Quality of care of Egyptian asthmatic children: Clinicians adherence to asthma guidelines

<p>Abstract</p> <p>Background</p> <p>Despite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice.</p> <p>Objectives</p> <p>To assess the physicians attitude towards asthma guidelines and their adherence to its recommendations.</p> <p>Methods</p> <p>Three hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification) engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both.</p> <p>Results</p> <p>Agreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1%) and secondly due to poor patient compliance (16%). Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p < 0.01), positive highly significant correlation between qualification and practice, (p < 0.01), and positive highly significant correlation between qualification and attitude, (p < 0.01).</p> <p>Conclusion</p> <p>The attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.</p

Oxidative Stress in Hemodialysis Pediatric Patients

BACKGROUND: Oxidative stress may play a role in complications of hemodialysis patients as atherosclerosis, thrombosis, and inflammation. AIM: The aim of the study was to evaluate the oxidative stress in hemodialysis pediatric patients through measurement of oxidative stress enzymes as paraoxanase activity (PON), arylesterase activity (ASA), superoxide dismutase (SOD) and also non-enzymatic antioxidant vitamins as vitamins A, C and E levels. METHODS: The study included 50 hemodialysis pediatric patients with mean age 11.4 ± 5.4 years and 30 normal children of matched sex and age as a control group. Assessment of oxidative stresses was done using ELIZA technique. RESULTS: SOD, ASA, and vitamin C were significantly lower among hemodialysis patients in comparison to control group (p = 0.004, 0.004, &gt; 0.001 respectively). CONCLUSION: The study concluded that oxidative stress was common finding in hemodialysis pediatric patients which may play a role in complications encountered among these patients

MicroRNA-208a: a Good Diagnostic Marker and a Predictor of no-Reflow in STEMI Patients Undergoing Primary Percutaneuos Coronary Intervention

MicroRNA-208a is a cardiac specific oligo-nucleotide. We aimed at investigating the ability of microRNA-208a to diagnose myocardial infarction and predict the outcome of primary percutaneuos coronary angiography (PCI). Patients (n = 75) presented by chest pain were recruited into two groups. Group 1 (n = 40) had ST elevation myocardial infarction (STEMI) and underwent primary PCI: 21 patients had sufficient reperfusion and 19 had no-reflow. Group 2 (n = 35) had negative cardiac troponins (cTns). Plasma microRNA-208a expression was assessed using quantitative polymerase chain reaction and patients were followed for occurrence of in-hospital major adverse cardiac events (MACE). MicroRNA-208a could diagnose of MI (AUC of 0.926). After primary PCI, it was superior to cTnT in prediction of no-reflow (AUC difference of 0.231, P = 0.0233) and MACE (AUC difference of 0.367, P = 0.0053). Accordingly, circulating levels of miR-208a can be used as a diagnostic marker of MI and a predictor of no-reflow and in-hospital MACE

The Algebraic Creativity in The Neutrosophic Square Matrices‏

The objective of this paper is to study algebraic properties of neutrosophic matrices, where a necessary and sufficient condition for the invertibility of a square neutrosophic matrix is presented by defining the neutrosophic determinant. On the other hand, this work introduces the concept of neutrosophic Eigen values and vectors with an easy algorithm to compute them. Also, this article finds a necessary and sufficient condition for the diagonalization of a neutrosophic matrix

The Determinant of Subjective Well-Being among the adult individuals in the UAE

Background: Enhancing individual wellbeing is a national priority in the United Arab Emirates. Up to date, wellbeing at the country level was measured through the national wellbeing survey that is sector specific comprising of 122 questions. The “World Health Organization 5 items (WHO-5) Well-being Index” is a reliable instrument to assess Subjective Well-Being, yet was never tested at national level in the UAE. Aim: This study examined the association of socio-economic determinants of health with the subjective well-being (SWB) using WHO-5 Well-being Index to inform public health policy in the UAE. Method: A cross-sectional survey from adults (aged 18+ and above) was conducted. About 10,000 individuals were randomly selected across all the seven Emirates. A total of 7367 adults (18 years and above) took part in the survey (response rate was 74%). The WHO-5 instrument is a valid screening measure as it includes only 5 items, is freely available in at least thirty-one languages, and is tremendously easy to complete, interpret and score. The social support of the respondents was evaluated by using the Multidimensional Scale of Perceived Social Support. Results: The results of the study demonstrate that majority of the participants (79.27%) reported moderate - high (≥50) well-being scores showing the good quality of life/well-being, whereas, only 20.72% of the individual reported ill-being/likely depression in the future. Respondent’s age, gender, marital status, monthly income (AED- UAE dirham), employment status and reporting at least one or more morbidity were found to be significantly associated with the SWB variables (p &lt; 0.05). A significant association was found between the comprehensive/emotional and /mental well-being and perceived social support. Conclusion: The WHO-5 index can be used as a reliable screening tool to identify wellbeing inequalities among adult individuals based on socio-economic determinants of health in the UAE. Addressing the socio- Hira Abdul Razzak1, Dr. Alya Harbi2, Ms. Mubarkah Jaber AlKarbi3, Dr. Amin Mohamed ElShamy4 , Dr. Lubna Al Shaali5, Dr. Rasha E Salama6 , Ms. Malaz Bakri7, Dr. Ahmed Alosi8, Ms. Amna AlDhmanie9 1678 © 2021 JPPW. All rights reserved economic determinants of health in the UAE can enhance subjective well-being (SWB) and help the UAE to achieve its strategic aspiration to make the UAE among the world leaders in quality of life

Catechol-O-Methyltransferase Expression and 2-Methoxyestradiol Affect Microtubule Dynamics and Modify Steroid Receptor Signaling in Leiomyoma Cells

CONTEXT: Development of optimal medicinal treatments of uterine leiomyomas represents a significant challenge. 2-Methoxyestradiol (2ME) is an endogenous estrogen metabolite formed by sequential action of CYP450s and catechol-O-methyltransferase (COMT). Our previous study demonstrated that 2ME is a potent antiproliferative, proapoptotic, antiangiogenic, and collagen synthesis inhibitor in human leiomyomas cells (huLM). OBJECTIVES: Our objectives were to investigate whether COMT expression, by the virtue of 2ME formation, affects the growth of huLM, and to explore the cellular and molecular mechanisms whereby COMT expression or treatment with 2ME affect these cells. RESULTS: Our data demonstrated that E(2)-induced proliferation was less pronounced in cells over-expressing COMT or treated with 2ME (500 nM). This effect on cell proliferation was associated with microtubules stabilization and diminution of estrogen receptor alpha (ERalpha) and progesterone receptor (PR) transcriptional activities, due to shifts in their subcellular localization and sequestration in the cytoplasm. In addition, COMT over expression or treatment with 2ME reduced the expression of hypoxia-inducible factor -1alpha (HIF-1 alpha) and the basal level as well as TNF-alpha-induced aromatase (CYP19) expression. CONCLUSIONS: COMT over expression or treatment with 2ME stabilize microtubules, ameliorates E(2)-induced proliferation, inhibits ERalpha and PR signaling, and reduces HIF-1 alpha and CYP19 expression in human uterine leiomyoma cells. Thus, microtubules are a candidate target for treatment of uterine leiomyomas. In addition, the naturally occurring microtubule-targeting agent 2ME represents a potential new therapeutic for uterine leiomyomas

A New Collaborative Multi-Agent Monte Carlo Simulation Model for Spatial Correlations Air Pollutions Global Risk Assessment

Air pollution risk assessment is complex due to dynamic data change and pollution source distribution. Air quality index concentration level prediction is an effective method of protecting public health by providing the means for an early warning against harmful air pollution. However, air quality index-based prediction is challenging as it depends on several complicated factors resulting from dynamic nonlinear air quality time-series data, such as dynamic weather patterns and the verity and distribution of air pollution sources. Subsequently, some minimal models have incorporated time series-based predicting air quality index at a global level (for a particular city or various cities). These models require interaction between the multiple air pollution sensing sources and additional parameters like wind direction and wind speed. The existing methods in predicting air quality index cannot handle short-term dependencies. These methods also mostly neglect the spatial correlations between the different parameters. Moreover, the assumption of selecting the most recent part of the air quality time series is not valid considering that pollution is cyclic behavior according to various events and conditions due to the high possibility of falling into the trap of local minimum and poor generalization. Therefore, this pa-per proposes a new air pollution global risk assessment (APGRA) model for predicting spatial correlations air quality index risk assessment to address these issues. The APGRA model incorporates autoregressive integrated moving average (ARIMA), Monte-Carlo simulation, and collaborative multi-agent system, and prediction algorithm for reducing air quality index prediction error and processing time. The proposed APGRA model is evaluated based on Malaysia and China real-world air quality datasets. The proposed APGRA model improves the average root mean squared error by 41%, mean and absolute error by 47.10% compared with the conventional ARIMA and ANFIS models

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

A calcineurin–Hoxb13 axis regulates growth mode of mammalian cardiomyocytes

10.1038/s41586-020-2228-6Nature5827811271-27

The application of omics in ruminant production: a review in the tropical and sub-tropical animal production context

The demand for animal products (e.g. dairy and beef) in tropical regions is expected to increase in parallel with the public demand for sustainable practices, due to factors such as population growth and climate change. The necessity to increase animal production output must be achieved with better management and production technologies. For this to happen, novel research methodologies, animal selection and postgenomic tools play a pivotal role. Indeed, improving breeder selection programs, the quality of meat and dairy products as well as animal health will contribute to higher sustainability and productivity. This would surely benefit regions where resource quality and quantity are increasingly unstable, and research is still very incipient, which is the case of many regions in the tropics. The purpose of this review is to demonstrate how omics-based approaches play a major role in animal science, particularly concerning ruminant production systems and research associated to the tropics and developing countriesinfo:eu-repo/semantics/acceptedVersio