Degrees Celsius Research Articles

An Experimental Study on the Effect of Nano Zinc Oxide on Reflective Coatings and Building Roof Temperatures

Most roofs on Earth are made of dark materials. Dark roof surfaces can retain heat better than light ones; in Iraq, summer time temperatures on the roofs of dark buildings reached 70–80 degrees Celsius in July and August. The effects of this temperature rise are detrimental to cooling and energy consumption. To lessen heat transfer into the building, use reflective surfaces that can reflect infrared radiation waves. Cool roofs have both short-term and long-term advantages. They can reduce a building's annual air conditioning energy consumption by up to 15%, extend the life of the roof and its service life, improve the energy efficiency of roofs particularly those with inadequate insulation at the front of the roof improve thermal comfort in buildings without air conditioning, and lower greenhouse gas emissions and air pollution. Solar heat is one of the main factors affecting the durability of roofing membranes, according to research and real-world experience with the deterioration of these materials over time. High solar reflectance materials can reflect more sunlight and maintain their coolness in the sun. This study examines a low-cost composite cool coating that uses 60% calcium carbonate and demonstrates a 15°C drop in surface concrete temperature for roof buildings when compared to an uncoated surface. Additionally, compared to 30%wt CaCO3, the effect of 60%CaCO3 in composite coating reduces adhesion strength. According to the study, the weight of CaCO3 in the composite coating increases while adhesion strength, surface roughness, and particle homogeneity distribution decrease. Conversely, the maximum weight of CaCO360% weight percent exhibits good IR reflectance and less tribological properties. While preserving good infrared reflectance, adding 10% ZnO to the coating solution (60% CaCO3/PVac) improves tribological properties. The adhesion strength of the 60% calcium carbonate polymer composite paint increased from 10.9 MPa to 40.2 MPa when the nanomaterial was present, while this material maintained the superior optical qualities of infrared reflection. The coefficient of thermal expansion varies between concrete and coating solutions. For instance, the coating that has 10% weight added ZnO has a peel resistance coefficient of 8*10-6 1/K. The 60%CaCO3/10%ZnO/PVac coating effectively lowers the temperature by 15–12 °C when applied to a building roof.

Assessing the state of cognitive performance of employees and determining the range of thermal comfort of different genders in Ilam hospitals

Introduction: Thermal comfort is essential for a productive work environment and affects the well-being and performance of employees, so maintaining optimal levels of satisfaction, productivity, and efficiency, especially in indoor spaces, is essential. Therefore, the present study's aim is to evaluate the state of cognitive performance. Employees and determination of the thermal comfort range of different genders of employees in the hospitals of Ilam city were done. Methods and Materials: This research was conducted by survey and field method to identify the state of thermal comfort and cognitive performance of people in the real conditions of therapeutic spaces. For this purpose, the responses of 400 employees of five hospitals in Ilam City were recorded by simple sampling from the beginning of August to November 1402. The reliability status of the questionnaires was confirmed using Cronbach's alpha, and the thermal comfort status of the people was determined through the regression model. Linearity and correlation analysis between measured variables were analyzed through SPSS27 software. Results: The analysis of the linear regression model showed that the range of thermal comfort between men and women differs by 1.79 degrees Celsius, and this difference is a tendency for warmer temperatures in men and a tendency for colder temperatures in women, the average scores obtained at Zagros Hospital In the visual-spatial/executive component (7.00), attention (4.34), memory (3.08) has the best performance, Imam Khomeini Hospital (RA) has the best performance in the verbal component (2.95), Hazrat Qaim Hospital (A) In the abstraction component (2.02), it has the best performance and awareness of time and place in all hospitals equal to 6.00. Conclusion: The level of coverage and activity rate among women significantly affects the feeling of thermal comfort, cognitive performance, and productivity of employees at work. The results of this research show the need to revise the current standards of workplace clothing, attendance time, and employee activity rate. Moreover, changes in cognitive performance among hospital staff highlight the need to consider targeted cognitive enhancement strategies to increase staff efficiency.

Exploring the Microbiome of Mobile Devices: Implications for Public Health and Hygiene

This study, which examined the diversity of microorganisms found on mobile phones, took a novel approach by identifying pathogenic microbes on phone users within different age groups. The study also aimed to test the effectiveness of a simple disinfection method using 70% sterile alcohol pads. Samples were collected using sterile cotton tip applicators and transport broth media before and after disinfection. The samples were cultured and incubated on Muller Hinton agar petri plates at 32 degrees Celsius for 48 hours. The isolated microbes were identified based on their morphological characteristics, gram-stain test, and biochemical analysis. The survey, conducted to determine the frequency of mobile phone usage and factors contributing to microbial contamination, revealed significant findings. Participants from two villages were surveyed using a structured questionnaire. The sample size of participants was generated using a sample size calculator. Two participants from each age group per village were selected randomly for microbial sample collection from their mobile phones using R Studio software. The results showed that older adults' mobile phones were more contaminated than younger adults and adolescents, providing valuable insights. The frequency of usage and hygiene did not determine the total viable count of pathogenic microbes found, challenging existing assumptions. The study also found that disinfection using 70% sterile alcohol pads was 76% effective in reducing microbial contamination.

Investigation of the Process Parameters in Rotary Friction Welded Dissimilar AA7075/AA5083 Aluminum Alloy Joints on Fatigue Initiation using FEA and ANN

The rotary friction welding (RFW) method is one of the most widespread methods in the world for producing bimetallic components that require high mechanical strength. Simulations play a vital role in improving energy efficiency and reducing environmental impact, aligning with the sustainability goals of modern industry. A neural network (NN)-based incremental learning system was developed to predict crack growth and fatigue for AA5083 and AA7075 aluminum alloys. The results indicate the ability of this method to accommodate the input temperatures and the S-N curve and provide reliable predictions of expected fatigue. This method can reduce labor costs and time spent on crack propagation tests, enhancing the effectiveness of production processes and reducing process costs. This work also reveals the ability of neural . It maynetworks (NN) in monotonic function extrapolation like the S-N curve, which may pave the way for a wide variety of monotonic function-predicting problems. In future studies, a neural network (NN)-based increment learning scheme could be trained with random parts of individual S–N curves and applied to predict the rest. Additionally, the verification utilizing AISI 2205 and AISI 1020 steel has observed that neural networks may obtain S-N curve values for another metal with less than an 8% error rate. Friction pressure increases temperature, deformation, and stress in welding processes. Friction pressure 17 MPa increases temperature to 355 degrees Celsius, while Friction pressure 23 MPa increases deformation to 0.020 mm. A friction pressure of 29 MPa increases equivalent stress to 110 MPa. The indication of the S-N curve shows that increasing welding pressure increases Alternating Stress. Friction pressure also increases life, with minimum life cycles reaching 171040 cycles at 17 MPa, 195560 cycles at 23 MPa, and 283690 cycles at 29 MPa. Comparing research and simulation results, convergence is less than 8%, reducing error.

Antibacterial Activity Test Of Epazote Leaf Infusion (Dysphania ambrosioides L.) Against Escherichia coli Bacteria

The most common health problem in Indonesia is bacterial infection. Dysphania ambrosioides L., also known as epazote leaves, is an herbal plant that has antimicrobial potential. This research was conducted to see at what concentration there is antibacterial activity of epazote leaf infusion Dysphania ambrosioides L. against Escherichia coli bacteria. This laboratory experimental study used a complete randomized design (RAL) research. Antibacterial activity testing of epazote leaves was carried out using the disc paper diffusion method with concentrations of 50%, 75%, and 100%. Epazote leaves are boiled in an infusion pan for 15 minutes, until the temperature reaches 90 degrees Celsius. Ampicillin positive control 10 ?g/disc. Based on the test results of secondary metabolites of positive epazote leaf infusion there are alkaloids, flavonoids, tannins, saponins, triterpenoids, and phenolics. The results of the study showed that infusion of epazote leaves inhibited Escherichia coli bacteria by diameter inhibition. Average at a concentration of 50% = 14.04 mm, 75% = 16.92 mm, 100% = 17.94 mm, which means that there is antibacterial activity of epazote leaf infusion against Escherichia coli bacteria.

The impedance drop early after energy delivery predicts steam pops during radiofrequency ablation

Abstract Background Steam pops during radiofrequency ablation (RFA) can cause serious complications. However, predictive factors for steam pops remain unclear. Purpose To investigate predictors for steam pops. Methods An in vitro experiment was performed using fresh bovine left ventricular myocardium. A myocardium cut into 4-5 cm slabs was fixed at the bottom of a constant temperature bath with temperature adjusted to 36.5 degrees Celsius, and a non-pulsatile flow rate of 5 L/min was generated. Using the catheter with a laser-cut 8Fr4.0mm flexible tip, RFA was applied at 30W, 60 seconds, perpendicular catheter placement to the tissue at various contact forces (5, 10, 20, 30, 40, 50g). A total of 138 lesions were created by applying RFA 23 times at each setting. Lesion depth and width were measured after RFA. Results Steam pops were observed in 49 of 138 lesions (36%). The higher impedance decrease in the first 5 seconds (-21.0±11.0Ω vs. -7.6±8.5Ω, P<0.0001), the larger impedance drop from initial to minimum impedance (if steam pop occurred, minimum impedance before steam pop was applied) (-28.9±13.0Ω vs. -13.1±12.9Ω, P<0.0001), higher initial impedance (132±48Ω vs. 87±38Ω, P<0.0001), power regulation by temperature control (44.9% vs 4.5%, P<0.0001), higher contact force (31.2±14.9g vs. 22.9±15.9g, P=0.0030), larger LSI (6.8±2.1 vs. 7.5±1.8, P=0.0037) were associated with steam pops. In multivariate analysis, the high impedance drops in the first 5 seconds (OR 2.0 for each 5Ω increase, 95%CI 1.0-1.3; P=0.033) and the power regulation by temperature control (OR 7.3, 95%CI 2.2-29.9; P=0.001) were independently related. In ROC curve analysis of the impedance drops in the first 5 seconds, an optimal cut-off value of steam pops was 8.0Ω (AUC 0.85, sensitivity 88%, specificity 73%) (figure 1). Steam pops were predicted with a sensitivity of 45% and specificity of 97% using both the impedance drop ≥ 8.0Ω in the first 5 seconds and power regulation by temperature control. Lesion depth and width were associated with total impedance reduction in lesions with an impedance drop < 8.0Ω during the first 5 seconds (R²=0.14, P=0.0012 with depth, R²=0.21, P<0.0001 with width), while were not associated with in lesions with an impedance drop ≥ 8.0Ω (figure 2). Conclusion The impedance drop early after RF energy delivery may predict steam pops during RFA.

Climate change and gastroenteritis projections in Albanian children

Abstract Background Human health can be affected by climate in direct and indirect ways. Increasing temperatures may affect ecosystems, water safety, and exposure to waterborne diseases. This is the first work in Albania aiming to demonstrate the link between gastroenteritis rate and climate in the country. This research was supported by UNICEF Albania through the WASH Global Thematic Fund, but it doesn’t necessarily represent UNICEF’s position. Methods Epidemiological surveillance reports of the period 2006-2022 were used for the yearly incidence of gastroenteritis in children 0-14 years old. Years 2020 and 2021 were not included because of pandemic confounding potential. Historic data for calculating the average summer temperatures were retrieved from timeanddate.com repository. Pearson coefficient is calculated to quantify the associations and linear regression is applied to project the increased rate in the future. Results There was a statistical association between gastroenteritis rate and summer temperatures during the study period (Pearson coefficient=0.78, p = 0.001). There was a tendency that in years with hotter summers higher incidence of gastroenteritis was reported by the health system. For each degree (Celsius) increase in the average summer day temperatures, the risk of gastroenteritis in children is expected to increase by 644/100 000 (CI 95%: 317 - 972). An excess rate of 966/100 000 is expected in the case of Intergovernmental Panel on Climate Change medium scenario projection of 1.5o C average temperature increase. That implies more than 4830 additional new cases every year in children 0-14 years old, attributed to climate change in the future in Albania. Conclusions The analysis demonstrated excess gastroenteritis risk may be related to higher summer temperatures observed in Albania. The expected gastroenteritis risk increase in a warmer future should be addressed by improvements in sanitation, education of parents and epidemiological intelligence. Key messages • A warmer climate is expected to affect the health by increasing the risk for diarrheic diseases. • Children will be the most at-risk population category.

Factual observations of dynamic bone crushing

Dynamic bone-crushing, exemplified by the pig bone rib, is characterized thermo-mechanically in relation to the bone’s microstructural characteristics. The cortical bone’s dominant role consists of shielding the trabecular component by resisting deformation, sustaining high load levels, and ultimately cracking. Here we present a qualitative factual study to show that this behavior is the absolute opposite of its quasi-static counterpart in which the trabecular bone was found to play the dominant role. Using infrared thermography, we observed for the first time a significant localized temperature rise of up to 11 degrees Celsius in both cortical and trabecular damaging regions. Such observations call for additional clinically oriented research. Such a high contrast between static and dynamic failure mechanisms was not reported previously, and it paves the way for forensic-oriented studies in which the nature of the sustained load must be determined.

Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with ROTEM®: a prospective observational study

BackgroundHypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using ROTEM®.MethodsPatients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing.ResultsIn total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels.ConclusionsThe combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis.Trial registrationThe study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313.

Spatial Analysis of the Impacts Caused by Changes in Land Use on the Estimation of Surface Temperature in the The City of Paracatu (MG)

The increase in built-up areas, coupled with the suppression of vegetation without the necessary mitigating measures to curb the effects of urbanization, causes changes in the microclimate and directly impacts the health of the local population. In this sense, the present study aims to analyze the influence of land cover type on the variation of Land Surface Temperature (LST) estimation in the city of Paracatu, Minas Gerais (MG), in the years 1990 and 2020.For this, the maps provided by the Annual Mapping of Land Cover and Land Use of Brazil (MapBiomas) and images from the LANDSAT-5 (1990) and LANDSAT-8 (2020) satellites were used. Four images, distributed across seasons, were utilized to estimate LST for these periods, aiming to obtain a representative LST estimate for that year. For the calculation of the LST with bands 6 and 10, respectively of the LANDSAT-5 and 8 satellites, the SCP plugin of the QGIS software was used, and the process of recovery of the LST in the scenes used occurred through conversion of the values of the Digital Number (DN) into radiance at the Top of the Atmosphere (ToA), conversion of radiance into brightness temperature in ToA, correction of atmospheric effects and obtaining LST in Kelvin and, subsequently, in degrees Celsius. After that, the average between them was performed by means of normalization of each of the scenes, obtaining a representative mosaic for the LST of each year,thus enabling the estimation of the spatial behavior of the minimum, mean, and maximum values.. Finally, in order to verify the influence of Changes in Use and Occupation (LULC) on the spatial variation of the LST, the classes found in Vegetation, Exposed Soil, Urban Area and Water Resources were segmented, and it was found that, while the urban area of Paracatu had its territorial extension practically doubled, the vegetation class decreased by almost 25%, a fact that implied in the average increase of the LST by more than 5º C. the minimum and maximum values of these classes varied around 4.5 and 3º C, and it is possible to conclude that, in this interval of 30 years, Paracatu had no urban growth occurring exponentially and without the proper mitigations for the transformation of the microclimate, implying the need for measures that can curb these changes in strategic points of the municipality, as in the Bom Pastor neighborhood, which had its use and occupation totally changed in this temporal hiatus. In addition, in view of the estimates of economic growth in the city, it is believed that these measures should be taken as a matter of urgency, so that the results presented here can support the decisions of the managing public agencies.

Evaluation of an Alternate Diluent for Tests to Ensure Timely Patient Management

Abstract Introduction/Objective Recently, backorder of Multi-diluent (MD) for various assays on ADVIA Centaur analyzer (Siemens Healthineers) led to delay in reporting numeric values to the clients when results above the analytical measurement range (AMR) had to be reported as “> value”. The samples were stored frozen (-20 degrees Celsius or - 80 degrees Celsius) for over 2 weeks until the diluent became available, then thawed and re-analyzed upon appropriate dilution. Delay in reporting results beyond AMR may impact patient management; therefore, this study evaluated saline as an alternative diluent for serum folate, carbohydrate antigen 19-9 (CA 19-9), and carbohydrate antigen 27-29 (CA 27.29). Methods/Case Report For each test, samples from 5 patients were tested in duplicate, and average of the results was considered the target value (results within undiluted AMR). Subsequently, the samples were diluted 20-fold with either MD or saline, tested in duplicate and average of the results was compared to the target value. The diluent was considered acceptable for use if the difference or % difference between diluted vs target value was less than the Total Allowable Error (TEA). Results (if a Case Study enter NA) For serum folate and CA 19-9, the bias between diluted and target value for each diluent (saline and Multi-diluent) was < TEA, and the average bias was also < TEA. For CA 19-9, the average difference from target for saline was smaller than that for Multi-diluent, suggesting it performs better (p-value of 0.0035). However, saline was not an acceptable diluent for CA 27.29 as the bias exceeded TEA. Conclusion Saline was an acceptable alternative diluent for serum folate and CA 19-9 but not for CA27.29.

