Search results for: long circulating liposomes

Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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Authors: R. Fernandez-Saavedra, M. B. Gomez-Mancebo, D. Gomez-Briceno

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The gradual corrosion of PWR (Pressurized Water Reactor) feedwater, condensate and drain systems results in the inevitable liberation of corrosion products, principally metallic oxides, to the secondary circuit. In addition, other contaminants and impurities are introduced into the makeup water, auxiliary feedwater and by condenser leaks. All these compounds circulating in the secondary flow can eventually be transported to steam generators and be transformed into deposits on their surfaces. Deposits that accumulate on the tube sheet are known as sludge piles and when they consolidate and harden become into hard sludge. Hard sludge is especially detrimental because it favors tube deformation or denting at the top of tube sheet and further stress corrosion cracking (SCC). These failures affect the efficiency of nuclear power plants. In a recent work, a model for the formation and consolidation of hard sludge has been formulated, highlighting the influence of aluminum and silicon compounds in the initial formation of hard sludge. In this work, an experimental study has been performed in order to get a deeper understanding of the behavior of Al and Si species in hard sludge formation and consolidation. For this purpose, the key components of hard sludge (magnetite, aluminum and/or silicon sources) have been isothermally autoclaved in representative secondary circuit conditions during one week, and the resulting products have been chemically and structurally characterized by XRF and XRD techniques, respectively.

Keywords: consolidation, hard sludge, secondary circuit, steam generator

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Authors: Vishaal Subramanian, Annuatha Vinod Kumar, Santosh Kumar Budankayala, M. Senthil Kumar

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This paper discusses the aerodynamic and structural design, simulation and optimization of a mini-High Altitude Long Endurance (HALE) UAV. The applications of this mini HALE UAV vary from aerial topological surveys, quick first aid supply, emergency medical blood transport, search and relief activates to border patrol, surveillance and estimation of forest fire progression. Although classified as a mini UAV according to UVS International, our design is an amalgamation of the features of ‘mini’ and ‘HALE’ categories, combining the light weight of the ‘mini’ and the high altitude ceiling and endurance of the HALE. Designed with the idea of implementation in India, it is in strict compliance with the UAS rules proposed by the office of the Director General of Civil Aviation. The plane can be completely automated or have partial override control and is equipped with an Infra-Red camera and a multi coloured camera with on-board storage or live telemetry, GPS system with Geo Fencing and fail safe measures. An additional of 1.5 kg payload can be attached to three major hard points on the aircraft and can comprise of delicate equipment or releasable payloads. The paper details the design, optimization process and the simulations performed using various software such as Design Foil, XFLR5, Solidworks and Ansys.

Keywords: aircraft, endurance, HALE, high altitude, long range, UAV, unmanned aerial vehicle

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Authors: Begna Tulu, Gobena Ameni

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Understanding the types of Mycobacterium bovis (M. bovis) strains circulating in a country and exploring its zoonotic potential has significant contribution in the effort to design control strategies. The main aim of this study was to review and compile the results of studies conducted on M. bovis genotyping and its zoonotic potential of M. bovis in Ethiopia. A systematic search and review of articles published on M. bovis strains in Ethiopia were made. PubMed and Google Scholar databases were considered for the search while the keywords used were 'Mycobacteria,' 'Mycobacterium bovis,' 'Bovine Tuberculosis' and 'Ethiopia.' Fourteen studies were considered in this review and a total of 31 distinct strains of M. bovis (N=211) were obtained; the most dominant strains were SB0133 (N=62, 29.4%), SB1176 (N=61, 28.9%), and followed by SB0134 and SB1476 each (N=18, 8.5%). The clustering rate of M. bovis strains was found to be 42.0%. On the other hand, 6 strains of M. bovis were reported from human namely; SB0665 (N=4), SB0303 (N=2), SB0982 (N=2), SB0133 (N=1), SB1176 (N=1), and 1 new strain. Similarly, a total of 8 strains (N=13) of M. tuberculosis bacteria were also identified from animal subjects; namely SIT149 (N=3), SIT1 (N=2), SIT1688 (n=2), SIT262 (N=2), SIT53 (N=1), SIT59 (N=1), and one new-Ethiopian strain. The result showed that the genetic diversity of M. bovis strains reported from Ethiopia are less diversified and highly clustered. And also the result underlines that there is an ongoing active transmission of M. bovis and M. tuberculosis between human and animals in Ethiopia because a significant number strains of both type of bacteria were reported from human and animals.

Keywords: mycobacterium bovis, Mycobacterium tuberculosis, zoonotic potential, genetic diversity, Ethiopia

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Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

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Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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Authors: Hirseland Andreas, Kerschbaumer Lukas

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In the case of Germany, there are about one million long-term unemployed – a figure that did not vary much during the past years. These long-term unemployed did not benefit from the prospering labor market while most short-term unemployed did. Instead, they are continuously dependent on welfare and sometimes precarious short-term employment, experiencing work poverty. Long-term unemployment thus turns into a main obstacle to become employed again, especially if it is accompanied by other impediments such as low-level education (school/vocational), poor health (especially chronical illness), advanced age (older than fifty), immigrant status, motherhood or engagement in care for other relatives. As can be shown by this current research project, in these cases the chance to regain employment decreases to near nil. Almost two-thirds of all welfare recipients have multiple impediments which hinder a successful transition from welfare back to sustainable and sufficient employment. Prospective employers are unlikely to hire long-term unemployed with additional impediments because they evaluate potential employees on their negative signaling (e.g. low-level education) and the implicit assumption of unproductiveness (e.g. poor health, age). Some findings of the panel survey “Labor market and social security” (PASS) carried out by the Institute of Employment Research (the research institute of the German Federal Labor Agency) spread a ray of hope, showing that unlikely does not necessarily mean impossible. The presentation reports on current research on these very scarce “success stories” of unlikely transitions from long-term unemployment to work and how these cases were able to perform this switch against all odds. The study is based on a mixed-method design. Within the panel survey (~15,000 respondents in ~10,000 households), only 66 cases of such unlikely transitions were observed. These cases have been explored by qualitative inquiry – in depth-interviews and qualitative network techniques. There is strong evidence that sustainable transitions are influenced by certain biographical resources like habits of network use, a set of informal skills and particularly a resilient way of dealing with obstacles, combined with contextual factors rather than by job-placement procedures promoted by Job-Centers according to activation rules or by following formal paths of application. On the employer’s side small and medium-sized enterprises are often found to give job opportunities to a wider variety of applicants, often based on a slow but steadily increasing relationship leading to employment. According to these results it is possible to show and discuss some limitations of (German) activation policies targeting the labor market and their impact on welfare dependency and long-term unemployment. Based on these findings, indications for more supportive small-scale measures in the field of labor-market policies are suggested to help long-term unemployed with multiple impediments to overcome their situation (e.g. organizing small-scale-structures and low-threshold services to encounter possible employers on a more informal basis like “meet and greet”).

Keywords: against-all-odds, mixed-methods, Welfare State, long-term unemployment

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Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski

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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.

Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease

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Authors: Simin Khodabakhshi, Hossein Rassi

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Hyperlipidemia refers to any of several acquired or genetic disorders that result in a high level of lipids circulating in the blood. Helicobacter pylori infection is a contributing factor in the progression of hyperlipidemia with serum lipid changes. The aim of this study was to detect of Helicobacter pylori by PCR and serological methods in patients with hyperlipidemia. In this case-control study, 174 patients with hyperlipidemia and 174 healthy controls were studied. Also, demographics, physical and biochemical parameters were performed in all samples. The DNA extracted from blood specimens was amplified by H pylori cagA specific primers. The results show that H. pylori cagA positivity was detected in 79% of the hyperlipidemia and in 56% of the control group by ELISA test and 49% of the hyperlipidemia and in 24% of the control group by PCR test. Prevalence of H. pylori infection was significantly higher in hyperlipidemia as compared to controls. In addition, patients with hyperlipidemia had significantly higher values for triglyceride, total cholesterol, LDL-C, waist to hip ratio, body mass index, diastolic and systolic blood pressure and lower levels of HDL-C than control participants (all p < 0.0001). Our result detected the ELISA was a rapid and cost-effective detection and considering the high prevalence of cytotoxigenic H. pylori strains, cag A is suggested as a promising target for PCR and ELISA tests for detection of infection with toxigenic strains. In general, it can be concluded that molecular analysis of H. pylori cagA and clinical parameters are important in early detection of hyperlipidemia and atherosclerosis with H. pylori infection by PCR and ELISA tests.

Keywords: Helicobacter pylori, hyperlipidemia, PCR, ELISA

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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Authors: Hyun-Koo Kim, Yonghun Kim, Yong-Hoon Kim, Ju Hee Lee, Myungho Song

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In this paper, we have described an efficient stereo matching method and pedestrian detection method using stereo types LWIR camera. We compared with three types stereo camera algorithm as block matching, ELAS, and SGM. For pedestrian detection using stereo LWIR camera, we used that SGM stereo matching method, free space detection method using u/v-disparity, and HOG feature based pedestrian detection. According to testing result, SGM method has better performance than block matching and ELAS algorithm. Combination of SGM, free space detection, and pedestrian detection using HOG features and SVM classification can detect pedestrian of 30m distance and has a distance error about 30 cm.

Keywords: advanced driver assistance system, pedestrian detection, stereo matching method, stereo long-wave IR camera

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Authors: Irena Basaric Ikodinovic, Dragoslav Rakic, Mirjana Vukicevic, Sanja Jockovic, Jovana Jankovic Pantic

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Large long-term settlement occurs at the municipal solid waste landfills over an extended period of time which may lead to breakage of the geomembrane, damage of the cover systems, other protective systems or facilities constructed on top of a landfill. Also, municipal solid waste is an extremely heterogeneous material and its properties vary over location and time within a landfill. These material characteristics require the formulation of a new constitutive model to predict the long-term settlement of municipal solid waste. The paper presents a new constitutive model which is formulated to describe the mechanical behavior of municipal solid waste. Model is based on Modified Cam Clay model and the critical state soil mechanics framework incorporating time-dependent components: mechanical creep and biodegradation of municipal solid waste. The formulated constitutive model is optimized and defined with eight input parameters: five Modified Cam Clay parameters, one parameter for mechanical creep and two parameters for biodegradation of municipal solid waste. Thereafter, the constitutive model is implemented in the software suite for finite element analysis (ABAQUS) and numerical analysis of the experimental landfill settlement is performed. The proposed model predicts the total settlement which is in good agreement with field measured settlement at the experimental landfill.

Keywords: constitutive model, finite element analysis, municipal solid waste, settlement

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Authors: Nutthawadee Jampanil, Kattareeya Kumthip, Niwat Maneekarn, Pattara Khamrin

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Rotavirus A is one of the leading causes of acute gastroenteritis in children younger than five years of age, especially in low-income countries in Africa and South Asia. Two live-attenuated oral rotavirus vaccines, Rotarix and RotaTeq, have been introduced into routine immunization programs in many countries and have proven highly effective in reducing the burden of rotavirus-associated morbidity and mortality. In Thailand, Rotarix and RotaTeq vaccines have been included in the national childhood immunization program since 2020. The objectives of this research are to conduct a molecular epidemiological study and to characterize rotavirus genotypes circulating in pediatric patients with acute diarrhea in Chiang Mai, Thailand, from 2020-2022 after the implementation of rotavirus vaccines. Out of 858 stool specimens, 26 (3.0%) were positive for rotavirus A. G3P[8] (23.0%) was detected as the most predominant genotype, followed by G1P[8] (19.2%), G8P[8] (19.2%), G9P[8] (15.3%), G2P[4] (7.7%), G1P[6] (3.9%), G9P[4] (3.9%), and G8P[X] (3.9%). In addition, the uncommon rotavirus strain G3P[23] (3.9%) was also detected in this study, and this G3P[23] strain displayed a genetic background similar to the porcine rotavirus. In conclusion, there was a dramatic change in the prevalence of rotavirus A infection and the diversity of rotavirus A genotypes in pediatric patients in Chiang Mai, Northern Thailand, in the rotavirus post-vaccination period. The finding obtained from this research contributes to a better understanding of rotavirus epidemiology after rotavirus vaccine introduction. Furthermore, the identification of unusual G and P genotype combination strains provides significant evidence for the potential interspecies transmission between human and animal rotaviruses.

Keywords: rotavirus, infectious disease, gastroenteritis, Thailand

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Authors: Majid Al-Busafi, Alexe Cristina Ioana, Alexe Dan Iulian

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The specific competition and pre-competition stress in professional track and field determined an increasing engagement, from a biological and psychological point of view, of the middle distance and long distance runners, to obtain the top performances that would get them to win in a competition. Under these conditions, if the psychological stress is not properly managed, the negative effects can lead to a total drop in self-confidence, and can affect the value, the talent, and the self-trust, which generates an even higher stress. One of the means at our disposal is the psychological training, specially adapted to the athlete's individual characteristics, to the characteristics of the athletic event, or of the competition. This paper aims to highlight certain original aspects regarding the effects of a specific psychological training program on the mood states characterized by psychological activation, vigor, vitality. The subjects were represented by 12 professional middle distance and long distance runners, subjected to an applicative intervention to which they have participated voluntarily, over the course of 6 months (a competition season). The results indicated that The application of a psychological training program, adapted to the track and field competition system, over a period of time characterized by high competition stress, can determine an increase in the states of vigor and psychological activation, at the same time diminishing those moods that have negative effects on the performance, in the middle distance and long distance running events. This conclusion confirms the hypothesis of this research.

Keywords: competition stress, psychological training, track and field, vigor-activity

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Authors: Rady A., Elsheshai A., Eltawel M.

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Introduction and Aim of work: Literature suggest that antipsychotic medications may decrease cortisol level, an effect that seems to be more present with second generation antipsychotic. Our study aims at assessing effect of long term use of antipsychotics on cortisol level Subjects and Methods: 30 chronic schizophrenic patients on antipsychotics compared to 20 drug naive schizophrenic patients as regards serum cortisol level Results: Cortisol level was significantly lower in chronic schizophrenic patients receiving antipsychotics compared to drug naive patients (P=0.002 <0.05) Conclusion: Antipsychotic medications seem to have the potential to decrease cortisol level in blood. Among hypothesis proposed in literature is the good control of pseudo stress due to psychotic features.

Keywords: schizophrenia, antipsychotic, cortisol, HPA

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Authors: Chun-Yu Chen, Kua-Rong Wu, Yu-Cheng Chen, Perng-Jy Tsai

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Cooking fumes are known containing polycyclic aromatic hydrocarbons (PAHs) and aldehydes, and some of them have been proven carcinogenic or possibly carcinogenic to humans. Considering their chronic health effects, long-term exposure data is required for assessing cooking workers’ lifetime health risks. Previous exposure assessment studies, due to both time and cost constraints, mostly were based on the cross-sectional data. Therefore, establishing a long-term exposure data has become an important issue for conducting health risk assessment for cooking workers. An approach was proposed in this study. Here, the generation rates of both PAHs and aldehydes from a cooking process were determined by placing a sampling train exactly under the under the exhaust fan under the both the total enclosure condition and normal operating condition, respectively. Subtracting the concentration collected by the former (representing the total emitted concentration) from that of the latter (representing the hood collected concentration), the fugitive emitted concentration was determined. The above data was further converted to determine the generation rates based on the flow rates specified for the exhaust fan. The determinations of the above generation rates were conducted in a testing chamber with a selected cooking process (deep-frying chicken nuggets under 3 L peanut oil at 200°C). The sampling train installed under the exhaust fan consisted respectively an IOM inhalable sampler with a glass fiber filter for collecting particle-phase PAHs, followed by a XAD-2 tube for gas-phase PAHs. The above was also used to sample aldehydes, however, installed with a filter pre-coated with DNPH, and followed by a 2,4-DNPH-cartridge for collecting particle-phase and gas-phase aldehydes, respectively. PAHs and aldehydes samples were analyzed by GC/MS-MS (Agilent 7890B), and HPLC-UV (HITACHI L-7100), respectively. The obtained generation rates of both PAHs and aldehydes were applied to the near-field/ far-field exposure model to estimate the exposures of cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration). For validating purposes, both PAHs and aldehydes samplings were conducted simultaneously using the same sampling train at both near-field and far-field sites of the testing chamber. The sampling results, together with the use of the mixed-effect model, were used to calibrate the estimated near-field/ far-field exposures. In the present study, the obtained emission rates were further converted to emission factor of both PAHs and aldehydes according to the amount of food oil consumed. Applying the long-term food oil consumption records, the emission rates for both PAHs and aldehydes were determined, and the long-term exposure databanks for cooks (the estimated near-field concentration), and helpers (the estimated far-field concentration) were then determined. Results show that the proposed approach was adequate to determine the generation rates of both PAHs and aldehydes under various fan exhaust flow rate conditions. The estimated near-field/ far-field exposures, though were significantly different from that obtained from the field, can be calibrated using the mixed effect model. Finally, the established long-term data bank could provide a useful basis for conducting long-term exposure assessments for cooking workers exposed to PAHs and aldehydes.

Keywords: aldehydes, cooking oil fumes, long-term exposure assessment, modeling, polycyclic aromatic hydrocarbons (PAHs)

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Authors: Woledegebrieal Aregay

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Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

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Authors: Dang HuynhMinhTam, Kuang-Cong Lu, Yi-Hung Chen, Zhung-Yu Lin, Cheng-Siang Cheng

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Carbon capture, utilization, and storage (CCUS) technology become a predominant technique to mitigate carbon dioxide and achieve net-zero emissions goals. This research targets to continuously capture the low concentration CO₂ from the tail gas of the regenerative thermal oxidizer (RTO) in the high technology industry. A rotating packed bed (RPB) reactor is investigated to capture the efficiency of CO₂ using a mixture of NaOH/Na₂CO₃ solutions to simulate the real absorbed solution. On a lab scale, semi-batch experiments of continuous gas flow and circulating absorbent solution are conducted to find the optimal parameters and are then examined in a continuous operation. In the semi-batch tests, the carbon capture efficiency and pH variation in the conditions of a low concentration CO₂ (about 1.13 vol%), the NaOH concentration of 1 wt% or 2 wt% mixed with 14 wt% Na₂CO₃, the rotating speed (600, 900, 1200 rpm), the gas-liquid ratio (100, 200, and 400), and the temperature of absorbent solution of 40 ºC are studied. The CO₂ capture efficiency significantly increases with higher rotating speed and smaller gas-liquid ratio, respectively, while the difference between the NaOH concentration of 1 wt% and 2 wt% is relatively small. The maximum capture efficiency is close to 80% in the conditions of the NaOH concentration of 1 wt%, the G/L ratio of 100, and the rotating speed of 1200 rpm within the first 5 minutes. Furthermore, the continuous operation based on similar conditions also demonstrates the steady efficiency of the carbon capture of around 80%.

Keywords: carbon dioxide capture, regenerative thermal oxidizer, rotating packed bed, sodium hydroxide

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Authors: Munisath Khandoker, Stephan Haefele, Andy Gregory

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Extracellular enzymes play a key role in soil organic carbon (SOC) decomposition and nutrient cycling and are known indicators for soil health; however, it is not understood how these enzymes respond to different land uses and their relationships to other soil properties have not been extensively reviewed. The relationships among the activities of three soil enzymes: β-glucosaminidase (NAG), phosphomonoesterase (PHO) and β-glucosidase (GLU), were examined. The impact of soil organic amendments, soil types and land management on soil enzyme activities were reviewed, and it was hypothesized that soils with increased SOC have increased enzyme activity. Long-term experiments at Rothamsted Research Woburn and Harpenden sites in the UK were used to evaluate how different management practices affect enzyme activity involved in carbon (C) and nitrogen (N) cycling in the soil. Samples were collected from soils with different organic treatments such as straw, farmyard manure (FYM), compost additions, cover crops and permanent grass cover to assess whether SOC can be linked with increased levels of enzymatic activity and what influence, if any, enzymatic activity has on total C and N in the soil. Investigating the interactions of important enzymes with soil characteristics and SOC can help to better understand the health of soils. Studies on long-term experiments with known histories and large datasets can better help with this. SOC tends to decrease during land use changes from natural ecosystems to agricultural systems; therefore, it is imperative that agricultural lands find ways to increase and/or maintain SOC in the soil.

Keywords: biological soil health indicators, extracellular enzymes, soil health, soil, microbiology

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Authors: Mayantoinette F. Watson

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During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with a significant need for nursing staff. Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses in nursing programs. The risk of psychological distress is at a maximum, and its effects can negatively impact not only nursing students but also nursing education and academia. The high exposures to interpersonal, economic, and academic demands contribute to the major health concerns, which include a potential risk for psychological distress. Achievement of educational success among nursing students is directly affected by the high exposure to anxiety and depression from experiences within the program. Working relationships and achieving academic success is imperative to positive student outcomes within the nursing program. The purpose of this study is to identify and establish influences and associations within multilevel factors, including the effects of the COVID-19 pandemic on psychological distress in nursing students. Neuman’s Systems Model Theory was used to determine nursing students’ responses to internal and external stressors. The research in this study utilized a mixed-methods, convergent study design. The study population included undergraduate nursing students from Southeastern U.S. The research surveyed a convenience sample of undergraduate nursing students. The quantitative survey was completed by 202 participants, and 11 participants participated in the qualitative follow-up interview surveys. Participants completed the Kessler Psychological Distress Scale (K6), the Perceived Stress Scale (PSS4), and the Dundee Readiness Educational Environment Scale (DREEM12) to measure psychological distress, perceived stress, and perceived educational environment. Participants also answered open-ended questions regarding their experience during the COVID-19 pandemic. Statistical tests, including bivariate analyses, multiple linear regression analyses, and binary logistics regression analyses were performed in effort to identify and highlight the effects of independent variables on the dependent variable, psychological distress. Coding and qualitative content analysis were performed to identify overarching themes within participants’ interviews. Quantitative data were sufficient in identifying correlations between psychological distress and multilevel factors of coping, marital status, COVID-19 stress, perceived stress, educational environment, and social support in nursing students. Qualitative data were sufficient in identifying common themes of students’ perceptions during COVID-19 and included online learning, workload, finances, experience, breaks, time, unknown, support, encouragement, unchanged, communication, and transmission. The findings are significant, specifically regarding contributing factors to nursing students’ psychological distress, which will help to improve learning in the academic environment.

Keywords: nursing education, nursing students, pandemic, psychological distress

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Authors: Fuji Astuti, Helen Onyeaka

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The aim of the study was to investigate the combine effects of cinnamaldehyde (0.25 and 0.45% v/v) on thermal resistance of pathogenic Escherichia coli during low temperature long time (LT-LT) cooking below 60℃. Three different static temperatures (48, 53 and 50℃) were performed, and the number of viable cells was studied. The starting concentrations of cells were 10⁸ CFU/ml. In this experiment, heat treatment efficiency for safe reduction indicated by decimal logarithm reduction of viable recovered cells, which was monitored for heating over 6 hours. Thermal inactivation was measured by means of establishing the death curves between the mean log surviving cells (log₁₀ CFU/ml) and designated time points (minutes) for each temperature test. The findings depicted that addition of cinnamaldehyde exhibited to elevate the thermal sensitivity of E. coli. However, the injured cells found to be well-adapted to all temperature tests after certain time point of cooking, in which they grew to more than 10⁵ CFU/ml.

