Comparison of the photoelectrochemical oxidation of methanol on rutile TiO 2 (001) and (100) single crystal faces studied by intensity modulated photocurrent spectroscopy

The photooxidation of methanol as a model substance for pollutants on rutile TiO 2 (001) and (100) surfaces was investigated using intensity modulated photocurrent spectroscopy (IMPS). The results are analyzed in view of the influence of the surface structure, the methanol concentration and the electrode potential on the rate constants of charge transfer and recombination. The obtained results have been explained with a model combining the theory of IMPS for a bulk semiconductor surface and the nature of the surface-bound intermediates (alternatively mobile or immobile OH radicals). The results indicate that water photooxidation proceeds via mobile OH radicals on both surfaces, while methanol addition gives rise to the involvement of immobile OH radicals on the (100) surface. Detailed analysis in view of the surface structures suggests that the latter observation is due to efficient electron transfer from bridging OH radicals on the (100) surface to methanol, while coupling of two of these radicals occurs in the absence of methanol, making them appear as mobile OH radicals. In the case of the (001) surface, the coupling reaction dominates even in the presence of methanol due to the smaller distance between the bridging OH radicals, leading to more efficient water oxidation, but less efficient methanol photooxidation on this surface. © the Owner Societies 2012

Genetic algorithm for the design and optimization of a shell and tube heat exchanger from a performance point of view

A new approach to optimize the design of a shell and tube heat exchanger (STHX) is developed via a genetic algorithm (GA) to get the optimal configuration from a performance point of view. The objective is to develop and test a model for optimizing the early design stage of the STHX and solve the design problem quickly. GA is implemented to maximize heat transfer rate while minimizing pressure drop. GA is applied to oil cooler type OKG 33/244, and the results are compared with the original data of the STHX. The simulation outcomes reveal that the STHX\u27s operating performance has been improved, indicating that GA can be successfully employed for the design optimization of STHX from a performance standpoint. A maximum increase in the effectiveness achieves 57% using GA, while the achieved minimum increase is 47%. Furthermore, the average effectiveness of the heat exchanger is 55%, and the number of transfer units (NTU) has improved from 0.475319 to 1.825664 by using GA

Optimizing the Steering of Driverless Personal Mobility Pods with a Novel Differential Harris Hawks Optimization Algorithm (DHHO) and Encoder Modeling

This paper aims to improve the steering performance of the Ackermann personal mobility scooter based on a new meta-heuristic optimization algorithm named Differential Harris Hawks Optimization (DHHO) and the modeling of the steering encoder. The steering response in the Ackermann mechanism is crucial for automated driving systems (ADS), especially in localization and path-planning phases. Various methods in the literature are used to control the steering, and meta-heuristic optimization algorithms have achieved prominent results. Harris Hawks optimization (HHO) algorithm is a recent algorithm that outperforms state-of-the-art algorithms in various optimization applications. However, it has yet to be applied to the steering control application. The research in this paper has been conducted in three stages. First, practical experiments were performed on the steering encoder sensor that measures the steering angle of the Landlex mobility scooter, and supervised learning was applied to model the results obtained for the steering control. Second, the DHHO algorithm is proposed by introducing mutation between hawks in the exploration phase instead of the Hawks perch technique, improving population diversity and reducing premature convergence. The simulation results on CEC2021 benchmark functions showed that the DHHO algorithm outperforms the HHO, PSO, BAS, and CMAES algorithms. The mean error of the DHHO is improved with a confidence level of 99.8047% and 91.6016% in the 10-dimension and 20-dimension problems, respectively, compared with the original HHO. Third, DHHO is implemented for interactive real-time PID tuning to control the steering of the Ackermann scooter. The practical transient response results showed that the settling time is improved by 89.31% compared to the original response with no overshoot and steady-state error, proving the superior performance of the DHHO algorithm compared to the traditional control methods. The MATLAB source code and the result files for the proposed algorithm are available at https://github.com/MohamedRedaMu/DHHO

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

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Validation of a Novel Fluorescent Lateral Flow Assay for Rapid Qualitative and Quantitative Assessment of Total Anti-SARS-CoV-2 S-RBD Binding Antibody Units (BAU) from Plasma or Fingerstick Whole-Blood of COVID-19 Vaccinees

Background: Limited commercial LFA assays are available to provide a reliable quantitative measurement of the total binding antibody units (BAU/mL) against the receptor-binding domain of the SARS-CoV-2 spike protein (S-RBD). Aim: This study aimed to evaluate the performance of the fluorescence LFA FinecareTM 2019-nCoV S-RBD test along with its reader (Model No.: FS-113) against the following reference methods: (i) the FDA-approved GenScript surrogate virus-neutralizing assay (sVNT); and (ii) three highly performing automated immunoassays: BioMérieux VIDAS®3, Ortho VITROS®, and Mindray CL-900i®. Methods: Plasma from 488 vaccinees was tested by all aforementioned assays. Fingerstick whole-blood samples from 156 vaccinees were also tested by FinecareTM. Results and conclusions: FinecareTM showed 100% specificity, as none of the pre-pandemic samples tested positive. Equivalent FinecareTM results were observed among the samples taken from fingerstick or plasma (Pearson correlation r = 0.9, p < 0.0001), suggesting that fingerstick samples are sufficient to quantitate the S-RBD BAU/mL. A moderate correlation was observed between FinecareTM and sVNT (r = 0.5, p < 0.0001), indicating that FinecareTM can be used for rapid prediction of the neutralizing antibody (nAb) post-vaccination. FinecareTM BAU results showed strong correlation with VIDAS®3 (r = 0.6, p < 0.0001) and moderate correlation with VITROS® (r = 0.5, p < 0.0001) and CL-900i® (r = 0.4, p < 0.0001), suggesting that FinecareTM can be used as a surrogate for the advanced automated assays to measure S-RBD BAU/mL.This work was made possible by grant number UREP28-173-3-057 from the Qatar National Research Fund (a member of Qatar Foundation). The statements made herein are solely the responsibility of the authors

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely