Implementation of an Automated Vacuum Elevator System

في السنوات الأخيرة أصبح مَصعَد الفراغ الهوائي هو خِياراً شائعاً في بيوتِنا والبنايات المنخفظة. يمثّل مَصعَد الفراغ الهوائي مَفهوم جَديد مُطوّر عن فِكرة استبدال الهواء المضغوط بالهواء المُفرّغ. إنّ مَصعَد الفراغ الهوائي قادر على نقل الأشخاص بين طوابق بناية بدون إستعمال لأيّ أحبال، أو أوزان، أو بكرات. في البحث الحالي تَمّ تركيب وتنفيذ نموذج لمنظومة مَصعَد فراغي كهرو هوائي بسيط ومُنخفض الكُلفة. نموذج نظام المصعَد يتألف من ثلاثة طوابق ويَرفع حُمولة 6 كيلوغرام. تَمّ تَوظيف المُسيطر المنطِقي القابل للبرمجة (PLC)، من سلسلة (LS\GLOFA-G7M-DR30U) ذو (16) مَدخل و(12) مَخرج ومُبرمج ببرامج المُخطط السُلمّي (Ladder)، للسيطرة المُؤتّمَتة الكامِلة على مَنظُومة المَصعَد. مِن المتوقع أن تَنتَشر فِكرة نِظام المَصعَد المُقترح على نحو واسع في البنايات السَكّنية الواطِئة.Pneumatic vacuum elevator (PVE) has become a popular choice for our homes and low-rise buildings in recent years. The Pneumatic vacuum elevator represents a new concept evolved from the idea of pressed air applied in the pneumatic elevator replaced by a vacuum air idea. The pneumatic vacuum elevator is able to transport people between building floors without using any cables, counterweight, or pulleys. A simple and low cost construction and implementation for an Electro-pneumatic vacuum elevator system prototype is presented in this paper. The elevator system prototype is constructed with three floors to elevate a maximum load of 6kg. Programmable Logic Controller (PLC) of (LS\GLOFA-G7M-DR30U) series with (16) inputs and (12) outputs programmed with Ladder diagram software is used for the fully automated the elevator system. The idea of the proposed elevator system may be predicted to be widely spread in the low-rise residential buildings

Performance Enhancement of Photovoltaic Panel Using Double-sides Water Glazing Chambers Cooling Technique

The efficiency of the solar PV panel decreases significantly as the PV panel’s operating temperature increases. There are many cooling techniques might be suitably deal with this problem to enhance the solar panel efficiency. The presented cooling technique used for solving the PV panel’s temperature elevation is an active close loop cooling system, accomplished using two water glazing chambers made from acrylic glass placed at the PV panel surfaces (rear and front). These champers are utilized for cooling down the PV cell’s temperature, as well as filtering the useful sunlight spectrum. The results show that the PV cell’s temperature reduction by 50.06% with using the cooling system, this leads to an average increase in the maximum output power and consequently electrical efficiency of the PV panel by about 12.69% and 14.2%, respectively

Assessment of disturbed voltage supply effects on steady-state performance of an induction motor

An electric power system is usually exposed to unequal and variable loads across its three phases, which leads to voltage unbalance and variation, making the three-phase voltages asymmetrical in nature at the distribution end. This problem is clearly evident in Iraq country, particularly with regard to the fluctuating voltage levels of electricity distribution during peak hours. Providing a three-phase motor with asymmetric voltages is badly affecting its working performance. Estimating the performance of this motor at steady-state under different conditions of voltage disturbances is investigated in this paper through Matlab simulation using Symmetrical component approach. The motor performance represented by active and reactive input powers, output put power, developed torque, power losses, efficiency and power factor is analyzed under full load conditions. Also, the steady-state power losses- and torque-slip characteristics at certain degrees of voltage unbalance have been calculated and plotte

Thermal Performance Analysis of Parabolic Trough Solar Concentrator with Helical Tube Receiver

In this paper, the experimental thermal performance for a parabolic trough solar concentrator (PTSC) combined with helical tube receiver and directed by two axes solar tracking system at different amount of water flow rates has been analyzed. The experimental test results of thermal performance with regard to temperature rise of water, useful heat gain and collector thermal efficiency for the PTSC prototype at controlled water flow rates (2.3, 22.5 and 29.4 L/h) are collected. The results show that the increase of water mass flow rates causes decrease in the average water output temperature as (120.8, 63.82 and 46.08oC), respectively, the maximum outlet temperature becomes (160.5, 76, 47) oC, respectively, and thus, the average useful heat gain will be (1249.4, 732, 732.5W), respectively and the average thermal efficiency decreases as (73.021, 49.51 and 44.31 %), respectively. The experimental results show that decrease the water mass flow rate by 74.4%, causes an increase in the thermal efficiency of the PTSC by 64.7%

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Distribution of Candida infections in patients and evaluation of the synergic interactions of some drugs against emerging fluconazole- and caspofungin-resistant C. auris

Pathogenic multidrug-resistant Candida species are considered some of the most important health risks. This work aimed to evaluate and monitor the prevalence of the human pathogenic Candida strains isolated from patients in King Fahd Medical City (KFMD), Riyadh, Saudi Arabia, and to evaluate the synergy of some antimicrobial agents against Candida species’ resistance to antifungal drugs. The retrospective analysis, identification using biochemical tests, minimal inhibitory concentrations using E-tests, determination of the fraction inhibitory concentration index value for synergic testing, and simulation of 100 experiments using Monte Carlo simulation methods were performed according to standard protocols. The findings showed that all age groups of males and females can be infected by Candida species; furthermore, human pathogenic Candida species can be isolated from several clinical samples and different human body sites. The minimal inhibitory concentration results showed that many multidrug-resistant Candida strains, such as C. albicans, emerged in 2020 compared to 2018. Candida albicans remains the most important pathogen among all Candia species, found in 51.7 % and 42.4 % of the isolates in 2018 and 2020, respectively. In 2018, many isolates of C albicans showed resistance to itraconazole, fluconazole, anidulafungin, amphotericin B, ketoconazole, voriconazole, caspofungin, and flucytosine. In 2018, all C. auris isolates (N = 94) were resistant to fluconazole, and more than 85 % (N = 76) of C. albicans isolates were resistant to itraconazole, while only 5.9 % (N = 2) were resistant in 2018. The study concluded that the resistance to antifungal drugs among pathogenic yeasts is increasing and constantly changing and that surveillance of these pathogens must continue. Also, the synergy between drugs remains an appropriate option for confronting this risk, especially between natural extracts and drugs. Despite the lack of evidence for any antifungal and antibacterial drug's ability to synergistically suppress the fluconazole- and caspofungin-resistant C. auris strains diagnosed in this study, the surveillance and synergic tactics continue to be viable options for dealing with these human pathogenic yeasts

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially