Use of antibiotics in children younger than two years in eight countries: A prospective cohort study

Objective: To describe the frequency and factors associated with antibiotic use in early childhood, and estimate the proportion of diarrhoea and respiratory illnesses episodes treated with antibiotics.Methods: Between 2009 and 2014, we followed 2134 children from eight sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa and the United Republic of Tanzania, enrolled in the MAL-ED birth cohort study. We documented all antibiotic use from mothers’ reports at twice-weekly visits over the children’s first two years of life. We estimated the incidence of antibiotic use and the associations of antibiotic use with child and household characteristics. We described treatment patterns for diarrhoea and respiratory illnesses, and identified factors associated with treatment and antibiotic class.Findings: Over 1 346 388 total days of observation, 16 913 courses of antibiotics were recorded (an incidence of 4.9 courses per child per year), with the highest use in South Asia. Antibiotic treatment was given for 375/499 (75.2%) episodes of bloody diarrhoea and for 4274/9661 (44.2%) episodes of diarrhoea without bloody stools. Antibiotics were used in 2384/3943 (60.5%) episodes of fieldworker-confirmed acute lower respiratory tract illness as well as in 6608/16742 (39.5%) episodes of upper respiratory illness. Penicillins were used most frequently for respiratory illness, while antibiotic classes for diarrhoea treatment varied within and between sites.Conclusion: Repeated antibiotic exposure was common early in life, and treatment of non-bloody diarrhoea and non-specific respiratory illnesses was not consistent with international recommendations. Rational antibiotic use programmes may have the most impact in South Asia, where antibiotic use was highest

A notched UWB microstrip patch antenna for 5G lower and FSS bands

In ASEAN countries, the fifth generation (5G) forum proposed a 5G application lower frequency band (4.5–5.5) GHz and the fixed satellite service (FSS) C-band at (3.3–4.2) GHz. Previous research works have demonstrated that the complexity of antenna design, large size and in most of the cases, active elements that were added to antenna has made the antenna costly. Therefore, this research work focused on developing a single band notched (SBN) and double band notched (DBN) antennas by creating notched bands for 5G lower band from 4.5 to 5.5 GHz and C-band 3.3 to 4.2 GHz applications in antenna UWB spectrum. An UWB antenna has been developed using low-cost FR-4 substrate with partial grounding (PG) on a rectangular patch. A single band and dual band notched UWB antennas were realized for the 5G lower band through the use of a slot at the top of the radiating patch and by adding an arc shape open loop (ASOL) on the UWB antenna. Both antennas are fabricated using the same FR-4 substrate and tested using Vector Network Analyzer (VNA). The voltage standing wave ratio (VSWR), return loss, gain, and 2-D radiation pattern of the test results prove that all antennas have excellent performance (compared to previous research works) in notched band and UWB band frequencies. Therefore, developed single notch and dual notch UWB antennas are proposed as good candidates for 5G lower band and C-band notched application environment

Emotion Recognition from EEG Signal Focusing on Deep Learning and Shallow Learning Techniques

Recently, electroencephalogram-based emotion recognition has become crucial in enabling the Human-Computer Interaction (HCI) system to become more intelligent. Due to the outstanding applications of emotion recognition, e.g., person-based decision making, mind-machine interfacing, cognitive interaction, affect detection, feeling detection, etc., emotion recognition has become successful in attracting the recent hype of AI-empowered research. Therefore, numerous studies have been conducted driven by a range of approaches, which demand a systematic review of methodologies used for this task with their feature sets and techniques. It will facilitate the beginners as guidance towards composing an effective emotion recognition system. In this article, we have conducted a rigorous review on the state-of-the-art emotion recognition systems, published in recent literature, and summarized some of the common emotion recognition steps with relevant definitions, theories, and analyses to provide key knowledge to develop a proper framework. Moreover, studies included here were dichotomized based on two categories: i) deep learning-based, and ii) shallow machine learning-based emotion recognition systems. The reviewed systems were compared based on methods, classifier, the number of classified emotions, accuracy, and dataset used. An informative comparison, recent research trends, and some recommendations are also provided for future research directions

Characteristics associated with the transition to partial breastfeeding prior to 6 months of age : Data from seven sites in a birth cohort study

ACKNOWLEDGMENTS The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) was carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH and the NIH/Fogarty International Center.Peer reviewedPublisher PD

Metabolic maturation in the first 2 years of life in resource-constrained settings and its association with postnatal growths

Funding Information: The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation (BMGF 47075), the Foundation for the National Institutes of Health, and the National Institutes of Health, Fogarty International Center, while additional support was obtained from BMGF for the examination of host innate factors on enteric disease risk and enteropathy (grants OPP1066146 and OPP1152146 to M.N.K.). Additional funding was obtained from the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases of the Johns Hopkins School of Medicine (to M.N.K.). Publisher Copyright: Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).Peer reviewedPublisher PD

Usnic acid as potential inhibitors of BCL2 and P13K protein through network pharmacology-based analysis, molecular docking and molecular dynamic simulation

Usnic acid (UA) lately piqued the interest of researchers for its extraordinary biological characteristics, including anticancer activity. Here, the mechanism was clarified through network pharmacology,molecular docking and molecular dynamic simulation. Sixteen proteins were selected through network pharmacology study as they are probable to interact with UA. Out of these proteins, 13 were filtered from PPI network analysis based on their significance of interactions (p < 0.05). KEGG pathway analysis has also aided us in determining the three most significant protein targets for UA, which are BCL2, PI3KCA and PI3KCG. Therefore molecular docking and molecular dynamic (MD) simulations throughout 100 ns were performed for usnic acid onto the three proteins mentioned. However, UA's docking score in all proteins is lower than their co-crystalised ligand, especially for BCL2 (−36.5158 kcal/mol) and PI3KCA (−44.5995 kcal/mol) proteins. The only exception is PI3KCG which has comparable results with the co-crystallised ligand with (−41.9351 kcal/mol). Furthermore, MD simulation has also revealed that usnic acid does not stay fit in the protein throughout the simulation trajectory for PI3KCA protein evident from RMSF and RMSD plots. Nevertheless, it still poses good ability in inhibiting BCL2 and PI3KCG protein in MD simulation. In the end, usnic acid has exhibited good potential in the inhibition of PI3KCG proteins, rather than the other proteins mentioned. Thus further study on structural modification of usnic acid could enhance the ability of usnic acid in the inhibition of PI3KCG as anti-colorectal and anti-small cell lung cancer drug candidate

Enteric dysfunction and other factors associated with attained size at 5 years : MAL-ED birth cohort study findings

Funding Information: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the NIH/Fogarty International Center. This work was also supported by the Fogarty International Center, NIH (D43-TW009359 to ETR).Peer reviewe

Telomere length is associated with growth in children in rural Bangladesh

Background: Previously, we demonstrated that a water, sanitation, handwashing, and nutritional intervention improved linear growth and was unexpectedly associated with shortened childhood telomere length (TL) (Lin et al., 2017). Here, we assessed the association between TL and growth. Methods: We measured relative TL in whole blood from 713 children. We reported differences between the 10th percentile and 90th percentile of TL or change in TL distribution using generalized additive models, adjusted for potential confounders. Results: In cross-sectional analyses, long TL was associated with a higher length-for-age Z score at age 1 year (0.23 SD adjusted difference in length-for-age Z score (95% CI 0.05, 0.42; FDR-corrected p-value = 0.01)). TL was not associated with other outcomes. Conclusions: Consistent with the metabolic telomere attrition hypothesis, our previous trial findings support an adaptive role for telomere attrition, whereby active TL regulation is employed as a strategy to address ‘emergency states’ with increased energy requirements such as rapid growth during the first year of life. Although short periods of active telomere attrition may be essential to promote growth, this study suggests that a longer overall initial TL setting in the first two years of life could signal increased resilience against future telomere erosion events and healthy growth trajectories

A review of the corrosion behavior of metallic heritage structures and artifacts

Awareness about restoring and preserving historically important structures and artifacts is gradually growing in many parts of the world. These artifacts and structures represent the culture, tradition and past of a nation. They are often also a source of national income through tourist activities. Besides masonry and wood work, metallic forms and relics are a vital part of the heritage which needs to be conserved. Certain metals have been used significantly throughout history in the creation of objects and structures. However, metals are prone to decay over time, particularly decay through corrosion. The basic mechanisms of metal corrosion, the various types of corrosion and existing remedial solutions are reviewed in this paper. The most significant factor affecting metal corrosion was found to be the surrounding environment, especially in marine areas. Different remedial measures can be implemented on corroded metals according to their specific properties. Recommendations for further study are offered at the end of the paper

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