25 research outputs found
bPolitical awareness of the Shi'ites in Lebanon : the role of Sayyid #Abd al-Husain Sharaf al-Din and Sayyid Musa al-Sadr.
Get PDFThe Lahawiyin: Identity and History in a Sudanese Arab Tribe
Get PDFThe Lahawiyin:
Identity and History in a Sudanese Arab Tribe
Tamador Ahmed Khalid Abdalla
Abstract
This thesis is concerned with the Lahawiyin of northern Sudan, and it explores
the relationship between identity and history in this Sudanese Arab tribe since
the late nineteenth century. The history of the Lahawiyin reveals continuous
crossings of borders and boundaries through a period of substantial political
and economic change, much of it driven by external forces.
The thesis demonstrates that the Lahawiyin Arab identity has been central to
the way that Lahawiyin leaders have sought to develop and maintain their
authority, and the ways in which ordinary Lahawiyin have tried to maintain a
particular way of life and patterns of social relations. Arab identity has been
used instrumentally to make claims or assert rights; but it has also shaped the
way in which Lahawiyin have understood their interests. The emphasis on
Arab identity has been closely linked to the prolonged campaign by some
Lahawiyin for a homeland (dar), and in the way that Lahawiyin have
negotiated their subordinate status within larger Arab confederations – first the
Kababish, then the Shukriyya. It has also shaped Lahawiyin relationships with
their own subordinates, particularly slaves. Though the Lahawiyin campaign
for a dar has not been successful, and their lifestyle of most Lahawiyin has
now changed irrevocably away from pastoralism, Arab identity has continued
to be important in current contests over the political status of potential leaders,
and the group as a whole.
The thesis makes use of a range of archival sources in the UK National
Archive, in Sudan Archive at Durham and at the National Records Office in
Khartoum. During the fieldwork various academic sources were consulted in
Khartoum and Gedarif which form an important aspect of the narratives
together with the many stories which were generated from the oral histories
told by the Lahawiyin.
Using these materials, the thesis discusses how the Lahawiyin, have utilized
their Arabness, and the way they present their history, to negotiate their status
with a series of regimes, from the Turco-Egyptian state of the nineteenth
century to the current regime of the National Congress Party
Diagnosing the Most Important Future Threats to the General External Environment on Iraqi and International Organizations Using PESTEL Analysis and Ways to Confront Them
Get PDFThe research aims at diagnosing the most important future threats to the general external environment on Iraqi and international organizations using (PESTEL) analysis and ways to confront them. Legal factors) since the field of research included all Iraqi and international organizations, and data and information were obtained from official reports issued by international organizations accredited in this field and to cover the field aspect of the research, the researchers used the scientific methodologies (deductive and inductive) in order to explain the research problem and find appropriate solutions to it, The research came out with a number of conclusions, the most important of which were:.
It is possible to diagnose the most important threats of the general external environment to Iraqi and international organizations and to develop appropriate solutions to confront them. However, these factors varied in importance, the most important of which is the economic factors that are the main driver for the other elements, especially the political ones.
The severity of these threats varies according to the PESTEL analysis and the adoption and integration of some of them with each other.
The research concluded with a number of proposals that would enhance the reality of Iraqi organizations and give them more competitive advantages in the labor market
Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study
No full text32324restrictedrestrictedDmitri Nepogodiev; Joana Ff Simoes; Elizabeth Li; Maria Picciochi; James C Glasbey; Glauco Baiocchi; Ruth Blanco-Colino; Daoud Chaudhry; Ehab AlAmeer; Kariem El-Boghdadly; Funmilola Wuraola; Dhruva Ghosh; Rohan R Gujjuri; Ewen M Harrison; Herman Lule; Haytham Kaafarani; Mohammad Khosravi; Irmgard Kronberger; Sezai Leventoğlu; Harvinder Mann; Kenneth A Mclean; Mengistu Gebreyohanes Mengesha; Maria Marta Modolo; Faustin Ntirenganya; Lisa Norman; Oumaima Outani; Riinu Pius; Peter Pockney; Ahmad Uzair Qureshi; April Camilla Roslani; Sohei Satoi; Catherine Shaw; Aneel Bhangu; Dmitri Nepogodiev; Omar M Omar; Waheed-Ul-Rahman Ahmed; Leah Argus; Alasdair Ball; Aneel Bhangu; Edward P Bywater; Ruth Blanco-Colino; Amanpreet Brar; Daoud Chaudhry; Brett E Dawson; Irani Duran; Muhammed Elhadi; James C Glasbey; Rohan R Gujjuri; Conor S Jones; Ewen M Harrison; Sivesh K Kamarajah; James M Keatley; Samuel Lawday; Elizabeth Li; Harvinder Mann; Ella J Marson; Kenneth A Mclean; Dmitri Nepogodiev; Lisa Norman; Riinu Ots; Oumaima Outani; Maria Picciochi; Irène Santos; Catherine Shaw; Joana Ff Simoes; Elliott H Taylor; Isobel M Trout; Chris Varghese; Mary L Venn; William Xu; Joana Ff Simoes; Irida Dajti; Arben Gjata; Salah Eddine Oussama Kacimi; Luis Boccalatte; Maria Marta Modolo; Daniel Cox; Peter Pockney; Philip Townend; Felix Aigner; Irmgard Elisabeth Kronberger; Elgun Samadov; Amer Alderazi; Kamral Hossain; Greg Padmore; Gabrielle van Ramshorst; Ismaïl Lawani; Anis Cerovac; Samir Delibegovic; Glauco Baiocchi; Gustavo Mendonça Ataíde Gomes; Igor Lima Buarque; Muhammad Gohar; Mihail Slavchev; Chukwuemeka Nwegbu; Arnav Agarwal; Amanpreet Brar; Janet Martin; Joshua Ng-Kamstra; Maria Marta Modolo; Maricarmen Olivos; Wenhui Lou; Dong-Lin Ren; Jose Andres Calvache; Carlos J Perez Rivera; Ana Danic Hadzibegovic; Tomislav Kopjar; Jakov Mihanovic; Pablo Mijahil Avilés Jiménez; Nikolaos Gouvas; Jaroslav Klat; René Novysedlák; Nicolas Amisi; Peter Christensen; Alaa El-Hussuna; Sylvia Batista; Eddy Lincango-Naranjo; Sameh Emile; Danilo Alfonso Arévalo Sandoval; Hailu Dhufera; Samuel Hailu; Mengistu G Mengesha; Joonas H Kauppila; Alexis P Arnaud; Zaza Demetrashvili; Markus Albertsmeier; Hans Lederhuber; Markus W Löffler; Daniel Kwesi Acquah; Bernard Ofori; Stephen Tabiri; Symeon Metallidis; Georgios Tsoulfas; Maria-Lorena Aguilera-Arevalo; Gustavo Recinos; Tamás Mersich; Dániel Wettstein; Dhruva Ghosh; Gabriele Kembuan; Peiman Brouki Milan; Mohammad Hossein Khosravi; Masoud Mozafari; Ahmed Hilmi; Helen Mohan; Oded Zmora; Gaetano Gallo; Francesco Pata; Gianluca Pellino; Yuki Fujimoto; Naoto Kuroda; Sohei Satoi; Mohamad K Abou Chaar; Faris Ayasra; Ildar Fakhradiyev; Intisar Hisham Said Hamdun; Jang Jin-Young; Mohammad Jamal; Lina Karout; Muhammed Elhadi; Aiste Gulla; Fanjandrainy Rasoaherinomenjanahary; Luc Hervé Samison; April Camilla Roslani; Iran Irani Durán Sánchez; Diana Samantha Gonzalez; Laura Martinez; María José Martínez; Alejandra Nayen; Antonio Ramos-De la Medina; 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Stefan Welter; Karine Nikolaieva; Andreas Roth; Judith Lindert; Konstantinos Gousias; Anke Rissmann; Valerie Catherine Linz; Nuh Rahbari; Marie-Claire Rassweiler-Seyfried; Anna Eleonora Gut; Jens Gempt; Daniel Reim; Arthur Wagner; Markus Albertsmeier; Alexander M Keppler; Mircea Gabriel Stoleriu; Tim Saier; Josef Stadler; Julia Christina Kaiser; Stefan M Brunner; Karin Pfister; Jonas Herzberg; Kai Nowak; Tobias Reinhard; Gregor A Stavrou; Alfred Königsrainer; Christian Konrads; Markus Quante; Simon Laban; Silke von Pusch; Markus Hirschburger; Johannes Doerner; Armin Wiegering; Ekaterini Christina Tampaki; Alitza Gutiérrez Ruiz; Alejandra Rodas; Ana Lucía Portilla; Gustavo Recinos; Maria-Lorena Aguilera-Arevalo; Jacqueline Carrera; Amalia Barrios Duarte; Megan Lowey; Sabrina Barillas; Atul Suroy; Dhaivat Vaishnav; Raghunandan Gorantlu Chowdappa; Irappa Madabhavi; Dhananjaya Bhat; Sunil Kumar Venkatappa; Sumit Thakar; Kavitha Jain; Aruna Kumar; Manoj Nagar; Tushar Mishra; Arunkumar Sekar; Anand Gupta; Lileswar Kaman; Madhivanan Karthigeyan; Manjul Tripathi; Ashwin Rammohan; Sudheer Othiyil Vayoth; Anupama Rajanbabu; Anbukkani Subbian; Rahul Gupta; Monish Raut; Nissi Evelyn; R Lavanya Kannaiyan; Anil Matai; Sanjeev Misra; Vishal Bhende; Sathish Muthu; Indranil Ghosh; Abhishek Sharma; Ankur Bajaj; Shiv Rajan; Gaurav Agarwal; Pranay Pawar; Philip Alexander; M Vijayakumar Vijayakumar; Zeeshan Hameed; L Badareesh; Navneet Kumar Chaudhry; Lipika Baliarsing; Satish Dharap; Amruta Kulkarni; Yuvaraja Thyavihally; Rahul Deo Sharma; C S Pramesh; Rajesh Soni; Surya Kumar Dube; Shilpa Sharma; Harvinder Singh; Lovenish Bains; Rahul Ghodke; Ashwani Kumar; Vivek Sodhai; Suvendu Maji; Somprakas Basu; Chandrashekhar Mahakalkar; Ravi Kannan; Asif Mehraj; N Ranganath; Ashish Phadnis; I Yadev; Alfie Kavalakat; Rohin Mittal; Karthik Chandra Vallam; Hamed Akhavizadegan; Esmaeil Rezghi Maleki; Naser Yousefzadeh Kandevani; Hilary Ikele; Catherine McNestry; Christina Fleming; Stephen O'Brien; Sami Abd Elwahab; 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Faraj Al Maadany; Ghadah Alkadeeki; Milad Gahwagi; Wafa Aldressi; Mohamed Amnaina; Arowa Hassan Abdulrahman Alansari; Akram Alkaseek; Ghozlan Yagoub; Anass Ben Amer; Marwa Salem; Ayman Almugaddami; Dania Burgan; Mohammed Abdelkabir; Khayriyah Alshareef; Rayet Al Islam Ben Jouira; Ayman Meelad; Ahmad Bouhuwaish; Sumayya Essayah Dwaga; Houda Khalifa; Bushray Almiqlash; Taha Suliaman; Mohammed Alawami; Fras Elhajdawe; Hajir Aboazamazem; Ibrahim Ellojli; Ahmed Msherghi; Ismail Ali Saleh; Mohammed Alayan; April Camilla Roslani; Marcel Didier Ndayishyigikiye; Akutu Munyika; Philipp Plarre; David W Borowski; Pueya Rashid Nashidengo; Milou Noltes; Pieter Steinkamp; Cameron Wells; Rebecca Teague; Brodie Elliott; David Kieser; Omar Mohyieldin; Chris Varghese; Nick McIntosh; Cheyaanthan Haran; Sarah Rennie; Jasmin King; Jeong Ha; Matthew James McGuinness; Opeoluwa Adesanya; Julius Olaogun; Akinola Akinmade; Kefas Bwala; Peter Agbonrofo; Akinwale Afolabi; Usang Usang; Sebastian Ekenze; Samson Olori; Taiwo Akeem Lawal; Justina Seyi-Olajide; Abiodun Okunlola; Omolara Williams; Adewale Adisa; Lukman Abdur-Rahman; Stephen Kache; Danjuma Sale; Lofty-John Anyanwu; Chukwuma Okereke; Musliu Adetola Tolani; Venko Filipce; Lazar Todorovic; Sofija Pejkova; Sotir Stavridis; John George Massoud; Sareyah Alsibai; Rizwan Sultan; Humera Naz Altaf; Abu Bakar Hafeez Bhatti; Shahzad Hussain Waqar; Aliya Aziz; Asad Ali Kerawala; Lajpat Rai; Mariyah Anwer; Aiman Tariq; Bushra Ayub; Sami Ullah Niazi; Muhammad Yasir Naseem; Muhammad Zeeshan Sarwar; Muhammad Imran Khokhar; Imdad Ahmad Zahid; Haroon Javaid Majid; Nabila Talat; Muhammad Asif; Muhammad Hamid Chaudhary; Umer Farooq; Siddique Ahmad; Waleed Mabood; Syed Imran Bukhari; Muhammad Tariq; Eesha Yaqoob; Saad Javed; Saad Javed; Muhammad Usman Malik; Hassan Nawaz Yaqoob; Moises Cukier; Glenda Marina Falcon Pacheco; Robinson Mas Melendez; Arazzelly Del Pilar Paucar Urbina; Jose Rios Chiuyari; Carlos Eduardo Otiniano Alvarado; Lorena Fuentes Rivera Lau; Giuliano Borda-Luque; Milagros Niquen-Jimenez; Claudia Arias; Sergio Zegarra; Jenner Betalleluz Pallardel; Regina Amparo Ugarte Oscco; Gian Mendiola; Yahaira Tatiana Carpio Colmenares; Carlos Shiraishi Zapata; Maria Rosa Ortiz; Marie Dione Sacdalan; Piotr Major; Filipe Castro Borges; Octavio Viveiros; Pedro Serralheiro; Paulo Santos-Costa; Filipa Mendes; Miguel Rocha Melo; Paulo Cardoso; Ana Soares; José Azevedo; Rita Gonçalves Pereira; Nelson Silva; André Caiado; Maria Luís Sacras; Pedro Azevedo; Rui Almeida-Reis; Miguel F Cunha; João Oliveira; Jorge Nogueiro; Mafalda Sampaio-Alves; Luciana Cidade Costa; Catarina Baía; Ana Cláudia Deus; Rita Branquinho; André Marçal; André Tojal; Ahmad Zarour; Ahmad Zarour; Silviu Tiberiu Makkai-Popa; Aurel Mironescu; Florin Grama; Elena Adelina Toma; Ionut Negoi; Daniela Filipescu; Nicolae Bacalbasa; Natalia Motas; Sebastian Ionescu; Octav Ginghina; Radu Costea; Narcis Octavian Zarnescu; Radu Drasovean; Eduard-Alexandru Bonci; Mihail-Gabriel Dimofte; Vlad Porumb; Mikhail Kirov; Yegor Molitvin; Andrey Litvin; Vadim Pykhteev; Marianna Raevskaya; Sergey Efetov; Aleksandr Butyrskii; Mushabab Alshahrani; Azah Althumairi; Nasser Alzerwi; Ahmed Al Ameer; Ahmed Al Ameer; Tariq Madkhali; Abddulrahman Saleh Almulhim; Salman Ghazwani; Abdu Ayoub; Othman Iskander; Mohammed Ghunaim; Mohammed Alharthi; Turki M Alzaidi; Azah Althumairi; Mohammad Alyami; Abdulrahman Al Amri; Azah Althumairi; Abdullah AlFakhri; Amal Alhefdhi; Sharfuddin Chowdhury; Thamer Nouh; Ameen Alshehri; Abdulrahman Alzahrani; Yousef Alalawi; Selmy Awad; Ibrahima Konate; Abdourahmane Ndong; Jacques Tendeng; Nan Zun Teo; Frederick Koh; Jurij Aleš Košir; Uros Bele; Sabra Aqil; Cristina Barrena López; Ana Sánchez Mozo; Antonio Rodriguez Infante; Patricia Caja Vivancos; Mikel Prieto; Igor Alberdi San Roman; Laura Gomez Fernandez; Josep Maria Muñoz Vives; Anna Carreras-Castañer; Berta Díaz-Feijoo; Ramon Sieira-Gil; Victor Turrado-Rodriguez; Anna Sánchez López; Santiago Sánchez-Cabús; Marta Jimenez Toscano; MªPilar Canals Sin; Saura García Laura; Oriol Martin Sole; Pedro Palazon Bellver; Sonia Pérez-Bertólez; Jordi Prat-Ortells; Mireia Riba Martínez; Josep Rubio-Palau; Xavier Tarrado; Jorge Nuñez; Veronica Alonso Mendoza; Coro Bescós; Eloy Espin-Basany; Martin Espinosa-Bravo; Daniel Gil-Sala; Susana González-Suárez; Nuria Montferrer Estruch; Jorge Nuñez; Lucia Porteiro Mariño; Ana Rodríguez-Tesouro; Fabian Rojas Portilla; M Pilar Tormos Pérez; Inmaculada Vives; Unai Garcia De Cortazar; Kiara Tudela; Aitor Landaluce-Olavarria; Mercedes Estaire Gómez; Jorge Almoguera; Bakarne Ugarte-Sierra; Virginia Jimenez; Marta Bertrand; Laura Cárdenas Puiggrós; Olga Delisau-Puig; Jorge Garcia-Adamez; David Julià Bergkvist; Eloy Maldonado-Marcos; Lucia Diego García; Marta Roldón Golet; Iván Soto-Darias; Aida Cristina Rahy-Martín; Diego Enjuto; Adolfo Ramos-Luengo; Juan Delgado Fernandez; Carolina Lugo Duarte; Cristina Ojeda Thies; Lucila Marquez; Diana Crego Vita; Jana Dziakova; Ana Maria Minaya Bravo; Jorge Caño Velasco; Olga Mateo-Sierra; Begoña Quintana-Villamandos; Cristina Rey Valcarcel; Javier Rio; Laura Román García de León; Marcello Di Martino; Jorge Prada; Javier Serrano González; Manuel Losada; Jose Tomas Castell Gomez; Ramon Corripio-Sanchez; Alexander Forero-Torres; José Manuel Morales-Puebla; Hanna Perez-Chrzanowska; Santiago Valderrabano Gonzalez; Alvaro Yebes; Ignacio Zapardiel; Manuel Diez Alonso; Nelson Morales Palacios; Alberto Cabañero Sánchez; Fátima Sánchez Fernández; Alfredo Abad Gurumeta; Ane Abad-Motos; Fernando Corella; Javier Ripollés-Melchor; Rosa Sanz-Gonzalez; Marta Alcaraz Fuentes; Maria Teresa Fernández Martín; Pablo Calvo Espino; Milagros Carrasco Prats; Antonio-José Fernández-López; Damián García Escudero; Vanesa Garcia Soria; Jesús Aarón Martínez Alonso; Miguel Ruiz-Marín; Beatriz Gómez Pérez; Joaquin Moya-Angeler; Daniel Fernández Martínez; Heura Llaquet Bayo; Enrique Colás-Ruiz; Susana Bella Romera; M Teresa Gavaldà Pellicé; Misericòrdia Jordà Solé; Enrique Jose Ruiz Velasquez; Bernardo Núñez; Raul Jimenez; Jon Zabaleta; Maria Jose González-Gimeno; Irene Ortega Vázquez; Antonio Perez Ferrer; Rubén Martín-Láez; Marcelo Moreno Suarez; Miguel Angel Freiria Eiras; Irene Ramallo-Solís; Juan-Carlos Gomez-Rosado; Jose Ramon Oliver Guillen; Mar Achalandabaso Boira; Juan Carlos Catalá Bauset; Julio Domenech; Rafael Badenes; Juan Carlos Bernal-Sprekelsen; Jorge Sancho-Muriel; Beatriz De Andrés-Asenjo; Francisco J Tejero-Pintor; Marc Vallve-Bernal; Alba Vazquez Melero; Laura Sánchez Blasco; Jorge Escartin; Victoria Duque Mallén; Selvaratnam Srishankar; Umesh Jayarajah; Charitha Sooriyabandara; Oshan Basnayake; Nalaka Gunawansa; Dakshitha Wickramasinghe; Prabuth Dulanjan Weeraddana; Thanusan Vimalakanthan; Shanthamoorthy Gishanthan; Pramodh Chandrasinghe; Eleftherios Gialamas; Marc-Olivier Sauvain; Ahmad Ghazal; Yusra Al-Sabbagh; Turki Alhassoun; Sara Maa Albared; Antoine Naem; Hareth Alnahr; Ghassan Jisry; Ali Hammed; Arda Isik; Okedi Francis Xaviour; Gaston Turinawe; Isaac Mubezi; Franck K Sikakulya; Andrew Kakeeto; Wilberforce M Kabweru; Hervé Monka Lekuya; Ronald Kiweewa; Herman Lule; Paul Matovu; Otolia Isaac; Mohamed Mashhour; Amin El Helw; Sattar Alshryda; Safeena Kherani; Awadelkarim Mohamed; Ferial Mohamed Ali Abbas; Diary Mohammed; Ehab Aldlyami; Rakesh Kundra; Mohamed Mashhour; Mohamed Mashhour; Antony Louis Rex Michael; Hayder Alsaadi; Kareem S Khalil; Rachel Dbeis; Shafaque Shaikh; Jenny Ferry; Aiman Jamal; Haleema Siddique; Rishi Das; Nikhil Ponugoti; Sivesh K Kamarajah; Pornjittra Rattanasirivilai; Asma Sultana; Frances Mosley; Matthew Chan; Antony Bateman; Gareth Davies-Jones; Fanourios Georgiades; Grant D Stewart; Navid Ahmadi; Aman Coonar; Mariam Baig; Chetan Khatri; Arthika Surendran; Julian Sonksen; Robert Sinnerton; Caitlin Brennan; Gemma Faulkner; Michael Greenhalgh; Hannah Emerson; Kiran Singisetti; Joshua Totty; Michael Wilson; Terence Lo; Harriet Corbett; Ijeoma Okonkwo; Gill Arbane; Kariem El-Boghdadly; Cyrus Kerawala; Chetan Parmar; Tom Abbott; Michael Bath; Funlayo Odejinmi; Jayesh Sagar; Rishi Talwar; Samuel Newman; John Hammond; John Moir; Natalie Duric; Tamas Szakmany; Ahmar Iftikhar Talib; Mina Youssef; Christopher Lewis-Lloyd; Christopher Lewis-Lloyd; Mariam Lami; Khurram Ayub; Benjamin Dean; Supriya Balasubramanya; Sathya Lakpriya; Luke Rogers; Paul Turner; Mark Maher; Kohila Sigamoney; John Edwards; Jihène El Kafsi; John Hardie; David Johnson; Christin Henein; Marianne Hollyman; Ketan Agarwal; Simon Powell; Govind Singh Chauhan; Rakesh Patel; Joel Gagnier; Heather Carmichael; Aurora; Kristofor A Olson; Eric Etchill; Joseph Incorvia; Sameer Hirji; Matthew Naunheim; Frederick Drake; Haytham Kaafar
Development of techno-industrial platform for large scale production of biotechnology based for dengue control
Get PDFNowadays, Dengue fever is one ofthe major epidemic diseases in urban, semi-urban, and rural areas in tropical and subtropical countries. This mosquito transmitted viral disease is considered as fastest transmitted mosquito disease and spread in over 100 countries. Based on WHO report in 2QI0, Southeast Asia (SEA) and Western Pacific (WP) regions bear nearly 75% of current disease population. This disease is transmitted using two species of mosquitoes, the main vector Aedes aegypti (L.) and the less competent vector A. albopictus. For many years, controlling dengue disease is carried out through killing the mosquito larvae. This is usually carried out by using chemical methods which cause many enviromnental problems and human and animal toxicity. Another approach was developed by using the biological control agent Bacillus thuringiensisI var israelensis as specific and safe larvicidal agent. However, after many years application, some resistance varieties were developed and thus decrease the agent efficiency. More recently, based on the many years and innovative research in University of Florida in USA, a newly discovered protein called Trypsin Modulating Oostatic Factor (TMOF) showed strong larvicidal activity in aquatic Enviromnent. TMOF consist of 10 amino acid sequence ofthe hormone (YDPAPPPPPP) kuown as mosquito decapeptide. The hormone synthesized by the ovaries after the blood meal, circulates in the hemolymph, binds to gut receptor and stops trypsin biosynthesis. A unique primary and stable amino acid from gut proteolytic enzymes that can interferes with digestion of mosquito larvae, leading to their starvation by termination of trypsin biosynthesis in their midgut. No harm to humans or the enviromnent is expected from use of TMOF as a pesticide active ingredient. The genes for making TMOF have been inserted into yeast cells (Pichia pastoris) so the yeast cells make large amounts of the protein. The yeast cells are then killed by exposure to extremely high temperatures. Killed yeast cells containing TMOF are applied to bodies of water to control mosquito larvae. Once eaten by mosquito larvae, TMOF interferes with the production of trypsin, a critical enzyme needed by the larval digestive system. Exposed larvae are unable to digest food and therefore starve to death. Since late 2008, Institute of Bioproduct Development (IBD) at Universiti Teknologi Malaysia (UTM) is working in long term strategic partner for EntoGenex Co. (the TMOF technology owner) for technology transfer, bioprocess development, large scale production, and final product formulation. The IBD bioprocessing microbial platform is a complete integrated upstream/downstream platform to complete the process and production chain from microbe vial to finished product. IBD is currently the first and biggest bioprocessing facilities among Malaysian universities and the currently the only approved facility by Genetic Modification Advisory Committee (GMAC) under the Biosafety Act 2007 for running living modified organism (LMO) for large scale production up to 1500 L fermentation capacity. The current presentation, will present the successful story of cooperation between IBD and biotechnology companies to produce highly demanded high technology product to solve big • health problem in National, regional, and international agenda. At first, IBD was worked as technology transfer hub and cell banking of the recombinant strain and improved the process oflarge scale production ofTMOF by recombinant P. pastoris. Second, a new process for high cell mass production for Bacillus thuringiensis var israelensis was developed to be used as complementary active ingredient in the final product formula. Third, IBD acted as final product formulation laboratory for the production ofwetable powder form and rice husk based formula for field trial. After all these many years successful cooperation, we act as large scale production platform for the company to cope with the world wide growing demand of the product and we work closely with the company to establish a larger scale production facility for bioactive ingredient production and formulation to cope with the high demand ofboth local and international markets
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
Get PDFnone10020SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.openNepogodiev, Dmitri; Simoes, Joana FF; Li, Elizabeth; Picciochi, Maria; Glasbey, James C; Baiocchi, Glauco; Blanco‐Colino, Ruth; Chaudhry, Daoud; AlAmeer, Ehab; El‐Boghdadly, Kariem; Wuraola, Funmilola; Ghosh, Dhruva; Gujjuri, Rohan R; Harrison, Ewen M; Lule, Herman; Kaafarani, Haytham; Khosravi, Mohammad; Kronberger, Irmgard; Leventoğlu, Sezai; Mann, Harvinder; Mclean, Kenneth A; Mengesha, Mengistu Gebreyohanes; Modolo, Maria Marta; Ntirenganya, Faustin; Norman, Lisa; Outani, Oumaima; Pius, Riinu; Pockney, Peter; Qureshi, Ahmad Uzair; Roslani, April Camilla; Satoi, Sohei; Shaw, Catherine; Bhangu, Aneel; Nepogodiev, Dmitri; Omar, Omar M; Ahmed, Waheed‐Ul‐Rahman; Argus, Leah; Ball, Alasdair; Bhangu, Aneel; Bywater, Edward P; Blanco‐Colino, Ruth; Brar, Amanpreet; Chaudhry, Daoud; Dawson, Brett E; Duran, Irani; Elhadi, Muhammed; Glasbey, James C; Gujjuri, Rohan R; Jones, Conor S; Harrison, Ewen M; Kamarajah, Sivesh K; Keatley, James M; Lawday, Samuel; Li, Elizabeth; Mann, Harvinder; Marson, Ella J; Mclean, Kenneth A; Nepogodiev, Dmitri; Norman, Lisa; Ots, Riinu; Outani, Oumaima; Picciochi, Maria; Santos, Irène; Shaw, Catherine; Simoes, Joana FF; Taylor, Elliott H; Trout, Isobel M; Varghese, Chris; Venn, Mary L; Xu, William; Simoes, Joana FF; Dajti, Irida; Gjata, Arben; Kacimi, Salah Eddine Oussama; Boccalatte, Luis; Modolo, Maria Marta; Cox, Daniel; Pockney, Peter; Townend, Philip; Aigner, Felix; Kronberger, Irmgard Elisabeth; Samadov, Elgun; Alderazi, Amer; Hossain, Kamral; Padmore, Greg; Ramshorst, Gabrielle; Lawani, Ismaïl; Cerovac, Anis; Delibegovic, Samir; Baiocchi, Glauco; Gomes, Gustavo Mendonça Ataíde; Buarque, Igor Lima; Gohar, Muhammad; Slavchev, Mihail; Nwegbu, Chukwuemeka; Agarwal, Arnav; Brar, Amanpreet; Martin, Janet; Ng‐Kamstra, Joshua; Modolo, Maria Marta; Olivos, Maricarmen; Lou, Wenhui; Ren, Dong‐Lin; Calvache, Jose Andres; Perez Rivera, Carlos J; Hadzibegovic, Ana Danic; Kopjar, Tomislav; Mihanovic, Jakov; Jiménez, Pablo Mijahil Avilés; Gouvas, Nikolaos; Klat, Jaroslav; Novysedlák, René; Amisi, Nicolas; Christensen, Peter; El‐Hussuna, Alaa; Batista, Sylvia; Lincango‐Naranjo, Eddy; Emile, Sameh; Sandoval, Danilo Alfonso Arévalo; Dhufera, Hailu; Hailu, Samuel; Mengesha, Mengistu G; Kauppila, Joonas H; Arnaud, Alexis P; Demetrashvili, Zaza; Albertsmeier, Markus; Lederhuber, Hans; Löffler, Markus W.; Acquah, Daniel Kwesi; Ofori, Bernard; Tabiri, Stephen; Metallidis, Symeon; Tsoulfas, Georgios; Aguilera‐Arevalo, Maria‐Lorena; Recinos, Gustavo; Mersich, Tamás; Wettstein, Dániel; Ghosh, Dhruva; Kembuan, Gabriele; Milan, Peiman Brouki; Khosravi, Mohammad Hossein; Mozafari, Masoud; Hilmi, Ahmed; Mohan, Helen; Zmora, Oded; Gallo, Gaetano; Pata, Francesco; Pellino, Gianluca; Fujimoto, Yuki; Kuroda, Naoto; Satoi, Sohei; Abou Chaar, Mohamad K.; Ayasra, Faris; Fakhradiyev, Ildar; Hamdun, Intisar Hisham Said; Jin‐Young, Jang; Jamal, Mohammad; Karout, Lina; Elhadi, Muhammed; Gulla, Aiste; Rasoaherinomenjanahary, Fanjandrainy; Samison, Luc Hervé; Roslani, April Camilla; Sánchez, Iran Irani Durán; Gonzalez, Diana Samantha; Martinez, Laura; Martínez, María José; Nayen, Alejandra; Medina, Antonio Ramos‐De; Nunez, Jade; Outani, Oumaima; Nashidengo, Pueya Rashid; Shah, Rakesh; Shrestha, Ashish Lal; Jonker, Pascal; Kruijff, Schelto; Noltes, Milou; Steinkamp, Pieter; Varghese, Chris; Wright, Deborah; Abdur‐Rahman, Lukman; Ademuyiwa, Adesoji; Adisa, Adewale; Osinaike, Babatunde; Seyi‐Olajide, Justina; Williams, Omolara; Williams, Emmanuel; Pejkova, Sofija; Al Balushi, Zainab; Qureshi, Ahmad Uzair; Sayyed, Raza; Mohsen, Mustafa Abo; Abukhalaf, Sadi A.; Cukier, Moises; Gomez‐Fernandez, Hugo; Yip, Sebastian Shu; Ojeda, Ximena Paola Vasquez; Sacdalan, Marie Dione; Major, Piotr; Azevedo, José; Cunha, Miguel F.; Santos, Irène; Zarour, Ahmad; Bonci, Eduard‐Alexandru; Negoi, Ionut; Efetov, Sergey; Kochetkov, Viktor; Litvin, Andrey; Ingabire, Jc Allen; Bucyibaruta, Georges; Faustin, Ntirenganya; Habumuremyi, Sosthene; Imanishimwe, Alphonsine; Dieu, Haragirimana Jean; Munyaneza, Emmanuel; Ncogoza, Isaie; Alameer, Ehab; Ndong, Abdourahmane; Radenkovic, Dejan; Chew, Min Hoe; Koh, Frederick; Ngu, James; Panyko, Arpád; Bele, Uros; Košir, Jurij Aleš; Daoud, Hassan; Blanco‐Colino, Ruth; Bravo, Ana Maria Minaya; Jayarajah, Umesh; Wickramasinghe, Dakshitha; Adam, Mohammed Elmujtba Adam Essa; Rutegård, Martin; Sund, Malin; Adamina, Michel; Gialamas, Eleftherios; Horisberger, Karoline; Alshaar, Muhammad; Huang, Abel; Lohsiriwat, Varut; Charles, Shane; Jlassi, Haithem; Isik, Arda; Leventoğlu, Sezai; Lekuya, Hervé Monka; Lekuya, Hervé Monka; Lule, Herman; Kopetskyi, Slava; Alsaadi, Hayder; Alshryda, Sattar; Alser, Osaid; Bankhead‐Kendall, Brittany; Breen, Kerry; Kaafarani, Haytham; Mashbari, Hassan; Cal, Fernando Bonilla; Al‐Naggar, Hamza; Maimbo, Mayaba; Mazingi, Dennis; Abbott, Tom; Adamina, Michel; Akhbari, Melika; Benson, Ruth; Bhanderi, Shivam; Biccard, Bruce; Caruana, Edward; Chakrabortee, Sohini; Chapatwala, Reema; Costas‐Chavarri, Ainhoa; Demetriades, Andreas K; Desai, Anant; Di Saverio, Salomone; Drake, Thomas; Edwards, John; Evans, Jonathan; Fiore, Marco; Ford, Samuel; Fotopoulou, Christina; Fowler, Alexander; Futaba, Kaori; Ganly, Ian; James, Harelimana Grace; Griffiths, Ewen; Gronchi, Alessandro; Hutchinson, Peter; Hyman, Gabriella Yael; Incorvia, Joseph; Jain, Ritu; Jenkinson, Michael; Khan, Tabassum; Knight, Stephen Richard; Kolias, Angelos; Kudsk‐Iversen, Søren; Kwan, Tsun Yu; Leung, Elaine; Mayol, Julio; McKay, Siobhan; Meara, John G.; Mills, Emily; Moug, Susan; Patel, Akshay; Perinotti, Roberto; Rice, Henry E.; Roberts, Keith; Schache, Andrew; Shaw, Richard; Smart, Neil; Stephens, Matthew; Stewart, Grant D.; Teasdale, Ella; Vaughan‐Shaw, Peter; Vidya, Raghavan; Wright, Naomi; Wuraola, Funmilola; Zimmelman, Natalie; Agastra, Ervis; Thereska, Dariel; Dajti, Irida; Lucchini, Sergio Martin; Laudani, Veronica; Boccalatte, Luis; Chwat, Carina; Salazar, Ivana Ines Pedraza; Pantoja Pachajoa, Diana Alejandra; Lucchini, Sergio Martin; Duro, Agustin; Arancibia, José Alfredo Calderón; Cox, Daniel; D’Aulerio, Giuliana; Dudi‐Venkata, Nagendra; Egoroff, Natasha; Farik, Shebani; Lott, Natalie; Moss, Jana‐Lee; Rennie, Sarah; Tan, Lorwai; Varghese, Chris; Vo, Uyen Giao; Watson, David; Watters, David; Wright, Deborah; Bright, Tim; Hollington, Paul; Zhou, Xuanyu; Kroon, Hidde M; Farfus, Anthony; Barker, John; Watson, Eleanor; Stevens, Sean; Latif, Haider; Dawson, Amanda Caroline; Chuan, Alwin; Muralidharan, Vijayaragavan; Wong, Enoch; Ackermann, Travis; Pacilli, Maurizio; Hodgson, Russell; Heriot, Alexander; Choong, Peter; Brown, Wendy; Lidder, Surjit; Yeung, Justin; Traeger, Luke; Regalo, Guillermo; Gourlay, Ralph; Pockney, Peter; Pockney, Peter; Badiani, Sarit; Koh, Cherry; Putnis, Soni; Dawson, Amanda Caroline; Haider, Fayza; Mitul, Ashrarur Rahman; Komen, Niels; Dhondt, Bert; Cappeliez, Serge; Pigeolet, Manon; Ramshorst, Gabrielle; Schoneveld, Martijn; Stijns, Jasper; Oosterlinck, Wouter; Flamey, Nicolas; Kpangon, Cyrille; Agbadebo, Mouhamed; Tobome, Smèvo Romaric; Lawani, Ismaïl; Cerovac, Anis; Barros, Aldo Vieira; Júnior, Samuel Aguiar; Baiocchi, Glauco; Amaral Campos, Heloisa Galvão; Gross, Jefferson; Coimbra, Felipe José Fernandez; Kowalski, Luiz Paulo; Makdissi, Fabiana; Nakagawa, Suely; Neto, Joao Pedreira Duprat; Vartanian, Jose Guilherme; Yazbek, Guilherme; Zequi, Stenio C; Flumignan, Ronald; Slavchev, Mihail; Jaworska, Natalia; Dell, Angela; Shanthanna, Harsha; Martin, Janet; Behzadi, Abdollah; Nessim, Carolyn; Mozel, Michelle; St‐germain, Pascal; Russell, Crispin; Groot, Gary; Safieddine, Najib; Wijeysundera, Duminda; Eskander, Antoine; Chadi, Sami; MacKenzie, Shawn; Flexman, Alana; Heredia, Fernando; Modolo, Maria Marta; Villanueva, Julio; Waissbluth, Sofia; Macchiavello, Roberto; Escudero, Mario I; Fuentes, Tyare; Mimica, Ximena; Olivos, Maricarmen; Saenz, Dinimo Bolivar; Caicedo, Lina; Alzate, Juan Pablo; Luna, Joaquin; Alonso, Nestor Fabian Pedraza; Silva, Camilo Ortiz; Perez Rivera, Carlos J; Rodriguez, Juliana; Silva‐Igua, Liliana; Torres, Martha Luz; Trujillo, Lina María; Calvache, Albaro José Nieto; Balanta‐Melo, Julián; Figueroa‐Casanova, Rafael; García‐Montoya, Oscar‐Julián; Toro, Carlos Andres Marulanda; Botero, Marcela Velez; Arango, Maria Clara Mendoza; Martinez, Eneida Diaz; Perdomo, Valentina Gutiérrez; Calvache, Jose Andres; Calvache, Jose Andres; Montenegro, Emileth; Mihanovic, Jakov; Jiménez, Pablo Mijahil Avilés; Gouvas, Nikolaos; Novysedlák, René; Rodriguez‐Abreu, Julia; Mejía, Dolores; Lincango‐Naranjo, Eddy; Abouelnagah, Galal; Shehata, Sameh; Rida, Ahmed Hossam Eldin Fouad; Hassan, Ramy A.; Saad, Mahmoud M.; Loaloa, Mohamed Reda; Mostafa, Badr; Qassem, Mohamed; Fahmy, Mohamed; Abozied, Hesham; Azzam, Ahmed Y; Ghozy, Sherief; Sallam, Asser; Shehta, Ahmed; Emile, Sameh; Abdelkhalek, Mohamed; Samaka, Rehab; Morsy, Amr; Sherif, Ahmed Elshawadfy; Sandoval, Danilo Alfonso Arévalo; Negussie, Abraham; Fisseha, Tigist; Shumbash, Kibruyisfaw; Abebe, Metasebia; Hailu, Samuel; Yasin, Seid Mohammed; Akililu, Yemisirach Bizuneh; Megersa, Abebe; Tefera, Teshome; Assefa, Melatework; Atnafu, Bahru; Tsegaye, Bereket; Bezabih, Yoseph Solomon; Sisay, Silamlak; Bekele, Kebebe; Jira, Moa; Mengesha, Mengistu G; Derilo, Habtamu; Degefa, Eyueal; Tadesse, Anteneh; Nidaw, Melkamu; Sarjanoja, Elise; Kauppila, Joonas H; Testelin, Sylvie; Boucher, Sophie; Jouffret, Lionel; Lakkis, Zaher; Le Bian, Alban Zarzavadjian; Harper, Luke; Déserts, Marc Danguy; André, Benoît; Slim, Karem; Verhaeghe, Romain; Police, Andrea; Girard, Edouard; Chebaro, Alexandre; Nkembi, Armande Subayi; Arnalsteen, Laurent; Ballouhey, Quentin; Mege, Diane; Jeandel, Clement; Duchalais, Emilie; Bouche, Pierre‐Alban; Manceau, Gilles; Crétolle, Célia; Hervieux, Erik; Girard, Noémie; Seguin‐Givelet, Agathe; Gaujoux, Sebastien; De Simone, Belinda; Boisson, Matthieu; Bergeat, Damien; Arnaud, Alexis P; Fredon, Fabien; Nappi, Francesco; Kassir, Radwan; Scalabre, Aurélien; Migliorelli, Federico; Verhaeghe, Romain; Ezanno, Anne‐Cecile; Seeliger, Barbara; Vaysse, Charlotte; Charbonneau, Helene; Misrai, Vincent; Abbo, Olivier; Angeles, Martina Aida; Brunaud, Laurent; Demetrashvili, Zaza; Modabber, Ali; Wolf, Sebastian; Kamphues, Carsten; Höhn, Philipp; Glowka, Tim R.; Rokohl, Alexander Christopher; Bork, Ulrich; Fluegen, Georg; Horch, Raymund E.; Schmedding, Andrea; Schnitzbauer, Andreas; Eberbach, Helge; Schlager, Daniel; Spelsberg, Fritz; Keppler, Lena; Hecker, Andreas; Wolfer, Susanne; Ronellenfitsch, Ulrich; Nitschke, Christine; Peiper, Christian; Hakami, Ibrahim; Welter, Stefan; Nikolaieva, Karine; Roth, Andreas; Lindert, Judith; Gousias, Konstantinos; Rissmann, Anke; Linz, Valerie Catherine; Rahbari, Nuh; Rassweiler‐Seyfried, Marie‐Claire; Gut, Anna Eleonora; Gempt, Jens; Reim, Daniel; Wagner, Arthur; Albertsmeier, Markus; Keppler, Alexander M.; Stoleriu, Mircea Gabriel; Saier, Tim; Stadler, Josef; Kaiser, Julia Christina; Brunner, Stefan M.; Pfister, Karin; Herzberg, Jonas; Nowak, Kai; Reinhard, Tobias; Stavrou, Gregor A.; Königsrainer, Alfred; Konrads, Christian; Quante, Markus; Laban, Simon; Pusch, Silke; Hirschburger, Markus; Doerner, Johannes; Wiegering, Armin; Tampaki, Ekaterini Christina; Ruiz, Alitza Gutiérrez; Rodas, Alejandra; Portilla, Ana Lucía; Recinos, Gustavo; Aguilera‐Arevalo, Maria‐Lorena; Carrera, Jacqueline; Duarte, Amalia Barrios; Lowey, Megan; Barillas, Sabrina; Suroy, Atul; Vaishnav, Dhaivat; Chowdappa, Raghunandan Gorantlu; Madabhavi, Irappa; Bhat, Dhananjaya; Venkatappa, Sunil Kumar; Thakar, Sumit; Jain, Kavitha; Kumar, Aruna; Nagar, Manoj; Mishra, Tushar; Sekar, Arunkumar; Gupta, Anand; Kaman, Lileswar; Karthigeyan, Madhivanan; Tripathi, Manjul; Rammohan, Ashwin; Vayoth, Sudheer Othiyil; Rajanbabu, Anupama; Subbian, Anbukkani; Gupta, Rahul; Raut, Monish; Evelyn, Nissi; Kannaiyan, R Lavanya; Matai, Anil; Misra, Sanjeev; Bhende, Vishal; Muthu, Sathish; Ghosh, Indranil; Sharma, Abhishek; Bajaj, Ankur; Rajan, Shiv; Agarwal, Gaurav; Pawar, Pranay; Alexander, Philip; Vijayakumar, M Vijayakumar; Hameed, Zeeshan; Badareesh, L; Chaudhry, Navneet Kumar; Baliarsing, Lipika; Dharap, Satish; Kulkarni, Amruta; Thyavihally, Yuvaraja; Sharma, Rahul Deo; Pramesh, C S; Soni, Rajesh; Dube, Surya Kumar; Sharma, Shilpa; Singh, Harvinder; Bains, Lovenish; Ghodke, Rahul; Kumar, Ashwani; Sodhai, Vivek; Maji, Suvendu; Basu, Somprakas; Mahakalkar, Chandrashekhar; Kannan, Ravi; Mehraj, Asif; Ranganath, N; Phadnis, Ashish; Yadev, I; Kavalakat, Alfie; Mittal, Rohin; Vallam, Karthik Chandra; Akhavizadegan, Hamed; Maleki, Esmaeil Rezghi; Kandevani, Naser Yousefzadeh; Ikele, Hilary; McNestry, Catherine; Fleming, Christina; O’Brien, Stephen; Elwahab, Sami Abd; Davis, Niall; Javadpour, Mohsen; McDonnell, Brendan; Connor, Clare O; Bolger, Jarlath; Clancy, Cillian; Croghan, Stefanie M; Donlon, Noel; Cullinane, Carolyn; Creavin, Ben; Muheilan, Muheilan; Earley, Helen; Kabir, Syed Mohammad Umar; Fahadullah, Muhammad; Ryan, éanna; Connelly, Tara; Zmora, Oded; Hashimoto, Daisuke; Alqudah, Majdi Ali; Alajalen, Amer; Omari, Rand Y.; Ayasra, Faris; Qasem, Abdulrahman; Alawneh, Yazan; Ahmad, Amer; Aladawi, Omar; Alrayes, Bourhan; Haidar, Hanan; Husain, Shatha; Qassem, Faisal; Sumadi, Adnan; Salhiyeh, Ala’a Abu; Al‐Manaseer, Balqees Mahmoud; Alsunna, Zaid; Ra’ed, Hazim; Hamad, Faten Reyad Bani; Abuleil, Amro; Abou Chaar, Mohamad K.; Jimaale, Elmi Ahmed Mohamed; Abu‐Mehsen, Marah; Olaywah, Noor; Wafi, Omar; Ababneh, Hazim; Abu‐Ismail, Luai; Khamees, Almu’atasim; Alkhatib, Ahmad; Bolatbekova, Raikhan; Kulimbet, Mukhtar; Nurgozhin, Talgat; Saliev, Timur; Zhussupov, Baurzhan; Almabayev, Ydyrys; Fakhradiyev, Ildar; Saliev, Timur; Kaidarova, Dilyara; Tamoos, Khalil; Aqeelah, Ahmed; Mohammed, Alsnosy Abdullah Khalefa; Al Maadany, Faraj; Alkadeeki, Ghadah; Gahwagi, Milad; Aldressi, Wafa; Amnaina, Mohamed; Alansari, Arowa Hassan Abdulrahman; Alkaseek, Akram; Yagoub, Ghozlan; Amer, Anass Ben; Salem, Marwa; Almugaddami, Ayman; Burgan, Dania; Abdelkabir, Mohammed; Alshareef, Khayriyah; Islam Ben Jouira, Rayet; Meelad, Ayman; Bouhuwaish, Ahmad; Dwaga, Sumayya Essayah; Khalifa, Houda; Almiqlash, Bushray; Suliaman, Taha; Alawami, Mohammed; Elhajdawe, Fras; Aboazamazem, Hajir; Ellojli, Ibrahim; Msherghi, Ahmed; Saleh, Ismail Ali; Alayan, Mohammed; Roslani, April Camilla; Ndayishyigikiye, Marcel Didier; Munyika, Akutu; Plarre, Philipp; Borowski, David W; Nashidengo, Pueya Rashid; Noltes, Milou; Steinkamp, Pieter; Wells, Cameron; Teague, Rebecca; Elliott, Brodie; Kieser, David; Mohyieldin, Omar; Varghese, Chris; McIntosh, Nick; Haran, Cheyaanthan; Rennie, Sarah; King, Jasmin; Ha, Jeong; McGuinness, Matthew James; Adesanya, Opeoluwa; Olaogun, Julius; Akinmade, Akinola; Bwala, Kefas; Agbonrofo, Peter; Afolabi, Akinwale; Usang, Usang; Ekenze, Sebastian; Olori, Samson; Lawal, Taiwo Akeem; Seyi‐Olajide, Justina; Okunlola, Abiodun; Williams, Omolara; Adisa, Adewale; Abdur‐Rahman, Lukman; Kache, Stephen; Sale, Danjuma; Anyanwu, Lofty‐John; Okereke, Chukwuma; Tolani, Musliu Adetola; Filipce, Venko; Todorovic, Lazar; Pejkova, Sofija; Stavridis, Sotir; Massoud, John George; Alsibai, Sareyah; Sultan, Rizwan; Altaf, Humera Naz; Bhatti, Abu Bakar Hafeez; Waqar, Shahzad Hussain; Aziz, Aliya; Kerawala, Asad Ali; Rai, Lajpat; Anwer, Mariyah; Tariq, Aiman; Ayub, Bushra; Niazi, Sami Ullah; Naseem, Muhammad Yasir; Sarwar, Muhammad Zeeshan; Khokhar, Muhammad Imran; Zahid, Imdad Ahmad; Majid, Haroon Javaid; Talat, Nabila; Asif, Muhammad; Chaudhary, Muhammad Hamid; Farooq, Umer; Ahmad, Siddique; Mabood, Waleed; Bukhari, Syed Imran; Tariq, Muhammad; Yaqoob, Eesha; Javed, Saad; Javed, Saad; Malik, Muhammad Usman; Yaqoob, Hassan Nawaz; Cukier, Moises; Pacheco, Glenda Marina Falcon; Melendez, Robinson Mas; Urbina, Arazzelly Del Pilar Paucar; Chiuyari, Jose Rios; Alvarado, Carlos Eduardo Otiniano; Lau, Lorena Fuentes Rivera; Borda‐Luque, Giuliano; Niquen‐Jimenez, Milagros; Arias, Claudia; Zegarra, Sergio; Pallardel, Jenner Betalleluz; Oscco, Regina Amparo Ugarte; Mendiola, Gian; Colmenares, Yahaira Tatiana Carpio; Zapata, Carlos Shiraishi; Ortiz, Maria Rosa; Sacdalan, Marie Dione; Major, Piotr; Borges, Filipe Castro; Viveiros, Octavio; Serralheiro, Pedro; Santos‐Costa, Paulo; Mendes, Filipa; Melo, Miguel Rocha; Cardoso, Paulo; Soares, Ana; Azevedo, José; Pereira, Rita Gonçalves; Silva, Nelson; Caiado, André; Sacras, Maria Luís; Azevedo, Pedro; Almeida‐Reis, Rui; Cunha, Miguel F.; Oliveira, João; Nogueiro, Jorge; Sampaio‐Alves, Mafalda; Costa, Luciana Cidade; Baía, Catarina; Deus, Ana Cláudia; Branquinho, Rita; Marçal, André; Tojal, André; Zarour, Ahmad; Zarour, Ahmad; Makkai‐Popa, Silviu Tiberiu; Mironescu, Aurel; Grama, Florin; Toma, Elena Adelina; Negoi, Ionut; Filipescu, Daniela; Bacalbasa, Nicolae; Motas, Natalia; Ionescu, Sebastian; Ginghina, Octav; Costea, Radu; Zarnescu, Narcis Octavian; Drasovean, Radu; Bonci, Eduard‐Alexandru; Dimofte, Mihail‐Gabriel; Porumb, Vlad; Kirov, Mikhail; Molitvin, Yegor; Litvin, Andrey; Pykhteev, Vadim; Raevskaya, Marianna; Efetov, Sergey; Butyrskii, Aleksandr; Alshahrani, Mushabab; Althumairi, Azah; Alzerwi, Nasser; Al Ameer, Ahmed; Al Ameer, Ahmed; Madkhali, Tariq; Almulhim, Abddulrahman Saleh; Ghazwani, Salman; Ayoub, Abdu; Iskander, Othman; Ghunaim, Mohammed; Alharthi, Mohammed; Alzaidi, Turki M; Althumairi, Azah; Alyami, Mohammad; Al Amri, Abdulrahman; Althumairi, Azah; AlFakhri, Abdullah; Alhefdhi, Amal; Chowdhury, Sharfuddin; Nouh, Thamer; Alshehri, Ameen; Alzahrani, Abdulrahman; Alalawi, Yousef; Awad, Selmy; Konate, Ibrahima; Ndong, Abdourahmane; Tendeng, Jacques; Teo, Nan Zun; Koh, Frederick; Košir, Jurij Aleš; Bele, Uros; Aqil, Sabra; López, Cristina Barrena; Mozo, Ana Sánchez; Infante, Antonio Rodriguez; Vivancos, Patricia Caja; Prieto, Mikel; Roman, Igor Alberdi San; Fernandez, Laura Gomez; Vives, Josep Maria Muñoz; Carreras‐Castañer, Anna; Díaz‐Feijoo, Berta; Sieira‐Gil, Ramon; Turrado‐Rodriguez, Victor; López, Anna Sánchez; Sánchez‐Cabús, Santiago; Toscano, Marta Jimenez; Sin, MªPilar Canals; Laura, Saura García; Sole, Oriol Martin; Bellver, Pedro Palazon; Pérez‐Bertólez, Sonia; Prat‐Ortells, Jordi; Martínez, Mireia Riba; Rubio‐Palau, Josep; Tarrado, Xavier; Nuñez, Jorge; Mendoza, Veronica Alonso; Bescós, Coro; Espin‐Basany, Eloy; Espinosa‐Bravo, Martin; Gil‐Sala, Daniel; González‐Suárez, Susana; Estruch, Nuria Montferrer; Nuñez, Jorge; Mariño, Lucia Porteiro; Rodríguez‐Tesouro, Ana; Portilla, Fabian Rojas; Pérez, M Pilar Tormos; Vives, Inmaculada; De Cortazar, Unai Garcia; Tudela, Kiara; Landaluce‐Olavarria, Aitor; Gómez, Mercedes Estaire; Almoguera, Jorge; Ugarte‐Sierra, Bakarne; Jimenez, Virginia; Bertrand, Marta; Puiggrós, Laura Cárdenas; Delisau‐Puig, Olga; Garcia‐Adamez, Jorge; Bergkvist, David Julià; Maldonado‐Marcos, Eloy; García, Lucia Diego; Golet, Marta Roldón; Soto‐Darias, Iván; Rahy‐Martín, Aida Cristina; Enjuto, Diego; Ramos‐Luengo, Adolfo; Fernandez, Juan Delgado; Duarte, Carolina Lugo; Thies, Cristina Ojeda; Marquez, Lucila; Vita, Diana Crego; Dziakova, Jana; Bravo, Ana Maria Minaya; Velasco, Jorge Caño; Mateo‐Sierra, Olga; Quintana‐Villamandos, Begoña; Valcarcel, Cristina Rey; Rio, Javier; León, Laura Román García; Di Martino, Marcello; Prada, Jorge; González, Javier Serrano; Losada, Manuel; Gomez, Jose Tomas Castell; Corripio‐Sanchez, Ramon; Forero‐Torres, Alexander; Morales‐Puebla, José Manuel; Perez‐Chrzanowska, Hanna; Gonzalez, Santiago Valderrabano; Yebes, Alvaro; Zapardiel, Ignacio; Alonso, Manuel Diez; Palacios, Nelson Morales; Sánchez, Alberto Cabañero; Fernández, Fátima Sánchez; Gurumeta, Alfredo Abad; Abad‐Motos, Ane; Corella, Fernando; Ripollés‐Melchor, Javi
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
Get PDFBackground Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.
Methods Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.
Results This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.
Conclusions Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
Get PDFBackground: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. Methods: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. Results: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6% ) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45). Conclusion: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. Trial registration: NCT02179112
Precursors to Effectiveness of Public Procurement Audits for Constituency Development Funds (CDF) in Kenya
Get PDFThis study examined the factors that affect effectiveness of public procurement audits for
constituency development funds in Kenya. Specifically it sought to investigate the effect of
the legal framework, auditor’s specific professional qualities, technical audit factors and
client-related factors on effectiveness of public procurement audits. A descriptive research
design was employed, using a stratified random sampling to ensure representativeness. Both
quantitative and qualitative methods of data analysis were used. Descriptive statistics as well
as regression analysis were used to facilitate examination of the relationship between the
variables of interest. The study findings indicate that technical audit factors have greatest
influence on effectiveness of public procurement audit, followed by regulatory framework,
client related factors and auditor’s professional qualities respectively. The study recommends
that a summarized regulatory framework for CDF procurement management be prepared by
policy makers, more public auditors be trained on public procurement audit and the CDF
managers be exposed to audit as a positive management tool
Empagliflozin in Patients with Chronic Kidney Disease
No full textBackground The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo
