bluuebunny/crossref_metadata_2025 huggingface dataset:
A GIS based approach to neighbourhood physical environment and walking among adults in Colombo Municipal Council Area, Sri Lanka
Authors: Weliange Shreenika De Silva , Fernando Dulitha , Withanage Shanthi , Gunatilake Jagath
Published: January 2021

Background Physical Activity (PA) promotes health and wellbeing and walking is one of the easiest and commonest way to incorporate activity into everyday life. This study examined the association between the objectively measured neighbourhood physical environment and walking among the adults in Colombo Municipal Council (CMC) area in Sri Lanka. Methods A cross sectional study was carried out and primary data collection carried out to assess walking, socio-demographic characteristics and geo location of residence. Secondary data was obtained to assess neighbourhood environment from existing spatially referenced data from the survey department of Sri Lanka. Geographic Information Systems (GIS) was used to calculate density measures (residential density, land use, connectivity and access) and distance measures, which were then correlated with walking. Results A sample consisted of 284 adults aged 29-59 years with a mean age of 40.6 (SD,10.9) years. The total mean minutes walked a week was 175.8 minutes with a standard deviation of 214.0. The mean and the standard deviations of walking per week for transportation and leisure were 158.4 (SD,196.6) and 17.5 (SD,70.1) respectively. Residential density measures, building foot print area, length of major roads, number of intersections, number of bus stops, and distance to nearest major roads showed significant moderate degree of correlations with total minutes of walked per week, (p < 0.001). These results were similar with walking for transportation. Conclusion There is indication that neighbourhood features are associated with walking among the adults in the CMC area using secondary data on physical environment. This paves way for further exploration to understand the relationship between neighbourhood physical environment and walking which could be used for effective interventions to promote walking.
Persistently higher serum sCD40L levels are associated with outcome in septic patients
Authors: Liang Yingjian , Zhu Chengrui , Sun Yini , Li Zhiliang , Wang Liang , Liu Yina , Li Xin , Ma Xiaochun
Published: January 2021

Background: Soluble CD40 ligand (sCD40L) exhibits proinflammatory and procoagulant effects. Recent data indicated that sCD40L plays a significant role in septic patients. The aim of the present study was to determine sCD40L changes in surgical patients without sepsis (SWS) and surgical sepsis patients (SS) during the first three days after intensive care unit (ICU) admission and to observe the association between sCD40L and mortality.Methods: Time changes in sCD40L levels were assessed for 3 days after ICU admission in 49 patients with SS and compared with those in 19 SWS patients. Serum sCD40L concentration was detected by ELISA. Survival at 28 days served as the endpoint.Results: SS had significantly higher sCD40L levels than SWS and control patients. We observed an association between sCD40L levels ≥1028.75 pg/mL at day 2 and 28-day mortality (odds ratio=7.888; 95% confidence interval=1.758 to 35.395; P=0.007). We could not discover any significant differences in sex, presence of septic shock, site of infection, length of stay in the ICU, PaO2/FiO2 ratio, incidence of AKI, ARDS, or type of surgery between nonsurvivors and survivors.Conclusions: Septic patients show persistently higher circulating sCD40L levels in the first three days after ICU admission, and serum sCD40L levels are associated with the mortality of patients with sepsis. Thus, serum sCD40L may be used as a reliable biomarker and therapeutic target in sepsis.
Long-term outcomes of prediction error after combined phacoemulsification and trabeculectomy in glaucoma patients
Authors: Kang Yeon Soo , Sung Mi Sun , Heo Hwan , Ji Yong Sok , Park Sang Woo
Published: January 2021

Background: To investigate long-term outcomes of prediction error after phacotrabeculectomy and to determine risk factors that may cause unstable prediction error after phacotrabeculectomy in glaucoma patients.Methods: A total 120 eyes of 120 patients who had underwent uncomplicated phacotrabeculectomy (combined group) or phacoemulsification (phaco-only group) were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) were measured before and after surgery, and anterior segment parameters including anterior chamber depth (ACD), lens vault (LV), and anterior vault (AV) measured using anterior-segment optical coherence tomography were compared between the two groups. The mean absolute error (MAE) at 3, 6, 12, and 24 months postoperatively were compared. Risk factors associated with unstable prediction error (MAE ≥ 0.5) were investigated in the combined group.Results: In both groups, BCVA was improved and IOP was decreased significantly. MAE at 3, 6, 12, 24 months postoperatively were not significantly different between two groups. The risk factors for unstable prediction error after 12 months of phacotrabeculectomy were old age and LV. Whereas, the only factor predicting unstable prediction error after 24 months of phacotrabeculectomy was LV. The cut-off value of LV for predicting unstable refractive error analyzed by the ROC curve was 0.855 mm.Conclusions: Phacotrabeculectomy may be an effective treatment with stable long-term outcomes of prediction error similar to phacoemulsification in patients with glaucoma. However, elderly patients or patients with large LV may be predisposed to unstable prediction error after phacotrabeculectomy.
Cognitive Functioning in Deaf Children Using Cochlear Implants
Authors: Almomani Fidaa , Almomani Murad O , Garadat Soha , Alqudah Safa , Kassab Manal , Hamadneh Shereen , Rauterkus Grant , Gans Richard
Published: January 2021

BACKGROUND: Cognitive abilities like language, memory, reasoning, visualization, and perceptual functioning shape human action and are considered critical to the successful interaction with the environment. Alternatively, hearing loss can disrupt a child’s ability to communicate, and negatively impact cognitive development. Cochlear implants (CI) restore auditory input thereby supporting communication and may enhance cognitive performance. This study compares general cognitive development after cochlear implantation (2017-2019) in two groups of Jordanian children implanted earlier (age:4-6 years, N=22) and later (7-9 years, N=16) to the development of randomly selected normal hearing peers (N=48).DESIGN: Visualization, reasoning, memory, and attention were assessed using the Leiter-R scale at baseline (before implantation), 8 months and 16 months post implantation for children with hearing loss. Same times of testing (baseline, 8 months and 16 months) were used for normal hearing peers. RESULTS: Over the 16-month period, the cognitive improvement of 4-6-year-old deaf children was greater than that of their normal hearing peers on the scales of visualization (5.62 vs. 4.40), reasoning (2.53 vs. 2.38) and memory (17.19 vs. 11.67). while the improvement of 7-9-year-old was less major than that of their normal hearing peers on all scales. CONCLUSIONS: These results suggest that CI not only enhances communication skills but may improve cognitive functioning in deaf children. However, the extent of this improvement was dependent on age at intervention; current results demonstrated that the children received CI at young ages had better cognitive improvements.
Hindlimb torsional alignment changes in growing rabbits after patellar dislocation
Authors: Niu Jinghui , Qi Qi , Piao Kang , Hao Kuo , Sharif Iftekhar , Wang Fei
Published: January 2021

Background: Torsional malalignment has been considered as a risk factor for patellar dislocation. But the influence of patellar dislocation for torsional alignment development remains unknown. The present study aims to investigate whether the torsional alteration of the hindlimb occurs after patellar dislocation in growing rabbits. Methods: In the present study, 30 one-month-old rabbits were included. The experimental group consisted of 30 left knees of rabbits which underwent patellar lateral dislocation. The control group consisted of 30 right knees of the rabbits which no surgical procedure was performed. The Computed Tomography (CT) scan was performed after the surgery and at the point the rabbits were skeletal mature (5 months post-surgery). The angles of femoral version and tibial torsion were measured using a three-dimensional method and analyzed between the experimental group and the control group. Results: After the surgery, the femoral version and tibial torsion in the experimental and control group were not significantly different. However, 5 months after surgery, the angle of femoral version in the experimental group (-5.50 ± 6.13°) was significantly different from that in the control group (-10.90 ± 4.74°) (P < 0.05). But the angle of tibial torsion in the experimental group (7.17 ± 7.25°) and control group (4.47 ± 6.34°) were not significantly different (P = 0.144). Conclusion: From this study, patellar dislocation can lead to alteration of femoral version in growing rabbits. So patellar dislocation may affect on lower extremity alignment. These findings may develop pathology and etiology of patellar dislocation.
Mapping the Organizational Readiness to Change Assessment to the Consolidated Framework for Implementation Research
Authors: Kononowech Jennifer , Hagedorn Hildi , Hall Carmen , Helfrich Christian D. , Lambert-Kerzner Anne C. , Miller Susan C. , Sales Anne E. , Damschroder Laura
Published: January 2021

Background: Implementation researchers recognize the influential role of organizational factors and thus, seek to assess these factors using quantitative measurement instruments. However, researchers are hindered by instruments that measure similar constructs but rely on different nomenclature and/or definitions. The Consolidated Framework for Implementation Research (CFIR) provides a taxonomy of constructs derived from prior frameworks and empirical studies of implementation-related constructs. The CFIR includes constructs based on the original Promoting Action Research into Health Services (PARiHS) framework which highlights the key roles of strength of evidence for a specific evidence-based intervention (EBI); favorability of organizational context for change; and capacities to facilitate implementation of the EBI. Although the CFIR is among the most frequently used implementation frameworks, it does not include quantitative measures. The Organizational Resource and Context Assessment (ORCA) is a quantitative measurement instrument that was developed based on PARiHS, assessing its three domains. Factors within these three domains are conceptually similar to constructs in the CFIR but do not match directly. The aim of this work was to map ORCA survey items to CFIR constructs to enable direct comparisons and syntheses of findings across studies using the CFIR and/or ORCA. Methods: Two distinct, independent research teams, each used rigorous constant comparative techniques with deliberation and consensus to map individual items from the ORCA to the five domains and 39 constructs of CFIR. Results: ORCA items were mapped primarily to three of five CFIR domains: Inner Setting, Process and Intervention Characteristics. The two research teams agreed on 88% of mappings at the higher domain level; at the lower construct level, their mappings aligned for 62.2% of the ORCA items. Conclusions: Mapping results reveal that the ORCA focuses measurement prominently on Inner Setting, Process, and Intervention Characteristics. This mapping guide can help improve consistency in measurement and reporting, enabling more efficient comparison and synthesis of findings that use either the ORCA instrument or the CFIR framework. The guide helps advance implementation science utilizing mixed methods by providing CFIR users with quantitative measures for selected constructs and enables ORCA users to map their findings to CFIR constructs.
Cost-effectiveness of Out-of-Hospital Continuous Positive Airway Pressure for Acute Respiratory Failure: Decision analytic modelling using data from a feasibility trial
Authors: Thokala Praveen , Fuller Gordon W , Goodacre Steve , Keating Samuel , Herbert Esther , Perkins Gavin , Rosser Andy , Gunson Imogen , Miller Joshua , Ward Matthew , Bradburn Mike , Harris Tim , Marsh Maggie , Ren Kate , Cooper Cindy
Published: January 2021

Background Standard prehospital management for Acute respiratory failure (ARF) involves controlled oxygen therapy. Continuous positive airway pressure (CPAP) is a potentially beneficial alternative treatment, however, it is uncertain whether this could improve outcomes and provide value for money. This study aimed to evaluate the cost-effectiveness of prehospital CPAP in ARF.Methods A cost-utility economic evaluation was performed using a probabilistic decision tree model synthesising available evidence. The model consisted of a hypothetical cohort of patients in a representative ambulance service with undifferentiated ARF, receiving standard oxygen therapy or prehospital CPAP. Costs and quality adjusted life years (QALYs) were estimated using methods recommended by NICE.Results In the base case analysis, using CPAP effectiveness estimates form the ACUTE trial, the mean expected costs of standard care and prehospital CPAP were £15,201 and £14,850 respectively and the corresponding mean expected QALYs were 1.190 and 1.128, respectively. The mean ICER estimated as standard oxygen therapy compared to prehospital CPAP was £5,685 per QALY which indicated that standard oxygen therapy strategy was likely to be cost-effective at a threshold of £20,000 per QALY (67% probability). The scenario analysis, using effectiveness estimates from an updated meta-analysis, suggested that prehospital CPAP was more effective (mean incremental QALYs of 0.157), but also more expensive (mean incremental costs of £1,522), than standard care. The mean ICER, estimated as prehospital CPAP compared to standard care, was £9,712 per QALY. At the £20,000 per QALY prehospital CPAP was highly likely to be the most cost-effective strategy (94%). Conclusions Cost-effectiveness of prehospital CPAP depends upon the estimate of effectiveness. When based on a small pragmatic feasibility trial, standard oxygen therapy is cost-effective. When based on meta-analysis of heterogeneous trials, CPAP is cost-effective. Value of information analyses support commissioning of a large pragmatic effectiveness trial, providing feasibility and plausibility conditions are met.
The Knowledge of Danger Signs of Obstetric Complications among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program
Authors: Ahmad Danish , Mohanty Itismita , Hazra Avishek , Niyonsenga Theo
Published: January 2021

Background: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Methods: Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the individual, household, and community level. Results: SHG member women receiving health literacy were 27 per cent more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. Conclusions: The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.
Frequency of Providing a Palliative Approach to Care in Family Practice: A Chart Review and Perceptions of Healthcare Practitioners in Canada
Authors: Gallagher Erin , Carter-Ramirez Daniel , Boese Kaitlyn , Winemaker Samantha , MacLennan Amanda , Hansen Nicolle , Hafid Abe , Howard Michelle
Published: January 2021

Background: Most patients nearing the end of life can benefit from a palliative approach in primary care. We currently do not know how to measure a palliative approach in family practice. The objective of this study was to describe the provision of a palliative approach and evaluate their clinicians’ perceptions of the results.Methods: We conducted a descriptive study of deceased patients in an interprofessional team family practice. We integrated conceptual models of a palliative approach to create a chart review tool to capture a palliative approach in the last year of life and assessed a global rating of whether a palliative approach was provided. Clinicians completed a questionnaire before learning the results and after, on perceptions of how often they believed a palliative approach was provided by the team.Results: Among 79 patients (mean age at death 73 years, 54% female) cancer and cardiac diseases were the top conditions responsible for death. One-quarter of patients were assessed as having received a palliative approach. 53% of decedents had a documented discussion about goals of care, 41% had nurse involvement, and 15.2% had a discussion about caregiver well-being. These indicators had the greatest discrimination between a palliative approach or not. Agreement that elements of a palliative approach were provided decreased significantly on the clinician questionnaire from before to after viewing the results. Conclusions: This study identified measurable indicators of a palliative approach in family practice, that can be used as the basis for quality improvement.
Cryopreserved human adipose-derived stromal vascular fraction maintains fracture healing potential via angiogenesis and osteogenesis in an immunodeficient rat model
Authors: Kamenaga Tomoyuki , Kuroda Yuichi , Nagai Kanto , Tsubosaka Masanori , Takashima Yoshinori , Kikuchi Kenichi , Fujita Masahiro , Ikuta Kemmei , Anjiki Kensuke , Maeda Toshihisa , Nakano Naoki , Takayama Koji , Hashimoto Shingo , Hayashi Shinya , Matsushita Takehiko , Niikura Takahiro , Kuroda Ryosuke , Matsumoto Tomoyuki
Published: January 2021

Background: Novel therapeutic strategies for the healing of nonunion, which has serious effects on the quality of life of patients, are needed. We evaluated the therapeutic effect of local transplantation of human stromal vascular fraction (SVF) cells on fracture healing in a rat non-healing fracture model and compared the effects between freshly isolated (F) and cryopreserved (C)-SVFs. Methods: Nonhealing fracture model was induced in the femur of female immunodeficient rats (F344/N Jcl rnu/rnu) with cauterizing periosteum. Immediately after the creation of non-healing fracture, rats received local transplantation of F and C-SVFs suspended in phosphate-buffered saline (PBS) or the same volume of PBS without cells using the same scaffold as a control group. During 8 weeks post-surgery, radiologic, histological, immunohistochemical, and biomechanical analyses were performed to evaluate fracture healing. The comparison of radiological results was performed with a chi-square test, and the multiple comparisons of immunohistochemical, histological and biomechanical results among groups were made using a one-way analysis of variance. A probability value of 0.05 was considered to denote statistical significance.Results: At week 8, in 60% of animals receiving F-SVF cells and in 50% of animals receiving C-SVF cells, the fracture radiologically healed with bone union whereas nonunion was observed in the control group. The healing potential was also confirmed by histological and biomechanical assessments. One of the mechanisms underlying healing involving intrinsic angiogenesis/osteogenesis was enhanced in F- and C-SVF groups compared with that in the control group. Human cells-derived vasculogenesis/osteogenesis, which was also confirmed in an in vitro differentiation assay, was also enhanced in the F- and C-SVF groups compared with that in the control groups and could be another mechanism for healing. Conclusions: SVF cells can enhance bone healing and cryopreserved cells have almost equal potential as fresh cells. SVF cells can be used for improving nonunion bone fracture healing as an alternative to other mesenchymal stem cells and the effect of SVF cells can be maintained under cryopreservation.
An Improved BM25 Algorithm for Clinical Decision Support in Precision Medicine based on Co-word Analysis and Cuckoo Search
Authors: zhang zicheng
Published: January 2021

Background: Retrieving gene and disease information from a vast collection of biomedical abstracts to provide doctors with clinical decision support is one of the important research directions of Precision Medicine. Method: We propose a novel article retrieval method based on expanded word and co-word analyses, also conducting Cuckoo Search to optimize parameters of the retrieval function. The main goal is to retrieve the abstracts of biomedical articles that refer to treatments. The methods mentioned in this manuscript adopt the BM25 algorithm to calculate the score of abstracts. We, however, propose an improved version of BM25 that computes the scores of expanded words and co-word leading to a composite retrieval function, which is then optimized using the Cuckoo Search. The proposed method aims to find both disease and gene information in the abstract of the same biomedical article. This is to achieve higher relevance and hence score of articles. Besides, we investigate the influence of different parameters on the retrieval algorithm and summarize how they meet various retrieval needs. Results: The data used in this manuscript is sourced from medical articles presented in Text Retrieval Conference (TREC):Clinical Decision Support (CDS) Tracks of 2017, 2018, and 2019 in Precision Medicine. A total of 120 topics are tested. Three indicators are employed for the comparison of utilized methods, which are selected among the ones based only on the BM25 algorithm and its improved version to conduct comparable experiments. The results showed that the proposed algorithm achieves better results.Conclusion: The proposed method, an improved version of the BM25 algorithm, utilizes both co-word implementation and Cuckoo Search, which has been verified achieving better results on a large number of experimental sets. Besides, a relatively simple query expansion method is implemented in this manuscript. Future research will focus on ontology and semantic networks to expand the query vocabulary.
Disaster Safety Assessment of Primary Healthcare Facilities: A Cross-Sectional Study in Kurdistan province of Iran
Authors: Yari Arezoo , Zarezadeh Yadolah , Fatemi Farin , Ardalan Ali , Vahedi Siamak , Khoshsabeghe Homa Yousefi- , Boubakran Mohsen Soufi , Bidarpoor Farzam , Motlagh Mohamad Esmaeil
Published: January 2021

Background: Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential.Methods: In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01-66.0) and high (>66.0). Results: The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. Conclusions: The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.
Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve functionality of patients with mechanical neck pain: a randomized control study
Authors: Mylonas Konstantinos , Angelopoulos Pavlos , Billis Evdokia , Tsepis Elias , Fousekis Konstantinos
Published: January 2021

Background: The purpose of this study was to evaluate the short- and intermediate-term effects of the combined application of instrument-assisted soft tissue mobilization (IASTM) techniques andneuromuscular exercises of the cervical and thoracic area on the improvement of the functionality of patients with mechanical neck pain and accompanying forward head posture (FHP).Methods: Twenty patients with neck pain and FHP were randomized and received eight treatment sessions of either targeted IASTM in combination with neuromuscular exercises (Group A) or a classical massage and the same set of exercises (Group B). The cervical vertebral angle, cervical range of motion (ROM) and strength, and pain and disability were measured throughout the treatment period and in the two- and four-week post-treatment periods.Results: The combined application of IASTM and neuromuscular exercise (Group A) contributed to a significantly greater improvement in FHP and disability than massage and the application of the same exercises (Group B). Both interventions improved cervical ROM and strength in the short term. Pain was also improved in both groups in both the short and intermediate term.Conclusions: Combining IASTM and exercises for the cervical and thoracic area can induce positive postural adaptations and improve the functional status of neck pain patients.Trial registration: ISRCTN, ISRCTN54231174. Registered 19 March 2020 - Retrospectively registered, https://doi.org/10.1186/ISRCTN54231174
Incidence, characteristics, and outcomes of delirium in patients with noninvasive ventilation: A prospective observational study
Authors: Zhang Rui , Bai Linfu , Han Xiaoli , Huang Shicong , Zhou Lintong , Duan Jun
Published: January 2021

Background: Factors that may increase the risk for delirium and the firm knowledge around mechanism for delirium in noninvasive ventilation (NIV) patients is lacking. We investigated the incidence, characteristics, and outcomes of delirium in NIV patients. Methods: A prospective observational study was performed in an intensive care unit (ICU) of a teaching hospital. Patients in whom NIV was used as a first-line intervention were enrolled. During NIV intervention, delirium was screened using the Confusion Assessment Method for the ICU each day. The association between delirium and poor outcomes (e.g., NIV failure, ICU and hospital mortality) was investigated using forward stepwise multivariate logistic regression analyses.Results: We enrolled 1083 patients. Of these, 196 patients (18.1%) experienced delirium during NIV intervention. Patients with delirium had higher NIV failure rates (37.8% vs. 21.0%, p < 0.01), higher ICU mortality (33.2% vs. 14.3%, p < 0.01), and higher hospital mortality (37.2% vs. 17.0%, p < 0.01) than subjects without delirium. They also had a longer duration of NIV (median 6.3 vs. 3.7 days, p < 0.01), and stayed longer in the ICU (median 9.0 vs. 6.0 days, p < 0.01) and the hospital (median 14.5 vs. 11.0 days, p < 0.01). These results were confirmed in COPD and non-COPD cohorts. According to subtype, compared to hyperactive delirium patients, hypoactive and mixed delirium patients spent more days and many more days on NIV (median 3.4 vs. 6.5 vs. 10.1 days, p < 0.01). Similar outcomes were found for length of stay in the ICU and hospital. However, NIV failure, ICU mortality, and hospital mortality did not differ among the three subtypes.Conclusions: Delirium is associated with increases in poor outcomes (NIV failure, ICU mortality, and hospital mortality) and the use of medical resources (duration of NIV, and lengths of stay in the ICU and hospital). Regarding subtype, hypoactive and mixed delirium are associated with higher, and much higher, consumption of medical resources, respectively, compared to hyperactive delirium.
“It makes me feel not so alone”: Features of the Choose to Move physical activity intervention that reduce loneliness in older adults
Authors: Franke Thea , Sims-Gould Joanie , Nettlefold Lindsay , Ottoni Callista , McKay Heather A.
Published: January 2021

Background: Despite the well-known health benefits of physical activity (PA), older adults are the least active citizens. Older adults are also at risk for loneliness. Given that lonely individuals are at risk for accelerated loss of physical functioning and health with age, PA interventions that aim to enhance social connectedness may decrease loneliness and increase long-term PA participation. The objectives of this mixed-method study are to: (1) evaluate whether an evidence-based PA intervention (Choose to Move; CTM) influenced PA and loneliness differently among self-identified ‘lonely’ versus ‘not lonely’ older adults and (2) to describe factors within CTM components most likely to promote social connectedness/reduce loneliness.Methods: ﻿ CTM is a flexible, scalable, community-based health promoting physical activity intervention for older adults. Two community delivery partner organizations delivered 56 CTM programs in 26 urban locations across British Columbia. We collected survey data from participants (n=458 at baseline) at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We conducted in depth interviews with a subset of older adults to understand how CTM facilitated or impeded their PA and social connectedness.Results: PA increased significantly from baseline to 3 months in lonely and not lonely participants. PA decreased significantly from 3-6 months in lonely participants; however, PA at 6 months remained significantly above baseline levels in both groups. Loneliness decreased significantly from baseline to 3 and 6 months in participants identifying as lonely at baseline. Factors within CTM components that promote social connectedness/reduce loneliness include: Activity coach characteristics/personality traits and approaches; opportunity to share information and experiences and learn from others; engagement with others who share similar/familiar experiences; increased opportunity for meaningful interaction; and accountability.Conclusion: Health promoting interventions that focus on PA and social connectedness through group-based activities can effectively reduce social isolation and loneliness of older adults. Given the ‘epidemic of loneliness’ that plagues many countries currently, these kinds of interventions are timely and important. Research that further delineates mechanisms (e.g., sharing experiences vs. lectures), that modify the effect of an intervention on social connectedness outcomes for older adults engaged in community-based PA programs would be a welcome addition to the literature.
Calcium-dependent cytosolic phospholipase A2 activation is implicated in neuroinflammation and oxidative stress associated with ApoE4
Authors: Wang Shaowei , Li Boyang , Solomon Victoria , Fonteh Alfred , Rapoport Stanley I. , Bennett David A. , Arvanitakis Zoe , Chui Helena C. , Miller Carol A. , Sullivan Patrick M. , Wang Hoau-Yan , Yassine Hussein
Published: January 2021

Background: Apolipoprotein E4 (APOE4) is associated with a greater response to neuroinflammation and the risk of developing late-onset Alzheimer's disease (AD), but the mechanisms for this association are not clear. The activation of calcium-dependent cytosolic phospholipase A2 (cPLA2) is involved in inflammatory signaling and is elevated within the plaques of AD brains. The relation between APOE4 genotype and cPLA2 activity is not known.Methods: Mouse primary astrocytes, mouse and human brain samples differing by APOE genotypes were collected for measuring cPLA2 expression, phosphorylation, and activity in relation to measures of inflammation and oxidative stress. Results: Greater cPLA2 phosphorylation and activity was identified in ApoE4 compared to ApoE3 in primary astrocytes and brains of ApoE-targeted replacement (ApoE-TR) mice. These differences were also demonstrated in brain homogenates from the inferior frontal cortex from AD patients carrying APOE3/4 compared to APOE3/3. Higher cPLA2 activation with APOE4 was associated with greater activation of the MAPK p38 pathway in human postmortem frontal cortical synaptosomes and astrocytes, as well as with higher levels of leukotriene B4 (LTB4), reactive oxygen species (ROS), and inducible nitric oxide synthase (iNOS) in astrocytes. Inhibition of cPLA2 reduced LTB4, ROS, and iNOS levels in ApoE4 primary astrocytes to those in ApoE3 astrocytes. Conclusions: Our findings implicate greater activation of cPLA2 signaling system with APOE4, which could represent a potential drug target for mitigating the increased neuroinflammation with APOE4 and AD.
Compensation for moral damage caused as a result of an injury at work or occupational
disease
Authors: Vodopian T.V.
Published: January 2021

State policy in the field of occupational safety is aimed at creating proper, safe, and healthy working conditions, prevention of accidents and occupational injuries. Despite this, unfortunately, in Ukraine, many injuries, as well as deaths resulting from workplace injuries and illnesses, are recorded annually. According to the requirements of the labor legislation, the owner or his authorized body shall be entrusted with ensuring safe and harmless working conditions. Moral damage caused by workplace injuries and illness issues is governed by the rules of civil law and labor law and social security law. In the event of harm to an employee, the employer has a duty to compensate for material and moral damage, whereby the latter is liable to compensation if the violations of the employee’s legal rights have resulted in moral suffering, loss of normal life ties, and require him / her extra life for organizing. Both the employer and the Social Insurance Fund are subject to compensation for material damage caused to the employee as a result of workplace injuries and illnesses, and only the employer is responsible for moral damage. There are no clear algorithms for calculating the number of moral damages, the lower or the upper limit, and the court must consider the requirements of reasonableness and fairness in determining the number of moral damages. Moral damage is compensated irrespective of the material damage to be recovered and is not related to the amount of such compensation. The amount of moral damage is determined by the court depending on the nature of the offense, the depth of physical and mental suffering, impairment of the victim’s abilities, or deprivation of their ability
to realize them, the degree of guilt of the person who caused the moral harm, if the fault is grounds for compensation, and also taking into account other essential circumstances.
An analysis of the case-law on claims by persons who have received workplace injuries and illnesses or their close relatives to employers for compensation for moral damage indicates that courts have applied unequal substantive law rules and a large range of amounts recovered for moral damage.

Keywords: moral harm, industrial injury, workplace illness, employer, employee.
PREVALENCE OF PROSTHODONTICS AND ASSOCIATED COMPLICATIONS: A CROSS-SECTIONAL STUDY
Authors:   Bds, ssc-ard, sf-di, Consultant In Restorative And Implant Dentistry, Program Director For Dental Implant Fellowship At Jeddah Specialty Dental Center- Moh, Kingdom Of Saudi Arabia., Hasan Sulimani Dr. Zainbganayah , Mohammed Said Abushal Dr. Amal ,   Bds, sbo-op, m-orth, tqm, Consultant Of Orthodontics, Sbo Program Director At Kau, King Abdulaziz University, Jeddah, Saudi Arabia., Abdulaziz Murad Dr. Manal ,   Assistant Professor Of Family Medicine, Consultant Family Medicine, Family Medicine Department, King Abdulaziz University, Jeddah., Jehad Abousada Dr. Hoda ,   Obestetric& Gynecology Physcian, Ksa., Yousef Tunkar Dr. Eyad ,   Resident Dentist, Ministry Of Health, Makkah, Ksa., Mohammed Almghamsi Dr. Ahmed ,   Resident Dentist. Ministry Of Health Madinah, Ksa., Abbas Eskndrani Dr. Mahmoud ,   Resident Dentist. Ministry Of Health Madinah, Ksa., Abadi alazhari Dr. Badi ,   General Dentist Ministry Of Health, Madinah, Ksa., Ahmed bahattab Dr. Thamir ,   resident Dentist. Ministry Of Health Jeddah Rabig Ksa., Ali alghamdi Dr. Ahmed ,   resident Dentist. Ministry Of Health Jeddah Rabig Ksa., Hassan Al Ghamdi Dr. Abdulaziz ,   resident Dentist. Ministry of Health Makkah Ksa., Mohammed Basheer Dr. Rowayda ,   Dental Intern, Bmc College, Jeddah, Ksa., Abdullah Alshehri Dr. Smaher ,   Dental Intern. Batterjee Medical College Jeddah Ksa., Fouad Bardi Dr. Lara ,   Dental Intern, Ibnsina National College ,Jeddah,Ksa.
Published: January 2021

Statement of problem: Prosthodontics has received significant attention both in research and practice. However, limited research examines its prevalence and how effective it is. Purpose: The purpose of this clinical study is to examine the prevalence of prosthodontics and its associated complications Material and methods: A sample of 1005 individuals derived from the general Saudi Arabia was used in this study. Data was collected using a questionnaire. The data collected was analyzed using SPSS. Results: There is a generally low prevalence of prosthodontics in Saudi Arabia. The common type of prosthodontics used is the fixed prosthodontics. Majority of those who have done prosthodontics didnt suffer any associated complications. However, for those who depicted complications, the common one was caries. Other complications include root fracture and porcelain veneer fracture. Conclusion: Prosthodontics is not widely used. On the other hand, it is not 100% effective in treating oral health problems. Clinical implications: There is need to develop better ways of dealing with poor oral health and patients need to be examined well to determine the underlying risk factors before prosthodontics is carried out.
A CROSS-SECTIONAL STUDY TO ASSESS THE RISK FACTORS FOR HYPOESTHESIA AFTER REPAIR OF FACIAL FRACTURES
Authors:   Consultant in Restorative and Implant Dentistry, Program Director for Dental Implant Fellowship at Jeddah Specialty Dental Center., Hasan Sulimani Dr. Zainbganayah , Abdulaziz Murad Manal ,   Arab Board & Jordanian Board Family Medicine Assistant Professor & Consultant Family Medicine Family Medicine Department Faculty of Medicine King Abdulaziz University., Jehad Abousada Hoda ,   Obstetrics and Gynecology Physician, King Fahad Armed Forces Hospital, Jeddah, KSA., Ali Gharawi Raidaa ,   Jeddah University, Jeddah, KSA., Abdulaziz Shahd ,   Dr.YasirComplex, Jeddah, KSA., Faiz malaikah Yusra ,   SafaaBioneer Dental Clinic, Jeddah, KSA., Mansour Shahd ,   King Fahad General Hospital,Jeddah,KSA., Saeed Alghamdi Abdullah ,   Prince Mishari Hospital, Baljurashi, KSA., Muhaysin alrushnudi Nawal ,   Eiat Dental Clinic, Jeddah, KSA.
Published: January 2021

Background: Hypoesthesia occurs as a result of injuries resulting in injury to the nerve fibres.The causes of injury include direct harm from the needle injections, around the nerve fibres, mechanical injuries resulting in an indirect pressure into the mandibular canal, during the dental surgical procures, as well as the toxicity of the local anaesthetic agents. Methods: This cross-sectional research was conducted by recruiting N=79 adult individuals (>18 years), who had visited the district hospital for acquiring clinical assistance and treatment of facial muscles or nerve-related complications in August 2020. Data collection for this research was carried out by using a specially designed questionnaire, which facilitated in acquiring data related to aetiology of trauma, identification of the hypoesthesia area, as well as the clinical complications experienced by the respondents. The clinical reports of the patients were also collected for analysing the hypoesthesia area. SPSS was utilised for data analysis, and statistical tests were conducted for assessing the risk factors for hypoesthesia after repair of facial fractures. Results: The statistical tests revealed that only a small percentage of the sample population, i.e., (N=9) or 11.8% experienced the facial bone fracture, male respondents had more exposure to the facial bone fractures, as compared to the females (Mean=1.81, SD= 0.397), and the individuals below 25 years of age had high exposure of facial bone fracture(Mean=1.78,SD= 0.428). A significant majority of hypoesthesia cases were at mandible, and orbit region. Conclusion: The dental treatment resulting in nerve manipulation results in nerve elongation, nerve compression, contributing to transient hypoesthesia. Hypoesthesia might also lead to other clinical complications.
Prenatal diagnosis of Ebstein's abnormality with atresia of the pulmonary
artery: statistical review in the Voronezh region from 2012 to 2019
Authors: N.A. Chibisova , M.A. Starokozhev , T.V. Fedotova et all
Published: January 2021

The overview statistics on the frequency of Ebstein anomaly in the structure of congenital heart defects
and a combination with other abnormalities in the prenatal period for the Voronezh region at 2012–2019 and
one latest clinical case of Ebstein anomaly are presented
Simonart syndrome: a brief review of the literature and your own
observation
Authors: L.I. Pavlenko, S.A. Gribova
Published: January 2021

A case of prenatal diagnosis of Simonart syndrome (syndrome of amniotic constrictions) is presented.
An amnioscopic operation was performed — dissection of the ligaments. There was an outpouring of amniotic
fluid due to a high rupture of the amniotic membranes and premature birth at 28 weeks of gestation. During
the external examination of the newborn, the data obtained during the ultrasound study was fully confirmed.
Monochorionic diamniotic twin with a Down syndrome in one of
the fetuses
Authors: O.V. Pribushenya , O.L. Zobikova , E.I. Golovataya et all
Published: January 2021

A clinical observation of monochorionic diamniotic twins with discordance of cytogenetic and clinical
manifestations of Down syndrome is presented. Pregnancy was complicated by feto-fetal transfusion syndrome
at 17 weeks of gestation. An ultrasound scan revealed a ventriculomegaly in a donor. Laser coagulation of
anastomoses was performed. Karyotype 46, XY was established in the recipient amniocytes. The pregnancy
ended in childbirth at 33 weeks with newborn boys weighing 1789 and 2080g. One of the newborns (donor) had
phenotypic signs of Down syndrome. When karyotyping peripheral blood lymphocytes of a child with clinical
manifestations of Down syndrome, karyotype mos 47,XY,+21[12]/46,XY [88] was established, and a child with
a normal phenotype was mos 47,XY,+21[14]/46,XY [86]. No malformations of internal organs were found.
When analyzing the buccal epithelium by the FISH method, it was found that in all the analyzed interphase
nuclei obtained from a child without clinical manifestations (recipient fetus), trisomy 21 was not detected. In
78% of the interphase nuclei of cells of a child with Down syndrome (fetus-donor), trisomy 21 was established.
Thus, the presence of a clone of cells with trisomy 21 in the recipient is associated with twin chimerism.
Interrupted aortic arch, type A: report of 3 cases
Authors: I.V. Novikova, N.A. Venchikova, O.A. Tarletskaya et all
Published: January 2021

Three cases of interrupted aortic arch of type A (IAA, type A) identified on prenatal ultrasound examination
are presented. IAA, type A was a component of 22q11.2 microdeletion syndrome, established by molecular
analysis of the aborted fetus`s tissues in the first case and a part of trisomy 13 in the second one. In the third fetus
with a normal karyotype, IAA, type A was diagnosed at 31 weeks of gestation and successful cardiac surgery was
performed after birth. In a fetus with 22q11.2 microdeletion syndrome, IAA was combined with ascending aorta
hypoplasia and ventricular septal defect. In fetuses with Patau syndrome and normal karyotype IAA type A was
accompanied by an aortopulmonary window.
“MİLLÎ / ERKEK”, “GAYR-I MİLLÎ / KADIN”: TÜRK ROMANINDA YABANCI OKULLAR VE CİNSİYETLER ÜZERİNE ETKİLERİ
Authors: OKTAY Gülçin
Published: January 2021

Birtakım kanun ve yönetmeliklerle denetim altına alınan yabancı okullar, millî kimlik önünde her zaman bir tehdit olarak görülür. Özellikle Balkanlardaki toprak kayıplarıyla yükselişe geçen Türkçülük düşüncesi, farklı kültürler konusunda sert bir politika benimsenmesine neden olur. Cumhuriyet döneminde de yabancı okulların Türk millî kimliği önünde tehdit oluşturabilecek yönleri engellenmeye çalışılır. Millî kimliğin inşa edilmesinde kanonlaştırılan romanlar da bu tehdide kayıtsız kalamaz. Müfide Ferit’in “Pervaneler”, Mehmet İrfan’ın “Kız mı Çiçek mi Yahut Mini Mini Nadire”, Halide Nusret’in “Gül’ün Babası Kim?” ve Necmettin Halil’in “Kolejli Nereye” adlı romanları yabancı okulları ana mesele hâline getirir. Halide Edib’in “Son Eseri” ile “Mev’ut Hüküm”, Yakup Kadri’nin “Sodom ve Gomore” ve Reşat Nuri’nin “Çalıkuşu” romanlarının odak noktası yabancı okullar olmasa da konu ile ilgili önemli noktalara işaret ederler. Bu anlamda yazarlar, konuya dair birbirlerinden farklı yaklaşımlar sergileseler de yabancı okulların olumsuz etkisine açık cinsiyetin kadın olduğu sonuca ulaşırlar. Ulaşılan bu sonuç ise cinsiyet ile etkilenme ilişkisi arasında -bilinçli veya bilinçsiz- kurulan bağı gösterir.