Factors Affecting the Reluctance to Pursue Teaching as a Career from the Perspective of Students in the Sultanate of Oman: A mixed-approach Investigation

هدفت الدراسة الحالية إلى الكشف عن العوامل المؤثرة في عزوف الطلبة عن مهنة التدريس بسلطنة عمان. استخدمت الدراسة المنهج المختلط، حيث تم جمع البيانات الكمية من خلال مقياس العوامل المؤثرة على اختيار مهنة التدريس بعد تعريبه وتكييفه لمجتمع الدراسة المكون من طلبة الصفوف 10-12 (ن= 3455)، أما البيانات النوعية فقد تم جمعها من خلال مجموعات النقاش البؤرية مع طلبة هذه الصفوف (ن= 253). أشارت النتائج إلى أن العوامل المؤثرة في عزوف الطلبة عن مهنة التدريس تمحورت حول: صعوبة المهنة، وقلة حوافزها المادية، وتدني المكانة الاجتماعية لها مقارنة بالمهن الأخرى، بينما بينت نتائج مجموعات النقاش البؤرية وجود آراء إيجابية وسلبية للمهنة، ووجود تحديات أبرزها: صعوبة التعامل مع عدد كبير من الطلبة، وتوقف ترقيات المعلمين، وتعيين المعلمين بعيدا عن أماكن إقامتهم. كما بين أغلبية طلبة المدارس من الجنسين بأنه ليس لديهم الرغبة والاتجاه الإيجابي لاختيار التدريس كمهنة المستقبل. كما أشارت نتائج الدراسة المتعلقة بالفروق بين الجنسين إلى وجود فروق دالة إحصائيا لصالح الذكور في العزوف عن مهنة التدريس

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Economic and environmental sustainability for anaerobic biological treatment of wastewater from paper and cardboard manufacturing industry

The sustainable application of an up-flow anaerobic baffled reactor (UABR) to treat real paper and cardboard industrial effluent (PCIE) containing bronopol (2-bromo-2-nitropropan-1, 3-diol) was investigated. At a hydraulic retention time (HRT) of 11.7 h and a bronopol concentration of 7.0 mg L-1, the removal efficiencies of total chemical oxygen demand (CODtotal), CODsoluble, CODparticulate, total suspended solids (TSS), volatile suspended solids (VSS), carbohydrates, and proteins were 55.3 +/- 5.2%, 26.8 +/- 2.3%, 94.4 +/- 4.6%, 89.4 +/- 2.6%, 84.5 +/- 3.2%, 72.1 +/- 1.8%, and 22.4 +/- 1.8%, respectively. The conversion of complex organics (e.g., carbohydrates and proteins) into bio-methane (CH4) was assisted via enzyme activities of, in U (100 mL)(-1), alpha-amylase (224-270), alpha-xylanase (171-188), carboxymethyl cellulase (CM-cellulase) (146-187), polygalacturonase (56-126), and protease (67,000-75300). The acidogenic condition was dominant at a short HRT of 2.9 h, where methane yield dropped by 32.5%. Under this condition, the growth of methanogenic bacteria could be inhibited by volatile fatty acids (VFA) accumulation. The analysis of Fourier-transform infrared (FTIR) spectra detected peaks relevant to methylene and nitro groups in the sludge samples, suggesting that entrapment/adsorption by the sludge bed could be a major mechanism for removing bronopol. The economic feasibility of UABR, as proposed to receive 100 m(3) d(-1) of PCIE, showed a payback period (profits from environmental benefits, biogas recovery, and carbon credit) of 7.6 yr. The study outcomes showed a high connection to the environmental-, economic-, and social related sustainable development goals (SDGs)

Biomarkers of acute kidney injury in children with congenital heart disease after cardiopulmonary bypass

Background: Acute kidney injury (AKI) is a serious postoperative complication after cardiac surgery in children and is a major contributor to patient outcome. This study aims to identify the incidence of AKI in children undergoing cardiac surgery and the role of Interleukin 18 (IL-18) and Kidney Injury Molecule 1 (KIM-1) in diagnosis of AKI in comparison to creatinine. Methods: Forty-four children who underwent open heart surgery using cardiopulmonary bypass) for congenital heart disease were assessed for AKI diagnosis according the KDIGO criteria, urinary IL-18 and KIM-1 were determined by Enzyme Linked Immunosorbent Assay in addition to the assessment of length of stay in PICU and outcome and the effect of AKI on these parameters. Results: twenty three percent of the patient developed AKI, there were no statistical correlation between AKI and the factors (Age, gender, CBP and Risk adjustment for congenital heart surgery (RACHS-1) complexity score). Eight of our patients needed peritoneal dialysis (PD), seven of them developed AKI and the 8th patient didn’t develop due to the early initiation of PD. There was strong correlation between the development of AKI and the Length of stay in ICU

Combating hematopoietic and hepatocellular abnormalities resulting from administration of cisplatin: role of liver targeted glycyrrhetinic acid nanoliposomes loaded with amino acids

The effectiveness of cisplatin in cancer treatment renders its use vital to clinicians. However, the accompanying side effects as cachexia, emesis and liver damage necessitate the use of a dietary supplement which is capable of hindering such undesirable complications. The branched chain amino acids as well as glutamine and arginine have been proven to be effective nutritional co-adjuvant therapeutic agents. Furthermore, new pharmaceutical approaches encompass designing organ-targeted nanoformulations to increase the medicinal efficacy. Therefore, the aim of the present study was to investigate the beneficial effects of liver-targeted amino acids-loaded nanoliposomes in counteracting the adverse hematopoietic and hepatic complications associated with cisplatin. Results revealed the use of the combination of two nanoliposomal formulations (one loading leucine + isolecuine + valine, and the other loading glutamine and arginine) given orally at a dose of 200 mg/kg for twelve days was effective against cisplatin-induced toxicities represented by improvement in the complete blood picture parameters, decrease in the serum hepatic enzymes levels, amelioration of the hepatic oxidative stress and cellular energy imbalance along with reduction in the histopathological abnormalities. It can be concluded that amino acids loaded nanoliposomes could be considered a new strategy in preventing cisplatin’s adverse effects.</p

Deep Learning Methods Used in Remote Sensing Images: A Review

Undeniably, Deep Learning (DL) has rapidly eroded traditional machine learning in Remote Sensing (RS) and geoscience domains with applications such as scene understanding, material identification, extreme weather detection, oil spill identification, among many others. Traditional machine learning algorithms are given less and less attention in the era of big data. Recently, a substantial amount of work aimed at developing image classification approaches based on the DL model’s success in computer vision. The number of relevant articles has nearly doubled every year since 2015. Advances in remote sensing technology, as well as the rapidly expanding volume of publicly available satellite imagery on a worldwide scale, have opened up the possibilities for a wide range of modern applications. However, there are some challenges related to the availability of annotated data, the complex nature of data, and model parameterization, which strongly impact performance. In this article, a comprehensive review of the literature encompassing a broad spectrum of pioneer work in remote sensing image classification is presented including network architectures (vintage Convolutional Neural Network, CNN; Fully Convolutional Networks, FCN; encoder-decoder, recurrent networks; attention models, and generative adversarial models). The characteristics, capabilities, and limitations of current DL models were examined, and potential research directions were discussed

OLD TEXTS, NEW MASKS: A CRITICAL REVIEW OF MISREADING EVOLUTION ONTO HISTORICAL ISLAMIC TEXTS

© 2019 by the Joint Publication Board of Zygon With the increasing interest in Islam and evolution, some Islamic thinkers have vehemently rejected evolution, while others have eagerly embraced it. However, those seeking to embrace evolution sometimes err in their interpretation of historical writings. Indeed, there are texts written by famous historical scholars of Islam who seem to suggest that humans have evolved from lower forms of species. These include Ibn Khaldūn, Jalāl ad-Dīn Rūmī, al-Jāhiz, and The Brethren of Purity (Ikhwān al Safā). Although this may be true, such readings are a mistaken interpretation of the aforementioned authors who are actually referring to some form of the scalae naturae (the Great Chain of Being). This reference to the Great Chain of Being is unknown to some contemporary readers who mistakenly believe these writers to be discussing an evolutionary or a proto-evolutionary theory. This article demonstrates how and why these historical records do not actually represent any notion of evolution as it is currently understood, in the hope of avoiding any further erroneous claims that seem to be proliferating among modern thinkers