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Background: The deployment of Community Health Workers (CHWs) is widely promoted as a strategy for reducing health inequities in low- and middle-income countries (LMIC). Yet there is limited evidence on whether and how CHW programmes achieve this. This systematic review aimed to synthesise research findings on the following questions: (1) How effective are CHW interventions at reaching the most disadvantaged groups in LMIC contexts? and (2) What evidence exists on whether and how these programmes reduce health inequities in the populations they serve? Methods: We searched six academic databases for recent (2014–2020) studies reporting on CHW programme access, utilisation, quality, and effects on health outcomes/behaviours in relation to potential stratifiers of health opportunities and outcomes (e.g., gender, socioeconomic status, place of residence). Quantitative data were extracted, tabulated, and subjected to meta-analysis where appropriate. Qualitative findings were synthesised using thematic analysis. Results: One hundred sixty-seven studies met the search criteria, reporting on CHW interventions in 33 LMIC. Quantitative synthesis showed that CHW programmes successfully reach many (although not all) marginalized groups, but that health inequalities often persist in the populations they serve. Qualitative findings suggest that disadvantaged groups experienced barriers to taking up CHW health advice and referrals and point to a range of strategies for improving the reach and impact of CHW programmes in these groups. Ensuring fair working conditions for CHWs and expanding opportunities for advocacy were also revealed as being important for bridging health equity gaps. Conclusion: In order to optimise the equity impacts of CHW programmes, we need to move beyond seeing CHWs as a temporary sticking plaster, and instead build meaningful partnerships between CHWs, communities and policy-makers to confront and address the underlying structures of inequity. Trial registration: PROSPERO registration number CRD42020177333. [ABSTRACT FROM AUTHOR]

Background: The deployment of Community Health Workers (CHWs) is widely promoted as a strategy for reducing health inequities in low- and middle-income countries (LMIC). Yet there is limited evidence on whether and how CHW programmes achieve this. This systematic review aimed to synthesise research findings on the following questions: (1) How effective are CHW interventions at reaching the most disadvantaged groups in LMIC contexts? and (2) What evidence exists on whether and how these programmes reduce health inequities in the populations they serve? Methods: We searched six academic databases for recent (2014–2020) studies reporting on CHW programme access, utilisation, quality, and effects on health outcomes/behaviours in relation to potential stratifiers of health opportunities and outcomes (e.g., gender, socioeconomic status, place of residence). Quantitative data were extracted, tabulated, and subjected to meta-analysis where appropriate. Qualitative findings were synthesised using thematic analysis. Results: One hundred sixty-seven studies met the search criteria, reporting on CHW interventions in 33 LMIC. Quantitative synthesis showed that CHW programmes successfully reach many (although not all) marginalized groups, but that health inequalities often persist in the populations they serve. Qualitative findings suggest that disadvantaged groups experienced barriers to taking up CHW health advice and referrals and point to a range of strategies for improving the reach and impact of CHW programmes in these groups. Ensuring fair working conditions for CHWs and expanding opportunities for advocacy were also revealed as being important for bridging health equity gaps. Conclusion: In order to optimise the equity impacts of CHW programmes, we need to move beyond seeing CHWs as a temporary sticking plaster, and instead build meaningful partnerships between CHWs, communities and policy-makers to confront and address the underlying structures of inequity. Trial registration: PROSPERO registration number CRD42020177333. [ABSTRACT FROM AUTHOR]

Background: The pediatric pulmonary multisystem Langerhans cell histiocytosis (PPM LCH) is associated with either low risk or high risk organ(s). The nodulo-cystic lung lesions although pathognomonic, yet are very variable in severity and remain a source of controversy in certifying pulmonary LCH diagnosis. The study aimed to examine the prognostic value of clinical respiratory manifestations and radiological lung lesions severity. This is through associating a CT chest triad of bilateral, extensive and diffuse lesions. It is a retrospective study of 350 LCH patients who received systemic treatment at Children's Cancer Hospital Egypt during the period from 2007 to 2020. Results: Sixty-seven patients (67/350–19.1%) had PPM LCH at presentation. Severe lung lesions were present in 24 of them. The median follow-up period was 61 months (IQR: 3.4–8.3). The 5-year overall survival (OS) and event free survival (EFS) was 89% and 56.6% respectively. The EFS, for severe radiological lesions triad was 38% ± 20.7 versus 66% ± 16.2 for non-severe lesions triad p 0.002, while for presence of chest X-ray changes 27% ± 22.344 versus absence of chest X ray changes 66% ± 14.7 p 0.001, for clinical respiratory manifestations 13% ± 13.9 versus none 62% ± 22.9 p < 0.001, for RO− with severe lung lesions 47% ± 30.4 versus RO− without severe lung lesions 69% ± 5.9 p 0.04. There was a tendency for the independent prognostic impact of severe lung involvement; aHR = 1.7 (95% CI 0.92–3.13, p = 0.09). Conclusion: Although the lung is a low -risk organ per se in LCH, our study demonstrates a non negligeable prognostic impact of severe lung involvement in the risk stratification of pediatric LCH. This warrants further study and external validation. [ABSTRACT FROM AUTHOR]

The fruit Punica granatum L. has been used for years in traditional medicine owing to the presence of several phytobiotics with antimicrobial and immunomodulatory properties. This study investigated the effects of dietary supplementation with Punica granatum L. by-products(PGB) on performance, immunity, intestinal and excreta microflora, and odorousgasemissions from excreta of broiler chickens. Three experimental dietscontaining 0, 0.5 and 1.0% PGB were fed to 240 one-day-old broiler chicksuntil 35 days. Dietary PGB linearly reduced the average daily feed intake and feed conversion ratio of broilers. Supplementation with 1% PGB led to a linear increase in the relative weight of the spleen and bursa of Fabricius. The concentration of serum IgA and IgG increased linearly in response to dietary PGB. In the ileal digesta, the concentration of Saccharomyces cerevisiae increased linearly and quadratically in response to dietary PGB. Moreover, dietary PGB led to a linear decrease in Escherichia coli and Salmonella spp. alongside reducing the pH of the ileal digesta. In the cecal digesta, the concentration of Bacillus bacteria increased linearly in response to both levels of dietary PGB, while the concentrations of E. coli and Salmonella decreased when the diet wass upplemented with 1% PGB, asdid cecal pH. At 35 day, both levelsof PGB increased the concentration of fecal Bacillus, whereasonly 1% PGB increased the concentration of S. cerevisiae at 21 day. Increasing levels of PGB induce a linear reduction in fecal E. coli at 21 and 35 day, whereas Salmonella only at 21 day. Regarding the average of 48 h, dietary PGB effectively reduced the emissions of ammonia and methanethiol from broiler excreta. In conclusion, the results suggest that, dietary PGB improved immunity and the intestinal microbial ecosystem of broilers along with reduced odorous gas emissions from excreta. [ABSTRACT FROM AUTHOR]

Escherichia coli and Salmonella spp. are considered to be the major pathogens associated with human transmissible infectious diseases in the air of poultry houses. Chlorine dioxide (ClO2) is an effective biocide against a wide range of microorganisms. Accordingly, this study investigated the efficiency of gaseous ClO2 application for disinfecting broiler houses by collecting air samples before and after fumigation using a passive method. Fumigation was performed with 125 mL or 250 mL of ClO2 liquid (containing 2,000 ppm of ClO2) and 3 trials were conducted for each dose. A total of 27 petri dishes were used for each trial (for each type of bacteria: E. coli or Salmonella) and placed in 3 different locations (front, middle and back) and 3 different positions (top, middle and floor) of the broiler shed. Air samples were collected at 10 min, 1 h, 3 h, 6 h, and 12 h before and after fumigation to evaluate the air quality in terms of the concentration of E. coli and Salmonella. Both levels of ClO2 were capable of reducing the concentration of E. coli from broiler house air during all measuring periods except 10 min, with highest disinfection rate being observed at 6 h. With the exception of 1 h, the concentration of Salmonella was also reduced after fumigation with ClO2 in all measuring period; with the highest disinfection rate occurring at 6 h. Fumigation with ClO2 had no negative effect on birds' health condition. Taken together, these results suggest that the application of gaseous ClO2 at the investigated levels can be an effective option for reducing bacterial load from broiler house environments. [ABSTRACT FROM AUTHOR]

The study was conducted to evaluate the supplementation of fermented seaweed (Undaria pinnatifida) by-product (FSB) on colostrum composition and immunoglobulin level in breeding Hanwoo cows and growth and immunity of their suckling calves. A total of 32 breeding Hanwoo cows with different parities were assigned to Control (basal diet) and FSB (basal diet + 10% FSB) dietary groups in a randomised block design for 2 months before parturition until weaning of their calves. Calves with FSB supplementation had greater weaning weight and average daily gain (P < 0.05). Dietary FSB supplementation increased calf serum immunoglobulin G level in the first parity (P < 0.05), whereas it was reduced in the second to fourth parities on Days 15 and 45. The immunoglobulin M level increased on Day 15 in the first parity and on Day 45 in the second to fourth parities (P < 0.05), whereas it decreased on Day 45 in the first parity (P < 0.05). Dietary FSB supplementation also elevated moisture, crude fat and crude protein content whereas it reduced the total solids content in colostrum for both parities (P < 0.05). Colostrum immunoglobulin G level was also increased in the first parity, whereas it was reduced in the second to fourth parities in FSB supplementation (P < 0.05). Overall, dietary FSB supplementation increased suckling calves weaning weight, average daily gain, serum immunoglobulin G level and colostrum immunoglobulin G level in the first parity. Moreover, moisture, crude fat and crude protein content of colostrum were elevated significantly in both parities in breeding Hanwoo cows. Therefore, FSB can be used as a functional feed additive to the basal diet in breeding Hanwoo cows. [ABSTRACT FROM AUTHOR]

In this experiment, we proposed and implemented a disease forecasting system using a received signal strength indication ZigBee-based wireless network with a 3-axis acceleration sensor to detect illness at an early stage by monitoring movement of experimentally infected weaned piglets. Twenty seven piglets were divided into control, Salmonella enteritidis (SE) infection, and Escherichia coli (EC) infection group, and their movements were monitored for five days using wireless sensor nodes on their backs. Data generated showed the 3-axis movement of piglets (X-axis: left and right direction, Y-axis: anteroposterior direction, and Z-axis: up and down direction) at five different time periods. Piglets in both infected groups had lower weight gain and feed intake, as well as higher feed conversion ratios than the control group (p<0.05). Infection with SE and EC resulted in reduced body temperature of the piglets at day 2, 4, and 5 (p<0.05). The early morning X-axis movement did not differ between groups; however, the Y-axis movement was higher in the EC group (day 1 and 2), and the Z-axis movement was higher in the EC (day 1) and SE group (day 4) during different experimental periods (p<0.05). The morning X and Y-axis movement did not differ between treatment groups. However, the Z-axis movement was higher in both infected groups at day 1 and lower at day 4 compared to the control (p<0.05). The midday X-axis movement was significantly lower in both infected groups (day 4 and 5) compared to the control (p<0.05), whereas the Y-axis movement did not differ. The Z-axis movement was highest in the SE group at day 1 and 2 and lower at day 4 and 5 (p<0.05). Evening X-axis movement was highest in the control group throughout the experimental period. During day 1 and 2, the Z-axis movement was higher in both of the infected groups; whereas it was lower in the SE group during day 3 and 4 (p<0.05). During day 1 and 2, the night X-axis movement was lower and the Z-axis movement was higher in the infected piglets (p<0.05). Overall, the movement of infected piglets was altered, and the acceleration sensor could be successfully employed for monitoring pig activity. [ABSTRACT FROM AUTHOR]

Chlorine dioxide (ClO2) is a powerful biocide that has long been used commercially to control microbial activity in various sectors. This study was conducted to determine the effectiveness of dietary ClO2 on growth performance, intestinal and excreta microorganisms, and the emission of odorous gas from broiler excreta. A total of 120 one-day-old broiler chicks were provided with experimental diets including ClO2 at 0, 0.05, or 0.1% of the diet at random. Dietary ClO2(0.05 and 0.1%) resulted in a significant reduction in feed intake and feed conversion ratio without affecting the growth rate of the broilers. Dietary ClO2 (0.05 and 0.1%) did not affect the Lactobacillus, Bacillus, and Salmonella concentrations in the ileal digesta; however, it significantly increased the level of yeast and mold. In contrast, dietary ClO2 at 0.1% significantly decreased the number of ileal E. coli. In the cecal digesta, the Bacillus, E. coli and Salmonella CFUs were reduced significantly in response to 0.05 and 0.1% ClO2. Both levels of ClO2 significantly reduced the concentrations of E. coli and Salmonella in broiler excreta by d 21, whereas significant reduction was observed only in response to 0.1% ClO2 supplementation by d 35. Dietary supplementation with 0.1% ClO2 resulted in significant reductions in excreta pH at 6, 12, and 48 h of incubation relative to the non-supplemented group. Fecal ammonia emissionwas significantly higher at 48 h in response to 0.1% ClO2 supplementation. In contrast, significantly lower emissions of hydrogen sulfide (3, 6, 12, and 24 h), sulfur dioxide (24 and 48 h), and mercaptans (0, 3, and 48 h) were recorded in response to dietary ClO2 supplementation. Overall, reduction of intestinal and excreta pathogenic microorganisms together with lower emissions of sulfur-containing odorous gas from broiler excreta were observed in response to dietary supplementation with 0.1% ClO2 without affecting the growth rate. [ABSTRACT FROM AUTHOR]

The effects of diets supplemented with four levels (0%, 0.5%, 1.0% and 2.0%) of pomegranate by-product (PB) on meat composition, fatty acid profile and oxidative stability of broiler meat were evaluated. The crude protein and moisture contents increased, whereas ether extract in breast and thigh meat and cholesterol in breast meat decreased in response to dietary PB supplementation ( p < 0.05). In breast and thigh meat, the sum of saturated fatty acids was lower, while the sum of mono-unsaturated and n − 3 fatty acids were higher, alongside lower n − 6/ n − 3 ratio in the 1.0% and 2.0% PB supplemented group ( p < 0.05). The TBARS values and pH of breast and thigh meat were reduced in the PB supplemented groups ( p < 0.05). Overall, the results presented herein indicate that supplementation of diets with up to 2% pomegranate by-products improved the meat composition, fatty acid profile and reduced lipid oxidation of broiler meat. [ABSTRACT FROM AUTHOR]

A total of 48 crossbred (Landra - ce×Yorkshire×Duroc) pigs (2 months old; 28.38±2.62 kg body weight) were randomly assigned to either a control (basal diet) or 0.5% artificial zeolite (AZ) [basal diet + 0.5% AZ, dry matter (DM) basis] dietary treatment group in a completely randomized block design. Growth performance, immunity, muscle composition, carcass quality, faecal microflora concentration and noxious gas emissions were then investigated. No significant variation was observed in average daily gain (ADG), average daily feed intake (ADFI) or gain:feed [kg gain/kg dry matter intake (DMI)] ratio between treatments. The IgM and IgA levels remained unchanged, whereas the IgG level increased in the AZ dietary group relative to the control (P<0.05). Carcass quality, muscle composition and cholesterol level were also unaffected by AZ supplementation (P>0.05). Although AZ had no significant effect on fecal yeast and Lactobacillus spp. concentrations, a significant reduction was observed for Bacillus spp. in growing and E. coli both in growing and finishing pigs (P<0.05). Additionally, AZ supplementation led to a reduction in faecal ammonia (NH3), sulphur dioxide (SO2) and hydrogen sulphide (H2S) gases relative to the control (P<0.05). Based on these results, AZ had positive effects on faecal E. coli concentration and noxious gas emissions; however, further study with different levels of AZ to better understand its effects on growth performance of grower to finisher pigs is warranted. [ABSTRACT FROM AUTHOR]

This experiment was conducted to investigate the effects of Bacillus amyloliquefaciens probiotic (BAP) as a direct-fed microbial on growth performance, cecal microflora, serum immunoglobulin levels, and fecal noxious gas emissions of broiler chickens. A total of 400 one-day-old broiler chicks (Ross 308) were randomly assigned to 1 of 5 treatment diets formulated to supply 0, 1, 5, 10, and 20 g/kg of BAP and were fed for 35 d. Each treatment had 8 replicate pens with 10 birds per replicate. On completion of the growth trial, fecal samples were collected, and ammonia (NH3) and hydrogen sulfide (H2S) emissions were measured. Increasing concentration of BAP had positive linear effect on the ADG of broilers (P < 0.05) throughout the experimental period, with the highest values being observed in broilers offered 20 g/kg of BAP. The ADFI increased linearly (P < 0.02) with the inclusion of BAP during the overall experimental period (d 0 to 35). Providing BAP had a negative linear effect on FCR from d 0 to 21 and d 0 to 35 (P < 0.01). Supplementation with BAP did not affect cecal Lactobacillus and Bacillus content, but exerted negative linear effect on cecal Escherichia coli (P < 0.05) with increasing the level of BAP in broiler diets. Additionally, BAP modified immune response of broilers by linearly increasing serum IgG and IgA (P < 0.01). Dietary BAP resulted in decreased fecal NH3 emissions at 0 (linear, P < 0.001), 3, 6, 12, 24, and 48 h of incubation (linear, P < 0.05; quadratic, P < 0.01). Supplementation of BAP exerted negative linear and quadratic effects on fecal emissions of H2S (P < 0.001) throughout the incubation period except at 48 h, and the optimum effect was found when BAP was provided at 5 g/kg of diet. Based on these results, Bacillus amyloliquefaciens could be suggested as a potential feed additive of broiler diets. [ABSTRACT FROM AUTHOR]

A high prevalence of rickets of unknown aetiology has been reported in Chakaria, Bangladesh. Classically, rickets is caused by vitamin D deficiency but increasing evidence from Africa and Asia points towards other nutritional deficiencies or excessive exposure to some metals. The aim of this study was to investigate the aetiology of rickets in rural Bangladeshi children. 64 cases with rickets-like deformities were recruited at first presentation together with age-sex-village matched controls. Data and sample acquisition included anthropometry, radiographs, fasted plasma and urinary samples, 24 h weighed dietary intake together with a 24 h urine collection, and 13C-breath tests to detect Helicobacter (H.) pylori infection. One child had active rickets and frank hypovitaminosis D (F, n = 1) and one had deformities with radiological features of Blount disease (M, n = 1). The remaining cases were grouped into those with active rickets, defined as a radiographic Thacher score ≥1.5 (Group A, n = 24, 12M, 12F) and rickets-like bone deformities but not active rickets (Group B, n = 38, 28M, 10F). All children had a low dietary calcium intake, but this was lower in Group A than their controls (mean (SD): 156 (80) versus 323 (249) mg/day, p = 0.005). Plasma 25-hydroxyvitamin D (25OHD) was lower in Group A compared to controls; 63% of Group A and 8% of controls had a concentration <25 nmol/L (p ≤ 0.0001). There was, however, no evidence of differences in skin sunshine exposure. Group A had lower plasma calcium and phosphate and higher 1,25-dihydroxyvitamin D (1,25(OH) 2 D) and parathyroid hormone (PTH). 88% of Group A and 0% of controls had undetectable plasma intact fibroblast growth factor (iFGF23), with c-terminal FGF23 (cFGF23) concentrations in the normal range. Urinary phosphate and daily outputs of environmental metals relative to creatinine were higher and tubular maximal phosphate reabsorption per unit glomerular filtration rate (TmP/GFR) was lower in Group A compared to controls. Although less pronounced than Group A, Group B had higher alkaline phosphatase, 1,25(OH) 2 D and PTH concentrations than controls but similar calcium intake, TmP/GFR, iFGF23 and cFGF23 concentrations. Mean 25OHD concentrations were also similar to controls and there was no significant difference in the percentage <25 nmol/L (Group B: 13%, controls: 5%, p = 0.2) No group differences were seen in prevalence of anaemia, iron deficiency or H. pylori infection. Nutritional rickets in this region is likely to be predominantly due to low calcium intake in the context of poor vitamin D status and exposure to environmental metals, but not H. pylori infection, anaemia or iron deficiency. • Rickets in Chakaria, Bangladesh was associated with low dietary calcium intake. • Low vitamin D status (>clinical deficiency range) and exposure to metals were noted. • Chronically low calcium intakes caused urinary phosphate wasting and rickets. • Phosphaturia was not driven by elevated FGF23 rather secondary hyperparathyroidism. • Rickets showed no relationship with H. pylori infection, anaemia or iron deficiency. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute myeloid leukemia (AML) is characterized by heterogeneity in phenotypic, genotypic, and clinical traits. miRNAs play an important role in pathogenesis and diagnosis of adult AML. Such information is not available about miRNA expression role in pediatric AML. OBJECTIVE: We aimed to investigate the expression of miR-370 and miR-375 as new diagnostic biomarkers to discriminate pediatric AML patients and to predict their roles in the disease molecular basis. METHODS: The expression of both miR-370 and miR-375 in peripheral blood (PB) of pediatric AML patients was assessed by QPCR; their impact for diagnosis was evaluated by ROC curve and their roles in pediatric AML development were predicted by bioinformatics analysis. RESULTS: The expression of miR-370 and miR-375 levels was significantly decreased in pediatric AML patients, suggesting them as tumor suppressor miRNAs as supported by bioinformatics analysis. miR-370 showed better potential and sensitivity toscreen pediatric AML patients and more significant correlation with AML risk than miR-375. This is the first study to report the positive correlation between both miR-370 and miR-375. CONCLUSION: miR-370 level in peripheral blood can serve as a potential non-invasive diagnostic biomarker and was significantly correlated with AML risk. We strongly recommend PB miRNAs as diagnostic biomarkers for pediatric AML. [ABSTRACT FROM AUTHOR]

Objective: Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in Pakistan.Design: Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).Results: From 45 712 results, seventeen studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF was found in all studies. Nine of fifteen studies assessing timing recorded CF introduced between 6 and 9 months. Five of nine observed dietary diversity across four of seven food groups; and two of four, minimum meal frequency in over 50 % of participants. Influencing factors included lack of CF knowledge, low maternal education, socio-economic status and cultural beliefs.Conclusions: This is the first systematic review to evaluate CF practices in Pakistan. Campaigns to change health and nutrition behaviour are needed to meet the substantial unmet needs of these children. [ABSTRACT FROM AUTHOR]

Objective: Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in India.Design: Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' and derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence).Results: From 45 712 abstracts screened, sixty-four cross-sectional, seven cohort, one qualitative and one case-control studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF practices were found in all studies. In twenty-nine of fifty-nine studies, CF was introduced between 6 and 9 months, with eight studies finding minimum dietary diversity was achieved in 6-33 %, and ten of seventeen studies noting minimum meal frequency in only 25-50 % of the study populations. Influencing factors included cultural influences, poor knowledge on appropriate CF practices and parental educational status.Conclusions: This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children. [ABSTRACT FROM AUTHOR]

A ground source geothermal heat pump (GSHP) was installed in a nursery pig house and the inlet and outlet temperature, coefficient of performance (COP), internal room temperature, energy consumption, CO 2 and noxious gas emissions and costs were then compared between a control (conventional heating) and GSHP supported room. The mean outflow temperature was higher ( P < 0.05) than the inflow in all three segments of the GSHP system. The GSHP room temperature was elevated in the entry, center and back position, except for a reduced temperature in the entry during the first week ( P < 0.05). The mean COP was calculated to be 4.46 for the GSHP system over the three week experimental period. Electricity consumption and CO 2 emissions were reduced by about 750.73 kW h and 405.39 kg, respectively, in the GSHP system relative to the control. Additionally, the overall energy cost was decreased by about 314.40 USD during the three week experimental period. Reduced NH 3 , H 2 S and SO 2 gas emissions were observed in the GSHP supported room relative to the control ( P < 0.05). Overall, the GSHP system has the potential to minimize energy consumption and reduce green-house and noxious gas emissions, making it an economical and environmentally friendly renewable energy source. [ABSTRACT FROM AUTHOR]