Prevalence of Clostridium diffiile infections among hospitalized patients in Amman, Jordan: A Multi-Center Study

Clostridium diffiile is a Gram-positive endospore-forming bacillus that was discovered as a bowel colonizer and pathogen in 1935. Healthy newborns and infants were found to be colonized with C. diffiil eat rates ranging from 45 to 70%. However, the prevalence of toxigenic strains was found to be as low as 13%. The colonization rates decline as individuals grow older, reaching rates lower than 5% in urban-dwelling healthy adults. However, colonization rates as high as 25-55% has been detected among adult hospitalized patientsand nursing home resident

Heart Rate as a Predictor of Challenging Behaviours among Children with Autism from Wearable Sensors in Social Robot Interactions

Children with autism face challenges in various skills (e.g., communication and social) and they exhibit challenging behaviours. These challenging behaviours represent a challenge to their families, therapists, and caregivers, especially during therapy sessions. In this study, we have investigated several machine learning techniques and data modalities acquired using wearable sensors from children with autism during their interactions with social robots and toys in their potential to detect challenging behaviours. Each child wore a wearable device that collected data. Video annotations of the sessions were used to identify the occurrence of challenging behaviours. Extracted time features (i.e., mean, standard deviation, min, and max) in conjunction with four machine learning techniques were considered to detect challenging behaviors. The heart rate variability (HRV) changes have also been investigated in this study. The XGBoost algorithm has achieved the best performance (i.e., an accuracy of 99%). Additionally, physiological features outperformed the kinetic ones, with the heart rate being the main contributing feature in the prediction performance. One HRV parameter (i.e., RMSSD) was found to correlate with the occurrence of challenging behaviours. This work highlights the importance of developing the tools and methods to detect challenging behaviors among children with autism during aided sessions with social robots

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

DETECTION AND COLLECTION OF WASTE USING A PARTIALLY SUBMERGED AQUATIC ROBOT

With the amount of waste being dispersed into oceans on the rise, mitigating this issue has become a global concern. In the past few decades, governments, scientists, organizations, and individuals have been attempting to attenuate the effects of global warming, partially caused by improper waste disposal into oceans. This study presents a solar powered partially submerged aquatic robot constructed from recycled, recyclable, upcycled, and sustainable materials. The robot aims to provide flexibility in the choice of construction materials by not being limited to what operating system, microcontroller, motors, and robot floaters are used. This robot detects and collects 7 different categories of commonly littered waste namely cardboard (95.3%), wrappers (94.1%), metal cans (93.8%), surgical face masks (93.2%), plastic bags (96.2%), polystyrene (92.6%), and plastic bottles (93.8%). The custom detection system was evaluated based on whether it is capable of detecting waste and how well if little, medium, and high movement was introduced to the robot. Furthermore, the detection system's performance in low light situations along with the drivetrain's effectiveness were tested. Future improvements include forming larger dataset, enhancing the detection system's low light capabilities, and attaching a larger battery

How to Attack a Disconnected Computer

This poster presents how a disconnected computer, that has no network access, can be attacked to retrieve data. Air-gapped devices are thought to be an impenetrable setup because the device is disconnected from the network and cannot be reached by an attacker. Therefore, an infected air-gapped computer cannot affect others around it preventing any potential information leaks. People believe/assume that leaking information from an air-gapped machine is impossible. This research effort invalidates this assumption by exploring possible covert channels to get data from victim machines. We take advantage of a hidden acoustic channel that employs the computer speakers and a tiny audio recording device to communicate sensitive data over inaudible near-ultrasonic signals. Data stored on this device can then be processed and displayed as useful information on the attacker's computer. Hacking methods and the search for new system exploits are being continuously developed and new techniques to obtain data unlawfully are on the rise. Therefore, this work alerts organizations regarding potential threats that they typically ignore by assuming that air-gapped systems are safe. In the past, security researchers have not devoted sufficient time and effort to innovate counter measures for such niche but capable attacks. Spreading awareness is one of the main objectives of this project. This is done by demonstrating that data can be stolen from an 'air-gapped' computer, by using methods that people neglect to consider when coming up with plans to protect their computers from attackers. An experiment, such as this, will hopefully push the security field researchers and developers to explore the uncommon methods of unlawful data acquisition and their prevention

Detection of challenging behaviours of children with autism using wearable sensors during interactions with social robots

Autism spectrum disorder is a neurodevelopmental disorder that is characterized by patterns of behaviours and difficulties with social communication and interaction. Children on the spectrum exhibit atypical, restricted, repetitive, and challenging behaviours. In this study, we investigate the feasibility of integrating wearable sensors and machine learning techniques to detect the occurrence of challenging behaviours in real-time. A session of a child with autism interacting with different stimuli groups that included social robots was annotated with observed challenging behaviors. The child wore a wearable device that captured different motion and physiological signals. Different features and machine learning configurations were investigated to identify the most effective combination. Our results showed that physiological signals in addition to typical kinetic measures led to more accurate predictions. The best features and learning model combination achieved an accuracy of 97%. The findings of this work motivate research toward methods of early detection of challenging behaviours, which may enable the timely intervention by caregivers and possibly by social robots

Heart Rate as a Predictor of Challenging Behaviours among Children with Autism from Wearable Sensors in Social Robot Interactions

Children with autism face challenges in various skills (e.g., communication and social) and they exhibit challenging behaviours. These challenging behaviours represent a challenge to their families, therapists, and caregivers, especially during therapy sessions. In this study, we have investigated several machine learning techniques and data modalities acquired using wearable sensors from children with autism during their interactions with social robots and toys in their potential to detect challenging behaviours. Each child wore a wearable device that collected data. Video annotations of the sessions were used to identify the occurrence of challenging behaviours. Extracted time features (i.e., mean, standard deviation, min, and max) in conjunction with four machine learning techniques were considered to detect challenging behaviors. The heart rate variability (HRV) changes have also been investigated in this study. The XGBoost algorithm has achieved the best performance (i.e., an accuracy of 99%). Additionally, physiological features outperformed the kinetic ones, with the heart rate being the main contributing feature in the prediction performance. One HRV parameter (i.e., RMSSD) was found to correlate with the occurrence of challenging behaviours. This work highlights the importance of developing the tools and methods to detect challenging behaviors among children with autism during aided sessions with social robots

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit