On existence and uniqueness of generalized solutions for a mixed-type differential equation.

In this paper, we study a boundary value problem for a mixed–type differential equation. The existence and uniqueness of generalized solution is proved. The proof is based on an energy inequality and the density of the range of the operator generated by this problem

THE PRACTICE AND PERCEPTION OF HOSPITAL PHARMACISTS TOWARDS ERRORS IN DISPENSING MEDICINES AND THEIR POSSIBLE CAUSES IN OMDURMAN MILITARY HOSPITAL, SUDAN

Introduction: Hospital pharmacies dispensing errors are common and investigating them for identifying factors involved in it and developing strategies to minimize their occurrence. Errors can arise at any stage during the dispensing process. Dispensing errors were identified by checking the prescribed drug against the dispensed medication. Materials and Methods: A cross sectional study involving 100 pharmacists who were administered a survey research designed to assess pharmacists' attitudes, factors associated with DEs and involvement in DE, conducted between 1st January 2019 and 1st February 2019 at Omdurman Military Hospital (OMH) Pharmacies. A data analyzed by Statistical Package for Social Sciences software version 21. Results: 55% from the pharmacists in the study have poor attitude toward dispensing errors. The most common factors influencing dispensing errors as stated by participants were lack of therapeutic training (stated by 81%), 62% from the participants stated that workload and time pressure are causes of dispensing errors in area of factors associated with the work environment. 48% from the pharmacists in the study committing dispensing errors, 41.7% from them committed dispensing errors once while 23% committed fourth or more. Conclusion: With the multiplicity of risk factors in our environment, there is urgent need to reinforce the training of pharmacists and the provision of resource materials and enabling work environment aimed at minimizing medication errors.                                  Peer Review History: Received: 8 September 2020; Revised: 7 October; Accepted: 20 October, Available online: 15 November 2020 Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewer(s) detail: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected]   Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Similar Articles: AWARENESS OF PHARMACISTS TOWARDS ASPARTAME SIDE EFFECTS IN KHARTOUM CITY, SUDA

ZAP-70 Expression in B-Chronic Lymphocytic Leukemia in Sudanese Patients

Background: Chronic lymphocytic leukemia is the most common form of leukemia in adults. The prognostic impact of ZAP-70 in CLL has been reported in several studies. The aim of conducting this study was to investigate the prevalence of ZAP-70 in Sudanese patients with chronic lymphocytic leukemia attending Khartoum Oncology Hospital.Materials and Methods: A total of 93 newly diagnosed patients with chronic lymphocytic leukemia were enrolled in this study. Lymphadenopathy and organomegaly were assessed in all participants using clinical examination, chest radiography, and abdominal ultrasound. Full blood count was carried out by an automated hematology analyzer. ZAP-70 was evaluated using flowcytometry on peripheral blood samples. ZAP-70 was defined as positive expression at a cutoff level of 20%. Results: There were 63 (67.7%) males and 30 (32.3%) females and the median age of the group was 63 years; 68 patients (73.1%) were presented with anemia and 66(70.9%) had lymphadenopath;y. Majority of our patients 35 (37.6%) were in Rai stage IV. ZAP-70 positivity was detected in 21 patients (22.6%). There was no statistically significant association of ZAP-70 with age, sex, lymphadenopathy, organomegaly, hemoglobin concentration, total white blood cell count, platelet count and Rai staging system (p-value > 0.05). Conclusion: Only 21 patients (22.6%) were ZAP-70 positive. There was no association between ZAP-70 and the study variables. Further studies to evaluate prognostic role of ZAP-70 in Sudanese patients with chronic lymphocytic leukemia are recommended

The association of hypertriglyceridemia with cardiovascular events and pancreatitis: a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Hypertriglyceridemia may be associated with important complications. The aim of this study is to estimate the magnitude of association and quality of supporting evidence linking hypertriglyceridemia to cardiovascular events and pancreatitis.</p> <p>Methods</p> <p>We conducted a systematic review of multiple electronic bibliographic databases and subsequent meta-analysis using a random effects model. Studies eligible for this review followed patients longitudinally and evaluated quantitatively the association of fasting hypertriglyceridemia with the outcomes of interest. Reviewers working independently and in duplicate reviewed studies and extracted data.</p> <p>Results</p> <p>35 studies provided data sufficient for meta-analysis. The quality of these observational studies was moderate to low with fair level of multivariable adjustments and adequate exposure and outcome ascertainment. Fasting hypertriglyceridemia was significantly associated with cardiovascular death (odds ratios (OR) 1.80; 95% confidence interval (CI) 1.31-2.49), cardiovascular events (OR, 1.37; 95% CI, 1.23-1.53), myocardial infarction (OR, 1.31; 95% CI, 1.15-1.49), and pancreatitis (OR, 3.96; 95% CI, 1.27-12.34, in one study only). The association with all-cause mortality was not statistically significant.</p> <p>Conclusions</p> <p>The current evidence suggests that fasting hypertriglyceridemia is associated with increased risk of cardiovascular death, MI, cardiovascular events, and possibly acute pancreatitis.</p> <p>Précis: hypertriglyceridemia is associated with increased risk of cardiovascular death, MI, cardiovascular events, and possibly acute pancreatitis</p

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify

Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 071 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 502% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.SUPPORTING INFORMATION : FIGURE S1. Data coverage by year. Here we visualise the volume of data used in the analysis by country and year. Larger circles indicate more data inputs. ‘NA’ indicates records for which no year was reported (eg, ‘pre-2000’). https://doi.org/10.1371/journal.pntd.0008824.s001FIGURE S2. Illustration of covariate values for year 2000. Maps were produced using ArcGIS Desktop 10.6. https://doi.org/10.1371/journal.pntd.0008824.s002FIGURE S3. Environmental suitability of onchocerciasis including locations that have received MDA for which no pre-intervention data are available. This plot shows suitability predictions from green (low = 0%) to pink (high = 100%), representing those areas where environmental conditions are most similar to prior pathogen detections. Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s003FIGURE S4. Environmental suitability prediction uncertainty including locations that have received MDA for which no pre-intervention data are available. This plot shows uncertainty associated with environmental suitability predictions colored from blue to red (least to most uncertain). Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s004FIGURE S5. Environmental suitability of onchocerciasis excluding morbidity data. This plot shows suitability predictions from green (low = 0%) to pink (high = 100%), representing those areas where environmental conditions are most similar to prior pathogen detections. Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s005FIGURE S6. Environmental suitability prediction uncertainty excluding morbidity data. This plot shows uncertainty associated with environmental suitability predictions colored from blue to red (least to most uncertain). Countries in grey with hatch marks were excluded from the analysis based on a review of national endemicity status. Areas in grey only represent locations masked due to sparse population. https://doi.org/10.1371/journal.pntd.0008824.s006FIGURE S7. Covariate Effect Curves for all onchocerciasis occurrences (measures of infection prevalence and disability). On the right set of axes we show the frequency density of the occurrences taking covariate values over 20 bins of the horizontal axis. The left set of axes shows the effect of each on the model, where the mean effect is plotted on the black line and its uncertainty is represented by the upper and lower confidence interval bounds plotted in dark grey. The figures show the fit per covariate relative to the data that correspond to specific values of the covariate. https://doi.org/10.1371/journal.pntd.0008824.s007FIGURE S8. Covariate Effect Curves for all onchocerciasis occurrences (measures of infection prevalence and disability). On the right set of axes we show the frequency density of the occurrences taking covariate values over 20 bins of the horizontal axis. The left set of axes shows the effect of each on the model, where the mean effect is plotted on the black line and its uncertainty is represented by the upper and lower confidence interval bounds plotted in dark grey. https://doi.org/10.1371/journal.pntd.0008824.s008FIGURE S9. ROC analysis for threshold. Results of the area under the receiver operating characteristic (ROC) curve analysis are presented below, with false positive rate (FPR) on the x-axis and true positive rate (TPR) on the y-axis. The red dot on the curve represents the location on the curve that corresponds to a threshold that most closely agreed with the input data. For each of the 100 BRT models, we estimated the optimal threshold that maximised agreement between occurrence inputs (considered true positives) and the mean model predictions as 0·71. https://doi.org/10.1371/journal.pntd.0008824.s009TABLE S1. Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) checklist. https://doi.org/10.1371/journal.pntd.0008824.s010TABLE S2. Total number of occurrence data classified as point and polygon inputs by diagnostic. We present the total number of occurrence points extracted from the input data sources by diagnostic type. ‘Other diagnostics’ include: DEC Patch test; Knott’s Method (Mazotti Test); 2 types of LAMP; blood smears; and urine tests. https://doi.org/10.1371/journal.pntd.0008824.s011TABLE S3. Total number of occurrence data classified as point and polygon inputs by location. https://doi.org/10.1371/journal.pntd.0008824.s012TABLE S4. Covariate information. https://doi.org/10.1371/journal.pntd.0008824.s013TEXT S1. Details outlining construction of occurrence dataset. https://doi.org/10.1371/journal.pntd.0008824.s014TEXT S2. Covariate rationale. https://doi.org/10.1371/journal.pntd.0008824.s015TEXT S3. Boosted regression tree methodology additional details. https://doi.org/10.1371/journal.pntd.0008824.s016APPENDIX S1. Country-level maps and data results. Maps were produced using ArcGIS Desktop 10.6 and shapefiles to visualize administrative units are available at https://espen.afro.who.int/tools-resources/cartography-database. https://doi.org/10.1371/journal.pntd.0008824.s017This work was primarily supported by a grant from the Bill & Melinda Gates Foundation OPP1132415 (SIH). Financial support from the Neglected Tropical Disease Modelling Consortium (https://www.ntdmodelling.org/), which is funded by the Bill & Melinda Gates Foundation (grants No. OPP1184344 and OPP1186851), and joint centre funding (grant No. MR/R015600/1) by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union (MGB).The Neglected Tropical Disease Modelling Consortium which is funded by the Bill & Melinda Gates Foundation, the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement which is also part of the EDCTP2 programme supported by the European Union (MGB).http://www.plosNTDS.orgam2022Medical Microbiolog

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

Solution of Integral Differential Equations by New Double Integral Transform (Laplace–Sumudu Transform)

The primary purpose of this research is to demonstrate an efficient replacement double transform named the Laplace–Sumudu transform (DLST) to unravel integral differential equations. The theorems handling fashionable properties of the Laplace–Sumudu transform are proved; the convolution theorem with an evidence is mentioned; then, via the usage of these outcomes, the solution of integral differential equations is built