The prevalence of blinding trachoma in northern states of Sudan.

BACKGROUND: Despite historical evidence of blinding trachoma, there have been no widespread contemporary surveys of trachoma prevalence in the northern states of Sudan. We aimed to conduct district-level surveys in this vast region in order to map the extent of the problem and estimate the need for trachoma control interventions to eliminate blinding trachoma. METHODS AND FINDINGS: Separate, population based cross-sectional surveys were conducted in 88 localities (districts) in 12 northern states of Sudan between 2006 and 2010. Two-stage cluster random sampling with probability proportional to size was used to select the sample. Trachoma grading was done using the WHO simplified grading system. Key prevalence indicators were trachomatous inflammation-follicular (TF) in children aged 1-9 years and trachomatous trichiasis (TT) in adults aged 15 years and above. The sample comprised 1,260 clusters from which 25,624 households were surveyed. A total of 106,697 participants (81.6% response rate) were examined for trachoma signs. TF prevalence was above 10% in three districts and between 5% and 9% in 11 districts. TT prevalence among adults was above 1% in 20 districts (which included the three districts with TF prevalence >10%). The overall number of people with TT in the population was estimated to be 31,072 (lower and upper bounds = 26,125-36,955). CONCLUSION: Trachoma mapping is complete in the northern states of Sudan except for the Darfur States. The survey findings will facilitate programme planning and inform deployment of resources for elimination of trachoma from the northern states of Sudan by 2015, in accordance with the Sudan Federal Ministry of Health (FMOH) objectives

A Parabolic Transform and Averaging Methods for General Partial Differential Equations

Averaging method of the fractional general partial differential equations and a special case of these equations are studied, without any restrictions on the characteristic forms of the partial differential operators. We use the parabolic transform, existence and stability results can be obtained

Effect of physical training on lung function and respiratory muscles strength in policewomen trainees

Background: Measurement of respiratory muscles strength has not been widely investigated in the context of physical training.Methods: This cross-sectional study has assessed pulmonary function and strength of respiratory muscles in two women groups: group I includes healthy policewomen (n=28) exposed to physical training 3 hours daily for at least 2 years and group II is a matched control group (n=31) of untrained apparently healthy second year medical students. Lung function tests including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEF) were performed using a digital spirometer and maximum inspiratory and expiratory pressures (MIP and MEP) as indicators for respiratory muscle strength were measured using a digital respiratory pressure meter.Results: The mean FVC (L), FEV1 (L), PEF (L/min) values were significantly higher in the police-trained group (p=0.000, 0.000 and 0.003 respectively). Similarly, the mean MIP and MEP (cm/H2O) values were significantly higher among trained group (p=0.000 and 0.003 respectively).Conclusions: Long-term regular physical exercise improves lung function as well as respiratory muscle power and may delay the age-related decline in lung function.

Isolation and Identification of Azospirillium zeae from Acacia tortilis at Riyadh, Saudi Arabia

The Study was conducted at Riyadh, Saudi Arabia to Isolate and Identify the Azospirillium zeae from Acacia tortilis. Useful bacteria associated with the plant roots have the potential to alleviate the burden of using costly and harmful agrochemicals in harsh environments. Finding of novel and appropriate bacteria for enhancing plant growth is among the main primary challenges involved in achieving the agronomic application of plant beneficial bacteria. A bacterium isolated from the rhizospheric soil of the legume Acacia tortilis was described based on several biochemical, morphological and molecular analyses. The bacterium H1P is motile, negative in biotin medium, no growth in 3% NaCl, negative D-Ribose, positive D- glucose. Identification of the isolate via 16s rDNA via the BLASTn revealed that the isolate is an Azospirillum species with a 96.9% similarity to Azospirillum zeae H1P. Phylogenetic analyses with MEGA6 software showed that the isolate shares an ancestor with Azospirillum zeae, eventually branching off into a separate taxon. Azospirillum zeae isolated from Acacia tortilis it is considered first report

Enhancement of clavulanic acid production by Streptomyces sp MU-NRC77 via mutation and medium optimization

Purpose: To enhance clavulanic acid production using UV-mutagenesis on Streptomyces sp. NRC77.Methods: UV-mutagenesis was used to study the effect of Streptomyces sp. NRC77 on CA production. Phenotypic and genotypic identification methods of the promising mutant strain were characterized. Optimization of the fermentation medium and culture conditions were investigatedResults: Out of the screened mutants, 120A3 mutant isolate was selected as promising. The phenotypic properties of 120A3 mutant showed culture characteristics similar to those of Streptomyces species. Phylogenetic analysis of 16S rRNA gene sequence indicate that this strain has similarity (99 %) to Streptomyces sp.T2-7; therefore it was suggested as Streptomyces sp. MU-NRC77 and has Gen Bank accession no. KT953342.Conclusion: Improvement of CA yield by 48 % was obtained from fermentation medium and culture condition optimization. Further optimization by addition of H2O2 and activated charcoal to the production medium increased CA yield to 646.12 and 682.94 mg/L respectively, i.e., 83 % more than that obtained prior to addition.Keywords: Clavulanic acid, Medium optimization, Phenotypic and Genotypic identification, Streptomyces sp. MU-NRC77, UV-Mutagenesi

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

Effect of Black Soldier Fly Larvae Frass as Organic Fertilizer on Postharvest Quality and Shelf Life of Open-field-grown Tomato (Solanum lycopersicon L.)

Open-field-grown tomatoes in Saudi Arabia are stressed by poor soil fertility because of the low organic matter content, low nutrient availability, and high pH. Thus, high chemical fertilizer inputs are crucial for commercial production; however, they cause economic loss as well as negatively affect environmental sustainability. The use of efficient organic fertilizers would be useful for developing more cost-effective, environmentally friendly, and sustainable agriculture. The current study evaluated the impact of Black soldier fly (Hermetia illucens L.) frass (BSFF) fertilizer applications as organic fertilizer on postharvest fruit quality and shelf life of open-field-grown F1 hybrid ‘Sinag Tala’ tomatoes compared with those grown under control treatment (received recommended doses of chemical fertilizers for tomato production under open field conditions). The experiment was conducted using a randomized complete block design with four replicates. The results showed that the application of BSFF fertilizer, especially at the higher rate (5 ton/ha; BSFF3), improved the overall quality of tomato fruit. The BSFF fertilizer treatments reduced weight loss, maintained higher firmness, antioxidants [vitamin C, total phenol content (TPC) and total flavinoid (TFC)], total soluble solids (TSS), and titratable acidity (TA) contents, and lowered the TSS/TA ratio of fruits during shelf life compared with those of the control. The decay incidence was only detected after 9 days of shelf life and was significantly lower in all the BSFF fertilizer treatments (range, 8.40%-12.05%) than in the control (15.9%). In addition, BSFF fertilizer treatments reduced both disease incidence and severity of gray mold following pathogen inoculation during shelf life compared with those of the control. These results might be attributable to the higher antioxidants content (vitamin C, TPC, and TFC) and higher polyphenol oxidase activity in BSFF-fertilized tomatoes. In conclusion, BSFF fertilizer could be used as a potential eco-friendly alternative to chemical fertilizers to improve tomato fruit quality during shelf life

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

Aim The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. Methods This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. Results Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P &lt; 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. Conclusion One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease