DEVELOPMENT OF THE IMPROVED METHODS OF FIGHT AGAINST DISTRIBUTION OF SMOKE ON SHIP WITH SYSTEMS OF JET WATER–GAS EJECTORS

The ways of improving the design of ship openings with the implementation of a method for reducing the intensity of the exit of flue gases through an opening (doors, hatches) of the emergency premise of the ship are considered. The output of flue gases from the emergency premise is proposed to be controlled by the control of gas–air currents with the help of a system of jet water–gas ejectors. Ejectors are equipped with devices for collecting flue gases from the emergency premise of the ship and the collectors of the output of the vapor–gas mixture back to the emergency premise. In case of fire, in the shortest possible time, a high temperature rises in the area of exit from the emergency premise of the ship and a large amount of smoke spreads along the corridors and premises of the ship. These factors require immediate sealing of the emergency premise, which limits the operational access of emergency teams to combat fire. The considered air suppression methods in the ship's aperture and devices for their implementation contribute to screening of heat energy and localization of flue gases in the emergency premise without its sealing to ensure prompt access of emergency teams

Bilateral Inferior Altitudinal Defects Secondary to Stroke: A Case Series

Strokes or cerebrovascular accidents are the third leading cause of death in Canada, comprising 6% of all deaths in the country.1 The elderly and the very young (fetus or newborn infants) are at highest risk for having a stroke with an associated increased risk of death or lasting neurological disability. According to the National Stroke Association recovery guidelines, 10% of stroke survivors will recover almost completely, 25% will recover with minor impairments, 40% will survive with moderate to severe impairments that require specialized care, 10% will require care in a long-term care facility, and 15% will die shortly after the stroke. The National Stroke Association estimates that there are 7 million people in the United States that have survived a stroke and are living with impairments. The Heart and Stroke Foundation’s 2013 Stroke Report has estimated that 315,000 Canadians are living with the effects of stroke. This case series serves as a reminder that, although rare, bilateral inferior altitudinal visual field defects can also occur as the result of a stroke, to highlight the difficulties of orientation and mobility that can result, and to offer potential rehabilitative strategies

Dry Eye: Age-related prevalence, correlation between symptoms and diagnoses, and significant associations

This study determined the prevalence of dry eye (DE) symptoms and clinical diagnosis over the age range of the human lifespan, the correlation of symptoms with diagnosis, and factors associated with DE. Data was abstracted from WatES, a retrospective file review (n=6397) of patient examinations at the University of Waterloo Optometry Clinic. The prevalence of DE symptoms and diagnosis were determined overall, in five year age groups and for individual symptoms. Using logistic regression, each symptom was analyzed for a significant association with DE diagnosis. Ocular and systemic factors, and common medications were analyzed for association with DE symptoms or diagnosis. Of all patients (0-93 years) 543 (8.5%) presented with DE symptoms. Prevalence within age groups was greatest for patients 30<35 (11.4 %) and 75<80 years (13.7 %). DE was diagnosed in 1140 patients (17.8%). Prevalence increased by 3.0% per year of age. No sex-related differences in meibomian gland dysfunction as a function of age were found. Less than half (43.5%) of symptomatic patients were diagnosed with DE. The following symptoms were associated with a DE diagnosis: dryness (OR= 7.56, 5.30-10.77 95% CI), injection (OR=3.62, 2.04-6.43 95%CI), burning/stinging/soreness (OR=2.67, 1.69-4.23 95%CI), and watery eyes/tearing (OR=1.66, 1.12-2.45 95%CI). Anterior blepharitis (OR=2.46, 2.05-2.95), being female (OR=1.24, 1.06-1.40 95%CI), contact lens wear (OR=1.34, 1.06-1.70 95%CI), and environmental allergies (OR=1.18, 1.00-1.41 95% CI) were statistically associated with a diagnosis of DE. In summary, specific presenting symptoms predicted DE diagnosis, DE was diagnosed in patients of all ages, and its prevalence increased steadily with age

The importance of drug metabolites synthesis: the case-study of cardiotoxic anticancer drugs

Anticancer drugs are presently guarantying more survivors as a result of more powerful drugs or combinations of drugs used in therapy. Thus, it has become more crucial to study and overcome the side effects of these therapies. Cardiotoxicity is one of the most relevant side effects on the long-term cancer survivors, because of its high social and economic impact. Drug metabolism can result in active metabolites or toxic metabolites that can lead to important side effects. The metabolites of anticancer drugs are possible culprits of cardiotoxicity; however, the cardiotoxicity of many of the metabolites in several drug classes was not yet suitably studied so far. On the other hand, the use of prodrugs that are bioactivated through metabolism can be a good alternative to obtain more cardio safe drugs. In this review, the methods to obtain and study metabolites are summarized and their application to the study of a group of anticancer drugs with acknowledged cardiotoxicity is highlighted. In this group of drugs, doxorubicin (DOX, 1), mitoxantrone (MTX, 2), cyclophosphamide (CTX, 3) and 5-fluorouracil (5-FU, 4) are included, as well as the tyrosine kinase inhibitors, such as imatinib (5), sunitinib (6) and sorafenib (7). Only with the synthesis and purification of considerable amounts of the metabolites can reliable studies be performed, either in vitro or in vivo that allow accurate conclusions regarding the cardiotoxicity of anticancer drug metabolites and then pharmacological prevention or treatment of the cardiac side effects can be done. © 2017 Informa UK Limited, trading as Taylor & Francis Group.This work was supported by FEDER funds through the Operational Programme for Competitiveness Factors?COMPETE and by national funds by the Funda??o para a Ci?ncia e Tecnologia (FCT) FCT/MCTES?Foundation for Science and Technology from the Minister of Science, Technology and Higher Education (PIDDAC) and European Regional Development Fund (ERDF) through the COMPETE?Programa Operacional Factores de Competitividade (POFC) programme, within the projects ?PTDC/DTP-FTO/1489/2014?POCI-01-0145-FEDER-016537?, in the framework of the programme PT2020 and by the project INNOVMAR - Innovation and Sustainability in the Management and Exploitation of Marine Resources (reference NORTE-01-0145-FEDER-000035, within Research Line NOVELMAR), supported by North Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). V.M.C. (SFRH/BPD/110001/2015) acknowledges ?Funda??o para a Ci?ncia e Tecnologia (FCT)? for her Post Doc grant

Sécheresse oculaire: Prévalence liée à l’âge, corrélation entre les symptômes et les diagnostics, et associations importantes

Cette étude canadienne a permis de déterminer la prévalence des symptômes de la sécheresse oculaire (SO) et le diagnostic clinique au cours de la vie humaine, la corrélation des symptômes avec un diagnostic et les facteurs associés à la SO. Les données ont été tirées de WatES, un examen rétrospectif des dossiers (n=6 397) d’examens de patients à la clinique d’optométrie de l’Université de Waterloo. La prévalence des symptômes et du diagnostic de la SO a été déterminée globalement, dans les groupes d’âge de cinq ans et pour les symptômes individuels. Chaque symptôme a été analysé par régression logistique afin de déterminer s’il y avait un lien significatif avec un diagnostic de SO. On a analysé les facteurs oculaires et systémiques ainsi que les médicaments courants en vue de déterminer leur association avec les symptômes ou le diagnostic de la SO. Parmi tous les patients (0 à 93 ans), 543 (8,5 %) présentaient des symptômes de SO. En ce qui concerne les groupes d’âge, la prévalence la plus élevée a été observée chez les patients de 30 à 35 ans (11,4 %) et de 75 à 80 ans (13,7 %). La SO a été diagnostiquée chez 1 140 patients (17,8 %). La prévalence augmentait de 3,0 % par année d’âge. Aucune différence liée au sexe dans le dysfonctionnement des glandes de Meibomius en fonction de l’âge n’a été décelée. Moins de la moitié (43,5 %) des patients symptomatiques ont reçu un diagnostic de SO. Les symptômes suivants ont été associés à un diagnostic de SO : sécheresse (RC = 7,56, 5,30-10,77 IC à 95 %), yeux rouges (RC = 3,62, 2,04-6,43 IC à 95 %), brûlure/piqûre/douleur (RC = 2,67, 1,69-4,23 IC à 95 %) et larmoiement des yeux (RC = 1,66, 1,12-2,45 IC). La blépharite antérieure (RC=2,46, 2,05-2,95), les femmes (RC=1,24, 1,06-1,40 IC à 95 %), le port de lentilles de contact (RC=1,34, 1,06-1,70 IC à 95 %) et les allergies environnementales (RC=1,18, 1,00-1,41 IC à 95 %) étaient associés de façon significative à un diagnostic de SO. Cette étude est unique en ce sens qu’elle couvre toute la durée de vie humaine pour le diagnostic de la sécheresse oculaire, les symptômes et le dysfonctionnement des glandes de Meibomius (DGM) et qu’elle fournit des données sur la prévalence de la sécheresse oculaire au Canada

Habitual wearers of colored lenses adapt more rapidly to the color changes the lenses produce

The visual system continuously adapts to the environment, allowing it to perform optimally in a changing visual world. One large change occurs every time one takes off or puts on a pair of spectacles. It would be advantageous for the visual system to learn to adapt particularly rapidly to such large, commonly occurring events, but whether it can do so remains unknown. Here, we tested whether people who routinely wear spectacles with colored lenses increase how rapidly they adapt to the color shifts their lenses produce. Adaptation to a global color shift causes the appearance of a test color to change. We measured changes in the color that appeared “unique yellow”, that is neither reddish nor greenish, as subjects donned and removed their spectacles. Nine habitual wearers and nine age-matched control subjects judged the color of a small monochromatic test light presented with a large, uniform, whitish surround every 5 s. Red lenses shifted unique yellow to more reddish colors (longer wavelengths), and greenish lenses shifted it to more greenish colors (shorter wavelengths), consistent with adaptation “normalizing” the appearance of the world. In controls, the time course of this adaptation contained a large, rapid component and a smaller gradual one, in agreement with prior results. Critically, in habitual wearers the rapid component was significantly larger, and the gradual component significantly smaller than in controls. The total amount of adaptation was also larger in habitual wearers than in controls. These data suggest strongly that the visual system adapts with increasing rapidity and strength as environments are encountered repeatedly over time. An additional unexpected finding was that baseline unique yellow shifted in a direction opposite to that produced by the habitually worn lenses. Overall, our results represent one of the first formal reports that adjusting to putting on or taking off spectacles becomes easier over time, and may have important implications for clinical management

Clinical Reasoning Assessment Methods

© by the Association of American Medical Colleges. Purpose An evidence-based approach to assessment is critical for ensuring the development of clinical reasoning (CR) competence. The wide array of CR assessment methods creates challenges for selecting assessments fit for the purpose; thus, a synthesis of the current evidence is needed to guide practice. A scoping review was performed to explore the existing menu of CR assessments. Method Multiple databases were searched from their inception to 2016 following PRISMA guidelines. Articles of all study design types were included if they studied a CR assessment method. The articles were sorted by assessment methods and reviewed by pairs of authors. Extracted data were used to construct descriptive appendixes, summarizing each method, including common stimuli, response formats, scoring, typical uses, validity considerations, feasibility issues, advantages, and disadvantages. Results A total of 377 articles were included in the final synthesis. The articles broadly fell into three categories: non-workplace-based assessments (e.g., multiple-choice questions, extended matching questions, key feature examinations, script concordance tests); assessments in simulated clinical environments (objective structured clinical examinations and technology-enhanced simulation); and workplace-based assessments (e.g., direct observations, global assessments, oral case presentations, written notes). Validity considerations, feasibility issues, advantages, and disadvantages differed by method. Conclusions There are numerous assessment methods that align with different components of the complex construct of CR. Ensuring competency requires the development of programs of assessment that address all components of CR. Such programs are ideally constructed of complementary assessment methods to account for each method\u27s validity and feasibility issues, advantages, and disadvantages

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

<p>Abstract</p> <p>Background</p> <p>Although a leading cause of visual impairment and a treatable cause of blindness globally, the pattern of refractive errors in many populations is unknown. This study determined the pattern of refractive ocular conditions, reasons for spectacles renewal and the effect of correction on refractive errors in a resource-limited community.</p> <p>Methods</p> <p>A retrospective review of case records of 1,413 consecutive patients seen in a private optometry practice, Nigeria between January 2006 and July 2007.</p> <p>Results</p> <p>A total number of 1,216 (86.1%) patients comprising of (486, 40%) males and (730, 60%) females with a mean age of 41.02 years SD 14.19 were analyzed. The age distribution peaked at peri-adolescent and the middle age years. The main ocular complaints were spectacles loss and discomfort (412, 33.9%), blurred near vision (399, 32.8%) and asthenopia (255, 20.9%). The mean duration of ocular symptoms before consultation was 2.05 years SD 1.92. The most common refractive errors include presbyopia (431, 35.3%), hyperopic astigmatism (240, 19.7%) and presbyopia with hyperopia (276, 22.7%). Only (59, 4.9%) had myopia. Following correction, there were reductions in magnitudes of the blind (VA<3/60) and visually impaired (VA<6/18-3/60) patients by (18, 58.1%) and (89, 81.7%) respectively. The main reasons for renewal of spectacles were broken lenses/frame/scratched lenses/lenses' falling off (47, 63.4%).</p> <p>Conclusions</p> <p>Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years.</p