Meeting report: ‘How do I incorporate research into my family practice?’: Reflections on experiences of and solutions for young family doctors

Background: Family doctors (FDs) focus on biopsychosocial components of health during consultations. However, much of the evidence employed by these doctors is produced by researchers who are not routinely involved in family practice. Family doctors competent in both clinical practice and research are essential to addressing this gap. With the growing recognition of family medicine as the specialty of choice for many young doctors, there is a scarcity of literature that describes their experiences in combining research and daily family practice. Aim: Members from Young Doctor Movements (YDMs) under the auspices of the World Organisation of Family Doctors (WONCA) sought to address this knowledge gap by reflecting on their experiences towards becoming researchers. With the assistance of senior doctors, they explored solutions that can help young FDs incorporate research into their family practice. Methods: Following an online YDM meeting, a summary of the experiences of young FDs as well as strategies useful for incorporating research into their everyday practice as FDs was prepared. Result: Nine thematic areas were derived, including experiences and motivation towards regular research, culture and environment of practice, relevance and gains of research, teamwork and mentorship. Conclusion: Family practices can incorporate research by promoting a personal and organisational research culture, highlighting gains and relevance of making it part of the profession and fostering teamwork, supportive networks and mentorship while making it enjoyable

Cardiorenal Effects of Newer NSAIDs (Celecoxib) versus Classic NSAIDs (Ibuprofen) in Patients with Arthritis

Background. Arthritis is a common condition that co-exists in the elderly population. This condition leads to frequent administration of comorbid analgesics especially non steroidal anti-inflammatory drugs (NSAIDs). Aim. To study cardiorenal toxicity of celecoxib versus ibuprofen in arthritic patients. Subjects and Methods. Seven hundred ninety-wo arthritic patients were enrolled in the study for 6 months. Three hundred ninety-six patients administered celecoxib 400 mg twice a day; 396 patients administered ibuprofen 300 mg three times a day. Effects measured included investigator-reported hypertension, edema, or congestive heart failure, increases in serum creatinine or reduction in serum creatinine clearance, and changes in serum electrolytes. Results. Celecoxib was associated with significant (P < .05) lower incidence of hypertension and edema in comparison with ibuprofen. Systolic hypertension occurred significantly less (P < .05) with celecoxib compared with ibuprofen. Serum creatinine was significantly increased (P < .05) in patients treated with ibuprofen in comparison with celecoxib. Creatinine clearance was significantly lower (P < .05) in cases treated with ibuprofen in comparison to celecoxib. Nonsignificant changes in serum body electrolytes occurred. Conclusion. The most important finding of this study was the lowering incidence of cardiorenal toxicity of celecoxib in comparison with ibuprofen

Electrical performance of efficient quad-crescent-shaped Si nanowire solar cell

The electrical characteristics of quad-crescent-shaped silicon nanowire (NW) solar cells (SCs) are numerically analyzed and as a result their performance optimized. The structure discussed consists of four crescents, forming a cavity that permits multiple light scattering with high trapping between the NWs. Additionally, new modes strongly coupled to the incident light are generated along the NWs. As a result, the optical absorption has been increased over a large portion of light wavelengths and hence the power conversion efficiency (PCE) has been improved. The electron–hole (e–h) generation rate in the design reported has been calculated using the 3D finite difference time domain method. Further, the electrical performance of the SC reported has been investigated through the finite element method, using the Lumerical charge software package. In this investigation, the axial and core–shell junctions were analyzed looking at the reported crescent and, as well, conventional NW designs. Additionally, the doping concentration and NW-junction position were studied in this design proposed, as well as the carrier-recombination-and-lifetime effects. This study has revealed that the high back surface field layer used improves the conversion efficiency by ∼ 80%. Moreover, conserving the NW radial shell as a low thickness layer can efficiently reduce the NW sidewall recombination effect. The PCE and short circuit current were determined to be equal to 18.5% and 33.8 mA/cm$^{2}$ for the axial junction proposed. However, the core–shell junction shows figures of 19% and 34.9 mA/cm$^{2}$. The suggested crescent design offers an enhancement of 23% compared to the conventional NW, for both junctions. For a practical surface recombination velocity of 10$^{2}$ cm/s, the PCE of the proposed design, in the axial junction, has been reduced to 16.6%, with a reduction of 11%. However, the core–shell junction achieves PCE of 18.7%, with a slight reduction of 1.6%. Therefore, the optoelectronic performance of the core–shell junction was marginally affected by the NW surface recombination, compared to the axial junction

Brucellosis remains a neglected disease inthe developing world: a call forinterdisciplinary action

Brucellosis places significant burdens on the human healthcare system and limits the economic growth of individuals, communities, and nations where such development is especially important to diminish the prevalence of poverty. The implementation of public policy focused on mitigating the socioeconomic effects of brucellosis in human and animal populations is desperately needed. When developing a plan to mitigate the associated consequences, it is vital to consider both the abstract and quantifiable effects. This requires an interdisciplinary and collaborative, or One Health, approach that consists of public education, the development of an infrastructure for disease surveillance and reporting in both veterinary and medical fields, and campaigns for control in livestock and wildlife species

Ruminant Brucellosis in the Kafr El Sheikh Governorate of the Nile Delta, Egypt: Prevalence of a Neglected Zoonosis

Brucellosis is a zoonosis of mammals caused by bacteria of the genus Brucella. It is responsible for a vast global burden imposed on human health through disability and on animal productivity. In humans brucellosis causes a range of flu-like symptoms and chronic debilitating illness. In livestock brucellosis causes economic losses as a result of abortion, infertility and decreased milk production. The main routes for human infection are consumption of contaminated dairy products and contact with infected ruminants. The control of brucellosis in humans depends on its control in ruminants, for which accurate estimates of the frequency of infection are very useful, especially in areas with no previous frequency estimates. We studied the seroprevalence of brucellosis and its geographic distribution among domestic ruminants in one governorate of the Nile Delta region, Egypt. In the study area, the seroprevalence of ruminant brucellosis is very high and has probably increased considerably since the early 1990s. The disease is widespread but more concentrated around major animal markets. These findings question the efficacy of the control strategy in place and highlight the high infection risk for the animal and human populations of the area and the urgent need for an improved control strategy

Electrical performance of efficient quad-crescent-shaped Si nanowire solar cell

The electrical characteristics of quad-crescent-shaped silicon nanowire (NW) solar cells (SCs) are numerically analyzed and as a result their performance optimized. The structure discussed consists of four crescents, forming a cavity that permits multiple light scattering with high trapping between the NWs. Additionally, new modes strongly coupled to the incident light are generated along the NWs. As a result, the optical absorption has been increased over a large portion of light wavelengths and hence the power conversion efficiency (PCE) has been improved. The electron–hole (e–h) generation rate in the design reported has been calculated using the 3D finite difference time domain method. Further, the electrical performance of the SC reported has been investigated through the finite element method, using the Lumerical charge software package. In this investigation, the axial and core–shell junctions were analyzed looking at the reported crescent and, as well, conventional NW designs. Additionally, the doping concentration and NW-junction position were studied in this design proposed, as well as the carrier-recombination-and-lifetime effects. This study has revealed that the high back surface field layer used improves the conversion efficiency by ∼ 80%. Moreover, conserving the NW radial shell as a low thickness layer can efficiently reduce the NW sidewall recombination effect. The PCE and short circuit current were determined to be equal to 18.5% and 33.8 mA/ cm 2 for the axial junction proposed. However, the core–shell junction shows figures of 19% and 34.9 mA/ cm 2. The suggested crescent design offers an enhancement of 23% compared to the conventional NW, for both junctions. For a practical surface recombination velocity of 10 2 cm/s, the PCE of the proposed design, in the axial junction, has been reduced to 16.6%, with a reduction of 11%. However, the core–shell junction achieves PCE of 18.7%, with a slight reduction of 1.6%. Therefore, the optoelectronic performance of the core–shell junction was marginally affected by the NW surface recombination, compared to the axial junction

Developed selenium dioxide-based ceramics for advanced shielding applications: Au2O3 impact on nuclear radiation attenuation

The current research article aims to study the radiation shielding competence of a newly developed PbO-B2O3-SeO2-Er2O3:Au2O3 glass ceramic. The concentrations of the constituent oxides were 40, 10, 49.5, and 0.5 mol % for PbO, B2O3, SeO2, and Er2O3, respectively. The studied ceramic specimens were denoted by EA0, EA25, EA50, EA75 and EA100, and their density values were 5.87, 5.92, 5.94, 6.09, and 6.10 g/cm3, respectively. The radiation shielding competence and photon buildup factors of the present ceramics were investigated under the Au2O3/SeO2 substitution with ratio up to 0.1 mol %. The obtained results reveal that the MAC values were reported with 0.233 cm2/g difference between the minimum and the maximum Au2O3 reinforced samples. The highest MAC values were reported for EA100 sample, which has the highest Au2O3 additive in its chemical structure. At 4 MeV photon energy, HVL values were reported as 3.2658 cm, 3.2352 cm, 3.2212 cm, 3.139 cm and 3.1309 cm for EA0, EA25, EA50, EA75 and EA100, respectively. Moreover, the highest values of EBF were observed for the EA100, and the lowest values of EBF were observed for EA0. Therefore, it can be concluded that the present ceramics possess high level shielding competence to use for various applications of gamma radiation. © 2021The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for the financial support through research groups program under grant number (R.G.P2/98/41)

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

Treatment of synthetic textile wastewater containing dye mixtures with microcosms

The aim was to assess the ability of microcosms (laboratory-scale shallow ponds) as a post polishing stage for the remediation of artificial textile wastewater comprising two commercial dyes (basic red 46 (BR46) and reactive blue 198 (RB198)) as a mixture. The objectives were to evaluate the impact of Lemna minor L. (common duckweed) on the water quality outflows; the elimination of dye mixtures, organic matter, and nutrients; and the impact of synthetic textile wastewater comprising dye mixtures on the L. minor plant growth. Three mixtures were prepared providing a total dye concentration of 10 mg/l. Findings showed that the planted simulated ponds possess a significant (p < 0.05) potential for improving the outflow characteristics and eliminate dyes, ammonium-nitrogen (NH4-N), and nitrate-nitrogen (NO3-N) in all mixtures compared with the corresponding unplanted ponds. The removal of mixed dyes in planted ponds was mainly due to phyto-transformation and adsorption of BR46 with complete aromatic amine mineralisation. For ponds containing 2 mg/l of RB198 and 8 mg/l of BR46, removals were around 53%, which was significantly higher than those for other mixtures: 5 mg/l of RB198 and 5 mg/l of BR46 and 8 mg/l of RB198 and 2 mg/l of BR46 achieved only 41 and 26% removals, respectively. Dye mixtures stopped the growth of L. minor, and the presence of artificial wastewater reduced their development