Physical and Fuel Properties of Bambusa vulgaris of Different Age Groups and Their Effect on Producing Biofuel

Bamboo can be used to produce solid, gaseous, and liquid fuels, as well as to generate heat and biofuels for transport and electricity. The main objective of this study was to investigate the physical and fuel properties of Bambusa vulgaris in three ecological zones for their utilization potential for the production of biofuels. Thirty-six samples of Bambusa vulgaris culms from 3 ecological zones in Ghana were milled to powder to assess the physical and fuel properties. The physical properties; moisture content, high heating values, bulk density, density, and ash content were investigated. The fuel properties were based on ultimate analysis, carbon, hydrogen nitrogen, and oxygen. The mean moisture content (MC) for the green bamboo ranged from 68.8% (dead culm) to 148% (mature culm) and 168% (juvenile culm). The MC for dried samples ranged from 9.09 to 13.06%. The results showed that the % MC of the samples increased with decreasing values of high heating and ash content. The mean density of the matured bamboo culms varied from 616.84 to 641.68 kg·m–3 and dead bamboo culms from 609.01 to 632.72 kg·m–3. Marginal reduction in density was observed in dead bamboo culms across the three ecological zones as compared to the mature bamboo culms. This implies that when B. vulgaris overgrows, its density decreases. High heating values ranged from 16.12 to 18.14 MJ·kg–1. Bulk density determines the transportation and storage of biomass; it ranged from 0.12 to 0.52 g·m–3. The ash contents were within the threshold (≥3%) of European standard. The mean values for the ultimate analysis of carbon (48.46 to 53.31%), hydrogen (5.60 to 6.56%), nitrogen (0.58 to 0.61%), and oxygen (39.73 to 41.35) were higher. Fuel properties of Bambusa vulgaris are comparable to some wood types, lower to denser wood types, but higher than most of the herbaceous energy crops and agricultural residues. This means that Bambusa vulgaris may be a good feedstock for the production of bioenergy in terms of heat, charcoal, biogas, bio-power, and transportation fuel

Sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of infection prevention in neonates in North Dayi District, Ghana

BackgroundNeonates are at a greater risk of infection, but data on the maternal knowledge and practice of infection prevention in neonates (IPNs) are scarce. This study aimed to assess sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of IPNs in North Dayi District, Ghana.MethodsThis was a multicenter cross-sectional study conducted among 612 mothers. A structured questionnaire was used for data collection adapted from previous studies and the IPN guidelines of the World Health Organization (WHO). Bivariable analyses were performed to determine the association between maternal knowledge and practice of IPNs and sociodemographic characteristics and reproductive health factors.ResultsAnalysis showed that less than one-fifth of the mothers (12.9%) had poor knowledge of IPNs, while 21.6% incorrectly practiced it. Mothers who had poor knowledge of IPNs [adjusted odds ratio (AOR) = 13.33 (95% CI: 7.69–23.26), p < 0.001] were more likely to have a poor practice of IPNs.ConclusionAbout one-fifth of the mothers in this study had poor knowledge or poor practice of IPNs according to the WHO’s guidelines. The Health Directorate of North Dayi District should explore the risk factors associated with poor IPNs and increase successful guideline adherence with intensified educational outreach and campaigns

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

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.This study was funded by: - The UK Medical Research Council (grant number MR/V034057/1) - The Wellcome Trust (Pathways to Equitable Healthy Cities grant 209376/Z/17/Z). - The AstraZeneca Young Health Programme and the European Commission (STOP project through EU Horizon 2020 research and innovation programme under Grant Agreement 774548)

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Data_Sheet_1_Sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of infection prevention in neonates in North Dayi District, Ghana.PDF

BackgroundNeonates are at a greater risk of infection, but data on the maternal knowledge and practice of infection prevention in neonates (IPNs) are scarce. This study aimed to assess sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of IPNs in North Dayi District, Ghana.MethodsThis was a multicenter cross-sectional study conducted among 612 mothers. A structured questionnaire was used for data collection adapted from previous studies and the IPN guidelines of the World Health Organization (WHO). Bivariable analyses were performed to determine the association between maternal knowledge and practice of IPNs and sociodemographic characteristics and reproductive health factors.ResultsAnalysis showed that less than one-fifth of the mothers (12.9%) had poor knowledge of IPNs, while 21.6% incorrectly practiced it. Mothers who had poor knowledge of IPNs [adjusted odds ratio (AOR) = 13.33 (95% CI: 7.69–23.26), p ConclusionAbout one-fifth of the mothers in this study had poor knowledge or poor practice of IPNs according to the WHO’s guidelines. The Health Directorate of North Dayi District should explore the risk factors associated with poor IPNs and increase successful guideline adherence with intensified educational outreach and campaigns.</p