Keywords: cinnamaldehyde, decimal logarithm reduction, Escherichia coli, LT-LT cooking

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Authors: Indira K., Valsamma Joseph, I. S. Bright

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Introduction :Biofuels could replace fossil fuels and reduce our carbon footprint on the planet by technological advancements needed for sustainable and economic fuel production. Micro algae have proven to be a promising source to meet the current energy demand because of high lipid content and production of high biomass rapidly. Marine diatoms, which are key contributors in the biofuel sector and also play a significant role in primary productivity and ecology with high biodiversity and genetic and chemical diversity, are less well understood than other microalgae for producing hydrocarbons. Method :The marine diatom samples selected for hydrocarbon analysis were a total of eleven, out of which 9 samples were from the culture collection of NCAAH, and the remaining two of them were isolated by serial dilution method to get a pure culture from a mixed culture of microalgae obtained from the various cruise stations (350&357) FORV Sagar Sampada along the west coast of India. These diatoms were mass cultured in F/2 media, and the biomass harvested. The crude extract was obtained from the biomass by homogenising with n-hexane, and the hydrocarbons was further obtained by passing the crude extract through 500mg Bonna Agela SPE column and the quantitative analysis was done by GCHRMS analysis using HP-5 column and Helium gas was used as a carrier gas(1ml/min). The injector port temperature was 2400C, the detector temperature was 2500C, and the oven was initially kept at 600C for 1 minute and increased to 2200C at the rate of 60C per minute, and the analysis of a mixture of long chain hydrocarbons was done .Results:In the qualitative analysis done, the most potent hydrocarbon was found to be Psammodictyon Panduriforme (NCAAH-9) with a hydrocarbon mass of 37.27mg/g of the biomass and 2.1% of the total biomass 0f 1.395g and the other potent producer is Biddulphia(NCAAH 6) with hydrocarbon mass of 25.4mg/g of biomass and percentage of hydrocarbon is 1.03%. In the quantitative analysis by GCHRMS, the long chain hydrocarbons found in most of the marine diatoms were undecane, hexadecane, octadecane 3ethyl 5,2 ethyl butyl, Eicosane7hexyl, hexacosane, heptacosane, heneicosane, octadecane 3 methyl, triacontane. The exact mass of the long chain hydrocarbons in all the marine diatom samples was found to be Nonadecane 12C191H40, Tritriacontane,13-decyl-13-heptyl 12C501H102, Octadecane,3ethyl-5-(2-ethylbutyl 12C261H54, tetratetracontane 12C441H89, Eicosane, 7-hexyl 12C261H54. Conclusion:All the marine diatoms screened produced long chain hydrocarbons which can be used as diesel fuel with good cetane value example, hexadecane, undecane. All the long chain hydrocarbons can further undergo catalytic cracking to produce short chain alkanes which can give good octane values and can be used as gasoline. Optimisation of hydrocarbon production with the most potent marine diatom yielded long chain hydrocarbons of good fuel quality.

Keywords: biofuel, hydrocarbons, marine diatoms, screening

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Authors: Jean De Dieu Ayabagabo, Paul A.Onjoro, Karubiu P. Migwi, Marie C. Dusingize

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This study investigated the effects of feed on milk yield and quality through feed monitoring and quality assessment, and the consequent enteric methane gas emissions from smallholder dairy farms in drier areas of Rwanda, using the Tier II approach for four seasons in three zones, namely; Mayaga and peripheral Bugesera (MPB), Eastern Savanna and Central Bugesera (ESCB), and Eastern plateau (EP). The study was carried out using 186 dairy cows with a mean live weight of 292 Kg in three communal cowsheds. The milk quality analysis was carried out on 418 samples. Methane emission was estimated using prediction equations. Data collected were subjected to ANOVA. The dry matter intake was lower (p<0.05) in the long dry season (7.24 Kg), with the ESCB zone having the highest value of 9.10 Kg, explained by the practice of crop-livestock integration agriculture in that zone. The Dry matter digestibility varied between seasons and zones, ranging from 52.5 to 56.4% for seasons and from 51.9 to 57.5% for zones. The daily protein supply was higher (p<0.05) in the long rain season with 969 g. The mean daily milk production of lactating cows was 5.6 L with a lower value (p<0.05) during the long dry season (4.76 L), and the MPB zone having the lowest value of 4.65 L. The yearly milk production per cow was 1179 L. The milk fat varied from 3.79 to 5.49% with a seasonal and zone variation. No variation was observed with milk protein. The seasonal daily methane emission varied from 150 g for the long dry season to 174 g for the long rain season (p<0.05). The rain season had the highest methane emission as it is associated with high forage intake. The mean emission factor was 59.4 Kg of methane/year. The present EFs were higher than the default IPPC value of 41 Kg from developing countries in African, the Middle East, and other tropical regions livestock EFs using Tier I approach due to the higher live weight in the current study. The methane emission per unit of milk production was lower in the EP zone (46.8 g/L) due to the feed efficiency observed in that zone. Farmers should use high-quality feeds to increase the milk yield and reduce the methane gas produced per unit of milk. For an accurate assessment of the methane produced from dairy farms, there is a need for the use of the Life Cycle Assessment approach that considers all the sources of emissions.

Keywords: footprint, forage, girinka, tier

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Authors: Karolina Mazur, Stanislaw Kuciel

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Polylactides (PLA) and polyhydroxyalkanoates (PHA) are the two groups of biodegradable and biocompatible thermoplastic polymers most commonly utilised in medicine and rehabilitation. The aim of this work is to determine the changes in the strength properties and the microstructures taking place in biodegradable polymer composites during their long-term storage in a highly cooled environment (i.e. a freezer at -24ºC) and to initially assess the durability of such biocomposites when used as single-use elements of rehabilitation or medical equipment. It is difficult to find any information relating to the feasibility of long-term storage of technical products made of PLA or PHA, but nonetheless, when using these materials to make products such as casings of hair dryers, laptops or mobile phones, it is safe to assume that without storing in optimal conditions their degradation time might last even several years. SEM images and the assessment of the strength properties (tensile, bending and impact testing) were carried out and the density and water sorption of two polymers, PLA and PHA (NaturePlast PLE 001 and PHE 001), filled with cellulose fibres (corncob grain – Rehofix MK100, Rettenmaier&Sohne) up to 10 and 20% mass were determined. The biocomposites had been stored at a temperature of -24ºC for 4 years. In order to find out the changes in the strength properties and the microstructure taking place after such a long time of storage, the results of the assessment have been compared with the results of the same research carried out 4 years before. Results shows a significant change in the manner of fractures – from ductile with developed surface for the PHA composite with corncob grain when the tensile testing was performed directly after the injection into a more brittle state after 4 years of storage, which is confirmed by the strength tests, where a decrease of deformation is observed at point of fracture. The research showed that there is a way of storing medical devices made out of PLA or PHA for a reasonably long time, as long as the required temperature of storage is met. The decrease of mechanical properties found during tensile testing and bending for PLA was less than 10% of the tensile strength, while the modulus of elasticity and deformation at fracturing slightly rose, which may implicate the beginning of degradation processes. The strength properties of PHA are even higher after 4 years of storage, although in that case the decrease of deformation at fracturing is significant, reaching even 40%, which suggests its degradation rate is higher than that of PLA. The addition of natural particles in both cases only slightly increases the biodegradation.

Keywords: biocomposites, PLA, PHA, storage

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Authors: Debneil Saha Roy

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Weather forecasting is a complex topic and is well suited for analysis by deep learning approaches. With the wide availability of weather observation data nowadays, these approaches can be utilized to identify immediate comparisons between historical weather forecasts and current observations. This work explores the application of deep learning techniques to weather forecasting in order to accurately predict the weather over a given forecast hori­zon. Three deep neural networks are used in this study, namely, Multi-Layer Perceptron (MLP), Long Short Tunn Memory Network (LSTM) and a combination of Convolutional Neural Network (CNN) and LSTM. The predictive performance of these models is compared using two evaluation metrics. The results show that forecasting accuracy increases with an increase in the complexity of deep neural networks.

Keywords: convolutional neural network, deep learning, long short term memory, multi-layer perceptron

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Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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Authors: Huei Chu Weng, Chien-Hung Liu

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This paper presents a study on the effect of second-order slip and jump on forced convection through a long isothermally heated or cooled planar microchannel. The fully developed solutions of thermal flow fields are analytically obtained on the basis of the second-order Maxwell-Burnett slip and Smoluchowski jump boundary conditions. Results reveal that the second-order term in the Karniadakis slip boundary condition is found to contribute a negative velocity slip and then to lead to a higher pressure drop as well as a higher fluid temperature for the heated-wall case or to a lower fluid temperature for the cooled-wall case. These findings are contrary to predictions made by the Deissler model. In addition, the role of second-order slip becomes more significant when the Knudsen number increases.

Keywords: microfluidics, forced convection, gas rarefaction, second-order boundary conditions

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Authors: Jan Bohata, Stanislav Zvanovec, Matej Komanec, Jakub Jaros, David Hruby

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Even though there is a rapid development in new optical networks, still optical communication infrastructures remain composed of thousands of kilometers of aging optical cables. Many of them are located in a harsh environment which contributes to an increased attenuation or induced birefringence of the fibers leading to the increase of polarization mode dispersion (PMD). In this paper, we report experimental results from environmental optical cable tests and characterization in the climate chamber. We focused on the evaluation of optical network reliability in a harsh environment. For this purpose, a special thermal chamber was adopted, targeting to the large temperature changes between -60 °C and 160 C° with defined humidity. Single mode optical cable 230 meters long, having six tubes and a total number of 72 single mode optical fibers was spliced together forming one fiber link, which was afterward tested in the climate chamber. The main emphasis was put to the polarization mode dispersion (PMD) changes, which were evaluated by three different PMD measuring methods (general interferometry technique, scrambled state-of-polarization analysis and polarization optical time domain reflectometer) in order to fully validate obtained results. Moreover, attenuation and chromatic dispersion (CD), as well as the PMD, were monitored using 17 km long single mode optical cable. Results imply a strong PMD dependence on thermal changes, imposing the exceeding 200 % of its value during the exposure to extreme temperatures and experienced more than 20 dB insertion losses in the optical system. The derived statistic is provided in the paper together with an evaluation of such as optical system reliability, which could be a crucial tool for the optical network designers. The environmental tests are further taken in context to our previously published results from long-term monitoring of fundamental parameters within an optical cable placed in a harsh environment in a special outdoor testbed. Finally, we provide a correlation between short-term and long-term monitoring campaigns and statistics, which are necessary for optical network safety and reliability.

Keywords: optical fiber, polarization mode dispersion, harsh environment, aging

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Authors: Xu Jiaqiao

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Text sentiment analysis is an important branch of natural language processing. This technology is widely used in public opinion analysis and web surfing recommendations. At present, the mainstream sentiment analysis methods include three parts: sentiment analysis based on a sentiment dictionary, based on traditional machine learning, and based on deep learning. This paper mainly analyzes and compares the advantages and disadvantages of the SVM method of traditional machine learning and the Long Short-term Memory (LSTM) method of deep learning in the field of Chinese sentiment analysis, using Chinese comments on Sina Microblog as the data set. Firstly, this paper classifies and adds labels to the original comment dataset obtained by the web crawler, and then uses Jieba word segmentation to classify the original dataset and remove stop words. After that, this paper extracts text feature vectors and builds document word vectors to facilitate the training of the model. Finally, SVM and LSTM models are trained respectively. After accuracy calculation, it can be obtained that the accuracy of the LSTM model is 85.80%, while the accuracy of SVM is 91.07%. But at the same time, LSTM operation only needs 2.57 seconds, SVM model needs 6.06 seconds. Therefore, this paper concludes that: compared with the SVM model, the LSTM model is worse in accuracy but faster in processing speed.

Keywords: sentiment analysis, support vector machine, long short-term memory, Chinese microblog comments

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Authors: Aysenur Ozturk, Aysen Yildiz, Hilal Yilmaz, Pinar Ergenekon, Melek Ozkan

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Water scarcity is one of the most important environmental problems of the World today. Desalination process is regarded as a promising solution to solve drinking water problem of the countries facing with water shortages. Reverse osmosis membranes are widely used for desalination processes. Nano structured biomimetic membrane production is one of the most challenging research subject for improving water filtration efficiency of the membranes and for reducing the cost of desalination processes. There are several researches in the literature on the development of novel biomimetic nanofiltration membranes by incorporation of aquaporin Z molecules. Aquaporins are cell membrane proteins that allow the passage of water molecules and reject all other dissolved solutes. They are present in cell membranes of most of the living organisms and provide high water passage capacity. In this study, GST (Glutathione S-transferas) tagged E. coli aquaporinZ and H. elongate aquaporin proteins, which were previously cloned and characterized, were purified from E. coli BL21 cells and used for fabrication of modified Polysulphone Membrane (PS). Aquaporins were incorporated on the surface of the membrane by using 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) phospolipids as carrier liposomes. Aquaporin containing proteoliposomes were immobilized on the surface of the membrane with m-phenylene-diamine (MPD) and trimesoyl chloride (TMC) rejection layer. Water flux, salt rejection and glucose rejection performances of the thin film composite membranes were tested by using Dead-End Reactor Cell. In this study, effect of proteoliposome concentration, and filtration pressure on water flux and salt rejection rate of membranes were investigated. Type of aquaporin used for membrane fabrication, flux and pressure applied for filtration were found to be important parameters affecting rejection rates. Results suggested that optimization of concentration of aquaporin carriers (proteoliposomes) on the membrane surface is necessary for fabrication of effective composite membranes used for different purposes.

Keywords: aquaporins, biomimmetic membranes, desalination, water treatment

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Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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