A Critical Evaluation of Prognostic Indicators of the Natural History of Chronic Obstructive Pulmonary Disease (COPD).

In order to monitor progression of COPD there is a need to develop indicators that accurately reflect observed symptoms. This information can then be used to inform treatment and also advice patients as to lifestyle changes that should be made to improve the outcome of the disease. Assessment of the natural history of COPD has, since the classic studies of Fletcher and Peto, historically used FEV1 decline as a marker of severity (GOLD Guidelines). However, the more recent introduction of the multidimensional index BODE, derived from Body Mass Index, the degree of airflow obstruction, Medical Research Council Dyspnoea score and Exercise capacity has brought further refinement into the assessment process. This study has investigated BOD, a model whereby the exercise test is omitted. BOD was evaluated using Body Mass Index, the degree of airflow obstruction, the Medical Research Council Dyspnoea score using a cohort of 458 patients. The results show that BOD is an effective index for the measurement COPD progression. The results also suggest that the BOD model may predicts COPD outcomes more accurately than the BODE and GOLD models. Each quartile increase of the BOD score was associated with a lower survival. The quartile with the worst BOD scores had a 10 year mortality rate of about 42% in contrast to the GOLD classification of severity where the worst stage (Grade 4) was associated with a mortality of 58%. The Cox model was utilized to determine if the BOD model could be improved upon by the inclusion of the other factors investigated. It is also observed that addition of pack years smoking history scores (S) in BOD scores improves its accuracy by 3%. Other factors that influence the progression of COPD have also been investigated as potential measures of disease outcome. These include: historical height, lean body mass, hand grip strength, symptoms duration, C reactive protein (CRP), assessments of health related quality of life and wellness. IV Studies into the concept of wellness suggest that assessment of the inner state of mind, as a means of determining wellness status, could be used to improve disease outcomes. The results suggest various stress factors, anger management and spirituality appear to play a vital role as the disease progresses and help to modify patient’s attitude, thinking and coping behaviour during illness. This study has shown that overall there is a need to develop an indicator that measures both physical factors together with a patients’ “wellness”. BOD together with the Sunderland Respiratory Wellness Questionnaire are the first novel steps in this process. _____________________________

A critical evaluation of prognostic indicators of the natural history of chronic obstructive pulmonary disease (COPD)

In order to monitor progression of COPD there is a need to develop indicators that accurately reflect observed symptoms. This information can then be used to inform treatment and also advice patients as to lifestyle changes that should be made to improve the outcome of the disease. Assessment of the natural history of COPD has, since the classic studies of Fletcher and Peto, historically used FEV1 decline as a marker of severity (GOLD Guidelines). However, the more recent introduction of the multidimensional index BODE, derived from Body Mass Index, the degree of airflow obstruction, Medical Research Council Dyspnoea score and Exercise capacity has brought further refinement into the assessment process. This study has investigated BOD, a model whereby the exercise test is omitted. BOD was evaluated using Body Mass Index, the degree of airflow obstruction, the Medical Research Council Dyspnoea score using a cohort of 458 patients. The results show that BOD is an effective index for the measurement COPD progression. The results also suggest that the BOD model may predicts COPD outcomes more accurately than the BODE and GOLD models. Each quartile increase of the BOD score was associated with a lower survival. The quartile with the worst BOD scores had a 10 year mortality rate of about 42% in contrast to the GOLD classification of severity where the worst stage (Grade 4) was associated with a mortality of 58%. The Cox model was utilized to determine if the BOD model could be improved upon by the inclusion of the other factors investigated. It is also observed that addition of pack years smoking history scores (S) in BOD scores improves its accuracy by 3%. Other factors that influence the progression of COPD have also been investigated as potential measures of disease outcome. These include: historical height, lean body mass, hand grip strength, symptoms duration, C reactive protein (CRP), assessments of health related quality of life and wellness. IV Studies into the concept of wellness suggest that assessment of the inner state of mind, as a means of determining wellness status, could be used to improve disease outcomes. The results suggest various stress factors, anger management and spirituality appear to play a vital role as the disease progresses and help to modify patient’s attitude, thinking and coping behaviour during illness. This study has shown that overall there is a need to develop an indicator that measures both physical factors together with a patients’ “wellness”. BOD together with the Sunderland Respiratory Wellness Questionnaire are the first novel steps in this process. ______________________________EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Technologies and solutions for location-based services in smart cities: past, present, and future

Location-based services (LBS) in smart cities have drastically altered the way cities operate, giving a new dimension to the life of citizens. LBS rely on location of a device, where proximity estimation remains at its core. The applications of LBS range from social networking and marketing to vehicle-toeverything communications. In many of these applications, there is an increasing need and trend to learn the physical distance between nearby devices. This paper elaborates upon the current needs of proximity estimation in LBS and compares them against the available Localization and Proximity (LP) finding technologies (LP technologies in short). These technologies are compared for their accuracies and performance based on various different parameters, including latency, energy consumption, security, complexity, and throughput. Hereafter, a classification of these technologies, based on various different smart city applications, is presented. Finally, we discuss some emerging LP technologies that enable proximity estimation in LBS and present some future research areas

Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

Abstract: University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02), depressive mood (OR 2.20; 95% CI 1.64–2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population

A Marketplace for Efficient and Secure Caching for IoT Applications in 5G Networks

As the communication industry is progressing towards fifth generation (5G) of cellular networks, the traffic it carries is also shifting from high data rate traffic from cellular users to a mixture of high data rate and low data rate traffic from Internet of Things (IoT) applications. Moreover, the need to efficiently access Internet data is also increasing across 5G networks. Caching contents at the network edge is considered as a promising approach to reduce the delivery time. In this paper, we propose a marketplace for providing a number of caching options for a broad range of applications. In addition, we propose a security scheme to secure the caching contents with a simultaneous potential of reducing the duplicate contents from the caching server by dividing a file into smaller chunks. We model different caching scenarios in NS-3 and present the performance evaluation of our proposal in terms of latency and throughput gains for various chunk sizes

Fourier Transform Infrared (FTIR) Spectroscopy of Gmelina arborea Roxb. Leaf Extracts

Gmelina arborea Roxb. is belong to the family of Verbenaceae, have been used for a long time in traditional medicine to treat a wide range of medical ailments. Through the use of the FTIR spectroscopy technique, the objective of this research is to investigate the effects of the extracts of Gmelina arborea leaves obtained from methanol, hydro alcohol, aqueous, hexane, and ethyl acetate. FTIR, which stands for "Fourier transform infrared spectroscopy," is an analytical method that is both rapid and nondestructive. In order to determine the usual peak values and the functional groups that are present in Gmelina arborea leaf extracts, Fourier transform infrared spectroscopy (FTIR) was used on a spectrophotometer system. FTIR testing confirmed that each extract did, in fact, contain a variety of functional groups that were biologically active