Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East respiratory syndrome coronavirus

Background There are no longitudinal data on the changes in hematologic, hepatic, and renal function findings in patients with Middle East respiratory syndrome coronavirus (MERS‐CoV) infection. Methods This is a retrospective cohort study of 16 MERS‐CoV patients, to describe the hematological, hepatic, and renal findings of patients with MERS‐CoV. Results During the 21 days of observation, there was no significant change in the hepatic panel or creatinine tests. There was a significant increase in the mean ± SD of the white blood cell count from 8.3 ± 4.6 to 14.53 ± 7 (P value = 0.001) and an increase in mean ± SD of the absolute neutrophil count from 6.33 ± 4.2 to 12 ± 5.5 (P value = 0.015). Leukocytosis was observed in 31% (5/16) of the patients on day 1 and in 80% (4/5) on day 21. Transient leukopenia developed in 6% (1/16) of the patients on day 1 and in 13% (1/8) on day 8. None of the patients had neutropenia. Lymphopenia was a prominent feature with a rate of 44% (7/16) of the patients on day 1 and 60% (3/5) on day 21. Lymphocytosis was not a feature of MERS‐CoV infection. Thrombocytopenia developed in 31% (5/16) of the patients on day 1 and 40% (2/5) on day 21. Thrombocytosis was not a prominent feature and was observed in 6% (1/16) of the patients on day 1 and 17% (1/6) on day 9. Conclusions Patients with MERS‐CoV infection showed variable hematologic parameters over time. Lymphocytosis and neutropenia were not features of MERS‐CoV infection

Challenges, applications and future of wireless sensors in Internet of Things: a review

The addition of massive machine type communication (mMTC) as a category of Fifth Generation (5G) of mobile communication, have increased the popularity of Internet of Things (IoT). The sensors are one of the critical component of any IoT device. Although the sensors posses a well-known historical existence, but their integration in wireless technologies and increased demand in IoT applications have increased their importance and the challenges in terms of design, integration, etc. This survey presents a holistic (historical as well as architectural) overview of wireless sensor (WS) nodes, providing a classical definition, in-depth analysis of different modules involved in the design of a WS node, and the ways in which they can be used to measure a system performance. Using the definition and analysis of a WS node, a more comprehensive classification of WS nodes is provided. Moreover, the need to form a wireless sensor network (WSN), their deployment, and communication protocols is explained. The applications of WS nodes in various use cases have been discussed. Additionally, an overlook of challenges and constraints that these WS nodes face in various environments and during the manufacturing process, are discussed. Their main existing developments which are expected to augment the WS nodes, to meet the requirements of the emerging systems, are also presented

Effect of Liaison Nurse Service on Transfer Anxiety of Patients Transferred From the Cardiac Surgery Intensive Care Unit to the General Ward

Background: Transition from intensive care unit to a general ward is a stressful situation for patients. It is believed that a liaison nurse can prevent adverse events during the transfer process. Objectives: This study aimed to examine the effect of a liaison nurse on anxiety related to the transportation of patients from the cardiac surgery intensive care unit to a general ward. Methods: This randomized clinical trial was conducted on 68 patients that were randomly assigned to the experimental and control groups. The demographic information and disease profile were collected at the baseline of the study. Liaison nurse services were provided for the experimental group during the transfer process. The Spielberger state-trait anxiety inventory (STAI) was used to measure the patients’ anxiety at the start of the transfer and two hours after admission to the general ward. Independent samples and paired t-tests were used to compare the anxiety mean scores in the experimental and control groups. Results: Before the intervention, the mean anxiety was 45.61 ± 12.42 and 40.11 ± 10.95 in the experimental and the control groups, respectively (P = 0.057). However, after the intervention, the mean anxiety score was significantly decreased to 33.20 ± 6.22 in the experimental group (P < 0.001) while it increased to 44.17 ± 10.23 in the control group (P < 0.001). Conclusions: Liaison nurse services affected the patients’ anxiety in the process of transition from the cardiac surgery intensive care unit to the general ward

Client Satisfaction Towards Quality of Health Services: an Assessment at Primary Healthcare of District Gujranwala

This survey designed to evaluate the satisfaction level and the factors that affect the patient satisfaction regarding health care delivery services with the aim to improve the services in the primary health care settings of Gujranwala. A Cross Sectional Study done on randomly selected patients attending the basic health units of Gujranwala, with more than18 years of age. Pretested structured "Liker scale questionnaire" was used for data collection. Out of total respondents, 62 (41.3%) clients were satisfied with the services provided by the basic health units of Gujranwala. The factors identified to determine patient satisfaction were accessibility of services, behavior of staff, health education, level of cleanliness, drug availability and miscellaneous services. Not a single ranked area of satisfaction noticed. Client\u27s occupation and income had significant relationship with the patient satisfaction level. Gender, age, and education of clients were not contributing factors; they not affect the client satisfaction level.Less than half clients were satisfied with the services provided by the basic health units. Management of health facilities needs to improve the services

New approaches to measurement and management for high integrity health systems

Healthcare economies across the globe are in crisis. High income countries—whether their healthcare economies are market driven like the US or tax funded like the UK—are struggling with relentless demand for more services that are increasingly costly to deliver. Low and middle income countries are struggling to provide better and more equitable access to potentially lifesaving interventions while wisely allocating scarce resources across all sectors that affect human and social development. In rich and poor countries alike, policy makers, citizens, and health professionals are drawn to technology but are not learning how to use it most effectively or from mistakes made when its limits go unrecognised or unheeded.1 Variation in regional rates of therapeutic and diagnostic interventions and hospital based care exists globally with no measurable benefit in populations receiving more services.2345 At the same time effective primary healthcare and social services that can have a greater effect on health and wellbeing are being underused.467 The failure to deliver the right care at the right time in the right place contributes to the waste of as much as 40% of healthcare expenditures.48 Recognition of this waste, which is often associated with harm to patients, has spurred health policy reforms across the globe. One common objective is people centred care, which focuses on the needs and wants of individuals and engages them in management of their own care, including behaviours that promote and sustain health and wellbeing. A policy forum held earlier this year, which included health ministers and other representatives from members of the Organisation for Economic Cooperation and Development and seven other countries, advocated a shift from “a system centred on providers to one centred on people’s individual needs and preferences.” The same shift has been advocated in China and for other countries investing heavily in developing healthcare economies.91011 Reform has been successful in some settings, but nowhere has the scale of reform been sufficient to allay concerns about personalised care or about system sustainability. A high integrity health system is one dedicated to providing services that people need and want—no less but no more—and that puts the interests of patients and the public above those of all other stakeholders.12 In this analysis, we discuss how next generation reforms towards a high integrity health system will need to move from the “what” to the “how” of change, to reflect a greater understanding of the sources of resistance, and to take new approaches to measurement and management to guide system performance and innovation

Measurement of zero degree single photon energy spectra for sqrt(s) = 7TeV proton-proton collisions at LHC

In early 2010, the Large Hadron Collider forward (LHCf) experiment measured very forward neutral particle spectra in LHC proton-proton collisions. From a limited data set taken under the best beam conditions (low beam-gas background and low occurance of pile-up events), the single photon spectra at sqrt(s)=7TeV and pseudo-rapidity (eta) ranges from 8.81 to 8.99 and from 10.94 to infinity were obtained for the first time and are reported in this paper. The spectra from two independent LHCf detectors are consistent with one another and serve as a cross check of the data. The photon spectra are also compared with the predictions of several hadron interaction models that are used extensively for modeling ultra high energy cosmic ray showers. Despite conservative estimates for the systematic errors, none of the models agree perfectly with the measurements. A notable difference is found between the data and the DPMJET 3.04 and PYTHIA 8.145 hadron interaction models above 2TeV where the models predict higher photon yield than the data. The QGSJET II-03 model predicts overall lower photon yield than the data, especially above 2TeV in the rapidity range 8.81<eta<8.99

Variability in lipid profile in patients with acute myocardial infarction from two tertiary care hospitals in Pakistan

Objective: To investigate changes in total cholesterol, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol and triglycerides in serum of Pakistani patients with AMI due to age, gender, body mass index (BMI), diabetes, hypertension, and smoking, and also find out the prevalence of hypercholesterolemia, hypertriglyceridemia, low HDL-cholesterol and isolated low-HDL cholesterol in them.Patients and Methods: Serum samples from 451 consecutive AMI patients (250 from National Institute of Cardiovascular Diseases, Karachi and 201 from Armed Forces Institute of Cardiology, Rawalpindi) were analyzed for total cholesterol, HDL-cholesterol and triglycerides using kit methods. LDL-cholesterol was determined using the Friedewald formula.Results: Mean serum concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides in AMI patients were found to be 181 +/- 50 mg/dl, 35.7 +/- 11.3 mg/dl, 110 +/- 47 mg/dl and 177 +/- 127 mg/dl, respectively. Mean levels of total cholesterol and HDL-cholesterol were not significantly affected by age, gender, BMI, diabetes mellitus, hypertension and smoking. Mean LDL-cholesterol concentration, however, was found to be significantly increased in diabetes mellitus (p=0.047), while age, gender, BMI, hypertension and smoking had no significant effect on the levels of this lipoprotein. Mean levels of triglycerides were significantly decreased in older patients (\u3e50 years) compared to younger (\u3c50 \u3eyears) ones (p=0.019). Gender, BMI, diabetes mellitus, hypertension and smoking, however, had no effect on triglyceride levels The frequencies of hypercholesterolemia, hypertriglyceridemia, low HDL-cholesterol and isolated low-HDL-cholesterol were found to be 30.6%, 30.1%, 48.6% and 34.1%, respectively.Conclusion: High prevalence of hypertriglyceridemia and low HDL-cholesterol (which constitute a component of metabolic syndrome) in Pakistani AMI patients is suggestive that these two lipid abnormalities could be playing a major role in the development of atherosclerosis in Pakistani population

Towards the Formal Reliability Analysis of Oil and Gas Pipelines

It is customary to assess the reliability of underground oil and gas pipelines in the presence of excessive loading and corrosion effects to ensure a leak-free transport of hazardous materials. The main idea behind this reliability analysis is to model the given pipeline system as a Reliability Block Diagram (RBD) of segments such that the reliability of an individual pipeline segment can be represented by a random variable. Traditionally, computer simulation is used to perform this reliability analysis but it provides approximate results and requires an enormous amount of CPU time for attaining reasonable estimates. Due to its approximate nature, simulation is not very suitable for analyzing safety-critical systems like oil and gas pipelines, where even minor analysis flaws may result in catastrophic consequences. As an accurate alternative, we propose to use a higher-order-logic theorem prover (HOL) for the reliability analysis of pipelines. As a first step towards this idea, this paper provides a higher-order-logic formalization of reliability and the series RBD using the HOL theorem prover. For illustration, we present the formal analysis of a simple pipeline that can be modeled as a series RBD of segments with exponentially distributed failure times.Comment: 15 page

THz Time-Domain Spectroscopy of Human Skin Tissue for In-Body Nanonetworks

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Highest Energy Cosmic Rays and results from the HiRes Experiment

The status of the field of ultrahigh energy cosmic rays is summarized, from the point of view of the latest results of the High Resolution Fly's Eye (HiRes) Experiment. HiRes results are presented, and compared with those of the Akeno Giant Air Shower Array (AGASA), plus the Telescope Array and Pierre Auger experiments. The HiRes measurements of the cosmic ray spectrum, and the observation of the GZK cutoff are presented. HiRes results on composition, searches for anisotropy, measurement of the proton-air total cross section, and shapes of shower profiles are presented.Comment: 31 pages, 18 figures, submitted to Journal of Physics