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BackgroundDiabetic retinopathy can cause blindness even in the absence of symptoms. Although routine eye screening remains the mainstay of diabetic retinopathy treatment and it can prevent 95% of blindness, this screening is not available in many low- and middle-income countries even though these countries contribute to 75% of the global diabetic retinopathy burden. ObjectiveThe aim of this study was to assess the diagnostic accuracy of diabetic retinopathy screening done by non-ophthalmologists using 2 different digital fundus cameras and to assess the risk factors for the occurrence of diabetic retinopathy. MethodsThis validation study was conducted in 6 peripheral health facilities in Bangladesh from July 2017 to June 2018. A double-blinded diagnostic approach was used to test the accuracy of the diabetic retinopathy screening done by non-ophthalmologists against the gold standard diagnosis by ophthalmology-trained eye consultants. Retinal images were taken by using either a desk-based camera or a hand-held camera following pupil dilatation. Test accuracy was assessed using measures of sensitivity, specificity, and positive and negative predictive values. Overall agreement with the gold standard test was reported using the Cohen kappa statistic (κ) and area under the receiver operating curve (AUROC). Risk factors for diabetic retinopathy occurrence were assessed using binary logistic regression. ResultsIn 1455 patients with diabetes, the overall sensitivity to detect any form of diabetic retinopathy by non-ophthalmologists was 86.6% (483/558, 95% CI 83.5%-89.3%) and the specificity was 78.6% (705/897, 95% CI 75.8%-81.2%). The accuracy of the correct classification was excellent with a desk-based camera (AUROC 0.901, 95% CI 0.88-0.92) and fair with a hand-held camera (AUROC 0.710, 95% CI 0.67-0.74). Out of the 3 non-ophthalmologist categories, registered nurses and paramedics had strong agreement with kappa values of 0.70 and 0.85 in the diabetic retinopathy assessment, respectively, whereas the nonclinical trained staff had weak agreement (κ=0.35). The odds of having retinopathy increased with the duration of diabetes measured in 5-year intervals (P

The difficulty with shale sampling and testing and the lack of pile load tests in shales have created challenges with shale classification, pile resistance prediction, and understanding time-dependent pile responses. Treating shale as soil can yield a conservative pile design. Shales were classified into soil-based and rock-based depending on their weathering conditions, mechanical properties, and measured pile resistances. Failure behaviors of soil- and rock-based shales are discussed. Prediction equations were developed to account for predicting shale properties. Properties of rock-based shales decrease with the increase in weathering. New static analysis (SA) methods were proposed to predict unit shaft resistance ([q.sub.s]) and unit end bearing ([q.sub.b]) of piles in shales and validated. Our study yields higher resistance and efficiency factors for the proposed SA methods and piles in shales than existing SA methods developed for piles in soils. The [q.sub.s] in the soil-based shale exhibits pile setup, while the [q.sub.s] in rock-based shales experience both setup and relaxation. The [q.sub.b] in both soil-based and highly weathered shales is likely to experience pile setup. However, the [q.sub.b] in the moderately and slightly weathered shales experience both setup and relaxation. Key words: driven piles, shale classification, static analysis method, load and resistance factor design, reliability analysis, pile setup and relaxation La difficulty d'echantillonnage et d'essai des schistes et le manque d'essais de charge des pieux dans les schistes ont cree des defis en matiere de classification des schistes, de prediction de la resistance des pieux et de comprehension des reponses des pieux en fonction du temps. En traitant le schiste comme un sol, on peut obtenir une conception conservatrice des pieux. Les schistes ont ete classes en sols et roches en fonction de leurs conditions d'alteration, de leurs proprietes mecaniques et des resistances mesurees des pieux. Les comportements de rupture des schistes a base de sol et de roche sont discutes. Des equations de prediction ont ete developpees pour tenir compte des proprietes previsibles du schiste. Les proprietes des schistes a base de roche diminuent avec l'augmentation de l'alteration. De nouvelles methodes d'analyse statique (SA) ont ete proposees et validees pour predire la resistance unitaire de l'arbre ([q.sub.s]) et l'appui unitaire d'extremite ([q.sub.b]) des pieux dans les schistes. Notre etude donne des facteurs de resistance et d'efficacite plus eleves pour les methodes SA proposees et les pieux dans les schistes que les methodes SA existantes developpees pour les pieux dans les sols. Le [q.sub.s] dans le schiste a base de sol presente une mise en place de la pile, tandis que le [q.sub.s] dans les schistes a base de roche presente a la fois une mise en place et une relaxation. Le [q.sub.b] dans les schistes a base de sol et dans les schistes fortement alteres est susceptible de connaitre une mise en place des piles. Cependant, les [q.sub.b] dans les schistes moderement et legerement alteres connaissent a la fois une mise en place et une relaxation. [Traduit par la Redaction] Mots-cles : pieux battus, classification des schistes, methode d'analyse statique, conception des facteurs de charge et de resistance, analyse de fiabilite, mise en place et relaxation des pieux, Introduction Driven steel piles are an excellent foundation system for shallow bedrock stratigraphy due to their economy and durability. Many states in North America have an extensive distribution of soft [...]

Cotton fiber consumption is higher than any other natural fiber due to its superior mechanical and physical properties. In the conventional reactive dyeing process, the dye undergoes hydrolysis due to hydrogen bonding and weak Van der Waals forces, yielding poor washing color fastness. Additionally, the post-dyeing wash-off process consumes significant amounts of water, energy, and time in order to remove the unreacted and hydrolyzed dye. Therefore, reactive dyes are predominantly utilized to color cotton fabrics as the covalent bond formed between dye and fiber results in excellent washing fastness for a wide range of colors, and improved ease of use. To support more efficient, economical, and sustainable reactive dyeing, polymers can be used as effective dye transfer inhibitors (DTIs) in the reactive wash-off process. In this study, poly(vinylpyrrolidone) (PVP) homopolymer and poly(vinylpyrrolidone)-co-poly(vinylimidazole) (PVP-co-PVI) were synthesized at different molecular weights. These polymers were then employed as DTIs to evaluate their performance during the wash-off process for dyed cotton fabrics treated with three reactive dyes (Reactive Red 195, Reactive Blue 221, and Reactive Yellow 145). It is noteworthy to mention that the alternative wash-off procedure involved only three stages, in contrast to the series of washing steps necessary in the conventional method. Evaluation of the DTIs was focused on parameters such as color strength, washing fastness, chemical oxygen demand (COD), as well as energy, water, and time consumption. The findings revealed that while the polymer DTIs generated minor differences in dyed fabric colors in comparison to conventional dyeing, they significantly improved washing fastness. The polymer DTIs studied display excellent potential to provide a much more sustainable dyeing process by saving 90% energy, 40% water, and 50% time versus conventional wash-off processing. The wastewater COD values from the polymer-assisted reactive dye wash-off process were higher for all reactive dyes tested than those from conventional processing. While the higher COD values are attributed to the lower water volumes, this finding highlights the need for further studies. In summary, PVP polymers successfully served as DTIs in the reactive dyeing washing-off process, providing massive water-energy-time efficiency improvements and, subsequently, a more sustainable process for cotton fabric dyeing. [ABSTRACT FROM AUTHOR]

Introduction: Efficient treatment of fecal sludge in densely populated settings is essential as it has a direct impact on public health and the environment. This study presents a comprehensive assessment of fecal sludge treatment technologies in Rohingya camps at Cox’s Bazar, Bangladesh, focusing on removal efficiencies and compliance with regulatory standards. Methods: Seventeen treatment plants of five different technologies were evaluated based on removal efficiency and standard discharge guidelines for various physicochemical and microbiological parameters. Results: Waste Stabilization Pond (WSP) was the top performer compared to four other different treatment technologies evaluated, achieving notable removal rates: 97.3% reduction in E. coli, 100% in helminth eggs, 98.3% for COD, 97.8% for BOD, 98.7% for TSS, 92.1% for TS, 82.8% for phosphate, and 93.3% for total nitrogen. Lime Stabilization Ponds showed lower removal rates, except for E. coli (98.9%), with reductions of 99.7% for helminth eggs, 81.6% for COD, 80.9% for BOD, 86.3% for TSS, 68.6% for TS, and 49.2% for phosphate. Upflow Filters demonstrated good removal efficiencies for E. coli (99.7%), TSS (95.9%), COD (91.7%), BOD (93.5%), and helminth eggs (93.7%). WSP consistently outperformed other technologies across all seasons. Despite these, none of the technologies fully met discharge standards. Discussion: These findings highlight the need for a comprehensive approach, the combination of physicochemical and biological processes, to enhance efficacy. Promoting improved fecal sludge management technologies through awareness campaigns and technical support can mitigate environmental health risks in densely populated humanitarian settings. [ABSTRACT FROM AUTHOR]