Strategic Value of Cloud Computing in Healthcare organisations using the Balanced Scorecard Approach: A case study from A Saudi Hospital

The evolution of Cloud Computing over the past few years has the potential to provide many benefits for healthcare organisations. However, healthcare organisations still need to discover the strategic values of adopting such a technology model. The paper discusses the strategic value of implementing Cloud Computing solutions in a Saudi hospital based on the Balanced Scorecard Approach. The paper also presents the strategy map and the KPIs that were used by the hospital. The results of this paper (KPIs, strategy map.) could act as guidelines for similar projects and similar organisations, while taking into consideration the uniqueness of each organisation

Soft Tissue Substitutes at Immediate Postextractive Implants to Reduce Tissue Shrinkage – 3-year Results From a Randomized Controlled Trial

PURPOSE. The aim of this parallel randomized controlled trial (RCT) was to evaluate whether placement of a soft tissue graft substitute (STGS) could decrease peri-implant tissue shrinkage at immediate post-extractive implants. MATERIALS AND METHODS. Twenty patients with one missing tooth between two adja-cent healthy teeth in aesthetic areas and at least 4 mm of bone apically to the tooth apex were randomly allocated after tooth extraction to receive or not a subepithelial buccal STGS. Implants were inserted with a torque of at least 30 Ncm and sites were grafted with a cancellous particulate allograft. Ten patients received a buccal STGS and 10 patients did not (control group). All patients were restored with non-occluding immediate provisional screw-retained crowns, replaced after 6 months by definitive metal-ceramic crowns, and were followed to 3-year after grafting/loading. RESULTS. Three-year after loading, no drop-out, crown or implant failure or complication occurred. No statistically significant difference or trends in aesthetics (difference = 0.2, 95% CI:-0.81 to 1.21; P = 0.97), peri-implant marginal bone loss (difference = 0.14 mm; 95% CI:-0.27 to 0.57; P = 0.58) and keratinized mucosa heights (difference = 0.8 mm; 95% CI:-1.79 to 3.39; P = 0.57) between the two groups were observed. CONCLUSIONS. Acknowledging that the sample size was small, no clinical benefits could be observed using a soft tissue graft substitute at immediate post-extractive implants up to 3-year after grafting. CONFLICT OF INTEREST STATEMENT. The manufacturer (BEGO Implant Systems, Bremen, Germany) of the implants used in this investigation, partially supported this trial, however data belonged to the authors and by no means the sponsor interfered with the conduct of the trial or the publication of its results

Self-consistent Green's function method for nuclei and nuclear matter

Recent results obtained by applying the method of self-consistent Green's functions to nuclei and nuclear matter are reviewed. Particular attention is given to the description of experimental data obtained from the (e,e'p) and (e,e'2N) reactions that determine one and two-nucleon removal probabilities in nuclei since the corresponding amplitudes are directly related to the imaginary parts of the single-particle and two-particle propagators. For this reason and the fact that these amplitudes can now be calculated with the inclusion of all the relevant physical processes, it is useful to explore the efficacy of the method of self-consistent Green's functions in describing these experimental data. Results for both finite nuclei and nuclear matter are discussed with particular emphasis on clarifying the role of short-range correlations in determining various experimental quantities. The important role of long-range correlations in determining the structure of low-energy correlations is also documented. For a complete understanding of nuclear phenomena it is therefore essential to include both types of physical correlations. We demonstrate that recent experimental results for these reactions combined with the reported theoretical calculations yield a very clear understanding of the properties of {\em all} protons in the nucleus. We propose that this knowledge of the properties of constituent fermions in a correlated many-body system is a unique feature of nuclear physics.Comment: 110 pages, accepted for publication on Prog. Part. Nucl. Phy

Hepatitis D double reflex testing of all hepatitis B carriers in low-HBV- and high-HBV/HDV-prevalence countries

Hepatitis D virus (HDV) infection occurs as a coinfection with hepatitis B and increases the risk of hepatocellular carcinoma, decompensated cirrhosis, and mortality compared to hepatitis B virus (HBV) monoinfection. Reliable estimates of the prevalence of HDV infection and disease burden are essential to formulate strategies to find coinfected individuals more effectively and efficiently. The global prevalence of HBV infections was estimated to be 262,240,000 in 2021. Only 1,994,000 of the HBV infections were newly diagnosed in 2021, with more than half of the new diagnoses made in China. Our initial estimates indicated a much lower prevalence of HDV antibody (anti-HDV) and HDV RNA positivity than previously reported in published studies. Accurate estimates of HDV prevalence are needed. The most effective method to generate estimates of the prevalence of anti-HDV and HDV RNA positivity and to find undiagnosed individuals at the national level is to implement double reflex testing. This requires anti-HDV testing of all hepatitis B surface antigen-positive individuals and HDV RNA testing of all anti-HDV-positive individuals. This strategy is manageable for healthcare systems since the number of newly diagnosed HBV cases is low. At the global level, a comprehensive HDV screening strategy would require only 1,994,000 HDV antibody tests and less than 89,000 HDV PCR tests. Double reflex testing is the preferred strategy in countries with a low prevalence of HBV and those with a high prevalence of both HBV and HDV. For example, in the European Union and North America only 35,000 and 22,000 cases, respectively, will require anti-HDV testing annually

The Neanderthal teeth from Marillac (Charente, Southwestern France): Morphology, comparisons and paleobiology

Few European sites have yielded human dental remains safely dated to the end of MIS 4/beginning of MIS 3. One of those sites is Marillac (Southwestern France), a collapsed karstic cave where archeological excavations (1967–1980) conducted by B. Vandermeersch unearthed numerous faunal and human remains, as well as a few Mousterian Quina tools. The Marillac sinkhole was occasionally used by humans to process the carcasses of different prey, but there is no evidence for a residential use of the site, nor have any hearths been found. Rare carnivore bones were also discovered, demonstrating that the sinkhole was seasonally used, not only by Neanderthals, but also by predators across several millennia. The lithostratigraphic units containing the human remains were dated to ∼60 kyr. The fossils consisted of numerous fragments of skulls and jaws, isolated teeth and several post-cranial bones, many of them with traces of perimortem manipulations. For those already published, their morphological characteristics and chronostratigraphic context allowed their attribution to Neanderthals. This paper analyzes sixteen unpublished human teeth (fourteen permanent and two deciduous) by investigating the external morphology and metrical variation with respect to other Neanderthal remains and a sample from modern populations. We also investigate their enamel thickness distribution in 2D and 3D, the enamel-dentine junction morphology (using geometric morphometrics) of one molar and two premolars, the roots and the possible expression of taurodontism, as well as pathologies and developmental defects. The anterior tooth use and paramasticatory activities are also discussed. Morphological and structural alterations were found on several teeth, and interpreted in light of human behavior (tooth-pick) and carnivores' actions (partial digestion). The data are interpreted in the context of the available information for the Eurasian Neanderthals

New strategies for the treatment of hepatitis C virus infection and implications of resistance to new direct-acting antiviral agents

Josep Quer1–3, Maria Buti1–3, Maria Cubero1–3, Jaume Guardia1–3, Rafael Esteban1–3, Juan Ignacio Esteban1–31Liver Unit, Internal Medicine Hospital Universitari Vall d’Hebron, Institut de Recerca (VHIR), Barcelona, Spain; 2Universitat Autònoma de Barcelona, Barcelona, Spain; 3Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, SpainAbstract: Persistent hepatitis C virus (HCV) infection is a leading cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma and the major indication for liver transplantation in adults. Current standard of care treatment (SOC) with pegylated-interferon-a 2 and ribavirin (RBV) has a limited efficacy and is associated with significant side effects frequently associated with poor compliance or treatment discontinuation, requiring specialized and frequent monitoring. To overcome the limited efficacy of SOC, more than 50 direct-acting antiviral agents (DAA) designed to target viral-encoded proteins essential in the HCV life cycle are currently under development. The rapid selection of resistant mutants associated with the quasispecies nature of HCV with high mutation and replication rates is one of the main challenges for the new HCV therapies. Predictive host and viral factors together with combination of DAAs with or without IFN and/or RBV need to be accurately evaluated to design the most effective individualized treatment strategy within the shortest time interval and with minimum side effects.Keywords: HCV, treatment, quasispecies, resistanc