Anaesthesia and subglottic airway obstruction

In this article, we describe the anaesthetic management and laser excision of a subglottic tumour that caused upper airway obstruction. Stridor was the presenting feature. A good history and careful assessment will reduce the likelihood of erroneous or delayed diagnosis and will improve patient outcome.This case report highlights the use of target-controlled infusions and jet ventilation (high-pressure source ventilation) in the surgical excision of a subglottic tumour.Keywords: shared airway; jet ventilation; TIVA/TCI; laser excision; monitorin

Evaluation of an Integrated Approach Involving Chemical and Biological Processes for the Detoxification of Gold Tailings Effluent in Ghana

Chemical and bio-remediation measures for the detoxification of pollutants such as cyanide and heavy metals in mine tailings effluent have been developed over the years. The study sought to evaluate the decrease in the concentrations of Cu, Zn, Fe, Cd, As and Pb through the integration of the processes involving photo-oxidation, activated carbon, hydrogen peroxide and bacterial degradation to decontaminate wastewater from the gold ore treatment plant until release into the environment in Ghana. The levels of trace metals Cu (0.345 mg l-1), Zn (0.07 mg l-1) and Fe (0.146 mg l-1) in treated effluent released into natural water bodies after bacterial degradation was generally within international and local standards for effluent discharges. Except for As, the levels of Cd and Pb which are hazardous heavy metals that may pose adverse health and environmental effects were within acceptable limits. The toxicity of these metals were in the increasing order Pb < Cd < As. The anthropogenic source of As in the chemically processed arseno-pyritic rock ores of the study area and the marginal 14–49% efficiency of As of the different detoxification processes could have contributed to the high levels of As in the effluent. If optimal conditions are attained for the decontamination processes used, the multi-remediation approach could be an effective solution for the decontamination of mine tailings effluent

Nitrogen mineralization trends of applied Mucuna pruriens var. utilis

The effect of method of applying Mucuna pruriens var. utilis on the release of mineral nitrogen in an acid soil was investigated in the laboratory. The above-ground parts of M. pruriens were dried, milled and applied at a rate of 0.3 g 100 g-1 of field moist soil. Two methods of applying milled M. pruriens were used, namely surface application (T2) and incorporation (T3). The control treatment (T1), involving soil only, was also used. The treated soil samples were incubated at room temperature for periods ranging from 0 to 90 days while maintaining their contents at 60 per cent water holding capacity. At the end of the appropriate incubation period, the mineral N contents of the soil samples were measured by extracting soil with 2 M KCI, filtered and the filtrates were then steam-distilled. The mineral N released increased with increasing incubation period. The T1, T2 and T3 had cumulative NH4 +-N values of 5, 5 and 8 kg ha-1, respectively, after the 90 days\' incubation period. The incorporation treatment had the largest amount of NO3-N (66 kg ha-1), followed by the surface application treatment (54 kg ha-1). The control treatment had the least (10 kg ha-1). The soil into which M. pruriens was incorporated (T3) had larger cumulative amount of mineral N (74 kg ha-1) than either T2 (59 kg ha-1) or T1 (15 kg ha-1). The efficiency of mineral N released from M. pruriens was 45 per cent for T2 and 61 per cent for T3. The results indicated that M. pruriens var. utilis, when applied to the soil, could be a potential source of mineral N for crop production.L\'effet de la méthode d\'application de Mucuna pruriens var. utilis sur le dégagement d\'azote (A) minéral dans un sol acide était enquêté au laboratoire. Les parties au-dessus du sol de M. pruriens étaient séchées, moulues et appliquées á raison de 0.3 g 100 g-1 de sol humide du champ. Deux méthodes d\'application de M. pruriens moulue étaient employées: à savoir, application superficielle (T2) et incorporation (T3). Le traitement de contrôle (T1) consistant le sol seulement était utilisé. Les prélèvements de sol traités étaient incubés à une température ambiante pour des périodes variant entre 0 et 90 jours en gardant le contenu d\'eau à 60% de la capacité de rétention d\'eau. A la fin de la période d\'incubation appropriée, les contenus de minéral A de prélèvements de sol étaient mésurés par l\'exraction du sol avec 2 M KCl, filtrés et les filtrats étaient ensuite distillés à vapeur. Le minéral A dégagé augmentait avec la prolongation de la période de l\'incubation. Les T1, T2 et T3 avaient les valeurs cumulatives de NH4 + _ N de 5, 5 et 8 kg ha-1, respectivement, après la période de 90 jours d\'incubation. Le traitement d\'incorporation avait la quantité élevée de NO3-N (66 kg ha-¹) suivi par le traitement d\'application superficielle (54 kg ha-¹). Le traitement de contrôle avait la moindre (10 kg ha-¹). Le sol dans lequel M. pruriens était incorporé (T3) avait la quantité cumulative plus élevée du minéral A (74 kg ha-¹) que le T2 (59 kg ha-¹). L\'efficacité de dégagement de minéral A de M. pruriens était 45% pour T2 et 61% pour T3. Les résultats indiquent que M. pruriens var. utilis lorsque appliquée au sol, pourrait être une source potentielle de minéral A pour la production culturale. Ghana Journal of Agricultural Science Vol. 40 (2) 2008: pp. 223-22

ROLE OF EFFECTIVE PROJECT MANAGEMENT IN REDUCING DRUG DEVELOPMENT COST

ABSTRACTPharmaceuticals are passing through the difficult phase due to increasing numbers of patents expiry along with increasing cost of drug development.Protocol design, regulatory cycle time, site selection, patient enrollment and monitoring are some of the cost contributing elements for late phaseclinical trials. This paper applies the principles of project management and suggests means to reduce the cost of late phase drug development. It alsothrows light on the critical role that a project manager can play in overall drug development process.Keywords: Cost of drug development, Effective project management, Reduction in cost of drug development

CDIO project on MaViCo heat compress for tackwondo players

Taekwondo is a traditional Korean martial arts sport which is currently practiced by many countries around the world. As claimed by the International Olympics Committee (2015), this sport made its debut in 1988 as a demonstration of Olympic sport in Korea and became an official medal sport in Sydney, Australia in the year 2000. The art of taekwondo develops posture, graceful movement, excellent coordination, and attention to detail. As a martial arts sport, taekwondo is characterized by its emphasis on dynamic techniques for taking mobile stances, speed, flexibility, and endurance in order to perform the whole process perfectly. Thus, athletes are required to have control over their shoulders, back, hips, knees, ankles, and feet when practicing this sport

Current Noninvasive MR-Based Imaging Methods in Assessing NAFLD Patients

The chapter will focus on the different aspects of nonalcoholic fatty liver disease (NAFLD). An update in noninvasive MR-based imaging will be offered in detail, pointing mainly to fat, iron, and fibrosis deposition and the accuracy of quantitative methods in disease grading and severity assessment. NAFLD is the most common cause of chronic liver disease (CLD) in Western countries. MRI is used to evaluate the disease, to assess the severity, and to quantify the amount of fat deposition, being also the method of choice to evaluate and quantify iron overload. Diagnosis and staging of liver fibrosis is one of the most challenging aspects of noninvasive imaging. “Virtual biopsy” refers to the possibility of imaging techniques to depict, map, and measure fibrosis minimizing the need for invasive liver biopsies in CLD. MRI allows an accurate determination of steatosis, iron overload, and fibrosis, even if they coexist

Deep Convolutional Neural Network Ensembles Using ECOC

Deep neural networks have enhanced the performance of decision making systems in many applications, including image understanding, and further gains can be achieved by constructing ensembles. However, designing an ensemble of deep networks is often not very beneficial since the time needed to train the networks is generally very high or the performance gain obtained is not very significant. In this paper, we analyse an error correcting output coding (ECOC) framework for constructing ensembles of deep networks and propose different design strategies to address the accuracy-complexity trade-off. We carry out an extensive comparative study between the introduced ECOC designs and the state-of-the-art ensemble techniques such as ensemble averaging and gradient boosting decision trees. Furthermore, we propose a fusion technique, that is shown to achieve the highest classification performance

Isonatraemic haemodialysis in the management of salt and water overload: a crossover trial at an academic hospital in Dakar, Senegal

Introduction: The aims of this study were to assess the impact of isonatraemic haemodialysis on reduction of interdialytic weight gain (IDWG) and blood pressure (BP) as well as its tolerability in our study population. Methods: This crossover trial, at the Aristide Le Dantec University Hospital in Senegal, was conducted on 32 patients with kidney failure who were stable on treatment with chronic haemodialysis. In the initial “control phase”, patients had nine haemodialysis sessions with a dialysate sodium (Na+) concentration (Na+ dialysate) of 138 mmol/L. The serum Na+ set point (SP) for each patient was calculated from three predialytic mid-week values. In the second phase, the “individualized phase”, patients had nine haemodialysis sessions with Na+ dialysate equal to their SP. Results: The mean age of the patients was 55.5 ± 12.1 years, with a male/female ratio of 1.3 and the most common cause of kidney disease was hypertension (47%). Mean predialytic serum Na+ concentration was 135.8 ± 1.9 mmol/L, with a mean intra-individual coefficient of variation of 2%. Mean interdialytic weight gain (IDWG) was 1.9 kg and 1.8 kg in the control and individualized phases, respectively (P = 0.75). A reduction in postdialytic systolic blood pressure (BP) was observed during the individualized phase (P = 0.04). A similar trend was noted in pre- and intradialytic BP but this was not statistically significant. Apart from headaches, which were more common in the individualized phase (P = 0.04), isonatraemic haemodialysis was well tolerated. Conclusions: IDWG as well as pre- and intradialytic BP were unaffected by isonatraemic haemodialysis. Postdialytic BP was significantly reduced. Introduction: Les objectifs de cette étude étaient d’évaluer l’impact de l’hémodialyse isonatrémique sur la réduction de la prise de poids inter-dialytique (PPID) et de la pression artérielle (PA) ainsi que sa tolérance dans notre population d’étude. Méthodes: Cet essai croisé a été mené au centre hospitalier universitaire Aristide Le Dantec de Dakar (Sénégal) chez des patients hémodialysés chroniques. Durant la première phase dite « phase contrôle », les patients ont eu neuf séances d’hémodialyse avec une concentration de sodium dans le dialysat (Na+ dialysat) de 138 mmol/L. Le set-point (SP) de la natrémie a été calculé pour chaque patient et correspondait à la moyenne de 3 natrémies pré-dialytiques en milieu de semaine. Durant la deuxième phase dite « phase individualisée », les patients ont eu neuf séances d’hémodialyse avec du Na+ dialysat égal à leur SP. Résultats: Trente-deux patients ont été inclus. L’âge moyen était de 55,5 ± 12,1 ans avec un ratio homme/femme de 1,3 et la néphropathie initiale la plus fréquente était l’hypertensive (47%). La natrémie pré-dialytique moyenne était de 135,8 ± 1,9 mmol/L, avec un coefficient de variation intra-individuel moyen de 2 %. La PPID moyenne était de 1,9 kg et 1,8 kg dans les phases de contrôle et individualisé, respectivement (P = 0,75). Une diminution de la PA systolique post-dialytique a été observée au cours de la phase individualisée (P = 0,04). Une tendance similaire sans significativité statistique a été notée sur les PA pré- et intra-dialytiques. Hormis les céphalées, plus fréquentes pendant la phase individualisée (P = 0,04), l’hémodialyse isonatrémique a été bien tolérée. Conclusions: La PPID, les PA pré- et intra-dialytiques n’ont pas été affectées par l’hémodialyse isonatrémique. La PA post-dialytique était significativement réduite