Rapid and sensitive detection of Pseudomonas aeruginosa by isothermal amplification combined with Cas12a-mediated detection.

CRISPR based technologies have been used for fast and sensitive detection of pathogens. To test the possibility of CRISPR based detection strategy in Pseudomonas aeruginosa infections, a combined method of recombinase polymerase amplification followed by Cas12a-mediated detection via fluorescence reader or lateral flow biosensor (named Cas12a-RCFL) has been established in this study. The Cas12a-RCFL can detect as low as 50 CFU/mL Pseudomonas aeruginosa. The whole detection process can be finished within one hour with satisfied detection specificity. Cas12a-RCFL also shows good sensitivity of detecting Pseudomonas aeruginosa inStaphylococcus aureus and Acinetobacter baumannii contaminated samples. For the detection of 22 clinical samples, Cas12a-RCFL matches with PCR sequencing result exactly without DNA purification. This Cas12a-RCFL is rapid and sensitive with low cost, which shows good quality to be adopted as a point-of-care testing method.

Testing the effectiveness of household fuel conservation strategies: Policy implications for increasing the affordability of exclusive clean cooking.

BACKGROUND: Exclusive clean fuel use is essential for realizing health and other benefits but is often unaffordable. Decreasing household-level fuel needs could make exclusive clean fuel use more affordable, but there is a lack of knowledge on the amount of fuel savings that could be achieved through fuel conservation behaviors relevant to rural settings in low- and middle-income countries. METHODS: Within a trial in Peru, we trained a random half of intervention participants, who had previously received a liquefied petroleum gas (LPG) stove and were purchasing their own fuel, on fuel conservation strategies. We measured the amount of fuel and mega joules (MJ) of energy consumed by all participants, including control participants who were receiving free fuel from the trial. We administered surveys on fuel conservation behaviors and assigned a score based on the number of behaviors performed. RESULTS: Intervention participants with the training had a slightly higher conservation score than those without (7.2 vs. 6.6 points; p = 0.07). Across all participants, average daily energy consumption decreased by 9.5 MJ for each 1-point increase in conservation score (p < 0.001). Among households who used exclusively LPG (n = 99), each 1-point increase in conservation score was associated with a 0.04 kg decrease in LPG consumption per household per day (p = 0.03). Using pressure cookers and heating water in the sun decreased energy use, while using clay pots and forgetting to close stove knobs increased energy use. CONCLUSION: Our findings suggest that a household could save 1.16 kg of LPG per month for each additional fuel conservation behavior, for a maximum potential savings of 8.1 kg per month. Fuel conservation messaging could be integrated into national household energy policies to increase the affordability of exclusive clean fuel use, and subsequently achieve the environmental and health benefits that could accompany such a transition.

Combined action observation and motor imagery improves learning of activities of daily living in children with Developmental Coordination Disorder.

Developmental coordination disorder (DCD) is characterised by poor motor coordination, which interferes with the ability to execute activities of daily living (ADLs). Combined action observation and motor imagery (AOMI) involves observing movement videos whilst imagining simultaneously the sensations of executing the same movement. Laboratory-based research indicates that AOMI can help improve movement coordination in children with DCD, but no previous research had investigated the efficacy of AOMI interventions for learning ADLs. This study investigated the efficacy of a home-based, parent-led, AOMI intervention for learning ADLs in children with DCD. Children with confirmed (n = 23) or suspected (n = 5) DCD (total sample n = 28), aged 7-12 years, were assigned to either an AOMI intervention or a control intervention (both n = 14). Participants attempted the following ADLs at pre-test (week 1), post-test (week 4), and retention test (week 6): shoelace tying, cutlery use, shirt buttoning, and cup stacking. Task completion times and movement techniques were recorded. The AOMI intervention produced significantly faster task completion times than the control intervention at post-test for shoelace tying, and significantly improved movement techniques for shoelace tying and cup stacking. Importantly, for children who could not tie shoelaces at pre-test (n = 9 per group), 89% of those following the AOMI intervention learnt the skill successfully by the end of the study, compared to only 44% of those following the control intervention. The findings indicate that home-based, parent-led, AOMI interventions can aid the learning of complex ADLs in children with DCD, and may be particularly effective for facilitating the learning of motor skills that do not currently exist within these children's motor repertoire.

SUREHYP: An Open Source Python Package for Preprocessing Hyperion Radiance Data and Retrieving Surface Reflectance.

Surface reflectance is an essential product from remote sensing Earth observations critical for a wide variety of applications, including consistent land cover mapping and change, and estimation of vegetation attributes. From 2000 to 2017 the Earth Observing-1 Hyperion instrument acquired the first satellite based hyperspectral image archive from space resulting in over 83,138 publicly available images. Hyperion imagery however requires significant preprocessing to derive surface reflectance. SUREHYP is a Python package designed to process batches of Hyperion images, bringing together a number of published algorithms and methods to correct at sensor radiance and derive surface reflectance. In this paper, we present the SUREHYP workflow and demonstrate its application on Hyperion imagery. Results indicate SUREHYP produces flat terrain surface reflectance results comparable to commercially available software, with reflectance values for the whole spectral range almost entirely within 10% of the software's over a reference target, yet it is publicly available and open source, allowing the exploitation of this valuable hyperspectral archive on a global scale.

Reducing household air pollution exposure to improve early child growth and development; a randomized control trial protocol for the "Poriborton-Extension: The CHANge trial".

BACKGROUND: Globally, household air pollution (HAP) is a leading environmental cause of morbidity and mortality. Our trial aims to assess the impact of liquefied petroleum gas (LPG) for cooking to reduce household air pollution exposure on child health outcomes, compared to usual cooking practices in Bangladesh. The primary aim is to evaluate if reduced exposure to HAP through the provision of LPG for cooking from early gestation through to age 2 improves child anthropometry, health, and neuro-cognitive developmental outcomes, compared to children exposed to emissions from usual practice. METHODS: Two-arm parallel cluster randomized controlled trial (cCRT). We will extend the intervention and follow-up of our existing "Poriborton" trial. In a subset of the original surviving participants, we will supply LPG cylinders and LPG stoves (intervention) compared to usual cooking practices and extend the follow-up to 24 months of age. The expected final sample size, for both (intervention and control) is 1854 children with follow-up to 2 years of age available for analysis. DISCUSSION: This trial will answer important research gaps related to HAP and child health and neuro-cognitive developmental outcomes. This evidence will help to understand the impact of a HAP intervention on child health to inform policies for the adoption of clean fuel in Bangladesh and other similar settings. TRIAL REGISTRATION: The Poriborton: Change trial: Household Air Pollution and Perinatal and early Neonatal mortality is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12618001214224, original trial registered on 19th July 2018, extension approved on 23rd June 2021. www.anzctr.org.au .

Assessing the Effects of Stove Use Patterns and Kitchen Chimneys on Indoor Air Quality during a Multiyear Cookstove Randomized Control Trial in Rural India.

We conducted indoor air quality (IAQ) measurements during a multiyear cookstove randomized control trial in two rural areas in northern and southern India. A total of 1205 days of kitchen PM2.5 were measured in control and intervention households during six ∼3 month long measurement periods across two study locations. Stoves used included traditional solid fuel (TSF), improved biomass, and liquefied petroleum gas (LPG) models. Intent-to-treat analysis indicates that the intervention reduced average 24 h PM2.5 and black carbon in only one of the two follow-up measurement periods in both areas, suggesting mixed effectiveness. Average PM2.5 levels were ∼50% lower in households with LPG (for exclusive LPG use: >75% lower) than in those without LPG. PM2.5 was 66% lower in households making exclusive use of an improved chimney stove versus a traditional chimney stove and TSF-exclusive kitchens with a built-in chimney had ∼60% lower PM2.5 than those without a chimney, indicating that kitchen ventilation can be as important as the stove technology in improving IAQ. Diurnal trends in real-time PM2.5 indicate that kitchen chimneys were especially effective at reducing peak concentrations, which leads to decreases in daily PM2.5 in these households. Our data demonstrate a clear hierarchy of IAQ improvement in real world, "stove-stacking" households, driven by different stove technologies and kitchen characteristics.

Substitution strategies for cooking energy: To use gas or electricity?

The Chinese government has called for clean and effective energy substitution for cooking in rural areas. This paper assesses the environmental and economic impacts of various types of cooking fuels and stoves. According to the assessment results, the environmental impacts are highly influenced by the types of fuels and the efficiency of stoves used for cooking. Using biogas, liquefied petroleum gas (LPG), and natural gas for cooking instead of solid fuels can significantly reduce environmental emissions. To provide 1 megajoule (MJ) of useful cooking heat, the environmental costs of lump coal, honeycomb briquettes, and straw are the largest, estimated to be 80.4 yuan/MJ, 73.1 yuan/MJ, and 71.4 yuan/MJ, respectively. In addition, the economic assessment results show that the most expensive source of cooking fuel is LPG, with an average annual cost of 1700 yuan, while the cost of straw and firewood is the cheapest, at less than 100 yuan. The average annual cost of electricity is higher than that of natural gas. Regarding the substitution effects, using natural gas for cooking is better than using electricity. The environmental benefit of electricity substitution is only 10%-20% of natural gas substitution, and the corresponding increasing cost for residents is 1.5 times that of natural gas substitution.

Fidelity and Adherence to a Liquefied Petroleum Gas Stove and Fuel Intervention during Gestation: The Multi-Country Household Air Pollution Intervention Network (HAPIN) Randomized Controlled Trial.

BACKGROUND: Clean cookstove interventions can theoretically reduce exposure to household air pollution and benefit health, but this requires near-exclusive use of these types of stoves with the simultaneous disuse of traditional stoves. Previous cookstove trials have reported low adoption of new stoves and/or extensive continued traditional stove use. METHODS: The Household Air Pollution Intervention Network (HAPIN) trial randomized 3195 pregnant women in Guatemala, India, Peru, and Rwanda to either a liquefied petroleum gas (LPG) stove and fuel intervention (n = 1590) or to a control (n = 1605). The intervention consisted of an LPG stove and two initial cylinders of LPG, free fuel refills delivered to the home, and regular behavioral messaging. We assessed intervention fidelity (delivery of the intervention as intended) and adherence (intervention use) through to the end of gestation, as relevant to the first primary health outcome of the trial: infant birth weight. Fidelity and adherence were evaluated using stove and fuel delivery records, questionnaires, visual observations, and temperature-logging stove use monitors (SUMs). RESULTS: 1585 women received the intervention at a median (interquartile range) of 8.0 (5.0-15.0) days post-randomization and had a gestational age of 17.9 (15.4-20.6) weeks. Over 96% reported cooking exclusively with LPG at two follow-up visits during pregnancy. Less than 4% reported ever running out of LPG. Complete abandonment of traditional stove cooking was observed in over 67% of the intervention households. Of the intervention households, 31.4% removed their traditional stoves upon receipt of the intervention; among those who retained traditional stoves, the majority did not use them: traditional stove use was detected via SUMs on a median (interquartile range) of 0.0% (0.0%, 1.6%) of follow-up days (median follow-up = 134 days). CONCLUSIONS: The fidelity of the HAPIN intervention, as measured by stove installation, timely ongoing fuel deliveries, and behavioral reinforcement as needed, was high. Exclusive use of the intervention during pregnancy was also high.

Beyond imagination: Hypnotic visual hallucination induces greater lateralised brain activity than visual mental imagery.

Hypnotic suggestions can produce a broad range of perceptual experiences, including hallucinations. Visual hypnotic hallucinations differ in many ways from regular mental images. For example, they are usually experienced as automatic, vivid, and real images, typically compromising the sense of reality. While both hypnotic hallucination and mental imagery are believed to mainly rely on the activation of the visual cortex via top-down mechanisms, it is unknown how they differ in the neural processes they engage. Here we used an adaptation paradigm to test and compare top-down processing between hypnotic hallucination, mental imagery, and visual perception in very highly hypnotisable individuals whose ability to hallucinate was assessed. By measuring the N170/VPP event-related complex and using multivariate decoding analysis, we found that hypnotic hallucination of faces involves greater top-down activation of sensory processing through lateralised neural mechanisms in the right hemisphere compared to mental imagery. Our findings suggest that the neural signatures that distinguish hypnotically hallucinated faces from imagined faces lie in the right brain hemisphere.

Quantifying the environmental impact of clustering strategies in waste management: A case study for plastic recycling from large household appliances.

The complex composition of waste electrical and electronic equipment (WEEE) plastics represents a challenge during post-consumption plastic recycling. A single WEEE category, e.g. large household appliances (LHA), can contain several different plastic types with overlapping material properties, making the sorting of individual plastics a challenge. Significant increases in plastic recovery rates can be expected by clustering product categories, as clustering can avoid mixing of non-compatible plastics with overlapping material properties. For this purpose, a life cycle assessment (LCA) is conducted to investigate the influence of different clustering strategies on the environmental performance of waste treatment and the production of recycled plastic from LHA waste stream. To assure comparability between waste treatment scenarios a system expansion approach is applied, and to allocate the burden of shared processes over the first and second use cycle of the material partitioning is applied. Results show that an increased separation of product clusters by plastic type can improve the plastic recovery rate from 5.8% to 47.1% and reduce the overall environmental impact, quantified with the ReCiPe (2016) method, by up to 23%. The environmental impacts of using recycled plastics from LHA waste can be reduced by 27 to 38% compared to single-use plastic. The holistic approach used in this study demonstrates (1) the potential benefits of implementing product clustering strategies for LHA plastic recycling, (2) the relevance of different allocation procedures when integrating recycling into an LCA, (3) the importance of using less virgin material and avoiding final waste treatment, and (4) the limitation of the recycling system to reduce the environmental burden associated with products.

In-use emissions from biomass and LPG stoves measured during a large, multi-year cookstove intervention study in rural India.

We conducted an emission measurement campaign as a part of a multiyear cookstove intervention trial in two rural locations in northern and southern India. 253 uncontrolled cooking tests measured emissions in control and intervention households during three ~3-month-long measurement periods in each location. We measured pollutants including fine particulate matter (PM2.5), organic and elemental carbon (OC, EC), black carbon (BC) and carbon monoxide (CO) from stoves ranging from traditional solid fuel (TSF) to improved biomass stoves (rocket, gasifier) to liquefied petroleum gas (LPG) models. TSF stoves showed substantial variability in pollutant emission factors (EFs; g kg-1 wood) and optical properties across measurement periods. Multilinear regression modeling found that measurement period, fuel properties, relative humidity, and cooking duration are significant predictors of TSF EFs. A rocket stove showed moderate reductions relative to TSF. LPG stoves had the lowest pollutant EFs, with mean PM2.5 and CO EFs (g MJdelivered-1) >90% lower than biomass stoves. However, in-home EFs of LPG were substantially higher than lab EFs, likely influenced by non-ideal combustion performance, emissions from food and possible influence from other combustion sources. In-home emission measurements may depict the actual exposure benefits associated with dissemination of LPG stoves in real world interventions.

Unmodified household coffee maker assisted extraction and purification of anticancer agents from Dillenia indica fruits.

Bioassay targeted, 80% aqueous ethanol crude extract of the fruits of Dillenia indica Linn, using the unmodified household coffee maker, afforded five compounds, namely betulinic acid (1), rhamnazin (2), dillenetin (3), luteolin-7-O-ß-D-glucoside (4) and hypolaetin-8-O-ß-D-glucoside (5). The crude extract, fractions and purified compounds were tested against MDA MB-231, A549 and HeLa cancer cell lines by MTT assay, using betulinic acid 1, as a positive control. Compound 3 showed the best activity against A549 (IC50 = 26.60 ± 2.5 µM) and HeLa cancer cell lines (IC50 =19.35 ± 0.9 µM), whereas compound 5 was found to show the best activity against MDA MB-231 (IC50 = 34.62 ± 5.2µM) cancer cell line. These highly potent anticancer compounds obtained from the fruits of D. indica may be suitable for herbal drug development and formulations.

Basic social resource needs screening in the gynecologic oncology clinic: a quality improvement initiative.

