bluuebunny/crossref_metadata_2025 huggingface dataset:
A numerical study of rotating Bödewadt flow of micropolar fluid over porous disk
Authors: Hina Sadia , Roman Umme , Inam Saba , Kanwal Shamsa , Bilal M
Published: March 2022

Micropolar fluids are microstructure fluids that represent liquids consisting of rigid, randomly oriented particles suspended in a viscous medium, ignoring the deformation of the fluid particles. The present paper treats steady micropolar fluid flow over a permeable stationary disk numerically. It is supposed that the three-dimensional Bödewadt flow with stabilized radial pressure gradient rotates about [Formula: see text] having consistent angular velocity [Formula: see text]. The developed flow model contains a suction and micro-rotational parameter. Governing equations representing steadily rotating micropolar fluid, are presented before being transformed into non-dimensional forms. The numerical solutions are verified with the bvp4c package based on the Lobatto IIIa formula. This collocation technique uses a mesh of points to divide the integration interval into subintervals. A numerical solution is determined by solving a system of differential equations resulting from the boundary conditions. Finally, the collocation conditions are imposed on all the subintervals. In this paper, the contribution of micro-rotation on the stationary disk is carefully scrutinized. Furthermore, the impact of varying choices of parameters on radial, axial and tangential velocity profiles are evaluated numerically. The influence of these parameters, following Bödewadt boundary conditions, on temperature profile, are also analyzed.
Determinants of Own Revenues in Urban Local Bodies: Evidence from an Indian State
Authors: Sridhar Kala Seetharam , Ravi Vishal
Published: March 2022

Our objective in this article is to understand the determinants of sustainable (own source) revenues of cities and empirically estimate it in the context of an econometric model. This article makes an attempt to understand the determinants of own revenues for ULBs in India, taking the case of a prominent state, Karnataka. We empirically examine the determinants of own source revenues, controlling for endogeneity of several variables, using valuable data for cities in Karnataka, a representative Indian state. We find that higher city per capita incomes and effective literacy rates lead to a large tax base for the city economy. Road length has a positive effect on the city’s tax base, presumably as it leads to accessing jobs easily and increased economic activity, which also gives the public more confidence and motivation to pay taxes. Per capita grants lead to higher own source revenues for the city. The policy implications are to educate the workforce in the cities better, and invest in roads, rather than viewing them as expenditure.
Impact of Virtual Try-On Technology on Customer’s Mental Imagery During COVID-19
Authors: Rathee Vijay , Kumari Sarita
Published: March 2022

During the lockdown period of this pandemic, online retailing is getting the place of offline retail. This study provides an insight about the mental imagery of customers toward the new developing technology: virtual try-on. This descriptive study provides empirical evidence that virtual try-on technology influences the customer’s mental imagery toward the product presented on an online platform. Primary data were collected from 142 online customers of the Delhi NCR region. Various journals, websites, and reports were used to collect secondary data. Mean, standard deviation, and one sample t-test were used to study the significance of different dimensions on mental imagery toward virtual try-on technology in this pandemic period. Three dimensions of mental imagery have been studied, namely “vividness, quantity, and elaboration.” The findings of this study show that virtual try-on technology positively influences all the dimensions of mental imagery. E-tailers might get help from these findings and fame their strategies accordingly to attract more traffic on their website, increase sales outcomes, and get competitive advantages during and after this pandemic.
Exploring the Influence of Emotional Intelligence on the Academic Performance of MBA Students
Authors: Venkteshwar Abhishek , Warrier Uma
Published: March 2022

Emotional intelligence (EI) has seen a rapid growth in the past decade and affects every aspect of human life. Academic performance is a key indicator of a students’ progress in higher education. This study is rooted in Bar-On et al.’s (2006) model of EI. The research aims to study the relationship between EI and academic performance of MBA students. Review of Literature has been done from 2010 to 2020, which spans across a decade. A total of 25 research articles were reviewed to identify the research gap. A conceptual model was framed and a research objective was identified. Hypotheses were formulated, in line with the objective of this study. This empirical study is based on a sample drawn from 960 MBA students across Karnataka using stratified sampling. Warrier’s EI Scale (a = 0.887) has been adapted, developed, and utilized for gathering the EI responses from the participants. Pearson’s correlation analysis reports that there is a direct relationship between academic performance and EI (r = 0.520). The study implicates that EI has a significant influence on academic performance. The findings are relevant to students, teachers, professors, educators, consultants, and parents who need to understand the role of EI in academics. It is recommended that the Ministry of Human Resource Development (MHRD) introduce EI as a subject for high school students, to enhance their academic performance as well as the quality of life. EI is effective and imperative for success in any job. Students deal with the emotions of faculty, non-teaching staff, peers, and family, therefore they need emotional management skills, to handle situations, that make for a healthier, productive, and rewarding life.
Recognition of power: The agency of Kurdish women in their everyday practices
Authors: Belçim Galip Özlem
Published: March 2022

Anthropological work on Kurdish women has hitherto adopted western stereotypes of power, representing it as non-existent, as women being deprived of agency in everyday practices, or totally politicized. In order to challenge prescriptive gender stereotypes, moving beyond objectification to subjectivity and offering a more complex analysis of gender relations, this study examines the position of women within their family and wider social structures in Şırnak in Turkish Kurdistan based on a sample of local women who are not employed in paid work, and their children. The implications of the results are discussed in order to enable understanding of the social structures that make it possible for women in Şırnak to exercise informal decision-making authority or to be part of the social power structures as subjects, highlighting their importance in household management and showing that ‘power’ does not necessarily equate straightforwardly with western understandings.
Structural deformation prediction model based on extreme learning machine algorithm and particle swarm optimization
Authors: Jiang Shouyan , Zhao Linxin , Du Chengbin
Published: March 2022

In this paper, an extreme learning machine (ELM) algorithm based on particle swarm optimization (PSO) is proposed to predict structural deformation. Taking an aqueduct located in Tiantai County, Zhejiang, China, as a case study, a series of observations of the aqueduct vertical displacements and crack openings were used to train a neural network. Then, variables representing environmental factors (air temperature), hydraulic factors (water level), and aging were selected as the influence factors input into the prediction model. Finally, the proposed PSO–ELM model was used to predict the vertical deformation and crack opening of the aqueduct, and the predicted results were compared with the monitored values using four evaluation indexes: mean absolute error ( MAE), mean squared error ( MSE), maximum absolute error ( S), and correlation coefficient ( R). The prediction results obtained using the PSO–ELM model were then compared with those obtained using the evolutionary ELM, conventional ELM, back propagation neural network, long short-term memory, and multiple linear regression models. The results indicate that the proposed PSO–ELM model has an evidently superior predictive ability, with higher values of R and lower values of MAE, MSE, and S. The proposed model can therefore be confidently used to serve as a tool similar to a “weather forecast” function to predict the vertical deformation and crack openings of an aqueduct and may be employed for other structural monitoring applications as well.
Diabetes mellitus and the causes of hospitalisation in people with heart failure
Authors: Malik Anam , Garland Ellis , Drozd Michael , Palin Victoria , Giannoudi Marilena , Straw Sam , Jex Nick , Walker Andrew MN , Gierula John , Paton Maria , Witte Klaus K , Kearney Mark T , Levelt Eylem , Cubbon Richard M
Published: March 2022

Introduction

Diabetes mellitus (DM) is associated with increased risk of hospitalisation in people with heart failure and reduced ejection fraction (HFrEF). However, little is known about the causes of these events.

Methods

Prospective cohort study of 711 people with stable HFrEF. Hospitalisations were categorised by cause as: decompensated heart failure; other cardiovascular; infection or other non-cardiovascular. Rates of hospitalisation and burden of hospitalisation (percentage of follow-up time in hospital) were compared in people with and without DM.

Results

After a mean follow-up of 4.0 years, 1568 hospitalisations occurred in the entire cohort. DM (present in 32% [ n=224]) was associated with a higher rate (mean 1.07 vs 0.78 per 100 patient-years; p<0.001) and burden (3.4 vs 2.2% of follow-up time; p<0.001) of hospitalisation. Cause-specific analyses revealed increased rate and burden of hospitalisation due to decompensated heart failure, other cardiovascular causes and infection in people with DM, whereas other non-cardiovascular causes were comparable. Infection made the largest contribution to the burden of hospitalisation in people with and without DM.

Conclusions

In people with HFrEF, DM is associated with a greater burden of hospitalisation due to decompensated heart failure, other cardiovascular events and infection, with infection making the largest contribution.
Venous outflow-targeted coil embolization of direct carotid-cavernous fistulas
Authors: Lee Sang Hyub , Park Hyun , Lee Kwangho , Hwang Soo Hyun , Lee Chul Hee , Kang Dong Ho , Go Kyeong-O
Published: March 2022

Background

Coil embolization is the mainstay treatment for carotid-cavernous fistulas (CCFs). However, few studies have reported entire occlusion of engorged veins to interrupt venous outflow. We report our experience with venous outflow-targeted coil embolization of direct CCFs.

Methods

We retrospectively reviewed all the patients diagnosed with direct CCFs treated with venous outflow-targeted coil embolization between November 2013 and February 2020. Venous outflow-targeted coil embolization of the CCFs was performed as follows. First, transarterial stent-assisted coil embolization of CCFs was performed. If the venous outflow to the engorged veins persisted after transarterial stent-assisted coil embolization, entire occlusion of the engorged veins and additional coil packing within the cavernous sinus were performed to interrupt the venous outflow.

Results

Ten patients had undergone venous outflow-targeted coil embolization, 6 women (60%) and 4 men (40%). Transfemoral cerebral angiography showed high-flow, direct CCFs in all the patients. Venous outflow occurred through the superior ophthalmic vein (SOV) in all the patients and was completely interrupted by the entire occlusion of the engorged veins with fibered coils. Three patients (30%) had undergone additional treatment in a supplementary manner because of recurrent symptoms (chemosis in 1 patient, faint tinnitus in 2 patients) in the early postprocedural period (1 to 4 weeks). All the symptoms were resolved on follow-up. No additional recurrence was found during follow-up (1–75 months). No peri-procedural complications were encountered.

Conclusions

Venous outflow-targeted coil embolization of CCFs would be a safe and effective treatment method.
Quality Assessment of Zingiber officinale Roscoe Essential Oil from Nepal
Authors: Kumar Poudel Darbin , Dangol Sabita , Rokaya Anil , Maharjan Salina , Kumar Ojha Pawan , Rana Janaki , Dahal Sumitra , Timsina Sujan , Dosoky Noura S. , Satyal Prabodh , Setzer William N.
Published: March 2022

Zingiber officinale Roscoe rhizome plays a vital role in food flavoring as well as utilization in folk medicine. Nepal is categorized among the leading countries of Z. officinale rhizome production and export. Mature Z. officinale rhizome collection is based on the major production sites within Nepal, but we are currently unaware of the chemical composition of essential oil for export. A comparative investigation of Z. officinale rhizome essential oil compositions, collected from 12 different sites of the eastern, mid, and western regions of Nepal, has been carried out. The analysis of essential oils chemical composition by gas chromatographic–mass spectral (GC-MS), enantiomeric composition by chiral gas chromatography–mass spectrometry (CGC-MS), and antimicrobial activity was evaluated. Essential oil yields ranged from 0.28% to 0.34%. The results showed that the essential oils obtained in this study contained α-zingiberene (8.6%-24.1%), camphene (7.2%-12.8%), β-phellandrene (3.8%-10.1%), neral (0.6%-11.8%), geranial (1.0%-17.4%), ar-curcumene (3.0%-10.3%), and β-sesquiphellandrene (3.7%-9.7%). With CGC-MS, the enantiomeric distributions of 21 chiral compounds were determined and showed no contrasting enantiomeric distributions. Two essential oil samples (G3 and G5) possessed good antibacterial activity against Pseudomonas aeruginosa (MIC = 78.1μg/mL) and excellent antifungal activity against Aspergillus niger (MIC = 39.1 μg/mL). Based on the content of α-zingiberene and citral (neral and geranial), samples collected from their respective areas might be used to identify an ideal Z. officinale rhizome production zone in Nepal.
Topical Administration of Carvacrol Improves Healing in Nasal Septal Perforation: An Experimental Animal Study
Authors: Çengel Kurnaz Senem , Kuruca Nilüfer , Güvenç Dilek , Kaya Muhammed Taha , Güvenç Tolga
Published: March 2022

Background

Clinicians are exploring alternative treatments for nasal septum perforation since surgical treatment is challenging.

Objective

The effects of topical carvacrol on the healing of nasal septal perforation were investigated in an animal model.

Method

Twenty-one male New Zealand rabbits were randomly divided into three equal groups. A 5-mm circular biopsy punch was used to perforate the nasal septum behind the columella. For 14 days, bilateral gelatin sponges impregnated with carvacrol in olive oil in group 1, and only olive oil in group 2 were placed. Perforation only was performed in the control group. Animals were then sacrificed, and their nasal septums were removed. The closure of the perforation was measured, and samples were examined histopathologically. MMP-9 reactivity was evaluated using the immunoperoxidase technique. Histopathologic parameters were scored as 0 = none, 1 = mild, 2 = moderate, and 3 = strong.

Results

The septum perforation closure in the carvacrol group was statistically significant compared with the other groups (p < 0.001). Cartilage regeneration, connective tissue density, and MMP-9 immunoreactivity were significantly higher in the carvacrol group (p = 0.020, p = 0.009, and p = 0.008, respectively).

Conclusion

Topically administered carvacrol enhances wound healing in rabbit nasal septum perforation. It accelerated perforation closure by increasing cartilage regeneration, connective tissue, and MMP-9 expression.
Burma Drinx Group (B) Strategizing for Corporate Governance in a Family Business
Authors: Degravel Daniel , Tun Christina Hui Min
Published: March 2022

Burma Drinx Group (BDG), a large family-owned conglomerate in Myanmar, operates in several industries but has the largest presence in the soft drinks industry, led by its flagship company, Burma Drinx Company (BDC). The case explores the challenges and issues that BDC and BDG are experiencing as a family-owned conglomerate operating in a ‘non-friendly’ business environment, and a turbulent political and economic context. It focuses on an urgent topic, the corporate governance transformation of BDC and BDG. The reader is invited to understand the specificities of BDG’s internal environment and to manage the idiosyncrasies of this family business conglomerate related to its corporate governance system. BDC’s decision-makers face critical challenges for the future and have to completely rebuild the governance system. This current case follows a first case (Degravel & Tun, 2021) titled BDG(A) ‘Strategizing for Succession in a Family Business’, which described and reflected on the process of succession that BDG implemented to successfully replace the former CEO and founder of the company, Aung Win. The current case proposes a consulting-case style where analysis enables the provision of relevant solutions to the top management. Material from the academic literature about corporate governance and change management is offered as a resource. This case continues the story of BDG after its CEO succession.
Cellular therapies for the treatment and prevention of SARS-CoV-2 infection
Authors: Conway Susan R. , Keller Michael D. , Bollard Catherine M.
Published: March 2022

Patients with blood disorders who are immune suppressed are at increased risk for infection with severe acute respiratory syndrome coronavirus 2. Sequelae of infection can include severe respiratory disease and/or prolonged duration of viral shedding. Cellular therapies may protect these vulnerable patients by providing antiviral cellular immunity and/or immune modulation. In this recent review of the field, phase 1/2 trials evaluating adoptive cellular therapies with virus-specific T cells or natural killer cells are described along with trials evaluating the safety, feasibility, and preliminary efficacy of immune modulating cellular therapies including regulatory T cells and mesenchymal stromal cells. In addition, the immunologic basis for these therapies is discussed.
Identification of novel γ-globin inducers among all potential erythroid druggable targets
Authors: Yu Lei , Myers Greggory , Schneider Emily , Wang Yu , Mathews Raven , Lim Kim Chew , Siemieniak David , Tang Vi , Ginsburg David , Balbin-Cuesta Ginette , Singh Sharon A. , Phuwakanjana Pongpon , Jearawiriyapaisarn Natee , Khoriaty Rami , Engel James Douglas
Published: March 2022

Human γ-globin is predominantly expressed in fetal liver erythroid cells during gestation from 2 nearly identical genes, HBG1 and HBG2, that are both perinatally silenced. Reactivation of these fetal genes in adult red blood cells can ameliorate many symptoms associated with the inherited β-globinopathies, sickle cell disease, and Cooley anemia. Although promising genetic strategies to reactivate the γ-globin genes to treat these diseases have been explored, there are significant barriers to their effective implementation worldwide; alternatively, pharmacological induction of γ-globin synthesis could readily reach the majority of affected individuals. In this study, we generated a CRISPR knockout library that targeted all erythroid genes for which prospective or actual therapeutic compounds already exist. By probing this library for genes that repress fetal hemoglobin (HbF), we identified several novel, potentially druggable, γ-globin repressors, including VHL and PTEN. We demonstrate that deletion of VHL induces HbF through activation of the HIF1α pathway and that deletion of PTEN induces HbF through AKT pathway stimulation. Finally, we show that small-molecule inhibitors of PTEN and EZH induce HbF in both healthy and β-thalassemic human primary erythroid cells.
Comparing clinical outcomes in patients with diabetes undergoing coronary artery bypass graft and percutaneous coronary intervention in real world practice in Iranian population
Authors: Arabi Arezo , Naghshtabrizi Behshad , Baradaran Hamid Reza , Moradi Yousef , Asadi-Lari Mohsen , Mehrakizadeh Ali
Published: March 2022

Background

Coronary artery bypass graft (CABG) is generally regarded as one the treatment options for coronary artery disease (CAD) in patients with diabetes. In recent years, with the advent of drug-eluting stents (DES), percutaneous coronary intervention (PCI) was introduced as a suitable alternative for CABG. The aim of this study was to compare the incidence of major adverse cardiac and cerebrovascular event (MACCE) during mid-term period in patients with diabetes treated with 2 revascularization strategies.

Methods

This historical cohort study was conducted on 750 consecutives patients with diabetes in a single cardiovascular center from July 2009 to March 2012 in Iran. We included previously known case of DM treated with antidiabetic medications (with or without end organ damage) and patient with preoperational evaluation FBS test > 126 (not on the day of the surgery) who were revascularized by 2 strategies. We excluded those patients whose follow-up was not possible.

Results

Finally, out of 697 eligible patients, 355 patients underwent a CABG and 342 underwent a PCI: 53 patients were lost to follow-up (27 in CABG and 26 in PCI groups). The mean follow-up time was 900.68 ± 462.03 days in the CABG and 782.60 ± 399.05 in PCI groups. There were 17 (9.13%) cardiac deaths in the CABG group and 8 (4.45%) in the PCI group; this difference was not significant (P = .11). There was 14 (7.58%) cerebrovascular accident in the CABG group and 4 (2.31%) in the PCI group; this difference was significant (P = .04). Moreover, the frequency of the target vessel revascularization in the CABG and PCI groups was 6 (3.32%) and 31 (17.11%) (P < .001), respectively. Myocardial infarction in the CABG group was 5 (2.77%) and 14 (7.86%) in the PCI group (P = .009). Finally, the frequency of MACCE in the CABG and PCI groups was 41(20.70%) and 47(24.16%) respectively; this difference was not statistically significant (P = .195).

Conclusion

Patients with CABG in this study experienced more CVA, while the frequency of TVR and non-fatal MI was higher in the PCI arm.
Fall determinants in hospitalised older patients: a nested case control design - incidence, extrinsic and intrinsic risk in Malaysia
Authors: Lee Fatt Soon , Sararaks Sondi , Yau Weng Keong , Ang Zen Yang , Jailani Anis-Syakira , Abd Karim Zulkarnain , Naing Lin , Krishnan Thillainathan , Chu Ai Reen , Junus Suria , Ahmad Mohd Shahril , Sapiee Norhayaty , Veloo Vicneas Wary , Manoharan Sangetavani , A. Hamid Maimunah
Published: March 2022

Background

The older person is at greater risk of falls due to multiple intrinsic and extrinsic factors. This is compounded when the elderly is admitted to hospitals, as they are acutely ill and placed in an unfamiliar environment. Delirium and polypharmacy further complicate these problems. As falls reflect quality of care with potential for grave outcomes, this study aimed to identify the extent and risk of falls in public hospitals.

Methods

We conducted a nested case control study in 12 public hospitals in Malaysia. In the cohort section, we screened all inpatients 60 years of age and above daily until discharge, or the end of the study period. Daily, we identified those who fell, inclusive of near falls, in the preceding 24 h. Our enumerators interviewed patients on experience of fall, and supplemented data from the nurses and caregivers. For each case, ten controls were chosen.

Results

The incidence of falls/near falls was 1.0 per 1000 patient days (95% CI: 0.9, 1.1). Intrinsic risk factors found to be significant included patients who were not from a nursing home or not cared for by a domestic helper prior to admission, had prior history of indoor fall either in home or hospital, had four or more clinical diagnoses or exited from the bed on the weak side. Significant extrinsic factors were the absence of transfer bar in toilet, call bells, light switches or walking aids that were not within reach, as well as not having a walking aid. Non-sturdy chair was associated with lesser falls than when sturdy chairs with armrests were present.

Conclusion

Querying patients for falls produced better results than incident reporting. Several intrinsic factors such as history of indoor or in-hospital fall, having four or more clinical diagnoses or exiting from weaker side and residence history may help to identify those at higher risk. Addressing significant extrinsic factors such as transfer bars and the identification of switches may help in reducing falls risk in hospitals.

Trial registration

This study was registered in National Medical Research Register of Malaysia (NMRR-07-772-1044; date 26/05/2008) with Ethics Approval from Medical Research and Ethics Committee (MREC: MRG-07-LOI-HSR-1).
A trespasser from a foreign land? A case report of primary mucosal leishmaniasis
Authors: Fleissig Yoram , Dan-Gur Mary , Michael-Gayego Ayelet , Maly Alexander , Tabib Rami , Jaffe Charles L. , Korem Maya
Published: March 2022

Background

We report a clinically challenging and unusual case of L. donovani oral mucosal leishmaniasis.

Case presentation

Israeli resident with a former travel to central and North Africa, with no documented or prior cutaneous lesions presented with oral lesions of the maxillary gingiva and the upper lip. A delay in diagnosis and treatment have led to progression of the maxillary gingival lesions towards the hard palatal and the soft palate that could have potentially compromised the upper airway.

Conclusions

This case highlights the importance of early diagnosis of leishmaniasis in patients with oral lesions and the laboratory workup necessary to appropriately characterize and treat the disease.
Newly arrived Asian-born gay men in Australia: exploring men’s HIV knowledge, attitudes, prevention strategies and facilitators toward safer sexual practices
Authors: Phillips Tiffany R. , Medland Nicholas , Chow Eric P. F. , Maddaford Kate , Wigan Rebecca , Fairley Christopher K. , Bilardi Jade E. , Ong Jason J.
Published: March 2022

Background

Asian-born gay, bisexual and other men who have sex with men (gbMSM) newly arrived in Australia are more than four times as likely than their Australian-born counterparts to be diagnosed with incident HIV. Our aim was to explore experiences of Asian-born gbMSM newly arrived in Australia and attending a sexual health centre with regards to their knowledge of and preference for HIV prevention strategies.

Results

Twenty-four gbMSM aged 20–30 years attending Melbourne Sexual Health Centre who were born in Asia and arrived in Australia in the preceding four years, participated in semi-structured face-to-face interviews from 8th May 2019 and 23rd December 2019. Men were excluded if they were living with HIV. Interviews were recorded, transcribed verbatim and analysed thematically. Men reported little knowledge of HIV prevention strategies outside of condom use prior to coming to Australia. Although participants reported basic knowledge of HIV transmission and treatment, exposure to sexual identity and HIV-related stigma in their countries of birth meant they imagined a HIV diagnosis would be devastating. Most relied on condoms to stay HIV negative however their consistency of use varied. Seven men were on pre-exposure prophylaxis (PrEP); all but one started PrEP after coming to Australia. Many indicated interest in PrEP but described it as too expensive given they do not have access to government-subsidized healthcare. Sexual health counselling and connections with LGBTQI community groups appeared to facilitate PrEP and consistent condom use.

Conclusions

Asian-born gbMSM newly-arrived to Australia may have limited knowledge of HIV prevention strategies aside from condom use. Increased connections with sexual health services and LGBTQI communities may facilitate more effective HIV prevention strategies.
A sharp decrease in reported non-COVID-19 notifiable infectious diseases during the first wave of the COVID-19 epidemic in the Rotterdam region, the Netherlands: a descriptive study
Authors: van Deursen Babette , Hagenaars Margot , Meima Abraham , van Asten Liselotte , Richardus Jan Hendrik , Fanoy Ewout , Voeten Helene
Published: March 2022

Background

The Public Health Services in the Rotterdam region, the Netherlands, observed a substantial decrease of non-COVID-19 notifiable infectious diseases and institutional outbreaks during the first wave of the COVID-19 epidemic. We describe this change from mid-March to mid-October 2020 by comparing with the pre-COVID-19 situation.

Methods

All cases of notifiable diseases and institutional outbreaks reported to the Public Health Services Rotterdam-Rijnmond between 1st January and mid-October 2020 were included. Seven-day moving averages and cumulative cases were plotted against time and compared to those of 2017–2019. Additionally, Google mobility transit data of the region were plotted, as proxy for social distancing.

Results

Respiratory, gastrointestinal, and travel-related notifiable diseases were reported 65% less often during the first wave of the COVID-19 epidemic than in the same weeks in 2017–2019. Reports of institutional outbreaks were also lower after the initially imposed social distancing measures; however, the numbers rebounded when measures were partially lifted.

Conclusions

Interpersonal distancing and hygiene measures imposed nationally against COVID-19 were in place between mid-March and mid-October, which most likely reduced transmission of other infectious diseases, and may thus have resulted in lower notifications of infectious diseases and outbreaks. This phenomenon opens future study options considering the effect of local outbreak control measures on a wide range of non-COVID-19 diseases. Targeted, tailored, appropriate and acceptable hygiene and distancing measures, specifically for vulnerable groups and institutions, should be devised and their effect investigated.
Tranexamic acid for reducing blood loss following vaginal delivery: a double-blind randomized controlled trial
Authors: Igboke Francis Nwabueze , Obi Vitus Okwuchukwu , Dimejesi Benedict Ikechukwu , Lawani Lucky Osaheni
Published: March 2022

Background

Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality worldwide. Tranexamic acid (TXA) is a useful drug for prevention of PPH and merits evaluation in Nigeria, where PPH is the leading cause of maternal death (25%) and severe maternal morbidity. This study evaluates the efficacy of TXA in reducing blood loss following vaginal delivery.

Methods

This was a double-blind randomized placebo-controlled study on the efficacy and safety of intravenous TXA in reducing blood loss in women undergoing vaginal delivery in a tertiary hospital. Data analysis was conducted with IBM SPSS software (version 20, Chicago II, USA). P-value < 0.05 was considered statistically significant.

Results

The mean estimated blood loss was lower in TXA compared with the placebo group. (174.87 ± 119.83 ml versus 341.07 ± 67.97 ml respectively; P < 0.0001). PPH (blood loss > 500 ml) was 5.13% in the study arm compared to the control arm 7.14%- risk ratio (RR) 0.71; 95% CI: 0.38–1.79, p = 0.5956]. Additional uterotonics was required more in the control group compared to the treatment group 14(16.67%) versus 3(3.85%), p-value= 0.007. There were no major complications noticed in the treatment group.

Conclusion

This study demonstrated that intravenous administration of TXA reduced blood loss following vaginal delivery. It also reduced the need for additional uterotonics. However, blood loss greater than 500 was not significantly reduced.

Trial registration

This trial was registered retrospectively.

Pan African Clinical Trial Registry: PACTR202010828881019 on 12/10/2020.
Prognostic significance of the skeletal muscle index and systemic inflammatory index in patients with lymph node-positive breast cancer after radical mastectomy
Authors: Tang Ru , Deng Jia-Peng , Zhang Lei , Zhang Wen-Wen , Sun Jia-Yuan , Chi Feng , Zhang Jun , Wu San-Gang , He Zhen-Yu
Published: March 2022

Background

The role of skeletal muscle index (SMI) and systemic inflammation index (SII) for patients with lymph node-positive breast cancer remain controversial. This retrospective study aims to evaluate the individual and synergistic value of SMI and SII in outcomes prediction in this population.

Methods

Lymph node-positive breast cancer patients who received mastectomy between January 2011 and February 2013 were included in this retrospective study. We used abdominal computed tomography (CT) to measure skeletal muscle mass at the third lumbar (L3) level. The optimal cut-off values of SMI and SII were determined through maximizing the Youden index on the receiver operating characteristic (ROC) curves. Kaplan–Meier method was used to assess the correlation between SMI, SII, and overall survival (OS). The prognostic value of SMI and SII were analyzed with the multivariable Cox proportional hazards model.

Results

Of 97 patients included in our study (mean age: 46 [range: 27–73] years; median follow-up: 62.5 months), 71 had low SMI (sarcopenia), 59 had low SII, and 56 had low SMI + SII. Kaplan–Meier survival curves showed that both high SMI (P = 0.021, 5-year OS: 84.0% vs. 94.1%) and high SII (P = 0.043, 5-year OS: 81.0% vs. 97.3%) were associated with worse OS. Additionally, patients with either low SMI or low SII had significantly better OS (P = 0.0059, 5-year OS: 100.0% vs. 84.6%) than those with high SMI + SII. Multivariable analysis confirmed the predictive values of high SMI (P = 0.024, hazard ratio [HR]: 9.87) and high SII (P = 0.048, HR: 6.87) for poor OS. Moreover, high SMI + SII was significantly associated with poor survival (P = 0.016, HR: 16.36).

Conclusions

In this retrospective analysis, both SMI and SII independently predicted the prognosis of patients with lymph node-positive breast cancer. SMI + SII might be a stronger prognostic factor than either alone based on our findings, but should be further verified in a larger study.
Young people’s perspectives of thyroid cancer screening and its harms after the nuclear accident in Fukushima Prefecture: a questionnaire survey indicating opt-out screening strategy of the thyroid examination as an ethical issue
Authors: Midorikawa Sanae , Ohtsuru Akira
Published: March 2022

Background

Overdiagnosis of thyroid cancer has become a major global medical issue. Ultrasound-based thyroid cancer screening has promoted overdiagnosis, and recently international recommendations state that it should not be conducted, even after a nuclear accident. The Fukushima thyroid cancer screening program was initiated in 2011 as a health policy after the nuclear accident. The risk of radiation-induced thyroid cancer was unlikely given the low radiation levels, but the thyroid cancer screening program has continued at 2-year intervals with a relatively high participation rate and is now in its fifth round. It is therefore crucial to clarify whether those targeted for screening understand the disadvantages of screening, and to identify factors that influenced their decision to participate.

Methods

We conducted an anonymous mail-based questionnaire among young people from Fukushima Prefecture (subjects) and a neighboring prefecture that was not targeted for screening (non-subjects). We asked them about the significance of the thyroid cancer screening in Fukushima Prefecture, their reasons for accepting or refusing screening, their perception of the harms of screening, and their opinions on thyroid examination at school. We compared the results of the questionnaire between subjects and non-subjects and between examinees (who were screened) and non-examinees (who declined screening).

Results

Only 16.5% of respondents were aware of the harms associated with thyroid cancer screening, with most perceiving that the benefits outweighed the harms. Comparison of subjects’ and non-subjects’ responses showed there were no significant differences between the two groups. Among subjects, there were also no differences in responses between examinees and non-examinees. The most common reason for participation in screening was that the screening was conducted in schools and perceived as obligatory.

Conclusions

These results highlighted a serious ethical issue in that school-based screening leads to making young people think that it is mandatory screening in an opt-out and default setting manner, with a lack of knowledge about the disadvantages of screening. Based on the autonomy of the subjects and the ethical principle of the post-disaster, surveys after a nuclear disaster should be conducted in an opt-in style without an opt-out style such as school-based screening.
Do the implementation processes of a school-based daily physical activity (DPA) program vary according to the socioeconomic context of the schools? a realist evaluation of the Active at school program
Authors: Gosselin Véronique , Laberge Suzanne
Published: March 2022

Background

Less than half of Canadian children meet the Canadian Physical Activity (PA) Guidelines, and the proportion is even lower among children living in underprivileged neighbourhoods. Regular PA supports physical, cognitive, and psychological/social health among school-aged children. Successful implementation of school-based daily physical activity (DPA) programs is therefore important for all children and crucial for children who attend schools in lower socioeconomic settings. The purpose of this study is to uncover what worked, for whom, how, and why during the three-year implementation period of a new “flexible” DPA program, while paying particular attention to the socioeconomic setting of the participating schools.

Methods

This study is a realist evaluation using mixed methods for data generation. Longitudinal data were collected in 415 schools once a year during the three-year implementation period of the program using questionnaires. Data analysis was completed in three steps and included qualitative thematic analysis using a mixed inductive and deductive method and chi-square tests to test and refine context-mechanism-outcome (CMO) configurations.

Results

Giving the school teams autonomy in the choice of strategies appropriate to their context have allowed schools to take ownership of program implementation by activating a community empowerment process, which resulted in a cultural shift towards a sustainable DPA provision in most settings. In rural underprivileged settings, the mobilization of local resources seems to have successfully created the conditions necessary for implementing and maintaining changes in practice. In disadvantaged urban settings, implementing local leadership structures (leader, committee, and meetings) provided pivotal assistance to members of the school teams in providing new DPA opportunities. However, without continued external funding, those schools seem unable to support local leadership structures on their own, jeopardizing the sustainability of the program for children living in disadvantaged urban areas.

Conclusion

By exploring CMO configurations, we have been able to better understand what worked, for whom, how and why during the three-year implementation period of the Active at School! program. When implementing DPA policies, decision makers should consider adjusting resource allocations to meet the actual needs of schools from different backgrounds to promote equal PA opportunities for all children.
Patient safety in distal femoral resection knee arthroplasty for non-tumor indications: a single-center consecutive cohort study of 45 patients
Authors: Corap Yasemin , Brix Michael , Emmeluth Claus , Lindberg-Larsen Martin
Published: March 2022

Background

Distal femoral resection knee arthroplasty may be a viable option for several indications other than bone tumors. Resection knee arthroplasty appears to be becoming more common, but patients requiring this type of surgery are often elderly and with high comorbidity. The aim of this study was to report in-hospital complications, readmissions, reoperations, and mortality after distal femoral resection knee arthroplasty for non-tumor indications.

Methods

We retrospectively identified a consecutive cohort of 45 knees (45 patients) treated with distal femoral resection knee arthroplasty in a single institution between 2012 and 2021. Indications for surgery were failure of osteosynthesis (8), primary fracture treatment (2), periprosthetic fracture (22), and revision arthroplasty with severe bone loss (13). A major reoperation was defined as a major component exchange procedure or amputation. Mean follow-up was 3.9 years.

Results

The mean age was 71.3 years (SD 12.3), and 64.4% were female; 8.9% were ASA I, 40% ASA II, and 51% ASA III. Median length of stay was 7 days (range 3–19) with no major in-hospital complications, but 55.6% (n = 25) required blood transfusion. The 90-day readmission rate was 17.8% (n = 8), of which 50% was prosthesis-related. Four patients (8.9%) underwent major reoperation due to infection (n = 2), mechanical failure (n = 1), or periprosthetic fracture (n = 1). The mortality rate was 0% ≤ 90 days and 2.2% ≤1 year.

Conclusions

Distal femoral resection knee arthroplasty in this fragile patient population appears to be a viable and safe option considering that it is a limp salvage procedure most cases.
Management algorithm of external fixation in lower leg arterial injury for limb salvages
Authors: Jin Lei , Zhang Song , Zhang Yuxuan , Lin Xin , Feng Dehong , Hu Kejia
Published: March 2022

Purpose

The aim of this study is to investigate the outcome of these limb-threatening injuries through external fixation treatment and to discuss the case of patients’ functional recovery after external fixation.

Methods

Demographics, surgical treatment and outcomes in 88 patients with lower leg arterial injuries treated by external fixation at two trauma centers from 2009 to 2018 were reviewed. The primary outcome was the rate of successful lower leg salvage, while secondary outcomes were complications and functional recovery.

Results

Eighty-eight patients were identified and 80 patients (90 legs) maintained a successful lower leg salvage. The mean age was 32.7 ± 10.8 years, and 81.8% were male. The primary outcomes included the following complications: pin-tract infection (8 legs), pins loosening (4 pins), wound superficial infection (7 legs), deep infection developed osteomyelitis (3 legs), bone nonunion or bone defect (17 legs) and amputation (8 legs). The average healing time of fracture was 5.6 ± 4.3 months. The maintain of external fixation average time was 5.8 ± 3.6 months. The improvement of scores of the pain, function and quality of life in our follow-up was statistically significant.

Conclusion

For the lower extremity fracture patients with vascular injuries, using external fixation correctly can improve clinical outcomes and produce the improvement of pain, function and the quality of life.

Level of evidence

Retrospective cohort, level IV.
The effect of functional mandibular advancement for adolescent patients with skeletal class II malocclusion on the TMJ: a systematic review and meta-analysis
Authors: Ding Lan , Chen Rui , Liu Jiaxin , Wang Yuan , Chang Qian , Ren Liling
Published: March 2022

Objectives

This study aimed to assess whether functional mandibular advancement (FMA) will cause temporomandibular joint disorders (TMD) or have side effects on temporomandibular joint (TMJ) in adolescent patients.

Methods

All searched databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trails and Scopus were searched. Gray literature and unpublished literature was also searched. Randomized controlled trails (RCT) and non-randomized studies of the effects of interventions (NRSI) directly observe the condition of adolescent patients’ TMJ after finishing treatment will be considered to include in our study. According to Cochrane Handbook, Cochrane Collaboration risk of bias tool was used to assess the quality of included RCTs, and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used to assess the quality of included NRSIs.

Result

Finally 18 researches were evaluated as eligible to include in this study. 5 of the studies were RCTs, 8 were NRSIs and 5 were systematic reviews. The data of RCTs and NRSIs were statistically pooled in meta-analysis. The number of samples under investigated among primary studies was 579 individuals,there were 80 patients who developed temporomandibular symptoms during or after treatment. But all the subjective symptoms disappeared during follow-up time. The statistical outcomes proved that patients received FMA didn’t show more tendency to develop temporomandibular symptoms [I2 = 27%, OR = 0.54, 95%CI (0.33,0.87), p = 0.01].

Conclusion

(1) TMJ symptoms may occur during the functional oral appliance wearing, but the symptoms will release or disappear after treatment or during the follow-up period. (2) Less convincing evidence indicates that slightly previous TMD and condyle-glenoid fossa relationship will be improved after treatment. (3) There is TMJ disc anterior displacement observed during treatment, but most of them will return to the normal position later. (4) Moderate evidence support that FMA will not have side effects on TMJ of adolescent patients.
Clinical application of concentrate growth factors combined with bone substitute in Alveolar ridge preservation of anterior teeth
Authors: Keranmu Dilinuer , Nuermuhanmode Nijiati , Ainiwaer Ailimaierdan , Guli  , Taxifulati Dilidaer , Shan Wang , Ling Wang
Published: March 2022

Objective

To investigate the clinical effect of concentrated growth factors (CGF) combined with deproteinized bovine bone mineral (DBBM) on Alveolar ridge preservation during implantology.

Methods

A total of 38 patients were selected and randomly divided into 2 groups, with 19 cases in each group. The extraction sockets were filled with DBBM with or without CGF. Visual analogue scale (VAS) pain score was recorded within1 week and Landry wound healing index (LWHI) was recorded at 1, 2 and 3 weeks after operation. CBCT was taken preoperatively and 3 and 6 months postoperatively to measure and compare the changes of vertical height, width and gray value of alveolar bone at extraction site. The changes of alveolar bone contour were observed clinically and compared between the two groups.

Results

The VAS score of CGF group was lower than control group on the 1st and 3rd day after operation (P < 0.05). The LWHI of CGF group was higher than control group 1 week after operation (P < 0.05). The absorption of the labial and palatal plates height and the width in the CGF group was significantly less than the control group at 3 months (P < 0.05). The gray value of alveolar bone in CGF group was significantly higher than control group at 3 months (P < 0.05). There was no significant difference in new bone contour between the two groups (P > 0.05). 94.7% cases in CGF group did not undergo bone grafting, which was significantly higher than control group (78.9%).

Conclusions

The use of CGF combined with DBBM can help to reduce postoperative pain at the early stage of healing, form sufficient keratinized gingival tissue, effectively maintain the height and width of alveolar bone in the three-dimensional direction and provide good conditions for implant repair in the future.