Influence of iron, phosphate, and silicate on arsenic removal from groundwater using a low-cost ceramic filter.

The ceramic filter amended with iron (Fe) has proven to be a potential low-cost method for arsenic (As) removal from groundwater. The presence of Fe, phosphate (P), and silicate (Si) significantly affects the As removal efficiency of the ceramic filter, which has not been passably investigated. The present research aimed to examine the effect of Fe, P, and (or) Si presence as single or in combination on As (III) removal from synthetics groundwater by a low-cost iron amended ceramic filter (IACF). Laboratory-scale filtration experiments at different compositions of Fe, P, Si, and As (III) were conducted by the IACF fabricated with a ceramic candle and iron netting box. Fe (II) in synthetic groundwater positively impacted As (III) removal. At a concentration of 2 mg/L of Fe (II), the As levels in the effluent decreased to less than the maximum contamination level (MCL) of 50 µg/L. Groundwater P concentration needed less than 3 mg/L or Si concentrations required less than 35 mg/L to effectively reduce As (III) to below the MCL at 5 mg/L of groundwater Fe (II). The cumulative effect of P and Si on As removal was found to be more significant than distinct contributions. The presence of 2 mg/L P and 35 mg/L or higher Si in the groundwater cumulatively reduced the As removal performance from 92% to 63%, and the MCL was not met. The negative impact of P and Si on As (III) removal followed the order of (P + Si) > P > Si. P competed with As for adsorption sites during the process, while Si inhibited the Fe release and floc formation, significantly reducing As removal performance. The study findings can potentially contribute to optimizing IACF as a low-cost method for As removal from groundwater.

Heat transport in inclined flow towards a rotating disk under MHD.

Flow towards a rotating disk is of highly practical significance in numerous engineering applications such as Turbine disks, rotary type machine systems and many more. In light of this, the current work is an attempt to explore MHD oblique flow towards a rotating disk. Hydromagnetic effects in addition to heat transfer is taken into consideration. The flow governing Partial Differential Equations are altered to a system to coupled non-linear Ordinary Differential Equations through scaling group of transformations which afterwards are tackled using Shooting Algorithm. The impact of obliqueness parameter γ, rotation ratio parameter [Formula: see text] and magnetic field parameter M on 2-dimensional and 3-dimensional stream contours are presented. Location of the shear center varies with magnetic field parameter. Heat flow at the disk surface boosts with magnet field parameter M and rotation ratio parameter [Formula: see text].

Variable fluid properties analysis for thermally laminated 3-dimensional magnetohydrodynamic non-Newtonian nanofluid over a stretching sheet.

This article is mainly focused on the viscous flow of cu-water/Methanol suspended nanofluids towards a three-dimensional stretching sheet reformed by magnetohydrodynamic phenomenon. The viscous effect is considered as temperature dependent with water treated as a base fluid. Similarity conversions are employed to set forth the non-linear equations of this physical problem. An innovative model for 3D analysis for cu-water/Methanol nanofluid with an irregular viscosity is presented in the present study. Reynold's model of viscosity is considered in the present study. Moreover, shooting technique is employed to elaborate the non-linear coupled governing equations with the relevant boundary conditions. The physical interpretation of these numerical calculations is presented through a graphical specimen of velocity, Nusselt number, temperature, and skin friction etc. The results of present model are showing quality harmony with the results of existing model. This model is being used for manipulating and designing the surfaces such as stretching/shrinking wrapping and panting devices in nanotechnology. The results also show the significant changes in flow characteristics with changing the value of stretching parameter. It is observed that with an increasing in nanoparticles volume fraction boundary layer thickness decreases. Further, it is also observed that with an increase in viscosity parameter, temperature increases because here we are considering temperature dependent viscosity.

Fear of COVID-19 as a precautionary measure to prevent the epidemic among the population of the Kurdistan Region/Iraq: based on a questionnaire survey.

Background and objectives: The World Health Organization (WHO) announced the appearance of a new coronavirus disease in Hubei province, China, to be a public health emergency of international concern. The objectives of this study can be highlighted through classifying the information sources for identifying protective practices, death probability, gender-death associations probability and education level. Methodology: This is a descriptive design study conducted among the Kurdistan Region/Iraq population via an online application between 1 March and 1 May 2020. Three hundred twenty people participated in this questionnaire study. The data were collected through an online form, relying upon a self-report questionnaire. The questionnaire had three main parts. The first part is related to the socio-demographic characteristics of the sample, including gender, age, family status, address status and education level. The second part involves the items related to precautionary measures using none, sometimes, and always. The last part contains items related to death probability owing to other causes and this includes five categories: extremely low, low, intermediate, high and extremely high. The validity and reliability of this questionnaire were revised by the panel of experts before the data collection. Results: The outcomes of the study revealed that the majority, ca. 73%, of the Kurdistan Region/Iraq population depended on TV to obtain information about COVID-19. Also, this investigation showed that there is a substantial association between participants with infection prevention and control practices relevant to COVID-19. Moreover, according to this study, there is a significant relationship between the death probability and COVID-19. Concurrently, there is not any significant association between other causes, namely cancer, heart diseases, diabetes and road traffic accidents, and the death probability. Conclusion: This study showed that for the majority of the Kurdistan Region/Iraq population the most reliable source of information for any COVID-19 related updates is the TV broadcast. This study also indicated that there is strong association for the majority of individuals regarding their practices for prevention from COVID-19 and death probability with COVID-19. However, there is not any substantial association between the epidemic and the other deadly calamities and the death probability.

Life Cycle Assessment of Construction and Demolition Waste Management in Riyadh, Saudi Arabia.

Extensive construction augmenting the infrastructure and real estate projects underpin Saudi Arabia's Vision 2030 of sustainable cities. A part of this struggle involves the transformation of the existing infrastructure together with new construction, which generates a large amount of construction and demolition waste (CDW). In the absence of a structured life cycle assessment (LCA) framework, the waste management companies are planning future scenarios (phased expansions of material recovery facilities to improve the recycling rate) primarily on economic grounds. This study assesses the environmental impacts of the existing and planned CDW management practices of the Saudi Investment Recycling Company in Riyadh City by dint of LCA. Impact 2002+ performs life cycle impact assessment of the base case (45% recycling), four treatments (61, 76, 88, and 100% recycling), and zero waste scenarios. The study demonstrates the benefits of current CDW (mixed soil, concrete blocks, clay bricks, glazed tiles, and asphalt) recycling in terms of avoided impacts of non-renewable energy, global warming, carcinogens, non-carcinogens, and respiratory inorganics potentially generated by landfilling. For the treatment scenario of 100% recycling, CDW conversion into a wide range of aggregates (0-50 mm) can replace 10-100% virgin aggregates in backfilling, precast concrete manufacturing, encasements and beddings of water mains and sewers, manholes construction, non-load bearing walls, and farm-to-market roads. To achieve long-term economic and environmental sustainability, municipalities need to improve source segregation, handling, and storage practices to enhance the existing (45%) recycling rate to 100% in the next five years and approach the zero-waste scenario by 2030. The findings of the present study motivate the generators for source reduction as well as encourage the recycling companies and concerned organizations in the continuous performance improvement of the CDW management systems across Saudi Arabia on environmental grounds, as an addition to the perceived economic benefits.

Exploration of bioconvection flow of MHD thixotropic nanofluid past a vertical surface coexisting with both nanoparticles and gyrotactic microorganisms.

This communication presents analysis of gravity-driven flow of a thixotropic fluid containing both nanoparticles and gyrotactic microorganisms along a vertical surface. To further describe the transport phenomenon, special cases of active and passive controls of nanoparticles are investigated. The governing partial differential equations of momentum, energy, nanoparticles concentration, and density of gyrotactic microorganisms equations are converted and parameterized into system of ordinary differential equations and the series solutions are obtained through Optimal Homotopy Analysis Method (OHAM). The related important parameters are tested and shown on the velocity, temperature, concentration and density of motile microorganisms profiles. It is observed that for both cases of active and passive control of nanoparticles, incremental values of thermophoretic parameters corresponds to decrease in the velocity distributions and augment the temperature distributions.

Preventable stillbirths in India and Pakistan: a prospective, observational study.

OBJECTIVE: Stillbirths occur 10-20 times more frequently in low-income settings compared with high-income settings. We created a methodology to define the proportion of stillbirths that are potentially preventable in low-income settings and applied it to stillbirths in sites in India and Pakistan. DESIGN: Prospective observational study. SETTING: Three maternity hospitals in Davangere, India and a large public hospital in Karachi, Pakistan. POPULATION: All cases of stillbirth at ≥20 weeks of gestation occurring from July 2018 to February 2020 were screened for participation; 872 stillbirths were included in this analysis. METHODS: We prospectively defined the conditions and gestational ages that defined the stillbirth cases considered potentially preventable. Informed consent was sought from the parent(s) once the stillbirth was identified, either before or soon after delivery. All information available, including obstetric and medical history, clinical course, fetal heart sounds on admission, the presence of maceration as well as examination of the stillbirth after delivery, histology, and polymerase chain reaction for infectious pathogens of the placenta and various fetal tissues, was used to assess whether a stillbirth was potentially preventable. MAIN OUTCOME MEASURES: Whether a stillbirth was determined to be potentially preventable and the criteria for assignment to those categories. RESULTS: Of 984 enrolled, 872 stillbirths at ≥20 weeks of gestation met the inclusion criteria and were included; of these, 55.5% were deemed to be potentially preventable. Of the 649 stillbirths at ≥28 weeks of gestation and ≥1000 g birthweight, 73.5% were considered potentially preventable. The most common conditions associated with a potentially preventable stillbirth at ≥28 weeks of gestation and ≥1000 g birthweight were small for gestational age (SGA) (52.8%), maternal hypertension (50.2%), antepartum haemorrhage (31.4%) and death that occurred after hospital admission (15.7%). CONCLUSIONS: Most stillbirths in these sites were deemed preventable and were often associated with maternal hypertension, antepartum haemorrhage, SGA and intrapartum demise. TWEETABLE ABSTRACT: Most stillbirths are preventable by better care for women with hypertension, growth restriction and antepartum haemorrhage.

Cost estimation alongside a multi-regional, multi-country randomized trial of antenatal ultrasound in five low-and-middle-income countries.

BACKGROUND: Improving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency. METHODS: We collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency. We assessed typical antenatal outpatient and hospital-based (facility) care for pregnant women, in general, with selective complication-related data collection in women participating in a large maternal health registry and clinical trial in five LMICs. We estimated average costs from a facility/health system perspective for outpatient and inpatient services. We converted all country-level currency cost estimates to 2015 United States dollars (USD). We compared average costs across countries for ANC visits, deliveries, higher-risk pregnancies, and complications, and conducted sensitivity analyses. RESULTS: Our study included sites in five countries representing different regions. Overall, the relative cost of individual ANC and delivery-related healthcare use was consistent among countries, generally corresponding to country-specific income levels. ANC outpatient visit cost estimates per patient among countries ranged from 15 to 30 USD, based on average counts for visits with and without US. Estimates for antenatal screening US visits were more costly than non-US visits. Costs associated with higher-risk pregnancies were influenced by rates of hospital delivery by cesarean section (mean per person delivery cost estimate range: 25-65 USD). CONCLUSIONS: Despite substantial differences among countries in infrastructures and health system capacity, there were similarities in resource allocation, delivery location, and country-level challenges. Overall, there was no clear suggestion that adding antenatal screening US would result in either major cost savings or major cost increases. However, antenatal screening US would have higher training and maintenance costs. Given the lack of clinical effectiveness evidence and greater resource constraints of LMICs, it is unlikely that introducing antenatal screening US would be economically efficient in these settings--on the demand side (i.e., patients) or supply side (i.e., healthcare providers). TRIAL REGISTRATION: Trial number: NCT01990625 (First posted: November 21, 2013 on https://clinicaltrials.gov ).

Analysis of non-Newtonian magnetic Casson blood flow in an inclined stenosed artery using Caputo-Fabrizio fractional derivatives.

BACKGROUND AND OBJECTIVE: Arterial diseases would lead to several serious disorders in the cardiovascular system such as atherosclerosis. These disorders are mainly caused by the presence of fatty deposits, cholesterol and lipoproteins inside blood vessel. This paper deals with the analysis of non-Newtonian magnetic blood flow in an inclined stenosed artery. METHODS: The Casson fluid was used to model the blood that flows under the influences of uniformly distributed magnetic field and oscillating pressure gradient. The governing fractional differential equations were expressed using the Caputo Fabrizio fractional derivative without singular kernel. RESULTS: The analytical solutions of velocities for non-Newtonian model were then calculated by means of Laplace and finite Hankel transforms. These velocities were then presented graphically. The result shows that the velocity increases with respect to Reynolds number and Casson parameter, while decreases when Hartmann number increases. CONCLUSIONS: Casson blood was treated as the non-Newtonian fluid. The MHD blood flow was accelerated by pressure gradient. These findings are beneficial for studying atherosclerosis therapy, the diagnosis and therapeutic treatment of some medical problems.

Association of haemoglobin levels in the first trimester and at 26-30 weeks with fetal and neonatal outcomes: a secondary analysis of the Global Network for Women's and Children's Health's ASPIRIN Trial.

OBJECTIVE: Limited data are available from low- and middle-income countries (LMICs) on the relationship of haemoglobin levels to adverse outcomes at different times during pregnancy. We evaluated the association of haemoglobin levels in nulliparous women at two times in pregnancy with pregnancy outcomes. DESIGN: ASPIRIN Trial data were used to study the association between haemoglobin levels measured at 6+0 -13+6  weeks and 26+0 -30+0  weeks of gestation with fetal and neonatal outcomes. SETTING: Obstetric care facilities in Pakistan, India, Kenya, Zambia, The Democratic Republic of the Congo and Guatemala. POPULATION: A total of 11 976 pregnant women. METHODS: Generalised linear models were used to obtain adjusted relative risks and 95% CI for adverse outcomes. MAIN OUTCOME MEASURES: Preterm birth, stillbirth, neonatal death, small for gestational age (SGA) and birthweight <2500 g. RESULTS: The mean haemoglobin levels at 6+0 -13+6  weeks and at 26-30 weeks of gestation were 116 g/l (SD 17) and 107 g/l (SD 15), respectively. In general, pregnancy outcomes were better with increasing haemoglobin. At 6+0 -13+6  weeks of gestation, stillbirth, SGA and birthweight <2500 g, were significantly associated with haemoglobin of 70-89 g/l compared with haemoglobin of 110-129 g/l The relationships of adverse pregnancy outcomes with various haemoglobin levels were more marked at 26-30 weeks of gestation. CONCLUSIONS: Both lower and some higher haemoglobin concentrations are associated with adverse fetal and neonatal outcomes at 6+0 -13+6  weeks and at 26-30 weeks of gestation, although the relationship with low haemoglobin levels appears more consistent and generally stronger. TWEETABLE ABSTRACT: Both lower and some higher haemoglobin concentrations were associated with adverse fetal and neonatal outcomes at 6-13 weeks and 26-30 weeks of gestation.

Source to Tap Risk Assessment for Intermittent Water Supply Systems in Arid Regions: An Integrated FTA-Fuzzy FMEA Methodology.

Water utilities in arid regions deal with multifaceted issues of natural groundwater contamination, high treatment costs, and low water rates. These utilities rely on intermittent supplies resulting in numerous water quality failures at source, treatment, distribution, and in-house plumbing systems. The present research presents an inclusive risk assessment methodology for managing water quality from source to tap. Three-year monitoring data for turbidity, TDS, pH, iron, ammonia, nitrates, residual chlorine, Coliform group, E. coli, and Fecal Streptococci identified the root causes of failures. The cause-effect relationships in the form of a fault tree were solved using multiple failure modes and effect analysis (FMEA) to handle both the Boolean operations. The fuzzy sets addressed the uncertainties associated with data limitations in calculating exceedance probabilities (Pe) and vagueness in expert opinion for subjective evaluation of severity and detectability. The methodology was applied on a smaller system serving 18,000 consumers in Qassim, Saudi Arabia. Potable supplied water underwent reoccurrence of TDS (Pe = 20%), turbidity (Pe = 10%), and Fe (Pe = 2%) failures in distribution that further increased up to 44%, 33%, and 11% at the consumer end. The Pe for residual chlorine failure soared up to 89%. Economic controls reduced the cumulative risk to 50%, while the shift to continuous supply can limit the remaining failures under the acceptable risk. The framework will help utilities manage water quality in intermittent systems from source to tap in Saudi Arabia, the Gulf, and elsewhere.

Spatiotemporal variations of DOM components in the Kushiro River impacted by a wetland.

Dissolved organic matter (DOM) has been recognized as a serious water quality problem in natural water bodies receiving pollution loads from point and nonpoint sources. The present study investigates the spatiotemporal variability of DOM composition in the Kushiro River and its tributaries (Eastern Hokkaido, Japan) impacted by the Kushiro wetland. Water samples were collected in the wet and dry seasons from several locations of the river and analyzed for DOM characteristics by UV-visible and excitation-emission matrix fluorescence spectroscopy techniques and by developing water quality index. Rather than the spatial effect, significant seasonal impacts on DOM pollution in the Kushiro River were observed. Overall concentrations of DOM decreased during the dry season. The increase of specific ultraviolet absorbance in the dry season indicated an increasing trend of humification, aromaticity and molecular weight of DOM. Five fluorescent peaks, including peaks A, C, M, B, and T were predicted by EEM spectra. Peaks A and C were found to be the most dominating peaks in both the seasons and indicated enrichment of humic-like matters in river water. The intensities of poly-aromatic humic substances as well as DOM components of microbial origin increase in the wet season and proteins like autochthonous DOM increase during the dry season. The study recognized the contribution of freshly produced DOM component by the decomposition of wetland plants in wet season and effect of snowfall in the dry season. Analysis of three fluorescence indices revealed that the river water primarily contains terrestrially dominated DOM. A significant impact of the adjacent WWTPs and wetland to the river water DOM were also observed. The water quality index of river water DOM showed low to medium levels of DOM pollution in the Kushiro River.

Bacterial mediated silver nanoparticles and their efficacy against MRSA.

Bacterial mediated Silver nanoparticles is considered as an emerging Ecofriendly approach to eradicate human pathogens. This paper aims to provide the biological approach for the synthesis of silver nanoparticles from indigenously isolated bacteria. This study will be beneficial to control the nosocomial infections triggered by MRSA (Methicillin-resistant Staphylococcus aureus). The current study is the extracellular synthesis of silver nanoparticles by using the cell free filtrate of bacterial strains isolated from the soil. The optimization study was also carried out to obtain the maximum production of silver nanoparticles. Nanoparticles were confirmed and characterized by UV-Vis spectroscopy and Transmission Electron Microscopy (TEM) having the plasmon resonance peak between 420-450nm with 10-60nm in size range and most were spherical in shape. Synthesized silver nanoparticles showed a potential antibacterial activity against MRSA (Methicillin Resistant Staphylococcus aureus) in-vitro study. This is the green approach for the production of AgNPs, as there was no previous work done on the synthesis of silver nanoparticles by bacteria in this region of Southern Punjab, Pakistan and these nanoparticles can be used to treat nosocomial infection. These silver nanoparticles can be used in effective disease management as antimicrobial agent.

Utilization of Cu-nanoparticles as medication agent to reduce atherosclerotic lesions of a bifurcated artery having compliant walls.

OBJECTIVE: A theoretical analysis is presented to study the bio-nanofluid with copper as medication agent for atherosclerotic bifurcated artery with flexible walls. DESIGN/APPROACH: The circulatory framework in human body is comprised of a system of veins that incorporate the bifurcation in this way the impact of copper nanoparticles on parent, at apex and on daughter artery regions (in the wake of being bifurcated) is watched. Streaming of blood along vessel segment is recognized to be newtonian. The consistent idea of the atherosclerotic arterial wall is additionally considered to make relationship with permeability aspects with arterial wall thickness. Copper nanoparticles are utilized to reduce the atherosclertic lesions for bifurcated stenotic artery. FINDINGS: The designed equations along with the experimental values of copper nanoparticles and blood are utilized for theoretical investigation. Moreover, hemodynamics impacts are also figure out to examine the flow of blood for atherosclertic artery. Comparison between parent and daughter artery is plotted through velocity profile. To see the theoretical assistance of this copper mediated model in biomedical field, graphical illustration is presented. At the end, noticed that the inclusion of copper nanoparticles enhances the velocity significantly both for parent as well as daughter artery. CONCLUSIONS: The circulation of blood is considered to be different from pressure between portions of atherosclerotic and non-atherosclerotic artery. Shear stress is reduces by changing the bifurcation angle for daughter artery while trend is reversed for parent artery. The size of inner circularting bolus decreases by changing compliant parameter for parent artery while shape is changed for daughter artery.

Numerical simulation of oscillatory oblique stagnation point flow of a magneto micropolar nanofluid.

The particular inquiry is made to envision the characteristics of magneto-hydrodynamic oscillatory oblique stagnation point flow of micropolar nanofluid. The applied magnetic field is assumed parallel towards isolating streamline. A relative investigation is executed for copper and alumina nanoparticles while seeing water type base fluid. To be more specific, in the presence of both weak and strong concentration, the physical situation of micropolar fluid is mathematically modeled in terms of differential equations. The transformed mixed system is finally elucidated by midpoint method with the Richardson extrapolation development and shooting mechanism with fifth order R-K Fehlberg technique. The impact of governing parameters are shown and explored graphically. The obtained results are compared with existing published literature. Moreover, it is found that the magnetic susceptibility of nanofluids shows provoking nature towards copper as compared to Alumina. Also it is perceived that Cu-water shows higher wall shear stress and heat transfer rate than Al2O3-water. Additional, the thickness of momentum boundary layer is thin for weak concentration as related to strong concentration.

Antineoplastic influence of nimesulide in chemically induced hepatocellular carcinoma by inhibition of DNA synthesis.

Hepatocellular carcinoma is emerging as one of the most common forms of cancer resulting in thousands of death worldwide. The purpose of this study was to screen nimesulide for anticancer activity in chemically induced hepatocellular carcinoma in Wistar rats as well as in BEL 7402 and HEP G2 cell lines. HCC in rats was induced by administering a single dose of diethyl nitrosamine (150 mg/kg) intraperitoneally. Duration of the in vivo study was 12 weeks and the anticancer potential was further confirmed by in vitro cell line study. Administration of DENA in Wistar rats significantly elevated the levels of serum biochemical parameters and α-feto protein. Treatment with different dose of nimesulide significantly decreased the markedly raised serum levels of biochemical parameters as well as maintained the histology of the liver tissues nearly similar to the normal. Further study of hepatocytes enzymes showed that treatment with nimesulide also improved the antioxidant enzyme levels. Our study also examined the cytotoxicity and DNA synthesis inhibition by nimesulide in BEL 7402 and Hep G2 cell lines. Cell viability was assessed by [3H]-thymidine uptake procedure. The results obtained by in vitro cell line study, histopathological and biochemical data concluded that nimesulide, a preferential COX-2 inhibitor, has anticancer activity, which is by first reducing the formation of reactive oxygen species and second by inhibiting the PGE2 effect via Wnt signaling pathway (cell invasion, angiogenesis, and cell proliferation).

Maternal anaemia and maternal, fetal, and neonatal outcomes in a prospective cohort study in India and Pakistan.

OBJECTIVE: To describe the association of maternal anaemia with maternal, fetal, and neonatal outcomes. DESIGN: Prospective cohort study. SETTING: Rural India and Pakistan. POPULATION: Pregnant women residing in the study catchment area. METHODS: We performed an analysis of a prospective pregnancy registry in which haemoglobin is commonly obtained as well as maternal, fetal, and neonatal outcomes for 42 days post-delivery. Women 40 years or older who delivered before 20 weeks or had a haemoglobin level of <3.0 g/dl were excluded. Our primary exposure was maternal anaemia, which was categorised in keeping with World Health Organization criteria based on a normal (≥11 g/dl), mild (>10-10.9 g/dl), moderate (7-9.9 g/dl) or severe (<7 g/dl). haemoglobin level. The primary maternal outcome was maternal death, the primary fetal outcome was stillbirth, and the primary neonatal outcome was neonatal mortality <28 days. RESULTS: A total of 92 247 deliveries and 93 107 infants were included, of which 87.8% were born to mothers who were anaemic (mild 37.9%, moderate 49.1%, and severe 0.7%). Maternal mortality (number per 100 000) was not associated with anaemia: normal 124, mild 106, moderate 135, and severe 325 (P = 0.64). Fetal and neonatal mortality was associated with severe anaemia: stillbirth rate (n/1000)-normal 27.7, mild 25.8, moderate 30.1, and severe 90.9; P < 0.0001; 28-day neonatal mortality (n/1000)-normal 24.7, mild 22.9, moderate 28.1, and severe 72.6 (P < 0.0001). Severe maternal anaemia was also associated with low birthweight (<2500 and <1500 g), preterm birth, and postpartum haemorrhage. CONCLUSION: Severe maternal anaemia is associated with higher risks of poor maternal, fetal, and neonatal outcomes but other degrees of anaemia are not. Interventions directed at preventing severe anaemia in pregnant women should be considered. TWEETABLE ABSTRACT: Severe maternal anaemia is associated with adverse fetal and neonatal outcomes in low/middle-income countries.

Small molecule targeting the Rac1-NOX2 interaction prevents collagen-related peptide and thrombin-induced reactive oxygen species generation and platelet activation.

Essentials Reactive oxygen species (ROS) generation by NOX2 plays a critical role in platelet activation. Rac1 regulation of NOX2 is important for ROS generation. Small molecule inhibitor of the Rac1-p67phox interaction prevents platelet activation. Pharmacologic targeting of Rac1-NOX2 axis can be a viable approach for antithrombotic therapy. SUMMARY: Background Platelets from patients with X-linked chronic granulomatous disease or mice deficient in nicotinamide adenine dinucleotide (phosphate) (NAD(P)H) oxidase isoform NOX2 exhibit diminished reactive oxygen species (ROS) generation and platelet activation. Binding of Rac1 GTPase to p67phox plays a critical role in NOX2 activation by facilitating the assembly of the NOX2 enzyme complex. Objective We tested the hypothesis that Phox-I, a rationally designed small molecule inhibitor of Rac-p67phox interaction, may serve as an antithrombosis agent by suppressing ROS production and platelet activation. Results Collagen-related peptide (CRP) induced ROS generation in a time-dependent manner. Platelets from Rac1-/- mice or human platelets treated with NSC23766, a specific Rac inhibitor, produced significantly less ROS in response to CRP. Treatment of platelets with Phox-I inhibited diverse CRP-induced responses, including: (i) ROS generation; (ii) release of P-selectin; (iii) secretion of ATP; (iv) platelet aggregation; and (v) phosphorylation of Akt. Similarly, incubation of platelets with Phox-I inhibited thrombin-induced: (i) secretion of ATP; (ii) platelet aggregation; (iii) rise in cytosolic calcium; and (iv) phosphorylation of Akt. In mouse models, intraperitoneal administration of Phox-I inhibited: (i) collagen-induced platelet aggregation without affecting the tail bleeding time and (ii) in vivo platelet adhesion/accumulation at the laser injury sites on the saphenous vein without affecting the time for complete cessation of blood loss. Conclusions Small molecule targeting of the Rac1-p67phox interaction may present an antithrombosis regimen by preventing GPVI- and non-GPVI-mediated NOX2 activation, ROS generation and platelet function without affecting the bleeding time.

Improving childhood tuberculosis detection and treatment through facility-based screening in rural Pakistan.

SETTING: Many children with tuberculosis (TB) remain undiagnosed due to the absence of services, lack of child-friendly diagnostics and underappreciation of TB as a common cause of childhood illness. OBJECTIVE: To show the impact of systematic verbal screening and contact tracing with appropriate management services on TB case finding in pediatric populations. DESIGN: Between October 2014 and March 2016, children were verbally screened at the pediatric out-patient departments of four public hospitals in Jamshoro District, Pakistan. Children with symptoms or risk of TB were referred for clinical evaluation and free chest X-ray and bacteriological tests. Children with TB were started on treatment and their care givers asked to bring household members to the hospital for screening. RESULTS: Over 105 000 children were verbally screened and 5880 presumptive childhood TB patients were identified; 1417 children (prevalence 1.3%) were diagnosed with TB; 43% were female. The median age was 5 years; 82% had pulmonary TB. An additional 390 children with TB were diagnosed through contact tracing. These activities resulted in a three-fold increase in pediatric TB case notifications. CONCLUSION: Systematic verbal screening with clinical evaluation and free diagnostics can identify children with TB who may otherwise be missed in rural health settings.

Molecular epidemiology, associated risk factors, and phylogenetic analysis of anaplasmosis in camel.

Camel Anaplasmosis is caused by members of family Anaplasmatacae, a tick transmitted, obligate intracellular bacteria. The etiological bacteria are transmitted by ixodid tick species. The species have multi host range distribution that is why it is crucial to diagnose it timely. The aim of present study was to investigate the molecular epidemiology i.e. prevalence and risk factors analysis of camel anaplasmosis. Furthermore, variations in hematological standards were also evaluated. The study found an overall 13.33% prevalence in camels. The confirmation of PCR positive samples for Anaplasma spp. was made through sequencing, the study isolatesshowed high homology with Iranian, Chinese, Philippines and South African isolates of Anaplasmatacae (Accession numbers'; KX765882, KP062964, KY242456, LC007100 and U54806) on BLAST queries. The phylogenetic analysis revealedthree study isolates of present study clustered with each other and the cluster was found closer to Chinese isolate of A. phagocytophilum (KY242456), A. marginale (KU586048), and Mongolian isolates of A. ovis (LC194134). Two of the isolates resembled Iranian isolate of Candidatus Anaplasmacamelii (KX765882), while one isolate resembled with Chinese isolates of A. Platys (KX987336) and Croatian isolates of A. Platys (KY114935). The key risk factors odds ratio (OR>1) identified for occurrence of camel anaplasmosis using regression model found sex and age of animal, previous tick history, tick infestation and tick control status, housing type, cracks in walls, rearing system and other species in surrounding as the key risk factors. The hematological parameters like lymphocytes, monocytes, granulocytes and platelets count were significantly decreased (p < 0.05) in diseased camels than healthy. This is the first ever molecular data on camel anaplasmosis in Pakistan. The disease should be monitored unceasingly as the etiologies have multi host distribution. Prompt attention should be offered to animals because neutropenia, lymphopenia and thrombocytopenia can exacerbate the disease by making the animal predisposed to otherdiseases.