An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

Molecular diagnosis of cystic fibrosis in South African populations

Cystic fibrosis (CF) is present in all South African population groups. In a significant proportion of patients a diagnosis of CF can be confirmed by DNAanalysis and the detection of two CF transmembrane conductance regulator (CFTR) mutations, using the panels of mutations developed in this study. The index of suspicion will also be raised in patients with a single CFTR mutation. DNAtesting is important, especially in region s without access to reliable sweat tests, and should be considered an aid to diagnosis. In addition to receiving appropriate treatment, patients and their families can receive more accurate genetic counselling, CF carrier testing and prenatal diagnosis

An adapted triage tool (ETAT) at Red Cross War Memorial Children’s Hospital Medical Emergency Unit, Cape Town: An evaluation

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children’s hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July 2009 were analysed. The number of children in each triage category (red (emergency), orange (urgent or priority) and green (non-urgent)) and their disposal were evaluated. Results. 1. The October 2007 series: 902 children aged 5 days - 15 years were evaluated. Their median age was 20 (interquartile range (IQR) 7 - 50) months, and 58.8% (n=530) were triaged green, 37.5% (n=338) orange and 3.8% (n=34) red. Over 90% of children in the green category were discharged (478/530), while 32.5% of children triaged orange (110/338) and 52.9% of children triaged red (18/34) were admitted. There was a significant increase in admission rate for each triage colour change from green through orange to red after adjustment for age category (risk ratio (RR) 2.6; 95% confidence interval (CI) 2.2 - 3.1). 2. The July 2009 cohort: 407 children with a median age of 22 months (IQR 7 - 53 months) were enrolled. Twelve children (2.9%) were triaged red, 187 (45.9%) orange and 208 (51.1%) green. A quarter (101/407) of the children triaged were admitted: 91.7% (11/12) from the red category and 36.9% (69/187) from the orange category were admitted, while 89.9% of children in the green category (187/208) were discharged. After adjusting for age category, admissions increased by more than 300% for every change in triage acuity (RR 3.2; 95% CI 2.5 - 4.1). Conclusions. The adapted ETAT process may serve as a reliable triage tool for busy paediatric medical emergency units in resource-constrained countries and could be evaluated further in community emergency settings

Sustainable and Regenerable Alkali Metal-Containing Carbons Derived from Seaweed for CO2 Post-Combustion Capture

Alkali-based CO2 sorbents were prepared from a novel material (i.e., Laminaria hyperborea). The use of this feedstock, naturally containing alkali metals, enabled a simple, green and low-cost route to be pursued. In particular, raw macroalgae was pyrolyzed at 800 °C. The resulting biochar was activated with either CO2 or KOH. KOH–activated carbon (AC) had the largest surface area and attained the highest CO2 uptake at 35 °C and 1 bar. In contrast, despite much lower porosity, the seaweed-derived char and its CO2-activated counterpart outweighed the CO2 sorption performance of KOH–AC and commercial carbon under simulated post-combustion conditions (53 °C and 0.15 bar). This was ascribed to the greater basicity of char and CO2–AC due to the presence of alkali metal-based functionalities (i.e., MgO) within their structure. These were responsible for a sorption of CO2 at lower partial pressure and higher temperature. In particular, the CO2–AC exhibited fast sorption kinetics, facile regeneration and good durability over 10 working cycles. Results presented in the current article will be of help for enhancing the design of sustainable alkali metal-containing CO2 captors

Limits to tDCS effects in language:failures to modulate word production in healthy participants with frontal or temporal tDCS

Transcranial direct current stimulation (tDCS) is a method of non-invasive brain stimulation widely used to modulate cognitive functions. Recent studies, however, suggests that effects are unreliable, small and often non-significant at least when stimulation is applied in a single session to healthy individuals. We examined the effects of frontal and temporal lobe anodal tDCS on naming and reading tasks and considered possible interactions with linguistic activation and selection mechanisms as well possible interactions with item difficulty and participant individual variability. Across four separate experiments (N, Exp 1A = 18; 1B = 20; 1C = 18; 2 = 17), we failed to find any difference between real and sham stimulation. Moreover, we found no evidence of significant effects limited to particular conditions (i.e., those requiring suppression of semantic interference), to a subset of participants or to longer RTs. Our findings sound a cautionary note on using tDCS as a means to modulate cognitive performance. Consistent effects of tDCS may be difficult to demonstrate in healthy participants in reading and naming tasks, and be limited to cases of pathological neurophysiology and/or to the use of learning paradigms

A low-cost way to reduce greenhouse effects

Oak wood precursor was used for preparing low-cost CO2 sorbents. Adsorption is proposed as a cheaper alternative to chemical absorption, which is uneconomical, thus reducing the cost associated with the capture step. The raw material has been carbonised either by pyrolysis or by a hydrothermal carbonisation (HTC). Resulting biochars were then activated using CO2 . Initial chars and their activated counterparts were characterised by SEM imaging and N2 sorption measurements at 77 K. A significant rise in the BET surface area, total pore volume and micropore volume (textural parameters) occurred for all of the pristine chars after the activation process. Fast CO2 sorption kinetics (saturation reached in 3 mins.) and CO2 uptakes of up to ca. 6 wt. % have been measured by thermogravimetric analysis (TGA) at 35 ºC and 1 atm. The activated carbons (ACs) thus synthesised showed competitive performances compared to a commercial AC standard. Although the sorbents’ performances decreased at higher temperatures, they were easily regenerated after the capture stage

Lung function in South African children with cystic fibrosis

Objective: To determine the pattern of lung function in stable cystic fibrosis (CF) patients and to investigate the relationship of abnormal lung function to demographic variables, CF genotype and pulmonary colonisation with Pseudomonas aeruginosa (PA)Design: A descriptive study done at the CF clinic at Red Cross War Memorial Children's Hospital in Cape Town.Methods: Data were recorded and pulmonary function testing (PFT) was performed in 42 CF patients.Results: 29 patients (69%) had mild disease,. while 11 (26%) and 2 (5%) had moderate and severe disease respectively. Twenty-four patients (57'%) demonstrated lower airway obstruction (LAO). Patients with moderate or severe disease were significantly older than those with mild disease (13.3 (3.7) years (mean (SD)) compared with 11.1 (3.0) years (t =2.1; P =OM)). PA colonisation status differed significantly with the pattern of lung function (X2 =6.6; P = 0.04) and severity of lung disease (X2=12.6; P =0.002.). Nine (35%) of the 26 patients tested before and after broncbodilator therapy showed a positive response.Conclusion: The majority of patients had mildly impaired or normal lung function, with LAO predominating. A minority of patients were bronchodilator-responsive. PA colonisation may be associated with the development of abnormal lung function and more severe pulmonary disease.

Indentation-based characterization of creep and hardness behavior of magnesium carbon nanotube nanocomposites at room temperature

The time-dependent plastic deformation response of magnesium/carbon nanotube (CNT) nanocomposites containing 0.25, 0.5, and 0.75 vol% of carbon nanotubes is investigated through depth nanoindentation tests against monolithic pure magnesium in the present study. The Mg-CNT nanocomposite materials were successfully synthesized via a powder metallurgy technique coupled with microwave sintering followed by hot extrusion to produce 8-mm diameter, long solid bars. All depth-sensing indentation creep tests were conducted at ambient (room) temperature employing a diamond Berkovich pyramidal indenter. These tests are dual-stage, i.e., loading to a prescribed peak load of 50 mN, holding the peak load constant for a dwell period of 500 s, and finally unloading. Various strain rates of 0.01, 0.1, 1, and 10 s−1were performed to assess the effects of strain rate and dwell time on the ambient temperature creep response of the Mg-CNT nanocomposites. The outcomes of these tests are explained through material hardness, microstructure, the extent of CNT content in each material, and strain rate sensitivity. Upon analyzing the nanoindentation creep tests, the dominant creep mechanism at room temperature was found to be a dislocation creep mechanism. It is also found that CNTs increase the creep resistance of magnesium. Findings of this study can be used as a starting point for a high-temperature creep study on Mg-CNT nanocomposites. This paper is a continued study from our group on time-dependent plastic deformation of Mg nanocomposites (i.e., see Haghshenas et al., Journal of Composite Materials, https://doi.org/10.1177/0021998318808358). The short-term goal is to provide a compressive picture of the controlling creep mechanisms and their dependency upon, time, temperature, strain rate, volume fraction of the nanoparticles, and the type of the nanoparticles. Mg, in general, is a notorious material for high-temperature application; therefore, the long-term objective is to propose Mg nanocomposite as reliable replacements for Mg when lightweight and creep resistance are needed. However, to be able to confidently suggest such a replacement detailed understanding on the controlling phenomena, mention as short-term goals, are required