Effect of Palm Fiber-Hydrated Lime Composition on the Permeability of Stabilised Sandy Soil

Sandy soil is one of the most conventional construction materials used as backfill materials in the retention of structures in foundations. This study to investigate the composition of admixture permeability experimental to stabilized sandy soil use the composition percentage (4, 6, & 8% hydrated lime only), sandy soil with 2% hydrated lime (0.5%, 1%, and 1.5% palm fiber) and 6% of hydrated lime (0.5%, 1% and 1.5% of palm fiber) proportionally. The results presented that the mixture of 2% and 6% hydrated lime with 0.5%, 1%, and 1.5% of palm fiber proportionally, decreased the percentage of reduction of permeability from 94.22% at 0 days to 66.67% at 7 days. The mixture of 6% of hydrated lime and 1.5% of palm fiber at 0 dan 7 curing time give a better performance. Thus, this helps in using the constant head method in Geotechnical practices

Improving Resnet-9 Generalization Trained on Small Datasets

This paper presents our proposed approach that won the first prize at the ICLR competition on Hardware Aware Efficient Training. The challenge is to achieve the highest possible accuracy in an image classification task in less than 10 minutes. The training is done on a small dataset of 5000 images picked randomly from CIFAR-10 dataset. The evaluation is performed by the competition organizers on a secret dataset with 1000 images of the same size. Our approach includes applying a series of technique for improving the generalization of ResNet-9 including: sharpness aware optimization, label smoothing, gradient centralization, input patch whitening as well as metalearning based training. Our experiments show that the ResNet-9 can achieve the accuracy of 88% while trained only on a 10% subset of CIFAR-10 dataset in less than 10 minuet

TensorDash: Exploiting Sparsity to Accelerate Deep Neural Network Training and Inference

TensorDash is a hardware level technique for enabling data-parallel MAC units to take advantage of sparsity in their input operand streams. When used to compose a hardware accelerator for deep learning, TensorDash can speedup the training process while also increasing energy efficiency. TensorDash combines a low-cost, sparse input operand interconnect comprising an 8-input multiplexer per multiplier input, with an area-efficient hardware scheduler. While the interconnect allows a very limited set of movements per operand, the scheduler can effectively extract sparsity when it is present in the activations, weights or gradients of neural networks. Over a wide set of models covering various applications, TensorDash accelerates the training process by $1.95{\times}$ while being $1.89\times$ more energy-efficient, $1.6\times$ more energy efficient when taking on-chip and off-chip memory accesses into account. While TensorDash works with any datatype, we demonstrate it with both single-precision floating-point units and bfloat16

MANAGEMENT AND ASSESSMENT OF DEHYDRATION IN PEDIATRICS

The level of fluid deficit may be difficult to scientifically quantify and there is no laboratory worth that is either delicate or details to approximate the degree of dehydration in children. Rehydration may take place by means of oral, subcutaneous, or IV paths. We performed a search using electronic databases; MEDLINE, science-direct, and EMBASE, through October, 2018. Dehydration related to gastroenteritis makes up a considerable worry of disease worldwide. Most of dehydration is amenable to ORT; only the treatment of severe dehydration needs IVF. Prior pilot data on the superiority of rapid IVF administration for rehydration has actually been refuted. Nevertheless, a new research suggests that initial rehydration with glucose including IVF trends toward lowering the return visits and decreasing the admission rates. More data on the efficiency and safety and security of antiemetics has actually been produced. Antiemetics have been proven well tolerated without masking severe alternate diagnoses, efficacious in improving the success of ORT, and affordable. These brand-new data supporters highly for the consolidation of antiemetics right into the scientific guidelines. Variability in guideline conformity has been shown, with doctors mentioning troubles in evaluating dehydration and scientific judgment as factors for variation

Geotechnical aspects of alluvial soils at different depths under sodium chloride action in Najran region, Saudi Arabia: Field supported by laboratory tests

The current research study is aimed at studying the impact of sodium chloride on the performance of semi-arid soils in the Najran area of Saudi Arabia. Experimental work has been undertaken to investigate how adding salt to the semi-arid soil collected in the Najran area affects the boundaries of Atterberg, compaction characteristics, California bearing ratio, and shear strength. All testing was conducted on soil samples from different zones of the Najran area at varying depths of 1.5, 3, and 4.5 m along the soil profiles. The soil samples were analyzed individually and then compared with the same soil samples mixed with NaCl at different percentages of 5, 10, and 20% by weight of the dry soil. Using advanced techniques, such as the scanning electron microscope, energy dispersive x-ray analysis, and X-ray diffraction analysis, the stabilization process was examined. The findings revealed that NaCl significantly impacts the geotechnical characteristics of semi-arid soils. The maximum dry density increased from 1.995, 1.93, and 1.96 to 2.02, 1.99, and 2.03 g/cm3, and the optimal water content decreased from 9.47, 13.7, and 11.29 to 7.01, 9.58%, and 8.09% with 20% NaCl added at various depths, respectively. Shear resistance parameters were improved by adding 20% NaCl, where the soil cohesion increased from 0.1333, 0.0872, and 0.0533 to 0.1843, 0.1034, and 0.0372 kg/cm2, and the angle of internal friction increased from 24°, 25.5°, and 29° to 27.8°, 30°, and 33°, respectively. The liquid and plastic limits and, in turn, the plasticity index reduced as the added percentage of NaCl increased. Furthermore, the California bearing ratio percentages significantly increased and reached more than 50%. As a result, it is established that NaCl is an excellent stabilizer, especially at 20% concentration, and might be used as a sub-base substance in highway construction

Budesonide as a first line therapy in autoimmune hepatitis: A systematic review

BackgroundAutoimmune hepatitis (AIH) Is a chronic liver disease with female predominance. Treatment of this condition required usually a long-term corticosteroid therapy.AimsCurrent review aimed to summarize the efficacy of budesonide as a first line treatment in AIH.Methods Pub Med, ‎Google Scholar, and EBSCO ‎ databases were ‎systematically search for relevant articles. The terms ‎ ‎‎autoimmune hepatitis, budesonide, prednisolone and ‎azathioprine ‎were used. out of hundred ‎and six, only ‎five fulfilled ‎the inclusion criteria. Results Out of 106 articles, only 5 included in this review. All patients included in current review were steroid naive. Budesonide in dose of 3 mg trice a day was the used in 2 out of 5 studies both document complete platelet response in 50–80 per cent. Azathioprine was added to budesonide in 3 out of 5 studies, 60 per cent of the budesonide treated patient had a complete platelet response versus 30–40 per cent of prednisolone treated group.ConclusionIn non-cirrhotic AIH patients, budesonide was as effective as prednisolone with fewer steroid related side effects.

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

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years