Psychosocial Implications and Quality of Life in Patients with Hidradenitis Suppurativa Compared to Those With Atopic Dermatitis and Psoriasis: a Cross-sectional Case-control Study

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has been reported to have the greatest negative impact on quality of life (QoL) and psychosocial factors when compared with other skin conditions.Objectives:  To assess psychosocial impact and QoL impairment in patients with HS.Methods: This cross-sectional case-control study included a case group with HS and a control group with psoriasis or atopic dermatitis diagnosed by a dermatologist at a public hospital in Jeddah, Saudi Arabia from 2016 to 2019. Data were obtained from medical records at a ratio of 1:2. Patients were contacted via telephone and asked to complete Arabic-validated questionnaires (Dermatology Life Quality Index [DLQI], Rosenberg Self-Esteem Scale, and Hospital Anxiety and Depression Scale) and a survey containing pictures to identify Hurley stage.Results: The study included 46 patients and 101 controls (eczema, 50; psoriasis, 51). Patients had significantly higher DLQI and depression scores than did controls (P < 0.05). Anxiety and depression scores were significantly higher in women than men (P < 0.05). Cases with Hurley stage 3 had significantly higher DLQI scores than those with Hurley stages 1 and 2. Controls had a significantly higher percentage of employed participants (P < 0.05).Conclusions: HS had a greater psychosocial impact on QoL than psoriasis or atopic dermatitis and was associated with a lower employment rate. Women were more affected by the disease than men. Therefore, we recommend paying close attention to the psychosocial aspects of the disease and establishing educational programs and support groups for patients with HS

Preferences for HIV testing services among young people in Nigeria.

BACKGROUND: Despite high HIV incidence rates among young people in Nigeria, less than 24% of this population have ever tested for HIV. These low HIV testing rates suggest that current testing services may not align with their testing preferences. To address this gap, the objective of this study was to assess preferences for HIV testing options among young people in Nigeria. METHODS: We conducted a cross-sectional study using survey to assess preferences for HIV testing options among 113 youth aged 14-24 years residing in Nigeria. The survey included a series of hypothetical HIV testing options, comprised of six characteristics centered around HIV testing service (i.e. location of testing, test administrator, mode of pre-test, mode of post-test counseling, type of HIV test, and cost of HIV test). For each characteristic, participants were asked to select one of the options that they prefer or indicate none of the above. A descriptive analysis of the preferences made by participants was conducted, summarizing proportions of participants who selected different options for HIV testing. RESULTS: The mean age of study participants was 19.5 years old (SD = 2.7). Most youth (73, 64.6%) had at least a secondary school degree. There was pronounced heterogeneity in HIV testing preferences among young people. Although most youth preferred free HIV testing, 14 (16.7%) reported preferring paying a small amount compared to free testing. More youth preferred blood-based HIV self-testing 39(48.8%) compared to facility-based HIV testing and oral HIV self-testing. CONCLUSIONS: Our finding suggest that young people have a range of HIV testing preferences in Nigeria. This suggests that a "one-size-fits-all" approach to delivering services to youth may be challenging in this context. HIV testing services can be optimized to reach young people if a variety options are provided to meet their unique preferences

Elaboration and Characterization of ZnO/FTO thin films under different concentrations - Study dedicated to the photovoltaic systems - Study d

© 2020 IEEE. This paper presents an elaboration of thin films dedicated to photovoltaic systems. Zinc oxide (ZnO) on fluorine tin oxide (FTO) coated glass substrates are one of the best semiconductors oriented to solar cell preparations. In this study, the ZnO solution is performed with some sol concentration (0.1 M to 0.5 M) to verify its effect on thin-film samples. On the other hand, samples prepared are analyzed and characterized in structural and the optical properties using different techniques as ultraviolet-visible (UV-vis) spectrometry, Fourier transform infrared spectroscopy (FT-IR) and X-ray diffraction (XRD). This work showed the variation of the energy gap (Eg) values. The Eg values allow us to ensure good solar cells. In this study, the thin films prepared showed that the energy gap values are ranged between 3.29 eV and 3.4 eV. These results led us to confirm the possibility of having an easy passage of the electrical current. In addition, the transmittance spectra of the ZnO/FTO thin films showed an average of ~75% in the visible region and presented sharp absorption edges at 375 nm. The experimental preparation ensures a good decision about electrical energy production which based on the photovoltaic systems

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Physical properties and up- conversion development of Ho3+ ions loaded in nano-composite silica titania thin film

Structural and fluorescence properties were investigated for different concentrations of Ho ^3+ ions doped silica titania nano-composite thin films. These films were deposited on glass substrates at two different annealing temperatures 300 and 500 °C for 3 h.The obtained films were transparent, smooth and adhesive to the substrate glass surface. The crystallite sizes were in the nano-scale phase with values ranged from 15 to 20 nm. The average thin film thickness was found to be equal to about 1.7 μ m. Blue, red and green up-conversion emissions are detected using 808 nm laser diode. The highest emission bands were observed in the doped film with 0.4 mol% of Ho ^3+ ions. The prepared thin films could be considered promising candidates for higher efficiency up-down shifting solar cell, photonic, photo-catalytic and optical sensor applications

Comparison Between Static Surgical Guides and Artificial Intelligence Navigation Systems On Implant Deviation In “All-On-4” Implant Placement (An in vitro Study)

Artificial intelligence techniques are recently used in different fields including implant placement. However, navigation systems based on such techniques still don’t have enough evidence to grant their success in implant placement. So, the purpose of the current study is to compare deviation of implant placement performed by static surgical guides versus artificial intelligence based systems in “All On 4 “implant treatment concept. Mandibular educational models will be used to place dental implants following the “All on 4 “protocol. The models will be randomised into two groups. In the group (SG), the dental implants will be placed using a static surgical guide. while in the group (AI), they will be placed using an artificial intelligence based system. The deviation of the dental implants using both techniques will be compared using CBCT radiographs. Lateral apical, lateral coronal and angular deviations will be assesse

Genotyping of Clostridium perfringens Isolates from Domestic Livestock in Saudi Arabia

The present study was undertaken to confirm the genetic identity of Clostridium perfringens isolates from domestic livestock in Saudi Arabia and to characterize the genes encoding to alpha, beta, epsilon, and iota (α-, β-, ε-, and ι-) toxins. C. perfringens were confirmed in 104 out of 136 isolates on multiplex polymerase chain reaction using specific primers amplifying genes related to toxins produced by C. perfringens. Genes encoding α-toxins were detected in 104 samples. Of the isolates, 80.8% were diagnosed as type A, 15.4% as type D, 2.9% as type C, and 0.96% as type B. None of the isolates has genes encoding iota (ι-) toxin. All isolates investigated yielded enterotoxin (cpe) products and none yielded β2 (cpb2-toxin) or NetB products. PLC gene sequences encoding α-toxin showed >96.7% similarity. Isolates which had α-toxins as well as enterotoxin (cpe) are regarded as type F. Phylogenetic analysis using maximum likelihood analysis yielded two clades, and the majority of the isolates were in one group while only two isolates clustered on the second clade. Within the Kingdom of Saudi Arabia strains, 54 variable positions and 23 polymorphic amino acids were noticed. Isolates with ε- and β-toxins were variable and were found to be close to those published for C. perfringens. ETX gene sequences encoding ε-toxins were found to be related to CPE sequences