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Pre-Operative Anaemia Predicts Poor Outcomes in Patients Undergoing Infra-Inguinal Bypass Surgery  [PDF]
K. Sierakowski, Y. T. Wong, C. Delaney, P. Hakendorf, K. Missen, J. I. Spark
World Journal of Cardiovascular Diseases (WJCD) , 2014, DOI: 10.4236/wjcd.2014.412072
Abstract: Objectives: Critical limb ischaemia (CLI) requiring infra-inguinal bypass is a common presentation to the vascular surgery service. A significant number of CLI patients also present with anaemia as a comorbidity, the impact of which is unknown. We reviewed the impact of anaemia on mortality and amputation in patients who underwent infra-inguinal bypass surgery. Methods: Demographic data from all patients who underwent infra-inguinal bypass surgery for CLI at the Flinders Medical Centre & Repatriation General Hospital, South Australia between January 2005 and January 2010 were recorded. Haemoglobin (Hb) level, serum creatinine (SCr) level, mortality and amputation events were also recorded for retrospective analysis. Results: 190 patients (141M, 49F) who underwent infra-inguinal bypass surgery over a 5 year period were analyzed. 100 (53%) of these patients had mild anaemia (mean Hb 113 g/L, mean for females 103 g/L, mean for males 116 g/L). Those who presented with anaemia were more likely to have diabetes and renal dysfunction as comorbidities. Anaemia had a significant negative impact on mortality with 30% deaths in those who were anaemic compared to 15.6% deaths in those without anaemia odds ratio (OR) 1.76, 95% CI: 0.90 - 3.48, p < 0.01. This relationship was similar when looking at amputation as an outcome; with the number of amputations in those who were anaemic preoperatively 14% vs 6.7% in those who were not anaemic, OR 2.56, 95% CI: 1.00 - 6.54, p = 0.05. The negative impact of anaemia on mortality 43.5% vs 18.8% was also noted in patients who did not have diabetes or impaired renal function as a comorbidity p < 0.05. Conclusions: Anaemia is a common comorbidity in patients presenting with CLI and it predicts poor outcomes after infra-inguinal bypass. The role of transfusion is debatable, but it is clear that this group of patients requires careful management during the perioperative period to ensure they are medically optimized.
Preparation for high-acuity clinical placement: confidence levels of final-year nursing students
Porter J,Morphet J,Missen K,Raymond A
Advances in Medical Education and Practice , 2013,
Abstract: Joanne Porter, Julia Morphet, Karen Missen, Anita Raymond School of Nursing and Midwifery, Monash University, Churchill, VIC, Australia Aim: To measure final-year nursing students’ preparation for high-acuity placement with emphasis on clinical skill performance confidence. Background: Self-confidence has been reported as being a key component for effective clinical performance, and confident students are more likely to be more effective nurses. Clinical skill performance is reported to be the most influential source of self-confidence. Student preparation and skill acquisition are therefore important aspects in ensuring students have successful clinical placements, especially in areas of high acuity. Curriculum development should aim to assist students with their theoretical and clinical preparedness for the clinical environment. Method: A modified pretest/posttest survey design was used to measure the confidence of third-year undergraduate nursing students (n = 318) for placement into a high-acuity clinical setting. The survey comprised four questions related to clinical placement and prospect of participating in a cardiac arrest scenario, and confidence rating levels of skills related to practice in a high-acuity setting. Content and face validity were established by an expert panel (α = 0.90) and reliability was established by the pilot study in 2009. Comparisons were made between confidence levels at the beginning and end of semester. Results: Student confidence to perform individual clinical skills increased over the semester; however their feelings of preparedness for high-acuity clinical placement decreased over the same time period. Reported confidence levels improved with further exposure to clinical placement. Conclusion: There may be many external factors that influence students’ perceptions of confidence and preparedness for practice. Further research is recommended to identify causes of poor self-confidence in final-year nursing students. Keywords: high acuity, clinical placement, confidence
Fine Needle Aspiration Cytology in the Diagnosis of Canine Cutaneous Transmissible Venereal Tumor— Case Report  [PDF]
Noeme Sousa Rocha, Tália Missen Tremori, Jo？o Alexandre Matos Carneiro
Open Journal of Veterinary Medicine (OJVM) , 2014, DOI: 10.4236/ojvm.2014.49024
Abstract: Fine needle aspiration cytology (FNAC) has been widely used in the diagnosis of lesions from various origins, especially neoplastic. The technique is simple, fast, safe, minimally invasive and inexpensive, which allows through the evaluation of cell morphology to establish prognosis, delineate surgical margins, monitor lesion growth, validate indication euthanasia during surgery and monitor chemotherapy protocols. Diagnosis of canine transmissible venereal tumor (TVT) can be accomplished with ease and precision, even to be rated, according to the degree of aggressiveness. The study objective was to demonstrate the effectiveness of the examination in the diagnosis of TVT plasmacytoid type. An eight-month dog presented to the veterinary hospital (HV), faculty of veterinary medicine and animal science, FMVZ, UNESP-Univ Estadual Paulista with clinical suspicion of cutaneous lymphoma. By presenting multiple nodular lesions, FNAC was performed to cytological diagnosis. The tissue showed cells consistent with TVT. The animal was treated, and a total cure was achieved. According to the literature, TVT mainly affects external genitalia of sexually active animals and its transmission is more frequent during intercourse. In addition, animals sexually immature and without contact to the street dogs, hardly have injuries by TVT. In this case, verrucous and ulcerated lesions on the vulva of its mother during pregnancy and childbirth infected the animal. Diffuse and predominant dorsal injuries occurred due to both exfoliation of breast tumor during delivery and immunosuppression of pup at birth, thus favoring an atypical transmission.
