A new acylated and oleanane-type triterpenoid saponin from Gypsophila arrostii roots

A new acylated and triterpenoidal saponin, named GS1, was isolated from the roots of Gypsophila arrostii Guss. On the basis of acid hydrolysis, comprehensive spectroscopic analyses and comparison with spectral data of known compounds, its structure was established as 3-O-β-D-xylopyranosyl-(1→2)-[β-D-xylopyranosyl-(1→3)]-β-D-glucopyranosyl-{21-O-[(E)-3,4,5trimethoxycinnamoyl]}21-hydroxygypsogenin 28-O-β-D-glucopyranosyl-(1→2)- [β-D-arabinopyranosyl-(1→3)]-β-D-xylopyranosyl-(1→3]-α-L-rhamnopyranosyl ester. This article deals with the isolation and structural elucidation of new acylated and oleanane-type saponin. © 2017 Taylor & Francis Group, LLC

Constituents, oxidant-antioxidant profile, and antimicrobial capacity of the essential oil obtained from ferulago sandrasica Peşmen and Quézel

Chemical constituents, total phenolic content, total oxidant status, total antioxidant status, lipid hydroperoxides, total free -SH levels, and antimicrobial activity of essential oil obtained from the Ferulago sandrasica (Umbelliferae) were investigated. The essential oil was obtained by hydrodistillation using a Clevenger-type apparatus. The chemical constituents were analyzed by gas chromatography-mass spectrometry. The main components of the essential oil were ocimene (30.5%), carene-δ-3 (27.4%), and pinene (17.8). The antimicrobial activity was tested by a disc diffusion method against E. coli MC 400, E. coli ATCC 25922, E. coli 0157 H7, E. colaecea ATCC 23355, E. feacalis ATCC 19433, P. aeruginosa NRRL B-2679, S. aureus ATCC 25923, B. nischenoformis NRRL B-1001, S. aureus ATCC 33862, B. cereus NRRL B-3711, B. subtilis NRRL B-209, M. luteus NRRL B-1013, L. monocytogenes ATCC 7644, B. subtulis ATCC 6633. © 2013 Copyright Taylor and Francis Group, LLC

Effect Of Bio-Based Lubricant Towards Emissions And Engine Breakdown Due To Spark Plug Fouling In A Two-Stroke Engine

Two-stroke also known as two-cycle gasoline engine is a spark ignition engine. Its uniqueness to the four-stroke engine is that this engine does not require lubricant sump, which makes construction lightweight and simple. Its lubricant is mixed with gasoline and burnt together during combustion. There are reports which stated that higher spark plug fouling is due to carbon deposition on the spark plug electrodes on a two-stroke engine when compared to the four-stroke. While many factors could have affected this situation, however, in this paper, the effect of mineral and bio-based lubricants towards carbon deposition and emissions are studied and reported. Idle, half and full throttle operation modes had been conducted on a two-stroke, 43 cubic centimeter engine. To keep combustion temperature below self-cleaning temperature on all three modes of operation, a zero-load test was utilized. This situation accelerates the deposition process as low temperature causes incomplete combustion. This could lead to the accumulation of char, unburned fuel, as well as condensed water and acids as the byproducts blanket the spark plug electrodes and the exhaust system. Five samples had been prepared with a commercially available mineral lubricant (T0) as reference. Trimethylolpropane Trioleate, TMPTO derived from plant origin was used as the bio-based candidate. It was then mixed with T0 which created another four lubricant samples namely T10, T15, T20 and T50 with 10%, 15%, 20% and 50% TMPTO accordingly. Results show that mineral lubricant T0 delivers the lowest hydrocarbon HC, carbon monoxide CO and smoke opacity during idle and half throttle operations. However, it exhibits a greasy deposit on the spark plug circumference and dry carbon deposits on its insulator tip. T0 also emits a liquid residue at the exhaust manifold. T10 and T50 show a wet deposit blanketing both electrodes. Severe deposition was recorded by T50 that caused the engine to fail half way with its emissions had the worst recording. T15 and T20 exhibit only dry carbon deposition on the spark plug circumference. However, T20 has outperformed T15 in terms of emissions with lower CO and CO2 emissions during idling and half-throttling. With better emissions than T15 and better carbon deposition than mineral (T0), T20 could be proposed to be used as a commercial two-stroke lubricant

Multipl miyelom tanılı hastalarda EORTC QLQ ile yaşam kalitesi değerlendirmesi: Çok merkezli çalışma

Objective: Both the length of the treatment period and the diversity of the agents used in the treatment significantly affect the quality of life (QoL) of the patients with multiple myeloma (MM). With the aid of the EORTC Quality of Life Questionnaire Consisting of 30 Questions “EORTC QLQ-C30” and the Quality of Life Questionnaire Multiple Myeloma Module “QLQ-MY20”, we aimed to obtain data on quality of life in MM patients in a representative sample of the general population of our country. Methods: One hundred sixty eight patients from 6 different centers followed between 2018-2020 were included in the study. The QLQ-C30, and the QLQ-MY20 questionnaires specific for MM patients were used and the results were reported statistically. Results: Seventy eight (46%) of the patients were female, while 90 (54%) were male. The median age was 64 (22-84). When the findings were analysed, it was found that there was a greater effect on the symptom scale compared to the functional scale. Conclusion: The importance of the treatment-related side effect management, together with the adequate administration of appropriate symptomatic treatment in holistic treatment management were emphasized as effective factors in terms of the QoL of patients with MM.Amaç: Hem tedavi süresinin uzunluğu, hem de tedavide kullanılan ajanların çeşitliliği multipl miyelomlu (MM) hastaların yaşam kalitesini (YK) önemli ölçüde etkiler. Otuz sorudan oluşan EORTC Yaşam Kalitesi Anketi “EORTC QLQ-C30” ve Yaşam Kalitesi Anketi-Multipl Miyelom Modülü “QLQ-MY20” yardımıyla MM hastalarında yaşam kalitesine ilişkin verileri elde etmeyi amaçladık. Yöntem: 2018-2020 yılları arasında takip edilen, 6 farklı merkezden 168 hasta çalışmaya dahil edildi. MM hastalarına özel QLQ-C30 ve QLQ-MY20 anketleri kullanılmış ve sonuçlar istatistiksel olarak rapor edilmiştir. Bulgular: Hastaların 78’i (%46) kadın, 90’ı (%54) erkekti. Ortanca yaş 64 (22-84) idi. Bulgular incelendiğinde semptom ölçeğinde fonksiyonel ölçeğe göre daha fazla etkinin olduğu görüldü. Sonuç: Bütüncül tedavi yönetiminde, uygun tedavinin yeterli uygulanması ile birlikte tedaviye bağlı yan etki yönetiminin önemi, MM’li hastaların yaşam kalitesi açısından etkili faktörler olarak vurgulanmıştır

Measurement of neutral current e+/-p cross sections at high Bjorken x with the ZEUS detector

The neutral current e+/-p cross section has been measured up to values of Bjorken x of approximately 1 with the ZEUS detector at HERA using an integrated luminosity of 187 inv. pb of e-p and 142 inv. pb of e+p collisions at sqrt(s) = 318GeV. Differential cross sections in x and Q2, the exchanged boson virtuality, are presented for Q2 geq 725GeV2. An improved reconstruction method and greatly increased amount of data allows a finer binning in the high-x region of the neutral current cross section and leads to a measurement with much improved precision compared to a similar earlier analysis. The measurements are compared to Standard Model expectations based on a variety of recent parton distribution functions.Comment: 39 pages, 9 figure

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe