Enhancing the Quality of Urban Life in Urban Poverty Areas through a Strategy of Integral Multi Approaches: Public Spaces as Arena for Change

Urban poverty areas (UPA) in the main cities of the emerging and developing countries are representing the product of a chaotic urban-isation process. This process started through the recent decades as a result of the economic reform in many Emerging countries, mainly in Asia, South America, and some cases in Africa such as Egypt and South Africa. Under the umbrella of the term UPA, there are many other terms such as slums, shantytowns and informal urbanism. In this study, the focus is on a special case of UPA which exist in the main cities of the emerging countries and some cases of developing countries. These UPA have some of the slums characteristics, which indicate the low quality of the urban life such as the pollution of the urban environment, the high density of built up area and the lack of social spaces. However, these areas mainly consist of permanent buildings which were built in most cases by the dwellers themselves due to their basic socio-economic needs, also in most of the cases the basic infrastructure are available. The study hypothesis is discussing the possibility of enhancing the quality of urban life in those UPA through a strategy of integral mul-ti approaches based on the potential opportunities of public spaces. In other words, the key to a successful strategy is “integration”, meaning that all approaches, policies, and projects are considered in relation to one another. This includes the using of new approaches such as green infrastructure (GI) through an integration framework with the other prevalent urban approaches such as participatory, towards innova-tively interactive urban communities. An analytical comparative study was done based on qualitative methods by studying various case studies of UPA in main cities of emerging and developing countries that were up-graded through a strategy of integral multi approaches. These rely on the public spaces as a medium for change, as well the using of quantitative and qualitative methods through actual case studies. The results represent lessons from practice. Based on actual cases, the cumulative urban experiences through various selected cases of upgrading UPA showed that the success depends on the using of an integral approach (multi-disciplinary) that relies on livable innovative public spaces. The new approaches such as GI cannot stand alone, but the strategies can be efficient by using integral an multi approach strategy. The cases also showed that public spaces in UPA are cen-ters of the daily socioeconomic activities, which is why these areas can act as arenas for change, towards better quality of urban life

POS-1 Regulation of Endo-mesoderm Identity in C. elegans: A Dissertation

How do embryos develop with such poise from a single zygote to multiple cells with different identities, and yet survive? At the four-cell stage of the C. elegans embryo, only the blastomere EMS adopts the endo-mesoderm identity. This fate requires SKN-1, the master regulator of endoderm and mesoderm differentiation. However, in the absence of the RNA binding protein POS-1, EMS fails to fulfill its fate despite the presence of SKN-1. pos-1(-) embryos die gutless. Conversely, the RNA binding protein MEX-5 prevents ectoderm blastomeres from adopting the endo-mesoderm identity by repressing SKN-1. mex-5(-) embryos die with excess muscle at the expense of skin and neurons. Through forward and reverse genetics, I found that genes gld-3/Bicaudal C, cytoplasmic adenylase gld-2, cye-1/Cyclin E, glp-1/Notch and the novel gene neg-1 are suppressors that restore gut development despite the absence of pos-1. Both POS-1 and MEX-5 bind the 3’UTR of neg-1 mRNA and its poly(A) tail requires GLD-3/2 for elongation. Moreover, neg-1 requires MEX-5 for its expression in anterior ectoderm blastomeres and is repressed in EMS by POS-1. Most neg-1(-) embryos die with defects in anterior ectoderm development where the mesoderm transcription factor pha-4 becomes ectopically expressed. This lethality is reduced by the concomitant loss of med- 1, a key mesoderm-promoting transcription factor. Thus the endo-mesoderm identity of EMS is determined by the presence of SKN- 1 and the POS-1 repression of neg-1, whose expression is promoted by MEX-5. Together they promote the anterior ectoderm identity by repressing mesoderm differentiation. Such checks and balances ensure the vital plurality of cellular identity without the lethal tyranny of a single fate

Pharmacogenomics In Pharmacy Practice: Current Perspectives.

