Solar System Using Parabolic Trough Collector for Water Desalination Unit

In this research, a parabolic trough solar collector was used for brackish water desalination. The aim of this research was to investigate the desalination characteristics of this solar system under variable operation parameters and to determine the most efficient design configuration. The experiments were performed on a locally fabricated parabolic trough collector composed of mirror collector, solar energy absorption system, steam-brine separation vessel, heat exchanger, electrical panel, and sun tracking device. The efficiency of the system was tested by changing the main parameters, namely, solar collector slope angle, brackish water feed flow rate, heat exchanger, incident angle, ambient temperature, and receiver temperature. The results showed that the maximum distilled water was 10.4 Lt/(5 hrs. (11:00 am to 16:00 pm)). This water production was achieved at feed water flow rate 4.8 Lt/hr, the incident angles were in the range of 10o to 54o, the ambient temperature was in the range of 30-32 oC, collector efficiency was in the range of 48-38%. In conclusion, this system proved to be promising and can be further developed to achieve better results

Awareness, Perceptions and Beliefs About Physiotherapy Profession Among Orthopedists and Neurosurgeons Working in the Main Hospitals of the Ministry of Health in Gaza Strip

Background: - Healthcare professions have rapidly developed due to advancements in technology along with innovations over years, and Physiotherapists are considered as a key-member of collaborative inter-professional teams due to their broad scope of practice. - Increasing disabilities in Palestine due to occupation and other reasons, life expectancy and the special circumstances made it one of the most imperative socioeconomic medical issues in Gaza Strip. This emphasizes the need for the development and recognition of physiotherapy in multidisciplinary healthcare structures. - In order to deliver effective care, communication, cooperation and agreement between physicians and physiotherapist is essential. - If a physician were well informed about physiotherapy abilities in helping the treatments, prevent complications and decrease hospital stays, that would decrease the burden on the healthcare system. - Lack of knowledge about physiotherapy among medical professionals affects several aspects, including patients, the role of physiotherapy as a part of the healthcare teams, and the outcomes. Objectives: - The aim of the study was to identify awareness, perception and believes about physiotherapy among orthopedists and neurosurgeons. Methods: - A cross-sectional study was conducted between January – June 2019 at the three main hospitals of the Ministry of Health in Gaza Strip. The study population included Orthopedists and Neurosurgeons who work according to the settings. - The total collected samples were 67, and participants of the study were recruited through a Non-Probability convenience sample. - Data was collected through a questionnaire, that was designed in English, with four main parts, a total of 30 items, then data analysis using the (SPSS-V.22) and several statistical operations were done including Cross tabulation using chi-squarer with significance value was defined as p≤0.05. Results: - Results of this study showed that the awareness of orthopedists and neurosurgeons about physiotherapy was 95.5%. The study showed that 54.7% of these physicians received their knowledge through their studying. The study showed that 78.1% of physicians believe that the intervention of physiotherapy is in therapeutic exercises, while 57.8% believe that the biggest intervention is the use of electrical modalities, and 60.9% believe that it is manual therapy. The study found that 96.9% of physicians believe that physiotherapy plays an important role in the treatment plan for the patient. And 71.9% of the physicians believe that the physiotherapist has the right to return the patient to the physician due to misdiagnosis. The study indicated that 90.6% of physicians believe it is important to discuss the patient's discharge with a physiotherapist, and shocking result was that 95.3% of physicians say that they write on the referral what should a physiotherapist do to a patient, and that is a huge violation of the physiotherapists right of making their own decision. Conclusions: - There is a close association between orthopedists and neurosurgeons about physiotherapy. The study has shown that they have a clear awareness, perception and beliefs about physiotherapy. - This relationship should be supported and developed to provide the best possible treatment to patients

ازالة البورن من مياه البحر باستخدام عملية التخثر الكهربائي و الطاقة الشمسية

Excess boron ion in drinking and irrigation water is a serious environment and health problems because it can be toxic to many crops and lead to various human and animals diseases with long-term consumption. Desalinated seawater from reverses osmosis (RO) plants often contains high boron content and need an expensive second pass RO membrane treatment, which calls for sustainable, cheaper and reliable alternatives. The current research studies the feasibility of the boron removal from synthesized water and real seawater using hybrid solar photovoltaic electrocoagulation (SPEC) process. Batch EC experiments were carried out on a laboratory scale using aluminum electrodes powered by solar photovoltaic energy to investigate several operational parameters on the boron removal efficiency such as current density, initial pH, initial boron concentration, supporting electrolyte type and concentration, electrodes material, gap between electrodes, stirring speed and anodes surface area to reactor volume ratio. Optimum removal efficiency (90.6%) corresponding to a final boron concentration of (0.47 mg/L) was achieved with parameter values of current density (4.17 mA/cm2), initial pH (7) and NaCl concentration (1.0g/L) within 120 min operating time. The corrosion of electrodes was characterized using FESEM. By-products obtained from the electrocoagulation cell were analyzed and explained using FTIR and XRD. Furthermore, a comparison between SPEC and conventional electrocoagulation was carried out. Results showed higher energy consumption using conventional power source compered to solar power source in order to achieve same boron removal efficiency. Use of batteries followed by DC-DC charge controller with photovoltaic panels provided more regular and efficient performance for the SPEC system. The obtained optimum conditions were applied to treat real seawater. The results showed that boron residual concentration in seawater decreases with an increasing electrolysis time and electrodes consumption. Comparative cost estimation with different operating parameters for synthetic and real seawater was adopted and presented as well. This study indicates that, SPEC is a promising alternative for the efficient removal of boron from seawater, which could be used as a pretreatment unit in a desalination plants

Determination of the Diagnostic Quality of ProCT for the Diagnosis and Prognosis of Sepsis in Comparison with Scoring Systems and Established Parameters of the Acute-Phase-Reaction

Titelblatt u. Inhaltsverzeichnis 1 Einleitung 9 2 Studiendesign und Setting 15 3 Ergebnisse 39 4 Diskussion 69 5 Zusammenfassung und Schlussfolgerungen 81 6 Literatur 83 7 Anhang 96 8 Lebenslauf 100 9 Danksagungen 102Hintergrund: Prokalzitonin (ProCT) ist ein Prohormon, das in jüngster Zeit in Zusammenhang mit Bakteriämie und Infektionen gebracht wurde. Ziel dieser Dissertation ist die Evaluierung der Akute-Phase-typischen Serumkinetik von ProCT und seine diagnostische und prognostische Bedeutung im Rahmen von inflammatorischen Wirtsreaktionen im Vergleich zu dem APACHE III-, und SOFA- score sowie den etablierten Parametern CRP und IL-6. Methodik: Die Messung der ProCT-Serumkonzentrationen erfolgte immunoluminometrisch. Es wurden zwei Gruppen gebildet; eine Kontrollgruppe bestehend aus Patienten mit postoperativer SIRS (n=35) und eine Gruppe bestehend aus Patienten mit severe sepsis /septic shock (n=63). Die Messungen und Kalkulationen der Scoringssysteme wurden täglich durchgeführt. Ergebnisse: Die in der Anstiegsphase berechnete Halbwertszeit betrug im Median 9,8 Stunden (Bereich: 3,3 27,3), die ProCT-Abfallserumhalbwertszeit betrug im Median 36,1 Stunden (Bereich: 19 91,1) Die ProCT-Antwort nach einem Gewebstrauma zeigt nach Amplitude und Dauer eine signifikante Abhängigkeit vom Ausmaß des Traumas. Eine infektiöse Ätiologie der inflammatorischen Wirtsantwort hat einen größeren Einfluß auf die ProCT-Sekretion als ein operativer/traumatischer Stimulus, wobei die ProCT-Serumkonzentrationsantwort bei Sepsis in der Amplitude auch eine Abhängigkeit vom Schweregrad des Sepsisfocus zeigt. Der Unterschied der ProCT-Serumkonzentrationen zwischen schwerem und mittelschwerem Sepsisfocus in der Gruppe der Sepsis-Überlebenden bei Sepsisbeginn war statistisch signifikant. Die Werte der ROC-AUCs von ProCT erreichten fast die Werte der Scoringsysteme APACHE III und SOFA und waren vom ersten Tag über den gesamten Zeitverlauf signifikant besser als die ROC-AUCs von CRP und IL-6. Es ließt sich eine äußerst enge Korrelation des ProCT- Serumkonzentrationsverlaufs zum Verlauf des SOFA-Scores nachweisen (r=0,51; p<0,05). Schlussfolgerungen: ProCT kann daher als valider Marker der akuten inflammatorischen Wirtsantwort betrachtet werden. Der Marker ist aber nicht spezifisch für eine infektiöse Ätiologie der inflammatorischen Aktivität, was beim gleichzeitigen Vorliegen von Gewebstraumata berücksichtigt werden muß. ProCT ist enger als die derzeit klinisch etablierten diagnostischen Meßparameter mit der Aktivität und dem Verlauf von generalisierten inflammatorischen Reaktionen assoziiert und besitzt eine ausgeprägte Eigenschaft, generalisierte von kompartimentalisierten Entzündungsantworten differenzieren zu können.OBJECTIVE: Procalcitonin (ProCT) is a prohormone, which has recently been published in correlation with bacteraemia and infections. The aim of this dissertation is the evaluation of acute-phase serum kinetics of ProCT and its diagnostic and prognostic value in inflammatory host response comparing APACHE III- und SOFA-scores as well as established parameters CRP and IL-6. METHODS:. ProCT were measured with a "sandwich" type luminescence immunoassay in a coated-tube technique. Two groups were built; the control group consisting of patients with postoperative SIRS (n=35) and the second group consisting of patients with severe sepsis /septic shock (n=63). All measurements and score calculations were performed daily. RESULTS: Calculated half-life of ProCT during the increase period was in median 9.8 hours (range 3.3 27.3), in the decrease period half-life was in median 36.1 hours (range 19 91.1). Amplitude and duration of the ProCT-response after tissue trauma was found to significantly depend on the extent of tissue trauma. An infectious etiology of the inflammatory horst response has a major influence on ProCT secretion compared with surgical or traumatic stimulus. The amplitude of ProCT levels in sepsis correlates with the severity of the sepsis. Differences in ProCT levels between survivors with severe and moderately severe sepsis were statistically significant already at the onset of sepsis. Values of ROC-AUCs of ProCT achieved the values of APACHE III- and SOFA- scores and they were from the first day and during the follow-up significantly better than the values of CRP and IL-6. In addition the ProCT levels were closely correlated to the SOFA- scores (r=0.51; p<0.05). CONCOLUSION: ProCT can be considered as a valid marker of inflammatory host response. This marker is not specific for the infectious etiology of the inflammatory reaction and should be considered if tissue trauma is present. ProCT is more closely correlated to the activity and course of the systematic inflammatory reaction than currently established diagnostic parameters. In addition, it is able to differentiate between systemic and localized inflammatory response

Der Infektionsmarker Procalcitonin in der Herzchirurgie

Der Einsatz der extrakorporalen Zirkulation führt zu einer erheblichen Stimulation der proinflammatorischen Reaktion. Dies kann bewirken, daß die zeitgerechte Diagnosestellung einer Infektion postoperativ erschwert wird und zeigt den Bedarf nach einem zuverläßigeren Sepsismarker in der postoperativen Phase nach herzchirurgischen Eingriffen.  Wir bestimmten den neuen Sepsismarker Procalcitonin (PCT) in zwei unterschiedlichen Patientengruppen, die jeweils dem Kontakt mit extrakorporalen Kreislaufsystemen ausgesetzt waren. Die erste Gruppe (VAD-Gruppe) bestand aus 38 Patienten mit terminalem Herzversagen, die mit einem ventrikulären Unterstützungssystem Typ Berlin Heart versorgt wurden. Die zweite Gruppe (EKZ-Gruppe) bestand aus 713 Patienten, die einem konventionellen herzchirurgischen Operationsverfahren unterzogen wurden. PCT wurde vor Operation und täglich nach der Operation gemessen. In der VAD-Gruppe waren die präoperativen PCT-Werte in der Lage, Patienten im kardiogenen Schock zu identifizieren, die nach der Operation an einer Infektion verstarben. Darüberhinaus hatten die Patienten, die vor Herztransplantation immer noch erhöhte PCT-Werte aufwiesen, eine schlechte Prognose nach Transplantation.  In der EKZ-Gruppe hatte kein Patient erhöhte PCT-Werte vor Operation. Patienten mit erhöhten Werten am ersten postoperativen Tag hatten eine hohe Inzidenz von Komplikationen in ihrem weiteren Verlauf, während Patienten ohne PCT-Erhöhung einen unkomplizierten Verlauf nahmen.  Sowohl bei Patienten mit kardiogenem Schock als auch nach Einsatz der Herz-Lungen-Maschine ist Procalcitonin in der Lage, bakterielle und pilzbedingte Infektionen zu identifizieren. Daher kann es zur Beurteilung der Transplantabilität von Patienten an Kreislaufunterstützungssystemen herangezogen werden. Der PCT-Wert scheint vom Blutkontakt zu Fremdoberflächen nicht beeinflußt zu werden. Allerdings zeigen eine Reihe von Patienten nach herzchirurgischen Routineeingriffen einen PCT-Verlauf. Die Komplikationsinzidenz ist in dieser Gruppe deutlich erhöht. Möglicherweise ist der PCT-Anstieg auf eine intestinale Minderperfusion während der extrakorporalen Zirkulation zurückzuführen. The use of extracorporal circulation in open heart surgery causes profound stimulation of proinflammatory reaction. Therefore, timely diagnosis of infectious complications may become extremely difficult, and a more reliable marker of sepsis under these circumstances is needed.  We measured the new marker for sepsis Procalcitonin (PCT) in two distinct groups of patients exposed to extracorporeal circulatory devices. Group VAD consisted of 38 patients in end-stage heart failure supported with ventricular assist devices (VAD) Type Berlin Heart. Group EEC included 713 patients undergoing standard open heart surgery procedures. PCT was measured before operation and daily thereafter. PCT levels before operation were able to identify patients in cardiogenic shock who after device implantation died of infectious complications. Patients on VAD who showed elevated PCT levels before heart transplantation had a very unfavorable outcome. In the ECC group, none of the patients had elevated PCT levels before surgery. On day one after the procedure PCT was elevated in those patients who in their further postoperative course developed complications. Patients without PCT elevation after open heart surgery had an uncomplicated recovery.  Under the conditions of cardiogenic shock as well as the use of extracorporeal circulation, PCT is able to identify bacterial and fungal infections. It is helpful in evaluating the transplantability of patients on VADs. PCT seams to be unaffected by the use of extracorporeal circulatory circuits. However, a substantial number of patients exhibit PCT increase after ECC, and the PCT level has some prognostic value. The increase of PCT may be due to intestinal malperfusion