To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals...To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.展开更多
Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings...Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load.Routine screening of behavioral health problems in primary care facilities enables early identification and treatment.However,deciding on sound,efficient,and scalable screening measures is sometimes arduous.Accordingly,this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety,depression,and conduct problems.Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17(PSC-17),the Patient Health Questionnaire-9(PHQ-9),and the Screen for Child Anxiety Related Emotional Disorders(SCARED)are delineated.Finally,clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.展开更多
Objective The present retrospective study was to explore the clinical value of Six-Item Screener （SIS）, which is constituted by 6 items from mini-mental status examination （MMSE）, to identify cognitive impairment....Objective The present retrospective study was to explore the clinical value of Six-Item Screener （SIS）, which is constituted by 6 items from mini-mental status examination （MMSE）, to identify cognitive impairment. Methods A total number of 1976 patients aged over 50 years, from the Memory Clinic of Huashan Hospital were employed in a battery of neuropsychological tests including MMSE. Subjects with severe conditions, unable to cooperate, or having been previously enrolled, were excluded from this study. The employed subjects were divided into 3 groups： subjective memory complaints （SMCs） （475 cases）, patients with mild cognitive impairment （MCI） （440 cases）, and patients with Alzheimer＇s disease （AD） （1061 cases, including 555 mild, 339 moderate, and 167 severe）. A total score of MMSE and a score of SIS composed of date, month, year, three-word delayed recall from MMSE were calculated. Data were analyzed based on educational background. Results The cut-off of SIS score was 〈 2 for illiterate, 〈 3 for elementary, and 〈 4 for junior high school or above. The sensitivity and specificity of SIS for detecting mild AD were 88.5% and 78.3%, respectively, with an overall accuracy of 83.8%, while for detecting MCI, the sensitivity and specificity were 34.3% and 90.1%, respectively, with an overall accuracy of 63.2%. Conclusion SIS is an effective and reliable instrument for dementia detection in outpatient department. However, it has limited value for MCI identification.展开更多
Fuel economy regulations have been issued in many countries to save energy,and it is one of the most essential performance requirements for Passenger Car Motor Oil(PCMO) this decade.The performance is also important t...Fuel economy regulations have been issued in many countries to save energy,and it is one of the most essential performance requirements for Passenger Car Motor Oil(PCMO) this decade.The performance is also important to reduce green house gas(GHG) emissions.Automotive,Oil and Additive industries have been developing fuel economy tests in fired engine for PCMO.The ASTM 5 Car test was started in 1982 and ASTM Sequence Ⅵ series test was also developed by the industries as one of fuel economy tests after the 5 Car test.However,the fired engine(combustion) test condition is more complicated and the combustion mode in engine introduce high variability into a fuel economy measurement.Screening by bench testing is complicated by the difficulty to reproduce friction conditions of all of engine parts.Based on the background,a motored engine friction torque test(MEFT) was developed as one of the solutions for fuel economy screening test.Using a newly developed MEFT,key additive chemistries were evaluated and compared in the test,and it distinguished the differences in additive chemistries,in addition to those in viscosity and friction modifiers.The Sequence Ⅵ-D FEI 1(Seq.Ⅵ-D FEI 1) and chassis dynamometer vehicle tests were also conducted in this study,and the test data has shown an excellent correlation among MEFT,Seq.Ⅵ-D FEI 1 and chassis dynamometer vehicle tests.展开更多
Ginger is a potential agricultural commodity to be developed in India. When the harvest comes, people still use a very simple method for harvesting ginger by using hoes, pick-axe and other farming equipments. The farm...Ginger is a potential agricultural commodity to be developed in India. When the harvest comes, people still use a very simple method for harvesting ginger by using hoes, pick-axe and other farming equipments. The farmers complain for the need of so many work forces for harvesting while the labor cost is getting increased and the time spent for harvesting process is too long. Although there is an alternative of imported ginger harvesting machines, those machines are not compatible with the farming environment in India, having a high initial and maintenance cost. This machine can be used in any farming condition in India and can be prepared at village level. This machine has three main parts namely, ginger digger, screener and power transmission system. This project is focusing on design and fabrication ginger harvesting machine. The screener will not only separate ginger from soil but also not let the ginger get harmed. The screener also uses for collectible part, to make this machine need some power transmission system from the engine. This machine needs Auto front petrol engine with rotation speed 20 - 25 rpm approximately with the aid of gear reduction.展开更多
A serious concern among post-9/11 Iraq and Afghanistan veterans (IAV) are health conditions from military and environmental exposure while serving. Many veterans are becoming suddenly ill and experiencing symptoms tha...A serious concern among post-9/11 Iraq and Afghanistan veterans (IAV) are health conditions from military and environmental exposure while serving. Many veterans are becoming suddenly ill and experiencing symptoms that have been associated with exposure to burning trash or “burn pits” set up to destroy waste produced by the military. IAVs are exhibiting respiratory conditions and other numerous health issues from exposure to burn pits during deployments. From the US military operations to the Middle East, 70% of the military personnel reported respiratory illnesses, with 17% experiencing symptoms serious enough to require medical care. Despite growing concerns, little research has been conducted on the health conditions of returning veterans. Many veterans have difficulty gaining appropriate access to care, unable to travel long distances to Veterans health facility, or have to deal with long wait times to see a provider. As a result, many veterans utilize civilian emergency rooms and healthcare facilities. Most healthcare facilities are not familiar with military-related health conditions. To address and prevent delays in care, it is helpful to have a veteran-specific screener questionnaire at the point of healthcare access. Getting a better understanding of the background and history of veterans can aid in accurately triaging this community and lead to better health care outcomes. Collecting and maintaining data regarding health issues that can arise from burn pit exposures can help direct the care of this specific community of veterans. In seeking to improve the understanding of IAV health issues from exposure to burn pits, the aim of this article is to help educate and raise awareness, and assist health care professionals to better triage and direct the care or resources necessary to help this underserved and at-risk community of our veterans.展开更多
文摘To identify missing childhood Tuberculosis (TB) cases, “screeners” (hospital-based health workers trained to screen accompanying contacts of TB patients for symptoms) were introduced in eight tertiary care hospitals of Sindh, Pakistan in 2013. There was a 55% increase in childhood TB notifications in 2014 compared to 2012 in facilities with screeners (n = 8) compared to 40% increase in facilities without screeners (n = 22). This apparent association disappeared when stratified by presence of “trained pediatrician” whose introduction was associated with a massive increase in notifications while transfer was associated with a marked decrease. In conclusion, screeners were not associated with increase in pediatric TB case notifications.
文摘Behavioral health concerns are surging in pediatric practices.Fortunately,integrated behavioral/medical health clinics are growing and child psychiatrists/psychologists are increasingly embedded in these care settings to help shoulder the clinical load.Routine screening of behavioral health problems in primary care facilities enables early identification and treatment.However,deciding on sound,efficient,and scalable screening measures is sometimes arduous.Accordingly,this article presents a clinician-friendly review of three common instruments useful in screening pediatric behavioral health concerns including anxiety,depression,and conduct problems.Psychometric findings and clinical applications of the Pediatric Symptom Checklist-17(PSC-17),the Patient Health Questionnaire-9(PHQ-9),and the Screen for Child Anxiety Related Emotional Disorders(SCARED)are delineated.Finally,clinical implications and recommendations for practicing pediatricians and child psychiatrists are offered.
文摘Objective The present retrospective study was to explore the clinical value of Six-Item Screener （SIS）, which is constituted by 6 items from mini-mental status examination （MMSE）, to identify cognitive impairment. Methods A total number of 1976 patients aged over 50 years, from the Memory Clinic of Huashan Hospital were employed in a battery of neuropsychological tests including MMSE. Subjects with severe conditions, unable to cooperate, or having been previously enrolled, were excluded from this study. The employed subjects were divided into 3 groups： subjective memory complaints （SMCs） （475 cases）, patients with mild cognitive impairment （MCI） （440 cases）, and patients with Alzheimer＇s disease （AD） （1061 cases, including 555 mild, 339 moderate, and 167 severe）. A total score of MMSE and a score of SIS composed of date, month, year, three-word delayed recall from MMSE were calculated. Data were analyzed based on educational background. Results The cut-off of SIS score was 〈 2 for illiterate, 〈 3 for elementary, and 〈 4 for junior high school or above. The sensitivity and specificity of SIS for detecting mild AD were 88.5% and 78.3%, respectively, with an overall accuracy of 83.8%, while for detecting MCI, the sensitivity and specificity were 34.3% and 90.1%, respectively, with an overall accuracy of 63.2%. Conclusion SIS is an effective and reliable instrument for dementia detection in outpatient department. However, it has limited value for MCI identification.
文摘Fuel economy regulations have been issued in many countries to save energy,and it is one of the most essential performance requirements for Passenger Car Motor Oil(PCMO) this decade.The performance is also important to reduce green house gas(GHG) emissions.Automotive,Oil and Additive industries have been developing fuel economy tests in fired engine for PCMO.The ASTM 5 Car test was started in 1982 and ASTM Sequence Ⅵ series test was also developed by the industries as one of fuel economy tests after the 5 Car test.However,the fired engine(combustion) test condition is more complicated and the combustion mode in engine introduce high variability into a fuel economy measurement.Screening by bench testing is complicated by the difficulty to reproduce friction conditions of all of engine parts.Based on the background,a motored engine friction torque test(MEFT) was developed as one of the solutions for fuel economy screening test.Using a newly developed MEFT,key additive chemistries were evaluated and compared in the test,and it distinguished the differences in additive chemistries,in addition to those in viscosity and friction modifiers.The Sequence Ⅵ-D FEI 1(Seq.Ⅵ-D FEI 1) and chassis dynamometer vehicle tests were also conducted in this study,and the test data has shown an excellent correlation among MEFT,Seq.Ⅵ-D FEI 1 and chassis dynamometer vehicle tests.
文摘Ginger is a potential agricultural commodity to be developed in India. When the harvest comes, people still use a very simple method for harvesting ginger by using hoes, pick-axe and other farming equipments. The farmers complain for the need of so many work forces for harvesting while the labor cost is getting increased and the time spent for harvesting process is too long. Although there is an alternative of imported ginger harvesting machines, those machines are not compatible with the farming environment in India, having a high initial and maintenance cost. This machine can be used in any farming condition in India and can be prepared at village level. This machine has three main parts namely, ginger digger, screener and power transmission system. This project is focusing on design and fabrication ginger harvesting machine. The screener will not only separate ginger from soil but also not let the ginger get harmed. The screener also uses for collectible part, to make this machine need some power transmission system from the engine. This machine needs Auto front petrol engine with rotation speed 20 - 25 rpm approximately with the aid of gear reduction.
文摘A serious concern among post-9/11 Iraq and Afghanistan veterans (IAV) are health conditions from military and environmental exposure while serving. Many veterans are becoming suddenly ill and experiencing symptoms that have been associated with exposure to burning trash or “burn pits” set up to destroy waste produced by the military. IAVs are exhibiting respiratory conditions and other numerous health issues from exposure to burn pits during deployments. From the US military operations to the Middle East, 70% of the military personnel reported respiratory illnesses, with 17% experiencing symptoms serious enough to require medical care. Despite growing concerns, little research has been conducted on the health conditions of returning veterans. Many veterans have difficulty gaining appropriate access to care, unable to travel long distances to Veterans health facility, or have to deal with long wait times to see a provider. As a result, many veterans utilize civilian emergency rooms and healthcare facilities. Most healthcare facilities are not familiar with military-related health conditions. To address and prevent delays in care, it is helpful to have a veteran-specific screener questionnaire at the point of healthcare access. Getting a better understanding of the background and history of veterans can aid in accurately triaging this community and lead to better health care outcomes. Collecting and maintaining data regarding health issues that can arise from burn pit exposures can help direct the care of this specific community of veterans. In seeking to improve the understanding of IAV health issues from exposure to burn pits, the aim of this article is to help educate and raise awareness, and assist health care professionals to better triage and direct the care or resources necessary to help this underserved and at-risk community of our veterans.
