Stock Market Reaction to Cash Dividend Announcement: Evidence from Palestine

In this study, we used the event study methodology to examine if cash dividend announcements affect the stock prices of companies listed on the Palestine Exchange. We studied 62 events announced from 1/1/2006 to 31/12/2015. Appropriate statistical tests were used to examine if the cumulative abnormal return is statistically significant around the announcement day, namely, 10 days before and 10 days after the event day. Results reveal that statistically significant differences exist between cumulative abnormal returns and zero. Thus, investors could realize abnormal returns during the event window for the study period. The findings also indicate that a statistically significant negative relationship exists between dividend announcements and abnormal returns starting from the day of dividend announcement. We conclude that the market reacts negatively to cash dividends after disclosure. Keywords: event study, abnormal return, cash dividend, Palestine Exchange, stock market reactio

Health care workers in conflict and post-conflict settings: Systematic mapping of the evidence

Background Health care workers (HCWs) are essential for the delivery of health care services in conflict areas and in rebuilding health systems post-conflict. Objective The aim of this study was to systematically identify and map the published evidence on HCWs in conflict and post-conflict settings. Our ultimate aim is to inform researchers and funders on research gap on this subject and support relevant stakeholders by providing them with a comprehensive resource of evidence about HCWs in conflict and post-conflict settings on a global scale. Methods We conducted a systematic mapping of the literature. We included a wide range of study designs, addressing any type of personnel providing health services in either conflict or post-conflict settings. We conducted a descriptive analysis of the general characteristics of the included papers and built two interactive systematic maps organized by country, study design and theme. Results Out of 13,863 identified citations, we included a total of 474 studies: 304 on conflict settings, 149 on post-conflict settings, and 21 on both conflict and post-conflict settings. For conflict settings, the most studied counties were Iraq (15%), Syria (15%), Israel (10%), and the State of Palestine (9%). The most common types of publication were opinion pieces in conflict settings (39%), and primary studies (33%) in post-conflict settings. In addition, most of the first and corresponding authors were affiliated with countries different from the country focus of the paper. Violence against health workers was the most tackled theme of papers reporting on conflict settings, while workforce performance was the most addressed theme by papers reporting on post-conflict settings. The majority of papers in both conflict and post-conflict settings did not report funding sources (81% and 53%) or conflicts of interest of authors (73% and 62%), and around half of primary studies did not report on ethical approvals (45% and 41%). Conclusions This systematic mapping provides a comprehensive database of evidence about HCWs in conflict and post-conflict settings on a global scale that is often needed to inform policies and strategies on effective workforce planning and management and in reducing emigration. It can also be used to identify evidence for policy-relevant questions, knowledge gaps to direct future primary research, and knowledge clusters

Comparing low-dose (DART) and enhanced low-dose dexamethasone regimens in preterm infants with bronchopulmonary dysplasia

IntroductionDetermining the optimal dexamethasone dosage for facilitating extubation in extremely low birth weight (ELBW) infants with bronchopulmonary dysplasia (BPD) remains uncertain. This study aims to compare the effectiveness of low-dose (DART) and enhanced low-dose dexamethasone regimens in achieving successful extubation in these infants.MethodsWe conducted a retrospective cohort study at the Women's Wellness and Research Center (WWRC) involving ELBW infants who received dexamethasone for BPD prevention or treatment, or for extubation between January 1st, 2015, and December 31st, 2019. Our goal was to assess successful extubation within various time points of treatement.ResultsA total of 77 patients, matched in gestational age and BW, were enrolled in the study, receiving a total of 121 dexamethasone courses. Low-dose dexamethasone courses were administered 75 times to 49 infants, while 46 courses of enhanced low-dose were given to 28 infants. Treatment commenced at 30.8 ± 3.4 weeks post-menstrual age, compared to 32.1 ± 2.5 weeks in the enhanced low-dose group (p = 0.014). The median (IQR) course duration was seven (3–10) days in the low-dose group, while it was 10 (8–14) days in the enhanced low-dose group (p < 0.001). The median (IQR) course dose was 0.73 (0.53–0.86) mg/kg in the low-dose group and 1.27 (0.97–2.05) mg/kg in the enhanced low-dose group (p < 0.001). There were no differences in extubation success at any time point between the two groups at 72 h and seven days after treatment initiation, by course completion, and within seven days after treatment completion. However, regression analysis identified several predictors of successful extubation; baseline FiO2, course duration, and duration of invasive mechanical ventilation were negatively associated with successful extubation at various time points, while received dose per kg and cumulative dose positively correlated with successful extubation at different time points. No significant differences were observed in secondary outcomes, including death or BPD.ConclusionThe choice between low-dose and enhanced low-dose dexamethasone regimens may not significantly impact extubation success. However, careful consideration of dosing, ventilation status, and treatment duration remains crucial in achieving successful extubation. This study highlights the need for personalized dexamethasone therapy in ELBW infants

العوامل المؤثرة في التوافق بين مخرجات التعليم و سوق العمل

تزايد الاهتمام برأس المال البشري باعتباره أحد القوى المحركة للتنمية الاقتصادية وتزايد معه الاهتمام بدراسة  كيفية سد الفجوة بين مخرجات التعليم العالي ومدخلات سوق العمل. ومن هنا تبرز أهمية البحث في تحليل مشكلة عدم التوافق بين مخرجات التعليم العالي واحتياجات سوق العمل في سورية ، تم  تحليل مشكلة عدم التوافق بين مخرجات التعليم العالي  في "جامعة تشرين" (عينة البحث)  واحتياجات سوق العمل للتعرف على متطلبات سوق العمل وتحليل العوامل التي تحكم العلاقة بين عرض العمل والطلب عليه وذلك لتقديم آلية تمكن من التوفيق بين التخصصات الجامعية المتاحة ومتطلبات سوق العمل من حيث نوعية التخصصات الجامعية، والمهارات المكتسبة للخريج ومدى مواءمتها مع متطلبات سوق العمل.  تم تصميم استبانتين بهدف جمع البيانات، الاستبانة الأولى لقياس رأي أصحاب العمل بشقيه (العام والخاص) و الاستبانة الثانية لقياس رأي الخريجين الجامعيين وتوصلت الدراسة إلى مجموعة من النتائج من أهمها : يتمتع الخريجون الجامعيون بقدرة جيدة على الالتزام بالعمل ومتطلباته وتعلّم المهارات التي يحتاجها، ويعانون من ضعف تأهيلهم من ناحية المهارات العملية المتممة لشهاداتهم العلمية التي يطلبها سوق العمل، و ذلك لضعف التنسيق بين المؤسسات التعليمية ومنظمات سوق العمل. ويركز القطاع العام بشكل كبير على تأمين فرص عمل لمختلف شرائح المجتمع، كما أنه يميل لتوظيف أعداد تفوق حاجته، عكس القطاع الخاص الذي يعمل على توظيف عدد محدد وفق حاجته دون زيادة أو نقصان وأوصى فريق البحث  بضرورة التركيز على الجانب العملي لتحقيق التكامل مع الجانب النظري في التعليم (الجامعي والتقاني) واستحداث وحدات تدريبية خاصة بكل كلية ومعهد تقاني. إدخال الجامعات كبيوت خبرة واستشارة وخاصة فيما يتعلق بتوطين المشروعات ذات الطابع الاقتصادي. وإعادة النظر في الاستثمارات الموظِفة لليد العاملة في الساحل خاصة بعد التغير الديموغرافي الحاصل بسبب الحرب على سورية من خلال: التشجيع على إقامة (المشاريع الصغيرة - المشاريع الانتاجية التكاملية (زراعية – صناعية) المولِدة لفرص العمل وخاصة للخريجين.

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Electromagnetic wave scattering by a sphere on a layered substrate

The problem of electromagnetic scattering by a sphere on a layered substrate is treated and numerical results are presented. Initially, the Rayleigh limit, where the sphere radius is small compared to the wavelength, is considered. Closed-form expressions for the far-zone scattered fields are derived from the radiation of the induced dipoles in the sphere in the presence of the substrate, and these incorporate in a rather explicit manner the various parameters of the problem. The general case, where the ratio sphere radius/wavelength is arbitrary, is also considered. A rigorous formulation is used based on the Mie solution for the scattering by a sphere in a homogeneous medium and an extension of Weyl's method for dipole radiation in the presence of a flat surface. Numerical results obtained using the rigorous formulation for electrically small spheres are in very good agreement with those obtained using the Rayleigh approximate method

Analysis of the structural response of Beirut port concrete silos under blast loading

Several months after August 4, 2020, Lebanon is still recovering from the enormous explosion at the port of Beirut that killed more than 200 people and injured more than 7500. This explosion ripped the city to shreds and significantly damaged the Beirut port silos. Saint Joseph University of Beirut “the school of engineering ESIB” in collaboration with “Amann” Engineering performed a 3D scan of the Beirut port silos to assess the silos’ level of damage. The obtained data was then compared to the numerical modelling results, obtained from Abaqus explicit, in order to estimate the blast magnitude and to check if the pile foundation can be reused in building new silos at the same place due to the limited space available at the port of Beirut while considering the soil-foundation-structure interaction effect. In addition, the silos’ structural response against the filling of the silos at the time of explosion was investigated. The displacement of the silos and the amount of silos’ damage obtained from the fixed and flexible numerical models indicate that a blast magnitude of 0.44 kt TNT (approximately 1100 tons of Ammonium Nitrate) best estimates the 20 to 30 cm silos’ tilting in the direction of the blast. In addition, the soil and the foundation played a positive role by absorbing part while dissipating less amount of the blast energy. Also, the grains at the time of the event did not affect the silos’ deformation and damage amount. Noting that the displacement of the pile foundation exceeded all limits set by design codes, indicating that the pile foundation cannot be reused to build new silos at the same place