Risk factors associated with wasting among children aged 6 to 24 months old in Gaza strip

Wasting contributes to morbidity and mortality for children under 5 years of age particularly in the developing countries. This study identified the various risk factors associated with wasting among children aged 6 to 24 months old in Gaza Strip. The study sample consisted of 98 wasted children and 98 control children. A questionnaire interview was used. The World Health Organization Anthro software for assessing nutritional status of the world's children was applied. Data were computer analyzed using SPSS/PC statistical package version 21. Anthropometric data showed that birth weight was significantly lower in cases than controls (2.9±0.8 versus 3.1±0.6 kg, P= 0.030). Weight and height were also significantly decreased in cases (P= 0.000). Wasting was significantly higher among children of less educated mothers (χ2= 8.110, P= 0.044) and among children of less family income (OR= 4.1, P= 0.000). Children not received nutritional help or donation had more frequent wasting than those did (P= 0.004). Wasting was significantly higher among non-exclusively breastfed children (OR= 2.1, P= 0.010) and among children who breastfed≤ 12 months (P= 0.021). Early introduction of complementary food increased wasting by 2.8 times (OR= 2.8, P= 0.001). Children with poor appetite had highest frequency of wasting (χ2= 6.139, P= 0.046). Wasting was significantly higher in respiratory and gastrointestinal tract infected children [OR= 2.9, P= 0.000 and OR= 3.1, P= 0.000, respectively). In conclusion, less income, not receive nutritional help or donation, non-exclusive breastfeeding and breastfeeding duration of≤ 12 months, early start of

TiO2- CuI Nanoparticle /Ru Solid State Dye-Sensitize Solar Cells

In this work  solid state dye sensitized solar cell (SSDSSC) type  (ITO / TiO2/ Ru / CuI / Ag) is fabricated. The thin films are prepared by pulse laser deposition (PLD) technique under the vacuum pressure of 3×10−3 mbar and annelid at 450 oC. In this technique  Nd:YAG laser at 1064 nm wavelength with (200 , 500 , 800) pulsed was used. It was noticed from (I-V) characteristics of the solar cell that  the photocurrent  collected  from  the  TiO2  (NP)  is increase as the number of  laser pulses increase. The conversion efficiency of TiO2 is increased  from 2.115%  up  to  5.654% and for CuI from 1.73 % to 5.19 % when the number of pulses increase from 200 up to 800

TiO2- CuI Nanoparticle /Ru Solid State Dye-Sensitize Solar Cells

In this work  solid state dye sensitized solar cell (SSDSSC) type  (ITO / TiO2/ Ru / CuI / Ag) is fabricated. The thin films are prepared by pulse laser deposition (PLD) technique under the vacuum pressure of 3×10−3 mbar and annelid at 450 oC. In this technique  Nd:YAG laser at 1064 nm wavelength with (200 , 500 , 800) pulsed was used. It was noticed from (I-V) characteristics of the solar cell that  the photocurrent  collected  from  the  TiO2  (NP)  is increase as the number of  laser pulses increase. The conversion efficiency of TiO2 is increased  from 2.115%  up  to  5.654% and for CuI from 1.73 % to 5.19 % when the number of pulses increase from 200 up to 800

Testosterone and gonadotropins in infertile men with Sertoli cell only syndrome from Gaza strip

Aim: To assess serum testosterone and gonadotropins in Sertoli cell only syndrome patients from Gaza Strip. Methods: Based on testicular biopsy, a cross section of 74 Sertoli cell only syndrome patients were enrolled in the study. Age matched 44 fertile men were served as controls. Patients and controls were questioned for their medical history. Blood samples were drawn and serum testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) were determined by enzyme-linked immunosorbent assay. Data were computer analyzed using SPSS/PC, version 18.0. Results: Varicocele and hormonal problems were significantly more frequent among patients than controls (P< 0.05). Serum testosterone was significantly lower in patients compared to controls (1.7±1.3 versus 5.0±2.2 ng/ml, P= 0.000). In contrast, LH and FSH were significantly higher in patients than controls (12.8±9.7 and 20.8±14.8 mlU/ml versus 6.3±3.1 and 7.7±3.9 mlU/ml, P= 0.000, respectively). Hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed lower levels of testosterone compared to the normal reference value (0.9±0.5 and 0.5±0.4 ng/ml versus 2.0-7.0 ng/ml). Higher levels of LH and FSH were recorded in hypergonadotrophic hypogonadism (24.5±2.6 and 37.4±6.7 mlU/ml) compared to the reference values of 2.0-13.0 and 2.5-10.0 mlU/ml, respectively whereas LH and FSH levels were lower in hypogonadotrophic hypogonadism (0.6±0.4 and 0.6±0.5 mlU/ml, respectively). In this context, all hypergonadotrophic hypogonadism and hypogonadotrophic hypogonadism patients showed abnormal levels of testosterone, LH

Enhancing Power Plants Safety by Accurately Predicting CO and NOx Leakages from Gas Turbines Using FFNN and LSTM Neural Networks

Gas power plants are fast-establishing power plants capable of producing reliable energy in high watts volumes. One of its significant features is its dependency on natural air as raw material to run the gas turbine. Air passes through several stages that involve heating the air to increase its pressure before being used in electric power generation. Leakage in gas power stations is considered a vital indication of irregular processes of those stages. Any fault existing in the meanwhile operations can result in lousy production performance. Considering the human and economic losses of gas leakage, it has become a challenge to prevent the same. One of the essential approaches to managing gas leakage reduction is an accurate prediction. This paper proposes an automatic prevention approach relying on deep learning technology for predicting gas leakage status. Furthermore, a novel dataset was supplied by a natural gas power plant to predict CO and NOx emissions. The dataset is used to train the deep learning models using Long-short Term Memory and Feed-Forward Neural Networks. The optimum accuracy obtained is over 92% for CO and over 58% for NOx while using the LSTM model as a predictor

Optimisation of rubberised concrete with high rubber content: an experimental investigation

This article investigates experimentally the behaviour of rubberised concrete (RuC) with high rubber content so as to fully utilise the mechanical properties of vulcanised rubber. The fresh properties and short-term uniaxial compressive strength of 40 rubberised concrete mixes were assessed. The parameters examined included the volume (0–100%) and type of mineral aggregate replacement (fine or coarse), water or admixture contents, type of binder, rubber particle properties, and rubber surface pre-treatments. Microstructural analysis using a Scanning Electron Microscope (SEM) was used to investigate bond between rubber and concrete at the Interface Transition Zone (ITZ). This initial study led to the development of an “optimum” RuC mix, comprising mix parameters leading to the highest workability and strength at all rubber contents. Compared to a non-optimised concrete with 100% replacement of fine aggregates with rubber, the compressive strength of concrete with optimised binder material and moderate water/binder ratio was enhanced by up to 160% and the workability was improved significantly. The optimisation proposed in this study will lead to workable high rubber content RuC suitable for sustainable high-value applications

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

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

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