39 research outputs found

    The feasibility of wind and solar energy application for oil and gas offshore platform

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    Renewable energy is an energy which is freely available in nature such as winds and solar energy. It plays a critical role in greening the energy sector as these sources of energy produce little or no pollution to environment. This paper will focus on capability of renewable energy (wind and solar) in generating power for offshore application. Data of wind speeds and solar irradiation that are available around SHELL Sabah Water Platform for every 10 minutes, 24 hours a day, for a period of one year are provided by SHELL Sarawak Sdn. Bhd. The suitable wind turbine and photovoltaic panel that are able to give a high output and higher reliability during operation period are selected by using the tabulated data. The highest power output generated using single wind energy application is equal to 492 kW while for solar energy application is equal to 20 kW. Using the calculated data, the feasibility of renewable energy is then determined based on the platform energy demand

    Patient preferences for whole-body MRI or conventional staging pathways in lung and colorectal cancer:a discrete choice experiment

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    OBJECTIVES: To determine the importance placed by patients on attributes associated with whole-body MRI (WB-MRI) and standard cancer staging pathways and ascertain drivers of preference.METHODS: Patients recruited to two multi-centre diagnostic accuracy trials comparing WB-MRI with standard staging pathways in lung and colorectal cancer were invited to complete a discrete choice experiment (DCE), choosing between a series of alternate pathways in which 6 attributes (accuracy, time to diagnosis, scan duration, whole-body enclosure, radiation exposure, total scan number) were varied systematically. Data were analysed using a conditional logit regression model and marginal rates of substitution computed. The relative importance of each attribute and probabilities of choosing WB-MRI-based pathways were estimated.RESULTS: A total of 138 patients (mean age 65, 61% male, lung n = 72, colorectal n = 66) participated (May 2015 to September 2016). Lung cancer patients valued time to diagnosis most highly, followed by accuracy, radiation exposure, number of scans, and time in the scanner. Colorectal cancer patients valued accuracy most highly, followed by time to diagnosis, radiation exposure, and number of scans. Patients were willing to wait 0.29 (lung) and 0.45 (colorectal) weeks for a 1% increase in pathway accuracy. Patients preferred WB-MRI-based pathways (probability 0.64 [lung], 0.66 [colorectal]) if they were equivalent in accuracy, total scan number, and time to diagnosis compared with a standard staging pathway.CONCLUSIONS: Staging pathways based on first-line WB-MRI are preferred by the majority of patients if they at least match standard pathways for diagnostic accuracy, time to diagnosis, and total scan number.KEY POINTS: • WB-MRI staging pathways are preferred to standard pathways by the majority of patients provided they at least match standard staging pathways for accuracy, total scan number, and time to diagnosis. • For patients with lung cancer, time to diagnosis was the attribute valued most highly, followed by accuracy, radiation dose, number of additional scans, and time in a scanner. Preference for patients with colorectal cancer was similar. • Most (63%) patients were willing to trade attributes, such as faster diagnosis, for improvements in pathway accuracy and reduced radiation exposure.</p

    Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

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    Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction&gt;0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk

    Assesing The Performance of Construction Workers in Peninsula Malaysia

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    Manpower is the most valuable asset in the construction industry. Workers’ performance is an important factor contributing to the timely completion and success of a construction project. The construction industry in Malaysia is labour intensive. Unfortunately, most empirical studies have revealed that the output of the industry is quite low when compared with many developed countries. This paper assesses the performance of construction workers in Peninsula Malaysia and finds some useful measures which would contribute towards its improvement

    Modification of the design of circular thin-walled tubes to enhance dynamic energy absorption characteristics: Experimental and finite element analysis

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    Abstract A thin-walled tube is an energy absorber device that functions to dissipate kinetic energy into another form of energy during impact. The design of thin-walled tubes is a significant factor which affects to the energy absorption characteristics. This paper provides a comparative study between the original thin-walled tube designs and several modified tube designs that have been proposed. The main objective is to improve the energy absorption characteristics, such as energy absorption capacity, initial peak load, specific energy absorption (SEA) and crush force efficiency (CFE). Throughout this research, aluminium alloy AA6061-T6 has been used as the material for all tubes. For comparison, all of the tubes are developed with a circular shape with the same diameter, thickness and length. In addition, they are also impacted at the same kinetic energy under dynamic axial loading. Validated LS-DYNA finite element (FE) models have been used to simulate the impact of the thin-walled tubes. Compared to the original tube design, the modified tubes have improved energy absorption characteristics. A conical tube with a flat end cap was identified as the best performing tube among the modified tubes because it had the lowest initial peak load, a moderate energy absorption capacity and an excellent CFE and SEA. The findings from this study can be used as a guidance in designing thin-walled structure.</jats:p

    Platelet function in fulminant hepatic failure and effect of charcoal haemoperfusion.

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    In 34 patients with fulminant hepatic failure, platelets, in addition to being reduced in numbers, were smaller than those of healthy controls. In keeping with this, capillary bleeding times were significantly longer than could be accounted for by reduction in numbers alone. In a small group of these patients use of charcoal haemoperfusion for temporary liver support produced a doubling of the capillary bleeding time despite only a small drop in arterial platelet counts. This disproportionate prolongation of bleeding time was almost certainly caused by the loss of larger platelets in the charcoal columns during perfusion, as the mean median volume also fell during perfusion. Rises in screen filtration pressure of blood leaving the columns were found during some perfusions and thought to be indicative of platelet aggregates. Release of vasoactive substances from platelets could account for the hypotension often found at this time
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