BACKGROUND: Social determinants of health are known to contribute to disparities in health outcomes. Routine screening for basic social needs is not a part of standard care; however, the association of those needs with increased healthcare utilization and poor compliance with guideline-directed care is well established. OBJECTIVE: In this study, we aimed to assess the prevalence of basic social resource needs identified through a quality improvement initiative in a gynecologic oncology outpatient clinic. In addition, we aimed to identify clinical and demographic factors associated with having basic social resource needs. STUDY DESIGN: We performed a prospective cohort study of women presenting to a gynecologic oncology clinic at an urban academic institution who were screened for basic social resource needs as part of a quality improvement initiative from July 2017 to May 2018. The following 8 domains of resource needs were assessed: food insecurity, housing insecurity, utility needs, financial strain, transportation, childcare, household items, and difficulty reading hospital materials. Women with needs were referred to resources to address those needs. Demographic and clinical information were collected for each patient. The prevalence of needs and successful follow-up interventions were calculated. Patient factors independently associated with having at least 1 basic social resource need were identified using multivariable Poisson regression. RESULTS: A total of 752 women were screened in the study period, of whom 274 (36%) reported 1 or more basic social resource need, with a median of 1 (range, 1-7) need. Financial strain was the most commonly reported need (171 of 752, 23%), followed by transportation (119 of 752, 16%), difficulty reading hospital materials (54 of 752, 7%), housing insecurity (31 of 752, 4%), food insecurity (28 of 752, 4%), household items (22 of 752, 3%), childcare (15 of 752, 2%), and utility needs (13 of 752, 2%). On multivariable analysis, independent factors associated with having at least 1 basic social resource need were being single, divorced or widowed, nonwhite race, current smoker, nonprivate insurance, and a history of anxiety or depression. A total of 36 of 274 (13%) women who screened positive requested assistance and were referred to resources to address those needs. Of the 36 women, 25 (69%) successfully accessed a resource or felt equipped to address their needs, 9 (25%) could not be reached despite repeated attempts, and 2 (6%) declined assistance. CONCLUSION: Basic social resource needs are prevalent in women presenting to an urban academic gynecologic oncology clinic and can be identified and addressed through routine screening. To help mitigate ongoing disparities in this population, screening for and addressing basic social resource needs should be incorporated into routine comprehensive care in gynecologic oncology clinics.

Interpretation of bulk nitrogen and carbon isotopes in archaeological foodcrusts on potsherds.

RATIONALE: Foodcrust, the charred deposit adhering to the surface of containers, is a possible source of information on the function of ancient vessels and the subsistence of prehistoric humans. While the carbon isotope ratios in those materials are useful in detecting the usage of C4 plants, the reliability of nitrogen isotopic signatures has not been fully investigated. METHODS: The validity of bulk nitrogen isotope ratios has previously been investigated in coastal or riverine environments, where multiple resources from terrestrial and aquatic ecosystems were available, but not in terrestrial settings which provide a simpler mixing of terrestrial animals and plants. Hence, we conducted an exhaustive study on charred deposits on potsherds at two inland archaeological sites belonging to prehistoric Jomon hunter-gathers in central Japan, focusing on δ15 N values and atomic N/C ratios determined using an isotope ratio mass spectrometer and an elemental analyzer, respectively. RESULTS: For both sites, the δ15 N values showed significant correlations with the N/C ratios among samples from the inner surface, suggesting that these have recorded animal contribution. Furthermore, previous studies of Neolithic pottery from North Europe and Far East Russia bearing strong marine signatures had shown reasonably higher δ15 N values and N/C ratios in comparison with our data from terrestrial settings. On the other hand, some charred materials probably originating from plant starch showed lower values with both parameters. Samples from the outer surface produced less meaningful isotopic and elemental ratios altered by a thermal effect and/or contamination from soot. CONCLUSIONS: When the samples of foodcrusts were selected carefully from the inner surface, bulk nitrogen isotopes and N/C ratios reflect the composition of what was cooked or processed in containers. This will provide useful information for understanding the human adaptation from the Late Pleistocene to the Holocene in conjunction with residual lipid analyses.

Enhancing LPG adoption in Ghana (ELAG): a factorial cluster-randomized controlled trial to Enhance LPG Adoption & Sustained use.

BACKGROUND: Three billion individuals worldwide rely on biomass fuel [dung, wood, crops] for cooking and heating. Further, health conditions resulting from household air pollution (HAP) are responsible for approximately 3.9 million premature deaths each year. Though transition away from traditional biomass stoves is projected curb the health effects of HAP by mitigating exposure, the benefits of newer clean cookstove technologies can only be fully realized if use of these new stoves is exclusive and sustained. However, the conditions under which individuals adopt and sustain use of clean cookstoves is not well understood. METHODS: The Enhancing LPG Adoption in Ghana (ELAG) study is a cluster-randomized controlled trial employing a factorial intervention design. The first component is a behavior change intervention based on the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) model. This intervention seeks to align these five behavioral factors with clean cookstove adoption and sustained use. A second intervention is access-related and will improve LPG availability by offering a direct-delivery refueling service. These two interventions will be integrated via a factorial design whereby 27 communities are assigned to one of the following: the control arm, the educational intervention, the delivery, or a combined intervention. Intervention allocation is determined by a covariate-constrained randomization approach. After intervention, approximately 900 households' individual fuel use is tracked for 12 months via iButton stove use monitors. Analysis will include hierarchical linear models used to compare intervention households' fuel use to control households. DISCUSSION: Literature to-date demonstrates that recipients of improved cookstoves rarely completely adopt the new technology. Instead, they often practice partial adoption (fuel stacking). Consequently, interventions are needed to influence adoption patterns and simultaneously to understand drivers of fuel adoption. Ensuring uptake, adoption, and sustained use of improved cookstove technologies can then lead to HAP-reductions and consequent improvements in public health. TRIAL REGISTRATION: NCT03352830 (November 24, 2017).

Modeling the potential health benefits of lower household air pollution after a hypothetical liquified petroleum gas (LPG) cookstove intervention.

INTRODUCTION: Improved biomass and advanced fuel cookstoves can lower household air pollution (HAP), but levels of fine particulate matter (PM2.5) often remain above the World Health Organization (WHO) recommended interim target of 35µg/m3. METHODS: Based on existing literature, we first estimate a range of likely levels of personal PM2.5 before and after a liquefied petroleum gas (LPG) intervention. Using simulations reflecting uncertainty in both the exposure estimates and exposure-response coefficients, we estimate corresponding expected health benefits for systolic blood pressure (SBP) in adults, birthweight, and pneumonia incidence among children <2years old. We also estimate potential avoided premature mortality among those exposed. RESULTS: Our best estimate is that an LPG stove intervention would decrease personal PM2.5 exposure from approximately 270µg/m3 to approximately 70µg/m3, due to likely continued use of traditional open-fire stoves. We estimate that this decrease would lead to a 5.5mmHg lower SBP among women over age 50, a 338g higher birthweight, and a 37% lower incidence of severe childhood pneumonia. We estimate that decreased SBP, if sustained, would result in a 5%-10% decrease in mortality for women over age 50. We estimate that higher birthweight would reduce infant mortality by 4 to 11 deaths per 1000 births; for comparison, the current global infant mortality rate is 32/1000 live births. Reduced exposure is estimated to prevent approximately 29 cases of severe pneumonia per year per 1000 children under 2, avoiding approximately 2-3 deaths/1000 per year. However, there are large uncertainties around all these estimates due to uncertainty in both exposure estimates and in exposure-response coefficients; all health effect estimates include the null value of no benefit. CONCLUSIONS: An LPG stove intervention, while not likely to lower exposure to the WHO interim target level, is still likely to offer important health benefits.

Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis-randomized clinical trial.

This study aims to evaluate the use of assistive devices as a strategy in non-pharmacological treatment for hand osteoarthritis (HOA). This is a randomized, prospective, parallel, assessor-blinded clinical trial, in which patients with a diagnosis of HOA were randomly allocated to an intervention group (IG), where they received assistive devices for daily life activities, or to a control group (CG), where they received a guideline leaflet with information on joint protection and disease features. The primary outcomes considered were occupational performance, measured by the Canadian Occupational Performance Measure (COPM), and hand function was evaluated through the Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (SACRAH). The secondary outcomes were pain, measured by the visual analog scale (VAS), and quality of life, measured by the World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF). We compared both outcomes before and after interventions and outcomes between groups. Participants from the two groups were assessed at the time of inclusion in the study, 30, and 90 days after initial evaluation. Out of the 39 patients included, 19 were allocated to the IG and 20 to the CG. Only two patients from the CG did not complete the follow-up period. The patients' hand function and occupational performance improved after intervention (30 days-SACRAH-p < 0.05; COPM-p < 0.05; VAS-p < 0.05). When comparing results between the groups, there was a statistical difference in COPM (performance-p < 0.001; and satisfaction-p < 0.001), in the first reevaluation carried out. The use of assistive devices has proved to be an effective alternative in non-pharmacological treatment for HOA. CLINICAL TRIAL REGISTRATION: NCT02667145.

Evaluating the Performance of Household Liquefied Petroleum Gas Cookstoves.

Liquefied petroleum gas (LPG) cookstoves are considered to be an important solution for mitigating household air pollution; however, their performance has rarely been evaluated. To fill the data and knowledge gaps in this important area, 89 laboratory tests were conducted to quantify efficiencies and pollutant emissions from five commercially available household LPG stoves under different burning conditions. The mean thermal efficiency (±standard deviation) for the tested LPG cookstoves was 51 ± 6%, meeting guidelines for the highest tier level (Tier 4) under the International Organization for Standardization, International Workshop Agreement 11. Emission factors of CO2, CO, THC, CH4, and NOx on the basis of useful energy delivered (MJd) were 142 ± 17, 0.77 ± 0.55, 130 ± 196, 5.6 ± 8.2, and 46 ± 9 mg/MJd, respectively. Approximately 90% of the PM2.5 data were below the detection limit, corresponding to an emission rate below 0.11 mg/min. For those data above the detection limit, the average emission factor was 2.4 ± 1.6 mg/MJd, with a mean emission rate of 0.20 ± 0.16 mg/min. Under the specified gas pressure (2.8 kPa), but with the burner control set to minimum air flow rate, less complete combustion resulted in a visually yellow flame, and CO, PM2.5, EC, and BC emissions all increased. LPG cookstoves met guidelines for Tier 4 for both CO and PM2.5 emissions and mostly met the World Health Organization Emission Rate Targets set to protect human health.

Effects of a liquefied petroleum gas stove intervention on pollutant exposure and adult cardiopulmonary outcomes (CHAP): study protocol for a randomized controlled trial.

BACKGROUND: Biomass fuel smoke is a leading risk factor for the burden of disease worldwide. International campaigns are promoting the widespread adoption of liquefied petroleum gas (LPG) in resource-limited settings. However, it is unclear if the introduction and use of LPG stoves, in settings where biomass fuels are used daily, reduces pollution concentration exposure, improves health outcomes, or how cultural and social barriers influence the exclusive adoption of LPG stoves. METHODS: We will conduct a randomized controlled, field intervention trial of LPG stoves and fuel distribution in rural Puno, Peru, in which we will enroll 180 female participants aged 25-64 years and follow them for 2 years. After enrollment, we will collect information on sociodemographic characteristics, household characteristics, and cooking practices. During the first year of the study, LPG stoves and fuel tanks will be delivered to the homes of 90 intervention participants. During the second year, participants in the intervention arm will keep their LPG stoves, but the gas supply will stop. Control participants will receive LPG stoves and vouchers to obtain free fuel from distributors at the beginning of the second year, but gas will not be delivered. Starting at baseline, we will collect longitudinal measurements of respiratory symptoms, pulmonary function, blood pressure, endothelial function, carotid artery intima-media thickness, 24-h dietary recalls, exhaled carbon monoxide, quality-of-life indicators, and stove-use behaviors. Environmental exposure assessments will occur six times over the 2-year follow-up period, consisting of 48-h personal exposure and kitchen concentration measurements of fine particulate matter and carbon monoxide, and 48-h kitchen concentrations of nitrogen dioxide for a subset of 100 participants. DISCUSSION: Findings from this study will allow us to better understand behavioral patterns, environmental exposures, and cardiovascular and pulmonary outcomes resulting from the adoption of LPG stoves. If this trial indicates that LPG stoves are a feasible and effective way to reduce household air pollution and improve health, it will provide important information to support widespread adoption of LPG fuel as a strategy to reduce the global burden of disease. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02994680 , Cardiopulmonary Outcomes and Household Air Pollution (CHAP) Trial. Registered on 28 November 2016.

Adoption of Clean Cookstoves after Improved Solid Fuel Stove Programme Exposure: A Cross-Sectional Study in Three Peruvian Andean Regions.

This study examined measures of clean cookstove adoption after improved solid fuel stove programmes in three geographically and culturally diverse rural Andean settings and explored factors associated with these measures. A questionnaire was administered to 1200 households on stove use and cooking behaviours including previously defined factors associated with clean cookstove adoption. Logistic multivariable regressions with 16 pre-specified explanatory variables were performed for three outcomes; (1) daily improved solid fuel stove use, (2) use of liquefied petroleum gas stove and (3) traditional stove displacement. Eighty-seven percent of households reported daily improved solid fuel stove use, 51% liquefied petroleum gas stove use and 66% no longer used the traditional cookstove. Variables associated with one or more of the three outcomes are: education, age and civil status of the reporting female, household wealth and size, region, encounters of problems with the improved solid fuel stove, knowledge of somebody able to build an improved solid fuel stove, whether stove parts are obtainable in the community, and subsidy schemes. We conclude that to be successful, improved solid fuel stove programmes need to consider (1) existing household characteristics, (2) the household's need for ready access to maintenance and repair, and (3) improved knowledge at the community level.