Primary Reliance Research Articles

Households With Access To Clean Fuels For Cooking And Associated Factors Towards Achieving Sustainable Development Goals In India: Insights From National Family Health Survey-5 (2019-21)

Background: Cooking using open fires or inefficient stoves fuelled by kerosene, biomass (wood, animal dung and crop waste) and coal generates harmful household air pollution. This study tried to estimate the proportion of Households with primary reliance on clean fuels and technology for cooking in India and determine the factors associated with it using the National Family Health Survey (NFHS) 5 data. Materials and methods: We used data from the 2019–2020, National Family Health Survey (NFHS-5) household level (IAHR7CFL) data. Clean cooking fuel was considered as household’s who are using electricity, LPG, biogas, natural gas and unclean cooking fuel was considered as any other fuel other than clean fuel. Multivariate logistic regression was performed to estimate the determinants of usage of unclean cooking fuel. Results: Total 6,36,699 households were included in final analysis. The national level proportion of household’s using clean fuel for cooking was 53%. Muslims, Sothern states, households with male Head of the Family (HoF), richest wealth index households, HoF with higher education status were more likely using clean fuels. Whereas Rural households, scheduled tribe households, households with kutcha houses, non-nuclear families and unmarried Hof were more likely using unclean fuels. Conclusions: More than 50 percentage of households do not have access to clean fuels and technologies for cooking. Focus should be on providing access to North Indian states, rural households, households with female as head of the family (HoF), HoF with poor education, non-nuclear families and Scheduled tribe households to fill the gap to achieve Sustainable Development goals (SDG) target by 2030.

Parasites provide evidence for fish consumption among Iron Age Siberian pastoralists

The subsistence economies of prehistoric pastoralists of the Eurasian steppes have long been viewed through an oversimplified model of reliance on domesticated animals. This conceptualization has begun to shift dramatically through the introduction of scientific analyses, pivoting towards an evidence-based interpretation of economic flexibility and adaptive heterogeneity. Here we provide insights into the dietary practices of Iron Age pastoralists in Siberia through an archaeoparasitological analysis. Soil samples from the Tunnug 1 site in southern Siberia reveal the presence of helminth eggs of Taenia sp. (likely), Trichuris sp., and Dibothriocephalus sp. This indicates that the diet of the analysed prehistoric population might have included beef and did include freshwater fish, occasionally consumed in undercooked or raw form. Despite the primary reliance on pastoralism and possibly small-scale millet agriculture, these populations engaged in diverse dietary practices, including fish consumption. Additionally, the presence of Trichuris sp. eggs points to poor sanitary conditions, possible consumption of contaminated plant foods, and the contamination of drinking water with feces. By providing direct evidence of dietary habits, archaeoparasitology complements isotopic analyses and contributes to a more nuanced understanding of the subsistence strategies.

AI chatbots show promise but limitations on UK medical exam questions: a comparative performance study

Large language models (LLMs) like ChatGPT have potential applications in medical education such as helping students study for their licensing exams by discussing unclear questions with them. However, they require evaluation on these complex tasks. The purpose of this study was to evaluate how well publicly accessible LLMs performed on simulated UK medical board exam questions. 423 board-style questions from 9 UK exams (MRCS, MRCP, etc.) were answered by seven LLMs (ChatGPT-3.5, ChatGPT-4, Bard, Perplexity, Claude, Bing, Claude Instant). There were 406 multiple-choice, 13 true/false, and 4 "choose N" questions covering topics in surgery, pediatrics, and other disciplines. The accuracy of the output was graded. Statistics were used to analyze differences among LLMs. Leaked questions were excluded from the primary analysis. ChatGPT 4.0 scored (78.2%), Bing (67.2%), Claude (64.4%), and Claude Instant (62.9%). Perplexity scored the lowest (56.1%). Scores differed significantly between LLMs overall (p < 0.001) and in pairwise comparisons. All LLMs scored higher on multiple-choice vs true/false or “choose N” questions. LLMs demonstrated limitations in answering certain questions, indicating refinements needed before primary reliance in medical education. However, their expanding capabilities suggest a potential to improve training if thoughtfully implemented. Further research should explore specialty specific LLMs and optimal integration into medical curricula.

Abstract We087: The mitochondrial citrate carrier SLC25A1 is a regulator of metabolic reprogramming and morphogenesis in the developing heart

Background: Congenital heart defects (CHDs) are the most common type of birth defect, yet the etiology of most CHDs are unknown. A major genetic risk factor for CHD is 22q11.2 deletion syndrome (22q11.2DS), a multisystem chromosomal microdeletion disorder where ~75% of patients present with CHD. SLC25A1 is a gene found within the 22q11.2DS microdeletion region that encodes for the mitochondrial citrate carrier, an inner membrane transporter that regulates intracellular citrate compartmentalization. Through this role, SLC25A1 is thought to contribute to cytosolic acetyl-CoA availability, and processes like protein acetylation and the epigenetic regulation of gene expression. We have previously found that SLC25A1 is a central gene contributing to the neurodevelopmental presentation of 22q11.2DS and importantly, neuronal mitochondrial function. Because the heart, like the brain, is highly reliant on energy derived from mitochondria, and the developing heart must undergo metabolic maturation whereby metabolism is reprogrammed from primary reliance on glycolysis towards mitochondrial oxidative metabolism, we hypothesized that SLC25A1 plays a key role in the metabolic maturation that is required for proper cardiac development. Objective: Here, we studied the role of Slc25a1 in the developing heart to examine the link between mitochondria and cardiac morphogenesis. Methods and Results: By studying mice with the systemic knockout of SLC25A1, we discovered that Slc25a1 null embryos displayed impaired growth, cardiac malformations, mitochondrial ultrastructural defects and impaired mitochondrial oxygen consumption. Transcriptomics analyses of metabolism-related genes revealed that Slc25a1 deletion causes widespread alterations in metabolic gene expression. Further, metabolic modelling predicted that loss of SLC25A1 downregulates oxidative phosphorylation, while increasing reliance on glucose. Finally, we found that loss of SLC25A1 decreases cardiac H3K9 acetylation levels at promoter regions of dysregulated metabolic genes. Mechanistically, SLC25A1 may regulating mitochondrial function and metabolism through epigenetic control of gene expression to promote metabolic remodeling in the developing heart. Conclusions: Our work suggests that SLC25A1 as an an important mitochondrial regulator of gene expression in the developing heart. Importantly, it positions SLC25A1 as a novel mitochondrial regulator of ventricular morphogenesis as well as cardiac metabolic maturation.

Syndromic Surveillance Tracks COVID-19 Cases in University and County Settings: Retrospective Observational Study.

Syndromic surveillance represents a potentially inexpensive supplement to test-based COVID-19 surveillance. By strengthening surveillance of COVID-19-like illness (CLI), targeted and rapid interventions can be facilitated that prevent COVID-19 outbreaks without primary reliance on testing. This study aims to assess the temporal relationship between confirmed SARS-CoV-2 infections and self-reported and health care provider-reported CLI in university and county settings, respectively. We collected aggregated COVID-19 testing and symptom reporting surveillance data from Cornell University (2020-2021) and Tompkins County Health Department (2020-2022). We used negative binomial and linear regression models to correlate confirmed COVID-19 case counts and positive test rates with CLI rate time series, lagged COVID-19 cases or rates, and day of the week as independent variables. Optimal lag periods were identified using Granger causality and likelihood ratio tests. In modeling undergraduate student cases, the CLI rate (P=.003) and rate of exposure to CLI (P<.001) were significantly correlated with the COVID-19 test positivity rate with no lag in the linear models. At the county level, the health care provider-reported CLI rate was significantly correlated with SARS-CoV-2 test positivity with a 3-day lag in both the linear (P<.001) and negative binomial model (P=.005). The real-time correlation between syndromic surveillance and COVID-19 cases on a university campus suggests symptom reporting is a viable alternative or supplement to COVID-19 surveillance testing. At the county level, syndromic surveillance is also a leading indicator of COVID-19 cases, enabling quick action to reduce transmission. Further research should investigate COVID-19 risk using syndromic surveillance in other settings, such as low-resource settings like low- and middle-income countries.

Assessing the health consequences of indoor air pollution from biomass fuel combustion on pediatric populations in rural communities of Pakistan

ABSTRACT Indoor air pollution arising from burning of biomass fuels poses a significant threat to child health in rural areas of Pakistan. This cross-sectional study aimed to assess health implications associated with indoor air pollution resulting from biomass burning among children under 12 years of age in rural Punjab. A questionnaire-based survey was conducted in six randomly selected rural districts of Punjab, characterized by their primary reliance on biomass fuels. The findings revealed that several characteristics, such as monthly household income, number of living rooms, secondary use of solid fuels, kitchen type, type of cooking stove, and presence of child in the kitchen with their mother, exhibited significant associations (p < 0.05) with negative health impacts among children. Reported health effects among the children included coughing (18.7%), watery eyes (17.7%), eye irritation (12.3%), runny nose (11.8%), breathing difficulties (8.5%), phlegm (38%), headache (25%), nausea (20.1%), dizziness (6.7%), asthma (6.4%), tuberculosis (1.8%), and pneumonia (1.5%).

AiroTouch: enhancing telerobotic assembly through naturalistic haptic feedback of tool vibrations.

Teleoperation allows workers to safely control powerful construction machines; however, its primary reliance on visual feedback limits the operator's efficiency in situations with stiff contact or poor visibility, hindering its use for assembly of pre-fabricated building components. Reliable, economical, and easy-to-implement haptic feedback could fill this perception gap and facilitate the broader use of robots in construction and other application areas. Thus, we adapted widely available commercial audio equipment to create AiroTouch, a naturalistic haptic feedback system that measures the vibration experienced by each robot tool and enables the operator to feel a scaled version of this vibration in real time. Accurate haptic transmission was achieved by optimizing the positions of the system's off-the-shelf accelerometers and voice-coil actuators. A study was conducted to evaluate how adding this naturalistic type of vibrotactile feedback affects the operator during telerobotic assembly. Thirty participants used a bimanual dexterous teleoperation system (Intuitive da Vinci Si) to build a small rigid structure under three randomly ordered haptic feedback conditions: no vibrations, one-axis vibrations, and summed three-axis vibrations. The results show that users took advantage of both tested versions of the naturalistic haptic feedback after gaining some experience with the task, causing significantly lower vibrations and forces in the second trial. Subjective responses indicate that haptic feedback increased the realism of the interaction and reduced the perceived task duration, task difficulty, and fatigue. As hypothesized, higher haptic feedback gains were chosen by users with larger hands and for the smaller sensed vibrations in the one-axis condition. These results elucidate important details for effective implementation of naturalistic vibrotactile feedback and demonstrate that our accessible audio-based approach could enhance user performance and experience during telerobotic assembly in construction and other application domains.

Materials and Methods for All-Cellulose 3D Printing in Sustainable Additive Manufacturing

Additive manufacturing, commonly referred to as 3D printing, is an exciting and versatile manufacturing technology that has gained traction and interest in both academic and industrial settings. Polymeric materials are essential components in a majority of the feedstocks used across the various 3D printing technologies. As the environmental ramifications of sole or primary reliance on petrochemicals as a resource for industrial polymers continue to manifest themselves on a global scale, a transition to more sustainable bioderived alternatives could offer solutions. In particular, cellulose is promising due to its global abundance, biodegradability, excellent thermal and mechanical properties, and ability to be chemically modified to suit various applications. Traditionally, native cellulose was incorporated in additive manufacturing applications only as a substrate, filler, or reinforcement for other materials because it does not melt or easily dissolve. Now, the exploration of all-cellulose 3D printed materials is invigorated by new liquid processing strategies involving liquid-like slurries, nanocolloids, and advances in direct cellulose solvents that highlight the versatility and desirable properties of this abundant biorenewable photosynthetic feedstock. This review discusses the progress of all-cellulose 3D printing approaches and the associated challenges, with the purpose of promoting future research and development of this important technology for a more sustainable industrial future.

Local State Capacity and Uneven Taxation across Industrial Firms

AbstractIn this research we investigate the association between local state capacity (LSC) and effective tax burdens (ETBs) on industrial firms within counties between 1998 and 2013. The LSC measures a state's capacity for policy implementation and specifically its ability to acquire low‐cost agricultural land for nonagricultural (industrial or commercial) purposes. Based on China's government‐led development experience since the 1990s, we draw on two unique household survey datasets to capture LSC at county level. We find robust evidence that greater LSC was associated with much lower ETBs on large industrial firms. This taxation pattern implies local government's primary reliance on larger manufacturing firms, while the ETBs for small‐and‐medium enterprises are not as prominently addressed. This research highlights that LSC can affect both the amount of revenue a local government can generate and the methods it uses to collect these revenues.

A Laboratory Investigation of the Adsorption Performance and Mechanism of Organics in Industrial Wastewater on mp-Zr(OH)4

We reported on the development of mesoporous zirconium hydroxide (mp-Zr(OH)4) sorbents with high capacity for adsorptive removal of organic pollutants from industrial wastewater. The sorbent was prepared by a one-step chemical precipitation method at room temperature. The adsorption capacity and removal efficiency for the chemical oxygen demand (COD) of the industrial wastewater were studied using an automatic adsorption measurement apparatus. The effects of different parameters (adsorbent dosage, adsorption time, regeneration times, adsorbate's molecular weight and adsorbate solubility), isotherm, thermodynamics, and kinetics were evaluated. By analyzing scanning electron microscopy (SEM) images and powder X-ray diffractograms (XRD) no obvious differences were observed for the sorbents before and after the adsorption of the organics, which indicated a structural stability of the sorbent. The specific surface area was reduced from 450 m2/g to 189 m2/g on adsorption, and after desorption of the organics the specific surface area was 350 m2/g. The adsorption of COD was analyzed in a Langmuir model that described the data better than the empirical Freundlich model. This finding points towards that the adsorption occurred as a monolayer on the mp-Zr(OH)4. The free energy of adsorption (ΔG) is in the range of −20 kJ/mol < ΔG < 0. Entropy changes are ΔS > 0. The kinetics of the adsorption of COD is better described with a Quasi-second-order dynamic model than with a Quasi-first-order dynamic model, which elucidates its primary reliance on porous adsorption surfaces and incorporation of chemical adsorption.

Cardiovascular disease mortality and air pollution in countries with different socioeconomic status.

Cardiovascular diseases (CVDs) account for 17.9 million deaths annually. Behavioral risk factors increase the risk of dying fromCVD. Air pollution is not included in this risk calculation since the appreciation of air pollution as a modifiable risk factor is still limited. The purpose of this study was to analyze CVD mortality attributed to air pollution in all World Health OrganizationWHO member states and demonstrate the association of CVD mortality with air pollution depending on countries'income level. The CVD death rate was calculated by dividing the number of deaths by the total population. The proportion of the population with primary reliance on clean fuels and technologies for cooking was calculated as an indicator of household air pollution. The annual mean concentration of fine particulate matter ≤2.5 µg/m3and ≤10.0 µg/m3to which the population is exposed was used as an indicator of ambient air pollution. There is a gradual increase in CVD mortality attributed to air pollution from high-income countries (HICs) to low-income countries (LICs). Household air pollution is the major cause of CVD mortality in LICs. Ischemic heart disease mortality attributed to ambient air pollution in all countries is higher than stroke mortality attributed to ambient air pollution. In LIC, mortality from stroke is attributed to household air pollution of 39.27 ± 14.47, which is more than twice the stroke mortality attributed to ambient air pollution at 18.60 ± 5.64, t = 7.17, p < 0.01. Air pollution control should be an essential component of the CVD preventive strategy, along with lifestyle modifications and effective disease management.

Redefining Malaysia's printing landscape: insights from Porter's CAN Model

Malaysia's burgeoning printing industry, while showcasing potential, grapples with challenges that constrain its growth and global reach, underscoring the need for a deep and structured assessment. This pivotal study is designed to unpack the competitiveness of the Malaysian printing sector within the vast expanse of the global market, with a spotlight on the commercial printing segment. It revolves around the central inquiry: "Which critical factors mold the competitiveness of Malaysia's printing industry, and how can insights from Porter's Competitive Advantage of Nations (CAN) model illuminate them?" Anchored in the renowned Porter's CAN model, the research undertakes a multifaceted analysis of industry pillars, including intricate demand patterns, supply chain dynamics, prevailing competition, and the overarching influence of government directives. Data, meticulously sourced from 2015-2019 through national agencies and global institutions, forms the bedrock of this systemic examination. The study reveals that Malaysia stands fortified by assets like adept labor, contemporary infrastructure, and cost-effective energy provisions. Yet, it's not devoid of challenges, notably, the lag in embracing cuttingedge production tech and the absence of razor-sharp competitive strategies. However, the surge in both domestic and international demand sketches a promising trajectory. Beyond validating the robustness of the CAN model, the study weaves a tapestry of insights for industry stakeholders. It underscores the pivotal role of agile government interventions and the pressing mandate to integrate digital innovations. The findings beckon a targeted strategy to navigate and neutralize identified pitfalls, amplifying the industry's global resonance. While the study carves a panoramic landscape, its primary reliance on secondary datasets is its Achilles' heel. Still, it emerges as an invaluable compass for industry stakeholders, directing strategic investments and policy recalibrations to elevate the global stature of Malaysia's printing industry.

An Updated Model Using a Reflection Coefficient for Predicting Performance of Pressure-Retarded Osmosis

Mathematical model was used to predict the performance of membrane process. In this study, an updatedmathematical model has been developed to study the forward osmosis (FO) and pressure-retarded osmosis (PRO) processes. This model has been advanced by taking into consideration the reflection coefficient, internal and external concentration polarizations, and structural membrane parameters, as well as the equations of applied pressure and mass transport for feed and draw solutions together. The model was validated through prediction of the water and salt fluxes using the membrane performance data published in other articles. The estimated values of the reflection coefficient ranged from 0.868 to 0.9 for FO and 0.9 to 0.95 for PRO. For this reason, it is not possible to consider the reflection coefficient to be equal to one as normally assumed in membrane modeling study. Other findings have showed that the varying salt fluxes at different concentrations and cross-flow velocities adversely impacted the FO and PRO modules. Internal and external concentration polarizations have been studied and compared with their effect on the effectiveness of the FO/PRO process. The model has demonstrated its ability to predict flux in the PRO greater than FO because of the model primary reliance on the applied pressure to drive the osmotic process. The ratio of must be effectively managed to correspond with operating limits and the value must also be kept to a minimum in order to avert the drastical drop in the flux, the fouling, and the membrane damage.

Rare Indication of Atlantoaxial Fusion-failed Conservative Management of Primary Atlantoaxial Osteoarthritis

Introduction: Osteoarthritis of the atlantoaxial joint is a significant cause of occipitocervical pain, which is often missed and has an increasing prevalence with age. The patients typically present with occipitocervical pain and restricted and painful neck rotations. Despite the primary reliance on conservative management for this pathology, surgical intervention becomes crucial for those not responding to standard conservative treatment. The presented case series highlights the rarity of the requirement of surgical intervention in the management of Atlantoaxial osteoarthritis (AAOA) and the clinical outcomes of surgical management in AAOA. Case Report: This paper presents a case series of four patients who were managed surgically with atlantoaxial fusion, from a database of 108 patients with AAOA. The case series includes three males and one female with a mean age of presentation being 67.5 years. All four patients presented with occipitocervical pain, and painful neck movements and were diagnosed with AAOA on the anteroposterior open mouth view radiographs showing changes of osteoarthritis such as bone erosions, sclerosis, osteophytes. The patients were managed conservatively with non-steroidal anti-inflammatory drugs, intra-articular steroid injections, and cervical collar immobilization. Those not responding to conservative management and with incapacitating pain were managed surgically with atlantoaxial fusion procedures. Conclusion: In a group of patients with a painful and debilitating degenerative AAOA only a small proportion of cases require surgical intervention. In this cohort, only 3.70 % of patients required surgery, highlighting the rarity of surgical intervention required in the management of AAOA. Nevertheless, when conducted, atlantoaxial fusion has proved to be efficacious with a low rate of serious complications and the patient self-rated outcome in terms of post-operative visual analog scale score and neck disability index scores indicating a high degree of satisfaction with the procedures. Keywords: Atlantoaxial, osteoarthritis, fusion, transarticular screws.

Discovery of Nanosota-2, -3, and -4 as super potent and broad-spectrum therapeutic nanobody candidates against COVID-19.

The COVID-19 pandemic exposed limitations of conventional antibodies as therapeutics, including high cost, limited potency, ineffectiveness against new viral variants, and primary reliance on injection-only delivery. Nanobodies are single-domain antibodies with therapeutic potentials. We discovered three anti-SARS-CoV-2 nanobodies, named Nanosota-2, -3, and -4, from an immunized alpaca. Nanosota-2 is super potent against prototypic SARS-CoV-2, Nanosota-3 is highly potent against the omicron variant, and Nanosota-4 is effective against both SARS-CoV-1 and SARS-CoV-2. In addition to their super potency and combined broad antiviral spectrum, these nanobodies are cost-effective, can be easily adapted to new viral variants through phage display, and can potentially be administered as inhalers. The Nanosota series are powerful therapeutic candidates to combat circulating SARS-CoV-2 and prepare for possible future coronavirus pandemics.

Cooking Fuel Choice and Wellbeing: A Global Perspective

This paper assesses the relationship between the proportion of the population with primary reliance on different types of fuels for cooking (national averages) and a number of key wellbeing indices. The study uses a data set created from a combination of the Gallup World Poll database and the World Health Organisation (WHO) Household Energy Database. The Gallup database comprises multinational survey data and contains wellbeing indices (Personal Health, Social Life, Civic Engagement, Life Evaluation, Negative Experience, etc.). The WHO database gives the proportion of a population with primary reliance on different types of cooking fuels. In order to understand the relative importance of the choice of cooking fuels in terms of wellbeing, regression modelling is used to control for the effects of demographic variables (income per capita, age, education level, employment, etc.), available in the Gallup database, on the wellbeing indices. The regression analysis results show that clean cooking fuels are strongly influential in health-related indices. By adding access to electricity as an additional predictor variable, the analysis highlights the potential for integrating eCooking into national electrification plans as part of sustainable energy transitions, given that health outcomes appear to be as closely linked to the choice of cooking fuels as to access to electricity.

Environmental pollution as health depreciator: the case of household generator use in nigeria

The peculiarities of poor electricity generation and distribution which has resulted in high reliance on generators is implicated in the profile of Nigeria’s environmental pollution situation. Still, the consequences of the pervasive use of generators on health is yet to be optimally captured empirically, and macro-wise. Hence, this work was designed to examine correlations between generator use and some selected indices of- health. depreciator. Cross national, secondary data used were extracted from the 2018/19 Nigerian General Household Survey Panel Component (the 2018/19 GHS-Panel). Data on generator use and some selected indices of ill-health were subjected to descriptive and Spearman rank correlational analysis. Results indicated that generator is owned in 24.6% of Nigerian households. Only 55.4% of households have access to electricity; 11.3% and 12.4% of them primarily and secondarily rely on generators respectively. Male and female respondents reporting any health problem was 22.6% and 22.5% respectively, of which only 20.5% consulted a health practitioner. Respondents reporting drug purchase were 28.8%. Primary reliance on generator significantly and positively correlated with consultation with health practitioner (r = .879, p&lt; 0.05), female health problems (r = .862, p&lt; 0.05), drug purchase (r = .700, p&lt; 0.05), cost of medication (r = .700, p&lt; 0.05), male health problems (r = .667, p = 0.05) and cost of consultation (r = .667, p = 0.05). On the other hand, the use of generator as a secondary or other source of electricity is only significantly and positively related to cost of medication (r = .733, p&lt; 0.05) and drug purchase (r = .717, p&lt; 0.05). Generators are leading assets whose use is becoming a significant element of the Nigerian way of life. Marginal or zero reliance on generator for access to electricity would have kept the Nigerian people healthier than they are currently. Certainly, generator use is a vast sponsor of ill-health and a vicious depreciator of health in Nigeria.

Has recording of seizures become obsolete?

Some patients with medically intractable epilepsy are considered for surgical treatment. In some surgical candidates, the investigation includes the placement of intracerebral electrodes and long-term monitoring to find the region of seizure onset. This region is the primary determinant of the surgical resection but about one-third of patients are not offered surgery after electrode implantation and among those operated only about 55% are seizure free after five years. This paper discusses why the primary reliance on the seizure onset maybe suboptimal and may be in part responsible for the relatively low surgical success rate. It also proposes to consider some interictal markers that may have advantages over seizure onset and may be easier to obtain.

Successful Lifetime/Long-Term Medical Treatment of Acid Hypersecretion in Zollinger-Ellison Syndrome (ZES): Myth or Fact? Insights from an Analysis of Results of NIH Long-Term Prospective Studies of ZES.

Analysis of the efficacy/pharmacology of long-term/lifetime medical treatment of acid hypersecretion in a large cohort of ZES patients in a prospective study. This study includes the results from all 303 patients with established ZES who were prospectively followed and received acid antisecretory treatment with either H2Rs or PPIs, with antisecretory doses individually titrated by the results of regular gastric acid testing. The study includes patients treated for short-term periods (<5 yrs), patients treated long-term (>5 yrs), and patients with lifetime treatment (30%) followed for up to 48 years (mean 14 yrs). Long-term/lifelong acid antisecretory treatment with H2Rs/PPIs can be successfully carried out in all patients with both uncomplicated and complicated ZES (i.e., with MEN1/ZES, previous Billroth 2, severe GERD). This is only possible if drug doses are individually set by assessing acid secretory control to establish proven criteria, with regular reassessments and readjustments. Frequent dose changes both upward and downward are needed, as well as regulation of the dosing frequency, and there is a primary reliance on the use of PPIs. Prognostic factors predicting patients with PPI dose changes are identified, which need to be studied prospectively to develop a useful predictive algorithm that could be clinically useful for tailored long-term/lifetime therapy in these patients.

The Impact of Complete Aviation Services on Airport Service Performance at Class III Numfor Airport

This study aims to analyze the development and use of Numfor Airport facilities, their impact on the performance of Numfor Airport, and the prioritized development and use of facilities at Numfor Airport. The research used mixed methods with the primary reliance on qualitative and quantitative data. While the qualitative data were obtained from interviews, the quantitative data were obtained from distributed questionnaires. The research participants and samples in this study amounted to 30 people, who were Numfor Airport employees, airline employees, and the public passengers. Quantitative data were processed using simple linear regression analysis. The results of the study show that 1) The development and utilization of facilities at Numfor Airport was far from optimal. 2) The development and utilization of facilities had a positive and significant effect on the performance of Numfor Airport. 3) It is necessary to prioritize the development and use of facilities at Numfor Airport for standardization of basic service facilities, procurement of the unavailable facilities, utilization of communication facilities, as well as procurement of special costs for transportation, postal and giro.