Three Dimentional Transvaginal U/S Measurements Of Uterine Junctional Zone Thickness And Its Relation To Implantation Success Rate In ICSI Cycles

Background: Sub-endometrial junction zone (JZ) plays an important role in most of reproductive functions. Objective: To find out the effect of the sub-endometrial JZ thickness assessment by 3-D transvaginal ultrasound (TVUS) on intracytoplasmic sperm injection (ICSI) outcomes in patients with unexplained recurrent implantation failure (RIF). Setting: ART Unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt. Duration: From April 2016 to October 2018. Study Design: A prospective observational study. Methds: Fifty couples with history of unexplained RIF in previous ICSI cycles and prepared for another ICSI cycle (group I) and fifty couples with unexplained infertility prepared for ICSI for the first time (group II) had been included in this study. At time of ovum pick up, 3-DTVUS was done for all cases in both groups for assessment of sub endometrial junction zone thickness and correlated with ICSI outcome. Results:There were statistically significant differences be- tween group I and group II in JZ thickness in the 3 uterine regions (fundus, anterior and posterior walls) with p < 0.001, but there were mildly statistically significant differences between both groups in chemical and clinical preg- nancy rates with p < 0.01. Conclusions: The thickness of JZ in patients with history of unexplained RIF was higher than those with unexplained infertility scheduled for ICSI. The JZ thickness was inversely correlated with increased embryo implantation rates in ICSI procedures, the thinner the JZ thickness was associated with higher pregnancy rates (both chemical and clinical pregnancy rates)

Bayesian Convolution for Stochastic Epidemic Model

Dengue Hemorrhagic Fever (DHF) is a tropical disease that always attacks densely populated urban communities. Some factors, such as environment, climate and mobility, have contributed to the spread of the disease. The Aedes aegypti mosquito is an agent of dengue virus in humans, and by inhibiting its life cycle it can reduce the spread of the dengue disease. Therefore, it is necessary to involve the dynamics of mosquito's life cycle in a model in order to obtain a reli- able risk map for intervention. The aim of this study is to develop a stochastic convolution susceptible, infective, recovered-susceptible, infective (SIR-SI) mod- el describing the dynamics of the relationship between humans and Aedes aegypti mosquitoes. This model involves temporal trend and uncertainty factors for both local and global heterogeneity. Bayesian approach was applied for the parameter estimation of the model. It has an intrinsic recurrent logic for Bayesian analysis by including prior distributions. We developed a numerical computation and carry out simulations in WinBUGS, an open-source software package to perform Mar- kov chain Monte Carlo (MCMC) method for Bayesian models, for the complex systems of convolution SIR-SI model. We considered the monthly DHF data of the 2016–2018 periods from 10 districts in Kendari-Indonesia for the application as well as the validation of the developed model. The estimated parameters were updated through to Bayesian MCMC. The parameter estimation process reached convergence (or fulfilled the Markov chain properties) after 50000 burn-in and 10000 iterations. The deviance was obtained at 453.7, which is smaller compared to those in previous models. The districts of Wua-Wua and Kadia were consistent as high-risk areas of DHF. These two districts were considered to have a signifi- cant contribution to the fluctuation of DHF cases

Toxicity of co-exposure of microplastics and lead in African catfish (Clarias gariepinus)

Microplastics (MPs) are an emerging threat to freshwater ecosystems with several ecotoxicological ramifications for fish. Microplastics (MPs) can adsorb heavy metals on their surfaces and increase their availability to aquatic organisms. The combined impact of lead and microplastics on fish has only been studied seldom utilizing a variety of markers. The present study aimed to evaluate the hematological, biochemical, and inflammatory signals (cytokines), as well as antioxidant enzymes in African catfish (Clarias gariepinus) exposed to lead (Pb) and MPs individually and combined for 15 days (acute toxicity experiment). The fish were split into four groups, the first of which was the control group. The second group received exposure to 1 mg/L of lead nitrate [Pb(NO3)2]. The third group was given 100 mg/L of MPs. A solution containing 100 mg/L of MPs and 1 mg/L of lead nitrate [Pb(NO3)2] was administered to the fourth group (the combination group). According to the findings, when MPs and Pb were combined for 15 days, the red blood cells (RBCs), thrombocytes, and lymphocytes were significantly reduced in comparison to the control fish. When compared to the control fish, the fish exposed to MPs and Pb alone or together showed a significant rise in blood interleukin-1β (IL-1β) and interleukin-6 (IL-6) cytokines. Both MPs and Pb exposure in catfish resulted in significant changes in the plasma electrolytes. The fish treated with MPs and Pb individually or in combination showed significant reduction in superoxide dismutase (SOD) and total antioxidant capacity (TAC) levels compared to the control group. The fish exposed to the combined action of MPs and Pb showed a considerable modification in all biochemical markers. The difference in the mean concentration of Pb (mg/L) between the fish exposed to Pb alone and the fish subjected to Pb and MPs combination was not statistically significant. In conclusion, according to this investigation, exposure to Pb caused an insignificant increase in Pb accumulation when MPs were present. However, co-exposure may result in anemia, cellular harm, extremely high levels of oxidative stress, and an inflammatory reaction

Bacterial Diseases Affecting the Cultured Sepia Officinalis Leading to Increase Mortality Rates in The Laboratory

The early growth, mortality rates and bacterial infections of the cultured Sepia Officinalis were experimentally studied in the laboratory. Two hundred eighty-five sepia larvae were hatched and placed in a 100-liter capacity rectangular glass aquarium (filled with seawater) in the laboratory. The Sepia individuals (285 individuals) were divided into two groups the first fed on a mixture of amphipods, rotifers and artemia and the second group fed only on amphipods to follow their growth and mortality. The second group was observed to grow faster with length 6.76 ± 0.06mm and weight 0.11 ± 0.01gm than the first one. The survival rate was 100% by the end of the first week and decreased gradually by the end of the second week. The recorded mortality rate reached 49% by the day 15th, where they infected with bacterial disease of Vibrio alginolyticus. The clinical signs of the diseased S. Officinalis were lethargic condition, food fasting and multiple skin ulcers with white-gray discoloration were observed and appeared on the body. The main postmortem lesions were congestion of the internal organ, beside the presence of ascetic fluid. The mortality among the diseased Sepia was increased by age; however, it may cause death of most individuals by increasing time more than two weeks. The findings of antibiotic sensitivity test cleared that the isolated V. alginolyticus was sensitive to amoxiclav (amoxicillin-clavulanate), streptomycin, ciprofloxacin and chloramphenicol. Controversially, it was resistant to oxytetracycline, tobramycin, gentamycin and enrofloxacin

Bacterial Diseases Affecting the Cultured Sepia Officinalis Leading to Increase Mortality Rates in The Laboratory

The early growth, mortality rates and bacterial infections of the cultured Sepia Officinalis were experimentally studied in the laboratory. Two hundred eighty five sepia larvae were hatched and placed in a 100 liter capacity rectangular glass aquarium (filled with seawater) in the laboratory. The Sepia individuals (285 individuals) were divided into two groups the first fed on a mixture of amphipods, rotifers and artemia and the second group fed only on amphipods to follow their growth and mortality. The second group was observed to grow faster with length 6.76 ± 0.06mm and weight 0.11 ± 0.01gm than the first one. The survival rate was 100% by the end of the first week and decreased gradually by the end of thesecond week. The recorded mortality rate reached 49% by the day 15th, where they infected with bacterial disease of Vibrio alginolyticus. The clinical signs of the diseased S. Officinalis were lethargic condition, food fasting and multiple skin ulcers with white-gray discoloration were observed and appeared on the body. The main post mortem lesions were congestion of the internal organ, beside the presence of ascetic fluid. The mortality among the diseased Sepia was increased by age; however it may causes death of most individuals by increasing time more than two weeks. The findings of antibiotic sensitivity test cleared that the isolated V. alginolyticus was sensitive to amoxiclav (amoxicillin-clavulanate), streptomycin, ciprofloxacin and chlormphinicol. Controversially, it was resistant to oxytetracycline, tobramycin, gentamycine and enrofloxacin.Keywords: Sepia Officinalis - growth rate - mortality rate - bacterial infection

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

Perspective Chapter: The Toxic Silver (Hg)

In the late 1950s, residents of a Japanese fishing village known as “Minamata” began falling ill and dying at an alarming rate. The Japanese authorities stated that methyl-mercury-rich seafood and shellfish caused the sickness. Burning fossil fuels represent ≈52.7% of Hg emissions. The majorities of mercury’s compounds are volatile and thus travel hundreds of miles with wind before being deposited on the earth’s surface. High acidity and dissolved organic carbon increase Hg-mobility in soil to enter the food chain. Additionally, Hg is taken up by areal plant parts via gas exchange. Mercury has no identified role in plants while exhibiting high affinity to form complexes with soft ligands such as sulfur and this consequently inactivates amino acids and sulfur-containing antioxidants. Long-term human exposure to Hg leads to neurotoxicity in children and adults, immunological, cardiac, and motor reproductive and genetic disorders. Accordingly, remediating contaminated soils has become an obligation. Mercury, like other potentially toxic elements, is not biodegradable, and therefore, its remediation should encompass either removal of Hg from soils or even its immobilization. This chapter discusses Hg’s chemical behavior, sources, health dangers, and soil remediation methods to lower Hg levels

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

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