A neonate with upper GI bleeding

Bleeding in the newborn is often a serious problem because of cardiovascular effects associated with a loss of blood and/or the damaging effects of bleeding on neonatal tissues, especially the brain. Gastric polyps are described as abnormal lesions that originate in the gastric epithelium or submucosa and protrude into the stomach lumen. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding. However, acute gastrointestinal bleeding in association with hyperplastic gastric polyps has been reported very rarely. We report a case of unusual upper gastrointestinal bleeding in newborn baby on 2nd day of life, secondary to gastric polyp, which was diagnosed and resected through endoscopy

Mechanical and comfort properties of Hydroentangled nonwovens from comber noil

Cotton fibre is one of the most important commodity fibre and is widely employed in apparels. At present, the share of natural fibres in production of nonwoven fabrics is low and employed in opt applications. The cotton fibre is conventionally converted into woven and knitted fabrics by short staple spinning methods. The comber noil is short fibre waste during production of combed cotton yarns. The aims of the current study were to employ comber noil for preparation of Hydroentangled cotton nonwovens at varying water jet pressures and conveyor speeds. The effect of these parameters is studied with respect to mechanical and comfort properties of prepared fabrics. The results showed that these variables can help to manufacture fibrous assemblies with engineered properties according to required application area

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

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 middle-income 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 low-income 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 low-income, 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

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

Predicting strength transfer efficiency of warp and weft yarns in woven fabrics using adaptive neuro-fuzzy inference system

310-316The application of adaptive neuro-fuzzy inference system for the prediction of strength transfer efficiencies of warp and weft yarns in woven fabrics has been studied. The developed neuro-fuzzy models are based on the input-output data sets of 264 woven fabric samples, out of which the data of 234 samples are used for developing the prediction models while data of 30 samples are used for models’ validation. The developed models are capable of predicting the warp and weft yarns strength transfer efficiencies quite accurately, given the strength of constituent yarns, the fabric count and the float length

EFFECT OF FABRIC COUNT ON THE TENSILE STRENGTH OF BLENDED WOVEN FABRICS

This study was undertaken to investigate the effect of fabric count on the tensile strength of polyester/cotton blended fabrics. Two sets of fabrics were prepared in this study: one with simultaneous increase in ends and picks and another with increasing number of picks /25mm while keeping the ends/25mm constant.Subsequently, the effect of increase in ends and picks was evaluated in quantitative terms. It was concluded that the tensile strength of a fabric is increased in both directions when fabric count is increased either in one direction or in both directions. However, the increase in tensile strength with increase in fabric countis not strictly linear. The higher the fabric count, the better is the transfer efficiency of yarn strength into fabric strength

MEASURING SERVICE QUALITY PERCEPTIONS OF THE CUSTOMERS OF RESTAURANTS IN PAKISTAN

This study aims to descriptively analyze different service quality attributes and ranking of services in renowned and successful restaurants. A sample of 407 customers of 10 reputed restaurants was gathered, operating in vicinity of twin cities of Islamabad and Rawalpindi of Pakistan, using abilingual survey instrument to measure service quality perceptions of customers.Five service quality attributes of restaurant staff, tips, tangibles, convenience, and food quality were used and their relationship with overall satisfaction was measured. Besides, key reasons to visit a restaurant were also inquired. Majority of the participants was comprised of private sector employees and students. Results of current study will be beneficial for the restaurants' managers in knowing customers evaluations and formulating future strategies accordingly

Determining the light transmission of woven fabrics through different measurement methods and its correlation with air permeability

The study aims to present a relationship between air permeability of woven fabrics and their light transmission properties. Polyester / cotton (48:52) blended woven fabrics were utilized in the study. Air permeability is measured using the standard test method already established while the light transmission through the fabric is measured by means of two different methods. One method is based on measurement of light transmitted from a back lit fabric by means of a light sensor. The second method is based on image processing techniques which require a digital back lit image of fabric and an algorithm is applied to measure the amount of light transmitted through it. Results from both methods are compared and correlated with the air permeability and porosity of woven fabrics. Analysis shows that the results from former method have a stronger and more significant relationship with air permeability of woven fabrics comparatively. © 2014, Association Nonwoven Fabrics Industry. All rights reserved

Tracing down the Updates on Dengue Virus—Molecular Biology, Antivirals, and Vaccine Strategies

Background: Nearly half of the world is at risk of developing dengue infection. Dengue virus is the causative agent behind this public healthcare concern. Millions of dengue cases are reported every year, leading to thousands of deaths. The scientific community is working to develop effective therapeutic strategies in the form of vaccines and antiviral drugs against dengue. Methods: In this review, a methodological approach has been used to gather data from the past five years to include the latest developments against the dengue virus. Results: Different therapeutics and antiviral targets against the dengue virus are at different stages of development, but none have been approved by the FDA. Moreover, various vaccination strategies have also been discussed, including attenuated virus vaccines, recombinant subunit vaccines, viral vector vaccines, DNA vaccines, nanotechnology, and plant-based vaccines, which are used to develop effective vaccines for the dengue virus. Many dengue vaccines pass the initial phases of evaluation, but only two vaccines have been approved for public use. DENGVAXIA is the only FDA-approved vaccine against all four stereotypes of the dengue virus, but it is licensed for use only in individuals 6–16 years of age with laboratory-confirmed previous dengue infection and living in endemic countries. Takeda is the second vaccine approved for use in the European Union, the United Kingdom, Brazil, Argentina, Indonesia, and Thailand. It produced sustained antibody responses against all four serotypes of dengue virus, regardless of previous exposure and dosing schedule. Other dengue vaccine candidates at different stages of development are TV-003/005, TDENV PIV, V180, and some DNA vaccines. Conclusion: There is a need to put more effort into developing effective vaccines and therapeutics for dengue, as already approved vaccines and therapeutics have limitations. DENGVAXIA is approved for use in children and teenagers who are 6–16 years of age and have confirmed dengue infection, while Takeda is approved for use in certain countries, and it has withdrawn its application for FDA approval

Narrowband Internet of Things (NB-IoT): From Physical (PHY) and Media Access Control (MAC) Layers Perspectives

Narrowband internet of things (NB-IoT) is a recent cellular radio access technology based on Long-Term Evolution (LTE) introduced by Third-Generation Partnership Project (3GPP) for Low-Power Wide-Area Networks (LPWAN). The main aim of NB-IoT is to support massive machine-type communication (mMTC) and enable low-power, low-cost, and low-data-rate communication. NB-IoT is based on LTE design with some changes to meet the mMTC requirements. For example, in the physical (PHY) layer only single-antenna and low-order modulations are supported, and in the Medium Access Control (MAC) layers only one physical resource block is allocated for resource scheduling. The aim of this survey is to provide a comprehensive overview of the design changes brought in the NB-IoT standardization along with the detailed research developments from the perspectives of Physical and MAC layers. The survey also includes an overview of Evolved Packet Core (EPC) changes to support the Service Capability Exposure Function (SCEF) to manage both IP and non-IP data packets through Control Plane (CP) and User Plane (UP), the possible deployment scenarios of NB-IoT in future Heterogeneous Wireless Networks (HetNet). Finally, existing and emerging research challenges in this direction are presented to motivate future research activities