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Jun 2026
De Coninck LeenCorresponding author
Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.
Jun 2026 DOI 10.14302/issn.2574-4496.jtc-26-6304
Elshafie OmaymaCorresponding author
Objective To evaluate the treatment outcomes of patients with Differentiated thyroid cancer (DTC) who underwent total thyroidectomy followed by RAI therapy at the Sultan Qaboos Comprehensive Cancer Care and Research Centre (SQCCCRC) in Oman. Methods This is a retrospective observational clinical study conducted at SQCCCRC. The study included all patients diagnosed with DTC who were admitted to SQCCCRC between June 2021 and November 2023. A total of 255 patients were identified and met the inclusion criteria for this study. Results The mean age at diagnosis was 39.9 ± 12.4 years (range: 14–79), with 78% of patients being female. The mean BMI was 30.3 ± 6.4 kg/m², with nearly half of the cohort (48.2%) classified as obese (BMI ≥ 30). Most patients had papillary thyroid carcinoma (92.9%), while follicular and Hürthle cell carcinoma accounted for 5.9% and 0.8% of cases, respectively. Based on the American Joint Committee on Cancer (AJCC) staging, 86.3% of the patients were classified as stage I and 3.9% as stage II. Six patients (2.4%) had stage IVB disease. According to American Thyroid Association (ATA) risk stratification the majority were low-risk. Patient age was strongly associated with disease stage. The distribution of metastatic cases varied by region, with the highest proportion observed in Dhofar. Most patients (87.1%) received a single dose of radioactive iodine (RAI), with a median cumulative dose of 3.7 mCi). At six months post-treatment, 70.2% of patients had a TG level < 0.2 ng/mL. Conclusion The outcome of therapy in majority of our patients is favorable with 72% having excellent biochemical response at last follow up. None of the patients with distant metastasis achieved excellent response and a high proportion of them came from the Dhofar governorate, a targeted intervention would be of benefit. Low risk patients require special attention and may need radioactive iodine during follow up, unlike other regions and hence warrant very close follow up and further review to establish the best practice guidelines in our region.
Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
H. Nelson MarkCorresponding author
Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.
Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5626
Kankindi PriscillieCorresponding author
Background Masculinity remains a dominant phenomenon in the social construction and performance of male roles in society, influencing economic participation, access to essential services, and decision-making at household levels. Research focusing on women's empowerment has been extensively done, with little focus on how masculine support from men impacts the well- being of married women. This study examined how married women perceive male support in the context of economic, emotional, and physical support in Luwero district, Uganda. Methods This was an exploratory qualitative study conducted among married women aged 18 to 49 years. Key informant interviews were conducted with community women aged 30 to 40 years, and village health teams aged 30 to 40 years. The study participants were purposively selected based on the inclusion criteria of the study. Data were analysed using content analysis and the findings were presented using themes/sub-themes along with participant quotes. Results We interviewed married women aged 18 to 49 years old, with the majority falling in the age category of 30 to 39 years (59.1%) and were married for over 6 to 9 years (45.5%). Concerning the key informants, 2 VHTs were aged between 30 to 39 years (66.7%), and the women leaders were aged between 30 to 40 years (60%). About male support among women, nine subthemes emerged, including low engagement in family affairs, lack of financial support and cultural traditions, women’s insecurity, emotional neglect, women as providers of emotional support, lack of emotional responsiveness, emotional support driven by institutional policy, shared domestic responsibilities, and lack of physical presence during sickness. Generally, male support towards women was found to be lacking. Conclusion Male support among married women remains insufficient, contributing to emotional strain and unequally distributed responsibilities. Strengthening community awareness and engaging men through tailored programs can foster a more supportive domestic environment.
Aug 2025
Toomey PaulCorresponding author
Background This study was undertaken to delineate the most predictive pattern at presentation for patients with non-metastatic pancreatic cancer compared to patients with metastatic pancreatic cancer who present to a medium sized hospital. Methods Data were collected at a medium sized hospital from 2009-2014 for patients with newly diagnosed pancreatic adenocarcinoma. Laboratory values, CT scans, pathology reports and ERCP results were obtained. Data are presented as mean (median +/- standard deviation). Results Fifty-two patients met the criteria for inclusion and were clinically diagnosed with pancreatic cancer. The median age was 71 years old. CEA levels for metastatic pancreatic cancer were 107.9 (20.6 +/- 166.7) ng/dl and 9 (6 +/- 11.6) ng/dl for non-metastatic cancer (P-value<0.05). Bilirubin levels for metastatic pancreatic cancer were 4.1 (0.7 +/- 6.6) mg/dl and 10.3 (10.4 +/- 8.1) mg/dl for non-metastatic cancer (p=0.009). CA19-9 levels for metastatic pancreatic cancer were 37,529 (644 +/- 88,352) U/ml and 5,150 (668 +/- 16,985) U/ml for non-metastatic cancer. Conclusion Elevated total bilirubin alongside low CEA appears to be a stronger predictor of non-metastatic disease at presentation compared to CA 19-9 alone.
Jul 2025 DOI 10.14302/issn.3070-2232.jf-25-5519
Ewur Banson KwaminaCorresponding author
The rising costs of conventional poultry feed ingredients, such as soybean, maize, and fish meal, have prompted the search for more affordable and sustainable alternatives in poultry production. This study investigates the use of phytase-supplemented Palm Kernel Cake (PKC) as a replacement for soybean meal to improve feed efficiency, nutrient absorption, and growth performance in poultry. White Leghorn layers, Rhode Island Red layers, broilers, and cockerels were fed three different feed formulations: conventional feed (CF), Moderate PKC with Phytase (MPP), and High PKC with Phytase (HPP). The results showed that PKC-based diets significantly reduced feed costs while maintaining satisfactory growth, although CF led to higher body weight gain and feed efficiency. The MPP formulation struck an optimal balance between cost savings and nutritional quality, making it a viable option for layers and cockerels, while CF remained the most effective for broilers. While the HPP formulation resulted in lower feed costs, it compromised weight gain and overall profitability. These findings highlight the potential of phytase-enhanced PKC as a sustainable, cost-effective alternative to conventional feed, particularly in regions with high feed costs. However, the study emphasizes the importance of balancing cost reductions with feed quality to maximize profitability. Future research should focus on optimizing PKC inclusion levels and exploring additional enzyme supplements to further enhance feed efficiency and support sustainable poultry farming practices. This study provides valuable insights into how strategic feed formulation can support both economic and production goals in the poultry industry.
Jul 2025 DOI 10.14302/issn.2379-8572.joa-25-5592
Zakariya Yahya Al Riyami ShadenCorresponding author
Objective The repair of the tympanic membrane has been attempted with large variety of synthetic, homologous and autologous tissue; however, temporalis fascia and cartilage-perichondrium are used most commonly today. Study Design This is a prospective study of patients confirmed to have CSOM and operated during the years of 2012-2013 at Al Nahdha Hospital, Muscat, Sultanate of Oman. The patients were followed up postoperatively at which we compared the graft success rate and level of hearing improvement. Setting ENT clinic at Al Nahda hospital Subjects Patients who presented to the ENT clinic at Al Nahda hospital, operated in the period between 2012 and 2013, diagnosed as CSOM and meeting our inclusion criteria. Methods We compared the outcome of the repair of the tympanic membrane perforation using temporalis fascia graft versus cartilage perichondrium grafts. Results 100% of the cartilage-perichondrium group showed a successful graft uptake in comparison to 98.9% in the temporalis fascia. Our data did not show significant differences in the average air bone gap change in both groups. Conclusion Both cartilage-perichondrium and temporalis fascia provide viable autograft material. Both achieve comparable and excellent graft uptake. Completion of our study is needed to study the hearing restoration in both groups.
Sep 2024 DOI 10.14302/issn.2577-137X.ji-24-5207
Olutola AyodotunCorresponding author
COVID-19 vaccine hesitancy has emerged as a major challenge to global efforts to control the pandemic, particularly in Nigeria, where hesitancy to other effective vaccines such as polio and measles has been widely reported. Several individual, societal, and structural factors contribute to this behaviour and prevent the effectiveness of COVID-19 prevention efforts. Objectives This study sought to identify the predictors of COVID-19 vaccine hesitancy in the seven states of North-Central, Nigeria. Methods A population-based cross-sectional online survey was conducted among residents using a semi-structured questionnaire adapted from the WHO SAGE vaccine hesitancy scale and distributed via social media networks over 8-weeks. Results A total of 1,429 responses met the inclusion criteria and were analysed. Among the respondents, 60.7% were males, 47.5% were between the ages of 26 and 45, and 80.1% had postsecondary education. A total of 421 respondents (29.5%) were hesitant and unwilling to receive the vaccine. The reasons for hesitancy were concerns about side effects (37.1%), doubt about the existence of COVID-19 (11.0%), and the perception of time required to receive the vaccine (9.6%). Post-secondary education (AOR: 0.49, 0.36-0.66) and people of the Islamic faith (AOR: 0.68, 0.52-0.90) were found to be associated with lower levels of hesitancy. Conclusion The study found that vaccine hesitancy is a complex problem that is linked with multiple social determinants of health as lower educational attainment, lower income and Christian faith were found to be predictors of vaccine hesitancy. Confidence, Complacency and Convenience factors were expressed by respondents as concerns about side effects, doubt about the existence of COVID-19 and time required to receive the vaccines were the most prominent reasons for unwillingness to receive the vaccine. In order to protect the public health of communities, targeted interventions are required to increase vaccine acceptance by cultivating trust in vaccines, disseminating accurate information, and engaging with community stakeholders including religious groups.
Jun 2024 DOI 10.14302/issn.2641-4538.jphi-24-5106
Mohammadnezhad MasoudCorresponding author
Introduction Compared to their heterosexual counterparts, cisgender LGBTQ+ youth are more likely to experience numerous mental health conditions, for instance, suicidal ideation, stress, and anxiety. This study aimed to explore mental health disparities among LGBTQ+ youth while identifying strategies to promote their well-being. Methodology Incorporating a systematic approach, studies were selected according to the predefined inclusion criteria, ensuring recentness and relevance. Five databases were systematically searched while the PRISMA flowchart was employed for illustrating the systematic selection process. The PEO framework directed the study selection. Thematic analysis was applied to identify themes that were related to the study aim. Results Five themes were emerged including policy changes and legal frameworks, contextual and cultural factors, family and social support, underlying factors of mental health, and healthcare services access. The synthesis of the literature uncovers the multifaceted relationship between cultural and contextual factors and policy changes, social and family support and healthcare services. The study also underlines the importance of implementing an intersectional minority stress model for comprehensively understanding mental health disparities among LGBTQ+ youth. Conclusion The results emphasize the importance of ongoing research in policy alterations, accessibility to healthcare, and creating supportive surroundings to tackle differences in mental health. Recognizing the complexity of these issues, this paper requires an in-depth examination that considers intersecting factors, promotes inclusivity, and involves long-term studies in providing mental health support to enhance the well-being of LGBTQ+ young individuals.
