The Effects of Tank Operation and Design Characteristics on Water Quality in Distribution System Storage Tanks

From the Executive Summary Background: Regional water systems utilize storage facilities to meet demand variations and pressure requirements of their systems. These storage facilities drain and fill in response to system water demands and water level control settings. Storage tanks are typically placed in strategic locations to maintain a consistent pressure in the distribution system. Storage facilities should be designed and operated such that the water is mixed to prevent stagnant water (old water that remains in the tank for an extended period). Stagnant water can lead to water quality issues, such as low disinfectant residuals, potential for microbial contamination, disinfectant by-product formation, and nitrification in chloraminated waters. Many tanks have been built without consideration of mixing. These tanks might have a single inlet/outlet, high height to diameter ratio, or have other design characteristics that do not promote mixing. Whether by design or not, tanks without artificial mixing depend upon movement of water during the filling process to mix the tank. A wide array of storage tank types and geometries are utilized in South Dakota’s regional rural water systems. Greater understanding of the relationships of these tank characteristics on stored water quality would enable water systems to optimize the design and operation of their tanks. Objective of Study:The objective of this study was to examine the impacts of tank design and operation on mixing and water quality in storage tanks in South Dakota’s regional rural water systems. This objective was met through a literature review, a survey of system characteristics and evaluation of water quality data obtained from several storage tanks

Simplification of the Finnegan Neonatal Abstinence Scoring System: Retrospective Study of Two Institutions in the USA

Objective To develop a simplified Finnegan Neonatal Abstinence Scoring System (sFNAS) that will highly correlate with scores ≥ 8 and ≥12 in infants being assessed with the FNAS. Design, setting and participants This is a retrospective analysis involving 367 patients admitted to two level IV neonatal intensive care units with a total of 40 294 observations. Inclusion criteria included neonates with gestational age ≥ 37 0/7 weeks, who are being assessed for neonatal abstinence syndrome (NAS) using the FNAS. Infants with a gestational age \u3c 37 weeks were excluded. Methods A linear regression model based on the original FNAS data from one institution was developed to determine optimal values for each item in the sFNAS. A backward elimination approach was used, removing the items that contributed least to the Pearson’s correlation. The sFNAS was then cross-validated with data from a second institution. Results Pearson’s correlation between the proposed sFNAS and the FNAS was 0.914. The optimal treatment cut-off values for the sFNAS were 6 and 10 to predict FNAS scores ≥ 8 and ≥ 12, respectively. The sensitivity and specificity of these cut-off values to detect FNAS scores ≥ 8 and ≥ 12 were 0.888 and 0.883 for a cut-off of 6, and 0.637 and 0.992 for a cut-off of 10, respectively. The sFNAS cross-validation resulted in a Pearson’s correlation of 0.908, sensitivity and specificity of 0.860 and 0.873 for a cut-off of 6, and 0.525 and 0.986 for a cut-off of 10, respectively. Conclusion The sFNAS has a high statistical correlation with the FNAS, and it is cross-validated for the assessment of infants with NAS. It has excellent specificity and negative predictive value for identifying infants with FNAS scores ≥ 8 and ≥ 12

Behaviour in therapeutic medical care: evidence from general practitioners in Austria

Aim: The present study examines monetary effects of general practioners’ behaviour in therapeutic medical care to identify sample characteristics that allow differentiating between the individual general practitioner and the basic population. Subjects and methods: Medical services, provided by 3,919 general practitioners in Austria, were operationalized by means of the dependent variable “costs per patient”. Statistical outliers were identified using Chebyshev’s inequality and categorized by investigating bivariate correlations between the dependent variable and the personal characteristics of each physician. Results: Variables that relate to the size of the customer base such as number of consultations (r = 0.385) and office days (r = 0.376), correlate positively with the costs for medical services. By analyzing the portfolio of the general practitioners, we found a correlation of 0.451 between this coefficient and the costs. Statistical outliers feature an average portfolio of 44.5 different services, compared to 30.45 among non-outliers. Laboratory services especially were identified as cost drivers (r = 0.408). Statistical outliers generate at least one laboratory parameter for 44.34% of their patients, opposed to 27.2% within the rest of the sample. Consequently outliers produce higher laboratory costs than their counterparts. Conclusion: We found some evidence that physicians have influence in the provision of their services. Considering entrepreneurial objectives, the extension of the portfolio can increase their profit. Our findings indicate supplier-induced demand for several groups of services. We assume that the effect is consolidated by the fee for service system and could be compensated by adequate reform

Oxidative Stress and Mitochondrial Functions in the Intestinal Caco-2/15 Cell Line

Although mitochondrial dysfunction and oxidative stress are central mechanisms in various pathological conditions, they have not been extensively studied in the gastrointestinal tract, which is known to be constantly exposed to luminal oxidants from ingested foods. Key among these is the simultaneous consumption of iron salts and ascorbic acid, which can cause oxidative damage to biomolecules.The objective of the present work was to evaluate how iron-ascorbate (FE/ASC)-mediated lipid peroxidation affects mitochondrion functioning in Caco-2/15 cells. Our results show that treatment of Caco-2/15 cells with FE/ASC (0.2 mM/2 mM) (1) increased malondialdehyde levels assessed by HPLC; (2) reduced ATP production noted by luminescence assay; (3) provoked dysregulation of mitochondrial calcium homeostasis as evidenced by confocal fluorescence microscopy; (4) upregulated the protein expression of cytochrome C and apoptotic inducing factor, indicating exaggerated apoptosis; (5) affected mitochondrial respiratory chain complexes I, II, III and IV; (6) elicited mtDNA lesions as illustrated by the raised levels of 8-OHdG; (7) lowered DNA glycosylase, one of the first lines of defense against 8-OHdG mutagenicity; and (8) altered the gene expression and protein mass of mitochondrial transcription factors (mtTFA, mtTFB1, mtTFB2) without any effects on RNA Polymerase. The presence of the powerful antioxidant BHT (50 microM) prevented the occurrence of oxidative stress and most of the mitochondrial abnormalities.Collectively, our findings indicate that acute exposure of Caco-2/15 cells to FE/ASC-catalyzed peroxidation produces harmful effects on mitochondrial functions and DNA integrity, which are abrogated by the powerful exogenous BHT antioxidant. Functional derangements of mitochondria may have implications in oxidative stress-related disorders such as inflammatory bowel diseases

Effective management of Colles fracture using Murivenna and Abha Guggulu – A case report

Colles fracture is the commonest fracture encountered in orthopedic practice that demands prompt therapeutic intervention, and adequate follow-up to ensure complete healing. Various types of fractures, methods of reduction, and healing have been explained in the classical Ayurveda texts. These techniques are scientific and time-tested. This paper aims to report the successful management of Colles fracture case using Ayurveda and modern techniques with the use of Murivenna (an oil-based herbal formulation mentioned in the contemporary texts of Ayurveda), half-cast POP, and aluminum splinted bandage along with the internal medicine Abha Guggulu. A 75-year-old moderately built woman diagnosed with Colles fracture was treated with a closed manipulative reduction technique followed by a below-elbow half-cast POP and an aluminum splint. Murivenna was poured anteriorly to the fractured site and Abha Guggulu was administered internally. Re-bandaging was done on the 7th day and 21st day. The bandage was removed on the 35th day. The patient's condition improved considerably with a good range of wrist movements and then she was advised to commence rehabilitation. This integrative method, adhering to Ayurvedic principles and modern techniques is unique, patient-friendly, and without adverse events

Kerala Traditional Ayurvedic Practices in Children for Enhancing Immunity - A Systematic Review

Kerala is rich in its culture for the traditional Ayurveda practices in children from the time of birth onwards. These traditional practices are mainly immune boosters and also enhance overall nourishment and development in children. Commonly used traditional Ayurveda practices are Uramarunnu Prayoga, Prakara Yoga, Abhyanga, Rasanadi churna lepana, Snana etc. for enhancing immunity and providing overall development to children.  Uramarunnu is a baby care practice comprising of a group of drugs administered to the child in the form of paste in breast milk, after 28 days till 2 years of age. Prakara Yogas are immunomodulatory recipes and procedures to be adopted right from the day after delivery. Abhyanga provides nourishment, health, protection, emotional well-being and improves skin tone. All these can be used for enhancing immunity and preventing recurrent infections thereby helps in the maintenance of health and prevention of diseases. This mentions the importance of Kerala traditional Ayurvedic practices in the field of primary child health care. So, the present study aims to compile Kerala’s traditional Ayurvedic practices in children, by reviewing regional textbooks like Arogyakalpadruma, Vaidya Tarakam, Parambarya Balachikitsa etc., and also interviewing Ayurveda pediatrician through telephone

RFC7939: Definition of Managed Objects for the Neighborhood Discovery Protocol

This document replaces RFC 6779; it contains revisions and extensions to the original document. It defines a portion of the Management Information Base (MIB) for use with network management protocols in the Internet community. In particular, it describes objects for configuring parameters of the Neighborhood Discovery Protocol (NHDP) process on a router. The extensions described in this document add objects and values to support the NHDP optimization specified in RFC 7466. The MIB module defined in this document, denoted NHDP-MIB, also reports state, performance information, and notifications about NHDP. This additional state and performance information is useful to troubleshoot problems and performance issues during neighbor discovery