Lead in the environment remains a matter of grave concern for public health. Lead has been associated with some traditional medicines and has been linked to cases of lead poisoning. A comprehensive compilation of these reports has not previously been conducted. The objective of this review is to explore how common is lead exposure after traditional medicine use, and which countries, systems and/or products are of most concern when it comes to lead contamination. A systematic search was conducted on PubMed, Ovid and EMBASE for studies published between 2005 and 2020. A grey literature search was conducted. Search terms related to lead and traditional medicine were developed for each database, and there were no limitations on language. Studies were included if they examined elevated lead in humans resulting from the use of traditional medicines reported in case reports, case-series, or observational studies. Of the papers discussing lead exposure, 85 case reports were identified and synthesized for the current review. Several themes were identified in the included studies. Traditional medicine has been used in the many parts of the world, however use is more common in South and Southeast Asian countries. The level of detectable lead in products varied widely by region and product types. Consumers of traditional medicines sought products for a wide variety of symptoms and ailments. The symptoms of lead poisoning from traditional medicine use reflected the typical symptom profile of lead poisoning, highlighting the need for awareness of traditional medicine products as a source of lead exposure. Traditional medicine usage remains an important part of health care in many regions, however there is a risk of lead exposure from several products. Health care practitioners in all regions of the world should be aware of the risk and explore the potential for traditional medicine use for patients presenting with elevated blood lead levels. Countries with a strong traditional medicine culture should explore policies for reducing lead exposure from traditional medicine products. JG, LO and MNBD are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy, or views of the World Health Organization.
ApPARENTLY the onl'y previous experiments made to determine the modulus of elasticity of ice are those of Benjamin Bevan.* He went to a pond where the ice was about ten centimeters thick and sawed one end and two sides of' a beam, leaving the other end attached to the main body of ice. He then loaded the free end and obtained the absolute modulus 54xlO·. Nothing is said about the ice returning to its first position when the load was removed, nor of the deflection due to the weight of the beam itself. As the weight of the beam was four or five times the heaviest weight used, this deflection would be q llite appreciable. The 10v"er surface of the ice apparently rested on the water of the pond which prevented it from deflecting as far as it would have done. The upward pressure of the water would in part counterbalance the effect of the weight of the beam. lIfethods of Obse1'vr;ttion.We first endeavored to obtain the modulus by a direct pull on a bar. For this purpose water was put in brass tubes closed at one end and boiled so as to expel bubbles of air, then frozen, sometimes artificiall'y. but generall'y by placing the tubes out of the window and allowing the water to freeze naturall'y. '1'he *
Current lateral buckling (LB) methodologies can be very expensive to implement and in some cases can have unsatisfactory trigger reliability. Imposing a designed Residual Curvature (RC) to provide an initiation point for lateral buckling, by appropriate modification to the straightener settings during reel-lay installation, is a relatively new and efficient method for LB initiation and has been applied in the field to single pipelines to date. The logical progression for this is to apply the RC methodology to the installation of reeled pipe in pipe (PiP). PiP systems which are laid by reel-lay require detailed finite element analysis to determine vessel pipelay settings which ensure that the product is straightened as it leaves the vessel. In addition, imposing an RC section has further technical requirements over standard pipeline installation, i.e. meeting residual strain requirements over a specified length to deliver the required in-situ curvature needed for LB initiation. It is important to identify and optimise the solution to ensure that both installation and in-service requirements can be met and are practically achievable. Therefore, justification for use of the RC methodology for reeled PiP requires a portfolio of in-depth reeling and installation analyses to understand the application of this method for a complex reeled system, and how vessel and environmental influences may impact on the final solution. To justify the implementation of the RC methodology for PiP, advanced non-linear FE analyses were used to assess vessel capabilities, the installation of PiP with RC and to determine the achievable in-situ RC for PiP. The effect and impact of reeling on the PiP is discussed in relation to both standard and RC pipelay. The paper discusses the technical challenges involved in the installation of an RC section for reeled PiP by presenting the methodologies employed in determining the achievable RC for PiP, the potential impact from environmental loading during installation and the resultant in-situ residual curvature that is expected.
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