Tracking internet interest in anabolic-androgenic steroids using Google Trends

Background: There is a perception that the prevalence of anabolic-androgenic steroid (AAS) use is increasing in the UK, with consequent individual and public health risks. Nevertheless, there is a lack of real-time surveillance data to support the development of effective policy. This paper explores the potential of Google Trends to complement existing surveillance methods by analysing user generated search term data. Methods: The Google Trends web tool was used to identify patterns of UK online interest in 15 AAS from January 2011 to December 2015, with 10 ultimately suitable for further analysis. Time series analysis was applied to the data. Results: 10 steroids were ranked from most to least popular. All compounds had peaks in interest between April to July, potentially indicating a consumer driven desire to attain a desired physique in time for summer. Oral steroids were among the most searched for drugs which may have relevance for current service provision to steroid users. Conclusion: Alternative data sources such Google Trends may provide useful additional information to supplement existing surveillance data. The limitations of this method however makes cautious interpretation and triangulation with other data sources essential

The Spin \u3cem\u3eL\u3c/em\u3e-Function of Quasi-Split \u3cem\u3eD\u3c/em\u3e\u3csub\u3e4\u3c/sub\u3e

We construct a multivariable Rankin-Selberg integral for the Spin L-function of a globally generic cuspidal representation of an arbitrary quasi-split group of type D4. This proves the meromorphic continuation of this L-function. When the quasi-split group of type D4 is associated to a cubic field extention, this L-function cannot be analyzed by the Langlands-Shahidi method

Hazards and incident investigation at palm oil mill industry

Occupational Safety and Health Act (OSHA) is a discipline with broad scope involving many specialized fields. This research was conducted to determine the relationship between the hazards occurring and the control measures to overcome the hazards occur in the Palm Oil Mill located at Ulu Keratong, Segamat, Johor. Nowadays, the workers are lack of safety and health practice from their companies based on the statistics that have shown the number of fatality and permanent disablement cases due to the accident in the palm oil mill. Which causes the accidents and injuries happened due to management control that does not emphasized on the safe practise of workers. Information and data collection were carried out by using HIRARC Form and Preliminary Hazard Analysis (PHA) in the Palm Oil Mill RISDA which will be further discuss in the methodology part. The main objective of this study is to promote adaptable occupational environment and suggest some countermeasures to solve the potential hazard and the consequent responsibilities relevant to professional engineering practice. There were seven hazards have been identified such as crash by rotating machine, struck by heavy palm fruit and slippery floor, excessive heat, excessive pressure of tractor tire, chemical spillage and noise hazard. From the result and findings, the hazards and control measures identified are able to determine improvements in knowledge and risk perceptions among the workers and visitors towards health policies and essential interventions for hazard prevention. Effective job safety and health programs help reduce worker injuries and illness in the long term

Integrating labor awareness to energy-efficient production scheduling under real-time electricity pricing : an empirical study

With the penetration of smart grid into factories, energy-efficient production scheduling has emerged as a promising method for industrial demand response. It shifts flexible production loads to lower-priced periods to reduce energy cost for the same production task. However, the existing methods only focus on integrating energy awareness to conventional production scheduling models. They ignore the labor cost which is shift-based and follows an opposite trend of energy cost. For instance, the energy cost is lower during nights while the labor cost is higher. Therefore, this paper proposes a method for energy-efficient and labor-aware production scheduling at the unit process level. This integrated scheduling model is mathematically formulated. Besides the state-based energy model and genetic algorithm-based optimization, a continuous-time shift accumulation heuristic is proposed to synchronize power states and labor shifts. In a case study of a Belgian plastic bottle manufacturer, a set of empirical sensitivity analyses were performed to investigate the impact of energy and labor awareness, as well as the production-related factors that influence the economic performance of a schedule. Furthermore, the demonstration was performed in 9 large-scale test instances, which encompass the cases where energy cost is minor, moderate, and major compared to the joint energy and labor cost. The results have proven that the ignorance of labor in existing energy-efficient production scheduling studies increases the joint energy and labor cost, although the energy cost can be minimized. To achieve effective production cost reduction, energy and labor awareness are recommended to be jointly considered in production scheduling. (C) 2017 Elsevier Ltd. All rights reserved

Rapid opioid overdose response system technologies

Purpose of review  Opioid overdose events are a time sensitive medical emergency, which is often reversible with naloxone administration if detected in time. Many countries are facing rising opioid overdose deaths and have been implementing rapid opioid overdose response Systems (ROORS). We describe how technology is increasingly being used in ROORS design, implementation and delivery. Recent findings  Technology can contribute in significant ways to ROORS design, implementation, and delivery. Artificial intelligence-based modelling and simulations alongside wastewater-based epidemiology can be used to inform policy decisions around naloxone access laws and effective naloxone distribution strategies. Data linkage and machine learning projects can support service delivery organizations to mobilize and distribute community resources in support of ROORS. Digital phenotyping is an advancement in data linkage and machine learning projects, potentially leading to precision overdose responses. At the coalface, opioid overdose detection devices through fixed location or wearable sensors, improved connectivity, smartphone applications and drone-based emergency naloxone delivery all have a role in improving outcomes from opioid overdose. Data driven technologies also have an important role in empowering community responses to opioid overdose. Summary  This review highlights the importance of technology applied to every aspect of ROORS. Key areas of development include the need to protect marginalized groups from algorithmic bias, a better understanding of individual overdose trajectories and new reversal agents and improved drug delivery methods.PostprintPeer reviewe

Order effects: a randomised study of three major cancer-specific quality of life instruments

BACKGROUND: In methodological studies and outcomes research, questionnaires often comprise several health-related quality of life (HRQoL) measures. Previous psychological studies have suggested that changing the sequential order of measurement scales within a questionnaire could alter the pattern of responses. Yet, information on the presence or absence of order effects on the assessment of HRQoL in cancer patients is limited. METHODS: An incomplete block design was used in this study of 1277 cancer patients. Each patient filled out a questionnaire package that contained two of the three major cancer-specific HRQoL instruments, namely the Functional Assessment of Cancer Therapy – General, the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire and the Functional Living Index – Cancer. Within a questionnaire package the sequential order of the instruments contained were randomised. Measurement properties of the instruments, including the number of missing values, mean HRQoL scores, known-groups validity and internal consistency were compared between samples of different presentation orders. RESULTS: No effect of presentation order on the four properties aforementioned was found. CONCLUSION: Presentation order is unlikely to alter the responses to these HRQoL instruments administered in cancer patients when any two of them are used together

Current clinical status and vascular complications among patients with type 2 diabetes mellitus at tertiary hospitals in Malaysia

Objective: To assess the prevalence of diabetic vascular complications and cardiovascular risk factors control in type 2 diabetic patients at tertiary settings. Methods: This cross-sectional study was conducted among 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two tertiary referral hospitals in Malaysia. Data regarding socio-demographics, macro- and microvascular complications, family health history, blood pressure, anthropometric indices, glycaemic control, and lipid profile were obtained from medical records, face-to-face interview and physical examination. Results: The mean age of patients was 55.7±9.2 years, mean diabetes duration was 10.1±8.1 years, and 52.1% were females. Approximately 36.1% patients had cardiovascular disease (CVD). There were high prevalence of established coronary artery disease (30.7%), cerebrovascular disease (10.2%), and peripheral vascular disease (5.1%). Peripheral neuropathy, diabetic nephropathy and retinopathy were present in 41.5%, 17.6% and 15.0% patients respectively. Only 14.1% of the patients reached optimal HbA1c level and 21.1% patients achieved target fasting plasma glucose. The overall prevalence of dyslipidemia was 89.1%, hypertension was 80.2%, and obesity was 35.9% (BMI) and 86.5% (waist-to-hip ratio). Conclusions: Diabetic vascular complications were highly prevalent among the type 2 diabetic patients. Cardiovascular risk factors control was suboptimal. Both awareness and application of recommended guidelines need to be reinforced

Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers

BackgroundAccess to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagement that permitted opportunities to meet their healthcare or housing needs. Barriers to accessing care provision include an itinerant lifestyle, difficulties with travel at unpredictable hours, impacting upon adherence to medication regimens including daily supervised consumption.ObjectivesTo use a co-produced, “health at the margins” approach, to reach the sex-working population in Leeds, and support informed choices about the potential to receive buprenorphine prolonged-release injection (BPRI) as a treatment option for OUD.MethodsBPRI was introduced using a theory of change model and improvements in sex-worker care delivery was reviewed. Strategies included buprenorphine micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based and trauma-informed approach.ResultsBenefits of BPRI included removal of the need for daily pharmacy visits, reducing the risk of diversion, improved medication adherence, stability and engagement with treatment and supportive services.ConclusionBPRI may offer an additional option for pharmacological interventions for people with OUD where there may be increased barriers to accessing treatment for example due to sex-working. Strategies for effective BPRI include micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based approach

Improvement design of existing threshing machine at Kilang Sawit Risda, Ulu Keratong

Palm oil is very important in the agricultural and economic sectors in Malaysia. It’s origin is in the tropical rain forest region of West Africa, which the main belt runs through the southern latitudes of Cameron, Cote D’ ivoire, Ghana, Liberia, Nigeria, Sierria Leone, Togo and into the equatorial region of Angola and the Congo (FAO,2004). The crude palm oil have a very wide range of application which is about 80% of the crude palm oil (CPO) produced can be converted into food products while the others can be used as non-food applications. The by-products or wasted product of palm oil fruit processing such as empty bunches and fibers can be processed as raw materials for potash fertilizer, pulp and paper manufacturing. The shell fragments can be used as renewable energy as fuels and also for decoration of living apartments

Prevalence of metabolic syndrome in type 2 diabetic patients: a comparative study using WHO, NCEP ATP III, IDF and Harmonized definitions

To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study involved 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two Malaysian tertiary hospitals. Socio-demographic data were assessed using a pre-tested interviewer-administered structured questionnaire. Anthropometric measurements were carried out according to standard protocols. Clinical and laboratory characteristics were examined. Kappa (k) statistics were used for the agreement between the four MetS definitions. The overall prevalence rates of MetS (95% CI) were 95.8% (93.6-98.1), 96.1% (94.0-98.3), 84.8% (80.8-88.9) and 97.7% (96.1-99.4) according to the WHO, NCEP ATP III, IDF and the Harmonized definitions, respectively. The Kappa statistics demonstrated a slight to substantial agreement between the definitions (k = 0.179-0.875, p < 0.001), where the WHO criteria revealed the highest concordance with the NCEP ATP III definition (k = 0.875, p < 0.001). The WHO against NCEP ATP III criteria evinced the highest sensitivity (99.66%) whereas Harmonized criteria against all the other three definitions showed the highest specificity (100%) in identifying MetS. In conclusion, the new Harmonized criteria established the highest prevalence of MetS among the four definitions applied. There was a very good concordance between the WHO and NCEP ATP III criteria. The extremely high prevalence of MetS observed in type 2 diabetic patients indicates an impending pandemic of CVD risk in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM