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The need for renewable energy sources is recently necessitated by attaining sustainability and climate change mitigation. Accordingly, the use of renewable energy sources has been growing rapidly during the last two decades. Yet, the potentials of renewable energy sources are generally influenced by several climatic factors that either determine the source of energy such as wind speed in the case of wind power or affect the performance of system such as the reduction in solar PV power production due to temperature increase. This highlights the need for assessing climate change impacts on renewable energy sources in the future to ensure their reliability and sustainability.This paper is intended to assess impacts of climate change on wind and solar potential energy in Egypt by the year 2065 under RCP 8.5 scenario. For this purpose, a GIS-based methodology of three main steps was applied. The results revealed that solar energy potential in Egypt is expected to be relatively less vulnerable to climate change compared to wind energy. In this respect, it was found that while wind energy potential was estimated to range ± 12%. By the year 2065 under RCP 8.5 scenario, PV module power is expected to decrease by about 1.3% on average. Such assessment can assist in developing more sustainable and flexible renewable energy policy in Egypt.
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Mudança Climática , Monitoramento Ambiental , Egito , Reprodutibilidade dos Testes , Energia Renovável , VentoRESUMO
BACKGROUND AND AIMS: The Portsmouth-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) is one of the scores that is used most frequently for determining the likelihood of mortality in patients undergoing emergency laparotomy. National Emergency Laparotomy Audit (NELA) presents a novel and validated score. Therefore, we aimed to compare the performance of the NELA and P-POSSUM mortality risk scores in predicting 30-day and 90-day mortality in patients undergoing emergency laparotomy. METHODS: Between August 2020 and October 2022, this cohort study was undertaken at Menoufia University Hospital. We compared the P-POSSUM, preoperative NELA, and postoperative NELA scores in patients undergoing emergency laparotomy. All variables needed to calculate the used scores were collected. The outcomes included the death rates at 30 and 90 days. By calculating the area under the curve (AUC) for every mortality instrument, the discrimination of the various methods was evaluated and compared. RESULTS: Data from 670 patients were included. The observed risk of 30-day and 90-day mortality was 10.3% (69/670) and 13.13% (88/670), respectively. Concerning 30-day mortality, the AUC was 0.774 for the preoperative NELA score, 0.763 for the preoperative P-POSSUM score, and 0.780 for the postoperative NELA score. Regarding 90-day mortality, the AUCs for the preoperative NELA score, preoperative P-POSSUM score, and postoperative NELA score were 0.649 (0.581-0.717), 0.782 (0.737-0.828), and 0.663 (0.608-0.718), respectively. There was noticeable difference in the three models' capacity for discrimination, according to pairwise comparisons. CONCLUSIONS: The probability of 30-day and 90-day death across the entire population was underestimated by the NELA and P-POSSUM scores. There was discernible difference in predictive performance between the two scores.
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Laparotomia , Humanos , Estudos de Coortes , Egito/epidemiologia , Hospitais Universitários , Fatores de RiscoRESUMO
PURPOSE: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort. METHODS: An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included. RESULTS: A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07-1.77), with a sensitivity of 57.1% and specificity of 64.4%. CONCLUSION: Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines.
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Adenocarcinoma Mucinoso , Carcinoma Ductal Pancreático , Neoplasias Intraductais Pancreáticas , Neoplasias Pancreáticas , Humanos , Neoplasias Intraductais Pancreáticas/cirurgia , Neoplasias Intraductais Pancreáticas/patologia , Adenocarcinoma Mucinoso/cirurgia , Adenocarcinoma Mucinoso/patologia , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/patologia , Pâncreas/cirurgia , Carcinoma Ductal Pancreático/cirurgia , Carcinoma Ductal Pancreático/patologia , Estudos RetrospectivosRESUMO
BACKGROUND: The genetic variants of the receptor for advanced glycation end products (RAGE) gene have been associated with vascular disease risk. The objective of this work was to explore the association of three single-nucleotide polymorphisms (SNPs) of RAGE gene (374T/A, 429T/C, and G82S) with vascular complications in SCD. METHODS: The study was conducted on 40 children with SCD and 40 healthy children served as controls. All participants were genotyped for the three studied RAGE polymorphisms by polymerase chain reaction (PCR). RESULTS: Regarding 374T/A polymorphism, the frequency of TA, TT genotypes and T allele were higher in patients (p < 0.001). T allele was associated with higher incidence of sickling crisis and stroke (p < 0.05). In the subgroup analyses of 429T/C polymorphism, an association between C allele and SCD vascular complications was observed (p < 0.05). Concerning the frequency of G82S genotypes of RAGE, GG variant was detected in 39 (97.5%) of the patients, as compared with 40 (100%) of controls (p = 0.3). A regression analysis proved that HbS%, serum ferritin, and the -374T and 429C alleles were significant independent predictors of frequent sickling episodes (p < 0.05). CONCLUSIONS: The C allele of -429T/C and T allele of 374T/A RAGE polymorphisms may be considered as predictors for vascular dysfunction in SCD. IMPACT: The C allele of -429T/C and T allele of 374T/A RAGE polymorphisms may be considered as predictors for vascular dysfunction in SCD patients. To our knowledge, our study is the first exploring the association of three single-nucleotide polymorphisms of RAGE gene (374T/A, 429T/C, and G82S) with vascular complications in SCD. Early identification of patients carrying these genetic variants might be of great importance not only to identify subjects at risk of vasculopathy but also to direct them to RAGE-targeted treatments.
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Anemia Falciforme/genética , Polimorfismo de Nucleotídeo Único , Receptor para Produtos Finais de Glicação Avançada/genética , Doenças Vasculares/genética , Adolescente , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico , Estudos de Casos e Controles , Criança , Estudos Transversais , Egito , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Masculino , Fenótipo , Prognóstico , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/genética , Doenças Vasculares/diagnósticoRESUMO
PURPOSE: Asparagine synthetase deficiency (ASNSD) is a rare neurometabolic disease. Patients may not demonstrate low asparagine levels, which highlights the advantage of molecular over biochemical testing in the initial work-up of ASNSD. We aimed to further delineate the ASNSD variant and phenotypic spectrum and determine the value of biochemical testing as a frontline investigation in ASNSD. METHODS: We retrospectively collected the clinical and molecular information on 13 families with ASNSD from the major metabolic clinics in Saudi Arabia. RESULTS: The major phenotypes included congenital microcephaly (100%), facial dysmorphism (100%), global developmental delay (100%), brain abnormalities (100%), spasticity (86%), and infantile-onset seizures (93%). Additional unreported phenotypes included umbilical hernia, osteopenia, eczema, lung hypoplasia, and hearing loss. Overall, seven homozygous variants accounted for ASNSD. The p.Tyr398Cys and p.Asn75Ile variants accounted for 54% of the cases. The clinical sensitivity and specificity of the proposed biochemical analysis of cerebrospinal fluid (CSF) for the detection of patients with ASNSD were 83% and 98%, respectively. CONCLUSION: Our study describes the largest reported ASNSD cohort with clinical, molecular, and biochemical characterization. Taking into consideration the suboptimal sensitivity of biochemical screening, the delineation of the phenotype variant spectrum is of diagnostic utility for accurate diagnosis, prognosis, counseling, and carrier screening.
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Aspartato-Amônia Ligase , Deficiência Intelectual , Microcefalia , Aspartato-Amônia Ligase/genética , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/genética , Estudos Retrospectivos , Arábia Saudita/epidemiologiaRESUMO
OBJECTIVE: To report if the association of epilepsy in pediatric patients (below the age of 15 years) with Insulin-dependent Diabetes (IDDM) at King Fahad Medical City (KFMC) is higher than the prevalence of epilepsy in the same age group (who have no IDDM) in our community. Consequently, we would determine if there is a relationship between the presence of epilepsy in diabetic children and the presence of positive antiGAD65 antibodies. METHODS: This cohort study included 305 pediatric patients below the age of 15 years with Insulin-dependent Diabetes Mellitus (IDDM). They were randomly recruited at the Pediatric Endocrinology Clinic in KFMC. The patients` caregivers were given a questionnaire between December 2015 till March 2019 to determine the seizure disorder history. There was also a retrospective review of 214 patients` files for anti-GAD 65 positivity. RESULTS: Our study found a significant relation between the presence of epilepsy in children with IDDM. Therefore, we could confirm the relationship between the existence of epilepsy in children with IDDM and having positive GAD65 antibodies. CONCLUSION: Our study supports the presence of consistent relation between having IDDM and having epilepsy in children and between the latter and the presence of positive GAD65 antibodies.
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Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/imunologia , Epilepsia/epidemiologia , Glutamato Descarboxilase/imunologia , Autoanticorpos/imunologia , Autoantígenos/imunologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Masculino , Prevalência , Estudos RetrospectivosRESUMO
The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.
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Atenção à Saúde/organização & administração , Saúde Global , Prioridades em Saúde , Cobertura Universal do Seguro de Saúde , HumanosRESUMO
BACKROUND: In December 2013, a multicomponent meningococcal serogroup B (4CMenB) vaccine was used before licensure on the basis of special consideration by the Food and Drug Administration to respond to an outbreak of Neisseria meningitidis B at a U.S. university. Data suggested that vaccination would control the outbreak because isolates expressed antigens that were closely related to the vaccine antigens (factor H-binding protein [fHbp] and neisserial heparin-binding antigen). We quantified the immune responses induced by 4CMenB during the outbreak. METHODS: We conducted a seroprevalence survey among students to assess vaccination status and collect serum specimens to quantify titers of serum bactericidal antibodies (SBA) with an assay that included human complement (hSBA). We compared the proportion of vaccinated and unvaccinated participants who were seropositive for the outbreak strain and for one closely related reference strain (44/76-SL, which included fHbp) and one mismatched reference strain (5/99, which included neisserial adhesin A), both of which were used in vaccine development. Seropositivity was defined as an hSBA titer of 4 or higher. RESULTS: Among the 499 participants who received two doses of the 4CMenB vaccine 10 weeks apart, 66.1% (95% confidence interval [CI], 61.8 to 70.3) were seropositive for the outbreak strain, although the geometric mean titer was low at 7.6 (95% CI, 6.7 to 8.5). Among a random subgroup of 61 vaccinees who also received two doses but did not have a detectable protective response to the outbreak strain, 86.9% (95% CI, 75.8 to 94.2) were seropositive for the 44/76-SL strain, for which there was a geometric mean titer of 17.4 (95% CI, 13.0 to 23.2), whereas 100% of these vaccinees (95% CI, 94.1 to 100) were seropositive for the 5/99 strain and had a higher geometric mean titer (256.3; 95% CI, 187.3 to 350.7). The response to the outbreak strain was moderately correlated with the response to the 44/76-SL strain (Pearson's correlation,0.64; P<0.001) but not with the response to the 5/99 strain (Pearson's correlation,-0.06; P=0.43). CONCLUSIONS: Eight weeks after the second dose of the 4CMenB vaccine was administered, there was no evidence of an hSBA response against the outbreak strain in 33.9% of vaccinees, although no cases of meningococcal disease caused by N. meningitidis B were reported among vaccinated students. (Funded by Princeton University and others.).
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Surtos de Doenças/prevenção & controle , Meningite Meningocócica/imunologia , Vacinas Meningocócicas/imunologia , Neisseria meningitidis Sorogrupo B/imunologia , Anticorpos Antibacterianos/sangue , Feminino , Humanos , Masculino , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/prevenção & controle , New Jersey/epidemiologia , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia , Universidades , Adulto JovemRESUMO
An increasing number of mitochondrial diseases are found to be caused by pathogenic variants in nuclear encoded mitochondrial aminoacyl-tRNA synthetases. FARS2 encodes mitochondrial phenylalanyl-tRNA synthetase (mtPheRS) which transfers phenylalanine to its cognate tRNA in mitochondria. Since the first case was reported in 2012, a total of 21 subjects with FARS2 deficiency have been reported to date with a spectrum of disease severity that falls between two phenotypes; early onset epileptic encephalopathy and a less severe phenotype characterized by spastic paraplegia. In this report, we present an additional 15 individuals from 12 families who are mostly Arabs homozygous for the pathogenic variant Y144C, which is associated with the more severe early onset phenotype. The total number of unique pathogenic FARS2 variants known to date is 21 including three different partial gene deletions reported in four individuals. Except for the large deletions, all variants but two (one in-frame deletion of one amino acid and one splice-site variant) are missense. All large deletions and the single splice-site variant are in trans with a missense variant. This suggests that complete loss of function may be incompatible with life. In this report, we also review structural, functional, and evolutionary significance of select FARS2 pathogenic variants reported here.
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Aminoacil-tRNA Sintetases/genética , Mitocôndrias/genética , Doenças Mitocondriais/genética , Proteínas Mitocondriais/genética , Fenilalanina-tRNA Ligase/genética , Adolescente , Adulto , Aminoacil-tRNA Sintetases/deficiência , Criança , Pré-Escolar , Feminino , Deleção de Genes , Humanos , Masculino , Mitocôndrias/enzimologia , Mitocôndrias/patologia , Doenças Mitocondriais/enzimologia , Doenças Mitocondriais/patologia , Proteínas Mitocondriais/química , Proteínas Mitocondriais/deficiência , Mutação/genética , Paraplegia/genética , Paraplegia/patologia , Fenilalanina/genética , Fenilalanina/metabolismo , Fenilalanina-tRNA Ligase/química , Fenilalanina-tRNA Ligase/deficiência , Isoformas de Proteínas/genética , Relação Estrutura-Atividade , Adulto JovemRESUMO
BACKGROUND: Soluble forms of RAGE (sRAGE) have been found circulating in plasma and tissues. Evidence is accruing in human subjects linking levels of sRAGE to oxidative stress in many disorders. Because sickle cell disease (SCD) is a state of oxidative stress, we tested the hypothesis that circulating sRAGE levels may be involved in the vascular pathology of SCD. OBJECTIVES: To determine the sRAGE levels in children and adolescents with SCD and investigate their association with markers of hemolysis, iron overload, and SCD-related organ complications. SUBJECTS AND METHODS: The level of sRAGE was measured in 40 children and adolescent with SCD compared with 40 healthy controls using enzyme-linked immunosorbent assay (ELISA). RESULTS: sRAGE was significantly higher in patients compared with controls (p < 0.001) and was elevated in patients with history of stroke, acute lung syndrome, and frequency of sickling crisis or serum ferritin > 2500 (p < 0.05). Patients with high sRAGE levels are candidates for chelation. sRAGE was positively correlated with HbS% (r = 0.422, p = 0.007), LDH (r = 0.329, p = 0.038), and serum ferritin levels (r = 0.516, p = 0.001). Multivariable regression analysis proved that both HbS% and serum ferritin were significant independent factors affecting sRAGE level (p < 0.05). CONCLUSION: Our findings suggest that sRAGE may be considered as a marker for vascular dysfunction in SCD patients.
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Anemia Falciforme/sangue , Biomarcadores/sangue , Produtos Finais de Glicação Avançada/sangue , Receptor para Produtos Finais de Glicação Avançada/sangue , Adolescente , Estudos de Casos e Controles , Quelantes/farmacologia , Criança , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Ferritinas/sangue , Hemoglobinas/análise , Humanos , Sobrecarga de Ferro , Pneumopatias/complicações , Masculino , Análise Multivariada , Estresse Oxidativo , Receptores Imunológicos/sangue , Acidente Vascular Cerebral/complicações , Talassemia beta/sangueRESUMO
We retrospectively reviewed Saudi patients who had a congenital disorder of glycosylation (CDG). Twenty-seven Saudi patients (14 males, 13 females) from 13 unrelated families were identified. Based on molecular studies, the 27 CDG patients were classified into different subtypes: ALG9-CDG (8 patients, 29.5%), ALG3-CDG (7 patients, 26%), COG6-CDG (7 patients, 26%), MGAT2-CDG (3 patients, 11%), SLC35A2-CDG (1 patient), and PMM2-CDG (1 patient). All the patients had homozygous gene mutations. The combined carrier frequency of CDG for the encountered founder mutations in the Saudi population is 11.5 per 10,000, which translates to a minimum disease burden of 14 patients per 1,000,000. Our study provides comprehensive epidemiologic information and prevalence figures for each of these CDG in a large cohort of congenital disorder of glycosylation patients.
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Biomarcadores Tumorais/genética , Defeitos Congênitos da Glicosilação/genética , Mutação , Proteínas Adaptadoras de Transporte Vesicular/genética , Adolescente , Criança , Pré-Escolar , Defeitos Congênitos da Glicosilação/epidemiologia , Feminino , Glicosilação , Homozigoto , Humanos , Lactente , Masculino , Manosiltransferases/genética , Proteínas de Membrana/genética , Oxigenases de Função Mista/genética , Proteínas de Transporte de Monossacarídeos/genética , N-Acetilglucosaminiltransferases/genética , Fenótipo , Estudos Retrospectivos , Arábia Saudita/epidemiologiaRESUMO
Inherited aberrancies in intracellular vesicular transport are associated with a variety of neurological and non-neurological diseases. RUSC2 is a gene found on chromosome 9p13.3 that codes for iporin, a ubiquitous protein with high expression in the brain that interacts with Rab proteins (GTPases implicated in intracellular protein trafficking). Although mutations in Rab proteins have been described as causing brain abnormalities and intellectual disability, until now no disease-causing mutations in RUSC2 have ever been reported in humans. We describe, to our knowledge for the first time, three patients with inherited homozygous nonsense mutations identified in RUSC2 on whole-exome sequencing. All three patients had central hypotonia, microcephaly, and moderate to severe intellectual disability. Two patients had additional features of early-onset epilepsy and absence of the splenium. This report adds to the ever-expanding landscape of genetic causes of intellectual disability and increases our understanding of the cellular processes underlying this important neurological entity.
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Proteínas de Transporte/genética , Deficiência Intelectual/genética , Microcefalia/genética , Adolescente , Agenesia do Corpo Caloso/genética , Criança , Epilepsia/genética , Feminino , Humanos , Masculino , Hipotonia Muscular/genética , Mutação , LinhagemRESUMO
OBJECTIVE: To detect autism spectrum disorder (ASD) cases within the High Risk Neonatal Follow up Program (HRNFP), as an indicator of the prevalence of ASD and associated risk factors in the Kingdom of Saudi Arabia (KSA). METHODS: We conducted this retrospective medical chart review in a tertiary care hospital in Riyadh, KSA. All patients admitted to the HRNFP were seen at 3 years corrected age between January 2012 and December 2013. Patients diagnosed with ASD from the HRNFP were referred to the King Fahad Medical City (KFMC) Autism Program for further assessment. The following potential risk factors for ASD were documented: low birth weight, gestational age less than 33 weeks, and male gender. RESULTS: In 2012, 59 patients were evaluated in the HRNFP. Three cases were diagnosed with ASD, with an ASD incidence rate of 5.1% (95% confidence interval [CI] calculated by adjusted Wald method: 1.2-14.5%). In 2013, 48 patients were evaluated and 2 cases were diagnosed with ASD, with an ASD incidence rate of 4.2% (95% CI: 0.4%-14.8%). The total ASD incidence rate during the 2-year study period was 4.7% (95% CI: 1.7%-10.8%). Factors associated with a higher likelihood of ASD were: male gender, low birth weight, and gestational age less than 33 weeks. CONCLUSION: Compared with the community, the prevalence of ASD was higher in the HRNFP. Further investigation is required to evaluate risk factors.
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Transtorno Autístico/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente Extremamente Prematuro , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Prevalência , Estudos Retrospectivos , Fatores de Risco , Arábia Saudita/epidemiologiaRESUMO
Prompted by the 20th anniversary of the 1993 World Development Report, a Lancet Commission revisited the case for investment in health and developed a new investment framework to achieve dramatic health gains by 2035. The Commission's report has four key messages, each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community. First, there is an enormous economic payoff from investing in health. The impressive returns make a strong case for both increased domestic financing of health and for allocating a higher proportion of official development assistance to development of health. Second, modeling by the Commission found that a "grand convergence" in health is achievable by 2035-that is, a reduction in infectious, maternal, and child mortality down to universally low levels. Convergence would require aggressive scale up of existing and new health tools, and it could mostly be financed from the expected economic growth of low- and middle-income countries. The international community can best support convergence by funding the development and delivery of new health technologies and by curbing antibiotic resistance. Third, fiscal policies -such as taxation of tobacco and alcohol- are a powerful and underused lever that governments can use to curb non-communicable diseases and injuries while also raising revenue for health. International action on NCDs and injuries should focus on providing technical assistance on fiscal policies, regional cooperation on tobacco, and funding policy and implementation research on scaling-up of interventions to tackle these conditions. Fourth, progressive universalism, a pathway to universal health coverage (UHC) that includes the poor from the outset, is an efficient way to achieve health and financial risk protection. For national governments, progressive universalism would yield high health gains per dollar spent and poor people would gain the most in terms of health and financial protection. The international community can best support countries to implement progressive UHC by financing policy and implementation research, such as on the mechanics of designing and implementing evolution of the benefits package as the resource envelope for public finance grows.
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Saúde Global , Saúde Pública , Planejamento em Saúde Comunitária , Países em Desenvolvimento , Financiamento Governamental , Organização do Financiamento , Objetivos , Política de Saúde , Promoção da Saúde , Humanos , Cooperação Internacional , Investimentos em Saúde , Serviços Preventivos de Saúde , Cobertura Universal do Seguro de SaúdeAssuntos
Encéfalo/diagnóstico por imagem , Lipogranulomatose de Farber/diagnóstico , Nervo Óptico/diagnóstico por imagem , Ceramidase Ácida/genética , Encéfalo/fisiopatologia , Pré-Escolar , Lipogranulomatose de Farber/diagnóstico por imagem , Lipogranulomatose de Farber/genética , Lipogranulomatose de Farber/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Mutação , Nervo Óptico/fisiopatologia , FenótipoRESUMO
<b>Background and Objective:</b> The clover plant (alfalfa) is considered the primary fiber source in the rabbit diet in Mediterranean Sea countries like Egypt, so researchers are always trying to find alternatives and aromatic and medicinal plant remnants could be one of them. So, this study was designed to determine the effects of some aromatic and medicinal plant remnants on New Zealand white rabbits' blood hematological and biochemical aspects. <b>Materials and Methods:</b> A total of 108 weaned white New Zealand rabbits at five weeks of age were used to consider the effect of using remnants of mint, fennel, basil and anise with or without probiotics to replace 50% from alfalfa hay in rabbits' diets. Four remnants were obtained after etheric oil distillation and were incorporated in rabbit diets at level 17.5% without probiotics and with probiotics (replacement 50% of alfalfa hay). Rabbits were randomly assigned into nine experimental groups; the experimental period lasted eight weeks. Rabbit blood hematological and blood biochemical were analyzed. <b>Results:</b> The highest values of RBC 6.03 µL, HCT 37.13%, WBC 12.70 µL and lymph percentage were found in the basil+probiotics group. In contrast, the highest value of hemoglobin (HGB 10,50 g/dL), MCV 64.13 fl, MCH 23.27pg, MCHC 36.40 g/dL, PLT 463 µL, urea 50.33 mg/dL and creatinine 1.30 mg/dL were found in anise+probiotic group. In contrast, RDW-CV 33.17%, Mid 13.17 µL, granulocytes (Gran 7.13 µL) and PDW 16.73 in the mint group. Furthermore, RDW-SD (34.40 fl) and procalcitonin (PCT 0.35%) were found in the control group and the highest values ALT 142 IU/L and AST 77.33 IU/L were found in the fennel group. The highest albumin value (3.10 g/dL) was found in the anise group and the highest total protein (TP 5.23 g/dL) was found in the mint+probiotic group. <b>Conclusion:</b> The results proved that using these medicinal plant remnants and probiotics as substitutes for half the amount of alfalfa used in the diet of New Zealand white rabbits did not have a negative effect and improved their health condition.
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Ração Animal , Foeniculum , Animais , Coelhos , Foeniculum/química , Ocimum basilicum/química , Probióticos , Dieta/veterinária , Ocimum , Medicago sativaRESUMO
This paper introduces a method aiming at enhancing the efficacy of speaker identification systems within challenging acoustic environments characterized by noise and reverberation. The methodology encompasses the utilization of diverse feature extraction techniques, including Mel-Frequency Cepstral Coefficients (MFCCs) and discrete transforms, such as Discrete Cosine Transform (DCT), Discrete Sine Transform (DST), and Discrete Wavelet Transform (DWT). Additionally, an Artificial Neural Network (ANN) serves as the classifier for this method. Reverberation is modeled using varying-length comb filters, and its impact on pitch frequency estimation is explored via the Auto Correlation Function (ACF). This paper also contributes to the field of cancelable speaker identification in both open and reverberation environments. The proposed method depends on comb filtering at the feature level, deliberately distorting MFCCs. This distortion, incorporated within a cancelable framework, serves to obscure speaker identities, rendering the system resilient to potential intruders. Three systems are presented in this work; a reverberation-affected speaker identification system, a system depending on cancelable features through comb filtering, and a novel cancelable speaker identification system within reverbration environments. The findings revealed that, in both scenarios with and without reverberation effects, the DWT-based features exhibited superior performance within the speaker identification system. Conversely, within the cancelable speaker identification system, the DCT-based features represent the top-performing choice.
Assuntos
Redes Neurais de Computação , Ruído , Acústica , Análise de OndaletasRESUMO
Barium phosphate (Ba3(PO4)2) is a class of material that has attracted significant attention thanks to its chemical stability and versatility. However, the use of Ba3(PO4)2 as a photocatalyst is scarcely reported, and its use as a photocatalyst has yet to be reported. Herein, Ba3(PO4)2 nanoflakes synthesis is optimized using sol-gel and hydrothermal methods. The as-prepared Ba3(PO4)2 powders are investigated using physicochemical characterizations, including XRD, SEM, EDX, FTIR, DRS, J-t, LSV, Mott-Schottky, and EIS. In addition, DFT calculations are performed to investigate the band structure. The oxidation capability of the photocatalysts is investigated depending on the synthesis method using rhodamine B (RhB) as a pollutant model. Both Ba3(PO4)2 samples prepared by the sol-gel and hydrothermal methods display high RhB photodegradation of 79% and 68%, respectively. The Ba3(PO4)2 obtained using the sol-gel process exhibits much higher stability under light excitation after four regeneration cycles. The photocatalytic oxidation mechanism is proposed based on the active species trapping experiments where O2 â¢â is the most reactive species. The finding shows the promising potential of Ba3(PO4)2 photocatalysts and opens the door for further investigation and application in various photocatalytic applications.
RESUMO
Visible-light-driven photocatalysis is an eco-friendly technology for wastewater treatment, where TiO2-based photocatalysts displayed outstanding performance in this regard. Dye sensitization is a promising approach for overcoming the common drawbacks of TiO2via improving its photocatalytic performance and extending its activity to visible light. Herein, we demonstrate the synthesis of the Thiophene-Hydrazinyl-Thiazole (THT) derivative as a novel organic dye sensitizer to be employed as a visible-light antenna for TiO2 nanoparticles. The physicochemical characteristics of the as-synthesized TiO2-based nanoparticles are examined by different techniques, which revealed the successful fabrication of the proposed THT-TiO2 heterojunction. The incorporation of THT molecules on the TiO2 surface led to slight disorders and deformation in the crystal lattice of TiO2, a remarkable improvement of its absorption in the visible light as a perfect visible-light antenna in the whole visible region, and significant enhancement in the charge transfer. Rhodamine B (RhB) is used as an organic dye model to assess the photocatalytic efficiency of the as-fabricated THT-TiO2 photocatalyst which achieved almost complete degradation (>95% in 150 min) with an observed rate constant (kobs) of 0.0164 min-1; total organic carbon (TOC) measurements suggested â¼75% mineralization. THT-TiO2 achieved 2.1-fold enhancement in photodegradation% and 4.1-fold enhancement in kobs compared to the bare TiO2. THT showed good activity under visible-light irradiation (RhB degradation% was >66% in 150 min and kobs = 0.0085 min-1). The influence of the initial pH of the solution was investigated and pH 4 was the optimum pH value for suitable interaction between RhB and the surface of THT-TiO2. Radical quenching experiments were conducted to assess the crucial reactive species where the âOH and O2.- were the most reactive species. THT-TiO2 showed promising stability over three successive cycles. Finally, the improvement mechanism of the photocatalytic activity of THT-TiO2 was attributed to the electron injection from the excited THT (the dye sensitizer) to TiO2 and enhanced charge separation.