The Effect of Vitamin D treatment on COVID 19- Patients, an Inverted Propensity Score Weighting (IPSW), and Inverted Probability of Treatment Weighting (IPTW) Analyzed Study

Background Vitamin D3 (1,25(OH)2 cholecalciferol) as a treatment for COVID 19 patients is being disputed, and a clear clinical benefit is not being confirmed. Methods A retrospective evaluation for COVID-19 patients who were treated with various cumulative doses of vitamin D. Data was extracted from the COVID-19 database, it included patients admitted to three hospitals in Amman, Jordan. Characteristics of patients were tabulated and compared for all-cohort, and propensity score index (PSI) adjustment, The comparison was based on two vitamin D strata ((≤ 149,000 i.u. and > 150,000 i.u.). Logistic regression analysis was utilized to predict recovery, the need for oxygen, and all-cause mortality for all-cohort, IPSW, and IPTW patients, based on vitamin D cumulative doses during their hospital stay. Results             1131 all-cohort and 768 PSI-adjusted patients were recruited. Except for antibiotics and antivirals, all other characteristics were balanced (P = NS). There were 1017 patients on vitamin D, 847 received cumulative ≤ 149,000 i.u., and 170 patients received cumulative dose ≥ 150,000 i.u. (Range 1000 – 385000). It was demonstrated that escalating cumulative doses of vitamin D did not contribute to the assessed outcomes; all-cohort patients (OR = 1.000, 95% C.I. 1.000 to 1.000), IPSW (OR = 1.000, 95% C.I. 1.000 to 1.000), and the IPTW (OR = 1.000, 95% C.I. 1.000 to 1.000). Conclusion             In our patients’ cohorts, we could not demonstrate a beneficial effect for vitamin D therapy in COVID-19 patients for recovery, the need for home oxygen, and all-cause mortality, by hospital discharge

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Prognosis of the surface water and groundwater balance of the Lottenbachtal, Bochum, Germany

The effects of anthropogenic and geogenic factors on the quantity and the quality of the water balance, in the Lottenbachtal, were investigated in this study. Many experiments were conducted to achieve this purpose. These include collecting and analysing long term climatic data, collecting and analysing water, soil and rock samples, collecting and analysing the anthropogenic materials from anthropogenic sources, observing and sampling the stream flow discharge, measuring the soil moisture and calculating the water balance. The results of these experiments show that the Lottenbachtal is significantly affected by abandoned coal mines and diversity of land use. These effects represent by additional loads of the chemical elements, which include calcium, magnesium, sodium, potassium, chloride, sulphate, nitrate, carbonate, iron, aluminium and zinc. The other effects are represented by increasing the direct surface runoff and decreasing the groundwater recharge

THE IMPACT OF THE EMERGING CORONA VIRUS ON THE PERFORMANCE OF INSURANCE COMPANIES IN JORDAN

This study aims at identifying the impact of the Corona pandemic on the performance of insurance companies. As this study was devoted to the year 2020 , the descriptive survey approach was used to suit the purposes of the study. The study consists of (24) GM &CEO insurance company in jordan. A scale found valid and reliable was set in order to collect data. The results of the study showed that the pandemic highly affected the performance of insurance companies in the technical,the technological and the human dimensions. Moreover, the financial dimension was moderately affected by the pandemic, and the technical dimension was negatively affected, especially by the decrease of the number of written documents in public insurance and personal insurances. On the other hand, the technological dimension was positively affected, as the study showed unique employment of technological potentials through remote work, conducting business and providing the necessary services to customers, accompanied by the availability of protection and safety measures that enable companies to work remotely. Insurance companies handeled people’s financial rights and health measures positively, and succeeded in creating a safe work environment. Studies showed that the caders were disciplined and reacted professionally to Covid-19

Extracorporeal shock wave as adjuvant therapy for wrist and hand spasticity in post-stroke patients: a randomized controlled trial

Abstract Background Stroke patients often present with upper limb spasticity which impairs the functional status of patients. Recently, extracorporeal shock wave therapy (ESWT) is reported to be a safe, non-invasive, alternative treatment for spasticity. Many articles have been published on the effect of ESWT on lower limb spasticity, but only few of them had focused on upper limb spasticity, so the aim of this study is to evaluate the clinical and electrophysiological effect of ESWT on wrist and hand spasticity of chronic stroke patients and its impact on functional performance. In this monocentric study, forty chronic stroke patients with upper limb spasticity were recruited and randomly allocated into two groups. Both groups continued to receive conventional stroke rehabilitative program, while group I received three sessions of radial extracorporeal shock wave therapy (rESWT) 1 week apart. Results There was a significant decrease in wrist and hand spasticity after treatment and at follow-up in group I compared to group II (Modified Ashworth Scale after rESWT 1.45 ± 0.16, 2.90 ± 0.18 and follow-up 1.55 ± 0.13, 3.00 ± .0.15 in groups I and II, respectively). Also, there was a significant improvement of wrist control and hand function after treatment and at follow-up in group I compared to group II (p < 0.001). The improvement of pinch grip was noticed at follow-up with a significant difference relative to baseline in group I (p < 0.05). Hmax/Mmax ratio was significantly decreased at follow-up in group I compared to group II (p < 0.001). Conclusion ESWT is a valuable adjuvant treatment for spasticity of the hand and wrist in stroke patients which is reflected as improvement of functional activity. Trial registration ClinicalTrials.gov, NCT04312581 . Registered on 18 March 2020

Incidence risk of bronchopneumonia in newborn calves associated with intrauterine diselementosis

Background and Aim: Macro- and micro-elements are required to ensure the normal course of biochemical processes in the development of an animal's body. Any excess, deficiency, or imbalance in chemical elements in an animal's body can cause the development of various latent or clinically expressed pathological conditions. Diselementosis in pregnant cows may lead to impaired embryo and fetal development, as well as reduced neonatal viability. The aim of this study was to analyze the content of macroelements and microelements in the blood serum of both calving cows and their calves to evaluate the relationship between indicators of mineral metabolism in the mother and newborn and to establish what role separate chemical elements play in making newborn calves more prone to bronchopneumonia. Materials and Methods: The content of potassium (K), sodium (Na), iron (Fe), Copper (Cu), Zinc (Zn), Strontium (Sr), arsenic (As), nickel (Ni), cobalt (Co), chromium (Cr), molybdenum (Mo), and selenium (Se) in the blood serum of 33 pregnant cows between 239 and 262 days of gestation and their 33 1-day old calves was determined using the Shimadzu AA6300 (Japan) atomic adsorption spectrophotometer. Calcium (Ca) and magnesium (Mg) content was determined using ion-selective electrodes from the Olympus-400 analyzer (Beckman Coulter, USA). During the 1st month of life, all calves in the sample set had some sort of respiratory diseases and seven of the calves had bronchopneumonia. Retrospectively, the samples of adult and newborn animals were divided into two groups each: Dams I – cows whose calves had uncomplicated bronchitis (n=26); Dams II – cows whose calves got bronchopneumonia (n=7); and Newborns I – calves with uncomplicated bronchitis (n=26); Newborns II – calves with bronchopneumonia (n=7). Results: The content of Ca, Mg, K, Na, Mo, and Se in dams in both groups of cows was within the reference range; the concentrations of Fe and Ni were higher than the reference range; and the concentrations of Cu, Zn, As, Co, and Cr were lower than the reference range. There were no significant differences in elemental status between the Dams I and Dams II groups. In newborn calves, the concentration of Ca and Mo corresponded to the reference range; the concentrations of Mg, Fe, Co, and Ni in both groups exceeded the reference range; and the concentrations of Cu, Zn, As, Cr, and Se were lower than the reference range. Results highlighted that there was a tendency to decrease concentration of Fe, Mo, and Se and a significant increase in the Ni concentration in calves of the Newborns II group compared with calves of the Newborns I group. It was also found that Zn, Co, Cr, and Mo actively accumulated in the body of newborn animals while the transplacental transfer of Cu, As, and Sr was limited; and transfer of Se and Ni was regulated by concentration ratios in the blood of the mother and the fetus. The excessive concentrations of Ni and Fe in the blood serum of cows and calves and the imbalance in the ratio of elements Fe–Cu–Zn, Fe–Cu–Co negatively affected erythropoiesis, formation of the immune system, and antioxidant status of the fetus and newborn. These changes were considered to be risk factors for the development of bronchopneumonia in calves. Conclusion: An excess of serum Fe and Ni and deficiency of Cu, Zn, As, Co, and Cr in cows during the gestation period can lead to similar impairments of the mineral status in newborn calves. At the systemic level, dyslementosis in combination with the influence of other adverse factors, can lead to an increased load on the respiratory and hematopoietic systems of calves during postnatal adaptation and can subsequently cause a decrease in the natural resistance of calves and development of bronchopneumonia

Computational study on the encapsulation of glucosamine anomers by cucurbit[6]uril and cucurbit[8]uril in aqueous solution

Recently, we have investigated the cucurbit[7]uril (CB7) recognition of the α- and β-anomers of neutral, protonated, and acetylated forms of glucosamine in water. In the present work, we employed molecular dynamics (MD) and thermodynamic integration methods (TI) to investigate the recognition of these molecules by cucurbit[6]uril (CB6) and cucurbit[8]uril (CB8). MD revealed the formation of stable 1:1 inclusion complexes by all studied molecules with cucurbit[n]urils (CBn), and 2:1 complex by the α-anomer of the acetylated form of glucosamine with the large homologue CB8. CB6 forms roughly twice as many hydrogen bonds with the guest molecules as CB8. MM-PBSA results indicated that the electrostatic contribution to the binding free energy of each guest:CB complex was larger for CB6 than for CB8, and that CB6 and CB8 have lower affinity toward the different forms of glucosamine compared to CB7. Furthermore, TI was used to estimate the relative affinities of CB6 and CB8 toward the α- and β-anomers for each form of the studied glucosamine and compare with CB7

Coexistence skills among mothers of children with multiple disabilities in the northern region of Jordan (IRBID)

The study aimed to verify the effectiveness of a cognitive-behavioral counseling program to develop the coping skills of mothers of children with multiple disabilities in the northern region of Jordan(IRBID), to achieve the objectives of the study, a quasi-experimental approach was used. The study sample consisted of (24) mothers, the results showed that the coping skills of mothers of children with disabilities, the multiple disabilities were all moderate, and no statistically significant differences appeared between the average scores of the experimental group in the post and follow-up measurements