Search results for: hospital waste

Authors: Z. Abdollahnejad, M. Kheradmand, F. Pacheco-Torgal

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The use of bio-based admixtures on construction materials is a recent trend that is gaining momentum. However, to our knowledge, no studies have been reported concerning the use of biopolymers on hybrid cement based mortars. This paper reports experimental results regarding the study of the influence of mix design of 43 hybrid cement mortars containing two different biopolymers on its mechanical performance. The results show that the use of the biopolymer carrageenan is much more effective than the biopolymer xanthan concerning the increase in compressive strength. An optimum biopolymer content was found.

Keywords: waste reuse, fly ash, waste glass, hybrid cement, biopolymers, mechanical strength

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Authors: Damian Graham, Ashleigh H. Hall, Damani R. Sulph, Michael A. James, Shawn B. Vassell

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This paper assesses the design and feasibility of a Materials Recovery Facility (MRF) in Jamaica as a possible green industry approach to the nation’s economic and solid waste management problems. Jamaica is a developing nation that is vulnerable to climate change that can affect its blue economy and tourism on which it is heavily reliant. Jamaica’s National Solid Waste Management Authority (NSWMA) collects only a fraction of all the solid waste produced annually which is then transported to dumpsites. The remainder is either burnt by the population or disposed of illegally. These practices negatively impact the environment, threaten the sustainability of economic growth from blue economy and tourism and its waste management system is predominantly a cost centre. The implementation of an MRF could boost the manufacturing sector, contribute to economic growth, and be a catalyst in creating a green industry with multiple downstream value chains with supply chain linkages. Globally, there is a trend to reuse and recycle that created an international market for recycled solid waste. MRFs enable the efficient sorting of solid waste into desired recoverable materials thus providing a gateway for entrance to the international trading of recycled waste. Research into the current state and effort to improve waste management in Jamaica in contrast with the similar and more advanced territories are outlined. The study explores the concept of green industrialization and its applicability to vulnerable small state economies like Jamaica. The study highlights the possible contributions and benefits derived from MRFs as a seeding factory that can anchor the reverse and forward logistics of other green industries as part of a logistic-cantered economy. Further, the study showcases an engineering economic analysis that assesses the viability of the implementation of an MRF in Jamaica. This research outlines the potential cost of constructing and operating an MRF and provides a realistic cash flow estimate to establish a baseline for profitability. The approach considers quantitative and qualitative data, assumptions, and modelling using industrial engineering tools and techniques that are outlined. Techniques of facility planning, system analysis and operations research with a focus on linear programming techniques are expressed. Approaches to overcome some implementation challenges including policy, technology and public education are detailed. The results of this study present a reasonable judgment of the prospects of incorporating an MRF to improve Jamaica’s solid waste management and contribute to socioeconomic and environmental benefits and an alternate pathway for economic sustainability.

Keywords: engineering-economic analysis, facility design, green industry, MRF, manufacturing, plant layout, solid-waste management, sustainability, waste disposal

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Authors: Lillian Musila, Valerie Oundo, Daniel Erwin, Willie Sang

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Staphylococcus aureus infections are a major cause of nosocomial infections in Kenya. Methicillin resistant S. aureus (MRSA) infections are a significant burden to public health and are associated with considerable morbidity and mortality. At a hospital in Western Kenya two clusters of MRSA cases emerged within short periods of time. In this study we explored whether these clusters represented a nosocomial outbreak by characterizing the isolates using phenotypic and molecular assays and examining epidemiological data to identify possible transmission patterns. Specimens from the site of infection of the subjects were collected, cultured and S. aureus isolates identified phenotypically and confirmed by APIStaph™. MRSA were identified by cefoxitin disk screening per CLSI guidelines. MRSA were further characterized based on their antibiotic susceptibility patterns and spa gene typing. Characteristics of cases with MRSA isolates were compared with those with MSSA isolated around the same time period. Two cases of MRSA infection were identified in the two week period between 21 April and 4 May 2015. A further 2 MRSA isolates were identified on the same day on 7 September 2015. The antibiotic resistance patterns of the two MRSA isolates in the 1st cluster of cases were different suggesting that these were distinct isolates. One isolate had spa type t2029 and the other had a novel spa type. The 2 isolates were obtained from urine and an open skin wound. In the 2nd cluster of MRSA isolates, the antibiotic susceptibility patterns were similar but isolates had different spa types: one was t037 and the other a novel spa type different from the novel MRSA spa type in the first cluster. Both cases in the second cluster were admitted into the hospital but one infection was community- and the other hospital-acquired. Only one of the four MRSA cases was classified as an HAI from an infection acquired post-operatively. When compared to other S. aureus strains isolated within the same time period from the same hospital only one spa type t2029 was found in both MRSA and non-MRSA strains. None of the cases infected with MRSA in the two clusters shared any common epidemiological characteristic such as age, sex or known risk factors for MRSA such as prolonged hospitalization or institutionalization. These data suggest that the observed MRSA clusters were multi strain clusters and not an outbreak of a single strain. There was no clear relationship between the isolates by spa type suggesting that no transmission was occurring within the hospital between these cluster cases but rather that the majority of the MRSA strains were circulating in the community. There was high diversity of spa types among the MRSA strains with none of the isolates sharing spa types. Identification of disease clusters in space and time is critical for immediate infection control action and patient management. Spa gene typing is a rapid way of confirming or ruling out MRSA outbreaks so that costly interventions are applied only when necessary.

Keywords: cluster, Kenya, MRSA, spa typing

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Authors: Sima Shakoorjavan, Dawid Stawski, Somaye Akbari

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In this study, the adsorption-desorption behavior of poly(amidoamine) (PAMAM) as a polycation and poly (acrylic acid) (PAA) as a polyanion deposited on aminolyzed-PLA nonwoven through layer-by-layer technique (lbl) was studied. The adsorption-desorption behavior was monitored by UV adsorbance spectroscopy and turbidity tests of the waste polyelectrolytes after each deposition. Also, the drying between each deposition step was performed to study the effect of drying on adsorption-desorption behavior. According to UV adsorbance spectroscopy of the waste polyelectrolyte after each deposition, it was revealed that drying has a great effect on the deposition behavior of the next layer. Regarding the deposition of the second layer, drying caused more desorption and removal of the previously deposited layer since the turbidity and the absorbance of the waste increased in comparison to pure polyelectrolyte. To deposit the third layer, the same scenario occurred and drying caused more removal of the previously deposited layer. However, the deposition of the fourth layer drying after the deposition of the third layer did not affect the adsorption-desorption behavior. Since the adsorbance and turbidity of the samples that were dried and those that were not dried were the same. As a result, it seemed that deposition of the fourth layer could be the starting point where lbl reached its constant state. The decrease in adsorbance and remaining turbidity of the waste same as a pure polyelectrolyte can indicate that most portion of the polyelectrolyte was adsorbed onto the substrate rather than complex formation in the bath as the subsequence of the previous layer removal.

Keywords: Adsorption-desorption behavior, lbl technique, poly(amidoamine), poly (acrylic acid), weak polyelectrolytes

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Authors: Shohreh Azizi, Memory Tekere, Wag Nel

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An evaluation of the characteristics of wastewater generated from small communities was carried out in relation to decentralized approach for domestic sewage treatment plant and design of biological nutrient removal system. The study included the survey of the waste from various individual communities such as a hotel, a residential complex, an office premise, and an educational institute. The results indicate that the concentration of organic pollutant in wastewater from the residential complex is higher than the waste from all the other communities with COD 664 mg/l, BOD 370.2 mg/l and TSS 248.8 mg/l. And the waste water from office premise indicates low organic load with COD428 mg/l, BOD 232mg/l and TSS 157mg/l. The wastewater from residential complex was studied under activated sludge process to evaluate this technology for decentralized wastewater treatment. The Activated sludge process was operated at different 12to 4 hrs hydraulic retention times and the optimum 6 hrs HRT was selected, therefore the average reduction of COD (85.92%) and BOD (91.28 %) was achieved. The issue of sludge recycling, maintenance of biomass concentration and high HRT reactor (10 L) volume are making the system non-practical for smaller communities.

Keywords: wastewater, small communities, activated sludge process, decentralized system

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Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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Authors: Hind Bouami

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Handling life-critical systems complexity requires to be equipped with appropriate technology and the right human agents’ functions such as knowledge, experience, and competence in problem’s prevention and solving. Human agents are involved in the management and control of human-machine system’s performance. Documenting human agent’s situation awareness is crucial to support human-machine designers’ decision-making. Knowledge about risks, critical parameters and factors that can impact and threaten automation system’s performance should be collected using preventive and retrospective approaches. This paper aims to document operators’ situation awareness through the analysis of automated organizations’ feedback. The analysis of automated hospital pharmacies feedbacks helps to identify and control critical parameters influencing human machine interaction in order to enhance system’s performance and security. Our human machine system evaluation approach has been deployed in Macon hospital center’s pharmacy which is equipped with automated drug dispensing systems since 2015. Automation’s specifications are related to technical aspects, human-machine interaction, and human aspects. The evaluation of drug delivery automation performance in Macon hospital center has shown that the performance of the automated activity depends on the performance of the automated solution chosen, and also on the control of systemic factors. In fact, 80.95% of automation specification related to the chosen Sinteco’s automated solution is met. The performance of the chosen automated solution is involved in 28.38% of automation specifications performance in Macon hospital center. The remaining systemic parameters involved in automation specifications performance need to be controlled.

Keywords: life-critical systems, situation awareness, human-machine interaction, decision-making

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Authors: Mahmoud A. Rabah, Said El Sheikh

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This work shows the preparation of chromium nanoparticles from tannery waste solution on glassy carbon by chemical method compared to electrokinetic process. The waste solution contains free and soluble fats, calcium, iron, magnesium and high sodium in addition to the chromium ions. Filtration helps removal of insoluble matters. Diethyl ether successfully extracted soluble fats. The method started by removing calcium as insoluble oxalate salts at hot conditions in a faint acidic medium. The filtrate contains iron, magnesium, chromium ions and sodium chloride in excess. Chromium was separated selectively as insoluble hydroxide sol-gel at pH 6.5, filtered and washed with distilled water. Part of the gel reacted with sulfuric acid to produce chromium sulfate solution having 15-25 g/L concentration. Electrokinetic deposition of chromium nanoparticles on a carbon cathode was carried out using platinum anode under different galvanostatic conditions. The chemical method involved impregnating the carbon specimens with chromium hydroxide gel followed by reduction using hydrazine hydrate or by thermal reduction using hydrogen gas at 1250°C. Chromium grain size was characterized by TEM, FT-IR and SEM. Properties of the Cr grains were correlated to the conditions of the preparation process. Electrodeposition was found to control chromium particles to be more identical in size and shape as compared to the chemical method.

Keywords: chromium, electrodeposition, nanoparticles, tannery waste solution

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Authors: Saad A. Aljlil

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Adsorption of cobalt ions on quartz and illite and calcite from waste water was investigated. The effect of pH on the adsorption of cobalt ions was studied. The maximum capacities of cobalt ions of the three adsorbents increase with increasing cobalt solution temperature. The maximum capacities were (4.66) mg/g for quartz, (3.94) mg/g for illite, and (3.44) mg/g for calcite. The enthalpy, Gibbs free energy, and entropy for adsorption of cobalt ions on the three adsorbents were calculated. It was found that the adsorption process of the cobalt ions of the adsorbent was an endothermic process. consequently increasing the temperature causes the increase of the cobalt ions adsorption of the adsorbents. Therefore, the adsorption process is preferred at high temperature levels. The equilibrium adsorption data were correlated using Langmuir model, Freundlich model. The experimental data of cobalt ions of the adsorbents correlated well with Freundlich model.

Keywords: adsorption, Langmuir, Freundlich, quartz, illite, calcite, waste water

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Authors: N. Metidji, N. Kasbadji Merzouk, O. Badaoui, R. Sellami, A. Djebli

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The Agro-industry is considered as one of the most waste producing industrial fields as a result of food processing. Upgrading and reuse of these wastes as animal or poultry food seems to be a promising alternative. Combined with the use of clean energy resources, the recovery process would contribute more to the environment protection. It is in this framework that a new solar dryer has been designed in the Unit of Solar Equipments Development. Indirect solar drying has, also, many advantages compared to natural sun drying. In fact, the first does not cause product degradation as it is protected by the drying chamber from direct sun, insects and exterior environment. The aim of this work is to study the drying kinetics of waste, generated during the processing of orange to make fruit juice, by using an indirect forced convection solar dryer at 50 °C and 60 °C, the rate of moisture removal from the product to be dried has been found to be directly related to temperature, humidity and flow rate. The characterization of these parameters has allowed the determination of the appropriate drying time for this product namely orange waste.

Keywords: solar energy, solar dryer, energy conversion, orange drying, forced convection solar dryer

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Authors: Yang Gon Seo, Chang-Joon Kim, Dae Hyeok Kim

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It is estimated that 1.5 billion tires are produced worldwide each year which will eventually end up as waste tires representing a major potential waste and environmental problem. Pyrolysis has been great interest in alternative treatment processes for waste tires to produce valuable oil, gas and solid products. The oil and gas products may be used directly as a fuel or a chemical feedstock. The solid produced from the pyrolysis of tires ranges typically from 30 to 45 wt% and have high carbon contents of up to 90 wt%. However, most notably the solid have high sulfur contents from 2 to 3 wt% and ash contents from 8 to 15 wt% related to the additive metals. Upgrading tire pyrolysis products to high-value products has concentrated on solid upgrading to higher quality carbon black and to activated carbon. Hydrogen sulfide and ammonia are one of the common malodorous compounds that can be found in emissions from many sewages treatment plants and industrial plants. Therefore, removing these harmful gasses from emissions is of significance in both life and industry because they can cause health problems to human and detrimental effects on the catalysts. In this work, pyrolytic carbon black from waste tires was used to develop adsorbent with good adsorption capacity for removal of hydrogen and ammonia. Pyrolytic carbon blacks were prepared by pyrolysis of waste tire chips ranged from 5 to 20 mm under the nitrogen atmosphere at 600℃ for 1 hour. Pellet-type adsorbents were prepared by a mixture of carbon black, metal oxide and sodium hydroxide or hydrochloric acid, and their adsorption capacities were estimated by using the breakthrough curve of a continuous fixed bed adsorption column at ambient condition. The adsorbent was manufactured with a mixture of carbon black, iron oxide(III), and sodium hydroxide showed the maximum working capacity of hydrogen sulfide. For ammonia, maximum working capacity was obtained by the adsorbent manufactured with a mixture of carbon black, copper oxide(II), and hydrochloric acid.

Keywords: adsorbent, ammonia, pyrolytic carbon black, hydrogen sulfide, metal oxide

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Authors: Abdul Rahim Al Umairi, Hamed Al Kindi

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The cement production process significantly contributes to greenhouse gas emissions, accounting for 25% of total industrial emissions. This study systematically examined new, underutilized materials—sewage sludge ash (SSA), marble waste (MW), and calcined clay (CC)—to evaluate their effects when partially replacing white Portland cement (WPC) in cement paste formulations. Various replacement proportions (10%, 20%, and 30%) were tested, along with different treatment temperatures (600°C, 630°C, 730°C, and 850°C) for SSA and CC. To gain a deeper understanding of the resulting materials, analyses such as XRF, XRD, and SEM were conducted. The highest compressive strength recorded for the 28-day cured cement paste was 91 MPa when 20% SSA (treated at 600°C) was used, compared to just 53 MPa for the control sample. Conversely, CC exhibited minimal enhancement in compressive strength, while MW had detrimental effects. Additionally, replacing WPC with SSA and CC at 9% and 21% resulted in slight improvements in compressive strength. This research highlights the potential of utilizing underexploited materials like SSA to improve the mechanical and chemical properties of cement paste, indicating that further investigation is necessary to enhance environmental sustainability.

Keywords: sewage sludge ash, calcined clay, marble waste, cement

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: K. S. Al-Mugren, A. Yahya, S. Alodah, R. Alharbi, S. H. Almsaid , A. Alqahtani, H. Jaber, A. Basaqer, N. Alajra, N. Almoghati, A. Alsalman, Khalid Alharbi

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Context: The production of biofertilizers from naturally occurring microorganisms is an area of research that aims to enhance agricultural practices by utilizing local resources. This research project focuses on isolating and screening indigenous microorganisms with PK-fixing and phosphate solubilizing characteristics from local sources. Research Aim: The aim of this project is to develop a biofertilizer product using indigenous microorganisms and composted agro waste as a carrier. The objective is to enhance crop productivity and soil fertility through the application of biofertilizers. Methodology: The research methodology includes several key steps. Firstly, indigenous microorganisms will be isolated from local resources using the ten-fold serial dilutions technique. Screening assays will be conducted to identify microorganisms with phosphate solubilizing and PK-fixing activities. Agro-waste materials will be collected from local agricultural sources, and composting experiments will be conducted to convert them into organic matter-rich compost. Physicochemical analysis will be performed to assess the composition of the composted agro-waste. Gamma and X-ray irradiation will be used to sterilize the carrier material. The sterilized carrier will be tested for sterility using the ten-fold serial dilutions technique. Finally, selected indigenous microorganisms will be developed into biofertilizer products. Findings: The research aims to find suitable indigenous microorganisms with phosphate solubilizing and PK-fixing characteristics for biofertilizer production. Additionally, the research aims to assess the suitability of composted agro waste as a carrier for biofertilizers. The impact of gamma irradiation sterilization on pathogen elimination will also be investigated. Theoretical Importance: This research contributes to the understanding of utilizing indigenous microorganisms and composted agro waste for biofertilizer production. It expands knowledge on the potential benefits of biofertilizers in enhancing crop productivity and soil fertility. Data Collection and Analysis Procedures: The data collection process involves isolating indigenous microorganisms, conducting screening assays, collecting and composting agro waste, analyzing the physicochemical composition of composted agro waste, and testing carrier sterilization. The analysis procedures include assessing the abilities of indigenous microorganisms, evaluating the composition of composted agro waste, and determining the sterility of the carrier material. Conclusion: The research project aims to develop biofertilizer products using indigenous microorganisms and composted agro waste as a carrier. Through the isolation and screening of indigenous microorganisms, the project aims to enhance crop productivity and soil fertility by utilizing local resources. The research findings will contribute to the understanding of the suitability of composted agro waste as a carrier and the efficacy of gamma irradiation sterilization. The research outcomes will have theoretical importance in the field of biofertilizer production and agricultural practices.

Keywords: biofertilizer, microorganisms, agro waste, nuclear technologies

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Authors: Robert Bušić, Ivana Miličević, Larisa Šargač

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The construction industry generates a large amount of waste, which poses a challenge for disposal and often requires significant areas for landfill. Therefore, recycling construction waste has become imperative. This study focuses on investigating the use of locally available recycled concrete as a substitute for traditional aggregates and analyzing the impact of this change on the mechanical and durability properties of concrete. The research begins with the crushing of locally available waste concrete, followed by sieving and sorting the aggregate into different fractions. Four concrete mix designs were created, with one serving as a reference mixture without recycled aggregate, while the remaining three mixes included recycled aggregate in varying proportions. The experimental part includes testing the key properties of concrete in both fresh and hardened states, including slump and flow tests, compressive strength, static modulus of elasticity, and shrinkage of the concrete, with the aim of assessing the impact of locally available recycled aggregate on concrete properties. By using experimental testing methods, the results were compared with conventional concrete, providing deeper insights into the potential advantages and disadvantages of using locally available recycled concrete in various construction projects.

Keywords: concrete, durability, recycled aggregate, sustainability

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Authors: S. I. Nwadioha, M. S. Odimayo, G. T. A. Jombo, E. O. P. Nwokedi

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Aims and Objectives: To determine the baseline CD4 positive T lymphocytes count of HIV/AIDS treatment naïve adults clients presenting for the first time treatment in Benue State University Teaching Hospital. Subjects and Methods: A total of 700 subjects age between 18 years to 70 years, were recruited for the study, comprising 600 HIV sero-positive patients and 100 healthy controls in Benue State University Teaching Hospital, Makurdi from 2013 to 2014. The CD4 counts of the subjects were evaluated using a Partec flow cytometer. Results: CD4 count of 200-299 cells/μl peaked with 25% (n=150/600)[control; 0%( n= 0/100)]. The study also showed that 44% (266/600) of HIV subjects had acquired immunodeficiency syndrome as defined by low CD4 counts below 200 cells/μl. Seventy-five per cent (n=451/600)of our patients would require to be placed on antiretroviral therapy with CD4 count of less than 350 cells/μl. At CD4 350 baseline criterion, age group 20-29 years had the highest demand 35%(160/451) for ARV followed by age groups 30-39 and 40-49 years with 28%(128/451) and 22%(98/451) respectively. Conclusion: There is a high prevalence of acquired immunodeficiency syndrome as defined by CD4 counts below 200 cells/μl, among the young active productive age group. The strict adopting of the ART WHO 2010 scale- up criteria doubles the number of the HIV clients that would qualify for ART with its attendant health benefits on the long run.

Keywords: CD4 counts, HIV patients, young age group, Nigeria

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Authors: Chiu-Hsuan Lee, Min-Hao Yuan, Kun-Cheng Lin, Qiao-Yin Tsai, Yun-Jie Lu, Yi-Jhen Wang, Hsin-Yi Lin, Chih-Hua Hsu, Jia-Rong Jhou, Si-Ying Li, Yi-Hung Chen, Je-Lueng Shie

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Raw food waste has a high-water content. If it is incinerated, it will increase the cost of treatment. Therefore, composting or energy is usually used. There are mature technologies for composting food waste. Odor, wastewater, and other problems are serious, but the output of compost products is limited. And bakelite is mainly used in the manufacturing of integrated circuit boards. It is hard to directly recycle and reuse due to its hard structure and also difficult to incinerate and produce air pollutants due to incomplete incineration. In this study, supercritical hydrothermal and subcritical glycolysis thermal conversion technology is used to convert biomass wastes of bakelite and raw kitchen wastes to carbon materials and biofuels. Batch carbonization tests are performed under high temperature and pressure conditions of solvents and different operating conditions, including wet and dry base mixed biomass. This study can be divided into two parts. In the first part, bakelite waste is performed as dry-based industrial waste. And in the second part, raw kitchen wastes (lemon, banana, watermelon, and pineapple peel) are used as wet-based biomass ones. The parameters include reaction temperature, reaction time, mass-to-solvent ratio, and volume filling rates. The yield, conversion, and recovery rates of products (solid, gas, and liquid) are evaluated and discussed. The results explore the benefits of synergistic effects in thermal glycolysis dehydration and carbonization on the yield and recovery rate of solid products. The purpose is to obtain the optimum operating conditions. This technology is a biomass-negative carbon technology (BNCT); if it is combined with carbon capture and storage (BECCS), it can provide a new direction for 2050 net zero carbon dioxide emissions (NZCDE).

Keywords: biochar, raw food waste, bakelite, supercritical hydrothermal, subcritical glycolysis, biofuels

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Authors: N. Stevulova, I. Schwarzova, V. Hospodarova, J. Junak, J. Briancin

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Sustainability is becoming a priority for developers and the use of environmentally friendly materials is increasing. Nowadays, the application of raw materials from renewable sources to building materials has gained a significant interest in this research area. Lignocellulosic aggregates and cellulosic fibers are coming from many different sources such as wood, plants and waste. They are promising alternative materials to replace synthetic, glass and asbestos fibers as reinforcement in inorganic matrix of composites. Natural fibers are renewable resources so their cost is relatively low in comparison to synthetic fibers. With the consideration of environmental consciousness, natural fibers are biodegradable so their using can reduce CO₂ emissions in the building materials production. The use of cellulosic fibers in cementitious matrices have gained importance because they make the composites lighter at high fiber content, they have comparable cost - performance ratios to similar building materials and they could be processed from waste paper, thus expanding the opportunities for waste utilization in cementitious materials. The main objective of this work is to find out the possibility of using different wastes: hemp hurds as waste of hemp stem processing and recycled fibers obtained from waste paper for making cement composite products such as mortars based on cellulose fibers. This material was made of cement mortar containing organic filler based on hemp hurds and recycled waste paper. In addition, the effects of fibers and their contents on some selected physical and mechanical properties of the fiber-cement plaster composites have been investigated. In this research organic material have used to mortars as 2.0, 5.0 and 10.0 % replacement of cement weight. Reference sample is made for comparison of physical and mechanical properties of cement composites based on recycled cellulosic fibers and lignocellulosic aggregates. The prepared specimens were tested after 28 days of curing in order to investigate density, compressive strength and water absorbability. Scanning Electron Microscopy examination was also carried out.

Keywords: Hemp hurds, organic filler, recycled paper, sustainable building materials

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: Pomila Sharma

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The rapid urbanization in India was not accompanied by the establishment of waste water treatment facility at similar and same pace. The inland fresh water ecosystem is increasingly subjected to great stress from various human activities. Jalmahal Lake is located in Jaipur city of Rajasthan state; the lake was constructed about 400 years ago and surrounded by hills. The lake was approximately 139 hectare in full spread and has catchment area of 23.5 sq. kilometer. Out of the total catchment area approximate 40% falls inside dense urban area of Jaipur city. During the showers, the treated and untreated waste waters and runoff waters get mixed and enter the lake through the various influx channels, and the lake water quality gets affected by the inflow of waste water. The main objective of this work was to use the Moringa oleifera seeds as a natural adsorbent for the treatment of wastewater in lake. Moringa oleifera is a tropical, multipurpose tree whose seeds contain high-quality edible oil 40% by weight and water soluble, non-toxic protein that act as an effective coagulant for the removal of organic matter in water and waste water treatment. Laboratory Jar test procedure had been used for coagulation studies; an experiment runs using lake water. Water extracts/powder of Moringa seed applied to treat polluted water of lake. In present study various doses of Moringa oleifera seed coagulant viz. 100 mg/L, 200 mg/L, and 400 mg/L were taken and checked for the efficiency dose on treated and untreated polluted water. Turbidity and color removal is one of the important steps in a waste water treatment processes. The results indicate significant reduction in turbidity and color. Standard plate count was significantly reduced fecal coliform levels too. All parameters were reduced with the increased dose of Moringa oleifera. It was clear from the study Moringa oleifera seed was shown to be a potential bio-coagulant, for treatment of sewage laden polluted water in the lake.

Keywords: coagulant, Moringa oleifera, plate count, turbidity, wastewater

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Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: F. N. Bolu-Steve, T. A. Ajiboye

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A study was carried out on the awareness of counselling needs of psychiatric patients as perceived by medical personnel in the Federal Neuropsychiatric hospital, Aro, Abeokuta, Nigeria. The respondents comprised of medical personnel of the Neuropsychiatric hospital in Aro. Purposive sampling technique was used to select the respondents. The target population of the study consisted of all medical doctors treating the psychiatric patients. A total of 200 respondents participated in the study out of which 143 were males and 57 of them were females. With their years of experience as a medical doctors, 49.5% of them have worked between 1-5 years, 30.5% of the respondents have 6-10 years’ experience while those with 16 years and above experience are 7.0%. The major counselling need of psychiatric patients as expressed by medical doctors is the need to have information about the right balance diet. The data were analyzed using percentages, mean, frequency, Analysis of Variance (ANOVA) and t-test statistical tools. The instrument used for data collection was the structured questionnaire titled “Counselling Needs of Psychiatric Patients Questionnaire” (CNPPQ). This instrument was drafted by the researchers through the review of related literature. The reliability of the instrument was established using test-retest method. A reliability index of 0.74 was obtained. Three of the hypotheses were rejected while two of them were accepted at 0.05 alpha level of significance. Based on the findings of the study, it was recommended that broad based counselling services should be provided to psychiatric patients in order to assist them to develop positive self- image and to cope with their challenges.

Keywords: counselling, needs, psychiatric, medical personnel, patients

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Authors: Rikke Lybæk

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This paper delves into the intricacies of recycling household plastic waste within Denmark, employing an exploratory case study methodology to shed light on the technical, strategic, and market dynamics of the plastic recycling value chain. Focusing on circular economy principles, the research identifies critical gaps and opportunities in recycling processes, particularly regarding plastic packaging waste derived from households, with a notable absence in food packaging reuse initiatives. The study uncovers the predominant practice of downcycling in the current value chain, underscoring a disconnect between the potential for high-quality plastic recycling and the market's readiness to embrace such materials. Through detailed examination of three leading companies in Denmark's plastic industry, the paper highlights the existing support for recycling initiatives, yet points to the necessity of assured quality in sorted plastics to foster broader adoption. The analysis further explores the importance of reuse strategies to complement recycling efforts, aiming to alleviate the pressure on virgin feedstock. The paper ventures into future perspectives, discussing different approaches such as biological degradation methods, watermark technology for plastic traceability, and the potential for bio-based and PtX plastics. These avenues promise not only to enhance recycling efficiency but also to contribute to a more sustainable circular economy by reducing reliance on virgin materials. Despite the challenges outlined, the research demonstrates a burgeoning market for recycled plastics within Denmark, propelled by both environmental considerations and customer demand. However, the study also calls for a more harmonized and effective waste collection and sorting system to elevate the quality and quantity of recyclable plastics. By casting a spotlight on successful case studies and potential technological advancements, the paper advocates for a multifaceted approach to plastic waste management, encompassing not only recycling but also innovative reuse and reduction strategies to foster a more sustainable future. In conclusion, this study underscores the urgent need for innovative, coordinated efforts in the recycling and management of plastic waste to move towards a more sustainable and circular economy in Denmark. It calls for the adoption of comprehensive strategies that include improving recycling technologies, enhancing waste collection systems, and fostering a market environment that values recycled materials, thereby contributing significantly to environmental sustainability goals.

Keywords: case study, circular economy, Denmark, plastic waste, sustainability, waste management

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Authors: M. Dyah Ayu Yuli, S. Faisal Dhio, P. Johandi, P. Muhammad Sofyan

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Pulp and paper mills generate various quantities of energy-rich biomass as wastes, depending on technological level, pulp and paper grades and wood quality. These wastes are produced in all stages of the process: wood preparation, pulp and paper manufacture, chemical recovery, recycled paper processing, waste water treatment. Energy recovery from wastes of different origin has become a generally accepted alternative to their disposal. Pulp and paper industry expresses an interest in adapting and integrating advanced biomass energy conversion technologies into its mill operations using Fluidized Bed Combustion. Industrial adoption of these new technologies has the potential for higher efficiency, lower capital cost, and safer operation than conventional operations that burn fossil fuels for energy. Incineration with energy recovery has the advantage of hygienic disposal, volume reduction, and the recovery of thermal energy by means of steam or super heated water that can be used for heating and power generation.

Keywords: biomass, fluidized bed combustion, pulp and paper mills, waste

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Authors: Yuan Long, Fabrizio Ceschin, David Harrison

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Environmental sustainability is under the threat of excessive single-use plastic packaging waste, and current waste management fails to address this issue. Therefore, it has led to a reidentification of the alternative, which can curb the packaging waste without reducing social needs. Reusable packaging represents a circular approach to close the loop of consumption in which packaging can stay longer in the system to satisfy social needs. However, the implementation of reusable packaging is fragmented and lacks systematic approaches. The product-service system (PSS) is widely regarded as a sustainable business model innovation for embracing circular consumption. As a result, applying PSS to reusable packaging solutions will be promising to address the packaging waste issue. This paper aims at filling the knowledge gap relating to apply PSS to reusable packaging solutions and provide a strategic design tool that could support packaging professionals to design reusable packaging solutions. The methodology of this paper is case studies and workshops to provide a design tool. The respondents are packaging professionals who are packaging consultants, NGO professionals, and entrepreneurs. 57 cases collected show that 15 archetypal models operate in the market. Subsequently, a polarity diagram is developed to embrace those 15 archetypal models, and a total number of 24 experts were invited for the workshop to evaluate the design tool. This research finally provides a strategic design tool to support packaging professionals to design reusable packaging solutions. The application of the tool is to support the understanding of the reusable packaging solutions, analyzing the markets, identifying new opportunities, and generate new business models. The implication of this research is to provide insights for academics and businesses in terms of tackling single-use packaging waste and build a foundation for further development of the reusable packaging solution tool.

Keywords: environmental sustainability, product-service system, reusable packaging, design tool

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Anusha Atmakuri, R. D. Tyagi, Patrick Drogui

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Landfilling is the most familiar and easy way to dispose solid waste. Landfill is generally received via wastes from municipal near to a landfill. The waste collected is from commercial, industrial, and residential areas and many more. Landfill leachate (LFL) is formed when rainwater passes through the waste placed in landfills and consists of several dissolved organic materials, for instance, aquatic humic substances (AHS), volatile fatty acids (VFAs), heavy metals, inorganic macro components, and xenobiotic organic matters, highly toxic to the environment. These components of LFL put a load on it, hence it necessitates the treatment of LFL prior to its discharge into the environment. Various methods have been used to treat LFL over the years, such as physical, chemical, biological, physicochemical, electrical, and advanced oxidation methods. This study focuses on the combination of biological and electrochemical methods- extracellular polymeric substances and electrocoagulation(EC). The coupling of electro-coagulation process with extracellular polymeric substances (EPS) (as flocculant) as pre and\or post treatment strategy provides efficient and economical process for the decontamination of landfill leachate contaminated with suspended matter, metals (e.g., Fe, Mn) and ammonical nitrogen. Electro-coagulation and EPS mediated coagulation approach could be an economically viable for the treatment of landfill leachate, along with possessing several other advantages over several other methods. This study utilised waste substrates such as activated sludge, crude glycerol and waste cooking oil for the production of EPS using fermentation technology. A comparison of different scenarios for the treatment of landfill leachate is presented- such as using EPS alone as bioflocculant, EPS and EC with EPS being the 1st stage, and EPS and EC with EC being the 1st stage. The work establishes the use of crude EPS as a bioflocculant for the treatment of landfill leachate and wastewater from a site near a landfill, along with EC being successful in removal of some major pollutants such as COD, turbidity, total suspended solids. A combination of these two methods is to be explored more for the complete removal of all pollutants from landfill leachate.

Keywords: landfill leachate, extracellular polymeric substances, electrocoagulation, bioflocculant.

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Authors: Uwizera Egide

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Introduction: Dermatological conditions are one of the most burdensome diseases in our health system. Global studies suggest that around 1 in 3 people gets a skin disease at a certain point in their life, though this does not necessarily guarantee the urge to consult. For a high-ranking disease, it is surprising how there is not enough data to support its effect on the economy and the general health system impact. It is for that reason that this study’s aim is to identify the burden of dermatological conditions in Rwanda so as to have a general picture of what our population is going through in regards to dermatological conditions. Methods: We used a cross sectional retrospective study. Data were obtained from patient’s information recorded in an open clinic at CHUB in a period of six months from July to December of the year 2021. Results: The study had a total of 4600 patients who attended dermatology service in a period of six months from July to December of the year 2021. We found a list of 102 dermatological diseases that presented at variable rates. The most prevalent disease was atopic dermatitis, at a rate of 23%. About 90% of presented conditions had only one choice of treatment from the hospital pharmacy. Most patients who presented were between 18-35 years old and with a predominance of the female gender; the level of education was either secondary or University Degree in our study, 65.4% of patients who presented were female; the majority, around 45% were between 18-35 years old, mostly being single 56%. The majority came from Southern province as it is the location of the hospital. The insurance mostly used was community-based health insurance with 63.8%, followed by RSSB with 18.5%, MS/UR, and other private insurances. The frequency of group drugs prescribed among all dermatological medications, steroids were the most commonly given medications at a rate of 39%, followed by emollients, antibiotics, and antifungal. The drugs prescribed were mostly available in the pharmacy of CHUB, with 60% and 40% being found in pharmacies outside the hospital. Conclusion: Dermatological conditions are prevalent in all age groups and distributed through all socioeconomic classes. About 9.2% of patient who consulted CHUB in 2021 presented one Dermatological condition of which 40 % of prescribed medications is never found in Hospital urging a need to buy medication in private pharmacies with more expenses and a risk of not complying on prescribed medication if in case they can’t afford paying them outside the CHUB. This finding urges a need to avail all essential dermatological drugs in hospital pharmacies to allow our patients to get them for the proper compliance of prescribed drugs in the management of skin diseases.

Keywords: atopic dermatitis, CHUB (centre hopitalier univerisitaire de butare), dermatological condition, fungal infections

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Authors: Zhanat Shomanova, Ruslan Safarov, Yuri Nosenko, Zheneta Tashmuchambetova, Alima Zharmagambetova

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An effective way of utilization of ferroalloy production wastes is preparing hydrocarbon refining catalysts from them. It is possible due to accordable transition metals containing in the wastes. In the work, we are presenting the results on elemental analysis of sludge samples from Aksu ferroalloy plant (Aksu, Kazakhstan), method of catalysts preparing, results of physical-chemical analysis of obtained catalysts (X-ray analysis, electron microscopy, the BET method etc.), results of using the catalysts in some hydrocarbons refining processes such as hydrocracking of rubber waste, cracking of gasoil, oxidation of cyclohexane. The main results of catalytic activity research are: a) In hydrocracking of rubber waste 64.9% of liquid products were fuel fractions; b) In cracking of gasoil conversion was 51% and selectivity by liquid products was 99%; c) In oxidation of cyclohexane the maximal product yield 87.9% and selectivity by cyclohexanol 93.0% were achieved.

Keywords: catalyst, cyclohexane oxidation, ferroalloy production waste, gasoil cracking

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Authors: Sonto Maputle

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Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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