FastSurfer-HypVINN: Automated sub-segmentation of the hypothalamus and adjacent structures on high-resolutional brain MRI

The hypothalamus plays a crucial role in the regulation of a broad range of physiological, behavioural, and cognitive functions. However, despite its importance, only a few small-scale neuroimaging studies have investigated its substructures, likely due to the lack of fully automated segmentation tools to address scalability and reproducibility issues of manual segmentation. While the only previous attempt to automatically sub-segment the hypothalamus with a neural network showed promise for 1.0 mm isotropic T1-weighted (T1w) MRI, there is a need for an automated tool to sub-segment also high-resolutional (HiRes) MR scans, as they are becoming widely available, and include structural detail also from multi-modal MRI. We, therefore, introduce a novel, fast, and fully automated deep learning method named HypVINN for sub-segmentation of the hypothalamus and adjacent structures on 0.8 mm isotropic T1w and T2w brain MR images that is robust to missing modalities. We extensively validate our model with respect to segmentation accuracy, generalizability, in-session test-retest reliability, and sensitivity to replicate hypothalamic volume effects (e.g. sex-differences). The proposed method exhibits high segmentation performance both for standalone T1w images as well as for T1w/T2w image pairs. Even with the additional capability to accept flexible inputs, our model matches or exceeds the performance of state-of-the-art methods with fixed inputs. We, further, demonstrate the generalizability of our method in experiments with 1.0 mm MR scans from both the Rhineland Study and the UK Biobank. Finally, HypVINN can perform the segmentation in less than a minute (GPU) and will be available in the open source FastSurfer neuroimaging software suite, offering a validated, efficient, and scalable solution for evaluating imaging-derived phenotypes of the hypothalamus.Comment: Submitted to Imaging Neuroscienc

Integration of solar chimney power plant with photovoltaic for co-cooling, power production, and water desalination

This work explores the technical possibilities of increasing the efficiency of a standard solar chimney power plant (SCPP) by integrating it with photovoltaic (PV) panels. The integration is possible by using the collector circumference to install the PV collectors, which provide a heat sink, allow for the better harvesting of the solar radiation, and increase energy production. The new design led to an increase in the annual electricity production from 380 to 494 MWh and water production from 278 to 326 k tons/year compared with the standard SCPP, marking an increase of 30% and 17%, respectively. The results also show that the integration reduced the greenhouse gas emissions (GHG), the localized cost of energy, and the capital cost of investment by 30%, 36%, and 20%, respectively. The proposed design supports the sustainable replacement of the existing desalination plants with zero operational costs and an excellent reduction in greenhouse gas emissions.The authors would like to the thank the Al Hussien Technical University, Amman, Jordan (www.htu.edu.jo, (accessed on 30 August 2021).) for their support in developing this work.Scopu

The Evaluation of Calcium Score Validity in the Diagnosis of Patients with Coronary Artery Disease by Using CT Angiography

Background: Coronary artery disease is one of important diseases as in many cases ends up with death. Among many types of coronary artery disease is the lipoprotein plaque deposition on the artery wall. Many reports appeared in the literature concerning the causes, investigation, and treatment of the coronary artery disease. As computed tomography scanners were developed, a new non-invasive procedure was introduced using the calcium present in the plaque as an indicator for the amount of plaque in the coronary artery. Objective: To investigate the validity of the calcium score in the diagnosis of coronary artery disease, and also to find the relation between calcium score with calcification and plaque. Patients and methods: Sixty one patients 40 were men and 21 were women evaluated for calcium score. They had symptoms of chest pain and were subjected to electro cardio gram examination to determine their eligibility for computed tomography angiography to investigate the coronary calcification as a marker of atherosclerosis. The history of diseases including hypertension and diabetes were recorded and check renal function test. Anthropometric measurements and the level of fasting lipid profile for patients and normal subjects were tasted. Patients were advised to come fasting prior to the   examination. They have been given Beta blocker to reduce the heart rate in the range of 55-65 beats/min. Contrast medium was injected IV by means of injector immediately before scanning. Results: Results revel that not all patients suffering from chest pain with electro cardio gram changes show high calcium score; on the other hand patients with high calcium score they have an increased plaque in their coronary artery. At low calcium score calcium score           (0-100), cholesterol, triglyceride and high density lipoprotein are generally inversely proportional with calcium score with the exception of LDL remains virtually unchanged throughout the whole range of calcium score (0 > 300) as appear in the figures . While at high calcium score concentration (>300) lipoproteins are directly proportional with calcium score in contrast with high density lipoprotein which is inversely proportional with calcium Score

التركيب المحصولى المصرى فى ظل المخاطرة والمتغيرات المحلية والدولية

Cropping pattern refers to the percentage of acreage occupied by various crops within the crop rotation. It is determined through cultivated' area assigned to each crop according to the sequence system necessitated by crop rotation considerations. The optimum crop pattern is the one, which achieves the highest possible net return depending on input and output prices together with crop yields. It is a dynamic process as it changes from time to another based on farmers' needs and crops profitability in the previous year. It also may differ based on whether we are looking from the point of view individual farmer, trader, middleman, and exporter or from the point of view the society as a whole. Various crops are competing on the limited land within the agricultural season. So expanding the acreage of any crop would automatically entail contraction of another competitive crop, as total supply of land is almost fixed and limited. The major objective behind designing an indicative cropping pattern is the issue of food security. This issue is important both from strategic perspective, as well as in the context of poverty. While there is emerging consensus on the definition of food security as aiming to assure the country adequate access to food, both internally and externally generated, there is still reference to the need to grow certain strategic crops. Moreover, there is a desire to achieve a measure of stabilization in producer and consumer prices through the development of buffer stocks. There are various options available, each of which has costs and benefits related to them. One option would be a high level of risk aversion, which would entail a cropping pattern that centers on subsistence crops. Another option may pursue efficiency pricing and therefore would result in crops being growing in which the country has a comparative advantage. For example, self-sufficiency for wheat could be enhanced to 75% in an efficient manner. Meanwhile the domestic production of rice and sugar cane may expand to a frontier that misallocates resources of water and land. The agricultural production is very susceptible to risks originated from natural, economic or social fosters that are difficult to predict or control. In Egypt, cropping pattern, is influenced by local economic variables to up prices, i.e., cropped area is determined by farmer response to changes in absolute or relative prices of the preceding season, in addition to profitability of crops of the last season, where farmer can not change supply of labor, the elapse of period of time curding to the nature of the crops being produced. Egypt's cropping pattern is also affected by international variables related to transactions with international markets for food products and to transactions with international markets for food products and to problem related to world production of biological fuel, world financial crisis, world food crisis, and rules imposed by the international trade system. As a result, there is a deficit in the Egyptian balance of trade for food commodities amounting to L.E. 8 milliards on average for the last few years. The upsurge in demand for agricultural crops like wheat, maize, soybeans, vegetable, oils, and sugar crops for the use in producing biological fuel has resulted in a drastic increase in prices of food, during 2005-2007 the average rate of price increase of food commodities has been estimated at 83% which led to a high increase in import bill in developing -and poor countries among them Egypt which is a not food importer. For many reasons developing an increase in domestic agricultural production of strategic food crops, i.e., cereals legumes. Vegetable, oils, and sugar crops, is the best way to confront international variables, Either through vertical or horizontal expansion of those crops in addition to reducing the acreage of high water consuming scraps, which is the objective behind suggesting the cropping pattern in the short and long terms. Each of these objectives is direct by associated with the master end of ensuring food serenity. Indicative cropping pattern during last years varies considerably as compared to the actual cropping pattern experienced by farmers' decisions irrespective of the agricultural policy of the government Egypt. However, indicative or proposed cropping pattern could be put into action by introducing economic, institution and organization instruments. Those various instruments should be streamlined and harmonized together. Economic instruments advisable for execution of cropping pattern could include subsidizing production and inputs for strategic export and import crops that minimize consumption of irrigation water, introducing contractual agricultural production system, especially, in regard to cotton, sugar cane and sugar beet in addition to other industrial crops. It is advisable to establish agricultural stabilization funds to insure' farmers against various types of risks notably price risks. More over incentives either negative like taxes or positive like interest rate reduction, and rescheduling of debts could also be provided and operated. One major organizational instrument that has been successful recently introduced at a probation scale in three governorates is the national project for development of the field irrigation system in wade and delta. It is estimated that application of that project would save 15% of water consumed for irrigation. The saved water could be used for ameliorating and reclaiming an estimated acreage of 3 million feddans. In addition it is suggested that elimination of camels and messages on the fields would save and area of 0.5 million feddans to be put under cultivation. The study has estimated risk associated with Egyptian cropping pattern by application of linear and non-linear mathematical programming. Three models of minimization risk have been proposed and manipulated including: (1) Minimization Of Total Absolute Deviations: (MOTAD). (2) Risk Input-Output MOTAD. (3) Two Stage Stochastic Programming – (TSSP-RIO-MOTAD). In addition to the various scenarios cited above with their respective major objective functions, the models do comprise acreage, means of production in terms of cost of production, monthly year round irrigation water, and annual agricultural labor on monthly basis. Sensitivity analysis has been estimated for depicting the effect of changing prices of wheat and rice on cropping pattern disposition, by the application of TSSP-RIO-MOTAD model. Among the major results of these analyses are: 1- An increment of gross margin to farmers at L.E 3.8 milliard which deeps that suggested cropping has achieved the profit maximization goal which producers would aim at. 2- A huge amount of irrigation water has been saved estimated at 2.6 milliard cubic meters. A magnitude of water saved of this amount could be assigned for reclaiming new lands at about 0.7 million feddans. 3- Capital resources saved estimated at L.E. 985 million. 4- Augmenting acreage under wheat to reach as much as 3 million feddans, which help contributing positives to the nation's food security goal. 5- Reduction in rice acreage so as not to exceed one million feddan. Adding to the nations objectives of saving irrigation water to be used for reclamation of additional new lands. 6- Augmenting acreage cultivated to Soya beans, sunflower, maize, and summer sorghum at 84.9%, 69.5%, 41%, and 12.3% respectively, which, once again, contributes to the nation's objective related to enhancing food security. 7- Augmenting areas under lentil, lupine, chickpeas, broad bean, and fenugreek by 111%, 62.2%, 39.5%, 19.8%, and 8.6% respectively, which positively adds to food security objective. The proposed cropping pattern derived through sensitivity analysis and based on varying farm- prices for wheat and rice is heavily dependent on the effectiveness and synergy of mechanisms and instruments suggested for addressing and implementing of the indicative cropping pattern. Securing the accomplishment of maximization of farmer's profit margin are very major and essential objectives of the proposed cropping pattern

التركيب المحصولى المصرى فى ظل المخاطرة والمتغيرات المحلية والدولية

Cropping pattern refers to the percentage of acreage occupied by various crops within the crop rotation. It is determined through cultivated' area assigned to each crop according to the sequence system necessitated by crop rotation considerations. The optimum crop pattern is the one, which achieves the highest possible net return depending on input and output prices together with crop yields. It is a dynamic process as it changes from time to another based on farmers' needs and crops profitability in the previous year. It also may differ based on whether we are looking from the point of view individual farmer, trader, middleman, and exporter or from the point of view the society as a whole. Various crops are competing on the limited land within the agricultural season. So expanding the acreage of any crop would automatically entail contraction of another competitive crop, as total supply of land is almost fixed and limited. The major objective behind designing an indicative cropping pattern is the issue of food security. This issue is important both from strategic perspective, as well as in the context of poverty. While there is emerging consensus on the definition of food security as aiming to assure the country adequate access to food, both internally and externally generated, there is still reference to the need to grow certain strategic crops. Moreover, there is a desire to achieve a measure of stabilization in producer and consumer prices through the development of buffer stocks. There are various options available, each of which has costs and benefits related to them. One option would be a high level of risk aversion, which would entail a cropping pattern that centers on subsistence crops. Another option may pursue efficiency pricing and therefore would result in crops being growing in which the country has a comparative advantage. For example, self-sufficiency for wheat could be enhanced to 75% in an efficient manner. Meanwhile the domestic production of rice and sugar cane may expand to a frontier that misallocates resources of water and land. The agricultural production is very susceptible to risks originated from natural, economic or social fosters that are difficult to predict or control. In Egypt, cropping pattern, is influenced by local economic variables to up prices, i.e., cropped area is determined by farmer response to changes in absolute or relative prices of the preceding season, in addition to profitability of crops of the last season, where farmer can not change supply of labor, the elapse of period of time curding to the nature of the crops being produced. Egypt's cropping pattern is also affected by international variables related to transactions with international markets for food products and to transactions with international markets for food products and to problem related to world production of biological fuel, world financial crisis, world food crisis, and rules imposed by the international trade system. As a result, there is a deficit in the Egyptian balance of trade for food commodities amounting to L.E. 8 milliards on average for the last few years. The upsurge in demand for agricultural crops like wheat, maize, soybeans, vegetable, oils, and sugar crops for the use in producing biological fuel has resulted in a drastic increase in prices of food, during 2005-2007 the average rate of price increase of food commodities has been estimated at 83% which led to a high increase in import bill in developing -and poor countries among them Egypt which is a not food importer. For many reasons developing an increase in domestic agricultural production of strategic food crops, i.e., cereals legumes. Vegetable, oils, and sugar crops, is the best way to confront international variables, Either through vertical or horizontal expansion of those crops in addition to reducing the acreage of high water consuming scraps, which is the objective behind suggesting the cropping pattern in the short and long terms. Each of these objectives is direct by associated with the master end of ensuring food serenity. Indicative cropping pattern during last years varies considerably as compared to the actual cropping pattern experienced by farmers' decisions irrespective of the agricultural policy of the government Egypt. However, indicative or proposed cropping pattern could be put into action by introducing economic, institution and organization instruments. Those various instruments should be streamlined and harmonized together. Economic instruments advisable for execution of cropping pattern could include subsidizing production and inputs for strategic export and import crops that minimize consumption of irrigation water, introducing contractual agricultural production system, especially, in regard to cotton, sugar cane and sugar beet in addition to other industrial crops. It is advisable to establish agricultural stabilization funds to insure' farmers against various types of risks notably price risks. More over incentives either negative like taxes or positive like interest rate reduction, and rescheduling of debts could also be provided and operated. One major organizational instrument that has been successful recently introduced at a probation scale in three governorates is the national project for development of the field irrigation system in wade and delta. It is estimated that application of that project would save 15% of water consumed for irrigation. The saved water could be used for ameliorating and reclaiming an estimated acreage of 3 million feddans. In addition it is suggested that elimination of camels and messages on the fields would save and area of 0.5 million feddans to be put under cultivation. The study has estimated risk associated with Egyptian cropping pattern by application of linear and non-linear mathematical programming. Three models of minimization risk have been proposed and manipulated including: (1) Minimization Of Total Absolute Deviations: (MOTAD). (2) Risk Input-Output MOTAD. (3) Two Stage Stochastic Programming – (TSSP-RIO-MOTAD). In addition to the various scenarios cited above with their respective major objective functions, the models do comprise acreage, means of production in terms of cost of production, monthly year round irrigation water, and annual agricultural labor on monthly basis. Sensitivity analysis has been estimated for depicting the effect of changing prices of wheat and rice on cropping pattern disposition, by the application of TSSP-RIO-MOTAD model. Among the major results of these analyses are: 1- An increment of gross margin to farmers at L.E 3.8 milliard which deeps that suggested cropping has achieved the profit maximization goal which producers would aim at. 2- A huge amount of irrigation water has been saved estimated at 2.6 milliard cubic meters. A magnitude of water saved of this amount could be assigned for reclaiming new lands at about 0.7 million feddans. 3- Capital resources saved estimated at L.E. 985 million. 4- Augmenting acreage under wheat to reach as much as 3 million feddans, which help contributing positives to the nation's food security goal. 5- Reduction in rice acreage so as not to exceed one million feddan. Adding to the nations objectives of saving irrigation water to be used for reclamation of additional new lands. 6- Augmenting acreage cultivated to Soya beans, sunflower, maize, and summer sorghum at 84.9%, 69.5%, 41%, and 12.3% respectively, which, once again, contributes to the nation's objective related to enhancing food security. 7- Augmenting areas under lentil, lupine, chickpeas, broad bean, and fenugreek by 111%, 62.2%, 39.5%, 19.8%, and 8.6% respectively, which positively adds to food security objective. The proposed cropping pattern derived through sensitivity analysis and based on varying farm- prices for wheat and rice is heavily dependent on the effectiveness and synergy of mechanisms and instruments suggested for addressing and implementing of the indicative cropping pattern. Securing the accomplishment of maximization of farmer's profit margin are very major and essential objectives of the proposed cropping pattern

Evaluation of Procalcitonin Test for Early Diagnosis of Neonatal Sepsis in Tikrit Teaching Hospital

The diagnosis of neonatal infection is challenging because traditional markers of infection are often misleading instead of diagnosing. This study was conducted to determine Procalcitonin (PCT) level as an early marker for diagnosis of suspected sepsis in neonates in comparison with C-reactive protein, blood culture, total and differential white blood cell counts. From August, 2008 till March, 2009, 114 blood samples were collected from neonates (males and females) admitted to the pediatricsneonatal wards at Tikrit Teaching Hospital who were clinically suspected with sepsis as diagnosed by the physician in the hospital with any features suggestive of sepsis. The results of blood culture showed that 53 (46%) of samples were positive, of them 32 (60%) were males and 21 (40%) were females. The number of negative cases were 61 (54%), of them 31 (51%) were females and 30 (49%)were males. The results of identification showed that the most frequent bacterial isolates were Coagulase Negative Staphylococci and Nocardia spp. (22% for each), followed by Listeria monocytogenes 17%, Klebsiella pneumoniae, 9% Pseudomonas aeruginosa 6% and Staphylococcus aureus 6%, while (Citrobacter diversus, Serratia marscesens, Serratia liquifascens, Lactobacillus spp., Peptostreptococcus spp., Micrococcus spp., Streptococcus pyogenes) were frequently less isolated recording 2% for each . The antibiotics susceptibility test revealed that Gram negative isolates showed high resistance to antibiotics used in the present study. Each isolate of the Gram positive bacteria showed different pattern of resistance against the antibiotics used. Results of virulence factor showed that 85%, 100%, 100% , 100% and 62% of Gram negative isolates and 61%, 100% , 89%, 94% and 78% of Gram positive isolated produced Urease , Hemolysin, Lipase, Lecithinase and alkaline protease, respectively. Results of routine hematological tests at which the differences were statistically significant showed that 33% of culture positive cases had leucopenia, 19% of cases had leukocytosis, while the rest were in the category of normal range. For CRP, the differences were not significant among culture positive and culture negative cases. With reference to PCT test which had been measured using the immunochromatographic semi-quantitative method. The results showed that 21% of culture positive cases were with PCT level with high levels distributed among levels of PCT≥0.5 ≥2 ≥10 ng/ml. As for culture negative cases, 49% of PCT were systemic infections cannot be excluded though they were culture negative. In addition PCT results did not fit with CRP all the time since some cases recorded higher level of PCT ≥10 ng/ml despite they were negative for CRP. The comparison between results of PCT and WBC for the same performed cases showed that 68% of cases were in the category of normal WBC range, meanwhile they had high level of PCT. Only 18% were in the category of leukocytosis, and the rest of percentage were in the category of leucopenia. When PCT was compared with other routinely measured parameters used in this study, It seemed to be significantly more sensitive in sepsis diagnosis. Accordingly, we can conclude that PCT is a more sensitive marker than other traditional tests (blood culture, CRP and WBC count) that could be used in early diagnosis of bacterial sepsis in neonate

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

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

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field