Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest

© 2017 Background Improving survival after out-of-hospital cardiac arrest (OHCA) is a priority for modern emergency medical services (EMS) and prehospital research. Advanced life support (ALS) is now the standard of care in most EMS. In some EMS, prehospital critical care providers are also dispatched to attend OHCA. This systematic review presents the evidence for prehospital critical care for OHCA, when compared to standard ALS care. Methods We searched the following electronic databases: PubMed, EmBASE, CINAHL Plus and AMED (via EBSCO), Cochrane Database of Systematic Reviews, DARE, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, NIHR Health Technology Assessment Database, Google Scholar and ClinicalTrials.gov. Search terms related to cardiac arrest and prehospital critical care. All studies that compared patient-centred outcomes between prehospital critical care and ALS for OHCA were included. Results The review identified six full text publications that matched the inclusion criteria, all of which are observational studies. Three studies showed no benefit from prehospital critical care but were underpowered with sample sizes of 1028–1851. The other three publications showed benefit from prehospital critical care delivered by physicians. However, an imbalance of prognostic factors and hospital treatment in these studies systematically favoured the prehospital critical care group. Conclusion Current evidence to support prehospital critical care for OHCA is limited by the logistic difficulties of undertaking high quality research in this area. Further research needs an appropriate sample size with adjustments for confounding factors in observational research design

Ethanol production from tropical sugar beet juice

Starch and sugar resources have been extensively researched to find a suitable renewable source of energy to supplement the world’s ever increasing demand for energy while also abating global warming by stemming the addition of earthbound carbon dioxide into the atmosphere. Sugar beet has been used as a source for sugar production for some time, but its development as a large scale agricultural crop in South Africa has been limited by the large production of sugarcane in tropical areas. Recent trials in the Eastern Cape region have shown some promise for cultivating sugar beets on a large scale. In this study, the influence of process variables such as initial sugar concentration (dilution), pH, yeast concentration and nitrogen source addition were investigated to assess the influence of these variables on the bioethanol production potential of tropical sugar beet. High ethanol yields were obtained without dilution (approximately 0.47 g.g sugar-1) while a pH of 4 and a concentration of 5 g.L-1 yeast (Saccharomyces cerevisiae) produced the largest amount of ethanol in the shortest fermentation time. The addition of a nitrogen source such as ammonium sulphate significantly  increased the ethanol yield. It was concluded from the results of this research that bioethanol can be produced economically from tropical sugar beet cultivars grown in South Africa.Key words: Tropical sugar beet, fermentation, dilution, pH, bioethanol yield

Exploring perceptions of accountability in the mining industry : a critical component in safety management

Mini Dissertation (MBA)--University of Pretoria, 2018.pt2019Gordon Institute of Business Science (GIBS)MBAUnrestricte

Risk for transfusion-transmitted infectious diseases in Central and South America.

We report the potential risk for an infectious disease through tainted transfusion in 10 countries of South and Central America in 1993 and in two countries of South America in 1994, as well as the cost of reagents as partial estimation of screening costs. Of the 12 countries included in the study, nine screened all donors for HIV; three screened all donors for hepatitis B virus (HBV); two screened all donors for Trypanosoma cruzi; none screened all donors for hepatitis C virus (HCV); and six screened some donors for syphilis. Estimates of the risk of acquiring HIV through blood transfusion were much lower than for acquiring HBV, HCV, or T. cruzi because of significantly higher screening and lower prevalence.rates for HIV. An index of infectious disease spread through blood transfusion was calculated for each country. The highest value was obtained for Bolivia (233 infections per 10,000 transfusions); in five other countries, it was 68 to 103 infections per 10,000. The risks were lower in Honduras (nine per 10,000), Ecuador (16 per 10,000), and Paraguay (19 per 10,000). While the real number of potentially infected units or infected persons is probably lower than our estimates because of false positives and already infected recipients, the data reinforce the need for an information system to assess the level of screening for infectious diseases in the blood supply. Since this information was collected, Chile, Colombia, Costa Rica, and Venezuela have made HCV screening mandatory; serologic testing for HCV has increased in those countries, as well as in El Salvador and Honduras. T. cruzi screening is now mandatory in Colombia, and the percentage of screened donors increased not only in Colombia, but also in Ecuador, El Salvador, and Paraguay. Laws to regulate blood transfusion practices have been enacted in Bolivia, Guatemala, and Peru. However, donor screening still needs to improve for one or more diseases in most countries