Search results for: multiple drug resistance

Authors: Thamer Alshuwaili, Yonglin Ren, Bob Du, Manjree Agarwal

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The warehouse beetle, Trogoderma variabile Ballion (Coleoptera: Dermestidae), is a major pest of packaged and processed stored products. Warehouse beetle is the common name which was given by Okumura (1972). This pest has been reported to infest 119 different commodities, and it is distributed throughout the tropical and subtropical parts of the world. Also, it is difficult to control because of the insect's ability to stay without food for long times, and it can survive for years under dry conditions and low-moisture food, and it has also developed resistance to many insecticides. The young larvae of these insects can cause damage to seeds, but older larvae prefer to feed on whole grains. The percentage of damage caused by these insects range between 30-70% in the storage. T. variabile is the species most responsible for causing significant damage in grain stores worldwide. Trogoderma spp. is a huge problem for cereal grains, and there are many countries, such as the USA, Australia, China, Kenya, Uganda and Tanzania who have specific quarantine regulations against possible importation. Also, grain stocks can be almost completely destroyed because of the massive populations the insect may develop. However, the purpose of the current research was to optimize conditions to collect volatile organic compound from Trogoderma variabile at different life stages by using headspace solid phase microextraction (SPME) coupled with gas chromatography-mass spectrometry (GC-MS) and flame ionization detection (FID). Using SPME technique to extract volatile from insects is an efficient, straightforward and nondestructive method. Result of the study shows that 15 insects were optimal number for larvae and adults. Selection of the number of insects depend on the height of the peak area and the number of peaks. Sixteen hours were optimized as the best extraction time for larvae and 8 hours was the optimal number of adults.

Keywords: Trogoderma variabile, warehouse beetle , GC-MS, Solid phase microextraction

Procedia PDF Downloads 110

Authors: Prof. Ammal Mokhtar Metwally, Samia M. Sami, Nihad A. Ibrahim, Fatma A. Shaaban, Iman I. Salama

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Objectives: Reducing neonatal mortality by 2030 is still a challenging goal in developing countries. low birth weight (LBW) is a significant contributor to this, especially where weighing newborns is not possible routinely. The present study aimed to determine a simple, easy, reliable anthropometric measure(s) that can predict LBW) and neonatal mortality. Methods: A prospective cohort study of 570 babies born in districts of El Menia governorate, Egypt (where most deliveries occurred at home) was examined at birth. Newborn weight, length, head, chest, mid-arm, and thigh circumferences were measured. Follow up of the examined neonates took place during their first four weeks of life to report any mortalities. The most predictable anthropometric measures were determined using the statistical package of SPSS, and multiple Logistic regression analysis was performed.: Results: Head and chest circumferences with cut-off points < 33 cm and ≤ 31.5 cm, respectively, were the significant predictors for LBW. They carried the best combination of having the highest sensitivity (89.8 % & 86.4 %) and least false negative predictive value (1.4 % & 1.7 %). Chest circumference with a cut-off point ≤ 31.5 cm was the significant predictor for neonatal mortality with 83.3 % sensitivity and 0.43 % false negative predictive value. Conclusion: Using chest circumference with a cut-off point ≤ 31.5 cm is recommended as a single simple anthropometric measurement for the prediction of both LBW and neonatal mortality. The predicted measure could act as a substitute for weighting newborns in communities where scales to weigh them are not routinely available.

Keywords: low birth weight, neonatal mortality, anthropometric measures, practical screening

Procedia PDF Downloads 80

Authors: Asamaporn Puetpaiboon, Sunisa Chatmongkolchart, Nalinee Kovitwanawong, Osaree Akaraborworn

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Traumatic patients with massive bleeding require intensive resuscitation. The actual cost of anesthesia per case has never been clarified, so our study aimed to quantify the direct cost, and cost-to-charge ratio of anesthetic care in traumatic patients with intraoperative massive bleeding. This study was a prospective, observational, cost analysis study, conducted in Prince of Songkla University hospital, Thailand, with traumatic patients, of any mechanisms being recruited. Massive bleeding was defined as estimated blood loss of at least one blood volume in 24 hours, or a half of blood volume in 3 hours. The cost components were identified by the micro-costing method, and valued by the bottom-up approach. The direct cost was divided into 4 categories: the labor cost, the capital cost, the material cost and the cost of drugs. From September 2017 to August 2018, 10 patients with multiple injuries were included. Seven patients had motorcycle accidents, two patients fell from a height and another one was in a minibus accident. Two patients died on the operating table, and another two died within 48 hours. The median Sequential Organ Failure Assessment (SOFA) score was 8. The median intraoperative blood loss was 3,500 ml. The median direct cost, per case, was 250 United States Dollars (2017 exchange rate), and the cost-to-charge ratio was 0.53. In summary, the direct cost was nearly half of the hospital charge, for these traumatic patients with massive bleeding. However, our study did not analyze the indirect cost.

Keywords: cost, cost-to-charge ratio, micro-costing, trauma

Procedia PDF Downloads 131

Authors: Foluke E. Sola-Ojo, Ibraheem A. Abubakar, Semiu F. Bello, Isiaka H. Fatima, Sule Bisola, Adesina M. Olusegun, Adeniyi C. Adeola

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The domesticated pigeon, Columba livia domestica, has many valuable characteristics, including high nutritional value and fast growth rate. There is a lack of information on its genetic diversity in Nigeria; thus, the genetic variability in mitochondrial cytochrome oxidase subunit I (COI) sequences of 150 domestic pigeons from four different locations was examined. Three haplotypes (HT) were identified in Nigerian populations; the most common haplotype, HT1, was shared with wild and domestic pigeons from Europe, America, and Asia, while HT2 and HT3 were unique to Nigeria. The overall haplotype diversity was 0.052± 0.025, and nucleotide diversity was 0.026± 0.068 across the four investigated populations. The phylogenetic tree showed significant clustering and genetic relationship of Nigerian domestic pigeons with other global pigeons. The median-joining network showed a star-like pattern suggesting population expansion. AMOVA results indicated that genetic variations in Nigerian pigeons mainly occurred within populations (99.93%), while the Neutrality tests results suggested that the Nigerian domestic pigeons’ population experienced recent expansion. This study showed a low genetic diversity and population differentiation among Nigerian domestic pigeons consistent with a relatively conservative COI sequence with few polymorphic sites. Furthermore, the COI gene could serve as a candidate molecular marker to investigate the genetic diversity and origin of pigeon species. The current data is insufficient for further conclusions; therefore, more research evidence from multiple molecular markers is required.

Keywords: Nigeria pigeon, COI, genetic diversity, genetic variation, conservation

Procedia PDF Downloads 168

Authors: Zohreh Fallah, Edward P. L. Roberts

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One of the big challenges for produced water treatment is removing oil from water in the form of emulsified droplets which are not easily separated. An attractive approach is adsorption, as it is a simple and effective process. However, adsorbents must be regenerated in order to make the process cost effective. Several sorbents have been tested for treating oily wastewater. However, some issues such as high energy consumption for activated carbon thermal regeneration have been reported. Due to their significant electrical conductivity, Graphite Intercalation Compounds (GIC) were found to be suitable to be regenerated electrochemically. They are non-porous materials with low surface area and fast adsorptive capacity which are useful for removal of low concentration of organics. An innovative adsorption/regeneration process has been developed at the University of Manchester in which adsorption of organics are done by using a patented GIC adsorbent coupled with subsequent electrochemical regeneration. The oxidation of adsorbed organics enables 100% regeneration so that the adsorbent can be reused over multiple adsorption cycles. GIC adsorbents are capable of removing a wide range of organics and pollutants; however, no comparable report is available for removal of emulsified oil in produced water using abovementioned process. In this study the performance of this technology for the removal of emulsified oil in wastewater was evaluated. Batch experiments were carried out to determine the adsorption kinetics and equilibrium isotherm for both real produced water and model emulsions. The amount of oil in wastewater was measured by using the toluene extraction/fluorescence analysis before and after adsorption and electrochemical regeneration cycles. It was found that oil in water emulsion could be successfully treated by the treatment process and More than 70% of oil was removed.

Keywords: adsorption, electrochemical regeneration, emulsified oil, produced water

Procedia PDF Downloads 570

Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

Procedia PDF Downloads 369

Authors: Mohammed M. Mahdy Tawfeek

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Objective: The aim of this work is to compare the outcome of photoactivated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) alone with combined PACK-CXL WA and standard anti-microbial therapy (SAT) for the treatment of infectious keratitis. Patients and Methods: This is a randomized prospective comparative clinical trial. Thirty eyes with clinically suspected infectious keratitis were randomly assigned into two equal groups of 15 eyes each: Group (A) was treated by PACK-CXL WA alone and group (B) was treated by PACK-CXL WA combined with SAT. Identification of organisms was made by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT). Written informed consent was obtained from all participants and the study was approved by the research ethics committee of the Faculty of Medicine, Zagazig University. The work has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results: Complete healing and resolution (Successful treatment) were observed in 10 eyes (66.7%) of a group (A) and 14 eyes (93.3%) of group (B) and failure was observed in 5 eyes (33.3%) of a group (A) and one eye (6.67%) of group (B). They were statistically significant (P =0.042 and 0.003) in a comparison between both groups regarding success and failure of treatment, respectively. Complete corneal healing was reported in the third month postoperatively in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B). Complications were absent in 12 patients (80%) in group (A) and 14 patients (93.3%) of group (B); however, perforation and impending perforation were found in 3 patients of group (A) and only one patient of group (B). Conclusion: PACK-CXL is a promising, non-invasive treatment option for infectious keratitis, especially when performed with the window absorption (WA) technique, either alone or combined with SAT. It has a synergistic effect with a standard antimicrobial treatment that gives good outcome results in the treatment of infectious keratitis. Also, it avoids the antibiotics resistance that has become rapidly spreading worldwide.

Keywords: corneal cross linking, infectious keratitis, PACK-CXL, window absorption

Procedia PDF Downloads 124

Authors: A. Kumar, V. Devadas

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Energy is the basic element for any country’s economic development. India is one of the most populated countries, and is dependent on fossil fuel and nuclear-based energy generation. The energy sector faces huge challenges and is dependent on the import of energy from neighboring countries to fulfill the gap in demand and supply. India has huge setbacks for efficient energy generation, distribution, and consumption, therefore they consume more quantity of energy to produce the same amount of Gross Domestic Product (GDP) compared to the developed countries. Technology and technique use, availability, and affordability in the various sectors are varying according to their economic status. In this paper, an attempt is made to quantify the domestic electrical energy consumption in Jodhpur, India. Survey research methods have been employed and stratified sampling technique-based households were chosen for conducting the investigation. Pre-tested survey schedules are used to investigate the grassroots level study. The collected data are analyzed by employing statistical techniques. Thereafter, a multiple regression model is developed to understand the functions of total electricity consumption in the domestic sector corresponding to other independent variables including electrical appliances, age of the building, household size, education, etc. The study resulted in identifying the governing variable in energy consumption at the household level and their relationship with the efficiency of household-based electrical and energy appliances. The analysis is concluded with the recommendation for optimizing the gap in peak electrical demand and supply in the domestic sector.

Keywords: appliance, consumption, electricity, households

Procedia PDF Downloads 102

Authors: Mindaugas Zavalis

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Analysis of experimental tests data of bending one-way reinforced concrete slabs from various articles of science revealed that voided slabs with a grid of hollow plastic inserts inside have smaller mechani-cal and physical parameters compared to continuous cross-section slabs (solid slabs). The negative influence of a reinforced concrete slab is impacted by hollow plastic inserts, which make a grid of voids in the middle of the cross-sectional area of the reinforced concrete slab. A formed grid of voids reduces the slab’s stiffness, which influences the slab’s parameters of serviceability, like deflection and cracking. Prima-ry investigation of data established during experiments illustrates that cracks occur faster in the tensile surface of the voided slab under bend-ing compared to bending solid slab. It means that the crack bending moment force for the voided slab is smaller than the solid slab and the reduction can variate in the range of 14 – 40 %. Reduce of resistance to cracking can be controlled by changing a lot of factors: the shape of the plastic hallow insert, plastic insert height, steps between plastic in-serts, usage of prestressed reinforcement, the diameter of reinforcement bar, slab effective depth, the bottom cover thickness of concrete, effec-tive cross-section of the concrete area about reinforcement and etc. Mentioned parameters are used to evaluate crack width and step of cracking, but existing analytical calculation methods for cracking eval-uation of voided slab with plastic inserts are not so exact and the re-sults of cracking evaluation in this paper are higher than the results of analyzed experiments. Therefore, it was made analytically calculations according to experimental bending tests of voided reinforced concrete slabs with hollow plastic inserts to find and propose corrections for the evaluation of cracking for reinforced concrete voided slabs with hollow plastic inserts.

Keywords: voided slab, cracking, hallow plastic insert, bending, one-way reinforced concrete, serviceability

Procedia PDF Downloads 58

Authors: S. Aberkane, N. Djabali, S. Fafi, A. Baghezza

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Chronic illnesses affect many Algerians. It is possible to investigate the impact of illness representations and coping on quality of life and whether illness representations are indirectly associated with quality of life through their influence on coping. This study aims at investigating the relationship between illness perception, coping strategies and quality of life with chronic illness. Illness perceptions are indirectly associated with the quality of life through their influence on coping mediation. A sample of 316 participants with chronic illness living in the region of Batna, Algeria, has been adopted in this study. A correlation statistical analysis is used to determine the relationship between illness perception, coping strategies, and quality of life. Multiple regression analysis was employed to highlight the predictive ability of the dimensions of illness perception and coping strategies on the dependent variables of quality of life, where mediation analysis is considered in the exploration of the indirect effect significance of the mediator. This study provides insights about the relationship between illness perception, coping strategies and quality of life in the considered sample (r = 0.39, p < 0.01). Therefore, it proves that there is an effect of illness identity perception, external and medical attributions related to emotional role, physical functioning, and mental health perceived, and these were fully mediated by the asking for assistance (c’= 0.04, p < 0.05), the guarding (c’= 0.00, p < 0.05), and the task persistence strategy (c’= 0.05, p < 0.05). The findings imply partial support for the common-sense model of illness representations in a chronic illness population. Directions for future research are highlighted, as well as implications for psychotherapeutic interventions which target unhelpful beliefs and maladaptive coping strategies (e.g., cognitive behavioral therapy).

Keywords: chronic illness, coping, illness perception, quality of life, self- regulation model

Procedia PDF Downloads 214

Authors: I. A. Landa-Fernandez, I. Monje-Ramirez, M. T. Orta-Ledesma

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Every year plant-parasitic nematodes diminish the yield of high-value crops worldwide causing important economic losses. Currently, Meloidogyne enterolobii has increased its importance due to its high aggressiveness, increasing geographical distribution and host range. Root-knot nematodes inhabit the rhizosphere soil around plant roots. However, they can come into contact with irrigation water. Thus, plant-parasitic nematodes can be transported by water, as eggs or juveniles. Due to their high resistance, common water disinfection methods are not effective for inactivating these parasites. Ozone is the most effective disinfectant for microbial inactivation. The objective of this study is to demonstrate that ozone treatment is an alternative method control in irrigation water of the root-knot nematode M. enterolobii. It has been shown that ozonation is an effective treatment for the inactivation of protozoan cysts and oocysts (Giardia and Cryptosporidium) and for other species of the genus Meloidogyne (M. incognita), but not for the enterolobii specie. In this study, the strain of M. enterolobii was isolated from tomatoes roots. For the tests, eggs were used and were inoculated in water with similar characteristics of irrigation water. Subsequently, the disinfection process was carried out in an ozonation unit. The performance of the treatments was evaluated through the egg's viability by assessing its structure by optical microscopy. As a result of exposure to ozone, the viability of the nematode eggs was reduced practically in its entirety; with dissolved ozone levels in water close to the standard concentration (equal to 0.4 mgO₃/L), but with high contact times (greater than 4 min): 0.2 mgO₃/L for 15 minutes or 0.55 mgO₃/L for 10 minutes. Additionally, the effect of temperature, alkalinity and organic matter of the water was evaluated. Ozonation is effective and a promising alternative for the inactivation of nematodes in irrigation water, which could contribute to diminish the agricultural losses caused by these organisms.

Keywords: inactivation process, irrigation water treatment, ozonation, plant-parasite nematodes

Procedia PDF Downloads 154

Authors: Abdelkrim Khadir, Sina Kavalakatt, Preethi Cherian, Ali Tiss

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Soluble epoxide hydrolase (sEH) is an emerging therapeutic target in several chronic states that have inflammation as a common underlying cause such as immunometabolic diseases. Indeed, sEH is known to play a pro-inflammatory role by metabolizing anti-inflammatory, epoxyeicosatrienoic acids (EETs) to pro-inflammatory diols. Recently, it was shown sEH to be linked to diet and microbiota interaction in rat models of obesity. Nevertheless, the functional contribution of sEH and its anti-inflammatory substrates EETs in obesity remain poorly understood. In the current study, we compared the expression pattern of sEH between lean and obese nondiabetic human subjects using subcutaneous adipose tissue (SAT) and peripheral blood mononuclear cells (PBMCs). Using RT-PCR, western blot and immunofluorescence confocal microscopy, we show here that the level of sEH mRNA and protein to be significantly increased in obese subjects with concomitant increase in endoplasmic reticulum (ER) stress components (GRP78 and ATF6α) and inflammatory markers (TNF-α, IL-6) when compared to lean controls. The observation that sEH was overexpressed in obese subjects’ prompt us to investigate whether physical exercise could reduce its expression. In this study, we report here 3-months supervised physical exercise significantly attenuated the expression of sEH in both the SAT and PBMCs, with a parallel decrease in the expression of ER stress markers along with attenuated inflammatory response. On the other hand, homocysteine, a sulfur containing amino acid deriving from the essential amino acid methionine was shown to be directly associated with insulin resistance. When 3T3-L1 preadipocytes cells were treated with homocysteine our results show increased sEH levels along with ER stress markers. Collectively, our data suggest that sEH upregulation is strongly linked to ER stress in adiposity and that physical exercise modulates its expression. This gives further evidence that exercise might be useful as a strategy for managing obesity and preventing its associated complications.

Keywords: obesity, adipose tissue, epoxide hydrolase, ER stress

Procedia PDF Downloads 124

Authors: Sharifah I. N. A. Syed Azmi, Nazarina Mohd Nasir

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The Billing & Customer Relationship Management (BCRM) project is an important enabler towards realizing customer experience transformation. It involves technological shifts for future scalability, revision of multiple business processes and adoption of change by the users and impacted employees. This massive transition, if not managed properly, may result in the decline of business performance due to productivity drop. Organizational change management is an essential element in BCRM project implementation to ensure the system is well understood and embraced by all stakeholders. In order to move impacted employees from unaware state or denial mode to full-acceptance mindset and committing themselves in using the new system, their involvement in the whole change process starting from the initial stage is imperative. Through the BCRM Change Management Plan, a holistic approach was taken whereby the strategy and program for five key components namely executive sponsorship, continuous communication, process change readiness, organizational readiness and individual readiness were all carefully established. Roles of the project sponsor, change agents, change ambassadors and community of practice (CoP) were clearly defined in gaining high commitment and support across the entire organization. Continuous communication and engagement initiatives throughout project implementation have been carried out to reach all stakeholders. The business readiness was constantly monitored and assessed including effectiveness of end-user training, thorough review of process documentation and completion of roles realignment exercise.

Keywords: BCRM, change management, organizational change, transformation project

Procedia PDF Downloads 126

Authors: S. G. Vasantharaju, Viswanath Guptha, Raghavendra Shetty

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Introduction: Aminophylline is a methylxanthine derivative belonging to the class bronchodilator. From the literature survey, reported methods reveals the solid phase extraction and liquid liquid extraction which is highly variable, time consuming, costly and laborious analysis. Present work aims to develop a simple, highly sensitive, precise and accurate high-performance liquid chromatography method for the quantification of Aminophylline in rat plasma samples which can be utilized for preclinical studies. Method: Reverse Phase high-performance liquid chromatography method. Results: Selectivity: Aminophylline and the internal standard were well separated from the co-eluted components and there was no interference from the endogenous material at the retention time of analyte and the internal standard. The LLOQ measurable with acceptable accuracy and precision for the analyte was 0.5 µg/mL. Linearity: The developed and validated method is linear over the range of 0.5-40.0 µg/mL. The coefficient of determination was found to be greater than 0.9967, indicating the linearity of this method. Accuracy and precision: The accuracy and precision values for intra and inter day studies at low, medium and high quality control samples concentrations of aminophylline in the plasma were within the acceptable limits Extraction recovery: The method produced consistent extraction recovery at all 3 QC levels. The mean extraction recovery of aminophylline was 93.57 ± 1.28% while that of internal standard was 90.70 ± 1.30%. Stability: The results show that aminophylline is stable in rat plasma under the studied stability conditions and that it is also stable for about 30 days when stored at -80˚C. Pharmacokinetic studies: The method was successfully applied to the quantitative estimation of aminophylline rat plasma following its oral administration to rats. Discussion: Preclinical studies require a rapid and sensitive method for estimating the drug concentration in the rat plasma. The method described in our article includes a simple protein precipitation extraction technique with ultraviolet detection for quantification. The present method is simple and robust for fast high-throughput sample analysis with less analysis cost for analyzing aminophylline in biological samples. In this proposed method, no interfering peaks were observed at the elution times of aminophylline and the internal standard. The method also had sufficient selectivity, specificity, precision and accuracy over the concentration range of 0.5 - 40.0 µg/mL. An isocratic separation technique was used underlining the simplicity of the presented method.

Keywords: Aminophyllin, preclinical pharmacokinetics, rat plasma, RPHPLC

Procedia PDF Downloads 205

Authors: Romeo A. Botes, Imelda Smit

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The demands of an ever changing and complex higher education environment, along with the profile of modern learners challenge current approaches to assessment and feedback. More learners enter the education system every year. The younger generation expects immediate feedback. At the same time, feedback should be meaningful. The assessment of practical activities in programming poses a particular problem, since both lecturers and learners in the information and computer science discipline acknowledge that paper-based assessment for programming subjects lacks meaningful real-life testing. At the same time, feedback lacks promptness, consistency, comprehensiveness and individualisation. Most of these aspects may be addressed by modern, technology-assisted assessment. The focus of this paper is the continuous development of an artefact that is used to assist the lecturer in the assessment and feedback of practical programming activities in a senior database programming class. The artefact was developed using three Design Science Research cycles. The first implementation allowed one programming activity submission per assessment intervention. This pilot provided valuable insight into the obstacles regarding the implementation of this type of assessment tool. A second implementation improved the initial version to allow multiple programming activity submissions per assessment. The focus of this version is on providing scaffold feedback to the learner – allowing improvement with each subsequent submission. It also has a built-in capability to provide the lecturer with information regarding the key problem areas of each assessment intervention.

Keywords: programming, computer-aided assessment, technology-assisted assessment, programming assessment software, design science research, mixed-method

Procedia PDF Downloads 283

Authors: Antonietta Maoloni, Federica Cardinali, Vesna Milanović, Andrea Osimani, Ilario Ferrocino, Maria Rita Corvaglia, Luca Cocolin, Lucia Aquilanti

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Table olives (Olea europaea L.) are among the most important fermented vegetables all over the world, while sea fennel (Crithmum maritimum L.) is an emerging food crop with interesting nutritional and sensory traits. Both of them are characterized by the presence of several bioactive compounds with potential beneficial health effects, thus representing two valuable substrates for the manufacture of innovative vegetable-based preserves. Given these premises, the present study was aimed at exploring the co-fermentation of table olives and sea fennel to produce new high-value preserves. Spanish style or Greek style processing method and the use of a multiple strain starter were explored. The preserves were evaluated for their microbial dynamics and key sensory traits. During the fermentation, a progressive pH reduction was observed. Mesophilic lactobacilli, mesophilic lactococci, and yeasts were the main microbial groups at the end of the fermentation, whereas Enterobacteriaceae decreased during fermentation. An evolution of the microbiota was revealed by metataxonomic analysis, with Lactiplantibacillus plantarum dominating in the late stage of fermentation, irrespective of processing method and use of the starter. Greek style preserves resulted in more crunchy and less fibrous than Spanish style one and were preferred by trained panelists.

Keywords: lactic acid bacteria, Lactiplantibacillus plantarum, metataxonomy, panel test, rock samphire

Procedia PDF Downloads 115

Authors: Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi

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Background: Higher consumption of white rice has been suggested as a risk factor for development of metabolic abnormalities. In this study we investigated the association between consumption of white rice and the 3-year occurrence of metabolic syndrome (MetS) in adults with and without abdominal obesity. Methods: This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 years. Dietary intakes were measured, using a 168-food items validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were evaluated at both baseline (2006-2008) and after 3-year follow-up (2009-2011). MetS and its components were defined according to the diagnostic criteria proposed by NCEP ATP III, and the new cutoff points of waist circumference for Iranian adults. Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of white rice consumption. Results: The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m2 at baseline. The prevalence of MetS in subjects with abdominal obesity was significantly higher (40.9 vs. 16.2%, P<0.01). There was no significant difference in white rice consumption between the two groups. Mean daily intake of white rice was 93±59, 209±58, 262±60 and 432±224 g/d, in the first to fourth quartiles of white rice, respectively. Stratified analysis by categories of waist circumference showed that higher consumption of white rice was more strongly related to the risk of metabolic syndrome in participants who had abdominal obesity (OR: 2.34, 95% CI:1.14-4.41 vs. OR:0.99, 95% CI:0.60-1.65) Conclusion: We demonstrated that higher consumption of white rice may be a risk for development of metabolic syndrome in adults with abdominal obesity.

Keywords: white rice, abdominal obesity, metabolic syndrome, food science, triglycerides

Procedia PDF Downloads 432

Authors: Zahid Ali Ghazi

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Supercapacitors (SCs) have emerged as auspicious energy storage devices because of their fast charge-discharge characteristics and high power densities. In the current study, a simple approach is used to coat activated carbon (AC) with a thin layer of nickel (Ni) by an electroless deposition process to enhance the electrochemical performance of the SC. The synergistic combination of large surface area and high electrical conductivity of the AC, as well as the pseudocapacitive behavior of the metallic Ni, has shown great potential to overcome the limitations of traditional SC materials. First, the materials were characterized using X-ray diffraction (XRD) for crystallography, scanning electron microscopy (SEM) for surface morphology and energy dispersion X-ray (EDX) for elemental analysis. The electrochemical performance of the nickel-coated activated carbon (Ni-AC) is systematically evaluated through various techniques, including galvanostatic charge-discharge (GCD), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS). The GCD results revealed that Ni/AC has a higher specific capacitance (1559 F/g) than bare AC (222 F/g) at 1 A/g current density in a 2 M KOH electrolyte. Even at a higher current density of 20 A/g, the Ni/AC showed a high capacitance of 944 F/g as compared to 77 F/g by AC. The specific capacitance (1318 F/g) calculated from CV measurements for Ni-AC at 10mV/sec was in close agreement with GCD data. Furthermore, the bare AC exhibited a low energy of 15 Wh/kg at a power density of 356 W/kg whereas, an energy density of 111 Wh/kg at a power density of 360 W/kg was achieved by Ni/AC-850 electrode and demonstrated a long life cycle with 94% capacitance retention over 50000 charge/discharge cycles at 10 A/g. In addition, the EIS study disclosed that the Rs and Rct values of Ni/AC electrodes were much lower than those of bare AC. The superior performance of Ni/AC is mainly attributed to the presence of excessive redox active sites, large electroactive surface area and corrosive resistance properties of Ni. We believe that this study will provide new insights into the controlled coating of ACs and other porous materials with metals for developing high-performance SCs and other energy storage devices.

Keywords: supercapacitor, cyclic voltammetry, coating, energy density, activated carbon

Procedia PDF Downloads 53

Authors: Junhong Li, Danni Cheng, Yaxin Luo, Xiaowei Yi, Ke Qiu, Wendu Pang, Minzi Mao, Yufang Rao, Yao Song, Jianjun Ren, Yu Zhao

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Background: The number of multiple cancer patients was increasing, and the impact of prior cancer history on salivary gland cancer patients remains unclear. Methods: Clinical, demographic and pathological information on salivary gland cancer patients were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2017, and the characteristics and prognosis between patients with a prior cancer and those without prior caner were compared. Univariate and multivariate cox proportional regression models were used for the analysis of prognosis. A risk score model was established to exam the impact of treatment on patients with a prior cancer in different risk groups. Results: A total of 9098 salivary gland cancer patients were identified, and 1635 of them had a prior cancer history. Salivary gland cancer patients with prior cancer had worse survival compared with those without a prior cancer (p<0.001). Patients with a different type of first cancer had a distinct prognosis (p<0.001), and longer latent time was associated with better survival (p=0.006) in the univariate model, although both became nonsignificant in the multivariate model. Salivary gland cancer patients with a prior cancer were divided into low-risk (n= 321), intermediate-risk (n=223), and high-risk (n=62) groups and the results showed that patients at high risk could benefit from surgery, radiation therapy, and chemotherapy, and those at intermediate risk could benefit from surgery. Conclusion: Prior cancer history had an adverse impact on the survival of salivary gland cancer patients, and individualized treatment should be seriously considered for them.

Keywords: prior cancer history, prognosis, salivary gland cancer, SEER

Procedia PDF Downloads 132

Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Yoftahe Nigussie

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This research explores the implementation of a vapor absorption refrigeration system (VARS) in mini-bus cars to enhance air conditioning efficiency. The conventional vapor compression refrigeration system (VCRS) in vehicles relies on mechanical work from the engine, leading to increased fuel consumption. The proposed VARS aims to utilize waste heat and exhaust gas from the internal combustion engine to cool the mini-bus cabin, thereby reducing fuel consumption and atmospheric pollution. The project involves two models: Model 1, a two-fluid vapor absorption system (VAS), and Model 2, a three-fluid VAS. Model 1 uses ammonia (NH₃) and water (H₂O) as refrigerants, where water absorbs ammonia rapidly, producing a cooling effect. The absorption cycle operates on the principle that absorbing ammonia in water decreases vapor pressure. The ammonia-water solution undergoes cycles of desorption, condensation, expansion, and absorption, facilitated by a generator, condenser, expansion valve, and absorber. The objectives of this research include reducing atmospheric pollution, minimizing air conditioning maintenance costs, lowering capital costs, enhancing fuel economy, and eliminating the need for a compressor. The comparison between vapor absorption and compression systems reveals advantages such as smoother operation, fewer moving parts, and the ability to work at lower evaporator pressures without affecting the Coefficient of Performance (COP). The proposed VARS demonstrates potential benefits for mini-bus air conditioning systems, providing a sustainable and energy-efficient alternative. By utilizing waste heat and exhaust gas, this system contributes to environmental preservation while addressing economic considerations for vehicle owners. Further research and development in this area could lead to the widespread adoption of vapor absorption technology in automotive air conditioning systems.

Keywords: room, zone, space, thermal resistance

Procedia PDF Downloads 58

Authors: Geevika J. Ganegama Arachchi, Steve H. Flint, Lynn McIntyre, Cristina D. Cruz, Beatrice M. Dias-Wanigasekera, Craig Billington, J. Andrew Hudson, Anthony N. Mutukumira

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In seafood processing plants, Listeriamonocytogenes(L. monocytogenes)likely exists in a metabolically stressed state due to the nutrient-deficient environment, processing treatments such as heating, curing, drying, and freezing, and exposure to detergents and disinfectants. Stressed L. monocytogenes cells have been shown to be as pathogenic as unstressed cells. This study investigated lytic efficacy of (LiMN4L, LiMN4p, and LiMN17) which were previouslycharacterized as virulent against physiologically stressed cells of three seafood borne L. monocytogenesstrains (19CO9, 19DO3, and 19EO3).Physiologically compromised cells ofL. monocytogenesstrains were prepared by aging cultures in TrypticaseSoy Broth at 15±1°C for 72 h; heat injuringcultures at 54±1 - 55±1°C for 40 - 60 min;salt-stressing cultures in Milli-Q water were incubated at 25±1°C in darkness for three weeks; and incubating cultures in 9% (w/v) NaCl at 15±1°C for 72 h. Low concentrations of physiologically compromised cells of three L. monocytogenesstrainswere challenged in vitrowith high titre of three phages in separate experiments using Fish Broth medium (aqueous fish extract) at 15 °C in order to mimic the environment of seafood processing plant. Each phage, when present at ≈9 log10 PFU/ml, reduced late exponential phase cells of L. monocytogenes suspended in fish protein broth at ≈2-3 log10 CFU/ml to a non-detectable level (< 10 CFU/ml). Each phage, when present at ≈8.5 log10 PFU/ml, reduced both heat-injured cells present at 2.5-3.6 log10 CFU/ml and starved cells that were showed coccoid shape, present at ≈2-3 log10 CFU/ml to < 10 CFU/ml after 30 min. Phages also reduced salt-stressed cellspresent at ≈3 log10 CFU/ml by > 2 log10. L. monocytogenes (≈8 log10 CFU/ml) were reduced to below the detection limit (1 CFU/ml) by the three successive phage infections over 16 h, indicating that emergence of spontaneous phage resistance was infrequent. The three virulent phages showed high decontamination potential for physiologically stressed L. monocytogenes strains from seafood processing environments.

Keywords: physiologically stressed L. monocytogenes, heat injured, seafood processing environment, virulent phage

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Authors: M. Pilar Valles-gonzalez, Alejandro Gonzalez Meije, Ana Pastor Muro, Maria Garcia-Martinez, Beatriz Gonzalez Caballero

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This paper studies a failure case of a fuel pressure supply tube from an aircraft engine. Multiple fracture cases of the fuel pressure control tube from aircraft engines have been reported. The studied set was composed of the mentioned tube, a welded connecting pipe, where the fracture has been produced, and a union nut. The fracture has been produced in one most critical zones of the tube, in a region next to the supporting body of the union nut to the connector. The tube material was X6CrNiTi18-10, an austenitic stainless steel. Chemical composition was determined using an X-Ray fluorescence spectrometer (XRF) and combustion equipment. Furthermore, the material has been mechanical, by hardness test, and microstructural characterized using a stereomicroscope and an optical microscope. The results confirmed that it is within specifications. To determine the macrofractographic features, a visual examination and a stereo microscope of the tube fracture surface have been carried out. The results revealed a tube plastic macrodeformation, surface damaged, and signs of a possible corrosion process. Fracture surface was also inspected by scanning electron microscopy (FE-SEM), equipped with a microanalysis system by X-ray dispersive energy (EDX), to determine the microfractographic features in order to find out the failure mechanism involved in the fracture. Fatigue striations, which are typical from a progressive fracture by a fatigue mechanism, have been observed. The origin of the fracture has been placed in defects located on the outer wall of the tube, leading to a final overload fracture.

Keywords: aircraft engine, fatigue, FE-SEM, fractography, fracture, fuel tube, microstructure, stainless steel

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Authors: Penrug Pengsombut, Worawut Hamarn, Teerawuth Suwannasri, Kittiphong Songrukkiat, Kanatip Ratanachoo

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PTT Public Company Limited or simply PTT has played an important role in strengthening national energy security of the Kingdom of Thailand by transporting natural gas to customers in power, industrial and commercial sectors since 1981. PTT has been constructing and operating natural gas pipeline system of over 4,500-km network length both onshore and offshore laid through different area classifications i.e., marine, forest, agriculture, rural, urban, and city areas. During project development phase, an Environmental Impact Assessment (EIA) is conducted and submitted to the Office of Natural Resources and Environmental Policy and Planning (ONEP) for approval before project construction commencement. Knowledge and experiences gained and revealed from EIA in the past projects definitely are developed to further advance EIA study process for newly 5th Transmission Natural Gas Pipeline Project (5TP) with approximately 415 kilometers length. The preferred pipeline route is selected and justified by SMARTi map, an advance digital one-map platform with consists of multiple layers geographic and environmental information. Sensitive area impact focus (SAIF) is a practicable impact assessment methodology which appropriate for a particular long distance infrastructure project such as 5TP. An environmental modeling simulation is adopted into SAIF methodology for impact quantified in all sensitive areas whereas other area along pipeline right-of-ways is typically assessed as an impact representative. Resulting time and cost deduction is beneficial to project for early start.

Keywords: environmental impact assessment, EIA, natural gas pipeline, sensitive area impact focus, SAIF

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Authors: Waqar Ahmad Butt, Gholamreza Vakili Nezhaad, Ali Soud Al Bemani, Yahya Al Wahaibi

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Miscible gas injection processes as secondary recovery methods can be applied to a huge number of mature reservoirs to improve the trapped oil displacement. Successful miscible gas injection processes require an accurate estimation of the minimum miscibility pressure (MMP) to make injection process feasible, economical, and effective. There are several methods of MMP determination like slim tube approach, vanishing interfacial tension and rising bubble apparatus but slim tube is the deployed experimental technique in this study. Slim tube method is assumed to be non-standardized for MMP determination with respect to both operating procedure and design. Therefore, 25 slim tube runs were being conducted with three different coil lengths (12, 18 and 24 m) of constant diameter using three different injection rates (0.08, 0.1 and 0.15 cc/min) to evaluate uniqueness and repeatability of determined MMP. A trend of decrease in MMP with increase in coil length was found. No unique trend was found between MMP and injection rate. Lowest MMP and highest recovery were observed with highest coil length and lowest injection rate. It shows that slim tube measured MMP does not depend solely on interacting fluids characteristics but also affected by used coil selection and injection rate choice. Therefore, both slim tube design and procedure need to be standardized. It is recommended to use lowest possible injection rate and estimated coil length depending upon the distance between injections and producing wells for accurate and reliable MMP determination.

Keywords: coil length, injection rate, minimum miscibility pressure, multiple contacts miscibility

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Authors: Sachin Paul James, Selvasundaram Rajagopal, Muraleedharan Nair, Babu Azariah

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The shot hole borer (SHB), Euwallacea fornicatus (= Xyleborus fornicatus) (Scolytidae: Coleoptera) is one of the major pests of tea in southern India and Sri Lanka. The partially dried cut stem of a jungle plant, Montanoa bipinnatifida (C.Koch) (Compositae: Asteraceae) reported to attract shot hole borer beetles in the field. Collection, isolation, identification and quantification of the emitted volatiles from the partially dried cut stems of M. bipinnatifida using dynamic head space and GC-MS revealed the presence of seven compounds viz. α- pinene, β- phellandrene, β - pinene, D- limonene, trans-caryophyllene, iso- caryophyllene and germacrene– D. Behavioural bioassays using electroantennogram (EAG) and wind tunnel proved that, among these identified compounds only α - pinene, trans-caryophyllene, β – phellandrene and germacrene-D evoked significant behavioral response and maximum response was obtained to a specific blend of these four compounds @ 10:1:0.1:3. Field trapping experiments of this blend conducted in the SHB infested field using multiple funnel traps further proved the efficiency of the blend with a mean trap catch of 176.7 ± 13.1 beetles. Mass trapping studies in the field helped to develop a kairomone trap for the management of SHB in the tea fields of southern India.

Keywords: electroantennogram, kairomone trap, Montanoa bipinnatifida, tea shot hole borer

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Authors: Philip T. Broughton, Mark P. Bettney, Isla L. Smail

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Effective treatment of ground instability is essential when managing the impacts associated with historic mining. A field trial was undertaken by the Coal Authority to investigate the geotechnical performance and potential use of composite materials comprising resin and fill or stone to safely treat surface collapses, such as crown-holes, associated with shallow mining. Test pits were loosely filled with various granular fill materials. The fill material was injected with commercially available silicate and polyurethane resin foam products. In situ and laboratory testing was undertaken to assess the geotechnical properties of the resultant composite materials. The test pits were subsequently excavated to assess resin permeation. Drilling and resin injection was easiest through clean limestone fill materials. Recycled building waste fill material proved difficult to inject with resin; this material is thus considered unsuitable for use in resin composites. Incomplete resin permeation in several of the test pits created irregular ‘blocks’ of composite. Injected resin foams significantly improve the stiffness and resistance (strength) of the un-compacted fill material. The stiffness of the treated fill material appears to be a function of the stone particle size, its associated compaction characteristics (under loose tipping) and the proportion of resin foam matrix. The type of fill material is more critical than the type of resin to the geotechnical properties of the composite materials. Resin composites can effectively support typical design imposed loads. Compared to other traditional treatment options, such as cement grouting, the use of resin composites is potentially less disruptive, particularly for sites with limited access, and thus likely to achieve significant reinstatement cost savings. The use of resin composites is considered a suitable option for the future treatment of shallow mining collapses.

Keywords: composite material, ground improvement, mining legacy, resin

Procedia PDF Downloads 344

Authors: Manohar Salla, Mark S. Butler, Ruby Pelingon, Geraldine Kaeslin, Daniel E. Croker, Janet C. Reid, Jong Min Baek, Paul V. Bernhardt, Elizabeth M. J. Gillam, Matthew A. Cooper, Avril A. B. Robertson

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MCC950 is a potent and selective inhibitor of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome that shows early promise for treatment of inflammatory diseases. The identification of major metabolites of lead molecule is an important step during drug development process. It provides an information about the metabolically labile sites in the molecule and thereby helping medicinal chemists to design metabolically stable molecules. To identify major metabolites of MCC950, the compound was incubated with human liver microsomes and subsequent analysis by (+)- and (−)-QTOF-ESI-MS/MS revealed a major metabolite formed due to hydroxylation on 1,2,3,5,6,7-hexahydro-s-indacene moiety of MCC950. This major metabolite can lose two water molecules and three possible regioisomers were synthesized. Co-elution of major metabolite with each of the synthesized compounds using HPLC-ESI-SRM-MS/MS revealed the structure of the metabolite (±) N-((1-hydroxy-1,2,3,5,6,7-hexahydro-s-indacen-4-yl)carbamoyl)-4-(2-hydroxypropan-2-yl)furan-2-sulfonamide. Subsequent synthesis of individual enantiomers and coelution in HPLC-ESI-SRM-MS/MS using a chiral column revealed the metabolite was R-(+)- N-((1-hydroxy-1,2,3,5,6,7-hexahydro-s-indacen-4-yl)carbamoyl)-4-(2-hydroxypropan-2-yl)furan-2-sulfonamide. To study the possible cytochrome P450 enzyme(s) responsible for the formation of major metabolite, MCC950 was incubated with a panel of cytochrome P450 enzymes. The result indicated that CYP1A2, CYP2A6, CYP2B6, CYP2C9, CYP2C18, CYP2C19, CYP2J2 and CYP3A4 are most likely responsible for the formation of the major metabolite. The biological activity of the major metabolite and the other synthesized regioisomers was also investigated by screening for for NLRP3 inflammasome inhibitory activity and cytotoxicity. The major metabolite had 170-fold less inhibitory activity (IC50-1238 nM) than MCC950 (IC50-7.5 nM). Interestingly, one regioisomer had shown nanomolar inhibitory activity (IC50-232 nM). However, no evidence of cytotoxicity was observed with any of these synthesized compounds when tested in human embryonic kidney 293 cells (HEK293) and human liver hepatocellular carcinoma G2 cells (HepG2). These key findings give an insight into the SAR of the hexahydroindacene moiety of MCC950 and reveal a metabolic soft spot which could be blocked by chemical modification.

Keywords: Cytochrome P450, inflammasome, MCC950, metabolite, microsome, NLRP3

Procedia PDF Downloads 235

Authors: Abel Olusegun Egunjobi, Olusegun Oyeleye Adesanya

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Teaching effectiveness of lecturers in a tertiary institution in Nigeria is one of the determinants of the lecturer’s productivity. In this study, therefore, lecturers’ teaching effectiveness was examined vis-à-vis their multimedia technologies utilisation in Colleges of Education (CoE) in South-West, Nigeria. This is for the purpose of ascertaining the relationship and contribution of multimedia technologies utilisation to lecturers’ teaching effectiveness in Nigerian colleges of education. The descriptive survey research design was adopted in the study, while a multi-stage sampling procedure was used in the study. A stratified sampling technique was used to select colleges of education, and a simple random sampling method was employed to select lecturers from the selected colleges of education. A total of 862 lecturers (627 males and 235 females) were selected from the colleges of education used for the study. The instrument used was lecturers’ questionnaire on multimedia technologies utilisation and teaching effectiveness with a reliability coefficient of 0.85 at 0.05 level of significance. The data collected were analysed using descriptive statistics, multiple regression, and t-test. The findings showed that the level of multimedia technologies utilisation in colleges of education was low, whereas lecturers’ teaching effectiveness was high. Findings also revealed that the lecturers used multimedia technologies purposely for personal and professional developments, so also for up to date news on economic and political matters. Also, findings indicated that laptop, Ipad, CD-ROMs, and computer instructional software were the multimedia technologies frequently utilised by the lecturers. There was also a significant difference in the teaching effectiveness between lecturers in the Federal and State COE. The government should, therefore, make adequate provision for multimedia technologies in the COE in Nigeria for lecturers’ utilisation in their instructions so as to boost their students’ learning outcomes.

Keywords: colleges of education, lecturers’ teaching effectiveness, multimedia technologies utilisation, Southwest Nigeria

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Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

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Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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