Palm Kernel Shell as Partial Replacement for Normal Weight Aggregate in Concrete

Palm Kernel Shells (PKS) are fractions of shells that result from the cracking of the nut to remove the seed for the production of palm kernel oil. They are of irregular shapes and vary in sizes from fine aggregate to coarse aggregate. The aim of this research was to determine the effect of PKS on Normal Weight Concrete (NWC) as partial replacement of normal weight aggregate (NWA). Effects of PKS on NWC considered were in terms of workability, density, compressive strength, splitting tensile strength, and the water absorption of the concrete. Batching was by volume since PKS was characterized as a light weight material, and substitutions were made at 0%, 25%, and 50%. The mix ratio adopted was 1:2:3 for cement, fine aggregate, and coarse aggregate with a constant free water to cement ratio (w/c) of 0.58. Curing method was by immersion and effect on the mechanical properties (compressive and tensile strengths) were determined at 7 and 28 days of curing. It was observed that the compressive, tensile strength, workability, and concrete density reduce as PKS content is increased in the mix. On the other hand, water absorption increases with increased in PKS content. However, results were in acceptable range for normal concrete. Keywords: Palm kernel shells, normal weight concrete, normal weight aggregat

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally