Evaluating the Effects of Human Activity over the Last Decades on the Soil Organic Carbon Pool Using Satellite Imagery and GIS Techniques in the Nile Delta Area, Egypt

The study aims to clarify the relationship between soil organic carbon (SOC) and human activity under arid conditions, in the east area of the Nile Delta, Egypt. SOC is one of the critical factors in food production and plays an important role in the climate change because it affects the physio-chemical soil characteristics, plant growth, and contributes to sustainable development on global levels. For the purpose of our investigations, 120 soil samples (0–30 cm) were collected throughout different land uses and soil types of the study area. Multiple linear regressions (MLR) were used to investigate the spatiotemporal relationship of SOC, soil characteristics, and environmental factors. Remote sensing data acquired from Landsat 5 TM in July 1995 and operational land imager (OLI) in July 2018 were used to model SOC pool. The results revealed significant variations of soil organic carbon pool (SOCP) among different soil textures and land-uses. Soil with high clay content revealed an increase in the percentage of soil organic carbon, and had mean SOCP of 6.08 ± 1.91 Mg C ha−1, followed by clay loams and loamy soils. The higher values of SOCP were observed in the northern regions of the study area. The phenomenon is associated with the expansion of the human activity of initiating fish ponds that reflected higher values of SOC that were related to the organic additions used as nutrients for fish. Nevertheless, the SOC values decreased in southeast of the study area with the decrease of soil moisture contents and the increase in the heavy texture profiles. As a whole, our findings pointed out that the human factor has had a significant impact on the variation of soil organic carbon values in the Eastern Nile Delta from 1995 to 2018. As land use changes from agricultural activity to fish ponds, the SOCP significantly increased. The agriculture land-use revealed higher SOCP with 60.77 Mg C ha−1 in clay soils followed by fish ponds with 53.43 Mg C ha−1. The results also showed a decrease in SOCP values due to an increasing in land surface temperature (LST) thus highlighting that influence of temperature and ambient soil conditions linked to land-use changes have a marked impact on surface SOCP and C sequestration

Routine versus selective plasma exchange before thymectomy in myasthenia gravis

Background: Prethymectomy plasma exchange may improve the outcome of surgery; however, the technique is associated with an increased risk of complications. Therefore, the objective of this study was to compare selective versus routine plasma exchange before thymectomy in patients with myasthenia gravis. Method: We conducted a prospective multi-center cohort study to compare two protocols for plasma exchange before thymectomy. We compared the routine plasma exchange in all patients undergoing thymectomy for myasthenia gravis (group I; n= 30) versus selective exchange (Group II; n= 30). Endpoints were the duration of postoperative mechanical ventilation, plasma exchange, and operative complications. Results: There was no difference in age between both groups (30± 10.1 vs. 29± 9.2 years in Group I and II, respectively; p= 0.69). There were 17 females in Group I (56.67%) vs. 16 in group II (53.33%) (p= 0.8). Comorbidities are comparable between groups. All patients preoperative pyridostigmine, and 27 patients (90%) in Group I and 26 patients (87%) in Group II received glucocorticoids. There was no difference in pulmonary function tests between groups. Plasma exchange related complications were not different between groups. Immediate extubation was achieved in 29 patients (97%) in Group II, and after 6 hours in one patient (3.33%). In Group I, 28 patients (93%) extubated immediately, and two patients were ventilated for 7-12 hours. The mean ICU stay was 1.5 days in Group I and 1.4 days in group II (p= 0.615). The mean hospital stay was 8.5 days in Group I and 9.2 days in group II (p= 0.118). There was no significant difference in pathology between groups (p= 0.137). Conclusion: Selective plasma exchange is feasible before thymectomy for myasthenia gravis. Selective plasma exchange may decrease exchange related complications without affecting the operative outcomes

Estimation of key potentially toxic elements in arid agricultural soils using Vis-NIR spectroscopy with variable selection and PLSR algorithms

Potentially toxic elements (PTEs) pose a significant threat to soil and the environment. Therefore, the fast quantification of PTEs is crucial for better management of contaminated sites. Versatile technique such as Visible near-infrared spectroscopy (Vis–NIRS) (350–2,500 nm) has attracted tremendous attention for assessing PTEs and has achieved promising results combined with successful multivariate analysis. This research investigated the potential of Vis–NIRS combined with partial least squares regression (PLSR) and variable selection methods to assess key PTEs (Cd, Co, Cu, Cr, Pb, and Zn) in agricultural soils under arid conditions. The soil samples (80) were collected from a polluted area around Al-Moheet drainage, Minya Governorate–upper Egypt. The samples were scanned using an ASD FieldSpec-4 spectroradiometer. Simulated annealing (SA) and uninformative variable elimination (UVE) were used to select the effective wavelengths in predicting PTEs. PLSR was used to develop the spectral models using the full range (FR-PLS) and feature-selected spectra techniques SA (SA-PLS) and UVE (UVE-PLS). The results indicated that UVE-PLS models performed better than FR-PLS and SA-PLS models in predicting the key PTEs. The obtained coefficient of determination (R2) and the ratio of performance to deviation (RPD) were 0.74 and 2.48 (Cr), 0.72 and 2.03 (Pb), 0.62 and 1.86 (Cd), 0.59 and 1.78 (Cu), 0.52 and 1.68 (Co), and 0.46 and 1.41 (Zn), respectively. The results suggested that the UVE-PLS spectral model is promising for predicting Cr, Pb, and Cd, and can be improved for predicting Cu, Co, and Zn elements in agricultural soils

Формирование водно-солевого режима почв при многолетнем орошении городскими сточными водами в условиях Египта

The water and salt regimes of alluvial soils of lacustrine origin, and gray-brown desert soil, located in the northern part of Egypt. We consider the soil moisture regime and its formation during irrigation wastewater. Established irrigation norm for the cultivation of maize for green fodder. The processes of salinization of alluvial soils and gray-brown desert soil proved that long-term wastewater irrigation enhances the processes of colonization and saline soils when irrigated with river and groundwater into being the medium of saline.В статье рассмотрены результаты исследований водного и солевого режимов аллювиальных почв озерного происхождения и пустынных серо-бурых почв, расположенных в северной части Египта, а также водный режим почв и его формирование при орошении сточными водами. Установлена оросительная норма при возделывании кукурузы на зеленую массу. Изучены процессы засоления аллювиальных и пустынных серо-бурых почв. Доказано, что многолетнее орошение сточными водами усиливает процессы засоления и слабозасоленные почвы при их орошении переходят в разряд среднезасоленных

Results of Radial Head Prosthetic Replacement in Management of Radial Head Fracture in Terrible Triad Injury of the Elbow

Background: The “terrible triad injury of the elbow” is complex fracture dislocation injury comprising a notorious combination of elbow dislocation and fractures of the coronoid process and radial head. Objectives: The work aimed to demonstrate the results of radial head prosthetic replacement in management of fracture head of radius in terrible triad injury of the elbow in terms of clinical and radiological outcomes. Patients and methods: This is a retrospective study that includes 20 patients that fulfilled inclusion criteria, presented with terrible triad injury of the elbow to Qena University Hospital trauma unit in the period between July 2018 and August 2022, managed with prosthetic replacement of the radial head using non-modular metal spacer and reconstruction of elbow ligaments. Results: We found that most patients (18 patients, 90%) reported return to previous work and daily activity, at least14 patients (70%) reported good functional ROM in their last follow-up with mean MEPS and QuickDASH scores 76 and 37.09 points, respectively. On the other hand, there was a high rate of complications. Most significantly, two patients (10%) experienced residual valgus instability. Another two (10%) patients demonstrated heterotrophic calcification. Four (20%) patients suffered nerve injury. Conclusion: Current surgical protocols made it possible to achieve acceptable outcome and regain the joint function using economically affordable, cost-effective, non-modular prosthesis. However, there is still significant risk of long-term disability and high rate of complications

Factor V G1691A (Leiden) is a major etiological factor in Egyptian Budd-Chiari syndrome patients

Objective: Budd-Chiari syndrome is a multifactorial disease in which several prothrombotic disorders may predispose patients to the development of thrombosis at this uncommon location (hepatic veins). The aim of this study was to determine the prevalence and characteristics of inherited thrombophilia in Egyptian Budd-Chiari syndrome patients.Materials and Methods: The study included 47 Budd-Chiari syndrome patients (20 children and 27 adults). Genotyping of Factor V G1691A (Leiden), prothrombin G20210A (PT), and methylenetetrahydrofolate reductase C677T were performed using real-time PCR and fluorescence melting curve detection analysis.Results: Factor V Leiden was observed in 29 patients (61.7%). It is the only factor that caused Budd-Chiari syndrome in 18 of the patients and in 5 of the patients with inferior vena cava involvement. Myeloproliferative disease was noted in 12 (25.5%) patients, antiphospholipid syndrome in 5 (10.6%), and Behcet’s disease in 3 (6.4%). Interestingly, 3 of the children with Budd-Chiari syndrome had lipid storage disease.Conclusion: Factor V Leiden was a major etiological factor in Egyptian Budd-Chiari syndrome patients, which may have been related to the high frequency of this mutation in the study region. Factor V Leiden was also a strong thrombophilic factor and the leading cause of inferior vena cava thrombosis in these patients. Lipid storage disease should be included as a risk factor for Budd-Chiari syndrome

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

The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care. . .'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Copyright

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo