The effect of nano silica on short term drying shrinkage of POFA cement mortars

This study investigates effects of nano silica on short-term drying shrinkage of mortars with palm oil fuel ash (POFA) during the first 28 days of curing. Furthermore, moisture content, hydration volume, and permeability were measured in order to study underlying mechanisms. It was revealed that addition of nano silica to samples with 30% POFA as cement replacement lowered the drying shrinkage by 7.5%. Also, it increased the strength development rate by 15% from 7 to 28 days of curing. Nano silica advantageously affected the shrinkage by refining the microstructure, increasing the hydration volume and lowering free water in cement matrix

WATER PERMEABILITY AND CHLORIDE AND SULPHATE RESISTANCE OF RUBBERISED FIBRE MORTAR

Non-biodegradable solids such as waste tyres and oil palm fruit fibre (OPFF) would cause environmental problems if not disposed properly. This research studied the water permeability and chloride and sulphate resistance of mixes with addition of OPFF and sand replacement with Treated Crumb Rubber (TCR). The mix known as Rubberised Fibre Mortar (RFM) is a composite of 10% to 30% of TRC and addition of 1% to 1.5% of OPFF. In total sixteen different mixes, with water to cement ratio of 0.48 were prepared and subjected to related tests up to 56 days. The specimens are separated to two water curing types; immersion and spraying. The results show immersion cured specimens is less permeable and more resistance to chloride and sulphate than spraying specimens. The TCR does reduce the water permeability of the mix when 20% and less replacement made, while addition of less than 1% OPFF allows medium permeability. The moderate chloride resistance is achieved in mix with less than 10% TCR replacement and OPFF is not added. While sulphate resistance of RFM with less than 30% TCR is acceptable but addition of OPFF must be limited to 1% to prevent large strength reduction. In conclusion, for indoor mortar applications such as partition wall, RFM made of less than 10% TCR and less than 1% OPFF is recommended

WATER PERMEABILITY AND CHLORIDE AND SULPHATE RESISTANCE OF RUBBERISED FIBRE MORTAR

Non-biodegradable solids such as waste tyres and oil palm fruit fibre (OPFF) would cause environmental problems if not disposed properly. This research studied the water permeability and chloride and sulphate resistance of mixes with addition of OPFF and sand replacement with Treated Crumb Rubber (TCR). The mix known as Rubberised Fibre Mortar (RFM) is a composite of 10% to 30% of TRC and addition of 1% to 1.5% of OPFF. In total sixteen different mixes, with water to cement ratio of 0.48 were prepared and subjected to related tests up to 56 days. The specimens are separated to two water curing types; immersion and spraying. The results show immersion cured specimens is less permeable and more resistance to chloride and sulphate than spraying specimens. The TCR does reduce the water permeability of the mix when 20% and less replacement made, while addition of less than 1% OPFF allows medium permeability. The moderate chloride resistance is achieved in mix with less than 10% TCR replacement and OPFF is not added. While sulphate resistance of RFM with less than 30% TCR is acceptable but addition of OPFF must be limited to 1% to prevent large strength reduction. In conclusion, for indoor mortar applications such as partition wall, RFM made of less than 10% TCR and less than 1% OPFF is recommended

Evaluation of hybrid ocean thermal energy conversion system plantwide performance

Ocean Thermal Energy Conversion (OTEC) is a renewable energy source in which energy is produced by converting the heat stored in the sea or the ocean thermal energy into valuable work, based on the temperature difference between the warm surface seawater and the cold deep seawater. One of the OTEC system requirements is to have a seawater temperature difference at a minimum of 20 °C within a depth of 1000 m below sea level. Recognizing the importance of optimum sea water temperature, several studies have been conducted to optimize the OTEC system. However, none of these studies was attempted under a hybrid ocean thermal energy conversion (H-OTEC) setup. A H-OTEC system is a combination of closed-cycle and open-cycle OTEC system. The objective of this study is to evaluate the performance of the H-OTEC process system based on the impact of seawater temperature variation by simulating H-OTEC process system. Aspen HYSYS was used as a chemical process simulation platform for conducting this study. After the model was completed, verification test was conducted before the simulated data was recorded. The data for the pump work input and the turbine work output were acquired to determine the net power output and system efficiency. The net power output, Carnot efficiency, and thermal efficiency were recorded approximately 1.39 kW, 5.7%, and 1.45%. The data for net power output and the efficiencies of the system was recorded for every 1 °C of increment in surface seawater temperature. The results showed that the net power output increased slightly by 0.5kW, with efficiency difference for both Carnot cycle and actual cycle, recorded to be less than 3% and 0.1% respectively

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A brief review on polyvinyl chloride plastic as aggregate for construction materials

Abstract Recycling plastic waste in construction applications is a common concept for innovative concrete development. Enormous studies have been conducted for the past three decades. Yet, there is a need in understanding the behavior of the plastic, its effects on cement composite, and the possible approaches for extending the usage of plastic waste to be an alternative resource component of cement composites. For the first section, the types of plastic and its characteristic as well as the overview on the plastic production and waste generated are discussed briefly. Further, the paper is focused on the relevant information on the plastic waste in cement composites and the polyvinyl chloride (PVC) plastic as plastic aggregate in cement composites. The review also includes the factors that influence PVC aggregate on cement composites which are physical characteristics of PVC plastic aggregate, the effect on mechanical and permeation properties of cement composites. The paper also examines the possible approaches in improving the PVC plastic aggregate characteristics, which can enhance the usage of PVC plastic aggregate for sustainable construction material