Wireless E-Nose Sensors to Detect Volatile Organic Gases through Multivariate Analysis

Gas sensors are critical components when adhering to health safety and environmental policies in various manufacturing industries, such as the petroleum and oil industry; scent and makeup production; food and beverage manufacturing; chemical engineering; pollution monitoring. In recent times, gas sensors have been introduced to medical diagnostics, bioprocesses, and plant disease diagnosis processes. There could be an adverse impact on human health due to the mixture of various gases (e.g., acetone (A), ethanol (E), propane (P)) that vent out from industrial areas. Therefore, it is important to accurately detect and differentiate such gases. Towards this goal, this paper presents a novel electronic nose (e-nose) detection method to classify various explosive gases. To detect explosive gases, metal oxide semiconductor (MOS) sensors are used as reliable tools to detect such volatile gases. The data received from MOS sensors are processed through a multivariate analysis technique to classify different categories of gases. Multivariate analysis was done using three variants—differential, relative, and fractional analyses—in principal components analysis (PCA). The MOS sensors also have three different designs: loading design, notch design, and Bi design. The proposed MOS sensor-based e-nose accurately detects and classifies three different gases, which indicates the reliability and practicality of the developed system. The developed system enables discrimination of these gases from the mixture. Based on the results from the proposed system, authorities can take preventive measures to deal with these gases to avoid their potential adverse impacts on employee health

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

Deciphering COVID-19 Severity : Assessing FGF-18, WNT-5A, IL-17, and IL-33 Levels in the Infected Patients

Background: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that causes an infectious disease named coronavirus disease-2019 (COVID-19). Objectives: To test some biomarkers (Fibroblastic growth factor (FGF)-18, wingless-related integration site (WNT-5A), interleukin (IL)-17, and IL-33 to predict the severity of COVID-19. Patients and Methods: A cross-sectional study was done on 180 participants (90 healthy control and 90 COVID-19-positive patients) at the emergency units of the hospitals in four cities of Northern Iraq from July 01 to December 01, 2021. The obtained serum from collected blood was tested to determine IL-17, IL-33, FGF-18, and WNT-5 levels using the ELISA technique. Additionally, CRP concentration was measured using immunoturbidimetry on Cobas c311. Results: Regarding the sociodemographic data, most moderately infected patients were aged 46-64 years and were males (35.6%, 64.4%, respectively). The most severely infected patients were older than 65 years and were females (60%). The highest mean serum levels of C-reactive protein (CRP) (59.53±40.06 mg/dl), IL-17 (36.90±22.61 pg/ml), FGF-18 (179.8±291.37 pg/mL), IL-33 (248.11±506.71 pg/ml) were reported among the severely infected patients, while the highest mean serum level of WNT-5A was observed among moderately infected patients (5.03±5.73 ng/ml). Regarding the correlations between biomarkers, in moderately infected patients, a negative correlation between CRP and IL-33; CRP and IL-17 was observed, with a positive correlation between IL-33 and IL-17. Conversely, no correlations were seen between IL-33 and WNT-5 whereas correlations between IL-33 and IL-17 were seen in severely infected individuals. Simultaneously, a correlation between the patient’s body mass index (BMI) and CRP was detected. Conclusions: The disease was more severe among elderly, females, and overweight patients. All biomarkers, except WNT-5A, were significantly associated with the severity of COVID-19

Reimagined MPFL Reconstruction: Retinacular Fixation of the Doubled Hamstring Graft at the Patella and Suture Anchor-Based Femoral Fixation

Background. Lateral patellar dislocation is frequently observed among teenagers and young adults. There is no consensus on the best type of graft or fixation strategy for the femur and patella, and complications such as iatrogenic patella fracture, tunnel malposition, and grafting failure are common. The objective of our research is to find out the functional outcome of a new method of medial patellofemoral ligament (MPFL) reconstruction, which involves two key components: (1) patellar fixation is accomplished by suturing the two limbs of the looped doubled hamstring graft in a divergent fashion to the retinaculum at the medial border of the upper half of patella and (2) the placement of a suture anchor tied to the graft at the isometric point on the medial femur condyle. Methods. This study is a retrospective assessment of patients who underwent MPFL reconstruction at our hospital between September 2018 and August 2020. Patients were monitored for at least 2 years after the initial procedure until August 2022. Results. A total of 29 patients were recruited for the study, with 22 being females and the average age being 30.38 years. During the postoperative period, none of the participants experienced instability, redislocation, patellar/femoral fractures, or abnormal distal femur growth. The Tegner–Lysholm knee score was good to excellent for 17 (58.6%) participants, fair for 10 (34.5%) participants, and poor for 2 (6.9%) participants. The Kujala anterior knee pain score was more than 80 for 19 (65.5%) participants. Conclusion. This research presents a significant achievement rate of the surgical procedure, accompanied by the mean Tegner–Lysholm knee score of 82.68 and the mean Kujala anterior knee pain score of 82.71. Notably, there were no complications observed in the postoperative period

A Brief Literature Review on the Management of Post-Haemorrhoidectomy Pain

The most commonly encountered complication after haemorrhoidectomy is post-operative pain. Relief of this pain may aid earlier recovery. A literature search was performed examining the different surgical and medical agents for the relief of post haemorrhoidectomy pain using Pubmed, MEDLINE, EMBASE, CINAHL and Cochrane library databases. Pain can be relieved by surgical or medical agents. Surgery incorporates a risk of incontinence. A number of studies examine the role of medical agents. A variety of surgical techniques and medical agents are available to the clinician in the treatment of post haemorrhoidectomy pain. Tailored management to individual patients should ensure appropriate symptomatic control and prompt recovery

Necrotizing fasciitis of the breast

Necrotizing fasciitis is a potentially fatal condition that can affect any part of the body. It can occur after trauma, around foreign bodies in surgical wounds, or can be idiopathic. We describe a case of necrotizing fasciitis involving the breast following an initial debridement of an inflammatory lesion

Assessment of Biofilm Production and Antibiotic Sensitivity Patterns in Klebsiella pneumoniae Isolates from Al-Qadisiyah Hospitals, Iraq

Background: Klebsiella pneumoniae is one of the most common causative agents of nosocomial infections. Opportunistic pathogens can generate a thick layer of biofilm as an important virulence factor. Objectives: The current study was aimed in the detection of biofilm formation in Klebsiella pneumoniae pathogenic capability as a common opportunistic pathogen accounting pneumonia, urinary tract infections, with in nosocomial infections. Materials and Methods: In this observational study, a total of 140 clinical samples obtained from patients with bacterial infections were analyzed. The identification of Klebsiella pneumoniae isolates was performed using selective culture media and biochemical tests. Additionally, biofilm strains were characterized using the Crystal Violet assay and polymerase chain reaction (PCR) techniques. Results: Among the 140 samples collected from various specimens, a total of 100 isolates (43.47%) were identified as Klebsiella pneumoniae culturing and biochemical tests. Out of these isolates, 58 (58%) were obtained from male individuals, while 42 (42%) were obtained from female individuals. Using the phenotypic method, the analysis revealed that 18% isolates were classified as strong biofilm producers, 33% as medium biofilm producers, 49% as weak biofilm producers, and 30 as non-biofilm producers. The frequency of specific genes in the isolates was reported as follows: wzm (47%) and markA (69%). Conclusion: The presence of the markA gene is significant in the context of biofilm formation in Klebsiella pneumoniae strains, as it serves as a marker for distinguishing various types of biofilms