Can Bioethanol Lead Pakistan Towards Sustainability and Prosperity? A Narrative Review

Economic recession, power and fuel shortage, waste management and pollution leading to global warming and climate change are few of the major issues faced by Pakistan, a developing country. These issues can be addressed to some extent by implementing policies and programmes by the government that will promote the development of the renewable energy sector in the country. Pakistan being an agricultural country has great potential to produce bioethanol, by using agricultural and municipal waste, and be able to fulfil its fuel requirements. Countries such as Canada, China and Brazil, the top producers of bioethanol in the world, can be followed as examples in terms of making policies for the growth and development of bioethanol industries. The government should make policies to replace traditional petroleum with ethanol-blended fuel to minimize the energy crisis and environmental pollution throughout the country. Keywords: Renewable energy, pollution, economic growth, sustainable development goals, global warming, waste management

Role of Health Education in Raising Tetanus Toxoid Vaccination Coverage among Pregnant Women and Mothers with Newborns in Khartoum North-Sudan, 2019

Tetanus is an acute disease caused by the toxin of a bacterium called Clostridium tetani which is often found in soil. It is a life-threatening bacterial disease, which causes severe mortality among maternal, neonatal, and young infant. It is so serious even it can waste pregnancy, harm her baby during pregnancy or after delivery. A quasi experimental community based study was conducted among pregnant women and mothers with newborns in Khartoum North Locality from 2015-2019 with the aim to assess the effectiveness of health education intervening in raising tetanus toxoid vaccination coverage among pregnant women and mothers with new born. 266 participants were selected by using a systematic random sampling technique. The intervention that continued for six months includes; health talks, home visits, video show, presentations with power points, focus groups discussion, exhibitions, distribution of printed materials, pamphlets, brochures and posters. The data was statistically analyzed by using the (SPSS) and significant t and c2 - tests. The result showed a significant increase in the participants’ knowledge after the intervention towards tetanus toxoid at P value 0.00, the mode of infection with tetanus at P value 0.00, vulnerable group to tetanus at p value is 0.00, the seriousness of the tetanus at P value 0.00, neonatal tetanus at P value 0.00. There was a significant positive modification of the participants’ attitudes towards the easiness to communicate with the health workers at P value 0.00. The result showed a significant change in the participants’ practices towards vaccination against tetanus toxic at P value 0.00 and significant change towards taking vaccine dose regularly at P value 0.00. The study recommended that Federal Ministry of Health has to conduct many health education interventions to raise the tetanus toxoid vaccination coverage

Enhancement of the fruit quality and postharvest life expectancy of mango fruit (Mangifera indica L.) applying ecofriendly bio-coatings

The higher losses of fruits and vegetables during post-harvest handling are a serious matter for any country whose economy is based on agriculture. The products of this plant are a significant source of horticultural produce storage used for the control of different post-harvest losses, which include diseases as well as microorganisms. Bio-coatings may be used as a better alternative to the synthetic chemicals. The impact of edible coating on the quality and storage life of mango (cv. ‘Anwar Rataul’) fruit was investigated by harvesting the fruits at a firm green stage of physiological maturity and coating them with corn oil, peanut oil, sunflower oil, soya bean oil, and animal fat. The uncoated and coated fruits were stored at 25 °C and the relative humidity (RH) was 75%. The fruits were analyzed for physicochemical quality attributes during storage at 0 (harvest time), 5, 10, 15, 20, and 25 days. The data showed that most of the parameters were affected significantly by the materials of coating and storage intervals (P ≤ 0.05). The fruits coated with animal fat had significantly superior fruit color, taste, aroma, firmness, total sugar content, and acidity of fruit juice, total soluble solids, and ascorbic acid content, as well as delayed ripening. Animal fat-coated fruits retained titratable acidity, ascorbic acid content (mg.100g-1) and fruit firmness (kg.cm-2) with minimal disease incidence, and weight loss (%), whereas uncoated fruits did not retain all quality attributes and deteriorated after 20 days of storage. In conclusion, mango fruits could be coated with animal fat and stored for up to 25 days without deterioration in quality

Excision and Reconstruction of Atypical Chest Dermatofibrosarcoma Protuberans Tumor: A Case Report and Literature Review

Introduction: Dermatofibrosarcoma protuberans (DFSP) originated as keloid sarcoma, gaining its current designation in 1925. DFSP exhibits slow growth, categorizing it as a low- to intermediate-grade malignant sarcoma. Initially presenting as a small, firm, irregular skin nodule, it undergoes sudden, rapid growth, forming a prominent mass. While locally aggressive, distant metastasis is rare. DFSP affects mainly the torso then proximal extremities. Case Presentation: In this case study, we described a 57-year-old male individual who presented with a chest midline swelling that was progressing in size. A punch biopsy showed inconclusive results. Thus, a wide local excision was carried out along with sending the initial biopsy slides to Mayo Clinic for second opinion. A diagnosis of DFSP was confirmed, which is an uncommon and locally aggressive tumor affecting soft tissues. The primary histological diagnosis relies on immunohistochemical stains, enabling the distinction between DFSP and other fibrous tumors. Conclusion: Diagnosing DFSP is challenging due to its similarity to other skin lesions. A multidisciplinary approach is vital for accurate diagnosis and management

Enhancement of the fruit quality and postharvest life expectancy of mango fruit (Mangifera indica L.) applying ecofriendly bio-coatings

The higher losses of fruits and vegetables during post-harvest handling are a serious matter for any country whose economy is based on agriculture. The products of this plant are a significant source of horticultural produce storage used for the control of different post-harvest losses, which include diseases as well as microorganisms. Bio-coatings may be used as a better alternative to the synthetic chemicals. The impact of edible coating on the quality and storage life of mango (cv. ‘Anwar Rataul’) fruit was investigated by harvesting the fruits at a firm green stage of physiological maturity and coating them with corn oil, peanut oil, sunflower oil, soya bean oil, and animal fat. The uncoated and coated fruits were stored at 25 °C and the relative humidity (RH) was 75%. The fruits were analyzed for physicochemical quality attributes during storage at 0 (harvest time), 5, 10, 15, 20, and 25 days. The data showed that most of the parameters were affected significantly by the materials of coating and storage intervals (P ≤ 0.05). The fruits coated with animal fat had significantly superior fruit color, taste, aroma, firmness, total sugar content, and acidity of fruit juice, total soluble solids, and ascorbic acid content, as well as delayed ripening. Animal fat-coated fruits retained titratable acidity, ascorbic acid content (mg.100g-1) and fruit firmness (kg.cm-2) with minimal disease incidence, and weight loss (%), whereas uncoated fruits did not retain all quality attributes and deteriorated after 20 days of storage. In conclusion, mango fruits could be coated with animal fat and stored for up to 25 days without deterioration in quality

Comparison of Measured and Estimated Resting Energy Expenditure in Adolescents and Young Adults With Severe Obesity Before and 1 Year After Sleeve Gastrectomy

Introduction: Resting energy expenditure (REE) is often evaluated in adults and adolescents with obesity to estimate caloric requirements when advising dietary changes. However, data are lacking regarding the accuracy of methods used to clinically assess REE in adolescents with severe obesity. Moreover, there are no data regarding the effects of sleeve gastrectomy (SG) on REE in adolescents. We evaluated the accuracy and error rate between estimated and measured REE in adolescents with severe obesity and changes in REE following (SG).Materials and Methods:Cross-sectional study (CSS): 64 adolescents and young adults, 14–22 years old, with moderate to severe obesity were enrolled. We measured REE (mREE) by indirect calorimetry and estimated REE (eREE) using Derumeaux (Deru), Mifflin-St Jeor (MS), Harris Benedict (HB), and World Health Organization (WHO) equations. DXA was used to determine body composition. Bland Altman analysis evaluated agreement between eREE and mREE. Longitudinal study: 12 subjects had repeat indirect calorimetry and DXA 1 year after SG. Longitudinal analysis was used to assess changes in REE and body composition.Results:CSS: Median BMI was 45.2 kg/m2 and median age was 18.0 (16.3–19.9) years. mREE correlated strongly with eREE . Bland Altman analysis demonstrated that only a few points were beyond the 1.96 SD limit of disagreement. However, there was considerable overestimation of mREE by most equations. Longitudinal Study: In the subset that underwent SG, after 12-months, absolute REE decreased from 1709 (1567.7–2234) to 1580.5 (1326–1862.5) Calories (p = 0.002); however, the ratio of REE/Total Body Weight (TBW) increased from 13.5 ± 2.3 at baseline to 15.5 ± 2.2 at 1 year (p = 0.043). When evaluating parameters affecting % total weight loss, we found that it correlated positively with REE/TBW at 12 months (R = 0.625; p = 0.03) and negatively with % fat mass at 12 months (R = −0.669; p = 0.024).Discussion: In adolescents with moderate-severe obesity, despite a correlation between mREE using indirect calorimetry and eREE using the Deru, MS, HB, and WHO equations, there is significant over-estimation of REE at the individual level, challenging their clinical utility. One year after SG, REE/TBW increased and strongly correlated with % total weight loss in adolescents

In vitro inhibition of biofilm and virulence factor production in azole-resistant strains of Candida albicans isolated from diabetic foot by Artemisia vulgaris stabilized tin (IV) oxide nanoparticles

The advent of nanotechnology has been instrumental in the development of new drugs with novel targets. Recently, metallic nanoparticles have emerged as potential candidates to combat the threat of drug-resistant infections. Diabetic foot ulcers (DFUs) are one of the dreadful complications of diabetes mellitus due to the colonization of numerous drug-resistant pathogenic microbes leading to biofilm formation. Biofilms are difficult to treat due to limited penetration and non-specificity of drugs. Therefore, in the current investigation, SnO2 nanoparticles were biosynthesized using Artemisia vulgaris (AvTO-NPs) as a stabilizing agent and were characterized using ultraviolet–visible (UV–vis) spectroscopy, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). Furthermore, the efficacy of AvTO-NPs against biofilms and virulence factors of drug-resistant Candida albicans strains isolated from DFUs was assessed. AvTO-NPs displayed minimum inhibitory concentrations (MICs) ranging from 1 mg/mL to 2 mg/mL against four strains of C. albicans. AvTO-NPs significantly inhibited biofilm formation by 54.8%–87%, germ tube formation by 72%–90%, cell surface hydrophobicity by 68.2%–82.8%, and exopolysaccharide (EPS) production by 69%–86.3% in the test strains at respective 1/2xMIC. Biosynthesized NPs were effective in disrupting established mature biofilms of test strains significantly. Elevated levels of reactive oxygen species (ROS) generation in the AvTO-NPs-treated C. albicans could be the possible cause of cell death leading to biofilm inhibition. The useful insights of the present study could be exploited in the current line of treatment to mitigate the threat of biofilm-related persistent DFUs and expedite wound healing

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

FINCH: A Blueprint for Accessible and Scientifically Valuable Remote Sensing Satellite Missions

Satellite remote sensing missions have grown in popularity over the past fifteen years due to their ability to cover large swaths of land at regular time intervals, making them suitable for monitoring environmental trends such as greenhouse gas emissions and agricultural practices. As environmental monitoring becomes central in global efforts to combat climate change, accessible platforms for contributing to this research are critical. Many remote sensing missions demand high performance of payloads, restricting research and development to organizations with sufficient resources to address these challenges. Atmospheric remote sensing missions, for example, require extremely high spatial and spectral resolutions to generate scientifically useful results. As an undergraduate-led design team, the University of Toronto Aerospace Team’s Space Systems Division has performed an extensive mission selection process to find a feasible and impactful mission focusing on crop residue mapping. This mission profile provides the data needed to improve crop residue retention practices and reduce greenhouse gas emissions from soil, while relaxing performance requirements relative to many active atmospheric sensing missions. This is accompanied by the design of FINCH, a 3U CubeSat with a hyperspectral camera composed of custom and commercial off-the-shelf components. The team’s custom composite payload, the FINCH Eye, strives to advance performance achieved at this form factor by leveraging novel technologies while keeping design feasibility for a student team a priority. Optical and mechanical design decisions and performance are detailed, as well as assembly, integration, and testing considerations. Beyond its design, the FINCH Eye is examined from operational, timeline, and financial perspectives, and a discussion of the supporting firmware, data processing, and attitude control systems is included. Insight is provided into open-source tools that the team has developed to aid in the design process, including a linear error analysis tool for assessing scientific performance, an optical system tradeoff analysis tool, and data processing algorithms. Ultimately, the team presents a comprehensive case study of an accessible and impactful satellite optical payload design process, in hopes of serving as a blueprint for future design teams seeking to contribute to remote sensing research

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