Determination Of The Risk Factors Of Pneumonia And The Evaluation Of The Cost Effectiveness Of Current Treatment Approach For Bacterial Pneumonia In Children Five Years And Younger

Pneumonia is a major cause of morbidity and mortality especially in developing countries. The prevention of pneumonia and its later disabilities can be achieved by the reduction of risk factors and evaluating subjects of high risk. Risk factors evaluation was one of the three aims of this retrospective age and gender matched case control study. A total of 260 children five years and younger diagnosed with pneumonia according to ICD-10 were involved, 43% of them (n = 113) having pneumonia of viral origin and 57% (n = 147) having bacterial pneumonia. Pneumonia risk factors were determined using Chi-square and Binary Logistic Regression. Incomplete immunization found to be the most significant risk predictor among all the analyzed factors (OR = 3.71, p< 0.001)

Addressing the Burden and Management Strategies for Disparities and Inequities Among Liver Transplant Professionals: The ILTS Experience.

Medical professional environments are becoming increasingly multicultural, international, and diverse in terms of its specialists. Many transplant professionals face challenges related to gender, sexual orientation or racial background in their work environment or experience inequities involving access to leadership positions, professional promotion, and compensation. These circumstances not infrequently become a major source of work-related stress and burnout for these disadvantaged, under-represented transplant professionals. In this review, we aim to 1) discuss the current perceptions regarding disparities among liver transplant providers 2) outline the burden and impact of disparities and inequities in the liver transplant workforce 3) propose potential solutions and role of professional societies to mitigate inequities and maximize inclusion within the transplant community

Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey

BackgroundDespite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers.MethodsA digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers.ResultsOut of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (−3.1, p = 0.002).ConclusionCOVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The Effect of the Blue Ocean Strategy on Realizing the Above-Average Model: An Applied Study at Zain Telecommunications—The Case of Iraq

The current research aims to analyze the effect of the blue ocean strategy on the model of above-average returns for the purpose of realizing superior revenues for Zain Telecommunications. The research involved 60 officials who filled in a questionnaire that was prepared for this purpose. The data were analyzed by employing the correlation coefficient and regression analysis using SPSS v. 24. The research reached some conclusions, the most significant of which were the presence of a significant effect of the blue ocean strategy with its four principles: reduce, raise, eliminate and create in realizing superior returns (above-average) which were translated with its secondary principles: resources, potentials, competitive advantages, attractive industry, preparing and implementing the strategy, and realizing superior returns

Fracture Resistance of Endodontically Treated Maxillary Premolar Teeth Restored with Wallpapering Technique: A Comparative In Vitro Study

Objectives. This in vitro study aimed to evaluate and compare the fracture resistance and mode of failure of endodontically treated maxillary premolar teeth restored with different direct composite restorative techniques. Materials and Methods. Forty freshly extracted maxillary premolar teeth with comparable sizes were used in this in vitro study. Each tooth received mesio-occluso-distal cavity preparation (3 mm width and 6 mm depth) followed by endodontic treatment. Canals were instrumented with RACE EVO rotary files (FKG, Dentaire, Switzerland) up to MAF 25/.06. Canals were obturated using a single cone technique, then the teeth were divided arbitrarily into five groups (n = 8): Group A: direct composite resin only using a centripetal technique, Group B: direct composite resin with glass fiber post, Group C: direct composite resin with short fiber-reinforced composite (everX Flow), Group D: direct composite resin with leno wave ultra high molecular weight polyethylene (LWUHMWPE) fibers placed on cavity floor, and Group E: direct composite resin with LWUHMWPE fibers placed circumferentially around the cavity walls (wallpapering technique). The teeth were then stored in distilled water at 37°C for 24 hr. The fracture resistance of each sample was measured using a universal testing machine in Newton (N). The data were analyzed using one-way analysis of variance (ANOVA) and the Bonferroni test with a significance level of 0.05. Results. Group E recorded the maximum mean of fracture load (2,139.375 N), while Group A recorded the minimum mean of fracture load (689.6250 N). The one-way ANOVA test revealed a significant difference between the groups. The Bonferroni test showed a significant difference between each two groups, with the exception of those between Groups B and C and between Groups D and E, where there were no statistically significant differences (p>0.05). Conclusion. Restoration of endodontically treated teeth using the wallpapering technique recorded the highest mean of fracture resistance with a repairable mode of fracture

Analysis of equatorial rainfall characteristics by drop size distributions and rain rate-radar reflectivity relation

In remote sensing, it is vital to do a proper analysis of rainfall for the retrieval of rain data. The rain-induced attenuation and radar reflectivity mainly rely on drop size distribution (DSD). The rain rate-radar reflectivity (ZR) relation varies broadly over different climatic regions, rainfall regimes, and seasonal characteristics, especially in the tropical region. This study examines a one year of continuous measureements of DSD using ground-based distrometers at three different equatorial locations and investigates the rain types classification based on the microphysical properties of the rainfall. A large variation in the ZR relation parameters was discovered, highlighting the localized climate nature in the region. Additionally, the accumulated rain amounts were mainly influenced by convective rain although lower occurrence time of convective rain in comparison with stratiform rain