May 2024 DOI 10.14302/issn.2998-4122.jlr-24-4985
Wondemagegne EliasCorresponding author
Despite a large number of studies examining syntactic features that are predictive of second language (L2) writing quality, assessed by human raters at the university level, few have systematically investigated this link using a large set of indices in the foreign language learning (EFL) classroom context. The current study sought to determine the extent to which a variety of syntactic complexity and sophistication indices are associated with and may predict writing quality by analyzing 30 argumentative essays written by undergraduate EFL students in an Ethiopian university classroom setting. To represent syntactic complexity as a multidimensional construct, we used conventional absolute measures, fine-grained clausal and phrasal indices, and newly proposed sophistication indices related to the use of verb argument constructions (VACs) indexed by TAASSC (Tool for the Automatic Analysis of Syntactic Sophistication and Complexity; 17. Essays were graded, and five separate predicted models of writing quality were created utilizing each complex feature index and all of the measures. Robust predictors of writing quality were identified at both syntactic complexity and sophistication dimensions. Regression analyses showed that the combined model including both fine-grained clausal complexity and VAC-based indices could account for 53.6% of the variance (the largest amount of variance in the study) in writing scores. The finding indicates that the inclusion of diversified adverbial modifiers and nonfinite clauses such as modal auxiliaries controlled by less frequent verbs were predictive of higher-quality writing. These findings shed light on some characteristics of L2 learners' writing growth and enable us to draw pedagogical implications for teaching and assessing writing in the Ethiopian EFL context.
Feb 2024 DOI 10.14302/issn.2998-4211.jalr-23-4813
del Carmen Teruel Hernández EstherCorresponding author
This study systematically reviews the literature on non-pharmacological interventions for disrupted sleep-in people meeting established criteria for moderate-severe dementia, and to analyze the methodological quality of the included studies. The PubMed, PEDro, Cochrane, Virtual Health Library, APA PsycInfo databases were searched using a systematic literature review approach to identify various types of non-pharmacological treatments that improve disrupted sleep-in subjects with moderate-severe dementia. In accordance with the inclusion criteria, eight studies were systematically reviewed and analyzed according to the type of non-pharmacological treatment carried out. This systematic review showed that 50% of the studies used bright light therapy, 12.5% the use of manual therapy, and 37.5% sleep hygiene or walking or a combination of these interventions. Based on the results of the present study, although there is some evidence to support these strategies, it is not significantly supported and highlights variation in the way the interventions were delivered. Disrupted sleep is highly prevalent in people with dementia and have a negative impact on the quality of life of the sufferer and the caregiver. Non-pharmacological approaches to its treatment are increasingly popular as an alternative to drugs, whose efficacy and side effects have raised concerns among the population. Currently, there is a need to carry out more future research to establish its effectiveness and to be able to provide clear guidelines at the time of clinical practice.
Dec 2023 DOI 10.14302/issn.2329-9487.jhc-23-4848
Dangwe Temoua NaibeCorresponding author
Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad.
Nov 2023 DOI 10.14302/issn.2381-862X.jwrh-23-4766
G. Ong EmilyCorresponding author
This study explored concerns and unsolicited advice relating to miscarriage shared on multiple social media platforms for mentions of questions, advocacy, medical advice, conflicts of interest, and terminology used to describe miscarriage. Public social media posts in English from January 1st, 2019 to June 30th, 2021 were searched using keywords related to miscarriage. A dataset of questions, advice, conflicts of interest, and terminology used was created from eligible posts determined by inclusionary and exclusionary criteria. The dataset was analyzed to identify themes and calculate statistics. Approximately 1000 posts were reviewed and 149 posts were found eligible for analysis. Of the total, 116 posts included advice and a subset of 71 posts offered questions. A total of 152 mentions of advice were identified from the total eligible posts with 82.9% of advice related to advocacy for destigmatizing miscarriage, enhancing community support, or expressing grief. 17.1% of posts offered medical advice eligible for evaluation of which 73% were accurate across all platforms. From the dataset, 103 questions were analyzed for common themes. The four most common themes of questions included grief, self-blame, quality of post-miscarriage counseling in different care settings, and inadequate medical counseling. This study indicates that women who experience miscarriage have many unanswered questions and powerful feelings relating to grief and self-blame that could have long-term impacts. Social media has become a place for women to self-advocate and connect with others for support, from which clinicians could increase their understanding of women’s unmet needs.
Sep 2023 DOI 10.14302/issn2474-9273.jbtm-23-4712
Erika HumphreysCorresponding author
The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. Methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. Theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety and pain associated with anxiety. Cultural considerations effecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.
