Wall panel structure design optimization of a hexagonal satellite

Considering that it satisfies high strength and stiffness at a low weight, the grid structure is the ideal option for meeting the requirements for developing the wall panel structure for the satellite. The most attractive grid structures for the satellite wall panel industry are isogrid and honeycomb structures. The first part of this work involves studying the mechanical and dynamic performance of five designs for the satellite wall panel made of 7075-T0 Al-alloy. These designs include two isogrid structures with different rib widths, two honeycomb structures with different cell wall thicknesses, and a solid structure for comparison. The performance of these designs was evaluated through compression, bending, and vibration testing using both finite element analysis (FEA) with the Ansys workbench and experimental testing. The FEA results are consistent with the experimental ones. The results show that the isogrid structure with a lower rib thickness of 2 mm is the best candidate for manufacturing the satellite wall panel, as this design reveals the best mechanical and dynamic performance. The second part of this work involves studying the influence of the length of the sides of the best isogrid structure in the range of 12 mm–24 mm on its mechanical and dynamic performance to achieve the lowest possible mass while maintaining the structure's integrity. Then, a modified design of skinned wall panels was introduced and dynamically tested using FEA. Finally, a CAD model of a hexagonal satellite prototype using the best-attained design of the wall panel, i.e., the isogrid structure with a 2 mm rib width and 24 mm-long sides, was built and dynamically tested to ensure its safe design against vibration. Then, the satellite prototype was manufactured, assembled, and successfully assessed

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Green chemistry approach for preparation of hydrogels for agriculture applications through modification of natural polymers and investigating their swelling properties

Two sets of hydrogel materials based on guar gum were prepared by grafting guar gum onto acrylic acid/acrylamide and acrylic acid/N-isopropylacrylamide copolymers by using persulphate radical as an initiator and N,N′ methylenebisacrylamide as a cross linker. The prepared hydrogels were denoted as AA-AcM-GG and AA-NIPAM-GG respectively. They were characterized by FTIR Spectroscopy and SEM. The effect of some composition variables on the swelling performance of PA-GG hydrogel was thoroughly studied. Furthermore, swelling behavior was monitored as a function of temperature and electrolyte concentration. A lab experiment was carried out in order to investigate the effect of the optimum hydrogels on the growth of guava plant. Keywords: Guar gum, Acrylate, N-isopropyl acryl amide, Green hydrogels, Temperature sensitive, Salt sensitiv

Synthesis and X-ray Crystal Structure Analysis of Substituted 1,2,4-Triazolo [4’,3’:2,3]pyridazino[4,5-b]indole and Its Precursor

The hit compound 1,2,4-triazolo[4’,3’:2,3]pyridazino[4,5-b]indole 3 was synthesized from the reflux of 4-amino-5-indolyl-1,2,4-triazole-3-thione 1 with 4′-bromoacetophenone 2 in methanol catalyzed by concentrated HCl and the desired final molecule was obtained by recrystallization from methanol. The suggested structures of compounds 1 and 3 based on the spectral characterizations were confirmed by X-ray single crystal diffraction analysis. Compound 3 crystallized in the triclinic crystal system and P-1 space group with a = 5.9308(2) Å, b = 10.9695(3) Å, c = 14.7966(4) Å, α = 100.5010(10)°, β = 98.6180(10)°, and γ = 103.8180(10)°. On the other hand, the crystal system of 1 is monoclinic, where a = 6.23510(10) Å, b = 26.0156(4) Å, c = 12.4864(2) Å, β = 93.243(2)° and the space group is P21. The triazole and indole rings are found twisted from each other in both compounds. The twist angle is higher in 3 (12.65°) than 1 (4.94–7.22°). In the case of the former, the H…H (39.6%), H…C (22.0%), N…H (12.8%) and Br…H (13.2%) contacts are the most dominant while the C…C, C…H, Br…H, N…H and S…S contacts have the characteristics of strong interactions. In the latter, the C…H, N…H, S…H, S…S, and C…C contacts are the most important. In this case, the percentages of the H…H, C…H, N…H and S…H contacts are in the range of 34.9–37.4, 20.5–24.0, 12.2–13.6, 14.0–15.8, respectively. In both systems, the shape index and curvedness of surfaces confirmed the presence of π–π stacking interactions.peerReviewe

Wall panel structure design optimization of a hexagonal satellite

Considering that it satisfies high strength and stiffness at a low weight, the grid structure is the ideal option for meeting the requirements for developing the wall panel structure for the satellite. The most attractive grid structures for the satellite wall panel industry are isogrid and honeycomb structures. The first part of this work involves studying the mechanical and dynamic performance of five designs for the satellite wall panel made of 7075-T0 Al-alloy. These designs include two isogrid structures with different rib widths, two honeycomb structures with different cell wall thicknesses, and a solid structure for comparison. The performance of these designs was evaluated through compression, bending, and vibration testing using both finite element analysis (FEA) with the Ansys workbench and experimental testing. The FEA results are consistent with the experimental ones. The results show that the isogrid structure with a lower rib thickness of 2 mm is the best candidate for manufacturing the satellite wall panel, as this design reveals the best mechanical and dynamic performance. The second part of this work involves studying the influence of the length of the sides of the best isogrid structure in the range of 12 mm–24 mm on its mechanical and dynamic performance to achieve the lowest possible mass while maintaining the structure’s integrity. Then, a modified design of skinned wall panels was introduced and dynamically tested using FEA. Finally, a CAD model of a hexagonal satellite prototype using the best-attained design of the wall panel, i.e., the isogrid structure with a 2 mm rib width and 24 mm-long sides, was built and dynamically tested to ensure its safe design against vibration. Then, the satellite prototype was manufactured, assembled, and successfully assessed

Factors influencing decision making regarding the acceptance of the COVID-19 vaccination in Egypt: A cross-sectional study in an urban, well-educated sample

Background: The COVID-19 pandemic has raised the necessity to rapidly develop safe and effective vaccines to limit the spread of infections. Meanwhile, vaccine hesitancy is a significant barrier to community vaccination strategies. Methods: An internet-based cross-sectional survey was conducted from March to April 2021 during the start of the vaccination campaigns. Results: A total of 1009 subjects participated, and the mean age (±SD) was 29.11 ± 8.2 years. Among them, 68.8% believed that vaccination is an effective method to control the spread of the disease, 81.2% indicated acceptance of the vaccine, and 87.09% reported that their doctor’s recommendation was essential for decision making. After adjusting for socioeconomic characteristics, rural residency (AOR 1.783, 95%CI: 1.256–2.531), working a part-time job (AOR 2.535, 95%CI: 1.202–5.343) or a full-time job (AOR 1.951, 95%CI: 1.056–3.604), being a student (AOR 3.516, 95%CI: 1.805–6.852) and having a partner (AOR 1.457, 95%CI: 1.062–2.00) were significant predictors for higher vaccine acceptance among the study participants. Believing in the vaccine’s efficacy showed the strongest correlation with vaccine acceptance (Spearman’s r = 0.309, p < 0.001). Conclusions: Although general vaccine acceptance is high (32.85%) in participants in our study, gender and geographic disparities were observed in the investigated urban population of young, well-educated Egyptian

Mental health, risk perception, and coping strategies among healthcare workers in Egypt during the COVID-19 pandemic.

BackgroundCoronavirus disease-19 emerged in December 2019. Healthcare workers were exposed to this highly infectious virus during the pandemic and suffered several social and psychological consequences, such as anxiety, psychological distress, and burnout.ObjectivesTo assess the psychological distress, anxiety, depression, coping strategies, risk perception, and attitude toward interprofessional teamwork among Egyptian healthcare workers during the COVID-19 pandemic.MethodsWe conducted a cross-sectional online survey which consisted of five sections. The primary outcomes were anxiety (GAD-7), depression (PHQ-9), risk perception towards COVID-19, interprofessional teamwork attitude, and coping strategies during the Coronavirus disease-19 pandemic. The web-based questionnaire was distributed to Egyptian healthcare workers from the 20th of April 2020 to the 20th of May 2020. A snowball sampling method was used. Regression analysis was conducted to test the relationship between the socioeconomic characteristics and the previously mentioned outcomes.ResultsA total of 403 participants responded to the online questionnaire. The majority were females (70.5%) and within the age group of 26-40 years (77.7%), with 2-5 years of work experience (43.2%). Most participants were pharmacists (33%) and physicians (22.1%). Eighty-two participants (21%) reported moderate to severe anxiety, and 79 participants reported (19.4%) moderate to severe depressive symptoms. In the univariate model, the marital status was associated with depression (OR 0.47, 95% CI 0.28-0.78), anxiety (OR 0.52, 95% CI 0.32-0.85), and an attitude toward interprofessional teamwork (β = -1.96 95% CI -2.72 to -1.2). Providing direct care to the patients was associated with lower anxiety symptoms (AOR 0.256, 95% CI 0.094-0.697). More severe anxiety and depressive symptoms were associated with difficulties in everyday life and the professional work environment (AOR 4.246 and 3.3, P = 0.003 and 0.01, respectively). Availability of mental health facilities at the workplace was associated with a lower risk perception towards COVID-19 (β = -0.79, 95% CI -1.24 to -0.34) and a more positive attitude towards teamwork (β = 2.77 95% CI 1.38-4.15).ConclusionsAccording to our results, the COVID-19 pandemic was associated with mild anxiety and depression among healthcare workers in Egypt, especially pharmacists and physicians. We recommend more research targeting the mental health of healthcare workers in Egypt. If proven cost-effective and needed, wide-scale mental health screening and public health campaigns can facilitate effective prevention and treatment strategies. In addition, the availability of mental health facilities at the workplace could alleviate some of the risk perception associated with health emergencies and improve interprofessional teamwork

The effect of dietary Crataegus Sinaica on the growth performance, immune responses, hemato-biochemical and oxidative stress indices, tissues architecture, and resistance to Aeromonas sobria infection of acrylamide-exposed Clarias gariepinus

This study investigated the effect of using a natural dietary supplement of Crataegus Sinaica (CS) to mitigate the negative impacts of waterborne acrylamide (ACR) on the health and performance of freshwater fish, African catfish (Clarias gariepinus). For this aim, 270 fish were divided into six groups (45 fish/group). Three groups were kept in non-contaminated water and fed a non-fortified basal diet, 1% CS, and 2% CS. The other three groups were exposed to ACR (26.6 mg/L water) and fed a basal diet, 1% CS, and 2% CS. After 60 days, the growth performance, liver and kidney function, stress indicators, oxidative stress indices, immunological response, vital tissue architecture, and resistance to Aeromonas sobria have been evaluated. Results indicated that CS dietary supplementation (1% and 2% CS) significantly counteracted ACR-induced reduced growth and survival. Furthermore, both CS dietary supplementation significantly balanced the ACR-induced leukopenia, anemia, hypoalbuminemia, hypoglobulinemia, and hypoproteinemia. Likewise, 1% and 2% CS addition to the ACR-exposed fish diets significantly reduced the ACR-induced increase in serum enzymes, bilirubin, renal damage products, hyperglycemia, and cortisol. Instead, the ACR-evoked depletion of antioxidant (glutathione peroxidase, superoxide dismutase, catalase, and reduced glutathione) and innate immune (lysozyme, complement3, and nitric oxide) components were significantly restored by both CS dietary supplementation. Besides, the ACR-induced pathological alterations in hepatic, renal, and splenic tissues were considerably lessened by CS. Besides, the reduced disease resistance of ACR-exposed fish was restored when challenged with A.sobria in a fish-fed 1% and 2% CS-fortified diet. Noteworthy, the inclusion of 2% CS produced better results than 1%. Overall, feeding C. gariepinus a diet supplemented with 2% CS significantly improved the fish's overall health, growth, and disease resistance, despite the ACR water pollution that consequently would sustain aquaculture