دور المحاسبة ومعايير التدقيق السحابي في تأكيد أمن البيانات والمعلومات ( دراسة ميدانية من وجهة نظر مدققي الحسابات الخارجيين في سورية)

هدفت هذه الدراسة إلى استقصاء آراء مدققي الحسابات الخارجيين في سورية حول دور فوائد ومخاطر المحاسبة والتدقيق السحابي عند تنبي الحلول السحابية ، وآرائهم حول دور معايير التدقيق السحابي ( المعيار SAS70،SSAE16،ISO295TC ) في تأكيد أمن البيانات والمعلومات ، إضافةً إلى استقصاء آرائهم حول مدى توافر ضوابط أمن البيانات والمعلومات الصادرة عن الهيئات والمنظمات المهنية الدولية في القواعد والنواظم الصادرة عن المُشرّع السوري ، واعتمدت الدراسة على تصميم استبانة تم توزيعها بشكل إلكتروني على عينة الدراسة وتم التوصل إلى عدة نتائج وهي وجود فروق ذات دلالة إحصائية في آراء مدققي الحسابات الخارجيين (عينة الدراسة)  حول كل من دور فوائد ومخاطر المحاسبة والتدقيق السحابي عند تبني الحلول السحابية، دور معايير التدقيق السحابي في تأكيد أمن البيانات والمعلومات ، وتوافر ضوابط أمن البيانات والمعلومات في القواعد والنواظم الصادرة عن المُشرّع السوري ، وقد جاءت هذه الفروق تبعاً للمؤهل العلمي ، التخصص العلمي ، وسنوات الخبرة في مجال التدقيق ، كما تم ااقتراح بعض التوصيات أهمها ضرورة تحقيق المواءمة بين فوائد ومخاطر المحاسبة والتدقيق السحابي عند تبني الحلول السحابية، توخي الحذر في اختيار مزودي الخدمات السحابية، النظر إلى أمن البيانات والمعلومات على أنه قضية إدارية وليس مُجرّد قضية تقنية

Preschool Experience as Predictor of Language Learning Outcomes among a Sample of Grades 1, 2, and 3 Students in Bahrain

The aim of the present study was to examine the effects of preschool experience on academic achievement, with specific reference to English language learning outcomes of Grades 1, 2 and 3 students in the Kingdom of Bahrain. Data from a representative sample of 402 students covering all three grades, from Bahrain public elementary schools were statistically analyzed using mean scores, t-test and one-way ANOVA test. The findings of the study revealed consistently higher mean scores in all the three grades for students who attended preschool compared with those who did not attend preschool. There was no significant difference found in ANOVA scores within the grades. The authors of this study recommend extensive research and the integration of pre schools with elementary schools as part of compulsory education; a national level quality measurement system is also recommended for a better future of the nation

Role of awake prone positioning in patients with moderate-to-severe COVID-19: An experience from a developing country

There is limited evidence on the efficacy of awake prone positioning (PP) in non-ventilated patients with COVID-19 who have hypoxemia. We, therefore, aim to describe our experience with the use of early proning in awake, non-intubated patients with confirmed COVID-19. In our retrospective observational study, 23 patients with confirmed positive PCR test results for Severe Acute respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and hypoxemia that required oxygen therapy with or without non-invasive ventilation were treated with PP. Patients were classified into mild, moderate and severe COVID-19 disease. There were no targeted number of hours for proning per day and patients were kept in prone position according to their tolerance. The primary outcome measure was the avoidance of intubation and secondary outcomes were in-hospital mortality, length of hospital stays and complications related to PP. The mean (standard deviation) age of our cohort was 54.5 (11.7) years, and the majority were males (21/23, 91.3%). Sixty-one per cent (14/23) of the patients were suffering from severe disease and 82.6% (19/23) had bilateral lung involvement with interstitial infiltrates. Majority of the patients were prone positioned for a median of 6 days (IQR 4 - 8). Only one patient required transfer to ICU for mechanical ventilation and subsequently died due to severe ARDS. All 22 patients showed progressive improvement in oxygen requirement and PF ratio, mostly after 3-5 days of proning. The mean length of hospital stay was 12 days. All patients, except one, were discharged in stable conditions, on room air or on a minimal oxygen requirement of 1-2 liters. No major complication of PP was recorded. Awake prone positioning is a valuable and safe therapeutic adjunct that can be applied in patients with moderate-to-severe COVID-19. It can also be included in the home-based management protocols of COVID-19 to improve patient outcomes and mitigate the burden on health care facilities

Lightweight encryption technique to enhance medical image security on internet of medical things applications

The importance of image security in the field of medical imaging is challenging. Several research works have been conducted to secure medical healthcare images. Encryption, not risking loss of data, is the right solution for image confidentiality. Due to data size limitations, redundancy, and capacity, traditional encryption techniques cannot be applied directly to e-health data, especially when patient data are transferred over the open channels. Therefore, patients may lose the privacy of data contents since images are different from the text because of their two particular factors of loss of data and confidentiality. Researchers have identified such security threats and have proposed several image encryption techniques to mitigate the security problem. However, the study has found that the existing proposed techniques still face application-specific several security problems. Therefore, this paper presents an efficient, lightweight encryption algorithm to develop a secure image encryption technique for the healthcare industry. The proposed lightweight encryption technique employs two permutation techniques to secure medical images. The proposed technique is analyzed, evaluated, and then compared to conventionally encrypted ones in security and execution time. Numerous test images have been used to determine the performance of the proposed algorithm. Several experiments show that the proposed algorithm for image cryptosystems provides better efficiency than conventional techniques

Assessment of Eating Habits and Lifestyle during Coronavirus Pandemic in the MENA region: A Cross-Sectional Study

© The Authors 2020. The coronavirus disease (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviors among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from 18 countries participated in the current study. During the pandemic, over 30% reported weight gain, 6.2% consumed five or more meals per day compared to 2.2% before the pandemic (p\u3c0.001), and 48.8% did not consume fruits on daily basis. Moreover, 39.1% did not engage in physical activity, over 35% spent more than five hours per day on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (p \u3c 0.001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability, and tension either all the time or a large part of the time during the pandemic (p \u3c 0.001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63% had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity, and psychological problems among adults in the MENA region

Precautions Compliance Among Respiratory Therapist, Radiology, Laboratory, Pharmacist And Nursing Teams, During COVID-19 Pandemic

Standard precautions effectively mitigate the transmission of pathogens inside hospital environments. Noncompliance with infection control measures among healthcare workers (HCWs) can heighten their susceptibility to infectious diseases, particularly during pandemics. The objective of this study was to evaluate the extent to which healthcare workers (HCWs) in various healthcare settings adhere to infection prevention and control methods, and to examine how their perspectives on workplace infection control measures during the COVID-19 pandemic are related to their level of compliance.The adherence to routine precautions by respiratory therapists, radiologists, laboratory personnel, pharmacists, and nursing teams during the COVID-19 pandemic was excellent. The average adherence ratings to the standard precautions may be linked to age and professional category. It is recommended to implement a continuous training program for healthcare personnel to improve their adherence to conventional precautions. This program should include ongoing monitoring and assessment

Digital tools in allergy and respiratory care

Patient care in the allergy and respiratory fields is advancing rapidly, offering the possibility of the inclusion of a variety of digital tools that aim to improve outcomes of care. Impaired access to several health care facilities during the COVID-19 pandemic has considerably increased the appetite and need for the inclusion of e-health tools amongst end-users. Consequently, a multitude of different e-health tools have been launched worldwide with various registration and access options, and with a wide range of offered benefits. From the perspective of both patients and healthcare providers (HCPs), as well as from a legal and device-related perspective, several features are important for the acceptance, effectiveness,and long-term use of e-health tools. Patients and physicians have different needs and expectations of how digital tools might be of help in the care pathway. There is a need for standardization by defining quality assurance criteria.Therefore, the Upper Airway Diseases Committee of the World Allergy Organization (WAO) has taken the initiative to define and propose criteria for quality, appeal, and applicability of e-health tools in the allergy and respiratory care fields from a patient, clinician, and academic perspective with the ultimate aim to improve patient health and outcomes of care

Noninvasive ventilation in COVID-19 patients aged ≥ 70 years—a prospective multicentre cohort study

Funding Information: COVIP study did not have any funding. Publication of this article was funded by the Priority Research Area qLife under the program “Excellence Initiative – Research University” at the Jagiellonian University in Krakow (06/IDUB/2019/94). Publisher Copyright: © 2022, The Author(s).Background: Noninvasive ventilation (NIV) is a promising alternative to invasive mechanical ventilation (IMV) with a particular importance amidst the shortage of intensive care unit (ICU) beds during the COVID-19 pandemic. We aimed to evaluate the use of NIV in Europe and factors associated with outcomes of patients treated with NIV. Methods: This is a substudy of COVIP study—an international prospective observational study enrolling patients aged ≥ 70 years with confirmed COVID-19 treated in ICU. We enrolled patients in 156 ICUs across 15 European countries between March 2020 and April 2021.The primary endpoint was 30-day mortality. Results: Cohort included 3074 patients, most of whom were male (2197/3074, 71.4%) at the mean age of 75.7 years (SD 4.6). NIV frequency was 25.7% and varied from 1.1 to 62.0% between participating countries. Primary NIV failure, defined as need for endotracheal intubation or death within 30 days since ICU admission, occurred in 470/629 (74.7%) of patients. Factors associated with increased NIV failure risk were higher Sequential Organ Failure Assessment (SOFA) score (OR 3.73, 95% CI 2.36–5.90) and Clinical Frailty Scale (CFS) on admission (OR 1.46, 95% CI 1.06–2.00). Patients initially treated with NIV (n = 630) lived for 1.36 fewer days (95% CI − 2.27 to − 0.46 days) compared to primary IMV group (n = 1876). Conclusions: Frequency of NIV use varies across European countries. Higher severity of illness and more severe frailty were associated with a risk of NIV failure among critically ill older adults with COVID-19. Primary IMV was associated with better outcomes than primary NIV. Clinical Trial RegistrationNCT04321265, registered 19 March 2020, https://clinicaltrials.gov.publishersversionpublishe

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation