MF Integrator: A Module for Converting METAFONT into Outline Font

METAFONT is a description language that generates TeX-oriented bitmap fonts which are not popular outside the TeX world. The number of fonts prepared with METAFONT are very small compared with outline fonts. Font libraries like FreeType, which are used to render fonts in outline and some bitmap formats doesn’t provide any support for METAFONT. A research, MFCONFIG module added an indirect support of METAFONT inside FreeType rasterizer but it has problems of performance and dependency. In this paper, we have proposed a module named MF Integrator for FreeType rasterizer. The proposed module overcome the problems of performance and dependency of MFCONFIG module. Authors tested proposed module with a client application which is used to display styled text on screen. Users can now take the benefits of METAFONT by using our proposed MF Integrator module

Association of Serum Gamma-Glutamyl Transferase and C-Reactive Protein as a Biomarkers of Oxidative Stress in Patients of Type 2 Diabetes Mellitus

Objective: To compare Serum gamma-glutamyl transferase and serum C-reactive protein as biomarker of oxidative stress in patients of type 2 Diabetes Mellitus. Study Design: Comparative cross-sectional study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Pathology, department of Chemical Pathology and Endocrinology Rawalpindi. The duration of study was 6 months i.e., 17 Nov 2021 – 17 May 2022 after approval from Institutional Review Board FC-CHP21-12/Read-IRB/22/846. Materials and Methods: An analytical, cross-sectional research was carried out at Armed Forces Institute of Pathology Rawalpindi. An overall 300 diabetic patients were included between ages of 45 – 65 years. Group I had 100 nondiabetic individuals of 45 – 65 years of age with HbA1c < 5.7 %. Group II and III included 100 patients each of DM of matched age with HbA1c 6.5 – 7 % and greater than 7 % respectively, without any other chronic disease. Serum gamma-glutamyl transferase, HbA1c, Serum C-Reactive Protein were analyzed. Moreover, some more biochemical investigations such as serum liver enzymes were measured to rule out any liver disease. One-way ANOVA was followed up by post-hoc Tukey analysis for intergroup comparison. Results: Mean serum gamma-glutamyl transferase levels were markedly increased in group III patients followed by group II and normal in group I. The mean of serum gamma-glutamyl transferase in group I was (9.38+4.05U/l), group II (34.27+15.07 U/l) and group III (47.08+20.56 U/l). The mean of Serum C-Reactive Protein in group I was (11+6.02 mg/l), group II (62.07+ 26.94 mg/l) and group III (107.73+57.03 mg/l). Pearson correlation revealed prominent positive correlation between HbA1c, serum gamma-glutamyl transferase and Serum C-Reactive Protein with r value of serum gamma-glutamyl transferase (0.838367) and Serum C-Reactive Protein (0.684722). One-way ANOVA and post-hoc Tukey analysis had p value of < 0.05 which was statistically significant. Conclusion: Serum gamma-glutamyl transferase is better marker of oxidative stress in patients of type 2 diabetes mellitus as compared to Serum C-Reactive Protein. The r value of serum gamma-glutamyl transferase is (0.838367) and Serum C-Reactive Protein is (0.684722) indicating strong positive correlation of serum gamma-glutamyl transferase with HbA1c. Therefore, Serum gamma-glutamyl transferase can be used for the prevention and monitoring of complications of type 2 Diabetes Mellitus

Photocatalytic degradation of organic dyes and biological potentials of biogenic zinc oxide nanoparticles synthesized using the polar extract of Cyperus scariosus R.Br. (Cyperaceae)

In this study, the polar root extract of Cyperus scariosus R.Br. was used for the biogenic synthesis of ZnO NPs. The results of this study show that ZnO NPs have a spherical structure with an average size of 85.4 nm. The synthesized catalysts were tested for their photocatalytic activity by degrading methyl orange and methylene blue under sunlight. Improved degradation efficiencies of 79.44% and 84.92% were achieved within 120 min. ZnO NPs exhibited strong antibacterial activity against both Gram-positive Listeria monocytogenes (18 mm) and Staphylococcus epidermidis (20 mm) and Gram-negative strains of Escherichia coli (16 mm) and Bordetella bronchiseptica (14 mm), as shown by the inhibition zones, which were comparable to the positive control (ceftriaxone) but larger than the plant root extract. ZnO NPs showed high antioxidant activity, as a ferric-reducing antioxidant power assay value of 66.29 µg (AAE µg·mL−1) and a DPPH value of 57.44 µg (AAE µg·mL−1) were obtained at a concentration of 500 µL, which was higher than those of the C. scariosus root extract. Quantification of the total phenolic and flavonoid content yielded values of 57.63 µg (GAE µg·mL−1) and 70.59 µg (QCE µg·mL−1), respectively. At a concentration of 500 μL (1 mg·mL−1), the tested nanoparticles (NPs) showed a greater anti-inflammatory effect (84.12%) compared to the root extract of C. scariosus (34.39%). Overall, our findings highlight the versatile properties of green synthesized ZnO NPs and demonstrate their potential for environmental remediation and antimicrobial formulations, as well as promising candidates for further investigation in biomedical fields such as drug delivery and therapy

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

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

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

FontNet: Closing the gap to font designer performance in font synthesis

Font synthesis has been a very active topic in recent years because manual font design requires domain expertise and is a labor-intensive and time-consuming job. While remarkably successful, existing methods for font synthesis have major shortcomings; they require finetuning for unobserved font style with large reference images, the recent few-shot font synthesis methods are either designed for specific language systems or they operate on low-resolution images which limits their use. In this paper, we tackle this font synthesis problem by learning the font style in the embedding space. To this end, we propose a model, called FontNet, that simultaneously learns to separate font styles in the embedding space where distances directly correspond to a measure of font similarity, and translates input images into the given observed or unobserved font style. Additionally, we design the network architecture and training procedure that can be adopted for any language system and can produce high-resolution font images. Thanks to this approach, our proposed method outperforms the existing state-of-the-art font generation methods on both qualitative and quantitative experiments.Comment: 5 pages, 2 Figures, 3 Tables. Accepted paper for AI4CC 2022 (https://ai4cc.net/

CCFont: Component-Based Chinese Font Generation Model Using Generative Adversarial Networks (GANs)

Font generation using deep learning has made considerable progress using image style transfer, but the automatic conversion/generation of Chinese characters still remains a difficult task owing to the complex character shape and large number of Chinese characters. Most known Chinese character generation models use the image conversion method of the Chinese character shape itself; however, it is difficult to reproduce complex Chinese characters. Recent methods have utilized character compositionality by separating up to three or four components to improve the quality of generated characters, but it is still difficult to generate high-quality results for complex Chinese characters with many components. In this study, we proposed the CCFont model (component-based Chinese font generation model using generative adversarial networks (GANs)) that automatically generates all Chinese characters using Chinese character components (up to 17 components). The CCFont model generates all Chinese characters in various styles using the components of Chinese characters based on conditional GAN. By acquiring local style information from the components, the information is more accurate and there is less information loss than when global information is obtained from the image of the entire character, reducing the failure of style conversion and improving quality to produce high-quality results. Additionally, the CCFont model generates high-quality results without any additional training (zero-shot font generation without any additional training) for the first-seen characters and styles. For example, the CCFont model, which was trained with only traditional Chinese (TC) characters, generates high-quality results for languages that can be divided into components, such as Korean and Thai, as well as simplified Chinese (SC) characters that are only seen during inference. CCFont can be adopted as a multi-lingual font-generation model that can be applied to all languages, which can be divided into components. To the best of our knowledge, the proposed method is the first to generate a zero-shot multilingual generation model using components. Qualitative and quantitative experiments were conducted to demonstrate the effectiveness of the proposed method