Escherichia coli (APEC). A total of 480 1-day-old Cherry Valley male ducks were randomly assigned to 8 treatments with 10 replicates, each replicate containing 10 ducks. A 4 × 2 factor design was used with four dietary zinc levels  and challenged with or without APEC at 8-days-old ducks. The trial lasted for 14 days. The results showed that a dietary Zn–Met supplementation significantly increased body weight (BW) of 14 days and BW gain, and decreased mortality during 7–14-days-old ducks (p < 0.05). Furthermore, dietary 30, 60, 120 mg/kg Zn–Met supplementation noticeably increased the thymus index at 2 days post-infection (2 DPI) and 8 DPI (p < 0.05), and 120 mg/kg Zn–Met enhanced the serum IgA at 2 DPI and IgA, IgG, IgM, C3 at 8 DPI (p < 0.05). In addition, dietary 120 mg/kg Zn–Met supplementation dramatically increased villus height and villus height/crypt depth (V/C) of jejunum at 2 DPI and 8 DPI (p < 0.05). The TNF-α and IFN-γ mRNA expression were downregulated after supplemented with 120 mg/kg Zn–Met in jejunum at 8 DPI (p < 0.05). Moreover, dietary 120 mg/kg Zn–Met supplementation stimulated ZO-3, OCLN mRNA expression at 2 DPI and ZO-2 mRNA expression in jejunum at 8 DPI (p < 0.05), and improved the MUC2 concentration in jejunum at 2 DPI and 8 DPI (p < 0.05). At the same time, the cecal Bifidobacterium and Lactobacillus counts were increased (p < 0.05), and Escherichia coli counts were decreased (p < 0.05) after supplemented with Zn–Met. In conclusion, inclusion of 120 mg/kg Zn–Met minimizes the adverse effects of APEC challenge on meat ducks by improving growth performance and enhancing immune function and intestinal health.This study was carried out to evaluate the effects of supplemental zinc methionine (Zn–Met) on growth performance, immune function, and intestinal health of meat ducks challenged with avian pathogenic  Escherichia coli is one of the most common and important diseases in poultry industry as it leads to reduced weight gain, increased mortality, and reduced flock uniformity   . Respirai (APEC) . Antibioi (APEC) . TherefoOccludin and Claudin-1 mRNA in Salmonella-infected broilers. Besides, zinc supplementation increased the populations of Lactobacillus and decreased epithelium cell apoptosis index in broilers challenged with Salmonella  more than the Zn requirement (60 mg/kg diet) recommended by the National Research Council  before initiation of the trial. A total of 480 1-day-old healthy Cherry Valley male ducks were obtained from a commercial hatchery and randomly divided into 8 treatments according to the principle of no difference in body weight (BW), each with 6 replicate pens of 10 ducks. The study adopted a completely randomized design with a 4 × 2 factorial pattern. Herein, four levels of Zn–Met supplementation  and APEC challenge (with or without), experimental treatments (diets) include (1) control diet (U0); (2) control + 30-mg/kg Zn–Met (U30); (3) control + 60-mg/kg Zn—Met (U60); (4) control + 120-mg/kg Zn–Met (U120); (5) control + APEC (C0); (6) control + APEC + 30-mg/kg Zn–Met (C30); (7) control + APEC + 60-mg/kg Zn–Met (C60); (8) control + APEC + 120-mg/kg Zn–Met (C120). The addition of graded Zn–Met caused the different content of methionine and we corrected it by addition of extra methionine in the premixes. Hence, all nutrients were kept at the same levels expect for the zinc content.ad libitum access to feed and water throughout the experiment period. The temperature and humidity control process according to the feeding standard of meat ducks (NY/T 2122–2012). A corn–soybean basal diet based on The ducks were raised for 14 days in cages (1.00 m × 1.00 m × 0.55 m) in a temperature- and humidity-controlled room with a continuous 24-h light supply. All ducks had °C, thawed and mixed, and inoculated into the sterilized liquid medium at the ratio of 1/1,000, incubated at 37°C on a 180 r/min constant temperature oscillator for 10–12 h. The optical density (OD) value of the bacterial solution was measured at 600 nm, and the concentration of the bacterial solution was calculated according to the standard curve. Then the medium was used to adjust the concentration to 1.0 × 109 CFU/ml. On day 7, the ducks in the APEC-challenged group were given a gavage of 0.5 ml of APEC suspension (1.0 × 109 CFU/ml) and ducks in the unchallenged group were given a gavage of 0.5 ml of sterilized saline.The strain used in this experiment is APEC (serotype: O78) of duck-origin supplied from College of Veterinary Medicine, Sichuan Agricultural University . Before the challenge test, the freezable bacterial solution was taken out at -80via the jugular vein and then centrifuged at 3500 g for 15 min at 4°C, taken serum into 1.5 ml microcentrifuge tube and stored at -20°C to determine biochemistry in serum. The thymus, spleen, and bursa of fabricius were removed intact and the surface blood stains were wiped off, then weighed and recorded. The middle segments (approximately 1–2 cm) of jejunum were excised for morphology analysis, removed the jejunal digesta, lightly rinsed with saline, and then the remaining jejunal tissue was divided into freezing tubes for testing the gene expression. In addition, at 8 DPI, cecal contents were aseptically collected into sterilized freezing tubes and assessed for enumeration of cecal bacteria.Sampling at 2 days post-infection (2 DPI) and 8 DPI, ducks were weighed after 8-h feed withdrawal, and the feed intake (FI) and mortality were recorded in detail on a per replicate basis. One experimental duck closest to the average weight of each replicate was selected and slaughtered by cervical dislocation. Blood was collected into no-additive blood collection vacuum tubes The experimental period was divided into two phases: 1–6 days  and 7–14 days . The BW, feed consumption, mortality, and feed loss of birds were recorded in detail by replicates. Then body weight gain (BWG), FI, and feed-to-weight ratio (F/G) were calculated for 1–6 days and 7–14 days, respectively. Mortality was only measured for 7-14 days.The thymus, spleen, and bursa of fabricius of each sampling duck were isolated and weighed. The relative organ weights were calculated by following the equation below:Organ weight indexes = Immune organ weight (g)/Body weight (g) × 100The concentrations of serum immunoglobulin A (IgA), IgG, IgM, complement component 3 (C3), and C4 were measured by an enzymatic chromatometric method using the duck-specific ELISA Kits . The specific operation steps are strictly in accordance with the kit operation manual.Jejunal tissue specimens were fixed in 4% (w/v) buffered paraformaldehyde for more than 48 h. Alcohol was used as dehydrating agent, and the tissue was dehydrated and placed in xylene for transparent treatment. Then the tissue was embedded in paraffin and cut into 5-μm thick slices and stained using hematoxylin and eosin (H&E). The slices were placed on slides for sectioning. Finally, the prepared tissue slices were used to measure villus height (VH) and crypt depth (CD) using a light microscope  equipped with a digital camera with a magnification of 40×. Ten intact VH and the corresponding CD were measured using Image Pro Plus 6.0 , and the mean value and V/C were calculated. The determination standard of VH and CD according to ® RT SuperMix for qPCR (+ gDNA wiper)  using the Bio-Rad DNA Engine (United States). The quantitative real-time polymerase chain reaction (RT-PCR) analysis was performed on CFX-96 Real-Time PCR System  using ChamQ SYBR Color qPCR Master Mix . To construct a 10-μl reaction system, including 1 μl of cDNA template, 1 μl of reverse primer (4 μM), 1 μl of forward primer (4 μM), 2 μl of dd H2O and 5 μl of ChamQ SYBR Color qPCR Master Mix (2×). Primers of the target gene were designed with Primer 5.0  and listed in -actin were selected as the reference genes, and the relative mRNA abundance of target gene mRNA was calculated using the method of 2Ct–ΔΔ, as described by The total RNA of jejunum tissue was extracted by RNA-easy™ Isolation Reagent  according to the manufacturer’s instructions, and then the concentration was determined using NanoDrop 2000 , RNA purity was verified by the ratio of absorbance at 260 nm/280 nm. Next, the total RNA was reverse-transcribed into complementary DNA (cDNA) by HiScript The jejunal MUC2 concentration was measured by the duck-specific mucin 2 kit , the specific operation steps are strictly in accordance with the kit instructions.Bacillus, Bifidobacterium, E. coli, and Lactobacillus were determined by q-PCR. The primer and probe sequences used for q-PCR were obtained from previously literature (2O and 5 μl ChamQ SYBR Color qPCR Master Mix (2×). The q-PCR of Bacillus, Bifidobacterium, E. coli and Lactobacillus by TaqMan probe method, and to establish a 20 μl reaction system including 0.4 μl of fluorescent probe (10 μM), 0.6 μl of each prime (10 μM), 1 μl of DNA template, 7.4 μl dd H2O, 10 μl SuperReal PreMix  . A specific standard curves were generated by constructing standard plasmids for bacterial quantification according to 10), and presented as total CFU/g digesta.The total microbial DNA in the cecal content was extracted by using the Stool DNA Kit (Omega Bio-Tech) according to the manufacturer’s instruction. The determination of purity and concentration of DNA by NanoDrop 2000. The populations of total bacteria, terature  and syntp-value of less than 0.05 was used as the criterion of statistically significant. The results were expressed as means and pooled standard error of the mean.All data were analyzed as a completely randomized design with a factorial arrangement (4 × 2) using the GLM procedure of SPSS 25.0 . The model equation included main effects  and their interactions. When the main effects and their interactions were significant, differences among treatment means were tested using Duncan’s test. A p > 0.05). However, APEC challenge significantly reduced BW at 14 days and BWG during 7–14 days, meanwhile markedly increased F/G and mortality during 7–14 days of ducks (p < 0.05). Ducks fed Zn–Met at 120-mg/kg diet had significantly higher BW at 14 