ESSENTIAL DRUGS AND THEIR ROLE IN THE HOSPITAL DRUG CONSUMPTION IN THE UNITED REGIONAL CLINICAL HOSPITAL-VARNA IN 1997

The consumption of the drugs included in the Model List of Essential Drugs (ED) of WHO was studied in the United Regional Clinical Hospital of Varna for the first time. The purpose of the study was to estimate the consumption of these drugs in the hospital as a whole as well as in every hospital division. The monthly variations of the consumption were analyzed according to the specific activity of these divisions. The mean ED consumption by the patients in all the divisions was calculated. Those of them with the highest frequency of ED usage recommended in the Model List were presented. Certain conclusions about the benefit of the introduction of this Model List of ED and its importance for some hospital pharmaco-economic factors were drawn

Broadband Records of Earthquakes in Deep Gold Mines and a Comparison with Results from SAFOD, California

For one week during September 2007, we deployed a temporary network of field recorders and accelerometers at four sites within two deep, seismically active mines. The ground-motion data, recorded at 200 samples/sec, are well suited to determining source and ground-motion parameters for the mining-induced earthquakes within and adjacent to our network. Four earthquakes with magnitudes close to 2 were recorded with high signal/noise at all four sites. Analysis of seismic moments and peak velocities, in conjunction with the results of laboratory stick-slip friction experiments, were used to estimate source processes that are key to understanding source physics and to assessing underground seismic hazard. The maximum displacements on the rupture surfaces can be estimated from the parameter Rv, where v is the peak ground velocity at a given recording site, and R is the hypocentral distance. For each earthquake, the maximum slip and seismic moment can be combined with results from laboratory friction experiments to estimate the maximum slip rate within the rupture zone. Analysis of the four M 2 earthquakes recorded during our deployment and one of special interest recorded by the in-mine seismic network in 2004 revealed maximum slips ranging from 4 to 27 mm and maximum slip rates from 1.1 to 6:3 m=sec. Applying the same analyses to an M 2.1 earthquake within a cluster of repeating earthquakes near the San Andreas Fault Observatory at Depth site, California, yielded similar results for maximum slip and slip rate, 14 mm and 4:0 m=sec

Investigating the effect of the defrost cycles of air-source heat pumps on their electricity demand in buildings

With the goal to reach net zero carbon emission, countries around the world are expected to switch from fossil fuel to more eco-friendly alternatives. This suggests that heating, transport, and energy sectors will be more dependent on electricity. Heat pump technology is expected to be the most common and clean technology to be used for heating in buildings due to its Coefficient of Performance. Air-source heat pumps are the most common type due to their ease of installation. This paper investigates how different climates around the world would affect the air-source heat pump electricity consumption and its defrost cycles; and hence the potential overall effect on the grid. A novel heat pump simulation model has been developed to understand the behaviour of the heat pump in cold weather scenarios. An experimental validation has been implemented to ensure the accuracy of the simulation model. Global case studies of cities from around the world including Amsterdam, Copenhagen, Helsinki, Stockholm, Vancouver, Ruse, Moscow, Reykjavik, Harbin and Nottingham are selected to assess the defrost cycles of air source heat pumps. The innovation of this research is in the in-depth investigation of heat pump defrost cycles. Electrifying the heating sector is expected to increase electricity consumption significantly, especially in cold weather. A detailed case study of the UK is presented with heat pumps and the examination of the impact this would have on the electricity grid is presented. Heating demands for buildings in cold weather was also simulated to calculate the required heating demand. The results show that the wide implementation of heat pumps in the UK, for example, would increase the total daily demand of electricity by approximately 144% relative to the present level of grid energy demand. In addition, the average daily energy consumption would increase by roughly 106% over the cold season. The findings are critical, and the novel methodology is applicable to many countries on global level in relation to the future effect of heat pumps on the grid and predicting the power demand needed by the additional heat pumps based on geographical location, u-values of building elements, and heating demand. It is crucial for a household to improve the insulation of their dwelling as this could considerably reduce the power demand by the heat pump and therefore the overall electricity consumption. This paper aims to inform future technology developers and policy makers regarding the expected effect of heat pump technology on the grid and the possible sudden peaks in demand

Longitudinal changes in respiratory and upper limb function in a pediatric type III spinal muscular atrophy cohort after loss of ambulation

Introduction/Aims: Spinal muscular atrophy (SMA) type III is a relatively mild form of SMA. Few studies have investigated the changes in both respiratory and upper limb function within this population after loss of ambulation. The aim of this study was to assess change in percentage of predicted forced vital capacity (FVC% predicted) and change in the Revised Upper Limb Module (RULM) score in these patients throughout a 24-month period after loss of ambulation. Effect of scoliosis and its surgical correction, disease duration since loss of ambulation, weight, and height were also investigated. / Methods: Retrospective analyses were performed on 24 nonambulant SMA III patients from data collected at two centers in the United Kingdom. / Results: The FVC% predicted score showed a significant progressive deterioration of 17% over the 24-month period. Respiratory deterioration correlated significantly with age, weight, disease duration since loss of ambulation, and spinal correctional surgery. Longitudinal RULM data were available for 16 patients; a significant deterioration was observed with a mean decrease in score of 3 over 24 months. Age correlated negatively with RULM score, as did height and time since loss of ambulation. A significant positive correlation between FVC% predicted and RULM was demonstrated. / Discussion: This study highlights how SMA type III patients have progressive deterioration of respiratory and upper limb function after loss of ambulation. Combining data from these assessments could provide insight into clinical progression, inform clinical trials, and provide assistance in managing disease progression expectations for patients

Standardization of electroencephalography for multi-site, multi-platform and multi-investigator studies: Insights from the canadian biomarker integration network in depression

Subsequent to global initiatives in mapping the human brain and investigations of neurobiological markers for brain disorders, the number of multi-site studies involving the collection and sharing of large volumes of brain data, including electroencephalography (EEG), has been increasing. Among the complexities of conducting multi-site studies and increasing the shelf life of biological data beyond the original study are timely standardization and documentation of relevant study parameters. We presentthe insights gained and guidelines established within the EEG working group of the Canadian Biomarker Integration Network in Depression (CAN-BIND). CAN-BIND is a multi-site, multi-investigator, and multiproject network supported by the Ontario Brain Institute with access to Brain-CODE, an informatics platform that hosts a multitude of biological data across a growing list of brain pathologies. We describe our approaches and insights on documenting and standardizing parameters across the study design, data collection, monitoring, analysis, integration, knowledge-translation, and data archiving phases of CAN-BIND projects. We introduce a custom-built EEG toolbox to track data preprocessing with open-access for the scientific community. We also evaluate the impact of variation in equipment setup on the accuracy of acquired data. Collectively, this work is intended to inspire establishing comprehensive and standardized guidelines for multi-site studies

DEAR project: Lunar dust surface interactions, risk and removal investigations

The DEAR project (Dusty Environment Application Research) investigates the interaction between lunar regolith and surfaces and components relevant for lunar exploration. Based on the TUBS regolith simulant which is representative in chemistry, size and shape properties to Moon soils to study the regolith transport, adhesion and strategies for cleaning. The regolith simulant will be applied to thermal, structural, optical sensor, sealing and other astronautic systems, providing input for requirements, justification and verification. The key applications are split in human space flight regolith investigations, wrinkled surface with random movement and hardware surfaces, flat material defined movement. The paper provides an overview of the DEAR project including a discussion of the first results, in particular vibration, shock and micro-vibration on regolith bearing surfaces. The investigation shall enable better understand the regolith layers interaction and the release mechanism, as well as potential cross contamination and cleaning strategies. The research is complemented by simulation of the regolith motion as parameter surface plasma interactions. The project is funded and supported by the European Space Agency (ESA). DEAR specifically addresses the development and testing of lunar dust removal strategies on optics, mechanisms and human space flight hardware (e.g., space suits). As the Moons regolith is known to be highly abrasive, electrically chargeable, and potentially chemically reactive, lunar dust might reduce the performance of hardware, such as cameras, thermal control surfaces and solar cells. The dust can cause malfunction on seals for on/off mechanisms or space suits. Of particular interest are risk assessment, avoidance, and cleaning techniques such as the use of electric fields to remove lunar dust from surfaces. Representative dust (e.g., regolith analogues of interesting landing sites) will be used in a dedicated test setup to evaluate risks and effects of lunar dust. We describe designs and methods developed by the DEAR consortium to deal with the regolith-related issues, in particular an electrode design to deflect regolith particles, cleaning of astronautical systems with CO2, design of a robotic arm for the testing within the DEAR chamber, regolith removal via shock, and regolith interaction with cleanroom textile

Optimal duration of risperidone or olanzapine adjunctive therapy to mood stabilizer following remission of a manic episode: A CANMAT randomized double-blind trial

Atypical antipsychotic adjunctive therapy to lithium or valproate is effective in treating acute mania. Although continuation of atypical antipsychotic adjunctive therapy after mania remission reduces relapse of mood episodes, the optimal duration is unknown. As many atypical antipsychotics cause weight gain and metabolic syndrome, they should not be continued unless the benefits outweigh the risks. This 52-week double-blind placebo-controlled trial recruited patients with bipolar I disorder (n=159) who recently remitted from a manic episode during treatment with risperidone or olanzapine adjunctive therapy to lithium or valproate. Patients were randomized to one of three conditions: discontinuation of risperidone or olanzapine and substitution with placebo at (i) entry (\u270-weeks\u27 group) or (ii) at 24 weeks after entry (\u2724-weeks\u27 group) or (iii) continuation of risperidone or olanzapine for the full duration of the study (\u2752-weeks\u27 group). The primary outcome measure was time to relapse of any mood episode. Compared with the 0-weeks group, the time to any mood episode was significantly longer in the 24-weeks group (hazard ratio (HR) 0.53; 95% confidence interval (CI): 0.33, 0.86) and nearly so in the 52-weeks group (HR: 0.63; 95% CI: 0.39, 1.02). The relapse rate was similar in the 52-weeks group compared with the 24-weeks group (HR: 1.18; 95% CI: 0.71, 1.99); however, sub-group analysis showed discordant results between the two antipsychotics (HR: 0.48, 95% CI: 0.17; 1.32 olanzapine patients; HR: 1.85, 95% CI: 1.00, 3.41 risperidone patients). Average weight gain was 3.2 kg in the 52-weeks group compared with a weight loss of 0.2 kg in the 0-weeks and 0.1 kg in the 24-weeks groups. These findings suggest that risperidone or olanzapine adjunctive therapy for 24 weeks is beneficial but continuation of risperidone beyond this period does not reduce the risk of relapse. Whether continuation of olanzapine beyond this period reduces relapse risk remains unclear but the potential benefit needs to be weighed against an increased risk of weight gain