15 research outputs found

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    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

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    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

    "Analytical study of Islamic architecture during the Mamluk period and how to use them in interior design (Wekalet al Sultan al- Ghouri at Al Azhar district)"

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    The research discusses the problem of loss of identity in the designs on the Arab and Islamic heritage where non-observance of values and aesthetic design of proportions and dimensions and measurements at simulation Heritage styles which could lead to loss of identity design as well as the absence of a design standards help to revive old styles and here we need to answer the following question: What is the extent of the possibility of developing standards and norms to revive old styles and imitated? Through the following: Study design style settings and their impact in the design process. Conclusion and documenting design criteria and values of Mamluke architecture and methods applied to the modern buildings. The Mameluke style heritage values in the work of the internal design of heritage designs. The analysis and assessment of the impact evaluation of existing architectural elements of functional and shape and performance. Study the possibility of reviving the heritage building, commensurate with the values and standards of Mamluke heritage. The study deals with the research and analysis model heritage building, which is " Wekalet al Sultan al- Ghouri at Al Azhar district " because of its historical importance, as it is located within a group architectural built at the end of the Mameluke era due importance to it had been established in the era of Sultan al-Ashraf Abu al-Nasr Qansuh al-Ghouri who took over rule of Egypt from the year 1501 to the year 1516 has been built his important architectural group which Located at the end of the Ghuria Street and take the form of distinctive architectural block, take along one lines appear in all parts of the bloc's architecture. As for Wekalet al Sultan al- Ghouri is regarded as a model for what it was the agencies in that era fortunately, remained large part of it, which helped to repair and return its original El-Wekala was trade centers between the countries which required the presence of suites for visitors coming from different states to Cairo. Wekalet al Sultan al- Ghouri was characterized by the otheres that it has retained most of its elements architecture. This is the agency open Museum of mashrabiya art where the 29 masterpieces mashrabiya. This research paper examines also compared the values of heritage for El-Ghuri group before and after reviving where negatives and positives sides through design criteria style

    Arabic lettering as a Visual Icon in Logo design

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    The Arabic alphabet is considered heritage of civilization and a declarative miracle. it's attached to literature thinking and religion. And once the man invented the shape of letters the writing emerged through civilization. The Arabic letters are characterized by the singular is ability to to be drawn in Multiple and distinctive shapes ranging between flexible and rigid. this special characteristic enabled altering The Familiar shapes of the letters. So, flexibility of these letters was the reason behind the emergence of different styles of Arabic fonts.The Arabic letters was an important mean of education and learning, later it became a manifestation of beauty. so, it has been improved and varied to become an artistic luxury no nation ever reach.it became an art of perfection, from the view of Islamic philosophy to perfection and integrality as synonyms of beauty or as a first witness to itزAs a result of the distinctive characteristics of the Arabic letters such as its flexibility, and formability, being stretched or circled, added corners to it, or overlapped the letters, being connected or separated, all that made it easier to combine them with the abstract symbols which made it possible to restructure the letters as a visual icon and in the field of logo design. On this basis, the care of research is to study how the Arabic letters can be utilised as a visual icon in logo design. by presenting different examples and analyse some of it. And study advantages of the Arabic letters such as flexibility and diverse formations which led it to be an aesthetic visual icon in the field of logo design. The study showed that The utilization of Arabic letters as a visual icon in logo design plays a great role reinforcing the Arabic culture and identity and facing the different foreign cultures, globalization imposed upon the society. In addition to that, The flexibility of the Arabic letter gives it the ability to be shaped in different ways that could serve the purpose of any logo. Because The design of the Arabic letter as a visual icon in logo design combines the verbal and pictorial representation. and The Arabic letter’s shape as a valuable and abstract sole element underlines the aesthetic and functional sides in logo design. The researcher then presents recommendations and references

    Optimal sampling and statistical inferences for Kumaraswamy distribution under progressive Type-II censoring schemes

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    Abstract In this paper, we study non-Bayesian and Bayesian estimation of parameters for the Kumaraswamy distribution based on progressive Type-II censoring. First, the maximum likelihood estimates and maximum product spacings are derived. In addition, we derive the asymptotic distribution of the parameters and the asymptotic confidence intervals. Second, Bayesian estimators under symmetric and asymmetric loss functions (Squared error, linear exponential, and general entropy loss functions) are also obtained. The Lindley approximation and the Markov chain Monte Carlo method are used to derive the Bayesian estimates. Furthermore, we derive the highest posterior density credible intervals of the parameters. We further present an optimal progressive censoring scheme among different competing censoring scheme using three optimality criteria. Simulation studies are conducted to evaluate the performance of the point and interval estimators. Finally, one application of real data sets is provided to illustrate the proposed procedures

    Influence of Irrigation Water Deficit on Forage Yield, and Water Utilization Efficiency for Sorghum and Cowpea Forage Crops

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    The present study was carried out at Sakha Agricultural Research Station (clayey soils) during 2018 and 2019 to find out the role of water deficit on yield and some water relations for sorghum and cowpea summer forage crops. Three irrigation levels were executed; 100% (full irrigation), 90% (10% deficit) and 80% (20% deficit). Results showed that increasing water deficit, markedly led to decreasing fresh, dry yield and plant height at the three cuts in the two seasons. Regarding water relations, irrigation level with 90% (10% deficit) resulted in several advantages; almost same yield as recorded under full irrigation, 10% water saving as well as the highest values of water productivity (WP) and productivity of irrigation water (PIW). The mean values of fresh sorghum forage yield can be arranged in descending order as; 2917.0 &gt; 2857.5 &gt; 2561.0 kg.plot-1, while the corresponding values of the dry weight were; 381.6&gt; 367.8&gt; 319.6 kg.plot-1. Plant height for cowpea slightly affected with different irrigation treatments. On the contrary, both fresh and dry yields were significantly affected with water level or deficit irrigation. Moreover, the effect was highly significant in connection with the combined analysis. In this regard, mean values of fresh yield descending arranged as; 1502.5&gt; 1447.0&gt; 1321.5 kg.plot-1 for treatments A(control), B (90%) and C (80%), respectively. The corresponding values regarding dry yield are 253.5, 241.0 and 215.4 kg.plot-1. Comparing the deficit treatments with the control irrigation (Trt. A), overall mean decrease in fresh yield was 3.7% for treatment B (90%) and 12% for treatment C (80%). While, the corresponding decrease in dry yield were 4.9% and 15.0%.We can conclude that forage yield of sorghum and cowpea &nbsp;not affect by water irrigation deficit about 10% at Middle North Nile Delta area

    Saline-Sodic Soils Treated with Some Soil Amendments and Foliar Application with Compost Tea and Proline for Improvement Some Soil Properties and Yield-Water Productivity of Rice

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    The improvement of saline and sodic soils aims to reduce the dissolved salts in the soil solution. In this context, an integrated management approach is required, which not only improves its effectiveness in improving soil properties but also increases water productivity and yields. To mitigate the negative effects of soil salinity, improvement of soil properties and yield –water productivity of rice plant, a field trial was carried out at El-Hamoul region, Kafer El-Sheikh, Egypt, during the summer seasons of 2019 and 2020. The experiments were conducted in split plot design, with three replicates. The main plots were assigned to soil amendments (control, compost (C) 10.0 Mg ha-1, gypsum (G) 100% from gypsum requirement 13.512 Mg ha-1 and G+C).Sub main plots were assigned to foliar application (control (tap water), compost tea (50 L ha-1), proline (3.6 g ha-1), and combination of compost tea + proilne). Generally, results showed that the impacts of main plots were in the following order: compost + gypsum ˃ gypsum ˃ compost ˃ control in both growing seasons. Also, soil amendments had a significant effect on decreasing some soil chemical properties i.e. pH, EC, ESP and increasing of CEC compared control treatment. The treatment compost +gypsum more pronounced the other treatment on soil bulk density and total porosity. Soil basic infiltration rate (IR) and hydraulic conductivity (K) high significantly increased by application of compost, gypsum and gypsum + compost and recorded the highest value by application of compost + gypsum. Chlorophyll, proline content, 1000-grain weight, straw and grain yield of rice were significant increased and recorded the highest values due to the interaction between compost + gypsum and foliar of compost tea and proline during two growing seasons. Water productivity (WP) and productivity of irrigation water (PIW) for grain yield of rice were high significantly increased and recorded the highest values due to the interaction between soil amendments, compost tea and proline. Total return, net return, benefit cost ratio and total return from water unit for rice yield were significant increased with treatment and recorded highest values due the interaction compost + gypsum and foliar &nbsp;application of compost tea and proline

    Faba Bean Yield and Water Productivity as Affected by Irrigation and Intercropping Systems

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    Irrigation with intensive intercropping, in water scarce region is evaluated and optimized. Water productivity (WP) is taken as an indicator and quantified. A field experiment was carried out in Sakha Agricultural Research Station in Egypt during 2019/2020 and 2020/2021 seasons. A split plot design was applied, main plots were devoted for irrigation treatments of two (I1), three (I2) and four (I3) irrigations. Whereas fennouil, red radish and brassica crops were intercropped with faba bean in the sub-plots. Results showed that the highest yield and yield attributes of faba bean were obtained from irrigation treatment of I3, faba bean with fennouil intercropping and the interaction between faba bean intercropping with fennouil and irrigation treatment of I3 in both seasons. Water consumptive use was increased by 17% and 24% after irrigation treatment of I2 and I3 compared to I1. Applied water were reduced by 21.6% and 8.2% for I1 and I2 compared to I3. The highest value of WP was obtained from the interaction between irrigation treatment I3 and faba bean with fennouil intercropping. It could be concluded that applying the interaction of I1 and faba bean with fennouil intercropping, because it saved significant amount of irrigation water and enhanced water productivity
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