Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
Despite a significant number of studies on the taxonomy of small mammals, very little of this work has been conducted on species in Egypt. External, cranial and dental morphometric analysis of the closely related Gerbillus andersoni, G. campestris and G. amoenus from different ecogeographical regions of Egypt were studied. Statistical analyses of cranial and dental variability allowed us to discriminate three morphological groups which are congruent with the three clusters suggested by previous morphological studies. Higher similarity is observed between G. andersoni populations in the Sinai and Western Mediterranean Coastal Desert despite the fact that they are separated from each other by about 200 km of the Nile Delta. Cluster and principal component analysis, show higher degree of divergence between the subgenus Dipodillus and the other two subgenera Gerbillus and Hendecapleura. This fact suggests that the morphometric differences observed among species within the genus Gerbillus are not mainly related to its phylogeny.
We report a 29-year-old patient who presented with coronavirus disease 2019 (COVID-19) upper respiratory tract infection in addition to clinical, laboratory, and radiological findings highly suggestive of peritoneal tuberculosis (TB) without pulmonary involvement. Two weeks after the resolution of COVID-19 infection, he presented with shortness of breath and oxygen desaturation requiring intubation and admission to the intensive care unit. The workup confirmed miliary pulmonary TB. The patient subsequently improved on antitubercular treatment. We discuss the possible contribution of COVID-19 infection to the rapid progression of TB infection to involve the lung in a miliary pattern, and how the coexistence of the two diseases might have led to a worse outcome.
Background: Amino acid polymorphisms in the mitochondrial cytochrome b (cytb) gene of four Gerbillus species have been investigated for their geographical distribution and possible functional significance. The sequences were obtained from a total of 20 specimens representing four species of genus Gerbillus collected from Siwa Oasis, Dabaa, Wadi El Natron, El Faiyum, and Baltim in Egypt. Results: Our results identified a group of amino acid variant polymorphisms that were useful for both species taxonomic and biogeographic assignments. The results demonstrated that amino acid variants L>F173 (Leucine>Phenylalanine), A>M203 (Alanine>Methionine), and I>V221(Isoleucine>Valine) were specific to G. andersoni, while the variant V>M283 (Valine>Methionine) was only specific to G. andersoni from Baltim. The variants, L>P263 (Leucine>Proline) and M>T311 (Methionine>Threonine) were specific only to G. amoenus collected from El Faiyum. Compared to other amino acid variants, L>P263 was remarkably less frequent, and it was predicted using PROVEAN database tool to have non-neutral effects. Conclusion: Amino acid polymorphisms within the cytochrome b gene could be assigned to specific geographic locations. They might prove suitable to track accumulated and recent environmental changes as they could represent signs of adaptive evolution.
These data highlight a novel role of sucrose non-fermenting AMPK related kinase/Pentraxin 3 axis in systemic lupus erythematosus pathogenesis. Sucrose non-fermenting AMPK related kinase/Pentraxin 3 combined role in immunometabolic signaling and DNA damage response is proposed to accelerate cardiovascular complications in systemic lupus erythematosus patients.
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