Pharmacogenomics (i.e., the application of genetic information in predicting an individual's response to drug therapy) plays an increasingly important role in drug development and decision-making regarding precision medicine. This has been shown to reduce the risk of adverse events and improve patient health-care outcomes through targeted therapies and dosing. As the field of pharmacogenomics rapidly evolves, the role of pharmacists in the education, implementation, and research applications of pharmacogenomics is becoming increasingly recognized. This paper aims to provide an overview and current perspectives of pharmacogenomics in contemporary clinical pharmacy practice and to discuss the future directions on advancing pharmacogenomics education, application, and research in pharmacy practice

Fgf-Signaling Is Compartmentalized Within the Mesenchyme and Controls Proliferation During Salamander Limb Development

Although decades of studies have produced a generalized model for tetrapod limb development, urodeles deviate from anurans and amniotes in at least two key respects: their limbs exhibit preaxial skeletal differentiation and do not develop an apical ectodermal ridge (AER). Here, we investigated how Sonic hedgehog (Shh) and Fibroblast growth factor (Fgf) signaling regulate limb development in the axolotl. We found that Shh-expressing cells contributed to the most posterior digit, and that inhibiting Shh-signaling inhibited Fgf8 expression, anteroposterior patterning, and distal cell proliferation. In addition to lack of a morphological AER, we found that salamander limbs also lack a molecular AER. We found that amniote and anuran AER-specific Fgfs and their cognate receptors were expressed entirely in the mesenchyme. Broad inhibition of Fgf-signaling demonstrated that this pathway regulates cell proliferation across all three limb axes, in contrast to anurans and amniotes where Fgf-signaling regulates cell survival and proximodistal patterning

Integrated aquaculture-agriculture: Fish culture and plant crops module for arid areas

This guide explains the integration between fish culture and conventional crop agriculture and discusses how farmers can maximize benefits from using these resources. The main concept for any system of integration is that the outputs of one organism or system function as a source of inputs for another organism or system. For fish farmers, this concept applies to the relationship between fish and crops, as theoutputs of the fish can be a rich source of nutrients for crops

The Dilemma of Peri-Procedural Warfarin Management: A Narrative Review

Periprocedural vitamin K antagonist management is a complex process and inherently entails multiple clinical issues. Marked variations have been reported in different aspects of this process. These differences were noted at the clinician and institutional levels owing to the lack of evidence-based data leading to many discrepancies in decision-making. This review aims to address the gap of vitamin K antagonist periprocedural management acknowledged by previously published prescribers' questionnaires. One of the components of this process is "bridging," which aims to provide minimal interruption of the anticoagulation period through the use of heparin products. Recent studies showed that bridging is increasing bleeding risk. Secondly, interruption decision relies on the classification of thromboembolism risk which depends on trials that did not include patients with atrial fibrillation. Thirdly, the interruption duration is different among different International normalization ratio levels, which strengthens the difference in the clinical practice of preoperative vitamin K antagonist management. Lastly, the resumption of a vitamin-K antagonist after surgery has many scenarios according to the procedure and patient risk of bleeding. Vitamin-K antagonist periprocedural management is complicated due to individual practice and the lack of strictly implemented institutional standardized protocols to guide, manage and evaluate the process.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Qatar National Library (QNL).Scopu

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex

Aim. To evaluate the possible structural and functional changes in the retinal nerve fibre layer (RNFL) and the ganglion cell complex (GCC) of chronic smokers and compare them with those of passive healthy smokers using spectral domain optical coherence tomography (SD-OCT) and pattern electroretinogram (PERG). Materials and Methods. We include 80 active chronic smokers and 80 age- and sex-matched healthy passive smokers. After a full ophthalmological examination, SD-OCT and PERG were tested for all participants. Urinary levels of cotinine and creatinine with subsequent calculation of the cotinine creatinine ratio (CCR). Results. Inferior and superior quadrants of RNFL were thinner in group I, but nasal and temporal quadrants did not show significant difference between the groups. There were no significant differences of GCC values between the two groups. There was no significant difference of PERG-P50 amplitude and latency; however, PERG-N95 showed significant difference between the two groups. Multiple regression analyses demonstrated that the number of cigarettes/day, urinary cotinine, and PERG-N95 amplitude are the most important determinants for both superior and inferior RNFL thicknesses. Conclusion. RNFL thickness decreases in chronic, healthy, heavy cigarette smokers, and this thinning is related to the number of cigarettes/day, urinary cotinine, and PERG-N95 latency and amplitude

Educational Program on Improving Quality of Nursing Care of Patients with Thalassemia Major as Regards Blood Transfusion

Abstract Quality of care is indicating that the right things are being done right, and is vital in improving the patient outcomes and safety. The aim of this study was to evaluate the effect of an educational program on improving quality of nursing care for patients with thalassemia major as regards blood transfusion. Research design: A quasi-experimental research design was utilized in this study. Research setting: The study was conducted at both in-and out-patient pediatric and adult medicine hematology departments affiliated to Ain Shams University Hospital. Sample: A purposive sample consisted of two groups: The first group included all nurses (n=30) working in the above mentioned settings; and the second group included adolescent and adult patients with thalassemia major (n=50), who were attending the above mentioned settings over a period of six months, they were chosen randomly. Tools: Data were collected through: (I) An interviewing questionnaire which include: sociodemographic data sheet for nurses and patients, nurse's knowledge sheet and routine blood transfusion knowledge questionnaire (RBTKQ) (II) An observational checklist to assess nurse's practice related to blood transfusion, assessment of the body system, measuring of vital signs and administration of intravenous iron chelation therapy. (III) Patient satisfaction scale. Based upon the actual need assessment of the study subjects an intervention program was designed and implemented. Results: The most important findings of the study revealed that, most of nurses had poor knowledge about blood transfusion and thalassemia. Besides, they don't follow a standard of quality of nursing care related to blood transfusion and other basic procedures as measuring of vital signs and administration of intravenous iron chelation therapy. In addition, the majority of patients were unsatisfied for quality of nursing care pre program, which improved to more than two thirds of patients were satisfied regarding quality of nursing care post program. The implementation of the education program has improved nurses' knowledge, practice and patients' satisfaction with statistically significant differences (p=< 0.05, 0.01 & 0.01). Conclusion: Findings revealed that, the educational program had a positive effect on nurses' knowledge and practice related to thalassemia and blood transfusion, which improved quality of nursing care as well as increased patients' satisfaction. The study recommended that, a specialized orientation program should be developed for newly appointed nurses to prepare them before working at the hematology departments further studies should be conducted to improve nurses' knowledge and practice regarding to blood transfusion care of patients with thalassemia

Prescribing patterns of antihypertensive medications: A systematic review of literature between 2010 and 2020

Background: Hypertension has affected over 1.13 billion people worldwide in 2015 and it's one of the most preventable risk-factors for morbidity and mortality. Antihypertensives significantly reduce cardiovascular risks. Several studies on antihypertensives' prescribing patterns were conducted worldwide, and guidelines were developed on hypertension management. However, no systematic reviews were conducted globally to synthesize the evidence from these studies. This review aims to evaluate antihypertensives' prescription patterns, and adherence to international guidelines for hypertension management worldwide. Methods: Full-text antihypertensives' prescribing patterns evaluation studies were included. Reviews, commentaries, guidelines, and editorials were excluded. Various databases were searched including PubMed, Embase, and others. Studies were limited to English only and to articles published from (01/01/2010) to (20/03/2020). Crowe Critical Appraisal Tool (CCAT) was used for quality assessment. Results: The most commonly prescribed antihypertensives as monotherapy in adult patients with no comorbidities were ACEIs/ARBs (Angiotensin converting enzyme inhibitors/Angiotensin receptor blockers), followed by CCBs (Calcium channel blockers), and BBs (Beta Blockers). Most commonly prescribed dual combinations were thiazide diuretics+ACEIs/ARBs, BBs + CCBs and CCBs+ACEIs/ARBs. Among diabetic patients, the most common agents were ACEIs/ARBs. Among patients with heart diseases, CCBs were prescribed frequently. While patients with kidney diseases, CCBs and ARBs were most prescribed. Of the 40 studies included in the review, only four studies directly assessed the prescribing patterns of antihypertensives in adherence to clinical practice guidelines. And only two studies confirmed adherence to guidelines. Furthermore, the quality of the majority of studies was moderate (50%), while 25% of articles were reported as either high or low quality. Conclusion: This review revealed that there are areas for improvement for prescribing practices of antihypertensives in concordance with the latest evidence and with clinical practice guidelines.This work was supported by a student grant (grant number QUST-2-CPH-2020-20 ) from Qatar University Office of Research and Graduate Studies . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Qatar University.Scopu