Utilization of idle time slot in spectrum sensing under noise uncertainty

Spectrum sensing in cognitive radio (CR) is a critical process as it directly influences the accuracy of detection. Noise uncertainty affects the reliability of detecting vacant holes in the spectrum, thus limiting the access of that spectrum by secondary users (SUs). In such uncertain environment; SUs sense the received power of a primary user (PU) independently with different measures of signal-to-noise ratio (SNR). Long sensing time serves in mitigating the effect of noise uncertainty, but on the cost of throughput performance of CR system. In this paper, the scheme of an asynchronous and crossed sensing-reporting is presented. The scheme reduces energy consumption during sensing process without affecting the detection accuracy. Exploiting the included idle time () in sensing time slot; each SU collects power samples with higher SNR directly performs the reporting process to a fusion center (FC) consecutively. The FC terminates the sensing and reporting processes at a specific sensing time that corresponds to the lowest SNR (). Furthermore, this integrated scheme aims at optimizing the total frame duration (). Mathematical expressions of the scheme are obtained. Analytical results show the efficiency of the scheme in terms of energy saving and throughput increment under noise uncerainty

Paediatric respiratory isolation: A challenge for a secondary care hospital! A service innovation project

Objective: The aim of this project was to broaden the secondary care hospital\u27s scope of services and provide safe, effective and quality care for the patient presenting with measles.Methods: Six Sigma DMAIC [define measure, analyze, improve, and control (DMAIC)] methodology was used in this quality improvement project. The quality project was started in October 2015 using a Gantt chart quality tool.Results: The paediatric team with the support of administration of the hospital has established isolation rooms and devised a policy for the care and management of patient with airborne infection to avoid cross transmission. During six months period after establishment of isolation room there were sixty two suspected or confirmed measles cases who were admitted in our hospital, out of them only 4(6.4%) of patients were referred because of their sick condition and need of ventilator support. Further, the percentage of patient\u27s satisfaction level also improved from 60 to 80%.Conclusions: After this clinical service innovation, there was significant reduction in referrals of measles patients to another hospital and consequently there was an increase in the patient\u27s satisfaction

Appling tracking game system to measure user behavior toward cybersecurity policies

Institutions wrestle to protect their information from threats and cybercrime. Therefore, it is dedicating a great deal of their concern to improving the information security infrastructure. Users’ behaviors were explored by applying traditional questionnaire as a research instrument in data collocate process. But researchers usually suffer from a lack of respondents' credibility when asking someone to fill out a questionnaire, and the credibility may decline further if the research topic relates to aspects of the use and implementation of information security policies. Therefore, there is insufficient reliability of the respondent's answers to the questionnaire’s questions, and the responses might not reflect the actual behavior based on the human bias when facing the problems theoretically. The current study creates a new idea to track and study the behavior of the respondents by building a tracking game system aligned with the questionnaire whose results are required to be known. The system will allow the respondent to answer the survey questions related to the compliance with the information security policies by tracking their behavior while using the system

A review on nanocellulosic fibres as new material for sustainable packaging: process an applications

The demand for exploring advanced and eco-friendly sustainable packaging materials with superior physical, mechanical and barrier properties is increasing. The materials that are currently used in packaging for food, beverage, medical and pharmaceutical products, as well as in industrial applications, are non-degradable, and thus, these materials are raising environmental pollution concerns. Numerous studies have been conducted on the utilization of bio-based materials in the pursuit of developing sustainable packaging materials. Although significant improvements have been achieved, a balance among environmental concerns, economic considerations and product packaging performance is still lacking. This is likely due to bio-based materials being used in product packaging applications without a proper design. The present review article intends to summarize the information regarding the potential applications of cellulosic nanofiber for the packaging. The importance of the design process, its principles and the challenges of design process for sustainable packaging are also summarized in this review. Overall it can be concluded that scientists, designers and engineers all are necessarily required to contribute towards research in order to commercially exploit cellulose nanofiber for sustainable packaging

Factors Influencing Participation in COVID-19 Clinical Trials: A Multi-National Study

In 2020, the World Health Organization has characterized COVID-19, a disease caused by infection with the SARS-CoV-2 virus, as a pandemic. Although a few vaccines and drugs have been approved to, respectively, prevent or treat the disease, several clinical trials are still ongoing to test new vaccines or drugs to mitigate the burden of the pandemic. Few studies have shown the role of host genetics in disease prognosis and drug response highlighting the importance of diverse participation in COVID-19 clinical trials. The goal of this study is to assess public attitudes in Egypt, Saudi Arabia, and Jordan toward participating in COVID-19 clinical trials and to identify the factors that may influence their attitude. An online questionnaire was developed and distributed among the target group through social media platforms. The number of responses was 1,576. Three quarters (74.9%) of participants heard about clinical trials before, 57.6% of them had a positive attitude toward participation in COVID-19 clinical trials. The conduct of clinical trials in accordance with the scientific, research, and ethical guidelines was a strong predictor of willingness to participate in clinical trials. Other positive factors also included protection of family from COVID-19 and contributing to the return to normal community life as well as receiving additional healthcare benefit was the fourth significant predictor. On the other hand, the thought that clinical trials can have a negative impact on the health of participants strongly predicted the unwillingness of individuals to participate in such trials. This was followed by having limited information about the novel coronavirus and COVID-19 and the lack of trust in physicians and hospitals. In general, Arab citizens are accepting the concept and have a positive attitude toward COVID-19 clinical trials. Increasing awareness of COVID-19 and clinical trials, enforcing the concept of altruism, and placing clear policies in conducting clinical trials are needed to increase participation in clinical trials among Arabs

Public awareness of the coronary artery disease and its risk factors in the population of Hail region, Saudi Arabia: a cross-sectional study

Background: Coronary Artery Disease (CAD) is a severe cardiovascular complication prevalent in the Kingdom of Saudi Arabia. The risk factors of this disease are so high that it became one of the major causes of mortality among middle-aged individuals. This study aimed to investigate the degree of awareness about risk factors for CAD among the Hail region population.  Methods: The study was carried out in the Hail region, Saudi Arabia, from April 2020 to May 2020. Data collected from five hundred and thirty-seven participants participated through an online survey. The process of selection of participants was through volunteer testing and an online review poll that was disseminated to them to complete. No limitations on age or sex were applied to the surveys.Results: Awareness of TV watching (88.5%), smoking (87.9%), lack of physical activities (78.4%) and family history of CAD (74.7%) as the leading cause of CAD has a notable higher percentage among the studied population whereas the family history of diabetes mellitus (51.6%), having diabetes mellitus (57.7%), family history of hypertension (65.7%) and family history of hyperlipidemia (69.1%) have the lowest percentages. Regarding the gender, the male participants have the poorest awareness degrees about risk factors for the CAD.Conclusion: The study revealed that the family history of hyperlipidemia, Family history of DM, having DM and family history of hypertension have the poorest degrees of awareness of the risk factors for CAD among the studied population.Keywords: Coronary artery disease; Risk factors; Awareness; Hail regio

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

The burden of antimicrobial resistance in the Americas in 2019: a cross-country systematic analysis

Background Antimicrobial resistance (AMR) is an urgent global health challenge and a critical threat to modern health care. Quantifying its burden in the WHO Region of the Americas has been elusive—despite the region’s long history of resistance surveillance. This study provides comprehensive estimates of AMR burden in the Americas to assess this growing health threat. Methods We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with AMR for 23 bacterial pathogens and 88 pathogen–drug combinations for countries in the WHO Region of the Americas in 2019. We obtained data from mortality registries, surveillance systems, hospital systems, systematic literature reviews, and other sources, and applied predictive statistical modelling to produce estimates of AMR burden for all countries in the Americas. Five broad components were the backbone of our approach: the number of deaths where infection had a role, the proportion of infectious deaths attributable to a given infectious syndrome, the proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of pathogens resistant to an antibiotic class, and the excess risk of mortality (or duration of an infection) associated with this resistance. We then used these components to estimate the disease burden by applying two counterfactual scenarios: deaths attributable to AMR (compared to an alternative scenario where resistant infections are replaced with susceptible ones), and deaths associated with AMR (compared to an alternative scenario where resistant infections would not occur at all). We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. Findings We estimated 569,000 deaths (95% UI 406,000–771,000) associated with bacterial AMR and 141,000 deaths (99,900–196,000) attributable to bacterial AMR among the 35 countries in the WHO Region of the Americas in 2019. Lower respiratory and thorax infections, as a syndrome, were responsible for the largest fatal burden of AMR in the region, with 189,000 deaths (149,000–241,000) associated with resistance, followed by bloodstream infections (169,000 deaths [94,200–278,000]) and peritoneal/intra-abdominal infections (118,000 deaths [78,600–168,000]). The six leading pathogens (by order of number of deaths associated with resistance) were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Together, these pathogens were responsible for 452,000 deaths (326,000–608,000) associated with AMR. Methicillin-resistant S. aureus predominated as the leading pathogen–drug combination in 34 countries for deaths attributable to AMR, while aminopenicillin-resistant E. coli was the leading pathogen–drug combination in 15 countries for deaths associated with AMR. Interpretation Given the burden across different countries, infectious syndromes, and pathogen–drug combinations, AMR represents a substantial health threat in the Americas. Countries with low access to antibiotics and basic health-care services often face the largest age-standardised mortality rates associated with and attributable to AMR in the region, implicating specific policy interventions. Evidence from this study can guide mitigation efforts that are tailored to the needs of each country in the region while informing decisions regarding funding and resource allocation. Multisectoral and joint cooperative efforts among countries will be a key to success in tackling AMR in the Americas.publishedVersio

Assessing disparities in medical students’ knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents

Background and aimsThe recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students’ knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries.MethodsA cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses.Results46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox.ConclusionThere were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control