283 research outputs found
A comparative study of various strategies used for the mitigation of global warming
The global temperature has risen yearly by a bit more than 1 degree Celsius during the industrial revolution. Many experts believe that if current greenhouse gas emissions continue, the planet will become hotter, ocean level will rise and climatic conditions will change excessively. Temperatures are expected to rise faster in the coming decades than they have in the previous 10,000 years, according to some scientists. Greenhouse gases are thought to be the most important factor causing climate change. CO2 is by far the most important anthropogenic greenhouse gas, with concentration in the atmosphere rising by more than 80% between 1970 and 2021. About 91 percent of total CO2 emissions from human sources come from fossil fuels. Controlling greenhouse gas emissions and preparing human settlements to withstand extreme climate change have emerged as two of our age\u27s most daunting challenges. The purpose of this study is to discuss and compare various strategies that can be used for reducing or eliminating carbon dioxide emissions. Various CO2 reduction approaches have been investigated, including the replacement of fossil fuels with renewable energy sources, carbon dioxide capture and storage, and carbon dioxide capture and utilization. The goal of this research is to look at several options for meeting energy needs for long-term development without causing negative climate change i.e. renewable energy sources, carbon dioxide capture and storage, carbon dioxide capture and utilization
Increased regeneration efficiency of _Brassica napus_ L. cultivars Star, Westar and Cyclone from hypocotyle and cotyledonary explants
The comparative organogenesis of _Brassica napus_ L cultivars Cyclone, Star and Westar was studied. The cotyledonary explants gave a higher response to all the combinations of 0.5 mg/L 2,4-D and BAP (0.5, 1.0,1.5 and 2.0 mg/L} used for optimizing the conditions for callus induction. The best mean weight and mean length of callus was obtained at 0.5 mg/L 2,4-D and 1.5mg/L BAP for Star cotyledonary explants. For the complete plant regeneration the new method of exposing the explants culture to Growth regulator free medium was performed. The method was applicable to both hypocotyl and cotyledonary explants. The Shoot Induction Frequency for hypocotyl (6-34%) in the three cultivars is higher than the cotyledonary explants (3-23%). The method is speedy and almost all of the shoots and some unshooted calli (78%) form roots on the same media without prior transfer to rooting medium
Measuring Patient Satisfaction Parameters: A Cross-Sectional Descriptive Study At PNS RAHAT Hospital Karachi.
Objective: To describe patient satisfaction with hospital services and staff dealing.
Materials and Methods: This cross-sectional study was carried out between January to April-2011 at out-patient departments of PNS Rahat. Randomly selected 96 patients entitled to free medical treatment were offered to voluntarily fill the pretested structured questionnaire in URDU(with mathematical scoring for each selected satisfaction index selected) to comment on the various aspects of services offered at the hospital. The four objective satisfaction scores included: 1-seating /waiting facilities, 2-length of waiting time, 3-staff attitude and 4-Cleanliness at the outpatient departments, radiology, laboratory and pharmacy.
Results: The availed mean score was 80.1 + 42.6. Out of the total possible score of 170 of the questionnaires filled. The mean patient score achieved was 57.4 + 33.9. Patients scored less on the satisfaction indices pertaining to waiting time [Average score=4.73/10] and comfortable stay [Average score=6.43/10] in the waiting areas of the hospital OPDs. Patients had a higher satisfaction score on indices related to sanitation/cleanliness issues [Average score=7.52/10] and staff attitude [Average score=7.71/10].
Conclusion: Prolonged waiting time and non-availability of quality stay in waiting areas of outpatient departments and diagnostic centers are the cause of lesser patient satisfaction during a patient's visit to hospital
Music and Six-Minute Walk-Distance- One Step at a Time: Commentary on “Rhythmic auditory stimulation increases 6-minute walk distance in individuals with COPD: A repeated measures study
The article by Hernandez and colleagues published in this edition of Heart & Lung, reports on original research exploring the use of rhythmic auditory stimulation (RAS) to increase the 6-minute distance walk with individuals diagnosed with chronic obstructive pulmonary disease (COPD). The authors provide clear rationale regarding the use of music to stimulate movement, increase exercise tolerance, and to distract participants from the perception of dyspnea. Through this report, we offer further insights specifically focused on the RAS process, including vital considerations when implementing a music-based intervention in clinical practice settings
Temperature Dependence of a Sub-wavelength Compact Graphene Plasmon-Slot Modulator
We investigate a plasmonic electro-optic modulator with an extinction ratio
exceeding 1 dB/um by engineering the optical mode to be in-plane with the
graphene layer, and show how lowering the operating temperature enables steeper
switching. We show how cooling Graphene enables steeping thus improving dynamic
energy consumption. Further, we show that multi-layer Graphene integrated with
a plasmonic slot waveguide allows for in-plane electric field components, and
3-dB device lengths as short as several hundred nanometers only. Compact
modulators approaching electronic length-scales pave a way for ultra-dense
photonic integrated circuits with smallest footprint
Challenges Associated with Resource Selection in Public Libraries of Khyber Pakhtunkhawa, Pakistan
Resource quality and users satisfaction in public libraries are correlated factors. In resource selection for both the formats i.e. (soft and hard) professional involvement as well as geographical and cultural position of people is mandatory for consideration. The unilateral decision making power of few under the centralized system has left no gap for policy designing by sitting across the table. This study was conducted to explore the challenges faced by Khyber Pakhtunkhawa public libraries in resource selection. A quantitative based study was conducted to collect the relevant data from twelve out of seventeen library professionals in the whole directorate of public libraries and its sub-offices. An in depth study of the relevant literature was carried out to collect the data through questionnaire. The data were later analyzed using SPSS. Results of the study showed that Khyber Pakhtunkhawa public libraries having no set pattern and concept for printed and e-resource selection and automation of printed materials. In the cyber age e-resources are superseding the printed materials Khyber Pakhtunkhawa public libraries are far away from e-resource provision which need serious consideration on immediate basis. Keywords: Library resources, library materials, resource management, resource selection, resource mechanism, Khyber Pakhtunkhawa public libraries
Preoperative STOP-BANG Scores and Postoperative Delirium and Coma in Thoracic Surgery Patients
Background
Obstructive sleep apnea (OSA) is associated with higher rates of postoperative delirium. The relationship between preoperative OSA risk and postoperative delirium and coma in thoracic surgery patients hospitalized in the intensive care unit (ICU) is not well understood. This study tests the hypothesis that thoracic surgery patients hospitalized in ICU with a higher preoperative risk for OSA are more likely to develop postoperative delirium and coma, resulting in longer hospital stays.
Methods
Preoperative OSA risk was measured using the STOP-BANG questionnaire. STOP-BANG scores of ≥ 3 were defined as intermediate-high risk for OSA. 128 patients who underwent major thoracic surgery completed the STOP-BANG questionnaire preoperatively. The Richmond Agitation and Sedation Scale was used to assess level of consciousness. The Confusion Assessment Method for the ICU was used to assess for delirium. Linear regression was used to assess the relationship between risk of OSA and outcome measures. Results were adjusted for age, gender, body mass index, Charlson Comorbidity Index, instrumental activities of daily living, and surgery type.
Results
96 out of 128 patients (76%) were in the intermediate-high risk OSA group. Adjusted analyses showed that the intermediate-high risk OSA group had a longer duration of postoperative ICU delirium and coma compared to the low risk OSA group (1.4 days ± 1.3 vs 0.9 days ± 1.4; P = 0.04). Total number of hospital days was not significantly different.
Conclusions
Higher preoperative risk for OSA in thoracic surgery patients was associated with a longer duration of postoperative delirium and coma
Post-Intensive Care Unit Psychiatric Comorbidity and Quality of Life
The prevalence of psychiatric symptoms ranges from 17% to 44% in intensive care unit (ICU) survivors. The relationship between the comorbidity of psychiatric symptoms and quality of life (QoL) in ICU survivors has not been carefully examined. This study examined the relationship between psychiatric comorbidities and QoL in 58 survivors of ICU delirium. Patients completed 3 psychiatric screens at 3 months after discharge from the hospital, including the Patient Health Questionnaire-9 (PHQ-9) for depression, the Generalized Anxiety Disorder-7 (GAD-7) questionnaire for anxiety, and the Post-Traumatic Stress Syndrome (PTSS-10) questionnaire for posttraumatic stress disorder. Patients with 3 positive screens (PHQ-9 ≥ 10; GAD-7 ≥ 10; and PTSS-10 > 35) comprised the high psychiatric comorbidity group. Patients with 1 to 2 positive screens were labeled the low to moderate (low-moderate) psychiatric comorbidity group. Patients with 3 negative screens were labeled the no psychiatric morbidity group. Thirty-one percent of patients met the criteria for high psychiatric comorbidity. After adjusting for age, gender, Charlson Comorbidity Index, discharge status, and prior history of depression and anxiety, patients who had high psychiatric comorbidity were more likely to have a poorer QoL compared with the low-moderate comorbidity and no morbidity groups, as measured by a lower EuroQol 5 dimensions questionnaire 3-level Index (no, 0.69 ± 0.25; low-moderate, 0.70 ± 0.19; high, 0.48 ± 0.24; P = 0.017). Future studies should confirm these findings and examine whether survivors of ICU delirium with high psychiatric comorbidity have different treatment needs from survivors with lower psychiatric comorbidity
Perioperative Risk Factors for Postoperative Delirium in Patients Undergoing Esophagectomy
Background
Postoperative delirium affects up to 50% of patients undergoing esophagectomy and is associated with negative outcomes. The perioperative risk factors for delirium in this population are not well understood. We conducted this study to assess perioperative risk factors for postoperative delirium among esophagectomy patients.
Methods
We performed a secondary data analysis of patients enrolled in a randomized controlled trial evaluating the efficacy of haloperidol prophylaxis postoperatively in reducing delirium among esophagectomy patients. Postoperative delirium was assessed twice daily using the Confusion Assessment Method for the ICU. Univariate and logistic regression analyses were performed to examine the association between perioperative variables and development of postoperative delirium.
Results
Of 84 consecutive esophagectomy patients, 27 (32%) developed postoperative delirium. Patients who developed postoperative delirium had higher APACHE II scores [22.1 (6.5) versus 17.4 (6.8); p=0.003], longer mechanical ventilation days [1.7 (1.4) versus 1.0 (1.1); p=0.001], and longer ICU days [5.1 (2.6) versus 2.6 (1.6); p<0.001]. In a logistic regression model, only ICU length of stay was found to have significant association with postoperative delirium [OR 1.65; 95% CI 1.21-2.25].
Conclusions
ICU length of stay was significantly associated with postoperative delirium. Other perioperative factors including duration of surgery, blood loss, and hemoglobin levels were not significantly associated with postoperative delirium
Antidepressant Use and Depressive Symptoms in Intensive Care Unit Survivors
Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms. For patients on an antidepressant at their initial CCRC visit (N = 69), younger age and being African American race were associated with a higher likelihood of having depressive symptoms. Future studies will need to confirm these findings and examine new approaches to increase access to depression treatment and test new antidepressant regimens for post-ICU depression
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