LINEARNO PROGRAMIRANJE KAO ALAT ZA PROJEKTIRANJE SIROVINSKE SMJESE U TVORNICI CEMENTA

This study uses linear programming to develop a methodology for selecting the best raw material mix in an ASCOM cement plant in Egypt. In cement factories, this type adheres to Egyptian chemical composition criteria for raw feed (e.g. 82.5% calcium carbonate, 14.08% silica, 2.5% alumina and 0.92% iron oxide). Furthermore, the model is bound by industry-specific characteristics (e.g. lime saturation factor, silica modulus, alumina modulus and loss of ignition). The results reveal that the model is able to accurately reproduce the mixing of high-quality feed with varying constituent percentages. It is also capable of determining the combining limitations of each ingredient. Furthermore, it demonstrates optimality for additive sourcing short-term planning and capping limestone quality to meet changeable component combinations. Additionally, improving the raw mix reduces limestone feed quality from 51 to 50.6%, resulting in the inclusion of extra limestone reserves.Studija prikazuje metodu linearnoga programiranja uporabljenu sa svrhom odabira najbolje sirovinske smjese u tvornici cementa ASCOM (Egipat). Takva smjesa poštuje egipatske standarde kemijskoga sastava sirovine (npr. 82,5 % kalcijeva karbonata, 14,08 % silikata, 2,5 % aluminijeva oksida, 0,92 % željeznoga oksida). Također, model je uvjetovan industrijskim standardima (npr. faktorom zasićenja vapnom, silikatnim i aluminatnim modulom te gubitkom (oksida) žarenjem). Modelom se mogla točno izračunati visokokvalitetna mješavina različitih (postotnih) komponenti te je dokazan kao optimalan za brz izračun raznih aditiva i postizanje najveće kvalitete vapnenačke sirovine uz doziranje ostalih komponenti. Time je udjel vapnenca bilo moguće smanjiti na 50,6 – 51 %, što je otvorilo put eksploataciji dodatnih rezervi te sirovine

Fungal Contamination of Airconditioner Units in Five Hospitals of Erbil Province- Kurdistan Region /Iraq

During April 2018, 75samples were collected from five hospitals in Erbil city. Samples were taken by sterile cotton swabs from the air dispenser window  of air conditioner units  (ACU) . They were cultured directly on Sabouraud's dextrose agar incubated at 25oC ±2. The samples were collected from five departments  in each hospital include out-patient ward (OP),in-patient ward (IP), emergency room (ER), intensive care unit(ICU), and operation theater (OT). A total of (410) fungal colonies were counted, they belong to13 genera include ten  hyphomycetes  and only one of zygomycetes ,basidiomycetes , and hemiascomycetes. Penicillium  represented in the highest  total occurrence (40%) followed by Aspergillus(38.66%) and Alternaria  (21.33%). The total frequency showed that Candidawas the highest (30%) followed by Penicillium(27.56%) and Aspergillus(13.17%). The highest density of filamentous fungi (no. of colony/sample) was detected in OP=16.75, and the lowest in OT=1.5. The diversity of isolates  showed that ( 9) genera were recorded from ER(60%)  and only one in OP (6%). All recorded genera in current study were regarded as indoor air pollutants. The predominant genera  Alternaria, Aspergillus, Penicillium ,Cladosporiumand Candida are  well-known allergens and may cause  several pulmonary disorders  as well as fetal infections in particular cases

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Neutrophil to lymphocyte ratio and in-hospital mortality among patients with SARSCoV-2 : a retrospective study

The goal of this study was to investigate in-hospital mortality in patients suffering from acute respiratory syndrome coronavirus 2 (SARS-CoV-2) relative to the neutrophil to lymphocyte ratio (NLR) and to determine if there are gender disparities in outcome. Between February 26 and September 8, 2020, patients having SARS-CoV-2 infection were enrolled in this retrospective cohort research, which was categorized by NLR levels ≥9 and < 9. In total, 6893 patients were involved included of whom6591 had NLR 9 had a significant effect on mortality. NLR ≥9 is an independent predictor of mortality(in-hospital) among SARS-CoV-2 patients