Search results for: supply routes for natural gas

Authors: Eng Rima Al-Awadhi, Abdul Jaleel Tharayil

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In a project-centric organization like KOC, managing the knowledge of the project is of critical importance to the success of the project and the organization. However, due to the very nature and complexity involved, each project engagement generates a lot of 'learnings' that need to be factored into while new projects are initiated and thus avoid repeating the same mistake. But, many a time these learnings are localized and remains as ‘tacit knowledge’ leading to scope re-work, schedule overrun, adjustment orders, concession requests and claims. While KOC follows an asset based organization structure, with a multi-cultural and multi-ethnic workforce and larger chunk of the work is carried out through complex, long term project engagement, diffusion of ‘learnings’ across assets while dealing with the natural entropy of the organization is of great significance. Considering the relatively higher number of mega projects, it's important that the issues raised during the project life cycle are centrally harvested, analyzed and the ‘learnings’ from these issues are shared, absorbed and are in-turn utilized to enhance and refine the existing process and practices, leading to improve the project performance. One of the many factors contributing to the successful completion of a project on time is the reduction in the number of variations or concessions triggered during the project life cycle. The project process integrated knowledge sharing framework discusses the knowledge harvesting methodology adopted, the challenges faced, learnings acquired and its impact on project performance. The framework facilitates the proactive identification of issues that may have an impact on the overall quality of the project and improve performance.

Keywords: knowledge harvesting, project integrated knowledge sharing, performance improvement, knowledge management, lessons learn

Procedia PDF Downloads 391

Authors: Rocío González-Sánchez, Sara Alonso-Muñoz

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Food waste implies an inefficient management of the final stages in the food supply chain. Referring to Sustainable Development Goals (SDGs) by United Nations, the SDG 12.3 proposes to halve per capita food waste at the retail and consumer level and to reduce food losses. In the linear system, food waste is disposed and, to a lesser extent, recovery or reused after consumption. With the negative effect on stocks, the current food consumption system is based on ‘produce, take and dispose’ which put huge pressure on raw materials and energy resources. Therefore, greater focus on the circular management of food waste will mitigate the environmental, economic, and social impact, following a Triple Bottom Line (TBL) approach and consequently the SDGs fulfilment. A mixed methodology is used. A total sample of 311 publications from Web of Science database were retrieved. Firstly, it is performed a bibliometric analysis by SciMat and VOSviewer software to visualise scientific maps about co-occurrence analysis of keywords and co-citation analysis of journals. This allows for the understanding of the knowledge structure about this field, and to detect research issues. Secondly, a systematic literature review is conducted regarding the most influential articles in years 2020 and 2021, coinciding with the most representative period under study. Thirdly, to support the development of this field it is proposed an agenda according to the research gaps identified about circular economy and food waste management. Results reveal that the main topics are related to waste valorisation, the application of waste-to-energy circular model and the anaerobic digestion process towards fossil fuels replacement. It is underlined that the use of food as a source of clean energy is receiving greater attention in the literature. There is a lack of studies about stakeholders’ awareness and training. In addition, available data would facilitate the implementation of circular principles for food waste recovery, management, and valorisation. The research agenda suggests that circularity networks with suppliers and customers need to be deepened. Technological tools for the implementation of sustainable business models, and greater emphasis on social aspects through educational campaigns are also required. This paper contributes on the application of circularity to food waste management by abandoning inefficient linear models. Shedding light about trending topics in the field guiding to scholars for future research opportunities.

Keywords: bibliometric analysis, circular economy, food waste management, future research lines

Procedia PDF Downloads 101

Authors: Hossein Rezaie

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Academic institutions, esp. universities, have been known as cradles of learning and teaching great thinkers while creating the type of knowledge that is supposed to be bereft of utilitarian motives. Nonetheless, it seems that such intellectual centers have entered into a competition with each other for attracting the attention of potential clients. The traditional values of (higher) education such as nurturing criticality and fostering intellectuality in students have been replaced with strategic planning, quality assurance, performance assessment, and academic audits. Not being immune from the whims and wishes of marketization, the system of higher education in the UK has been recalibrated by policy makers to address the demand and supply of student education, academic research and other university activities on the basis of monetary factors. As an immediate example in this vein, the Russell Group in the UK, which is comprised of 24 leading UK research universities, has explicitly expressed it policy on its official website as follows: ‘Russell Group universities are global businesses competing for staff, students and funding with the best in the world’. Furthermore, certain attempts have been made to corporatize the system of HE which have been manifested in remodeling of university governing bodies on corporate lines and developing measurement scales for indicating the performance of teaching practitioners. Nevertheless, it seems that such structural changes in policies toward the system of HE have bearing on the practices of practitioners and educators as well as the identity of students who are the customers of educational services. The effects of marketization have been examined mainly in terms of students’ perceptions and motivation, institutional policies and university management. However, the teaching practitioner side seems to be an under-studied area with regard to any changes in its expectations, satisfaction and perception of professional identity in the aftermath of introducing market-wise values into HE of the UK. As a result, this research aims to investigate the possible outcomes of market-driven values on the practitioner side of HE in the UK and finally seeks to address the following research questions: 1-How is the change in the mission of HE in the UK reflected in institutional documents? 1-A- How is the change of mission represented in job adverts? 1-B- How is the change of mission represented in university prospectuses? 2-How are teaching practitioners represented regarding their roles and obligations in the prospectuses and job ads published by UK HE institutions? In order to address these questions, the researcher will analyze 30 prospectuses and job ads published by Russel Group universities by taking Critical Discourse Analysis as his point of departure and the analytical methods of genre analysis and Systemic Functional Linguistics to probe into the generic features and representation of participants, in this case teaching practitioners, in the selected corpus.

Keywords: higher education, job advertisements, marketization of higher education, prospectuses

Procedia PDF Downloads 241

Authors: Paula Quiterio, Arlete Apolinario, Celia T. Sousa, Joao Azevedo, Paula Dias, Adelio Mendes, Joao P. Araujo

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Nowadays one of the mankind's greatest challenges has been the supply of low-cost and environmentally friendly energy sources as an alternative to non-renewable fossil fuels. Hydrogen has been considered a promising solution, representing a clean and low-cost fuel. It can be produced directly from clean and abundant resources, such as sunlight and water, using photoelectrochemical cells (PECs), in a process that mimics the nature´s photosynthesis. Hematite (alpha-Fe2O3) has attracted considerable attention as a promising photoanode for solar water splitting, due to its high chemical stability, nontoxicity, availability and low band gap (2.2 eV), which allows reaching a high thermodynamic solar-to-hydrogen efficiency of 16.8 %. However, the main drawbacks of hematite such as the short hole diffusion length and the poor conductivity that lead to high electron-hole recombination result in significant PEC efficiency losses. One strategy to overcome these limitations and to increase the PEC efficiency is to use 1D nanostructures, such as nanotubes (NTs) and nanowires (NWs), which present high aspect ratios and large surface areas providing direct pathways for electron transport up to the charge collector and minimizing the recombination losses. In particular, due to the ultrathin walls of the NTs, the holes can reach the surface faster than in other nanostructures, representing a key factor for the NTs photoresponse. In this work, we prepared hematite NWs and NTs, respectively by hydrothermal process and electrochemical anodization. For hematite NWs growing, we studied the effect of variable hydrothermal conditions, different annealing temperatures and time, and the use of Ti and Sn dopants on the morphology and PEC performance. The crystalline phase characterization by X-ray diffraction was crucial to distinguish the formation of hematite and other iron oxide phases, alongside its effect on the photoanodes conductivity and consequent PEC efficiency. The conductivity of the as-prepared NWs is very low, in the order of 10-5 S cm-1, but after doping and annealing optimization it increased by a factor of 105. A high photocurrent density of 1.02 mA cm-2 at 1.45 VRHE was obtained under simulated sunlight, which is a very promising value for this kind of hematite nanostructures. The stability of the photoelectrodes was also tested, presenting good stability after several J-V measurements over time. The NTs, synthesized by fast anodizations with potentials ranging from 20-100 V, presented a linear growth of the NTs pore walls, with very low thicknesses from 10 - 18 nm. These preliminary results are also very promising for the use of hematite photoelectrodes on PEC hydrogen applications.

Keywords: hematite, nanotubes, nanowires, photoelectrochemical cells

Procedia PDF Downloads 221

Authors: Vivek Vaishnav, Shamim Akhtar Ansari

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Teak (Tectona grandis L.f.) belonging to plant family Lamiaceae and the most commercialized timber species is endemic to South-Asia. The adaptive fitness of the species metapopulation was evaluated through its genetic differentiation and assessing the influence of geo-climatic conditions. 290 genotypes were sampled from 29 locations of its natural distribution and the genetic data was incorporated with geo-climatic parameters. Through Bayesian approach based analysis of 43 highly polymorphic ISSR markers, six homogeneous clusters (0.8% genetic variability) were identified. The six clusters were found with the various regimes of the temperature range, i.e., I - 9.10±1.35⁰C, II -6.35±0.21⁰C, III -12.21±0.43⁰C, IV - 10.8±1.06⁰C, V - 11.67±3.04⁰C, and VI - 12.35±0.21⁰C. The population had a very high percentage of LD (21.48%) among the amplified loci possibly due to experiencing restricted gene flow as well as co-adaptation and association of distant/diverse loci/alleles as a result of the stabilized climatic conditions and countless cycles of historical recombination events on a large geological timescale. The same possibly accounts for the narrow distribution of teak as a climax species in the tropical deciduous forests of the country. The regions of strong LD in teak genome significantly associated with climatic parameters also reflect that the species is tolerant to the wide regimes of the temperature range and may possibly withstand global warming and climate change in the coming millennium.

Keywords: Bayesian analysis, inter simple sequence repeat, linkage disequilibrium, marker-geoclimatic association

Procedia PDF Downloads 258

Authors: Aleksandr Medvedev, Zakhar Slukovsii

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Waterbodies, which are located either within urban areas or nearby towns, permanently undergo anthropogenic load. The extent of the load can be determined via investigations of chemical composition of both water and sediments. Lakes, as a rule, are considered as a landscape depressions, hence they are capable of natural material accumulating, which has been delivered from the catchment area through rivers as well as temporary flows. As a result, lacustrine sediments (especially closed-basin lakes sediments) are considered as perfect archives, which are served for reconstructing past sedimentation process, assessment of the modern contamination level, and prognostication of possible ways of changing in the future. The purposes of the survey are to define a heavy metals content in lake sediments cores, which were retrieved from four urban lakes located in the southern part of Karelia Republic, and to ascertain the main sources of heavy metals input to these waterbodies. It is really crucial to be aware of heavy metals content in environment, because chemical composition of a landscape may have a significant effect on living organisms and people’s health. Sediment columns were sampled in a field with 2-cm intervals by a gravitational corer called «Limnos». The sediment samples were analyzed by inductively coupled plasma spectrometry (ICP MS) for 8 chemical elements (Pb, Cd, Zn, Cr, Ni, Cu, Mn, V). The highest concentrations of trace elements were established in the upper and middle layers of the cores. It has also been ascertained that the extent of contamination mostly depends on a remoteness of a lake from various pollution sources and features of the sources.

Keywords: bottom sediments, environmental pollution, heavy metals, lakes

Procedia PDF Downloads 137

Authors: Maryam Atapour

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Chemical pesticides, which are widely used in agriculture, cause problems such as soil and water pollution, reducing biodiversity and creating pest resistance. These problems have led to increased attention to alternative and more sustainable methods such as natural-based pesticides. Herbal pesticides have been developed based on essential oils or extracts from different parts of plants, such as leaves, roots, and flowers. Herbal pesticides are compatible with the environment and can be used in integrated pest management programs. Despite the many benefits, herbal pesticides, especially essential oil-based compounds, have low durability in the environment, and their production costs are high, so the use of herbal extracts with appropriate formulations is more justified in all aspects. In the current study and based on the results of previous studies, aqueous and 70% ethanolic extract of Artemisia absinthium L. was prepared by the percolation method and formulated as an emulsion and water-soluble powder. To produce powder formulation, 20% maltodextrin was used with the spray-dryer method. Different concentrations of these compounds were sprayed on bushes infected with rose aphid Macrosiphum rosae (L.). Sampling was done randomly and the percentage of aphids’ mortality was checked. The results showed that the use of different concentrations of ethanolic extracts created a significant difference in the mortality rate of aphids, while water-soluble powder formulation caused less mortality. The current results showed that the extract of this plant has practical usability to control aphids, and with the appropriate formulation, it can be used as a good alternative to chemical pesticides.

Keywords: contact toxicity, formulation, extract, aphid, Artemisia absinthium.

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Authors: Yu-Hsi Huang, Ying-Der Tsai

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Piezoelectric circular plates can provide out-of-plane vibrational displacements on low frequency and in-plane vibrational displacements on high frequency. Piezoelectric semi-spherical shell, which is double-curvature structure, can induce three-dimensional vibrational displacements over a large frequency range. In this study, three-dimensional vibrational characteristics of piezoelectric semi-spherical shells with free boundary conditions are investigated using three experimental methods and finite element numerical modeling. For the experimental measurements, amplitude-fluctuation electronic speckle pattern interferometry (AF-ESPI) is used to obtain resonant frequencies and radial and azimuthal mode shapes. This optical technique utilizes a full-field and non-contact optical system that measures both the natural frequency and corresponding vibration mode shape simultaneously in real time. The second experimental technique used, laser displacement meter is a point-wise displacement measurement method that determines the resonant frequencies of the piezoelectric shell. An impedance analyzer is used to determine the in-plane resonant frequencies of the piezoelectric semi-spherical shell. The experimental results of the resonant frequencies and mode shapes for the piezoelectric shell are verified with the result from finite element analysis. Excellent agreement between the experimental measurements and numerical calculation is presented on the three-dimensional vibrational characteristics of the piezoelectric semi-spherical shell.

Keywords: piezoelectric semi-spherical shell, mode shape, resonant frequency, electronic speckle pattern interferometry, radial vibration, azimuthal vibration

Procedia PDF Downloads 225

Authors: Layal Karam, Rayan Roustom, Mohamad G. Abiad, Tahra El-Obeid, Ioannis N. Savvaidis

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The demand for marinated chicken worldwide, is continuously growing. To date, limited data on addition of active components of Essential Oils (EOs) to marinades for chicken preservation are available. The antimicrobial effect of carvacrol and thymol, added at 0.4 and 0.8% v/w to marinated fresh chicken, stored in air and under vacuum packaging (VP), for 21 days at 4°C, was examined. The samples were monitored for microbiological (total viable count (TVC), lactic acid bacteria (LAB), Brochothrix thermosphacta, Pseudomonas spp., total coliforms, Escherichia coli, yeasts and molds) and sensory attributes (odor characteristics). Our data supports that among the tested microorganisms, Pseudomonas spp., LAB and B. thermosphacta were the most dominant microbiota in the marinated chicken samples. Additionally, the use of active EOs components, especially the higher concentration (0.8% v/w) in combination with VP, retarded the growth of spoilage microbiota and resulted in a significant reduction of about 2.9-3.1 log cfu/g and a microbiological shelf-life extension of marinated chicken by > 6 days, as judged by TVC data. Interestingly, the combination of active components of EOs at the lower concentration (0.4% v/w) and packaging (air or vacuum) resulted in a significant sensorial shelf-life extension of 15 and >21 days, as compared to the controls’ shelf-life of 9 days. The results of our study demonstrated the potential of the active components, carvacrol and thymol, as natural effective antimicrobial hurdles to control the growth of spoilage microorganisms in marinated chicken meat.

Keywords: chicken, essential oils compounds, marination, meat spoilage, preservation

Procedia PDF Downloads 177

Authors: T. Deepa, S. R. Inchara, S. V. Venkatesh, Seema Tharannum

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Concrete is the most widely used structural material. It is made using locally available materials. However, Concrete has low tensile strength and may crack in the early days with exothermic hydration. Bacillus subtilis bacteria that form endospores is the biological agent considered in this study for Biomineralization or MICP (Microbially Induced Calcite Precipitation) Technique and to address the increased Construction water demand, Recycled Grey Water which is obtained from STP of PES University, opted in place of Potable water. In this work, M30 grade conventional concrete is designed using OPC 53 grade cement, Manufactured Sand, Natural coarse aggregates, and Potable water. Conventional Concrete (CC), Bacterial Concrete with Potable water (BS), and Recycled Grey Water concrete (RGW) are the three different concrete specimens casted. Experimental studies such as the strength test and the surface hardness test are conducted on Conventional and Bacterial concrete samples after 7, 28, and 56 days of curing. Concrete cubes are subjected to a temperature of 50° C to investigate the effect of higher temperature. Cracked cube specimens are observed for Self-healing - as well as microstructure analysis with Scanning Electron Microscope (SEM), Energy Dispersive X-Ray Analysis (EDAX), and X-Ray Diffraction Analysis (XRD).Noticeable Calcium salt deposition is observed on the surface of BS and RGW cracked specimen. Surface hardness and EDAX test gave promising result on the advantage of using spore-forming bacteria in concrete. This is followed by the strength gain in Compression and Flexure. Results also indicate that Recycled Grey Water can be a substitute for Normal water in concrete.

Keywords: bacillus subtilis, bacterial concrete, recycled grey water, self-healing, surface hardness of concrete

Procedia PDF Downloads 127

Authors: Tamar Khardziani, Violeta Berikashvili, Amrosi Chkuaseli, Vladimir Elisashvili

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The main objectives of this proposal are to develop low-cost, innovative, and competitive technologies for the production of mycelial biomass of medicinal mushrooms as a natural food supplement for poultry. To fulfill this task, industrial strains of Lentinus edodes, Ganoderma lucidum, and Pleurotus ostreatus were used in this study. The solid-state fermentation (SSF) of wheat grains, wheat bran, and soy flour was performed in flasks and bags. Among nine mushroom strains, P. ostreatus 2191 appeared to be the most productive in protein biomass accumulation in the SSF of wheat bran. All mushrooms produced exopolysaccharide with the highest yield of 5-8 mg/mL depending on fungal strain and growth substrate. Supplementation of medium with 1% glycerol and 2-4% peptone favored mushroom growth and protein accumulation. Among inorganic nitrogen sources, KNO₃ also provided high biomass and protein production. The SSF of all growth substrates was accompanied by the secretion of cellulase and xylanase activities. The highest CMCase activity (12-13 U/g) was revealed in the cultivation of P. ostreatus 2191 using wheat bran as a growth substrate and ammonium sulfate or yeast extract as a nitrogen source, whereas the highest xylanase activity was detected in the fermentation of soy flour supplemented with peptone. Acknowledgments: This work was supported by the Shota Rustaveli National Science Foundation of Georgia (Grant number STEM-22-2077).

Keywords: mushrooms, plant raw materials, fermentation, biomass protein, cellulase

Procedia PDF Downloads 67

Authors: Valentina Narvaez Gaitan, Paula K. Rodriguez Ramirez, Derian D. Espinosa

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Corrective orthosis has great importance in orthopedic treatments providing assistance in improving mobility and stability in order to improve the quality of life for a different patient. The corrective orthosis studied in this article can correct deformities, reduce pain, and improve the ability to perform daily activities. This work describes the design and evaluation of a corrective orthosis for knee hyperextension. This orthosis is capable of generating a progressive and variable alignment of the joint, limiting the range of motion according to medical criteria. The main objective was to design a corrective knee orthosis capable of correcting knee hyperextension progressively to return to its natural angle with greater economic affordability and adjustable size. The limiting mechanism is based on a goniometer to determine the desired angles. The orthosis was made of acrylic to reduce costs and maintenance; neoprene is also used to make comfortable contact; additionally, Velcro was used in order to adjust the orthosis for various sizes. Simulations of static and fatigue analysis of the mechanism were performed to verify its resistance and durability under normal conditions. A biomechanical gait study of gait was carried out on 10 healthy subjects without the orthosis and limiting their knee extension capacity in a normal gait cycle with the orthosis to observe the efficiency of the proposed system. In the results obtained, the knee angle curves show that the maximum extension angle was the established angle by the orthosis. Showing the efficiency of the proposed design for different leg sizes.

Keywords: biomechanical study, corrective orthosis, efficiency, goniometer, knee hyperextension.

Procedia PDF Downloads 69

Authors: Nani Mchedlishvili, Nino Omiadze, Marine Abutidze, Jose Neptuno Rodriguez-Lopez, Tinatin Sadunishvili, Nikoloz Pruidze, Giorgi Kvesitadze

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Recently, there is an increased interest in the development of food natural colorants as alternatives to synthetic dyes because of both legislative action and consumer concern. Betalains are widely used in the food industry as an alternative of synthetic colorants. The interest of betalains are caused not only by their coloring effect but also by their beneficial properties. The aim of the work was to study of stability of crude and purified red pigments of pokeberry (Phytolacca america L.). The pokeberry fruit juice was filtrated and concentrated by rotary vacuum evaporator up to 25% and the concentrated juice was passed through the Sepadex-25(fine) column (20×1.1 cm). From the column the pigment elution rate was 18 ml/hr. 1.5ml fractions of pigment were collected. In the fractions the coloring substances were determined using CuS04 x 7 H2O as a standard. From the Sephadex G-25 column only one fraction of the betalain red pigment was eluted with the absorption maximum at 538 nm. The degree of pigment purification was 1.6 and pigment yield from the column was 15 %. It was shown that thermostability of pokeberry fruit red pigment was significantly decreased after the purification. For example, during incubation at 100C for 10 min crude pigment retained 98 % of its color while under the same conditions only 72% of the color of purified pigment was retained. The purified pigment was found to be characterized by less storage stability too. The storage of the initial crude juice and the pigment fraction obtained after the gelfiltration for 10 days at 4°C showed the lost of color by 29 and 74 % respectively. From the results obtained, it can be concluded that during the gelfiltration the pokeberry fruit red pigment gets separated from such substances that cause its stabilization in the crude juice.

Keywords: betalains, gelfiltration, pokeberry fruit, stability

Procedia PDF Downloads 284

Authors: H. Khanfari, M. Johari Fard

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Dealing with carbonate reservoirs can be mind-boggling for the reservoir engineers due to various digenetic processes that cause a variety of properties through the reservoir. A good estimation of the reservoir heterogeneity which is defined as the quality of variation in rock properties with location in a reservoir or formation, can better help modeling the reservoir and thus can offer better understanding of the behavior of that reservoir. Most of reservoirs are heterogeneous formations whose mineralogy, organic content, natural fractures, and other properties vary from place to place. Over years, reservoir engineers have tried to establish methods to describe the heterogeneity, because heterogeneity is important in modeling the reservoir flow and in well testing. Geological methods are used to describe the variations in the rock properties because of the similarities of environments in which different beds have deposited in. To illustrate the heterogeneity of a reservoir vertically, two methods are generally used in petroleum work: Dykstra-Parsons permeability variations (V) and Lorenz coefficient (L) that are reviewed briefly in this paper. The concept of Lorenz is based on statistics and has been used in petroleum from that point of view. In this paper, we correlated the statistical-based Lorenz method to a petroleum concept, i.e. Kozeny-Carman equation and derived the straight line plot of Lorenz graph for a homogeneous system. Finally, we applied the two methods on a heterogeneous field in South Iran and discussed each, separately, with numbers and figures. As expected, these methods show great departure from homogeneity. Therefore, for future investment, the reservoir needs to be treated carefully.

Keywords: carbonate reservoirs, heterogeneity, homogeneous system, Dykstra-Parsons permeability variations (V), Lorenz coefficient (L)

Procedia PDF Downloads 210

Authors: Fikrat Abdullayev, Narmin Huseynli

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Archaeology is a science that learns ancient people’s life and household on the basis of samples of material culture. The key research object of this science is artefacts, which are acquired during archaeological excavations. These artefacts can be seen in museums. Museums are the main institutions that give impressions of daily life and household of people in ancient times. Therefore, systematization, exhibition and presentation of archaeological items in museums should be adapted to trace the development of productive forces and its reflection on the household of people. In Gobustan museum which was commissioned in 2011, you can get information about the life and household, as well as religious beliefs, of people at all stages of history from the end of the Upper Palaeolith to the Middle Ages through archaeological items, rock inscriptions and modern technologies. The main idea of museum exposition is to give an idea to visitors about the environment, society and production relations during the Stone and Metal Age. Stimulation of development of production factors and production relationships of environmental factors that are influenced by natural forces can be easily seen through exhibits of Gobustan Museum. At the same time, creating of new ideological attributes in the changing society and the process of transforming people into a dominant position in a belief system can be seen in the substitution of motives of rock carvings in the chronological context. The historical and cultural essence of rock carvings in Gobustan Museum is demonstrated through modern technological means and traditional museum concepts. In addition, Gobustan Preserve is one of the rare places where visitors can directly contact with rock carvings.

Keywords: Gobustan, rock art, museum, productive forces

Procedia PDF Downloads 503

Authors: Ibrahim Iddrisu, Joseph Ayariga, Junhuan Xu, Ayomide Adebanjo, Boakai K. Robertson, Michelle Samuel-Foo, Olufemi Ajayi

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The rise of antimicrobial resistance is a global public health crisis that threatens the effective control and prevention of infections. Due to the emergence of pan drug-resistant bacteria, most antibiotics have lost their efficacy. Bacteriophages or their components are known to target bacterial cell walls, cell membranes, and lipopolysaccharides (LPS) and hydrolyze them. Bacteriophages, being the natural predators of pathogenic bacteria, are inevitably categorized as ‘human friends’, thus fulfilling the adage that ‘the enemy of my enemy is my friend’. Leveraging on their lethal capabilities against pathogenic bacteria, researchers are searching for more ways to overcome the current antibiotic resistance challenge. In this study, we expressed and purified epsilon 34 phage tail spike protein (E34 TSP) from the E34 TSP gene, then assessed the ability of this bacteriophage protein in the killing of two CBD-resistant strains of Salmonella spp. We also assessed the ability of the tail spike protein to cause bacteria membrane disruption and dehydrogenase depletion. We observed that the combined treatment of CBD-resistant strains of Salmonella with CBD and E34 TSP showed poor killing ability, whereas the mono treatment with E34 TSP showed considerably higher killing efficiency. This study demonstrates that the inhibition of the bacteria by E34 TSP was due in part to membrane disruption and dehydrogenase inactivation by the protein. The results of this work provide an interesting background to highlight the crucial role phage proteins such as E34 TSP could play in pathogenic bacterial control.

Keywords: cannabidiol, resistance, Salmonella, antimicrobials, phages

Procedia PDF Downloads 58

Authors: Naser Zouri

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Purpose: Measures of formulate and implementation strategy shows amount of product rate-market based strategic management category such as courtesy, competence, and compliance to reach the high loyalty of financial ecosystem. Despite, it solves the market place error intention to fair trade organization. Finding: Finding shows the ability of executives’ level of management to motivate and better decision-making to solve the treatments in business organization. However, it made ideal level of each interposition policy for a hypothetical household. Methodology/design. Style of questionnaire about the data collection was selected to survey of both pilot test and real research. Also, divide of questionnaire and using of Free Scale Semiconductor`s between the finance employee was famous of this instrument. Respondent`s nominated basic on non-probability sampling such as convenience sampling to answer the questionnaire. The way of realization costs to performed the questionnaire divide among the respondent`s approximately was suitable as a spend the expenditure to reach the answer but very difficult to collect data from hospital. However, items of research survey was formed of implement strategy, environment, supply chain, employee from impact of implementation strategy on reach to better financial consequences and also formulate strategy, comprehensiveness strategic design, organization performance from impression on formulate strategy and financial consequences. Practical Implication: Dynamic capability approach of formulate and implement strategy focuses on the firm-specific processes through which firms integrate, build, or reconfigure resources valuable for making a theoretical contribution. Originality/ value of research: Going beyond the current discussion, we show that case studies have the potential to extend and refine theory. We present new light on how dynamic capabilities can benefit from case study research by discovering the qualifications that shape the development of capabilities and determining the boundary conditions of the dynamic capabilities approach. Limitation of the study :Present study also relies on survey of methodology for data collection and the response perhaps connection by financial employee was difficult to responds the question because of limitation work place.

Keywords: financial ecosystem, loyalty, Malaysian market error, dynamic capability approach, rate-market, optimization intelligence strategy, courtesy, competence, compliance

Procedia PDF Downloads 294

Authors: Lorenzo Petrucci

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This paper is intended to give insight into the potential use of small-scale off-grid trigeneration systems powered by biogas generated in a dairy farm. The off-grid plant object of analysis comprises a dual-fuel Genset as well as electrical and thermal storage equipment and an adsorption machine. The loads are the different apparatus used in the dairy farm, a household where the workers live and a small electric vehicle whose batteries can also be used as a power source in case of emergency. The insertion in the plant of an adsorption machine is mainly justified by the abundance of thermal energy and the simultaneous high cooling demand associated with the milk-chilling process. In the evaluated operational scenario, our research highlights the importance of prioritizing specific small loads which cannot sustain an interrupted supply of power over time. As a consequence, a photovoltaic and thermal panel is included in the plant and is tasked with providing energy independently of potentially disruptive events such as engine malfunctioning or scarce and unstable supplies of fuels. To efficiently manage the plant an energy dispatch strategy is created in order to control the flow of energy between the power sources and the thermal and electric storages. In this article we elaborate on models of the equipment and from these models, we extract parameters useful to build load-dependent profiles of the prime movers and storage efficiencies. We show that under reasonable assumptions the analysis provides a sensible estimate of the generated energy. The simulations indicate that a Diesel Generator sized to a value 25% higher than the total electrical peak demand operates 65% of the time below the minimum acceptable load threshold. To circumvent such a critical operating mode, dump loads are added through the activation and deactivation of small resistors. In this way, the excess of electric energy generated can be transformed into useful heat. The combination of PVT and electrical storage to support the prioritized load in an emergency scenario is evaluated in two different days of the year having the lowest and highest irradiation values, respectively. The results show that the renewable energy component of the plant can successfully sustain the prioritized loads and only during a day with very low irradiation levels it also needs the support of the EVs’ battery. Finally, we show that the adsorption machine can reduce the ice builder and the air conditioning energy consumption by 40%.

Keywords: hybrid power plants, mathematical modeling, off-grid plants, renewable energy, trigeneration

Procedia PDF Downloads 168

Authors: Ahmed Inal, Samir Rouidi, Samir Bachouche

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The present study is focused on the distribution and composition of seafloor marine litter associated to trawlable fishing areas along Algerian coast. The sampling was done with a GOC73 bottom trawl during four (04) demersal resource assessment cruises, respectively, in 2016, 2019, 2021 and 2022, carried out on board BELKACEM GRINE R/V. A total of 254 fishing hauls were sampled for the assessment of marine litter. Hauls were performed between 22 and 600 m of depth, the duration was between 30 and 60 min. All sampling was conducted during daylight. After the haul, marine litter was sorted and split from the catch. Then, according to the basis of the MEDITS protocol, litters were sorted into six different categories (plastic, rubber, metal, wood, glass and natural fiber). Thereafter, all marine litter were counted and weighed separately to the nearest 0.5 g. The results shows that the maximums of marine litter densities in the seafloor of the trawling fishing areas along Algerian coast are, respectively, 1996 item/km2 in 2016, 5164 item/km2 in 2019, 2173 item/km2 in 2021 and 7319 item/km2 in 2022. Thus, the plastic is the most abundant litter, it represent, respectively, 46% of marine litter in 2016, 67% in 2019, 69% in 2021 and 74% in 2022. Regarding the weight of the marine litter, it varies between 0.00 and 103 kg in 2016, between 0.04 and 81 kg in 2019, between 0.00 and 68 Kg in 2021 and between 0.00 and 318 kg in 2022. Thus, the maximum rate of marine litter compared to the total catch approximate, respectively, 66% in 2016, 90% in 2019, 65% in 2021 and 91% in 2022. In fact, the average loss in catch is estimated, respectively, at 7.4% in 2016, 8.4% in 2019, 5.7% in 2021 and 6.4% in 2022. However, the bathymetric and geographical variability had a significant impact on both density and weight of marine litter. Marine litter monitoring program is necessary for offering more solution proposals.

Keywords: composition, distribution, seabed, marine litter, algerian coast

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Authors: Ng Wei Yan, Lim Jee Hock, Lee Foo Wei, Mo Kim Hung, Yip Chun Chieh

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The burgeoning accumulation of glass waste in Malaysia, particularly from the food and beverage industry, has become a prominent environmental concern, with disposal sites reaching saturation. This study introduces a distinct approach to addressing the twin challenges of landfill scarcity and natural resource conservation by repurposing discarded glass bottle waste into a viable construction material. The research presents a comprehensive evaluation of the strength characteristics of cement mortar when dark glass waste powder is used as a partial sand replacement. The experimental investigation probes the density, flow spread diameter, and key strength parameters—including compressive, splitting tensile, and flexural strengths—of the modified cement mortar. Remarkably, results indicate that a full replacement of sand with glass waste powder significantly improves the material's strength attributes. A specific mixture with a cement/sand/water ratio of 1:5:1.24 was found to be optimal, yielding an impressive compressive strength of 7 MPa at the 28-day mark, accompanied by a favourable 200 mm spread diameter in flow table tests. The findings of this study underscore the dual benefits of utilizing glass waste powder in cement mortar: mitigating Malaysia's glass waste dilemma and enhancing the performance of construction materials such as bricks and concrete products. Consequently, the research validates the premise that increasing the incorporation of glass waste as a sand substitute promotes not only environmental sustainability but also material innovation in the construction industry.

Keywords: glass waste, strength properties, cement mortar, environmental friendly

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Authors: Sohair Hassan, Olfat Hammam, Sahar Hussein, Wessam Magdi

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Objective: Acute liver failure (ALF) is a clinical condition with an unclear history of pathophysiology, making it a challenging task for scientists to reverse the disease in its initial phase and to help the liver re-function customary: this study aimed to estimate the hepatoprotective effects of Punica granatum Lpeel and Pistacia atlantica leaves as a multi-rich antioxidants ingredients either in their normal and/or in their nanoforms against thioacetamide induced acute liver failure in a rodent model. Method: Male Wistar rats (n=60) were divided into six equal groups, the first group employed as a control; The second group administered a dose of 350 mg /Kg/ b.w of thioacetamide (TAA)-IP, from the third to the sixth group received TAA + [2mls / 100 g b.w/d] of aqueous extracts of Punica granatum L and Pistacia atlantica either in their normal and/or Nano forms consecutively for (14 days) Results: Recorded significant elevation in liver enzymes, lipid profiles, LPO (p= 0.05) and NO with a marked significant decrease in GSH and SOD accompanied by an elevation in inflammatory cytokine (IL6, TNF-α, and AFP) in addition to a noticeable increase in HSP70 level & degradation in DNA respectively in TAA challenged group. However significant and subsequent amelioration of most of the impaired markers was observed with ip nano treatment of both extracts. Conclusion: The current results highlighted the high performance of both plant nano extracts and their hepatoprotective impact and their possible therapeutic role in the amelioration of TAA induced acute liver failure in experimental animals.

Keywords: acute liver failure HPLC, IL6, nano extracts, thioacetamide, TNF-α

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Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed

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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.

Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management

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Authors: Lijuan Wang, Junsheng Huo, Jing Sun, Wenxian Li, Jian Huang, Lin Ling, Yiping Zhou, Chengyu Huang, Jifang Hu

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Backgrounds and Objective: This study aimed to evaluate the impact of highly nutrient-dense complementary food supplement-Yingyangbao, at the time of 3 months after Wenchuan earthquake, on the anemia of young children in a county in Sichuan province. Methods: The young children aged 6-23 months in the county were fed one sachet Yingyangbao per day. Yingyangbao were distributed for 15 months for free. The children entering 6 months age would be included. The length, weight and hemoglobin of the children aged 6-29 months were assessed at baseline (n=257) and Yingyangbao intervention for 6 (n=218) and 15 months (n=253) by cluster sampling. Growth status has not been described in the paper. The analysis was conducted based on 6-11, 12-17, 18-23 and 24-29 months. Results: It showed that the hemoglobin concentration in each group among the 4 groups increased by 4.9, 6.4, 8.0, 9.5 g/L after 6 months and 12.7, 11.4, 16.7, 15.7 g/L after 15 months compared to the baseline, respectively. The total anemia prevalence in each group was significantly lower after 6 and 15 months than the baseline (P<0.001), except the 6-11 months group after 6 months because of fewer Yingyangbao consumption. Total moderate anemia rate decreased from 18.3% to 5.5% after 6 months, and kept decreasing to 0.8% after another 9 months. The hemoglobin concentration was significantly correlated with the amount of Yingyangbao consumption(P<0.001) The anemia rate was significantly different based on the Yingyangbao compliance (P<0.001). Conclusion: It was concluded that Yingyangbao which contains quality protein, vitamins and micronutrients intervened 15 months could be effective for the improvement of anemia of young children. The study provides the support that the application of the complementary food supplements to reduce the anemia of young children in the emergency of natural disaster.

Keywords: young children, anemia, nutrition intervention, complementary food supplements, Yingyangbao

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Authors: Mrunalini Sonne

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Aquaculture uses a variety of broad spectrum antibiotics to manage and prevent a variety of diseases without understanding their mechanisms of action. This has led to water pollution in the modern world. The necessity for alternate control measures against bacterial illnesses in the aquaculture sector is highlighted by issues brought on by antibiotic-resistant bacteria and the dearth of effective control strategies. Bacteriophages (phages) have shown promise as therapeutic agents for the efficient management of bacterial infections in aquaculture. In the current study, a variety of investigations were conducted to determine if utilizing lytic phages to reduce Aeromonas spp. infection in fish aquaculture was appropriate. Motile Aeromonas septicaemia is a fish disease that has caused financial harm to the aquaculture sector. Currently, the production of aquaculture depends significantly on antibiotics, which adds to the worldwide problem of the rise of bacteria that are resistant to medicines and resistance genes. To decrease the usage of antibiotics in aquaculture systems, it is crucial to create efficient antibiotic substitutes. Bacteriophages are capable of acting as a natural antagonist, mostly because of their great specificity, capacity for self-replication, and ability to quickly eradicate dangerous bacteria. There is a need for research that goes beyond just isolating and characterising lytic bacteriophages to examine their morphology, stability, and efficacy in various environmental conditions. Bacteriophage (or phage) therapy is a promising technique to control dangerous microbes in farmed fish. More phage therapy research in aquaculture is required in order to effectively employ phage treatment to lessen infection in fish brought on by Aeromonas.

