Search

Imaging is essential for managing COVID-19 pneumonia. In resource-limited settings, chest radiography is the only practicable imaging modality. The Brixia radiographic scoring system, an objective method of assessing pulmonary involvement, is yet to be studied in India. (a) To study the association between the clinical severity of COVID-19 patients with their Brixia scores and, (b) to evaluate the utility of the score as a predictor for invasive ventilation. Peripheral rural hospital by Indian Armed Forces; Cross-sectional study. A thousand patients diagnosed with COVID-19 and hospitalized were classified as having a mild, moderate, and severe disease based on their least oxygen saturation (SpO2 >94: mild, between 90-94: moderate, and <90: severe) recorded. The highest Brixia score was calculated for each patient. The mean Brixia scores of the three groups were compared. The Brixia score of each intubated patient was calculated as was the mean score of all intubated patients. Statistical analysis was performed on SPSS software. Seven hundred fifty-six (756) patients were classified as mild, 104 as moderate, and 140 as severe with a mean Brixia score of 0.12, 2.35, and 10.9, with a standard deviation of 0.66, 2.98, and 2.66, respectively. The difference in means between these groups was statistically significant (p < 0.0001). The median Brixia score of 13 for the intubated patients was significantly higher than for the non-intubated. The clinical severity of the patients and their requirement for invasive ventilation correlated well with their Brixia scores. The Brixia system may be usefully incorporated into our Medicare systems. [ABSTRACT FROM AUTHOR]

The economic significance of Internet of Things (IoT) platforms is evident from the proliferation of smart home assistant platforms like Amazon Alexa and Google Home that center themselves around providing unique and connected experiences to users. Customers do not perceive these platforms valuable if they do not experience adequate levels of quality and security from both the platform and applications (apps) they use. Therefore, the IoT platform provider as well as app developers need to go beyond collaboration and cocreate quality and security for each app on the platform. In this setting, we study the dynamics of the financial sustainability of the platform provider and app developers and find that the collaborative nature of the IoT platform has a significant role in the behavior and profitability of all parties. Specifically, a neutral entrant to the platform not only increases the effort levels of all existing parties, but also increases the profits due to network effects that are intertwined with economies of scale. We further find that a substantial number of apps are needed in the platform for an economically viable platform and that a less efficient platform leader needs even a larger application base. However, based on the number of apps on the platform and which party is more effective in the collaboration, the platform provider might need to provide additional incentives, or sometimes, extract additional rent from the app developers to financially sustain the platform. Furthermore, we verify our results in the presence of competition or complementarity among apps and further derive additional interesting results and managerial insights. For example, we find that the entry of a competing app may be beneficial for existing apps under some conditions. [ABSTRACT FROM AUTHOR]

This paper proposes the use of a multicriteria assessment technique to evaluate the methane flow during gas extraction from a sanitary landfill. A number of parameters determine the gas generation and the feasibility for its extraction from a landfill. These parameters form a complex set of information with unknown mathematical interrelationships making potential gas flow evaluations difficult and elusive. In addition, the data available for a particular landfill are very often imprecise, uncertain, or subjective, making it even more difficult to evaluate the potential for gas extraction without conducting pilot tests. The method proposed in this paper uses fuzzy composite programming that allows for the use of imprecise information. A landfill gas potential index has been defined, which can be determined by easily obtainable climatological, geological, and landfill parameters. The landfill gas (LFG) potential index is related to the landfill gas flow using an empirical equation. The LFG potential model was calibrated and verified using data obtained from 61 landfills where gas extraction is being conducted. A sensitivity analysis was done to study the impact of variations in the input data on model output. CE Database subject headings: Landfills; Municipal wastes; Fuzzy sets; Gas flow; Methane; Energy.

Abstract Introduction Eosinophilic mucin rhinosinusitis is an inflammatory pathological condition of the nose and paranasal sinuses. It is rare, occurs in immunocompetent patients and is characterised by peripheral eosinophilia and extensive bilateral sinus disease. To the best of our knowledge, visual loss with this condition has not been previously reported. Case presentation We present the case of a 26-year-old Asian woman with a background history of chronic sinusitis who presented with acute left-sided visual loss. Imaging showed significant opacification in the frontal, ethmoidal and sphenoidal sinuses as well as evidence of a unilateral optic neuritis. Histological analysis of sinus mucin revealed dense eosinophilic infiltrate and, despite medical and surgical intervention, vision was not restored in her left eye. Conclusion We introduce visual loss as a complication of eosinophilic mucin rhinosinusitis. This adds further evidence to previous reports in the literature that optic neuropathy in sinusitis can occur secondary to non-compressive mechanisms. We also describe a rare finding: the vision in this patient did not improve following steroid therapy, antifungal therapy or surgical intervention. There are very few such cases described in the literature. We conclude that chronic sinusitis is an indolent inflammatory process which can cause visual loss and we reiterate the importance of recognizing and considering sinusitis as a cause of visual loss in patients in order that prompt medical and surgical treatment of the underlying disease can be initiated.

In India, high strength spent wash (SW) produced from alcohol distilleries is preferably treated by biomethanation process. However, biomethanated SW (BMSW) still contains intensified dark brown colour, high chemical oxygen demand (COD) and poor biodegradability which requires further treatment before disposal. Wet oxidation (WO) is considered an effective treatment for high strength non-biodegradable wastewaters (COD > 10 g/L). Hence, the present study explored WO of BMSW (pH = 5.7, COD = 65.5 g/L, and total organic carbon (TOC) = 23.5 g/L) in a high pressure batch reactor (0.7 L capacity) at temperatures ranging from 160-220°C and oxygen pressure of 1.1 MPa. At 220°C temperature, TOC, COD and color removals of 39%, 59% and 90%, respectively, were observed after 3 h of reaction period. Meanwhile, biodegradability index (BI) was enhanced from 0.27 to 0.81. Carbon balance calculations showed that the oxidation reaction contribution in TOC removal was enhanced with increase in temperature (64 - 92% of total carbon removal). Fourier transform infrared (FTIR) analysis suggested the precipitation of carbonyl group and nitrogen containing compounds. During the reaction, volatile fatty acids (oxalic acid, malonic acid and acetic acid) formation was also confirmed in the treated wastewater. [ABSTRACT FROM AUTHOR]

With the rise in living standards and evolution of science, there is a rise in life expectancy world over. This demographic transition has led to a rise in older persons, increasing the dependency ratios and "demographic burden." Management of such old patients requires special considerations and understanding as aging is a physiological phenomenon in which the functional capacity of organs decreases due to degenerative changes in the structure. An important aspect to remember in Geriatric Anesthesia is that in spite of adequate compensatory mechanisms for age-related changes, there is a limitation of physiological reserve, especially in stressful circumstances like perioperative period. Geriatric patients are more sensitive to all medications and anesthetic agents. Lesser amount of drug is required to achieve the desired clinical effect, but have a prolonged effect. This elderly but well-preserved patient, possibly a case of small gut obstruction was posted for emergency laparoscopy and proceed. Seeing his age and easy friability, a well-planned preoperative assessment and optimization was done prior to wheeling him into operation theater. Administration of short-acting anesthetic drugs in titrated quantities and awareness about postoperative cognitive dysfunction (POCD) helped us to get better and faster recovery in the patient. [ABSTRACT FROM AUTHOR]