Clinical Pathways for Non-ST Elevation Acute Coronary Syndrome in Oman: An Oman Heart Association Protocol for Hospital Quality Improvement Initiative

In 2012, Oman Heart Association (OHA) published its own guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction, the aim was not to be comprehensive but rather simplified and practical in order to reduce the gap between the long comprehensive guidelines and our actual practice. However, we still feel that the busy registrars and residents need simpler and direct clinical pathways or protocol to be used in the emergency departments, coronary care units and in the wards. Clinical pathways are now one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes in acute care

An assistive and research framework methodology for ships’ upkeep and repair organisational learning performance

The Omani Dockyard (OD) requires the development of a research methodology, which encompasses an assistive framework to maintain the research boundary to support a research framework. A research framework is developed to understand the behaviour of variables. A deductive/quantitative – survey questionnaire is employed in the main research to statistically understand the ‘mindsets/opinions’ of a large population and an inductive/qualitative – semi-structured interview using selected senior managers for the total research. Another questionnaire was used to critically learn from the agreement of the senior managers if the proposed contributions were in line with the ships’ upkeep and repair ‘organisational performance’. The initial and most definitive requirement is also to understand the strength of independent and mediation constructs applicability for the enhancement of performance. The problem is in the area of ‘enhancement of organisational learning on knowledge and competencies’ to underpin ships’ upkeep and repair support performance for better availability of operational ships. This research methodology was designed for a ‘major piece of research’ involving a doctorate dissertation in ships’ support performance. The conclusion and recommendation for a ‘major piece of research’ formulated the framework/model to underpin performance. This study concentrates on the research methodology that was used for ships’ upkeep and repair performance of the Omani dockyard with a compressive description of the total results, which can be generalized for other studies

Molecular characterization of glucose-6-phosphate dehydrogenase deficient variants in Baghdad city - Iraq

Background: Although G6PD deficiency is the most common genetically determined blood disorder among Iraqis, its molecular basis has only recently been studied among the Kurds in North Iraq, while studies focusing on Arabs in other parts of Iraq are still absent. Methods: A total of 1810 apparently healthy adult male blood donors were randomly recruited from the national blood transfusion center in Baghdad. They were classified into G6PD deficient and non-deficient individuals based on the results of methemoglobin reduction test (MHRT), with confirmation of deficiency by subsequent enzyme assays. DNA from deficient individuals was studied using a polymerase chain reaction-Restriction fragment length polymorphism (PCR-RFLP) for four deficient molecular variants, namely G6PD Mediterranean (563 C®T), Chatham (1003 G®A), A- (202 G®A) and Aures (143 T®C). A subset of those with the Mediterranean variant, were further investigated for the 1311 (C®T) silent mutation. Results: G6PD deficiency was detected in 109 of the 1810 screened male individuals (6.0%). Among 101 G6PD deficient males molecularly studied, the Mediterranean mutation was detected in 75 cases (74.3%), G6PD Chatham in 5 cases (5.0%), G6PD A- in two cases (2.0%), and G6PD Aures in none. The 1311 silent mutation was detected in 48 out of the 51 G6PD deficient males with the Mediterranean variant studied (94.1%). Conclusions: Three polymorphic variants namely: the Mediterranean, Chatham and A-, constituted more than 80% of G6PD deficient variants among males in Baghdad. Iraq. This observation is to some extent comparable to othe

Prevalence and molecular characterization of Glucose-6-Phosphate dehydrogenase deficient variants among the Kurdish population of Northern Iraq

<p>Abstract</p> <p>Background</p> <p>Glucose-6-Phosphate dehydrogenase (G6PD) is a key enzyme of the pentose monophosphate pathway, and its deficiency is the most common inherited enzymopathy worldwide. G6PD deficiency is common among Iraqis, including those of the Kurdish ethnic group, however no study of significance has ever addressed the molecular basis of this disorder in this population. The aim of this study is to determine the prevalence of this enzymopathy and its molecular basis among Iraqi Kurds.</p> <p>Methods</p> <p>A total of 580 healthy male Kurdish Iraqis randomly selected from a main regional premarital screening center in Northern Iraq were screened for G6PD deficiency using methemoglobin reduction test. The results were confirmed by quantitative enzyme assay for the cases that showed G6PD deficiency. DNA analysis was performed on 115 G6PD deficient subjects, 50 from the premarital screening group and 65 unrelated Kurdish male patients with documented acute hemolytic episodes due to G6PD deficiency. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for five deficient molecular variants, namely G6PD Mediterranean (563 C→T), G6PD Chatham (1003 G→A), G6PD A- (202 G→A), G6PD Aures (143 T→C) and G6PD Cosenza (1376 G→C), as well as the silent 1311 (C→T) mutation.</p> <p>Results</p> <p>Among 580 random Iraqi male Kurds, 63 (10.9%) had documented G6PD deficiency. Molecular studies performed on a total of 115 G6PD deficient males revealed that 101 (87.8%) had the G6PD Mediterranean variant and 10 (8.7%) had the G6PD Chatham variant. No cases of G6PD A-, G6PD Aures or G6PD Cosenza were identified, leaving 4 cases (3.5%) uncharacterized. Further molecular screening revealed that the silent mutation 1311 was present in 93/95 of the Mediterranean and 1/10 of the Chatham cases.</p> <p>Conclusions</p> <p>The current study revealed a high prevalence of G6PD deficiency among Iraqi Kurdish population of Northern Iraq with most cases being due to the G6PD Mediterranean and Chatham variants. These results are similar to those reported from neighboring Iran and Turkey and to lesser extent other Mediterranean countries.</p

Registration-Based Encryption: Removing Private-Key Generator from IBE

In this work, we introduce the notion of registration-based encryption (RBE for short) with the goal of removing the trust parties need to place in the private-key generator in an IBE scheme. In an RBE scheme, users sample their own public and secret keys. There will also be a ``key curator\u27\u27 whose job is only to aggregate the public keys of all the registered users and update the short public parameter whenever a new user joins the system. Encryption can still be performed to a particular ecipient using the recipient\u27s identity and any public parameters released subsequent to the recipient\u27s registration. Decryption requires some auxiliary information connecting users\u27 public (and secret) keys to the public parameters. Because of this, as the public parameters get updated, a decryptor may need to obtain a few additional auxiliary information for decryption. More formally, if $n$ is the total number of identities and $\kappa$ is the security parameter, we require the following. Efficiency requirements: (1) A decryptor only needs to obtain updated auxiliary information for decryption at most $O(\log n)$ times in its lifetime, (2) each of these updates are computed by the key curator in time $poly(\kappa,\log n)$, and (3) the key curator updates the public parameter upon the registration of a new party in time $poly(\kappa,\log n)$. Properties (2) and (3) require the key curator to have \emph{random} access to its data. Compactness requirements: (1) Public parameters are always at most $poly(\kappa,\log n)$ bit, and (2) the total size of updates a user ever needs for decryption is also at most $poly(\kappa,\log n)$ bits. We present feasibility results for constructions of RBE based on indistinguishably obfuscation. We further provide constructions of \emph{weakly efficient} RBE, in which the registration step is done in $poly(\kappa, n)$, based on CDH, Factoring or LWE assumptions. Note that registration is done only once per identity, and the more frequent operation of generating updates for a user, which can happen more times, still runs in time $poly(\kappa,\log n)$. We leave open the problem of obtaining standard RBE (with $poly(\kappa,\log n)$ registration time) from standard assumptions

Registration-Based Encryption from Standard Assumptions

The notion of Registration-Based Encryption (RBE) was recently introduced by Garg, Hajiabadi, Mahmoody, and Rahimi [TCC\u2718] with the goal of removing the private-key generator (PKG) from IBE. Specifically, RBE allows encrypting to identities using a (compact) master public key, like how IBE is used, with the benefit that the PKG is substituted with a weaker entity called key curator who has no knowledge of any secret keys. Here individuals generate their secret keys on their own and then publicly register their identities and their corresponding public keys to the key curator. Finally, individuals obtain rare decryption-key updates from the key curator as the population grows. In their work, they gave a construction of RBE schemes based on the combination of indistinguishability obfuscation and somewhere statistically binding hash functions. However, they left open the problem of constructing RBE schemes based on standard assumptions. In this work, we resolve the above problem and construct RBE schemes based on standard assumptions (e.g., CDH or LWE). Furthermore, we show a new application of RBE in a novel context. In particular, we show that anonymous variants of RBE (which we also construct under standard assumptions) can be used for realizing abstracts forms of anonymous messaging tasks in simple scenarios in which the parties communicate by writing messages on a shared board in a synchronized way

Allergic rhinitis in northern vietnam: increased risk of urban living according to a large population survey

<p>Abstract</p> <p>Background</p> <p>Little is known about prevalence and risk factors of allergic rhinitis and chronic nasal symptoms among adults in Vietnam. We aimed to estimate the prevalence, risk factor patterns and co-morbidities of allergic rhinitis and chronic nasal symptoms in one urban and one rural area in northern Vietnam.</p> <p>Methods</p> <p>A cross-sectional questionnaire survey was conducted from August 2007 to January 2008 in urban Hoankiem and rural Bavi in Hanoi among adults aged 21-70 years. Of 7008 randomly selected subjects, 91.7% participated in Bavi and 70.3% in Hoankiem.</p> <p>Results</p> <p>Allergic rhinitis ever or chronic nasal symptoms were reported by 50.2%. The prevalence of allergic rhinitis ever was considerably higher in Hoankiem compared to Bavi, 29.6% vs 10.0% (p < 0.001). Allergic rhinitis ever and chronic nasal symptoms were both significantly associated with asthma and respiratory symptoms, respectively (p < 0.001). Exposure to gas, dust or fumes at work was significantly associated with allergic rhinitis ever, OR 1.57 (95% CI 1.34 - 1.84), nasal blocking, OR 1.90 (95% CI 1.68 - 2.15) and runny nose, OR 1.32 (95% CI 1.17 - 1.49), while somewhat surprisingly no association with smoking was found. Female sex was a significant risk factor for both nasal blocking and runny nose.</p> <p>Conclusions</p> <p>Allergic rhinitis ever was considerably more common in the urban area. Nasal blocking and runny nose was each reported by about one third of the studied sample with no major urban-rural difference. Further, exposure to air pollution at work was significantly associated with allergic rhinitis ever, nasal blocking and runny nose.</p

Verifiable Registration-Based Encryption

In a recent work, Garg, Hajiabadi, Mahmoody, and Rahimi (TCC 18) introduced a new encryption framework, which they referred to as Registration-Based Encryption (RBE). The central motivation behind RBE was to provide a novel methodology for solving the well-known key-escrow problem in Identity-Based Encryption (IBE) systems. Informally, in an RBE system there is no private-key generator unlike IBE systems, but instead it is replaced with a public key accumulator. Every user in an RBE system samples its own public-secret key pair, and sends the public key to the accumulator for registration. The key accumulator has no secret state, and is only responsible for compressing all the registered user identity-key pairs into a short public commitment. Here the encryptor only requires the compressed parameters along with the target identity, whereas a decryptor requires supplementary key material along with the secret key associated with the registered public key. The initial construction by Garg et al. (TCC 18) based on standard assumptions only provided weak efficiency properties. In a follow-up work by Garg, Hajiabadi, Mahmoody, Rahimi, and Sekar (PKC 19), they gave an efficient RBE construction from standard assumptions. However, both these works considered the key accumulator to be honest which might be too strong an assumption in real-world scenarios. In this work, we initiate a formal study of RBE systems with malicious key accumulators. To that end, we introduce a strengthening of the RBE framework which we call Verifiable RBE (VRBE). A VRBE system additionally gives the users an extra capability to obtain short proofs from the key accumulator proving correct (and unique) registration for every registered user as well as proving non-registration for any yet unregistered identity. We construct VRBE systems which provide succinct proofs of registration and non-registration from standard assumptions (such as CDH, Factoring, LWE). Our proof systems also naturally allow a much more efficient audit process which can be perfomed by any non-participating third party as well. A by-product of our approach is that we provide a more efficient RBE construction than that provided in the prior work of Garg et al. (PKC 19). And, lastly we initiate a study on extension of VRBE to a wider range of access and trust structures

Conceptualizing pathways linking women's empowerment and prematurity in developing countries.

BackgroundGlobally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity.MethodsThe key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors.ResultsThere is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving access to and receipt of recommended health services during pregnancy and delivery to help prevent prematurity and improve survival of premature babies.ConclusionsWomen's empowerment is an important distal factor that affects prematurity through several intervening factors. Improving women's empowerment will help prevent prematurity and improve survival of preterm babies. Research to empirically show the links between women's empowerment and prematurity is however needed