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Among them, six variables are statistically significant and of the same sign in both models “Nursing homes beds”, “Proportion of care homes over 100 beds”, “Log GDP per capita”, “Aeroplane passengers”, “Proportion of urban people”, and the dummy variable “Island region”.

The different socioeconomic, demographic and healthcare determinants of each region have a significant effect on the mortality rate and estimated cumulative incidence of COVID-19 in territories where the measures initially adopted to control the pandemic have been identical.

The different socioeconomic, demographic and healthcare determinants of each region have a significant effect on the mortality rate and estimated cumulative incidence of COVID-19 in territories where the measures initially adopted to control the pandemic have been identical.

For a long time, surgical difficulty is mainly evaluated based on subjective perception rather than objective indexes. Saracatinib in vivo Moreover, the lack of systematic research regarding the evaluation of surgical difficulty potentially has a negative effect in this field. This study was aimed to evaluate the risk factors for the surgical difficulty of anterior cervical spine surgery (ACSS).

This was a retrospective cohort study totaling 291 consecutive patients underwent ACSS from 2012.3 to 2017.8. The surgical difficulty of ACSS was defined by operation time longer than 120min or intraoperative blood loss equal to or greater than 200ml. Evaluation of risk factors was performed by analyzing the patient’s medical records and radiological parameters such as age, sex, BMI, number of operation levels, high signal intensity of spinal cord on T2-weighted images, ossified posterior longitudinal ligament (OPLL), sagittal and coronal cervical circumference, cervical length, spinal canal occupational ratio, coagulation function isociated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

This study indicated that the operational level, OPLL, high signal intensity of spinal cord, and spinal canal occupational ratio were independently associated with surgical difficulty and a predictive nomogram can be established using the identified risk factors. Optimal performance was achieved for predicting surgical difficulty of ACSS based on preoperative factors.

The scaling up of public health interventions has received greater attention in recent years; however, there remains paucity of systematic investigations of the scaling up processes. We aim to investigate the overall process, actors and contexts of polio immunization scaling up in Indonesia from 1988 until 2018.

A mixed method study with sequential explanatory design was conducted. We carried out a quantitative survey of 323 actors involved in the polio program at national and sub-national levels, followed by Key Informant Interviews (KII)s. Document review was also carried out to construct a timeline of the polio eradication program with milestones. We carried out descriptive statistical analysis of quantitative data and thematic analysis of qualitative data.

The scaling up of polio immunization in Indonesia started as a vertical expansion approach led by the Ministry of Health within a centralized health system. The coverage of immunization increased dramatically from 5% in the earlier 80s to 67.5% indent as a role model and the engine of multi sector actors. Posyandu (integrated health posts) played an important role, yet its revitalization after the reform-decentralization era has not been optimum.

Vertical scaling up of polio immunization program intervention was successful during the centralized era, with involvement of the president as a role model and the engine of multi sector actors. Posyandu (integrated health posts) played an important role, yet its revitalization after the reform-decentralization era has not been optimum.

International literature clearly describes factors associated with problematic internet use, including substance dependence, online gambling, social impairment, and functional difficulties. Therefore, it was imperative to assess the extent to which young adolescents in Lebanese schools are affected by problematic internet use (PIU) and the factors associated with it. This large-scale Lebanese survey aims to evaluate the relationship between PIU, depression, and substance use, including alcohol consumption and nicotine use (cigarettes and waterpipe) among adolescents in Lebanese schools.

This cross-sectional study conducted between January and May 2019 assessed internet use through the Internet Addiction Test (IAT), with ‘severe internet use’ being the threshold for problematic internet use. It enrolled a total of 1810 adolescents aged 14 to 17 from 16 schools from all Lebanese Mohafazat.

The majority of the participants had an average internet use 74.8% (95% Confidence Interval (CI) 0.72-0.76), 20.7% (9and alcohol), are associated with more problematic internet use among Lebanese adolescents. These results could serve as the first step for policymakers towards implementing early awareness campaigns to look at this problem more in-depth and come up with efficient actions to avoid it.

With the continuous improvement of surgical instruments in vitrectomy, the use of a trocar and cannula not only optimizes the incision process but also facilitates insertion and withdrawal of instruments during the procedure. Nevertheless, incision-related complications have also been reported in the literature. However, cannula fractures during 25G+ minimally invasive vitrectomy have rarely been reported.

A 62-year-old man underwent 25G+ pars plana vitrectomy for proliferative diabetic retinopathy. At the beginning of the operation, we used a trocar with a cannula to perform the sclerotomy. After the trocar was pulled out, the cannula was not seen on the surface of the sclera. Thus the inside and outside of the eye were carefully searched. The broken cannula tip was found in the ciliary body corresponding to the superonasal sclerotomy site and was subsequently removed.

Awareness regarding the risk of intraoperative fractures of 25G+ minimally invasive ocular surgical instruments is imperative. Whenever a broken or missing cannula is encountered, the residual part should be immediately extracted to avoid revision surgeries and postoperative complications.