Clinical and Biological Effects of Adjunctive Photodynamic Therapy in Refractory Periodontitis

Introduction: To date, no novel treatment approach is available for optimum outcomes regarding refractory periodontitis. The aim of the present study was to assess the efficiency of photodynamic therapy (PDT) in treating patients diagnosed with refractory periodontitis and compare the clinical and biological outcomes of conventional periodontal treatment with or without adjunctive PDT in these patients, by assessing clinical parameters (plaque index [PI], gingival recession [GR], bleeding on probing [BOP], periodontal probing depth [PPD] and clinical attachment level [CAL]) as well as biological parameters (IL-1β) in the gingival crevicular fluid (GCF).Methods: Sixteen patients within the age of 30 to 60 years, with a mean age of 40 years old, diagnosed with refractory periodontitis were included. In this split mouth design study, 2 quads (1 upper + 1 lower) from the same patient were randomly treated with (scaling and root planing [SRP]+PDT) together. The other 2 quadrants (1 upper + 1 lower) were treated by SRP only and selected to serve as controls. Clinical parameters including PI, GR, BOP, PPD and CAL and biological parameters (IL-1β) in the GCF were measured at baseline, then at, 2 and 6 months after therapy.Results: A statistically significant reduction in several clinical parameters as, BOP (P < 0.001), PI (P < 0.001), PPD (P < 0.001) and CAL (P < 0.001) in quadrant treated with SRP and adjunctive PDT when compared to control group treated with SRP alone was observed and both therapies showed non-statistically significant differences in the reduction of IL-1β level.Conclusion: The inclusion of PDT as an adjunctive measure to nonsurgical conventional periodontal treatment seems to be a useful therapeutic measure in refractory periodontitis treatment

The Obstacles Hindering the Promotion of Awareness among Jordanian School Students about the Risks of Cyber-Terrorism and Educational Suggestions for Activating the Role of those Schools in Such Promotion

هدفت الدراسة إلى الكشف عن أبرز المعوقات التي تحول دون توعية طلبة المدارس الأردنية بمخاطر الإرهاب الإلكتروني، وعن المقترحات التربوية لتفعيل دورها في توعية طلبتهم بمخاطر الإرهاب الإلكتروني من وجهة نظر طلبة كليات العلوم التربوية، والكشف عن وجود فروق ذات دلالة إحصائية عند مستوى (0.05=α) في استجابة عينة الدراسة تعزى لمتغيرات: (الجنس والتخصص والخبرة في التعامل مع التطبيقات الحاسوبية والخبرة التدريسية والإقليم)، انتهجت الدراسة منهج البحث الوصفي الكمي. وبلغت عينة الدراسة (250) طالباً وطالبة. أظهرت نتائج الدراسة أن درجة مرتفعة لتقدير أفراد عينة الدراسة على معوقات توعية طلبة المدارس الأردنية بمخاطر الإرهاب الإلكتروني وعلى مقترحات لزيادة دور المدارس الأردنية في توعية طلبتهم بمخاطر الإرهاب الإلكتروني. ولم تظهر النتائج فروقا دلالة إحصائيا في استجابة عينة الدراسة تعزى لمتغيرات الدراسة. وفي ضوء نتائج الدراسة أوصى الباحثان بضرورة العمل من قبل قياديّي النظام التربوي على معالجة معوقات تنمية وعي طلبة المدارس بمخاطر الإرهاب الإلكتروني، والأخذ بالمقترحات التي خرجت بها الدراسة.This study explored the most significant obstacles hindering the promotion of awareness among Jordanian school students about the risks of Cyber-terrorism. It aimed to offer educational suggestions for activating the role of those schools in such promotion from the perspective of the students in the educational sciences faculties. It aimed to explore whether there is a significant difference- at the significance level of a=0.05- between respondents’ attitudes which can be attributed to gender, major, experience in using computer applications, academic qualification, experience, and province. The researcher of the present study adopted the descriptive qualitative approach because its suits this type of study. The sample consists of 250 female and male students. It was found that the severity of the obstacles hindering the promotion of awareness among Jordanian school students about the risks of Cyber-terrorism is high from the perspective of the members of the sample. The same applies to the suggestions made for activating the role of those schools in such promotion from the perspective of the students in the educational sciences faculties. It was found that there isn’t any significant difference- at the significance level of a=0.05- between respondents’ attitudes which can be attributed to gender, major, experience in using computer applications, experience and province. In the light of the study’s results, the researchers of the present study offered several recommendations. He recommends taking measures by the leaders in academic institutions to address the obstacles hindering the promotion of awareness among Jordanian school students about the risks of Cyber-terrorism. They recommend taking the suggestions mentioned in this study into consideratio

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

دور معلمي المدرسة الثانوية في تنمية الوعي بالأمن السيبراني لدى طلابها من وجهة نظر المعلمين في مدارس التعليم الخاص في مدينة عمان

الأهداف: هدفت الدراسة إلى تعرف دور معلمي المدرسة الثانوية في تنمية الوعي بالأمن السيبراني لدى طلابها من وجهة نظر المعلمين في مدارس التعليم الخاص في مدينة عمان. المنهجية: انتهجت هذه الدراسة منهج البحث الكمي الوصفي، وتكوّن المجتمع من جميع معلمي المرحلة الثانوية في المدارس الخاصة الأردنية للعام الدراسي 2020/2021. بعينة بلغت (223) تم اختيارهم بالأسلوب الطبقي العشوائي. النتائج: أظهرت النتائج أن تقدير أفراد العينة لمجالات واقع دور معلمي المدرسة الثانوية في توعية طلبتهم بالأمن السيبراني جاء بدرجة مرتفعة. وأن لا فروق ذات دلالة إحصائية في مجال معوقات التوعية بالأمن السيبراني تعزى لمتغيرات الجنس، الخبرة في التعامل مع التطبيقات الحاسوبية والمؤهل العلمي والخبرة التدريسية. ولا فروق كذلك تعزى لمتغير التخصص في مجالَيْ مدى وعي المعلمين بمفاهيم ومخاطر الأمن السيبراني ومعوقات توعية الطلبة. فيما ظهرت فروق على واقع التوعية بمفاهيم الأمن السيبراني، تعزى لمتغير التخصص ولصالح المواد الإنسانية. ولمجال مدى وعي المعلمين بمفاهيم ومخاطر الأمن السيبراني تبعًا لمتغير الخبرة التدريسية بين أقل من 5 سنوات و5-10 سنوات ولصالح 5-10 سنوات، ولمجال واقع التوعية بمفاهيم الأمن السيبراني تبعًا للمؤهل العلمي ولصالح الشهادة الأدنى. وأن درجة تقدير أفراد العينة على المقترحات لتفعيل دور معلمي المدارس الثانوية في توعية طلبتهم بالأمن السيبراني جاءت بدرجة مرتفعة. وأنه لا توجد فروق في استجابة العينة على مقترحات التفعيل تعزى لمتغيرات: الجنس والتخصص والخبرة في التعامل مع التطبيقات الحاسوبية والمؤهل العلمي والخبرة التدريسية. الخلاصة: تعميم مقترحات الدراسة على إدارات ومعلمي المدارس الثانوية، وتعاون الجهات المختلفة من أجل توفير التدريب الكافي للمعلمين

A comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center

Objectives: This study aims to provide a comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center. Methods: This is a descriptive cross-sectional survey-based study, from patients receiving treatment in an addiction rehabilitation center in Damascus. Syria. The study was conducted over a period of nine months. Results: A total of 82 participants were recruited, the majority of them were males (n = 78.95.1%). More than half of those investigated reported multi-level failure (n = 46, 56.1%) during their education. Most of the participants (n = 44, 53.7%) started to use drugs at a friend’s home. The family was shown to play a positive role in stopping the initial drug taking trials at early stages (33/56, 58.9%). Again, friends' effect was the main reason for the return of abusing drugs (20/56, 35.7%). Sources of drugs were mainly from drug promoters for most of the participants (n = 58, 70.7%) followed by friends (n = 28, 34.1%). Participants revealed that taking drugs were mostly accompanied by additional habits such as cigarette smoking before using their drugs (n = 65, 79.3%), or drinking alcohol (57.3%). Surprisingly, participants believed that drug abuse does not lead to addiction (n = 52, 63.4%). The most common experienced feeling was depressed, desperate, or sad (n = 47, 57.3%), followed by anxiety and the desire to escape reality and resort to imaginations (n = 44, 53.7%). Conclusions: The findings of this study indicate the need of policymakers to give more attention, in developing preventive strategies, to friends, as a main cause of addiction, in addition to the family influences on individual’s drug abuse, addiction behaviors, and mindsets. Understanding the influencing factors could spot the light on the key to solve the addiction problem. A realist rehabilitation programs must be well designed and implemented as the level of individuals, institutions and communities to face this problematic addiction disaster

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids