MULTI-OBJECTIVE STRATEGY FOR OPTIMIZING REPETITIVE CONSTRUCTION PROJECTS USING LINEAR PROGRAMMING MODELS

Decision making has become much more complicated than in the past due to increased decision alternatives, uncertainty, and cost of making errors. As a result, it is very difficult to rely on a trial and error approach in decision making. Nowadays business managers are dealing with different types of projects ranging from implementing a large scale manufacturing plant to a simple sales campaign. While dealing with projects, to become competitive, sometimes it is required to complete a project within the predetermined deadline to keep cost at lowest possible level. Failure to do so ultimately leads to increase in total cost. This would direct managers to encounter a decision situation: which activities of the project will be crashed to minimize the total cost of crashing project. In this paper, we provide a hypothetical example to clarify the framework of how to convert from LOB to CPM and then how to create a model to crash a project time to reach an optimum time-cost solution. Microsoft Excel custom made sheets used to the conversion, also Solver add-in used to solve the model while it implements Linear Programming. As a check, results from Solver and LiPS software are compared

The Effect of two Schedules of Intermittent Enteral Feeding on the Development of Gastric Colonization

Nutritional support is an important aspect of the care of traumatized patients and it can result in improving wound healing, decreasing catabolic response to injury, enhancing immune system function, improving gastrointestinal structure and function, and improving clinical outcomes. However, many complications are associated with enteral feeding including gastric colonization. Routine enteral feeding schedule is not allowing time to acidify stomach with gastric pH. This may predispose the traumatized patients to acquire gastric colonization which may predispose to aspiration pneumonia. Aim: this study was carried out to investigate the effect of two schedules of intermittent enteral feeding on the development of gastric colonization Design: a quasi-experimental design. Setting: trauma ICU at Assiut University Hospitals, Egypt. Patients: A convenience sample of 80 adults' traumatized patients on enteral feeding constituted the study sample. The patients were assigned into two equal groups (group 1 and group 2, 40 patients each). Methods: The only manipulation was in the rest period and time interval in which the group 1 patients were rested 8hours at night as compared to 6hours for the group 2 ones, as well group 1 patients were having 4hours time interval between each two consecutive feeding as compared to 2hours for group 2 patients. Results: ninety percent of group 2 patients developed gastric colonization as compared to 40% of the group 1 patients with a highly significant statistical difference between both groups in this regard (p= 0.000).Conclusion: intermittent 4-hour interval enteral feeding schedule inhibit the development of gastric colonization. Keywords: intermittent enteral feeding, gastric colonization

Structural changes in cattle immature oocytes subjected to slow freezing and vitrification.

This study was conducted to evaluate the effect of different cryopreservation methods (slow-freezing and vitrification) on structural changes of bovine immature oocytes. Bovine ovaries were collected from local abattoirs. Cumulus-oocytecomplexes (COCs) were retrieved using aspiration method from 2-6 mm follicles. In Experiment 1, selected oocytes were randomly divided into 4 treatment groups namely freezing solution-exposed, frozen-thawed, vitrification solution-exposed and vitrified-thawed and then oocytes abnormalities were examined under a stereomicroscope. In Experiment 2, oocytes were randomly allocated to the same grouping as experiment 1 plus control group. Following freezing or vitrification, all oocytes were fixed in glutaraldehyde and processed for transmission electron microscopy. In experiment 1, there was a higher incidence of abnormalities in the frozen-thawed and vitrified-warmed oocytes compared to those in freezing solution and vitrification solution-exposed groups (P <0.05). In experiment 2, there were marked alterations in the perivitelline space, microvilli and vesicles of frozenthawed and vitrified-warmed oocytescharacterized by loss of elasticity and integrity of cytoplasmic processes and microvilli following cooling and warming. In conclusion, ethylene glycol-based freezingand vitrification solutions are suitable choices for cryopreservation of immature oocytes and most organelles are able to retain their normal morphology followingcryopreservation and thawing processe

IMPACT OF BIOPOLYMERS ON ENHANCING SOIL PHYSICAL PROPERTIES

ones are the most dominant in the new reclaimed areas in Egypt. The main production constraints of this type  of  soil  are  low in organic carbon,  porosity,  stable aggregates, water retention capacity, and biological  activities. Agriculture soil should have not only a good structure but also a good structure which can persist for a long time (e.g., a structure of high quality and stability). Soil aggregates are structural units of soil, which create complex pore systems controlling gas and water storage and fluxes in soil. Formation and stability of natural soil aggregates are affected by dozens of different factors and their individual effects are hardly distinguishable. Therefore, to observe more clear the mechanisms governing their water and mechanical stability, it was found necessary to  study soil  aggregates. In that sence, some studies showed encouraging findings of increasing soil stable aggregates due to using different soil conditioners. The objective of this work is to assess some extracellular polysaccharides biopolymers, i.e., Dextran, Alginate, Xanthan, Pullulan, and Curdlan, which were produced in our laboratory under the most suitable production conditions, to test their effects on the physical proprerties of soil taken   from Toshka region at Aswan Governorate of Egypt. Data showed that soil porosity and MWDwet values have significant differences between all treatments and control under un-leaching processes. On the Other hand, in leaching processes, significant differences between all treatments and control were observed except in some treatments that using lower ratios of Pullulan and Curdlan biopolymers (i. e. 0.4, 0.6 and 0.8%). Generally, the beneficial order of enhancement of aggregate stability was obtained with Dextran, followed by Alginate, Xanthan, Pullulan, and Curdlan

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

Role of insulin, insulin sensitivity and abomasal functions monitors in evaluation of the therapeutic regimen in ketotic dairy cattle using combination therapy with referring to milk yield rates

Background: Ketosis is one of the most critical metabolic disorders that occur in dairy cows after parturition due to negative energy balance (NEB) around calving. Aim: The study evaluated a specific therapeutic regimen of ketosis in Holstein dairy cattle by using combination therapy including hormones, corticosteroids, propylene glycol, and vitamin B12 as well as the use of milk yield rates, insulin, insulin sensitivity, and abomasal functions monitors as diagnostic biomarkers for the recovery of ketotic cows either pre-therapy (0 days) or post-therapy (7 and 14 days). Methods: This study was conducted on ketotic cattle (n=20) belonged to different dairy farms in Cairo and Giza governorates, Egypt. The diseased cows were undergoing clinical and biochemical investigations for the estimation of serum insulin. Quantitative Insulin Sensitivity Check Index (RQUICKI) and abomasal functions monitor mainly serum levels of gastrin, pepsinogen, and chloride. Results: The milk production rates, cost: benefit analysis ratio, and benefit of the dairy farm in ketotic animals were significantly increased post-treatment. An improvement of insulin sensitivity was stated as serum insulin, and RQUICKI were remarkably increased in post-therapeutic ketotic cows. Monitors of the abomasal function revealed abomasal functions improvement through the significant elevation of blood gastrin and a substantial reduction in serum pepsinogen due to treatment. Conclusion: the study revealed high efficacy of the applied therapeutic strategy regime. It led to a high recovery rate and a very low relapse rate for ketosis. An improvement in milk yield rates, insulin sensitivity, and abomasal function monitors was reported. Hypoinsulinaemia was still reported, however, serum insulin was improved

Role of insulin, insulin sensitivity, and abomasal functions monitors in evaluation of the therapeutic regimen in ketotic dairy cattle using combination therapy with referring to milk yield rates

Background: Ketosis is one of the most critical metabolic disorders that occur in dairy cows after parturition due to negative energy balance around calving. Aim: The study evaluated a specific therapeutic regimen of ketosis in Holstein dairy cattle by using the combination therapy including hormones, corticosteroids, propylene glycol, and vitamin B12 as well as the use of milk yield rates, insulin, insulin sensitivity, and abomasal functions monitors as diagnostic biomarkers for the recovery of ketotic cows either pre-therapy (0 days) or post-therapy (7 and 14 days). Methods: This study was conducted on ketotic cattle (n = 20) belonged to different dairy farms in Cairo and Giza governorates, Egypt. The diseased cows were undergoing clinical and biochemical investigations for the estimation of serum insulin. Quantitative Insulin Sensitivity Check Index (RQUICKI) and abomasal functions monitor mainly serum levels of gastrin, pepsinogen, and chloride. Results: The milk production rates, cost: benefit analysis ratio, and benefit of the dairy farm in ketotic animals were significantly increased post-treatment. An improvement of insulin sensitivity was stated as serum insulin, and RQUICKI were remarkably increased in post-therapeutic ketotic cows. Monitors of the abomasal function revealed abomasal functions improvement through the significant elevation of blood gastrin and a substantial reduction in serum pepsinogen due to treatment. Conclusion: The study revealed high efficacy of the applied therapeutic strategy regime. It led to a high recovery rate and a very low relapse rate for ketosis. An improvement in milk yield rates, insulin sensitivity, and abomasal function monitors was reported. Hypoinsulinaemia was still reported, however, serum insulin was improved

Biosynthesis and Characterization of Extracellular Silver Nanoparticles from <i>Streptomyces aizuneusis</i>: Antimicrobial, Anti Larval, and Anticancer Activities

The ability of microorganisms to reduce inorganic metals has launched an exciting eco-friendly approach towards developing green nanotechnology. Thus, the synthesis of metal nanoparticles through a biological approach is an important aspect of current nanotechnology. In this study, Streptomyces aizuneusis ATCC 14921 gave the small particle of silver nanoparticles (AgNPs) a size of 38.45 nm, with 1.342 optical density. AgNPs produced by Streptomyces aizuneusis were characterized by means of UV-VIS spectroscopy and transmission electron microscopy (TEM). The UV-Vis spectrum of the aqueous solution containing silver ion showed a peak between 410 to 430. Moreover, the majority of nanoparticles were found to be a spherical shape with variables between 11 to 42 nm, as seen under TEM. The purity of extracted AgNPs was investigated by energy dispersive X-ray analysis (EDXA), and the identification of the possible biomolecules responsible for the reduction of Ag+ ions by the cell filtrate was carried out by Fourier Transform Infrared spectrum (FTIR). High antimicrobial activities were observed by AgNPs at a low concentration of 0.01 ppm, however, no deleterious effect of AgNPs was observed on the development and occurrence of Drosophila melanogaster phenotype. The highest reduction in the viability of the human lung carcinoma and normal cells was attained at 0.2 AgNPs ppm