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Dietary Patterns and Risk of Inflammatory Bowel Disease: Findings from a Case-Control Study 饮食模式与炎症性肠病的风险:一项病例对照研究的结果
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0082
R. Tayyem
Scientific evidence shows that dietary patterns are associated with the risk of IBD, particularly among unhealthy and Western dietary patterns. However, Western dietary patterns are not exclusive to Western countries, as Jordanians are steadily moving towards a Western lifestyle, which includes an increased consumption of processed foods. This study aims to investigate the association between dietary patterns and the risk factors for IBD cases among Jordanian adults. This case-control study was conducted between November 2018 and December 2019 in the largest three hospitals in Jordan. Three hundred and thirty-five Jordanian adults aged between 18–68 years were enrolled in this study: one hundred and eighty-five IBD patients who were recently diagnosed with IBD (n = 100 for ulcerative colitis (UC) and n = 85 for Crohn’s disease (CD)) and 150 IBD-free controls. Participants were matched based on age and marital status. In addition, dietary data was collected from all participants using a validated food frequency questionnaire. Factor analysis and principal component analysis were used to determine the dietary patterns. Odds ratios (OR) and their 95% confidence interval (CI) were calculated using a multinomial logistic regression model. Two dietary patterns were identified among the study participants: high-vegetable and high-protein dietary patterns. There was a significantly higher risk of IBD with high-protein intake at the third and fourth quartiles in the non-adjusted model as well as the other two adjusted models. In contrast, the high-vegetable dietary pattern shows a significantly protective effect on IBD in the third and fourth quartiles in all the models. Thus, a high-vegetable dietary pattern may be protective against the risk of IBD, while a high-protein dietary pattern is associated with an increased risk of IBD among a group of the Jordanian population.
科学证据表明,饮食模式与IBD的风险有关,特别是不健康的饮食模式和西方饮食模式。然而,西方的饮食模式并不是西方国家所独有的,因为约旦人正在稳步走向西方的生活方式,其中包括增加加工食品的消费。本研究旨在调查约旦成年人IBD病例的饮食模式和危险因素之间的关系。这项病例对照研究于2018年11月至2019年12月在约旦最大的三家医院进行。335名年龄在18-68岁之间的约旦成年人参加了这项研究:185名最近被诊断为IBD的IBD患者(溃疡性结肠炎(UC)患者为100人,克罗恩病(CD)患者为85人)和150名无IBD的对照组。参与者根据年龄和婚姻状况进行匹配。此外,通过有效的食物频率问卷收集了所有参与者的饮食数据。采用因子分析和主成分分析确定饮食模式。使用多项逻辑回归模型计算优势比(OR)及其95%置信区间(CI)。在研究参与者中确定了两种饮食模式:高蔬菜和高蛋白饮食模式。在非调整模型和其他两个调整模型中,高蛋白摄入的第三和第四个四分位数患IBD的风险明显更高。相反,在所有模型中,高蔬菜饮食模式在第三和第四个四分位数中对IBD显示出显著的保护作用。因此,在约旦人群中,高蔬菜饮食模式可能对IBD风险有保护作用,而高蛋白饮食模式与IBD风险增加有关。
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引用次数: 0
Pyocyanin pigment from Pseudomonas aeruginosa modulates innate immune defenses in macrophages 铜绿假单胞菌的Pyocyanin色素调节巨噬细胞的先天免疫防御
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0137
Yasmin A. Mahgoub, R. Arif, S. Zughaier
Background: Pseudomonas aeruginosa is a well-known opportunistic pathogen. The gram-negative bacillus, commonly associated with hospital-acquired infections, utilizes the host’s impaired immune responses to establish infection. Of its many virulence factors, pyocyanin is essential for P. aeruginosa to establish its full infectivity. Macrophages act as sentinels of the innate immune system, as well as play other roles in homeostasis, tissue remodeling, and bridging between the innate and adaptive immune systems. Aim: This study aimed to investigate the effects of pyocyanin on macrophage innate immune defenses by assessing the function of macrophages treated with pyocyanin and TLR ligands. Phagocytosis of opsonized zymosan, LPS-induced nitric oxide release and cytokine release were used as measures of functional responses. Results: This study found that pyocyanin inhibited phagocytosis-induced ROS release in a dose-dependent manner and reduced nitric oxide release from macrophages induced with P. aeruginosa LPS. In addition, pyocyanin modulated cytokines and chemokines release from macrophages exposed to P. aeruginosa LPS in a dose-dependent manner. Pyocyanin significantly enhanced IL-1β release as well as several chemokines. Therefore, pyocyanin facilitates Pseudomonas aeruginosa to persevere in the immunocompromised host through modulating macrophage’s innate immune defenses. Conclusion: Pyocyanin inhibits macrophage functional defense responses to facilitate Pseudomonas aeruginosa infection.
背景:铜绿假单胞菌是一种众所周知的条件致病菌。革兰氏阴性杆菌通常与医院获得性感染有关,它利用宿主受损的免疫反应来建立感染。在其众多的毒力因子中,绿脓杆菌是绿脓杆菌建立其完全感染性所必需的。巨噬细胞作为先天免疫系统的哨兵,在体内平衡、组织重塑以及先天免疫系统和适应性免疫系统之间的桥梁等方面也发挥着重要作用。目的:通过观察pyocyanin和TLR配体对巨噬细胞的作用,探讨pyocyanin对巨噬细胞先天免疫防御的影响。以调理酶的吞噬作用、lps诱导的一氧化氮释放和细胞因子释放作为功能反应的测量指标。结果:本研究发现,pyocyanin以剂量依赖的方式抑制吞噬诱导的ROS释放,并减少P. aeruginosa LPS诱导的巨噬细胞的一氧化氮释放。此外,花青素以剂量依赖的方式调节暴露于铜绿假单胞菌LPS的巨噬细胞的细胞因子和趋化因子释放。Pyocyanin显著提高IL-1β和几种趋化因子的释放。因此,pyocyanin通过调节巨噬细胞的先天免疫防御,促进铜绿假单胞菌在免疫功能低下的宿主中持续存在。结论:Pyocyanin抑制巨噬细胞功能防御反应,促进铜绿假单胞菌感染。
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引用次数: 1
Smart City and Preservation of Identity in Doha 多哈智慧城市与身份保护
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0199
Huzeyfe Altiok
The globalization and modernization process of the 20th-21st centuries decreased diversity and created similar cultures—the modern culture also created" modern" cities. Modern cities provided humanity the integration into production. Transportation, accommodation, and the other needs of people integrated into the output have been designed into those cities. However, later developments and research denote that the cities are not sustainable for the long term. Air pollution, water supply, food, and access to services are modern cities' main concerns. Therefore, a new development in the concept of cities was created, which is smart cities. The theory of smart cities provides the administrative power of a country with a well-established, sustainable, and smart development. The theory implemented in Doha is one example of the latest developed/developing cities. The limited population of Qatar and the significant wealth of natural gas provide them the means to establish a smart city. The main catch phrase for Qataris on that development project is “modernization with protecting the heritage.” This study examines Qatar's attempts to create Doha as an example of a smart city while protecting tradition and culture. The focus of that study will be the economic, societal, and environmental developments to denote the harmony of modernity and tradition in Doha. The research indicates that the Qatari administration builds Doha on three pillars: smart society, smart environment, and smart development.
20 -21世纪的全球化和现代化进程减少了多样性,创造了相似的文化——现代文化也创造了“现代”城市。现代城市为人类提供了融入生产的机会。交通、住宿和其他融入产出的人的需求被设计到这些城市中。然而,后来的发展和研究表明,这些城市不是长期可持续的。空气污染、供水、食品和服务是现代城市的主要问题。因此,在城市概念上创造了一个新的发展,这就是智慧城市。智慧城市理论为一个国家的行政权力提供了一个完善的、可持续的、智慧的发展。多哈实施的理论是最新的发达/发展中城市的一个例子。卡塔尔有限的人口和巨大的天然气财富为他们提供了建立智慧城市的手段。卡塔尔人对该开发项目的主要口号是“保护遗产的现代化”。本研究考察了卡塔尔在保护传统和文化的同时,试图将多哈打造为智慧城市的典范。该研究的重点将是经济、社会和环境发展,以表明多哈现代与传统的和谐。研究表明,卡塔尔政府以“智慧社会”、“智慧环境”、“智慧发展”三大支柱建设多哈。
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引用次数: 0
The prevalence of statin prescription for primary prevention of Arteriosclerotic Cardiovascular Diseases among patients with Type 2 Diabetes in Qatar 他汀类药物在卡塔尔2型糖尿病患者动脉硬化性心血管疾病一级预防中的患病率
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0098
Alaa Hasan Daban
Background: Qatar has one of the highest prevalence rates for diabetes in the world. Arteriosclerotic cardiovascular diseases (ASCVDs) are responsible for nearly 50% of deaths among patients with diabetes in Qatar. Treating with statins is a simple and effective approach for preventing ASCVD among patients with diabetes. Local and international guidelines recommend the use of statins for primary prevention of ASCVD in patients with diabetes, especially for those 40-75 years of age. Yet statins are still under-prescribed to diabetic individuals for primary prevention of ASCVD worldwide, especially in primary care settings which is where most of the medical management of diabetes occurs. Little is known about the prevalence of statin prescription for primary prevention of ASCVD among diabetics in primary care settings in Qatar. Objectives: To measure the proportion of T2dm patients receiving statins for primary prevention of ASCVD in primary care settings and to investigate patients’ characteristics associated with statin prescription. Results: Of 23,934 patients with complete data, 57% were males and 31.9% were Qatari nationals. Average age for participants was 54.8 ± 8.25 years. 66 % of the patients received statins at least once during the year 2019. The statin prescription rate for Non-Qatari males was 70.1% and was significantly higher than non-Qatari females, Qatari females, or Qatari males (62.2%, 62.9% and 63.9% respectively P value <0.000) In a multivariable model analysis and after controlling for other covariates in the model, statin prescription was positively associated with being male (adjusted odds ratio (aOR): 1.2, [95% CI: 1.12-1.28]), history of smoking, i.e. former smoker (aOR 1.16 [95% CI: 1.03-1.29]), current smoker (aOR 1.11 [95% CI: 1.01-1.22 ]), associated diagnosis of hypertension (aOR 1.51 [95% CI: 1.41-1.61]), being prescribed other non-statin lipids lowering medications (aOR 1.44 [95% CI: 1.27-1.63]), increased age (aOR 1.03/year [95% CI: 1.026-1.034]), increasing daily pill burden (aOR 1.23/pill [95% CI: 1.21-1.25]), increasing number of daily medication injections (aOR 1.29/injection [95% CI: 1.23-1.35]), and frequent visits to GP clinic (aOR 1.22/visit [95% CI: 1.19-1.24]). Statin prescription was negatively associated with having a history of diabetic neuropathy (aOR 0.87 [95% CI: 0.75-1.0]), increasing BMI (aOR 0.996/unit [95% CI: 0.9892-1.00]), being Qatari (aOR 0.87 [95% CI: 0.81-0.93]) or being prescribed an anti-platelet (aOR 0.96/unit [95% CI: 0.89-1.03]). Significant negative effect modification between hypertension and either male gender or Qatari nationality was found, further lowering the odds for Qatari males. Conclusion: Prevalence of statin prescription for primary prevention of ASCVD among patients with T2dm was suboptimal in primary care settings in Qatar and need to be improved. Factors associated with a lower prevalence of statin prescription namely female gender and Qatari nationality needs to be ad
背景:卡塔尔是世界上糖尿病患病率最高的国家之一。在卡塔尔,动脉硬化性心血管疾病(ascvd)占糖尿病患者死亡人数的近50%。他汀类药物治疗是预防糖尿病患者ASCVD的一种简单有效的方法。当地和国际指南推荐使用他汀类药物作为糖尿病患者ASCVD的一级预防,特别是40-75岁的糖尿病患者。然而,他汀类药物在世界范围内用于糖尿病患者ASCVD一级预防的处方仍然不足,特别是在初级保健机构中,这是大多数糖尿病医学管理发生的地方。在卡塔尔的初级保健机构中,他汀类药物处方用于ASCVD初级预防的流行程度尚不清楚。目的:测量在初级保健机构中接受他汀类药物一级预防ASCVD的2型糖尿病患者的比例,并调查与他汀类药物处方相关的患者特征。结果:在23,934例数据完整的患者中,57%为男性,31.9%为卡塔尔国民。参与者平均年龄为54.8±8.25岁。66%的患者在2019年至少接受过一次他汀类药物治疗。非卡塔尔男性的他汀类药物处方率为70.1%,显著高于非卡塔尔女性、卡塔尔女性和卡塔尔男性(分别为62.2%、62.9%和63.9% P值<0.000)。在多变量模型分析中,在控制了模型中的其他协变量后,他汀类药物处方与男性(调整优势比(aOR): 1.2, [95% CI: 1.12-1.28])、吸烟史(aOR 1.16 [95% CI: 1.16])呈正相关。1.03-1.29])、当前吸烟者(aOR 1.11 [95% CI: 1.01-1.22])、相关高血压诊断(aOR 1.51 [95% CI: 1.41-1.61])、正在服用其他非他汀类降脂药物(aOR 1.44 [95% CI: 1.27-1.63])、年龄增加(aOR 1.03/年[95% CI: 1.026-1.034])、每日服药负担增加(aOR 1.23/片[95% CI: 1.21-1.25])、每日药物注射次数增加(aOR 1.29/片[95% CI: 1.23-1.35])、频繁就诊GP诊所(aOR 1.22/次[95% CI: 1.22 -1.22])。1.19 - -1.24])。他汀类药物处方与糖尿病神经病变史(aOR 0.87 [95% CI: 0.75-1.0])、BMI升高(aOR 0.996/单位[95% CI: 0.9892-1.00])、卡塔尔人(aOR 0.87 [95% CI: 0.81-0.93])或服用抗血小板药物(aOR 0.96/单位[95% CI: 0.89-1.03])呈负相关。研究发现,高血压与男性或卡塔尔国籍之间存在显著的负相关改变,进一步降低了卡塔尔男性患高血压的几率。结论:在卡塔尔的初级保健机构中,他汀类药物用于2型糖尿病患者ASCVD一级预防的患病率尚不理想,需要改进。需要解决与他汀类药物使用率较低相关的因素,即女性和卡塔尔国籍。需要进一步的研究来探索卡塔尔他汀类药物处方率低的原因。
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引用次数: 0
Study of the In Vitro Biodegradation Behavior of Mg–2.5Zn–xES Composite for Orthopedic Application 骨科用Mg-2.5Zn-xES复合材料体外生物降解行为研究
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0097
A. Bahgat, P. Okonkwo, G. Manoj, N. Alqahtani, R. Shakoor, A. Abdullah
Non-degradable steel and titanium implants used to replace defects of the locomotor system or fabricate vascular stents provide maximum stability but have too many drawbacks. However; the defects in oxide layer and the corrosive nature of physiological environment, the thermodynamic tendencies make the alloys susceptible to release of cationic species in the form of corrosion, which result in triggering various biological factors and compromises the mechanical integrity of the implanted materials. Currently, biodegradable magnesium alloys are considered as promising materials for creation of fixation devices in orthopedics and cardiovascular surgery. In this work, zinc (Zn) and eggshell (ES) reinforced biodegradable magnesium alloy (Mg–2.5Zn), and environment concise (eco) composite (Mg–2.5Zn–xES) was fabricated using disintegrated melt deposition (DMD) technique. In vitro experiments were conducted to explore the effect variable concentration of ES ( 3 and 7 wt%) on the biodegradation behavior of Mg–Zn alloy using simulated body fluid (SBF) at 37 ℃. The corrosion behavior of the Mg–2.5Zn–xES alloys was explored in SBF solution using different techniques such as weight loss measurement, hydrogen evolution, potentiodynamic polarization, electrochemical Impedance Spectroscopy (EIS). EIS revealed increased in vitro degradation of the biodegradable magnesium alloy, and ecofriendly composite as the percentage of ES reinforcement was increased. X-ray diffraction (XRD) was performed to observe the chemical composition of elements and reaction products present in the degraded samples after the corrosion process.
不可降解的钢和钛植入物用于替代运动系统的缺陷或制造血管支架,提供了最大的稳定性,但有太多的缺点。然而;氧化层的缺陷和生理环境的腐蚀性、热力学倾向使合金容易以腐蚀的形式释放阳离子,从而引发各种生物因素,损害植入材料的机械完整性。目前,可生物降解镁合金被认为是制造骨科和心血管外科固定装置的有前途的材料。本文采用崩解熔融沉积(DMD)技术制备了锌(Zn)和蛋壳(ES)增强的可生物降解镁合金(Mg-2.5Zn)和环境简洁(eco)复合材料(Mg-2.5Zn - xes)。体外实验探讨了不同浓度ES (3 wt%和7 wt%)对37℃模拟体液(SBF)降解Mg-Zn合金行为的影响。采用失重测量、析氢、动电位极化、电化学阻抗谱(EIS)等方法研究Mg-2.5Zn-xES合金在SBF溶液中的腐蚀行为。随着ES增强率的增加,生物可降解镁合金和生态友好型复合材料的体外降解能力增强。通过x射线衍射(XRD)观察腐蚀后降解样品中元素和反应产物的化学组成。
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引用次数: 0
Artificial Intelligence assisted Prediction of COVID-19 Hotspots in Third Wave using EHTERAZ 基于EHTERAZ的人工智能辅助第三波疫情热点预测
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0156
Mustafa Ahmed, Mohammed Houkan, K. K. Sadasivuni
The present study conceptualizes fusion of artificial intelligence and contract tracking mobile application for predicting the COVID-19 hot spots. The findings suggest that mobile technology can be used to provide real-time data on the national and local state of the pandemic, enabling policy makers to make informed decisions in a quickly moving pandemic.
本研究将人工智能与合同跟踪移动应用程序融合,用于新冠肺炎热点预测。研究结果表明,移动技术可用于提供有关国家和地方大流行状况的实时数据,使决策者能够在迅速蔓延的大流行中做出明智的决定。
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引用次数: 1
Identification of a miRNA signature as a diagnostic and prognostic marker in renal cell carcinoma 鉴别一个miRNA标记作为肾细胞癌的诊断和预后标志物
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0109
M. A. Zahid, A. Agouni
Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC). If diagnosed in later stages, ccRCC is associated with high renal cancer related morbidity and poor prognosis. Recently, microRNAs (miRNAs) have attracted interest as potential diagnostic and prognostic biomarkers due to their important role in cancer development and progression. Availability of big omics data in the cancer genome atlas (TCGA) coupled with data mining and machine learning have revolutionized the identification of robust diagnostic and prognostic signatures in different types of cancers. In this study, we have utilized the miRNA sequencing data of 516 ccRCC patients from TCGA to identify a diagnostic and prognostic signature by using a combined approach of differential expression analysis, survival analysis and machine learning. Differential expression analysis identified 30 downregulated and 20 upregulated miRNAs in the primary tumor as compared to solid tissue normal samples. Out of these 50 differentially expressed miRNAs, higher expression of 7 and lower expression of 6 miRNAs were found to be significantly associated with poor survival when analyzed using the Kaplan-Maier survival method. Pathway enrichment analyses related to the differentially expressed miRNAs revealed that fatty acid biosynthesis was the most significantly enriched KEGG pathway while proteoglycans in cancer pathway was enriched by the highest number of survival-associated miRNAs target genes. Differential expression and association with poor survival was used as a prefilter for training a support vector machine model capable of classifying tumor samples from solid tissue normal samples with an accuracy and precision of 99.23% and 98.50%, respectively. We have identified here a nine-miRNA signature in ccRCC patients that is capable of segregating tumor from normal tissue samples with high accuracy and precision. The future validation of this classification model in in a clinical cohort will support translation of these findings into clinical practice for early detection and follow-up of ccRCC.
透明细胞肾细胞癌(ccRCC)是肾细胞癌(RCC)最常见的亚型。如果在晚期诊断,ccRCC与肾癌相关的高发病率和不良预后相关。最近,由于microRNAs在癌症发生和进展中的重要作用,其作为潜在的诊断和预后生物标志物引起了人们的兴趣。癌症基因组图谱(TCGA)中大组学数据的可用性,加上数据挖掘和机器学习,已经彻底改变了对不同类型癌症的可靠诊断和预后特征的识别。在这项研究中,我们利用来自TCGA的516例ccRCC患者的miRNA测序数据,通过差异表达分析、生存分析和机器学习相结合的方法来确定诊断和预后特征。差异表达分析发现,与实体组织正常样本相比,原发肿瘤中有30个下调的mirna和20个上调的mirna。在这50个差异表达的mirna中,当使用Kaplan-Maier生存法分析时,发现7个mirna的高表达和6个mirna的低表达与较差的生存显著相关。与差异表达的mirna相关的途径富集分析显示,脂肪酸生物合成是KEGG途径中最显著富集的途径,而癌症途径中蛋白聚糖被最多数量的生存相关mirna靶基因富集。使用差异表达和与生存差的关联作为预过滤器来训练支持向量机模型,该模型能够从实体组织正常样本中分类肿瘤样本,准确率和精密度分别为99.23%和98.50%。我们在ccRCC患者中发现了一个9 - mirna特征,能够以高精度和精密度将肿瘤从正常组织样本中分离出来。未来在临床队列中对该分类模型的验证将支持将这些发现转化为临床实践,用于ccRCC的早期发现和随访。
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引用次数: 0
Atmospheric Black Carbon over Qatar: Seasonal Variability and Source Apportionment 卡塔尔上空大气黑碳:季节变率和来源分配
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0041
Ersin Tutsak, Mohamed M. Mahfouz, I. Shahid
The earth’s atmosphere contains minute particles suspended within it. These atmospheric particles influence the earth's radiation budget through their ability to absorb and scatter radiation. Black carbon (BC) is a type of carbonaceous particle, characterized by highly absorbing solar radiation. Unlike sulfate and sea-salt aerosols, black carbon causes positive radiative forcing due to its absorbing nature. With the accumulation of greenhouse gases in the atmosphere, the average global temperature increased by 1.09°C (IPCC, 2021), between 1850-1900 and the last decade. Since black carbon is one of the major light-absorbing components of aerosol, there is a need to assess BC concentration, their origin, and the contribution of both human-induced combustion and biomass burning emissions to BC levels. In this study, four-year measurements of aerosol absorption at seven wavelengths were investigated in order to determine the daily and seasonal behavior of black carbon and contribution of fossil fuel (FF) and biomass burning (BB) emissions to total BC mass concentration in a suburban area located north of Doha. The highest concentrations of BC were observed during the winter and the lowest values during the summer. The absorption coefficient (Babs) at 470 nm (950 nm) showed large daily variability, ranging from 7 (3) to 187 (95) Mm-1. The mean Babs at 470 nm and 950 nm for the full period were 55± 29 Mm -1 and 25 ± 13 Mm -1, respectively. Fossil fuel emissions were found to be the major source of BC levels. Nonetheless, the influence of biomass burning should not be disregarded. Future studies must be done to fully identify the enhanced absorption in shorter wavelengths.
地球大气层中含有悬浮在其中的微小颗粒。这些大气粒子通过吸收和散射辐射的能力影响地球的辐射收支。黑碳(BC)是一种碳质粒子,具有高度吸收太阳辐射的特点。与硫酸盐和海盐气溶胶不同,黑碳由于其吸收特性而引起正辐射强迫。随着大气中温室气体的积累,从1850-1900年到最近十年,全球平均气温上升了1.09°C (IPCC, 2021年)。由于黑碳是气溶胶的主要吸光成分之一,因此有必要评估BC浓度、它们的来源以及人为燃烧和生物质燃烧排放对BC水平的贡献。在这项研究中,为了确定黑碳的日常和季节行为,以及化石燃料(FF)和生物质燃烧(BB)排放对多哈北部郊区总BC质量浓度的贡献,研究了为期四年的七个波长气溶胶吸收测量结果。BC浓度在冬季最高,夏季最低。吸收系数(Babs)在470 nm (950 nm)处表现出较大的日变化,变化范围为7 (3)~ 187 (95)Mm-1。在470 nm和950 nm处,整个周期的平均Babs分别为55±29 Mm -1和25±13 Mm -1。化石燃料排放被发现是BC水平的主要来源。尽管如此,生物质燃烧的影响不应被忽视。未来的研究必须充分确定短波长的增强吸收。
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引用次数: 0
A Framework for Time-Driven Activity-Based Costing for Orthopedic Procedure 骨科手术时间驱动的作业成本核算框架
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0116
Bayan Holozadah, S. Pokharel
This study used method of Time-Driven Activity-Based costing (TDABC) approach to examined cost reduction in healthcare sector, Knee Arthroplasty Department in Al-Emadi Hospital as case-study for delivering a primary knee arthroplasty consultation. The purpose of the study is to propose an optimization model that tends to determine significant and insignificant resources and cost uncertainties in a particular healthcare service. Then compare results of optimization model with current costing methods used in healthcare. Eight-steps of TDABC method are applied to obtain Capacity Cost Rate (CCR) of each human resource involved in care-delivery cycle. Data was collected from interviewing staff and patients, financial reports, and human resource reports. Multiple linear regression (MLR) model is used to test strength of relationship between time and cost variable. Optimization model applied to decrease uncertainties by using Least Square method. Optimized model showed that human resources are not fully utilized which leads to error in costing model. Seven human resources out of eight are significant to model. Accuracy of optimized model is equal to 3%, with RMSE equal to 6. Total cost of the optimized model equal $177,492.45 which is better simulate actual cost $180,048. The research value is about building a new statistical model using MLR analysis to predict behavior and data trend of main healthcare segmentation: Human Resource. Also, propose a generic optimization model that can be used for specific healthcare service costing.
本研究采用时间驱动的基于活动的成本核算(TDABC)方法来检查医疗保健部门的成本降低,Al-Emadi医院膝关节置换术科作为提供初级膝关节置换术咨询的案例研究。本研究的目的是提出一个优化模型,倾向于确定在特定的医疗保健服务显著和不显著的资源和成本的不确定性。然后将优化模型的结果与当前医疗成本计算方法进行比较。采用TDABC方法的8个步骤,得到了每个人力资源在护理提供周期中的能力成本率(CCR)。数据收集自对工作人员和患者的访谈、财务报告和人力资源报告。采用多元线性回归(MLR)模型检验时间与成本变量之间的关系强度。应用最小二乘法优化模型来减小不确定性。优化模型表明人力资源没有得到充分利用,导致成本计算模型出现误差。8个人力资源中有7个对模型很重要。优化后的模型精度为3%,RMSE为6。优化模型的总成本为$177,492.45,较好地模拟了实际成本$180,048。研究价值在于利用MLR分析建立新的统计模型来预测医疗保健主要细分市场:人力资源的行为和数据趋势。此外,提出可用于特定医疗保健服务成本计算的通用优化模型。
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引用次数: 0
Comparison of Available Methods for Investigating The in vitro Activity of Colistin Against Different Gram-Negative Bacilli 多粘菌素体外抗不同革兰氏阴性杆菌活性研究方法的比较
Pub Date : 2021-10-20 DOI: 10.29117/quarfe.2021.0121
Noora Shams, Hanin N. AlHiraky, Nabila Moulana, Maissa Riahihi, Kaltham Alsowaidi, Khawlah Albukhati, Susu M. Zughair, Nahla O. Eltai
Background: The surge in the prevalence of multidrug-resistant (MDR) Gram-negative bacterial infections with limited treatment options and the decrease in the development of new antibiotics are challenges that lead to the reuse of colistin to treat infections caused by MDR pathogens. This study aimed to determine economical, simple, and reliable colistin susceptibility testing methods as an alternative to the time and effort-consuming microdilution technique and identify the colistin resistance's genetic determinants to find if it affects the testing method. Material and Methods: Seven colistin susceptibility testing methods, namely, Disk diffusion, E-test, ComASPTM SensiTest, broth disk elution, colistin agar test, CHROMagarTM COL-APSE, and BD Phoenix ID/AST, were compared to the gold standard broth microdilution. Data of the 63 studied isolates were analyzed using very major error (VME), major error (ME), categorical agreement (CA), sensitivity, specificity, Kappa, positive and negative predictive values. Whole-genome sequencing was performed on all isolates to determine if the genetic resistant factors affect the accuracy of the specific colistin susceptibility testing method. Results: Our results revealed that disk diffusion is still an ineffective method for measuring colistin susceptibility with the highest ME (31.75%), the lowest Kappa 0 (0%), and CA (68.25%) values. In contrast, the highest sensitivity, specificity, CA, kappa value, positive and negative predictive values were reported on Phoenix, ComASPTM sensitest, and E-test methods compared with the microbroth dilution reference method. Our study did not ensure any relation between the type of colistin resistance genetic determinant (chromosomal/plasmid-mediated) and the performance of the specific colistin susceptibility test Conclusions: Phoenix, E-test, and CompASPT SensiTest methods have remained superior in reproducibility, sturdiness, simplicity of use with a performance similar to the current recommended BMD procedure. These methods can be an alternative to the current laborious, impractical broth microdilution technique, especially in microbiology laboratories with a large workload.
背景:多药耐药(MDR)革兰氏阴性细菌感染的流行率激增,治疗选择有限,新抗生素的开发减少,这是导致重复使用粘菌素来治疗多药耐药病原体引起的感染的挑战。本研究旨在确定经济、简单、可靠的粘菌素药敏检测方法,替代耗时费力的微稀释法,并确定粘菌素耐药的遗传决定因素,以确定其是否影响检测方法。材料与方法:采用纸片扩散法、E-test法、ComASPTM SensiTest法、肉汤纸片洗脱法、粘菌素琼脂法、CHROMagarTM coll - apse法、BD Phoenix ID/AST法与金标准肉汤微量稀释法进行比较。采用非常严重误差(VME)、严重误差(ME)、分类一致性(CA)、敏感性、特异性、Kappa、阳性预测值和阴性预测值对63株分离株的数据进行分析。对所有分离株进行全基因组测序,以确定遗传耐药因素是否影响特异性粘菌素药敏试验方法的准确性。结果:纸片扩散法仍然是测定粘菌素敏感性的无效方法,其ME值最高(31.75%),Kappa值最低(0%),CA值最低(68.25%)。与微肉汤稀释参比法相比,Phoenix法灵敏度最高,特异度最高,CA值、kappa值、阳性预测值和阴性预测值最高,ComASPTM法灵敏度最高,E-test法预测值最高。我们的研究没有确定粘菌素耐药性遗传决定因素(染色体/质粒介导)的类型与特异性粘菌素敏感性试验的性能之间的任何关系。结论:Phoenix、E-test和CompASPT SensiTest方法在重复性、可靠性、使用简单性方面仍然具有优势,其性能与目前推荐的BMD程序相似。这些方法可以替代目前费力,不切实际的肉汤微量稀释技术,特别是在工作量大的微生物实验室。
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引用次数: 1
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Building Resilience at Universities: Role of Innovation and Entrepreneurship
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