The Impact of Business Strategy on Budgetary Control System Usages in Jordanian Manufacturing Companies

This research aims at investigating the impact of business strategy on budgetary control system usage in Jordanian manufacturing companies.A survey methodology was utilized using questionnaires to gather data from eighty one Jordanian manufacturing companies listed in Amman Stock Exchange. A total of sixty four usable questionnaires were received and were used for data analysis. Regression analyses were used to achieve the research objectives.The main findings reveal that only low cost strategy has a significant impact on budgetary usages  in the Jordanian manufacturing companies. The findings of this research raise important issues and implications for management accounting researchers and practitioners that is hoped to enhance knowledge on budgetary control system usage . Keywords: Budgets Usages , Low Cost Strategy , Differentiation Strategy, Management Control Systems, Jordanian Manufacturing Companies

Environmental Remediation of Contaminated Wastewater with Ammonium Using Clay-Based Adsorbents

Due to a lack of water treatment technology, developing and emerging nations have become significant polluters and water shortage is exacerbated by pollution. Ammonium toxicity is a huge global environmental concern with no clear solution. Population growth and industrialization destroy the ecosystem. Common and industrial products contain ammonium ions. Water pollution damages fish and other aquatic life. An inexpensive and green wastewater treatment method is adsorption. Adsorbent polymers that remove ammonium ions from wastewater have been explored. Ammonium ions are very hazardous when deposited into surface waters. Surfaces of bentonite and montmorillonite clay may attach sodium ammonium ions. They are cheap and abundant, therefore used to treat drain water. Bentonite outperformed montmorillonite in eliminating ammonium ions from water. Bentonite and montmorillonite clays were used to remove residual ammonium ions. These are utilized for bentonitic and montmorillonitic clays. Both clays were absorbed in a neutral pH, and it was free of sulfuric acid, ammonium ions, and phosphorus ions. Montmorillonitic clay boosted TDS by nearly 10% whereas bentonitic clay only raised TDS by 1%. Adsorption may inexpensively filter water and the surface charge of adsorbents affect their adsorption capacity. Ammonium ions may be recycled, and several bioreactors can remove ammonium ions from liquid and solid phases. Iterate over several models and the Freundlich isotherm model outperforms the Langmuir model by 5%. And bentonite clay adsorbs better due to iron oxide content

Predictors of Long Covid 19 Syndrome

Background: Symptoms of covid persist in most cases with development of a multisystem syndrome called long covid syndrome.Objective: The aim of the work was to evaluate symptoms that persist after the acute stage of the disease in a cohort of patients with confirmed or suspected COVID 19 and to define the predictors for long COVID syndrome.Patients and method: This retrospective study involved 164 patients with previously confirmed or highly suspected COVID 19 and still attending to the post covid outpatient clinic in El-Minia University Chest Hospital complaining from persistence of symptoms or for regular follow up. Their data was obtained from their previous medical reports. Results: Post Covid 19 symptoms were found in about 86 % of the studied patients with 42.7% reported neuropsychiatric symptoms and 26.8% reported respiratory symptoms. The most common reported symptoms in nonsevere cases were the anxiety disorders (18.9%), followed by chronic fatigue and neuropathy (15.2%), while chronic dyspnea in 9.8% mostly in severe cases, while vertigo and headache in 9.1%, musculoskeletal symptoms in 6.1% and skin lesions in 3.7%.Conclusion: It could be concluded that persistence of symptoms is very common after acute Covid 19 infection. Chronic dyspnea was reported more frequently in severe cases while anxiety reported mostly by patients with mild disease

The usefulness of Veno-Arterial Extracorporeal Membranous Oxygenation in Patients with Cardiogenic Shock

BACKGROUND: Venoarterial extracorporeal membranous oxygenation is a form of temporary mechanical circulatory support that gets as a salvage technique in patients with cardiogenic shock, we intended to evaluate the effect of (VA ECMO) support on hemodynamics and lactate levels in patients with cardiogenic shock.AIM: The aim of our study is to detect the ability to introduce veno-arterial extracorporeal membranous oxygenation (VA ECMO) as a temporary extracorporeal life support system (ECLS) in our unit, demonstrate the role of ECMO in cardiogenic shock patients regarding improving hemodynamics and microcirculation, and demonstrate the complications and drawbacks in our first center experience regarding VA ECMO.MATERIAL AND METHODS: This was a single-centre observational study that included 10 patients admitted with cardiogenic shock for which VA ECMO was used as mechanical circulatory support. RESULTS: The MAP increased after initiation of the support. It was 41.8 ± 9.3 mmHg and 59.5 ± 6.8 mmHg (P = 0.005). The use of VA ECMO support was associated with a statistically significant decrease in the base deficit (-10.6 ± 4.2 and -6.3 ± 7.4, P = 0.038). The serum lactate declined from 5.9 ± 3.5 mmoL/L to 0.6 ± 4.4 mmoL/L by the use of VA ECMO; a statistically significant change (P = 0.005).CONCLUSIONS: We concluded that VA ECMO as mechanical support for patients with cardiogenic shock might improve mean arterial blood pressure, base deficit and lactate clearance

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Association of inflammatory biomarkers with coronavirus disease 2019 severity: a retrospective study in the UAE

Background The inflammatory process involved in severe acute respiratory syndrome coronavirus 2 infection is one of great interest in understanding the pathophysiology and severity of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association of inflammatory markers with severe COVID-19. Patients and methods The data were collected from patient files admitted to two tertiary hospitals in UAE during the COVID-19 pandemic from April to July 2020. During first COVID-19 wave that hits UAE, general symptoms as well as radiographic, blood, and immunological findings were also recorded. Results The study included 320 patients. Men (84.1%) outnumbered women (15.9%). Most (73.8%) patients had no comorbidities. The patients were from several nationalities, with Indians being the majority (51.9%). Most patients (65.6%) had mild, whereas 26.6% had severe manifestations. Only 25 patients were asymptomatic. C-reactive protein level had a significant relation to COVID-19 severity. Some parameters such as lactate dehydrogenase, ferritin, D-dimer, neutrophil/lymphocyte ratio, ICU admission, and death rates as well as radiological findings in the severe group had significant differences compared with the mild and asymptomatic groups. Conclusions These data are valuable contributions to the monitoring, severity assessment, and prognosis of patients with COVID-19