Characterization in Bakhtiar Ali's novel “Jamshid Khani Mamm”

This research entitled (Characterization in Bakhtiar Ali's Novel Jamshid Khani Mamm) is a new perspective on the concept of characterization and how Bakhtiar Ali deals with this concept in his novel Jamshid Khani Mamm. This study discusses the characters and their types and their use in the novel, an attempt to answer what is meant by characterization. What are the types of characters? How does Bakhtiar Ali create the characters in his novels? Can we see all kinds of characters in this novel? This research is conducted according to the (descriptive-analytical) approach, consists of an introduction and two main sections and finally the results are presented in several points

Patient’s Satisfaction with Health Care Services in Erbil City/Iraq

Background and objective: Patient satisfaction is one of the most important factors to determine the success of a health care facility. It is a relative phenomenon, which evaluates the patients’ perceived needs, their expectations from a health system, and the experience of health care. Patient satisfaction is the main goal today for most health care organizations, from hospitals to physician practices and other health care agencies. This study aimed to compare patient satisfaction with the health care services provided by public and private hospitals in Erbil City. Methods: A cross-sectional study was conducted using a non-probability purposive sample of 450 patients (225 from public and 225 from private hospitals) who were seeking health care in hospitals in Erbil City. The data were collected between the 7th of January and 15th of November 2016 by direct interviews and filling of the standardized questionnaires (Patient Satisfaction Questionnaire-18). Results and Discussion: Most of the patients in public hospitals expressed a neutral level of satisfaction with received health services (80.9%) while 10.7% were dissatisfied and only 8.4% were satisfied with the provided health care. On the contrary, most of the patients in private hospitals (80%) were satisfied with their care, with only 20% expressing a neutral level of satisfaction with private health care services. These findings show that there is a very high statistical difference between patient satisfaction in the governmental and private hospitals in Erbil City (Mean ± Standard Deviation 45.35 ± 3.520), (56.42 ± 5.696) (p-value= <0.001). Conclusion: Most of the patients were satisfied with private health care services but not with public hospitals health services in selected hospitals in Erbil City in Iraq

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Orthodontic Implementation of Machine Learning Algorithms for Predicting Some Linear Dental Arch Measurements and Preventing Anterior Segment Malocclusion: A Prospective Study

Background and Objectives: Orthodontics is a field that has seen significant advancements in recent years, with technology playing a crucial role in improving diagnosis and treatment planning. The study aimed to implement artificial intelligence to predict the arch width as a preventive measure to avoid future crowding in growing patients or even in adult patients seeking orthodontic treatment as a tool for orthodontic diagnosis. Materials and Methods: Four hundred and fifty intraoral scan (IOS) images were selected from orthodontic patients seeking treatment in private orthodontic centers. Real inter-canine, inter-premolar, and inter-molar widths were measured digitally. Two of the main machine learning models were used: the Python programming language and machine learning algorithms, implementing the data on k-nearest neighbor and linear regression. Results: After the dataset had been implemented on the two ML algorithms, linear regression and k-nearest neighbor, the evaluation metric shows that KNN gives better prediction accuracy than LR does. The resulting accuracy was around 99%. Conclusions: it is possible to leverage machine learning to enhance orthodontic diagnosis and treatment planning by predicting linear dental arch measurements and preventing anterior segment malocclusion

Potentiometric urea biosensor utilizing nanobiocomposite of chitosan-iron oxide magnetic nanoparticles

The iron oxide (Fe3O4) magnetic nanoparticles have been fabricated through a simple, cheap and reproducible approach. Scanning electron microscope, x-rays powder diffraction of the fabricated nanoparticles. Furthermore, the fabrication of potentiometric urea biosensor is carried out through drop casting the initially prepared isopropanol and chitosan solution, containing Fe3O4 nanoparticles, on the glass fiber filter with a diameter of 2 cm and a copper wire (of thickness −500 μm) has been utilized to extract the voltage signal from the functionalized nanoparticles. The functionalization of surface of the Fe3O4 nanoparticles is obtained by the electrostatically immobilization of urease onto the nanobiocomposite of the chitosan- Fe3O4 in order to enhance the sensitivity, specificity, stability and reusability of urea biosensor. Electrochemical detection procedure has been adopted to measure the potentiometric response over the wide logarithmic concentration range of the 0.1 mM to 80 mM. The Fe3O4 nanoparticles based urea biosensor depicts good sensitivity with ~42 mV per decade at room temperature. Durability of the biosensor could be considerably enhanced by applying a thin layer of the nafion. In addition, the reasonably stable output response of the biosensor has been found to be around 12 sec

Infant with Life Threatening Thymic Carcinoma

Thymic epithelial neoplasms consist of thymomas, thymic carcinoids and thymic carcinomas. Carcinomas are malignant tumors of the thymus; they compromise only 4%-14% of thymic epithelial neoplasms. Thymic carcinoma cells do not resemble healthy cells but similar to cancer cells that originate from other parts of the body and grow more quickly when the tumor is found and more difficult to treat. Thymic carcinoma rarely occurs in children. We reported a case of undifferentiated thymic carcinoma in 11 months old female. After two courses of chemotherapy the patient developed increasing respiratory compression and unfortunately died because of respiratory failure