PATH INTEGRAL QUANTIZATION OF LAGRANGIANS WITH LINEAR ACCELERATIONS

The Lagrangian with linear acceleration can be considered as a model of singular system. The constrained Hamiltonian systems with linear acceleration are investigated by using the Hamilton-Jacobi method. The Hamilton-Jacobi function is constructed by applying the integrability condition on this function to obtain the path integral quantization. It is shown that the equations of motion can be obtained from the action integra

Kernel Functions and New Applications of an Accurate Technique

In this article, some general reproducing kernel Sobolev spaces was constructed. We find the general functions in these reproducing kernel Sobolev spaces. Many higher order boundary value problems can be investigated by these special functions

Reinforced Concrete Corbels – State of the Art.

This paper represents a historical review, state-of-the-art review, on the experimental researches carried out on corbels in general and strengthening of corbels in particular. The corbels discussed are made of normal, high-strength and self-compacting concrete and subjected to two types of loading, monotonic and repeated loadings. Moreover, a review on the techniques of strengthening used to enhance the load carrying capacities of reinforced concrete corbels is presented too. Finally, directions for future work are proposed and a comprehensive list of references is provided

The Impact of Water Price on the Financial Sustainability of the Palestinian Water Service Providers

The impactof water sales price on the performance of water service providers is typically something of a mystery. High prices mean more revenue and profit; but it may lead to less bills collection and encourage the illegal connections. Yet, this argument has not been fully addressed in the Palestinian water sector; this research evaluates the effect of average water prices on the financial sustainability key indicators as collection efficiency, profit or loss percentage, non-revenue water, staff productivity, daily consumption, operating, and maintenance cost. The average price of cubic meter sold is segmented into low, medium, and high categories. Multivariate analysis shows that there are significant differences in profit or working ratio, daily consumption, and operating cost based on the different price categories. Further significant differences have been found in non-revenue water, collection efficiency, and water production based on low and high price categories. On the other hand, no significant difference has been found in staff productivity. The results show high price set by Palestinian water providers, leads to an increase in the bill collection rate and profit margin. However, negative relationship has been found between the price on one hand, and non-revenue water, average daily consumption, and water production on the other hand. The implication of these findings reveal that the Palestinian water providers should increase water prices gradually to cover operating and maintenance cost for better financial performance and sustainability.This research paper has been made possible through the support from MEDRC Water Research at the Sultanate of Oman. We would like to express our deepest appreciation to MEDRC for publishing this paper. The deepest gratitude also to Palestinian Water Authority (PWA) for valuable, effective supervision, coordination of the scientific researches, and directing them toward finding creative solutions for current water problems

Maternal Depression and Its Associated Factors among the Mothers at Narayanganj in Bangladesh

Maternal depression is becoming a serious public health concern in the world day by day. The purpose of the current study was to assess the maternal depression and its associated factors among the mothers of Narayanganj city in Bangladesh. A cross-sectional study was conducted in six different areas at Narayanganj in Dhaka among 377 mothers having children of five to ten years between the periods of May, 2019 to September, 2019. The respondents were selected by simple random sampling method. All data analysis was done by using IBM SPSS version 20.0. The mean age of the pregnant women was 26±4 years. It was found that about 77% of mothers had high depressive symptoms whereas 10.7%, 6.63% and 6.36% of mothers had moderate, mild and no depressive symptoms, respectively.  It was observed that family income, family size, age of children and age at marriage were significantly (p<0.05) associated with maternal depression status. Further investigations might be carried out to assess the effect size of the associated factors mentioned above. Keywords: Maternal depression, mothers, children, associated factors. DOI: 10.7176/JHMN/102-06 Publication date:September 30th 2022

Epidemiological and Clinical Features of Salmonella Typhi Infection Among Adult Patients in Qatar: A Hospital-based Study

Objectives: We sought to describe the epidemiological and clinical features of typhoid fever in Qatar. Methods: We conducted a retrospective study of adult patients treated for typhoid fever at Hamad General Hospital and Alkhor Hospital between 2005 and 2012. Results: The mean age of the 354 patients enrolled in the study was 28.4±9.3 years; 296 (83.6%) were males. There were 42, 48, 39, 44, 46, 47, 52, and 36 cases of adults with typhoid fever in 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012, respectively. Overall, 343 (96.9%) patients had a history of travel to endemic areas. Among them, 93.0% acquired typhoid fever in the Indian subcontinent. Fever was observed in all cases, and the other predominant symptoms were abdominal pain (38.1%), diarrhea (35.6%), and headache (33.1%). Salmonella typhi, showed high resistance to ciprofloxacin (n = 163; 46.0%), and low resistance to ceftriaxone (n = 2; 0.6%). Four patients developed intestinal perforation, which was surgically repaired in two cases. Two patients (0.6%) died. Conclusions: Typhoid fever was frequent among immigrants to endemic areas. Travelers returning from endemic areas with suspected typhoid fever should be treated empirically with third-generation cephalosporin after obtaining appropriate cultures. Moreover, preventive measurements such as education on food and water hygiene, and effective vaccination of travelers should be practiced widely among travelers to endemic areas to reduce morbidity and mortality

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

التعرّف البصري على صور الأحرف المسمارية (أبجدية أوغاريت)

يهدف البحث إلى تقديم مساهمة جديدة في عملية تطوير خوارزمية فعّالة لقراءة المخطوطات الأوغاريتية انطلاقاً من استخراج السّمات الشكلية والهندسية (Shape and Geometric Features) للحرف. يتمّ بداية تعرّف معالجة صورة النص للوصول إلى أقلّ قدر ممكن من الضجيج, و أعلى نسبة وضوح في الصورة مع تعديل السويات الرمادية عن طريق مساواة الهيستوغرام التكيفي (Adaptive Histogram Equalization ) يتم الحصول على صورة ثنائية بالاعتماد على التعتيب الديناميكي وفق خوارزمية أوتسو، يتمّ بعد ذلك تقطيع النص إلى الأسطر المكونة له , ثمّ إلى الأحرف المكوّنة لكلّ سطر بالاعتماد على العمليات المورفولوجية. يلي ذلك مرحلة استخلاص السّمات الهندسية والشكلية لكلّ حرف من الأحرف المقتطعة , ثم تحديد السمات الأكثر أهمية. وتسبق مرحلة التعرف مرحلة مهمّة وأساسية تُنفّذ لمرة واحدة عند تصميم البرنامج , وهي مرحلة التدريب Training التي تشكّل الأساس في عملية التعرف اللاحقة.  يتمّ في هذه المرحلة إنتاج قاعدة لنماذج الأحرف المختلفة بأشكالها وحالاتها المتباينة. بعد عملية التعليم يكون قد تكَّون لدى نظام التعرف قاعدة معطيات لجميع الأشكال الأساسية المحتملة لورود الحرف.  تُنظّم قاعدة المعطيات وتُخزّن لاستخدامها في المرحلة اللاّحقة. يتمّ في المرحلة الأخيرة التعرّف على صورة نصّ مخزّن كصورة اختبار، حيث يتمّ معالجة الصورة بنفس خطوات المعالجة المذكورة أعلاه, ثم تقطيع النصّ إلى الأسطر, ثمّ المحارف الأساسية، ثمّ استخلاص سمات الأحرف المقتطعة.  تُقارن بعد ذلك سمات كل حرف مع سمات جميع النماذج الموجودة في قاعدة المعطيات المخزنة مسبقاً، ويُختبر مدى التشابه بينها اعتماداً على عدّة مصنفات مقترحة هي مصنف الشبكة العصبونية ومصنف SVM ومصنف المسافة الأصغري وصولاً لاختيار الحرف ذي قيمة التشابه الأكبر. تمّ الحصول من عملية تجزيء صور قاعدة الاختبار على 270 محرفاً من محارف اللغة المسمارية وكانت نسبة التجزيئ الصحيح97.4%  , اختبر النظام على  على تسعة سيناريوهات مختلفة وكان معدل التعرف 93.33% بزمن وسطي قدره 0.186 ثانية