Antimicrobial resistance of Staphylococcus aureus, fecal streptococci, Enterobacteriaceae and Pseudomonas aeruginosa isolated from the coastal water of the Gaza strip-Palestine

Objectives: To document the occurrence and distribution of antibiotic resistance of clinically important bacteria in the seawater of Gaza strip-Palestine. Methods: Seawater samples were collected at 16 location distributed along the coast of the Gaza strip. Sampling was accomplished during 12 months, from March 2014 to June 2015. The microbial composition including Enterobacteriaceae, Staphylococcus aureus, fecal streptococci and Pseudomonas aeruginosa was recorded and tested for their resistance to specific antimicrobial agents according to CLSI using the disc diffusion method. Results: A total of 816 isolates of Enterobacteriaceae (377), S. aureus (29), fecal enterococci (FS)(369), and P. aeruginosa (29) were recovered and identified. Enterobacteriaceae, P. aeruginosa, FS and S. aureus isolates exhibited the highest rates of resistance against β-lactam drugs. The isolates also showed resistance to at least

Association of Inherited Thrombophilia with Recurrent Pregnancy Loss in Palestinian Women

Objective. This study aimed at analyzing the association between recurrent pregnancy loss (RPL) and factor V G1691A (FVL), prothrombin G20210 (FII); and MTHFR C677T (MTHFR) in Palestinian women. Method. We studied 329 Palestinian women with RPL and/or stillbirth (SB); and compared them to 402 healthy reproductive Palestinian women. Cases and controls were tested for the above mutations. Odds ratio (OR) at confidence interval (CI) of 95% was used as a measure of association between the mutations and RPL. Results. Our statistical analysis showed a slightly increased association, which was not significant between FVL and RPL (OR 1.32, 95% CI 0.90–1.94), and no association between FII (OR 0.84, 95% CI 0.38–1.92), MTHFR (OR 0.58, 95% CI 0.32–1.03), and RPL. Further analysis of RPL subgroups revealed an association between FVL and first-trimester loss (OR 1.33, 95% CI 0.892–1.989), and second-trimester loss (OR 1.13, 95% CI 0.480–2.426), both were not statistically significant. Furthermore, the only statistically significant association was between FVL and SB (OR 2.0, 95% CI 1.05–3.70). Conclusion. Our analysis had failed to find a significant association between FVL, FII, MTHFR; and RPL in either the first or second trimester. FVL was significantly associated with fetal loss if the loss was a stillbirth

An Outcome based approach to developing a Belarusian Qualification Framework

http://iesed.esy.es/The Higher Education landscape of Belarus is characterised by high quality institutions offering world class expertise and facilities, and a very high participation rate in higher education. However, it has also been recognised by the state that the degree of individuality and autonomy prevalent in these institutions works against the current mood of globalisation in Higher Education. An obvious example is international exchanges. It is particularly difficult in the case of students since the programmes are usually organised in an insular way and lack a precise specification of the level at which any contributory course is delivered. A stated objective of the Belarusian Ministry of Education is to seek membership of the European Higher Education Area (EHEA). To this end a road map (Eastern Partnership Civil Society Forum, 2017), designed to afford increased international compatibility of the Belarusian Higher Education Framework, has been defined and is being implemented by the Belarusian Ministry of Education. This paper considers how the EU funded project IESED could directly contribute to the realisation of this Road Map

Antimicrobial resistance of Staphylococcus aureus, fecal streptococci, Enterobacteriaceae and Pseudomonas aeruginosa isolated from the coastal water of the Gaza strip-Palestine

Objectives: To document the occurrence and distribution of antibiotic resistance of clinically important bacteria in the seawater of Gaza strip-Palestine. Methods: Seawater samples were collected at 16 location distributed along the coast of the Gaza strip. Sampling was accomplished during 12 months, from March 2014 to June 2015. The microbial composition including Enterobacteriaceae, Staphylococcus aureus, fecal streptococci and Pseudomonas aeruginosa was recorded and tested for their resistance to specific antimicrobial agents according to CLSI using the disc diffusion method. Results: A total of 816 isolates of Enterobacteriaceae (377), S. aureus (29), fecal enterococci (FS) (369), and P. aeruginosa (29) were recovered and identified. Enterobacteriaceae, P. aeruginosa, FS and S. aureus isolates exhibited the highest rates of resistance against β-lactam drugs. The isolates also showed resistance to at least one antimicrobial in the range between 99.7 to 78%. Multiple resistance occurred in almost 85% of all isolates; 99.2% of Enterobacteriaceae, 96.6% of P. aeruginosa, 72.1% of FS and 61% of S.aureus. The incidence of multiple resistance of isolates from all sampling locations ranged from 69.2 to 94.1%. Antibiotic resistance indices were found to be highest in P. aeruginosa (0.57), followed by E. coli (0.53), FS (0.49), Enterobacter (0.41), S. marcescens (0.40), Klebsiella (0.39) and finally Proteus (0.28). Most of the isolates showed multiple antibiotic resistance (MAR) index value higher than 0.2. Conclusions: This study demonstrated that the seawater of the Gaza strip is highly contaminated with antibiotic resistant bacteria which can be transmitted to humans through recreational and other activities. Therefore, there is a need to apply appropriate and rationale use of antibiotic to minimize the occurrence of multiple antibiotic resistant bacteria in the marine environment. Proper treatment of sewage before it is discharged to the sea is highly recommended.Keywords: Multiple antimicrobial resistance, Gaza strip, seawater, fecal enterococci, P. aeruginosa, Enterobacteriaceae, S. aureus

Providing Personalized Guidance in Arithmetic Problem Solving

Supervising a student's resolution of an arithmetic word problem is a cumbersome task. Di erent students may use di erent lines of reasoning to reach the nal solution, and the assistance provided should be consistent with the resolution path that the student has in mind. In addition, further learning gains can be achieved if the previous student's background is also considered in the process. In this paper, we outline a relatively simple method to adapt the hints given by an Intelligent Tutoring System to the line of reasoning that the student is currently following. We also outline possible extensions to build a model of the student's most relevant skills, by tracking user's actions

Development of targeted therapy for ovarian cancer mediated by a plasmid expressing diphtheria toxin under the control of H19 regulatory sequences

<p>Abstract</p> <p>Background</p> <p>Ovarian cancer ascites fluid (OCAF), contains malignant cells, is usually present in women with an advanced stage disease and currently has no effective therapy. Hence, we developed a new therapy strategy to target the expression of diphtheria toxin gene under the control of H19 regulatory sequences in ovarian tumor cells. H19 RNA is present at high levels in human cancer tissues (including ovarian cancer), while existing at a nearly undetectable level in the surrounding normal tissue.</p> <p>Methods</p> <p>H19 gene expression was tested in cells from OCAF by the in-situ hybridization technique (ISH) using an H19 RNA probe. The therapeutic potential of the toxin vector DTA-H19 was tested in ovarian carcinoma cell lines and in a heterotopic animal model for ovarian cancer.</p> <p>Results</p> <p>H19 RNA was detected in 90% of patients with OCAF as determined by ISH. Intratumoral injection of DTA-H19 into ectopically developed tumors caused 40% inhibition of tumor growth.</p> <p>Conclusion</p> <p>These observations may be the first step towards a major breakthrough in the treatment of human OCAF, while the effect in solid tumors required further investigation. It should enable us to identify likely non-responders in advance, and to treat patients who are resistant to all known therapies, thereby avoiding treatment failure.</p

Pharmacogenetics: data, concepts and tools to improve drug discovery and drug treatment

Variation in the human genome is a most important cause of variable response to drugs and other xenobiotics. Susceptibility to almost all diseases is determined to some extent by genetic variation. Driven by the advances in molecular biology, pharmacogenetics has evolved within the past 40 years from a niche discipline to a major driving force of clinical pharmacology, and it is currently one of the most actively pursued disciplines in applied biomedical research in general. Nowadays we can assess more than 1,000,000 polymorphisms or the expression of more than 25,000 genes in each participant of a clinical study – at affordable costs. This has not yet significantly changed common therapeutic practices, but a number of physicians are starting to consider polymorphisms, such as those in CYP2C9, CYP2C19, CYP2D6, TPMT and VKORC1, in daily medical practice. More obviously, pharmacogenetics has changed the practices and requirements in preclinical and clinical drug research; large clinical trials without a pharmacogenomic add-on appear to have become the minority. This review is about how the discipline of pharmacogenetics has evolved from the analysis of single proteins to current approaches involving the broad analyses of the entire genome and of all mRNA species or all metabolites and other approaches aimed at trying to understand the entire biological system. Pharmacogenetics and genomics are becoming substantially integrated fields of the profession of clinical pharmacology, and education in the relevant methods, knowledge and concepts form an indispensable part of the clinical pharmacology curriculum and the professional life of pharmacologists from early drug discovery to pharmacovigilance

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised