Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE-NI): an extension of the STROBE statement for neonatal infection research.

Neonatal infections are estimated to account for a quarter of the 2·8 million annual neonatal deaths, as well as approximately 3% of all disability-adjusted life-years. Despite this burden, few data are available on incidence, aetiology, and outcomes, particularly regarding impairment. We aimed to develop guidelines for improved scientific reporting of observational neonatal infection studies, to increase comparability and to strengthen research in this area. This checklist, Strengthening the Reporting of Observational Studies in Epidemiology for Newborn Infection (STROBE- NI), is an extension of the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. STROBE-NI was developed following systematic reviews of published literature (1996-2015), compilation of more than 130 potential reporting recommendations, and circulation of a survey to relevant professionals worldwide, eliciting responses from 147 professionals from 37 countries. An international consensus meeting of 18 participants (with expertise in infectious diseases, neonatology, microbiology, epidemiology, and statistics) identified priority recommendations for reporting, additional to the STROBE statement. Implementation of these STROBE-NI recommendations, and linked checklist, aims to improve scientific reporting of neonatal infection studies, increasing data utility and allowing meta-analyses and pathogen-specific burden estimates to inform global policy and new interventions, including maternal vaccines

Search for the pair production of light top squarks in the e(+/-)mu(-/+) final state in proton-proton collisions at root s=13 TeV

A search for the production of a pair of top squarks at the LHC is presented. This search targets a region of parameter space where the kinematics of top squark pair production and top quark pair production are very similar, because of the mass difference between the top squark and the neutralino being close to the top quark mass. The search is performed with 35.9 fb(-1) of proton-proton collisions at a centre-of-mass energy of root s = 13 TeV, collected by the CMS detector in 2016, using events containing one electron-muon pair with opposite charge. The search is based on a precise estimate of the top quark pair background, and the use of the M-T2 variable, which combines the transverse mass of each lepton and the missing transverse momentum. No excess of events is found over the standard model predictions. Exclusion limits are placed at 95% confidence level on the production of top squarks up to masses of 208 GeV for models with a mass difference between the top squark and the lightest neutralino close to that of the top quark.Peer reviewe

Visual outcome after high volume cataract surgery in Pakistan.

AIM: To determine the visual outcome and factors influencing visual outcome after cataract surgery in an urban charity hospital in Pakistan. METHODS: A series of selected outpatients were examined who had undergone cataract surgery in the preceding 24 months. RESULTS: 181 patients aged 45-82 years were examined. The type of cataract operations they had had were extracapsular cataract extraction (ECCE) only in 50% (91), phacoemulsification (phaco) only in 11% (20), ECCE with intraocular lens (IOL) in 17% (31), and phaco with IOL in 22% (39). At presentation, 49.7% (90) had poor functional vision; after refraction 68% (123) had a good visual outcome. Functional vision in eyes undergoing ECCE with IOL was good in 77% (22) and with phaco with IOL in 71.8% (28). After refraction a higher proportion of eyes with IOL surgery (93%) had a good outcome than those with non-IOL surgery (53%). Uncorrected refractive error, present in 75.5% (68), was the commonest cause of poor functional vision. CONCLUSION: This study demonstrates that it is possible to obtain good results with IOL surgery in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery. More attention should be directed towards ensuring that successful outcomes are indeed being realised by continued visual monitoring postoperatively

Lincoln ’S Highway - A Forgotten Abscess.

ABSTRACT Introduction: Carotid space is a deep neck space within the carotid sheath. .Mosher called carotid sheath as the Lincoln Highway of the neck. Abscess in this space is rare to be seen by young Ear, Nose and Throat (ENT) surgeons in this era of early diagnosis and good antibiotics. We are reporting a case of isolated carotid space abscess in a 20 year old male to familiarize young surgeons with this abscess. Case report: A 20 year old young boy came to our Outpatient Department (OPD) with complaints of fever, painful neck swelling, progressive diffi culty in swallowing from the last 7 days. Contrast Enhanced Computed Tomography (CECT) was done which revealed abscess located adjacent to carotid artery in the carotid sheath. Incision and drainage was done and carotid sheath was opened and pus drained .Patient was discharged after few days on oral antibiotics. Conclusion: Carotid space abscesses are rarely seen in developed countries. Tender and fl uctuating swelling over the carotid artery area points towards it. CECT is the investigation of choice. Needle aspiration should be avoided especially by less trained persons. Small abscesses may respond to intravenous antibiotics but when frank and large abscess is formed, incision and drainage is the treatment of choice

Effect of Caralluma tuberculata on the cytological and biochemical changes induced by cyclophosphamide in mice.

Treatment with Caralluma tuberculata extract induced complex biochemical and cytological changes in mice. Its cytotoxicity in the bone marrow cells of mice was comparable with that of the standard drug cyclophosphamide (CP); however, unlike CP, C. tuberculata was not clastogenic (as shown by the micronucleus assay). A dose-dependent decrease in the RNA content of liver and testes was produced by C. tuberculata treatment whereas there was no effect on the content of nucleic acid and protein in the brain. In the extract-treated animals there was a significant and dose-dependent increase in the DNA content of the liver, with a negligible effect on the protein content. Combined treatment with C. tuberculata and CP showed that C. tuberculata diminished the effect of CP on DNA levels; however, RNA levels were further suppressed, resulting in increased cytotoxicity. Pretreatment with C. tuberculata extract significantly reduced the clastogenicity of CP. These results indicated the involvement of different phytoconstituents acting by different routes

TruSDN : Bootstrapping trust in cloud network infrastructure

Software-Defined Networking (SDN) is a novel architectural model for cloud network infrastructure, improving resource utilization, scalability and administration. SDN deployments increasingly rely on virtual switches executing on commodity operating systems with large code bases, which are prime targets for adversaries attacking the network infrastructure. We describe and implement TruSDN, a framework for bootstrapping trust in SDN infrastructure using Intel Software Guard Extensions (SGX), allowing to securely deploy SDN components and protect communication between network endpoints. We introduce ephemeral flow-specific pre-shared keys and propose a novel defense against cuckoo attacks on SGX enclaves. TruSDN is secure under a powerful adversary model, with a minor performance overhead.5G-ENSUR

Managing neonatal and early childhood syndromic sepsis in sub-district hospitals in resource poor settings: improvement in quality of care through introduction of a package of interventions in rural Bangladesh

Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled 'Interrupting Pathways to Sepsis Initiative' (IPSI) introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics.Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite 'Program Coaches', facilitating triage and rapid transfer of patients through 'Welcoming Persons' and enabling rapid treatment through 'Task Shifting' from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department.From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of which 82% were admitted. More neonates (30%) were referred to higher level facilities than post-neonates (6%) (p<0.05). Immediately after admission, around 99% were assessed for hypoxemia, hypoglycaemia and hypothermia. Around 21% were hypoxemic (neonate-37%, post-neonate-18%, p<0.05), among which 94% received immediate oxygenation. Vascular access was established in 78% cases and 85% received recommended broad spectrum antibiotics parenterally within 1 hour of admission. There was significant improvement in the rate of establishing vascular access and choice of recommended first line parenteral antibiotic over time. After arrival in the emergency department, the median time taken for identification of syndromic sepsis and completion of admission procedure was 6 minutes. The median time taken for completion of assessment for complications was 15 minutes and administration of first dose of broad spectrum antibiotics was 35 minutes. There were only 3 inpatient deaths during the reporting period.Needs based health systems strengthening, supportive-supervision and task shifting can improve the quality and timeliness of in-patient management of syndromic sepsis in resource limited settings