Numerical Evaluation and Analysis for Hydrogen Production Via Ethanol Steam Reforming

In the present study, two series of Ni/Ce/ZrO2 catalysts were prepared. The first one is n% Ni/Ce0.74Zr0.26O2 (n = 0, 2, 10 and 20 wt %). The second is 10%Ni / m (Ce/ZrO2) (m = 0, 4, 6 and 8). Catalysts have been investigated for ethanol steam reforming (ESR) to produce hydrogen. The reaction was studied in an atmospheric flow system, the temperature range was 200-600 ºC and water/ethanol (6, 8, 10 molar ratio). The effect of using H2O2 as an oxidant in auto-thermal reforming of ethanol has been also investigated (at 400 ºC, and H2O2/ethanol ratio = 8) to get highest hydrogen selectivity with lower CO ratio. Numerical evaluation and analysis have been performed for the above obtained results. It has been observed that the ethanol conversion, hydrogen production and some of the various investigated relations are functions of more than one independent variable. So, the response surface methodology (RSM) has been employed to evaluate these relations. Key Words: Numerical analysis, Response surface methodology, Ethanol steam reforming, Ni/Ce/ZrO2 catalysts

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 SPINAL DECOMPRESSION ON PAIN IN PATIENTS WITH CHRONIC LUMBAR DISC PROLAPSE

Background: DRX9000 spinal decompression is slightly known for treating chronic lumbar disc prolapse. The aim of the study was to examine the effectiveness of DRX9000spinal decompression on pain in chroniclumbar disc prolapse (CLDP). Methods: twenty male subjects with chronic lumbar disc prolapse,aged between 40:60 years were included in the study. They were assessed forpain intensity byslump test,straight leg raising test (SLR),modified Oswestery questionnaire (OQ) and visual analogue scale (VAS). The study continued forsix weeks, the 20 patients were equally divided into two groups. Group A (experimental) received spinal decompression, stability and McKenzie exercises; and ice, at a rate of 3 days per week, the duration of each session was 60 minutes. While group B (control) were treated by exercises and ice only. Results: Majority of patients had positive findings in reducing pain clinically; however, statistically there was no significant difference. Conclusion: It can be concluded that spinal decompression has an effect, but not statistically significant in decreasing pain on patients with lumbar disc prolapse. This may be due to limited number of patients. We can recommend increasing the sample size to generalize the results, MRI scan follow up should be done after one year to determine if the effects are permanent or transient, comparing the effects of decompression between acute & chronic cases of lumbar disc prolapse, also male & female patients

Effect of stretching, strengthening exercises and walking on the management of restless legs syndrome: A cross sectional study

Background: Restless Leg Syndrome (RLS) is one of the most common causes of sleep disorders that cause functional disability in the lower limb. Due to it is self-limiting, it forces the person to seek treatment. Unfortunately, most of the times, it is misdiagnosed by the doctors and even if it is diagnosed, till date there is no guide program or treatment in the physical therapy. There is huge dearth of knowledge regarding benefits of physical therapy in RLS. Objective: The aim of the present study was to investigate the effect of stretching, strengthening exercises as well as walking on RLS symptoms. Also, to find out the impact of muscle strength and flexibility in relation to the severity of RLS symptoms. Methods: An inquiry of 418 questionnaires randomly distributed was done. A total of 20 participants diagnosed with Restless Leg Syndrome were included in the current study. Pre-post assessment was done for range of motion (by goniometer), functional testing of the foot and ankle, RLS rating scale and RLS ordinal scale. Six participants received physical therapy program for a total of 4 weeks. Twenty patients who had one visit to have the measurement were studied for the correlation study. Results: There was a significant correlation between leg muscles flexibility, strength and the severity of the symptoms. Also, there was a highly significant alleviation of symptoms in the other 6 patients. Conclusion: It can be concluded that physical therapy is effective in relieving symptoms of RLS

IMPACT OF REFLEXOLOGY ON MECHANICAL LOW BACK PAIN

Background: Low-back pain (LBP) is one of the highest common and costly musculoskeletal conditions in current society. Seventy to 85% of the populations will exhibits LBP at some time in their lives. There is little known about specific manual therapy techniques used to treat chronic LBP. Reflexology is a treatment that involves using gentle pressure to reflex points located on all of the outsides of the feet and hands. The aim of the study was to investigate the efficacy of reflexology technique in subjects with chronic low back pain (CLBP). Methods: Twenty patients with nonspecific chronic low back pain were included in the study and were assessed regarding range of motion via goniometer and pain threshold (via modified Oswestery scale and visual analogue scale), the 20 patients were allocated into two groups 10 patients in each group. Group A received reflexology sittings at rate of 3 days per week, and the duration of each sitting was 30 minutes. While group B were control. The study was continued for 3 weeks Results: According to VAS, the results revealed a non-significant variance between the study group and control group before intervention (p= 0.43). While after intervention, there was a significant decline of pain in the study group compared to that of the control group (p=0.000). Moreover, there was a very highly significant decrease in pain within the study group after treatment (p= 0.005). Conclusion: The present study indicated that the reflexology technique was effective and safe to be applied for cases of mechanical low back pain. It results in a significant decrease in pain within the study group after treatment

IMPACT OF REFLEXOLOGY ON MECHANICAL LOW BACK PAIN

Background: Low-back pain (LBP) is one of the highest common and costly musculoskeletal conditions in current society. Seventy to 85% of the populations will exhibits LBP at some time in their lives. There is little known about specific manual therapy techniques used to treat chronic LBP. Reflexology is a treatment that involves using gentle pressure to reflex points located on all of the outsides of the feet and hands. The aim of the study was to investigate the efficacy of reflexology technique in subjects with chronic low back pain (CLBP). Methods: Twenty patients with nonspecific chronic low back pain were included in the study and were assessed regarding range of motion via goniometer and pain threshold (via modified Oswestery scale and visual analogue scale), the 20 patients were allocated into two groups 10 patients in each group. Group A received reflexology sittings at rate of 3 days per week, and the duration of each sitting was 30 minutes. While group B were control. The study was continued for 3 weeks Results: According to VAS, the results revealed a non-significant variance between the study group and control group before intervention (p= 0.43). While after intervention, there was a significant decline of pain in the study group compared to that of the control group (p=0.000). Moreover, there was a very highly significant decrease in pain within the study group after treatment (p= 0.005). Conclusion: The present study indicated that the reflexology technique was effective and safe to be applied for cases of mechanical low back pain. It results in a significant decrease in pain within the study group after treatment

Patellar tendon ultrasonographic properties and lower limb function in rheumatoid arthritis patients

Aim of work The aim of this work was to investigate patellar tendon (PT) biomechanical properties in rheumatoid arthritis (RA) patients through changes in ultrasonographic tendon properties and its effect on lower limb function. Patients and methods Forty RA patients and 20 healthy participants were included in this study. The physical function was assessed by Health Assessment Questionnaire, the activity of RA by disease activity score 28 and range of motion for all knees by a manual goniometer. RA patients were divided into the following groups: group I comprised patients with low disease activity score 28, who were further subdivided according to the presence of knee flexion deformity into two subgroups (GIA and GIB) and group II patients in the remission stage. Ultrasonography was used for measuring PT elongation and cross-sectional area and quadriceps’ muscle strength was measured. The lower limb function was assessed clinically by 50-foot walk test and smart balance master system through unilateral stance test, step up and over and sit to stand tests. Results There was an increased elongation of PT of all RA groups relative to the control group (P=0.001); no significant difference was found in the PT (cross-sectional area). RA patients showed quadriceps’ muscle strength reduction (P=0.001) and delayed walking time of the 50-foot walk test (P=0.05). Unilateral stance test showed increased center of gravity sway velocity during either eye open or eye closed conditions in RA groups and deterioration in all parameters of step up and over and sit to stand tests (P=0.05–0.001). All physical function evaluation of RA patients showed impairment associated with a reduction of PT stiffness and quadriceps’ strength. Conclusion Inflammation of the PT and peritendinous tissues in RA alters its biomechanical properties; this impairs RA patients’ physical and lower limb functions