Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

卫星波束标校信号码型对比分析

针对GEO轨道通信卫星同步定点后会出现周期性漂移,导致波束指向不确定的问题,本文对波束标校系统中的信号捕获进行了研究。由于标校信号捕获依赖于标校信号之间的正交性及其自相关特性,因此文中提出了标校系统中信号码型选择需要考虑的关键问题。特别是在天线存在指向误差时,Ka频段标校站接收信号功率最大差异可达近30 dB,这给标校信号码型设计和标校信号的捕获带来了困难,因此文中从码型的抗干扰性能、实现复杂度、能量估计精度和捕获特性等几个方面,分析和对比了m序列信号、Walsh信号、单频信号和Chirp信号(扫频信号)这4种码型各自的优点和缺点,并用MATLAB进行了仿真。结果表明:在抗干扰性能上,伪随机序列信号和Walsh信号最好,Chirp信号次之,单频信号最差;在复杂度方面,Chirp最复杂,伪随机序列和Walsh序列次之,单频方式最简单;在估计精度方面,三者的估计精度相当;在捕获性能方面,Walsh信号的捕获性能明显优于m序列,而且当两个标校站的接收信号功率之间存在较大差异时,Walsh信号的捕获性能明显优于m序列。因此标校系统可优先选择Walsh码作为标校信号。

Uniaxial compressive behaviour of a FRP standing support made of mine wastes

Twenty-seven specimens were tested to investigate the uniaxial compression behaviour of an innovative standing support for underground space applications.The innovative standing support consisted of an external fibre reinforced polymer(FRP)jacket and the infill column made of cementitious grout,tailings and coal wash rejects.Effects of the FRP layers number and water to the cementitious grout(w/g)ratio were evaluated.Test results indicated that lower w/g ratios produced stronger infill columns.With FRP confinement,the standing support demonstrated strain-hardening loading characteristics with a significant improvement in both strength and ductility.The highest strength and strain of the specimens achieved was 58.4 MPa and 11.8%respectively.Compared with the unconfined specimens,the confinement with four FRP layers increased the specimen strength and associated strain up to 3.6 and 27.0 times respectively.A correlation between the compressive strength of the infill material and the ultrasonic pulse velocity was also investigated.Furthermore,a simple design-oriented model was proposed to predict the peak strength and the corresponding strain of the innovative standing support.

Remediation of oily soil using acidic sophorolipids micro-emulsion

A sophorolipids(SLs)micro-emulsion in Winsor type Ⅰ form was used for crude oil contaminated soil washing treatment.The micro-emulsion shows higher oil removal rate than SLs aqueous solution and diesel oil.The type Ⅰ micro-emulsion with w(SLs)=6%,w(NaCl)=1%,w(diesel)=13.36% gave a high oil removal rate of 95.6% and the eluate remained in type Ⅰ state.The recovered oil showed lower viscosity,mainly caused by the entering of diesel from the micro-emulsion phase into the oil phase and the lower removal rate of the heavier components,such as the resin and asphaltene.The initial heavily saline-alkaline soil changed into mildly saline-alkaline state after washing treatment,favoring the germination and growth of plants,with ryegrass showing better germination and growth effect than alfalfa.The ryegrass showed good phytoremediation effect on the contaminated soil after SLs micro-emulsion washing.The combination process of SL micro-emulsion washing and ryegrass phytoremediation is prospective for oily soil treatment.

Orientational Separation of Sulfur in Petroleum Coke by Alkali Calcining and Reflux Washing

The application of high-sulfur petroleum coke after desulfurization in aluminum electrolysis anodes is an important development trend. However, removing sulfur from high-sulfur petroleum coke is still a significant challenge.This study proposes alkali calcining and reflux washing to examine the impacts of temperature, particle size, the mass ratio of Na_(2)CO_(3) to NaOH, and total sodium addition on the desulfurization efficiency and mechanism. The results show that the desulfurization rate increases with increasing temperature, increasing total sodium content, and decreasing particle size. The addition of alkali can significantly reduce the opening-ring reaction temperature of thiophene and convert organic sulfur into inorganic sulfur(Na_(2)S). Three washing methods were compared, and reflux washing was selected to separate inorganic sulfur(Na_(2)S) from calcined petroleum coke. The sulfur content in petroleum coke decreased from 7.29% to 1.90%, with a desulfurization rate of 80.13% under optimal conditions. The petroleum coke was analyzed before and after desulfurization using X-Ray diffraction(XRD), Scanning Electron Microscopy(SEM), Infrared Spectroscopy(IR), Thermogravimetric Analysis and Differential Scanning Calorimetry(TG-DSC), Gaschromatography-mass Spectrometry(GC-MS). The results show that thiophene and benzothiophene in petroleum coke are decomposed and converted into octane and ethyl cyclohexane. These new observations are expected to provide further understanding and guidance for the utilization of highsulfur petroleum coke.

In the Lake Zone of Tanzania, Behavioral Determinants Are Associated with Hygiene but Not Sanitation Practice

Understanding why individuals do or do not adopt optimal water, sanitation, and hygiene (WASH) practices is critical to designing successful behavior change interventions. However, policy makers and program implementers often fail to obtain the context-specific information on behavioral determinants of WASH practices. This two-stage, randomized survey among 5000 female primary caregivers in the Lake Zone of Tanzania assessed associations between behavioral determinants and a range of hygiene and sanitation practices. Behavioral determinants of hygiene were almost always significantly associated with cleaning one’s own hands after cleaning the baby’s bottom and being able to show at least one place where family members wash their hands. In regression models, those who knew when to wash their own hands (OR = 1.8, 95% CI: 1.5, 2.1) and their child’s hands (OR = 1.5, 95% CI: 1.3, 1.7) and mothers who thought that their female friends washed their hands after cleaning the baby’s bottom (OR = 5.5, 95% CI: 4.5, 6.7) were significantly more likely to frequently clean their own hands after cleaning the baby’s bottom. This research suggests that in the Lake Zone of Tanzania, numerous determinants are associated with hygiene practices. Identifying context-specific determinants of WASH behaviors is the first step toward developing effective interventions.

Discussion on the Treatment of Palmoplantar Keratosis by TCM Soaking and Washing

By combing the mechanism and advantages of traditional Chinese medicine(TCM)soaking and washing and combining TCM syndrome differentiation with western medicine differentiation of diseases,guided by the view that"the principle of external treatment is that of internal treatment",this article discusses the differentiation and treatment ideas of palmoplantar keratosis by TCM soaking and washing,which will provide a reference for clinical treatment.

Hand Hygiene by Ward Staff at Dapaong Regional Hospital in Togo

Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.

Is Peritoneal Cytology a Prognostic Factor in Endometrial Cancer?

The International Federation of Gynecology and Obstetrics (FIGO) changed the surgical staging criteria for endometrial cancer in 2009, namely combining FIGO 1988 Stage IA and IB in FIGO 2009 Stage IA, eliminating cervical glandular involvement from Stage II, and removing peritoneal cytology as criteria from Stage IIIA (3). This review of the literature sheds light on the continued debate among authorities on the utility of peritoneal cytology in surgical staging of endometrial cancer. At the time FIGO removed peritoneal cytology from the staging criteria in 2009, there was little to no evidence to support its removal. In fact, FIGO continues to recommend obtaining peritoneal cytology, which is in contradiction to their staging criteria. While a few small studies support the idea that peritoneal cytology does not preclude a worse prognosis, a number of large scale studies with at least 300 patients demonstrate a clear association between survival and the presence of malignant peritoneal cytology (11 - 12, 15 - 19). In one of the largest studies, investigators reviewed 14,704 from the SEER’s database, demonstrating that malignant peritoneal cytology is associated with decreased survival across Stage I/II disease even when controlled for histology, grade, and other risk factors. Malignant peritoneal cytology should be considered when counseling patients on the risk of recurrence and overall survival of endometrial cancer. However, the role of adjuvant treatment in this setting remains unclear.

WASH通过与核内不均一核糖核蛋白A1(hnRNP A1)的相互作用调控选择性剪接和基因转录

目的探讨Wiskott-Aldrich综合征蛋白和富含脯氨酸同源物(WASH)与核内不均一核糖核蛋白A1(hnRNP A1)的相互作用及其生物学功能.方法利用质谱鉴定、免疫共沉淀技术,研究WASH复合体核心成员WASH/FAM21与hnRNP A1相互作用.使用实时定量PCR检测WASH沉默细胞与对照细胞中端粒长度.使用RNA-Seq检测WASH沉默细胞与对照细胞转录谱.结果质谱鉴定结果显示包括hnRNP A1在内的多种hnRNP家族成员与FAM21-d219N相互作用.免疫沉淀结果验证了内源WASH/FAM21与hnRNP A1的相互作用.WASH沉默并未对端粒的相对长度产生影响,但明显提高了外显子跳跃的数量,并且影响包括部分核因子κB(NF-κB)靶基因在内的数百基因的转录.结论细胞核内的WASH可与hnRNP A1相互作用,参与选择性剪接和基因转录的调控.

Value of early diagnosis of sepsis complicated with acute kidney injury by renal contrast-enhanced ultrasound

BACKGROUND The incidence of acute kidney injury(AKI)in patients with sepsis is high,and the prognosis of patients with septic AKI is poor.The early diagnosis and treatment of septic AKI is of great significance in improving the prognosis of patients with sepsis.AIM To explore the value of contrast-enhanced ultrasound(CEUS),serum creatinine(Scr),and other indicators in the early diagnosis of septic AKI.METHODS Ninety patients with sepsis during hospitalization at Tongji Hospital of Tongji University were recruited as subjects.Each patient was recorded with relevant basic data,clinical indicators,and CEUS results.The patients were divided into AKI group and non-AKI group according to the results of renal function diagnosis after 48 h.On the 7th day,the renal function of the non-AKI group was re-evaluated and the patients were further divided into AKI subgroup and non-AKI subgroup.The differences of the indicators in different groups were compared,and the diagnostic value of each indicator and their combination for septic AKI was analyzed.RESULTS Systemic inflammatory response score(2.58±0.75),blood lactic acid(3.01±1.33 mmol/L),Scr(141.82±27.19μmol/L),blood urea nitrogen(4.41±0.81mmol/L),and rise time(10.23±2.63 s)in the AKI group were higher than those in the non-AKI group.Peak intensity(PI)(10.78±3.98 dB)and wash in slope(WIS)(1.07±0.53 dB/s)were lower than those in the non-AKI group.The differences were statistically significant(P<0.05).The PI(12.83±3.77 dB)and WIS(1.22±0.68 dB/s)in the AKI subgroup were lower than those in the non-AKI subgroup,and the differences were statistically significant(P<0.05).The area under curve(AUC)of Scr for the diagnosis of septic AKI was 0.825 with a sensitivity of 56.76% and a specificity of 100%.The AUCs of WIS and PI(0.928 and 0.912)were higher than those of Scr.Their sensitivities were 100%,but the specificities were 71.70% and 75.47%.The AUC of the combination of three indicators for the diagnosis of septic AKI was 0.943,which was significantly higher than the AUC diagnosed by each single indicator.The sensitivity was 94.59%,and the specificity was 81.13%.CONCLUSION The combination of Scr,PI,and WIS can improve the diagnostic accuracy of septic AKI.PI and WIS are expected to predict the occurrence of early septic AKI.

Preparation and Characterization of Microporous Nano-Tungsten Trioxide and Its Photocatalytic Activity after Doping Rare Earth

Aqueous sols and gels of tungstic acid were prepared from Na2WO4 with protonated cation-exchange resin. Nano-tungsten oxide of a microporous lamella was synthesized by means of washing of WO3· 2H2O with distilled water under ultrasonic wave agitation and centrifuging repeatedly, and the specific surface area tended to increase gradually with washing and centrifuging. The sample of centrifuged 7 h has more than 2 times highs specific surface area and more high photocatalytic activity . The mechanisms are also discussed.

Washed microbiota transplantation reduces proton pump inhibitor dependency in nonerosive reflux disease

BACKGROUND The pathogenesis of gastroesophageal reflux disease(GERD)is closely associated with the intestinal bacteria composition and their metabolites.AIM To investigate whether washed microbiota transplantation(WMT)improves symptoms of nonerosive reflux disease(NERD)with proton pump inhibitor(PPI)dependency.METHODS Patients with recurrent NERD and PPI dependency at the First Affiliated Hospital of Guangdong Pharmaceutical University from 2017 to 2018 were included and divided into a WMT or PPI group treated with PPI with/without WMT.The endpoint was NERD symptom frequency evaluated 1 mo after WMT using reflux disease questionnaire(RDQ)and GERD questionnaire(GERDQ)scores,remission time,PPI dose,and the examination of intestinal mucosal barrier function.RESULTS In the WMT(n=15)and PPI(n=12)groups,the total remission rate at 1 mo after treatment was 93.3%vs 41.7%.Compared with the PPI group,the WMT group showed better results in GERDQ(P=0.004)and RDQ(P=0.003)and in remission months(8 vs 2,P=0.002).The PPI dose was reduced to some extent for 80%of patients in the WMT group and 33.3%in the PPI group.In 24 patients,intestinal mucosal barrier function was examined before treatment,and changes in the degree of damage were observed in 13 of these patients after treatment.Only one of the 15 patients had minor side effects,including a mushy stool two or three times a day,which resolved on their own after 1 wk.CONCLUSION This study is the first to demonstrate that WMT may be safe and effective for relieving NERD symptoms and reducing PPI dependency and recurrence.

Effect of Water Washing Pre-treatment on the Properties of Glass-ceramics from Incinerator Fly Ash Using Electronic Arc Furnace

Production of glass-ceramics by sintering the molten slag obtained from electric arc furnace treatment of fly ash was investigated. The effect of washing pretreatment prior to melting the fly ash on the microstructure and properties of the glass-ceramics was examined. The results show that washing pretreatment of fly ash can decrease alkali metal chloride and increase network former in fly ash, which results in the increase of peak crystallization temperature of parent glass and strengthening of properties of bending strength and chemical stability of the glass-ceramics. The optimal heat treatment temperature for parent glass of washed fly ash is 1 173 K, at which the crystalline phase of glass-ceramics is composed of gelignite （Ca2A12SiO7） and akermanite （Ca2MgSi207）. Glass-ceramics produced at optimal heat treatment temperature are excellent in term of the physical and chemical properties and leaching characteristics, indicating attractive potential as substitute of nature materials.

WATER WAVES IN AN ELASTIC VESSEL

Linear and nonlinear analyses of water waves in an elastic vessel are carried out to study the dramatic phenomena of Dragon Wash as well as related controllable experiments. It is proposed that the capillary edge waves are generated by parametric resonance, which is shown to be a possible mechanism for both rectangular an circular vessels. For circular vessel, the normal geometric resonance is also operating, thus greatly. enhance the dramatic effect. The mechanism of nonlinear mode-mode interaction is proposed far the generation of axisymmetric low-frequency gravity waves by the high-frequency external excitation. A simple model system is studied numerically to demonstrate explicitly this interaction mechanism.

THEORY OF WATER WAVES IN AN ELASTIC VESSEL

Recent experiments related to the Dragon Wash phenomena showed that axisymmetric capillary waves appear first from excitation, and circumferential capillary waves appear after increase of the excitation strength. Based on this new finding, a theory of parametric resonance is developed in detail to explain the on- set of the prominent circumferential capillary waves. Numerical computation is also carried out and the results agree generally with the experiments. Analysis and nu- merical computation are also presented to explain the generation of axisymmetric low-frequency gravity waves by tile high-frequency external excitation.

Efficacy and Safety of Washed Microbiota Transplantation to Treat Patients with Mild-to-Severe COVID-19 and Suspected of Having Gut Microbiota Dysbiosis: Study Protocol for a Randomized Controlled Trial

Objective:Coronavirus disease 2019(COVTD-19)is often accompanied by gastrointestinal symptoms,which are related to gut microbiota dysbiosis(GMD).Whether washed microbiota transplantation(WMT)is an effective treatment for COV1D-19 patients suspected of having GMD by restoring the gut microbiota is unknown.This study is designed to explore the efficacy and safety of WMT in COVID-19 patients suspected of having GMD.Methods:This is a randomized,multicenter,single-blind prospective study.COVID-19 patients suspected of having GMD will be randomly divided to receive routine treatment only or to receive routine treatment and WMT.The frequency of WMT will be once a day for three consecutive days.Laboratory and imaging examinations will be performed at admission,1 and 2 weeks after treatment,and on the day of discharge.Then a telephone follow-up will be conducted at 1st week,2nd week,and 6th month after discharge.The clinical efficacy and safety of WMT in COVD-19 patients suspected of having GMD and the effects of WMT on the organ function,homeostasis,inflammatory response,intestinal mucosal barrier function,and immunity of the patients will be evaluated.Results:By following the proposed protocol,WMT is expected to be efficacious and safe for the treatment of COVID-19 patients suspected of having GMD,and the therapeutic effect is expected to be associated with improvement of the intestinal mucosal barrier function,inflammatory response,and immunity.Conclusion:The findings from this study may offer a new approach for the prevention and treatment of COVID-19 patients suspected of having GMD.

Study of polluted soil remediation based on freezing and thawing cycles

It is generally known that soil pollution poses a terrible hazard to the environment, but the present techniques of contaminated soil remediation cannot control this growing threat. This paper compares the pollutant extraction efficiency of traditional pumping and treating, which is a typical washing technology for the remediation of contaminated soils, with methods that utilize freeze-thaw cycles. In the soil freezing process, water shifts from unfrozen soils to the freezing front, and the permeability of soil will be enhanced under certain temperature gradients and water conditions. Therefore, this paper discusses the purification of contaminated soil through freeze-thaw action. We conducted a cleansing experiment on clay and silica sand infused with NaCl（simulation of heavy metals） and found that the efficiency of purification was enhanced remarkably in the latter by the freeze-thaw action. To assess the effective extraction of DNAPLs in soil, we conducted an experiment on suction by freezing, predicated on the different freezing points of moisture and pollutants. We found that the permeability coefficient was significantly increased by the freezing-thawing action, enabling the DNAPL contaminants to be extracted selectively and effectively.

In advanced gastric cancer:Prognosis and treatment of patients with positive peritoneal cytology

Positive peritoneal cytology in gastric cancer is classified as M1 disease by the 7thEdition of American Joint Committee on Cancer staging system.With the introduction of laparoscopy and peritoneal washing cytology in the staging of gastric cancer a new category of patients has been identified.These are patients with no macroscopic peritoneal metastases but with peritoneal cytology positive(P0C1).Prognosis and treatment of such patientsrepresent a controversial issue.We evaluate the state of the art of staging system in gastric cancer and discusss tandardisation in staging and treatment procedures.There is still a lack of uniformity in the use of laparoscopy with peritoneal cytology in clinical decision making and in the surgical treatment for gastric cancer.Survival of this patient subset remains poor.Multimodal therapies and new therapeutic strategies are required to improve the survival of these patients.