Clinical and financial consequences of setting up an asthma clinic at St. Luke’s Hospital

The effects of setting up an asthma clinic were assessed in an audit study. A comparison was made between the quality and quantity of medication used by patients before and after attending the asthma clinic. The number and severity of exacerbations during a six month period before and a six month period after attending were also assessed. The cost of treatment before and after was also calculated. In 14% of patients, occupational factors, drugs or underlying lung disease were significant contributors to asthma. The number of acute episodes of severe asthma were reduced from 98 to 47, with hospital admissions falling from 26 to 1. Pulmonary function (%FEV1) improved in the group as a whole with the number of patients having their best FEV above 80% improving from 44 to 71. In spite of the expense of high cost drugs and the running costs of the clinic there were substantial savings largely from the reduced number of hospital admissions. The calculated annual cost fell from Lm 22,769 to Lm 10,654.peer-reviewe

Inheritance Law and Investment in Family Firms

Entrepreneurs may be legally bound to bequeath a minimal stake to non-controlling heirs. The size of this stake can reduce investment in family firms, by reducing the future income they can pledge to external financiers. Using a purpose-built indicator of the permissiveness of inheritance law and data for 10,004 firms from 38 countries in 1990-2006, we find that stricter inheritance law is associated with lower investment in family firms, but does not affect investment in non-family firms. Moreover, as the model predicts, inheritance law affects investment only in family firms that experience a succession

Preliminary Investigations into the Usability of 3D Environments for 2D GIS Users

Although the need for 3D GIS is growing, migrating from traditional 2D to 3D GIS can be frustrating due to the familiarity of users with 2D. This paper describes a preliminary investigation into the problems that users encounter when migrating from 2D to 3D environments from a theoretical perspective and via two usability evaluation tests: Cognitive Walkthrough and User Testing. As expected, the results demonstrate the influence of 2D perceptions when interacting with 3D GIS and that users experienced more difficulties interacting in 3D, resulting in lower confidence and satisfaction

Determination of serum zinc levels in normal Maltese adults by atomic absorption spectrophotometry

The importance of zinc as one of the essential trace elements in the living organisms is becoming increasingly recognised. In the process of carrying out measurements to establish normal reference values for our laboratory, it was noticed that the values being obtained, generally appeared to be higher than those published in the literature where similar techniques had been employed. It is important to gain further understanding of this metal in both health and disease as it appears that zinc is essential to an important variety of metabolic processes in man. We are unable to offer a satisfactory explanation for the difference in serum zinc levels in the two groups reported in this paper. Local water does not appear to have high zinc content and Maltese soil is known to be zinc deficient. It is known however that local farmers use a zinc containing fungicide (Zineb) on a large scale.peer-reviewe

From the axial line to the walked line: Evaluating the utility of commercial and user-generated street network datasets in space syntax analysis

Data availability, reliability and cost are some of the most constraining factors in space syntax analysis and wider commercial acceptance. In recent years user-created Volunteered Geographic Information (VGI) that is free to all via the Internet has gained wider acceptance and proven reliability (Haklay, 2010). Furthermore it has the property of being created by the people who inhabit the spaces being mapped; therefore it captures local knowledge and detail to a far greater degree than commercial mapping agencies. From a space syntax perspective it also relates more closely to the pedestrian network as it is used on foot and captures details of pedestrian routes through the urban fabric that other road-centric data sources ignore. This paper demonstrates the methodological approaches and analytic outcomes of a space syntax sensitivity analysis of Open Street Map (OSM) VGI road network data, the UK national mapping agency Ordnance Survey Integrated Transport Network (ITN) road data and a hand-drawn Axial map for four areas within the Greater London Region. The space syntax segment analysis was completed within the Depthmap application. The segment analysis was completed on the ITN model, OSM model and hand-drawn model separately and then it was carried out on a combined model of the ITN and OSM that integrated all the network elements from both. The integration and comparison of the network models was carried out through the usage of a new algorithm currently under development at University College London that identifies and extracts the differences between two line network datasets (Koukoletsos, forthcoming) and standard GIS processing techniques. The space syntax measures were evaluated on four areas in outer London that are the focus of the Adaptable Suburbs project at the Bartlett School of Graduate Studies. The analysis was carried out using length-weighted angular segment and choice analysis at radii 800m, 2000m and n (Turner, 2007). Comparative statistics were then generated for the areas to evaluate the analysis outcomes of the different network models. The London-wide network that was created through the combination of the OSM and ITN networks had a total length of 32,000km representing an increase of approximately 20% over the Ordnance Survey ITN network. The dramatic increase in network length alone demonstrates the divergent realities of the two mapping techniques and the representation of the world that they capture. It is anticipated that the sensitivity analysis will find that there was no significant difference in the global syntax values between the ITN and OSM and Axial models but at the local level the additional network segments for pedestrian routes within the OSM data will provide greater network accuracy and syntax values that model the reality on the ground better than the Ordnance Survey ITN model. Furthermore it captures potential pedestrian routes that are not present in the other data sets. The work carried out seeks to understand whether Volunteered Geographic Information is a viable alternative to official mapping sources when creating models for analysis of small urban areas. If this proves to be the case such data would provide not only a cost effective alternative to commercially produced data but indeed a more reliable network model for the analysis to be carried out. Open source geographic data have the capability to improve and enrich space syntax analysis whilst removing high price barriers that commercial data sources impose

Genetic and Serological Markers in Identifying Unclassified Colitis

In 5–15% of the patients with inflammatory bowel disease (IBD) limited to the colon, it is difficult to distinguish histologically between ulcerative and Crohn’s colitis. This is described as unclassified colitis. Distinguishing between the two is important in terms of prognosis, since patients with Crohn’s disease (CD) have a higher risk of strictures and fistulae, which may predict a more severe disease course, as well as an increased risk for surgery. In addition, colectomy may be curative in ulcerative colitis patients not responding to medical therapy, while Crohn’s patients undergoing colectomy can have relapses in other areas of the bowel and, therefore, need to be followed-up. In inflammatory bowel disease, intestinal inflammation is believed to occur secondary to an altered immune response in a genetically susceptible host. Genetic and serological markers (antibodies) may have a role in identifying unclassified colitis. Anti-Saccharomyces cerevisiae antibody (ASCA) and anti-neutrophil cytoplasmic antibodies (pANCA) have the highest sensitivity in distinguishing ulcerative from Crohn’s colitis. Nucleotide oligomerization domain 2 (NOD2) and autophagy-related 16-like 1 (ATG16L1) polymorphisms are strongly associated with Crohn’s disease, while epithelial barrier genes are significantly associated with ulcerative colitis. This chapter describes which gene polymorphisms and serological markers may be used to distinguish between ulcerative colitis and Crohn’s disease in patients with histologically unclassified colitis

Dexterous actuation

Methods that have been developed for actuation system evaluation are normally generic, and primarily intended to facilitate actuator selection. Here, we address specifically those engineering devices that exhibit multiple-degree-of-freedom motions under space and weight constraints, and focus on the evaluation of the total actuation solution. We suggest a new measure that we provisionally call ‘Actuation Dexterity’, which interrogates the effectiveness of this total solution and serves as a design support tool. The new concept is developed in the context of artificial hands, and the approach is based on the review and analysis of thirty-six different artificial hand projects described in the literature. We have identified forty-eight unique evaluation criteria that are relevant to the actuation of devices of this type, and have devised a scoring method that permits the quantification of the actuation dexterity of a given device. We have tested this approach by evaluating and quantifying the actuation dexterity of five different artificial hands from the literature. Finally, we discuss the implications of this approach to the design process, and the portability of the approach between different device types.peer-reviewe

HOW CAN 3D GIS BE USED TO BETTER STORE, INTEGRATE AND COMMUNICATE RESULTS OF ENVIRONMENTAL IMPACT ASSESSMENTS?

In the United Kingdom, the process of conducting the Environmental Impact Assessment (EIA) is a legal requirement for projects of considerable size or those that can affect the environment. EIA results are presented as an Environmental Statement, which includes multiple long reports often covering thousands of pages on large developments and includes complex information that is hard to understand for the intended audience of planners and the general public. To facilitate understanding, environmental professionals often use 2D maps. However, this approach is only partially useful, as it is difficult to locate specific information or to identify information related to a specific location on a very large site. This paper presents a pilot study into whether 3D GIS provide an alternative to better present, integrate and communicate the EIA results, with specific focus on three core environmental datasets: noise, air quality and bats’ flight paths, in relation to the building model of a real world development site. We focus in particular on off-the-shelf technologies that would be available to a standard Environmental Consultancy not having access to bespoke development, and will be usable by the planners, public and other decision makers, and look at tasks including 3D georeferencing, integration and visualisation of the data to be explored. It was concluded that while 3D GIS has a potential for environmental modelling, current technology and standards of data collection limit the practical use of 3D GIS at this stage

PREFACE

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