Hair Analysis of Mammals of Brazilian Wildlife for Forensic Purposes  [PDF]
Tália Missen Tremori, Fernanda Marion Monteiro Garcia, Luis Mauricio Montoya Flórez, Bianca Picado Gon？alves, Bárbara Wagner Duarte Ferraz de Camargo, Claire Gwinnett, Carlos Roberto Teixeira, Noeme Sousa Rocha
Open Journal of Animal Sciences (OJAS) , 2018, DOI: 10.4236/ojas.2018.83025
Abstract: Wildlife trafficking is classified as the fourth largest illegal commerce in the world. Taxonomic identification of wildlife is an ordinary process for forensics experts. The aim of this study was to analyze animal’s hair from Brazilian’s wildlife through microscopic and compare morphology of bristle among species analyzed. Hair samples of nine species were analyzed. Glass slides were analyzed through optical microscopy and following measurements were obtained: total length, medulla diameter, overall diameter and overall ratio diameter of the medulla’s diameter. The images obtained at identification of animals through the morphology of hair and the statistics analysis corroborates in favor for the validation of the technique.
Incorporating cardiopulmonary resuscitation training into a cardiac rehabilitation programme: A feasibility study
Diane Missen,Dion Stub,James Shaw,Janet E Bray,Judith Finn,Lauren Barker,Rosalind Case,Susie Cartledge
- , 2018, DOI: 10.1177/1474515117721010
Abstract: Patients with a cardiac history are at future risk of cardiac events, including out-of-hospital cardiac arrest. Targeting cardiopulmonary resuscitation (CPR) training to family members of cardiac patients has long been advocated, but is an area in need of contemporary research evidence. An environment yet to be investigated for targeted training is cardiac rehabilitation. To evaluate the feasibility of providing CPR training in a cardiac rehabilitation programme among patients, their family members and staff. A prospective before and after study design was used. CPR training was delivered using video self-instruction CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Cardiac patient participation rates in CPR classes were high (n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use skills significantly increased post-training (both p<0.001). Post training participants demonstrated a mean compression rate of 112 beats/min and a mean depth of 48 mm. Training reach was doubled as participants shared the video self-instruction kit with a further 87 people. Patients, family members and cardiac rehabilitation staff had positive feedback about the training. We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using video self-instruction CPR training kits enabled further training reach to the target population
Causes of interruption of bevacizumab therapy in age-related macular degeneration
Nunes, Renata Portella;Nóbrega, Mário Junqueira;De Novelli, Fernando José;Coral, Samuel ？ngelo;Berti, Thais Bacha;Missen, Marina Maria Drumm;Correa, Marina Canuto;
Arquivos Brasileiros de Oftalmologia , 2010, DOI: 10.1590/S0004-27492010000200009
Abstract: purpose: to evaluate the rate and the causes of interruption of bevacizumab intravitreal therapy in patients with exudative age-related macular degeneration (amd) in a referential eye-care center in joinville, southern brazil. methods: retrospective, non-comparative, consecutive case series. cases included all patients with exudative age-related macular degeneration who were treated with one or more bevacizumab intravitreal injections at sadalla amin ghanem eye hospital between january, 2006 and january, 2008. data were obtained from patients' medical records and telephone interviews. discontinuity criterion was the absence of patient follow-up after a minimum of 3 months from the last ophthalmic examination. results: eighty-two patients were treated. among them, 24 (29.3%) interrupted follow-up inadvertently. the mean age was 75.2 years old (range 65-89 yo). mean number of bevacizumab intravitreal injections was 2.0 (range 1-6). nineteen patients answered to telephone questionnaires. the main alleged causes of discontinuity of therapy were unexpected poor visual results (8 cases, 42.1%), lack of information about followup visits (5 cases, 26.3%) and comorbidities (3 cases, 15.8%). conclusions: a high number of patients interrupted follow-up after beginning bevacizumab therapy. many of them related avoidable causes for discontinuity of treatment. efforts must be done to improve education of age-related macular degeneration patients, especially in relation to functional outcomes and prolonged follow-up care.
IoT for Development of Smart Dairy Farming
Akbar, Muhammad Osama,Akhtar, Nadeem,Ali, Muhammad Jamshaid,Hussain, Azfar,Missen, Malik Saad,Pasha, Maruf,Pasha, Urooj,Qaiser, Ghazia,Shahbaz khan, Muhammad Saad
- , 2020, DOI: https://doi.org/10.1155/2020/4242805
Abstract: Internet of things (IoT) and data-driven techniques are creating greater opportunities for smart dairy farming. The demand for milk is continuously increasing due to increasing population of the world. The consumption of the dairy products is more in developed countries as compared to developing countries. To meet this increased demand for milk products, better technological techniques for improving milk yield are required. It is expected that the use of IoT and different AI techniques can assist a farmer to overcome different traditional farming challenges and increase the milk production. In this research, the authors address different challenges that a dairy farmer has to face in daily life. Brief introduction of smart dairy farming (SDF) is presented with respect to the innovation in production and the processes of smart dairy farming. This review focuses on different aspects of smart dairy farming, and finally a state-of-the-art framework that can assist the farmers to increase the milk yield by using different latest technologies has been proposed. These technological methods can decrease the factors negatively affecting milk production and increase those positively affecting production with minimal resources
The Constrained Mean-Semivariance Portfolio Optimization Problem with the Support of a Novel Multiobjective Evolutionary Algorithm  [PDF]
K. Liagkouras, K. Metaxiotis
Journal of Software Engineering and Applications (JSEA) , 2013, DOI: 10.4236/jsea.2013.67B005
Abstract:

The paper addresses the constrained mean-semivariance portfolio optimization problem with the support of a novel multi-objective evolutionary algorithm (n-MOEA). The use of semivariance as the risk quantification measure and the real world constraints imposed to the model make the problem difficult to be solved with exact methods. Thanks to the exploratory mechanism, n-MOEA concentrates the search effort where is needed more and provides a well formed efficient frontier with the solutions spread across the whole frontier. We also provide evidence for the robustness of the produced non-dominated solutions by carrying out, out-of-sample testing during both bull and bear market conditions on FTSE-100.

Design of a Cantilever - Type Rotating Bending Fatigue Testing Machine  [PDF]
K. K. Alaneme
Journal of Minerals and Materials Characterization and Engineering (JMMCE) , 2011, DOI: 10.4236/jmmce.2011.1011078
Abstract: This research is centered on the design of a low–cost cantilever loading rotating bending fatigue testing machine using locally sourced materials. The design principle was based on the adaptation of the technical theory of bending of elastic beams. Design drawings were produced and components/materials selections were based on functionality, durability, cost and local availability. The major parts of the machine: the machine main frame, the rotating shaft, the bearing and the bearing housing, the specimen clamping system, pulleys, speed counter, electric motor, and dead weights; were fabricated and then assembled following the design specifications. The machine performance was evaluated using test specimens which were machined in conformity with standard procedures. It was observed that the machine has the potentials of generating reliable bending stress – number of cycles data; and the cost of design (171,000 Naira) was lower in comparison to that of rotating bending machines from abroad. Also the machine has the advantages of ease of operation and maintenance, and is safe for use.
Wireless Sensor Network Lifetime Enhancement Using Modified Clustering and Scheduling Algorithm  [PDF]
K. Ramesh, K. Somasundaram
Circuits and Systems (CS) , 2016, DOI: 10.4236/cs.2016.78154
Abstract: Random distribution of sensor nodes in large scale network leads redundant nodes in the application field. Sensor nodes are with irreplaceable battery in nature, which drains the energy due to？repeated collection of data and decreases network lifetime. Scheduling algorithms are the one way？of addressing this issue. In proposed method, an optimized sleep scheduling used to enhance the？network lifetime. While using the scheduling algorithm, the target coverage and data collection？must be maintained throughout the network. In-network, aggregation method also used to remove the unwanted information in the collected data in level. Modified clustering algorithm？highlights three cluster heads in each cluster which are separated by minimum distance between them.？The simulation results show the 20% improvement in network lifetime, 25% improvement in？throughput and 30% improvement in end to end delay.
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