Neonatal Stridor

Neonatal stridor is an important condition, in many cases implying an impending disaster with a very compromised airway. It is a sign that has to be considered with the rest of the history and examination findings, and appropriate investigations should then be undertaken to confirm the source of the noise. Neonates with stridor should be managed in a multidisciplinary setting, by clinicians familiar with the intricate physiology of these children, and with access to the multitude of medical and surgical investigative and therapeutic options required to provide first-rate care

Using Automated Planning for Traffic Signals Control

Solving traffic congestions represents a high priority issue in many big cities. Traditional traffic control systems are mainly based on pre-programmed, reactive and local techniques. This paper presents an autonomic system that uses automated planning techniques instead. These techniques are easily configurable and modified, and can reason about the future implications of actions that change the default traffic lights behaviour. The proposed implemented system includes some autonomic properties, since it monitors the current traffic state, detects if the system is degrading its performance, sets up new sets of goals to be achieved by the planner, triggers the planner that generates plans with control actions, and executes the selected courses of actions. The obtained results in several artificial and real world data-based simulation scenarios show that the proposed system can efficiently solve traffic congestion.</p

Using Automated Planning for Traffic Signals Control

Solving traffic congestions represents a high priority issue in many big cities. Traditional traffic control systems are mainly based on pre-programmed, reactive and local techniques. This paper presents an autonomic system that uses automated planning techniques instead. These techniques are easily configurable and modified, and can reason about the future implications of actions that change the default traffic lights behaviour. The proposed implemented system includes some autonomic properties, since it monitors the current traffic state, detects if the system is degrading its performance, sets up new sets of goals to be achieved by the planner, triggers the planner that generates plans with control actions, and executes the selected courses of actions. The obtained results in several artificial and real world data-based simulation scenarios show that the proposed system can efficiently solve traffic congestion.</p

A Comparison of Welded Structure Cost Calculation Methods

With the increase in material and labour costs, the optimization of welded steel structures is gradually becoming a necessity. Precise cost calculation methods are a prerequisite for the optimization process; they enable the designers to differentiate between product variations and select the best one. However, while the calculation of the material cost is simple, the calculation of fabrication costs, which include the costs of cutting, handling, welding, and surface preparation, is harder to define. Thus, in this paper, two available cost calculation methods are compared by observing two specific welded structures: a welded I beam and a gearbox housing. Both the total and the partial costs were compared. Based on the results, it was concluded that the methods are in agreement considering the total cost values and that both methods can differentiate between the design variations comparably. On the other hand, partial costs of process segments differed, mostly due to variations in the pre-defined scope of each process (e.g., one method included handling in the material costs, while the other included it in the welding costs)

Otitis media with effusion: current treatment, new understanding of its aetiopathogenesis, and a novel therapeutic approach

Otitis Media with Effusion (OME) is a common childhood condition leading to hearing loss, and its treatment with ventilation tubes (VTs) is one of the commonest surgical procedures. However, aetiology of OME is poorly understood, and its current treatment requires improvement as OME frequently recurs once VTs extrude. The first, clinical part of this thesis showed that 63.6% of children randomised to VT insertion in a clinical trial will require VTs again, and even with additional adenoidectomy the need for repeat surgery remains high. Although published national guidelines set out criteria for surgery, the multicentre study presented here showed that only 32.2% of children that had VTs met these criteria, and guidelines' publication had limited impact on clinical practice. The second, laboratory part of this thesis demonstrated the importance that bacteria and biofilms play in aetiology of OME, as live bacteria were demonstrated in 91.9% of middle ear effusions (using culture and confocal microscopy). Following from this, a Staphylococcus aureus biofilm model was developed, and used to show that biofilm eradication requires antibiotic (rifampicin and lindamycin) levels 1,000 times higher than those required to inhibit planktonic bacteria, over a period of 2-3 weeks. To achieve this in the middle ear, a local delivery strategy using biodegradable poly (Iactic-coglycolic acid) antibiotic pellets was proposed. Drug release from these pellets was investigated with High Performance Liquid Chromatography and Serial Plate Transfer Testing, which demonstrated that antibiotics can be released for up to 3 weeks. Importantly, the pellets were able to eradicate biofilms in the in vitro model. This thesis has shown that current OME treatment has significant deficiencies, but better understanding of OME pathogenesis raises the possibility of rational new therapeutic strategies. Biodegradable antibiotic pellets designed to eradicate OME biofilms may be a better future treatment that could improve the lives of countless children

Update on otitis media – prevention and treatment

Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment

Evaluation of combinations of putative anti-biofilm agents and antibiotics to eradicate biofilms of Staphylococcus aureus and Pseudomonas aeruginosa

Objectives To evaluate potential anti-biofilm agents for their ability to enhance the activity of antibiotics for local treatment of localized biofilm infections. Methods Staphylococcus aureus and Pseudomonas aeruginosa in vitro biofilm models were developed. The putative antibiotic enhancers N-acetylcysteine, acetylsalicylic acid, sodium salicylate, recombinant human deoxyribonuclease I, dispersin B, hydrogen peroxide and Johnson’s Baby Shampoo (JBS) were tested for their anti-biofilm activity alone and their ability to enhance the activity of antibiotics for 7 or 14 days, against 5 day old biofilms. The antibiotic enhancers were paired with rifampicin and clindamycin against S. aureus and gentamicin and ciprofloxacin against P. aeruginosa. Isolates from biofilms that were not eradicated were tested for antibiotic resistance. Results Antibiotic levels 10× MIC and 100× MIC significantly reduced biofilm, but did not consistently eradicate it. Antibiotics at 100× MIC with 10% JBS for 14 days was the only treatment to eradicate both staphylococcal and pseudomonal biofilms. Recombinant human deoxyribonuclease I significantly reduced staphylococcal biofilm. Emergence of resistance of surviving isolates was minimal and was often associated with the small colony variant phenotype. Conclusions JBS enhanced the activity of antibiotics and several other promising anti-biofilm agents were identified. Antibiotics with 10% JBS eradicated biofilms produced by both organisms. Such combinations might be useful in local treatment of localized biofilm infections

LIQUIFIED NATURAL GAS (LNG) CARRIERS

Moderni brodovi za prijevoz ukapljenog prirodnog plina su brodovi s dvostrukim dnom čija se klasifikacija vrši prema tipu spremnika. Spremnici su posebno projektirani budući da se u njima skladišti prirodni plin ohlađen na -161 °C, što je temperatura vrelišta metana. Bitna karakteristika ukapljenog prirodnog plina je visoka zapaljivost, o čemu treba voditi računa pri projektiranju i rukovanju brodom. Razvoj brodova za ukapljeni prirodni plin započeo je sredinom dvadesetog stoljeća. Veličina skladišnog prostora tih brodova stupnjevito je rasla do današnje maksimalne veličine od oko 260000 m3. Svjetska flota brodova za ukapljeni prirodni plin danas broji više od 300 plovila.Modern liquefied natural gas carriers are double-bottom ships classified according to the type of LNG tank. The tanks are specially designed to store natural gas cooled to -161°C, the boiling point of methane. Since LNG is highly flammable, special care must be taken when designing and operating the ship. The development of LNG carriers has begun in the middle of the twentieth century. LNG carrier storage space has gradually grown to the current maximum of 260000 m3. There are more than 300 LNG carriers currently in operation

Indistinctly Synchronous Lung and Base of the Tongue Adenocarcinoma: Case Report and Discussion of Possi- ble Patterns of Disease Development

Adenokarcinom pluća čini oko 40% svih karcinoma pluća i karakteriziraju ga različite stanične i molekularne značajke. Česte su udaljene metastaze iz primarnog karcinoma pluća, međutim metastaze u jeziku prilično su rijetke i neočekivane. Ako postoje dokazi o metastazama u jeziku, primarni tumor je najvjerojatnije širen, a prognoza loša. Takvi pacijenti zahtijevaju cjelovitu obradu kako bi se procijenio opseg bolesti, jer stadij tumora igra glavnu ulogu u određivanju izbora liječenja. U ovom slučaju želimo predstaviti neobičan slučaj istodobnog adenokarcinoma pluća i baze jezika i razgovarati o mogućim obrascima razvoja bolesti.Lung adenocarcinoma accounts for about 40% of all lung cancers and is characterized by distinct cellular and molecular features. Distant metastases from primary lung cancer are frequent, howev- er metastasis of the tongue is quite rare and unexpected. If there is existing evidence of metastasis in tongue, primary tumor is most probably generally disseminated and prognosis is poor. Such patients require a complete staging workup to evaluate the extent of disease, because tumor stage plays a major role in determining the choice of treatment. In this case report we want to present an unusual case of simultaneous lung and base of the tongue adenocarcinoma and discuss the possible patterns of disease development