The frequency of vitamin D deficiency among asthmatic Egyptian children

Background: Vitamin D plays a role in the pathogenesis of asthma as it has a potent immunomodulatory effect acting on the cells of the innate immunity. It also reduces the risk of respiratory viral infections which are important initiators of asthma exacerbations. Besides, it potentiates the antiinflammatory action of corticosteroids which are considered the mosteffective controllers of asthma. Objective: To detect the frequency of vitamin D insufficiency and deficiency among Egyptian asthmatic children and to correlate vitamin D levels to the severity of asthma. Methods: This case control study was conducted on 60 asthmatic children and 40 healthy controls. All were subjected to clinical history taking including history of sun exposure and asthma medications and full clinical examination. Laboratory investigations included measurement of serum calcium, serum alkaline phosphatase and serum 25-OH-D levels and lung functions (spirometery). Results: There was a significant correlation between vitamin D deficiency and severity of asthma, yet there was no significant relation between sun exposure and 25-OH-D level. Moreover, there was a significant relation between decreased serum 25-OH-D levels and the intensity of corticosteroid use. Vitamin D was also significantly lower in asthmatic patients with coexistent allergic rhinitis. Conclusion: Vitamin D deficiency is prevalent in Egyptian children with asthma .Lower levels of serum vitamin D are associated with high asthma severity, reduced asthma control and increased corticosteroid use.Keywords: Vitamin D, Bronchial asthma, Egyptian, Childre

Coastline changes and sedimentation related with the opening of an artificial channel: the Valo Grande Delta, SE Brazil

The role played by human activity in coastline changes indicates a general tendency of retreating coasts, especially deltaic environments, as a result of the recent trend of sea level rise as well as the blockage of the transfer of sediments towards the coast, especially due to the construction of dams. This is particularly important in deltaic environments which have been suffering a dramatic loss of area in the last decades. In contrast, in this paper, we report the origin and evolution of an anthropogenic delta, the Valo Grande delta, on the south-eastern Brazilian coast, whose origin is related to the opening of an artificial channel and the diversion of the main flow of the Ribeira de Iguape River. The methodology included the analysis of coastline changes, bathy metry and coring, which were used to determine the sedimentation rates and grain-size changes over time. The results allowed us to recognize the different facies of the anthropogenic delta and establish its lateral and vertical depositional trends. Despite not being very frequent, anthropogenic deltas represent a favorable environment for the record of natural and anthropogenic changes in historical times and, thus, deserve more attention from researchers of different subjects.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [06/04344-2]info:eu-repo/semantics/publishedVersio

PERANCANGAN SISTEM KNOWLEDGE MANAGEMENT PADA PT. HEKSAGON TIWIKRAMA

PERANCANGAN SISTEM KNOWLEDGE MANAGEMENT PADA PT. HEKSAGON TIWIKRAMA

International Survey on Frailty Assessment in Patients with Cancer.

BACKGROUND: Frailty negatively affects the outcomes of patients with cancer, and its assessment might vary widely in the real world. The objective of this study was to explore awareness and use of frailty screening tools among the ONCOassist healthcare professionals (HCPs) users. MATERIALS AND METHODS: We sent 2 emails with a cross-sectional 15-item survey in a 3-week interval between April and May 2021. Differences in the awareness and use of tools according to respondents' continents, country income, and job types were investigated. RESULTS: Seven hundred thirty-seven HCPs from 91 countries (81% physicians, 13% nurses, and 5% other HCPs) completed the survey. Three hundred and eighty-five (52%) reported assessing all or the majority of their patients; 518 (70%) at baseline and before starting a new treatment. Three hundred and four (43%) HCPs were aware of performance status (PS) scores only, 309 (42%) age/frailty/comorbidity (AFC) screening, and 102 (14%) chemotoxicity predictive tools. Five hundred and thirty-seven (73%) reported using tools; 423 (57%) just PS, 237 (32%) AFC, and 60 (8%) chemotoxicity ones. Reasons for tools non-use (485 responders) were awareness (70%), time constraints (28%), and uselessness (2%). There were significant differences in awareness and use of screening tools among different continents, country income, job types, and medical specialties (P < .001 for all comparisons). CONCLUSION: Among selected oncology HCPs, there is still a worldwide lack of knowledge and usage of frailty screening tools, which may differ according to their geography, country income, and education. Targeted initiatives to raise awareness and education are needed to implement frailty assessment in managing patients with cancer