Pulsed electric field at resonance frequency combat Klebsiella pneumonia biofilms.

Healtcare-associated infections have increased due to the development of antimicrobial resistance (AMR) of Gram-negative pathogens (GNPs) and the development of outbreacks over the past two decades. In this work, we investigated how exposure to positive electric pulses affects the growth characteristics of Klebsiella pneumonia (K. pneumonia), a common cause of pneumonia. We explored the impact of varying exposure frequencies (0.2-2 Hz) and time (15-90 min, at resonance frequency) on bioelectric signals produced during cell division, biofilm formation, and bacterial antibiotic susceptibility. Our research found that an extremely low-frequency pulsed electric field (ELF-PEF) significantly inhibited K. pneumonia growth. Specifically, exposure to 0.8 Hz for one hour increased the antibiotic susceptibility of K. pneumonia to inhibitors of cell wall formation, proteins, ß-lactamase, DNA, and other substances. We also noticed a notable decrease in K. pneumonia biofilm development exposed to ELF-PEF. Our results suggest that the interaction of K. pneumonia cells with ELF-PEF at the specified frequency and time alters cellular activity and bacterial structure. This technique may be used in the future to treat K. pneumonia infections both in vitro and in vivo.

An integrated socio-economic agent-based modeling framework towards assessing farmers' decision making under water scarcity and varying utility functions.

A spatio-temporal Agent Based Modeling (ABM) framework is developed to probabilistically predict farmers' decisions concerning their future farming practices when faced with potential water scarcity induced by future climate change. The proposed framework forecasts farmers' behavior assuming varying utility functions. The functionality of the proposed ABM is illustrated in an agriculturally dominated plain along the Eastern Mediterranean coastline. The model results indicated that modelling farmers as agents, who were solely interested in optimizing their agro-business budget, was only able to reproduce 35% of the answers provided by the farmers through a administered field questionnaire. Model simulations highlighted the importance of representing the farmers' combined socio-economic attributes when assessing their future decisions on land tenure. This approach accounts for social factors, such as the farmers' attitudes, subjective norms, social influence, memories of previous civil unrest and farming traditions, in addition to their economic utility to model farmer decision making. Under this scenario, correspondence between model simulations and farmers' answers reached 95%. Additionally, the model results show that when faced with the negative impacts of climate change, the majority of farmers seek adaptive measures, such as changing their crops and/or seeking new water sources, only when future water shortages were predicted to be low to moderate. Most opt to cease farming and allow their lands to urbanize or go fallow, when future water shortages were predicted to be high. Meanwhile, incorporating and modeling the social influence structures within the ABM diminished farmers' willingness to adapt and doubled their propensity to sell or quit their land. The proposed framework is able to account for a variety of utility functions and to successfully capture the actions and interactions between farmers and their environment; thus, it represents an innovative modeling approach for assessing farmers' behavior and decision-making in the face of future climate change. The nonspecific structure of the framework allows its application at any agriculturally dominated setting facing future water shortages promulgated by a changing climate.

The relationship between ratings of perceived exertion (RPE) and relative strength for a fatiguing dynamic upper extremity task: A consideration of multiple cycles and conditions.

The goal of this study was to evaluate the relationship between ratings of perceived exertion (RPE) and relative strength with respect to baseline for a fatiguing free dynamic task targeting the upper extremity, namely simulated order picking, and determine whether the relationship remains the same for different conditions (i.e., pace and weight) and with fatigue. Fourteen participants (seven males, seven females) performed four sessions that included two 45-min work periods separated by 15 min of rest. The work periods involved picking weighted bottles from shoulder height and packaging them at waist height for four combinations of bottle mass and picking rate: 2.5 kg-15 bottles per minute (bpm), 2.5 kg-10 bpm, 2.5 kg-5 bpm, and 1.5 kg-15 bpm. Participants reported their RPEs every 5 min and performed a maximum isometric shoulder flexion exertion every 9 min. Pearson product-moment correlation was used to evaluate the linear relationship between RPE and relative strength for each subject and work period. Then, the effects of condition and work period on the average relationship were assessed using a repeated-measures analysis of variance (ANOVA). For the first 45-min period, there were no significantly different correlations between RPE and relative strength across conditions (average r = -0.62 (standard deviation = 0.38); p = 0.57). There was a significant decrease in average correlation for the second work period (r = -0.39 (0.53)). These results suggest that individual subjective responses consistently increase while relative strength declines when starting from a non-fatigued state. However, correlations are weaker when re-engaging in work following incomplete recovery. Thus, starting fatigue levels should be accounted for when considering the expected relationship between RPE and relative strength.

Platelets Modulate IFN-γ Production against Candida albicans in Peripheral Blood Mononuclear Cells via Prostaglandins.

Platelets are known to have immunomodulatory properties. They modulate immune responses of leukocytes against various pathogens, including fungi. Candida albicans can cause systemic infection in immunocompromised individuals that is associated with a high mortality and morbidity. In the current study, we explored the role of platelets in antifungal host defense against C. albicans PBMCs were stimulated with heat-killed (HK) C. albicans in the presence or absence of isolated washed platelets. Cytokines were quantified from culture supernatants by ELISA. Inhibition of platelet receptors and cytokine pathways were used to elucidate the mechanisms involved in platelet-leukocyte interaction. In the presence of platelets, PBMCs produced less IFN-γ upon stimulation with HK C. albicans This effect was dependent on the direct contact between platelets and leukocytes but was independent of the platelet GPIb and P-selectin receptors. The attenuation of IFN-γ was not a direct effect on T cells but was dependent on the presence of APC and T cells. Platelets did not modulate the Th-1-polarizing cytokines IL-12 and IL-18. The addition of PG (PGE2) further diminished IFN-γ levels in PBMCs, and supplementation of cells with nonsteroidal anti-inflammatory drugs was able to restore the level of IFN-γ. Overall, we show that modulation of the Th1 response against C. albicans by platelets is dependent on PGs.

Assessment of safety and quality aspects of boiling treatment of quail eggs.

A total of 300 quail eggs were collected randomly from different markets in Cairo and Giza Governorates. Five eggs were represented as one egg sample. Shell and content of each egg were examined for their microbiological contents, sensory evaluation and study of Escherichia coli O157 survival in artificially contaminated eggs. Moreover, qualitative detection of antimicrobial residues by seven plates microbiologically bioassay and confirmed by validated high-performance liquid chromatography (HPLC) methods for positively reacted antimicrobials in raw and boiled samples. There was a significant difference (P < 0·05) between the grading score of eggs after the boiling at 2-, 4-, 5- and 7-min. Based on the survival results, the refrigeration storage and boiling for 5 min of quail eggs was confirmed that such eggs are without E. coli O157. After the boil, the concentrations of oxytetracycline (OTC) and 4-Epi-OTC residues were significantly reduced, and there was no effect on the concentration of sulphadimidine (SDD), amoxicillin (AMO) and Diketo residues. Samples that exceeded the maximum residual limits (MRLs) were 17·0%, 12·0%, 10·0%, 16·0% and 14·0% for SDD, OTC, 4-Epi-OTC, AMO and Diketo, respectively. After boiling, no significant change was noted for SDD, AMO and Diketo, but all OTC and 4-Epi-OTC were completely below MRLs. Therefore, SDD and AMO with their metabolite (Diketo) are heat-stable antimicrobial residues with multiple human health hazards.

Desialylation of platelets induced by Von Willebrand Factor is a novel mechanism of platelet clearance in dengue.

Thrombocytopenia and platelet dysfunction are commonly observed in patients with dengue virus (DENV) infection and may contribute to complications such as bleeding and plasma leakage. The etiology of dengue-associated thrombocytopenia is multifactorial and includes increased platelet clearance. The binding of the coagulation protein von Willebrand factor (VWF) to the platelet membrane and removal of sialic acid (desialylation) are two well-known mechanisms of platelet clearance, but whether these conditions also contribute to thrombocytopenia in dengue infection is unknown. In two observational cohort studies in Bandung and Jepara, Indonesia, we show that adult patients with dengue not only had higher plasma concentrations of plasma VWF antigen and active VWF, but that circulating platelets had also bound more VWF to their membrane. The amount of platelet-VWF binding correlated well with platelet count. Furthermore, sialic acid levels in dengue patients were significantly reduced as assessed by the binding of Sambucus nigra lectin (SNA) and Maackia amurensis lectin II (MAL-II) to platelets. Sialic acid on the platelet membrane is neuraminidase-labile, but dengue virus has no known neuraminidase activity. Indeed, no detectable activity of neuraminidase was present in plasma of dengue patients and no desialylation was found of plasma transferrin. Platelet sialylation was also not altered by in vitro exposure of platelets to DENV nonstructural protein 1 or cultured DENV. In contrast, induction of binding of VWF to glycoprotein 1b on platelets using the VWF-activating protein ristocetin resulted in the removal of platelet sialic acid by translocation of platelet neuraminidase to the platelet surface. The neuraminidase inhibitor oseltamivir reduced VWF-induced platelet desialylation. Our data demonstrate that excessive binding of VWF to platelets in dengue results in neuraminidase-mediated platelet desialylation and platelet clearance. Oseltamivir might be a novel treatment option for severe thrombocytopenia in dengue infection.

Investigation of Heterogeneity Sources for Occupational Task Recognition via Transfer Learning.

Human activity recognition has been extensively used for the classification of occupational tasks. Existing activity recognition approaches perform well when training and testing data follow an identical distribution. However, in the real world, this condition may be violated due to existing heterogeneities among training and testing data, which results in degradation of classification performance. This study aims to investigate the impact of four heterogeneity sources, cross-sensor, cross-subject, joint cross-sensor and cross-subject, and cross-scenario heterogeneities, on classification performance. To that end, two experiments called separate task scenario and mixed task scenario were conducted to simulate tasks of electrical line workers under various heterogeneity sources. Furthermore, a support vector machine classifier equipped with domain adaptation was used to classify the tasks and benchmarked against a standard support vector machine baseline. Our results demonstrated that the support vector machine equipped with domain adaptation outperformed the baseline for cross-sensor, joint cross-subject and cross-sensor, and cross-subject cases, while the performance of support vector machine equipped with domain adaptation was not better than that of the baseline for cross-scenario case. Therefore, it is of great importance to investigate the impact of heterogeneity sources on classification performance and if needed, leverage domain adaptation methods to improve the performance.

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy.

OBJECTIVE: We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence. BACKGROUND: Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue. METHOD: A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency. RESULTS: Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused (N = 28 studies, nine interventions), workplace-focused (N = 12 studies, five interventions), and multiple interventions (N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size. CONCLUSION: This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions. APPLICATION: Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

SWOT risk analysis towards sustainable aquifer management along the Eastern Mediterranean.

This study examines the risks of seawater intrusion (SWI) in data scarce aquifers along the Eastern Mediterranean by quantifying the interaction of the main natural, anthropogenic and climatic drivers, while also considering varying abilities of implementing adaptation and mitigation measures. For this purpose, we conducted a semi-quantitative Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis representing a first attempt at integrating a complex physical process with multi layered influences in a SWOT analysis model that was tested at 26 coastal aquifers with varying levels of SWI severity. The analysis results showed alarming signs of SWI at several eastern and southeastern aquifers, particularly those underlying densely populated centers (i.e. Beirut, Lebanon; Magoza, Cyprus; Gaza, Palestine and the Nile Delta, Egypt). The analysis also highlighted adaptive capabilities that appear to be strong in Cyprus, Israel and Turkey, emerging in Egypt, and weak in Lebanon, Syria, and Palestine. The risks exhibited a strong and statistically significant positive relationship with the reported status of SWI at the tested aquifers thus providing an effective decision-making tool towards the preliminary assessment of SWI in regions with data scarcity. The study concludes with proposing a framework for sustainable aquifer management in the East Med region with emphasis on controlling SWI risks.

Sun-protection and sun-exposure habits among sailors: results of the 2018 world's largest sailing race Barcolana' skin cancer prevention campaign.

BACKGROUND: Epidemiologic data suggest an increased risk of melanoma (MM) and non-melanoma skin cancer (NMSC) in persons with intense recreational sun-exposure such as marathon runners or surfers. Up to data little is known about the sun-exposure habits, sun-protection behaviours and risk factors for MM and NMSC among sailors. OBJECTIVE: The objective of this prospective, cross-sectional study was to investigate the sun-exposure and sun-protective habits and risk factors for skin cancer among sailors attending the 50° edition of Barcolana, the largest sailing race in of the world, which took place in October 2018 in Trieste, Italy as an integrative component of a public sun-prevention campaign. METHODS: The study consisted of 2 parts: (i) a self-administered questionnaire focusing on sun-exposure and protective habits and (ii) a free skin examination carried out by volunteer dermatologists. Participation was optional and anonymous, and open to visitors and sailors attending the event. RESULTS: Overall, 431 (52.4%) sailors and 391 (47.6%) visitors responded to the questionnaire, while a total of 437 individuals including 189 (43.3%) sailors and 248 (56.6%) visitors participated in the skin examination group. The majority of sailors reported a past history of severe sunburns (20.2%), applied sunscreen never (14.4%) to sometimes (45.7%) or only once daily (59%) on the face (55%) and shoulders (26%). Moreover, 14% of sailors had a personal history of non-melanoma skin cancer (NMSC). During the dermatological examination, suspicious lesions for skin cancer (including MM and NMSC) were identified in 37% of the sailors. CONCLUSION: Our findings support the need to develop and promote primary and secondary prevention strategies to improve the sun-exposure and sun-protective habits among sailors.

A Review of Data Analytic Applications in Road Traffic Safety. Part 1: Descriptive and Predictive Modeling.

This part of the review aims to reduce the start-up burden of data collection and descriptive analytics for statistical modeling and route optimization of risk associated with motor vehicles. From a data-driven bibliometric analysis, we show that the literature is divided into two disparate research streams: (a) predictive or explanatory models that attempt to understand and quantify crash risk based on different driving conditions, and (b) optimization techniques that focus on minimizing crash risk through route/path-selection and rest-break scheduling. Translation of research outcomes between these two streams is limited. To overcome this issue, we present publicly available high-quality data sources (different study designs, outcome variables, and predictor variables) and descriptive analytic techniques (data summarization, visualization, and dimension reduction) that can be used to achieve safer-routing and provide code to facilitate data collection/exploration by practitioners/researchers. Then, we review the statistical and machine learning models used for crash risk modeling. We show that (near) real-time crash risk is rarely considered, which might explain why the optimization models (reviewed in Part 2) have not capitalized on the research outcomes from the first stream.

A Review of Data Analytic Applications in Road Traffic Safety. Part 2: Prescriptive Modeling.

In the first part of the review, we observed that there exists a significant gap between the predictive and prescriptive models pertaining to crash risk prediction and minimization, respectively. In this part, we review and categorize the optimization/ prescriptive analytic models that focus on minimizing crash risk. Although the majority of works in this segment of the literature are related to the hazardous materials (hazmat) trucking problems, we show that (with some exceptions) many can also be utilized in non-hazmat scenarios. In an effort to highlight the effect of crash risk prediction model on the accumulated risk obtained from the prescriptive model, we present a simulated example where we utilize four risk indicators (obtained from logistic regression, Poisson regression, XGBoost, and neural network) in the k-shortest path algorithm. From our example, we demonstrate two major designed takeaways: (a) the shortest path may not always result in the lowest crash risk, and (b) a similarity in overall predictive performance may not always translate to similar outcomes from the prescriptive models. Based on the review and example, we highlight several avenues for future research.

The External Jugular Vein Used as Recipient Vessel in Head and Neck Free Flap Reconstruction: Outcomes Compared to the Internal Jugular Vein.

BACKGROUND: Contradictory data exists on the success rates of employing the external jugular (EJ) vein as a recipient vessel for venous outflow in free flap head and neck reconstruction compared with the internal jugular (IJ) vein. The authors hereby present a retrospective study of prospectively collected data over a 14-year period. METHODS: Five hundred seventy-eight patients underwent 639 free flap head and neck over 14 years. Two hundred seventy-eight free flaps employed the EJ vein as the recipient vessel while 326 free flaps employed the IJ vein. Rates of acute and late complications were compared. RESULTS: There were no differences in rates of complications: flap loss, venous thrombosis, arterial thrombosis, bleeding, hematoma, or infection between the EJ and IJ vein groups. CONCLUSION: The external jugular vein as a recipient vessel for venous outflow in head and neck free flap reconstruction of postoncologic resection defects is a valid option for both primary reconstructions and secondary surgeries.

A machine learning approach to detect changes in gait parameters following a fatiguing occupational task.

The purpose of this study is to provide a method for classifying non-fatigued vs. fatigued states following manual material handling. A method of template matching pattern recognition for feature extraction ($1 Recognizer) along with the support vector machine model for classification were applied on the kinematics of gait cycles segmented by our stepwise search-based segmentation algorithm. A single inertial measurement unit on the ankle was used, providing a minimally intrusive and inexpensive tool for monitoring. The classifier distinguished between states using distance-based scores from the recogniser and the step duration. The results of fatigue detection showed an accuracy of 90% across data from 20 recruited subjects. This method utilises the minimum amount of data and features from only one low-cost sensor to reliably classify the state of fatigue induced by a realistic manufacturing task using a simple machine learning algorithm that can be extended to real-time fatigue monitoring as a future technology to be employed in the manufacturing facilities. Practitioner Summary: We examined the use of a wearable sensor for the detection of fatigue-related changes in gait based on a simulated manual material handling task. Classification based on foot acceleration and position trajectories resulted in 90% accuracy. This method provides a practical framework for predicting realistic levels of fatigue.

Biophysical control of the growth of Agrobacterium tumefaciens using extremely low frequency electromagnetic waves at resonance frequency.

Isolated Agrobacterium tumefaciens was exposed to different extremely low frequencies of square amplitude modulated waves (QAMW) from two generators to determine the resonance frequency that causes growth inhibition. The carrier was 10 MHz sine wave with amplitude ±10 Vpp which was modulated by a second wave generator with a modulation depth of ± 2Vpp and constant field strength of 200 V/m at 28 °C. The exposure of A. tumefaciens to 1.0 Hz QAMW for 90 min inhibited the bacterial growth by 49.2%. In addition, the tested antibiotics became more effective against A. tumefaciens after the exposure. Furthermore, results of DNA, dielectric relaxation and TEM showed highly significant molecular and morphological changes due to the exposure to 1.0 Hz QAMW for 90 min. An in-vivo study has been carried out on healthy tomato plants to test the pathogenicity of A. tumefaciens before and after the exposure to QAMW at the inhibiting frequency. Symptoms of crown gall and all pathological symptoms were more aggressive in tomato plants treated with non-exposed bacteria, comparing with those treated with exposed bacteria. We concluded that, the exposure of A. tumefaciens to 1.0 Hz QAMW for 90 min modified its cellular activity and DNA structure, which inhibited the growth and affected the microbe pathogenicity.

Combination of bacteriolytic therapy with magnetic field for Ehrlich tumour treatment.

Referable to the limited response of the current available cancer treatment modalities, new effective cancer fighting treatments are needed. This work investigates the efficiency of intratumoural injection of Pseudomonas aeruginosa bacteria combined with a local tumour exposure to extremely low frequency square pulsed magnetic field (ELF SPMF) in the mouse Ehrlich tumour. 64 Ehrlich ascites tumour-implanted female albino BALB/C mice were equally split up into 4 groups. Group 1 (GP1) was the positive control group. Group 2 (GP2) received a single intratumoural injection of P. aeruginosa bacteria. Group 3 (GP3) was exposed to ELF SPMF for tumour local exposure. Group 4 (GP4) was treated with P. aeruginosa intratumoural injection followed by local exposure of the tumour to ELF SPMF. Treatment monitoring was evaluated using ultrastructural examination, flow cytometry analysis in addition to the measurement of tumour dielectric properties. Tumour cell apoptosis was obvious in GP2 and GP4, but, with higher severity and percentages in GP2. Tumour biophysical properties revealed a significant increase in static conductivity σS of GP2, and decreases in dielectric increment Δɛ´of both GP2 and GP4 compared to the GP1. Unfortunately, GP2 mice showed severe signs of toxicity. We advocate the utilization of the combination of P. aeruginosa and SPMF to yield the most effective antitumour agent with less bacteria-related toxicity.

Implications of adopting a biodiversity-based vulnerability index versus a shoreline environmental sensitivity index on management and policy planning along coastal areas.

In this study, a multi-criteria index was developed to assess anthropogenic stressors along the Mediterranean coastline. The index aimed at geo-locating pollution hotspots for informed decision making related to coastal zone management. The index was integrated in a Geographical Information System based geodatabase implemented at several pilot areas along the Northern (Italy and France), Eastern (Lebanon), and Southern (Tunisia) Mediterranean coastlines. The generated stressor maps were coupled with a biodiversity richness index and an environmental sensitivity index to produce vulnerability maps that can form the basis for prioritizing management and mitigation interventions towards the identification of pollution hotspots and the promotion of sustainable coastal zone management. The results identified significant differences between the two assessment methods, which can bias prioritization in decision making and policy planning depending on stakeholders' interests. The discrepancies emphasize the need for transparency and understanding of the underlying foundations behind vulnerability indices and mapping development.

The effects of severe iron-deficiency anaemia on maternal and neonatal outcomes: A case-control study in an inner-city London hospital.

This case-control study investigates the effects of severe iron-deficiency anaemia in pregnancy on maternal and neonatal outcomes in a relatively deprived inner-city population in a North London hospital. The study group comprised of 106 women with haemoglobin (Hb) < 8 g/dl at any point during pregnancy, while controls were 106 women with Hb > 11 g/dl throughout pregnancy. The study group lost an average of 80 ml more blood at delivery (p = 0.032) and had higher rates of postpartum haemorrhage than the control group (27 vs 12 patients, p = 0.012). However, anaemia did not appear to influence other maternal or neonatal outcomes; these may have been confounded by antenatal intervention with oral haematinics or blood transfusion.