Performance of Concrete Mixes Containing TBM Muck as Partial Coarse Aggregate Replacements.

This study investigated the potential utilization of the TBM muck obtained from the Gold Line of the Doha Metro Project as a partial replacement of coarse aggregates in concrete mixes. First, the TBM muck particles were screened to coarse aggregate standard sizes. Then, concrete mixes were prepared using 0%, 25%, 50%, and 75% TBM muck replacement of coarse aggregates. The compressive and flexural strengths were determined for all mixes at 28 and 56 days. Moreover, the results obtained were validated using EDX analysis and SEM images. A t-statistical analysis did not show a significant impact of TBM muck usage on the compressive strength results of the concrete mixes. However, another t-statistical analysis showed that TBM muck replacement of coarse aggregates had adversely affected the flexural strength results. The EDX analysis indicated the presence of Na+ ions, which can replace the Ca2+ ions in the C-S-H gel, cause discontinuities of it, and hence reduce the strength at later ages. Finally, the SEM images showed that the ettringite and carbon hydroxide (C-H) contents in the mixes with TBM muck were higher than that of the control mix, while the C-S-H gel was less in such mixes.

A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.

OBJECTIVES: To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives. DESIGN: A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies. DATA SOURCES: We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature). REVIEW METHODS: Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies. RESULTS: The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control). CONCLUSIONS: MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients.

Predictive modeling techniques for nanosecond-laser damage growth in fused silica optics.

Empirical numerical descriptions of the growth of laser-induced damage have been previously developed. In this work, Monte-Carlo techniques use these descriptions to model the evolution of a population of damage sites. The accuracy of the model is compared against laser damage growth observations. In addition, a machine learning (classification) technique independently predicts site evolution from patterns extracted directly from the data. The results show that both the Monte-Carlo simulation and machine learning classification algorithm can accurately reproduce the growth of a population of damage sites for at least 10 shots, which is extremely valuable for modeling optics lifetime in operating high-energy laser systems. Furthermore, we have also found that machine learning can be used as an important tool to explore and increase our understanding of the growth process.

Probability of growth of small damage sites on the exit surface of fused silica optics.

Growth of laser damage on fused silica optical components depends on several key parameters including laser fluence, wavelength, pulse duration, and site size. Here we investigate the growth behavior of small damage sites on the exit surface of SiO2 optics under exposure to tightly controlled laser pulses. Results demonstrate that the onset of damage growth is not governed by a threshold, but is probabilistic in nature and depends both on the current size of a damage site and the laser fluence to which it is exposed. We also develop models for use in growth prediction. In addition, we show that laser exposure history also influences the behavior of individual sites.

Exploration of the multiparameter space of nanosecond-laser damage growth in fused silica optics.

Historically, the rate at which laser-induced damage sites grow on the exit surface of SiO2 optics under subsequent illumination with nanosecond-laser pulses of any wavelength was believed to depend solely on laser fluence. We demonstrate here that much of the scatter in previous growth observations was due to additional parameters that were not previously known to affect growth rate, namely the temporal pulse shape and the size of a site. Furthermore, the remaining variability observed in the rate at which sites grow is well described in terms of Weibull statistics. The effects of site size and laser fluence may both be expressed orthogonally in terms of Weibull coefficients. In addition, we employ a clustering algorithm to explore the multiparameter growth space and expose average growth trends. Conversely, this analysis approach also identifies sites likely to exhibit growth rates outside the norm. The ability to identify which sites are likely to grow abnormally fast in advance of the manifestation of such behavior will significantly enhance the accuracy of predictive models over those based on average growth behaviors.

What constitutes a prescribing error in paediatrics?

OBJECTIVE: To develop a practitioner led definition of a prescribing error for use in prevalence/incidence studies in paediatric practice. DESIGN: A two stage Delphi technique was used to obtain the views of a panel of expert health professionals working in the hospital paediatric setting. The extent of their agreement on a definition of a prescribing error, and on 40 scenarios that might be classified as prescribing errors in paediatric practice, was obtained. RESULTS: Response rates were 84% (n = 42) in the first Delphi round and 95% (n = 40) in the second. Consensus was to accept the general definition of a prescribing error. In addition, there was consensus that 27 of the 40 scenarios should be included as prescribing errors, 10 should be excluded, and three may be considered prescribing errors depending on the individual clinical situation. Failure to communicate essential information, transcription errors and the use of drugs, formulations, or doses inappropriate for the individual patient were considered prescribing errors. Deviations from policies or guidelines, use of unlicensed and off-label drugs, and omission of non-essential information were not considered prescribing errors. CONCLUSION: A general definition of a prescribing error has been developed that is applicable to the paediatric setting, together with more detailed guidance regarding the types of events that should be included. These findings are suitable for use in future research into the incidence and nature of prescribing errors in paediatrics.

Isolation of shiga toxigenic Escherichia coli from raw beef in Palestine.

Shiga toxigenic Escherichia coli (STEC) isolated from raw beef samples in northern Palestine during a 1-year period were characterized for virulence genes by a polymerase chain reaction (PCR) assay and screened for their antibiotic resistance. STEC was identified in 44 (14.7%) of 300 raw beef samples. Twelve (27.3%) of the STEC isolates were serotype O157. Nine of those were isolated during summer. The majority of STEC isolates (70.5%) harbored both stx1 and stx2 genes, while the others harbored either stx1 or stx2. High levels of resistance against different antimicrobial agents were detected. Resistance to at least three drugs was found in 55% of the isolates.

Estrogen-dependent induction of persistent vaginal candidosis in naïve mice.

The capacity of estrogen to induce vaginal candidosis (VC) in the absence of previous or concurrent Candida albicans infections was examined. Adult female Balb/c mice were evaluated for vaginal C. albicans burden, C. albicans-specific delayed type hypersensitivity (DTH) responses and vaginal lymphocyte population kinetics at several time-points while receiving weekly injections of 0.5 mg estrogen. Estrogen treatment resulted in the appearance of significant levels of C. albicans vaginal colonization, which persisted for a period of 4 weeks. A marked suppression of DTH responses mounted against subsequent C. albicans challenge was observed. Absolute number of vaginal T lymphocytes gradually increased by several folds especially at weeks 5-6 following the start of estrogen treatment. These results clearly indicate that estrogen, independent of other predisposing factors, is capable of perturbing the commensal relationship between the host and the fungus, which results in the induction of persistent VC.

Vaginal T lymphocyte population kinetics during experimental vaginal candidosis: evidence for a possible role of CD8+ T cells in protection against vaginal candidosis.

Vaginal candidosis represents a significant health problem to women of childbearing age worldwide. It has been postulated that localized T cells play a role in protection against vaginal candidosis. In an attempt to evaluate the role of vaginal T cells in protection against vaginal candidosis, T cell population kinetics was evaluated using an oestrogen-dependent vaginal candidosis murine model. Vaginal T lymphocytes were isolated at different time points post C. albicans inoculation, viable cells were enumerated, phenotypically analysed for the expression of CD3, CD4 and CD8 T cell markers and absolute numbers of T cell subsets were calculated. Oestrogen-induced persistence of vaginal candidosis resulted in a significant increase in the total number of vaginal lymphocytes within 24-48 h post infection; increased vaginal lymphocyte numbers persisted throughout the infection period. The number of CD3+ T cells dramatically increased following C. albicans administration and was maintained at high levels throughout the infection period. The majority of CD3+ T cells were of the CD8+ type; however, considerable numbers of both CD4+ T cells and CD4+CD8+ T cells were also observed throughout the infection period. The considerable and persistent increase in vaginal T cell numbers in general and that of CD8+ T cells in particular are evidence of the possible role played by localized T cells in protection against vaginal candidosis.

Persistent colonization and transient suppression of DTH responses in an estrogen-dependent vaginal candidosis murine model.

Recurrence of vaginal candidosis in women of childbearing age has been attributed to several predisposing factors including the presence of significant amounts of estrogen in the reproductive tract. In this study, the effect of estrogen on the level of C. albicans colonization, persistence of infection and suppression of DTH responses was investigated in an estrogen-dependent vaginal candidosis murine model. Mice were first injected subcutaneously with 0.5 mg of estradiol valerate 72 hours prior to C. albicans intravaginal inoculation and at weekly intervals thereafter for a period of up to 4 weeks; the inoculum consisted of 2 x 10(7) stationary-phase C. albicans blastoconidia in a volume of 20 microl. C. albicans colonization was evaluated in the spleen, liver, kidney, small intestine and reproductive tract of estrogen-treated and control mice 72 hours following inoculation, DTH responses were evaluated 2 and 5 weeks following primary inoculation and persistence of infection was evaluated at days 2, 3, 4, 8, 12, 19 and 26 post inoculation. Estrogen-treated mice exhibited higher levels of C. albicans colonization compared with control mice; this was most evident in the small intestine and reproductive tract. Estrogen treatment resulted in pronounced suppression of C. albicans-specific DTH responses; in that average footpad swelling was 4.7 mm in untreated mice compared with 2.3 mm in estrogen-treated mice. Long-term estrogen treatment resulted in the persistence of infection; in contrast, C. albicans infection resolved by day 8 post inoculation in untreated mice. DTH responses assayed 5 weeks post primary inoculation in treated mice were on average 4.1 mm, this was similar to that observed in untreated mice tested for DTH response 2 and 5 weeks post primary inoculation. These results suggest that, on the one hand, estrogen has an enhancing effect on C. albicans colonization and persistence of infection. On the other, estrogen seems to suppress DTH responses within the first 2 weeks post infection; persistence of infection under the influence of estrogen, however, seems to coexist with detectable systemic cell-mediated immunity.