Search results for: Aidan Duane
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14

Search results for: Aidan Duane

14 Research Networks and Knowledge Sharing: An Exploratory Study of Aquaculture in Europe

Authors: Zeta Dooly, Aidan Duane

Abstract:

The collaborative European funded research and development landscape provides prime environmental conditions for multi-disciplinary teams to learn and enhance their knowledge beyond the capability of training and learning within their own organisation cocoons. Whilst the emergence of the academic entrepreneur has changed the focus of educational institutions to that of quasi-businesses, the training and professional development of lecturers and academic staff are often not formalised to the same level as industry. This research focuses on industry and academic collaborative research funded by the European Commission. The impact of research is scalable if an optimum research network is created and managed effectively. This paper investigates network embeddedness, the nature of relationships, links, and nodes within a research network, and the enhancement of the network’s knowledge. The contribution of this paper extends our understanding of establishing and maintaining effective collaborative research networks. The effects of network embeddedness are recognized in the literature as pertinent to innovation and the economy. Network theory literature claims that networks are essential to innovative clusters such as Silicon valley and innovation in high tech industries. This research provides evidence to support the impact collaborative research has on the disparate individuals toward their innovative contributions to their organisations and their own professional development. This study adopts a qualitative approach and uncovers some of the challenges of multi-disciplinary research through case study insights. The contribution of this paper recommends the establishment of scaffolding to accommodate cooperation in research networks, role appointment, and addressing contextual complexities early to avoid problem cultivation. Furthermore, it suggests recommendations in relation to network formation, intra-network challenges in relation to open data, competition, friendships, and competency enhancement. The network capability is enhanced by the adoption of the relevant theories; network theory, open innovation, and social exchange, with the understanding that the network structure has an impact on innovation and social exchange in research networks. The research concludes that there is an opportunity to deepen our understanding of the impact of network reuse and network hoping that provides scaffolding for the network members to enhance and build upon their knowledge using a progressive approach.

Keywords: research networks, competency building, network theory, case study

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13 A New and Simple Method of Plotting Binocular Single Vision Field (BSVF) using the Cervical Range of Motion - CROM - Device

Authors: Mihir Kothari, Heena Khan, Vivek Rathod

Abstract:

Assessment of binocular single vision field (BSVF) is traditionally done using a Goldmann perimeter. The measurement of BSVF is important for the management of incomitant strabismus, viz. orbital fractures, thyroid orbitopathy, oculomotor cranial nerve palsies, Duane syndrome etc. In this paper, we describe a new technique for measuring BSVF using a CROM device. Goldmann perimeter is very bulky and expensive (Euro 5000.00 or more) instrument which is 'almost' obsolete from the contemporary ophthalmology practice. Whereas, CROM can be easily made in the DIY (do it yourself) manner for the fraction of the price of the perimeter (only Euro 15.00). Moreover, CROM is useful for the accurate measurement of ocular torticollis vis. nystagmus, paralytic or incomitant squint etc, and it is highly portable.

Keywords: binocular single vision, perimetry, cervical rgen of motion, visual field, binocular single vision field

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12 Acoustic Absorption of Hemp Walls with Ground Granulated Blast Slag

Authors: Oliver Kinnane, Aidan Reilly, John Grimes, Sara Pavia, Rosanne Walker

Abstract:

Unwanted sound reflection can create acoustic discomfort and lead to problems of speech comprehensibility. Contemporary building techniques enable highly finished internal walls resulting in sound reflective surfaces. In contrast, sustainable construction materials using natural and vegetal materials, are often more porous and absorptive. Hemp shiv is used as an aggregate and when mixed with lime binder creates a low-embodied-energy concrete. Cement replacements such as ground granulated blast slag (GGBS), a byproduct of other industrial processes, are viewed as more sustainable alternatives to high-embodied-energy cement. Hemp concretes exhibit good hygrothermal performance. This has focused much research attention on them as natural and sustainable low-energy alternatives to standard concretes. A less explored benefit is the acoustic absorption capability of hemp-based concretes. This work investigates hemp-lime-GGBS concrete specifically, and shows that it exhibits high levels of sound absorption.

Keywords: hemp, hempcrete, acoustic absorption, GGBS

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11 A Computational Analysis of Flow and Acoustics around a Car Wing Mirror

Authors: Aidan J. Bowes, Reaz Hasan

Abstract:

The automotive industry is continually aiming to develop the aerodynamics of car body design. This may be for a variety of beneficial reasons such as to increase speed or fuel efficiency by reducing drag. However recently there has been a greater amount of focus on wind noise produced while driving. Designers in this industry seek a combination of both simplicity of approach and overall effectiveness. This combined with the growing availability of commercial CFD (Computational Fluid Dynamics) packages is likely to lead to an increase in the use of RANS (Reynolds Averaged Navier-Stokes) based CFD methods. This is due to these methods often being simpler than other CFD methods, having a lower demand on time and computing power. In this investigation the effectiveness of turbulent flow and acoustic noise prediction using RANS based methods has been assessed for different wing mirror geometries. Three different RANS based models were used, standard k-ε, realizable k-ε and k-ω SST. The merits and limitations of these methods are then discussed, by comparing with both experimental and numerical results found in literature. In general, flow prediction is fairly comparable to more complex LES (Large Eddy Simulation) based methods; in particular for the k-ω SST model. However acoustic noise prediction still leaves opportunities for more improvement using RANS based methods.

Keywords: acoustics, aerodynamics, RANS models, turbulent flow

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10 Media Framing and Agenda-Setting of Hurricane Harvey’s News Coverage: A Content Analysis of The New York Times, The Wall Street Journal, and The Houston Chronicle from 2017 To 2018

Authors: S M Asger Ali, Duane A. Gill

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During crisis moments like a natural disaster, people tend to rely on the mass media to get up-to-date information and stay informed. However, when media are covering crisis news, they may lose some objectivity, and rather than providing balanced news coverage, media may become critical towards the government and private sectors for their participation in disaster response and recovery processes. This paper investigated the print media coverage of Hurricane Harvey and utilized data from three newspapers: the New York Times (online), the Wall Street Journal (online), and the Houston Chronicle. By examining the media's use of descriptors, quotes, wording, and images, this research explored how media coverage framed government and private sectors for their role in Harvey's response and recovery. Findings revealed that the human-interest frame received the most media attention, and the morality frame received less attention. Regarding tone, this study found that the media's overall tone for government response was neutral. However, the tone for the federal government was slightly negative, while the tone for city and state level of government was slightly positive. By examining the media's tone and frame, this research contributes to the literature on risk communication, mass media, and disaster studies.

Keywords: hurricane Harvey, mass media, risk communication, disaster response, media framing, crisis news coverage

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9 A Brief Trauma Treatment Program for Survivors of Trauma: A Single-Case Design

Authors: Duane Booysen, Ashraf Kagee

Abstract:

There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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8 Sustainable Development in Orthodontics: Orthodontic Archwire Waste

Authors: Saarah Juman, Ilona Johnson, Stephen Richmond, Brett Duane, Sheelagh Rogers

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Introduction: Researchers suggest that within 50 years or less, the available supply of a range of metals will be exhausted, potentially leading to increases in resource conflict and largescale production shortages. The healthcare, dental and orthodontic sectors will undoubtedly be affected as stainless steel instruments are generally heavily relied on. Although changing orthodontic archwires are unavoidable and necessary to allow orthodontic tooth movement through the progression of an archwire sequence with fixed appliances, they are thought to be manufactured in excess of what is needed. Furthermore, orthodontic archwires require trimming extraorally to allow safe intraoral insertion, thus contributing to unnecessary waste of natural resources. Currently, there is no evidence to support the optimisation of archwire length according to orthodontic fixed appliance stage. As such, this study aims to quantify archwire excess (extraoral archwire trimmings) for different stages of orthodontic fixed appliance treatment. Methodology: This prospective, observational, quantitative study observed trimmings made extraorally against pre-treatment study models by clinicians over a 3-month period. Archwires were categorised into one of three categories (initial aligning, sequence, working/finishing arcwhires) within the orthodontic fixed appliance archwire sequence. Data collection included archwire material composition and the corresponding length and weight of excess archwire. Data was entered using a Microsoft Excel spreadsheet and imported into statistical software to obtain simple descriptive statistics. Results: Measurements were obtained for a total of 144 archwires. Archwire materials included nickel titanium and stainless steel. All archwires observed required extraorally trimming to allow safe intraoral insertion. The manufactured lengths of orthodontic initial aligning, sequence, and working/finishing arcwhires were at least 31%, 26%, and 39% in excess, respectively. Conclusions: Orthodontic archwires are manufactured to be excessively long at all orthodontic archwire sequence stages. To conserve natural resources, this study’s findings support the optimisation of orthodontic archwire lengths by manufacturers according to the typical stages of an orthodontic archwire sequence.

Keywords: archwire, orthodontics, sustainability, waste

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7 Improving Infant Vaccination Rates Through Expanded Access to Care

Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

Abstract:

Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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6 A Review of the Nutritional, Health and Medicinal Benefits of Selected Endangered Food Spice Crops in South Eastern Nigeria

Authors: Poly-Mbah C. P., Offor J. I., Onyeneke E. N., Poly-Mbah J. C.

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Many food spice crops are being endangered into extinction in Nigeria because of climate change as well as deforestation occasioned by population pressure and urbanization and also due to neglect of research and agronomic attention. This review was aimed at identifying the nutritional and health benefits of these endangered aromatic food spice crops. The findings of this review will help to popularize their cultivation and increase research efforts made in the agronomy of these food spice species. Nine aromatic food spice crop species identified to be facing the danger of extinction include: Guinea pepper ( Piper guineensis), Utazi ( Gongronema latifolium), Hoary or Thai lemon basil ( Ocimum africanum), Mint basil ( Ocimum gratissimum), Whole country onions( Afrostyrax lepidophyllus), Jansa ( Cussonia bateri), Negro pepper ( Xylopia aethiopica), Ataiko or Orima (Afromomium Danielle), Aidan (Tetrapleura tetraptera). Findings from this review revealed that these species are capable of improving the nutrition and health of the rural dwellers but yet, are minimally cultivated. This paper also reviewed research made in the agronomy of these identified threatened food spice crops in the semi-urban Southeastern Nigeria environment and discovered that there is little research attention on them. The availability of these food spice crop species was discovered to come from collections made from nearby bushes and forests. This paper therefore recommends that agronomic packages such as pre-planting, planting and post-planting requirements be investigated and recommended in order to initiate and increase the cultivation of the selected endangered food spice crops as well as their productivity.

Keywords: review, endangered, food spice crops, South Eastern Nigeria

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5 Synthesis of Fluorescent PET-Type “Turn-Off” Triazolyl Coumarin Based Chemosensors for the Sensitive and Selective Sensing of Fe⁺³ Ions in Aqueous Solutions

Authors: Aidan Battison, Neliswa Mama

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Environmental pollution by ionic species has been identified as one of the biggest challenges to the sustainable development of communities. The widespread use of organic and inorganic chemical products and the release of toxic chemical species from industrial waste have resulted in a need for advanced monitoring technologies for environment protection, remediation and restoration. Some of the disadvantages of conventional sensing methods include expensive instrumentation, well-controlled experimental conditions, time-consuming procedures and sometimes complicated sample preparation. On the contrary, the development of fluorescent chemosensors for biological and environmental detection of metal ions has attracted a great deal of attention due to their simplicity, high selectivity, eidetic recognition, rapid response and real-life monitoring. Coumarin derivatives S1 and S2 (Scheme 1) containing 1,2,3-triazole moieties at position -3- have been designed and synthesized from azide and alkyne derivatives by CuAAC “click” reactions for the detection of metal ions. These compounds displayed a strong preference for Fe3+ ions with complexation resulting in fluorescent quenching through photo-induced electron transfer (PET) by the “sphere of action” static quenching model. The tested metal ions included Cd2+, Pb2+, Ag+, Na+, Ca2+, Cr3+, Fe3+, Al3+, Cd2+, Ba2+, Cu2+, Co2+, Hg2+, Zn2+ and Ni2+. The detection limits of S1 and S2 were determined to be 4.1 and 5.1 uM, respectively. Compound S1 displayed the greatest selectivity towards Fe3+ in the presence of competing for metal cations. S1 could also be used for the detection of Fe3+ in a mixture of CH3CN/H¬2¬O. Binding stoichiometry between S1 and Fe3+ was determined by using both Jobs-plot and Benesi-Hildebrand analysis. The binding was shown to occur in a 1:1 ratio between the sensor and a metal cation. Reversibility studies between S1 and Fe3+ were conducted by using EDTA. The binding site of Fe3+ to S1 was determined by using 13 C NMR and Molecular Modelling studies. Complexation was suggested to occur between the lone-pair of electrons from the coumarin-carbonyl and the triazole-carbon double bond.

Keywords: chemosensor, "click" chemistry, coumarin, fluorescence, static quenching, triazole

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4 Effect of Low to Moderate Altitude on Football Performance: An Analysis of Thirteen Seasons in the South African Premier Soccer League

Authors: Khatija Bahdur, Duane Dell’Oca

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There is limited information on how altitude impacts performance in a team sport. Most altitude research in football has been conducted at high elevation ( > 2500m), resulting in a chasm of understanding whether low to moderate altitude affects performance. The South African Premier Soccer League (PSL) fixtures entail matches played at altitudes from sea level to 1700m above mean sea level. Despite coaches highlighting the effect of altitude on performance outcomes in matches, further research is needed to establish whether altitude does impact match results. Greater insight into if and how altitude impacts performance in the PSL will assist coaches in deciding if and how to incorporate altitude in their planning. The purpose of this study is to fill in this gap through the use of a retrospective analysis of PSL matches. This quantitative study is based on a descriptive analysis of 181 PSL matches involving one team based at sea-level, taking place over a period of thirteen seasons. The following data were obtained: altitude at which the match was played, match result, the timing of goals, and timing of substitutions. The altitude was classified in 2 ways: inland ( > 500m) and coastal ( < 500m) and also further subdivided into narrower categories ( < 500m, 500-1000m, 1000-1300m; 1300-1500m, > 1500m). The analysis included a 2-sample t-test to determine differences in total goals scored and timing of goals for inland and coastal matches and the chi-square test to identify the significance of altitude on match results. The level of significance was set at the alpha level of 0.05. Match results are significantly affected by the altitude and level of altitude within inland teams most likely to win when playing at inland venues (p=0.000). The proportion of draws was slightly higher at the coast. At altitudes between 500-1000m, 1300-1500m, and 1500-1700m, a greater percentage of matches were won by coastal teams as opposed to draws. The timing of goals varied based on the team’s base altitude and the match elevation. The most significant differences were between 36-40 minutes (p=0.023), 41-45 minutes (p=0.000) and 50-65 minutes (p=0.000). When breaking down inland team’s matches to different altitude categories, greater differences were highlighted. Inland teams scored more goals per minute between 10-20 minute (p=0.009), 41-45 minutes (p=0.003) and 50-65 minutes (p=0.015). The total number of goals scored per match at different altitudes by a) inland teams (p=0.000), b) coastal teams (p=0.006). Coastal teams made significantly more substitutions when playing at altitude (p=0.034), although there were no significant differences when comparing the different altitude categories. The timing of all three changes, however, did vary significantly at the different altitudes. There were no significant differences in timing or number of substitutions for inland teams. Match results and timing of goals are influenced by altitude, with differences between the level of altitude also playing a role. The trends indicate that inland teams win more matches when playing at altitude against coastal teams, and they score more goals just prior to half-time and in the first quarter of the second half.

Keywords: coastal teams, inland teams, timing of goals, results, substitutions

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3 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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2 An Explorative Analysis of Effective Project Management of Research and Research-Related Projects within a recently Formed Multi-Campus Technology University

Authors: Àidan Higgins

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Higher education will be crucial in the coming decades in helping to make Ireland a nation is known for innovation, competitive enterprise, and ongoing academic success, as well as a desirable location to live and work with a high quality of life, vibrant culture, and inclusive social structures. Higher education institutions will actively connect with each student community, society, and business; they will help students develop a sense of place and identity in Ireland and provide the tools they need to contribute significantly to the global community. It will also serve as a catalyst for novel ideas through research, many of which will become the foundation for long-lasting inventive businesses in the future as part of the 2030 National Strategy on Education focuses on change and developing our education system with a focus on how we carry out Research. The emphasis is central to knowledge transfer and a consistent research framework with exploiting opportunities and having the necessary expertise. The newly formed Technological Universities (TU) in Ireland are based on a government initiative to create a new type of higher education institution that focuses on applied and industry-focused research and education. The basis of the TU is to bring together two or more existing institutes of technology to create a larger and more comprehensive institution that offers a wider range of programs and services to students and industry partners. The TU model aims to promote collaboration between academia, industry, and community organizations to foster innovation, research, and economic development. The TU model also aims to enhance the student experience by providing a more seamless pathway from undergraduate to postgraduate studies, as well as greater opportunities for work placements and engagement with industry partners. Additionally, the TUs are designed to provide a greater emphasis on applied research, technology transfer, and entrepreneurship, with the goal of fostering innovation and contributing to economic growth. A project is a collection of organised tasks carried out precisely to produce a singular output (product or service) within a given time frame. Project management is a set of activities that facilitates the successful implementation of a project. The significant differences between research and development projects are the (lack of) precise requirements and (the inability to) plan an outcome from the beginning of the project. The evaluation criteria for a research project must consider these and other "particularities" in works; for instance, proving something cannot be done may be a successful outcome. This study intends to explore how a newly established multi-campus technological university manages research projects effectively. The study will identify the potential and difficulties of managing research projects, the tools, resources and processes available in a multi-campus Technological University context and the methods and approaches employed to deal with these difficulties. Key stakeholders like project managers, academics, and administrators will be surveyed as part of the study, which will also involve an explorative investigation of current literature and data. The findings of this study will contribute significantly to creating best practices for project management in this setting and offer insightful information about the efficient management of research projects within a multi-campus technological university.

Keywords: project management, research and research-related projects, multi-campus technology university, processes

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1 Pulmonary Complication of Chronic Liver Disease and the Challenges Identifying and Managing Three Patients

Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

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Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

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