Follow-Up to the Overlap between Human Activities and the Variation in the Physio-chemical Characteristics of the Sector of Tigris River between Baghdad and El-Dejail

The current study has been applied on the sector of the Tigris River runs from the Dejail area in Salaheldin province even the outskirts of the city of Baghdad near Muthanna Bridge, for the purpose of the follow-up changes of the physico-chemical factors of river water as a result of human activities affecting in the river environment and of throwing household waste, wastewater, fish cages, agricultural and industrial wastes, six different stations were selected along the course for a distance of about 50 km, and chosen on the basis of the diversity of human activities and given symbols (ST1, ST2, ST3, ST4, ST5and ST6), respectively. Water samples have been collected per month for a full year from January up to December (2014). Many factors such as temperature of air and water, water flow velocity, depth, light transmittance, turbidity, (EC, TDS, pH, DO, BOD5, Ca, Mg , TH, TA, NO2 , NO3, PO4, SiO3, SO4,) in addition to Cl were measured. The results showed that the ranges of air and water temperature were between (12.16-40.13 and 10.5-30.27) °C respectively, and flow velocity ranged from (0.29 to 4.17) m/sec; depth (3.75 -7.5) meters, light transmittance (10.0-133) cm, turbidity (10-300) NUT, EC, (673-2028) ms/cm, salinity (0.41-1.2) part per thousand, TDS (574-1017) mg/l, pH (6.70-7.9), DO (2.1-11.7) mg/l, BOD5 (0.18-5.66) mg/l , Ca (132-520) mg/l, Mg (19 -47) mg/l, TH value varied from (231 to 640) and TA (69-158) mg CaCO3/l, NO2 (0.001-0.008), NO3 (0.30-1.4) mg/l, PO4 (0.004-5.12) mg/l, SiO3 (1.95-5.5) mg/l, SO4 (62-702) mg/l and Cl, (26-110) mg/l. From the results, it can be concluded that the volatility in most of the studied factors between the sites and the values of months significantly subjected to the effects of human activities and diversity, and most of these values have exceeded the conditions by Iraqi and international determinants of the river water

Inhibitory Immune Checkpoint Receptors and Ligands as Prognostic Biomarkers in COVID-19 Patients.

Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2. During T-cell activation, the immune system uses different checkpoint pathways to maintain co-inhibitory and co-stimulatory signals. In COVID-19, expression of immune checkpoints (ICs) is one of the most important manifestations, in addition to lymphopenia and inflammatory cytokines, contributing to worse clinical outcomes. There is a controversy whether upregulation of ICs in COVID-19 patients might lead to T-cell exhaustion or activation. This review summarizes the available studies that investigated IC receptors and ligands in COVID-19 patients, as well as their effect on T-cell function. Several IC receptors and ligands, including CTLA-4, BTLA, TIM-3, VISTA, LAG-3, TIGIT, PD-1, CD160, 2B4, NKG2A, Galectin-9, Galectin-3, PD-L1, PD-L2, LSECtin, and CD112, were upregulated in COVID-19 patients. Based on the available studies, there is a possible relationship between disease severity and increased expression of IC receptors and ligands. Overall, the upregulation of some ICs could be used as a prognostic biomarker for disease severity. [Abstract copyright: Copyright © 2022 Al-Mterin, Alsalman and Elkord.

Users, Planners, and Governments Perspectives: A Public Survey on Autonomous Vehicles Future Advancements

Autonomous vehicles (AVs) are expected to change driving perspectives once they are available in the markets. This type of vehicle has received substantial attention lately from media and researchers. This technology is still under rapid advancements, and further research studies are needed to address the potential outcomes, opportunities, and challenges. The fuel system of the AVs is expected to be electrical; therefore, this study addresses the current status of electric vehicles (EVs), including charging time, charging type, and driving range. The study also discusses the barriers that may hindrance the transformation to AVs from the users, planners, and government perspectives. These barriers include the current charging stations of EVs, which provide 2kW power. These stations can be insufficient for the AVs since these cars are expected to utilize advanced sensors and computers. The authors also propose comprehensive recommendations that could facilitate the so-called transformation of EVs to AVs and AVs' associated marketing. The authors found out that conducting a survey is essential to observe the public perception, and marketing and communication plans are essential to educating the public regarding AVs’ features and advantages. Also, a collaboration between auto manufacturers and planners is critical to the success of these vehicles. Finally, a public survey which consisted of 95 participants were conducted to examine the general perspective as surveys are necessary to assist planners, governments and automakers for their future movement toward a sustainable transportation system

An Effective Wireless Sensor Network Routing Protocol Based on Particle Swarm Optimization Algorithm

Improving wireless communication and artificial intelligence technologies by using Internet of Things (Itoh) paradigm has been contributed in developing a wide range of different applications. However, the exponential growth of smart phones and Internet of Things (IoT) devices in wireless sensor networks (WSNs) is becoming an emerging challenge that adds some limitations on Quality of Service (QoS) requirements. End-to-end latency, energy consumption, and packet loss during transmission are the main QoS requirements that could be affected by increasing the number of IoT applications connected through WSNs. To address these limitations, an effective routing protocol needs to be designed for boosting the performance of WSNs and QoS metrics. In this paper, an optimization approach using Particle Swarm Optimization (PSO) algorithm is proposed to develop a multipath protocol, called a Particle Swarm Optimization Routing Protocol (MPSORP). The MPSORP is used for WSN-based IoT applications with a large volume of traffic loads and unfairness in network flow. For evaluating the developed protocol, an experiment is conducted using NS-2 simulator with different configurations and parameters. Furthermore, the performance of MPSORP is compared with AODV and DSDV routing protocols. The experimental results of this comparison demonstrated that the proposed approach achieves several advantages such as saving energy, low end-to-end delay, high packet delivery ratio, high throughput, and low normalization load.publishedVersio

Intelligent Malaysian Sign Language Translation System Using Convolutional-Based Attention Module with Residual Network

(e deaf-mutes population always feels helpless when they are not understood by others and vice versa. (is is a big humanitarian problem and needs localised solution. To solve this problem, this study implements a convolutional neural network (CNN), convolutional-based attention module (CBAM) to recognise Malaysian Sign Language (MSL) from images. Two different experiments were conducted for MSL signs, using CBAM-2DResNet (2-Dimensional Residual Network) implementing “Within Blocks” and “Before Classifier” methods. Various metrics such as the accuracy, loss, precision, recall, F1-score, confusion matrix, and training time are recorded to evaluate the models’ efficiency. (e experimental results showed that CBAM-ResNet models achieved a good performance in MSL signs recognition tasks, with accuracy rates of over 90% through a little of variations. (e CBAM-ResNet “Before Classifier” models are more efficient than “Within Blocks” CBAM-ResNet models. (us, the best trained model of CBAM-2DResNet is chosen to develop a real-time sign recognition system for translating from sign language to text and from text to sign language in an easy way of communication between deaf-mutes and other people. All experiment results indicated that the “Before Classifier” of CBAMResNet models is more efficient in recognising MSL and it is worth for future research

Circulating and tumor-infiltrating immune checkpoint-xepressing CD8+ Treg/T Cell subsets and their associations with disease-free survival in colorectal cancer patients

T cells in the tumor microenvironment (TME) have diverse roles in anti-tumor immunity, including orchestration of immune responses and anti-tumor cytotoxic attack. However, different T cell subsets may have opposing roles in tumor progression, especially in inflammation-related cancers such as colorectal cancer (CRC). In this study, we phenotypically characterized CD3+CD4- (CD8+) T cells in colorectal tumor tissues (TT), normal colon tissues (NT) and in circulation of CRC patients. We investigated the expression levels of key immune checkpoints (ICs) and Treg-related markers in CD8+ T cells. Importantly, we investigated associations between different tumor-infiltrating CD8+ T cell subpopulations and disease-free survival (DFS) in CRC patients. We found that FoxP3 expression and ICs including PD-1, CTLA-4, TIM-3, and LAG-3 were significantly increased in tumor-infiltrating CD8+ T cells compared with NT and peripheral blood. In the TME, we found that TIM-3 expression was significantly increased in patients with early stages and absent lymphovascular invasion (LVI) compared to patients with advanced stages and LVI. Importantly, we report that high levels of certain circulating CD8+ T cell subsets (TIM-3-expressing, FoxP3-Helios-TIM-3+ and FoxP3-Helios+TIM-3+ cells) in CRC patients were associated with better DFS. Moreover, in the TME, we report that elevated levels of CD25+ and TIM-3+ T cells, and FoxP3+Helios-TIM-3+ Tregs were associated with better DFS

Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries:results of an internet-based global point prevalence survey

Summary: Background: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. Methods: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015. Hospitals were classified as primary, secondary, tertiary (including infectious diseases hospitals), and paediatric hospitals. Five main ward types were defined: medical wards, surgical wards, intensive-care units, haematology oncology wards, and medical transplantation (bone marrow or solid transplants) wards. Data recorded included patient characteristics, antimicrobials received, diagnosis, therapeutic indication according to predefined lists, and markers of prescribing quality (eg, whether a stop or review date were recorded, and whether local prescribing guidelines existed and were adhered to). We report findings for adult inpatients. Findings: The Global-PPS for 2015 included adult data from 303 hospitals in 53 countries, including eight lower-middle-income and 17 upper-middle-income countries. 86 776 inpatients were admitted to 3315 adult wards, of whom 29 891 (34·4%) received at least one antimicrobial. 41 213 antimicrobial prescriptions were issued, of which 36 792 (89·3%) were antibacterial agents for systemic use. The top three antibiotics prescribed worldwide were penicillins with β-lactamase inhibitors, third-generation cephalosporins, and fluoroquinolones. Carbapenems were most frequently prescribed in Latin America and west and central Asia. Of patients who received at least one antimicrobial, 5926 (19·8%) received a targeted antibacterial treatment for systemic use, and 1769 (5·9%) received a treatment targeting at least one multidrug-resistant organism. The frequency of health-care-associated infections was highest in Latin America (1518 [11·9%]) and east and south Asia (5363 [10·1%]). Overall, the reason for treatment was recorded in 31 694 (76·9%) of antimicrobial prescriptions, and a stop or review date in 15 778 (38·3%). Local antibiotic guidelines were missing for 7050 (19·2%) of the 36 792 antibiotic prescriptions, and guideline compliance was 77·4%. Interpretation: The Global-PPS showed that worldwide surveillance can be accomplished with voluntary participation. It provided quantifiable measures to assess and compare the quantity and quality of antibiotic prescribing and resistance in hospital patients worldwide. These data will help to improve the quality of antibiotic prescribing through education and practice changes, particularly in low-income and middle-income countries that have no tools to monitor antibiotic prescribing in hospitals. Funding: bioMérieux

Use of the WHO Access, Watch, and Reserve classification to define patterns of hospital antibiotic use (AWaRe): an analysis of paediatric survey data from 56 countries

BACKGROUND: Improving the quality of hospital antibiotic use is a major goal of WHO's global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally. We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions. METHODS: 1-day point prevalence survey antibiotic prescription data were combined from two independent global networks: the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children and the Global Point Prevalence Survey on Antimicrobial Consumption and Resistance networks. We included hospital inpatients aged younger than 19 years receiving at least one antibiotic on the day of the survey. The WHO AWaRe classification was used to describe overall antibiotic use as assessed by the variation between use of Access, Watch, and Reserve antibiotics, for neonates and children and for the commonest clinical indications. FINDINGS: Of the 23 572 patients included from 56 countries, 18 305 were children (77·7%) and 5267 were neonates (22·3%). Access antibiotic use in children ranged from 7·8% (China) to 61·2% (Slovenia) of all antibiotic prescriptions. The use of Watch antibiotics in children was highest in Iran (77·3%) and lowest in Finland (23·0%). In neonates, Access antibiotic use was highest in Singapore (100·0%) and lowest in China (24·2%). Reserve antibiotic use was low in all countries. Major differences in clinical syndrome-specific patterns of AWaRe antibiotic use in lower respiratory tract infection and neonatal sepsis were observed between WHO regions and countries. INTERPRETATION: There is substantial global variation in the proportion of AWaRe antibiotics used in hospitalised neonates and children. The AWaRe classification could potentially be used as a simple traffic light metric of appropriate antibiotic use. Future efforts should focus on developing and evaluating paediatric antibiotic stewardship programmes on the basis of the AWaRe index. FUNDING: GARPEC was funded by the PENTA Foundation. GARPEC-China data collection was funded by the Sanming Project of Medicine in Shenzhen (SZSM2015120330). bioMérieux provided unrestricted funding support for the Global-PPS

Predictors of Intensive Care Admission Among Adult Patients with Sickle Cell Disease in Eastern Province of Saudi Arabia

Mortadah Alsalman,1 Zaenb Alsalman,2 Hussain Abduljaleel Alkhalifa,3 Aman N Alfaraj,3 Ali Alkhalifah,4 Qasem Almulihi5 1Department of Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 2Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia; 3Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 4Emergency Department, Eastern Health Cluster, Dammam, Saudi Arabia; 5Emergency Department, King Fahad University Hospital, Al Khobar, Saudi ArabiaCorrespondence: Zaenb Alsalman, Departments of Family and Community Medicine, College of Medicine, King Faisal University, Po Box 3311, AlAhsa, 36346, Saudi Arabia, Tel +966545611633, Email [email protected]: Sickle cell disease (SCD) comprises a complex group of hematologic disorders that are collectively the most common monogenic disorder and are associated with increased risk of intensive care unit admission (ICU). The purpose of this study is to investigate factors that predict admission of adult patients with SCD to the ICU.Patients and Methods: This was a cross-sectional study that enrolled adult patients with SCD from Saudi Arabia.Results: A total of 107 patients with SCD, with a median age 31.9± 12.1 years, were evaluated retrospectively. Regarding predictors of ICU admission, patients who indicated a history of blood transfusions were at 8.047-fold higher risk of ICU admission (OR=8.047; 95% CI=2.392– 27.07; p=0.001). Patients who started hydroxyurea were at least 3.071 times more likely to be admitted than those who did not (OR=3.071; 95% CI=1.164– 8.104; p=0.023). We also observed three or more hospitalizations per year to be associated with increased risk of ICU admission (OR=3.393; 95% CI=1.285– 8.960; p=0.014), with those making 3 to 5 visits annually having at least 10.4 times higher risk (OR=10.38; 95% CI=10.098– 98.19; p=0.041) and those with 6 to 10 ER admissions having 18 times higher risk (OR=18.00; 95% CI=2.149– 150.8; p=0.008). Finally, patients with high WBC were predicted to have at least 3.34 times higher risk of ICU admission (OR=3.337; 95% CI=1.131– 9.846; p=0.029).Conclusion: SCD is a multi-systemic disease associated with increased morbidity and mortality. Recognition of high-risk features in patients helps to eliminate subjectivity in ICU referral decision. Frequent hospitalization and emergency visits, multiple blood transfusions, and elevated white blood cell count were significantly associated with a higher rate of ICU admission despite hydroxyurea usage.Keywords: sickle cell disease, intensive care unit, hydroxyure