Prevalence, Concordance, and Heritability of Vitreomacular Interface Abnormalities in a Twin Study

PURPOSE: The relative importance of genetic factors in common vitreomacular interface (VMI) abnormalities is unknown. The aim of this classical twin study is to determine the prevalence case wise concordance between monozygotic and dizygotic twin pairs, and heritability of common VMI abnormalities, including epiretinal membrane (ERM), posterior vitreous detachment (PVD), vitreomacular adhesion (VMA), vitreomacular traction (VMT), lamellar macular holes (LMHs), and full-thickness macular holes (FTMHs). METHODS: This is a single-center, cross-sectional classical twin study of 3406 TwinsUK participants over the age of 40 years who underwent spectral domain macular optical coherence tomography (SD-OCT) scans which were graded for signs of VMI abnormalities. Case wise concordance was calculated and the heritability of each VMI abnormality was estimated using OpenMx structural equation modeling. RESULTS: In this population (mean age = 62.0 years [SD = 10.4 years], range = 40–89 years) the overall prevalence of ERM was 15.6% (95% confidence interval [CI] = 14.4–16.9) and increased with age, posterior vitreous detachment affected 21.3% (20.0–22.7), and VMA was diagnosed in 11.8% (10.8–13.0). Monozygotic twins were more concordant for all traits than dizygotic twins, and age, spherical equivalent refraction (SER), and lens status-adjusted heritability was estimated at 38.9% (95% CI = 33.6–52.8) for ERM, 53.2% (95% CI = 41.8–63.2) for PVD, and 48.1% (95% CI = 33.6–58) for VMA. CONCLUSIONS: Common VMI abnormalities are heritable and therefore have an underlying genetic component. Given the sight-threatening potential of VMI abnormalities, further genetic studies, such as genomewide association studies, would be useful to identify genes and pathways implicated in their pathogenesis

State of air quality in and outside of hospital wards in urban centres – A case study in Lahore, Pakistan

Particulate pollution in healthcare facilities is a potential threat to healthcare workers, patients and visitors. A study was carried out to monitor particulate levels in and outside of five wards of Sheikh Zayed Hospital, a tertiary healthcare facility of Lahore. Measurements indicated that the hourly mean concentrations of PM2.5 in a medical, pulmonology (chest), surgical, pediatric and nephrology ward were 78 ± 37, 86 ± 46, 94 ± 48, 169 ± 122 and 488 ± 314 µg m-3 respectively. The outside levels of PM2.5 of the same wards were 69 ± 27, 81 ± 49, 178 ± 85, 282 ± 164 and 421 ± 240 µg m-3. Indoor levels were higher than outdoors in all the wards except surgical and pediatric ward. Such elevated levels of PM can result in aggravation of the poor health status of the patients as well as affecting the hospital staff and visitors

Noise Level in Textile Industries: Case Study Al-Hillah Textile Factory-Company for Textile Industries, Al-Hillah-Babylon-Iraq

In this study, Al-Hillah Textile Factory, in Al-Hillah city-Iraq follows to State Company for Textile Industries was selected to study the intensity of noise in 2014. Measurements of the noise level were carried out in different workshops for each of the production stages including the spinning machinery workshop (parts 1 and 2), the rotating machinery room, the preparations room, and the textile machinery room (Roti model), weaving machines: Techmash model room Russian-made model room, Sheets' machinery room, and operator machines room; using two noise meters (model 2237 Fulfici). Fifty samples were collected in each part of these rooms to give realistic results for the noise level. After recording the noise level data, the highest and lowest values and the average of noise intensity readings were calculated in each of the rooms and compared with the global standards permitted by the EPA for industrial facilities. The results of this study showed that the general rate of noise intensity in all rooms exceeded the permissible limits, which impose a noise level of 65-70dB for such industrial establishments according to EPA recommendations in 2008

Controlling metal ion migration in contaminated groundwater with Iraqi clay barriers for water resource protection

This study investigates the effectiveness of using Iraqi clay as a low-permeability layer to prevent the migration of lead and nickel ions in groundwater-aquifers. Tests of batch operation have been conducted to determine the optimal conditions for removing Pb2+ ions, which were found to be 120 minutes of contact time, a pH of 5, 0.12 g of clay per 100 mL of solution, and an agitation of 250 rpm. These conditions resulted in a 90% removal efficiency for a 50 mg L−1 initial concentration of lead ions. To remove nickel ions with an efficiency of 80%, the optimal conditions were 60 minutes of contact time, a pH of 6, 12 g of clay per 100 mL of solution, and an agitation of 250 rpm. Several sorption models were evaluated, and the Langmuir formula was found to be the most effective. The highest sorption capacities were 1.75 and 137 mg g−1 for nickel and lead ions, respectively. The spread of metal ions was simulated using finite element analysis in the COMSOL multiphysics simulation software, taking into account the presence of a clay barrier. The results showed that the barrier creates low-discharge zones along the down-gradient of the barrier, reducing the rate of pollutant migration to protect the water sources

An Open Randomized Comparison of Gatifloxacin versus Cefixime for the Treatment of Uncomplicated Enteric Fever

OBJECTIVE: To assess the efficacy of gatifloxacin versus cefixime in the treatment of uncomplicated culture positive enteric fever. DESIGN: A randomized, open-label, active control trial with two parallel arms. SETTING: Emergency Room and Outpatient Clinics in Patan Hospital, Lagankhel, Lalitpur, Nepal. PARTICIPANTS: Patients with clinically diagnosed uncomplicated enteric fever meeting the inclusion criteria. INTERVENTIONS: Patients were allocated to receive one of two drugs, Gatifloxacin or Cefixime. The dosages used were Gatifloxacin 10 mg/kg, given once daily for 7 days, or Cefixime 20 mg/kg/day given in two divided doses for 7 days. OUTCOME MEASURES: The primary outcome measure was fever clearance time. The secondary outcome measure was overall treatment failure (acute treatment failure and relapse). RESULTS: Randomization was carried out in 390 patients before enrollment was suspended on the advice of the independent data safety monitoring board due to significant differences in both primary and secondary outcome measures in the two arms and the attainment of a priori defined endpoints. Median (95% confidence interval) fever clearance times were 92 hours (84-114 hours) for gatifloxacin recipients and 138 hours (105-164 hours) for cefixime-treated patients (Hazard Ratio[95%CI] = 2.171 [1.545-3.051], p<0.0001). 19 out of 70 (27%) patients who completed the 7 day trial had acute clinical failure in the cefixime group as compared to 1 out of 88 patients (1%) in gatifloxacin group(Odds Ratio [95%CI] = 0.031 [0.004 - 0.237], p<0.001). Overall treatment failure patients (relapsed patients plus acute treatment failure patients plus death) numbered 29. They were determined to be (95% confidence interval) 37.6 % (27.14%-50.2%) in the cefixime group and 3.5% (2.2%-11.5%) in the gatifloxacin group (HR[95%CI] = 0.084 [0.025-0.280], p<0.0001). There was one death in the cefixime group. CONCLUSIONS: Based on this study, gatifloxacin is a better treatment for uncomplicated enteric fever as compared to cefixime. TRIAL REGISTRATION: Current Controlled Trials ISRCTN75784880

Influences of H on the Adsorption of a Single Ag Atom on Si(111)-7 × 7 Surface

The adsorption of a single Ag atom on both clear Si(111)-7 × 7 and 19 hydrogen terminated Si(111)-7 × 7 (hereafter referred as 19H-Si(111)-7 × 7) surfaces has been investigated using first-principles calculations. The results indicated that the pre-adsorbed H on Si surface altered the surface electronic properties of Si and influenced the adsorption properties of Ag atom on the H terminated Si surface (e.g., adsorption site and bonding properties). Difference charge density data indicated that covalent bond is formed between adsorbed Ag and H atoms on 19H-Si(111)-7 × 7 surface, which increases the adsorption energy of Ag atom on Si surface

Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017

© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. Funding: Bill & Melinda Gates Foundation