bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmaceutical policies and regulations of oral antiviral drugs for treatment of hepatitis C in Egypt—case study
Authors: Teaima Mahmoud H. , Al-Nuseirat Adi , Abouhussein Dalia , Badary Osama A. , El-Nabarawi Mohamed A.
Published: December 2021

Background

There are limited studies on the role of efficient regulatory mechanisms in facilitating greater access to Hepatitis C virus (HCV) treatment. Evidence to support the importance of effective pharmaceutical policies and regulations in improving access to oral viral drugs towards the elimination of HCV is needed. This study aims to explore the adequacy of the implemented pharmaceutical policies and regulations in Egypt and their role to improve the availability and affordability of direct-acting antivirals (DAAs) to achieve universal access to the treatment of HCV.

Methods

The study adopts a qualitative methodology using desk review of regulatory and legislative information, literature review, and semi-structured interviews with key experts from the concerned governmental regulatory agencies, pharmaceutical industries, academic organizations, professional associations, civil society organizations, and clinicians who are working in researching treatments for hepatitis C.

Findings

The common DAAs available in the market are Daclatasvir, Sofosbuvir, and Sofosbuvir-based direct-acting antiviral combinations. Fast-track medicines registration pathway for marketing authorization of DAAs is used to reduce market access time frames. The pricing policies are supplemented using price negotiation to set up affordable prices that led to a reasonable price for DAAs. Using Trade-Related Aspects of Intellectual Property Rights (TRIPs) flexibility and local production of quality generics DAAs at lower prices. In addition, political will and collaboration between the government, civil society, and pharmaceutical companies improved patients' access to affordable DAAs and succeeding hepatitis C treatment in Egypt.

Conclusions

The study findings indicated that the implemented pharmaceutical policies and regulations have an immense role in enhancing access to medicines towards the elimination of hepatitis C in Egypt.
Do our children learn enough in Sky Class? A case study: online learning in Chinese primary schools in the COVID era March to May 2020
Authors: Zhao Lina , Thomas Peter , Zhang Lingling
Published: December 2021

All human being’s ways of living, working and studying were significantly impacted by the Covid-19 in 2020. In China, the Ministry of Education reacted fast in ensuring that primary school students could learn online at home by promoting the Sky Class program from February 2020. Educators, parents, and students all faced the challenges of adapting to new online teaching and learning environments. In this small-scale case study, Sky Class’s content and the participants’ experiences, will be presented. Four primary school teachers and five primary school students and their parents participated in three-rounds of interviews sharing their perspectives and experiences of online learning. The study showed that the students gained more parental support and that they benefited from using multimedia functions, like replay, in their Sky Classes. However, the majority of participants reported that the students learnt less. By mapping the learning activities and themes from Sky Class against Cope and Kalantzis’ e-learning ecologies, our study found that only ubiquitous learning and multimodal meaning were achieved. We suggest the reason may be that high cognitive learning was not achieved due to less teachers’ supervision, lack of interaction, delayed feedback, shorter learning times and communication. In conclusion, innovative pedagogies, which can foster different types of learning from the e-learning ecologies may overcome the negative aspects reported about Sky Class. Further research is required for implementing online technology as a catalyst for educational change.
Recovery patterns in patients undergoing revision surgery of the primary knee prosthesis
Authors: Liu W. Y. , van der Steen M. C. , van Wensen R. J. A. , van Kempen R. W. T. M.
Published: December 2021

Purpose

Despite good survival rates of revised knee prostheses, little is known about recovery trajectories within the first 12 months after surgery. This retrospective observational study explored recovery trajectories in terms of pain, function and quality of life in patients after revision knee arthroplasty over 12 months.

Methods

Eighty-eight revision knee arthroplasty patients rated changes in daily physical functioning using the anchor question (0: very much worsened; 7: very much improved). Patient reported outcome measures (PROMs) of pain (range 0–10), function (Oxford Knee Score) and quality of life (EQ-5D-3L) were assessed preoperatively, at 3 and 12 months postoperatively. Four recovery trajectories were identified using the anchor question at 3 and 12 months postoperatively: no improvement, late improvement, early improvement, and prolonged improvement. Repeated measures ANOVA was conducted with recovery trajectories as dependent variable and PROM assessments as independent variables.

Results

Sixty percent reported improvement in daily physical functioning at 12 months postoperatively. Age and reason for revision differed between groups. Pain, function and EQ-5D-3L differed between groups over time. Late and prolonged improvement groups improved on all PROMs at 12 months. The early improvement group did not report improvement in daily physical functioning at 12 months, while improvements in function and pain during activity were observed.

Conclusions

Different recovery trajectories seem to exist and mostly match PROMs scores over time. Not all patients may experience beneficial outcome of revision knee arthroplasty. These findings are of importance to provide appropriate information on possible recovery trajectories after revision knee arthroplasty to patients.

Level of evidence

III
Seasonal and regional differences in migration patterns and conservation status of Swan Geese (Anser cygnoides) in the East Asian Flyway
Authors: Damba Iderbat , Zhang Junjian , Yi Kunpeng , Dou Huashan , Batbayar Nyambayar , Natsagdorj Tseveenmyadag , Davaasuren Batmunkh , Cao Lei , Fox Anthony David
Published: December 2021

Background

The Swan Goose (Anser cygnoides) breeds across Mongolia and adjacent China and Russia and winters exclusively in China. It is globally threatened, showing long-term major range contractions and declining abundance, linked to habitat loss and degradation. We remain ignorant about the biogeographical subpopulation structure of the species and potential differences in their migration timing, stopovers and schedules, information that could be vital to effective conservation of different elements of the species population, which we address here with results from a telemetry study.

Methods

In 2017–2018, we attached GPS/GSM telemetry devices to 238 Swan Geese on moulting sites in three discrete parts of their summering area (Dauria International Protected Area, Central Mongolia and Western Mongolia), generating 104 complete spring and autumn migration episodes to compare migration speed and nature between birds of different summer provenances.

Results

Birds from all three breeding areas used almost completely separate migration routes to winter sympatrically in the Yangtze River floodplain. Although many features of the spring and autumn migrations of the three groups were similar, despite the significantly longer migration routes taken by Western Mongolian tagged birds, birds from Dauria Region arrived significantly later in winter due to prolonged staging in coastal areas and took longer to reach their breeding areas in spring. Among birds of all breeding provenances, spring migration was approximately twice as fast as autumn migration. Areas used by staging Swan Geese (mainly wetlands) in autumn and spring almost never fell within national level protected areas, suggesting major site safeguard is necessary to protect these critical areas.

Conclusions

This study showed the discreteness of migration routes taken by birds of different summer provenances and differences in their migratory patterns, highlighting key staging areas (Yalu River Estuary in China/North Korea for Dauria Region breeding birds, Daihai Lake for Central Mongolian and Ordos Basin for Western Mongolian birds). Based on this new knowledge of the biogeographical subpopulation structure of the Swan Goose, we need to combine data on subpopulation size, their distribution throughout the annual life cycle and conservation status, to develop more effective conservation strategies and measures to reverse population decline throughout the range.
Continuous subcutaneous apomorphine infusion allowing awake deep brain stimulation in a Parkinson’s disease patient
Authors: Spagnolo Francesca , Romeo Francesco , Proto Piermassimo , Rini Augusto Maria , Leopizzi Emanuela , Tedesco Andrea , Frizzi Marco , Passarella Bruno
Published: December 2021

Background

Subthalamic Deep Brain Stimulation (DBS) have demonstrated in the last decades to determine an important clinical improvement in advanced and selected Parkinson’s disease (PD) patients. However, only a minority of parkinsonian patients meet the criteria to undergo DBS, and the surgical procedure itself is often stressful, especially for patients experiencing severe OFF state. Subcutaneous Apomorphine continuous administration is suitable as an adjunctive therapy capable of improving a suboptimal DBS result. Here we hypothesize a possible role for subcutaneous apomorphine infusion to alleviate severe OFF state in parkinsonian patients undergoing DBS, thus allowing intraoperative microrecording and patient’s collaboration during clinical testing.

Case presentation

A 68-year-old man, suffering from a very long PD-history, characterized by a severe akinetic status and dramatic non-motor features while in OFF, underwent Subthalamic-DBS keeping a slight but continuous apomorphine infusion (1.8 mg/hour), able to guarantee the right degree of patient’s collaboration without interfering with microelectrode recordings. There were no intra or perioperative complications and after the procedure he experienced a marked clinical benefit, being able to stop apomorphine administration.

Conclusions

Here we described the first Subthalamic DBS procedure performed with a low and stable dopaminergic stimulation guaranteed by subcutaneous Apomorphine continuous infusion. For its rapidity of action and prompt reversibility, apomorphine could be particularly suitable for use during difficult surgical procedures in PD, allowing more therapeutic opportunities for patients who would otherwise be excluded from the DBS option.
Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol
Authors: Sabogal Iliana Milena Ulloa , Nariño Claudia Consuelo Domínguez , Monsalve Mary Alejandra Mendoza
Published: December 2021

Background

Adolescent mothers have lower rates of initiation, continuation, and exclusivity of breastfeeding, and even more so in the first pregnancy. Current interventions target adult women, and little evidence is available for breastfeeding promotion among adolescents.

Methods

This is a pilot study protocol with a parallel, single-blind, randomized, and controlled trial design, to evaluate the feasibility of the intervention “Lactation Counseling” in first-time adolescent mothers to maintain exclusive breastfeeding in the first 6 months of life. The control group will receive routine education in prenatal care and prenatal and childbirth classes, the experimental group will receive additionally the intervention “Lactation Counseling”, for 4 weeks, both conducted by trained nurses. Feasibility outcome includes recruitment and dropout rates, and, pilot outcomes will be the exclusive breastfeeding rate and the breastfeeding knowledge. Measurements will be taken at baseline, post-intervention, and 2, 4, and 6 months after childbirth.

Discussion

Exclusive breastfeeding rates could be increased in adolescent mothers through nursing counseling interventions that are previously structured and evaluated from their feasibility. This study will allow the evaluation of the feasibility of an intervention in low-income, Latin American population adolescents.

Trial registration

ClinicalTrials.gov NCT04655846, Registered 7 December 2020.
COVID-19 vaccine hesitancy among the adult population in Ghana: evidence from a pre-vaccination rollout survey
Authors: Alhassan Robert Kaba , Aberese-Ako Matilda , Doegah Phidelia Theresa , Immurana Mustapha , Dalaba Maxwel Ayindenaba , Manyeh Alfred Kwesi , Klu Desmond , Acquah Evelyn , Ansah Evelyn Korkor , Gyapong Margaret
Published: December 2021

Background

Coronavirus disease 2019 (COVID-19) has already claimed over four million lives globally and over 800 deaths in Ghana. The COVID-19 vaccine is a key intervention towards containing the pandemic. Over three billion doses of the vaccine have already been administered globally and over 800,000 doses administered in Ghana, representing less than 5% vaccination coverage. Fear, uncertainty, conspiracy theories and safety concerns remain important threats to, a successful rollout of the vaccine if not managed well.

Objective

Ascertain the predictors of citizens’ probability of participating in a COVID-19 vaccine trial and subsequently accept the vaccine when given the opportunity.

Methodology

The study was an online nation-wide survey among community members (n = 1556) from 18th September to 23rd October, 2020 in the 16 regions in Ghana. Binary probit regression analysis with marginal effect estimations was employed to ascertain the predictors of community members’ willingness to participate in a COVID-19 vaccine trial and uptake the vaccine.

Results

Approximately 60% of respondents said they will not participate in a COVID-19 vaccine trial; 65% will take the vaccine, while 69% will recommend it to others. Willingness to voluntarily participate in COVID-19 vaccine trial, uptake the vaccine and advise others to do same was higher among adults aged 18–48 years, the unmarried and males (p < 0.05). Significant predictors of unwillingness to participate in the COVID-19 vaccine trial and uptake of the vaccine are: married persons, females, Muslims, older persons, residents of less urbanised regions and persons with lower or no formal education (p < 0.05). Predominant reasons cited for unwillingness to participate in a COVID-19 vaccine trial and take the vaccine included fear, safety concerns, lack of trust in state institutions, uncertainty, political connotations, spiritual and religious beliefs.

Conclusion

The probability of accepting COVID-19 vaccine among the adult population in Ghana is high but the country should not get complacent because fear, safety and mistrust are important concerns that have the potential to entrench vaccine hesitancy. COVID-19 vaccine rollout campaigns should be targeted and cognisant of the key predictors of citizens’ perceptions of the vaccine. These lessons when considered will promote Ghana’s efforts towards vaccinating at least 20 million people to attain herd immunity.
Sensory systems processing in children with spastic cerebral palsy: a pilot study
Authors: Barakat Mennatallah Khamis AbdelHafiez , Elmeniawy Gehan Hassan , Abdelazeim Faten Hassan
Published: December 2021

Background

The study of the sensory aspect alongside the motor aspect in children with spastic cerebral palsy is critical. Knowledge may help improve intervention, children’s quality of life, activity, and participation.

The study aims to analyze the sensory systems processing in children with spastic cerebral palsy classified by Gross Motor Function Classification System (GMFCS) as levels I, II, and III using Child Sensory Profile 2 (CSP-2). Caregivers of children with spastic cerebral palsy aged 6–9 years (n = 20) completed the CSP-2. Children with severe comorbidities besides cerebral palsy (i.e., diabetes, myopathy, neuropathy, and uncontrolled epilepsy), autism, burn injuries, hearing or vision loss were excluded.

Results

All twenty participating children showed sensory processing difficulties in at least one of the sensory sections. With 14 out of 20 showing abnormalities in more than one section, the majority showed problems in the body position section, followed by the movement section. There was a significant difference between raw scores means of children with unilateral and bilateral SCP at the “body position” section, unlike the rest of the other sections.

Conclusions

Children with spastic cerebral palsy (GMFCS levels I, II, and III) show sensory systems processing difficulties compared to normative data, especially at vestibular and proprioceptive processing.
Micro RNA-23b as a potential biomarker in rheumatoid arthritis disease activity and severity: clinical, laboratory, and radiological cross-sectional study
Authors: Abdeen Hanaa Maher , Gharbia Ola Mohammad , Bassiouni Sherine Abdel Rahman Abdel Karim , Zaki Maysaa El Sayed , Abdullah Hazem , Morsi Heba Kamal
Published: December 2021

Background

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease. It is characterized by an inflammatory polyarthritis that preferentially affects the small joints leading to joint damage and eventual deformity and disability, and can also present with extra-articular manifestations. Micro RNA (miRNA) is a class of non-coding RNAs which negatively regulate messenger RNA (mRNA) expression. Several studies had shown that miRNA-23b has a close relationship with inflammation and autoimmune diseases. An increasing evidence has suggested that miRNA-23b is closely associated with many inflammatory and autoimmune diseases. The current study aimed to evaluate the plasma expression of miRNA-23b in rheumatoid arthritis (RA) patients and to explore its potential association with diseases activity.

Results

RA patients had a significantly higher plasma miRNA-23b expression than controls (P < 0.001). The miRNA-23b plasma expression was significantly associated with the clinical and laboratory indices of RA activity as well as with the DAS28-ESR score (P = 0.009) and grades (P < 0.001). The miRNA-23b plasma expression was significantly correlated with the radiological severity of RA (P = 0.002).

Conclusions

Plasma expression of miRNA-23b is significantly increased in patients with RA than controls. In RA patients, plasma expression of miRNA-23b was significantly correlated with the activity and radiological severity of RA. miRNA-23b may represent a potential therapeutic target that can retard progression of RA.
Reverse time migration of phase-encoded all-order multiples
Authors: Liu Yike , Zhang Yanbao , Zheng Yingcai
Published: December 2021

Multiples follow long paths and carry more information on the subsurface than primary reflections, making them particularly useful for imaging. However, seismic migration using multiples can generate crosstalk artifacts in the resulting images because multiples of different orders interfere with each other and crosstalk artifacts greatly degrade the quality of an image. We form a supergather by applying phase-encoding functions to image multiples and stacking several encoded controlled-order multiples. The multiples are separated into different orders using multiple decomposition strategies. The method is referred to as the phase-encoded migration of all-order multiples (PEM). The new migration can be performed by applying only two finite-difference solutions to the wave equation. The solutions include backward extrapolating the blended virtual receiver data and forward propagating the summed virtual source data. Our approach can significantly attenuate crosstalk artifacts and also significantly reduce computational costs. Numerical examples demonstrate that PEM can remove relatively strong crosstalk artifacts generated by multiples and is a promising approach for imaging subsurface targets.
Sedimentary characteristics and sand-body distributions in the Lower Permian He 8 Member, Ordos Basin, China
Authors: Lu Zhiyuan , He Zhiliang , Ma Shizhong , He Yu
Published: December 2021

The Lower Permian He 8 Member (P1h8) in the Ordos Basin is a typical producing zone of tight lithologic gas reservoirs. Analyses of sedimentary characteristics, electrofacies, and sand-body distributions of P1h8, conducted on modern fluvial deposits, outcrops, cores, and well logs, revealed that braided rivers that developed in the Lower P1h8 and Upper P1h8 are characterized by meandering river. Within these fluvial deposits, the procedure consists of analyzing high-resolution sequence stratigraphy and sedimentary dynamics defined from calibrated logging curve signatures and depositional studies. According to modern and ancient fluvial deposits, we have developed a process-based sedimentary conceptual model for interpreting and predicting the distribution and geometries of sand bodies in braided and meandering deposits. The main sand body of the braided river system was bars and channel fill deposits. The braided river sand bodies are distributed over multiple vertical superimpositions and overlapping horizontal connections. The meandering river sand bodies are mainly point-bar deposits, which are bead-shaped and exhibit scattered development in the vertical direction. This comparison indicates that there were significant differences between braided and meandering deposystems. The sand bodies in the Lower P1h8 were multidirectionally connected and primarily distributed in a stacked pattern. In contrast, the sand bodies in the Upper P1h8 were distributed in an isolated manner, and fine grains (mud and silt) were deposited between the sand bodies with poor connectivity. We interpreted the fluvial deposits that control the distributions of the sand body of the He8 Member in the eastern Sulige gas field and constructed a corresponding prediction model of a braided-meandering reservoir. This model will promote understanding of the extent of fluvial deposits and sand-body distribution of P1h8, thus elucidating hydrocarbon-bearing sand units of the Ordos Basin for future exploration.
Impact of Hematology Electronic Consultations on Utilization of Referrals and Patient Outcomes in an Integrated Health Care System
Authors: Dosani Talib , Xiang Jenny , Wang Kaicheng , Deng Yanhong , Connell Nathan T. , Connery Donna , Levin Forrest , Roy Alicia , Wadia Roxanne J. , Wong Ellice Y. , Rose Michal G.
Published: December 2021

INTRODUCTION:

Electronic consultations (e-consults) may be a valuable tool in the current era of increased demand for hematologists. Despite the increasing use of e-consults in hematology, their optimal utilization and impact on patient outcomes and workload are largely unknown.

METHODS:

In this retrospective cohort study, we studied the hematology consult experience at Veterans Affairs Connecticut from 2006 to 2018. We included 7,664 hematology consults (3,240 e-consults and 4,424 face-to-face [FTF] consults) requested by 1,089 unique clinicians.

RESULTS:

We found that e-consults were rapidly adopted and used equally among physicians of different degrees of experience. The number of FTF consults did not decrease after the introduction of e-consult services. E-consults were preferentially used for milder laboratory abnormalities that had been less likely to result in a consult before their availability. Referring clinicians used e-consults preferentially for periprocedural management, anemia, leukopenia, and anticoagulation questions. Eighty-three percent of e-consults were resolved without needing an FTF visit in the year after the consult. Consults for pancytopenia, gammopathy, leukocytosis, and for patients with known malignancy were less likely to be resolved by e-consult. Among patients who were diagnosed with a new hematologic malignancy after their consult, having an e-consult before an FTF visit did not adversely affect survival.

CONCLUSION:

In summary, e-consults safely expanded delivery of hematology services in our health care system but increased total consult volume. We report novel data on what types of consults may be best suited to the electronic modality, the impact of e-consults on workload, and their optimal use and implementation.
Different Associations Between Inpatient or Outpatient Palliative Care and End-of-Life Outcomes for Hospitalized Patients With Cancer
Authors: Yeh Jonathan C. , Urman Arielle R. , Besaw Robert J. , Dodge Laura E. , Lee Kathleen A. , Buss Mary K.
Published: December 2021

PURPOSE:

Palliative care (PC) improves outcomes in advanced cancer, and guidelines recommend early outpatient referral. However, many PC teams see more inpatient than outpatient consults. We conducted a retrospective study of hospitalized patients with cancer to quantify exposure to inpatient and outpatient PC and describe associations between PC and end-of-life (EOL) quality measures.

METHODS:

We identified all decedents admitted to an inpatient oncology unit in 1 year (October 1, 2017-September 30, 2018) and abstracted hospitalization statistics, inpatient and outpatient PC visits, and EOL outcomes. Descriptive statistics, univariate tests, and multivariate analysis evaluated associations between PC and patient outcomes.

RESULTS:

In total, 522 decedents were identified. 50% saw PC; only 21% had an outpatient PC visit. Decedents seen by PC were more likely to enroll in hospice (78% v 44%; P < .001), have do-not-resuscitate status (87% v 55%; P < .001), have advance care planning documents (53% v 31%; P < .001), and die at home or inpatient hospice instead of in hospital (67% v 40%; P < .01). Decedents seen by PC had longer hospital length-of-stay (LOS; 8.4 v 7.0 days; P = .03), but this association reversed for decedents seen by outpatient PC (6.3 v 8.3 days; P < .001), who also had longer hospice LOS (46.5 v 27.1 days; P < .01) and less EOL intensive care (6% v 15%; P < .05).

CONCLUSION:

PC was associated with significantly more hospice utilization and advance care planning. Patients seen specifically by outpatient PC had shorter hospital LOS and longer hospice LOS. These findings suggest different effects of inpatient and outpatient PC, underscoring the importance of robust outpatient PC.
Time Difference in the Social Transformation of China and Korea: A Case Study of Water-Moon Avalokiteśvara Paintings of the Song and Yuan Dynasties and the Koryŏ Dynasty
Authors: Lee Hyun Joo
Published: December 2021

The Water-Moon form of Avalokiteśvara arose in China during the process of nativization of Buddhism in Tang China. Extant images of Water-Moon Avalokiteśvara tend to have been painted in either China or Korea, but there is an odd dislocation in the changes of style, with the colorful Koryŏ dynasty images paralleling not contemporary Song trends but rather those from hundreds of years earlier. That this effect might simply be a delay caused by geographical distance seems unlikely given the active cultural exchange between the two realms. Dramatic changes occurred in the Tang-Song era, including the rise of plebeian culture and Zen Buddhism. This carried over to a more minimalist style of art in China. Meanwhile, in Koryŏ, Buddhism continued to receive royal sponsorship and remain influential. This article argues that the differences in images and techniques between Koryŏ and Song-Yuan paintings of Water-Moon Avalokiteśvara were caused by the time difference in the social transformations of China and Korea.
ICON 2022 Supplement
Authors: Amanullah Farhana , Ansari Naila Baig
Published: December 2021

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5770

How to cite this:Amanullah F, Baig-Ansari N. ICON 2022 Supplement. Pak J Med Sci. 2022;38(2):333.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5770

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Congenital Pouch Colon in a Neonate
Authors: Niaz Sana , Naz Sahira , Raziq Rumaissa Abdul
Published: December 2021

Congenital Pouch Colon (CPC) is a rare anorectal malformation (ARM) in which a part of or the entire colon is replaced by pouch-like dilatation. Males are more likely to be diagnosed with the condition compared to females. The highest incidence of the disease is in South Asia, with a significant number of cases reported from India. Early diagnosis can be made when there are hypoechogenic lesions on antenatal ultrasound scans. We report a case of a neonate with routine antenatal scans who presented with a distended abdomen and inability to pass feces. The diagnosis was made in the early neonatal period, followed by surgical management.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5771

How to cite this:Niaz S, Naz S, Raziq RA. Congenital Pouch Colon in a Neonate. Pak J Med Sci. 2022;38(2):426-429.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5771

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Wound closure after total knee replacement: Comparison between staples and sutures
Authors: Khan Mansoor Ali , Memon M. Waseem , Chinoy Amin , Javed Salman , Barkat Rahil , Jiwani Ahsun
Published: December 2021

Background and Objective: Total Knee Arthroplasty is a commonly performed procedure for arthritic knees. Preventing complications is of utmost importance for good functional outcomes and preventing morbidity. Wound closure after the procedure is as important as the replacement aspect of surgery.The objective of this study was to provide subjective and objective evidence of better closure technique and material; we conducted the study so that the outcome of TKA can be further improved.

Methods: We conducted a randomized trial at The Indus Hospital, Karachi, from December 2018 to June 2020. All patients from age 40 to 70 years who underwent total knee arthroplasty were included in the study. The wound of one knee was closed with Polypropylene (Prolene) sutures, and the other with staples. The wound was assessed independently by two assessors using Hollander’s score; lower score means a worse outcome. All data was entered and analyzed using STATA version 16.

Results: Thirty patients who underwent bilateral total knee replacement were included in the analysis, among which 71.8% were female. The average age of participants was 57.3 (± 7.5) years. The mean incision length on the right knee was 17.6 ± 1.1 cm, while on the left the incision length was 18.3 ± 1.2 cm. Overall, the mean Hollander score was significantly different among participants in the sutures and staples group in both the right (p-value=0.001) and left knees (p-value=0.001). The score was significantly higher in knees closed with sutures as compared to staples. Also, the mean Hollander score is significantly higher in females than males in both the right knee (B=0.56, p-value=0.049) and the left knee (B=0.38, p-value=0.044).

Conclusion: The study has shown that Hollander’s score was significantly higher in knees closed with sutures as compared to the patients in whom staples were used for wound closure.

doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782

How to cite this:Khan MA, Memon MW, Chinoy A, Javed S, Barkat R, Jiwani A. Wound closure after total knee replacement: Comparison between staples and sutures. Pak J Med Sci. 2022;38(2):340-344. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
New and rare lichens and allied fungi from Arkhangelsk Region, North-West Russia. II
Authors: Tarasova Viktoria N. , Androsova Vera I. , Sonina Angella V.
Published: December 2021

Information about 38 species of lichens is presented. In total, 18 species are newly recorded for Arkhangelsk Region, 11 species are new for its mainland area. New localities for 9 rare species are presented. Thalloidima physaroides is new for the territory of Northwest Russia. The species Sclerophora peronella is reported for the second time in the whole territory of Russia, Calicium pinicola – in European Russia and Rhizocarpon simillimum – in Northwest Russia. For Vezdaea rheocarpa and Pilophorus robustus the westernmost localities in Russia are reported. The new localities of 9 species included in the Red Data Book of Arkhangelsk Region are presented. Six species are added to the list of lichens of Vodlozersky National Park.
Communication Tools to Protect Brand Reputation
Authors: Golub O. , Selivanyuk A.
Published: December 2021

The article actualizes the problem of developing a strategy and tactics for protecting a brand’s reputation in a crisis situation. The key elements of a crisis communication plan are described, tools are analyzed that help to reduce the reputational costs of an organization in a crisis. The virtualization of communications and the expansion of network interactions necessitate the use of the potential of modern media for wider coverage of target audiences in order to strengthen brand reputation. It is shown that the effective management of information flows, the use of PR technologies in new media along with traditional methods of organizing crisis communications in new media makes it possible to reduce reputational risks to a minimum. Implementation of the policy of active Internet presence through the organization and management of network communications forms another basis for successfully overcoming crisis phenomena, correcting reputation, increasing awareness, and ensuring a more stable brand position.
Strategic Partnership in the Shadow of History
Authors: Sawicz Agnieszka
Published: December 2021

The article analyses selected problems in the implementation of the Polish-Ukrainian strategic partnership assumptions. The aspects of bilateral relations that undoubtedly made it difficult to engage in a constructive dialogue in the 21st century, were outlined. It was also pointed out that the implementation of foreign policy assumptions in both countries is often the result of a historical politics and a mythologized image of a neighbouring country. In addition, putting the historical discourse over political, economic and social took part in the events. Kwaśniewski recalled then “the bravery and merits of those soldiers problems may result in lowering the standards of democracy, and the expectation from the other side to accept a specific vision of the past may indicate that politicians are focused on domestic politics at the expense of the country’s position on the international arena.
Investigación en educación artística desde la perspectiva del interaccionismo simbólico.
Authors: Castro-León Elke
Published: December 2021

Se presenta este trabajo como un ejercicio de reflexión científica al respecto de la investigación cualitativa en el ámbito de la educación artística, que se centra en la perspectiva del interaccionismo simbólico y la intersubjetividad generada entre los individuos que constituyen una comunidad en interacción. Se parte de la premisa de una concepción del aprendizaje como proceso social y dinámico de construcción del conocimiento e institución de relaciones conceptuales. Es considerado que, durante este proceso, el sujeto inferido por sus esquemas interpretativos y sus sentimientos interviene activamente en un entorno determinado ocasionando el surgimiento de nuevas significaciones y la recreación constante de sentidos. Se establece que el interaccionismo simbólico, como metodología de investigación que se desarrolla siguiendo un proceso heurístico encaminado a explorar los acontecimientos que tienen lugar en el ecosistema del aula, nos ofrece un marco de interpretación que posibilita analizar la perspectiva del sujeto que experiencia situaciones de aprendizaje artístico. Al tiempo que favorece el acercamiento y la comprensión de la realidad operativa definida por nuestros estudiantes.
Verbal Aggression Between Allies: Canada in Donald Trump’s Trade War Rhetoric
Authors: Soroka Tomasz
Published: December 2021

The article explores Donald Trump’s protectionist rhetoric relating to bilateral trade relations between Canada and the U.S. In particular, it presents how Trump’s isolationist economic platform evolved into trade war rhetoric and how this rhetoric affected Canada. To that end, the article analyzes President Trump’s statements and policies regarding the renegotiations of NAFTA, his administration’s tariff policies relating to imports of Canadian softwood lumber, steel and aluminum, and Trump’s opinions published in social media, mainly on Twitter. It also takes a comparative look on Donald Trump’s and Justin Trudeau’s ideological profiles to explain Trump’s lack of sympathy and hardline rhetoric against Canada.
Między Marokiem a Algierią
Authors: Kłosowicz Robert
Published: December 2021

Between Morocco and Algeria: Mauritania and the question of Western Sahara
Following the change of government and the election of a new president, Mauritania makes it clear that it hopes to resolve the issue of Western Sahara, which has divided Morocco and Algeria since the mid-1970s and still poses a serious problem to Mauritanian foreign policy. Mauritania in this dispute is between the proverbial rock and a hard place, trying not to come into conflict with any of the powerful neighbors, each of whom aspires to the role of a leader in the region. The conflict also casts a shadow on regional cooperation within the Arab Maghreb Union, which, if it functioned, could greatly help in the economic development of the region, especially important for the economically weakest Mauritania. Over the last few years, Nouakchott has maintained the position of the so-called “positive neutrality” which irritated the authorities in Rabat and created tense political relations with Morocco. The current striving for a more active role in the process of resolving the Western Saharan conflict seems to be largely dictated by the internal situation in Algeria and its troubles related to social protests demanding changes at the top of the government. Algeria has been the greatest ally of the Polisario Front and the Sahrawi cause so far. It is also not without significance that Morocco, after years of absence, returned to the African Union – the move, which definitely strengthened Morocco’s position among the countries of the continent.
Postapokaliptyczna wizja Rosji (na przykładzie współczesnej antyutopii rosyjskiej)
Authors: Duda Katarzyna
Published: December 2021

Post-apocalyptic Vision of Russia (Based on Modern Russian Distopia)
The following article focuses on the new genre of antiutopia which appeared after the collapse of the USSR. Not only do we consider the antiutopia as the literary genre but as the attitude toward reality and the style of thinking as well. Modern antiutopia (like Kysh by Tatyana Tolstoy) does not warn us against communism together with its concentration camps, tortures and utopian ideas… It shows what can happen with people when they will lose their culture, especially literature and language. The human beings change into creatures with special ugly effects, their mentality is badly disturbed and they behave as newborn children. The citizens of Russian country presented in Kysh, are afraid of everything and everybody only because they do not know their history, the knowledge about themselves. Books are strictly forbidden, thinking and reading seem to be the worst illness. Paradoxically special brigade of firemen was created in order to burn down books and to kill their holders. It turned out that people may regain their identity only by overcoming their fear.
Uczestnictwo społeczne a pandemia w warunkach rosyjskich. A. D. 2020
Authors: Jach Anna
Published: December 2021

Social Participation and the Pandemic in Russian Conditions: A.D. 2020
The aim of this analysis is a diagnosis of grassroots social (individual and group) participation in the conditions of the state in deepening crisis – the state which not for the first time has turned out to be not only unprepared, but also unable and uninterested in undertaking effective actions preventing and mitigating the results of the pandemic. The accompanying question concerns the endurance of the civil society emerging in an authoritarian state the RF undoubtedly is – the society which, having once tasted self-organization and independence, will not be interested in giving up their constitutional civil freedoms or political, cultural and social rights. What invariably remains an important tool used in the analyzed process is the Internet, which still is beyond the control of Russian state structures.
Miejsce Rosji w doktrynie Giedroycia
Authors: Siudak Michał
Published: December 2021

The Place of Russia in Giedroyć’s Doctrine: Between Partnership and Rivalry
This article is devoted to the presence of Russia and the Soviet Union in the doctrine of Jerzy Giedroyc, the founder of the Paris-based Kultura – a political centre which significantly influenced and continues to influence Polish Eastern policy. The evolution of the centre's views on the role and place of Russia in the geopolitical security system of Central and Eastern Europe from the immediate post-war period to the fall of communism and Polish accession to the EU and NATO is presented. The article discusses the issue of Polish-Russian geopolitical and geocultural rivalry in Central and Eastern Europe with particular emphasis on Ukraine, and tries to analyse the vision of Polish-Russian relations proposed by the representatives of Polish political and geopolitical thought in exile. The author also asks the question about the topicality of the discussed doctrine in the changing geopolitical system.
Regulacje „antyfaszystowskie” jako narzędzie transformacji ustrojowej w Polsce: kazus tzw. małego kodeksu karnego z 1946 r.
Authors: Val Katarzyna du
Published: December 2021

“Antifascist” Regulations as a Tool of Systemic Transformation in Poland: The Case of the So-called Small Penal Code of 1946
In Poland in the mid-1940s a number of „anti-fascist” regulations came into force. However, they served mostly as a propaganda tool aimed at fighting political opponents and building a new order. In this context, attention should be drawn to „anti-fascist” provisions contained in a Decree on particularly dangerous crimes during the rebuilding of the State of June 13, 1946 (aka „small penal code”).
Epidemias en los márgenes: la peste bubónica (1903-1905) y la COVID-19 en el sur andino peruano
Authors: Palma Patricia , Lizarme Villcas Nashely
Published: December 2021

Introducción: la epidemia de COVID-19 ha dejado en evidencia una serie de problemas de desigualdad en el acceso a la salud pública en Perú, especialmente en las provincias alejadas de la capital, donde se observa precariedad tanto en infraestructura como en personal sanitario. Este artículo analiza cómo el Gobierno y la población han hecho frente a epidemias en el sur de Perú, usando como casos de estudio el COVID-19 y la peste bubónica ocurrida en 1903 y 1905, con el fin de entender continuidades en el manejo de la crisis epidémica y su respuesta a ellas. Desarrollo: se estudia la epidemia de la peste bubónica en las ciudades de Arequipa y Mollendo en 1903 y 1905 y el COVID-19, con un enfoque en el funcionamiento del sistema de salud local y nacional, en la infraestructura sanitaria disponible para enfrentar epidemias y, finalmente, en las respuestas sociales de la población respecto al escepticismo de las medidas impuestas por las autoridades y al incremento de la automedicación. Conclusiones: la epidemia del COVID-19 en el sur de Perú presenta importantes similitudes con la epidemia de peste bubónica que afectó a la región a inicios del siglo XX: desorden de responsabilidades, falta de previsión para hacer frente a enfermedades epidémicas, infraestructura precaria y una población con alto grado de desconfianza frente a las recomendaciones de las autoridades civiles y sanitarias.
Modifying Transactional Databases to Hide Sensitive Association Rules
Authors: Menon Syam , Ghoshal Abhijeet , Sarkar Sumit
Published: December 2021

Although firms recognize the value in sharing data with supply chain partners, many remain reluctant to share for fear of sensitive information potentially making its way to competitors. Approaches that can help hide sensitive information could alleviate such concerns and increase the number of firms that are willing to share. Sensitive information in transactional databases often manifests itself in the form of association rules. The sensitive association rules can be concealed by altering transactions so that they remain hidden when the data are mined by the partner. The problem of hiding these rules in the data are computationally difficult (NP-hard), and extant approaches are all heuristic in nature. To our knowledge, this is the first paper that introduces the problem as a nonlinear integer formulation to hide the sensitive association rule while minimizing the alterations needed in the data set. We apply transformations that linearize the constraints and derive various results that help reduce the size of the problem to be solved. Our results show that although the nonlinear integer formulations are not practical, the linearizations and problem-reduction steps make a significant impact on solvability and solution time. This approach mitigates potential risks associated with sharing and should increase data sharing among supply chain partners.
Frontiers: The Persuasive Effect of Fox News: Noncompliance with Social Distancing During the COVID-19 Pandemic
Authors: Simonov Andrey , Sacher Szymon , Dubé Jean-Pierre , Biswas Shirsho
Published: December 2021

Cable news channels—and Fox News in particular—affected the extent to which viewers’ complied with experts’ social distancing guidelines early on in the COVID-19 pandemic.
Fair Cake Division Under Monotone Likelihood Ratios
Authors: Barman Siddharth , Rathi Nidhi
Published: December 2021

This work develops algorithmic results for the classic cake-cutting problem in which a divisible, heterogeneous resource (modeled as a cake) needs to be partitioned among agents with distinct preferences. We focus on a standard formulation of cake cutting wherein each agent must receive a contiguous piece of the cake. Although multiple hardness results exist in this setup for finding fair/efficient cake divisions, we show that, if the value densities of the agents satisfy the monotone likelihood ratio property (MLRP), then strong algorithmic results hold for various notions of fairness and economic efficiency. Addressing cake-cutting instances with MLRP, first we develop an algorithm that finds cake divisions (with connected pieces) that are envy free, up to an arbitrary precision. The time complexity of our algorithm is polynomial in the number of agents and the bit complexity of an underlying Lipschitz constant. We obtain similar positive results for maximizing social, egalitarian, and Nash social welfare. Many distribution families bear MLRP. In particular, this property holds if all the value densities belong to any one of the following families: Gaussian (with the same variance), linear, Poisson, and exponential distributions, linear translations of any log-concave function. Hence, through MLRP, the current work obtains novel cake-cutting algorithms for multiple distribution families.