compared with 42.9months (CI 37.1-56.3) for those selected for NACT. Conclusions In this single-institution analysis, the best survival outcomes were observed in patients who were deemed eligible for PDS followed by platinum-based chemotherapy. Selection criteria for NACT require further definition and should take institutional surgical strategy into account.

This paper presents Evaluation K-mean and Fuzzy c-mean image segmentation based Clustering classifier. It was followed by thresholding and level set segmentation stages to provide accurate region segment. The proposed stay can get the benefits of the K-means clustering. The performance and evaluation of the given image segmentation approach were evaluated by comparing K-mean and Fuzzy c-mean algorithms in case of accuracy, processing time, Clustering classifier, and Features and accurate performance results. The database consists of 40 images executed by K-mean and Fuzzy c-mean image segmentation based Clustering classifier. The experimental results confirm the effectiveness of the proposed Fuzzy c-mean image segmentation based Clustering classifier. The statistical significance Measures of mean values of Peak signal-to-noise ratio (PSNR) and Mean Square Error (MSE) and discrepancy are used for Performance Evaluation of K-mean and Fuzzy c-mean image segmentation. The algorithm’s higher accuracy can be found by the increasing number of classified clusters and with Fuzzy c-mean image segmentation.

Objective In 1994, our hospital reported a significant gender disparity in the treatment of peripheral artery disease (PAD). The objective of this study was to determine if this gender-based treatment disparity still persists after 15 years. Methods A retrospective review of patients with PAD and carotid artery disease based on vascular laboratory studies was performed from January 2006 to February 2008. PAD was identified by ankle-brachial index ≤ 0.9 or abnormal waveform. Treatable carotid artery disease was identified by symptomatic stenosis 60%-99% or asymptomatic stenosis 80%-99%. Patients with interventions before January 2006 were excluded. Demographics, risk factors, and interventions were recorded. Univariate and multivariate analyses were performed to identify risk factors and independent predictors of intervention. Results Of 2,313 peripheral artery studies, 592 patients with PAD and no prior intervention were identified. Sixty-five (21.7%) of 299 men and 47 (16.0%) of 293 women underwent angioplasty, stenting, endarterectomy, or bypass grafting. This difference was not significant ( P = .077). However, by multivariate analysis of patients with critical limb ischemia, Caucasian race was an independent predictor of intervention ( P = .010; odds ratio [OR] 3.363). Of 3,505 carotid duplex studies, 253 patients with treatable carotid artery disease and no prior intervention were identified. Seventy-eight (52.7%) of 148 men and 43 (41.0%) of 105 women underwent carotid endarterectomy (CEA) or stenting. This difference was not significant ( P = .065). However, by multivariate analysis, Caucasian race was identified as an independent predictor of intervention ( P = .015, OR 3.033). Insurance status was not a predictor of intervention in either the PAD ( P = .70) or carotid artery disease cohort ( P = .99). Conclusion Our data reveal that gender was not an independent predictor of intervention for PAD or carotid artery disease; however, Caucasian race independently predicted a greater likelihood of intervention in PAD patients with critical limb ischemia and in the carotid artery disease cohort. This study demonstrates the importance of performance assessments in uncovering unsuspected treatment disparities.

e16579 Background: This is a retrospective chart review evaluating the use of NACT and primary debulking surgery (PDS) before and after a landmark trial was published demonstrating non-inferiority ...