Epidemiology, mortality and effectiveness of prophylaxis for Pneumocystis jiroveci pneumonia among rheumatic patients: a territory-wide study

Background Pneumocystis jiroveci pneumonia (PJP) is an opportunistic infection affecting immunocompromised individuals. However, evidence regarding the burden and effectiveness of prophylaxis among rheumatic patients remains limited. Delineating the epidemiology and efficacy of prophylaxis among rheumatic patients is urgently needed. Methods We performed a territory-wide cohort study of rheumatic patients in Hong Kong. All patients with a diagnosis of anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), immune-mediated myositis (IMM), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), or spondyloarthritis (SpA) between 2015 and 2019 were included. Prevalence, frequency of prophylaxis and mortality of PJP were calculated. Number needed to treat (NNT) analysis was also performed. Results Out of 21,587 patients (54% RA, 25% SLE, 13% SpA, 5% IMM, 2% AAV and 1% SSc), 1141 (5.3%) patients were prescribed PJP prophylaxis. 48/21,587 (0.2%) developed PJP. No patients who developed PJP received prophylaxis prior to infection. The incidence of PJP was highest among SSc, AAV, and IMM patients. Among these diseases, the majority of PJP occurred while patients were on glucocorticoids at daily prednisolone-equivalent doses of 15 mg/day (P15) or above. PJP prophylaxis was effective with NNT for SSc, AAV and IIM being 36, 48 and 114 respectively. There were 19 PJP-related mortalities and the mortality rate was 39.6%. Conclusion PJP is an uncommon but important infection among rheumatic patients, PJP prophylaxis is effective and should be considered in patients with SSc, AAV and IMM, especially those receiving glucocorticoid doses above P15.

Utilization of ECMWF Seasonal Rainfall Forecast System (SEAS5) for forest fire prediction over Sumatera Island, Indonesia

As part of the lungs of the world, the forest which covers Sumatra Island has a significant impact on the world oxygen production and the absorption of carbon dioxide. Drought over Sumatra Island often causes forest fires that can damage the function of forests as the world's lungs. Prediction of the seasonality of forest fires is needed to prevent and overcome forest fires that will occur next month. This study utilized seasonal rainfall predictions to predict the incidence of forest fires based on the drought index obtained. The result showed that ECMWF SEAS5 had good performance to predict rainfall over Sumatera Island for the first until the fourth months (lead time of 0 - 3). The Negative Standardized Precipitation Index (SPI) coincided with the increasing number of the hotspots. Furthermore, a linear equation has been applied to the calculated number of hotspots based on SPI from ECMWF.

Age-specific rates of population’s need for inpatient medical rehabilitation

To date, the issue of population’s need for medical rehabilitation (MR) remains little studied.Aim. To determine the age-specific rates of the Russian adult population’s need for intrahospital MR.Material and methods. The paper presents the estimated age-specific need of the adult population for inpatient MR, constituting the hospitalization number per year per 10,000 population of a particular age for diseases corresponding to ICD10 codes. During the study, the adult population was divided into 6 age groups (18- 29, 30-39, 40-49, 50-59, 60-69 and 70 and older). Medical experts have developed indications for intrahospital MR immediately after the treatment of acute conditions, exacerbation of chronic diseases, the outcomes of injuries and surgeries. The indications were developed taking into account the disease stage and the severity of a patient’s condition. The necessary conditions for MR (in- or outpatient) have also been determined. Taking into account these indications during analyzing medical documentation, the experts concluded that further MR of inpatients is necessary. The duration of MR was also determined.Results. The largest number of inpatients in need of MR falls on the older age groups (60-69 years (874,7 per 10,000 population) and ≥70 years (1346,3 per 10,000 population)), while the smallest — on the people aged 18-29 years (106,2 per 10,000 population). This is due to the fact that in older age groups the number of diseases requiring MR is increasing, including in inpatients conditions. In other age groups, the need for intrahospital MR was as follows: 115,2 hospitalizations per 10,000 population in the 30-39 age group; 328,9 — in the 40-49 age group; 512,5 — in the 50-59 age group.Conclusion. The healthcare executive authorities in any Russian regions can estimate the age-specific population’s need for MR using the proposed calculated number of adult population hospitalizations for inpatient MR.

Investigation of Parameters Influencing Tubular-Shaped Chitosan-Hydroxyapatite Layer Electrodeposition

Tubular-shaped layer electrodeposition from chitosan-hydroxyapatite colloidal solutions has found application in the field of regeneration or replacement of cylindrical tissues and organs, especially peripheral nerve tissue regeneration. Nevertheless, the quantitative and qualitative characterisation of this phenomenon has not been described. In this work, the colloidal systems are subjected to the action of an electric current initiated at different voltages. Parameters of the electrodeposition process (i.e., total charge exchanged, gas volume, and deposit thickness) are monitored over time. Deposit structures are investigated by scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR). The value of voltage influences structural characteristics but not thickness of deposit for the process lasting at least 20 min. The calculated number of exchanged electrons for studied conditions suggests that the mechanism of deposit formation is governed not only by water electrolysis but also interactions between formed hydroxide ions and calcium ions coordinated by chitosan chains.

Association of British Neurologists: UK neurology workforce survey

A neurology workforce survey was conducted by the Association of British Neurologists and compared with the annual Royal College of Physicians census in November 2018-March 2019. 46% of consultants and 35% of trainees responded. Based on the clinical work contracted (excluding academic and other work), the calculated number of consultant neurologists was 1 per 91,175 of the population. There is significant geographical variation in the number of consultants throughout the UK. There is a gradual shift when comparing the trainee and consultant data towards better gender and ethnic representation in the former. The data highlights potential future workforce planning issues including the potential impact of the increasing number of female trainees.

A statistical forecast of LOW mortality (< 400,000 deaths) due to COVID-19, for the whole WORLD

OBJECTIVETo forecast the death toll of COVID-19 in the whole world by fitting the time series of reported deaths with a parametric equation (integrated Gaussian equation) related to Farr’s law.DATAThe time series of cumulative deaths due to COVID-19 produced by John Hopkins University and stored in a github repository.RESULTSThe projected total death toll will be 261680 (392520 – 183176) which represents the 0.003 % of world population. This number amounts to 0.054 deaths per 1000, while the mean in the world (all causes) is 7.7. The daily peak of deaths (7270 (+/-500)) happened the 15 (+/- 3) of April, meaning that we are in descending curve of the pandemic. The outbreak will end completely the 23th (+/-3) of June. However, already on 9th (+/- 3) of May, 2 σ (95.45%) of the deaths will have be occured. The projected death toll is much lower (5-10 times) than those forecasted by the Imperial College Group (ICG) even considering the best scenario of total suppression of virus transmission. Using actual mortality rates it is possible to back calculate which number of infected individuals would produce such mortality. The death toll arises from a number of infected individuals between 53 (worst case) and 3.3 million. The calculated number of infected individuals is significantly lower than that calculated by ICG (227.5 millions) with suppression.

The Culture of Emergency Department in a Public Hospital

The research revolves around the culture of emergency department. Hospital emergency departments make a distinctive subculture inside the healthcare, in an atmosphere of social interaction and variation. Every organization can create its own values. Hospitals or other primary care centers having emergency departments usually. Initially, the emergency room was planned as a treatment room for emergency cases such as road accident cases or other acute conditions in which life is on risk. This department later specialized in the treatment of emergency cases which were presented with no consultation, by an emergency vehicle or any transport available at that time. It was taken place in the Emergency department of Tehsil Headquarter Hospital Pind Dadan Khan. The patients were interviewed regarding their experience, their time of arrival, the medical personnel who received them and their satisfaction level with the provided treatment and care. The other method which was used is participant as observer. The most consistently observed finding associated with higher levels of satisfaction, was the patient-oriented care provided by doctors, nurses and paramedic staff. Doctors and nurses who spent more time with the patient, had better communication skills, showed more empathy and treated the patients within 5 minutes of arrival in the emergency resulted in more patient satisfaction. On the basis of these characteristics, the calculated number of satisfied patients turned was more than the patients who were not satisfied. However, major emergency patients responded that they would not prefer emergency departments of public sector hospitals of Tehsil Pind Dadan Khan for future because major emergency services were not available.

Inhibition of CpLIP2 Lipase Hydrolytic Activity by Four Flavonols (Galangin, Kaempferol, Quercetin, Myricetin) Compared to Orlistat and Their Binding Mechanisms Studied by Quenching of Fluorescence

The inhibition of recombinant CpLIP2 lipase/acyltransferase from Candida parapsiolosis was considered a key model for novel antifungal drug discovery and a potential therapeutic target for candidiasis. Lipases have identified recently as potent virulence factors in C. parapsilosis and some other yeasts. The inhibition effects of orlistat and four flavonols (galangin, kaempferol, quercetin and myricetin) characterized by an increasing degree of hydroxylation in B-ring, were investigated using ethyl oleate hydrolysis as the model reaction. Orlistat and kaempferol (14 µM) strongly inhibited CpLIP2 catalytic activity within 1 min of pre-incubation, by 90% and 80%, respectively. The relative potency of flavonols as inhibitors was: kaempferol > quercetin > myricetin > galangin. The results suggested that orlistat bound to the catalytic site while kaempferol interacted with W294 on the protein lid. A static mechanism of interactions between flavonols and CpLIP2 lipase was confirmed by fluorescence quenching analyses, indicating that the interactions were mainly driven by hydrophobic bonds and electrostatic forces. From the Lehrer equation, fractions of tryptophan accessibility to the quencher were evaluated, and a relationship with the calculated number of binding sites was suggested.

PENGARUH ROA, TINGKAT INFLASI DAN NILAI TUKAR RUPIAH TERHADAP HARGA SAHAM

His study aims to analyze the effect of Return On Assets, Inflation Rate and Rupiah Exchange Rate on the share price of banking companies on the Indonesia Stock Exchange. Based on the results of the research processed for the variables Return on Assets, Inflation Rate and Rupiah Exchange Rate on Stock Prices shows the simultaneous and significant influence. This is shown in the results of hypothesis testing with F count. 36.99996> F table 3.06. With a significance of 0.000000 <0.05. The Return On Assets variable is partially negative and insignificant on the Stock Price. This is shown in the results of hypothesis testing with the number t count <t table that is 0.577606 <1.65566 with a significance value of 0.5647> 0.05. Variable Inflation Levels on Stock Prices show a positive and significant influence. This is shown in the results of hypothesis testing with a calculated number of 14.42283> t table 1.65566 with a significance value of 0.0000 <0.05. While the Rupiah Exchange Rate partially has a negative but significant effect on the Stock Price. This is shown in the results of hypothesis testing with the number t -12.45095 <t table 1.65566 with a significance value of 0.0000 <0.05.

The requirements in medical rehabilitation of adult population of different age groups in hospital conditions

The study was carried out to determine requirements of adult population of Russia in medical rehabilitation in hospital conditions depending on age groups. To determine requirements of country population in medical rehabilitation in hospital conditions the age-specific indicators derived from data massive from three territories were standardized on population and morbidity in Russia in 2010. The number of hospitalized patients being in need of medical rehabilitation in hospital conditions was determined as indicator characterizing requirements of population in medical rehabilitation in hospital conditions. The age-specific requirements of adult population in medical rehabilitation in hospital conditions was determined and analyzed on the basis of number of cases of annual hospitalization for medical rehabilitation in hospital conditions according main classes and particular diseases. The largest number ofpatients being in need of medical rehabilitation in hospital conditions goes to elder age groups 60-69 years (874.7 cases per 10 000 of population) and 70 years and older (1346.3 cases per 10 000 of population). The least number of this kind of patients goes to age group of 18-29 years (106.2 cases per 10 000 of population). The proposed calculated number of cases of hospitalization of adult population for medical rehabilitation in hospital conditions can be implemented by executive authorities of subjects of the Russian Federation in health care sector of any territory for determining requirements ofparticular region in medical rehabilitation with consideration for age structure of population.