Search results for: salinity increase

Authors: Mamdouh Milad Adly Morkos

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Sara D. Garduno-Diaz, Lorena Loriato

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Food selection is one of the main modifiable risk factors for the avoidance of several detrimental health conditions. Excessive and regular sugar intake has been identified as highly unfavorable, yet a highly occurring practice. A proposed approach to modify this eating practice is the online program developed here. The program targets a modification of mindset and lifestyle habits around food, through a four week raw-vegan guided eating program. While the focus of the program is to set up sustainable changes in sugar intake reduction, it also aims to promote a plant-based eating style. Three pilot sessions have been run with participants from seven different countries. Participants are guided through the program via a combination of daily e-mails, a 24-hour support platform, and by-weekly remote live sessions. Meal preparation techniques, as well as cooking instructions, are provided, following set menus developed by a team of professional chefs and nutritionists. Goal setting, as well as alternatives to specific food-related challenges, is addressed. While the program is intended for both women and men, the majority of participants to date have been female. Feedback has been positive, with changes in eating habits have included an elimination of added sugars, an increase in home cooking and vegetable intake, and a reduction in foods of animal origin. Difficulties in following the program have been reported as unavailability of certain ingredients depending on the country of residence of the participants, social and cultural hurdles, and time restrictions. Nevertheless, the results obtained to date indicate this to be a highly interactive program with the potential to be scaled up and applied to various populations as a public health measure on the way to better health.

Keywords: eating habits, food addiction, nutrition education, plant-based, remote practice

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Authors: S. Hussain, N. Ahmad, S. Alam, M. Bezabhi, W. H. Hendriks, P. Yu, J. W. Cone

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The high content of lignin in cell walls is the major limiting factor in the digestion and utilisation of cereal crop residues by ruminants. The aim of this study was to evaluate the effectiveness of the white rot fungus, Pleurotus ostreatus (P. ostreatus), to degrade lignin and to enhance the rumen degradability of maize stover, rice straw, wheat straw and their mixture in equal proportion on a dry-matter (DM) basis. Four samples of each substrate were incubated aerobically in triplicate with P. ostreatus for 0 (Control), 21, 28 and 35 days under solid-state conditions (temperature, 24 ͦ C; humidity, 70± 5%). The changes in chemical composition, DM and nutrient losses, and rumen fermentation characteristics using in vitro DM digestibility (DMD) and the in vitro gas production (GP) technique were measured. The results showed that incubation with P. ostreatus decreased (P < 0.001) the contents of neutral detergent fibre and lignin with a concomitant increase (P < 0.001) in the contents of ash and crude protein. The losses of nutrients differed (P < 0.001) among the straw types, with rice straw and maize stover showing the largest (P < 0.05) lignin degradation compared to wheat and mixed straws. The DMD and 72-h cumulative GP increased (P < 0.001) consistently with increasing fungal incubation period and for all substrates the highest values of DMD and GP were measured after 35 days of incubation with P. ostreatus. The lignin degradation was strongly associated with hemicellulose degradation (r = 0.71) across the various straws. Results of the present study demonstrated that incubation of low-quality crop residues with P. ostreatus under solid-state conditions upgrades their feeding value by reducing the content of lignin and increasing the content of crude protein and ruminal degradation.

Keywords: crop residues, lignin degradation, maize stovers, wheat straws, white rot fungi

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Authors: Sara Sallam, Mohamed Taqi, Naoual Belouaggadia

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Solar thermal power plants using parabolic trough collectors (PTC) are currently a powerful technology for generating electricity. Most of these solar power plants use thermal oils as heat transfer fluid. The latter is heated in the solar field and transfers the heat absorbed in an oil-water heat exchanger for the production of steam driving the turbines of the power plant. Currently, we are seeking to develop PTCs with direct steam generation (DSG). This process consists of circulating water under pressure in the receiver tube to generate steam directly into the solar loop. This makes it possible to reduce the investment and maintenance costs of the PTCs (the oil-water exchangers are removed) and to avoid the environmental risks associated with the use of thermal oils. The pressure drops in these systems are an important parameter to ensure their proper operation. The determination of these losses is complex because of the presence of the two phases, and most often we limit ourselves to describing them by models using empirical correlations. A comparison of these models with experimental data was performed. Our calculations focused on the evolution of the pressure of the liquid-vapor mixture along the receiver tube of a PTC-DSG for pressure values and inlet flow rates ranging respectively from 3 to 10 MPa, and from 0.4 to 0.6 kg/s. The comparison of the numerical results with experience allows us to demonstrate the validity of some models according to the pressures and the flow rates of entry in the PTC-DSG receiver tube. The analysis of these two parameters’ effects on the evolution of the pressure along the receiving tub, shows that the increase of the inlet pressure and the decrease of the flow rate lead to minimal pressure losses.

Keywords: direct steam generation, parabolic trough collectors, Ppressure drop, empirical models

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Authors: Tania Sharmin

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Energy use, overheating and thermal discomfort in low-income tropical housing remains an under-researched area. This research attempts to explore these aspects in the Loving Community, a housing colony created for former leprosy patients and their families in Ahmedabad in India. The living conditions in these households and working practices of the inhabitants in terms of how the building and its internal and external spaces are used, will be explored through interviews and monitoring which will be based on a household survey and a focus group discussion (FGD). The findings from the study will provide a unique and in-depth account of how the relocation of the affected households to the new, flood-resistant and architecturally-designed buildings may have affected the dwellers’ household routines (health and well-being, comfort, satisfaction and working practices) and overall living conditions compared to those living in poorly-designed, existing low-income housings. The new houses were built under an innovative building project supported by De Montfort University Leicester (DMU)’s Square Mile India project. A comparison of newly-built and existing building typologies will reveal how building design can affect people’s use of space and energy use. The findings will be helpful to design healthier, energy efficient and socially acceptable low-income housing in future, thus addressing United Nation’s sustainable development goals on three aspects: 3 (health and well-being), 7 (energy) and 11 (safe, resilient and sustainable human settlements). This will further facilitate knowledge exchange between policy makers, developers, designers and occupants focused on strategies to increase stakeholders’ participation in the design process.

Keywords: thermal comfort, energy use, low-income housing, tropical climate

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Authors: Wael M. El-Deeb

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The aim of this study was to assess the pathophysiological importance of lipid profile, acute phase proteins, proinflammatory cytokines and oxidative stress markers in sheep with pneumonic pasteurellosis. Blood samples were collected from 36 Pasteurellamultocida-infected sheep, together with 20 healthy controls. Samples for bacteriological examination (nasal swabs, bronchoalveolar lavage) were collected from all animals and subjected to bacteriological examinations. Moreover, heart blood and lung samples were collected from the dead pneumonic sheep and subjected also to bacteriological examinations. A lipid profile was determined, along with a blood picture and other biochemical parameters. The acute phase proteins (fibrinogen, haptoglobin, serum amyloid A), the proinflammatory cytokine tumour necrosis factor-alpha, interleukins (IL-1α, IL-1β, IL-6), interferon-gamma and the oxidative stress markers malondialdehyde, super oxide dismutase, glutathione and catalase were also measured. The examined biochemical parameters were increased in the pneumonic sheep, except for cholesterol and high-density lipoprotein cholesterol (HDL-c), which were significantly lower than control group. Acute phase proteins and cytokines were significantly higher in the pneumonic sheep when compared to the healthy sheep. There was a significant increase in the levels of malondialdehyde; however, a significant decrease in the levels of super oxide dismutase, glutathione and catalase was observed. The present study shed the light on the possible pathphysiological role of lipid profile, acute phase proteins (APPs), proinflammatory cytokines and oxidative stress markers in pneumonic pasteurelosis in sheep.

Keywords: acute phase proteins, sheep, pasteurella, interleukins, stress

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Authors: Seema Ahlawat, Parul Saxena, Malik Zainul Abdin

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Malaria is a major health problem in many developing countries. The parasite responsible for the vast majority of fatal malaria infections is Plasmodium falciparum. Unfortunately, most Plasmodium strains including P. falciparum have become resistant to most of the antimalarials including chloroquine, mefloquine, etc. To combat this problem, WHO has recommended the use of artemisinin and its derivatives in artemisinin based combination therapy (ACT). Due to its current use in artemisinin based-combination therapy (ACT), its global demand is increasing continuously. But, the relatively low yield of artemisinin in A. annua L. plants and unavailability of economically viable synthetic protocols are the major bottlenecks for its commercial production and clinical use. Chemical synthesis of artemisinin is also very complex and uneconomical. The hairy root system, using the Agrobacterium rhizogenes LBA 9402 strain to enhance the production of artemisinin in A. annua L., is developed in our laboratory. The transgenic nature of hairy root lines and the copy number of trans gene (rol B) were confirmed using PCR and Southern Blot analyses, respectively. The effect of different concentrations of Piriformospora indica on artemisinin production in hairy root cultures were evaluated. 3% P. indica has resulted 1.97 times increase in artemisinin production in comparison to control cultures. The effects of P. indica on artemisinin production was positively correlated with regulatory genes of MVA, MEP and artemisinin biosynthetic pathways, viz. hmgr, ads, cyp71av1, aldh1, dxs, dxr and dbr2 in hairy root cultures of A. annua L. Mass scale cultivation of A. annua L. hairy roots by plant tissue culture technology may be an alternative route for production of artemisinin. A comprehensive investigation of the hairy root system of A. annua L. would help in developing a viable process for the production of artemisinin. The efficiency of the scaling up systems still needs optimization before industrial exploitation becomes viable.

Keywords: A. annua L., artemisinin, hairy root cultures, malaria

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Authors: Frieda Amitai

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The field of Translation Studies includes both descriptive and applied aspects, one of which is developing curricula. Within this topic there are theories dealing with curricula aimed at translator training, and theories meant to explore teaching translation as means through which awareness to language is developed in order to enhance language knowledge. An example of the latter is a unique study program in Israeli high schools – Teaching Translation Skills Program (TTSP). This study program has been taught in Israel for more than two decades and is aimed at raising students' meta-linguistic awareness as well as their language proficiency in both source language and target language in order to enable them become better language learners. The objective of the current research was to examine whether the goals of this program are achieved – increase in students' metalinguistic awareness and language proficiency. A follow-up case study was aimed at examining the level of proficiency which would develop most by this way of teaching English. The study was conducted in two stages – before and after participating in the program. 400 subjects took part in the first stage, and 100 took part in the second. In both parts of the study, participants were given the same five tasks in both Hebrew and English in addition to a questionnaire, in which they were asked about their own knowledge of Hebrew and in comparison to that of their peers. Their teachers were asked about the success of the program and about the methodology they use in class. Findings show significant change in the level of meta-linguistic awareness of the students as well as their language proficiency. A comparison between their answers before and after the program shows that their meta-linguistic awareness increased, as did their ability to recognize linguistic mistakes. These findings serve as strong evidence for the positive effect such study program has on the development of meta-linguistic awareness and linguistic knowledge. The follow-up case study tests the change among weaker language learners.

Keywords: comparison, metalinguistic awareness, language learning, translation skills

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Authors: Saman Keshavarzi

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The process of planning, designing and building neighborhoods is a complex and multidimensional part of urban planning. Understanding the elements that give a neighborhood a sense of identity can lead to successful city planning and result in a cohesive and functional community where people feel a sense of belonging. These factors are important in ensuring that the needs of the urban population are met to live in a safe, pleasant and healthy society. This research paper aims to identify the elements of the identity of traditional neighborhoods in Isfahan and analyzes ways of using these elements in the design of modern neighborhoods to increase social interaction between communities and cultural reunification of people. The neighborhood of Jolfa in Isfahan has a unique socio-cultural identity as it dates back to the Safavid Dynasty of the 16^th century, and most of its inhabitants are Christian Armenians of a religious minority. The elements of the identity of Jolfa were analyzed through the following research methods: field observations, distribution of questionnaires and qualitative analysis. The basic methodology that was used to further understand the Jolfa neighborhood and deconstruct the identity image that residents associate with their respective neighborhoods was a qualitative research method. This was done through utilizing questionnaires that respondents had to fill out in response to a series of research questions. From collecting these qualitative data, the major finding was that traditional neighborhoods that have elements of identity embedded in them are seen to have closer-knit communities whose residents have strong societal ties. This area of study in urban planning is vital to ensuring that new neighborhoods are built with concepts of social cohesion, community and inclusion in mind as they are what lead to strong, connected, and prosperous societies.

Keywords: development, housing, identity, neighborhood, policy, urbanization

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Authors: Vivek Upadhayay, Siddharth Deshmukh

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In recent years utilization of renewable energy sources has increased majorly because of the increase in global warming concerns. Organization these days are generally operated by Micro grid or smart grid on a small level. Power optimization and optimal load tripping is possible in a smart grid based industry. In any plant or industry loads can be divided into different categories based on their importance to the plant and power requirement pattern in the working days. Coming up with an idea to divide loads in different such categories and providing different power management algorithm to each category of load can reduce the power cost and can come handy in balancing stability and reliability of power. An objective function is defined which is subjected to a variable that we are supposed to minimize. Constraint equations are formed taking difference between the power usages pattern of present day and same day of previous week. By considering the objectives of minimal load tripping and optimal power distribution the proposed problem formulation is a multi-object optimization problem. Through normalization of each objective function, the multi-objective optimization is transformed to single-objective optimization. As a result we are getting the optimized values of power required to each load for present day by use of the past values of the required power for the same day of last week. It is quite a demand response scheduling of power. These minimized values then will be distributed to each load through an algorithm used to optimize the power distribution at a greater depth. In case of power storage exceeding the power requirement, profit can be made by selling exceeding power to the main grid.

Keywords: power flow optimization, power trading enhancement, smart grid, multi-object optimization

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Authors: Yuxuan Yang, Zhaoping Zhong

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Municipal solid waste and sludge are important sources of waste energy and their proper disposal is of great importance. Pyrolysis can fully decompose solid wastes and sludge, and the pyrolysis products (charcoal, oil and gas) have important recovery values. Due to the complex composition of solid wastes and sludge, the pyrolysis process at high temperatures is prone to heavy metal emissions, which are harmful to humans and the environment and reduce the safety of pyrolysis products. In this paper, heavy metal emissions during pyrolysis of municipal sewage sludge, paper mill sludge, municipal domestic waste, and aged refuse at 450-650°C were investigated and the emissions and hazards of heavy metals (Pb, Cr, Cd, Cu and Zn) were effectively reduced by adding modified vermiculite as an additive. The vermiculite was modified by intercalation with cetyltrimethylammonium bromide, which resulted in more than twice the original layer spacing of the vermiculite. Afterward, the interpolated vermiculite was made into vermiculite flakes by exfoliation modification. After that, the expansion rate of vermiculite flakes was increased by Mg2+ modification and thermal activation. The expanded vermiculite flakes were acidified to improve the textural characteristics of the vermiculite. The modified vermiculite was analysed by XRD, FT-IR, BET and SEM to clarify the modification effect. The incorporation of modified vermiculite resulted in more than 80% retention of all heavy metals at 450°C. Cr, Cu and Zn were better retained than Pb and Cd. The incorporation of modified vermiculite effectively reduced the risk of heavy metals, and all risks were low for Pb, Cr, Cu and Zn. The toxicity of all heavy metals was greatly reduced by the incorporation of modified vermiculite and the morphology of heavy metals was transformed from Exchangeable and acid-soluble (F1) and Reducible (F2) to Oxidizable (F3) and Residual (F4). In addition, the increase in temperature favored the stabilization of heavy metal forms. This study provides a new insight into the cleaner use of energy and the safe management of solid waste.

Keywords: heavy metal, pyrolysis, vermiculite, solid waste

Procedia PDF Downloads 52

Authors: J. S. P. Barbosa, L. C. Pereira, K. R. Garcia, P. C. P. Bouchardet, S. C. T. Vieira, A. O. Gomes, S. S. Funghetto, M. G. O. Kanikowski

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For this population, height seems to be a good predictor of strength and body composition. This increase in life expectancy of the Brazilian's population is associated with sociodemographic variables, but also to more access to health services in the prevention and better living conditions. With the growth of elderly population, a problem that has been a concern to health's professionals and public health at all is the use of psychoactive substances. The purpose of this study was to identify the sociodemographic profile of the elderly people who was attended at the Center of Psychosocial Care of alcohol and other drugs in the Federal District of Brazil. 408 medical records of people aged 60 years or over were evaluated, and it is possible to know that most of them were males (85.3%), with a mean age of 64 years (DP ± 4.16), 60 and 84 years and a mean age of 64 years (DP ± 4.42); 88.2% have some family ties, are married and have children, with relatives living in masonry housing. The educational level of drug users was considered low with more emphasis on those who had elementary education being the majority retired or unemployed. Regarding the street situation, there was no significance (p = 0.084), and the women (OR = 2.98) had few chances of street situations compared to men (OR = 0.89). As for substance consumption, the highest quantity of drug consumption bids in relation to the number of illicit. It did not present significant statistical value, and there is a greater probability of consumption/abuse of legal and/or illicit drugs for both sexes (OR = 0.96) for men and (OR = 1.32) for women. In relation to the use of multiple drugs, there was no significant difference between the sexes, (OR = 1.1) male sex and (OR = 0.74) female sex. Based on the results found in the present study, it was concluded that alcohol consumption is the main agent that causes vulnerability in the elderly and predisposes the latter to the consumption of other associated drugs.

Keywords: centers of attention psychosocial alcohol and drugs, elderly, mental disorder due to drug use, street situations

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Authors: Mrudula Kudtarkar, Rajesh Mane

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Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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Authors: Nora A. Guerrero, Adan Leon, María I. Sandoval, Romel Perez, Samuel Munoz

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The addition of solvents in cyclic steam stimulation is a technique that has shown an impact on the improved recovery of heavy oils. In this technique, it is possible to reduce the steam/oil ratio in the last stages of the process, at which time this ratio increases significantly. The mobility of improved crude oil increases due to the structural changes of its components, which at the same time reflected in the decrease in density and viscosity. In the present work, the effect of the variables such as temperature, time, and weight percentage of naphtha was evaluated, using a factorial design of experiments 23. From the results of analysis of variance (ANOVA) and Pareto diagram, it was possible to identify the effect on viscosity reduction. The experimental representation of the crude-vapor-naphtha interaction was carried out in a batch reactor on a Colombian heavy oil of 12.8° API and 3500 cP. The conditions of temperature, reaction time, and percentage of naphtha were 270-300 °C, 48-66 hours, and 3-9% by weight, respectively. The results showed a decrease in density with values in the range of 0.9542 to 0.9414 g/cm³, while the viscosity decrease was in the order of 55 to 70%. On the other hand, simulated distillation results, according to ASTM 7169, revealed significant conversions of the 315°C+ fraction. From the spectroscopic techniques of nuclear magnetic resonance NMR, infrared FTIR and UV-VIS visible ultraviolet, it was determined that the increase in the performance of the light fractions in the improved crude is due to the breakdown of alkyl chains. The methodology for cyclic steam injection with naphtha and laboratory-scale characterization can be considered as a practical tool in improved recovery processes.

Keywords: viscosity reduction, cyclic steam stimulation, factorial design, naphtha

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Albina Vodyanitskaya

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Given the culture- and language-specific nature of evaluation, this phenomenon is widely studied around the linguistic world and may be regarded as a challenge for translators. Evaluation penetrates all the levels of a scientific text, influences its composition and the reader’s attitude towards the information presented. One of the most challenging and rarely studied phenomena is the individual style of the scientific writer, which is mostly reflected in the use of evaluative language means. The evaluative and expressive potential of a scientific text is becoming more and more welcoming area for researchers, which stems in the shift towards anthropocentric paradigm in linguistics. Other reasons include: the cognitive and psycholinguistic processes that accompany knowledge acquisition, a genre-determined nature of a scientific text, the increasing public concern about the quality of scientific papers and some such. One more important issue, is the fact that linguists all over the world still argue about the definition of evaluation and its functions in the text. The author analyzes various approaches towards the study of evaluation and scientific texts. A comparative analysis of English and Russian dissertations and other scientific papers with regard to evaluative language means reveals major differences and similarities between English and Russian scientific style. Though standardized and genre-specific, English scientific texts contain more figurative and expressive evaluative means than the Russian ones, which should be taken into account while translating scientific papers. The processes that evaluation undergoes while being expressed by means of a target language are also analyzed. The author offers a target-language-dependent strategy for the translation of evaluation in English and Russian scientific texts. The findings may contribute to the theory and practice of translation and can increase scientific writers’ awareness of inter-language and intercultural differences in evaluative language means.

Keywords: academic discourse, evaluation, scientific text, scientific writing, translation

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: Reyhan Ozbask, Emek Moroydor Derin, Mustafa Dogu

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There are a limited number of global companies in the world that manufacture and commercially offer thermoplastic composite prepregs in accordance with aerospace requirements. High-performance thermoplastic materials supplied for aerospace structural applications are PEEK (polyetheretherketone), PPS (polyphenylsulfite), PEI (polyetherimide), and PEKK (polyetherketoneketone). Among these, PEEK is the raw material used in the first applications and has started to become widespread. However, the use of these thermoplastic raw materials in composite production is very difficult due to their high processing temperatures and impregnation difficulties. This study, it is aimed to develop carbon fiber-reinforced thermoplastic PEEK composites that comply with the requirements of the aviation industry that are superior mechanical properties as well as being lightweight. Therefore, it is aimed to obtain high-performance thermoplastic composite materials with improved interface properties by using the sizing method (suspension development through chemical synthesis and functionalization), to optimize the production process. The use of boron nitride nanotube as a bonding agent by modifying its surface constitutes the original aspect of the study as it has not been used in composite production with high-performance thermoplastic materials yet. For this purpose, laboratory-scale studies on the application of thermoplastic compatible sizing will be carried out in order to increase the fiber-matrix interfacial adhesion. The method respectively consists of the selection of appropriate sizing type, laboratory-scale carbon fiber (CF) / poly ether ether ketone (PEEK) polymer interface enhancement studies, manufacturing of laboratory-scale BNNT coated CF/PEEK woven prepreg composites and their tests.

Keywords: carbon fiber reinforced composite, interface enhancement, boron nitride nanotube, thermoplastic composite

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Authors: Ezeddin Kolaib

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Paracetamol tablets and cimetidine tablets were prepared by single-step granulation/tabletting and by compression after high shear granulation. The addition of PVP (polyvinylpyrrolidone) was essential for single-step granulation/tabletting of formulation containing high concentrations of paracetamol or cimetidine. Paracetamol tablets without and with PVP obtained by single-step granulation/tabletting exhibited a significantly higher tensile strength, a significantly lower disintegration time, a lower friability and a faster dissolution compared to those prepared by compression after high shear granulation. Cimetidine tablets with PVP obtained by single-step granulation/tabletting exhibited a significantly lower tensile strength, a significantly lower disintegration time and a faster dissolution compared to those prepared by compression after high shear granulation. Single-step granulation/tabletting allowed to produce tablets containing up to 80% paracetamol or cimetidine with a dissolution profile complying with the USP requirements. For pure paracetamol or pure cimetidine the addition of crospovidone as a disintegrant was required to obtain a dissolution profile that complied with the pharmacopoeial requirements. Long term and accelerated stability studies of paracetamol tablets produced by single-step granulation/tabletting over a period of one year showed no significant influence on the tablet tensile strength, friability and dissolution. Although a significant increase of the disintegration time was observed, it remained below 10 min. These results indicated that single-step granulation/tabletting could be an efficient technique for the production of highly dosed drugs such as paracetamol and cimetidine.

Keywords: single-step granulation/tabletting, twin screw extrusion, high shear granulation, high dosage drugs, paracetamol, cimetidine

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Authors: R. Morbidelli, C. Saltalippi, A. Flammini, A. Garcia-Marin, J. L. Ayuso-Munoz

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The climate change, mainly due to greenhouse gas emissions associated to human activities, has been modifying hydrologic processes with a direct effect on air surface temperature that has significantly increased in the last century at global scale. In this context the Mediterranean area is considered to be particularly sensitive to the climate change impacts on temperature indices. An analysis finalized to study the evolution of temperature indices and to check the existence of significant trends in the Umbria Region (Italy) is presented. Temperature data were obtained by seven meteorological stations uniformly distributed in the study area and characterized by very long series of temperature observations (at least 60 years) spanning the 1924-2015 period. A set of 39 temperature indices represented by monthly and annual mean, average maximum and average minimum temperatures, has been derived. The trend analysis was realized by applying the non-parametric Mann-Kendall test, while the non-parametric Pettit test and the parametric Standard Normal Homogeneity test (SNHT) were used to check the presence of breakpoints or in-homogeneities due to environmental changes/anthropic activity or climate change effects. The Umbria region, in agreement with other recent studies exploring the temperature behavior in Italy, shows a general increase in all temperature indices, with the only exception of Gubbio site that exhibits very light negative trends or absence of trend. The presence of break points and in-homogeneity was widely explored through the selected tests and the results were checked on the basis of the well-known metadata of the meteorological stations.

Keywords: reception theory, reading, literary translation, horizons of expectation, reader

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Armend Kelmendi, Adnan Ahmeti

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The purpose of our study was to assess the impact of soccer in the overall wealth fare (education, health, and economic prosperity) of youth in Kosovo (age: 7-18). The research conducted measured a number of parameters (training methodologies, conditions, community leadership impact) in a sample consisting of 6 different football clubs’ academies across the country. Fifty (50) male and female football youngsters volunteered in this study. To generate more reliable results, the analysis was conducted with the help of a set of effective project management tools and techniques (Gantt chart, Logic Network, PERT chart, Work Breakdown Structure, and Budgeting Analysis). The interviewees were interviewed under a specific lens of categories (impact in education, health, and economic prosperity). A set of questions were asked i.e. what has football provided to you and the community you live in?; Did football increase your confidence and shaped your life for better?; What was the main reason you started training in football? The results generated explain how a single sport, namely that of football in Kosovo can make a huge social change, improving key social factors in a society. There was a considerable difference between the youth clubs as far as training conditions are concerned. The study found out that despite financial constraints, two out of six clubs managed to produce twice as more talented players that were introduced to professional primary league teams in Kosovo and Albania, including other soccer teams in the region, Europe, and Asia. The study indicates that better sports policy must be formulated and associated with important financial investments in soccer for it to be considered fruitful and beneficial for players of 18 plus years of age, namely professionals.

Keywords: youth, prosperity, conditions, investments, growth, free movement

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Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

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Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

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Authors: Hannah S. Waldron

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Background: The government has proposed sugar reduction targets in an effort to tackle childhood obesity, focussing on those of low socioeconomic status (SES). Supermarkets are a key location for reducing the amount of sugar purchased, but success so far in this environment has been limited. Building on previous research, this study will assess the impact of restricting the availability of higher sugar biscuits as a strategy to encourage lower sugar biscuit purchasing, and whether the effects vary by customer SES. Method: 14 supermarket convenience stores were divided between control (n=7) and intervention (n=7) groups. In the intervention stores, biscuits with sugar above the government’s target (26.2g/100g) were removed from sale and replaced with lower sugar ( < 26.2g sugar/100g) alternatives. Sales and customer demographic information were collected using loyalty card data and point-of-sale transaction data for 8-weeks pre and post the intervention for lower sugar biscuits, total biscuits, alternative higher sugar products, and all products. Results were analysed using three-way and two-way mixed ANOVAs. Results: The intervention resulted in a significant increase in lower sugar biscuit purchasing (p < 0.001) and a significant decline in overall biscuit sales (p < 0.001) between the time periods compared to control stores. Sales of higher sugar products and all products increased significantly between the two time periods in both the intervention and control stores (p < 0.05). SES showed no significant effect on any of the reported outcomes (p > 0.05). Conclusion: Restricting the availability of higher sugar products may be a successful strategy for encouraging lower sugar purchasing across all SES groups. However, larger-scale interventions are required in additional categories to assess the long term implications for both consumers and retailers.

Keywords: biscuits, nudging, sugar, supermarket

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Authors: Gopika Rajagopal, Sudheesh Thiyyakkandi

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Back-to-back reinforced earth (RE) walls are extensively used in these days as bridge abutments and highway ramps, owing to their cost efficiency and ease of construction. High quality select fill is the most suitable backfill material due to its excellent engineering properties and constructability. However, industries are compelled to use low quality, locally available soil because of its ample availability on site. However, several failure cases of such walls are reported, especially subsequent to rainfall events. The stiffness of reinforcement is one of the major factors affecting the performance of RE walls. The present study focused on analyzing the effect of reinforcement stiffness on the performance of complete select fill, complete marginal fill, and hybrid-fill (i.e., combination of select and marginal fills) back-to-back RE walls, immediately after construction and upon rainwater infiltration through finite element modelling. A constant width to height (W/H) ratio of 3 and height (H) of 6 m was considered for the numerical analysis and the stiffness of reinforcement layers was varied from 500 kN/m to 10000 kN/m. Results showed that reinforcement stiffness had a noticeable influence on the response of RE wall, subsequent to construction as well as rainwater infiltration. Facing displacement was found to decrease and maximum reinforcement tension and factor of safety were observed to increase with increasing the stiffness of reinforcement. However, beyond a stiffness of 5000 kN/m, no significant reduction in facing displacement was observed. The behavior of fully marginal fill wall considered in this study was found to be reasonable even after rainwater infiltration when the high stiffness reinforcement layers are used.

Keywords: back-to-back reinforced earth wall, finite element modelling, rainwater infiltration, reinforcement stiffness

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Authors: Michelle Nighswander

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Suicide can be a tragic response to mental illness. It is difficult for people to disclose or discuss suicidal impulses. The stigma surrounding mental health can create a reluctance to seek help for mental illness. Patients may feel pressure to exhibit a socially desirable demeanor rather than reveal these issues, especially if they sense their healthcare provider is pressed for time or does not have an extensive history with their provider. Overcoming these barriers can be challenging. Although there are several validated depression and suicide risk instruments, varying processes used to administer these tools may impact the truthfulness of the responses. A literature review was conducted to find evidence of the impact of the environment on the accuracy of depression screening. Many investigations do not describe the environment and fewer studies use a comparison design. However, three studies demonstrated that computerized self-reporting might be more likely to elicit truthful and accurate responses due to increased privacy when responding compared to a face-to-face interview. These studies showed patients reported positive reactions to computerized screening for other stigmatizing health conditions such as alcohol use during pregnancy. Computerized self-screening for depression offers the possibility of more privacy and patient reflection, which could then send a targeted message of risk to the healthcare provider. This could potentially increase the accuracy while also increasing time efficiency for the clinic. Considering the persistent effects of mental health stigma, how these screening questions are posed can impact patients’ responses. This literature review analyzes trends in depression screening methodologies, the impact of setting on the results and how this may assist in overcoming one barrier caused by stigma.

Keywords: computerized self-report, depression, mental health stigma, suicide risk

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Authors: Sepideh Mohammadi

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Iran is a country that boasts of ethnic diversity, comprising various groups such as Turks, Lors, Arabs, Baluchs, Persians, Kurds, Gliks, Azaris, and Tabaris. The majority of people in Iran are Persians and as such, the Persian language is the official language of the country. However, it is also a common language among different ethnic groups. It is worth noting that there is a longstanding history of coexistence and cultural relations between the Turkic and Lor ethnic groups. The purpose of this article is to study the range of intercultural sensitivities of Turks and Lor peoples to identify the state of intercultural competence and reduce conflicts in the direction of cultural policy. It is important to gain insight into the mutual perceptions of Lor and Turkic people towards each other. Understanding these perceptions can greatly aid in fostering stronger relationships and promoting effective communication between the two ethnic groups. The study employed a qualitative content analysis approach to gather data using a semi-structured interview tool. The participants consisted of ten individuals from the Lor ethnic and ten individuals from the Turk ethnic. According to Milton Bennett's six-stage model, our findings reveal that the Turkish and Lor ethnic groups tend to exhibit higher intercultural sensitivity in the second stage, which consists of defense against differences. Both groups tend to emphasize the differences between them, and the notion of "us and the other" holds significant importance for them. It is important to acknowledge that both the Turk and Lor ethnicities consist of various clans, which significantly shape intercultural relations between them. A common stereotype in this regard is that the Turks of Tabriz province often do not recognize the Turks of other provinces of the country as their own. Moreover, our study indicates that an increase in interaction and communication between the Lor and Turk ethnic groups may lead to a reduction in cultural sensitivities between them.

Keywords: intercultural communication, intercultural sensitivity, Iran, Lor, Turk

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Authors: Heiko Scholz

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When feeding high qualitysilagetoheifersfromthe age of two, there is a riskofenergyoversupply. Depending on the feeding valueorscarceavailability ofsilageorcorn silage diets withhighproportionsof straw is often incorporated. Foran energetically standardized young cattle supply of strawproportion can be more than 20% of dry matter. It was investigated whether the grinding of straw with the strawmillselective feeding significantly limits. The investigation has been carried out with young cattle in the second year. 78 animals were kept and fed under similar conditions in two groups. The experimental group (EG) consisted of cattle 12 to 15 months, and in the control group (CG), the cattle were 15 to 20 months old. The experimental feeding took place in five days of feed distribution, and residual feed were weighed. The ration of EG contained ground with the straw mill straw, and CG was further fed rotor-cut pressed straw. To determine the selective seizure samples of feed distributionandtheremainingfood with the particle separator boxandthecrude protein-and energy-content have been determined. The grinding of the straw increased the daily feed intake.IntheEGan increase infeed intakewas observedby grinding of the straw. Feed intakedirectlyon the day for changing the dietoflongonground straw increased by more than 2.0 kgofDMper animal. In the following days, the feed intakewasincreasedby 0.9kg DMper animal and day on average (7.4 vs. 8.3 kg DM per day). The results of the screen distribution of residual feed point to a differentiated feeding behavior between the groups. In the EG, the particle length of the residual feed to a large extent with the template matches. The acid-base-balance (NSBA)valuesofEGarewithin normal limits. Ifstrawsharesof25% and more are federations to young cattle (heifers), the theparticlelengthof straw has significant impact ontheselectivefeeding behavior. Aparticlelength of 1.5cmcompared to7.5 cmlongpreventedstrawcertainly discarding of the straw on the feeding barn. The feed intake increases whenshortstrawis mixed into theTMR.

Keywords: straw mill, heifer, feed selection, dry matter intake

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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Authors: Ezeugwunne Ifeoma Priscilla, Charles Chinedum Onyenekwe, Joseph Eberendu Ahaneku, Rosemary Adanma Analike, Adesuwa Peace Eidangbe

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This study was designed to assess the effect of malaria parasitaemia on serum reproductive hormone levels of asymptomatic HIV adult subjects. A total of 271 participants aged between 17 and 58 ears were conveniently recruited. 135 asymptomatic HIV-infected subjects participated in the study; 67 of them had malaria parasitaemia. 136 HIV seropositive control subjects, 68 of them had malaria parasitaemia. Blood samples were collected from the participants for the determination of HIV status by immunoassay and immunochromatography. Enzyme-linked immunosorbent assay (ELISA) was used to assay for serum LH, FSH, Estrogen, testosterone, progesterone, prolactin, and PSA levels, CD4+T cell counts by Cyflow method, thick and thin films determination of malaria parasitaemia count and density by WHO. Student's t-tests and ANOVA were used to compare means. P<0.05 was considered statistically significant. The results showed significant differences in serum levels of LH, FSH, PSA, estrogen, progesterone, and testosterone amongst the groups at P<0.05, respectively. The serum levels of LH, FSH, and PSA were significantly higher in malaria-infected asymptomatic HIV subjects than in asymptomatic HIV subjects with malaria parasitaemia (P<0.05 in each case). Also, the serum levels of LH, FSH, PSA, estrogen, and progesterone were significantly higher in malaria-infected asymptomatic HIV subjects compared with malaria-infected HIV seronegative subjects (P<0.05, respectively). The mean MP counts and MP density were significantly higher in asymptomatic HIV subjects compared to HIV seronegative subjects (P<0.05, in each case). The mean serum levels of testosterone were significantly lower in both malaria-infected and malaria uninfected HIV seronegative subjects (P<0.05, in each case). In conclusion, Malaria and HIV co-infection might increase the burden of hypogonadism as well as primary testicular failure, hyperprogesteronaemia, elevated levels of estrogen, and PSA in adult males asymptomatic HIV subjects.

Keywords: malaria parasitaemia, HIV, CD4, reproductive hormones

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