days and BWG during 7–14 days, and lower mortality during 7–14 days of ducks (p < 0.05). There was an interaction between Zn–Met and APEC challenge observed in mortality. The C120 group had a dramatically lower mortality rate than C0 (p < 0.05).As shown in p < 0.05). Furthermore, dietary Zn–Met supplementation had an impact on thymus index at 2 DPI and 8 DPI. Ducks fed Zn–Met at 30, 60, and 120-mg/kg diets had a higher thymus index at 2 DPI compared to no Zn–Met supplementation ducks (p < 0.05), and the impact lasted in those fed diets with 120-mg/kg Zn–Met supplementation until the 8 DPI (P < 0.05). There were no significant interactions between Zn–Met and APEC challenge observed in immune organ index (textitp > 0.05).As demonstrated in p < 0.05). The serum IgA, IgG, IgM levels at 8 DPI were increased in ducks fed Zn–Met at 60 and 120-mg/kg diets compared to no Zn–Met supplementation ducks (p > 0.05). In addition, the serum IgM level at 2 DPI and C3 level at 8 DPI were increased at Zn–Met inclusion of 120-mg/kg (p > 0.05). There were no significant interactions between Zn–Met and APEC challenge observed in immunoglobulins and complement components (p > 0.05).As illustrated in p < 0.05). The jejunal VH and V/C at 2 DPI and 8 DPI were improved in ducks fed Zn–Met at 120-mg/kg diet than that of those receiving no Zn–Met supplementation (p < 0.05). In addition, the jejunal VH was increased at Zn–Met inclusion of 30- and 60-mg/kg (p > 0.05). There was an interaction between Zn–Met and APEC challenge observed in the VH of jejunum at 2 DPI, which was higher in C30, C60, and C120 than C0 (p < 0.05).As shown in IL-1β, IL-6, TLR4, Myd88, NF-κB mRNA expression at 2 DPI and IL-1β, IL-6, IFN-γ, TNF-α, Myd88, NF-κB mRNA expression at 8 DPI in jejunum (p < 0.05). At 8 DPI, the mRNA expression of TNF-α and IFN-γ were downregulated in the ducks fed Zn–Met at 60- and 120-mg/kg diets, respectively, than those fed diets without Zn–Met supplementation (p < 0.05). Furthermore, dietary Zn–Met supplementation tended to downregulate IL-1β (p = 0.079), Myd88 (p = 0.065), NF-κB (p = 0.084) at 2 DPI and Myd88 (p = 0.075) mRNA expression at 8 DPI in jejunum. There were no significant interactions between Zn–Met and APEC challenge observed in the mRNA expression of inflammatory cytokines and TLR4 signaling pathway in jejunum (p > 0.05).As shown in ZO-1, ZO-2, ZO-3, OCLN mRNA expression at 2 DPI and ZO-1, ZO-2, ZO-3 mRNA expression at 8 DPI in jejunum (p < 0.05). At the same time, the jejunal mRNA expression of sIgA and AvBD2 were upregulated after APEC challenge (p < 0.05). Ducks fed Zn–Met at 120-mg/kg diet had a higher ZO-3, OCLN mRNA expression at 2 DPI and ZO-2, ZO-3 mRNA expression at 8 DPI compared to those fed diets without Zn–Met supplementation (p < 0.05). In addition, a dietary Zn–Met supplementation tended to upregulated CLDN2 mRNA expression at 2 DPI (p = 0.065). The interactions between Zn–Met and APEC challenge had no influence on the mRNA expression of barrier-related gene in jejunum (p > 0.05).As shown in p < 0.05), and gradually increased with the Zn–Met supplementation increased (p < 0.05). At 2 DPI, the jejunal MUC2 concentration were increased in ducks fed Zn–Met at 30, 60, and 120-mg/kg diets compared to no Zn–Met supplementation ducks (p < 0.05). In addition, the jejunal MUC2 concentration at 8 DPI were increased at Zn–Met inclusion of 60- and 120-mg/kg diets (p > 0.05). There were no significant interactions between Zn–Met and APEC challenge observed in the MUC2 concentration in jejunum (p > 0.05).As shown in Bifidobacterium, E. coli and Lactobacillus in the cecal digesta. APEC challenge significantly increased the populations of E. coli, while decreasing the populations of Bifidobacterium and Lactobacillus (p < 0.05). On the contrary, an increase in Bifidobacterium and Lactobacillus populations, and a decrease in E. coli populations were found in ducks fed Zn–Met at 120-mg/kg diets when compared to no Zn–Met supplementation ducks (p < 0.05). There were no significant interaction effects on microbial population in the cecal digesta between dietary Zn–Met and APEC challenge (p > 0.05).As shown in E. coli challenged on growth performance was reported in chicken . The promotion effect on growth performance may be attributed to the fact that Zn–Met, as a source of organic zinc can be absorbed more efficiently than inorganic zinc, especially in case of impaired intestine  at 2 DPI. Similarly, IL-8 mRNA expression and upregulated IL-8 in jejunum of broiler chickens challenged with coccidia plus Clostridium perfringens. Moreover, organic zinc was found to be more effective in reducing serum IL-1β concentration of hens after administered with lipopolysaccharide (LPS) compared to ZnSO4  and then activates NF-κB through cascade reaction, which eventually induces the expression of pro-inflammatory cytokines , chemokines, and immune co-stimulatory molecules , which are specific molecules on host cells that recognize PAMPs, the specific target molecules of pathogens, and TLRs are crucial members of the PRRs . Generalolecules . We foun studies , it was  effects . Zinc suytokines . CombineZO-1, ZO-2, ZO-3, OCLN were downregulated in jejunum after APEC challenge, indicating the destruction of intestinal physical barrier, which is consistent with report of ZO-2, ZO-3 and OCLN. This was consistent with the report of Claudin-1 and OCLN in ileum of broiler chickens challenged with Salmonella.The intestinal barrier ensures the entrance of essential nutrients from the intestinal lumen and also effectively prevents harmful substances in the intestinal lumen (such as bacteria and various toxins) from entering the blood circulation and internal organs through the intestinal mucosa . The barsIgA) secreted by epithelial cell is the main effector of the immunological barrier, its role is not only in the protection of the intestinal epithelium from enteric pathogens and toxins, but is also important for communication with gut-associated lymphoid tissue and restoration of homeostasis in pathology  is the major gel-forming mucin of the chemical barrier, which serves as a biophysical layer against the luminal hostile environment . The jej of zinc . A studyE. coli was increased, while the number of Bifidobacterium and Lactobacillus was reduced after APEC infection, which is similar to Bifidobacterium and Lactobacillus counts, and decreasing E. coli counts. Lactobacillus group in cecal contents of Salmonella-infected broilers. Through 16S rRNA sequencing analyses, Proteobacteria, as a potential diagnostic signature of dysbiosis and risk of disease, at the phylum level, while decreased the relative abundance of Desulfovibrio, Peptococcus, and increased Lactobacillus, Romboutsia, Anaerotruncus at the genera level in rats challenged with E. coli. Further research found the function of enrichment of carbohydrate metabolism and the metabolism of cofactors and vitamins were dramatically increased in CS-Zn treatment with the change of intestinal flora. However, our results did not evaluate gut microbiota community structure from different taxonomic levels, which should be further investigated.Numerous commensal microbiota inhabited in the gastrointestinal tract can not only participate in the digestion and absorption of nutrients, but also plays a crucial role in the prevention and resolution of pathogenic infections. On the one hand, microbiota can resist pathogens by producing bacteriocins or microcins with antibacterial and bactericidal activity in a direct manner. On the other hand, microbiota defense against intestinal pathogens by regulating the processes of differentiation of T-cells, B-cell development, and antibody production in an indirect manner . IntestiIn conclusion, dietary Zn–Met supplementation alleviated the deleterious effects induced by APEC challenge. Inclusion of 120-mg/kg Zn–Met enhanced immune function by stimulating the development of immune organ, secretion of immunoglobulins, and promoted intestinal health by improving intestinal barrier downregulating of pro-inflammatory cytokines and regulating of the cecal microbiota, ultimately improving the growth performance in APEC-challenged meat ducks.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.The animal study was reviewed and approved by the Animal Health and Care Committee of Sichuan Agricultural University (No. 20180718).JM: conceptualization, methodology, and writing original draft preparation. YC and ZZ: software, data curation, and revising the manuscript. TY, FW, and HZ: visualization and investigation. BW, GL, XC, GT, and JC: supervision, software, and validation. GJ: writing–reviewing and editing. All authors contributed to the article and approved the submitted version.BW was employed by the company Chelota Group. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


First, the target characteristics in terms of compressive strength (minimum of 2 MPa), thermal conductivity (less than 0.2 Wm−1K−1) and density (800 kg/m3) were achieved. It was noted that pozzolanic additions slightly improved the mechanical and thermal strength of non-autoclaved foamed concrete, while the addition of hemp shives improved the thermal strength but had an unfavourable effect on the mechanical strength. Moreover, both reduced the CO2 emissions.In this study, new foam concretes incorporating hemp shives without the use of autoclaving have been developed and studied. Several protocols and parameters were investigated. Firstly, the influence of the addition of pozzolanic additives on the resulting density, mechanical behaviour and thermal conductivity was examined. Secondly, the effects of the incorporation of hemp shives at 5, 10 and 15 vol% on the previous three properties in such concretes were investigated. Moreover, economic cost and CO Therefore, it is a non-structural material [−1K−1) compared to usual concretes . FC plays an important role in building thermal insulation [3, which corresponds to 168 kg CO2/m3 of emission. According to Couasnet [In recent years, lightweight, aerated and foam concretes have been used in construction for their manyfold benefits, such as concrete for thermal insulation, renovation, screeds, etc. Generally, the Foamed Concrete (FC) is based on the incorporation of air or gas bubbles in the mineral matrix and is formulated to reach a low density ranging from 400 to 1800 kg/msulation . UsuallyCouasnet , this emSome of the available experimental developments that consider replacing a portion of the cements are focused on evaluating the use of fly ash, metakaolin and Ground Granulated Blast Furnace Slag (GGBFS), which is known for its pozzolanic activity, as it promotes the hydration process ,11,12,13Several studies have focused on the performance and behaviour of FC with different raw material additives, such as pozzolans, phosphogypsum and polypropylene fibres ,17,18,19Most of the published studies in the literature have also focused on the thermal and hygrometric qualities of hemp shiv concrete (HSC) due to the high porous structure of hemp shiv (larger than 70%) ,22. RegaHemp shives are largely used in studies of biobased concretes as a vegetable aggregate. The most important characteristics of hemp concrete are their lightweight, prefect moisture buffer capability, acoustic insulation and low thermal conductivity, which all allow reduced building energy consumption and gas emissions ,17. Mean−1K−1 and 800 kg/m3, respectively. BFCs containing hemp shiv as a bio-based raw material up to 15 vol% were investigated, with and without pozzolanic additives and as a function of hemp shive contents. Hemp shiv was used as a substitute to decrease the use of cement, thereby decreasing CO2 emissions.This work attempts to create Biobased Foam Concretes (BFC) for non-structural applications (self-supporting), combining foamed and bio-based concrete technologies. The target characteristics are a compressive strength of at least 2 MPa  and thermal conductivity and density smaller than 0.2 Wm−3 and the bulk density was 2200 kg·m−3.Portland Cement CEM I 52.5N, in accordance with the EN 197-1 standard. The absolute density was 3100 kg·m−3.Ground Granulated Blast Furnace Slag, fulfilling EN 206-1, a by-product from iron production with an absolute density of 2900 kg·m−3, obtained by kaolinite flash calcination at approximately 700 °C, the presence of MK acted as an activator that neutralised the retarding effect of GGBFS at the early age of resistance development and improved resistance at later ages [Metakaolin (MK) with an absolute density of 2600 kg·mter ages .−3, bulk density of 140 kg·m−3, thermal conductivity of 0.048 Wm−1K−1 and hemp shiv particle size distribution ranging between 0.6 and 5 mm. Plant materials composed of 95% hemp shives and 5% hemp fibres. A characterisation of hemp shiv particles according to the recommendations of the RILEM TC 236 BBM Technical Committee was investigated . Hemp shThe materials used to produce BFCs were:Pozzolans are well-known for increasing resistance to sulphate attack, decreasing the heat of hydration, increasing durability and reducing energy cost per unit of cement , which i3. Foaming agent used, and the HS had a negative effect on the degree of hardening of the concrete [To improve the workability of the mixture, a superplasticiser (SP), MasterGlenium ACE 550 from BASF, based on modified polycarboxylate and phosphonates was introduced into each specimen to reduce the amount of water used while keeping a good fluidity of fresh mix. A commercial protein-based foaming agent (FAG), Betomouss from SIKA, was used to produce a more stable bubble network, and the density of the foam was approximately 70 kg/mconcrete . Therefo2 emissions, as in Page [Eight formulations of foam concretes were prepared, each of them composed of three samples see . Two for in Page .3 and called CxPyHz, where C, P and H stand for cement, pozzolanic additions and hemp shiv, and x, y and z stand for their content in wt%, respectively.The composition of all foamed concretes studied in this paper  were desDue to the high-water absorption capacity of HS (247% of hemp shiv mass), hemp shiv particles absorb water, which reduces the water content that reacts with the mineral binder during the production of concrete containing hemp. In other words, hemp particles absorb the water needed to hydrate the binder ,32. ThisIn 2 emissions, and to determine their effects in foamed concrete. The preformed foam method was used for the specimen elaboration. It was based, firstly, on the production of a light aqueous foam, which was then progressively added into a mineral suspension. On one hand, the foam was generated by mixing the diluted foaming agent (in a 1:30 ratio by volume) with water. On the other hand, the powdered constituents and the hemp shives were first mixed dry in a mortar mixer with a capacity of approximately 20 L. Then, water with superplasticiser and accelerator were added and the mixture was mixed until a homogeneous paste was obtained. Finally, the mineral mix was added to the foam progressively and mixed until the mixture became homogeneous. The obtained foamed concrete was fluid and placed without any vibration in prisms 4 × 4 × 16 cm3 for the testing of mechanical properties and 30 × 30 × 7 cm3 for the testing of thermal properties, and all protected from drying out. After 48 h of curing at 20 °C, the specimens were removed from the moulds and stored in a damp room .Hemp shives were added to the mixes to reduce cost and CO3 parallelepiped samples were dried at the temperature of 60 °C until the weight loss stabilised. Density was then calculated from the stabilised weight value and the volume.The fresh and dry density were measured according to NF EN 12350-6 and NF EN 12390-1 standards, respectively. Three 4 × 4 × 16 cm® 250KN press) with a load velocity of 0.05 kN/s was used to determine the unconfined compressive strength (UCS) and the flexural strength (Rf). These tests were controlled by adopting the NF EN 679 and NF EN 196 standards.After 7 and 28 days, one specimen was broken in half during a flexural test and the compressive strength (Rc) was measured for both halves. A universal press , TBottom = 10 °C (temperature of bottom plate), Tmean = 20 °C, ∆T = 20.The images obtained allowed a first observation of the BFC structure and interfaces between sample matrices and HS particles.3 (C100P0H0) and 560 kg/m3 (C85P0H15) (3).The main factors affecting concrete density are air content, aggregate density, binder and water content . The den85P0H15) , meaning−3 and MK: 2600 kg·m−3) being lower than the density of cement (3100 kg·m−3).Density decreased regularly and by approximately 7% as the hemp shiv content reached 5% , since tIn general, the compressive strength of foamed concrete largely relates to age, raw materials, porosity and dry density ,36. In oPage et al.  remarkedThe density of the material decreased with the addition of hemp shiv . In the As for C55P30H15 and C85P0H15, bio-based foam concretes (BFC) with the same amount of hemp shives but different cement contents, presented significant differences in compressive strength. This is also due to the mix of GGBFS and MK, which can improve the cohesion in the mineral matrix . MoreoveFlexural strength  followedTo better understand the effect of hemp shiv on flexion and on compression, the ratio Rf/Rc can give us an indication. For example, in the case of fibres, this ratio becomes greater than in the case of concrete, considering that the behaviour of fibres in flexion is much more important than in compression, while the behaviour of concrete in compression is more important, so the ratio becomes smaller. The ratio Rf/Rc of the BFC samples ranged between 0.28 and 0.45. This ratio is larger than that of FC found in the literature, with a ratio between 0.2 and 0.4, and for ordinary concretes with a ratio between 0.1 and 0.2 . Compari−1K−1 [As an overall behaviour , thermal−1K−1 ) is lowe−1K−1 .−1K−1 at 7 days, and 0.1392 and 0.1312 Wm−1K−1 at 28 days, respectively, while without pozzolans  the COis study . Thermalanalysis . CO2 emimaterial , and the3 of BFCs is high. More than 50% of the cost comes from high-dose additives . The optimisation of formulations would be necessary to reduce the addition of the admixture and then the cost.Cost per produced m2 emission value, while C70P30H0 exhibited low thermal insulation and high compressive strength together with moderate CO2 emissions. However, C70P30H0’s cost is high because of the metakaolin, and admixtures are expensive.Remarkably, the foamed concrete with 100% cement showed high thermal conductivity with a high CO−1K−1), high compressive strength (Rc = 3.22 MPa) and approximately half the amount of CO2 emissions of C100P0H0. In conclusion, the effects of incorporating hemp shives in foamed concretes is mainly the decrease in thermal conductivity through the decrease in density. The resulting mechanical performance decrease was due to using the pozzolan additions to compensate for the HS incorporation.Among bio-based foamed concretes, C55P30H15 could also be considered as a good compromise as it had relatively low thermal conductivity  with the same amount of hemp shives show a significant difference in compressive strength and thermal conductivity.3) and a good thermal insulator , with a reasonably large compressive strength (Rc = 3.22 MPa) and CO2 emission values about half of the ones of a traditional foam concrete. Therefore, BFCs are potential alternative materials to target semi-structural concrete applications in the construction industries.The bio-based foam concrete C55P30H15 is considered a bio-based lightweight concrete (ρ = 593 kg/mIn addition, the right balance then has to be found between acceptable mechanical strengths conditioned mainly by cement contents, porosities for lightweight applications and porosity-HS amounts controlling thermal behaviour. Moreover, the pore structure, size and distribution of air bubbles will be important aspects to study, especially if one can help control the stability of air bubbles in the cementitious structure and then affect the mechanical and thermal conductivity.


Comité Euro-International du Béton (CEB). These values are then compared with the physically non-linear analysis in the long-term cracked state with SAP2000. Two structural codes were used in the numerical and analytical methods, Regulamento de Estruturas de Betão Armado e Pré-Esforçado (REBAP) and Eurocode 2 (EC2), to evaluate their differences in deformation control. Therefore, the main goal is to establish comparisons between the two methods of analysis in order to show that non-linear finite element modelling provides values that are lower than the analytical calculation, thus allowing greater economy in the design of structural reinforced concrete elements. In addition, it can be noted that EC2 has some inconsistencies in the design of simply supported slabs, requiring a greater thickness than a flat square slab and that indirect deformation for REBAP is underestimated for beams and, in some cases, for slabs.This paper aims to use non-linear physical analysis to calculate the displacement of beams and slabs in a cracked state. This study uses the commercial software SAP2000 to perform a numerical analysis using the finite element formulation, applying the multi-layer method. Initially, a parametric study was carried out to evaluate the vertical displacement for service loads of reinforced concrete beams and slabs using different spans, support conditions and geometry. In order to validate the finite element model, the study compared displacement values for linear analysis using Bares tables. Subsequently, simplified methods of displacement calculation in the long term are applied, using an abacus from  The idea of using non-linear analysis in reinforced concrete structures to promote efficient and economic structural design is not new ,2, but tThe effects on the strength of reinforced concrete (RC) beams with fiber-reinforced polymer were investigated experimentally and numerically in a precracked condition , showingRegulamento de Estruturas de Betão Armado e Pré-Esforçado  and Euro (REBAP ), providThe allowable values for maximum displacement are listed in ISO 4356:1997, referenced by both EC2 and REBAP, and depend mainly on the dimensions of the structural elements and the type of use of the structure. These two structural codes on the control of deformations in reinforced concrete structures indicate two different ways of controlling them. In simple terms, they are the direct control and the indirect control. The first is the explicit calculation of the maximum displacement and its comparison with the maximum allowable value. On the other hand, the second considers that the use of the limit slenderness allows the exemption from the calculation of explicit deformation. That is, it can be designed at the level of the geometry of the structural elements to avoid the verification by direct control.The present study is intended to analyze the performance of these two criteria for the control of structural deformations of reinforced concrete beams and slabs. For this purpose, structural elements are designed to verify the indirect control of the deformations for each code. Each element explicitly calculates the respective deformations and compares them with the limit values. In this way, it is possible to understand how much leeway indirect control offers compared to these limits and whether the increased difficulty at the level of deformation calculation in direct control can be compensated by assumed solutions with less effort.The calculation is presented in two ways: an analytical study using expressions and a non-linear numerical analysis  using a The current structural codes in Portugal allow the exemption from the control of deformations if the criteria for slenderness of the structural elements are met. In this section, the criteria required to avoid direct control of deformation are given, as well as the minimum height for slabs and beams for each code. Finally, the methodology for calculating the long-term deformations is explained.h is beam height; li = l ∗ α is span equivalent to the beam, where l is the theoretical span and α is a coefficient depending on the support conditions and η is a coefficient depending on the type of steel. Article 102° specifies the value of the thickness of the slab, in which the parameters have the same denomination as before, through:The design principles of structural elements shall be established to relieve the verification of deformation by explicit calculation according to REBAP. According to Article 72° of REBAP, this satisfies the safety of deformation limits when conditions specified in Articles 89°, 102° and 113° are met. Article 89° establishes that the following expression calculates the minimum height of the beam:α depends on the support conditions and is given in Table XIII of Article 89° and Table XV of Article 102°, respectively, for beams and slabs. The steel used in this work is A500NR. Therefore, the parameter η is 0.8. This study also recommends that the thickness be less than 7 cm if it is a slab subjected mainly to a distributed load, and 15cm for a slab supported directly on pillars. The parameter Article 113° establishes the theoretical span to be considered for the lightened slabs, which is not discussed in this paper. The width of the compression flange of T beams was taken into account in the design of beams. According to Gomes et al. , the diml/d) sufficient to avoid verification of direct deformations.l—the span of beam and slab; d—useful height of the slab or beam, assuming the value of 3 cm for the first coating and 5cm for the second; K—coefficient of the different structural systems; 0ρ—required reference reinforcement ratio calculated by ρ—required tensile reinforcement ratio at middle span and ρ’—required compressive reinforcement ratio at middle span. The expression used to calculate the parameter ρ is:b—cross-section width; d—cross-section useful height and sA—required tensile reinforcement at middle span. It was assumed that the beam is heavily loaded, thus ρ = 1.5% is required. The slabs, on the other hand, were assumed to be subjected to minor stresses, thus ρ = 0.5% is required. Therefore, these reinforcement levels were used in a very simplified way in the models studied, assuming that the ultimate limit states were checked. REBAP does not specify reinforcement ratios required for expressions that do not require direct control of deformation. Hence, the same reinforcement ratios were applied in EC2. The K values were taken from Table 7.4N in [In this subsection, the design principles for structural elements are presented to allow the verification of deformation by explicit calculation (direct control) according to EC2. Expressions 7.16a and 7.16b from EC2 [The value used for the width of the beam was 40% of the estimated value for the height of the beam. However, according to item 5.3.2.1 of EC2, it is possible to take into account an effective width of the flanges. In this way, the value of the effective width was taken into account in the analytical inertia calculations of the beam to obtain a structural behavior closer to reality.To verify indirect deformation control, this section gives the minimum thicknesses and heights of beams and slabs required by EC2 and REBAP, respectively, for a span varying from 4 m to 8 m. Therefore, a 5 cm and 3 cm thick coating was assumed for beams and slabs, respectively. For the last case, the square flat slab, the minimum thickness is given in cf—Failure stress of compressive concrete; ctf—Failure stress of tensile concrete; cE, sE—Young’s modulus of concrete and steel; uε—Ultimate deformation of concrete and steel; uf—Failure stress of steel, and yf—Yield stress of steel.This subsection is about understanding how the material properties of concrete and steel affect the behavior of reinforced concrete. For this purpose, it is important to define the stress-strain curves of these materials (Equations (6) and (7) present the constitutive model for concrete used in this work, which is taken from EC2. cmE—secant Young’s modulus of concrete; cε—deformation of concrete; c∞ε—infinite deformation of concrete; c,tε—deformation of concrete in a given period of time (see Creep is defined according to  as the itime see b. The vaIM is considered to be below the cracking moment (crM), and IIM is superior to this momentum. Cracking in a particular cross-section is said to occur when the most stressed fiber reaches the minimum strength and shows up as a crack in the concrete. Therefore, the tensile stress passes into the steel and causes a sudden rupture of its structural stiffness , as can r is the radius) is defined in Equation (9), where the subscript c indicates the parameters for concrete, the subscript I indicates whether it is state I or II, M is the moment due to the actual load on the structure, and I is the inertia. Thus, the curvature is constant and corresponds to the curvature in state I until the crack. After cracks appear, there is then an abrupt loss of stiffness in the structure with a reduction of Young’s modulus, increasing the overall deformability of the structure. One then speaks of a curvature in the state II, which results from a cracked cross-section [From the above it can be seen that the difficulty of the analytical calculation is due to the value of the beam stiffness to be used, since in reinforced concrete structures it is not constant with increasing load, notably, immediately after reaching the crack in the most stressed cross-section. When analyzing the deformation of a reinforced concrete structure under a specific load, it is necessary to consider whether a cross-section will crack under that load. The curvature (-section .(9)(1r)ctmf is the average value of the tensile strength of the concrete, cI is the inertia of the concrete, and z is the distance between the neutral axis and the most stressed tensile fiber.The cracking moment is defined in Equation (10), where η is a coefficient depending on the percentage of compressive and tensile reinforcement and the Young’s modulus of steel and concrete, tk is a coefficient from [ca is the deflection value.Finally, based on CEB , the lonent from , and ac For the calculation of deflections in slabs, Barés  tables wγ (Equation (12)) must be determined [a and b are the spans of the slab, and the coefficient varies between 0.5 to 2.0, since outside this range the slab is considered to have a cylindrical bending behavior. Finally, the deflection value of the slab is given in Equation (13) [To obtain the deflection of slabs, the coefficient termined , where tion (13) .(12)γ=al indicates that it is an integral over the length of the element, M’ is the momentum at that point due to a unit load with the direction at the point of displacement to be calculated. Thus, to calculate the deformation of the element, one must determine its curvature. Although it is a simple estimate, the deflection value is degraded because it is not very representative of reality. It therefore does not take into account factors relevant to the deformability of reinforced concrete, such as the influence of reinforced cracks and long-term effects such as creep and retraction.On the other hand, the deflection of a beam is calculated using the PVW, which has the mathematical formulation below  δi=q=qx+qy) . By replThe materials to be defined in the finite element model in SAP2000 are steel and concrete. To achieve this, it is necessary to analyze their isotropy and non-linearity. The numerical model for the definition of concrete uses isotropic material definition, and the steel was uniaxial material. The material non-linearity is considered with the directional model. Thus, several stress-strain curves are modelled for one or more components. In this work, a Shell element (with 6 degrees of freedom in each node) was used to model slabs and beams to obtain more accurate results. Furthermore, a thick slab formulation (Mindlin/Reissner) , referreThe multi-layer method is a heterogeneous cross-section designed along the thickness of the shell by independent layers. In the heterogeneous cross-section, it is possible to consider the non-linearity of the material. The schematics of the slab and the beam are illustrated in It is appropriate to define a high number of layers, because in this way the correct stress distribution in the reinforced concrete cross-section is achieved. In SAP2000, it is possible to define a stress-strain curve of the material used, which makes it possible to model a cracked cross-section, as shown in ckf), average tensile strength (ctmf), and Young’s modulus  after twenty-eight days are described in ykf) and Young’s modulus (sE) are listed in The parametric study developed aims mainly to evaluate the deformations previously described by analytical and numerical models. Three different cases have been developed, the difference being in the behavior adopted for the different materials. In the different models, the materials used are always the same, but with different stress-strain curves. For the concrete, C30/37 was chosen because it is a commonplace type whose characteristic compressive strength (The cases were divided into a linear model and two non-linear models. The linear model (LM) admits that the cross-sections are made exclusively of concrete with linear elastic behavior in both compression and tension, showing the stress-strain curve a with a 2 was applied to the slab to analyze the deformations of the structural elements. It is worth mentioning that this load is close to the permanent combination of loads  for the current residential pavement uses. In order to study the differences between the deformations determined from analytical and numerical models, the ratio  can be found in annex D of [A uniform load of 10 kN/mnex D of . FinallyIt is challenging to find a slab designed to be simply supported a. However) of the analytical and numerical values of the simply supported slab designed according to EC2 and REBAP for LM. Observation of r values are close to 1.0, so the LM is valid. The remaining graphs for this type of slab are in annex D1 of [The following figure shows the ratios  [2) [2). Slabs and beams are designed according to The first study case deals with a fixed-ended slab of a housing floor. The architectural blueprint can be found in Annex E1 of . The arr2) ; (iv) pe2) [2)  and (v) 2) [2)   [2).The last study case is a garage floor with a flat slab supported by structural walls at the edges and columns on the interior. The architectural blueprint can be found in Annex E5 of . The lay2)  and (iii2)  (2.5 kN/The design values of the slab in this case of study are shown in This work’s main objective was to numerically simulate the deformation of reinforced concrete slabs and beams according to the slenderness criteria of EC2 and REBAP. The numerical models were based in finite element shells with layers of reinforced concrete material, providing non-linear analysis. Validation was performed using known analytical expressions and long-term deformations with CEB . The non


Serum IgG4 ≥ 52 mg/dL showed the best accuracy for differentiation of IgG4-SC from CCA, with a sensitivity and specificity of 80% and 82%, respectively, but this was statistically not significant (p = 0.405). Conclusions: The serum IgG4/IgG1 or IgG4/(IgG1+IgG3) level may help to differentiate IgG4-SC from PSC. IgG4 alone is the most accurate serologic marker for the differentiation of IgG4-SC from CCA.Background: The differential diagnosis of immunoglobulin G4-sclerosing cholangitis (IgG4-SC) from primary sclerosing cholangitis (PSC) or cholangiocarcinoma (CCA) is important. In this study, we aimed to find the best combinations of serum IgG subclasses and IgG4 levels for differentiating IgG4-SC from PSC or CCA. Methods: In total, 31 patients with IgG4-SC, 27 patients with PSC, and 40 patients with CCA were enrolled from 2003 to 2017 at a single tertiary referral center. We retrospectively assessed the IgG4, IgG4/IgG1, IgG4/(IgG1+IgG3), and (IgG4+IgG2)/(IgG1+IgG3) in each of the patients. ROC curves were established to obtain the optimal cutoff value for each parameter. McNemar’s test was used to compare the sensitivities, specificities, and accuracies of diagnostic algorithms. Results: In differentiating IgG4-SC from PSC, the accuracies of IgG4/IgG1 ≥ 0.087 and of IgG4/(IgG1+IgG3) ≥ 0.081 were significantly higher than that of IgG4 ≥ 135 mg/dL alone (78% vs. 66%,  IgG4-related sclerosing cholangitis (IgG4-SC) is a biliary manifestation of IgG4-related systemic disease ,2. IgG4-Serum IgG, the predominant isotype in the human body, is divided into four subclasses: IgG1, IgG2, IgG3, and IgG4 . Among tWe analyzed 31 patients with IgG4-SC, 27 patients with PSC, and 40 patients with CCA who underwent IgG subclass from 2003 to 2017 at Samsung Medical Center. IgG4-SC patients with autoimmune pancreatitis (AIP) were excluded from the analysis. Moreover, biopsy-proven CCA patients who had distant metastasis, biliary strictures, and vascular invasion at the time of diagnosis were excluded from the analysis. This study was conducted according to the Declaration of Helsinki and approved by the Institutional Review Board of Samsung Medical Center, Seoul, Korea (No. SMC 2017-09-122).We collected patient demographic data and IgG subclass data. We also reviewed medical charts, pathology results, clinical outcomes, and image findings. IgG4-SC was diagnosed based on the criteria proposed by the Research Committee of IgG4-Related Diseases and the Research Committee of Intractable Diseases of Liver and Biliary Tract, in association with the Ministry of Health, Labor, and Welfare, Japan, and the Japan Biliary Association in 2012 .PSC was diagnosed according to several characteristics, such as (1) clinical symptoms ; (2) cholestatic laboratory profile, such as elevated alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and bilirubin level; (3) bile duct image findings with multifocal strictures and segmental dilatations using endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP); and (4) pathologic profile (in some patients) . Secondap-value of <0.05 was considered statistically significant. Statistical analyses were performed using SAS version 9.4  and SPSS Statistics 23 .We used the Kruskal–Wallis test to compare categorical and continuous data between groups. Receiver operator characteristic (ROC) curves were used to confirm optimal cutoff values of IgG subclass combinations and serum IgG4 to differentiate IgG4-SC from PSC or CCA. McNemar’s test was used to compare the sensitivities, specificities, and accuracies of the diagnostic algorithms. Additionally, Bennett’s test was used to compare the positive predictive value (PPV) and the negative predictive value (NPV). A p = 0.008). Sex did not show a statistically significant difference. Except for IgG3, all IgG subclasses showed statistically significant differences among the three groups. The mean IgG1 (mg/dL) level was 962.1 ± 460.4 in the IgG4-SC group, 846.7 ± 327.0 in the PSC group, and 654.9 ± 239.8 in the CCA group (p = 0.001). The mean IgG2 (mg/dL) level was 743.8 ± 343.9 in the IgG4-SC group, 586.2 ± 252.3 in the PSC group, and 511.0 ± 198.2 in the CCA group (p = 0.007). The mean IgG3 (mg/dl) level was 80.5 ± 79.8 in the IgG4-SC group, 74.2 ± 47.8 in the PSC group, and 42.5 ± 25.8 in the CCA group (p = 0.053). The mean IgG4 (mg/d:) level was 226.5 ± 184.2 in the IgG4-SC group, 37.3 ± 20.1 in the PSC group, and 46.5 ± 48.7 in the CCA group (p < 0.001). Elevated IgG4 levels (>135 mg/dL) were noted in 17 patients (54.8%) in the IgG4-SC group and two patients (5%) in the CCA group. The PSC group patients did not show elevated IgG4 levels (p < 0.001).In The comparison of the diagnostic performance of each IgG subclass combination between IgG4-SC and PSC is demonstrated in p = 0.025).We compared IgG4/subclass ratios to distinguish IgG4-SC from PSC by using ROC curves. The IgG4/subclass ratios consisted of the following groups: IgG4/IgG1, IgG4/(IgG1+IgG3), and (IgG4+IgG2)/(IgG1+IgG3). The largest areas under the curve (AUC) reached the optimal combination of sensitivity and specificity at 0.087, 0.081, and 1.159 in IgG4/IgG1, IgG4/(IgG1+IgG3), and (IgG4+IgG2)/(IgG1+IgG3), respectively. In terms of accuracy, the IgG4/IgG1 and IgG4/(IgG1+IgG3) groups were found to be the highest in terms of sensitivity (70%) and specificity (100%), with statistically significantly higher sensitivity and accuracy than IgG4 ≥ 135 mg/dL (p = 0.005). However, the accuracy of IgG4 ≥ 52 mg/dL was not statistically significant compared to IgG4 ≥ 135 mg/dL (p = 0.405). Plus, the specificity of IgG4 ≥ 52 mg/dL was much lower than that of IgG4 ≥ 135 mg/dL  vs. 95% (95% CI: 83–98); p = 0.025).The comparison of the diagnostic performance of each IgG subclass combination between IgG4-SC and CCA is demonstrated in The AUCs (95% CIs) of the serum IgG subclass combinations for the differentiation of IgG4-SC from PSC are presented in In this study, we assessed the best combination of serum IgG subclasses and IgG4 levels for differentiating IgG4-SC from PSC or CCA. According to the AUCs of the serum IgG subclass combinations, IgG4/(IgG1+IgG3) ≥ 0.081 was found to be the most relevant combination for distinguishing IgG4-SC from PSC. The accuracy of IgG4 ≥ 135 mg/dL  was lower than that of IgG4/(IgG1+IgG3) ≥ 0.081 . On the contrary, IgG4 ≥ 52 mg/dL was the most relevant combination of serum IgG subclasses and IgG4 levels for distinguishing IgG4-SC from CCA. Even though the accuracy of IgG4 ≥ 52 mg/dL  was higher than that of IgG4 ≥ 135 mg/dL  for differentiating IgG4-SC from CCA, the specificity of IgG4 ≥ 52 mg/dL  was lower than that of IgG4 ≥ 135 mg/dL . In clinical practice, it is more important to exclude patients with CCA from other benign diseases. Therefore, the diagnostic value of IgG4 ≥ 52 mg/dL seems less practical than the preexisting IgG4 ≥ 135 mg/dL as a serologic marker.Three representative diagnostic criteria for IgG4-SC have been proposed ,6,7. It In IgG4-SC, only a small number of studies have reported the cutoff level of serum IgG4 for distinguishing IgG4-SC from other biliary diseases, such as PSC and CCA, although a cutoff level of serum IgG4 ≥ 135 mg/dL has also been widely used. In a previous comparative study, Nakazawa et al. reported that the serum IgG4 based on cholangiography classification is a useful diagnostic criterion for distinguishing IgG4-SC from PSC and CCA [Several previous studies have found a significant association between the elevated level of the serum IgG subclass (IgG2 and IgG4) and IgG4-related disease (IgG4-RD) ,16,19,20In our study, patients with IgG4-SC presented elevated mean values in the IgG2 and IgG4 subclasses. In contrast, the mean values of the serum IgG subclasses were not elevated in those patients with PSC and CCA. These differences may have resulted for several possible immunopathological and genetic reasons. First, similarity of the molecular mass 146 kD), number of amino acids in the hinge region (12 amino acids), and affinity to the Fc receptor between the IgG2 and IgG4 subclasses have been reported . These s6 kD, numIn a recent study, Boonstra et al. documented that only 28% of their study patients with IgG4-SC showed elevated serum IgG4 levels ranging between 140 and 280 mg/dL . Severaln = 27). The reason for this small number of patients with PCS is because PSC is rare in East Asia [There are some limitations to our present study. First, our study data were collected retrospectively, resulting in the potential for selection bias. Thus, prospective validation cohort studies are required to confirm our results. The second limitation is the small number of study patients, especially patients with PCS  ≥ 0.081 showed the strongest predictive power for distinguishing IgG4-SC from PSC. In distinguishing IgG4-SC from CCA, IgG4 ≥ 52 mg/dL showed the strongest predictive power. Our findings indicate that the novel measurement of serum IgG4/IgG1 or IgG4/(IgG1+IgG3) level may help to differentiate IgG4-SC from PSC. Additionally, IgG4 alone was shown to be the most accurate serologic marker for the differentiation of IgG4-SC from CCA. However, further large-scale multicenter prospective studies are required to confirm the suitability of the use of these combinations of serum IgG subclasses and IgG4 levels, as well as our results.


Oxytenanthera abyssinica (A. Richard) is among the threatened bamboo species. Furthermore, the effect of climate change on the distribution of bamboo has not yet been adequately studied. Therefore, this study aims to model and map the current and future distribution of O. abyssinica in Africa under four representative concentration pathways (RCPs), such as RCP2.6, RCP4.5, RCP6, and RCP8.5. The future projections were done for the years 2050 and 2070 using SDM ensemble approaches. To model the current and future distribution of O. abyssinica in Africa, 737 presence data were collected from various sources. For this study, a total of eight (8) temperature and precipitation-related variables were used as inputs to the Species Distribution Model (SDM). Finally, the model performance was assessed based on the area under the curve (AUC) and true skills statistics (TSS) measures of statistics. Our results showed an upsurge in the distribution of O. abyssinica across the study area for the low and moderate suitability classes for the climatic conditions considered in this study. However, a steady shrinkage in the habitat was found for the higher suitability classes. The model indicated climatic-related factors such as precipitation during the cold and warm quarters (57.8%), followed by mean temperature during the coldest quarter, isothermality (41.9%) and topographic factors such as elevation and slope (31.6%) were identified as the main limiting factors for the growth of O. abyssinica. Precipitation and temperature during the dry period, on the other hand, had the least impact on the growth of O. abyssinica. Except for RCP2.6, the majority of south-western African countries and the Sahel region remain the most climatically stable ecosystems for O. abyssinica growth under the three climatic scenarios RCP45, RCP6 and RCP8.5. Our results revealed a steady increase in the future suitable habitat for O. abyssinica all over the continent under the considered climatic scenarios. Therefore, to support the future restoration of dryland ecosystems, countries should scheme a restoration policy that allows the sustainable utilization of O. abyssinica tree species. The future policy direction for biodiversity conservation and management should encourage the use of O. abyssinica as a major plant species for improving the livelihoods of people living in dryland areas.Bamboo is the world's most widely exploited plant resource, with significant socio-economic and cultural values. In most parts of Africa, the population is in jeopardy due to the high pressure from human and natural forces. Of these,  Oxytenanthera abyssinica; Climate change; SDM (Ensemble approach); Africa. It has Oxytenanthera abyssinica (A. Richard) and Arundinaria alpine (K. Schum.) are two bamboo species endemic to Africa   . The speamineae)  and annuamineae) . The speamineae) . Currentd Zambia . O. abys 7 years . In its  7 years , and man 7 years , 2003.2.2https://www.gbif.org/), Flora of Zimbabwe (22:https://www.zimbabweflora.co.zw), Vegetationmap4africa (296: https://vegetationmap4africa.org/), databases, and GPS points collected by the authors (127) between 2011 and 2012 . The data is interpolated from more than 10,000 weather stations throughout the world and has a resolution of 5 arc minutes (https://cran.r-project.org) in R, and then downscaled to the boundary of Africa using the clip tool in QGIS version 2.8. The bioclimatic data might have a collinearity issue, resulting in model instability and leading to the wrong interpretation of the model  bioclimatic variables were collected from the freely accessible WorldClim database version 2.1  from the coupled climate model HadGEM2-AO for the Coupled Model Inter-comparison Project phase 5 (CMIP5). The Worldclim database (https://worldclim.org/data/v1.4/cmip5.html)was used to obtain the input data (O. abyssinica in the year 2050 (2041–2060) and the 2070s (2061–2080), RCP4.5 (the intermediate scenario for GHG emissions), RCP8.5 (the highest scenario for GHG emissions), and RCP2.6 (the minimum scenario for GHG emissions), were used  are the most powerful tools in the disciplines such as climate change impact assessment, ecological study, and conservation planning , and in O. abyssinica, an ensemble modeling approach was adopted, which assimilates the different model results. This modeling approach has been recommended as one of the best in species distribution modeling  based on the area under the curve (AUC)  and trueeference . The indeference . For eva2.6O. abyssinica was conducted using the four Representation Concentration Pathways (RCPs), 2.6, 6., 4.5, and 8.5, for the years 2020 (current circumstances), 2050 (average for 2041–2060), and 2070 (average for 2061–2080)  maps were created, consisting of one map for current suitability (2020) and eight suitability maps connected with the four RCPs for the years 2050s and 2070s. The final ensemble maps were created using a weighted averaging method. Finally, for each range of suitability class, the area percentage was calculated in QGIS Version 2.8.The current and projected habitat suitability change analysis of 61–2080) . Based o61–2080) . Then, t2.7abyssinica suitable habitat ranges. As a result, four evaluation criteria were used to estimate current and future suitable habitat change based on  was done following the method of .To compute the effect of climate changes on the likelihood change rate of suitable habitat of ethod of  and  and the warmest quarter precipitation (bio18), which explained the distribution of the species by 34.1%, 25.2%, and 23.7%, respectively  and precipitation-related variables (bio18 and bio19) together contributed roughly 99.7% to the ensemble model prediction of O. abyssinica distribution. Similarly, topographic characteristics such as elevation and slope (31.6%) were shown to be among the most relevant factors affecting O. abyssinica distribution in Africa.Predictor’s variables affecting the distribution of ectively . On the 3.2O. abyssinica's establishment was about 19.04% of the continent. About 15.46% of the area is categorized as low-suitable, 3.32% as moderate, and 0.26% as a highly suitable habitat for O. abyssinica establishment. However, in the current climatic scenario, about 80.97% of the continent remains potentially unsuitable for the species  area for  species .Table 3TO. abyssinia, under the current climatic conditions. Countries like the United Republic of Tanzania, Zambia, Mozambique, the Democratic Republic of the Congo (southeast), Madagascar, Ethiopia, Nigeria, South Sudan (southern), Cameroon, Central African Republic, Guinea, Ghana, Uganda, Malawi, Kenya, Eritrea, and Cote d'Ivoire were found among the most suitable areas for O. abyssinica. Similarly, our model predicted the presence of small suitable habitat patches for O. abyssinica in countries like Liberia, Cape Verde, Lesotho, Guinea-Bissau, Niger, Gambia, and Comoros  and end (2070) century, except for the RCP2.6 and RCP8.5 (moderate suitability class range). Nevertheless, the highly suitable area was projected to decrease in all RCP's for both periods (2050s and 2070s). Correspondingly, the future projection has shown a decreasing trend in the non-suitable areas in all considered RCP's. Overall, our habitat suitability assessment demonstrated a significant impact of future climate change on the potential establishment of O. abyssinica in Africa  and TSS (74%) values, putting it quite close to the optimal prediction range. Furthermore, the visual evaluation of the sample sites using overlay analysis proved this. The result demonstrated the robustness of ensemble models in predicting the targeted species and is consistent with previous research . Our stuO. abyssinica distribution. The population distribution of O. abyssinica in its native habitat is under threat as a result of multiple interrelated human-induced and natural processes (O. abyssinica plant species would have a more restricted geographic range and thus have a lower occurrence probability with future climate warming; typically, a large decrease in the species' distribution area was observed under the high-intensity climatic projection compared to the low-intensity climatic scenarios. Previous research findings has clearly proven the impact of long-term climate change on native plant species shifting from their original niche ranges to new locations (O. abyssinica. O. abyssinica. Climate change appears to be the most significant environmental factor influencing the range of rocesses , with clocations . Our finO. abyssinica to establish well in its current area (O. abyssinica in its original habitats.Designing a proper management and conservation strategy which takes into account the existing dynamics will help ent area , where ient area . Above aent area , carbon ent area  and for ent area . This suThe SDM model in this study only took into account the most important bioclimatic and topographic factors; however, land-cover, vegetation index, including other anthropogenic and natural factors that might threaten the species survival, are not integrated in the model, though they are important variables in improving the model results. As a result, we strongly suggest future studies take these variables into account. Nevertheless, the absence of future data could limit their use for studies. Despite the many expectations and uncertainties in species distribution models, yet SDM remain an important data source for projecting species distributions and appraising scientific adaptation strategies for mitigating the effect of future warming on plant species at various scales .5O. abyssinica distributions across the continent are considered good. Areas regarded as low and moderately suitable for O. abyssinica under the intermediate and end-of-century climatic scenarios for the 2050s and 2070s are anticipated to increase across the study area. However, our current study showed a significant contraction of the highly suitable area range for O. abyssinica establishment across the continent. If the current trend continues, a total habitat shift from its natural niche will be anticipated shortly. Therefore, this study indicates the need to incorporate future climate change scenarios into the existing conservation and management strategies and seeks possible recommendations for protecting the species in its current niche. Finally, this research enabled us to understand the most important bioclimatic factors affecting the distribution of O. abyssinica on the continent of Africa.Despite a steady shrinkage in the highly suitable area, the current findings show that Weldemariam Ch. Elias: Conceived and designed the experiments; Performed the experiments; Contributed materials, analysis tools or data; Analyzed and interpreted the data; Wrote the paper.Dejene W. Sintayehu & Bobasa F. Arbo: Conceived and designed the experiments; Analyzed and interpreted the data; Wrote the paper.Abraha K. Hadera: Analyzed and interpreted the data.This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Data will be made available on request.The authors declare no conflict of interest.No additional information is available for this paper.


The increase trend became more apparent for both materials after a threshold of 40–55% of the corresponding ultimate compressive strengths, which is within the service load of structures, indicating that damage should be considered for chloride ions and water transport in concrete in the tidal zone. The predicted moisture diffusivities of damaged mortar and concrete show marginal difference from those of sound materials because the damage-representative radius could be underestimated due to elastic recovery of materials after unloading.The moisture transport of axial-compression-damaged mortar and concrete was experimentally and analytically studied in this paper. Five stress levels, i.e., 25%, 40%, 55%, 70%, and 85%, of the corresponding ultimate compressive strengths were selected for mortar and concrete specimens with the water cement ratio (w/c) of 0.5. Porosities and sorptivities of mortar or concrete before and after axial compression were measured and compared. Based on the Lucas–Washburn equation on absorption, the relationship between sorptivity and pore size distribution as well as porosity was established. A damage-representative radius was proposed to simply quantify the variation of pore characteristics of damaged mortar and concrete, and the moisture transport of axial-compression-damaged mortar and concrete could be predicted by summing the contributions to water absorption from the original pore system and the pore-equivalent microcrack system. It is shown that the porosities of mortar and concrete only slightly increase with the damage level, but the sorptivities are sensitive to axial compression damage, i.e., increasing nearly monotonically with the stress level from 0.3326 to 0.3533 mm/min The degradation mechanisms of concrete structures mainly include freeze–thaw damage, carbonation, alkali–silica reaction, and mechanical-load-induced damage for concrete and corrosion for reinforcement. Among all the mechanisms, moisture, including liquid water and water vapor, either acts as the medium to transport aggressive agents into concrete or directly participates in the degradation process as a reactant. Therefore, establishing an accurate analytical model and determining its characteristic parameters related to moisture transport are essential for the life-cycle design of concrete structures.In atmospheric environments, the mechanism of moisture ingress into unsaturated concrete greatly depends on the boundary conditions of the structure. When concrete is in a high-humidity environment, the ingress of water vapor from the air into the concrete can be recognized as moisture adsorption, and the moisture diffusivity, With the assumed relationship between the moisture diffusivity and relative humidity or water content in undamaged cementitious materials, many empirical models for moisture diffusivity in undamaged cementitious materials have been proposed ,2,3,4,5.During their service stage, cementitious materials are inevitably subjected to some unfavorable actions, such as external loading, drying shrinkage, and thermal gradients, etc., which may produce microcracks inside the materials. The microcracks can be the development of initial capillary pores, new nucleation in the cement paste, or an interfacial transition zone (ITZ). Superposition of the microcracks onto the original pore network will enhance the mass-transport performance of the materials and impair the durability of structures. Ghasemzadeh and Pour-Ghaz  proved tMany experimental investigations have been carried out to understand the influence of microcracks on moisture transport in cementitious materials. Microcracks were produced by different methods, such as tension ,17,18,19This paper proposed an analytical method to predict the moisture transport in unsaturated mortar and concrete during their service stage. The method assumed that axial compression induced the microcracks as a new pore system was superimposed on the original pore system in sound mortar and concrete. The characteristics of the new pore system were inferred from water-absorption experiments. Then, the moisture transport of axial-compression-damaged mortar and concrete could be calculated by combining the moisture transport in the two pore systems. This method shows the correlation of the extent of the stress-induced damage with the variation of the pore characteristics; that is, it can calibrate the damage level of cementitious materials through the sorption test data on the one hand, and, on the other hand, can predict the moisture transport in unsaturated damaged cementitious materials once the pore characteristics are known. This paper is organized as follows. 3 was used. Fine aggregates were well-graded river sands with the fineness modulus of 2.5–2.6 and an apparent density of 2604 kg/m3  while in the oven. The drying-and-cooling procedure was repeated until the difference of the mass, weighed successively, was less than 5% of the smaller value, and the smaller weight was deemed as the dry mass, earchers  have sugearchers  for CEM The porosity measurements were obtained as follows: (1) the slices were soaked in a water-filled plastic drum and weighed after being towel-dried every 12 h; (2) the soaking and weighing were repeated until the difference in the mass, weighed successively, was less than 5% of the higher value; (3) the procedure was stopped, and the higher value was taken as the saturated mass, The porosity of the wax-sealed slices can be expressed as3.The porosity of the wax-free slices can be expressed asThe weighing method used in this sorption experiment is traditional and widely used. A schematic of the homemade simple device is shown in 0.5); 2); 3). Equation (3) shows a linear relationship between the cumulative sorption length, 0.5.The timing began once the soaked face was immersed in the water. The mass of each slice, TM C1585  . For porous media, such as the cementitious materials, pore sizes are continuous and can be set as m, can be calculated by the integration on the real range of pore sizes, that isSince the pore radius, The areal porosity, fined asΦs=∑ with Equation (2), the sorptivity, Substituting the pore size distribution function, The damage evolution of loaded cementitious materials is a process of the nucleation, propagation, and interconnection of internal microcracks until macrocracks appear on specimen surfaces. This process changes the pore characteristics of cementitious materials, such as porosity, pore size distribution, and pore connectivity, etc., enhancing the transport of moisture. Generally, surface cracks cannot be observed until the post-peak phase for cementitious materials under axial compression. Therefore, only the development of inner microcracks is considered for the pre-peak damage process. Moreover, for cementitious materials in service, the stress level is less than 80% of the ultimate compressive strength in most situations, so it is reasonable to assume that the development of microcracks is relatively stable and homogeneous and that the dimensions of microcracks, especially after unloading, are comparable to the pore size.To consider the effect of axial-compression-induced damage on moisture transport, the basic idea of the dual porous medium model  was adapThen, the damage-representative radius, The damage-representative radii for damaged mortar and concrete were calculated and listed in From The moisture diffusivity,  follows :(15)DhcpHere, Among Equations (16)–(18), The derivation of Equations 16)–(18) occurred as follows: first, a formula for the thickness of the adsorbed layer was proposed using Kelvin’s equation [–(18) occThe damaged concrete is treated as a two-phase composite material comprised of damaged cement paste and undamaged aggregate, and its moisture diffusivity can be obtained by employing the composite theory , as follnt paste , so thatThe moisture diffusivities of concrete subjected to the stress level of 85% of the ultimate compressive strength were calculated with the damage-representative radius, This paper experimentally and analytically investigated the influence of axial-compression-induced damage on the moisture transport of unsaturated mortar and concrete.It was found from the experiments that both the porosities and sorptivities of the undamaged cement paste, mortar, and concrete increased with the w/c. The porosities of damaged mortar and concrete were slightly bigger than those of undamaged ones. However, the sorptivity was sensitive to the damage caused by axial compression above a threshold, i.e., 40–55% of the ultimate compressive strength, indicating that damage from chloride ion and water transport should be considered for concrete in tidal zones.The experiments also show that the pore size distributions of mortar and concrete can be accurately derived from that of cement paste; that is, the pore size distribution of cement paste can serve as a reference for that of mortar or concrete with the same w/c when the ITZ is neglected, which can greatly simplify the sample preparation of mortar or concrete for pore size distribution measurements without losing much accuracy.An analytical model for the sorptivities of damaged mortar and concrete has been deduced and verified, in which damage was simplified to single tubes. The damage-representative radius of the tubes is equal to or nearly zero when the axial compressive stress level is below 40% of the ultimate compressive strength, and increases rapidly once the stress level exceeds 55%. The damage-representative radii of damaged mortar and concrete have marginal differences under the same stress level when the stress level is below 85%.


Antibiotic resistance is a major public health concern driven by antibiotic overuse. Antibiotic stewardship programs are often limited to clinical settings and do little to address non-prescription antibiotic use in community settings. This study investigates the association between non-prescription antibiotic use and healthcare system distrust in the United States and Mexico. An online survey was deployed in the United States and Mexico with enhanced sampling through in-person recruiting in the border region. Non-prescription antibiotic use was defined as having bought or borrowed non-prescription oral or injectable antibiotics within the last 3 years. The survey included a previously validated 10-item scale to measure healthcare system distrust. Logistic regression was used to model the use of non-prescription antibiotics by the level of healthcare system distrust, adjusted for demographic characteristics and antibiotic knowledge. In total, 568 survey participants were included in the analysis, 48.6% of whom had used non-prescription oral or injectable antibiotics in the last 3 years. In the fully adjusted regression model, the odds of using non-prescription antibiotics were 3.2  times higher for those in the highest distrust quartile versus the lowest. These findings underscore the importance of community-based antibiotic stewardship and suggest that these programs are particularly critical for communities with high levels of healthcare system distrust. Antibiotic resistance is a growing public health concern that is driven primarily by overuse of antibiotics and requires urgent attention ,3,4,5,6.With the exception of some over-the-counter topical antibiotics, the law in both the United States and Mexico requires antibiotic users to have a prescription from a clinician ,15. HoweIn both the United States and Mexico, healthcare system distrust is a potential motivator for non-prescription antibiotic use. Healthcare system distrust includes both distrust in one’s provider as well as an overarching skepticism of the medical system as a whole, including a sense of whether or not they will be able to access services when necessary. Now more than ever, public skepticism and distrust of the healthcare system, including hospitals, health insurance companies, and medical research, is persistent and continues to grow ,23,24. HThere are multiple potential confounders to consider when examining the relationship between healthcare system distrust and non-prescription antibiotic use. Previous studies have shown that young adults are the most likely to self-medicate as they become more independent and are encouraged to be independent about self-care ,32. OldeFor the primary analysis, 568 participants were included from the 983 original responses after the exclusion criteria were applied . In geneIn unadjusted comparisons,  age, eduBefore adjusting for potential confounding, we found that as healthcare system distrust increases, the odds of non-prescription antibiotic use also increase . More spAfter adjusting for all potential confounders, we saw a similar relationship, whereas the quartile of distrust increased, and so did the odds of non-prescription antibiotic use. Someone in quartile 2 had 1.33  times the odds of using non-prescription antibiotics, quartile 3 had 2.10  times the odds, and quartile 4 had 3.20  times the odds compared to quartile 1. The significant confounders that we included in our partially adjusted model included race and antibiotic knowledge scores. We also included political views in this model since it was only marginally insignificant in our fully adjusted model . Our partially adjusted model yielded similar results to our unadjusted and fully adjusted models, with non-prescription antibiotic use increasing with the level of healthcare system distrust. Quartile 2 had 1.34  times the odds of using non-prescription antibiotics compared to quartile 1, quartile 3 had 2.36  times the odds, and quartile 4 had 3.51  times the odds. All three of these models are also visualized in As shown in This study demonstrated that individuals with high levels of healthcare system distrust have higher odds of using non-prescription antibiotics compared to those with lower levels of healthcare system distrust. Notably, almost half of the study sample (48.6%) had used non-prescription antibiotics, revealing how prevalent the practice of antibiotic use outside the sanction of the medical system is today. Race and antibiotic knowledge remained significant in the adjusted models, and political views was marginally significant. These findings indicate that the relationship between healthcare system distrust and non-prescription antibiotic use is complex, and these significant covariates could be potential predictors to explore further in future research. After redefining “non-prescription antibiotic use” to either buying non-prescription antibiotics or borrowing them from a family member or friend, the effect of healthcare system distrust on non-prescription antibiotic use was greater for those who borrowed from a family member or friend. Further exploring the nuances to how individuals are choosing to access antibiotics is an important next step in future research. This study was one of the first of its kind in identifying antibiotic use and practices on this scale. Many prior non-prescription antibiotic use studies have focused on specific populations ,40,41,42The biggest limitation of this study was that the study sample was not well distributed between Mexico and United States participants, which is a deviation from our sampling goals. The sample was mostly from the United States, and therefore the study sample was not as representative of Mexico as it was of the United States. According to responses in our survey, participants from Mexico obtained antibiotics primarily from community pharmacies, family members or friends, health stores, and medical clinics. Prior literature suggests that prescriptions for antibiotics in Mexico are very easy to obtain, as physician consultation offices have started to emerge within pharmacies . The UniPrior literature suggests that non-prescription antibiotic use is not a phenomena limited to this study alone ,21,37,38It is important that antimicrobial stewardship programs are meeting people where they are, regardless of beliefs or healthcare practices. The relationship between healthcare system distrust and nonprescription antibiotic use reveals how important it is that appropriate antibiotic use messaging and AMR education are not solely limited to clinical settings. Community-based programming is an important step in bridging the gap between antimicrobial stewardship programs and non-prescription antibiotic use. Antimicrobial stewardship programs need to acknowledge that people make decisions outside of the healthcare system, and that trust is a big driver of this practice. We must avoid relying on language such as “talk to your provider” when delivering education on antibiotic use and antibiotic resistance. Further research should be done to assess how community-based programming might be leveraged to improve antimicrobial stewardship programs most effectively.Researchers from the University of Arizona and University of Sonora-Hermosillo designed an online survey to understand antibiotic seeking in the United States and Mexico during the COVID-19 pandemic. Recruitment throughout the United States and Mexico was done through Amazon Mechanical Turk, a website that allows individuals to respond to surveys for compensation . SurveysSurveys were deployed to individuals over the age of 18 living in the United States or Mexico. The analysis was restricted to antibiotic users in the past three years, excluding those who used topical antibiotics only as they can be legally obtained over the counter. To account for any insincere responses, anyone who had a completion time of fewer than seven minutes, decided a priori, was excluded. Participants were also eliminated if they were missing data for questions concerning non-prescription antibiotic use or demographics. To prevent answers from internet bots, anyone who incorrectly answered the question, “Please select C to make sure you are human”, was also removed. See Non-prescription antibiotic use was defined by using two true or false questions from the survey: “I have bought non-prescription oral or injectable antibiotics within the past 3 years” and “I have asked my friends or family for leftover oral or injectable antibiotics within the past 3 years.” If a participant responds true to either of the questions, they will be considered to have sought out non-prescription antibiotics. If they answer false for both questions, they will not fall under this classification. The primary exposure of interest, healthcare system distrust, was measured using a 10-question scale. This scale was validated in previous literature using qualitative methods such as focus groups, pilot testing, and a cross-sectional telephone survey . Each quPotential covariates were selected for the adjusted model a priori based on past knowledge and a review of the literature ,46,47,48For the sample of interest, descriptive statistics were calculated by stratifying on non-prescription antibiotic use history and compared using chi-square or t-tests. Unadjusted and adjusted logistic regression models were ran to estimate the odds  of non-prescription antibiotic use in each distrust quartile, using the lowest quartile as a reference group. The fully adjusted model included the covariates chosen a priori, described above. A partially adjusted model was also included, only including covariates that were statistically significant in the fully adjusted model. Statistical significance was defined as having a confidence interval that did not include 1.0.Three sensitivity analyses were run. First, to ensure results were consistent with current antibiotic regulations, the inclusion criteria were redefined to only individuals who had used antibiotics within the year they had completed their survey. The second and third sensitivity analyses separated the outcome variable into those who borrowed non-prescription antibiotics from family or friends from those who purchased them. First, non-prescription antibiotic users were classified as anyone who answered “True” to the question “I have bought non-prescription oral or injectable antibiotics within the past 3 years” and anyone who answered “False” was classified as a prescription antibiotic user. In the next analysis, anyone who answered “True” to the question “I have asked my friends or family for leftover oral or injectable antibiotics within the past 3 years,” was classified as a non-prescription antibiotic user. All statistical analyses performed in this study used SAS OnDemand for Academics .This study reveals that healthcare system distrust is a potential motivator for seeking out antibiotics outside of the medical system, especially when individuals are borrowing non-prescription antibiotics from a family member or friend. In all models, including those adjusted for demographic factors and knowledge about antibiotics, healthcare system distrust was positively correlated with non-prescription antibiotic use. With non-prescription antibiotic use being so common, it is crucial that antimicrobial stewardship programs expand their reach to include community-based programming outside of clinical settings. Further research should be conducted to further understand the complexities of healthcare system distrust and non-prescription antibiotic use as well as the development and implementation of community-based antimicrobial stewardship programs.


The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing.The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing.This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse.Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from −8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 .The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from −10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990–1.560, Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing. Non-Hodgkin lymphoma, Kaposi's sarcoma, and cervical cancer, which are known as AIDS-defining cancers (ADCs), occur more frequently in HIV/AIDS patients than in HIV-negative individuals , 2. In oIn addition to being one of these NADCs, prostate cancer is the second leading cause of cancer death among men in the United States. While the effects of prostate cancer detection and treatment on the mental health of sexual minorities, such as males who are sexually attracted to males or transgender females, remain unknown, there is a growing body of evidence that suggests that these treatments may be beneficial , 4. The According to a number of qualitative studies, sexual minority communities have substantial cancer health inequalities , 7. As aAdditionally, few oncology professionals have received training on how to best serve the needs of Sexual and Gender Minority (SGM) patients, and few cancer centers have implemented policies or regular procedures to gather sexual orientation and gender identity information in the electronic medical record, utilize gender-neutral language on forms, provide SGM-specific support services, and/or mandate SGM cultural humility training for all personnel . Until dConsequently, the effects of HIV/AIDS and cancer on the mental health of HIV/AIDS-related cancer patients are deserving of study. Although there has historically been a paucity of literature on sexual minorities among cancer patients, there has been a substantial increase in research on the topic in recent years, solidifying its position as an important area of inquiry. This study aims to synthesize current research on the impact of HIV/AIDS and cancer on the psychological wellbeing of LGBT patients.When it comes to defining sexual minorities, because they are a notion brought and transferred from outside, the academic field largely agrees with the United Nations Development Programme's 2016 survey report on the survival of sexual minorities in refer to those belonging to minorities in terms of sexual orientation, gender identity and gender expression . Sexual Gender identity refers to an individual's emotional proclivity and psychological identification with a certain gender. Transgender individuals, for instance, identify as females when their biological gender at birth is male, despite the fact that their biological gender was female, or as males when their biological gender was female, thus constituting a minority in terms of gender identity , 19. GenIndividuals will experience significant pain in their body, mind, and interpersonal connection following cancer diagnosis and therapy, leading to a variety of mental conditions , 28. SucSimultaneously, the greater the level of self-esteem, the more satisfied patients are with their therapy . Self-esCurrently, there is no real treatment for HIV/AIDS . When inDiscrimination against HIV/AIDS-related groups is primarily motivated by two factors. To begin, a large percentage of AIDS patients are men who have sex with men, intravenous drug users, and commercial sex traders . These iThis research used a systematic review and meta-analysis as its methodology. The primary techniques of study include literature review, questionnaires, and meta-analysis. Meta-analysis is a mathematical process that integrates the findings of many studies conducted in the same field under similar circumstances. The researcher mostly utilizes stata.16 as the statistical analysis program to generate the meta-analysis table and forest map, and the statistics are obtained from the internet and Google academic. The PRISMA 2020 Flow Diagram is employed to conduct a literature screening for publications involving older men who have sex with men with cancer. The authors gathered a total of 370 relevant papers through Google academic and websites, and eliminated several due to their younger age and imprecise statistical representation. Lastly, the meta-analysis comprised 27 papers on HIV/AIDS and 33 studies on cancer.Numerous researches have been conducted on the psychological wellbeing of HIV/AIDS and Cancer sufferers, but few on the psychological wellbeing of HIV/AIDS and Cancer LGBT sufferers. This research performed a systematic review and meta-analysis of articles published between August 1, 2018 and August 1, 2021 in Google scholarly and Web of Science. Such personal records investigated homosexuality, cancer sufferers, geriatric populations, and psychotherapy treatments. The authors mostly utilizes PRISMA 2020 Flow Diagram (Registered Code: CRD42022314571) to conduct literature searches .To conduct research on the effect of cancer and HIV/AIDS on the mental wellbeing of the LGBT community, we must collect data on the psychological wellbeing of gays and cancer sufferers. We solely considered retrospective or prospective observational research and omitted other kinds of literature . Additionally, research lacking the whole text was eliminated.All databases were queried using the keywords, and the results were exported to the citation management system EndNote Reference, where the duplicates were removed. The second stage is to review the abstracts and titles of the remaining publications to determine which are relevant to the study at hand. Before evaluating the papers based on the qualifying criteria, three reviewers  conducted a preliminary screening. After title screening, full-text research must meet inclusion and exclusion criteria. The qualifying conditions are shown in Upon removing redundant publications from the bibliographic database's research outcomes, three independent researchers  evaluated the remaining titles and abstracts for papers that may qualify for full-text evaluation. Additionally, the bibliography of publications included in this manner is carefully researched. Following an examination of the raw data and consultation with another researcher (ANOSI), any discrepancies were addressed through conversation.The same scholars finished and inspected data extraction. Gender, cancer, demographic factors , clinical signs (primarily inflammation and fibrosis), and patient objective records  are all retrieved –67.As per clinical capability at the time of writing, AIDS is an untreatable illness. In the present research, there are limited papers on the impact of inflammation and fibrosis on the psychological wellbeing of AIDS sufferers. Prisma 2020 was used to conduct a search of the literature, some of which had issues including a huge sample size or a lack of clarity in the reporting of findings. Ultimately, twenty-seven papers were chosen for meta-analysis. The following are the findings:Z = 86.58 and P < 0.001).The majority of the research reports a favorable score disparity. This demonstrates that AIDS-related inflammation and fibrosis will have a detrimental effect on the psychological wellbeing of LGBT AIDS sufferers. After analyzing 27 publications on the psychological wellbeing of the AIDS LGBT community, we discovered that the gap in psychological wellbeing scores between the HIV/ AIDS LGBT community and the general population ranges from −10.86 to 15.63. The overall findings indicated a 1.270 point gap in psychological wellbeing scores between the AIDS LGBT population and the general population .SMD is the disparity in scores between the two categories, and the majority of research shows that cancer inflammation and fibrosis have a detrimental effect on the psychological wellbeing of LGBT cancer sufferers. According to the 33 research on the psychological wellbeing of cancer LGBT individuals examined in this study, the disparity in psychological wellbeing scores between cancer LGBT individuals and the general population varies between −8.77 and 20.94. The overall findings indicated that there was a 12.48 point gap in psychological wellbeing scores between the cancer LGBT subgroup and the general group . The disparity in psychological wellbeing scores between cancer LGBT individuals and the general population ranges between −8.77 and 20.94, according to the 33 papers on the psychological wellbeing of cancer LGBT individuals examined for this study. The overall findings revealed a 12.48-point difference in psychological wellbeing scores between the cancer LGBT subgroup and the general population . The aforementioned findings indicate that the inflammation and fibrosis associated with HIV/AIDS and cancer have a significant negative impact on the psychological wellbeing of the LGBT community.We discovered through meta-analysis that the disparity in psychological wellbeing scores between HIV/AIDS LGBT individuals and the general population ranged between −10.86 and 15. The overall findings revealed a 1.270-point difference in psychological wellbeing scores between the HIV/AIDS LGBT group and the general population , State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong's Faculty Innovation Award (4620528), Direct Grant for Research (4054510 and 4054668), and Postdoctoral Fellowship Scheme 2021-22 (NL/LT/PDFS2022/0360/22lt).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.