Mean Increase Research Articles

Characterization of a cohort of Angolan children with sickle cell anemia treated with hydroxyurea

BackgroundSickle Cell Anemia (SCA) is a monogenic disease, although its severity and response to treatment are very heterogeneous. ObjectivesThis study aims to characterize a cohort of Angolan children with SCA and evaluate their response to hydroxyurea (HU) treatment and the potential side effects and toxicity. MethodsThe study enrolled 215 patients between 3 and 12 years old before and after the administration of HU, at a fix dose of 20 mg/kg/day for 12 months. ResultsA total of 157 patients started HU medication and 141 of them completed the 12-month treatment. After initiating HU treatment, the frequency of clinical events decreased (transfusions 53.4 %, hospitalizations 47.1 %). The response to HU medication varied among patients, with some experiencing an increase in fetal hemoglobin (HbF) of <5 %. The mean increase in HbF was 11.9 %, ranging from 1.8 % to 31 %. Responders to HU treatment were 57 %, inadequate responders 38.7 % and non-adherent 4.2 %. No clinical side effects related to HU were reported. Hematological toxicities were transient and reversible. Children naïve to HU and with lower HbF reported higher number of hospitalizations caused by malaria infection. During HU treatment, the frequency of malaria episodes did not appear to be affected by HbF levels. Conclusionsthe present study provided a valuable contribution to the understanding of the clinical and laboratory profiles of Angolan children with SCA. These findings support the evidence that the implementation of prophylactic measures and treatment with HU is associated with increased survival in children with SCA.

Evaluation of net carbon sequestration and ecological benefits from single biochar-incorporated sorghum farmland systems in saline-alkali areas of Inner Mongolia, China

Biochar is widely recognized as a soil amendment to reduce greenhouse gas emissions and enhance soil carbon storage in agroecosystems; however, the systematic focus on carbon balance and ecological benefits in cropping systems remains unclear in saline-alkali areas under water-saving irrigation. Here, a 2-yr field experiment with carbon footprint method was conducted to determine soil carbon budgets, biochar carbon efficiency performance, and the economic and ecological benefits of mulched drip-irrigated sorghum production, in an arid salinized region of Inner Mongolia, China. Corn straw-derived biochar dosages of 0 (CK), 15 (B15), 30 (B30), and 45 (B45) t hm−2 were just applied into the soil in the first crop growing season. A single application of biochar to soil significantly reduced CO2 emissions for the current and subsequent crop-growing seasons, with 13.1%, 16.7%, and 12.5% reductions for B15, B30, and B45, respectively. Compared with the non-biochar control plots, B15, B30, and B45 also increased NPP by 36.7%, 38.4%, and 27.1%, respectively. The actual effects on improving net carbon sequestration for B15, B30, and B45 in the first year were higher than those in the second year, with mean increases of 1.27, 1.47, and 1.36 times, respectively; however, the efficiencies of biochar for fixing carbon per biochar dosage input for B15 were 72.8% and 64.1% higher than those of B30 and B45, respectively. Net profits were significantly improved by 57.2–87.1% by biochar treatments. The environmental benefits of biochar carbon trading revenues for B15, B30, and B45 increased by 105.9%, 162.1%, and 109.6%, respectively. The minimum observation for carbon productivity and the maximum measurements for both the economic and ecological benefits were B15. The B15 also significantly increased sorghum yield and grain number. Results demonstrate that biochar application in the current growing season helps reduce soil carbon emissions, increases net carbon sequestration for current and subsequent sorghum agroecosystems, and enhances net profit and ecological benefits. The optimal positive synergistic effect was observed at a biochar application rate of 15 t hm−2 for reducing soil carbon emissions, increasing crop production, and improving the ecological environment.

Productivity of the Common as Property in the Context of the Symbolic Propertization of Indigenous Knowledge: The Biopolitics of Traditional Malay Wau Bulan and Wau Kucing Kelantanese Kite Making as State Symbolic Property

This essay examines factors responsible for the increase of productivity in traditional Malay wau bulan and wau kucing kite-making, indigenous to the Malaysian state of Kelantan and appropriated by the state as a common biopolitical production and symbolic property. This increase in productivity means increased accessibility of the commons among the community, achieved through state economic support and efforts by the community and state to promote the kite-making craft. Such increased productivity contradicts Michael Hardt’s reasoning that property’s productivity is usually reduced. Extending Hardt’s theory to Ernesto Laclau’s ideas on the relationship between the particular and the universal, the essay argues that the symbolic propertization of Kelantan kite making does not reflect a distinction between the kites’ qualities as common versus symbolic property. Input from selected authoritative kite-making practitioners and recent cultural memory shows that the Kelantan community benefits economically from the state’s appropriation of its traditional kites.

Corneal tomography changes following major (6 mm) medial rectus muscle recession: a prospective cohort study using Pentacam®

ABSTRACT Introduction The aim of this study is to evaluate changes in corneal astigmatism, axial anterior corneal curvature, as well as changes in the anterior chamber depth and central corneal thickness, 2 months following the unilateral recession of medial rectus muscle in children. Methods Thirty-three children with esotropia were prospectively evaluated following unilateral medial rectus muscle recession, using Pentacam®. Comparisons were made between the operated and fellow unoperated eyes, pre, and postoperatively. The assessment was made for changes in the radius of axial curvature on major meridians at 3 and 3.5 mm from the optical corneal center in the mid-peripheral zone. Astigmatism changes of the anterior and posterior corneal surface were calculated using vector analysis software (astigMATIC®). ANOVA model was used to examine the interaction between age or central corneal thickness and postoperative changes in anterior and posterior surface corneal astigmatism. Results In the intervention group, changes in anterior and posterior corneal surface astigmatism were statistically significant, with a mean increase of 0.59Dx92 and 0.08Dx91, respectively. In the mid-peripheral corneal zone, there is an increase in the radius of anterior corneal axial curvature more evident nasally 3.5 mm from the corneal center on the horizontal meridian, with corresponding decrease superiorly and inferiorly at 3 and 3.5 mm from the corneal center on the vertical meridian. Discussion The changes in total astigmatism of the operated eyes are mainly attributed to the anterior corneal surface. These changes are associated with flattening in the 180 meridian of the cornea, leading to a shift to “with-the-rule” astigmatism.

Assessment of basic life support theoretical knowledge of football coaches after traditional and online education

Athletes are at risk for cardiac arrest and arrhythmia due to high physical activity during intense training and matches. When such a situation occurs, it is crucial that those around the athlete are able to provide basic life support (BLS) to prevent death from out-of-hospital cardiac arrest. Therefore, in this study, football coaches were given both online and traditional face-to-face BLS training, and then it was aimed to investigate whether the training model affected the increase in BLS knowledge. The study was conducted between 21 April and 21 May. A pre-test measuring theoretical BLS knowledge was applied to 261 football coaches. Then the coaches chose voluntarily basis what type of BLS training (traditional or online) they would receive. After the training, the post-test was applied to the participants. The obtained results were evaluated and the score increases between the 2 groups were compared. The overall level of knowledge was significantly higher in both course models after education (64&gt;86.5 for the Traditional group and 63.9&gt;83.6 for the Online group). Results showed that the mean increase in post-test scores was higher in the traditional education group (22.5 points for the traditional group and 19.6 points for the online group, p&lt;0.001). In conclusion, although traditional education seems to be more successful than online education in our study, there is no clear answer about the effectiveness of tranining models. Online BLS education may serve as an alternative to traditional education for groups that cannot participate in traditional education. Rather than choosing one over the other, an adaptive approach can be tailored to the needs of different groups.

"Submarine-Shaped" Radial Forearm Flap for Simultaneous Reconstruction of Oral and Lower Lip Defects".

Reconstruction of the oral cavity commonly results in trismus and lip incompetence. In this study, we aim to describe an innovative design of a radial forearm free flap for resurfacing bilateral buccal defects and simultaneous functional lower lip reconstruction in a single stage. Between January 2010 and December 2019, 6 males underwent simultaneous buccal and lower lip reconstruction with a radial forearm free flap. The mean age of the patients was 57.3 years (range, 50-68 years). The defects were caused by trismus release and due to previous treatments. The mean size of the defects was 17.9 cm in length and 3.25 cm in width. Flaps were harvested, including the proximal perforators of the radial vessels, and the inset began in the buccal area opposite the anastomosis side. Flap size ranged from 16 to 21 × 2 to 4 cm. The recipient vessels used were the superficial temporal (4) and facial (2). All flaps survived. Lip infection was seen in 2 cases and managed conservatively. The mean follow-up was 19.2 months (range, 12-28 months). The mean increase in the interincisal distance was 10.7 mm. Oral continence was good in all patients. Speech intelligibility was considered total in 4 patients and partial in the remaining 2. The radial forearm flap constitutes an option for simultaneous lower lip reconstruction and resurfacing of bilateral buccal areas after trismus release. The procedure provides a thin and pliable reconstruction using only 1 donor site and 1 set of recipient vessels.

Fluctuations in extreme temperatures in northern Morocco and the impact of climate change: Contribution of the Regional Climate Model (RegCM)

In this study, we use the RegCM4.6 regional climate model to simulate extreme air temperatures in northern Morocco, with a focus on the Tangier-Tetouan-Al Hoceima (TTA) region. In pursuit of this, we evaluate its performance by comparing its simulations with CRU observational data and HadGEM2-ES historical simulations over 35 years for the purpose of predicting future temperature evolution by the end of the century in the region using the validated RegCM4.6 model. The results show a slight underestimation of temperatures compared to observations, with a preference for the RegCM4.6 model over HadGEM2-ES. Projections indicate a mean temperature increase of 2°C (RCP4.5) to 4.62°C (RCP8.5) by 2099, highlighting the need for regional adaptation strategies.

The Effect of Semangit Tempeh Cookies on MUAC, Hb, and Serum Ferritin in Pregnant Women with CED

This study aimed to analyze the effect of semangit tempeh cookies on Mid-Upper Arm Circumference (MUAC), Hemoglobin (Hb), and Serum Ferritin (SF) of pregnant women with Chronic Energy Deficiency (CED) in Lebak, Banten. The study included 47 pregnant women with MUAC&lt;23.5 cm who were divided into Control Group (CG) (n=22) and Intervention Group (TSG) (n=25). The mean increase in MUAC in the intervention group was 0.72±0.97 cm, while that in the control group was 0.75±1.23 cm (p&gt;0.05), and there was an increase in hemoglobin levels of 0.84 mg/dL in the control group and 0.18 mg in the intervention group. The level of adherence to consumption of semangit tempeh cookies in the intervention group was lower than in the control group (p&gt;0.05). The supplemental feeding of semangit tempeh cookies to pregnant women in intervention group did not have a significant effect on MUAC, Hb and serum ferritin compared to control group.

Holistic Treatment of Inflammatory Disease for the Mobility Impaired

Background: Previous studies have demonstrated the positive impact of yoga and deep breathing exercises on overall physical wellness. The effects of deep breathing alone on metabolic rate, weight, and cholesterol management have not been studied well. Objective: This study assessed changes in C-Reactive Protein (CRP) following a 60-day intervention of a 12-minute deep breathing program. Methods: Sixty-six participants with a BMI &gt;27 kg/m2 and 18 years - 70 years were enrolled in this study. Participants were assigned to either the control or intervention group in a single-blind manner. The intervention group followed the novel deep breathing program, while the control group did not modify their lifestyle or exercise. Anthropometric measurements and metabolic markers were evaluated and compared between the two groups after 60 days. Results: After 60 days, the control group exhibited a mean increase change in CRP of 3.9%. The intervention group showed a mean reduction of CRP by 25%. Conclusion: A guided daily 12-minute-deep breathing program can lead to reductions in inflammation marker CRP even without additional lifestyle modifications or medication modifications. Further investigations are warranted to explore the effects of novel deep breathing programs on metabolic markers and elucidate the underlying mechanisms of CRP reduction.

Impact of Teaching Nutritional Biochemistry Concepts Using Pop Culture: Why Zombies Crave Brains

In recent years, the allure of zombie culture has found its way into innovative teaching of biology and medical courses. In this current example, we employ zombie imagery and context to facilitate an understanding of applied nutritional biochemistry. This novel approach is compared to teaching identical material using traditional examples and context. Specifically, we investigated the impact on short-term and long-term learning by incorporating zombie lore into the delivery of a lecture on the inflammatory cascade as it relates to essential fatty acids. We hypothesized that given the popularity of zombies and dystopian/apocalyptic environments, intertwining nutritional concepts with these dramatic scenarios would enhance interest and attention, hence improving learning. Two presentations were offered in basic nutrition (synchronous) or introductory anatomy and physiology (asynchronous). This audience was selected to ensure minimal baseline knowledge on the topic of essential fatty acids. Half of the students received a non-zombie lecture while half received the same information as it relates to zombies. Learning was assessed using a five-question survey. Testing was conducted before, immediately following, and 4 weeks after the lecture. The mean score increase pre- versus post-test in both groups was dramatic but not significantly different between groups (zombie vs non-zombie and synchronous vs asynchronous). Results were as follows: the pre-test average for both groups was 42.37%; the immediate post-test average was 85.96%. At 4 weeks, the average performance dropped to 70.30%. On average, students indicated a mild interest in zombies. In this instance, teaching with pop culture did not significantly impact short-term or long-term retention.

