The Effect of Age on Corneal Topographic Indices, Keratometry and Visual Acuity After Combined Intrastromal Corneal Ring Segment (ICRS) Implantation and Corneal Crosslinking

We aimed to assess age-related changes in corneal topographic indices, keratometry and visual acuity after sequential intracorneal ring segment implantation (ICRS) and crosslinking (CXL). This was a retrospective matched case-control series including 26 eyes of patients ≤18 years as the cases and 26 eyes of adult patients as control. All eyes received ICRS+CXL for progressive keratoconus. Eyes were matched regarding the keratoconus parameters and the treatment (type, number and thickness of ICRS). Data was analyzed for refractive and topographic values [uncorrected and corrected distance visual acuity (UDVA; CDVA) sphere; cylinder; spherical equivalent; maximum keratometry (Kmax); flat keratometry (Kflat); steep keratometry (Ksteep); all 7 pentacam topographic indices] preoperatively and one year postoperatively. Preoperatively, there was no significant difference for any refractive, clinical or topographic parameters between the groups except for vertical asymmetry. After one year, children had a significantly higher improvement in Ksteep (3.05D) than adults (2.10D; P=0.036) and a trend to significance for Kflat (2.7D compared to 1.78D, respectively; P=0.081). UDVA improved by 4.3 ETDRS lines in children compared to 3.3 ETDRS lines in adults and CDVA improved by 1.7 ETDRS lines in children compared to 1.2 ETDRS lines in adults, but with no statistical significance. The effects on keratometry indicated that corneal response after ICRS and CXL for keratoconus is more pronounced in young patients than adults. This assumption is also supported by functional improvement and by the fact that a few eyes (5) of some very young patients (<13years) showed highly remarkable improvements after surgery (higher than any adult eye)

Factors associated with female genital mutilation : A systematic review and synthesis of national, regional, and community-based studies.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Acknowledgment We would like to acknowledge the assistance of Ms. Sandra Kahwaji and Ms. Jana Abu Ayash for their help in the title and abstract screening of articles. We thank Dr. Sawsan Abdulrahim for insightful comments and edits on preliminary drafts.Peer reviewedPublisher PD

Toward a Specific Classification of Polypoidal Choroidal Vasculopathy: Idiopathic Disease or Subtype of Age-Related Macular Degeneration

PURPOSE To suggest a clinical distinction between idiopathic polypoidal choroidal vasculopathy (PCV) and secondary polyps associated with neovascular age-related macular degeneration (NV-AMD). METHODS The study was a retrospective case series of 52 eyes of 52 consecutive patients (31 females and 21 males) diagnosed with PCV. Initial diagnosis was based on scanning laser ophthalmoscope-indocyanine green angiography (SLO-ICGA) in association with fluorescein angiography (FA) and optical coherence tomography (OCT). All the data and images were analyzed in a masked fashion by four experienced examiners in two different sessions: the first, to classify patients into the two hypothesized groups (idiopathic polyps or NV-AMD-related polyps); the second, following a predetermined scheme, to describe objective features. The results obtained in each session underwent a cross multivariate analysis to identify statistically significant differences (P ≤ 0.05) between the two groups. RESULTS The two groups were clinically different on the basis of FA (leakage origin [P = 0.001] and presence of drusen [P = 0.001]), ICGA (evidence of choroidal neovascularization [CNV; P = 0.001] and/or branching vascular network [BVN; P = 0.001]), OCT imaging (type of pigmented epithelium detachment [P = 0.001], presence of BVN [P = 0.001], and subfoveal choroidal thickness [P = 0.001]). Further significant differences were observed according to the location of lesion (uni- or multifocal) (P = 0.001), type of CNV (P = 0.001), and best-corrected visual acuity (P = 0.001). CONCLUSIONS Our study demonstrated clinical and statistically significant differences between idiopathic PCV and NV-AMD-related polyps that could be considered as distinct entities. Although they share some similarities, mainly the sub-RPE location, the ability to identify a specific clinical pattern suggests a more specific therapeutic approach for these two entities

Self-reported antibiotic stewardship and infection control measures from 57 intensive care units: An international ID-IRI survey

We explored the self-reported antibiotic stewardship (AS), and infection prevention and control (IPC) activities in intensive care units (ICUs) of different income settings. A cross-sectional study was conducted using an online questionnaire to collect data about IPC and AS measures in participating ICUs. The study participants were Infectious Diseases-International Research Initiative (IDI-IR) members, committed as per their institutional agreement form. We analyzed responses from 57 ICUs in 24 countries (Lower-middle income (LMI), n = 13; Upper-middle income (UMI), n = 33; High-income (HI), n = 11). This represented (similar to 5%) of centers represented in the ID-IRI. Surveillance programs were implemented in (76.9%-90.9%) of ICUs with fewer contact precaution measures in LMI ones (p = 0.02); (LMI:69.2%, UMI:97%, HI:100%). Participation in regional antimicrobial resistance programs was more significantly applied in HI (p = 0.02) (LMI:38.4%,UMI:81.8%,HI:72.2%). AS programs are implemented in 77.2% of institutions with AS champions in 66.7%. Infectious diseases physicians and microbiologists are members of many AS teams (59%&50%) respectively. Unqualified healthcare professionals(42.1%), and deficient incentives(28.1%) are the main barriers to implementing AS. We underscore the existing differences in IPC and AS programs' implementation, team composition, and faced barriers. Continuous collaboration and sharing best practices on APM is needed. The role of regional and international organizations should be encouraged. Global support for capacity building of healthcare practitioners is warranted. (C) 2022 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences

The state of HRM in the Middle East:Challenges and future research agenda

Based on a robust structured literature analysis, this paper highlights the key developments in the field of human resource management (HRM) in the Middle East. Utilizing the institutional perspective, the analysis contributes to the literature on HRM in the Middle East by focusing on four key themes. First, it highlights the topical need to analyze the context-specific nature of HRM in the region. Second, via the adoption of a systematic review, it highlights state of development in HRM in the research analysis set-up. Third, the analysis also helps to reveal the challenges facing the HRM function in the Middle East. Fourth, it presents an agenda for future research in the form of research directions. While doing the above, it revisits the notions of “universalistic” and “best practice” HRM (convergence) versus “best-fit” or context distinctive (divergence) and also alternate models/diffusion of HRM (crossvergence) in the Middle Eastern context. The analysis, based on the framework of cross-national HRM comparisons, helps to make both theoretical and practical implications

Selective laser trabeculoplasty: past, present, and future

Over the past two decades, selective laser trabeculoplasty (SLT) has increasingly become an established laser treatment used to lower intraocular pressure in open-angle glaucoma and ocular hypertensive patients. In this review we trace the origins of SLT from previous argon laser trabeculoplasty and review the current role it has in clinical practice. We outline future directions of SLT research and introduce emerging technologies that are further developing this intervention in the treatment paradigm of glaucoma.Eye advance online publication, 5 January 2018; doi:10.1038/eye.2017.273

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Uncovering the role of human resources in corporate social responsibility: case evidence from Lebanon

Over the past two decades, the interest in the concept of Corporate Social Responsibility (CSR) within both the academic and practitioner discourse has been rapidly increasing. CSR has developed to become a strategic objective for many organizations, with the credibility of CSR hinging on implementation as statements. This thesis aims to explore the role that Human Resources (HR) can play in CSR strategy development and implementation. Through a systematic review of relevant literatures on CSR and HR, the researcher highlights important CSR-HR interfaces and proposes a newly synthesised conceptual model, the CSR-HR value chain, which captures the CSR domain and strategy, and the domains of HR’s added values into CSR and their metaphor roles and outcome benefits. This research adopts two main theoretical frames when building the CSR-HR value chain and its initial proposition. The first frame is the strategic approach for CSR understanding and practice that draws on previous CSR models especially the CSR domains and social responsiveness approach in addition to the stakeholder theory. The second frame is the strategic HR partnership framework which includes the resource based view of the firm as a base for evaluating HR’s conurbation into CSR. Within this theoretical background, the research’s main proposition is for a strategic HR partner role within a strategic CSR approach.The CSR-HR value chain model and its embodied proposition were evaluated within the context of four organizations operating in Lebanon, a country which is witnessing a recent evolving interest in the strategic application of CSR within both the academic and managerial contexts. Within each organization, semi-structured interviews were conducted with a wide range of stakeholders in addition to gathering and analysing secondary documentation data related to the examined phenomenon. Empirical findings revealed that the role of HR is mainly being operational on the short-term range focus practiced mainly within a philanthropic CSR approach. The plausible explanation for the role of HR in CSR was thus identified and the factors affecting this role were discussed. This research contributes to knowledge through presenting the model which uncovers the role of HR in CSR and its outcome benefits. Also, this research contributes to managerial practices, especially for HR managers seeking to assume more strategic roles in CSR through providing them with the guideline for HR’s domains of added value into CSR, and the dynamics and factors shaping the role of HR in CSR

Nanostructuration par photolithographie DUV de matériaux organiques

The main objective of this thesis was to develop a montage of lithography at 193 nm (Deep UV, DUV), to obtain nanostructures with a period of 100 nm on large surfaces (cm2) in different organic materials. Thus, an important part of this thesis was to establish an achromatic interferometer for the DUV, as well as methods for analyzing samples at different scales.L'objectif principal de ce travail de thèse a été de développer un montage de lithographie à 193 nm (Deep-UV, DUV), avec comme but d'obtenir des nanostructures de période l 00 nm sur des surfaces relativement importantes (cm2) dans différents matériaux organiques. Ainsi, une partie importante de cette thèse a consisté à mettre en place un interféromètre achromatique pour le DUV, ainsi que les méthodes d'analyse des échantillons aux différentes échelles. Le premier chapitre a pour but d'énoncer les enjeux et techniques de nanofabrication en comparant notamment les deux grandes approches dites « top-down » et « bottom-up ». Dans ce chapitre, une part importante est donnée aux techniques lithographiques dans lesquelles s'inscrit la technique utilisée ici. Le deuxième chapitre décrit les techniques utilisées, pour la nanofabrication (photolithographie interférentielle DUV) et les méthodes de caractérisation. Le troisième chapitre expose les résultats obtenus au sujet de résines positives, dites « à amplification chimique », formulées à partir des nouveaux polymères, et destinées à des applications en microélectronique. Le quatrième chapitre décrit les résultats obtenus en photolithographie DUV de polymères déposés par voie plasma. Il se présente sous la forme d'une compilation de 4 articles précédés d'une introduction pour expliquer les enjeux de cette démarche.Enfin, le cinquième chapitre constitue une ouverture vers une nouvelle technique de nanofabrication qui s'appuie sur la photolithographie 193 nm. Il s'agit d'utiliser une approche hybride de nanofabrication qui repose sur l'auto­organisation de films de copolymères dibloc dans des espaces nanoconfinés