Clinical and financial consequences of setting up an asthma clinic at St. Luke’s Hospital

The effects of setting up an asthma clinic were assessed in an audit study. A comparison was made between the quality and quantity of medication used by patients before and after attending the asthma clinic. The number and severity of exacerbations during a six month period before and a six month period after attending were also assessed. The cost of treatment before and after was also calculated. In 14% of patients, occupational factors, drugs or underlying lung disease were significant contributors to asthma. The number of acute episodes of severe asthma were reduced from 98 to 47, with hospital admissions falling from 26 to 1. Pulmonary function (%FEV1) improved in the group as a whole with the number of patients having their best FEV above 80% improving from 44 to 71. In spite of the expense of high cost drugs and the running costs of the clinic there were substantial savings largely from the reduced number of hospital admissions. The calculated annual cost fell from Lm 22,769 to Lm 10,654.peer-reviewe

Alveolar cell carcinoma

Symptoms of alveolar cell carcinoma, a lung cancer, usually tend to occur rather late due to the slow progression of the tumour. The tumour may remain localized for long periods, even for years. The incidence of symptoms increases with extension of the lesion. Productive cough, breathlessness, chest pain and weight loss are common complaints, occasionally patients may present with hemoptysis, pyrexia or joint pains. One feature that is often stressed is the production of copious watery sputum, but this is in fact an inconstant finding and when it is present the carcinoma is usually advanced beyond surgical treatment. Finger clubbing may be an early sign. This type of lung cancer has a much better prognosis than other forms if the diagnosis is made early when the lesion may be resectable.peer-reviewe

Inheritance Law and Investment in Family Firms

Entrepreneurs may be legally bound to bequeath a minimal stake to non-controlling heirs. The size of this stake can reduce investment in family firms, by reducing the future income they can pledge to external financiers. Using a purpose-built indicator of the permissiveness of inheritance law and data for 10,004 firms from 38 countries in 1990-2006, we find that stricter inheritance law is associated with lower investment in family firms, but does not affect investment in non-family firms. Moreover, as the model predicts, inheritance law affects investment only in family firms that experience a succession

Pulmonary infarction in healthy young males

It is widely recognised that the elderly immobilised, sick, traumatised or postoperative patient is the most likely candidate to develop pulmonary embolism and infarction, and that the risk increases in direct proportion to the duration of the illness and to the age of the patient. Over the past few years, a number of autopsy studies have stressed the high incidence of deep venous thrombosis and pulmonary embolism in individuals who are otherwise normal. Unfortunately, many clinicians have been slow to appreciate this point and fail to recognise the condition unless well-established predisposing factors are present. This paper reports the findings in four young male patients who developed pulmonary infarction in the absence of obvious precipitating causes.peer-reviewe

Determination of serum zinc levels in normal Maltese adults by atomic absorption spectrophotometry

The importance of zinc as one of the essential trace elements in the living organisms is becoming increasingly recognised. In the process of carrying out measurements to establish normal reference values for our laboratory, it was noticed that the values being obtained, generally appeared to be higher than those published in the literature where similar techniques had been employed. It is important to gain further understanding of this metal in both health and disease as it appears that zinc is essential to an important variety of metabolic processes in man. We are unable to offer a satisfactory explanation for the difference in serum zinc levels in the two groups reported in this paper. Local water does not appear to have high zinc content and Maltese soil is known to be zinc deficient. It is known however that local farmers use a zinc containing fungicide (Zineb) on a large scale.peer-reviewe

THE EUROSDR GEOBIM PROJECT - DEVELOPING CASE STUDIES for the USE of GEOBIM in PRACTICE

Although the use of location-based data (location coupled with semantic information) within Geographical Information Systems (GIS) and from Earth Observation (e.g. satellite) sources has been long established for decision makers, this has only recently been reflected in the construction sector with a more recent move from Computer Aided Design (CAD) to Building Information Modelling. BIM has opened up an additional source of valuable location-based data, with particular focus on the architecture, structural and engineering detail of both buildings and infrastructure projects. As with most if not all location data, while BIM can be used on its own, major benefits are to be derived from integration with other data sources. When this is done with GIS, the result is known as GeoBIM and although there are some similarities between the two, challenges to integration are both technical and non technical, in particular the need for clear case studies to motivate both developers and senior management. There are synergies to be gained from a multi-national, coordinated approach when addressing these challenges, where participants can benefit from each-others' experience and where the needs of users and the National Mapping and Cadastral Agency (NMCA) perspective underpin the research. This paper summarises final outcomes and findings of the EuroSDR GeoBIM research project, which was set up to provide the required multi-national, user-centric collaborative framework, which had as its overall aim the development of best practice guidelines for GeoBIM, and due to its situation within EuroSDR has an NMCA focus. The paper updates information with regard to GeoBIM projects and maturity in the participant countries, and provides an overview of the two case studies developed

3D Cadastre visualization and dissemination: Most recent progresses and future directions

The 3D Cadastre has been investigated from many viewpoints (including legal, organizational and technical). However, to date little research has focused specifically on visualizationrelated aspects despite the value-added of the third dimension. The paper first proposes an overview of progress made in the last five years in 3D cadastral visualization. The authors then summarize discussions at the 2014 3D Cadastre workshop regarding future research and development on the topic. This synthesis is complemented by a broad review of the most recent advances in 3D visualization beyond the 3D cadastral domain, with the goal of providing a number of important directions for further work, allowing researchers, developers and users to consolidate their respective activities, and encouraging collaboration

GeoBIM for built environment condition assessment supporting asset management decision making

The digital transformation in management of the built environment is more and more evident. While the benefits of location data, from Building Information Modelling or Geographical Information Systems, have been explored separately, their combination - GeoBIM - in asset management has never been explored. Data collection for condition assessment is challenging due to quantity, types, frequency and quality of data. We first describe the opportunities and challenges of GeoBIM for condition assessment. The theoretical approach is then validated developing an integrated GeoBIM model of the digital built environment, for a neighbourhood in Milan, Italy. Data are collected, linked, processed and analysed, through multiple software platforms, providing relevant information for asset management decision making. Good results are achieved in rapid massive data collection, improved visualisation, and analysis. While further testing and development is required, the case study outcomes demonstrated the innovation and the mid-term service-oriented potential of the proposed approach

GeoBIM Benchmark 2019: Intermediate results

An investigation into the implementation state of open standards in software is currently ongoing through the ISPRS/EuroSDR 'GeoBIM benchmark 2019' initiative, which kicked off earlier this year. The benchmark activity provides a way of assessing and comparing the functionality of different software packages in GIS and BIM in terms of their ability to handle standardised data (IFC and CityGML) and undertake various tasks using this data. Approximately 65 people have registered to participate so far, with participants from a wide range of backgrounds and proposing to test a variety of software packages. This confirms that the issues under investigation are of interest, and also meets the wider benchmark aim of having a variety of participants, since the project is conceived as using a bottom-up approach with cross-disciplinary and cross-expertise participation. While full benchmark results are not due to be submitted until later this year, interim results have highlighted a number of common issues across multiple software packages, and a web meeting for participants held in July 2019 also led to some improvements in how the benchmark results are being captured

Geobim benchmark 2019: Design and initial results

GeoBIM, the integration of 3D geoinformation (Geo) with building information models (BIM), is a subject of increasing attention in both domains. A well-known practical challenge for this integration is the mixed state of software support for open standards in each domain that would ease the integration. This is often known by practitioners but poorly documented. In order to solve this problem, we devised the GeoBIM benchmark, in which we compile the experiences of volunteering participants, who perform a guided study to test the software they are most familiar with against a few provided datasets structured in open standards. The aim of the tests is to improve the knowledge of the state of the art in the software support for GeoBIM open standards and to identify points for improvement. In this paper, we present the design of the benchmark, especially explaining and discussing the chosen data to be used with their connected issues to be tested, and some initial results