Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Shari’ah concepts in Islamic banking

The paper analyses the main Shari’ah concepts in Islamic banking, a system which operates in accordance with the Islamic law principles, the most important being the prohibition against the payment or acceptance of interest charges (riba), replaced by profit-and-loss-sharing arrangements(PLS), Mudharabah. Also, the paper presents a survey of the historical evolution of the Islamic banking system in Muslim countries, starting with the first Islamic bank, early in the 60’s, Mit Ghamr Local Savings Bank in Egypt. In conclusion, the Islamic banking system is a rapid growth one. It is expected that this presentation will be helpful in increasing the interest in the Islamic principles of banking and financing

Mergers and acquisitions in the international banking sector

The economic crisis emphasized the risks that banks assume and run. Reducing them is a strong reason for the acceleration of mergers and acquisitions in the international banking field. The merger of banking entities has established itself as a modern method of global credit risk management within every country and internationally. The main objective of this article is to highlight the latest developments on the bank mergers and acquisitions market in the U.S. and EU and on emerging market trends

L cell virus: infectivity for type N and B mouse embryo cells.

The efficiency of focus formation of four L cell virus populations was significantly higher on type N mouse embryo fibroblast cultures than on type B cells. [5-3H]uridine-incorporating material sedimenting at a density of 1.158/g/cm3 was observed in the supernatant fluids of type N and B cultures infected with the four viral populations

Paramagnetic defects in neutron-irradiated α-quartz: Novel Al-associated E’ centers

Two new paramagnetic defects ($E'_{14}$ and $E'_{16}$ ) have been revealed in neutron-irradiated natural ${\alpha}$ -quartz by using electron paramagnetic resonance (EPR) spectroscopy. The EPR spectra of the $E'_{16}$ center as well as a previously reported but incompletely characterized $E'_{11}$ center demonstrate that their super-hyperfine structures arise from interaction with 27Al, the first-ever examples of Al-associated $E'$ centers in crystalline quartz. The matrices g and $\textbf{A}(^{29}\text{Si})$ , $\textbf{A}(^{27}\text{Al})$ of $E'_{11,16}$ , g and $\textbf{A}(^{29}\text{Si})$ of the $E'_{14}$ center, have been determined

Exposure to ethanol during neurodevelopment modifies crucial offspring rat brain enzyme activities in a region-specific manner

The experimental simulation of conditions falling within “the fetal alcohol spectrum disorder” (FASD) requires the maternal exposure to ethanol (EtOH) during crucial neurodevelopmental periods; EtOH has been linked to a number of neurotoxic effects on the fetus, which are dependent upon the extent and the magnitude of the maternal exposure to EtOH and for which very little is known with regard to the exact mechanism(s) involved. The current study has examined the effects of moderate maternal exposure to EtOH (10 % v/v in the drinking water) throughout gestation, or gestation and lactation, on crucial 21-day-old offspring Wistar rat brain parameters, such as the activities of acetylcholinesterase (AChE) and two adenosine triphosphatases (Na+,K+-ATPase and Mg2+-ATPase), in major offspring CNS regions (frontal cortex, hippocampus, hypothalamus, cerebellum and pons). The implemented experimental setting has provided a comparative view of the neurotoxic effects of maternal exposure to EtOH between gestation alone and a wider exposure timeframe that better covers the human third trimester-matching CNS neurodevelopment period (gestation and lactation), and has revealed a CNS region-specific susceptibility of the examined crucial neurochemical parameters to the EtOH exposure schemes attempted. Amongst these parameters, of particular importance is the recorded extensive stimulation of Na+,K+-ATPase in the frontal cortex of the EtOH-exposed offspring that seems to be a result of the deleterious effect of EtOH during gestation. Although this stimulation could be inversely related to the observed inhibition of AChE in the same CNS region, its dependency upon the EtOH-induced modulation of other systems of neurotransmission cannot be excluded and must be further clarified in future experimental attempts aiming to simulate and to shed more light on the milder forms of the FASD-related pathophysiology. © 2015, Springer Science+Business Media New York

Temperature dependence of ion track formation in quartz and apatite

Ion tracks were created in natural quartz and fluorapatite from Durango, Mexico, by irradiation with 2.2GeV Au ions at elevated temperatures of up to 913K. The track radii were analysed using small-angle X-ray scattering, revealing an increase in the io

Temperature dependence of ion track formation in quartz and apatite

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101875/1/S0021889813022802.pd