Managing coastal aquifer salinity under sea level rise using rice cultivation recharge for sustainable land cover

Data Availability: No data was used for the research described in the article.Code availability: Upon request.Supplementary material is available online at https://www.sciencedirect.com/science/article/pii/S2214581823001532#sec0095 .Copyright © 2023 The Authors. Study region: The coastal aquifer of Nile Delta, Egypt is used to develop the current study. Study focus: Excess water from rice irrigation is a source of incidental recharge to mitigate seawater intrusion. This paper numerically explores the optimal location of rice cultivations by subdividing the delta domain into three distinct recharging regions (north, central and south). Additionally, SEAWAT code was simulated under a combination of rice cultivation relocation and sea level rise (SLR). New hydrological insights for the region: The study findings revealed significant variations in salt volume reduction depending on the location of rice cultivation in the delta. Placing rice cultivation in the northern region resulted in the highest reduction of salt volume (19 %). In contrast, locating the recharge in the central region yielded a salt volume reduction of 0.50 %, while rice cultivation in the southern region produced a 15 % increase. Considering the projected SLR of 61 cm by 2100, there was an overall salt volume increment of 3 %. However, when accounting for both SLR and rice cultivation recharge in the northern region, a substantial salt volume reduction of 17 % was observed. The results demonstrated that incidental recharge by rice cultivation in coastal aquifers is an effective method for enhancing saltwater intrusion control. Moreover, this study improves our understanding of hydrological processes and expected responses in the delta under future climate scenarios

Challenges of nursing students during clinical training: A nursing perspective

Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. This study aimed to explore the perceived challenges nursing students face during clinical training. An explorative cross-sectional study was applied. A proportionate, stratified, random sample was enrolled in the study with inclusive criteria, including nursing students (2nd - 4th year) and interns who attended their internship in regional hospitals. A validated electronic questionnaire was used for data collection, which consisted of three sections and 29 items. The section that focused on the difficulties experienced by nursing students during their practical training included six elements: teachers, healthcare professionals, the students themselves, tasks, time management, and the location of the training. Another section inquired about the students' perspectives on the benefits of clinical training. A three-point “Likert scale” was applied. The findings indicated that mild (24%), moderate (62%), and severe (14%) degree of challenges were perceived by the study participants. The mean score for the total challenges during clinical training was 2.00 ± 0.28, and there were variations in the perceived challenges among grade levels. In conclusion, there are variations in the perceived challenges during clinical training among different grade levels. These challenges were related to teachers, health workers, the students, tasks, the time, and the place. Enhancing the nursing curricula alignment with practical training objectives is recommended, focusing on the development of technical and interpersonal skills with appropriate guidance, alongside positive clinical settings to help nursing students learn and boost their confidence in their approach

Plant growth-promoting microorganisms as biocontrol agents of plant diseases: Mechanisms, challenges and future perspectives

Plant diseases and pests are risk factors that threaten global food security. Excessive chemical pesticide applications are commonly used to reduce the effects of plant diseases caused by bacterial and fungal pathogens. A major concern, as we strive toward more sustainable agriculture, is to increase crop yields for the increasing population. Microbial biological control agents (MBCAs) have proved their efficacy to be a green strategy to manage plant diseases, stimulate plant growth and performance, and increase yield. Besides their role in growth enhancement, plant growth-promoting rhizobacteria/fungi (PGPR/PGPF) could suppress plant diseases by producing inhibitory chemicals and inducing immune responses in plants against phytopathogens. As biofertilizers and biopesticides, PGPR and PGPF are considered as feasible, attractive economic approach for sustainable agriculture; thus, resulting in a “win-win” situation. Several PGPR and PGPF strains have been identified as effective BCAs under environmentally controlled conditions. In general, any MBCA must overcome certain challenges before it can be registered or widely utilized to control diseases/pests. Successful MBCAs offer a practical solution to improve greenhouse crop performance with reduced fertilizer inputs and chemical pesticide applications. This current review aims to fill the gap in the current knowledge of plant growth-promoting microorganisms (PGPM), provide attention about the scientific basis for policy development, and recommend further research related to the applications of PGPM used for commercial purposes

Biliary fistula and late recurrence of liver hydatid cyst: Role of cysto-biliary communication: A prospective multicenter study

Background: Hydatid cyst disease (HCD) is common in certain locations. Surgery is associated with postoperative biliary fistula (POBF) and recurrence. The primary aim of this study was to identify whether occult cysto-biliary communication (CBC) can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase (ALP) levels in predicting POBF and recurrent HCD. Aim: To identify whether occult CBC can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD. Methods: From September 2010 to September 2016, a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty. Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence. Results: There was a highly statistically significant association (P ≤ 0.001) between cystic fluid biochemical indices and the development of biliary complications (of 16 patients with POBF, 15 patients had high cyst fluid bilirubin and ALP levels), where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications. There was a highly statistically significant association (P ≤ 0.001) between biliary complications, biochemical indices, and the occurrence of recurrent HCD (of 30 patients with recurrent HCD, 15 patients had high cyst fluid bilirubin and ALP; all 16 patients who had POBF later developed recurrent HCD), where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts, respectively. Conclusion: Occult CBC can predict recurrent HCD. Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD

Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis

Background: Activity-based funding (ABF) of hospitals is a policy intervention intended to re-shape incentives across health systems through the use of diagnosis-related groups. Many countries are adopting or actively promoting ABF. We assessed the effect of ABF on key measures potentially affecting patients and health care systems: mortality (acute and post-acute care); readmission rates; discharge rate to post-acute care following hospitalization; severity of illness; volume of care.     Methods: We undertook a systematic review and meta-analysis of the worldwide evidence produced since 1980. We included all studies reporting original quantitative data comparing the impact of ABF versus alternative funding systems in acute care settings, regardless of language. We searched 9 electronic databases (OVID MEDLINE, EMBASE, OVID Healthstar, CINAHL, Cochrane CENTRAL, Health Technology Assessment, NHS Economic Evaluation Database, Cochrane Database of Systematic Reviews, and Business Source), hand-searched reference lists, and consulted with experts. Paired reviewers independently screened for eligibility, abstracted data, and assessed study credibility according to a pre-defined scoring system, resolving conflicts by discussion or adjudication.     Results: Of 16,565 unique citations, 50 US studies and 15 studies from 9 other countries proved eligible (i.e. Australia, Austria, England, Germany, Israel, Italy, Scotland, Sweden, Switzerland). We found consistent and robust differences between ABF and no-ABF in discharge to post-acute care, showing a 24% increase with ABF (pooled relative risk = 1.24, 95% CI 1.18–1.31). Results also suggested a possible increase in readmission with ABF, and an apparent increase in severity of illness, perhaps reflecting differences in diagnostic coding. Although we found no consistent, systematic differences in mortality rates and volume of care, results varied widely across studies, some suggesting appreciable benefits from ABF, and others suggesting deleterious consequences.     Conclusions: Transitioning to ABF is associated with important policy- and clinically-relevant changes. Evidence suggests substantial increases in admissions to post-acute care following hospitalization, with implications for system capacity and equitable access to care. High variability in results of other outcomes leaves the impact in particular settings uncertain, and may not allow a jurisdiction to predict if ABF would be harmless. Decision-makers considering ABF should plan for likely increases in post-acute care admissions, and be aware of the large uncertainty around impacts on other critical outcomes

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

ICAR: endoscopic skull‐base surgery

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A decision support system for Acute Leukaemia classification based on digital microscopic images

In the era of digital microscopic imaging, Image Processing, data analysis, classification, decision support systems have emerged as one of the most important tools for diagnostic research. Physicians can observe cellular internal structures abnormalities by visualizing and analyzing images. Leukemia is a malignant disease characterized by the uncontrolled accumulation of abnormal white blood cells. The recognition of acute leukemia blast cells in colored microscopic images is a challenging task. The first important step in the automatic recognition of this disease, image segmentation, is considered to be the most critical step. In this study, we present a decision support system that includes the panel selection, segmentation using K-means clustering to identify the leukemia cells and features extraction, and image refinement. After the decision support system successfully identifies the cells and its internal structure, the cells are classified according to their morphological features of this analysis the decision support system was tested using a public dataset designed to test segmentation techniques for identifying specific cells, and the results of this analysis were compared with those of other techniques, which were suggested by other researchers, applied to the same data. The algorithm was then applied to another dataset, extracted under the supervision by an expert pathologist, from a local hospital; the total dataset consisted of 757 images gathered from two datasets. The images of the datasets are labeled with three different labels, which represents three types of leukemia cells: blast, myelocyte, and segmented cells. The process of labeling of these images was revised by the expert pathologist. The algorithm testing using this dataset demonstrated an overall accuracy of 99.517%, the sensitivity of 99.348%, and specificity of 99.529%. Therefore, this algorithm yielded promising results and warrants further research. Keywords: Decision support system, Leukaemia, Image processing, Classificatio

Surface Parameters and Corrosion Inhibition of Some Isothiouranium Derivatives

712-718Four alkyl isothiouronium halide compounds in which the alkyl groups are dodecyl, hexadecyl, and octadecyl, respectively, are prepared. The measured surface tension at various concentrations as aqueous solutions of each of these compounds at various temperatures enable the calculation of surface and thermodynamic parameters. The critical micelle concentrations of these compounds decreases with increase in temperature. The calculated free energy changes for micelle formation and ad sorption of these compounds shows that these processes are spontaneous in nature. The corrosion inhibition properties of these compounds for mild steel in sulphuric acid as determined through potentiodynamic polarization measurements, indicates that dodecyl isothiouronium bromide exhibits better inhibitor efficiency than its higher homologues. For the same compound studied, the iodide salt gives a better inhibitor efficiency than the bromide

Comparative Study on Performance Improvement of SPWM/THIPWM based DCMLI Grid Connected DFIG

Multi-level voltage source converter is integrated in various fields in renewable energy power generation technologies such as wind and solar sources for applications that need higher voltage and higher power. In wind power generation market, doubly fed induction generator (DFIG) based on wind power generation is now the leading technology as they are economically feasible, they do offer a variable speed and efficient substitute to the fossil fuel. This paper proposes a DFIG based on a back to back diode clamped multilevel converter systems (DCMLI) fired comparatively by sinusoidal pulse width modulation (SPWM) and third harmonic injection pulse width modulation (THIPWM) techniques. By using these technologies, the DFIG performance is compared for different wind speeds under normal operation condition. The proposed approach shows that the DCMLI systems generate a near sinusoidal voltage with lower values in total harmonic distortion (THD) thus, upgrading the power quality that is produced by DFIG. Lastly, the variation of frequency of induced rotor voltage and the active power flow due to the wind speed changes when the rotor speed changes from super synchronous to sub synchronous speeds is investigated