Testing limits to airflow perturbation device (APD) measurements

<p>Abstract</p> <p>Background</p> <p>The Airflow Perturbation Device (APD) is a lightweight, portable device that can be used to measure total respiratory resistance as well as inhalation and exhalation resistances. There is a need to determine limits to the accuracy of APD measurements for different conditions likely to occur: leaks around the mouthpiece, use of an oronasal mask, and the addition of resistance in the respiratory system. Also, there is a need for resistance measurements in patients who are ventilated.</p> <p>Method</p> <p>Ten subjects between the ages of 18 and 35 were tested for each station in the experiment. The first station involved testing the effects of leaks of known sizes on APD measurements. The second station tested the use of an oronasal mask used in conjunction with the APD during nose and mouth breathing. The third station tested the effects of two different resistances added in series with the APD mouthpiece. The fourth station tested the usage of a flexible ventilator tube in conjunction with the APD.</p> <p>Results</p> <p>All leaks reduced APD resistance measurement values. Leaks represented by two 3.2 mm diameter tubes reduced measured resistance by about 10% (4.2 cmH₂O·sec/L for control and 3.9 cm H₂O·sec/L for the leak). This was not statistically significant. Larger leaks given by 4.8 and 6.4 mm tubes reduced measurements significantly (3.4 and 3.0 cm cmH₂O·sec/L, respectively). Mouth resistance measured with a cardboard mouthpiece gave an APD measurement of 4.2 cm H₂O·sec/L and mouth resistance measured with an oronasal mask was 4.5 cm H₂O·sec/L; the two were not significantly different. Nose resistance measured with the oronasal mask was 7.6 cm H₂O·sec/L. Adding airflow resistances of 1.12 and 2.10 cm H₂O·sec/L to the breathing circuit between the mouth and APD yielded respiratory resistance values higher than the control by 0.7 and 2.0 cm H₂O·sec/L. Although breathing through a 52 cm length of flexible ventilator tubing reduced the APD measurement from 4.0 cm H₂O·sec/L for the control to 3.6 cm H₂O·sec/L for the tube, the difference was not statistically significant.</p> <p>Conclusion</p> <p>The APD can be adapted for use in ventilated, unconscious, and uncooperative patients with use of a ventilator tube and an oronasal mask without significantly affecting measurements. Adding a resistance in series with the APD mouthpiece has an additive effect on resistance measurements, and can be used for qualitative calibration. A leak size of at least the equivalent of two 3.2 mm diameter tubes can be tolerated without significantly affecting APD measurements.</p

Impact of Pakistan-Malaysia Fta on Indonesian Export of Refined Bleached Deodorized (Rbd) Olein

Indonesia needs to increase its export products in order to maintain surplus balance of payment. However, Pakistan-Malaysia FTA could make Indonesian RBD Olein in adifficult situation. This paper aims to examine the impact of a decrease in import tariff of Malaysian RBD olein in Pakistan on Indonesian export of RBD Olein using Trade analysisemploying Armington model that distinguishes the product by the country of origin. RBD olein trade model consists of four endogenous countries and one exogenous rest of theworld (ROW). The endogenous countries are Indonesia, Malaysia, the United State of America and Pakistan. The results indicate that the reduction in import tariff of Malaysian RBD Olein by 10 percent will cause the price to decrease by around 7.3 percent. The decline in Malaysian RBD olein price will increase its demand in Pakistan by around 4.4 percent. While import demand of Indonesian RBD Olein in Pakistan estimated to increase by only 0.35 percent, this is because the price of Indonesian RBD Olein rises by 0.17percent. In other word, calculated based on the average of export volume and implicit price in the period 2005-2007, import of Indonesian RBD Olein in Pakistan will only increase by around 2.1 thousand tones, or US$ 1.03 million,

Kebutuhan Dasar Kesehatan Masyarakat di Pulau Kecil: Studi Kasus di Pulau Gangga Kecamatan Likupang Barat Kabupaten Minahasa Utara Provinsi Sulawesi Utara

Latar belakang: Akses pelayanan kesehatan dari masyarakat yang tinggal di pulau-pulau kecil di Indonesia terhalang dengan keadaan geografi , keadaan cuaca, jauh dari penyedia dan fasilitas kesehatan. Walaupun kebijakan dan petunjuk teknis untuk penyediaan pelayanan kesehatan telah ada, namun demikian data primer untuk kebutuhan kesehatan dari masyarakat khusus dari perspektif sektor publik sangat terbatas. Studi kasus ini menekankan pada pendekatan yang layak terhadap kegiatan dari sektor publik khususnya di bidang kesehatan dan sektor-sektor terkait dengan memahami kebutuhankesehatan masyarakat. Tujuan dari studi kasus ini adalah mempresentasikan dan mereview kepustakaan kebutuhan kesehatan dari masyarakat yang tinggal di pulau kecil di Pulau Gangga Kabupaten Minahasa Utara Provinsi SulawesiUtara, di mana tekanannya terhadap kebutuhan kesehatan yang diekspresikan dan dirasakan. Termasuk hal-hal yang teridentifikasi dari penyedia pelayanan kesehatan dasar dari sektor kesehatan. Metode: Metode kualitatif diaplikasikan untuk studi kasus ini melalui wawancara mendalam dan diskusi kelompok terarah terhadap responden yang terpilih. Hasil: Hasil dari studi kasus ini antara lain kebutuhan kesehatan masyarakat yang tinggal di pulau-pulau kecil meningkat bersamaan dengan kurangnya akses terhadap infrastruktur, peralatan kesehatan, obat-obatan, medical dan consumable supplies. Halyang paling penting pula adalah terbatasnya sumber daya manusia kesehatan dari sektor kesehatan. Saran: Rekomendasi dari studi kasus ini antara lain diperlukannya suatu kerangka konsep untuk pelayanan kesehatan dalam hal pemenuhan kebutuhan kesehatan bagi masyarakat yang tinggal di pulau-pulau kecil, termasuk membantu dalam hal memprioritaskan program-program kesehatan dan implementasinya untuk penyedia pelayanan kesehatan

Laboratorium Diagnosis of Clostridium Difficile Infection

Clostridium difficile is the most important cause of antibiotic associated diarrhea, and pseudomembranous colitis, a severe infection of the colon. Strain Clostridium difficile produce two potent toxin, toxin A (enterotoxin) and toxin B (cytotoxin). These two toxins are both responsible for the diarrhoea and inflammation seen in patients treated due to infection, especially the broad spectrum antibiotics. Direct detection of Clostridium difficile cytotoxin from faecal specimen using mammalian tissue culture lines is considered the standard diagnostics test of Clostridium difficile infection. This test is very sensitive but requires a minimum two days to complete. In order to improve the threshold of diagnosis and treatment, a number of enzyme immunoassay Methods have been used, with a reported sensitivity to either toxin A or toxin B

Strategi Pemasaran Ekspor Pala pada PT. Gunung Intan Permata Manado

This study aims to analyze how marketing strategies implemented by PT. Gunung Intan Permata Manado in exporting the nutmeg products in order to compete with other companies. This study uses data obtanined from direct observation and interviews using questionnaires. Data analysis methods used were Matrix of Internal Factor Evaluation (IFE), Matrix of External Factor Evaluation (EFE), dan SWOT Analysis (Strengths, Weakness, Opportunities, Threats). The results showed that the marketing strategy of nutmeg export applied by PT. Gunung Intan Permata is an aggressive growth strategy (growth oriented strategy). This strategy is a profitable strategy, because the company has the power that can be used to achieve the opportunities that exist. This strategy can be implemented through several alternative strategies, namely maintaining product quality and further tightening quality control to keep nutmeg demand high and maintain product quality and corporate image to maintain good business relationships and customer loyalty

Analisis Kerentanan Pantai Pulau Bengkalis Berbasis Sistem Imformasi Geografis

Coastal area has an important role for the people who live nearby but it is prone to damage. The damage to the coastal area require countermeasures so that its impact can be minimised or eliminated. Prior to countermeasure, vulnerability analysis needs to be done by specifying coastal vulnerability index (CVI). This research was conducted along the northern coast of Bengkalis Island which is directly adjacent to Malacca Strait. Coastal vulnerability index is calculated with the value of the physical variables such as shoreline changes, visual observation, the length and width of the damage, the width of the green belt, lithology, wave height, tidal range, land use, and coastal slope. The required data for the research are landsat imagery, hydro-oceanography, bathymetry, and visual observation of damage. Results of anaysis showed that Simpang Ayam Village, Jangkang Village, Teluk Papal Village, Bantan Air Village, Teluk Pambang Village have very high coastal vulnerability. Sekodi Village has high coastalvulnerability. Area that has a moderate coastal vulnerability is Prapat Tunggal Village. Selat Baru Village, Teluk Kembung Luar Village, dan Teluk Lancar Village have low vulnerability.Keys word: Coastal vulnerablity Index (CVI), Landsat Imagery, Prone to damag

Corneoscleral laceration and ocular burns caused by electronic cigarette explosions

PURPOSE: To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. METHODS: Case series. RESULTS: We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries. CONCLUSIONS: Given these cases and the number of recent media reports, ECs pose a significant public health risk. Users should be warned regarding the possibility of severe injury, including sight-threatening ocular injuries ranging from corneal burns to full-thickness corneoscleral laceration

IN VITRO EFFICACY TESTING OF NEEM (AZADIRACHTA INDICA) EXTRACT AGAINST AEROBIC AND ANAEROBIC BACTERIA

Objective: To experiment the antimicrobial susceptibility of crude extract from neem (Azadirachta indica) leaves against Staphylococcus aureus, Escherichia coli and Clostridium perfringens. Methods: Through the water extraction method, the aqueous crude extract of neem leaves were obtained. Separate colonies of Staphylococcus aureus, Escherichia coli and Clostridium perfringens were isolated and identified on different agars. Agar cup diffusion method was done to test the antimicrobial susceptibility of the neem leaves crude extract against those bacteria on Mueller-Hinton agar. Susceptibility was determined based on the zone of inhibition formed on the agar of each bacterium culture. Result: Neem was effective against&nbsp;Staphylococcus aureus&nbsp;and&nbsp;Clostridium perfringens. It was not effective against&nbsp;Escherichia coli. Conclusion: Neem extract has some promisable antimicrobial effects against Staphylococcus aureus&nbsp;and&nbsp;Clostridium perfringens&nbsp;causative bacterial infections