Domiciliary nasal respiratory support : first experiences in Malta

Nasal respiratory support is a non-invasive alternative to conventional assisted ventilation with endotracheal intubation, or the more cumbersome negative pressure ventilators. The two main types of this relatively new therapy are nasal intermittent positive pressure ventilation (NIPPV) and nasal continuous positive airway pressure (NCPAP) respiratory support, which are mostly used in chronic hypoventilatory states and obstructive sleep apnoea (OSA) respectively. We have introduced these two types of respiratory support to five patients suffering from neuromuscular disorders and twenty-four patients with OSA with marked improvement in the quality of life of all patients concerned. Our experiences with these patients should hopefully lead to further development in the diagnostic and therapeutic facilities in this field in Malta.peer-reviewe

Discourse Awareness And Issues In Est Materials Design

Understanding text structure (knowledge of discourse and genre) within specific contexts plays a very important part in EST materials development for language teaching and learning. It is argued that for students to comprehend particular texts and to learn a language well, language teaching should begin with an understanding of text structure. It is thus essential for EST teachers to be aware that linguistic patterns exist across stretches of text within different text types and an understanding of these patterns would make text comprehension and reading to learn in the content area easier. Thus, teachers need to be trained to develop discourse-based materials as an understanding of different text types can enhance language learning. This paper discusses the importance of discourse awareness and issues of design, development and application in the development of EST materials in relation to written texts by introducing frameworks for designing discourse-based materials

Retroperitoneal fibrosis: a case of a patient (63y/o) treated with low-dose methotrexate (MTX) and 6-methylprednisolone (6-MP)

Retroperitoneal fibrosis (RPF), is a rare fibroinflammatory disease. The pathogenesis of RPF is still unclear and numerous theories have been reported such as environmental factors, immunologic process, genetic component, local inflammation and advanced atherosclerosis. RPF is characterized by the presence of a particular retroperitoneal fibrotic tissue which is white, woody and involving retroperitoneal structures such as the great vessels, ureters and psoas muscle. The main complication of RPF is the obstruction of local structures such as the ureters due to the fibrosis and the treatment of this aspect represents the main challenge for this pathology. RPF medical treatment consists of corticosteroids or/and immunosuppressive therapy. We report a case of a patient (63y/o) affected by idiopathic RPF treated with low-dose methotrexate (MTX) and 6-methylprednisolone (6-MP) for two years, describing and confirming the effectiveness and safety of a long-term low-dose MTX and 6-MP treatment

Investigating the impact of exit availability on egress time using computer based evacuation simulation

This paper examines the influence of exit availability on evacuation time for a narrow body aircraft under certification trial conditions using computer simulation. A narrow body aircraft which has previously passed the certification trial is used as the test configuration. While maintaining the certification requirement of 50% of the available exits, six different exit configurations are examined. These include the standard certification configuration (one exit from each exit pair) and five other exit configurations based on commonly occurring exit combinations found in accidents. These configurations are based on data derived from the AASK database and the evacuation simulations are performed using the airEXODUS evacuation simulation software. The results show that the certification practice of using half the available exits predominately down one side of the aircraft is neither statistically relevant nor challenging. For the aircraft cabin layout examined, the exit configuration used in certification trial produces the shortest egress times. Furthermore, three of the six exit combinations investigated result in predicted egress times in excess of 90 seconds, suggesting that the aircraft would not satisfy the certification requirement under these conditions

Hydrozoa, fjord Comau, Chile.

The shallow-water hydrozoan fauna of fjordComau is surveyed. A total of thirty three specieswere recorded. They have been assigned to eightfamilies of Athecata, eight families of Thecata,two families of Narcomedusae and one family ofTrachymedusae. Their ecology is brieflydiscussed

Gas Purity effect on GEM Performance in He and Ne at Low Temperatures

The performance of Gas Electron Multipliers (GEMs) in gaseous He, Ne, He+H2 and Ne+H2 was studied at temperatures in the range of 3-293 K. This paper reports on previously published measurements and additional studies on the effects of the purity of the gases in which the GEM performance is evaluated. In He, at temperatures between 77 and 293 K, triple-GEM structures operate at rather high gains, exceeding 1000. There is an indication that this high gain is achieved through the Penning effect as a result of impurities in the gas. At lower temperatures the gain-voltage characteristics are significantly modified probably due to the freeze-out of these impurities. Double-GEM and single-GEM structures can operate down to 3 K at gains reaching only several tens at a gas density of about 0.5 g/l; at higher densities the maximum gain drops further. In Ne, the maximum gain also drops at cryogenic temperatures. The gain drop in Ne at low temperatures can be re-established in Penning mixtures of Ne+H2: very high gains, exceeding 104, have been obtained in these mixtures at 30-77 K, at a density of 9.2 g/l which corresponds to saturated Ne vapor density at 27 K. The addition of small amounts of H2 in He also re-establishes large GEM gains above 30 K but no gain was observed in He+H2 at 4 K and a density of 1.7 g/l (corresponding to roughly one-tenth of the saturated vapor density). These studies are, in part, being pursued in the development of two-phase He and Ne detectors for solar neutrino detection.Comment: 4 pages, 7 figure

Experimental and survey studies on the effectiveness of dynamic signage systems

Signage systems are widely used in the built environment to aid occupant wayfinding during both circulation and evacuation. Recent research conducted by the authors shows that only 38% of people ‘see’ conventional static emergency signage in presumed emergency situations in an unfamiliar built environment, even if the sign is located directly in front of them and their vision is unobstructed. However, most people who see the sign follow the sign. These results suggest that current emergency guidance signs are less effective as an aid to wayfinding than they potentially can be and that signs are likely to become more effective if their detectability can be improved while upholding the comprehensibility of the guidance information they provide. A novel dynamic signage design is proposed to address this issue. The effectiveness of the new sign is tested under almost identical experimental settings and conditions as in the previous experiments examining conventional, static signs. The results show that 77% of people ‘see’ the dynamic sign and 100% of them go on to follow the sign. In addition, a dynamic method to identify that an exit route is no longer viable is tested using an international survey to gauge understanding of the new signage concept. Survey results suggest that the purpose of the new sign can be clearly understood by over 90% of the sample

Wayfinding behavior within buildings - An international survey

A building wayfinding questionnaire study is presented which analyses the importance of a set of wayfinding criteria from a building evacuation perspective. The main path selection criteria tested in this questionnaire are handedness and length of the first leg of the path. The study involved 1166 participants from 36 countries. The results suggest that the handedness, a genetic factor, and the side of the road people drive on, a cultural factor, exert a significant influence on path choice. The results of this study clarify misconceptions existing in urban wayfinding studies regarding the importance of the length of the first leg of a path. Path selection criteria along with their relative rankings are suggested for inclusion in wayfinding algorithms used within evacuation models. It is further suggested that these rankings may be country specific