Geoelectrical Investigation for Possible Artificial Groundwater Recharge Site in Al-Jiftlik / Wadi Al-Faria

Al-Faria watershed is located in the northeastern region of the West Bank. The watershed extends for 30 km from Nablus in the west to the Jordan River in the east, with area of 331 km2 .Wadi Al-Faria area is considered an important agricultural resource in Palestine. Fresh water is scarce in Palestine, and especially in Al-Faria area. Since more than three million cubic meters of fresh water flow in the Wadi during winter months, the idea of this research is to store this good quality fresh water in underground with minimum negative quality impact and to make it possible for extraction during summer time when demand reach the highest peak. Through Vertical Resistivity Sounding, the underground lithological profile with a depth up to 150 m is constructed. The investigated site locates in the lower part of Al-Jiftlik area, and cover an area of 1.5 k 2m. A gravel layer with 20 m thick, and located by 20 m depth, with total volume of 30X106 cm could be to store 8-10 mcm. Deep infiltration ponds or injection wells are recommended to be used in ground water artificial recharge because of low hydraulic conductivity ( 38.9 x10-6 m/s) that dominate the soil cover and remnants of Lisan formation, which locate in some locations very close to the surface which could influence the quality of infiltrated water through this method. The hydrochemistry of the groundwater of the area shoes its un suitability for domestic purposes, since it's EC is very high (≈4.0 mS/cm), and the chloride concentration is range between 700 and 1000mg/

Exploring biomedical and traditional care pathways for people with psychosis in Karachi, Pakistan

BACKGROUND: Psychosis is known to have an adverse impact on an individual’s quality of life, social and occupational functioning. A lack of treatment options for psychotic disorders such as schizophrenia contributes to adverse outcomes for individuals. A significant proportion of people with psychosis consult both formal and traditional routes of care. This warrants a need to explore perceptions around treatment options provided by diverse care providers, as the identification of avenues for support can improve psychiatric, alternative treatment and social outcomes. METHODS: Focus groups discussions (FGDs) and in-depth interviews (IDIs) were used. Interactive Research and Development (IRD) research staff conducted 20 IDIs and 2 FGDs to obtain information about the perspectives, treatment pathways and experiences of individuals with psychosis, their caregivers, and service providers. Questions for clinician care providers and faith healers revolved around perceptions of psychosis, service users’ background, subject knowledge and treatment, feedback and referral mechanisms, and promotion of services. A thematic analysis was used to analyze the interviews and coding was conducted on NVivo. RESULTS: The results were categorized into five themes: perception of psychosis, experience of seeking/receiving care, assessment and diagnosis methods, promotion of services, and living with psychosis. Across service providers and patients, there was a wide variety of causes attributed to psychosis, and an overall lack of awareness regarding severe mental health conditions from both formal and informal care-providers. Biomedical treatment received mixed reviews, while some reported it as beneficial, the limited number of institutes and clinicians to cater for patients, stigma within society and care providers, the burden of caregiving, and misinformation from faith healers were all significant barriers to treatment. CONCLUSION: The results highlight the use of traditional healing practices for psychosis in Pakistan, which, coupled with inadequate referral mechanisms, present an opportunity to bridge the treatment gap between clinical and traditional healing practices through integration of treatment within community structures and systems. Better awareness of psychosis and its treatment methods, alongside interventions that reduce stigma could help facilitate help-seeking behavior and reduce the burden of caregiving

Hypertensive supratentorial intracerebral Hemorrhage: early surgery and functional Outcome; a tertiary care hospital experience from Karachi, Pakistan.

BACKGROUND: Spontaneous supratentorialintracerebral hemorrhage (ICH) has a high morbidity and mortality and places a significant burden on health and social services.The role and timing of operative neurosurgical intervention remain controversial and the practice and timing of surgery continue to be haphazard. METHODOLOGY: Our study was a descriptive study conducted at Civil hospital Karachi, Pakistan. Sample size was calculated. The sampling technique of our study was non probability. The data was collected and analyzed using spssvs 17. Data was observed for any descriptive and inferential statistics. RESULTS: There were 38 males (63.3%) and 22 females (36.7%). The mean age of patients was 52.7 years. 36 patients (60%) had right hemispheric hemorrhage while 24 patients (40%) had left hemispheric hemorrhage. 48 patients (80%) had typical putaminal hemorrhage while 6 (5%) patients had subcortical and 6 (5%) occipital bleed. Regarding the improvement of neurological status, 16 patients (26%) were able to perform daily activities. 9 patients (15%) were able to take care of themselves at home while 07 patients (11%) required partial care. 10 patients (16%) were vegetative and 18 (30%) patients died. CONCLUSION: Our study revealed that early evacuation of large hematoma resulted in short ICU and short hospital stay, less postoperative complications and overall good functional recovery particularly in middle aged and younger patients with non dominant hemispheric hemorrhage therefore early surgical intervention definitely has the role in the management of extensive intracerebral hemorrhage

Antiplasmodium and chloroquine resistance reversing effects of embelin against Plasmodium falciparum K1

Background: Emergence of chloroquine (CQ) resistance among different strains of Plasmodium falciparum is the worst catastrophe that has ever perplexed efforts to eradicate malaria. This behooved the scientists to search for new alternatives or sensitizers that augment its action. Method: In this experiment, the potential of embeline, a quinonoid phytochemical obtained from the Indian plant Embelia ribes, to inhibit the growth and sensitize CQ action was screened using SYBRE green-1 based drug sensitivity assay and isobologram technique respectively. Its effect on both RBCs and Vero cells stability and RBCs fragility was screened to assess its safety. To depict its molecular mechanism, its effect on hemozoin formation and the new permeation pathway (NPP) of the host RBCs membrane were screened. Furthermore, its anti-oxidant activity was measured using the conventional in vitro tests and its molecular characters were obtained using Molispiration program. Results: The results showed that its antiplasmodial effect was weaker than CQ but synergism was obtained when they were combined together. Its low anti-plasmodial potency and poor selectivity toward RBCs reduces its eligibility to be introduced as an antimalarial. Nevertheless, it synergized CQ at a concentration within the safe limit. Embelin did not produce any impact on NPP but its impact on hemozoin formation was pronounced. Its antiplasmodium effect can be attributed to the latter or to its effect on RBCs membrane but further investigations are required to detect its CQ resistance. Conclusion: Overall, embelin is not ideal to be used as antiplasmodium but can be suggested as CQ resistance reversing agent

Molecular detection of Strongyloides ratti in faecal samples from wild rats in Serdang, Malaysia

Purpose: To detect Strongyloides ratti in faecal samples using conventional methods and to confirm the identification using a sensitive and specific method, namely, polymerase chain reaction (PCR). Methods: A PCR method targeting the small subunit of the rRNA gene was performed in this study for the detection of DNA from Strongyloides ratti (an animal model of S. stercoralis) in faecal samples of wild Brown rats, Rattus norvegicus. Results: Strongyloides ratti was detected in 34.2 % of collected rats by different conventional techniques and confirmed by PCR. The essay presented 100 % sensitivity with Strongyloides universal primer. Conclusion: The findings of this study suggest that the application of PCR with universal primer is a very sensitive methodology to detect S. ratti in faecal material of wild rats infected even with very low parasite burden

Vitamin K1 As A Potential Molecule For Reducing Single-Walled Carbon Nanotubes-Stimulated α-Synuclein Structural Changes And Cytotoxicity

Aims: Different kinds of vitamins can be used as promising candidates to mitigate the structural changes of proteins and associated cytotoxicity stimulated by NPs. Therefore, the structural changes of α-syn molecules and their associated cytotoxicity in the presence of SWCNTs either alone or co-incubated with vitamin K1 were studied by spectroscopic, bioinformatical, and cellular assays. Methods: Intrinsic and ThT fluorescence, CD, and Congo red absorption spectroscopic approaches as well as TEM investigation, molecular docking, and molecular dynamics were used to explore the protective effect of vitamin K1 on the structural changes of α-syn induced by SWCNTs. The cytotoxicity of α-syn/SWCNTs co-incubated with vitamin K1 against SHSY5Y cells was also carried out by MTT, LDH, and caspase-3 assays. Results: Fluorescence spectroscopy showed that vitamin K1 has a significant effect in reducing SWCNT-induced fluorescence quenching and aggregation of α- syn. CD, Congo red adsorption, and TEM investigations determined that co-incubation of α- syn with vitamin K1 inhibited the propensity of α-syn into the structural changes and amorphous aggregation in the presence of SWCNT. Docking studies determined the occupation of preferred docked site of SWCNT by vitamin K1 on α- syn conformation. A molecular dynamics study also showed that vitamin K1 reduced the structural changes of α- syn induced by SWCNT. Cellular data exhibited that the cytotoxicity of α- syn co-incubated with vitamin K1 in the presence of SWCNTs is less than the outcomes obtained in the absence of the vitamin K1. Conclusion: It may be concluded that vitamin K1 decreases the propensity of α- syn aggregation in the presence of SWCNTs and induction of cytotoxicity

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

Global, regional and national burden of bladder cancer and its attributable risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease study 2019

Introduction The current study determined the level and trends associated with the incidence, death and disability rates for bladder cancer and its attributable risk factors in 204 countries and territories, from 1990 to 2019, by age, sex and sociodemographic index (SDI; a composite measure of sociodemographic factors). Methods Various data sources from different countries, including vital registration and cancer registries were used to generate estimates. Mortality data and incidence data transformed to mortality estimates using the mortality to incidence ratio (MIR) were used in a cause of death ensemble model to estimate mortality. Mortality estimates were divided by the MIR to produce incidence estimates. Prevalence was calculated using incidence and MIR-based survival estimates. Age-specific mortality and standardised life expectancy were used to estimate years of life lost (YLLs). Prevalence was multiplied by disability weights to estimate years lived with disability (YLDs), while disability-adjusted life years (DALYs) are the sum of the YLLs and YLDs. All estimates were presented as counts and age-standardised rates per 100 000 population. Results Globally, there were 524 000 bladder cancer incident cases (95% uncertainty interval 476 000 to 569 000) and 229 000 bladder cancer deaths (211 000 to 243 000) in 2019. Age-standardised death rate decreased by 15.7% (8.6 to 21.0), during the period 1990–2019. Bladder cancer accounted for 4.39 million (4.09 to 4.70) DALYs in 2019, and the age-standardised DALY rate decreased significantly by 18.6% (11.2 to 24.3) during the period 1990–2019. In 2019, Monaco had the highest age-standardised incidence rate (31.9 cases (23.3 to 56.9) per 100 000), while Lebanon had the highest age-standardised death rate (10.4 (8.1 to 13.7)). Cabo Verde had the highest increase in age-standardised incidence (284.2% (214.1 to 362.8)) and death rates (190.3% (139.3 to 251.1)) between 1990 and 2019. In 2019, the global age-standardised incidence and death rates were higher among males than females, across all age groups and peaked in the 95+ age group. Globally, 36.8% (28.5 to 44.0) of bladder cancer DALYs were attributable to smoking, more so in males than females (43.7% (34.0 to 51.8) vs 15.2% (10.9 to 19.4)). In addition, 9.1% (1.9 to 19.6) of the DALYs were attributable to elevated fasting plasma glucose (FPG) (males 9.3% (1.6 to 20.9); females 8.4% (1.6 to 19.1)). Conclusions There was considerable variation in the burden of bladder cancer between countries during the period 1990–2019. Although there was a clear global decrease in the age-standardised death, and DALY rates, some countries experienced an increase in these rates. National policy makers should learn from these differences, and allocate resources for preventative measures, based on their country-specific estimates. In addition, smoking and elevated FPG play an important role in the burden of bladder cancer and need to be addressed with prevention programmes.publishedVersio

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020