Anticoagulation Control and Major Adverse Clinical Events in Patients with Operated Valvular Heart Disease with and without Atrial Fibrillation Receiving Vitamin K Antagonists.

BackgroundGood quality anticoagulation among patients with operated valvular heart disease is needed to reduce ischaemic and thromboembolic complications. There is limited evidence regarding factors that affect anticoagulation control in patients implanted with mechanical or tissue prosthetic valve(s).AimTo examine the quality of and factors that affect anticoagulation control, major adverse clinical events and all-cause death in operated valvular heart disease patients with and without atrial fibrillation who are receiving a vitamin K antagonist.MethodsQuality of anticoagulation were retrospectively assessed among 456 operated valvular heart disease patients [164 (36%) with AF and 290 (64%) without AF] via time in therapeutic range (TTR) (Rosendaal method) and percentage of INRs in range (PINRR) over a median of 6.2 (3.3-8.5) years. VHD was defined by the presence of a mechanical or tissue prosthetic valve at the mitral, aortic, or both sites.ResultsMean age 51 (14.7), 64.5% men. Most (96.1%) had a mechanical prosthesis and 64% had aortic valve replacement. Overall, mean TTR was 58.5% (14.6) and PINRR was 50.1% (13.8). Operated valvular heart disease patients with AF had significantly lower mean TTR and PINRR (TTR: 55.7% (14.2) vs. 60.1% (14.6); p = 0.002, respectively, PINRR: 47.4% (13.5) vs. 51.6% (13.7); p = 0.002, respectively), and a lower proportion of TTR ≥ 70%, despite a similar number of INR tests compared to those without AF. Predictors of TTR p ConclusionsOperated valvular heart disease patients with AF at baseline have poorer anticoagulation control compared to those without AF. The presence of concomitant AF, anaemia/bleeding history and female sex independently predicted poor TTR. Stringent INR monitoring is needed to improve anticoagulation control and prevent major adverse clinical events in patients with operated valvular heart disease

Comparison between lignin extraction by alkaline and ultrasound-assisted alkaline treatment from oil palm empty fruit bunch

Lignin is the second most abundant terrestrial biopolymer after cellulose and is the largest renewable source of aromatic groups in nature. In this work, the study was carried out on the selective extraction of lignin from oil palm empty fruit bunch (OPEFB) using alkaline and ultrasound-assisted alkaline methods. OPEFB is available in high amounts as solid waste of palm oil industries, which is considered as lignocellulosic and has fairly high lignin content. The pretreatment of OPEFB for lignin production depends on the effect of particle size, liquid to solid ratio, the concentration of NaOH, reaction temperature, type of solvent, and sonication time. OPEFB was treated with 7.5%, 10%, and 15% NaOH at 900C for 1.5h without ultrasound irradiation and with ultrasonic time for 10, 20, 30, and 40 min. Extracted lignin was characterized by FT-IR, UV-Vis, TGA, and elemental analysis. Considerably improved results were obtained by using the ultrasound-assisted time for 30 min. The percentage yield and purity of lignin extracted by the ultrasound-assisted alkali method was higher than that lignin fraction which was achieved by the alkali method, and their purity was improved with the addition of sonication time from 10 to 30 min

Occupational safety and health assessment in metal industry within small and medium enterprise

According to annual report from the Social Security Organization (SOCSO) between years 2009 and 2011, metal industry has the highest reported number of accidents compared to the other manufacturing industry in small and medium enterprises (SMEs). Therefore, the aim of this study is to investigate the actual causes of problems that lead to the accidents involving metal industries within SMEs. In this study, checklist through site visits has been used to collect the data. The overall result reveals that the main causes of accident are due to organization failure, human factor, machine failure and surrounding environment

Morphological and molecular characterization of Curvularia and related species associated with leaf spot disease of rice in Peninsular Malaysia

Curvularia species are important phytopathogens reported worldwide. They are closely related; consist of major destructive pathogens mainly for grasses and cereal plants including rice (Oryza sativa). A leaf spot symptom of rice is one of the common symptoms found in the rice field and caused reduction of rice yield. However, there are no reports on Curvularia species associated with rice leaves showing spot symptoms. The objectives are to isolate and characterize Curvularia and related species from leaf spot of rice by using morphological and molecular characterization and to determine the phylogenetic relationship between the isolated fungi. Fungal isolation was done from diseased rice leaves showing leaf spot symptoms collected throughout Peninsular Malaysia. Thirty-three isolates were recovered and identified based on their morphological characteristics such as conidia morphology, colony appearance, pigmentation and growth rate for species delimitation. Internal transcribed spacer (ITS) region was amplified to confirm the species identification. The 33 isolates were identified as Bipolaris sorokiniana (10 isolates), Curvularia hawaiiensis (8 isolates), C. geniculata (6 isolates), C. eragrostidis (6 isolates), C. aeria (2 isolates) and C. lunata (1 isolate). A phylogenetic tree was constructed based on ITS sequences using neighbour-joining method. The tree grouped members of Curvularia and Bipolaris into different clades. The phylogenetic tree indicated that the presence of two groups of fungi species; highly virulent and mild pathogens. In conclusion, Curvularia species and Bipolaris sorokiniana were present in rice field in Malaysia and associated with leaf spot of rice

Harmonized-Multinational qEEG Norms (HarMNqEEG)

This paper extends the frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific variance, increasing qEEG nuisance variance. We ameliorate these weaknesses. i) Create lifespan Riemannian multinational qEEG norms for cross-spectral tensors. These norms result from the HarMNqEEG project fostered by the Global Brain Consortium. We calculate the norms with data from 9 countries, 12 devices, and 14 studies, including 1564 subjects. Instead of raw data, only anonymized metadata and EEG cross-spectral tensors were shared. After visual and automatic quality control, developmental equations for the mean and standard deviation of qEEG traditional and Riemannian DPs were calculated using additive mixed-effects models. We demonstrate qEEG "batch effects" and provide methods to calculate harmonized z-scores. ii) We also show that the multinational harmonized Riemannian norms produce z-scores with increased diagnostic accuracy to predict brain dysfunction at school-age produced by malnutrition only in the first year of life. iii) We offer open code and data to calculate different individual z-scores from the HarMNqEEG dataset. These results contribute to developing bias-free, low-cost neuroimaging technologies applicable in various health settings

Load-deformation analysis on a slope at Gunung Pulai water treatment plant, Sultan Ibrahim reservoir

The Sultan Ibrahim Reservoir located at Gunung Pulai catchment area was previously managed by the Singapore's Public Utilities Board before the Board handed over the reservoir to Johor State Government under current management of the Syarikat Air Johor. At the present time, the Syarikat Air Johor is operating a Gunung Pulai Water Treatment Plant consisted of two main plants, i.e. Water Sedimentation Plant and Water Filtration Plant for treating raw water from the reservoir before supplying to the consumers. However, the integrity of water treatment plant's structure should be checked due to several cracks were observed, and moreover the structure was built over more than 90 years. The formation of the cracks in the Gunung Pulai Water Treatment Plant may be induced by movement of the sloping area to the south-east of Water Sedimentation Plant. The calculated Factor of Safety (FOS) via sensitivity analysis for cross sections of original slope indicates any decrease in friction angle and/or cohesion strength or increase in horizontal seismic load will further cause instability on slope. Also, the results of Load-Deformation analysis on cross sections of original slope show significant vertical displacement and horizontal displacement on the bottom and both sides of sedimentation tanks, respectively. The results indicate applied structural and water loads significantly affect deformation at both vertical and horizontal directions which could have contributed to FOS < 1 in slope stability analysis

Demulsificaton (Breaking) Of Water-In-Crude Oil Emulsion via Microwave Heating Technology

Traditional ways of breaking emulsions using heat and chemicals are disadvantageous from both economic and environmental perspectives. In this research, the potentials of microwave technology in demulsification of water-in-crude oil emulsions were investigated. The study began with some characterization studies to provide understandings of fundamental issues such as formation, formulation, and breaking of emulsions by both chemical and microwave approaches. The aim was to obtain optimized operating conditions as well as fundamental understanding of water-in-oil emulsion stability upon which further developments on demulsification processes could be developed. It was found that emulsion stability was related to some parameters such as, the surfactant concentration, water content, temperature and agitation speed. Experimental results found that microwave radiation method can enhance the demulsification of water-inoil emulsions in a very short time compared to the conventional heating methods. The results obtained in this study have exposed the capability of microwave technology in demulsification of water-in-oil emulsion. Further works are nevertheless required to provide deeper understanding of the mechanisms involved in facilitating the development of an optimum system applicable to the industry