Keywords: aquaculture, bacteriophages, fish, freshwater

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

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

Keywords: CO2, intensive care, plastic, transport

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Authors: Ciro Cursio, Pio Luigi Cursio, Giulia Cursio, Isabella Chiardi, Luigi Cursio

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Introduction: Full-face aesthetic treatments often present a difficult task: since different patients possess different anatomical and tissue characteristics, there is no guarantee that the same treatment will have the same effect on multiple patients; additionally, full-face rejuvenation and beautification treatments require not only a high degree of technical skill but also the ability to choose the right product for each area and a keen artistic eye. Method: We present an artificial intelligence-based algorithm that can generate realistic post-treatment 3D models based on the patient’s requests together with the doctor’s input. These 3-dimensional predictions can be used by the practitioner for two purposes: firstly, they help ensure that the patient and the doctor are completely aligned on the expectations of the treatment; secondly, the doctor can use them as a visual guide, obtaining a natural result that would normally stem from the practitioner's artistic skills. To this end, the algorithm is able to predict injection zones, the type and quantity of hyaluronic acid, the injection depth, and the technique to use. Results: Our innovation consists in providing an objective visual representation of the patient that is helpful in the patient-doctor dialogue. The patient, based on this information, can express her desire to undergo a specific treatment or make changes to the therapeutic plan. In short, the patient becomes an active agent in the choices made before the treatment. Conclusion: We believe that this algorithm will reveal itself as a useful tool in the pre-treatment decision-making process to prevent both the patient and the doctor from making a leap into the dark.

Keywords: hyaluronic acid, fillers, full face, artificial intelligence, 3D

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Authors: Nasiru Medugu Idris

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This research is aimed at assessing the vulnerability of climate change to rural communities (farmers, herdsmen and fishermen) in Nigeria with the view to study the underlying causes and degree of vulnerability to climate change and examine the conflict between farmers and herdsmen as a result of climate change. This research employed the use of quantitative and qualitative means of data gathering techniques as well as physical observations. Six states (Kebbi, Adamawa, Nasarawa, Osun, Ebonyi, and Akwa Ibom) have been selected on the ground that they are key food production areas in the country and are therefore essential to continual food security in the country. So also, they also double as fishing communities in order to aid the comprehensive study of all the effects on climate on farmers and fishermen alike. Community focus group discussions were carried out in the various states for an interactive session and also to have firsthand information on their level of awareness on climate change. Climate data from the Nigerian Meteorological Agency over the past decade were collected for the purpose of analyzing trends in climate. The study observed that the level of vulnerability of rural dwellers most especially farmers, herdsmen and fishermen to climate change is very high due to their socioeconomic, ethnic and historical perspective of their trend. The study, therefore, recommends that urgent step needs to be put in place to help control natural hazards and man-made disasters and serious measures are also needed in order to minimize severe societal, economic and political crises; some of which may either escalate to violent conflicts or could be avoided by efforts of conflict resolution and prevention by the initiation of a process of de-escalation. So this study has recommended the best-fit adaptive and mitigation measures to climate change vulnerability in rural communities of Nigeria.

Keywords: adaptation, farmers, fishermen, herdsmen

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Authors: Shailly Kumar

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Gender is a social construction resulting in defining roles and responsibilities to carried out according to masculine and feminine traits. The main aim of the study was to explore gender awareness among college going students of Delhi. The objectives of studies were to find out (i) the understanding of term gender and roles and responsibilities associated with male and female as masculine and feminine traits in our society. (ii)Gender images representing the attributes and characteristics attached to particular gender. (iii) Gender discrimination prevailing among girls and boys in our society. (iv)Gender stereotypes resulting in gendering with respect to religion, culture, family and media. The sample of study consisted of 100 undergraduate college girl students. The findings of study stated that the students had this understanding that sex is a natural phenomenon and gender is socially constructed. Gender defines the roles and responsibilities among two sexes. On a gender image students concluded that males are represented as a powerful members of society showing physical strength and violence, force and society gave the power to men oppress and subjugate women in society that's why women are treated inferior and given secondary position in society. On gender discrimination, girl students stated that they faced discrimination at all level such as family, media ,education, workplace etc .There is strong prevailing gender stereotypes among girls and boys with respect to religious practices, choice of career ,preference of child etc. This study concluded that students were aware of gendered practices in various domains of life. The study helped to interpret the notions and perceptions of students towards gendering of social spaces and in their lives.

Keywords: gender, gender awareness, gender role, masculinity and feminity

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Authors: Sameh El Mahdy

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Recording and documenting archaeological collections, especially photographic documentation, is considered one of the very important matters that museums care about and give great priority, as photographic documentation is of great importance. We monitor some of them for example, Photographs of collectibles are considered evidence and an archival record that proves the condition of the collectibles at various stages. A photo of the possessions is placed on the paper record of the possessions registration. These photos are used in inventorying archaeological collections. These pictures are viewed by researchers and scholars interested in studying these collections. These images are used in advertising campaigns for museum displays of archaeological collections. The Grand Egyptian Museum is considered one of the museums that is a unique model in terms of establishing a specific system that is used when photographing archaeological collections. The Grand Egyptian Museum sets standards for the photos that are taken inside the Grand Egyptian Museum. We mention some of them for example, Pictures must be of high quality. It is necessary to set a color scale for the drawing in order to clarify the dimensions of the collectibles in the picture and also in order to clarify the natural colors of the collectibles without any additions. Putting the numbers of the collectibles in the pictures, especially the number of the Grand Egyptian Museum. To take a good photo of the artifacts in the Grand Egyptian Museum, there are many steps: (1) Create a good location, (2) How to handle the Artifacts. (3) Choose the best position for the artifact, (4) Make the light to create a good photo without shadows to make the photo represent all the artifact details. (5) Be sure of the camera settings, and their quality. All of these steps and other ones are the best criteria for taking the best photo, which helps us in the database to represent the details of the artifact in our interface.

Keywords: grand egyptian museum, photographing, museum collections, registration and documentation

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Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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