Automated leaf alignment and partial shape feature extraction for plant leaf classification

The last few decades have witnessed various approaches to automate the process of plant classification using the characteristics of the leaf. Several approaches have been proposed, and the majority focused on global shape features. However, one challenge that faces this task is the high interclass similarity amongst the leaves of different species in terms of the global shape. Furthermore, there always has been an obstacle against full automation as several approaches require user intervention to align the leaf. Therefore, a new set of Quartile Features (QF) is proposed in this paper to describe the partial shape of the leaf, in addition to an automated alignment approach to automate the system. The QF are extracted from the horizontal and vertical leaf quartiles to describe the partial shape of the leaf and the relations among its parts. The well-known Flavia dataset has been selected for the evaluation of the proposed system. The experimental results indicate the ability of the proposed alignment algorithm to align leaves with different shapes and maintain a correct classification accuracy regardless of the orientation of the input leaf samples. Furthermore, the proposed QF indicated promising results by increasing the accuracy of the classification by a range of approximately 26% to 30% when combined with Hu’s Moment Invariants, using k-fold cross-validation technique

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

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Asthma care: Structural foundations at primary health care at Al-Qassim region, Saudi Arabia

<b>BACKGROUND: </b> Proper structural foundations for asthma care at primary health care centers [PHCCs], are of essential importance, regarding its management. <b> OBJECTIVE: </b> To assess the adherence of PHCCs to the recommended structural foundation for asthma care. <b> MATERIALS AND METHODS: </b> 35 PHCCs were selected in a cluster random fashion. A questionnaire for structural standards was designed, based on the Saudi national protocol for the management of asthma (SNPMA). A physician and a nurse, each from PHCC, were trained for data collection.<b> </b> Structural facilities deficiency was arbitrarily classified into: least deficient (>75&#x0025;), moderate to severe deficient (25-75&#x0025;) and most deficient (&#60; 25&#x0025;).<b> RESULTS: </b> The<b> </b> total population registered, was 131190 [urban: 85701 (65.4&#x0025;), rural: 45489 (34.6&#x0025;)]. Total registered asthmatics was 4093 [urban: 2585 (63.1&#x0025;), rural: 1508 (36.9&#x0025;)]. The asthma prevalence rate did not differ significantly between urban (3&#x0025;) and rural (3.3&#x0025;) areas<b> . </b> Structural facilities distribution for asthma care, did not significantly vary among urban and rural PHCCs and none of them fulfilled 100&#x0025; of the desired standards. The least deficient, were the availability of asthma register and salbutamol, in its various forms. The moderately to severely deficient were the SNPMA, peak flow meter (PFM), nebulizer system, Theophylline and systemic corticosteroid. However, they were most deficient in trained doctors and nurses, record charts for Peak flow meter, spacer, educational material and inhalers of corticosteroid or cromoglycate.<b> CONCLUSION: </b> Proper structural foundations for asthma care at PHCCs, at AL-Qassim region, were below the desired national standards. They were most deficient in trained doctors and nurses, record charts for PFM, spacers, educational material and anti-inflammatory inhalers. Future health directorate strategies have to provide such beneficial interventions for proper asthma care

Automated Leaf Alignment and Partial Shape Feature Extraction for Plant Leaf Classification

The last few decades have witnessed various approaches to automate the process of plant classification using the characteristics of the leaf. Several approaches have been proposed, and the majority focused on global shape features. However, one challenge that faces this task is the high interclass similarity amongst the leaves of different species in terms of the global shape. Furthermore, there always has been an obstacle against full automation as several approaches require user intervention to align the leaf. Therefore, a new set of Quartile Features (QF) is proposed in this paper to describe the partial shape of the leaf, in addition to an automated alignment approach to automate the system. The QF are extracted from the horizontal and vertical leaf quartiles to describe the partial shape of the leaf and the relations among its parts. The well-known Flavia dataset has been selected for the evaluation of the proposed system. The experimental results indicate the ability of the proposed alignment algorithm to align leaves with different shapes and maintain a correct classification accuracy regardless of the orientation of the input leaf samples. Furthermore, the proposed QF indicated promising results by increasing the accuracy of the classification by a range of approximately 26% to 30% when combined with Hu's Moment Invariants, using k-fold cross-validation technique

Study of empirical electron density models using stereoscopic observations of solar Type III burst

International audienceWe study the properties of solar Type III radio bursts that were simultaneously observed by RPWS/Cassini, URAP/Ulysses and WAVES/Wind experiments. The observations covered a time interval of about one year during which the spacecraft trajectories where localized in the ecliptic plane for Wind and Cassini, and at high heliographic latitudes (of about -75°) for Ulysses spacecraft. The data set consists of the flux density and the arrival time as a function of frequency in the range of a few kHz to 16 MHz. This leads us to determine the time profiles associated to the electron beam evolution along the interplanetary magnetic field where the trajectory is supposed to be an Archimedean spiral. We assume that the trajectories are contained in the plane of the ecliptic and the velocity of the solar wind is constant and equal to 400 km/s. Several empirical models of electron density are considered in the estimation of the electron beam evolution. We show that some of these models may be used to outline the real Type III burst trajectory, and others not. We discuss the particularity of each model and we attempt to classify them taking into consideration the different regions where the radio was propagating, i.e. the solar corona (few solar radii) and the interplanetary medium up to the orbit of the Earth (~ 1 AU) and Jupiter (~ 5 AU)

Frequency-Time Structures of VLF/LF Emissions

International audienceThe ICE experiment onboard the DEMETER satellite recorded structured emissions at sub-latitude regions. This experiment provided a survey of the electric field over a wide frequency range. In this work we report on VLF and LF radio emissions observed in a frequency interval between a few kHz and up to 300 kHz. Those emissions appeared on night- and day-sides and are associated, respectively, to up- and down-going satellite half-orbits. The first emission appears as a continuum between a few kHz and 100 kHz. It displays positive and negative frequency drift rates in the southern and northern hemispheres, at latitudes between 40° and 20°. Its frequency bandwidth increases toward the magnetic equatorial plane. The second type of radiation exhibits multiple spaced frequency bands between 50 kHz and 300 kHz, and occasionally harmonic components appear at about 3 MHz. Those bands are recorded near the magnetic equatorial plane with an enhancement in the intensity level when the satellite latitude is between -5° and +5°. The origin of the continuum emissions and the spaced frequency bands seems to be different since their spectral patterns are not comparable. We discuss the source locations and the physical mechanisms which seem to be linked to the plasma environment in the vicinity of the magnetic equatorial plane