bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the social status, risk factors and lifestyle changes of tuberculosis patients in Sri Lanka during the treatment period: a cross-sectional study
Authors: Buddhika Senanake Madapathage Gayan , Wickramasinghe Sumudu Indika , Samaraweera Sudath , De Silva Pubudu , Edirippulige Sisira
Published: January 2020

Background: Tuberculosis (TB) is a major global health problem, commonly seen in underdeveloped countries. The probability of contracting the disease is significantly higher among the economically vulnerable and the socially disadvantaged. Risk factors associated with TB can also change over time. In the Sri Lankan context, no study has explored how these factors impact patients. Therefore, we aimed to explore social status, associated risk factors and lifestyle changes during the treatment period of TB patients attending a tertiary respiratory center in Colombo, Sri Lanka.
Methods: The descriptive cross-sectional study was conducted in 2011. The study population consisted of diagnosed tuberculosis patients above the age of 15 years. Patient records were retrieved from the TB patient registry for the Colombo district. Systematic sampling was used to identify patients to be invited to the study. An interviewer-administered questionnaire was used for data collection. Data were collected on social status (example, level of education, employment, and income), associated risk factors (example, smoking and alcohol consumption, contact history, narcotic drug use) and lifestyle changes during treatment (example, employment status, social interactions). The analysis included a logistic regression model to explore the association between social status and risk factors.
Results: The total number of patients included in the study was 425. Tuberculosis was found to be strongly prevalentamong participants from the lower socio-economic status. It was also common in participants with a low level of education, unemployed, if employed, those who are engaged in unskilled employment and have low levels of income.
Risk factors associated with the patients were smoking, alcohol consumptions, narcotic drug use, imprisonment, closecontact history with active TB patients and chronic medical conditions. Changes in employment and the reduction ofsocial-interactions were the main lifestyle changes of the participants occurred during the treatment period. The analysis also showed positive correlation between low-level social status and sputum smear infectivity, and use of dangerous drugs. Even after adjusting for confounders, tuberculosis negatively affected social interactions and income levels of participants from the low social status.
Conclusion: Low socio-economic status negatively affected the lifestyle and social interactions of patients during the treatment period. Though competent treatment programs exist in Sri Lanka, it is still important to identify and mitigate risk factors associated with tuberculosis patients. A comprehensive multi-disciplinary approach considering patient lifestyle,  and the implications of the disease and treatment on social interactions may strengthen the current preventive strategies.
Quick relaxation exercise for people with chronic obstructive pulmonary disease: explorative randomized controlled trial
Authors: Volpato Eleonora , Banfi Paolo , Nicolini Antonello , Pagnini Francesco
Published: January 2020

Background: People with Chronic Obstructive Pulmonary Disease (COPD) suffer from dyspnoea, which may be increased by anxiety. Previous studies suggest that relaxation techniques may have positive effects in pulmonary rehabilitation. The main aim of this study is to explore the clinical impact of a quick, one-session, relaxation training for people with COPD. Methods: In this perspective, 38 participants with COPD were recruited and randomly assigned to listen to a relaxing audio or to watch a neutral stimulus, during their routine exams. Participants were assessed for psychological and physiological variables, analysed through non-parametric tests. Results: Those who joined the relaxation training showed more positive outcomes about respiratory and cardiac assessments, as well as for state anxiety and positive affections, in comparison with the baseline and the control group. Conclusions: Study results suggest that relaxation has a potential to produce improvements in respiratory and cardiac functions, together with a positive emotional effect and a reduction of anxiety.
Outdoor air pollution and respiratory health: a bibliometric analysis of publications in peer-reviewed journals (1900 – 2017)
Authors: Sweileh Waleed M. , Al-Jabi Samah W. , Zyoud Sa’ed H. , Sawalha Ansam F.
Published: January 2020

Background: Outdoor air pollution is a major threat to global public health that needs responsible participation of researchers at all levels. Assessing research output is an important step in highlighting national and international contribution and collaboration in a certain field. Therefore, the aim of this study was to analyze globally-published literature in outdoor air pollution – related respiratory health.

Method: Outdoor air pollution documents related to respiratory health were retrieved from Scopus database. The study period was up to 2017. Mapping of author keywords was carried out using VOSviewer 1.6.6.

Results: Search query yielded 3635 documents with an h-index of 137. There was a dramatic increase in the number of publications in the last decade of the study period. The most frequently encountered author keywords were: air pollution (835 occurrences), asthma (502 occurrences), particulate matter (198 occurrences), and children (203 occurrences). The United States of America ranked first (1082; 29.8%) followed by the United Kingdom (279; 7. 7%) and Italy (198; 5.4%). Annual research productivity stratified by income and population size indicated that China ranked first (22.2) followed by the USA (18.8). Analysis of regional distribution of publications indicated that the Mediterranean, African, and South-East Asia regions had the least contribution. Harvard University (92; 2.5%) was the most active institution/organization followed the US Environmental Protection Agency (89; 2.4%). International collaboration was restricted to three regions: Northern America, Europe, and Asia. The top ten preferred journals were in the field of environmental health and respiratory health. Environmental Health Perspective was the most preferred journal for publishing documents in outdoor pollution in relation to respiratory health.

Conclusion: Research on the impact of outdoor air pollution on respiratory health had accelerated lately and is receiving a lot of interest. Global research networks that include countries with high level of pollution and limited resources are highly needed to create public opinion in favor of minimizing outdoor air pollution and investing in green technologies.
Effect of pirfenidone on wound healing in lung transplant patients
Authors: Mortensen Amber , Cherrier Lauren , Walia Rajat
Published: January 2020

Background: The drug pirfenidone has been shown to slow the progression and decrease mortality of idiopathic pulmonary fibrosis (IPF). Its exact mechanism is unknown, but it likely inhibits pro-fibrotic cytokine transforming  growth factor beta, a known contributor to wound healing. We evaluated whether patients taking pirfenidone until lung transplantation had increased risk of impaired wound healing post-transplant. This information could determine whether pirfenidone should be discontinued prior to listing to allow for a wash-out period. Methods: We retrospectively reviewed patients who underwent lung transplantation for pulmonary fibrosis at Norton Thoracic Institute in Phoenix, Arizona, from January 2014 to December 2015. Results: We describe 18 patients who took pirfenidone up to a month before transplant. Aside from one patient who experienced sternal dehiscence due to a surgical issue, all remaining patients did well with no evidence of airway dehiscence. Each of these 17 patients had been on pirfenidone for at least 30 days; nine patients had been on pirfenidone for over 90 days. Baseline characteristics including age, sex, body mass index, renal function, liver function, glucose level, pre-transplant corticosteroid use, and post-transplant immunosuppressant therapy were similar. Conclusions: In our experience, pirfenidone may be safely continued until lung transplantation. Only one patient in our series experienced impaired wound healing related to a surgical issue, even when pirfenidone was continued until lung transplantation. We found no evidence of impaired wound healing or airway complications after lung transplantation in patients who were treated with pirfenidone before lung transplantation.
Nurses and physicians’ viewpoints about decision making of do not attempt resuscitation (DNAR)
Authors: Fallahi Masoud , Mahdavikian Somaye , Abdi Alireza , Borhani Fariba , Taghizadeh Parvin , Hematpoor Behzad
Published: January 2020

Background: Despite advances with regard to “do not attempt resuscitation order”, physicians are still reluctant to implement it. In fact, while the nurses could be of great help in making decision about “do not attempt resuscitation order,” they are mostly neglected in this process. The current study was conducted to determine the nurses and physicians’ viewpoints about decision making process of “do not attempt resuscitation order”. Methods: A descriptive analytical study was carried out with participation of 152 physicians and 152 nurses. The participants were selected through stratified quota sampling from three educational hospitals affiliated with Kermanshah University of Medical Sciences. Data gathering tools were a demographics checklist and a researcher-designed questionnaire with 20 statements for measuring the attitudes of the respondents about the decision-making process and implementation of “do not attempt resuscitation order” of incurable patients. Results: Totally, 304 respondents (152 nurses and 152 physicians) participated in the study. The nurses’ attitude score about the consent of the competent patients to “do not attempt resuscitation” was significantly lower in comparison with the physicians, (p < 0.001). However, the nurses’ attitude was more positive than the physicians attitude about the belief that “taking the patient’s consent is the physician’s responsibility” (p < 0.001). Moreover, the nurses’ attitude was more negative compared with the physicians’ attitude about the idea that “obtaining the patient’s consent is the nurse’s responsibility” (p < 0.001). Both groups believed that the nurses cannot recommend “do not attempt resuscitation order” (p < 0.770). Both groups of the respondents believed that the nurses were not qualified to issue the “do not attempt resuscitation order” (physicians’ mean score = 2.85, nurses’ mean score = 2.89). The physicians’ believe in “necessity to negotiate with the nurses about the order” was less deep than that of the nurses (p = 0.035). Conclusions: Given the different attitudes of the nurses and the physicians about the decision-making process of “do not attempt resuscitation,” it is necessary to codify a medical guideline and clarify the decision making and implementation process. The guideline needs to clearly state physician's, nurse's, patient's, and other medical team members’ responsibilities and roles, respectively.
Predictors of yearly influenza vaccination in hospitalized and community-based patients
Authors: Attard Camilleri Stephanie , Casingena Juanita Camilleri , Yamagata Kentaro , Balzan Martin
Published: January 2020

Background: Understanding positive and negative influences on adult immunization status can help healthcare providers to better identify and target patients who are likely to need immunization. Our aim was to assess and compare influenza and pneumococcal (IV/PV) immunisation rates to identify vaccination predictors in Malta.

Methods: One group consisted of all medical patients discharged from Mater Dei Hospital (MDH) over a one week period in February 2013. Patients were administered a phone questionnaire. A second group of patients receiving community-based care at local health centres over a one week period in March 2013 were interviewed, identifying vaccination eligibility as per 2010 WHO recommendations.

Results: A total of 150 community (Mean age 61.5 SD 15.8, Male 60%) and 149 hospitalised (Mean age 66.8, SD 13. 6%, Male 48.3%) patients in whom influenza vaccine was indicated were recruited. In the current year, 44 and 48.3% received the seasonal influenza vaccine, while 32.0, and 49% vaccinated yearly respectively. Pneumococcal vaccination advice was less than 5% in both groups. On stepwise binary regression, vaccination predictors for the current year were regular yearly influenza vaccination (OR 93.62, CI: 31.8–275.5, p < 0.001) and vaccination reminders (OR 27.5, CI: 9.63–78.31, p < 0.001). Nursing home residence (OR 5.78, CI: 1.22–27.4,p = 0.011), congestive cardiac failure (OR 2.11, CI: 1.1–4.08, p = 0.02) and diabetes mellitus (OR 1.68, CI: 1.04–2.72, p = 0.034) were all predictors for vaccination on exclusion of the strongest two predictors. For successive yearly vaccination, influenza vaccine recommendation by healthcare professionals (OR 12.35, CI: 4.5–33.91, p < 0.001) and vaccination reminders (OR 5.99, CI: 3.13–11.45, p < 0.01) were main predictors. Congestive cardiac failure (OR 2.37, CI: 1.20–4.7, p = 0.13) and nursing home residence (OR 7.07, CI: 1.45–34.5, p = 0,005) were also positive predictors. Male gender was a negative predictor (OR 0.51, CI: 0.31–0.83, p = 0.006). Some of those who did not vaccinate were unaware of such need (40.5% of community and 15.6% of hospitalised patients).

Conclusions: Just under half of the patient population received the IV during 2012–2013 period. Hospitalized patients are more likely to vaccinate regularly while a large proportion of community patients are unaware of the indication to vaccinate.
Breathlessness, but not cough, suggests chronic obstructive pulmonary disease in elderly smokers with stable heart failure
Authors: Clini Enrico M. , Roversi Sara , Beghè Bianca , Schito Michela , Garofalo Martina , Stendardo Mariarita , Ruggieri Valentina , Tonelli Roberto , Fucili Alessandro , D’Amico Roberto , Banchelli Federico , Fabbri Leonardo M.
Published: January 2020

Chronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD. Patients with HF and COPD were more symptomatic, but only breathlessness when walking up a hill was an independent predictor of COPD (odds ratio = 1.33, p = 0.0484). Interestingly, COPD-specific symptoms such as cough and phlegm were not significant. Thus, in elderly smokers with stable HF, significant breathlessness when walking up a hill is most indicative of associated COPD, and may indicate the need for further lung function evaluation.
Alpha-1 antitrypsin deficiency as a common treatable mechanism in chronic respiratory disorders and for conditions different from pulmonary emphysema? A commentary on the new European Respiratory Society statement
Authors: Aliberti Stefano , Gramegna Andrea , Confalonieri Marco , Corsico Angelo , Richeldi Luca , Vancheri Carlo , Blasi Francesco
Published: January 2020

Background: The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease. Main body: The clinical spectrum of AATD lung disease might include different manifestations and the traditional paradigm of a younger emphysematous patient has been revealing insufficient. Targeting with appropriate testing only COPD patients might be considered a limited approach leading to underestimation of the real prevalence of the disease. Several reports have suggested the association between AATD and other chronic respiratory conditions, as asthma and bronchiectasis. A deeper evaluation of clinical, radiological, microbiological and functional variables is, therefore, needed in order to investigate different phenotypes in AATD patients. In addition, a new line of translational research in AATD might focus on the development of personalized therapeutic regimens taking into account the patient clinical profile and needs. Conclusions: Over the past years, AATD has been interpreted as a common mechanism of inflammatory disequilibrium and tissue damage across different conditions. Future research is gradually pointing toward this new paradigm by expanding the evidence of the role of AAT as a potent immunomodulatory and anti-inflammatory drug in conditions different from pulmonary emphysema.
Assessment of survival in patients with idiopathic pulmonary fibrosis using quantitative HRCT indexes
Authors: Torrisi Sebastiano Emanuele , Palmucci Stefano , Stefano Alessandro , Russo Giorgio , Torcitto Alfredo Gaetano , Falsaperla Daniele , Gioè Mauro , Pavone Mauro , Vancheri Ada , Sambataro Gianluca , Sambataro Domenico , Mauro Letizia Antonella , Grassedonio Emanuele , Basile Antonio , Vancheri Carlo
Published: January 2020

Background: The assessment of Idiopathic Pulmonary Fibrosis (IPF) using HRCT requires great experience and is limited by a significant inter-observer variability, even between trained radiologists. The evaluation of HRCT through automated quantitative analysis may hopefully solve this problem. The accuracy of CT-histogram derived indexes in the assessment of survival in IPF patients has been poorly studied. Methods: Forty-two patients with a diagnosis of IPF and a follow up time of 3 years were retrospectively collected; HRCT and Pulmonary Function Tests (PFTs) performed at diagnosis time were analysed; the extent of fibrotic disease was quantified on HRCT using kurtosis, skewness, Mean Lung Density (MLD), High attenuation areas (HAA%) and Fibrotic Areas (FA%). Univariate Cox regression was performed to assess hazard ratios for the explored variables and a multivariate model considering skewness, FVC, DLCO and age was created to test their prognostic value in assessing survival. Through ROC analysis, threshold values demonstrating the best sensitivity and specificity in predicting mortality were identified. They were used as cut-off points to graph Kaplan-Meier curves specific for the CT-indexes. Results: Kurtosis, skewness, MLD, HAA% and FA% were good predictors of mortality (HR 0.44, 0.74, 1.01, 1.12, 1.06; p = 0.03, p = 0.01, p = 0.02, p = 0.02 and p = 0.017 respectively). Skewness demonstrated the lowest Akaike’s information criterion value (55.52), proving to be the best CT variable for prediction of mortality. Significant survival differences considering proposed cut-off points were also demonstrated according to kurtosis (p = 0. 02), skewness (p = 0.005), MLD (p = 0.003), HAA% (p = 0.009) and FA% (p = 0.02) – obtained from quantitative HRCT analysis at diagnosis time. Conclusions: CT-histogram derived indexes may provide an accurate estimation of survival in IPF.
The upward shift of hilar structures and tracheal deviation in pleuroparenchymal fibroelastosis
Authors: Ishii Hiroshi , Kinoshita Yoshiaki , Kushima Hisako , Ogura Takashi , Watanabe Kentaro
Published: January 2020

The upward shift of hilar structures is a characteristic finding on chest radiographs in pleuroparenchymal fibroelastosis (PPFE). However, the relationship between the hilar shift and clinical parameters is unclear. In this study, the ratio of the length of the lung apex to the hilum and the length of the apex to the base of the right lung was measured using chest computed tomography (CT) at the time of the diagnosis, and the relationship with clinical parameters was investigated. We also examined the deviations of the trachea on chest radiographs and compared them with those in idiopathic pulmonary fibrosis (IPF) and early-stage lung cancer. Thirty-eight PPFE patients in a previous study included 20 patients who simultaneously showed the lower lobe lesions. The median ratio of the length of the apex to the hilum/apex to the base was 0.32 (range: 0.10–0.41) in PPFE, and this value was significantly lower than that in IPF (0.39; 0.32–0.45, n = 38) and in lung cancer (0.41; 0.33 to 0.45, n = 38) (p < 0. 001, respectively). However, the ratio of the length of the apex to the hilum/apex to the base did not correlate with the dyspnea scale, body mass index or pulmonary function in PPFE. Tracheal deviations were observed in 41 out of 52 PPFE patients (36 with rightward deviations, 5 with leftward deviations) and in 30 out of 52 IPF patients (30 with rightward deviations) (p = 0.01). Although the existence of the upward shift of hilar structures on chest images might lead to a diagnosis of PPFE, the extent of hilar elevation does not necessarily reflect disease progression. Tracheal deviation is not a specific finding for PPFE.
Bronchoalveolar lavage cell profiles and proteins concentrations can be used to phenotype extrinsic allergic alveolitis patients
Authors: Sterclova Martina , Smetakova Magdalena , Stehlik Ludek , Skibova Jelena , Vasakova Martina
Published: January 2020

Background: Extrinsic allergic alveolitis (EAA) patients form heterogenous group with different clinical manifestation and different prognosis. We aimed to determine how to phenotype distinct EAA subgroups. Predictive role of the bronchoalveolar lavage fluid (BALF) IL-4Rα concentration at the time of diagnosis with regard to the clinical behavior in EAA patients was studied. Methods: Concentrations of MMP-7, IL-4Rα, TNF-α, and PAR-2 were measured in the BALF od 71 EAA patients at the time of diagnosis. Lung functions and outcome data were assessed at 12 months after the diagnosis. Correlations between the BALF protein concentration, cell profile, lung functions and patient outcome were determined. Results: We found positive correlations between BALF IL-4Rα concentration and BALF eosinophils (p = 0,006), negative correlation between IL-4Rα BALF concentration and diffusing capacity (DLco) (p = 0,003), negative correlation between IL-4Rα BALF concentration and forced vital capacity (FVC) (p = 0,004) and negative correlation between IL-4Rα concentration and BALF lymphocytes (p = 0,04). The BALF concentration of IL-4Rα was significantly higher in acute exacerbation patients (p = 0,0032) and in patients progressing despite corticosteroid treatment (p = 0,04). We observed a positive correlation between MMP-7 BALF concentration and the BALF lymphocytes (p = 0.05), negative correlation between the PAR-2 BALF concentration and DLco (p = 0.04) and a negative correlation between the BALF TNF-α concentration and DLco (p = 0.03). Conclusions: Specific subgroup of EAA patients with more severe functional impact, distinct BALF cell profile and higher IL-4Rα BALF concentration can be differentiated. Correlations between the BALF concentrations of PAR-2, MMP-7 and TNF-α with clinical parameters may reflect the role of inflammation in the pathogenesis of EAA.
Does transbronchial lung cryobiopsy give useful information in asthmatic patients?
Authors: Colella Sara , Ravaglia Claudia , Massaccesi Chiara , D’Emilio Vittorio , Panella Gianluca , Fioretti Federica , Conte Emanuele Giovanni , Collina Guido , Pela Riccardo , Poletti Venerino
Published: January 2020

Introduction: Lung biopsy in asthmatic patients is justified in case of atypical presentations of asthma, when other differential diagnoses, such as hypersensitivity pneumonitis or eosinophilic granulomatosis with polyangiitis, could be possible or for research purposes. Aim: We aim to describe the utility and the safety of TBLC (transbronchial lung cryobiopsy) in asthmatic patients, providing data on the pathological changes occurring in the airways and in the lung parenchyma. Methods: We reviewed asthmatic patients that underwent TBLC, that eventually had only a final diagnosis of asthma. Results: Three patients were detected. TBLC described pathological abnormalities in peribronchiolar and alveolar spaces already well identified with SLB (surgical lung biopsy); the pathological information provided could be useful to better understand the pathobiology of the disease. Finally, we had no complications, confirming a satisfactory safety profile of TBLC. Conclusion: We suggest the potential role of TBLC in asthmatic patients: its safety and its acceptable diagnostic accuracy lead to consider this procedure instead of SLB when histological changes in lung parenchyma are needed for the differential diagnosis. Furthermore, TLBC could be useful for research in the pathobiology of asthma and severe asthma.
Treatment of COPD: the simplicity is a resolved complexity
Authors: Candela Marco , Costorella Rosario , Stassaldi Annalisa , Maestrini Vanessa , Curradi Giacomo
Published: January 2020

The introduction of simple and reproducible functional parameters as Forced Expiratory Volume in 1 s (FEV1) and Forced Vital Capacity (FVC) has been fundamental to diagnose, classify and measure the progression of Chronic Obstructive Pulmonary Disease (COPD). However, it has been recently emphasized that these parameters do not allow an overview of the complexity and heterogeneity of COPD. In fact, the disease can show several intrapulmonary and extrapulmonary components with non-linear dynamic interactions of which not all these components are present in all patients nor in individual patients, at all time points [1]. These differences have justified the recognition of different phenotypes among patients with COPD. The objective of this review is to overhaul the evidences recently published in order to define COPD characteristics able to suggest a therapeutic algorithm.
Prevalence, risk factors and outcomes of patients coming from the community with sepsis due to multidrug resistant bacteria
Authors: Capsoni Nicolò , Bellone Pietro , Aliberti Stefano , Sotgiu Giovanni , Pavanello Donatella , Visintin Benedetto , Callisto Elena , Saderi Laura , Soldini Davide , Lardera Luca , Monzani Valter , Brambilla Anna Maria
Published: January 2020

Background: Although previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria. Methods: An observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015. Primary study outcome was in-hospital mortality. Results: Among 518 patients, at least one MDR bacteria was isolated in 88 (17%). ESBL+ Enterobacteriaceae were the most prevalent MDR bacteria (9.7%) followed by MRSA (3.9%). Independent risk factors for sepsis due to MDR bacteria were septic shock (OR: 2.2; p = 0.002) and hospitalization in the previous 90 days (OR: 2.3; p = 0.003). Independent risk factors for sepsis due to ESBL+ bacteria were hospitalization in the previous 90 days (OR: 2.1; p = 0.02) and stroke (OR: 2.1; p = 0.04). A significantly higher mortality was detected among patients with vs. without MDR bacteria (40.2% vs. 23.1% respectively, p = 0.001). Independent risk factors for mortality among patients with sepsis were coagulation dysfunction (OR: 3.2; p = 0.03), septic shock (OR: 3.2; p = 0.003), and isolation of a MDR bacteria (OR: 4.6; p < 0.001). Conclusion: In light of the prevalence and impact of MDR bacteria causing sepsis in patients coming from the community, physicians should consider ESBL coverage when starting an empiric antibiotic therapy in patients with specific risk factors, especially in the presence of septic shock.
Occupational risk factors associated with respiratory symptoms among tannery workers in Mojo town, Southeast Ethiopia, 2018: a comparative cross-sectional study
Authors: Dalju Innawu , Dessie Awrajaw , Bogale Laekemariame , Mekonnen Tesfaye Hambisa
Published: January 2020

Introduction: Work-related respiratory diseases (WRDs) account for 10–20% of all chronic respiratory illnesses affecting hundreds of millions of people of all ages. Tannery industries are often associated with hazardous working conditions favourable for respiratory conditions. However, information about the prevalence and occupational factors that predispose to respiratory symptoms is meagre in Ethiopia. This study aimed to investigate the magnitude and risk factors associated with work-related respiratory symptoms among tannery industry workers in Mojo town, Ethiopia. Methods: A comparative cross-sectional study was conducted from March to May 2018. A total of 602 (299 exposed to tannery factories) and 303 unexposed (civil servants) were included using the stratified sampling method. The British Medical Research Council (BMRC) questionnaire was pretested and interviewer-administered for data collection. A binary logistic regression analysis was performed to identify the factors associated with respiratory symptoms. The significance of associations was ascertained at a < 0.05 p and adjusted odds ratio with a 95% CI was computed to evaluate the strength of associations. Results: The prevalence of respiratory symptoms among exposed workers was 27.1% [95% CI (21.7, 32.1)] and 8.3% [95% CI (5.3, 11.6)] among unexposed workers in the previous 12 months and the prevalence was significantly different (X2 = 36.82; p < 0. 00001). The odds of developing respiratory symptoms was 3.37 times higher among tannery workers than unexposed workers [AOR: 3.37; 95% CI (1.71, 6.46)]. Female sex [AOR:1.80; 95% CI (1.24, 3.34)], temporarily workers [AOR = 3.43; 95% CI (2.63, 7.95)], working in a poorly ventilated working unit [AOR = 1.88; 95% CI (1.22, 3.98)], absence of occupational health and safety training [AOR = 2.37; 95% CI (1.14, 4.92)], and not using personal protective equipment [AOR = 2.30; 95% CI (1.25, 3.46)] were significant factors. Conclusion: The prevalence of respiratory symptoms was higher among exposed workers compared to unexposed ones. Sex, employment status, ventilation of working units, absence of occupational health and safety training, and not using personal protective equipment were the factors associated with occupational-related respiratory symptoms. Strategies targeting health and safety training, creating awareness on the use of personal protective equipment, and improving workplace conditions, like the provision of adequate ventilation are useful means for assuaging the condition.
Patients' usability of seven most used dry-powder inhalers in COPD
Authors: Dal Negro Roberto W. , Turco Paola , Povero Massimiliano
Published: January 2020

Introduction: Inhalation devices affect both the effectiveness and the therapeutic outcomes in persistent airway obstruction, and the effects are largely independent of the drug(s) assumed. Usability is a complex and comprehensive indicator of inhalation devices’ performance. The Global Usability Score (GUS) Questionnaire is an investigational tool designed to assess objectively the patients’-related and unrelated domains of devices’ usability. Methods: The GUS questionnaire was administered to all consecutive COPD patients referring for three months to the Lung Unit of CEMS Specialist Centre (Verona, Italy). The usability of seven Dry Powder Inhalers (DPIs) indicated as appropriate in COPD was tested and compared: Breezhaler, Diskus, Ellipta, Genuair, Nexthaler, Spiromax, and Turbohaler. Patients were divided in two groups, checked separately, according to their DPIs previous experience. A Bayesian Indirect Comparison (IC) model was built to assess “global usability” ranking. Results: A total of 103 patients were investigated: 74 patients already instructed in DPI use and 29 naive to DPIs. IC analysis proved Ellipta as the device characterized by the highest usability, while Breezhaler the device with the lowest usability in both groups of COPD patients (both with probability > 90%). Moreover, Turbohaler ranked second according to the Bayesian pooling, followed by Diskus, Spiromax, Nexthaler, and Genuair in patients already instructed in DPI use, while the ranking order was not as much well defined in naïve patients, likely due to their too small sample. Conclusions: Usability is a multifaceted indicator that contributes to assess the factual DPIs’ convenience in real life. DPIs are characterized by different levels of real-life usability, which can be checked, compared and ranked by means of the GUS score.
Approaching two decades of cystic fibrosis research in Qatar: a historical perspective and future directions
Authors: Hammoudeh Samer , Gadelhak Wessam , AbdulWahab Atqah , Al-Langawi Mona , Janahi Ibrahim A.
Published: January 2020

Cystic fibrosis (CF) is a genetic disease caused by a defect of CF transmembrane conductance regulator (CFTR) gene. CF affects multiple systems, predominantly with respiratory involvement. In Qatar, researchers have been exploring various aspects of the disease for almost 20 years. PubMed and Google Scholar were reviewed for articles related to CF in Qatar. The first publication appeared in the year 2000. Since then, several studies have been conducted on CF patients in Qatar considering a variety of topics. The presence of the CFTR I1234V mutation in a certain Arab tribe stands out as a distinguishing characteristic of CF patients in Qatar when compared to the larger Arab region or even worldwide. We aim here to summarize the existing CF research conducted in Qatar over the years as well as to introduce topics for future research.
Social responsibility: The changing role of business in South Africa
Authors: Wagenaar C. F.
Published: January 2020

Business in South Africa is becoming increasingly involved in the solution of the social problems of the country, and business managers face growing demands concerning the corporate social responsibility of the private sector. The author investigated the nature and scope of corporate social responsibility in South Africa, considering both the viewpoint of business managers, and the expectations of the public. Both questionnaires and interviews were used in the investigation. The attitudes of managers and the expectations of society are set out in detail, and are then compared, showing that society is significantly more in favour of corporate social responsibility than the business community. There is, however, also a growing social awareness among South African business leaders.Sake-ondernemings in Suid-Afrika word toenemend betrek by die oplossing van die sosiale probleme van die land, en bestuurders is blootgestel aan toenemende eise wat betref die sosiale verantwoordelikheid van die private onderneming. Die skrywer het die aard en trefwydte van die sosiale verantwoordelikheid van Suid-Afrikaanse ondernemings ondersoek, met inagneming van sowel die standpunt van sakebestuurders as die verwagtings van die publiek. Vraelyste en personlike onderhoude is in die ondersoek gebruik. Die houdings van bestuurders en die verwagtings van die gemeenskap word volledig uiteengesit, en word dan vergelyk. Dit blyk dat die gemeenskap betekenisvol meer ten gunste is van sosiaal-verantwoordelike optrede deur ondernemings, as die sakelui. Daar is egter ook 'n groeiende bewustheid van sosiale verantwoordelikheid onder Suid-Afrikaanse sakeleiers.
Theory of portfolio selection
Authors: Kilroe Patrick
Published: January 2020

No abstract available.
South Africa in international perspective
Authors: Marais Jan S.
Published: January 2020

Adress delivered at an economic seminar on South Africa on 20 June 1979 at Palm Springs, California, USA.
On building a nation
Authors: Rathebe S. L.L.
Published: January 2020

Address delivered during the Shell Conference held on 15 August 1979 at Mmabatho, Bophuthatswana.
Die taak van die bemarkingsbestuur
Authors: Kieser P. J.
Published: January 2020

No abstract available.
The determination of an optimal size for building societies' branch offices in South Africa
Authors: Gerber P. D.
Published: January 2020

The size of a building society's branch office can have a significant influence on its profitability. In this article a model for an optimal size branch office is established on the basis of three criteria, i.e. the ability of the branch office to generate income, efficiency of labour and control of administrative expenses. A revenue potential index is compiled based on the assumption that revenue potential depends on the volume of funds handled by a branch office. On this basis, weights are allocated, and a ranking order is established for revenue potential according to branch office size. Labour efficiency is measured in terms of average assets controlled per employee. Efficient control of administrative expenses is evaluated in terms of average administrative expenses per employee. From these findings a clear guideline could be established for the optimal branch office size from the profitability viewpoint.Die grootte van 'n bouvereniging takkantoor kan 'n belangrike invloed op die winsgewendheid daarvan uitoefen. In hierdie artikel word 'n model vir 'n optimale grootte takkantoor aan die hand van drie kriteria bepaal, naamlik die vermoe daarvan om inkomste te genereer, die doeltreffendheid van arbeid, en beheer oor administratiewe uitgawes. 'n Inkomstepotensiaalindeks word saamgestel op die veronderstelling dat dit afhang van die volume fondse wat deur 'n takkantoor hanteer word. Op grond hiervan word gewigte toegeken en 'n rangorde bepaal vir inkomstepotensiaal volgens takkantoorgrootte. Arbeidsdoeltreffendheid word gemeet in terme van gemiddelde bates per werknemer beheer. Doeltreffende beheer oor administratiewe uitgawes word beoordeel in terme van gemiddelde administratiewe uitgawes per werknemer. Uit hierdie bevindings kon 'n duidelike riglyn vir die optimale takkantoorgrootte uit die winsgewendheidsoogpunt neergele word.
The likely future tax structure in the RSA and urgently required tax reform
Authors: Menof Michael P.
Published: January 2020

Address delivered to the Regional Congress of the Orange Free State of the Association of the Chambers of Commerce of South Africa at Welkom, June 18, 1980.
Exploration on Surface Roughness in Abrasive Water Jet Cutting of AA6063-TiC Composites for Vehicle Structural Applications
Authors: Saravanan S. , Vijayan V. , Balan A.V. , Sathish T. , Parthiban A.
Published: January 2020

This paper deals a set of studies performed on AA6063-TiC composites produced by adding 3%, 6% and 9% wt. of TiC in aluminium alloy 6063 and processed with abrasive water jet cutting that are formed with garnet abrasive of 80 mesh size. These studies are effectively meant to evaluate the surface roughness (Ra) of abrasive water jet cutting on various compositions of AA6063-TiC produced by stir casting route. Abrasive water jet cutting was carried out on cylindrical samples of various compositions of AA6063-TiC composites by varying traverse speed, stand-off distance and abrasive flow rate at three different levels. The experiments were performed using Taguchiâ€™s L27 orthogonal array. Contribution of these parameters on the Ra was determined by ANOVA and regression analysis to optimize the process parameters for effective machining. Among the interaction effects, traverse speed and stand-off distance combinations contribute more to the Ra. The microstructures of machined surfaces were also analysed by scaning electron microscope images and F-profile plots.
Enhancing the Mechanical Properties and Formability of Cold Rolled Closed Annealed Sheet for Automobile Applications
Authors: Sundar Singh Sivam S.P. , Ganesh Babu L. , Kumaran D.
Published: January 2020

Designers of high pace advanced vehicles in aerospace industries particularly vehicle manufacturing types are placing more needs at the sheet metal forming enterprise by designing components from the high strength thermal resistance alloy. The principle goal of the observation is to test the mechanical, formability parameters and Erichsen cupping values of a sample of cold rolled closed annealed sheet. The quantity of strain that a metallic sheet can tolerate just before localized failure is called limit strain. The boundaries of formability in sheet metal operations are defined regarding the primary traces via the forming limit diagram (FLD). To be useful for engineering purposes, FLD needs to be simple enough so its parameters can be evaluated without difficulty ideally by way of uniaxial tests. The consequences confirmed that the formability of steel having decreased percentage of carbon is forming lesser. It changed into pressure distribution and the grain density of the sheet verifies the formability. The best grouping of strength and ductile properties are noted for metal with the low carbon and higher forming assets.
Prevalência de acidentes de trabalho em unidade psiquiátrica de referência
Authors: Nylander Bertho Vinícius Rocha , Miranda Andréa Dantas , Rodrigues Max Rafael Almeida , Lopes Yan Tavares Bandeira , Peixoto Osvaldo da Silva
Published: January 2020

Objetivo: Identificar a prevalência dos acidentes de trabalho em profissionais de saúde mental em um Hospital de referência em Belém do Pará no período de 2008-2018. Método: Estudo descritivo, retrospectivo e de corte transversal da violência contra os profissionais de saúde mental, que trabalhem na Fundação Hospital de Clínicas Gaspar Vianna através da coleta das fichas de notificações de acidentes registrado pelo Serviço Especializado em Engenharia de Segurança e em Medicina do Trabalho. Resultados: Houve um total de 147 acidentes notificados no período de 2008-2018, sendo demonstrado pelo Qui-Quadrado significância estatística, em comparação com cada ano, com relação ao turno do dia e o cargo do profissional, mas não demonstrou significância com relação ao gênero. Conclusão: Observa-se que os técnicos de enfermagem são o grupo que apresenta maior índice de notificações de acidente, assim como há uma maior prevalência pelo turno da manhã, sendo necessário aprimoramento e auxilio, como técnicas de autodefesa para auxiliar diminuir esse índice de acidentes, além de comparar com outros centro de referência psiquiátrico para averiguar se eles apresentam maior notificações do gênero feminino, pois na pesquisa o resultado não foi significativo
Sistema de posicionamiento en interiores utilizando señales de radio estaciones FM comerciales y Deep Learning
Authors: Roman J. , Marquez-Viloria D. , Velásquez R. A. , Botero-Valencia J.
Published: January 2020

Para dar solución al problema de posicionamiento en interiores, muchos autores han propuesto el uso de diversas técnicas. Desde la simulación de un Sistema de Posicionamiento Global (GPS) a través de antenas Pseudolites, la construcción de campos magnéticos artificiales, el uso de diversos sensores como visión, ultrasonido, unidades de medida inercial, entre otros. Hasta el uso de transmisores y receptores en el rango de la Radio Frecuencia como los presentes en una oficina. Muchos de los sistemas anteriormente mencionados dependen para su correcto funcionamiento de una instalación y configuración de equipos en el lugar de posicionamiento, lo cual puede llevar en ocasiones a costosas implementaciones. Es por esto que para realizar este trabajo hemos propuesto una metodología de posicionamiento en interiores que no requiere de adecuaciones e instalaciones en el lugar de aplicación. La metodología propuesta hace uso de las radio estaciones FM existentes y utiliza algoritmos de Deep Learning como algoritmo de posicionamiento.
Clasificación de objetos usando percepción bimodal de palpación única en acciones de agarre robótico
Authors: Velasco E. , Zapata-Impata B.S. , Gil P. , Torres F.
Published: January 2020

Este trabajo presenta un método para clasificar objetos agarrados con una mano robótica multidedo combinando en un descriptor híbrido datos propioceptivos y táctiles. Los datos propioceptivos se obtienen a partir de las posiciones articulares de la mano y los táctiles se extraen del contacto registrado por células de presión instaladas en las falanges. La aproximación propuesta permite identificar el objeto aprendiendo de forma implícita su geometría y rigidez usando los datos que facilitan los sensores. En este trabajo demostramos que el uso de datos bimodales con técnicas de aprendizaje supervisado mejora la tasa de reconocimiento. En la experimentación, se han llevado a cabo más de 3000 agarres de hasta 7 objetos domésticos distintos, obteniendo clasificaciones correctas del 95%con métrica F1, realizando una única palpación del objeto. Además, la generalización del método se ha verificado entrenando nuestro sistema con unos objetos y posteriormente, clasificando otros nuevos similares.
Detección de anomalías basada en técnicas inteligentes de una planta de obtención de material bicomponente empleado en la fabricación de palas de aerogenerador
Authors: Jove E. , Casteleiro-Roca J. , Quintián H. , Méndez-Pérez J. A. , Calvo-Rolle J. L.
Published: January 2020

Los avances tecnológicos en general, y en el ámbito de la industria en particular, conllevan el desarrollo y optimización de las actividades que en ella tienen lugar. Para alcanzar este objetivo, resulta de vital importancia detectar cualquier tipo de anomalía en su fase más incipiente, contribuyendo, entre otros, al ahorro energético y económico, y a una reducción del impacto ambiental. En un contexto en el que se fomenta la reducción de emisión de gases contaminantes, las energías alternativas, especialmente la energía eólica, juegan un papel crucial. En la fabricación de las palas de aerogenerador se recurre comúnmente a materiales de tipo bicomponente, obtenidos a través del mezclado de dos substancias primarias. En la presente investigación se evalúan distintas técnicas inteligentes de clasificación one-class para detectar anomalías en un sistema de mezclado para la obtención de materiales bicomponente empleados en la elaboración de palas de aerogenerador. Para lograr los modelos inteligentes que permitan la detección de anomalías, se han usado datos reales extraídos de una planta de mezclado en operación durante su correcto funcionamiento. Los clasificadores obtenidos para cada técnica son validados a través de anomalías generadas de manera artificial, obteniéndose resultados altamente satisfactorios.
Manipulador móvil, bibrazo y diestro con nuevas ruedas omnidireccional
Authors: Suárez R. , Palomo-Avellaneda L. , Martínez J. , Clos D. , García N.
Published: January 2020

Este artículo describe un manipulador móvil, bimanual y con capacidad de manipulación diestra denominado MADAR (de Mobile Anthropomorphic Dual-Arm Robot). Básicamente puede dividirse en dos partes, una base móvil y una estructura superior portando dos brazos en configuración antropomorfa con manos mecánicas diestras equipadas con sensores táctiles. La base, completamente de desarrollo propio, es de forma circular y tiene tres ruedas con un diseño novedoso que permiten una movilidad omnidireccional. La estructura superior integra elementos comerciales, como los brazos, las manos y distintos sensores, que han sido adaptados para su funcionamiento conjunto. El artículo incluye tanto la descripción de los principales elementos del hardware como del software desarrollado para su control y uso.