Off-Pump Myocardial Revascularization in a High-Risk Patient With Essential Thrombocythemia

Essential thrombocythemia is a rare type of myeloproliferative disorder. Cerebral, myocardial, and peripheral thrombosis are all frequent complications of the disease. A 71-year-old man presented with severe coronary artery disease, associated with cerebral vascular ischemic changes and erythromelalgia. His platelet count was 1,486 ×103/μL. The patient underwent successful myocardial revascularization by means of an off-pump technique after his platelet count had been reduced by hydroxycarbamide administration. We conclude that the use of off-pump cardiopulmonary bypass in high-risk patients with essential thrombocythemia is safe. Reducing platelet count via the administration of hydroxycarbamide and the careful balancing of antiplatelets and anticoagulants is crucial in determining the outcome of surgery

An intelligent rule-oriented framework for extracting key factors for grants scholarships in higher education

Education is a fundamental sector in all countries, where in some countries students com-pete to get an educational grant due to its high cost. The incorporation of artificial intelli-gence in education holds great promise for the advancement of educational systems and pro-cesses. Educational data mining involves the analysis of data generated within educational environments to extract valuable insights into student performance and other factors that enhance teaching and learning. This paper aims to analyze the factors influencing students' performance and consequently, assist granting organizations in selecting suitable students in the Arab region (Jordan as a use case). The problem was addressed using a rule-based tech-nique to facilitate the utilization and implementation of a decision support system. To this end, three classical rule induction algorithms, namely PART, JRip, and RIDOR, were em-ployed. The data utilized in this study was collected from undergraduate students at the University of Jordan from 2010 to 2020. The constructed models were evaluated based on metrics such as accuracy, recall, precision, and f1-score. The findings indicate that the JRip algorithm outperformed PART and RIDOR in most of the datasets based on f1-score metric. The interpreted decision rules of the best models reveal that both features; the average study years and high school averages play vital roles in deciding which students should receive scholarships. The paper concludes with several suggested implications to support and en-hance the decision-making process of granting agencies in the realm of higher education

Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Background Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings Globally, in 2019, among HIV-negative individuals, there were 1.18 million (95% uncertainty interval 1.08-1.29) deaths due to tuberculosis and 8.50 million (7.45-9.73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000-279 000) deaths due to tuberculosis and 1.15 million (1.01-1.32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000-425 000) more deaths and 1.01 million (0.82-1.23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820-11 400) more deaths and 81 100 (63 300-100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1.5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4.27 (3.69-5.02), 6.17 (5.48-7.02), and 1.17 (1.07-1.28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2.23 (2.03-2.44) times greater among males than females, whereas the fraction due to unsafe sex was 1.06 (1.05-1.08) times greater among females than males. Interpretation As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestone

Assessment for the Quality of the Distance Education Delivered by the Emirati Public Schools during the Coronavirus Crisis

This study aimed to assess the quality of the distance education delivered by the Emirati public schools during the Coronavirus crisis. The researcher adopted the descriptive analytical approach. He designed and used a five point Likert questionnaire to obtain data from the sampled. He designed the questionnaire.  The population consists from all the teachers who taught during the Coronavirus crisis in Emirati public schools. The sample was chosen purposively.  It consists from 150 teachers chosen from twelve (12) Emirati public schools. Four schools of them are located in Abu Dhabi, four schools of them are located in Dubai and four schools of them are located in Sharjah. The questionnaire forms were passed by hand. All the forms were filled and retrieved. They are valid for the analysis. The SPSS program was used. The researcher found that the quality of the distance education delivered by the Emirati public schools during the Coronavirus crisis is high. That’s because the extent of meeting the standards related to the design and development of curricula, student assessment, infrastructure, student services, teachers and teaching-learning process are high. He recommends encouraging teachers and administrators to meet the standards of quality in education. Financial and moral incentives must be set for encouraging them to meet such standards. Keywords: Quality, distance education, Emirati public schools, Emirate, Coronavirus crisis DOI: 10.7176/JEP/13-15-17 Publication date:May 31st 202

Notes on some common flora and its uses in Wadi Gaza, Gaza Strip

Wadi Gaza is an indispensable part of natural life in Palestine and has a rich biodiversity in terms of fauna and flora. This study aims at surveying the common flora of Wadi Gaza ecosystem during the spring season of 2004 and providing notes on their possible uses by the Palestinian community depending on direct observations, discussions with local people and available literature. As many as 70 plant species belonging to 32 families and 24 orders were identified during the spring months of 2004 in Wadi Gaza. The aster or daisy family (Compositae) was the largest family and comprised 14 plant species (20%) of the recorded species. The natural flora of Wadi Gaza was commonly used in different ways as a food source, herbal medicine, fodder for grazing animals and timber and fuel production. The other direct human uses for specific floristic species were also mentioned. Many wildlife species were found to utilize the wild vegetation of Wadi Gaza for multi-purposes as well. Finally, the authors recommend carrying out detailed scientific works regarding the ecology, distribution and uses of particular floristic species in the Gaza Strip. Key words: Flora – survey – uses – herbal medicine – Wadi Gaza – Gaza Stri

Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Background: Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods: We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings: Globally, in 2019, among HIV-negative individuals, there were 1·18 million (95% uncertainty interval 1·08–1·29) deaths due to tuberculosis and 8·50 million (7·45–9·73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000–279 000) deaths due to tuberculosis and 1·15 million (1·01–1·32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000–425 000) more deaths and 1·01 million (0·82–1·23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820–11 400) more deaths and 81 100 (63 300–100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1·5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4·27 (3·69–5·02), 6·17 (5·48–7·02), and 1·17 (1·07–1·28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2·23 (2·03–2·44) times greater among males than females, whereas the fraction due to unsafe sex was 1·06 (1·05–1·08) times greater among females than males. Interpretation: As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestones. Funding: Bill & Melinda Gates Foundation. © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens