Diversity of multi-drug resistant Acinetobacter baumannii population in a major hospital in Kuwait

Acinetobacter baumannii is one of the most important opportunistic pathogens that causes serious health care associated complications in critically ill patients. In the current study we report on the diversity of the clinical multi-drug resistant (MDR) A. baumannii in Kuwait by molecular characterization. One hundred A. baumannii were isolated from one of the largest governmental hospitals in Kuwait. Following the identification of the isolates by molecular methods, the amplified blaOXA-51-like gene product of one isolate (KO-12) recovered from blood showed the insertion of the ISAba19 at position 379 in blaOXA-78. Of the 33 MDR isolates, 28 (85%) contained blaOXA-23, 2 (6%) blaOXA-24 and 6 (18%) blaPER-1 gene. We did not detect blaOXA-58, blaV IM, blaIMP, blaGES, blaV EB, and blaNDM genes in any of the tested isolates. In three blaPER-1 positive isolates the genetic environment of blaPER-1 consisted of two copies of ISPa12 (tnpiA1) surrounding the blaPER-1 gene on a highly stable plasmid of ca. 140-kb. Multilocus-sequence typing (MLST) analysis of the 33 A. baumannii isolates identified 20 different STs, of which six (ST-607, ST-608, ST-609, ST-610, ST-611, and ST-612) were novel. Emerging STs such as ST15 (identified for the first time in the Middle East), ST78 and ST25 were also detected. The predominant clonal complex was CC2. Pulsed-field gel electrophoresis and MLST defined the MDR isolates as multi-clonal with diverse lineages. Our results lead us to believe that A. baumannii is diverse in clonal origins and/or is undergoing clonal expansion continuously while multiple lineages of MDR A. baumannii circulate in hospital ward simultaneously

Predictors of breastfeeding duration among women in Kuwait: results of a prospective cohort study

The purposes of this paper are to report the prevalence of breastfeeding to six months among women in Kuwait and to determine the factors that are associated with the duration of breastfeeding. A cohort of 373 women recruited from maternity wards in four hospitals in Kuwait city were followed from birth to 26 weeks postpartum. The association of any and full breastfeeding duration and predictor variables were explored using multivariate Cox’s proportional hazards models. At six months, 39% of all infants were receiving some breast milk and only 2% of infants had been fully breastfed to 26 weeks. Women born in other Arab countries were less likely to discontinue breastfeeding than women born in Kuwait. Other factors positively associated with breastfeeding duration were level of maternal education, higher parity, infant being demand fed in hospital and a preference for breastfeeding on the part of the infant’s father and maternal grandmother. The introduction of a pacifier before four weeks of age and the mother intending to return to work by six months were negatively associated with duration. These findings present a number of opportunities for prolonging breastfeeding duration in Kuwait

Social Media and the Spiral of Silence: The Case of Kuwaiti Female Students Political Discourse on Twitter

The theory of the Spiral of Silence (Noelle-Neumann, 1984), explained why the view of a minority is not presented when the majority view dominates the public sphere. For years the theory of the spiral of silence was used to describe the isolation of minority opinions when seeking help from traditional media, which play a significant role in increasing the isolation. The fear of isolation makes many people afraid of exchanging their views face-to-face with others. The main fear comes from identifying the people who hold a minority opinion. However, with the proliferation of social networks people have moved online to exchange their views, whether they hold a minority or a majority opinion, as long as their identities are concealed. Although women are the majority population in many Arab societies, their voices are still considered a minority view. In addition to the effects described in the spiral of silence, there are other obstacles to self-expression. Religion, culture, tradition, and education may have a negative effect, preventing women’s voice being made public. Social networks have helped to promote women’s voices while removing offline obstacles. This paper uses the theory of the spiral of silence in relation to women’s online political participation in Twitter, even though they may not be willing to share their opinions offline (face-to-face), to learn whether the theory is still useful as an account of online relationships. The results show that the spiral of silence does not explain the behavior of women, either face-to-face or online

Determinants of breastfeeding initiation among mothers in Kuwait

<p>Abstract</p> <p>Background</p> <p>Exclusive breastfeeding is recommended as the optimal way to feed infants for the first six months of life. While overall breastfeeding rates are high, exclusive breastfeeding is relatively uncommon among Middle Eastern women. The objective of this study was to identify the incidence of breastfeeding amongst women in the six governorates of Kuwait and the factors associated with the initiation of breastfeeding.</p> <p>Methods</p> <p>A sample of 373 women (aged 17-47 years), recruited shortly after delivery from four hospitals in Kuwait, completed a structured, interviewer-administered questionnaire. Multivariate logistic regression analysis was used to identify those factors independently associated with the initiation of breastfeeding.</p> <p>Results</p> <p>In total, 92.5% of mothers initiated breastfeeding and at discharge from hospital the majority of mothers were partially breastfeeding (55%), with only 30% of mothers fully breastfeeding. Prelacteal feeding was the norm (81.8%) and less than 1 in 5 infants (18.2%) received colostrum as their first feed. Only 10.5% of infants had been exclusively breastfed since birth, the remainder of the breastfed infants having received either prelacteal or supplementary infant formula feeds at some time during their hospital stay. Of the mothers who attempted to breastfeed, the majority of women (55.4%) delayed their first attempt to breastfeed until 24 hours or more after delivery. Breastfeeding at discharge from hospital was positively associated with paternal support for breastfeeding and negatively associated with delivery by caesarean section and with the infant having spent time in the Special Care Nursery.</p> <p>Conclusions</p> <p>The reasons for the high use of prelacteal and supplementary formula feeding warrant investigation. Hospital policies and staff training are needed to promote the early initiation of breastfeeding and to discourage the unnecessary use of infant formula in hospital, in order to support the establishment of exclusive breastfeeding by mothers in Kuwait.</p

Techno-Economic Study of Series Current Limiting Reactor and Its Impact in the 11KV Network with Harmonic Pollution

Survey &amp; selection of oil filled fault current limiting  series reactor  for limiting short circuit  fault  currents from 40KA to 22KA at 11KV level in an existing distribution substation due to change of source substation.  The impact of source X/R ratio variation, maximum &amp; minimum short circuit currents on the acceleration times of the 11KV motors and variance in voltage regulation due to change(s) in the conventional Series reactor impedance is studied. Impact of power factor improvement capacitors on the short circuit level and on series reactor impedance is assessed. Expected harmonic pollution due to VSD’s is estimated and its influence on the series reactor impedances is assessed for resonant conditions.  Transient Recovery Voltage and Rate of Rise of Recovery Voltage are studied for verification of circuit breakers’ ability to isolate the fault conditions.  Techno - economic evaluation of series reactor(s) impedance(s) for cost effectiveness along with the ability of reputed international testing houses for testing is assessed. The study results reflect that the constraints of test laboratories to test the specified series reactors will have an impact on the selection of series reactor impedance.  While higher impedance selection will be useful from the short circuit point of view, it will pose difficulties with reference to physical dimensions of the equipment, cost and other related issues. Keywords: Current Limiting Reactor (CLR), Short Circuit Current, Harmonics, Cos

Regional scale dryland vegetation classification with an integrated lidar-hyperspectral approach

The sparse canopy cover and large contribution of bright background soil, along with the heterogeneous vegetation types in close proximity, are common challenges for mapping dryland vegetation with remote sensing. Consequently, the results of a single classification algorithm or one type of sensor to characterize dryland vegetation typically show low accuracy and lack robustness. In our study, we improved classification accuracy in a semi-arid ecosystem based on the use of vegetation optical (hyperspectral) and structural (lidar) information combined with the environmental characteristics of the landscape. To accomplish this goal, we used both spectral angle mapper (SAM) and multiple endmember spectral mixture analysis (MESMA) for optical vegetation classification. Lidar-derived maximum vegetation height and delineated riparian zones were then used to modify the optical classification. Incorporating the lidar information into the classification scheme increased the overall accuracy from 60% to 89%. Canopy structure can have a strong influence on spectral variability and the lidar provided complementary information for SAM’s sensitivity to shape but not magnitude of the spectra. Similar approaches to map large regions of drylands with low uncertainty may be readily implemented with unmixing algorithms applied to upcoming space-based imaging spectroscopy and lidar. This study advances our understanding of the nuances associated with mapping xeric and mesic regions, and highlights the importance of incorporating complementary algorithms and sensors to accurately characterize the heterogeneity of dryland ecosystems

Modelling timing and tempo of adrenarche in a prospective cohort study

To better understand how health risk processes are linked to adrenarche, measures of adrenarcheal timing and tempo are needed. Our objective was to describe and classify adrenal trajectories, in terms of timing and tempo, in a population of children transitioning to adolescence with repeated measurements of salivary dehydroepiandrosterone (DHEA), DHEAsulphate, and testosterone. We analysed data from the Childhood to Adolescence Transition Study (CATS), a longitudinal study of 1239 participants, recruited at 8-9 years old and followed up annually. Saliva samples were assayed for adrenal hormones. Linear mixedeffect models with subject-specific random intercepts and slopes were used to model longitudinal hormone trajectories by sex and derive measures of adrenarcheal timing and tempo. The median values for all hormones were higher at each consecutive study wave for both sexes, and higher for females than males. For all hormones, between-individual variation in hormone levels at age 9 (timing) was moderately large and similar for females and males. Between-individual variation in hormone progression over time (tempo) was of moderate magnitude compared with the population average age-slope, which itself was small compared with overall hormone level at each age. This suggests that between-individual variation in tempo was less important for modelling hormone trajectories. Between-individual variation in timing was more important for determining relative adrenal hormonal level in childhood than tempo. This finding suggests that adrenal hormonal levels at age 8-9 years can be used to predict relative levels in early adolescence (up to 13 years)

Detection of enteric parasites and molecular characterization of Giardia duodenalis and Blastocystis sp. in patients admitted to hospital in Ankara, Turkey.

This epidemiological study assesses the occurrence of enteric parasites in 4303 patients attended at two public hospitals in Ankara (Turkey) during 2018-2019. Microscopy was used as a screening test. Giardia duodenalis was also identified using a commercial ELISA for the detection of parasite-specific coproantigens. Giardia-positive samples by microscopy/ELISA were confirmed by real-time PCR and characterized using a multilocus genotyping scheme. Blastocystis sp. was genotyped in a sample subset. Blastocystis sp. (11.1%, 95% CI 11.4‒14.8%) and G. duodenalis (1.56%, 95% CI 1.22‒1.96) were the most prevalent pathogens found. Cryptosporidium spp., Entamoeba histolytica and intestinal helminths were only sporadically (<0.5%) found. For G. duodenalis, sequence (n = 30) analyses revealed the presence of sub-assemblages AII (23.3%), discordant AII/AIII (23.3%) and mixed AII + AIII (6.7%) within assemblage A, and BIII (10.0%), BIV (3.3%) and discordant BIII/BIV (23.3%) within assemblage B. Two additional sequences (6.7%) were assigned to the latter assemblage but sub-assemblage information was unknown. No associations between G. duodenalis assemblages/sub-assemblages and sociodemographic and clinical variables could be demonstrated. For Blastocystis sp., sequence (n = 6) analyses identified subtypes ST1, ST2 and ST3 at equal proportions. This is the first molecular characterization of G. duodenalis based on MLG conducted in Turkey to date.This research was partially funded by the Scientific Research Unit of Gazi University (Ankara, Turkey) under project number 01/2017-15, and by the Health Institute Carlos III (ISCIII), Ministry of Science, Innovation and Universities (Spain) under grant number PI16CIII/00024N

Involvement of private investors on the financial market of the Russian Federation: analysis of problems and actions of regulating authorit

In this article, the problems of attracting private investment in the financial markets of the Russian Federation are examined. The analysis of measures carried out by the regulator of the financial market on achievement of positive dynamics in attraction of savings of the population in the financial markets is carried out. Conclusions have been made about the need for additional instruments of impact on the population and on the pfessional market participants who would help stimulate the population in choosing the Russian stock market