Validating a Pneumatic Tube System for Blood Product Delivery

Abstract Introduction/Objective Timely delivery of blood products can be of utmost importance to providing quality care. We aimed to validate the use of a high-speed pneumatic tube system (PTS) that was already installed at our hospital. By reducing delivery times, patient resuscitation and survivability can be increased. Methods/Case Report We followed the Association for the Advancement of Blood & Biotherapies (AABB) guidelines to validate a PTS in a large tertiary academic medical center. The requirements include: verifying product suitability, ensuring product integrity, temperature monitoring, transportation time measurements, and proper packaging and tracking of product receipt. We validated the transfer of packed red blood cells (PRBC), plasma, platelets, and cryoprecipitate from the central blood transfusion services lab (BTS) to nursing stations in a separate building up to 1500 feet (>1/4 mile) away using a Swisslog Translogic® PTS Inclusion with foam inside the PTS carriers helped reduce bumps during transit and insulated products from heat. Results (if a Case Study enter NA) The mean temperature of the PRBC was 6.6 degrees Celsius and none exceeded the AABB maximum of 10 degrees Celsius. The mean time for blood products transit to the nursing stations was 3 minutes (m) and 33 seconds (s). The median time was 3m 31s, and it ranged from 2m 18s to 5m 38s. The PTS reduced delivery times of blood products by up to 10-12 minutes compared to manual porters. Conclusion Transporting blood products via PTS is an efficient method that reduces the required manpower and leads to better utilization of resources. However, it is essential to validate the PTS system before implementing it operationally.

Tracking Blood Product Wastage over a 6-year Period in Virginia Commonwealth University Medical Center

Abstract Introduction/Objective Blood transfusions are a necessary practice for hospital emergency and surgical department. In emergent situations, blood components are in unmonitored settings during transit of critically ill patients. Any unused blood products are returned to the blood banks outside of a controlled temperature environment and are no longer viable to use. This study seeks to collect the average amount of blood products wasted in the Emergency and Surgery Department at Virginia Commonwealth University’s (VCU) Main Hospital. In addition, the study intends to highlight the budget that is impacted by these wasted blood units. Methods/Case Report Emergency Stock Records of VCU’s Hospital Emergency Department, Operating Room, Children’s Hospital of Richmond’s (CHoR) Emergency Department, and the CHoR’s Operating Room were collected and accumulated by the Transfusion Service’s Quality Assurance Coordinator. VCU’s Main Hospital Emergency Department monitors blood unit viability with a sensitive temperature indicator on each unit of blood stored in unmonitored refrigerators. Blood units above 10 degrees Celsius trigger the indicator and are required to be discarded. Our study collected a tally of these discarded units due to a triggered temperature indicator from 2018 to 2023. Acquisition cost per blood unit was estimated to be approximately $250 and overhead cost per unit was estimated to be $760. Results (if a Case Study enter NA) From 2018 to 2023, VCU’s health system wasted an average of 89.16 blood units per year due to the triggered temperature indicators, with a total of 535 units wasted over six years. The average annual cost of the wasted units totaled $90,058.33 per year ($22,291.67 and $67,766.67 in acquisition and overhead costs, respectively); cumulative cost over the 6 years amounted to $540,350 ($133,750 and $406,600 in acquisition and overhead costs, respectively). Conclusion With a notable number of resources and funding lost in the process due to blood unit wastage, an administrative discussion should focus on the use of high-level remote- controlled automated refrigerators in lieu of manual temperature indicator to reduce the expenditure and wastage of blood products.

Effects of winter soil warming on crop biomass carbon loss from organic matter degradation

Global warming poses an unprecedented threat to agroecosystems. Although temperature increases are more pronounced during winter than in other seasons, the impact of winter warming on crop biomass carbon has not been elucidated. Here we integrate global observational data with a decade-long field experiment to uncover a significant negative correlation between winter soil temperature and crop biomass carbon. For every degree Celsius increase in winter soil temperature, straw and grain biomass carbon decreased by 6.6 ( ± 1.7) g kg-1 and 10.2 ( ± 2.3) g kg-1, respectively. This decline is primarily attributed to the loss of soil organic matter and micronutrients induced by warming. Ignoring the adverse effects of winter warming on crop biomass carbon could result in an overestimation of total food production by 4% to 19% under future warming scenarios. Our research highlights the critical need to incorporate winter warming into agricultural productivity models for more effective climate adaptation strategies.

Low temperature machining advantages for sintered NdFeB magnets: A comparative experimental study of WAWJ with laser and WEDM

Sintered NdFeB magnets exhibit excellent magnetic properties and high reliability, making them widely used in fields such as new energy vehicles and electronic communications. However, NdFeB magnets have a low Curie temperature and poor thermal stability. Common machining methods such as laser cutting and EDM (Electrical Discharge Machining) often involve cutting temperatures in the hundreds or even thousands of degrees Celsius, leading to defects such as melting and cracks on the magnet surface. These defects degrade the surface quality and magnetic properties of the magnet. To avoid thermal damage to the magnet during processing, WAWJ (Wet Abrasive Waterjet) cutting was employed on sintered NdFeB. Experimental results indicate that at an ambient temperature of 4.5 °C, the maximum cutting temperature remains below 50 °C, with an average cutting temperature below 25 °C. No heat-affected zones or oxidation layers are exhibited on the cutting surface of the magnet. Jet pressure is identified as the primary factor influencing the maximum cutting temperature, accounting for 96.13 %. With jet pressure increasing from 200 MPa to 280 MPa, the maximum cutting temperature rises from 38.7 °C to 47.9 °C. Furthermore, to validate the necessity of low-temperature cutting for NdFeB magnets, WEDM (Wire Electrical Discharge Machining) and laser cutting were employed on sintered NdFeB magnets. The cutting surfaces of both methods exhibit defects such as cracks, craters, and melting. Compared to the original magnet surface, no significant changes in elemental content were observed on the WAWJ-cut surface. Under high-temperature conditions, the oxidation rate increased, leading to a 18.9 % and 19.8 % increase in oxygen content on the WEDM and laser machined surfaces, respectively. Some neodymium (Nd) and iron (Fe) elements exist in the form of oxides such as FeO and Nd2O3, resulting in loss of magnetism. Moreover, the presence of oxides reduces the continuity of magnetic phases, adversely affecting the magnetic properties of the magnet.

High Mortality Rates and Antimicrobial Resistance in Children with Invasive Bacterial Infections in a Tertiary Care Facility in West Africa

Abstract Background Childhood data on infection mortality and antimicrobial resistance in Sub-Saharan Africa are emerging but remain limited. The University of Maryland Center for Vaccine Development (CVD) and CVD-Mali have been conducting a prospective observational study at L’Hopital Gabriel Toure (HGT), a referral hospital in Bamako, Mali, since 2002 to identify causes of invasive bacterial infections (IBI) in children. These data have been used to initiate vaccination programs to decrease the burden of Haemophilus influenzae type b and Streptococcus pneumoniae. Additional demographic and antimicrobial susceptibility data have been collected since 2021, allowing for more detailed resistance and mortality analyses. Methods All children presenting to HGT are screened. Children ages 0-15 years with temperature of at least 39 degrees Celsius and/or suspicion of IBI are eligible. Eligible children have blood cultures collected with additional site-specific cultures when focal infection is suspected. Cultures are performed using the Bactec system; when positive, Gram staining, sub-culturing, and antimicrobial susceptibility testing (by disk diffusion using standard methods) are performed. Organisms thought to be contaminants are excluded. American type culture collection strains are utilized for quality control. Results Between 1/14/2021 and 9/14/2023, 28703 patients were screened. 2156 patients were included. 212 patients (10%) had 235 pathogens isolated. Gram positive organisms were most frequently isolated (N=112), followed by Gram negative Enterobacterales (N=81), non-Enterobacterales Gram negatives (N=36), and yeast (N=6). Staphylococcus aureus was the most frequently isolated Gram positive organism (59 bloodstream isolates, 2 joint isolates, 2 subcutaneous isolates) followed by S.pneumoniae (10 bloodstream isolates, 17 cerebrospinal fluid isolates, 1 joint isolate) and Enterococcus species (16 bloodstream isolates). Klebsiella pneumoniae (28 bloodstream isolates, 2 cerebrospinal fluid isolates) and Escherichia coli (18 bloodstream isolates, 3 cerebrospinal fluid isolates, 2 subcutaneous isolates) were the most frequently isolated Gram negative Enterobacterales, with Pseudomonas species most common among non-Enterobacterales Gram negative organisms (16 bloodstream isolates, 1 cerebrospinal fluid isolate). Mortality rates in both culture-positive and culture-negative patients were high (52% and 28%, respectively), with greater than 50% of deaths occurring within 48 hours in both groups. 88% of Gram negative Enterobacterales were ceftriaxone resistant or intermediate, with 56% ciprofloxacin resistant or intermediate; 55% of isolates were resistant or intermediate to both. 71% of isolates were gentamicin resistant. Imipenem resistance remained low, with 91% of isolates retaining sensitivity. 24% of S. aureus isolates were oxacillin resistant and 34% of isolates were resistant or intermediate to trimethoprim/sulfamethoxazole. 100% of S. aureus isolates tested (14/60) retained sensitivity to clindamycin. Only 54% of pneumococcal isolates had positive oxacillin screens, implying frequent penicillin resistance, and only 60% of enterococcal species were ampicillin sensitive, although 92% retained vancomycin sensitivity. Conclusion We found higher mortality rates in our study than in similar studies; the contribution of issues such as limited access to advanced supportive care and delay in presentation is an area for further study. The high frequency of multidrug-resistant organisms is alarming, suggesting an urgent need to investigate underlying contributing factors, increase access to affordable broad-spectrum antibiotics, and create robust antimicrobial stewardship programs.

Adoption of a Semi-elective Lung Transplantation Practice by Safely Extending Cold Ischemic Times

Lung transplantation is a complex surgical procedure performed by specialized teams. Practice changes to eliminate overnight lung transplants were implemented at our center and patient outcomes were evaluated. Patient and donor organ selection were performed in the standard fashion. All donors with a cross clamp after 6 PM matched to any of our listed recipients-independent of their surgical complexity or risk-were kept in a temperature-controlled iceless cooler from procurement to recipient implant. All recipients had a 7 AM in-room start. Data were prospectively collected and compared to a cohort of recipients from the previous fifteen months. 82 transplants were performed at a single academic institution between 7/1/22 and 1/7/24, 21% of which included allografts with extended ischemic times utilizing the iceless cooler (n=18) with a median average temperature of 6.81 degrees Celsius. Median ischemic times were 13.9 (12.5 - 15.6) hours, more than twice the length of ischemic times in the standard group (n=64, 6.8 (6.1 - 7.4) hours). Post-operative outcomes were similar between groups, including post-operative ICU duration (12 vs 9 days in the standard group), length of stay (24 vs 20 days), PGD3 (17% vs 20%), post-operative ECMO (22% vs 20%), and six-month survival (94% vs 91%). Donor lungs preserved in an iceless cooler were successfully transplanted after extended cold ischemic times. Adoption of a semi-elective transplant strategy can be successfully implemented without compromising patient outcomes. Additional advantages may be gleaned through daytime transplantation with standard transplant surgical teams rather than overnight, on call-teams.

Implementasi Hot Pack Untuk Peningkatan Suhu Tubuh Pada Pasien Hipotermi Pasca Operasi

Introduction: As a kind of therapy, surgery involves cutting into the patient in order to reach the targeted location of the body. The risk of hypothermia is a potential consequence of anesthesia. A dangerous drop in core temperature, below 36 degrees Celsius, causes hypothermia. One way to alleviate cold symptoms is using a warm compress. An alternative to using hot packs to raise core temperature is a warm compress. Hot packs have many advantages over buli-buli, the most notable of which is that they can be reused and never run out of steam. Objective: This community service activity is to implement hot packs on hypothermic patients. Method: As part of their community service, volunteers take patients' temperatures using electronic thermometers. Including thirty individuals who were found to have hypothermia. Result: Impact of Volunteer Work Hypothermia after administration of a hot pack, with a pre-package average temperature of 35.20 degrees Celsius Average core temperature before administration of the hot pack: 36.50 °C Body temperature values ranged from 34.10C before implementation to 36.70C thereafter, with a low value of 35.10C and a high value of 35.90C before and after, respectively. Conclusion: This proves that there is an increase in body temperature in hypothermic patients after implementing Hot packs.

A-123 Comparative Assessment of Unmanned High-Speed Aerial Vehicles in Medical Logistics: Blood Sample Transportation Amidst Weather Variability

Abstract Background Drones, as an innovative technology, hold transformative potential in the field of medical logistics, especially in the transportation of sensitive medical materials like blood samples. This study aimed to assess and compare the impact of high-speed drone transportation with conventional car transportation on the integrity and preanalytics of blood samples, taking into account various blood materials and analytes. Methods Blood samples, including EDTA whole blood, serum, and plasma anticoagulated with Citrate and Lithium-Heparin transported as whole blood, were subjected to transportation via both drone and car. Drone flights were tested under diverse weather conditions (ranging between 4 and 20 degrees Celsius), and results were compared to samples stored without transportation. The maximum drone speed exceeded 100 km/h. A total of 28 analytes were tested on Serum, 20 on EDTA, 26 on Lithium-Heparin, and 5 on Citrate blood. Statistical analyses were performed using Passing Bablok and Bland-Altman methods. Results For Serum samples, the correlation coefficient (r) ranged from 0.830 to 1.000, and slopes varied from 0.913 to 1.111. Five analytes (total bilirubin, Calcium, Ferritin, Kalium, and Sodium) exhibited discrepancies between the negative control and the transported sample, with r lower than 0.800, slopes not between 0.8 and 1.2, and mean (%) not between +/- 10%. However, no significant differences were noted between drone and car transportation. Similar patterns emerged for EDTA, Lithium-Heparin, and Citrate samples, with r ranging from 0.829 to 0.997, 0.939 to 0.998, and 0.830 to 1.000, respectively. Slopes ranged from 0.956 to 1.051, 0.938 to 1.085, and 0.913 to 1.111. Despite identifying a few discrepancies in specific analytes, no significant differences were observed between transportation methods. Conclusions n comparison to transportation by car, drone transportation of blood samples did not lead to alterations in concentrations of commonly used analytes. Notably, instances of differences before and after transportation were attributed to the transportation process itself rather than the mode of transportation. This suggests that the use of drones for medical sample transport can be deemed comparable to, if not superior to, traditional car transportation methods.

A Study on the Energy Efficiency of an Energy Management System for Convenience Stores

This research presents a solution for improving energy efficiency in convenience stores by implementing a building energy management system (BEMS) that uses new logic control in air conditioning and refrigeration systems. These systems currently consume the most energy in convenience stores. Implementing this system not only reduces the energy consumption of the compressors in both systems but also minimizes energy loss due to low desired temperatures in the sale area while maintaining the cabinet temperature at the same level. An experiment was conducted at a 314-square-meter convenience store that was open from 6:00 a.m. to 11:00 p.m., and we demonstrated a 4.4-year payback period by controlling AC units close to the desired sale-area temperature of 25 degrees Celsius and increasing the suction pressure at a medium-temperature CDU by 0.3 bar or 31 kPa. This resulted in energy savings of 7.1 kilowatt-hours per day, or 2591.5 kilowatt-hours per year, for the air conditioning system and 2.8 kilowatt-hours per day, or 1022.0 kilowatt-hours per year, for the refrigeration system, resulting in a total energy savings of 9.9 kilowatt-hours per day, or 3613.5 kilowatt-hours per year. The convenience store can use the results of this research to improve the energy efficiency of its cooling system, which includes air conditioning and refrigeration systems, thereby promoting sustainable energy conservation.