Inducible clindamycin resistance and nasal carriage rates of Staphylococcus aureus among healthcare workers and community members

Background: Nasal carriage of Staphylococcus aureus is becoming an increasing problem among  healthcare workers and community individualsObjectives: To determine the prevalence of methicillin-resistant S. aureus (MRSA) nasal colonization and inducible clindamycin resistance (ICR) of S. aureus among healthcare workers at Soba University Hospital and community members in Khartoum State, Sudan.Methods: Five hundred nasal swabs samples were collected during March 2009 to April 2010. Isolates were identified using conventional laboratory assays and MRSA determined by the disk diffusion method. The D-test was performed for detection of ICR isolates with Clinical Laboratory Standard Institute guidelines.Results: Of the 114 S. aureus isolated, 20.2% represented MRSA. The occurrence of MRSA was  significantly higher among healthcare worker than community individuals [32.7% (18/55) vs. 6.9% (5/59)] (p=0.001). Overall the 114 S. aureus isolates tested for ICR by D-test, 29 (25.4%) yielded inducible resistance. Significantly higher (p=0.026) ICR was detected among MRSA (43.5%) than methicillin-susceptible S. aureus (MSSA) (20.9%).Conclusion: MRSA nasal carriage among healthcare workers needs infection control practice in hospitals to prevent transmission of MRSA. The occurrence of ICR in S. aureus is of a great concern, D- test should be carried out routinely in our hospitals to avoid therapeutic failure.Keywords: S. aureus nasal carriage, healthcare workers, community members, inducible clindamycin resistanc

Can Absence of Cardiac Activity on Point-of-Care Echocardiography Predict Death in Out-of-Hospital Cardiac Arrest?

AimThe purpose of this systematic review and meta-analysis was to evaluate the accuracy of the absence of cardiac motion on point-of-care echocardiography (PCE) in predicting termination of resuscitation (TOR), short-term death (STD), and long-term death (LTD), in adult patients with cardiac arrest of all etiologies in out-of-hospital and emergency department setting.MethodsA systematic review and meta-analysis was conducted based on PRISMA guidelines. A literature search in Medline, EMBASE, Cochrane, WHO registry, and ClinicalTrials.gov was performed from inspection to August 2022. Risk of bias was evaluated using QUADAS-2 tool. Meta-analysis was divided into medical cardiac arrest (MCA) and traumatic cardiac arrest (TCA). Sensitivity and specificity were calculated using bivariate random-effects, and heterogeneity was analyzed using I2 statistic.ResultsA total of 27 studies (3657 patients) were included in systematic review. There was a substantial variation in methodologies across the studies, with notable difference in inclusion criteria, PCE timing, and cardiac activity definition. In MCA (15 studies, 2239 patients), the absence of cardiac activity on PCE had a sensitivity of 72% [95% CI 62–80%] and specificity of 80% [95% CI 58–92%] to predict LTD. Although the low numbers of studies in TCA preluded meta-analysis, all patients who lacked cardiac activity on PCE eventually died.ConclusionsThe absence of cardiac motion on PCE for MCA predicts higher likelihood of death but does not have sufficient accuracy to be used as a stand-alone tool to terminate resuscitation. In TCA, the absence of cardiac activity is associated with 100% mortality rate, but low number of patients requires further studies to validate this finding. Future work would benefit from a standardized protocol for PCE timing and agreement on cardiac activity definition

The role of hepatic progenitor cells in predicting response to therapy in Egyptian patients with chronic hepatitis C, genotype 4

Background: Interferon therapy is used as a line of treatment of chronic hepatitis C virus (HCV) in several areas of the world including Egypt.Objective: Our aim was to investigate the value of hepatic progenitor cells (HPCs) in predicting response of patients with chronic HCV, genotype 4 to pegylated interferon (PEGIFN) plus ribavirin (RBV) therapy.Methods: Pre-treatment liver biopsies obtained from 110 patients with chronic HCV, genotype 4 were examined immunohisto- chemically for HPCs using cytokeratin19. The mean number of HPCs as ductular reaction (DR) and as isolated progenitor cells (IPCs) was counted in each case. The patients were classified into: those with sustained virological response (SVR) and those who did not achieve SVR. The results were compared between the two groups. Also, the relationships between HPCs and other clinico-pathologic variables were estimated using multivariate analysis.Results: The mean number of HPCs was the only independent predictor of therapeutic response, being significantly higher in non-responders (P = 0 for DR and P = 0.03 for IPCs). On the other hand, fibrosis stage and steatosis were the only independent factors which showed a significant direct association with the mean number of HPCs in the form of DR and IPCs (P = 0 for each).Conclusion: The number of HPCs provides prognostic information in chronic HCV since it is significantly associated with stage of fibrosis. More importantly, it can be used as a marker to predict response of patients with chronic HCV to PEGIFN plus RBV therapy.Keywords: Chronic hepatitis C, genotype 4, response to therapy, hepatic progenitor cells

Simple and Realistic Composite Higgs Models in Flat Extra Dimensions

We construct new composite Higgs/gauge-Higgs unification (GHU) models in flat space that overcome all the difficulties found in the past in attempting to construct models of this sort. The key ingredient is the introduction of large boundary kinetic terms for gauge (and fermion) fields. We focus our analysis on the electroweak symmetry breaking pattern and the electroweak precision tests and show how both are compatible with each other. Our models can be seen as effective TeV descriptions of analogue warped models. We point out that, as far as electroweak TeV scale physics is concerned, one can rely on simple and more flexible flat space models rather than considering their unavoidably more complicated warped space counterparts. The generic collider signatures of our models are essentially undistinguishable from those expected from composite Higgs/warped GHU models, namely a light Higgs, colored fermion resonances below the TeV scale and sizable deviations to the Higgs and top coupling.Comment: 30 figures, 9 figures; v2: minor improvements, one reference added, version to appear in JHE

Prognostic scores in brain metastases from breast cancer

<p>Abstract</p> <p>Background</p> <p>Prognostic scores might be useful tools both in clinical practice and clinical trials, where they can be used as stratification parameter. The available scores for patients with brain metastases have never been tested specifically in patients with primary breast cancer. It is therefore unknown which score is most appropriate for these patients.</p> <p>Methods</p> <p>Five previously published prognostic scores were evaluated in a group of 83 patients with brain metastases from breast cancer. All patients had been treated with whole-brain radiotherapy with or without radiosurgery or surgical resection. In addition, it was tested whether the parameters that form the basis of these scores actually have a prognostic impact in this biologically distinct group of brain metastases patients.</p> <p>Results</p> <p>The scores that performed best were the recursive partitioning analysis (RPA) classes and the score index for radiosurgery (SIR). However, disagreement between the parameters that form the basis of these scores and those that determine survival in the present group of patients and many reported data from the literature on brain metastases from breast cancer was found. With the four statistically significant prognostic factors identified here, a 3-tiered score can be created that performs slightly better than RPA and SIR. In addition, a 4-tiered score is also possible, which performs better than the three previous 4-tiered scores, incl. graded prognostic assessment (GPA) score and basic score for brain metastases (BSBM).</p> <p>Conclusion</p> <p>A variety of prognostic models describe the survival of patients with brain metastases from breast cancer to a more or less satisfactory degree. However, the standard brain metastases scores might not fully appreciate the unique biology and time course of this disease, e.g., compared to lung cancer. It appears possible that inclusion of emerging prognostic factors will improve the results and allow for development and validation of a consensus score for broad clinical application. The model that is based on the authors own patient group, which is not large enough to fully evaluate a large number of potential prognostic factors, is meant to illustrate this point rather than to provide the definitive score.</p

Improved Melting of Latent Heat Storage Using Fin Arrays with Non-Uniform Dimensions and Distinct Patterns

Data Availability Statement: Not applicable.Copyright: © 2022 by the authors. Employing phase-change materials (PCM) is considered a very efficient and cost-effective option for addressing the mismatch between the energy supply and the demand. The high storage density, little temperature degradation, and ease of material processing register the PCM as a key candidate for the thermal energy storage system. However, the sluggish response rates during their melting and solidification processes limit their applications and consequently require the inclusion of heat transfer enhancers. This research aims to investigate the potential enhancement of circular fins on intensifying the PCM thermal response in a vertical triple-tube casing. Fin arrays of non-uniform dimensions and distinct distribution patterns were designed and investigated to determine the impact of modifying the fin geometric characteristics and distribution patterns in various spatial zones of the heat exchanger. Parametric analysis on the various fin structures under consideration was carried out to determine the most optimal fin structure from the perspective of the transient melting evolution and heat storage rates while maintaining the same design limitations of fin material and volume usage. The results revealed that changing the fin dimensions with the heat-flow direction results in a faster charging rate, a higher storage rate, and a more uniform temperature distribution when compared to a uniform fin size. The time required to fully charge the storage system (fully melting of the PCM) was found to be reduced by up to 10.4%, and the heat storage rate can be improved by up to 9.3% compared to the reference case of uniform fin sizes within the same fin volume limitations.Funding: This research received no external funding

Clinical map document based on XML (cMDX): document architecture with mapping feature for reporting and analysing prostate cancer in radical prostatectomy specimens

<p>Abstract</p> <p>Background</p> <p>The pathology report of radical prostatectomy specimens plays an important role in clinical decisions and the prognostic evaluation in Prostate Cancer (PCa). The anatomical schema is a helpful tool to document PCa extension for clinical and research purposes. To achieve electronic documentation and analysis, an appropriate documentation model for anatomical schemas is needed. For this purpose we developed cMDX.</p> <p>Methods</p> <p>The document architecture of cMDX was designed according to Open Packaging Conventions by separating the whole data into template data and patient data. Analogue custom XML elements were considered to harmonize the graphical representation (e.g. tumour extension) with the textual data (e.g. histological patterns). The graphical documentation was based on the four-layer visualization model that forms the interaction between different custom XML elements. Sensible personal data were encrypted with a 256-bit cryptographic algorithm to avoid misuse. In order to assess the clinical value, we retrospectively analysed the tumour extension in 255 patients after radical prostatectomy.</p> <p>Results</p> <p>The pathology report with cMDX can represent pathological findings of the prostate in schematic styles. Such reports can be integrated into the hospital information system. "cMDX" documents can be converted into different data formats like text, graphics and PDF. Supplementary tools like cMDX Editor and an analyser tool were implemented. The graphical analysis of 255 prostatectomy specimens showed that PCa were mostly localized in the peripheral zone (Mean: 73% ± 25). 54% of PCa showed a multifocal growth pattern.</p> <p>Conclusions</p> <p>cMDX can be used for routine histopathological reporting of radical prostatectomy specimens and provide data for scientific analysis.</p

The role of hepatic progenitor cells in predicting response to therapy in Egyptian patients with chronic hepatitis C, genotype 4

Background: Interferon therapy is used as a line of treatment of chronic hepatitis C virus (HCV) in several areas of the world including Egypt. Objective: Our aim was to investigate the value of hepatic progenitor cells (HPCs) in predicting response of patients with chronic HCV, genotype 4 to pegylated interferon (PEGIFN) plus ribavirin (RBV) therapy. Methods: Pre-treatment liver biopsies obtained from 110 patients with chronic HCV, genotype 4 were examined immunohistochemically for HPCs using cytokeratin19. The mean number of HPCs as ductular reaction (DR) and as isolated progenitor cells (IPCs) was counted in each case. The patients were classified into: those with sustained virological response (SVR) and those who did not achieve SVR. The results were compared between the two groups. Also, the relationships between HPCs and other clinico-pathologic variables were estimated using multivariate analysis. Results: The mean number of HPCs was the only independent predictor of therapeutic response, being significantly higher in non-responders (P = 0 for DR and P = 0.03 for IPCs). On the other hand, fibrosis stage and steatosis were the only independent factors which showed a significant direct association with the mean number of HPCs in the form of DR and IPCs (P = 0 for each). Conclusion: The number of HPCs provides prognostic information in chronic HCV since it is significantly associated with stage of fibrosis. More importantly, it can be used as a marker to predict response of patients with chronic HCV to PEGIFN plus RBV therapy. DOI: https://dx.doi.org/10.4314/ahs.v19i1.14 Cite as: Helal T El A, Radwan NA, Mahmoud HA, Zaki AME, Ahmed NS, Wahib AAA, et al. The role of hepatic progenitor cells in predicting response to therapy in Egyptian patients with chronic hepatitis C, genotype 4. Afri Health Sci. 2019;19(1). 1411-1421. https://dx.doi.org/10.4314/ahs.v19i1.1

Annealing study and thermal investigation on bismuth sulfide thin films prepared by chemical bath deposition in basic medium

This is a post-peer-review, pre-copyedit version of an article published in Applied Physics A 124.2 (2018): 166. The final authenticated version is available online at: http://doi.org/10.1007/s00339-018-1584-7Bismuth sulfide thin films were prepared by chemical bath deposition using thiourea as sulfide ion source in basic medium. First, the effects of both the deposition parameters on films growth as well as the annealing effect under argon and sulfur atmosphere on as-deposited thin films were studied. The parameters were found to be influential using the Doehlert matrix experimental design methodology. Ranges for a maximum surface mass of films (3 mg cm-2) were determined. A well crystallized major phase of bismuth sulfide with stoichiometric composition was achieved at 190°C for 3 hours. The prepared thin films were characterized using Grazing Incidence X-ray diffraction (GIXRD), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray analysis (EDX). Second, the band gap energy value was found to be 1.5 eV. Finally, the thermal properties have been studied for the first time by means of the electropyroelectric (EPE) technique. Indeed, the thermal conductivity varied in the range of 1.20 - 0.60 W m-1 K-1 while the thermal diffusivity values increased in terms of the annealing effect ranging from 1.8 to 3.5 10-7 m2s-1This work was financially supported by the Tunisian Ministry of Higher Education and Scientific Research and by the WINCOST (ENE2016-80788-C5-2-R) project funded by the Spanish Ministry of Economy and Competitivenes

Chrysolina herbacea Modulates Terpenoid Biosynthesis of Mentha aquatica L.

Interactions between herbivorous insects and plants storing terpenoids are poorly understood. This study describes the ability of Chrysolina herbacea to use volatiles emitted by undamaged Mentha aquatica plants as attractants and the plant's response to herbivory, which involves the production of deterrent molecules. Emitted plant volatiles were analyzed by GC-MS. The insect's response to plant volatiles was tested by Y-tube olfactometer bioassays. Total RNA was extracted from control plants, mechanically damaged leaves, and leaves damaged by herbivores. The terpenoid quantitative gene expressions (qPCR) were then assayed. Upon herbivory, M. aquatica synthesizes and emits (+)-menthofuran, which acts as a deterrent to C. herbacea. Herbivory was found to up-regulate the expression of genes involved in terpenoid biosynthesis. The increased emission of (+)-menthofuran was correlated with the upregulation of (+)-menthofuran synthase