Nonatonic obstetric haemorrhage: effectiveness of the nonpneumatic antishock garment in egypt.

The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss > 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P < 0.0001). EAO decreased with use of the garment (2.9% versus 4.4%, (OR 0.65, 95% CI 0.24-1.76)). In conclusion, using the NASG improved maternal outcomes despite the worse condition on study entry. These findings should be tested in larger studies

Anemia in Kassala Area Eastern Sudan

ObjectiveThe objective of this study was to determine the types and the ways of diagnosis of anemia at Kassala region, Sudan.MethodsIn this study we examined and investigate 210 patients with anemia.Full blood cell count including peripheral picture, blood film for malaria, urine analysis and stool examination were done for every patient.Bone marrow aspiration was done for patients with splenomegaly with or without pancytopenia and or presence of immature cells in the peripheral blood. Serum iron and serum ferritin, for confirmation of iron deficiency were measured in some patients.ResultsOut of all patients, 45(21%) had chronic illness, 42(20%) had history of repeated attacks of malaria and 3(18%) patients had nutritional anemia.Sixty three (30%) patients presented with severe anemia, 32(15%) with mild anemia and 115(55%) with moderate anemia. Eighty patients presented with enlarge spleen. 26 (33%) out of the latter group had features of hypersplenism.ConclusionCommon causes of anemia in this area were chronic illness, followed by nutritional and repeated malaria infection. Splenomegaly and  hypersplenism are common. We recommended that full blood count, peripheral blood picture and estimation of serum iron andserum ferritin should be performed for every anaemic patient. Blood film for malaria should be done for every anaemic patient and negative films should be repeated by immunochromatography test for plasmodium falciparum and vivax.Keywords: Splenomegaly, hypersplenism, immunochromatography, malaria

Students' and teachers' perceptions of clinical assessment program: A qualitative study in a PBL curriculum

<p>Abstract</p> <p>Background</p> <p>"Examinations drive students' learning." This statement refers to what is assumed to be one of the strongest relationships in education. We explored in this research how and why students differ in their approaches to learning, how assessment affects deep learning, and which barriers stand in the way of good assessment and learning in the clinical years of a Problem Based Learning (PBL) graduate entry medical curriculum.</p> <p>Findings</p> <p><b>Method: </b>We conducted a qualitative, phenomenological study using semi-structured group interviews with students and semi-structured individual interviews with teachers and students. The transcripts were analyzed, and themes were identified.</p> <p><b>Setting</b>: The research was conducted at the King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia from November 2007 to March 2008.</p> <p><b>Results: </b>A total of 28 students participated in 7 focus group interviews. Semi-structured individual interviews were conducted with 12 teachers and 12 students. The analysis yielded four themes: summative assessment, formative assessment, continuous assessment of clinical attachments, and learning objectives.</p> <p>Conclusions</p> <p>The results of this study confirm that assessment affects students' perceptions of learning and how they learn. These effects are not uniformly positive. According to the students, the predominantly summative assessment program offers little inducement to engage in deep learning. They express a clear preference for formative assessment, which may foster a deeper approach to learning. Efforts to achieve more clinically relevant assessment with adequate balance between the various types of assessment are required. Research is needed to decide this balance.</p

Efficient Photoelectrochemical Performance of Gamma Irradiated gC3N4 and its g-C3N4@BiVO4 Heterojunction for Solar Water Splitting

This is the author accepted manuscript. The final version is available from the American Chemical Society via the DOI in this recordComprehensive experimental and density functional theory simulations have been performed for the enhanced photoelectrochemical performance of gamma irradiated g-C3N4 and its heterojunction with BiVO4. The structure and morphology of g-C3N4@BiVO4 as a heterojunction were analyzed and verified from the correlation of experimental and theoretical data. It is found that gamma radiations have changed the bonding structure of g-C3N4 which ultimately reduces the optical bandgap energy. Moreover, the performance of gamma-irradiated g-C3N4 is two-fold, compared to that of non-irradiated one; increases from 3.59 to 5.86 µAcm-2 at 1.23 V versus Ag/AgCl in 0.5 M Na2SO4 electrolyte solution (pH 7). Finally, it is observed that the performance of gamma irradiated g-C3N4 in g-C3N4@BiVO4 heterojunction increased from 0.53 mA cm-2 to 1.38 mA cm-2, compared to that of the non–irradiated one. In summary, it has been concluded that gamma-irradiated g-C3N4 and its heterojunction is potentially be applied in PEC solar water splitting.National University of Malaysi

Integrated Heat Regenerator (IHR) Designs with Hydrogen Preheater and Thermoelectric Generator for Power Enhancement of a 2 kW Fuel Cell Vehicle

The power train efficiency of fuel cell vehicles (FCV) can be enhanced by improving the hydrogen energy utilization. Based on a mini FCV running on a 2 kW open-cathode Polymer Electrolyte Membrane (PEM) fuel cell, a waste heat recovery system design needs to be developed as an approach towards higher energy efficiency. The novelty of the system is on the integration of thermoelectric generator technology with hydrogen preheating process for a combined heat and power output. This manuscript presents the proposed integrated heat regenerator (IHR) designs, analysed using numerical computational modelling. Three IHR designs were proposed where the main design criteria are (i) a minimum of 10oC hydrogen preheating degree, and (ii) non-parasitic active cooling for the TEG cells. Three design concepts were studied to identify its design and performance limitations. The numerical results were validated with theoretical modelling analysis for hydrogen exit temperatures and TEG surface temperatures. The analysis on predicted fuel cell power enhancement, TEG power generation and waste heat utilization were performed by relating the temperature profiles of the hydrogen reactant and TEG surfaces to fuel cell reaction models and TEG power relationships. A compact IHR design that produced 7.7 to 8 % total power enhancement and suitable in size for a mini FCV was identified for future development work

Insights Into the Immune Response of the Black Soldier Fly Larvae to Bacteria

In insects, a complex and effective immune system that can be rapidly activated by a plethora of stimuli has evolved. Although the main cellular and humoral mechanisms and their activation pathways are highly conserved across insects, the timing and the ef\ufb01cacy of triggered immune responses can differ among different species. In this scenario, an insect deserving particular attention is the black soldier \ufb02 y (BSF), Hermetia illucens (Diptera: Stratiomyidae). Indeed, BSF larvae can be reared on a wide range of decaying organic substrates and, thanks to their high protein and lipid content, they represent a valuable source of macromolecules useful for different applications (e.g., production of feedstuff, bioplastics, and biodiesel), thus contributing to the development of circular economy supply chains for waste valorization. However, decaying substrates bring the larvae into contact with different potential pathogens that can challenge their health status and growth. Although these life strategies have presumably contributed to shape the evolution of a sophisticated and ef \ufb01 cient immune system in this dipteran, knowledge about its functional features is still fragmentary. In the present study, we investigated the processes underpinning the immune response to bacteria in H. illucens larvae and characterized their reaction times. Our data demonstrate that the cellular and humoral responses in this insect show different kinetics: phagocytosis and encapsulation are rapidly triggered after the immune challenge, while the humoral components intervene later. Moreover, although both Gram-positive and Gram-negative bacteria are completely removed from the insect body within a few hours after injection, Gram-positive bacteria persist in the hemolymph longer than do Gram-negative bacteria. Finally, the activity of two key actors of the humoral response, i.e., lysozyme and phenoloxidase, show unusual dynamics as compared to other insects. This study represents the \ufb01 rst detailed characterization of the immune response to bacteria of H. illucens larvae, expanding knowledge on the defense mechanisms of this insect among Diptera. This information is a prerequisite to manipulating the larval immune response by nutritional and environmental factors to increase resistance to pathogens and optimize health status during mass rearing

The Trail Pheromone of the Venomous Samsum Ant, Pachycondyla sennaarensis

Ant species use branching networks of pheromone trails for orientation between nest and resources. The current study demonstrated that workers of the venomous samsum ant, Pachycondyla sennaarensis (Mayr) (Hymenoptera: Formicidae: Ponerinae), employ recruitment trail pheromones discharged from the Dufour's gland. Secretions of other abdomen complex glands, as well as hindgut gland secretions, did not evoke trail following. The optimum concentration of trail pheromone was found to be 0.1 gland equivalent/40 cm trail. This concentration demonstrated effective longevity for about one hour. This study also showed that P. sennaarensis and Tapinoma simrothi each respond to the trail pheromones of the other species as well as their own

Modulation of Sn concentration in ZnO nanorod array: intensification on the conductivity and humidity sensing properties

Tin (Sn)-doped zinc oxide (ZnO) nanorod arrays (TZO) were synthesized onto aluminum-doped ZnO-coated glass substrate via a facile sonicated sol–gel immersion method for humidity sensor applications. These nanorod arrays were grown at different Sn concentrations ranging from 0.6 to 3 at.%. X-ray diffraction patterns showed that the deposited TZO arrays exhibited a wurtzite structure. The stress/strain condition of the ZnO film metamorphosed from tensile strain/compressive stress to compressive strain/tensile stress when the Sn concentrations increased. Results indicated that 1 at.% Sn doping of TZO, which has the lowest tensile stress of 0.14 GPa, generated the highest conductivity of 1.31 S cm− 1. In addition, 1 at.% Sn doping of TZO possessed superior sensitivity to a humidity of 3.36. These results revealed that the optimum performance of a humidity-sensing device can be obtained mainly by controlling the amount of extrinsic element in a ZnO film

Obstetric hemorrhage and shock management: using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities

Abstract Background Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG) is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings. Methods This study employed a pre-intervention/intervention design in four facilities in Nigeria and two in Egypt. Primary outcomes were measured mean and median blood loss, severe end-organ failure morbidity (renal failure, pulmonary failure, cardiac failure, or CNS dysfunctions), mortality, and emergency hysterectomy for 1442 women with ≥750 mL blood loss and at least one sign of hemodynamic instability. Comparisons of outcomes by study phase were assessed with rank sum tests, relative risks (RR), number needed to treat for benefit (NNTb), and multiple logistic regression. Results Women in the NASG phase (n = 835) were in worse condition on study entry, 38.5% with mean arterial pressure &lt;60 mmHg vs. 29.9% in the pre-intervention phase (p = 0.001). Despite this, negative outcomes were significantly reduced in the NASG phase: mean measured blood loss decreased from 444 mL to 240 mL (p &lt; 0.001), maternal mortality decreased from 6.3% to 3.5% (RR 0.56, 95% CI 0.35-0.89), severe morbidities from 3.7% to 0.7% (RR 0.20, 95% CI 0.08-0.50), and emergency hysterectomy from 8.9% to 4.0% (RR 0.44, 0.23-0.86). In multiple logistic regression, there was a 55% reduced odds of mortality during the NASG phase (aOR 0.45, 0.27-0.77). The NNTb to prevent either mortality or severe morbidity was 18 (12-36). Conclusion Adding the NASG to standard shock and hemorrhage management may significantly improve maternal outcomes from hypovolemic shock secondary to obstetric hemorrhage at tertiary care facilities in low-resource settings

Protein profiling in hepatocellular carcinoma by label-free quantitative proteomics in two west african populations.

Background Hepatocellular Carcinoma is the third most common cause of cancer related death worldwide, often diagnosed by measuring serum AFP; a poor performance stand-alone biomarker. With the aim of improving on this, our study focuses on plasma proteins identified by Mass Spectrometry in order to investigate and validate differences seen in the respective proteomes of controls and subjects with LC and HCC. Methods Mass Spectrometry analysis using liquid chromatography electro spray ionization quadrupole time-of-flight was conducted on 339 subjects using a pooled expression profiling approach. ELISA assays were performed on four significantly differentially expressed proteins to validate their expression profiles in subjects from the Gambia and a pilot group from Nigeria. Results from this were collated for statistical multiplexing using logistic regression analysis. Results Twenty-six proteins were identified as differentially expressed between the three subject groups. Direct measurements of four; hemopexin, alpha-1-antitrypsin, apolipoprotein A1 and complement component 3 confirmed their change in abundance in LC and HCC versus control patients. These trends were independently replicated in the pilot validation subjects from Nigeria. The statistical multiplexing of these proteins demonstrated performance comparable to or greater than ALT in identifying liver cirrhosis or carcinogenesis. This exercise also proposed preliminary cut offs with achievable sensitivity, specificity and AUC statistics greater than reported AFP averages. Conclusions The validated changes of expression in these proteins have the potential for development into high-performance tests usable in the diagnosis and or monitoring of HCC and LC patients. The identification of sustained expression trends strengthens the suggestion of these four proteins as worthy candidates for further investigation in the context of liver disease. The statistical combinations also provide a novel inroad of analyses able to propose definitive cut-offs and combinations for evaluation of performance