Accidental Occupational Exposures among Dental Healthcare Workers in Asir Region, Saudi Arabia

Aims and objectives: This study aims to assess the prevalence of accidental occupational injuries among dental healthcare workers in Asir region, Saudi Arabia, and thus the risk involved. Materials and methods: Self-administered questionnaires were distributed among dental specialists, general dental practitioners, dental interns, hygienists and dental assistants working in dental college (College of Dentistry, King Khalid University, Abha, KSA). Dentists working in private clinics and government hospitals in Asir Province, Saudi Arabia, were also included in this study. Results: Of the total 300 questionnaires, 190 were returned with a response rate of 63.3%. Of the respondents, 138 (72.63%) were males and the rest 52 (27.3%) were females. The response rate in this study was 63.3%. The total number of occupational injuries among DHCWs was 138 (72.5%) with a density rate of 0.72 per 100 persons per year which is significantly high. In the present study, a higher incidence of injuries occurred in the dental operatory and most of them being from needlestick injuries, i.e. 78 (56.2%). Conclusion: (1) Accidental occupational exposure incidence rate among DHCWs in Asir region, Saudi Arabia, is high as compared to other studies, (2) the majority of the injuriesoccurred in the dental operatory. Most of these injuries were caused by syringe needles and involved the finger or thumb.&nbsp

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Studi Fundamental Intensi Cashless Society Pada Millennials Dan Post Millennials Indonesia

Perkembangan transaksi ekonomi keuangan digital telah mengalami pertumbuhan yang sangat pesat kemudian mengantarkan alat transaksi keuangan konvensional pada ujung masanya. Beberapa pakar bersepakat bahwa Indonesia saat ini tengah berada pada ambang gerbang “kiamat uang kertas“ dan peralihan pola perilaku masyarakat Indonesia untuk mengarah pada cashless society. Penelitian ini akan mengembangkan model UTAUT yang dimodifikasi dalam menilai perilaku intensi penggunaan transaksi elektronik pada generasi Millennials dan Post Millennials Indonesia. Penelitian ini melibatkan 218 responden yang merupakan orang yang lahir pada rentang tahun 1980 sampai dengan tahun 2000 dan aktif bertransaksi menggunakan pembayaran elektronik e-money minimal 5 kali dalam kurun waktu sebulan terakhir. Hasil penelitian menunjukkan bahwa variabel Performance Expectancy, Effort Expectancy, dan Social Influence berpengaruh signifikan dan variabel Facilitating Conditions tidak berpengaruh signifikan terhadap Continuance Intention. Variabel Gender tidak dapat memoderasi pengaruh semua variabel independen terhadap Continuance Intention, kecuali Social Influence. Variabel Trust tidak dapat memoderasi pengaruh semua variabel independen terhadap Continuance Intention, kecuali Performance Expectancy dan Social Influence. Kata Kunci: Cashless Society; e-money; Electronic Payment; Millennials; Post Millennial

Sporadic Fibrodysplasia Ossificans Progressiva in an Egyptian Infant with c.617G > A Mutation in ACVR1 Gene: A Case Report and Review of Literature

Fibrodysplasia ossificans progressiva (FOP) is an autosomal dominant severe musculoskeletal disease characterized by extensive new bone formation within soft connective tissues and unique skeletal malformations of the big toes which represent a birth hallmark for the disease. Most of the isolated classic cases of FOP showed heterozygous mutation in the ACVR1 gene on chromosome 2q23 that encodes a bone morphogenetic protein BMP (ALK2). The most common mutation is (c.617G > A) leading to the amino acid substitution of arginine by histidine (p.Arg206His). We currently report on an Egyptian infant with a sporadic classic FOP in whom c.617G > A mutation had been documented. The patient presented with the unique congenital malformation of big toe and radiological evidence of heterotopic ossification in the back muscles. The triggering trauma was related to the infant's head, however; neither neck region nor sites of routine intramuscular vaccination given during the first year showed any ossifications. Characterization of the big toe malformation is detailed to serve as an early diagnostic marker for this rare disabling disease

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)