Efficacy of a Ready-to-Drink Gelled Water and of a Thickening Powder in Patients with Oropharyngeal Dysphagia: a Crossover Randomized Study

Management of oropharyngeal dysphagia (OD) is mainly based on modifying liquid viscosity and solid consistency in order to preserve oral feeding while avoiding unsafe swallowing. Adding thickening powders (TP) to water is the most common practice in patients suffering from OD to liquids, but ready-to-use gelled waters (RGW) can also be proposed. The main objective of this study was to assess the efficacy of a RGW and a TP on swallowing in hospitalized patients with different OD etiologies. This open, crossover, multicenter trial recruited thirty hospitalized patients with OD to liquids, confirmed by positive 3-ounce water test or positive Practical Aspiration Screening Scheme test. The patient’s ability to swallow 120 g of a RGW (IDDSI level 4) and a drink prepared with TP (nectar viscosity; NTP, 291 cP, IDDSI level 2; or if necessary, honey; HTP, 769 cP, IDDSI level 3) was evaluated in a random order at 1- to 3-day intervals. The main criterion was the efficacy of each product, defined as the proportion of patients who successfully swallowed without immediate reflexive cough. The RGW and TP were successfully swallowed in respectively 93.3% (95% CI: 77.9–99.2) and 82.8% (95% CI: 64.2–94.2) of patients with different dysphagia etiologies (stroke, neurodegenerative diseases, or aging) and unable to swallow thin water. Taste and texture of both study products were well appreciated by patients, with a preference for the RGW over TP. Therefore, the use of these thickened products could be part of the therapeutic strategy for patients with OD to liquids.

FACTORS WATER CHARACTERISTIC AS PREDICTING DIARRHEA UNDER 5 YEARS

Risk Factors diarrhea deaths associated to unsafe water and inadequate sanitation. Water supply is very important to decrease of diarrhea disease. Living around canal is a one of risk diarrhea incident. Improved water sanitation, water facilities, and hygiene water decrease of diarrhea disease. Study aims to know dominant factor related water sanitation which is more appropriate than diarrhea in volcano area disaster. Study design used cross sectional community-based survey. Population and sample size were required 1142 household. Data collected such as sufficient of water source, water colored, smelly water, taste water, water cooked, distance of absorption. Data were analyzed performed using SPSS. Data analysis performed a descriptive analysis, statistic test with chi square and logistic regression with confidence interval 95%. Study that sufficient of water 97.2%, no water colored 98.4%, no smelly water (95.3%), no taste water 95.4%, water cooked 98.2%, distance of absorption 11 meter 78%. Risk factor for diarrhea such as taste water OR = 7.3 (3.7-14.4), smelly water OR = 6.9 (3.5-13.6) and distance of absorption OR = 3.4 (2.0-5.7). Factor highest contribution for diarrhea is distance absorption (Exp β = 1.70 CI; 1.701-4.906). Distance absorption 11 meters is main factor contributing for diarrhea. Factor dominant contribution for diarrhea is distance of absorption 11 meter.

The role of livestock in sustainable food production systems in Canada

Global drivers such as the growing human population, evolving consumer preferences, globalization, and climate change have put pressure on the agri-food sector to produce more livestock products with less land, feed and water. Taste, nutritional value, cost, convenience, source, animal welfare and environmental sustainability of food are criteria upon which purchasing decisions are made. In response, an environmental footprint analysis composed of greenhouse gas emissions, nutrient and water use efficiency, water quality, carbon storage and biodiversity has been completed for many commodities. However, as livestock production systems occur within complex agro-ecosystems, it is extremely challenging to formulate a single overall sustainability metric. There is no “silver bullet” to solve the environmental concerns of all livestock production systems as they operate under different constraints on different landscapes, with different water and nutrient cycles, and soil types. Furthermore, the lack of scientific evidence regarding the interactions between livestock production, human nutritional adequacy and the health of our environment makes it difficult for consumers to interpret this information and make informed food choices. This review examines these complex interactions and trade-offs, as well as the potential impacts of changes in consumer dietary choice on environmental sustainability, nutritional adequacy and land use.

SOSIALISASI MANFAAT KARBON AKTIF SEBAGAI MEDIA FILTRASI AIR GUNA MENINGKATKAN KESADARAN AKAN PENTINGNYA AIR BERSIH DI SMK PGRI CIKAMPEK

ABSTRAKKetersediaan air bersih menjadi sangat penting terutama di masa pandemi seperti saat ini. Indikator air bersih tidak hanya dilihat dari warna, tetapi juga dari aroma dan rasa. Untuk memperoleh air bersih salah satunya dapat menggunakan alat filtrasi air dengan karbon aktif sebagai salah satu media filtrasinya. Karbon aktif dapat menyerap zat-zat atau mineral yang mencemari air. Adapun manfaat karbon aktif dalam proses filtrasi air sebagai penyerap bau, warna, klorin atau mineral lain dan membuat rasa segar pada air. Selain menggunakan karbon aktif sebagai media filtrasinya, pada alat filtrasi air juga menggunakan media yang lain untuk membantu menghilangkan kontaminan pada air yang tercemar seperti menggunakan kerikil, ijuk dan pasir. Selain itu juga alat filtrasi dapat didesain dengan sangat baik sehingga aliran air tetap mengalir dengan cepat serta dilengkapi dengan adanya sinar UV untuk membunuh kuman atau bakteri pada air sehingga menjadi lebih steril. Adapun tujuan dari pengabdian ini adalah memberikan edukasi terhadap siswa/i SMK PGRI Cikampek dalam memanfaatkan karbon aktif sebagai salah satu media filtrasi air dalam multi-media water filter. Selain memberikan pelatihan pembuatan dan penggunaan alat filtrasi air, juga disampaikan cara pembersihan dan perawatan alat tersebut serta mengedukasi pentingnya air bersih dalam kehidupan terutama di masa pandemi covid-19 seperti saat ini. Kata kunci: covid-19; karbon aktif; multi-media water filter. ABSTRACTThe availability of clean water is very important, especially during a pandemic like today. The indicator of clean water is not only seen from color, but also by smell and taste. To obtain clean water, one of them can use a water filtration device with activated carbon as one of the filtration media. Activated carbon can absorb substances or minerals that pollute water. As for the benefits of activated carbon in the water filtration process as an absorber of odors, color, chlorine or other minerals and makes the water taste fresh. Apart from using activated carbon as the filtration media, the water filtration device also uses other media to help remove contaminants in polluted water such as using gravel, palm fiber and sand. In addition, the filtration device can be designed very well so that the water flow continues to flow quickly and is equipped with UV rays to kill germs or bacteria in the water so that it becomes more sterile. The purpose of this programme is to provide education to students of SMK PGRI Cikampek in utilizing activated carbon as one of the water filtration media in a multi-media water filter. In addition to providing training on the manufacture and use of water filtration devices, it was also conveyed how to clean and maintain these devices and educate the importance of clean water in life, especially during the Covid-19 pandemic like today. Keywords: covid-19; activated carbon; multi-media water filters.

In-situ techniques for monitoring drinking water quality

<p>Efficient management of drinking water quality is critical for the water supply, so effective monitoring of supply and storage systems is a priority. This project aims to predict the presence of Taste and Odour (T&O) compounds in drinking water reservoirs, using molecular analyses and smart in-situ monitoring systems. The most common T&O compounds, Geosmin and 2-MIB, are secondary metabolites that can be produced in waterbodies by cyanobacteria and actinomycetes and impact drinking water taste and odour. Although there is no evidence of related health risks, they can be perceived by humans at very low concentrations (5-10 ng/L) and the treatment process to remove them from drinking water is costly. Early assessment of T&O risk is crucial, but currently requires time-consuming and costly sampling as well as laboratory analysis which prevents real-time monitoring and a timely management response.</p><p>Cyanobacterial species responsible for T&O production can be monitored with eDNA techniques and potentially provide an early warning of T&O episodes. Moreover, detection of the genes that are responsible for T&O production within the DNA of the freshwater community can help to speed up analysis. We show that qPCR methods can target the Geosmin synthase gene (geoA) and that this correlates significantly with Geosmin concentrations >15 ng/L. Alternatively, in-situ sensors that can be deployed remotely and transmit data, can provide real-time monitoring for early warning and potentially predictive capacity. Commercially available sensors do not currently exist for T&O compounds, but they do for many other water quality parameters. We consider the analytes that could be effective for T&O warning systems, using a Welsh reservoir as an exemplar case. Assessment of nutrient dynamics suggests N and P ratios are critical, hence we evaluate the sensors that are available for these compounds and associated environmental controls on their behaviour. We present recommendations for the design of an in-situ monitoring programme and introduce the planned tests that will evaluate it.</p>

A fuzzy logic approach for the prediction of sapid compounds concentration in a water supply system under climate change

<p>Climate change is expected to have a significant impact on water resource systems, affecting both water quantity and quality. Among other probable impacts on raw water, the increase of sapid compounds such as geosmin and MIB (2-methylisoborneol) is one of the most challenging for urban water supply, as it alters both water taste and odour. Water managers and water utility companies need to anticipate events that increase the concentration of sapid compounds. Proper methods and tools are necessary to design adaptation strategies for future drinking water supply. In this research we analyse the drivers of MIB and geosmin growth, and study the consequence that an increasing occurrence and intensity of sapid compounds events will have on the required water treatments. The research has been developed for a Mediterranean reservoir used for water supply to the city of Valencia, the 3<sup>rd</sup> largest city in Spain.</p><p> </p><p>The methodology applies a chain of models that integrates water quantity and quality processes in the same modelling framework. The modelling framework includes climate models, hydrological and water resource management models at the basin scale, and a reservoir management and quality models. Key environmental variables were selected using statistical analysis and expert criteria.  Fuzzy logic systems were then applied to predict MIB and geosmin concentration under different time periods and climate change scenarios. Two representative concentration pathways (RCP 4.5 and 8.5) and two-time horizons (short term 2020-2040, and mid term 2041-2070) were considered.</p><p> </p><p>Results show a significant increase of MIB and geosmin under climate change, especially during spring and summer. Concentrations of MIB would steadily rise until they double, reaching peaks of up to 0.50 µg/l by 2070 for all scenarios, while the World Health Organization maximum safe concentration is 0.01 µg/l. Geosmin concentrations also increase in all scenarios, reaching 0.05 µg/l by 2070. The microbiological data shows that benthic cyanobacteria Aphanocapsa delicatissima could be associated with MIB. Decreasing water storage, higher nitrate concentrations, and higher temperatures would stimulate MIB production, favoured by a likely increased of light penetration and resuspension of cyanobacteria present in the benthos of the reservoir. These environmental conditions appear mainly during drought events and force water treatment plants to change their processes to face the higher concentration of sapid compounds in raw water.</p><p> </p><p>Acknowledgements</p><p>This study has been supported by the European Research Area for Climate Services programme (ER4CS) under the INNOVA project (Grant Agreement 690462) and the Agencia Estatal de Investigación (PCIN-2017-066), and by the ADAPTAMED project (RTI2018-101483-B-I00), funded by the Ministerio de Economia y Competitividad (MINECO) of Spain and with EU FEDER funds.</p>

16p microtriplication case report associated with autistic spectrum disorder

Context: The literature on interstitial microtriplications at the 16p11.2 locus is scarce and unclear. We bring a rare case of microtriplications in the 16p11.2 locus associated with Syndromic Autistic Spectrum Disorder (ASD) and Intellectual Disability (ID) to stimulate discussion about this rare and complex condition. Case report: A.M.C., female, 10 years old, with history of agitation and aggression. Referred to neuropediatrician at 6 years old for behavioral change, socialization difficulties, agitation, heteroaggressiveness, developmental delay and school difficulty. She is not literate, has motor stereotypes when agitated, preferably plays with younger children, has tactile (water), taste (food) and sound sensory dysfunction, a low frustration threshold, difficulty in accepting routine changes and BMI of 14. Genetic evaluation showed interstitial triplication of 610Kb in the short arm of chromosome 16, raising diagnostic hypotheses of ASD and ID. Conclusions: Changes in microduplication in this locus are predisposing genetic factors for neurodevelopmental delays, ASD and ID. Changes in the number of 16p11.2 copies are believed to promote BMI index body change and brain changes in a dose-dependent manner on the phenotype. Brain changes include areas associated with reward, language and cognition. We bring this case to bring attention and discussion about to this rare condition.

Barriers and Enabling Factors for Central and Household Level Water Treatment in a Refugee Setting: A Mixed-Method Study among Rohingyas in Cox’s Bazar, Bangladesh

Water chlorination is widely used in emergency responses to reduce diarrheal diseases, although communities with no prior exposure to chlorinated drinking water can have low acceptability. To better inform water treatment interventions, the study explored acceptability, barriers, and motivating-factors of a piped water chlorination program, and household level chlorine-tablet distribution, in place for four months in Rohingya refugee camps, Cox’s Bazar, Bangladesh. We collected data from June to August 2018 from four purposively selected refugee camps using structured observation, key-informant-interviews, transect-walks, group discussions, focus-group discussions, and in-depth-interviews with males, females, adolescent girls, and community leaders. Smell and taste of chlorinated water were commonly reported barriers among the population that had previously consumed groundwater. Poor quality source-water and suboptimal resultant treated-water, and long-queues for water collection were common complaints. Chlorine-tablet users reported inadequate and interrupted tablet supply, and inconsistent information delivered by different organisations caused confusion. Respondents reported fear of adverse-effects of "chemicals/medicine" used to treat water, especially fear of religious conversion. Water treatment options were reported as easy-to-use, and perceived health-benefits were motivating-factors. In vulnerable refugee communities, community and religious-leaders can formulate and deliver messages to address water taste and smell, instil trust, allay fears, and address rumours/misinformation to maximise early uptake.