WDEP Strategy for Increasing the Meaning of Life of High School Students

Meaning of Life is an important part of students' future where the problems in it are related to students' psychology and have an impact on their learning activities at school. The aim of this research is to find out whether the WDEP strategy is able to increase students' Meaning of Life. This research is quantitative research where data was obtained from class XII students. Data was collected using questionnaires, interviews and observations. After the data was obtained, the data was analyzed using a paired t-test. The results of this research show that the Wilcoxon test regarding increasing the Meaning of Life of students obtained a calculated Z value of -2.810 where the Asymp Sig (2-tailed) value was 0.00. These results indicate that the Asymp sig value is less than 0.05 (0.00 0.05). These results indicate an increase in students' Meaning of Life after receiving WDEP treatment. This shows that Ho is rejected and Ha is accepted. These results show that the WDEP strategy is able to increase students' Meaning of Life. With WDEP, students have clear goals, life satisfaction, freedom of will, self-control, and attitudes towards death and are able to have a reason to continue to exist.

Evaluation of the FAST HUG implementation effect on the mortality and length of stay in admitted patient in Intensive Care Unit (ICU) of a hospital

Objective: We aimed to determine new version of the FAST HUG implementation effect on the mortality and length of stay in admittedpatient in Intensive Care Unit (ICU) of a hospital. Methods: We conducted a prospective cohort study on 406 patients who admitted in medical and surgical ICU of Imam Hossein Hospitalof Tehran province in Iran from July 1, 2022, to September 30, 2022. We identified predictors of ICU mortality by logistic regression model,predictors of 28-day mortality/re-hospitalization/recovery by generalized ordered logit model, predictors of length of stay (LOS) by linearregression, predictors of mechanical ventilation by generalized ordered logit and predictors of SOFA score by hurdle model. Results: This mnemonic had protective impact (OR = 0.56, P-value = 0.01) on the 28-days mortality. One unit increase in mean of FAST HUGscore had a preventive effect on the outcome of death (OR = 0.21). Surgical admission type (Coefficient = –3.24, P-value = 0.00) and FASTHUG implementation (Coefficient =1.58, P-value= 0.0) were strongest factors on the LOS. Conclusion: Our study results approved the importance of the FAST HUG implementation on the decrease of patient mortality in ICU and28 days after discharge. Additionally, this checklist had a statistically significant role in declining SOFA scores in ICU patients.

Efficient population representation with more genetic markers increases performance of a steelhead (Oncorhynchus mykiss) genetic stock identification baseline.

Genetic stock identification (GSI) is an important fisheries management tool to identify the origin of fish harvested in mixed stock fisheries. Periodic updates of genetic baselines can improve performance via the addition of unsampled or under-sampled populations and the inclusion of more informative markers. We used a combination of baselines to evaluate how population representation, marker number, and marker type affected the performance and accuracy of genetic stock assignments (self-assignment, bias, and holdout group tests) for steelhead (Oncorhynchus mykiss) in the Snake River basin. First, we compared the performance of an existing genetic baseline with a newly developed one which had a reduced number of individuals from more populations using the same set of markers. Self-assignment rates were significantly higher (p < 0.001; +5.4%) for the older, larger baseline, bias did not differ significantly between the two, but there was a significant improvement in performance for the new baseline in holdout results (p < 0.001; mean increase of 25.0%). Second, we compared the performance of the new baseline with increased numbers of genetic markers (~2x increase of single-nucleotide polymorphisms; SNPs) for the same set of baseline individuals. In this comparison, results produced significantly higher rates of self-assignment (p < 0.001; +9.7%) but neither bias nor leave-one-out were significantly affected. Third, we compared 334 SNPs versus opportunistically discovered microhaplotypes from the same amplicons for the new baseline, and showed the latter produced significantly higher rates of self-assignment (p < 0.01; +2.6%), similar bias, but slightly lower holdout performance (-0.1%). Combined, we show the performance of genetic baselines can be improved via representative and efficient sampling, that increased marker number consistently improved performance over the original baseline, and that opportunistic discovery of microhaplotypes can lead to small improvements in GSI performance.

Impact of Counseling on Patient Education and Dietary in Quality of Lifestyle and Nutritional Anemia in Diabetes Mellitus Patient: A Case-Control Study

The study’s goal was to see how w education and dietary guidance improved the quality of lifestyle and nutritional anemia in people with diabetes type 2. This 6 month prospective study was conducted in a hospital in Jaipur, Rajasthan. The demographic information (age, gender, social position, and economic status) was gathered using a form HRQoL after gaining the patient’s assent. In the intervention group n is 21 and also in the control group n is 21 so the total; patient was chosen 42. The baseline Hb and health-related quality score were taken in consideration in 1, 2 and baseline visits in a month-long study as a part of the design. Each visit concluded with the measurement of the hemoglobin level and health-related quality of life scores for both the intervention and control groups. The intervention group’s Hblevel changed significantly more than the control group’s after the nutrition education intervention finished [0.56–0.40 vs. 0.16–0.82 gm/dl, p = 0.002]. In contrast to the control group, where the mean increase in general health from baseline to second follow-up was statistically insignificant, the intervention group’s mean increase in general health from baseline to second follow-up was found to be significant as from the result obtained. Thus, nutrition education was found to be substantially linked to higher Hb levels, better dietary consumption, and improved health-related quality.mmune inflammatory illness distinguished by inflammation of hands, knees, wrists, and feet, causing bone and cartilage degradation, joint deformity, and muscle atrophy and thus movement limitations. Inflammatory mediators like necrosis factor and interleukins along with other inflammatory cytokines, execute a vital role in the initiation and advancement of rheumatoid arthritis (RA) as well as muscle atrophy. Existing literature discusses extensively the RA condition. However, the muscle atrophy related to this condition has received little attention, despite the substantial role of muscle atrophy in morbidity caused by RA. The review aims to highlight the relationship between muscle atrophy and RA, the mechanisms of muscle atrophy in RA and the association between oxidative stress and muscle atrophy in RA. This review will be useful for getting insights into the etiopathogenesis of muscle atrophy brought on by rheumatoid arthritis and available treatment alternatives for RA and muscle atrophy caused by RA. Discussion on the potential therapeutic targets and agents to treat skeletal muscle atrophy will help advance the knowledge to improve the condition of muscle atrophy associated with RA.

Safety and efficacy profile of intravitreal ranibizumab vs dexamethasone in treatment of naïve diabetic macular edema.

To compare the safety and efficacy parameters of intravitreal ranibizumab vs intravitreal dexamethasone (IVD) in the treatment of patients with naïve diabetic macular edema (DME) in terms of best-corrected visual acuity (BCVA), central macular thickness (CMT), and possible complications like intraocular pressure (IOP) rise and cataract progression. A hospital-based prospective and comparative study of naïve DME patients was conducted between November 2020 and October 2021 with a minimum follow-up (F/U) period of 6 months. Thirty phakic patients received one dose of IVD implant (Group A) and the other 30 (Group B) received three consecutive monthly doses of ranibizumab. The main exclusion criteria were steroid responders and the presence of ocular inflammation. The mean pre-injection CMT in Group A was 405µ and reduced to 297.07µ at 3 months and 278.35µ at 6 months. Mean increase in logMAR BCVA was 0.55. The mean pre-injection IOP was 16.28 and 17.64 mm of Hg at 6 months. In Group B, the mean pre-injection CMT was 401.07µ and reduced to 276.1µ at 3 months and 292.9µ at 6 months. Mean BCVA increased to 0.37. The mean pre-injection IOP was 17.28 mm Hg and 16.42 mm Hg at 6 months. There was no significant progression of cataract in both groups. The mean decrease in CMT was comparable in both the groups at 6 months F/U with an improvement of BCVA with no significant IOP fluctuation or cataract progression. Hence, IVD appears to be noninferior to ranibizumab in the treatment of naïve DME.

Engineering of CD34+ progenitor-derived natural killer cells with higher-affinity CD16a for enhanced antibody-dependent cellular cytotoxicity

Background aimsNatural killer (NK) cell transfer is a promising cellular immunotherapy for cancer. Previously, we developed a robust method to generate large NK cell numbers from CD34+ hematopoietic stem and progenitor cells (HSPCs), which exhibit strong anti-tumor activity. However, since these cells express low levels of the Fc receptor CD16a in vitro, antibody-dependent cellular cytotoxicity (ADCC) by these cells is limited. To broaden clinical applicability of our HSPC-NK cells toward less NK-sensitive malignancies, we aimed to improve ADCC through CD16a transduction. MethodsUsing wildtype and S197P mutant greater-affinity (both with V158) CD16a retroviral transgenes (i.e., a cleavable and noncleavable CD16a upon stimulation), we generated CD16a HSPC-transduced NK cells, with CD34+ cells isolated from umbilical cord blood (UCB) or peripheral blood after G-CSF stem cell mobilization (MPB). CD16a expressing NK cells were enriched using flow cytometry–based cell sorting. Subsequently, phenotypic analyses and functional assays were performed to investigate natural cytotoxicity and ADCC activity. ResultsMean transduction efficiency was 34% for UCB-derived HSPCs and 20% for MPB-derived HSPCs, which was enriched by flow cytometry-based cell sorting to >90% for both conditions. Expression of the transgene remained stable during the entire NK expansion cell generation process. Proliferation and differentiation of HSPCs were not hampered by the transduction process, resulting in effectively differentiated CD56+ NK cells after 5 weeks. Activation of the HSPC-derived NK cells resulted in significant shedding of wildtype CD16a transcribed from the endogenous gene, but not of the noncleavable mutant CD16a protein expressed from the transduced construct. The mean increase of CD107+IFNγ+ expressing NK cells after inducing ADCC was tenfold in enriched noncleavable CD16a HSPC-NK cells. Killing capacity of CD16a-transduced NK cells was significantly improved after addition of a tumor-targeting antibody in tumor cell lines and primary B-cell leukemia and lymphoma cells compared to unmodified HSPC-NK cells. ConclusionsTogether, these data demonstrate that the applicability of adoptive NK cell immunotherapy may be broadened to less NK-sensitive malignancies by upregulation of CD16a expression in combination with the use of tumor-targeting monoclonal antibodies.

Unexpected contribution of cloud seeding to NPP increase during drought

Abstract Cloud seeding is generally used to secure additional water resources, which is not an easy goal to achieve, as the spatial variability of rainfall is high. Instead, the increased rain may moisten the neighboring forest. This study focuses on this situation and estimates the possible increase in the net primary production (NPP) due to cloud seeding. This study considers the Boryeong Dam basin in Korea as a study area and uses the Carnegie–Ames–Stanford Approach (CASA) model to estimate the NPP at 8-day intervals. As a result, first, the increase of the current 8-day NPP is greater when the rainfall amount during the last 16-day period is 50 mm or more. The mean increase of the 8-day NPP is estimated at about 1.873 g/m2 of carbon. Second, the increase of the NPP with the target 16-day rainfall of 50 mm is estimated at about 3%, which is about 4% with the target 16-day rainfall of 100 mm. Simply extrapolating the derived result to the entire forest in Korea, the increased carbon accumulation can be extended to about 0.6 and 0.8% of the total carbon emission in 2018, respectively. These amounts correspond to about 1.2 and 1.5% of the target amount of carbon reduction by 2030 in Korea.

Long-term application of controlled-release urea reduced ammonia volatilization, raising the risk of N2O emissions and improved summer maize yield

ContextWith the extensive promotion of controlled-release urea (CRU), its N-release pattern has been shown to match the crop’s N-demand period and improve crop yield by reducing N losses. Nevertheless, the impacts of CRU on summer maize yield, especially on greenhouse gas emissions, have rarely been reported during its long-term use. ObjectiveIt is necessary through long-term positioning field experiment with CRU application to investigate the regulatory mechanisms of maize yield formation, nitrogen use efficiency (NUE), ammonia volatilization and greenhouse gas emissions. MethodsThe long-term fertilizer positioning experiment for ten years, four treatments were performed: polymeric-coated controlled-release urea (CRF, 42% N, 3-months controlled-release period), sulfur-coated controlled-release urea (SCF, 35% N, 3-months controlled-release period), common urea (CCF, 46% N) and no nitrogen fertilizer (CK). ResultsResults showed that the two coated controlled-release fertilizers significantly increased NUE and dry matter accumulation in summer maize, and ultimately improved grain yield. Compared to CCF, CRF and SCF treatments increased post-silking dry matter accumulation by 16.3% and 13.3%; NUE by 42.3% and 28.9%. The 2-year mean grain yield of CRF and SCF treatment increased 9.0% and 12.4% compared to CCF treatment. CRF treatment significantly increased the NO3--N content in 0–60 cm soil layer; while CRF and SCF treatments showed a significantly higher NH4+-N concentration in the 0–20 cm soil layer than CCF treatment. Compared to CCF treatment, the CRF and SCF treatments significantly reduced peak ammonia volatilization, and the average cumulative emissions of ammonia volatilization of two years were reduced by 80.8% and 53.2%, respectively. CRF treatment had lower peak of N2O emissions but longer N2O emission duration than other N application treatments. The two-year average cumulative N2O emissions from CRF treatment increased by 49.6%, and SCF treatment increased by 61.1% compared to CCF treatment. Compared to CK treatment, total cumulative CH4 uptake was 36.1% lower in CRF treatment, 60.9% in SCF and 78.9% in CCF treatment. The higher cumulative N2O emissions from CRF and SCF treatment resulted in a significantly higher global warming potential (GWP) than CCF treatment. The two-year mean increase in greenhouse gas intensity (GHGI) was 36.2% for CRF treatment and 44.7% for SCF treatment compared to CCF treatment. ConclusionsLong-term application of coated controlled-release fertilizers could achieve high yields and nitrogen use efficiency. However, there is a risk of increased N2O emissions, causing elevated GHGI. SignificanceIn the future, it is necessary to strengthen the research on the comprehensive effects of long-term reduced application of CRU on crop yield and greenhouse gas emissions, in order to promote the wide application of environmentally friendly CRU in the field.

Climate resilience and energy performance of future buildings in Nigeria based on RCP 4.5 and 8.5 scenarios

The predicted rise in global temperature by the Intergovernmental Panel on Climate Change IPCC appeals for a review of the methods and materials used for building construction for reduced emissions and comfort in buildings. Buildings account for the most carbon emissions in the globe. This study presents the impact of temperature change across the 36 state capitals in Nigeria, and the Federal Capital Territory, FCT, based on Representative Concentration Pathways, RCPs 4.5 for 2020 and 8.5 for 2090. A simple studio apartment with optimised alternatives for retrofits and new builds was simulated using EnergyPlus for both climate scenarios to determine the strategies for improving the energy performance of future buildings. The result of the study shows a significant increase in mean monthly outdoor temperature of about 5⁰c across the states, with potential heat stress affecting buildings in future climates. Moreover, about one-third of the locations experience a shift in climatic zones to hotter ones. The impact of this climate drift will be more severe in the Northcentral and Southwest regions of the country. The design strategies recommended to mitigate the effects of a changing climate focused on building envelope insulation, thermal mass, and solar shading. The performance of the optimised models under future scenarios accounts for up to 25% and 73% savings in cooling energy for retrofits and new builds, respectively. To protect existing buildings from the impact of future climates, developers must make massive investments in solar shading of buildings. In contrast, a combination of envelope insulation and solar shading strategies proves effective for new builds.

Vaccine administration by pharmacy technicians: Impact on vaccination volume, pharmacy workflow and job satisfaction

BackgroundImmunizing pharmacy technicians (IPTs) have become more prevalent in recent years, but their impact on community pharmacy practice has yet to be determined. ObjectivesDetermine the impact of implementing IPTs on vaccination volume in a community pharmacy chain and assess pharmacy staff's perspectives on the clinical abilities of IPTs and their impact on pharmacy workflow and job satisfaction. MethodsRetrospective data analysis comparing the number of vaccines administered in a supermarket pharmacy chain from September to March 2019–2020 and 2020–2021 in pharmacies with IPT(s) versus those without IPT(s). For the secondary objective, investigators developed and deployed two role-based mixed quantitative/qualitative surveys among pharmacy staff. ResultsPharmacies with IPT(s) observed a greater mean increase in vaccination volume from 2019–2020 to 2020–2021 versus those without IPTs (+159.35 vs. +104.57, p = 0.011). Among IPT survey respondents, 50/75 (66.7%) felt more satisfied with their job after receiving immunization training. Among pharmacist respondents, 80/119 (67.3%) felt that IPTs positively impacted their job satisfaction and 61.7% felt that pharmacist clinical services were either somewhat positively affected, or positively affected. ConclusionImplementing IPTs can increase the volume of vaccines administered in a chain pharmacy and may positively affect job satisfaction and pharmacy workflow.