On the derivatives of a family of analytic functions

For $\beta< 1$, n = 0, 1, 2, . . ., and $-\pi <\alpha\leq\pi$, we let $M_n(\alpha,\beta)$ denote the family of functions $f(z) = z +\ldots$ that are analytic in the unit disk and satisfy there the condition $Re\{(D^n f)'+\frac{1+e^{i\alpha}}{2(n+1)}z(D^n f)''\}>\beta$, where $D^n f(z)$ is the Hadamard product or convolution of f with $z/(1 − z){n+1}$. We prove the inclusion relations $M_{n+1}(\alpha,\beta) \subset M_n(\alpha,\beta$, and $M_n(\alpha,\beta) < M_n(\pi,\beta), \beta < 1$. Extreme points, as well as integral and convolution characterizations, are found. This leads to coefficient bounds and other extremal properties. The special cases $M_0(\alpha,0)\equiv \mathcal{L}_\alpha$, $M_n(\pi,\beta)\equiv M_n(\beta)$ have previously been studied [16], [1]

On Some Subclasses of Harmonic Functions Defined by Fractional Calculus

The purpose of this paper is to study subclasses of normalized harmonic functions with positive real part using fractional derivative. Sharp estimates for coefficients and distortion theorems are given

NEW EXAMPLES OF S-UNIMODAL MAPS WITH A SIGMA-FINITE ABSOLUTELY CONTINUOUS INVARIANT MEASURE

We construct new types of examples of S-unimodal maps &#38;#966; on an interval I that do not have a finite absolutely continuous invariant measure but that do have a &#38;#963; - finite one. These examples satisfy two important properties. The first property is topological, namely, the forward orbit of the critical point c is dense, i.e., &#38;#969;(c) = I. On the other hand, the second property is metric, we are able to conclude that this measure is infinite on every non-trivial interval. In the process, we show that we have the following dichotomy. Every absolutely continuous invariant measure, in our setting, is either &#38;#963; - finite, or else it is infinite on every set of positive Lebesgue measure. Our method of construction is based on the method of inducing a power map defined piecewise on a countable collection of non-overlapping intervals that partition I modulo a Cantor set of Lebesgue measure zero. The power map then satisfies what is known as the Folklore Theorem and therefore has a finite a.c.i.m. that is pulled back to define our &#38;#966; - invariant measure on I, with the above stated properties

Risk Assessment and Travelers Characteristics: 6-Month Travel Clinic Experience From Qatar

Introduction: The number of international travelers is increasing, yet currently, there is no data on risk assessment and travelers’ characteristics from Qatar. To identify and minimize the risks associated with travel, a detailed knowledge of travelers’ characteristics is needed. Methods: This retrospective descriptive study was conducted in a travel clinic in the Communicable Disease Center, Qatar. All patients seen in the clinic from February 2017 to August 2017 were included. Data was analyzed using SPSS version 22 software. Results: A total of 279 travelers were included in this study. The top 2 most visited countries were Tanzania and Kenya. Tourism (57.3%) was the number one purpose for travel, while travelers visiting friends and relatives (VFRs) accounted for 10.7% of travel. Among the study population, 21% of participants had pre-existing medical conditions with hypertension and diabetes as the most common comorbidities. Mean travel duration was 46.5 days (range = 3 to 90 days). Vaccinations were required by 97% of the study population with the most commonly prescribed vaccines being the typhoid (69%), Tdap (62%), hepatitis A (55%), flu (49.3%), and yellow fever (39%) vaccines. Conclusion: Travelers from Qatar tend to visit high-risk destinations; the lack of proper travel medicine services and awareness among travelers may increase the risk of illness, especially in Qatar where a large number of expatriates reside and travel frequently to and from their home countries (VFRs)

Endobronchial Tuberculosis Simulating Lung Cancer and Healing without Bronchial Stenosis

Endobroncheal tuberculosis is defined as tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. The disease is usually mistaken for other lung diseases including lung cancer. Bronchial stenosis is a common complication of this type of tuberculosis despite the use of effective anti-tuberculous chemotherapy. We are presenting a case of endobronchial tuberculosis that simulated lung cancer and healed without residual bronchial stenosis

Statins Formulary Selection in Qatar, Based on Multi-Indication Pharmacotherapeutic Multi-Criteria Scoring, and Clinician Preference

Purpose: Statins selection for the largest hospital formulary in Qatar is not systematic, not comparative, not cost saving, and does not consider the multi-indication nature of statins. There are no literature reports of multi-indication based comparative scoring models of statins, or reports of statins selection criteria weights that are primarily based on local clinicians' preference and experiences. The study sought to comparatively evaluate statins for first-line therapy in Qatar, and to evaluate the economic impact of this. Methods: An evidence-based, multi-indication, multi-criteria pharmacotherapeutic model was developed for the scoring of statins. This was from the perspective of the main healthcare provider in Qatar, the Hamad Medical Corporation (HMC). Literature and an expert panel informed the selection criteria of statins. Relative weighting of selection criteria was based on the input of the relevant local clinician population. The targeted clinician population was of all specialists and consultants in the departments of cardiology, internal medicine, and nephrology in HMC. Statins were comparatively evaluated according to their total pharmacotherapeutic selection scores, with only the statins that score more than 95% of the highest scoring statin getting recommended for formulary inclusion. Remaining statins that score more than 90% of the highest scoring statin will also be considered, but as non-formulary alternative. The remaining did not progress. Sensitivity analyses were conducted to investigate the robustness of the study outcomes against variations in study inputs. These included deterministic, probabilistic as well as scenario analyses, via @Risk-5.5 Palisade, USA. Findings: This is the first literature report to inform formulary inclusion in Qatar or the Middle Eastern region, and the first in literature that comparatively score statins based on multiple indications, as compared to the typical pharmacoeconomics evaluation method, comparing differences in cost and effect between two statins for an indication of interest to guide the formulary inclusion decisions. With 95% confidence interval and 5% margin of error, the scoring model was successfully developed. Selection criteria comprised 28 sub-criteria, under the following main criteria: clinical efficacy, best publish evidence and experience, adverse effects, drug interaction, dosing time, and fixed dose combination availability. Outcome measures of multiple indications related to effects on LDL-cholesterol, HDL-cholesterol, triglyceride, total cholesterol, and c-reactive protein. Atorvastatin, pravastatin and rosuvastatin exceeded defined pharmacotherapeutic thresholds. Atorvastatin and pravastatin were suggested for first-line use in HMC, followed by rosuvastatin as a non-formulary alternative. Fluvastatin and simvastatin were recommended for exclusion from any hospital drug lists. This was estimated to produce 17.6% in cost savings, reducing the annual statins expenditure from QAR 152, 118, 200 to QAR 125, 367, 620;. Sensitivity analyses confirmed the robustness of the evaluation outcomes. The comparative criterion that affected the study conclusion was the availability of fixed dose combination. The possibility of 30% non-formulary drug utilization scenario resulted in an annual expenditure of QAR 129, 654, 180, still associated with up to 14.8% cost saving. Implications: Incorporating a comparative evaluation of statins in Qatari practices, based on a locally-developed, transparent, multi-indication, multi-criteria scoring model, has the potential to considerably reduce the expenditure on statins. Atorvastatin and pravastatin should be the first-line statin therapies in the main Qatari healthcare provider, with rosuvastatin as an alternative. Important, is that the study results are consistent with published clinical guidelines, as well as with practices in overseas.qscienc

Evaluation of Progress of an ACGME-International Accredited Residency Program in Qatar

Background: The American College of Physicians' (ACP) Internal Medicine In-Training Examination (IM-ITE) is designed to evaluate the cognitive knowledge of residents to aid them and program directors in evaluating the training experience. Objective: To determine the impact of the curriculum reform accompanied by the Accreditation Council for Graduate Medical Education (ACGME)-I alignment and accreditation on the internal medicine residency program (IMRP) using residents' performance in the ACP's ITE from 2008 to 2016, and where the IMRP stands in comparison to all ACGME and ACGME-I accredited programs. Methods: This is a descriptive study conducted at a hospital-based IMRP in Doha, Qatar from 2008 to 2016. The study population is 1052 residents at all levels of training in IMRP. The ACP-generated ITE results of all the United States and ACGME-I accredited programs were compared with IM-ITE results in Qatar. These results were expressed in the total program average and the ranking percentile. Results: There is a progressive improvement in resident performance in Qatar as shown by the rise in total average program score from 52% in 2008 to 72% in 2016 and the sharp rise in percentile rank from 3rd percentile in 2008 to 93rd percentile in 2016 with a dramatic increase during the period 2013 to 2014 (from 32nd percentile to 73rd percentile), which represents the period of ACGME-I accreditation. None of the factors (ethnicity, USMLE or year of residency) were statistically significant with a p value >0.05 and standard coefficient ( ? 0.017-0.495). There was negligible correlation between the USMLE test scores with the residents' ITE scores with a p value = 0.023 and a Pearson correlation r = 0.097. Conclusion: The initial ACGME-I alignment followed by the accreditation, together with whole curriculum redesign to a structured, competency-based program starting from 2008, has led to an improvement in the ITE scores in the IMRP. This was further evidenced by the lack of change in the residency entry selection criteria.qscienc

Epidemiology of respiratory infections among adults in Qatar (2012-2017).

Limited data is available about the etiology of influenza like illnesses (ILIs) in Qatar. This study aimed at providing preliminary estimates of influenza and other respiratory infections circulating among adults in Qatar. We retrospectively collected data of about 44,000 patients who visited Hamad General Hospital clinics, sentinel sites, and all primary healthcare centers in Qatar between 2012 and 2017. All samples were tested for influenza viruses, whereas about 38,000 samples were tested for influenza and a panel of respiratory viruses using Fast Track Diagnostics (FTD) RT-PCR kit. Among all ILIs cases, 20,278 (46.5%) tested positive for at least one respiratory pathogen. Influenza virus was predominating (22.6%), followed by human rhinoviruses (HRVs) (9.5%), and human coronaviruses (HCoVs) (5%). A detection rate of 2-3% was recorded for mycoplasma pneumonia, adenoviruses, human parainfluenza viruses (HPIVs), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ILIs cases were reported throughout the year, however, influenza, RSV, and HMPV exhibited strong seasonal peaks in the winter, while HRVs circulated more during fall and spring. Elderly (>50 years) had the lowest rates of influenza A (13.9%) and B (4.2%), while presenting the highest rates of RSV (3.4%) and HMPV (3.3%). While males had higher rates of HRVs (11.9%), enteroviruses (1.1%) and MERS CoV (0.2%), females had higher proportions of influenza (26.3%), HPIVs (3.2%) and RSV (3.6%) infections. This report provides a comprehensive insight about the epidemiology of ILIs among adults in the Qatar, as a representative of Gulf States. These results would help in improvement and optimization of diagnostic procedures, as well as control and prevention of the respiratory infections.This study was supported by funds from Hamad Medical Corporation (grant # 16335/16) and Qatar University (grant # QUCG-BRC-2018/2019-1)

Qatar Biobank: COVID-19 biorepository project

Background: The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its resulting disease (COVID-19) is one of the greatest global public health crisis of the recent decades 1 . The COVID-19 Biorepository is a national project aimed to support the high demand of biomedical research by multiple groups and the need to have access to high quality, curated clinical data, and specimens contributing to the understanding of, and response to, the COVID-19 pandemic and its impacts in Qatar 2, 3 . Methods/Case presentation: Patients with a laboratory diagnosis of COVID-19, who were Qatar residents that could communicate in Arabic, English, Hindi, and Urdu were eligible to participate in the study. COVID-19 diagnosed patients were recruited at the time of their disease period from the main three public hospitals (Communicable Disease Center, Cuban, and Hazm Mebaireek Hospitals) serving as isolation facilities of symptomatic patients in Qatar, during a 7-month period from March 2020 until September 2020. Consented participants were followed up on a weekly basis until recovery, and then monthly for a year. Sociodemographic and clinical data were collected in electronic questionnaires via a face-to-face interview by trained Qatar Biobank (QBB) staff. Results: A total of 2097 consented participants were recruited up to September 2020, males (N = 1050) and females (N = 1047), with a mean age of 41 years (SD: 15.5). 61.0% of the participants had at least one follow up while 27% adhered to monthly follow up visits. Data was collected for 99.7% of the participants, while the follow up process is still ongoing. In total there are 107,171 high quality specimens in the biorepository including plasma, erythrocytes, buffy coat, serum, PAXgene whole blood, nasopharyngeal secretions, and DNA. Conclusion: The COVID-19 Biorepository is a national asset to illuminate the pathophysiological and identify markers of disease prognosis as well as to describe the clinical features and epidemiology of COVID-19 in Qatar and worldwide.qscienc

Does pleural tuberculosis disease pattern differ among developed and developing countries

SummaryBackground: A number of reports from developed countries have documented a rising age at which pleural tuberculosis occurs and increase in the frequency of reactivation disease being as the main cause of pleural involvement.Objective: To determine the age at which pleural tuberculosis occurs, study its clinical pattern, and to determine whether pleural tuberculosis is a result of reactivation of pulmonary tuberculosis or it is a primary one comparing our findings with results from developed countries.Method: Retrospective study of 100 cases discharged from Hamad General Hospital with the diagnosis of pleural tuberculosis from January 1996 to December 2002.Results: Pleural tuberculosis tends to affect younger age groups (84% are below the age of 45 years, with mean age of 31.5). The disease tends to be mostly a primary infection. Fever is the most common symptom (90%) and the disease is usually an acute or sub acute one. Weight loss precedes other symptoms. Exudative pleural effusion with predominant lymphocytosis is characteristic. Majority of patients have no predisposing conditions for the disease.Conclusion: In contrast to what has been reported in some developed countries, Pleural tuberculosis tends to be a primary disease in the present study. Younger age groups are particularly affected