Vessel-to-Rail Intermodal Connectivity Analysis for The Port of Houston

Freight transportation is a crucial element of the economy and development of regions. Still, its dramatic growth in the road sector is rapidly offsetting the benefits through such impacts as congestion, noise, pollution, and environmental damage. Alternative transportation solutions such as a combined transportation network can help to reduce these impacts. Container rail-water intermodal transportation broadly means with the premise of rail transportation and water transportation as the primary, compatible with other modes of transportation to accomplish the complete transfer of the containers. As a fast-growing port, the Port of Houston Authority has grown to be very important because of its large tonnage handling capacity and its impact on the nation\u27s economy. With the growth in the economy which results in increased port activities, the port of Houston is gradually approaching capacity and sees the need for expansion of infrastructure needed for service efficiency provided. This study aims to identify the critical components of a vessel-rail intermodal system, analyze the significance of each of them, compare the competitiveness of the Port of Houston among the similar ports, pinpoint the gap between the existing condition and state of the art practices. The report will also focus on the feasibility of the Rail Intermodal System compared to the truck freight of the Port of Houston. Based on the existing intermodal system of the Port of Houston, the report will help identify critical factors and recommend processes that will promote the competitiveness of the system in handling and servicing future economic growth

Steady MHD Free Convection Flow with Thermal Radiation past a Vertical Porous Plate Immersed in a Porous Medium

Abstract: The present study is concerned with thermal radiation in a steady two-dimensional MHD free convection flow through a porous vertical flat plate immersed in a porous medium. In the analysis a DarcyForchhemier model is considered while the fluid is taken to be gray, absorbing-emitting radiation. The nonlinear governing equations have been transformed by the usual similarity transformation to a system of ordinary differential equations. These dimensionless similar equations are then solved numerically employing the Nachtsheim-Swigert shooting iteration technique along with sixth order Runge-Kutta integration scheme. Finally the effects of the pertinent parameters are examined

What did the public think of health services reform in Bangladesh? Three national community-based surveys 1999–2003

BACKGROUND: Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP). They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP. METHODS: We carried out three household surveys (1999, 2000 and 2003) of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers. RESULTS: Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition. CONCLUSION: Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically helped the poorest people. User satisfaction could be increased if government doctors improved their interaction with patients and if waiting times were reduced by better management of facilities

Miller Fisher Variant of Guillain-Barré Syndrome: A Case Report & Clinical Review

Miller Fisher syndrome (MFS) is an uncommon variant of Guillain-Barré syndrome (GBS). It is characterized by external ophthalmoplegia, ataxia, and areflexia. The incidence of MFS as a proportion of GBS was reported to be 1 to 5 % in western countries and considerably higher in Eastern Asia i.e. 19% in Taiwan and 25% in Japan. Here we report the clinical features of a patient who initially presented with ataxia then subsequently developed limb weakness, areflexia and ophthalmoplegia. CSF study and NCV study supported our clinical diagnosis. Patient was managed conservatively. No intravenous immunoglobulin was given but the patient gradually improved in symptoms including power, ataxia, ophthalmoparesis. After one month the patient was discharged from hospital with complete recovery.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11028 BSMMU J 2012; 5(1):69-71

Coronavirus disease 2019 and future pandemics: Impacts on livestock health and production and possible mitigation measures

The World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. COVID-19, the current global health emergency, is wreaking havoc on human health systems and, to a lesser degree, on animals globally. The outbreak has continued since the first report of COVID-19 in China in December 2019, and the second and third waves of the outbreak have already begun in several countries. COVID-19 is expected to have adverse effects on crop production, food security, integrated pest control, tourism, the car industry, and other sectors of the global economy. COVID-19 induces a range of effects in livestock that is reflected economically since human health and livelihood are intertwined with animal health. We summarize the potentially harmful effects of COVID-19 on livestock and possible mitigation steps in response to this global outbreak. Mitigation of the negative effects of COVID-19 and future pandemics on livestock requires the implementation of current guidelines

Sustainable Antibiotic-Free Broiler Meat Production: Current Trends, Challenges, and Possibilities in a Developing Country Perspective

Antibiotic-free broiler meat production is becoming increasingly popular worldwide due to consumer perception that it is superior to conventional broiler meat. Globally, broiler farming impacts the income generation of low-income households, helping to alleviate poverty and secure food in the countryside and in semi-municipal societies. For decades, antibiotics have been utilized in the poultry industry to prevent and treat diseases and promote growth. This practice contributes to the development of drug-resistant bacteria in livestock, including poultry, and humans through the food chain, posing a global public health threat. Additionally, consumer demand for antibiotic-free broiler meat is increasing. However, there are many challenges that need to be overcome by adopting suitable strategies to produce antibiotic-free broiler meat with regards to food safety and chicken welfare issues. Herein, we focus on the importance and current scenario of antibiotic use, prospects, and challenges in the production of sustainable antibiotic-free broiler meat, emphasizing broiler farming in the context of Bangladesh. Moreover, we also discuss the need for and challenges of antibiotic alternatives and provide a future outlook for antibiotic-free broiler meat production

Pilot study on the current management of children with COVID-19 in hospitals in Bangladesh; findings and implications

Objective: The focus on COVID-19 in children in low- and middle-income countries including Bangladesh has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic violence and child labour. However, the focus on optimally managing children in hospitals is changing with new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates. The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national guidance. Consequently, there is a need to document the current management of children with COVID-19 in Bangladesh and use the findings for future guidance. Methods: Rapid analysis of the management of children with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. Results: Overall low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%) and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was typically 5 to 10 days. Conclusion: Encouraging to see low hospitalisation rates and limited use of antimicrobials apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this

Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH