Health professionals are expected to be knowledgeable on disaster medicine and prepared to deal with medicine disasters. This study aimed to assess the level of knowledge, attitude, and readiness to ...practice disaster medicine among health care workers in the United Arab Emirates (UAE) and determine the influence of sociodemographic factors on the practice of disaster medicine. A cross-sectional survey conducted among various healthcare professionals in different healthcare facilities in the UAE. An electronic questionnaire was used and randomly distributed throughout the country. Data were collected from March to July 2021. The questionnaire consisted of 53 questions distributed among four sections: demographic information, knowledge, attitude and readiness to practice. The questionnaire distribution involved a 5-item of demographic information, a 21-item of knowledge, a 16-item of attitude and an 11-item of practice. A total of 307 (participation rate ~80.0%, n = 383) health professionals practicing in the UAE responded. Of these, 191 (62.2%) were pharmacists, 52 (15.9%) were physicians, 17 (5.5%) were dentists, 32 (10.4%) were nurses, and 15 (4.9%) were others. The mean experience was 10.9 years SD ±7.6 (median 10, IQR 4-15). The median (IQR) overall knowledge level was 12 (8-16) and the maximum knowledge level was 21. The overall knowledge level differed significantly between the age groups of the participants (p = 0.002). The median (IQR) of overall attitude was (57, 50-64) for pharmacists, (55, 48-64) for physicians, (64, 44-68) for dentists, (64, 58-67) for nurses, and (60, 48-69) for others. The total attitude score differed significantly between the different professional groups (p = 0.034), gender (p = 0.008) and workplace (p = 0.011). In terms of readiness to practice, respondents' scores were high and not significantly related to age (p = 0.14), gender (p = 0.064), professional groups (p = 0.0.762), and workplace (p = 0.149). This study showed that health professionals in the UAE have moderate levels of knowledge, positive attitudes, and high readiness to engage in disaster management. Gender and place of work can be considered as influencing factors. Professional training courses and educational curriculums related to disaster medicine can be beneficial to further reduce the knowledge-attitude gap.
Thrombus load in STEMI patients remains a challenge in practice. It aggravates coronary obstruction leading to impaired myocardial perfusion, worsened cardiac function, and adverse clinical outcomes. ...Various strategies have been advocated to reduce thrombus burden.
This meta-analysis aimed to evaluate the effectiveness of intracoronary-administered thrombolytics or glycoprotein IIb/IIIa inhibitors (GPI) in comparison with aspiration thrombectomy (AT) as an adjunct to percutaneous coronary intervention (PCI) among patients presenting with ST-segment elevation myocardial infarction (STEMI).
A comprehensive literature search for randomized trials that compared intracoronary-administered thrombolytics or GPI with AT in STEMI patients who underwent PCI, was conducted using various databases (e.g., MEDLINE, EMBASE, CENTRALE). Primary outcome was procedural measures (e.g., TIMI flow grade 3, TIMI myocardial perfusion grade (TMPG) 3, Myocardial blush grade (MBG) 2/3, ST-segment resolution (STR)).
Twelve randomized trials enrolled 1,466 patients: 696 were randomized to intracoronary-administered pharmacological interventions and 553 to AT. Patients randomized to PCI alone were excluded. Thrombolytics significantly improved TIMI flow grade 3 (odds ratio = 3.71, 95% CI: 1.85-7.45), complete STR (odds ratio = 3.64, 95% CI: 1.60-8.26), and TMPG 3 (odds ratio = 5.31, 95% CI: 2.48-11.36). Thrombolytics significantly reduced major adverse cardiovascular events (MACE) (odds ratio = 0.29, 95% CI: 0.13-0.65) without increasing bleeding risk. Trial sequential analysis assessment confirmed the superiority of thrombolytics for the primary outcome. Intracoronary GPI, either alone or combined with AT, did not improve procedural or clinical outcomes.
Compared with AT, intracoronary-administered thrombolytics significantly improved myocardial perfusion and MACE in STEMI patients.
Studies focused on comprehensive assessment of self-perceived competency of community pharmacists to manage minor ailments are scanty despite that self-perceived competency is a valid determinant of ...task performance. The objectives of the study were to assess community pharmacists' self-perceived competency to manage fourteen common minor ailments in Qatar, and identify its significant predictors. A cross-sectional assessment of 307 community pharmacists was conducted with a pre-tested 20-item questionnaire. Self-perceived competency was assessed with nine elements on a scale of 1-10 (Maximum obtainable score: Each minor ailment = 90; each element = 140). Mann-Whitney U and bivariate logistic regression were used for data analyses. The response rate was 91.9% (282/307). The majority of the respondents were males (68.1%; 192/282), within the age range of 31-40 years (55.3%; 156/282). The minor ailments with the highest median competency score were constipation (76), and cold/catarrh (75) while travel sickness (69), and ringworm (69) had the lowest. The two condition-specific competency elements with the highest median score were recommendation of over-the-counter (OTC) medicines (115), and provision of instructions to guide its use (115). Ability to differentiate minor ailments from other medical conditions had the lowest median competency score (109). The significant predictors self-perceived competency were female gender (OR = 2.39, 95%CI: 1.34-4.25, p = 0.003), and working for chain pharmacies (OR = 2.54, 95%CI: 1.30-4.96, p = 0.006). Overall, Community pharmacists' self-perceived competency was adequate for majority of the common minor ailments, and it was highest for constipation and cold/catarrh, and specifically for the recommendation of OTC medicines and provision of instructions to guide its use. However, diagnostic ability to differentiate minor ailments from other medical conditions with similar features had the lowest median competency score. Female gender and working in chain pharmacies were the significant predictors of self-perceived competency to manage minor ailments.
•The basics and algorithms of computer vision.•The role of deep learning and computer vision in tackling complexity in cities.•The application of computer vision in understanding cities ...to-date.•Challenges and opportunities for relying on computer vison in tackling urban issues.•Recommendations towards AI-generated urban policies.
Modelling urban systems has interested planners and modellers for decades. Different models have been achieved relying on mathematics, cellular automation, complexity, and scaling. While most of these models tend to be a simplification of reality, today within the paradigm shifts of artificial intelligence across the different fields of science, the applications of computer vision show promising potential in understanding the realistic dynamics of cities. While cities are complex by nature, computer vision shows progress in tackling a variety of complex physical and non-physical visual tasks. In this article, we review the tasks and algorithms of computer vision and their applications in understanding cities. We attempt to subdivide computer vision algorithms into tasks, and cities into layers to show evidence of where computer vision is intensively applied and where further research is needed. We focus on highlighting the potential role of computer vision in understanding urban systems related to the built environment, natural environment, human interaction, transportation, and infrastructure. After showing the diversity of computer vision algorithms and applications, the challenges that remain in understanding the integration between these different layers of cities and their interactions with one another relying on deep learning and computer vision. We also show recommendations for practice and policy-making towards reaching AI-generated urban policies.
Electrooxidation of urea was investigated by use of electrospun nanofibers through electrochemical impedance analyses (EIS) which is the best technique to study the electron transfer in anodic ...reactions. The effects of the fitting method, urea concentration and polarized potential on the impedance behavior are deeply studied to understand more about the anodic process of urea. The best-fitting equivalent circuit (Rh, R1/CPE1, R2/CPE2) should have two charge transfer processes in addition to electrolyte resistance, i.e., the formation of NiOOH and urea degradation. The Nyquist (Z/, -Z//) plots showed two semicircles in the presence of urea/KOH, which can be related to the conversion of Ni(OH)2 to NiOOH and urea oxidation at high and low-frequency regions, respectively. At higher urea contents, the electrode surface was covered by more urea beside OH−, and hence the Ni-activation process was decreased which interpreted the decreasing of oxidation at higher urea concentrations. Among the investigated polarized potentials, the best impedance behavior was observed at 0.40 V. The higher impedance behavior in the case of higher potentials can be interpreted via the adsorption of intermediates at the surface of the electroactive catalyst. The mechanism of electrooxidation was suggested deeply to understand the anodic behavior of urea-fuel cells.
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•The anodic process of direct-urea fuel cells was investigated by electrospun nanofibers through impedance analyses.•The estimated relaxation time of urea decomposition was higher than that of Ni-activation.•The ratio of KOH/urea should be more than 6 for high-efficiency anodic process.•The best-applied voltage is 0.4 V to study the urea electrooxidation via impedance analyses.•The deep mechanism for urea electrooxidation was suggested.
In the current study, a significant amount of ulvan was extracted from
Ulva
lactuca
collected from Alexandria coastline, Egypt, using a simple extraction method. According to the chemical analysis, ...the obtained polysaccharide content is estimated to be 36.50 g/100 g with a high sulfate content of 19.72%. Physio-chemically, the FTIR analysis confirmed the presence of sulfated groups attached to the carbohydrate backbone. The GC–MS results revealed the presence of various monosaccharides with relative abundances in the order: fucopyranose (22.09%) > L-rhamnose (18.17%) > L-fucose (17.46%) > rhamnopyranose (14.29%) > mannopyranose (8.59%) > α-D-glactopyranose (7.64%) > galactopyranose (6.14%) > β-arabinopyranose (5.62%). In addition, the SEM–EDX depicted an amorphous architecture with a majority wt% for the elements of C, O, and S. The partially purified ulvan demonstrated potent antimicrobial activity against some fish and human pathogenic microbes. The inhibition zone diameter ranged from 11 to 18 mm. On the other hand, the prepared ulvan-chitosan hydrogel significantly improved the antimicrobial activity as the inhibition zone diameter ranged from 12 to 20. Moreover, when compared to the controls, the extracted ulvan demonstrated anti-fouling properties and successfully disrupted the biofilm formed on a glass slide submerged in seawater.
Iron deficiency anaemia (IDA) is a major health issues and common type of nutritional deficiency worldwide. For IDA treatment, intravenous (IV) iron is a useful therapy. To determine the efficacy and ...cost-effectiveness (CE) of intravenous (IV) Ferric Carboxymaltose (FCM) versus IV Iron Sucrose (IS) in treating IDA. Electronic medical record i.e. Cerner.sup.® system. IV Ferric Carboxymaltose versus IV Iron Sucrose. With regard to responses to treatment i.e., efficacy of treatment with FCM & IS in IDA patients, hemoglobin (Hgb), ferritin, and transferrin saturation (TSAT) levels were the primary outcomes. Additionally, the researchers also collected levels of iron, platelet, white blood cell (WBC), red blood cell (RBC), mean corpuscular hemoglobin (MCH), and mean corpuscular volume (MCV). The costs i.e. resources consumed (obtained from NCCCR-HMC) and the CE of FCM versus IS were the secondary outcomes. There was a significant improvement in Hgb, RBC and MCH levels in the IS group than the FCM group. The overall cost of IS therapy was significantly higher than FCM. The medication cost for FCM was approximately 6.5 times higher than IS, nonetheless, it is cheaper in terms of bed cost and nursing cost. The cost effectiveness (CE) ratio illustrated that FCM and IS were significantly different in terms of Hgb, ferritin and MCH levels. Further, Incremental Cost Effectiveness Ratio (ICER) indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes. Not applicable. The higher cost of FCM versus IS can be offset by savings in healthcare personnel time and bed space. ICER indicated that further justifications and decisions need to be made for FCM when using Hgb, iron, TSAT, MCH and MCV levels as surrogate outcomes.
Photosynthesis is a fundamental biosynthetic process in plants that can enhance carbon absorption and increase crop productivity. Heat stress severely inhibits photosynthetic efficiency. Melatonin is ...a bio-stimulator capable of regulating diverse abiotic stress tolerances. However, the underlying mechanisms of melatonin-mediated photosynthesis in plants exposed to heat stress largely remain elucidated. Our results revealed that melatonin treatment (100 μM) in tomato seedlings increased the endogenous melatonin levels and photosynthetic pigment content along with upregulated of their biosynthesis gene expression under high-temperature stress (42 °C for 24 h), whereas heat stress significantly decreased the values of gas exchange parameters. Under heat stress, melatonin boosted CO2 assimilation, i.e., Vc,max (maximum rate of ribulose-1,5-bisphosphate carboxylase, Rubisco), and Jmax (electron transport of Rubisco generation) and also enhanced the Rubisco and FBPase activities, which resulted in upregulated photosynthetic related gene expression. In addition, heat stress greatly reduced the photochemical chemistry of photosystem II (PSII) and photosystem I (PSI), particularly the maximum quantum efficiency of PSII (Fv/Fm) and PSI (Pm). Conversely, melatonin supplementation increased the chlorophyll a fluorescence parameters led to amplifying the electron transport efficiency. Moreover, heat stress decreased the actual PSII efficiency (ΦPSII), electron transport rate (ETR) and photochemical quenching coefficient (qP), while increasing nonphotochemical quenching (NPQ); however, melatonin reversed these values, which helps to fostering the dissipation of excess excitation energy. Taken together, our results provide a concrete insight into the efficacy of melatonin-mediated photosynthesis performance in a high-temperature regime.
•Melatonin increased photosynthetic pigment contents and CO2 assimilation of tomato seedlings exposed to heat stress.•Melatonin protected the photosystem II and photosystem I reaction center and reduced photoinhibition under thermal stress.•Melatonin enhanced photosynthesis efficiency by elevating the Rubisco and FBPase enzyme activities.•Melatonin treatment efficiently enhanced the heat-induced reduction of chlorophyll a fluorescence photochemistry.
Modelling the spread of coronavirus globally while learning trends at global and country levels remains crucial for tackling the pandemic. We introduce a novel variational-LSTM Autoencoder model to ...predict the spread of coronavirus for each country across the globe. This deep Spatio-temporal model does not only rely on historical data of the virus spread but also includes factors related to urban characteristics represented in locational and demographic data (such as population density, urban population, and fertility rate), an index that represents the governmental measures and response amid toward mitigating the outbreak (includes 13 measures such as: 1) school closing, 2) workplace closing, 3) cancelling public events, 4) close public transport, 5) public information campaigns, 6) restrictions on internal movements, 7) international travel controls, 8) fiscal measures, 9) monetary measures, 10) emergency investment in health care, 11) investment in vaccines, 12) virus testing framework, and 13) contact tracing). In addition, the introduced method learns to generate a graph to adjust the spatial dependences among different countries while forecasting the spread. We trained two models for short and long-term forecasts. The first one is trained to output one step in future with three previous timestamps of all features across the globe, whereas the second model is trained to output 10 steps in future. Overall, the trained models show high validation for forecasting the spread for each country for short and long-term forecasts, which makes the introduce method a useful tool to assist decision and policymaking for the different corners of the globe.
Coronavirus Disease 2019 (COVID-19) is an evolving pandemic that urged the need to investigate various antiviral therapies. This study was conducted to compare efficacy and safety outcomes of ...darunavir-cobicistat versus lopinavir-ritonavir in treating patients with COVID-19 pneumonia.
This retrospective, multicenter, observational study was conducted on adult patients hospitalized in one of the COVID-19 facilities in Qatar. Patients were included if they received darunavir-cobicistat or lopinavir-ritonavir for at least three days as part of their COVID-19 treatments. Data were collected from patients' electronic medical records. The primary outcome was a composite endpoint of time to clinical improvement and/or virological clearance. Descriptive and inferential statistics were used at alpha level of 0.05. A total of 400 patients was analyzed, of whom 100 received darunavir-cobicistat and 300 received lopinavir-ritonavir. Majority of patients were male (92.5%), with a mean (SD) time from symptoms onset to start of therapy of 7.57 days (4.89). Patients received lopinavir-ritonavir had significantly faster time to clinical improvement and/or virological clearance than patients received darunavir-cobicistat (4 days IQR 3-7 vs. 6.5 days IQR 4-12; HR 1.345 95%CI: 1.070-1.691, P = 0.011). Patients received lopinavir-ritonavir had significantly faster time to clinical improvement (5 days IQR 3-8 vs. 8 days IQR 4-13; HR 1.520 (95%CI: 1.2-1.925), P = 0.000), and slower time to virological clearance than darunavir-cobicistat (25 days IQR 15-33 vs. 21 days IQR 12.8-30; HR 0.772 (95%CI: 0.607-0.982), P = 0.035). No significant difference in the incidence or severity of adverse events between groups. The study was limited to its retrospective nature and the possibility of covariates, which was accounted for by multivariate analyses.
In patients with COVID-19 pneumonia, early treatment with lopinavir-ritonavir was associated with faster time to clinical improvement and/or virological clearance than darunavir-cobicistat. Future trials are warranted to confirm these findings.
ClinicalTrials.gov number, NCT04425382.
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