Nosocomial imipenem-resistant Acinetobacter baumannii infections in intensive care units: incidence and risk factors assessment

Imipenem-resistant Acinetobacter baumannii (A. baumannii) (IRAB) has emerged as a challenging nosocomial pathogen particularly in intensive care units (ICUs). Studying the risk factors associated with IRAB infection is of paramount importance for appropriate control of IRAB spread. The aim of this study was to assess the incidence rate and possible risk factors associated with nosocomial IRAB infections in ICUs. A prospective cohort study was carried out in surgical and emergency ICUs of a tertiary care hospital in Egypt. All patients who developed nosocomial A. baumannii infection from the start of January 2014 to the end of December 2015 were included. Isolates were identified as A. baumannii using API 20NE and E-test was used to define IRAB. Out of 146 A. baumannii isolates, 11 were found to be IRAB (7.5% incidence rate), of them 72.7% (8/11) were found to be multidrug resistant (MDR). Univariate analysis demonstrated that hospital stay before ICU admission [Relative risk (RR) 3.51, 95% confidence interval (CI) 1.0- 12.7, P= 0.04)], longer ICU stay (P= 0.005), exposure to emergent surgery (RR 17.5, CI 7.39-41.4, P= 0.000), the presence of central venous catheter (RR 3.26, CI 1.0-10.6, P= 0.04) and previous carbapenem use (RR 4.05, CI 1.12-14.6, P =0.02) were significant risk factors for IRAB infection. In conclusion, a relatively high IRAB incidence was recorded in ICUs of our hospital. Hospital stay before ICU admission, longer ICU stay, exposure to emergent surgery, the presence of central venous catheter and previous carbapenem use were significant risk factors for IRAB infection. Rationale use of carbapenems in ICUs should be considered.Keywords: Imipenem-resistant, Acinetobacter baumannii, Intensive care unit

Parallel Distributed Compensation-PID Controller Design for Maximum Power Point Tracking of Dynamic Loaded Photovoltaic System

Control issues come from the output voltage of PV installations and systems operating in a range of irradiance and temperature. By using a DC converter, such systems are able to maintain a constant output voltage despite fluctuations in the generated voltage and load. The design of a maximum power point tracking (MPPT) on DC converter controller is presented in this article for a system. Fractional Order-Proportional Integral Derivative (FO-PID) and Parallel Distributed Compensation-Proportional Integral Derivative (PDC-PID) controllers have been implemented to the system converter as a proposed control approach. Particle Swarm Optimization (PSO) is used as optimization technique for determining the optimal parameters of (FO-PID) and (PDC-PID) controllers for tracking the output voltage from trained Adaptive Neuro Fuzzy Inference System (ANFIS) that is corresponding to maximum power generated from (PV) module. The PV system with the dynamic load is modeled and simulated by using the MATLAB/Simulink environment. The system performance is displayed in the form of a family of curves under different operating conditions

Changes in Physico-Chemical Quality and Volatile Compounds of Orange-Carrot Juice Blends During storage

The present study aimed to determine the changes in physico-chemical parameters (pH, total soluble solids “TSS”, total acidity, vitamin C, total carotene, total phenolic and antioxidant activity) as well as sensory evaluation and volatile constituents of the orange juice samples mixed with carrot juice at ratios (1:3, 3:1 and 1:1). While, the polyphenol content was determined using Folin–Ciocalteu, antioxidant activity was measured using two in vitro assays 2,2'-diphenyl-1-picrylhydrazyl (DPPH0) and metal chelating assays. While, the acidity increased, total carotene and pH of the juice decreased during the storage period. There were no significant changes in total phenolics throughout the storage period at the three blending ratios. A slight increase in antioxidant capacity during the storage period had been observed. The headspace volatiles of fresh orange and carrot juices as well as fresh and stored blend juice with ratio (1:3) for 14 days at refrigerator were collected and subjected to Gas chromatography (GC) and Gas chromatography-Mass spectrometery (GC-MS) analysis. A total of 26 volatile compounds were identified in samples of fresh orange and carrot juices as well as fresh and stored blend including 7 alcohols, 4 aldehydes, 9 monoterpene hydrocarbon and 6 esters. Limonene was the one most abundant monoterpene, representing in orange, carrot, fresh and stored blend 47.38, 42.37, 39.24 and 37.25%, respectively. Keywords: Orange- carrot juice, Blend, Antioxidant, Volatile compound

Performance Enhancement of Reverse Osmosis (RO) Membrane Using Nanocomposite Materials

Many attempts were made to enhance the performance of reverse osmosis (RO) membranes in the desalination process. Using ion exchange (IX) bed before RO process and modifying the structure of RO membranes are some of these attempts. Thin film nanocomposite (TFN) membrane is the novel type of RO membranes which is the best in nanofiltration applications. TFN membranes have many new advantages due to the change of their structure in comparison with traditional membranes. In this study the performance of a TFN membrane was compared with that of standard thin film composite (TFC) spiral wound water desalination RO membrane for filtration of IX produced water. The results from the filtration process showed that the flux and water permeability of TFN are 1.55 and 1.56 times that of TFC for feed water with 2050 ppm NaCl concentration with nearly unchanged level of the membrane salt rejection, which will reduce the filtrated water cost

Progressive Coding and Transmission of Digital Diagnostic Pictures

In radiology, as a result if the increased utilization of digital imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), over a third of the images produced in a typical radiology department are currently in digital form, and this percentage is steadily increasing, Image compression provides a means for the economical storage and efficient transmission of these diagnostic pictures. The level of coding distortion than can be accepted for clinical diagnosis purposes is not yet well-defined. In this paper we introduce some constraints on the design of existing transform codes in order to achieve progressive image transmission efficiently. The design constraints allow the image quality to be asymptotically improved such that the proper clinical diagnoses are always possible. The modified transform code outperforms simple spatial-domain codes by providing higher quality of the intermediately reconstructed images. The improvement is 10 dB for a compression factor of 256:1. and it is as high as 17.5 dB for a factor of 8:1. A novel progressive quantization scheme is developed for optimal progressive transmission of transformed diagnostic images. Combined with a discrete cosine transform, the new approach delivers intermediately reconstructed images of comparable quality twice as fast as the more usual zig-zag sampled approach. The quantization procedures is suitable for hardware implementation

Immunohistochemical Study of Androgen Receptor Expression in Estrogen Receptor-Negative Invasive Breast Carcinoma and its Relation with Clinicopathologic Factors

BACKGROUND: Estrogen receptor (ER)-negative breast carcinomas lack the expression of ER and they have no targeted hormone therapies. The androgen receptor (AR) is a newly emerge biomarker. Detecting AR in these tumors may provide a target for future therapies. AIM: The aim of the study is to examine the immunohistochemical expression profiles of AR protein in ER-negative invasive breast carcinomas and to assess the relation between AR expression and the clinicopathologic factors such as age, tumor size, tumor grade, tumor type, immunohistochemical type, lymph node status, and Ki67 expression. METHODS: Sixty paraffin blocks of ER-negative invasive breast carcinoma cases were stained immunohistochemically by AR. Positive expression was defined as ≥1% nuclear staining. RESULTS: AR positivity was detected in 55% of the studied cases. The positive cases were scored by H-score with a median=117, and a range of 3–285 and by Allred score with a median=7, and a range of 3-8. AR is expressed in 60.9% of triple-negative breast carcinoma cases. AR expression was higher in older age, and there were significant positive correlations between the degree of AR expression (AR%, AR intensity, and H-score) and age (p=0.050, 0.007, 0.033, respectively). There was non-significant negative correlation between Ki67% and the degree of AR expression (AR%, AR intensity, H-score, and Allred score). Regarding different histological types, tumor grade, tumor size, lymph node status, and immunohistochemical types, there was no significant difference between AR positive and AR negative cases. CONCLUSION: AR is frequently expressed in ER-negative invasive breast carcinoma; especially in older age, and in a large number of triple-negative subtypes. This may give chance to benefit from future AR target therapy. We recommend further research work on AR expression in the special histologic subtypes of ER-negative breast carcinoma and in the triple negative group

Control of hyperphosphatemia in regular hemodialysis (HDx) patients by calcium acetate (CA) versus calcium carbonate (CC). A double blind crossover prospective study

This study included fourty chronic renal failure patients aged 37-83 years (mean 51.3±7) on thrice weekly HDx for 4-144 month (Kt/V >1.2). Acetate dialysate with calcium concentration of 3 mEq/L was used. All phosphate binders were discontinued for one month. Patients were divided in two groups. Group I (20 cases) received CA, while group II (20 cases) received CC in equimolar dose (10 mmol, of either t.i.d.) for one month. Crossover of treatment was done for another month while keeping patients on the same diet.Serum levels of total calcium (Ca), ionized Ca (iCa), phosphorus (P), alkaline phosphates (AP), urea (U), creatinine (Cr), ALT, AST, total proteins (TP) and albumin (Alb) were estimated before, and at the end of each month of CA and CC treatment. Serum Ca and iCa were significantly lower in group I after CA compared to values after CC (p<0.01). Similar results in Ca levels were observed in group II (P<0.05). In group II only serurn P was significantly lower after CA compared to its values after CC (P<0.05). There was no significant difference in AP, U, Cr, ALT, AST, TP and Alb before, and at the end of each month of CA and CC treatment (P>0.05 in all). We excluded 12.5% of cases due to CA intolerance while non of cases had similar intolerance to CC.Conclusion: 1) CA is not very superior to CC in control of hyperphosphataemia. 2) CA can be safely increased without the risk of hypercalcemia. 3) Active Vitamin D and high dialysate Ca can be used to suppress parathyroid activity more safely with CA than with CC. 4) Tolerability to CC is superior

A revision of the biostratigraphy and strontium isotope dating of Oligocene-Miocene outcrops in East Java, Indonesia

The biostratigraphic ranges of identified larger benthic and planktonic foraminifera from Tertiary exposures in East Java Basin have been tied to the ages constrained from the Strontium isotope dating of some of the most abundant large benthic foraminifera. Foraminiferal assemblages and Strontium data have provided precise age ranges of the different stratigraphic units. The age of the exposed Lower Kujung Formation (late Early Oligocene, Rupelian P20 to Late Oligocene, Te1-4, equivalent to 28.78 - 28.27 Ma). The age of the exposed Upper Kujung Formation is Late Oligocene, Chattian, P22, Te1-4 to Early Miocene, Aquitanian, -N5a, -Te5, equivalent to 24.31- 23.44 Ma. The age of the exposed Tuban Formation is late Early Miocene, Burdigalian to Middle Miocene, Langhian, N5b to N9, Te5-Tf1, equivalent to 20.80 – 15.25 Ma. The age of the exposed Ngrayong Formation is late Middle Miocene, Serravallian, N12 to N13, Tf2, equivalent to ~15.00 to ~13.00 Ma. The age boundaries between the lithostratigraphic units have also been obtained such as Upper Kujung - Tuban (22 Ma), Tuban-Ngrayong (15.25 Ma) Formations and Ngrayong Formation-Bulu Member of Wonocolo Formation (12.98 Ma)

Measuring Impact of Air and Agricultural Soil Pollution on Social Development in Saudi Arabia

This research aimed to measure the impact of air and agricultural soil pollution on social development in Saudi Arabia from the period 1995–2019 by using social development indicators, concentrating on the percentages of expenditure on education and health, and the Human Development Index. In addition, this study uses multiple regressions in estimating the model to study the impact of air pollution and agricultural soil on social development. Results of the study showed that a 10% change in the number of chemical fertilizers and pesticides used in Saudi agriculture leads to a change in the total number of inpatients by 0.7% and 0.5%, respectively. It was also found that an increased percentage of health expenditure to total government spending by 10% leads to a decrease in the total number of patients in the hospital by 1.8%. An increase in air pollution, expressed as a 10% increase in CO2 emissions, increases the total number of hospitalized patients by 11.1%.  The increasing total number of patients by 10% leads to a decrease in the total productivity of the worker, as an indicator of 1.8%. Furthermore, a change of 10% in the ratio of education expenditure to total government expenditure leads to a change in the same direction of the Human Development Index by 9.6%. In light of these results, it can be recommended that the country need to reduce air pollution by expanding the use of natural gas in the industrial and transportation sectors, in addition to reducing the use of nitrogenous fertilizers and pesticides in Saudi agriculture through the expansion of clean farming and good agricultural practices