In ovo protective effects of chicoric and rosmarinic acids against Thiacloprid-induced cytotoxicity, oxidative stress, and growth retardation on newly hatched chicks

Thiacloprid (TH) is a neonicotinoid insecticide employed in agriculture to protect fruits and vegetables against different insects. It showed different deleterious effects on the general health of non-target organisms including birds and animals, however, its developmental toxicity has yet to be fully elucidated. Chicoric (CA) and rosmarinic (RA) acids are polyphenolic compounds with a wide range of beneficial biological activities. In this study, the possible protective effects of CA and RA were investigated in chick embryos exposed in ovo to TH (1mg/egg) with or without CA (100 mg/egg) or RA (100 mg/egg) co-exposure. TH reduced the hatchling body weight, body weight/egg weight, and relative weight of bursa of Fabricius in the one-day-old hatchlings. Examination of the 7-day-old chicks revealed a decline in feed intake, daily weight gain, feed conversion ratio (FCR), and plasma levels of T3, T4, and growth hormone. Serum ALT, AST activities, and total cholesterol levels showed significant elevations. Hepatic MDA was increased with a reduction in SOD activity and GSH level and downregulation of the liver SOD and GST gene expression pattern. Serum IgG and IgM levels were reduced, and various histopathological alterations were noticed in the liver. Co-administration of CA or RA with TH mitigated the toxic effects on hatchlings. When both CA and RA are combined, they present a synergistic protective effect. CA and RA can be used as protective agents against TH toxicity as they improve growth performance and have hepatoprotective and immunostimulant effects in newly hatched chicks

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 opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

EGYPTIAN DEMAND FOR FABA BEANS FROM THE MOST IMPORTANT INTERNATIONAL IMPORT MARKETS

The crops of the legumes, especially the domestic beans, are considered the most important food groups due to their high nutritional value, in addition to their importance in improving soil properties. The state aims to encourage the expansion of the faba bean production to fill the food gap and also to supply hard currency. Egypt is one of the most important importing countries for beans. The legume crops are considered the most important food groups because of the high nutritional value. The bean is a strategic commodity for the Egyptian citizen. The study aims at reducing the imports of the Egyptian faba bean. Egypt's demand for faba bean, estimation of the competitive advantage of the main exporting countries of Egypt, and the comparative advantage index. The study found that the quantity of Egyptian bean imports increased by an annual rate of about 2.41 thousand tons. This increase is statistically insignificant at 0.05 level, and the value of Egypt's imports of faba bean has taken an upward trend at an annual rate of about 7 million dollar This increase is statistically insignificant at 0.05 level, and the price of Egypt's imports of faba bean has taken an downward trend at an annual rate of about 14.5 dollar/tons This increase is statistically insignificant at 0.05 level and the study of the geographical distribution of imports of Egyptian fab beans shows that the United Kingdom, Australia and France Representing 88 % Of Egypt's imports of beans. The percentage of Egypt's imports of faba bean decreased at a growth rate of 14%. The volume of exports of the United Kingdom and France decreased by 38% and 96%, respectively, while Australia increased its exports by 5% The elasticity of demand functions also showed that the elasticity of the price demand of Australia's export price indicates that the de mand is inelastic and Egypt needs this commodity from the Australian market, and the income elasticity shows that the commodity is poor by increasing income. The explanation of the elasticity of the demand for the price of France's exports shows that the demand is inelastic and Egypt needs this commodity from the French market. It is also evident from the income elasticity that the commodity is normal, i.e., the increase in income is the required quantity of the commodity, while the elasticity of the price demand of the UK export price shows that demand is not Flexible and Egypt needs this commodity from the British market, as evidenced by the income elasticity that the commodity is poor by increasing the income decreases the required quantity of the commodity. The study of forecasting Egypt's imports of Australian beans shows that the volume of imports of beans is expected to increase from about 136 thousand tons in 2018 to about 245.6 thousand tons in 2025. It is expected that the quantity of imports of British beans will increase from about 58 thousand tons 2018 to about 277.3 thousand tons in 2025. It is expected that the quantity of imports of French beans will fall from about 0.334 thousand tons in 2018 to about 45.9 thousand tons. It is also expected that the quantity of Egyptian imports of beans will increase from about 410 thousand tons in 2018 to about 500 thousand tons in 2025, is expected to decrease the amount of domestic production of beans from about 144 thousand tons in 2018 to about 16 thousand tons And it was found that the available amount of consumption is expected to decrease from about 281 thousand tons in 2018 to about 72.5 thousand tons in 2025

Experimental Investigation on Machinability of α/β Titanium Alloys with Different Microstructures

In the current study, Ti-6Al-4V (Ti64) and Ti-6Al-7Nb (Ti67) alloys were prepared by vacuum arc melting. The produced samples were then subjected to different heat treatment regimes. The evolved microstructures and their corresponding hardness were investigated. Computerized drilling tests using TiAlN-coated high-speed steel bits were performed to assess the machinability of the prepared specimen regarding cutting force, tool wear, and thickness of the deformed layer. It was observed that Ti64 specimens that were water quenched from either α/β or β range contained martensitic phase. In Ti67, samples showed martensite only when water quenched from the β-phase range (1070 °C). Formation of martensite resulted in higher hardness and hence led to higher cutting forces and increased tool wear during the drilling process. Machined samples with higher hardness formed a thicker subsurface deformation area (white layer) and increased burr heights. Surface roughness in Ti64 workpieces was generally higher compared to Ti67 specimens. The coat of the drilling bit was partially attacked in the as-cast specimens, which was evident by elemental N on the machining chips. The machining tool deteriorated further by increasing the workpiece hardness through martensitic formation, where elements such as Cr, V, Fe, etc. that came from the tool steel were detected

Combined Treatment of Adipose Derived-Mesenchymal Stem Cells and Pregabalin Is Superior to Monotherapy for the Treatment of Neuropathic Pain in Rats

Aims. Neuropathic pain following nerve injury does not respond well to most available pharmacological remedies. We aimed to compare the outcome of the addition of adipose-derived mesenchymal stem cells (ADMSCs) to pregabalin for neuropathic pain treatment. Methods. Adult female albino rats (n=100) were randomized to receive traumatic sciatic nerve injury or sham. Animals were then randomized to ADMSC treatment with or without pregabalin. We conducted a battery of neurobehavioral and electrophysiological to assess neuropathic pain. Following sacrifice, we evaluated the histological changes and gene expression of brain-derived neurotrophic factor (BDNF) in the sciatic nerve. Serum and sciatic nerve tissue pro- and inflammatory cytokine levels were also assessed. Results. (1) All treatments significantly improved thermal withdrawal latency, sciatic nerve conduction velocity, and proinflammatory cytokine levels in injured animals, with no significant effect of the combined treatments compared to pregabalin monotherapy (p<0.05 each). (2) Combined treatment significantly improved medial gastrocnemius electromyographic amplitude and sciatic function index compared to pregabalin monotherapy (p<0.05 each). (3) Combined treatment significantly increased the BDNF expression, decreased anti-inflammatory cytokine (p<0.05 each), and restored the structural nerve damage, compared to pregabalin monotherapy. Conclusions. Combined treatment is associated with greater improvement of the sciatic nerve structure and function. Further studies are warranted to study the mechanism of action of the combined treatment to improve neuropathic pain

Assessment of nurses' knowledge and practice regarding prevention of deep venous thrombosis among hospitalized patients with COVID-19

Background: Venous thromboembolism is a leading cause of patient morbidity. In hospitalized patients with COVID-19, it is a common and potentially fatal complication. Knowledge and effective practice on VTE prophylaxis are vital for the proper management of patients. Inadequate knowledge and poor practice of health professionals towards Venous thromboembolism prophylaxis increased patients' complications. The aim of this study assess nurses' knowledge and practice regarding prevention of deep venous thrombosis among hospitalized patients with COVID-19. Design: A descriptive expletory design. Setting: The study was conducted at New Al Kasr Al Einy Teaching Hospital (Cairo University Hospitals. Egypt). Subject: A convenient sample included 100 nurses from the previously mentioned setting.&nbsp; Tools: Data were collected using two tools; a self-administrated questionnaire and, an observational checklist. Results: showed that, less than half of the studied nurses were more than 30 years. Majority of them were female, more than half had Institute of nursing, and majority of them had experience more than 6 years. About three quadrants of them had unsatisfactory level of knowledge and incompetent level of practice regarding prevention of deep venous thrombosis among hospitalized patients with COVID-19.&nbsp

Influence of Microstructure and Alloy Composition on the Machinability of α/β Titanium Alloys

A comparative study was conducted for the machining of two α/β titanium alloys, namely Ti-6Al-4V (Ti64) and Ti-6Al-7Nb (Ti67), using wire electric discharge machining (WEDM). The influence of cutting speed and cutting mode on the machined surfaces in terms of surface roughness (Ra), recast layer (RL), and micro-hardness have been evaluated. Rough cut (RC) mode at a cutting speed of 50 µm/s resulted in thermal damage; Ra was equal to 5.68 ± 0.44 and 4.52 ± 0.35 µm for Ti64 and Ti67, respectively. Trim-cut mode using seven cuts (TRC-VII) at the same speed decreased the Ra to 1.02 ± 0.20 µm for Ti64 and 0.92 ± 0.10 µm for Ti67. At 100 µm/s, Ra reduced from 2.34 ± 0.28 µm to 0.88 ± 0.12 µm (Ti64), and from 1.42 ± 0.15 µm to 0.90 ± 0.08µm (Ti67) upon changing from TRC-III to TRC-VII. Furthermore, a thick recast layer of 30 ± 0.93 µm for Ti64 and 14 ± 0.68 µm for Ti67 was produced using the rough mode, while TRC-III and TRC-VII modes produced layers of 12 ± 1.31 µm and 5 ± 0.72 µm for Ti64 and Ti67, respectively. Moreover, rough cut and trim cut modes of WEDM played a significant role in promoting the surface hardness of Ti64 and Ti67. By employing the Response Surface Methodology, it was found that the machining mode followed by cutting speed and the interaction between them are the most influential parameters on surface roughness. Finally, mathematical models correlating machining parameters to surface roughness were successfully developed. The results strongly promote the trim-cut mode of WEDM as a promising machining route for two-phase titanium alloys