Antimicrobial resistance (AMR) is a serious challenge for infectious disease prevention and treatment, according to the World Health Organization. It is a worldwide problem caused primarily by ...inappropriate and insufficient therapy, misuse of antimicrobials without physician supervision, unnecessary hospital readmissions, and other factors. AMR has several consequences, including increased medical costs and mortality. The present study aimed to evaluate imipenem resistance in gram-negative bacteria in Central Pediatric Teaching Hospital in Baghdad, Iraq, and determine this bacteria resistance in different samples. Initially, a total of 100 different samples were collected from child patients from October 1, 2020, to August 31, 2021. Each isolate was identified using VITEK 2 automated microbiology system. The recorded data showed that the isolated organisms resistant to imipenem included
(n=21),
(n=19), and
(n=16). In the current study,
was the most common pathogen in males (n=57) compared to female (n=43), followed by
and
, particularly in the age range of 1 day- 3 years. Depending on the sample type,
, the most imipenem-resistant bacteria, was found more in the urine of patients with urinary tract infections.
was equally found in blood, urine, wound swab, and sputum samples. In comparison to other samples,
was found in greater numbers in the blood and in an equal number in urine and cerebrospinal.
Objectives
HIV infection is well known to cause impairment of the human immune system, and until recently was a leading cause of death. It has been shown that T lymphocytes are the main targets of ...HIV. The virus inactivates T lymphocytes by interfering with a wide range of cellular and molecular targets, leading to suppression of the immune system. The objective of this review is to investigate to what extent microRNAs (miRNAs) are involved in HIV pathogenesis.
Methods
The scientific literature (Pubmed and Google scholar) for the period 1988–2019 was searched.
Results
Mounting evidence has revealed that miRNAs are involved in viral replication and immune response, whether by direct targeting of viral transcripts or through indirect modulation of virus‐related host pathways. In addition, exosomes have been found to act as nanoscale carriers involved in HIV pathogenesis. These nanovehicles target their cargos (i.e. DNA, RNA, viral proteins and miRNAs) leading to alteration of the behaviour of recipient cells.
Conclusions
miRNAs and exosomes are important players in HIV pathogenesis. Additionally, there are potential diagnostic applications of miRNAs as biomarkers in HIV infection.
Purpose
Surgical workflow analysis seeks to systematically break down operations into hierarchal components. It facilitates education, training, and understanding of surgical variations. There are ...known educational demands and variations in surgical practice in endoscopic transsphenoidal approaches to pituitary adenomas. Through an iterative consensus process, we generated a surgical workflow reflective of contemporary surgical practice.
Methods
A mixed-methods consensus process composed of a literature review and iterative Delphi surveys was carried out within the Pituitary Society. Each round of the survey was repeated until data saturation and > 90% consensus was reached.
Results
There was a 100% response rate and no attrition across both Delphi rounds. Eighteen international expert panel members participated. An extensive workflow of 4 phases (nasal, sphenoid, sellar and closure) and 40 steps, with associated technical errors and adverse events, were agreed upon by 100% of panel members across rounds. Both core and case-specific or surgeon-specific variations in operative steps were captured.
Conclusions
Through an international expert panel consensus, a workflow for the performance of endoscopic transsphenoidal pituitary adenoma resection has been generated. This workflow captures a wide range of contemporary operative practice. The agreed “core” steps will serve as a foundation for education, training, assessment and technological development (e.g. models and simulators). The “optional” steps highlight areas of heterogeneity of practice that will benefit from further research (e.g. methods of skull base repair). Further adjustments could be made to increase applicability around the world.
Network scale-up is one of the most important indirect methods of estimating the size of clandestine populations and people with high-risk behaviors. The present study is an indirect estimation of ...the population size of students with high-risk behaviors in select universities of medical sciences.
A total of 801 students from two University of Medical Sciences at Tehran and Alborz University of Medical Sciences were selected through convenience sampling. Six subgroups of high-risk behaviors were examined in the study, including Tramadol use, cannabis use, opium use, alcohol consumption, extramarital heterosexual intercourse, and heterosexual intercourse in return for money. To estimate the social network size in the study population, each participant was asked to name their close student friends from the two select universities. Data were collected using a checklist designed for this purpose.
The participants' mean number of close friends from the selected medical universities was C = 8.14 (CI: 7.54-8.75). Within these social networks, friends with extramarital heterosexual intercourse (5.53%) and friends who consumed alcohol (4.92%) had the highest frequency, and friends who used opium (0.33%) had the lowest frequency. The variables of age, gender, marital status, type of residence and academic degree were significantly related to the likelihood of having close friends with certain high-risk behaviors (P<0.001).
According to the results obtained, alcohol consumption and extramarital heterosexual intercourse are very common among students. Special HIV prevention programs are therefore necessary for this age group.
The effect of a brief analytical treatment interruption (ATI) on the HIV-1 latent reservoir of individuals who initiate antiretroviral therapy (ART) during chronic infection is unknown.
We evaluated ...the impact of transient viremia on the latent reservoir in participants who underwent an ATI and at least 6 months of subsequent viral suppression in a clinical trial testing the effect of passive infusion of the broadly neutralizing Ab VRC01 during ATI.
Measures of total HIV-1 DNA, cell-associated RNA, and infectious units per million cells (IUPM) (measured by quantitative viral outgrowth assay QVOA) were not statistically different before or after ATI. Phylogenetic analyses of HIV-1 env sequences from QVOA and proviral DNA demonstrated little change in the composition of the virus populations comprising the pre- and post-ATI reservoir. Expanded clones were common in both QVOA and proviral DNA sequences. The frequency of clonal populations differed significantly between QVOA viruses, proviral DNA sequences, and the viruses that reactivated in vivo.
The results indicate that transient viremia from ATI does not substantially alter measures of the latent reservoir, that clonal expansion is prevalent within the latent reservoir, and that characterization of latent viruses that can reactivate in vivo remains challenging.
ClinicalTrials.gov NCT02463227FUNDING. Funding was provided by the NIH.
Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels ...and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories.
We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.
Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.
Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.
Bill & Melinda Gates Foundation, National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.
Limonene, a major constituent of citrus essential oil isolated from abraded fresh peels of bitter orange Citrus aurantium L., was tested for its toxicity against early 4th instar larvae of Culex ...quinquefasciatus Say. The response of treated larvae was concentration-dependent and LC(90s) were 53.80 and 32.52 ppm after 24 and 48h of treatment respectively. Limonene treated water was less favorable for oviposition by females of Cx. quinquefasciatus
In this study three new maps of Moho depths beneath the Arabian plate and margins are presented. The first map is based on the combined gravity model, EIGEN 06C, which includes data from satellite ...missions and ground-based studies, and thus covers the whole region between 31°E and 60°E and between 12°N and 36°N. The second map is based on seismological and ground-based gravity data while the third map is based only on seismological data. Both these maps show gaps due to lack of data coverage especially in the interior of the Arabian plate. Beneath the interior of the Arabian plate the Moho lies between 32 and 45km depth below sea level. There is a tendency for higher Pn and Sn velocities beneath the northeastern parts of the plate interior with respect to the southwestern parts of the plate interior. Across the northern, destructive margin with the Eurasian plate, the Moho depths increase to over 50km beneath the Zagros mountains. Across the conservative western margin, the Dead Sea Transform (DST), Moho depths decrease from almost 40km beneath the highlands east of the DST to about 21–23km under the southeastern Mediterranean Sea. This decrease seems to be modulated by a slight depression in the Moho beneath the southern DST. The constructive southwestern and southeastern margins of the Arabian plate also show the Moho shallowing from the plate interior towards the plate boundaries. A comparison of the abruptness of the Moho shallowing between the margins of the Arabian plate, the conjugate African margin at 26°N and several Atlantic margins shows a complex picture and suggests that the abruptness of the Moho shallowing may reflect fundamental differences in the original structure of the margins.
► Three new maps of Moho depths beneath the Arabian plate and margins are presented. ► The first map based on gravity model EIGEN 06C includes data from satellite missions. ► The other maps are based on seismological and ground-based gravity data. ► Moho depths vary dramatically beneath the margins of the Arabian plate. ► Moho depth variations across the margins correlate with the known geology.
Abstract
Composites of NbC/ZrO
2
reinforced with different weight ratios of Cr metal were prepared by dynamic compaction combustion from a blend of Nb
2
O
5
–Zr–Cr powders. Factors controlling the ...synthesis process, the microstructure, and the mechanical properties of the samples, such as Cr wt% and the compression loads were studied. The samples were characterized by XRD, SEM, porosity, and hardness measurements. The porosity value of the sample with no additives was high and reached 31.6 vol%. A sudden decrease in the sample porosity to 2.4 vol % was noticed for the sample containing 3.0 wt% of Cr. A high‐density sample with less than 2.0 vol % porosity and maximum hardness of 1038 HV was produced using 5.0 wt% Cr under 300 MPa compression load. Detailed thermodynamic calculations for the effect of Cr additives on the physicochemical properties of the system were introduced.
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