Strength and Durability Performance of Ultra-High-Performance Cementitious Composite Enhanced with Carbon Nanofibres

Ultra-high-performance concrete (UHPC) is known for exhibiting excellent strength and a more durable matrix compared to conventional concrete. Typically UHPC consists of carefully selected constituent materials of: ultrafine graded sand, silica fume (or other alternative binders), steel micro-fibres, and ordinary (or special blends) Portland cement. This study was initiated to synthesize a new blend of Ultra-high-performance cementitious composite (UHPCC) with compressive strength higher than 150 MPa under normal curing conditions, and to investigate the influence of two different sources of carbon nanofibres (CNF) on its strength, durability and microstructure properties. Several mix designs with different CNF percentages were designed, optimised and analysed to obtain the optimal proportion for the UHPCC, and their strength development were monitored up to 28 days. Subsequently, the durability performance of the selected UHPCC mixes were characterised though the rapid chloride permeability, Mercury Intrusion Porosimetry and water penetration tests. It was found that a stable dispersion with low CNF percentage (0.06%wt) was able to improve the water penetration, lower the rapid chloride permeability and reduced the pore sizes of the UHPCC matrix. The overall findings of the research assert that a stable dispersion of CNF contributes in positive effect on the strength and durability characteristics of UHPCC, and is feasible to enhance overall microstructure and contribute to a denser matrix. This study is part of the larger research programme to synthesize an innovative UHPCC mix for specialised applications for structures under impulsive loadings

Review: Identification of roadmap of fourth construction industrial revolution

Industrial revolution is a series of events driven by the growth of technological innovations, and so far, the world had witnessed the first three industrial revolutions. Today, a new revolution referred to as the fourth industrial revolution is entering even though it is still in its early stages of development. Many developed countries had established their own roadmap or strategic plan as a first step. However, only a few of them touched the construction sector even though the construction industry provides a significant contribution to the country’s GDP. Based on this understanding, there is a fundamental need to give a clear view of Industry 3.0 to Industry 4.0 from the construction industry’s perspective, since most users are still finding their way in this transition. An extensive literature review is used to define the scope and terms of the field of construction in the industrial revolution. Towards this goal, a clear definition and concept of each revolution, key technologies related to construction and challenges faced by the industry will be explored. Simultaneously, this review paper also benchmarked a few documents as a simple guide in the transition process to the fourth industrial revolution to avoid a lag in a world where changes are swift and sudden. Therefore, this review paper contributes by providing a better understanding of the challenges and trends in Construction 4.0 to academics and practitioners. Moreover, it will spark new ideas on the policy or strategic roadmap development in the future

The Effects of Mixed Vitamins, Minerals, Fatty Acids and Amino Acids Supplementation into Drinking Water on Broiler Chickens’ Performance and Carcass Traits

The present study was conducted to evaluate the effects of different levels of the feed supplement containing minerals, fatty acids, vitamins, and amino acids added to drinking water on broiler chickens’ performance and carcass traits. A total of 100 one-day-old Cobb 707 (mean weight 46.7 g) were randomly assigned into four treatments, including control group (C), C + 2.25 ml/L Viterna Plus (V1), C + 2.50 ml/L Viterna Plus (V2), and C + 2.75 ml/L Viterna Plus (V3). Each treatment group contained 5 replicates of 5 birds in each (25 birds per treatment). Birds were maintained for 28 days. The results suggested that feed supplement at 2.50 ml/L could successfully improve final body weight, performance index, and carcass weight (P < 0.05). Concurrently, the treatment also reduced the percentage of abdominal fat (P < 0.05). In the current study, there were no significant differences in terms of feed intake and feed conversion ratio among treatment groups (P > 0.05). In conclusion, the incorporation of commercial feed supplement containing mixed of minerals, vitamins, and amino acids at 2.50 ml/L into drinking water improved the overall performance of the broiler chickens. Keywords: Broiler chicken, Carcass, Feed supplement, Tropics, Viterna plus

Isoprene hotspots at the Western Coast of Antarctic Peninsula during MASEC′16

Isoprene (C5H8) plays an important role in the formation of surface ozone (O3) and the secondary organic aerosol (SOA) which contributed to the climate change. This study aims to determine hourly distribution of tropospheric isoprene over the Western Coast of Antarctic Peninsula (WCAP) during the Malaysian Antarctic Scientific Expedition Cruise 2016 (MASEC′16). In-situ measurements of isoprene were taken using a custom-built gas chromatography with photoionization detector, known as iDirac. Biological parameters such as chlorophyll a (chl-a) and particulate organic carbon (POC) were compared to the in-situ isoprene measurements. Significant positive correlation was observed between isoprene and POC concentrations (r2 = 0.67, p < 0.001), but not between isoprene and chl-a. The hotspots of isoprene over maritime Antarctic were then were investigated using NAME dispersion model reanalysis. Measurements showed that isoprene mixing ratio were the highest over region of King George Island, Deception Island and Booth Island with values of ∼5.0, ∼0.9 and ∼5.2 ppb, respectively. Backward trajectory analysis showed that air masses may have lifted the isoprene emitted by marine algae. We believe our findings provide valuable data set of isoprene estimation over the under sampled WCAP

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study

Background Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. Methods We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. Results Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19–1.94), wheeze (OR 1.37, 95% CI 1.16–1.63) and dyspnoea (OR 1.83, 95% CI 1.53–2.20), but not lower FVC (β=0.02 L, 95% CI −0.02–0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI −0.49–0.58%). Some findings differed by sex and gross national income. Conclusion At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.publishedVersio

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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 &lt; 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

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)