Relationship between exposure to particulate matter and biomarkers among bus driver In Klang Valley.

This cross-sectional comparative study investigates the association between particulate matters (PM; PM10, PM2.5 and ultrafine particle (UFP) and concentration of biomarkers; Interleukin-6 (IL-6) and Tumor Necrosis Factor- Alpha (TNF-α) using 62 bus drivers as exposed group and 62 administrative staff as comparative group in Klang Valley, Malaysia. T-test results showed that the mean exposure level of PM10 (t = 8.14, p<0.01), PM2.5 (t = 9.95, p<0.01) and UFP (t = 19.61, p<0.01) were significantly higher among the bus drivers compared to comparative group. Mann-Whitney U test of IL-6 (z = -2.43, p<0.05) and TNF-α (z = -5.88, p<0.01) were also found to be significantly higher in the bus drivers. Positive correlations were found between the exposure level of PM and concentration of biomarkers. In conclusion, the bus drivers showed higher concentration of IL-6 and TNF-α and were at a higher risk of getting respiratory illnesses compared to comparative group. Thus, more attention should be given on the control of high level of exposure to PM in order to minimize the adverse health effects among the groups at risk

Relationship between exposure to particulate matter and biomarkers among bus drivers in Klang Valley, Malaysia

This cross-sectional comparative study investigates the association between particulate matters (PM; PM10, PM2.5 and ultrafine particle (UFP) and concentration of biomarkers; Interleukin-6 (IL-6) and Tumor Necrosis Factor-Alpha (TNF-α) using 62 bus drivers as exposed group and 62 administrative staff as comparative group in Klang Valley, Malaysia. T-test results showed that the mean exposure level of PM10 (t = 8.14, p<0.01), PM2.5 (t = 9.95, p<0.01) and UFP (t = 19.61, p<0.01) were significantly higher among the bus drivers compared to comparative group. Mann-Whitney U test of IL-6 (z = -2.43, p<0.05) and TNF-α (z = -5.88, p<0.01) were also found to be significantly higher in the bus drivers. Positive correlations were found between the exposure level of PM and concentration of biomarkers. In conclusion, the bus drivers showed higher concentration of IL-6 and TNF-α and were at a higher risk of getting respiratory illnesses compared to comparative group. Thus, more attention should be e given on the control of high level of exposure to PM in order to minimize the adverse health effects among the groups at risk

Knowledge, Attitude, and Practices Towards Standard Precautions on COVID-19 among Nursing Students at A Selected Private College

Since January 2021, higher education students are returning to their institutions to continue the banned education with serious application of preventive measures for COVID-19. It is essential to ensure all higher education students have adequate knowledge, favorable attitude, and good practice toward standard precautions for COVID-19. This study to assess the level of knowledge, attitude, and practices toward standard precautions on COVID-19 among nursing students at a private college. This study used a cross-sectional survey and a correlational study among 300 nursing students at a selected private nursing college. Data were collected using a self-administered questionnaire via Survey Monkey. Result of this study was most of the students have moderate knowledge (68.6%), good attitude (72.3%) and often (59%) practice Standard Precautions on COVID-19. For inferential analysis, all dependent variables did not have any relationship when the r-value is less than 1, but the attitude significantly differs significantly between knowledge (p=0.051) and practice (p=0.000). Moreover, the finding determined that the length of study gave influenced the knowledge (p=0.030) and practice (p=0.010) while education (p=0.018) and occupation (p=0.026) gave effect to the practice. Adequate information should be given to nursing students regarding the standard precautions of COVID-19

Fuzzy-TOPSIS based Cluster Head selection in mobile sensor networks

One of the critical parameters of Wireless Sensor Networks (WSNs) is node lifetime. There are various methods to increase WSN node lifetime, the clustering technique is being one of them. In clustering, selection of a desired percentage of Cluster Heads (CHs) is performed among the sensor nodes (SNs). Selected CHs are responsible for collecting data from their member nodes, aggregating the data and finally sending it to the sink. In this paper, we propose a Fuzzy-TOPSIS technique, based on multi criteria decision making, to choose CH efficiently and effectively to maximize the WSN lifetime. We will consider several criteria including: residual energy; node energy consumption rate; number of neighbor nodes; average distance between neighboring nodes; and distance from the sink. A threshold based intra-cluster and inter-cluster multi-hop communication mechanism is used to decrease energy consumption. We have also analyzed the impact of node density and different types of mobility strategies in order to investigate impact over WSN lifetime. In order to maximize the load distribution in the WSN, a predictable mobility with octagonal trajectory is proposed. This results in improvement of overall network lifetime and latency. Results shows that the proposed scheme improves the network lifetime by 60%, conserve energy by 80%, a significant reduction of frequent Cluster Head (CH) per round selection by 25% is achieved as compared to the conventional Fuzzy and LEACH protocols

Human sputum interleukin-6 by exposure to PM10 among bus drivers in Klang Valley

Epidemiologic evidences suggest a positive association between elevated levels of Particulate Matter (PM) pollution and respiratory illness including acute and chronic lung diseases and respiratory symptoms. This study aimed to investigate the association between particulate matter 10 (PM10) and induction of inflammatory mediators; Interleukin-6 (IL-6). A total of 56 bus drivers as exposed group and 56 administrative staff as comparative group in Klang Valley were involved in this study. Exposure of PM10 was measured using Dust Trak Aerosol Monitor while ELISA technique was used for the analysis of IL-6. Questionnaire adapted from American Thoracic Society (ATS) was used to collect information on respondent's socio-economic status, working history, and respiratory symptoms. The results of socioeconomic status were showed that there were no significant differences found between the groups. The exposure level of PM10 were significantly higher among the bus drivers (t = 7.57, p<0.001) than to comparative group which the PM10 was almost 4 times higher in bus drivers. Similarly, the concentrations of IL-6 were also found significantly higher among bus drivers with (z = -2.28, p<0.05). A positive correlation was observed between the PM10 and IL-6 among the exposed and the comparative group of the present study. Moreover, prevalence of respiratory symptoms among the bus drivers was significantly higher compared the administrative staff. In conclusion, the bus drivers have higher level of IL-6 and at higher risk for respiratory symptoms compared to comparative group due to the exposure to PM10

Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography

AIMS: The totality of atherosclerotic plaque derived from coronary computed tomography angiography (CCTA) emerges as a comprehensive measure to assess the intensity of medical treatment that patients need. This study examines the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes. METHODS AND RESULTS: From a large multi-center CCTA registry the Leiden CCTA score was calculated in 24 950 individuals. A total of 11 678 women (58.5 ± 12.4 years) and 13 272 men (55.6 ± 12.5 years) were followed for 3.7 years for major adverse cardiovascular events (MACE) (death or myocardial infarction). The age where the median risk score was above zero was 12 years higher in women vs. men (64-68 years vs. 52-56 years, respectively, P 20: HR 6.71 (4.36-10.32) in women, and score 6-20: HR 1.64 (1.29-2.08); score > 20: HR 2.38 (1.73-3.29) in men. The risk was significantly higher for women within the highest score group (adjusted P-interaction = 0.003). In pre-menopausal women, the risk score was equally predictive and comparable with men. In post-menopausal women, the prognostic value was higher for women [score 6-20: HR 2.21 (1.57-3.11); score > 20: HR 6.11 (3.84-9.70) in women; score 6-20: HR 1.57 (1.19-2.09); score > 20: HR 2.25 (1.58-3.22) in men], with a significant interaction for the highest risk group (adjusted P-interaction = 0.004). CONCLUSION: Women developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts, which may have implications for the medical treatment intensity.publishersversionpublishe

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries