Search results for: teaching innovative health care delivery method

Authors: Yichao Liu, Peter Fransson, Julian Heidecke, Jonas Wallin, Joacim Rockloev

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Dengue, a mosquito-borne viral disease, poses a significant public health challenge in endemic tropical or subtropical countries, including Sri Lanka. To reveal insights into the complexity of the dynamics of this disease and study the drivers, a comprehensive model capable of both robust forecasting and insightful inference of drivers while capturing the co-circulating of several virus strains is essential. However, existing studies mostly focus on only one aspect at a time and do not integrate and carry insights across the siloed approach. While mechanistic models are developed to capture immunity dynamics, they are often oversimplified and lack integration of all the diverse drivers of disease transmission. On the other hand, purely data-driven methods lack constraints imposed by immuno-epidemiological processes, making them prone to overfitting and inference bias. This research presents a hybrid model that combines machine learning techniques with mechanistic modelling to overcome the limitations of existing approaches. Leveraging eight years of newly reported dengue case data, along with socioeconomic factors, such as human mobility, weekly climate data from 2011 to 2018, genetic data detecting the introduction and presence of new strains, and estimates of seropositivity for different districts in Sri Lanka, we derive a data-driven vector (SEI) to human (SEIR) model across 16 regions in Sri Lanka at the weekly time scale. By conducting ablation studies, the lag effects allowing delays up to 12 weeks of time-varying climate factors were determined. The model demonstrates superior predictive performance over a pure machine learning approach when considering lead times of 5 and 10 weeks on data withheld from model fitting. It further reveals several interesting interpretable findings of drivers while adjusting for the dynamics and influences of immunity and introduction of a new strain. The study uncovers strong influences of socioeconomic variables: population density, mobility, household income and rural vs. urban population. The study reveals substantial sensitivity to the diurnal temperature range and precipitation, while mean temperature and humidity appear less important in the study location. Additionally, the model indicated sensitivity to vegetation index, both max and average. Predictions on testing data reveal high model accuracy. Overall, this study advances the knowledge of dengue transmission in Sri Lanka and demonstrates the importance of incorporating hybrid modelling techniques to use biologically informed model structures with flexible data-driven estimates of model parameters. The findings show the potential to both inference of drivers in situations of complex disease dynamics and robust forecasting models.

Keywords: compartmental model, climate, dengue, machine learning, social-economic

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Authors: António J. Gano, Carmen Rangel

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Currently, electric energy storage systems for stationary applications have known an increasing interest, namely with the integration of local renewable energy power sources into energy communities. Li-ion batteries are considered the leading electric storage devices to achieve this integration, and Battery Management Systems (BMS) are decisive for their control and optimum performance. In this work, the advancement of a smart BMS (sBMS) prototype with a modular distributed topology is described. The system, still under development, has a distributed architecture with modular characteristics to operate with different battery pack topologies and charge capacities, integrating adaptive algorithms for functional state real-time monitoring and management of multicellular Li-ion batteries, and is intended for application in the context of a local energy community fed by renewable energy sources. This sBMS system includes different developed hardware units: (1) Cell monitoring units (CMUs) for interfacing with each individual cell or module monitoring within the battery pack; (2) Battery monitoring and switching unit (BMU) for global battery pack monitoring, thermal control and functional operating state switching; (3) Main management and local control unit (MCU) for local sBMS’s management and control, also serving as a communications gateway to external systems and devices. This architecture is fully expandable to battery packs with a large number of cells, or modules, interconnected in series, as the several units have local data acquisition and processing capabilities, communicating over a standard CAN bus and will be able to operate almost autonomously. The CMU units are intended to be used with Li-ion cells but can be used with other cell chemistries, with output voltages within the 2.5 to 5 V range. The different unit’s characteristics and specifications are described, including the different implemented hardware solutions. The developed hardware supports both passive and active methods for charge equalization, considered fundamental functionalities for optimizing the performance and the useful lifetime of a Li-ion battery package. The functional characteristics of the different units of this sBMS system, including different process variables data acquisition using a flexible set of sensors, can support the development of custom algorithms for estimating the parameters defining the functional states of the battery pack (State-of-Charge, State-of-Health, etc.) as well as different charge equalizing strategies and algorithms. This sBMS system is intended to interface with other systems and devices using standard communication protocols, like those used by the Internet of Things. In the future, this sBMS architecture can evolve to a fully decentralized topology, with all the units using Wi-Fi protocols and integrating a mesh network, making unnecessary the MCU unit. The status of the work in progress is reported, leading to conclusions on the system already executed, considering the implemented hardware solution, not only as fully functional advanced and configurable battery management system but also as a platform for developing custom algorithms and optimizing strategies to achieve better performance of electric energy stationary storage devices.

Keywords: Li-ion battery, smart BMS, stationary electric storage, distributed BMS

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Authors: G. Kiran Kumar, K. Padmaja

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The rise of urban and peri-urban agriculture (UPA) is an important urban phenomenon that needs to be well understood before we pronounce a verdict whether it is beneficial or not. The challenge of supply of safe and nutritious food is faced by urban inhabitants. The definition of urban and peri-urban varies from city to city depending on the local policies framed with a view to bring regulated urban habitations as part of governance. Expansion of cities and the blurring of boundaries between urban and rural areas make it difficult to define peri-urban agriculture. The problem is further exacerbated by the fact that definition adopted in one region may not fit in the other. On the other hand the proportion of urban population is on the rise vis-à-vis rural. The rise of UPA does not promise that the food requirements of cities can be entirely met from this practice, since availability of enormous amounts of spaces on rooftops and vacant plots is impossible for raising crops. However, UPA reduces impact of price volatility, particularly for vegetables, which relatively have a longer shelf life. UPA improves access to fresh, nutritious and safe food for the urban poor. UPA provides employment to food handlers and traders in the supply chain. UPA can pose environmental and health risks from inappropriate agricultural practices; increased competition for land, water and energy; alter the ecological landscape and make it vulnerable to increased pollution. The present work is based on case studies in peri-urban agriculture in Hyderabad, India and relies on secondary data. This paper tries to analyze the need for more intensive production technologies without affecting the environment. An optimal solution in terms of urban-rural linkages has to be devised. There is a need to develop a spatial vision and integrate UPA in urban planning in a harmonious manner. Zoning of peri-urban areas for agriculture, milk and poultry production is an essential step to preserve the traditional nurturing character of these areas. Urban local bodies in conjunction with Departments of Agriculture and Horticulture can provide uplift to existing UPA models, without which the UPA can develop into a haphazard phenomenon and add to the increasing list of urban challenges. Land to be diverted for peri-urban agriculture may render the concept of urban and peri-urban forestry ineffective. This paper suggests that UPA may be practiced for high value vegetables which can be cultivated under protected conditions and are better resilient to climate change. UPA can provide models for climate resilient agriculture in urban areas which can be replicated in rural areas. Production of organic farm produce is another option for promote UPA owing to the proximity to informed consumers and access to markets within close range. Waste lands in peri-urban areas can be allotted to unemployed rural youth with the support of Urban Local Bodies (ULBs) and used for UPA. This can serve the purposes of putting wastelands to food production, enhancing employment opportunities and enhancing access to fresh produce for urban consumers.

Keywords: environment, food security, urban and peri-urban agriculture, zoning

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Authors: Breanna Wright, Peter Bragge

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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.

Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error

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Authors: Prescilla Lambert, Christophe Roos, Mounim Lebrini

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For several years, the Caribbean islands and West Africa have had to deal with the massive arrival of the brown seaweed Sargassum. Overall, this macroalgae, which constitutes a habitat for a great diversity of marine organisms, is also an additional stress factor for the marine environment (e.g., coral reefs). In addition, the accumulation followed by the significant decomposition of the Sargassum spp. biomass on the coast leads to the release of toxic gases (H₂S and NH₃), which calls into question the functioning of the economic, health and tourist life of the island and the other interested territories. Originally, these algae are formed by the eutrophication of the oceans accentuated by global warming. Unfortunately, scientists predict a significant recurrence of these Sargassum strandings for years to come. It is therefore more than necessary to find solutions by putting in place a sustainable management plan for this phenomenon. Martinique, a small island in the Caribbean arc, is one of the many areas impacted by Sargassum seaweed strandings. Since 2011, there has been a constant increase in the degradation of the materials present in this region, largely due to toxic/corrosive gases released by the algae decomposition. In order to protect the structures and the vulnerable building materials while limiting the use of synthetic/petroleum based molecules as much as possible, research is being conducted on molecules of natural origin. Thus, thanks to the chemical composition, which comprise molecules with interesting properties, algae such as Sargassum could potentially help to solve many issues. Therefore, this study focuses on the green extraction and characterization of molecules from the species Sargassum fluitans and Sargassum natans present in Martinique. The secondary metabolites found in these extracts showed variability in yield rates due to local climatic conditions. The tests carried out shed light on the anticorrosive and antibacterial potential of the algae. These extracts can thus be described as natural inhibitors. The effect of variation in inhibitor concentrations was tested in electrochemistry using electrochemical impedance spectroscopy and polarization curves. The analysis of electrochemical results obtained by direct immersion in the extracts and self-assembled molecular layers (SAMs) for Sargassum fluitans III, Sargassum natans I and VIII species was conclusive in acid and alkaline environments. The excellent results obtained reveal an inhibitory efficacy of 88% at 50mg/L for the crude extract of Sargassum fluitans III and efficacies greater than 97% for the chemical families of Sargassum fluitans III. Similarly, microbiological tests also suggest a bactericidal character. Results for Sargassum fluitans III crude extract show a minimum inhibitory concentration (MIC) of 0.005 mg/mL on Gram-negative bacteria and a MIC greater than 0.6 mg/mL on Gram-positive bacteria. These results make it possible to consider the management of local and international issues while valuing a biomass rich in biodegradable molecules. The next step in this study will therefore be the evaluation of the toxicity of Sargassum spp..

Keywords: Sargassum, secondary metabolites, anticorrosive, antibacterial, natural inhibitors

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Authors: Mabel Y. C. Yau, Roy C. F. Lai, Hugo Y. H. Or

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This study is a pilot surveillance of hygiene compliance and food microbial safety of both licensed and mobile vendors selling Chinese ready–to-eat snack foods in Hong Kong. The study reflects similar situations in running mobile food vending business on trucks. Hong Kong is about to launch the Food Truck Pilot Scheme by the end of 2016 or early 2017. Technically, selling food on the vehicle is no different from hawking food on the street or vending food on the street. Each type of business bears similar food safety issues and cast the same impact on public health. Present findings demonstrate exemplarily situations that also apply to food trucks. 9 types of Cantonese style snacks of 32 samples in total were selected for microbial screening. A total of 16 vending sites including supermarkets, street markets, and snack stores were visited. The study finally focused on a traditional snack, the steamed rice cake with red beans called Put Chai Ko (PCK). PCK is a type of classical Cantonese pastry sold on push carts on the street. It used to be sold at room temperature and served with bamboo sticks in the old days. Some shops would have them sold steam fresh. Microbial examinations on aerobic counts, yeast, and mould, coliform, salmonella as well as Staphylococcus aureus detections were carried out. Salmonella was not detected in all samples. Since PCK does not contain ingredients of beef, poultry, eggs or dairy products, the risk of the presence of Salmonella in PCK was relatively lower although other source of contamination might be possible. Coagulase positive Staphylococcus aureus was found in 6 of the 14 samples sold at room temperature. Among these 6 samples, 3 were PCK. One of the samples was in an unacceptable range of total colony forming units higher than 105. The rest were only satisfactory. Observational evaluations were made with checklists on personal hygiene, premises hygiene, food safety control, food storage, cleaning and sanitization as well as waste disposals. The maximum score was 25 if total compliance were obtained. The highest score among vendors was 20. Three stores were below average, and two of these stores were selling PCK. Most of the non-compliances were on food processing facilities, sanitization conditions and waste disposal. In conclusion, although no food poisoning outbreaks happened during the time of the investigation, the risk of food hazard existed in these stores, especially among street vendors. Attention is needed in the traditional practice of food selling, and that food handlers might not have sufficient knowledge to properly handle food products. Variations in food qualities existed among supply chains or franchise eateries or shops. It was commonly observed that packaging and storage conditions are not properly enforced in the retails. The same situation could be reflected across the food business. It did indicate need of food safety training in the industry and loopholes in quality control among business.

Keywords: cantonese snacks, food safety, microbial, hygiene, street food

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Authors: Geisa Lima Mesquita Zambrosi, Maisa Ciampi Guillardi, Flávia Rodrigues Patrício, Oliveiro Guerreiro Filho

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Certified agricultural products are important components of the food industry. However, certifiers have been expanding the list of restricted or prohibited pesticides, limiting the options of products for phytosanitary control of plant diseases, but without offering alternatives to the farmers. Soybean and coffee leaf rust, brown eye spots, and Phoma leaf spots are the main fungal diseases that pose a serious threat to soybean and coffee cultivation worldwide. In conventional farming systems, these diseases are controlled by using synthetic fungicides, which, in addition to intensify the occurrence of fungal resistance, are highly toxic to the environment, farmers and consumers. In organic, agroecological, or regenerative farming systems, product options for plant protection are limited, being available only copper-based compounds, biodefensives or non-standard homemade products. Therefore, there is a growing demand for effective bioprotectors with low environmental impact for adoption in more sustainable agricultural systems. Then, to contribute with the covering of such a gap, we have developed a compound based on plant extracts and metallic elements for foliar application. This product has both biostimulant and bioprotective action, which promotes sustainable disease control, increases productivity as well as reduces the dependence on imported technologies the damages to the environment. The product's components have complementary mechanisms that promote protection against the disease by directly acting on the pathogens and activating the plant's natural defense system. The protective ability of the product against three coffee diseases (coffee leaf rust, brown eye spot, and Phoma leaf spot) and against soybean rust disease was evaluated, in addition to its ability to promote plant growth. Our goal is to offer an effective alternative to control the main coffee fungal diseases and soybean fungal diseases, with a biostimulant effect and low toxicity. The proposed product can also be part of the integrated management of coffee and soybean diseases in conventional farming associated with chemical and biological pesticides, offering the market a sustainable coffee and soybean with high added value and low residue content. Experiments were carried out under controlled conditions to evaluate the effectiveness of the product in controlling rust, phoma, and cercosporiosis in comparison to a control-inoculated plants that did not receive the product. The in vitro and in vivo effects of the product on the pathogen were evaluated using light microscopy and scanning electron microscopy, respectively. The fungistatic action of the product was demonstrated by a reduction of 85% and 95% in spore germination and disease symptoms severity on the leaves of coffee plants, respectively. The formulation had both a protective effect, acting to prevent infection by coffee leaf rust, and a curative effect, reducing the rust symptoms after its establishment.

Keywords: plant disease, natural fungicide, plant health, sustainability, alternative disease management

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Authors: Abha Gupta, Deepak K. Mishra

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Food security issue in India has surrounded over availability and accessibility of cereal which is regarded as the only food group to check hunger and improve nutrition. Significance of fruits, vegetables, meat and other food products have totally been neglected given the fact that they provide essential nutrients to the body. There is a need to shift the emphasis from cereal-based approach to a more diverse diet so that aim of achieving food security may change from just reducing hunger to an overall health. This paper attempts to analyse how far dietary diversity level has been achieved across different socio-economic groups in India. For this purpose, present paper sets objectives to determine (a) percentage share of different food groups to total food expenditure and consumption by background characteristics (b) source of and preference for all food items and, (c) diversity of diet across socio-economic groups. A cross sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of Uttar Pradesh, India. Information on amount of food consumed, source of consumption and expenditure on food (74 food items grouped into 10 major food groups) was collected with a recall period of seven days. Per capita per day food consumption/expenditure was calculated through dividing consumption/expenditure by household size and number seven. Food variety score was estimated by giving 0 values to those food groups/items which had not been eaten and 1 to those which had been taken by households in last seven days. Addition of all food group/item score gave result of food variety score. Diversity of diet was computed using Herfindahl-Hirschman index. Findings of the paper show that cereal, milk, roots and tuber food groups contribute a major share in total consumption/expenditure. Consumption of these food groups vary across socio-economic groups whereas fruit, vegetables, meat and other food consumption remain low and same. Estimation of dietary diversity show higher concentration of diet due to higher consumption of cereals, milk, root and tuber products and dietary diversity slightly varies across background groups. Muslims, Scheduled caste, small farmers, lower income class, food insecure, below poverty line and labour families show higher concentration of diet as compared to their counterpart groups. These groups also evince lower mean intake of number of food item in a week due to poor economic constraints and resultant lower accessibility to number of expensive food items. Results advocate to make a shift from cereal based diet to dietary diversity which not only includes cereal and milk products but also nutrition rich food items such as fruits, vegetables, meat and other products. Integrating a dietary diversity approach in food security programmes of the country would help to achieve nutrition security as hidden hunger is widespread among the Indian population.

Keywords: dietary diversity, food Security, India, socio-economic groups

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Authors: Thomas D. Collin, Rachel Cunningham, Bruce Jefferson, Raffaella Villa

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Fats, oils and grease (FOG) are by-products of food preparation and cooking processes. FOG enters wastewater systems through a variety of sources such as households, food service establishments, and industrial food facilities. Over time, if no source control is in place, FOG builds up on pipe walls, leading to blockages, and potentially to sewer overflows which are a major risk to the Environment and Human Health. UK water utilities spend millions of pounds annually trying to control FOG. Despite UK legislation specifying that discharge of such material is against the law, it is often complicated for water companies to identify and prosecute offenders. Hence, it leads to uncertainties regarding the attitude to take in terms of FOG management. Research is needed to seize the full potential of implementing current practices. The aim of this research was to undertake a comprehensive study to document the extent of FOG problems in sewer lines and reinforce existing knowledge. Data were collected to develop a model estimating quantities of FOG available for recovery within Thames Water wastewater catchments. Geographical Information System (GIS) software was used in conjunction to integrate data with a geographical component. FOG was responsible for at least 1/3 of sewer blockages in Thames Water waste area. A waste-based approach was developed through an extensive review to estimate the potential for FOG collection and recovery. Three main sources were identified: residential, commercial and industrial. Commercial properties were identified as one of the major FOG producers. The total potential FOG generated was estimated for the 354 wastewater catchments. Additionally, raw and settled sewage were sampled and analysed for FOG (as hexane extractable material) monthly at 20 sewage treatment works (STW) for three years. A good correlation was found with the sampled FOG and population equivalent (PE). On average, a difference of 43.03% was found between the estimated FOG (waste-based approach) and sampled FOG (raw sewage sampling). It was suggested that the approach undertaken could overestimate the FOG available, the sampling could only capture a fraction of FOG arriving at STW, and/or the difference could account for FOG accumulating in sewer lines. Furthermore, it was estimated that on average FOG could contribute up to 12.99% of the primary sludge removed. The model was further used to investigate the relationship between estimated FOG and number of blockages. The higher the FOG potential, the higher the number of FOG-related blockages is. The GIS-based tool was used to identify critical areas (i.e. high FOG potential and high number of FOG blockages). As reported in the literature, FOG was one of the main causes of sewer blockages. By identifying critical areas (i.e. high FOG potential and high number of FOG blockages) the model further explored the potential for source-control in terms of ‘sewer relief’ and waste recovery. Hence, it helped targeting where benefits from implementation of management strategies could be the highest. However, FOG is still likely to persist throughout the networks, and further research is needed to assess downstream impacts (i.e. at STW).

Keywords: fat, FOG, GIS, grease, oil, sewer blockages, sewer networks

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Authors: Pedro Llanos, Diego García

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This paper is addressed to expanding our understanding of the effects of hypoxia training on our bodies to better model its dynamics and leverage some of its implications and effects on human health. Hypoxia training is a recommended practice for military and civilian pilots that allow them to recognize their early hypoxia signs and symptoms, and Scientist Astronaut Candidates (SACs) who underwent hypobaric hypoxia (HH) exposure as part of a training activity for prospective suborbital flight applications. This observational-analytical study describes physiologic responses and symptoms experienced by a SAC group before, during and after HH exposure and proposes a model for assessing predicted versus observed physiological responses. A group of individuals with diverse Science Technology Engineering Mathematics (STEM) backgrounds conducted a hypobaric training session to an altitude up to 22,000 ft (FL220) or 6,705 meters, where heart rate (HR), breathing rate (BR) and core temperature (Tc) were monitored with the use of a chest strap sensor pre and post HH exposure. A pulse oximeter registered levels of saturation of oxygen (SpO₂), number and duration of desaturations during the HH chamber flight. Hypoxia symptoms as described by the SACs during the HH training session were also registered. This data allowed to generate a preliminary predictive model of the oxygen desaturation and O₂ pressure curve for each subject, which consists of a sixth-order polynomial fit during exposure, and a fifth or fourth-order polynomial fit during recovery. Data analysis showed that HR and BR showed no significant differences between pre and post HH exposure in most of the SACs, while Tc measures showed slight but consistent decrement changes. All subjects registered SpO₂ greater than 94% for the majority of their individual HH exposures, but all of them presented at least one clinically significant desaturation (SpO₂ < 85% for more than 5 seconds) and half of the individuals showed SpO₂ below 87% for at least 30% of their HH exposure time. Finally, real time collection of HH symptoms presented temperature somatosensory perceptions (SP) for 65% of individuals, and task-focus issues for 52.5% of individuals as the most common HH indications. 95% of the subjects experienced HH onset symptoms below FL180; all participants achieved full recovery of HH symptoms within 1 minute of donning their O₂ mask. The current HH study performed on this group of individuals suggests a rapid and fully reversible physiologic response after HH exposure as expected and obtained in previous studies. Our data showed consistent results between predicted versus observed SpO₂ curves during HH suggesting a mathematical function that may be used to model HH performance deficiencies. During the HH study, real-time HH symptoms were registered providing evidenced SP and task focusing as the earliest and most common indicators. Finally, an assessment of HH signs of symptoms in a group of heterogeneous, non-pilot individuals showed similar results to previous studies in homogeneous populations of pilots.

Keywords: slow onset hypoxia, hypobaric chamber training, altitude sickness, symptoms and altitude, pressure cabin

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Authors: Ramanpreet, Gursatej Gandhi

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Background: Dependence on electromagnetic radiations involved in communication and information technologies has incredibly increased in the personal and professional world. Among the numerous radiations, sources are fixed site transmitters, mobile phone base stations, and power lines beside indoor devices like cordless phones, WiFi, Bluetooth, TV, radio, microwave ovens, etc. Rather there is the continuous emittance of radiofrequency radiations (RFR) even to those not using the devices from mobile phone base stations. The consistent and widespread usage of wireless devices has build-up electromagnetic fields everywhere. In fact, the radiofrequency electromagnetic field (RF-EMF) has insidiously become a part of the environment and like any contaminant may pose to be health-hazardous requiring assessment. Materials and Methods: In the present study, cytogenetic damage was assessed using the Buccal Micronucleus Cytome (BMCyt) assay as a function of radiation exposure after Institutional Ethics Committee clearance of the study and written voluntary informed consent from the participants. On a pre-designed questionnaire, general information lifestyle patterns (diet, physical activity, smoking, drinking, use of mobile phones, internet, Wi-Fi usage, etc.) genetic, reproductive (pedigrees) and medical histories were recorded. For this, 24 hour-personal exposimeter measurements (PEM) were recorded for unrelated 60 healthy adults (40 cases residing in the vicinity of mobile phone base stations since their installation and 20 controls residing in areas with no base stations). The personal exposimeter collects information from all the sources generating EMF (TETRA, GSM, UMTS, DECT, and WLAN) as total RF-EMF uplink and downlink. Findings: The cases (n=40; 23-90 years) and the controls (n=20; 19-65 years) matched for alcohol drinking, smoking habits, and mobile and cordless phone usage. The PEM in cases (149.28 ± 8.98 mV/m) revealed significantly higher (p=0.000) electric field strength compared to the recorded value (80.40 ± 0.30 mV/m) in controls. The GSM 900 uplink (p=0.000), GSM 1800 downlink (p=0.000),UMTS (both uplink; p=0.013 and downlink; p=0.001) and DECT (p=0.000) electric field strength were significantly elevated in the cases as compared to controls. The electric field strength in the cases was significantly from GSM1800 (52.26 ± 4.49mV/m) followed by GSM900 (45.69 ± 4.98mV/m), UMTS (25.03 ± 3.33mV/m), DECT (18.02 ± 2.14mV/m) and was least from WLAN (8.26 ± 2.35mV/m). The higher significantly (p=0.000) increased exposure to the cases was from GSM (97.96 ± 6.97mV/m) in comparison to UMTS, DECT, and WLAN. The frequencies of micronuclei (1.86X, p=0.007), nuclear buds (2.95X, p=0.002) and cell death parameter (condensed chromatin cells) were significantly (1.75X, p=0.007) elevated in cases compared to that in controls probably as a function of radiofrequency radiation exposure. Conclusion: In the absence of other exposure(s), any cytogenetic damage if unrepaired is a cause of concern as it can cause malignancy. Larger sample size with the clinical assessment will prove more insightful of such an effect.

Keywords: Buccal micronucleus cytome assay, cytogenetic damage, electric field strength, personal exposimeter

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Authors: Katharina Raab, Ralf Wagner

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With the decrease of poverty, the focus on the solid waste challenge shifts away from affluent, mostly Westernized consumers to the base of the pyramid. The relevance of considering the disposal behavior of impoverished people arises from improved welfare, leading to an increase in consumption opportunities and, consequently, of waste production. In combination with the world’s growing population the relevance of the topic increases, because solid waste management has global impacts on consumers’ welfare. The current annual municipal solid waste generation is estimated to 1.9 billion tonnes, 30% remains uncollected. As for the collected 70% is landfilling and dumping, 19% is recycled or recovered, 11% is led to energy recovery facilities. Therefore, aim is to contribute by adding first insights about poor people's disposal behaviors, including the framing of their rationalities, emotions and cognitions. The study provides novel empirical results obtained from qualitative semi-structured in-depth interviews near Guatemala City. In the study’s framework consumers have to choose from three options when deciding what to do with their obsolete possessions: Keeping the product: The main reason for this is the respondent´s emotional attachment to a product. Further, there is a willingness to use the same product under a different scope when it loses its functionality–they recycle their belongings in a customized and sustainable way. Permanently disposing of the product: The study reveals two dominant disposal methods: burning in front of their homes and throwing away in the physical environment. Respondents clearly recognized the disadvantages of burning toxic durables, like electronics. Giving a product away as a gift supports the integration of individuals in their peer networks of family and friends. Temporarily disposing of the product: Was not mentioned–to be specific, rent or lend a product to someone else was out of question. Contrasting the background to which extend poor people are aware of the consequences of their disposal decisions and how they feel about and rationalize their actions were quite unexpected. Respondents reported that they are worried about future consequences with impacts they cannot anticipate now–they are aware that their behaviors harm their health and the environment. Additionally, they expressed concern about the impact this disposal behavior would have on others’ well-being and are therefore sensitive to the waste that surrounds them. Concluding, the BoP-framed life and Westernized consumption, both fit in a circular economy pattern, but the nature of how to recycle and dispose separates these two societal groups. Both systems own a solid waste management system, but people living in slum-type districts and rural areas of poor countries are less interested in connecting to the system–they are primarily afraid of the costs. Further, it can be said that a consumer’s perceived effectiveness is distinct from environmental concerns, but contributes to forecasting certain pro-ecological behaviors. Considering the rationales underlying disposal decisions, thoughtfulness is a well-established determinant of disposition behavior. The precipitating events, emotions and decisions associated with the act of disposing of products are important because these decisions can trigger different results for the disposal process.

Keywords: base of the pyramid, disposal behavior, poor consumers, solid waste

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Authors: Ola Hall, Ibrahim Wahab, Thorsteinn Rognvaldsson, Mattias Ohlsson

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The subfield of poverty and welfare estimation that applies machine learning tools and methods on satellite imagery is a nascent but rapidly growing one. This is in part driven by the sustainable development goal, whose overarching principle is that no region is left behind. Among other things, this requires that welfare levels can be accurately and rapidly estimated at different spatial scales and resolutions. Conventional tools of household surveys and interviews do not suffice in this regard. While they are useful for gaining a longitudinal understanding of the welfare levels of populations, they do not offer adequate spatial coverage for the accuracy that is needed, nor are their implementation sufficiently swift to gain an accurate insight into people and places. It is this void that satellite imagery fills. Previously, this was near-impossible to implement due to the sheer volume of data that needed processing. Recent advances in machine learning, especially the deep learning subtype, such as deep neural networks, have made this a rapidly growing area of scholarship. Despite their unprecedented levels of performance, such models lack transparency and explainability and thus have seen limited downstream applications as humans generally are apprehensive of techniques that are not inherently interpretable and trustworthy. While several studies have demonstrated the superhuman performance of AI models, none has directly compared the performance of such models and human readers in the domain of poverty studies. In the present study, we directly compare the performance of human readers and a DL model using different resolutions of satellite imagery to estimate the welfare levels of demographic and health survey clusters in Tanzania, using the wealth quintile ratings from the same survey as the ground truth data. The cluster-level imagery covers all 608 cluster locations, of which 428 were classified as rural. The imagery for the human readers was sourced from the Google Maps Platform at an ultra-high resolution of 0.6m per pixel at zoom level 18, while that of the machine learning model was sourced from the comparatively lower resolution Sentinel-2 10m per pixel data for the same cluster locations. Rank correlation coefficients of between 0.31 and 0.32 achieved by the human readers were much lower when compared to those attained by the machine learning model – 0.69-0.79. This superhuman performance by the model is even more significant given that it was trained on the relatively lower 10-meter resolution satellite data while the human readers estimated welfare levels from the higher 0.6m spatial resolution data from which key markers of poverty and slums – roofing and road quality – are discernible. It is important to note, however, that the human readers did not receive any training before ratings, and had this been done, their performance might have improved. The stellar performance of the model also comes with the inevitable shortfall relating to limited transparency and explainability. The findings have significant implications for attaining the objective of the current frontier of deep learning models in this domain of scholarship – eXplainable Artificial Intelligence through a collaborative rather than a comparative framework.

Keywords: poverty prediction, satellite imagery, human readers, machine learning, Tanzania

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Authors: Zenaida Chitu, Roxana Bojariu, Liliana Velea, Roxana Burcea

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A number of studies show that extreme air temperature affects mortality related to cardiovascular diseases, particularly among elderly people. In Romania, the summer thermal discomfort expressed by Universal Thermal Climate Index (UTCI) is highest in the Southern part of the country, where Bucharest, the largest Romanian urban agglomeration, is also located. The urban characteristics such as high building density and reduced green areas enhance the increase of the air temperature during summer. In Bucharest, as in many other large cities, the effect of heat urban island is present and determines an increase of air temperature compared to surrounding areas. This increase is particularly important during heat wave periods in summer. In this context, the researchers performed a temperature-mortality analysis based on daily deaths related to cardiovascular diseases, recorded between 2010 and 2019 in Bucharest. The temperature-mortality relationship was modeled by applying distributed lag non-linear model (DLNM) that includes a bi-dimensional cross-basis function and flexible natural cubic spline functions with three internal knots in the 10th, 75th and 90th percentiles of the temperature distribution, for modelling both exposure-response and lagged-response dimensions. Firstly, this study applied this analysis for the present climate. Extrapolation of the exposure-response associations beyond the observed data allowed us to estimate future effects on mortality due to temperature changes under climate change scenarios and specific assumptions. We used future projections of air temperature from five numerical experiments with regional climate models included in the EURO-CORDEX initiative under the relatively moderate (RCP 4.5) and pessimistic (RCP 8.5) concentration scenarios. The results of this analysis show for RCP 8.5 an ensemble-averaged increase with 6.1% of heat-attributable mortality fraction in future in comparison with present climate (2090-2100 vs. 2010-219), corresponding to an increase of 640 deaths/year, while mortality fraction due to the cold conditions will be reduced by 2.76%, corresponding to a decrease by 288 deaths/year. When mortality data is stratified according to the age, the ensemble-averaged increase of heat-attributable mortality fraction for elderly people (> 75 years) in the future is even higher (6.5 %). These findings reveal the necessity to carefully plan urban development in Bucharest to face the public health challenges raised by the climate change. Paper Details: This work is financed by the project URCLIM which is part of ERA4CS, an ERA-NET initiated by JPI Climate, and funded by Ministry of Environment, Romania with co-funding by the European Union (Grant 690462). A part of this work performed by one of the authors has received funding from the European Union’s Horizon 2020 research and innovation programme from the project EXHAUSTION under grant agreement No 820655.

Keywords: cardiovascular diseases, climate change, extreme air temperature, mortality

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Authors: Georgina Cherry, Taranpreet Rai, Luke Boyden, Sitira Williams, Andrea Wright, Richard Brown, Viva Chu, Alasdair Cook, Kevin Wells

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Estimating population-level burden, abilities of pet-parents to identify disease and demand for veterinary services worldwide is challenging. The purpose of this study is to compare a feline pruritus survey with social media listening (SML) data discussing this condition. Surveys are expensive and labour intensive to analyse, but SML data is freeform and requires careful filtering for relevancy. This study considers data from a survey of owner-observed symptoms of 156 pruritic cats conducted using Pet Parade® and SML posts collected through web-scraping to gain insights into the characterisation and management of feline pruritus. SML posts meeting a feline body area, behaviour and symptom were captured and reviewed for relevance representing 1299 public posts collected from 2021 to 2023. The survey involved 1067 pet-parents who reported on pruritic symptoms in their cats. Among the observed cats, approximately 18.37% (n=196) exhibited at least one symptom. The most frequently reported symptoms were hair loss (9.2%), bald spots (7.3%) and infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin (8.2%). Notably, bald spots were the primary symptom reported for short-haired cats, while other symptoms were more prevalent in medium and long-haired cats. Affected body areas, according to pet-parents, were primarily the head, face, chin, neck (27%), and the top of the body, along the spine (22%). 35% of all cats displayed excessive behaviours consistent with pruritic skin disease. Interestingly, 27% of these cats were perceived as non-symptomatic by their owners, suggesting an under-identification of itch-related signs. Furthermore, a significant proportion of symptomatic cats did not receive any skin disease medication, whether prescribed or over the counter (n=41). These findings indicate a higher incidence of pruritic skin disease in cats than recognized by pet owners, potentially leading to a lack of medical intervention for clinically symptomatic cases. The comparison between the survey and social media listening data revealed bald spots were reported in similar proportions in both datasets (25% in the survey and 28% in SML). Infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin accounted for 31% of symptoms in the survey, whereas it represented 53% of relevant SML posts (excluding bumpy skin). Abnormal licking or chewing behaviours were mentioned by pet-parents in 40% of SML posts compared to 38% in the survey. The consistency in the findings of these two disparate data sources, including a complete overlap in affected body areas for the top 80% of social media listening posts, indicates minimal biases in each method, as significant biases would likely yield divergent results. Therefore, the strong agreement across pruritic symptoms, affected body areas, and reported behaviours enhances our confidence in the reliability of the findings. Moreover, the small differences identified between the datasets underscore the valuable insights that arise from utilising multiple data sources. These variations provide additional depth in characterising and managing feline pruritus, allowing for more comprehensive understanding of the condition. By combining survey data and social media listening, researchers can obtain a nuanced perspective and capture a wider range of experiences and perspectives, supporting informed decision-making in veterinary practice.

Keywords: social media listening, feline pruritus, surveys, felines, cats, pet owners

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Authors: Kumar Satyam Das, Murali Raghunathan

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This note discusses the feasibility of field development of a challenging shallow offshore field in South East Asia and how its learnings can be applied to marginal field development across the world especially developing marginal fields in this low oil price world. The field was found to be economically challenging even during high oil prices and the project was put on hold. Shell started development study with the aim to significantly reduce cost through competitively scoping and revive stranded projects. The proposed strategy to achieve this involved Improve Per platform recovery and Reduction in CAPEX. Methodology: Based on various Benchmarking Tool such as Woodmac for similar projects in the region and economic affordability, a challenging target of 50% reduction in unit development cost (UDC) was set for the project. Technical scope was defined to the minimum as to be a wellhead platform with minimum functionality to ensure production. The evaluation of key project decisions like Well location and number, well design, Artificial lift methods and wellhead platform type under different development concept was carried out through integrated multi-discipline approach. Key elements influencing per platform recovery were Wellhead Platform (WHP) location, Well count, well reach and well productivity. Major Findings: Reservoir being shallow posed challenges in well design (dog-leg severity, casing size and the achievable step-out), choice of artificial lift and sand-control method. Integrated approach amongst relevant disciplines with challenging mind-set enabled to achieve optimized set of development decisions. This led to significant improvement in per platform recovery. It was concluded that platform recovery largely depended on the reach of the well. Choice of slim well design enabled designing of high inclination and better productivity wells. However, there is trade-off between high inclination Gas Lift (GL) wells and low inclination wells in terms of long term value, operational complexity, well reach, recovery and uptime. Well design element like casing size, well completion, artificial lift and sand control were added successively over the minimum technical scope design leading to a value and risk staircase. Logical combinations of options (slim well, GL) were competitively screened to achieve 25% reduction in well cost. Facility cost reduction was achieved through sourcing standardized Low Cost Facilities platform in combination with portfolio execution to maximizing execution efficiency; this approach is expected to reduce facilities cost by ~23% with respect to the development costs. Further cost reductions were achieved by maximizing use of existing facilities nearby; changing reliance on existing water injection wells and utilizing existing water injector (W.I.) platform for new injectors. Conclusion: The study provides a spectrum of technically feasible options. It also made clear that different drivers lead to different development concepts and the cost value trade off staircase made this very visible. Scoping of the project through competitive way has proven to be valuable for decision makers by creating a transparent view of value and associated risks/uncertainty/trade-offs for difficult choices: elements of the projects can be competitive, whilst other parts will struggle, even though contributing to significant volumes. Reduction in UDC through proper scoping of present projects and its benchmarking paves as a learning for the development of marginal fields across the world, especially in this low oil price scenario. This way of developing a field has on average a reduction of 40% of cost for the Shell projects.

Keywords: benchmarking, full field development, CAPEX, feasibility

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Authors: A. Chávez, A. Rodríguez, F. Pinzón

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Society is concerned about measures of environmental, economic and social impacts generated in the solid waste disposal. These places of confinement, also known as landfills, are locations where problems of pollution and damage to human health are reduced. They are technically designed and operated, using engineering principles, storing the residue in a small area, compact it to reduce volume and covering them with soil layers. Problems preventing liquid (leachate) and gases produced by the decomposition of organic matter. Despite planning and site selection for disposal, monitoring and control of selected processes, remains the dilemma of the leachate as extreme concentration of pollutants, devastating soil, flora and fauna; aggressive processes requiring priority attention. A biological technology is the activated sludge system, used for tributaries with high pollutant loads. Since transforms biodegradable dissolved and particulate matter into CO2, H2O and sludge; transform suspended and no Settleable solids; change nutrients as nitrogen and phosphorous; and degrades heavy metals. The microorganisms that remove organic matter in the processes are in generally facultative heterotrophic bacteria, forming heterogeneous populations. Is possible to find unicellular fungi, algae, protozoa and rotifers, that process the organic carbon source and oxygen, as well as the nitrogen and phosphorus because are vital for cell synthesis. The mixture of the substrate, in this case sludge leachate, molasses and wastewater is maintained ventilated by mechanical aeration diffusers. Considering as the biological processes work to remove dissolved material (< 45 microns), generating biomass, easily obtained by decantation processes. The design consists of an artificial support and aeration pumps, favoring develop microorganisms (denitrifying) using oxygen (O) with nitrate, resulting in nitrogen (N) in the gas phase. Thus, avoiding negative effects of the presence of ammonia or phosphorus. Overall the activated sludge system includes about 8 hours of hydraulic retention time, which does not prevent the demand for nitrification, which occurs on average in a value of MLSS 3,000 mg/L. The extended aeration works with times greater than 24 hours detention; with ratio of organic load/biomass inventory under 0.1; and average stay time (sludge age) more than 8 days. This project developed a pilot system with sludge leachate from Doña Juana landfill - RSDJ –, located in Bogota, Colombia, where they will be subjected to a process of activated sludge and extended aeration through a sequential Bach reactor - SBR, to be dump in hydric sources, avoiding ecological collapse. The system worked with a dwell time of 8 days, 30 L capacity, mainly by removing values of BOD and COD above 90%, with initial data of 1720 mg/L and 6500 mg/L respectively. Motivating the deliberate nitrification is expected to be possible commercial use diffused aeration systems for sludge leachate from landfills.

Keywords: sludge, landfill, leachate, SBR

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Authors: R. G. Ariyawansa, M. A. N. R. M. Perera

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“House” is a powerful symbol of socio-economic background of individuals and families. In fact, housing provides all types of needs/wants from basic needs to self-actualization needs. This phenomenon can be realized only having analyzed hidden motives of buyers and sellers of the housing market. Hence, the aim of this study is to examine the socio-economic insight of the secondary housing market in Colombo suburbs. This broader aim was achieved via analyzing the general pattern of the secondary housing market, identifying socio-economic motives of sellers of the secondary housing market, and reviewing sellers’ experience of buyer behavior. A purposive sample of 50 sellers from popular residential areas in Colombo such as Maharagama, Kottawa, Piliyandala, Punnipitiya, and Nugegoda was used to collect primary data instead of relevant secondary data from published and unpublished reports. The sample was limited to selling price ranging from Rs15 million to Rs25 million, which apparently falls into middle and upper-middle income houses in the context. Participatory observation and semi-structured interviews were adopted as key data collection tools. Data were descriptively analyzed. This study found that the market is mainly handled by informal agents who are unqualified and unorganized. People such as taxi/tree-wheel drivers, boutique venders, security personals etc. are engaged in housing brokerage as a part time career. Few fulltime and formally organized agents were found but they were also not professionally qualified. As far as housing quality is concerned, it was observed that 90% of houses was poorly maintained and illegally modified. They are situated in poorly maintained neighborhoods as well. Among the observed houses, 2% was moderately maintained and 8% was well maintained and modified. Major socio-economic motives of sellers were “migrating foreign countries for education and employment” (80% and 10% respectively), “family problems” (4%), and “social status” (3%). Other motives were “health” and “environmental/neighborhood problems” (3%). This study further noted that the secondary middle income housing market in the area directly related with the migrants who motivated for education in foreign countries, mainly Australia, UK and USA. As per the literature, families motivated for education tend to migrate Colombo suburbs from remote areas of the country. They are seeking temporary accommodation in lower middle income housing. However, the secondary middle income housing market relates with the migration from Colombo to major global cities. Therefore, final transaction price of this market may depend on migration related dates such as university deadlines, visa and other agreements. Hence, it creates a buyers’ market lowering the selling price. Also it was revealed that the buyers tend to trust more on this market as far as the quality of construction of houses is concerned than brand new houses which are built for selling purpose.

Keywords: informal housing market, hidden motives of buyers and sellers, secondary housing market, socio-economic insight

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Authors: M. Markova, E. Filova, O. Kaplan, R. Matejka, L. Bacakova

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The porcine pericardium is used as a material for cardiac and aortic valves substitutes. Current biological aortic heart valve prosthesis have a limited lifetime period because they undergo degeneration. In order to make them more biocompatible and prolong their lifetime it is necessary to reseed the decellularized prostheses with endothelial cells and with valve interstitial cells. The endothelialization of the prosthesis-surface may be supported by suitable chemical surface modification of the prosthesis. The aim of this study is to prepare bioactive fibrin layers which would both support endothelialization of porcine pericardium and enhance differentiation and maturation of the endothelial cells seeded. As a material for surface adjustments we used layers of fibrin with/without heparin and some of them with adsorbed or chemically bound FGF2, VEGF or their combination. Fibrin assemblies were prepared in 24-well cell culture plate and were seeded with HSVEC (Human Saphenous Vein Endothelial Cells) at a density of 20,000 cells per well in EGM-2 medium with 0.5% FS and without heparin, without FGF2 and without VEGF; medium was supplemented with aprotinin (200 U/mL). As a control, surface polystyrene (PS) was used. Fibrin was also used as homogeneous impregnation of the decellularized porcine pericardium throughout the scaffolds. Morphology, density, and viability of the seeded endothelial cells were observed from micrographs after staining the samples by LIVE/DEAD cytotoxicity/viability assay kit on the days 1, 3, and 7. Endothelial cells were immunocytochemically stained for proteins involved in cell adhesion, i.e. alphaV integrin, vinculin, and VE-cadherin, markers of endothelial cells differentiation and maturation, i.e. von Willebrand factor and CD31, and for extracellular matrix proteins typically produced by endothelial cells, i.e. type IV collagen and laminin. The staining intensities were subsequently quantified using a software. HSVEC cells grew on each of the prepared surfaces better than on control surface. They reached confluency. The highest cell densities were obtained on the surface of fibrin with heparin and both grow factors used together. Intensity of alphaV integrins staining was highest on samples with remained fibrin layer, i.e. on layers with lower cell densities, i.e. on fibrin without heparin. Vinculin staining was apparent, but was rather diffuse, on fibrin with both FGF2 and VEGF and on control PS. Endothelial cells on all samples were positively stained for von Willebrand factor and CD31. VE-cadherin receptors clusters were best developed on fibrin with heparin and growth factors. Significantly stronger staining of type IV collagen was observed on fibrin with heparin and both growth factors. Endothelial cells on all samples produced laminin-1. Decellularized pericardium was homogeneously filled with fibrin structures. These fibrin-modified pericardium samples will be further seeded with cells and cultured in a bioreactor. Fibrin layers with/without heparin and with adsorbed or chemically bound FGF2, VEGF or their combination are good surfaces for endothelialization of cardiovascular prostheses or porcine pericardium based heart valves. Supported by the Ministry of Health, grants No15-29153A and 15-32497A, and the Grant Agency of the Czech Republic, project No. P108/12/G108.

Keywords: aortic valves prosthesis, FGF2, heparin, HSVEC cells, VEGF

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Authors: J. Yang, M. Monnot, T. Eljaddi, L. Simonian, L. Ercolei, P. Moulin

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The application of membrane technology to wastewater treatment has expanded rapidly under increasing stringent legislation and environmental protection requirements. At the same time, the water resource is becoming precious, and water reuse has gained popularity. Particularly, ultrafiltration (UF) is a very promising technology for water reuse as it can retain organic matters, suspended solids, colloids, and microorganisms. Nevertheless, few studies dealing with operating optimization of UF as a tertiary treatment for water reuse on a semi-industrial scale appear in the literature. Therefore, this study aims to explore the permeate water quality and to optimize operating parameters (maximizing productivity and minimizing irreversible fouling) through the operation of a UF pilot plant under real conditions. The fully automatic semi-industrial UF pilot plant with periodic classic backwashes (CB) and air backwashes (AB) was set up to filtrate the secondary effluent of an urban wastewater treatment plant (WWTP) in France. In this plant, the secondary treatment consists of a conventional activated sludge process followed by a sedimentation tank. The UF process was thus defined as a tertiary treatment and was operated under constant flux. It is important to note that a combination of CB and chlorinated AB was used for better fouling management. The 200 kDa hollow fiber membrane was used in the UF module, with an initial permeability (for WWTP outlet water) of 600 L·m-2·h⁻¹·bar⁻¹ and a total filtration surface of 9 m². Fifteen filtration conditions with different fluxes, filtration times, and air backwash frequencies were operated for more than 40 hours of each to observe their hydraulic filtration performances. Through comparison, the best sustainable condition was flux at 60 L·h⁻¹·m⁻², filtration time at 60 min, and backwash frequency of 1 AB every 3 CBs. The optimized condition stands out from the others with > 92% water recovery rates, better irreversible fouling control, stable permeability variation, efficient backwash reversibility (80% for CB and 150% for AB), and no chemical washing occurrence in 40h’s filtration. For all tested conditions, the permeate water quality met the water reuse guidelines of the World Health Organization (WHO), French standards, and the regulation of the European Parliament adopted in May 2020, setting minimum requirements for water reuse in agriculture. In permeate: the total suspended solids, biochemical oxygen demand, and turbidity were decreased to < 2 mg·L-1, ≤ 10 mg·L⁻¹, < 0.5 NTU respectively; the Escherichia coli and Enterococci were > 5 log removal reduction, the other required microorganisms’ analysis were below the detection limits. Additionally, because of the COVID-19 pandemic, coronavirus SARS-CoV-2 was measured in raw wastewater of WWTP, UF feed, and UF permeate in November 2020. As a result, the raw wastewater was tested positive above the detection limit but below the quantification limit. Interestingly, the UF feed and UF permeate were tested negative to SARS-CoV-2 by these PCR assays. In summary, this work confirms the great interest in UF as intensified tertiary treatment for water reuse and gives operational indications for future industrial-scale production of reclaimed water.

Keywords: semi-industrial UF pilot plant, water reuse, fouling management, coronavirus

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Authors: Léa Chawki, Émilie Cappe

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Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

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Authors: Lesly Y Carmona-Sarabia, Luisa Barraza-Vergara, Vilmalí López-Mejías, Wandaliz Torres-García, Maribella Domenech-Garcia, Madeline Torres-Lugo

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Biosensors are used in many applications providing real-time monitoring to treat long-term conditions. Thus, understanding the physicochemical properties and biological side effects on the skin of polymers (e. g., poly(methyl methacrylate), PMMA) employed in the fabrication of wearable biosensors is crucial for the selection of manufacturing materials within this field. The PMMA (hydrophobic and thermoplastic polymer) is commonly employed as a coating material or substrate in the fabrication of wearable devices. The cytotoxicityof PMMA (including residual monomers or degradation products) on the skin, in terms of cells and tissue, is required to prevent possible adverse effects (cell death, skin reactions, sensitization) on human health. Within this work, accelerated aging of PMMA (Mw ~ 15000) through thermal and photochemical degradation was under-taken. The accelerated aging of PMMA was carried out by thermal (200°C, 1h) and photochemical degradation (UV-Vis, 8-15d) adapted employing ISO protocols (ISO-10993-12, ISO-4892-1:2016, ISO-877-1:2009, ISO-188: 2011). In addition, in vitro cytotoxicity evaluation of PMMA degradation products was performed using NIH3T3 fibroblast cells to assess the response of skin tissues (in terms of cell viability) exposed with polymers utilized to manufacture wearable biosensors, such as PMMA. The PMMA (Mw ~ 15000) before and after accelerated aging experiments was characterized by thermal gravimetric analysis (TGA), differential scanning calorimetric (DSC), powder X-ray diffractogram (PXRD), and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) to determine and verify the successful degradation of this polymer under the specific conditions previously mention. The degradation products were characterized through nuclear magnetic resonance (NMR) to identify possible byproducts generated after the accelerated aging. Results demonstrated a percentage (%) weight loss between 1.5-2.2% (TGA thermographs) for PMMA after accelerated aging. The EDS elemental analysis reveals a 1.32 wt.% loss of carbon for PMMA after thermal degradation. These results might be associated with the amount (%) of PMMA degrade after the accelerated aging experiments. Furthermore, from the thermal degradation products was detected the presence of the monomer and methyl formate (low concentrations) and a low molecular weight radical (·COOCH3) in higher concentrations by NMR. In the photodegradation products, methyl formate was detected in higher concentrations. These results agree with the proposed thermal or photochemical degradation mechanisms found in the literature.1,2 Finally, significant cytotoxicity on the NIH3T3 cells was obtained for the thermal and photochemical degradation products. A decrease in cell viability by > 90% (stock solutions) was observed. It is proposed that the presence of byproducts (e.g. methyl formate or radicals such as ·COOCH₃) from the PMMA degradation might be responsible for the cytotoxicity observed in the NIH3T3 fibroblast cells. Additionally, experiments using skin models will be employed to compare with the NIH3T3 fibroblast cells model.

Keywords: biosensors, polymer, skin irritation, degradation products, cell viability

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Authors: Zeynep Busra Velioglu, Deniz Pulat, Beril Demirbakan, Burak Ozcan, Ece Bayrak, Cevat Erisken

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Bone tissue has the ability to perform a wide array of functions including providing posture, load-bearing capacity, protection for the internal organs, initiating hematopoiesis, and maintaining the homeostasis of key electrolytes via calcium/phosphate ion storage. The most common cause for bone defects is extensive trauma and subsequent infection. Bone tissue has the self-healing capability without a scar tissue formation for the majority of the injuries. However, some may result with delayed union or fracture non-union. Such cases include reconstruction of large bone defects or cases of compromised regenerative process as a result of avascular necrosis and osteoporosis. Several surgical methods exist to treat bone defects, including Ilizarov method, Masquelete technique, growth factor stimulation, and bone replacement. Unfortunately, these are technically demanding and come with noteworthy disadvantages such as lengthy treatment duration, adverse effects on the patient’s psychology, repeated surgical procedures, and often long hospitalization times. These limitations associated with surgical techniques make bone substitutes an attractive alternative. Here, it was hypothesized that a 3D printed scaffold will mimic trabecular bone in terms of biomechanical properties and that such scaffolds will support cell attachment and survival. To test this hypothesis, this study aimed at fabricating poly(lactic acid), PLA, structures using 3D printing technology for trabecular bone defects, characterizing the scaffolds and comparing with bovine trabecular bone. Capacity of scaffolds on human bone marrow stem cell (hBMSC) attachment and survival was also evaluated. Cubes with a volume of 1 cm³ having pore sizes of 0.50, 1.00 and 1.25 mm were printed. The scaffolds/grafts were characterized in terms of porosity, contact angle, compressive mechanical properties as well cell response. Porosities of the 3D printed scaffolds were calculated based on apparent densities. For contact angles, 50 µl distilled water was dropped over the surface of scaffolds, and contact angles were measured using ‘Image J’ software. Mechanical characterization under compression was performed on scaffolds and native trabecular bone (bovine, 15 months) specimens using a universal testing machine at a rate of 0.5mm/min. hBMSCs were seeded onto the 3D printed scaffolds. After 3 days of incubation with fully supplemented Dulbecco’s modified Eagle’s medium, the cells were fixed using 2% formaldehyde and glutaraldehyde mixture. The specimens were then imaged under scanning electron microscopy. Cell proliferation was determined by using EZQuant dsDNA Quantitation kit. Fluorescence was measured using microplate reader Spectramax M2 at the excitation and emission wavelengths of 485nm and 535nm, respectively. Findings suggested that porosity of scaffolds with pore dimensions of 0.5mm, 1.0mm and 1.25mm were not affected by pore size, while contact angle and compressive modulus decreased with increasing pore size. Biomechanical characterization of trabecular bone yielded higher modulus values as compared to scaffolds with all pore sizes studied. Cells attached and survived in all surfaces, demonstrating higher proliferation on scaffolds with 1.25mm pores as compared with those of 1mm. Collectively, given lower mechanical properties of scaffolds as compared to native bone, and biocompatibility of the scaffolds, the 3D printed PLA scaffolds of this study appear as candidate substitutes for bone repair and regeneration.

Keywords: 3D printing, biomechanics, bone repair, stem cell

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Authors: Sanaa Riaz

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The free people, Amazigh (plural Imazighen), often known by the more popular exonym, Berber, are spread across several North African countries with the highest population in Morocco have been substantially misunderstood and differentially showcased by entities from western-school educated scholars to human, health and women’s rights organizations, to the State to the international community. This paper is an examination of the various conceptualization of the Imazighen. With the popularity of the Arab Spring movement to oust monarchical and dictatorial rulers across the Middle East and North Africa in Morocco, the Moroccan monarchy introduced various reform programs to win public favor. These included social, economic and educational reforms to incorporate marginalized groups such as the Imazighen. The monarchy has ushered Amazigh representation in public offices and landscape through Amazigh script, even though theirs has been an oral culture. After the Arab Spring, the Justice and Development party, an Islamist party took over in Morocco due to its accessibility to the masses, In Sept. 2021, unlike the case of Egypt and Tunisia where military and constitutional means were sought, Morocco successfully removed it from power through the ballot, resulting in a real victory for the neutral monarchy and its representation as a moderate, secular and liberal force for the nation. As a result, supporting the perpetuation of Amazigh linguistic identity also became synonymous to making a secular statement as a Muslim. It has led to the telling of Amazigh identity at state museums as one representing the indigenous, pure, diverse, culturally-rich and united Morocco. Reform efforts have also prioritized an amiable look towards the economic and familial links of Moroccan Jews with the few thousand families still left in the country and a showcasing through museums and cultural centers of the Jewish identity as Moroccan first. In that endeavor, it is interesting to note the coverage of Jews as the indigenous of Morocco through the embracing of their “folk” cultural and religious practices, those that are not continued outside Morocco. In this epistemology, the concept of the Moroccan Jew becomes similar to the indigenous Amazigh, both cherished as the oldest peoples of Morocco and symbols of its unity and resilience. In the urban discourse, Amazigh identity is a concept that continues to be part of the deliberations of elites and scholars graduating from French schools on the incorporation of rural and illiterate Morocco in economic and educational advancement. Yet, with the constant influx of migrants from Western Sahara into cities like Fez and Marrakesh, Amazigh has often been described as the umbrella term of those of “mixed” ethnic ancestry who constitute the country’s free population. In sum, Amazigh identity highlights the changing discourse on marginalized communities, human rights, representation, Moroccan nationhood, and regional and transnational politics. The aim of this paper is to analyze perceptions of Amazigh identity in Morocco post-2021 ousting of the Islamist party using data from state-sponsored museum displays and cultural centers collected in Summer 2022 and scholarly analyses of Amazigh identity, representation and rights in Morocco.

Keywords: Amazigh identity, Morocco, representation, state politics

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Authors: Tolga Levent

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Throughout the past few decades, forced immigration has been a significant problem for many developing countries. Turkey is one of those countries, which has experienced lots of forced immigration waves in the Republican era. However, the ongoing forced immigration wave of Syrians started with Syrian Civil War in 2011, is strikingly influential due to its intensity. In six years, approximately 3,4 million Syrians have entered to Turkey and presented high-level spatial concentrations in certain cities proximate to the Syrian border. These concentrations make Syrians and their problems relatively visible, especially in those cities. The problems of Syrians in Turkish cities could be associated with all dimensions of daily lives. Within economical dimension, high rates of Syrian unemployment push them to informal jobs offering very low wages. The financial aids they continuously demand from public authorities trigger anti-Syrian behaviors of local communities. Moreover, their relatively limited social adaptation capacities increase integration problems within social dimension day by day. Even, there are problems related to public health dimension such as the reappearance of certain child's illnesses due to the insufficiency of vaccination of Syrian children. These problems are significant but relatively easy to be prevented by using different types of management strategies and structural policies. However, there are other types of problems -urban problems- emerging with socio-spatial impacts of Syrians on Turkish cities in a very short period of time. There are relatively limited amount of studies about these impacts since they are difficult to be comprehended. The aim of the study, in this respect, is to understand these rapidly-emerging impacts and urban problems resulted from this massive immigration influx and to discuss new qualities of urban planning facing them. In the first part, there is a brief historical consideration of forced immigration waves in Turkey. These waves are important to make comparison with the ongoing immigration wave and to understand its significance. The second part is about quantitative and qualitative analyses of the spatial existence of Syrian immigrants in the city of Mersin, as an example of cities where Syrians are highly concentrated. By using official data from public authorities, quantitative statistical analyses are made to detect spatial concentrations of Syrians at neighborhood level. As methods of qualitative research, observations and in-depth interviews are used to define socio-spatial impacts of Syrians. The main results show that there emerges 'cities in cities' though sharp socio-spatial segregations which change density surfaces; produce unforeseen land-use patterns; result in inadequacies of public services and create degradations/deteriorations of urban environments occupied by Syrians. All these problems are significant; however, Turkish planning system does not have a capacity to cope with them. In the final part, there is a discussion about new qualities of urban planning facing these impacts and urban problems. The main point of discussion is the possibility of resilient urban planning under the conditions of uncertainty and unpredictability fostered by immigration crisis. Such a resilient planning approach might provide an option for countries aiming to cope with negative socio-spatial impacts of massive immigration influxes.

Keywords: cities, forced immigration, Syrians, urban planning

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Authors: D. Kekelidze, G. Tsotadze, G. Maisuradze, L. Akhalbedashvili, M. Chkhaidze

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Statement of Problem: The problem of solid wastes -dangerous sources of environmental pollution,is the urgent issue for Georgia as there are no waste-treatment and waste- incineration plants. Urban peripheral and rural areas, frequently along small rivers, are occupied by landfills without any permission. The study of the pollution of some environmental objects in the adjacent territories of solid waste landfill in Tbilisi carried out in 2020-2021, within the framework of project: “Ecological monitoring of the landfills surrounding areas and population health risk assessment”. Research objects: This research had goal to assess the ecological state of environmental objects (soil cover and surface water) in the territories, adjacent of solid waste landfill, on the base of changes heavy metals' (HM) concentration with distance from landfill. An open sanitary landfill for solid domestic waste in Tbilisi locates at suburb Lilo surrounded with densely populated villages. Content of following HM was determined in soil and river water samples: Pb, Cd, Cu, Zn, Ni, Co, Mn. Methodology: The HM content in samples was measured, using flame atomic absorption spectrophotometry (spectrophotometer of firm Perkin-Elmer AAnalyst 200) in accordance with ISO 11466 and GOST Р 53218-2008. Results and discussion: Data obtained confirmed migration of HM mainly in terms of the distance from the polygon that can be explained by their areal emissions and storage in open state, they could also get into the soil cover under the influence of wind and precipitation. Concentration of Pb, Cd, Cu, Zn always increases with approaching to landfill. High concentrations of Pb, Cd are characteristic of the soil covers of the adjacent territories around the landfill at a distance of 250, 500 meters.They create a dangerous zone, since they can later migrate into plants, enter in rivers and lakes. The higher concentrations, compared to the maximum permissible concentrations (MPC) for surface waters of Georgia, are observed for Pb, Cd. One of the reasons for the low concentration of HM in river water may be high turbidity – as is known, suspended particles are good natural sorbents that causes low concentration of dissolved forms. Concentration of Cu, Ni, Mn increases in winter, since in this season the rivers are switched to groundwater feeding. Conclusion: Soil covers of the areas adjacent to the landfill in Lilo are contaminated with HM. High concentrations in soils are characteristic of lead and cadmium. Elevated concentrations in comparison with the MPC for surface waters adopted in Georgia are also observed for Pb, Cd at checkpoints along and below (1000 m) of the landfill downstream. Data obtained confirm migration of HM to the adjacent territories of the landfill and to the Lochini River. Since the migration and toxicity of metals depends also on the presence of their mobile forms in water bodies, samples of bottom sediments should be taken too. Bottom sediments reflect a long-term picture of pollution, they accumulate HM and represent a constant source of secondary pollution of water bodies. The study of the physicochemical forms of metals is one of the priority areas for further research.

Keywords: landfill, pollution, heavy metals, migration

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Authors: Sandhya Rijal, Saroj Adhikari, Ramesh R. Pant

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Non-Timber Forest Products (NTFPs) have attracted substantial interest in the recent years with the increasing recognition that these can provide essential community needs for improved and diversified rural livelihood and support the objectives of biodiversity conservation. Nevertheless, various challenges are witnessed in their sustainable harvest and management. Assuming that sustainable management with community stewardship can offer one of the solutions to existing challenges, the study assesses the linkages between NTFPs and rural livelihood in Lamabagar village of Dolakha, Nepal. The major objective was to document the status of NTFPs and their contributions in households of Lamabagar. For status documentation, vegetation sampling was done using systematic random sampling technique. 30 plots of 10 m × 10 m were laid down in six parallel transect lines at horizontal distance of 160 m in two different community forests. A structured questionnaire survey was conducted in 76 households (excluding non-response rate) using stratified random sampling technique for contribution analysis. Likewise, key informant interview and focus group discussions were also conducted for data triangulations. 36 different NTFPs were recorded from the vegetation sample in two community forests of which 50% were used for medicinal purposes. The other uses include fodder, religious value, and edible fruits and vegetables. Species like Juniperus indica, Daphne bholua Aconitum spicatum, and Lyonia ovalifolia were frequently used for trade as a source of income, which was sold in local market. The protected species like Taxus wallichiana and Neopicrorhiza scrophulariiflora were also recorded in the area for which the trade is prohibited. The protection of these species urgently needs community stewardship. More than half of the surveyed households (55%) were depending on NTFPs for their daily uses, other than economic purpose whereas 45% of them sold those products in the market directly or in the form of local handmade products as a source of livelihood. NTFPs were the major source of primary health curing agents especially for the poor and unemployed people in the study area. Hence, the NTFPs contributed to livelihood under three different categories: subsistence, supplement income and emergency support, depending upon the economic status of the households. Although the status of forest improved after handover to the user group, the availability of valuable medicinal herbs like Rhododendron anthopogon, Swertia nervosa, Neopicrorhiza scrophulariiflora, and Aconitum spicatum were declining. Inadequacy of technology, lack of easy transport access, and absence of good market facility were the major limitations for external trade of NTFPs in the study site. It was observed that people were interested towards conservation only if they could get some returns: economic in terms of rural settlements. Thus, the study concludes that NTFPs could contribute rural livelihood and support conservation objectives only if local communities are provided with the easy access of technology, market and capital.

Keywords: contribution, medicinal, subsistence, sustainable harvest

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Authors: Anna Mucha, Ewa Wojtyna, Anita Pollak

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The environment in which an individual resides and observes may play a meaningful role in well-being and related constructs. Contact with nature may have a positive influence of natural environments on individuals, impacting mood and psychophysical sensations, such as pain relief. Conversely, urban settings, dominated by concrete elements, might lead to mood decline and heightened stress levels. Similarly, the situation may appear in the case of the perception of virtual environments. However, this is a topic that requires further exploration, especially in the context of relationships with pain. The aforementioned matters served as the basis for formulating and executing the outlined experimental research within the realm of environmental psychology, leveraging new technologies, notably virtual reality (VR), which is progressively gaining prominence in the domain of mental health. The primary objective was to investigate the impact of a simulated virtual environment, mirroring a natural setting abundant in greenery, on the perception of acute pain induced by thermal stimuli (high temperature) – encompassing intensity, unpleasantness, and pain tolerance. Comparative analyses were conducted between the virtual natural environment (intentionally constructed in the likeness of a therapeutic garden), virtual urban environment, and a control group devoid of virtual projections. Secondary objectives aimed to determine the mutual relationships among variables such as positive and negative emotions, preferences regarding virtual environments, sense of presence, and restorative experience in the context of the perception of presented virtual environments and induced thermal pain. The study encompassed 126 physically healthy Polish adults, distributing 42 individuals across each of the three comparative groups. Oculus Rift VR technology and the TSA-II neurosensory analyzer facilitated the experiment. Alongside demographic data, participants' subjective feelings concerning virtual reality and pain were evaluated using the Visual Analogue Scale (VAS), the original Restorative Experience in the Virtual World questionnaire (Doświadczenie Regeneracji w Wirtualnym Świecie), and an adapted Slater-Usoh-Steed (SUS) questionnaire. Results of statistical and psychometric analyses, such as Kruskal-Wallis tests, Wilcoxon tests, and contrast analyses, underscored the positive impact of the virtual natural environment on individual pain perception and mood. The virtual natural environment outperformed the virtual urban environment and the control group without virtual projection, particularly in subjective pain components like intensity and unpleasantness. Variables such as restorative experience, sense of presence and virtual environment preference also proved pivotal in pain perception and pain tolerance threshold alterations, contingent on specific conditions. This implies considerable application potential for virtual natural environments across diverse realms of psychology and related fields, among others as a supportive analgesic approach and a form of relaxation following psychotherapeutic sessions.

Keywords: environmental psychology, nature, acute pain, emotions, vitrual reality, virtual environments

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Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa

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Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.

Keywords: menorrhagia, hysterectomy, ablation, resection

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Authors: Muhammad Shahzad Hussain

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Two major problems are facing generally by conventional poultry farming that is disease outbreaks and poor performance, which results due to improper management. To enhance the growth performance and efficiency of feed and reduce disease outbreaks, antibiotic growth promoters (AGPs) which are antibiotics at sub-therapeutic levels, are extensively used in the poultry industry. European Union has banned the use of antibiotics due to their presence in poultry products, development of antibiotic-resistant pathogens, and disturbance of normal gut microbial ecology. These residues cause serious health concerns and produce antibiotic resistance in pathogenic microbes in human beings. These issues strengthen the need for the withdrawal of AGPs from poultry feed. Nowadays, global warming is a major issue, and it is more critical in tropical areas like Pakistan, where heat stress is already a major problem. Heat stress leads to poor production performance, high mortality, immuno-suppression, and concomitant diseases outbreak. The poultry feed industry in Pakistan, like other countries of the world, has been facing shortages and high prices of local as well as imported feed ingredients. Prebiotics are potential replacer for AGP as prebiotics has properties to enhance the production potential and reduce the growth of harmful bacteria as well as stimulate the growth/activity of beneficial bacteria. The most commonly used prebiotics in poultry includes mannan oligosaccharide (MOS). MOS is an essential component of the yeast cell wall (YCW) (Saccharomyces cerevisiae); therefore, the YCW wall possesses prebiotic properties. The use of distillery yeast wall (YCW) has the potential to replace conventional AGPs and to reduce mortality due to heat stress as well as to bind toxins in the feed. The dietary addition of YCW has not only positive effects on production performance in poultry during normal conditions but during stressful conditions. A total of 168-day-old broilers were divided into 6 groups, each of which has 28 birds with 4 replicates (n=7).Yeast cell wall (YCW) supplementation @ 0%, 1%, 1.5%, 2%, 2.5%, 3% from day 0 to 35. Heat stress was exposed from day 21 to 35 at 30±1.1ᵒC with relative humidity 65±5%. Zootechnical parameters like body weight, FCR, Organ development, and histomorphometric parameters were studied. A significant weight gain was observed at group C supplemented @ 1.5% YCW during the fifth week. Significant organ weight gain of Gizzard, spleen, small intestine, and cecum was observed at group C supplemented @ 1.5% YCW. According to morphometric indices Duodenum, Jejunum, and Ileum has significant villus height, while Jejunum and Ileum have also significant villus surface area in the group supplemented with 1.5% YCW. IEL count was only decreased in 1.5% YCW-fed group in jejunum and ileum, not in duodenum, that was less in 2% YCW-supplemented group. Dietary yeast cell wall of saccharomyces cerevisiae partially reduced the effects of high ambient temperature in terms of better growth and modified gut histology and components of mucosal immune response to better withstand heat stress in broilers.

Keywords: antibiotics, AGPs, broilers, MOS, prebiotics, YCW

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