Feb 2023 DOI 10.14302/issn.2643-2811.jmbr-22-4265
Bund ArgerCorresponding author
The work environment, in its most general conception, alludes to biased expectations of risks and benefits around a function and in relation to the performance of a working group, but in its factorial structure, dimensions have been found that explain a moderate percentage of the variance of the construct. In this sense, the objective of this paper is to specify a model for the study of the work climate, considering the institutionalism and human capital of a public university. An exploratory study was carried out with an intentional sample of 125 administrative personnel. From a structural model it was found that the relationship climate factor explained the highest percentage of the variance (21%) and it was the reflective dimension of the construct (0.524). The inclusion of the task climate is recommended due to its link with the leadership and the collaborative climate.
Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4325
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
The aim of this study is determine the prevalence and factors associated with caesarean section among women delivered at Kirehe District Hospital. A retrospective study was conducted among women delivered at Kirehe District Hospital from January 2018 to December 2019. The medical files of all women delivered at the hospital who meet the inclusion criteria were reviewed. Data were checked for completeness, cleaned, coded and entered into excel sheet, and then exported to SPSS version 22.0 for further analysis. Descriptive statistics was used to estimate the prevalence and description of study participants. Multivariable logistic regression models were used to estimate risk for CS with 95% confidence intervals (CIs). The study was conducted in accordance with the research protocol Mount Kenya University Rwanda research ethical committee. The majority 806 (69.9%) of women who delivered at Kirehe district hospital from January 2018 to December 2019 were aged 22-35 years old. The prevalence of C-section at Kirehe District Hospital was 23.1%. Demographic and economic factors associated with Caesaren section in bivariate and multivariate analysis was respondent’s type of health insurance where women who used private health insurance were 3 times more likely to deliver by C-section. The findings from multivariate analysis revealed that women who experienced eclampisa had 45% risk of C-Setion compared to those without Eclampsia. Women in rural area of Rwanda seem to have increased access to and use of CS. However, the significant increase in the rate of CS is of concern due to the potential of unnecessary CS.
Jun 2022 DOI 10.14302/issn.2641-4538.jphi-22-4197
A. Attah TimothyCorresponding author
National Space Research and Development Agency (NASRDA), Obasanjo Space Centre, Umaru Musa Yar'adua expressway, P.M.B. 437, Lugbe, Abuja, Nigeria
Aim and Objective Despite the growing concerns about the relationship between exposure to radiofrequency radiation (RFR) and detrimental health effects due to the changes in biological processes of experimental animals, there is still ongoing debate on the significance of these findings in causing significant public health problems with the growing advancement in internet technology. The aim of this study is to review existing literature on the effects of high RFR on wistar rats. Method A search was conducted on Google scholar and PubMed to identify relevant peer-reviewed articles to be included into the review. Studies eligible for inclusion included free full text articles on wistar rats exposed to ≥ 2.45GHz RFR conducted in the past 5 years. Studies included in this review were written or transcribed in English language. From 286 titles, 36 eligible studies were included in the review and assessed for quality using the Strengthening the Report of Observational Studies in Epidemiology – Veterinary Extension (STROBE-Vet) quality assessment tool. Results Studies included in this review generally had good quality (>60%) based on the STROBE-Vet assessment. This review identified numerous biological changes in wistar rats exposed to high RFR including variations in biochemical, cholinergic, genetic, histopathologic, psychological, optical, and dermatological parameters. In this review, studies identified variations in protein and liver enzymes while high RFR was found to induce oxidative stress and cellular damage of exposed wistar rats compared to the unexposed groups. This was seen in the changes in protein, lipids, enzymatic and non-enzymatic antioxidants. Studies also identified changes in expression of genes and neurotransmitters with imbalance in hormones. In addition, this review identified structural changes of cells, tissues and organs indicative of apoptosis, damage and death. Exposed rats were identified to have behavioral changes indicative of anxiety and memory decline while studies identified optical and dermatologic changes in exposed rats compared to the unexposed. Conclusion With numerous biological changes identified in wistar rats exposed to high RFR, there is an increasing risk of detrimental health events giving the advancement in internet technology and limited regulations to control exposures to RFR. Therefore, studies should be conducted to identify strategies to mitigate human exposure to RFR while policies are developed and enforced to protect human health.
Feb 2022
K Al Miraj ACorresponding author
Research Assistant, Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU)Dhaka, Bangladesh.
Introduction Calcium (Ca2+) plays an important role in the pathogenesis of ischemic cell damage. Intracellular Ca2+ accumulation leads to neuronal damage by triggering the cycle of cytotoxic events, however the relationship of serum Ca levels and the pathways involved in ischemic injury is unclear. Aim of Study To investigate the relationship of serum Ca2+ levels with severity of acute ischaemic stroke, serum calcium (Ca2+) levels were measured within the first 48 hours and were compared with the clinical severity of acute ischaemic stroke. Material and Methods A hospital based cross sectional study was performed among 100 patients of acute ischaemic stroke who fulfilled the inclusion criteria. The Study was done from July 2020 to August 2021 in SPRC & Neurology Hospital Dhaka, Bangladesh And BSMMU Hospital Dhaka, Bangladesh. After hospitalization presenting complaints, physical findings of the patients were recorded. Severity of stroke was measured by NIHSS scale. Serum calcium level of every patient was measured. Calcium level was divided into 3 groups by weighted average. Statistical analysis was carried out by a non-parametric Ruska Wallis test. Results Among the 100 patients 59% were male. Among all patients 57% of patients were found to be smokers (98% male, 2% female). Among all patients 63% patients were found hypertensive and 21% of all patients (24% male, 17% female) were diabetic. Mean cholesterol level was 257.98mg/dl with standard deviation 55.49 which is above the reference range suggesting hypercholesterolemia, Triglyceride was borderline and LDL cholesterol was slightly higher and HDL cholesterol was slightly lower. Calcium level was divided into 3 groups and NIHSS score was calculated for every patient in each group. The median NIHSS score for group1 (calcium level ≤8.8 mg/dl) was 9(2-20), for group 2 (calcium level 8.9-9.6 mg/dl) was 6 (1-17) and for group 3 (calcium level ≥9.7mg/dl) was 4 (1-16). Conclusion Commonest risk factor of ischaemic stroke is hypertension. Other risk factors are smoking, diabetes mellitus and hyperlipidemia, cardiac disease. Higher serum calcium level is associated with less severity of ischaemic stroke.
Dec 2021 DOI 10.14302/issn.2575-1212.jvhc-21-4034
Fernando Díaz-Otero,Corresponding author
CENID-Salud Animal e Inocuidad. Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias (INIFAP). Carretera México-Toluca, Km. 15.5, C.P. 05110, Ciudad de México, México.
In bovine tuberculosis (bTB), cellular, humoral, or both types of immune responses have been observed. The purpose of this study was to examine the immune status of tuberculous cows based on the differential cytokine gene expression associated with Th1 (IFN-γ, IL-2), or Th2 (IL-4, IL-10) responses. Twenty-three (23) cows belonging to a dairy herd located in a rural region of the State of Hidalgo, México, were selected for the study. Single Intradermal Comparative Cervical Tuberculin (SICCT) Test, Interferon-Gamma (IFN-γ) Release Assay (BOVIGAM), and Enzyme-Linked Immunosorbent Assay (ELISA) were used for detection of cattle infected by M. bovis. Thirteen cows were positive to all the tests (Group 1); ten cows were positive only to ELISA (Group 2), and the remaining Group (Group 3, control) included cows negative to all the tests. Peripheral blood mononuclear cells (PBMC) from animals were in vitro stimulated by bovin purified protein derivative (PPD), avian PPD, and Concanavalin A (Con A) mitogen for 72h. Changes in the levels of expression of mRNA of the respective cytokines was measured by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) using β-actin gene as internal control. In group 1, PPD bovis and Con A-stimulated cells exhibited high production of IFN-γ, IL-2 and IL-4, but not IL-10. In contrast, PPD avium-stimulated cells displayed a low production of cytokine transcripts. In group 2, cells showed a significant production of IL-10 in response to bovine PPD (P< 0.001). In the control group, a high production of IFN-γ and IL-2 was observed only in Con A-stimulated cells. Post-mortem examinations in animals of group 1 showed slight and medium lesions in lymph nodes, whereas in group 2, the lesions were more extensive. Results indicate differences on gene expression levels of cytokines considered to determine balance in Th1/Th2 response among the evaluated groups. In addition, high levels of antibodies against M. bovis and high IL-10 expression in PBMC together are indicators of progressive bTB when both tuberculin test and IFN-γ assay are negative in tuberculous anergic cattle. Inclusion of serology and IL-10 cytokine expression in in the diagnosis checklist improves detection of infected cattle to help control bovine tuberculosis.
Aug 2021 DOI 10.14302/issn.2643-6655.jcap-21-3888
Monique J. Grant CokeCorresponding author
The number of children with SEN is continuously growing, leading to pressure on the few special schools available in the USA. Furthermore, the adoption of a special school system has been criticized on the basis that it isolates and discriminates against children with special educational needs and disabilities. Even though inclusive education can address such limitations, the application of the most appropriate pedagogical approaches for SEN learners is still a challenge. The presented study focused on critically appraising the pedagogical approaches for SEN learners in the 21st century and beyond. In order to achieve this goal, a systematic review of the literature approach was adopted. The literature search process was conducted on three databases: Education Full Text, Linguistics and Language Behavior Abstracts, and PsycINFO. The selection of these databases was influenced by their reputation of hosting high quality and up-to-date literature about special education. The initial literature search process generated 6129 hits, but only ten studies were finally selected for review after the application of inclusion and exclusion criteria. A critical review of the evidence presented in the selected studies generated eight themes describing various pedagogical approaches for special education, within both blended and mainstream learning environment. Knowledge generated in this systematic review can be used by the special education sector of the U.S to develop pedagogical approaches for SEN students, leading to improved performance and social skill development.
Nov 2020 DOI 10.14302/issn.2473-1005.jdoi-20-3595
C SzuhanekCorresponding author
Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Victor Babes’, Timisoara, Romania
Aesthetic and functional problems associated with significant facial asymmetry can negatively affect the patient's facial appearance, nutritional and psychosocial development. Therefore, a critical assessment and accurate treatment planning is absolutely necessary. The aim of this study was to evaluate the parameters of PA cephalometric analysis defined by Ricketts and Grummons and establish statistically relevant correlations and their importance in diagnosing orthodontic patients with varying degrees facial asymmetries. The research included facial asymmetry Romanian patients from the Department of Orthodontics and Dento-Facial Orthopedics of UMF "Victor Babes", Timisoara. The PA cephalogram investigations that met the inclusion criteria were digitally analyzed. Dental and skeletal cephalometric parameters described by Ricketts, Grummons and Kappeyne Van De Coppello were collected through linear, angular and volumetric measurements. Statistically significant correlations between the degree of asymmetry and the dimension of the internal structures were observed.Our conclusion is that PAcephalograms are cost effective and useful investigations in identifying and evaluating skeletal and dental imbalances in orthodontic facial asymmetry patients.
Sep 2020 DOI 10.14302/issn.2835-513X.ijl-20-3454
Gupta AnjuCorresponding author
Department of Mechanical, Industrial and Manufacturing Engineering, University of Toledo, Toledo, OH 43614, USA
We investigated physical steric and thermal stability effects induced by cholesterol and polyethylene glycol (PEG) in liposomes encapsulated with riboflavin. The composition of liposome was varied systematically to decipher the individual and combined effects of cholesterol and PEG on the stabilization of liposomes, specially the photopolymerizable liposomes for their potential applications in photo-treatments. Our results indicate that inclusion of PEG in the lipids enhances the steric stabilization by adopting a brush-like regime that prevents the agglomeration of encapsulated liposomes. A mechanistic differential scanning calorimetry studies reveal the phase transitions and enthalpy changes in the lipid bilayer due to the presence of cholesterol suggesting its role in regulating membrane fluidity. Supporting in- vitro studies confirm the efficacy of PEGylated formulations encapsulating riboflavin.
Jun 2020 DOI 10.14302/issn.2691-6622.ijar-20-3312
I. A AdebayoCorresponding author
Department of Fisheries and Aquaculture, Ekiti State University, Ado-Ekiti, Nigeria
An 84 day feeding trial was conducted on the juveniles (42.51±0.09g) of hybrid catfish, Heteroclarias, in order to evaluate the nutritional potential of 30 minutes autoclaved castor seed cake isonitrogenous (40% crude protein) and isocaloric (3212Kcal/Kg) diets replacing soybean meal at 0, 12.5, 25, 37.5 and 50%, the diets being designated D1, D2, D3, D4 and D5 respectively. Prior to this, the castor seeds (Ricinus communis L.), ZiboCastor No. 3 variety, collected from Ado-Ekiti metropolis, Nigeria were subjected to 0, 20, 30 and 40 minutes autoclaved at 121oC, dehauled, grounded, oil extracted to form cake, then the proximate and antinutrients analysis were carried out. The preliminary tests on the seeds revealed 30 minutes level of autoclaved seeds was the best. The growth performance result showed that there were significant differences (p<0.05) in the mean weight gain (MWG), specific growth rate (SGR), feed conversion ratio (FCR), protein efficiency ratio (PER) and apparent net protein utilization (NPU) among the various diet levels with the progressive decline in the values of each parameter (except FCR that showed progressive increment) along the trend of increment of castor seed cake inclusion (D1, 0%; D2, 12.5%; D3, 25%; D4, 37.5% and D5, 50%). The survival rate followed the same trend of declination with the highest percentage recorded for D1 (93.33±6.67%), followed by D2 (83.33±3.33%), D3 (76.57±3.33%), D4 (66.67±3.33%) and D5 (60.00±5.77%) respectively. Hence the best growth performance and nutrient utilization was shown in D1 (control) followed by D2. It is therefore recommended that autoclaved castor seed cake at 121oC be included at not more than 12.5% inclusion level to reduce cost of feed without necessarily compromising fish growth rate.
Mar 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3231
Patel NaiyaCorresponding author
University of Louisville, Department of Health management and Policy
Health services research is a multidisciplinary field which involves policy makers, health care providers, as well as quality outcomes professionals of the health services provided in an organizational setting to name some. Using qualitative research methodology to get insights of both the provider and patient experience down the pipeline can help strengthen what is lacking. Bridging the gap of translation research by not just surveys 1 might be an appropriate research methodology, however, inclusion of case studies, ethnographies might help stakeholders in the field, to visualize in depth phenomenon occurring in health services research field. Telly medicine, commercial digital health status trackr might be some of the inetrventions to improvise health care services, however, knowing what are the actual needs at individual level might efficiently help in redistribution of resources or policy laws. Recruiting for clinical trials through story telling communication technology2,3, might help in recruitment for novel drug therapies to explore possibilities, however, exploring the barriers to enroll for the clinical trials, or why the drug might work effectively in some cultural population and why not on others, can only be efficiently explored through qualitative research methodologies.
Aug 2019 DOI 10.14302/issn.2572-3030.jcgb-19-2597
Oluwafemi Oyamakin S.Corresponding author
Department of Statistics, University of Ibadan, Nigeria
In other to present a series of stochastic models from population dynamics capable of describing rudimentary aspects of genetic evolution, we studied two-allele Wright–Fisher and the Moran models for evolution of the relative frequencies of two alleles at a diploid locus under random genetic drift in a population of fixed size “simplest form, selection, and random mutation”. Principal results were presented in qualitative terms, illustrated by Monte Carlo simulations from R and http://www.radford.edu/~rsheehy/Gen_flash/popgen. Moran and the Wright-Fisher Models exhibited the same fixation probabilities, only that the Moran model runs twice as fast as the Wright-Fisher Model. A clue that can help us to understand this result is provided by the variance in reproductive success in the two models. Genetic changes due to drift were neither directional nor predictable in any deterministic way. Nonetheless, genetic drift led to evolutionary change in the absence of mutation (P=0.5), natural selection or gene flow. In general, alleles drift to fixation is significantly faster in smaller populations. Probability of fixation of an allele A was approximately equivalent to the initial frequency of that allele. With the inclusion of selection in our model, probability of fixation of a favoured allele due to natural selection increased with increase in fitness advantage and population size. The time taken to reach fixation is much slower, in case of no selective advantage, than a fixation under mutation with selective advantage.
Apr 2019 DOI 10.14302/issn.2643-6655.jcap-19-2764
Emanuela ZappellaCorresponding author
Department of Human and Social Sciences, University of Bergamo, Italy
Entry into the world of work is an important moment for people with disabilities and for their professional inclusion. Using a case study, This research presents the project of school/work alternation carried out with a student with intellectual disability within a supermarket during the frequency of the last year in a higher institute in northern Italy. This study intends to describe the process and highlight the strategies used in this experience. The paper ends with an analysis of the factors that can favour a positive experience and which can be a starting-point for other, similar experiences. This experience shows that, with adequate training, people with intellectual disabilities can be protagonists of an experience that favors their well-being and social inclusion.
Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-2646
Oladejo Thomas ADEPOJUCorresponding author
Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
The potential of Nigerian indigenous tree leaves as vegetable source, pharmaceuticals and other therapeutic materials have been reported. However, Silk cotton (Ceiba pentandra) leaf is still underutilised as vegetable in parts of Nigeria where it exists despite its potential great health benefits. The aim of the study was to assess the micronutrient and phytochemical potential contribution to nutrient intake of its consumers, and acceptability of its cooked soup and sauce ‘as consumed’. Fresh young shoots and leaves of Ceiba pentandra were harvested from Ihitte/Uboma in Imo State, Nigeria. Composite sample of the leaf was prepared and divided into four portions. One portion was labelled as raw sample, and others blanched, cooked to soup and sauce. The four samples were analysed for proximate, minerals, vitamins and phytochemical composition using standard methods of AOAC. Sensory evaluation of soup and sauce was carried out using 9-point hedonic scale with 30 untrained panelists. Data were analysed using ANOVA at p<0.05 Raw Ceiba pentandraleaf contained 80.9g moisture, 3.9g protein, 0.8g fat, 15.3g carbohydrate, 68.40 kcal gross energy, 183.40mg potassium, 119.38mg calcium, 112.99mg phosphorus, and 3.46mg iron/100g sample. The leaf was rich in phytochemicals such as saponins, flavonoid and alkaloids. Raw sample was highest in water-soluble vitamins while the sauce was highest in β-carotene (339.72µg/100g). Cooking the leaf to soup and sauce significantly increased the mineral content of the products (P<0.05) with reduction in water-soluble vitamins and phytochemicals (P<0.05). The sensory attributes of the soup and sauce were generally acceptable to the panelists, with the sauce being more acceptable. The leaf and its products were rich in essential minerals, vitamins and phytochemicals. The sauce retained more nutrients compared to other samples. Inclusion of this underutilised vegetable in diets will reduce micronutrient malnutrition, promote dietary diversity, good health and wellness.
Feb 2019 DOI 10.14302/issn.2470-5020.jnrt-18-2554
Volicer LadislavCorresponding author
School of Aging Studies, University of South Florida, Tampa FL, USA
Background Controversy exists about definition of agitation and especially about inclusion of aggression as a part of agitation in people with dementia. Methods Papers describing neurobiological indices related to behavioral symptoms of dementia were reviewed. Papers comparing indices in persons exhibiting aggression and persons exhibiting agitation were selected for this review. Results The survey found seven papers which compared neuroanatomical indices and three papers which compared neurochemical indices. The neuroanatomical indices differentiating agitation and aggression included changes in brain perfusion, sizes of brain areas, distribution of neurofibrillary tangles, and white matter changes. The neurochemical indices differentiating agitation and aggression included relationships with neurotransmitter variables and the cell count in the locus coeruleus. Conclusion Despite the small number of papers and some methodological problems, the presented information clearly indicates that aggression and agitation are two distinct unrelated syndromes in persons with dementia.
Jan 2019 DOI 10.14302/issn.2379-7835.ijn-18-2469
Kawasaki YoheiCorresponding author
Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
Background Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are categorized as omega-3 poly unsaturated fatty acids (PUFAs) that are present in fish oil, etc. DHA and EPA omega-3 PUFAs have a well-established fasting serum triglycerides (TG) lowering effect that may result in normal lipidemia in hyperlipidemic patients. In general, omega-3 PUFAs, such as DHA and EPA, can be ingested easily, and because they are highly safe, they are assumed to be suitable for controlling fasting serum TG in the serum of those who do not require drug treatment. To the best of our knowledge, however, almost all systematic reviews on the effects of omega-3 PUFAs on lowering fasting serum TG are directed at patients fulfilling the diagnostic criteria of dyslipidemia. Objectives To review and confirm the preventive effect of omega-3 PUFAs against hypertriglyceridemia or the effect on nondrug treatment in patients with a mild disease, a systematic review was conducted to determine whether there was a fasting serum TG-lowering effect in subjects without disease and those with a slightly higher triglyceride level who consumed DHA and/or EPA orally compared to those with placebo or no intake of DHA and/or EPA. Search Methods We evaluated articles from searches of PubMed (1946-February 2016), Ichushi-Web (1977-February 2016), and J Dream III (JST Plus, 1981-February 2016; JMED Plus, 1981-February 2016). The keywords were set as follows: “DHA” or “docosahexaenoic acid” or “EPA” or “eicosapentaenoic acid” and “TG” or “triglyceride” or “triglycerol” or “triacylglycerol” or “neutral lipid.”. In addition to the literature group obtained by the database search, we included participants not suffering from any disease (i.e., excluding mild hypertriglyceridemia). Eligibility Criteria Before the test selection process, the following inclusion criteria were defined. Participants were healthy men and women including those with mild hypertriglyceridemia (fasting serum TG level, 150-199 mg/dL [1.69-2.25 mmol/L)). Intervention was defined as orally ingested DHA and/or EPA. Comparison was made to placebo intake or no intake of DHA and/or EPA. Results were measured for the fasting serum TG level. The test design was RCT, and quasi-RCT. Data Abstraction Various characteristics were extracted from original reports using a standardized data extraction form, including the author of the study, research year, research design, subject characteristics (sex, age, sample size), period, dose of DHA and/or EPA (mg/day), and comparison group. Main Results We identified 37 documents for review. Among the 37 reports used to integrate literature results, 25 revealed a decrease in fasting serum TG level due to the oral ingestion of DHA and/or EPA. Sixteen studies on subjects without disease and 21 on subjects with slightly higher fasting serum TG levels were separated and stratified analysis was conducted. Ten of the 16 (normal TG participant) and 15 of the 21 studies (slightly higher TG participant) respectively, indicated that at least 133 mg/day of DHA and/or EPA intervention provided a statistically significant decrease in the fasting serum TG level between an intervention group versus a placebo group.
Oct 2018 DOI 10.14302/issn.2326-0793.jpgr-18-2312
Saad Zaghloul Salem MohammadCorresponding author
Professor of Medical Genetics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
All aspects of life activities in living cells are mediated/executed and regulated by a vast number of networks, comprising a wide spectrum of components, starting with simple biomolecules and ending with the whole organism, and functioning within a precisely organized tight framework. Proper mediation of cellular activities necessitates their inclusion within the context of structured and organized network systems capable of regulating/coordinating and synchronizing the countless numbers of biological processes occurring within living cells. The number of biological networks and pathways within the living cell is considerably huge, being dependent on the structural complexity and functional capabilities of the cell. Pathogenesis and progression of human diseases result from functional disturbances of biological networks within the cell as disturbed network function leads to deleterious effects on physiological processes dependent on, and mediated by, affected network(s). Ensuing pathological processes, defined by the nature of disturbed networks and the specific organs or tissues affected, pave the way for the development of pathognomonic and characteristic disease entities. As most network functions are dependent on relatively small number of key regulatory biomolecules, i.e. enzymes/proteins and signal transducing factors, it follows that functional disturbances of biological networks and pathogenesis of disease states can be attributed, in most instances, to quantitative and/or qualitative abnormalities of these key regulatory molecules. Study and analysis of the structural designs and the functional mechanisms of biological networks would have crucial and important impacts on many theoretical and applied aspects of biology, in general, and of medical sciences in particular. Meticulous study of biological networks represents an important and integral aspect in study of biology. Interpretation and analysis of key information deduced from observing and analyzing structural designs and functional characteristics and dynamics of biological networks discloses and defines the basic framework within which life activities in living cells are initiated, adapted to physiological requirements, maintained, and terminated upon completion of their aims. More important, however, is the contribution of this information to proper understanding of the different mechanisms responsible for regulating and synchronizing the functions and performances of the vast spectrum of different network categories within the cell. In addition to its vital scientific significance, discovering and defining the key pivotal structural and regulatory molecules within life-mediating networks, and along different pathways responsible for controlling functional dynamics of the network, represent an indispensable diagnostic approach insistent for designing proper therapeutic approaches to diseases caused by network defects.
Sep 2018
Di Gianfilippo RiccardoCorresponding author
The University of Michigan - School of Dentistry, Department of Periodontics and Oral Medicine, 1011 North University Avenue, 48109-1078, Ann Arbor, MI – USA
MicroRNAs are short sequences of non-coding RNAs crucial in regulation of cell development, proliferation and differentiation. Some of them showed to be related with the expression of osteogenic genes. Aim of the present review was to evaluate the biological effects of titanium implant surfaces activated with miRNAs or antimiRNAs. A bibliographical electronic research was carried out on PubMed/Medline. Articles investigating the influences of miRNA functionalized surfaces on human or animal cells were included. Reports were excluded if investigating surfaces modified with molecules different from miRNAs, if miRNAs were not loaded to titanium surfaces. Five articles met the inclusion criteria. Surfaces functionalized with miRNAs showed to up-regulate the expression of osteogenic genes like RUNX2, OPN, OCN, BMP, OSX, ALP, COL1 and COL3. Investigated surfaces additionally showed more bone-like mineralized tissues, bone lacunae, osteocytes and new blood vessels. MiRNAs loaded to titanium implant surfaces stimulate the expression of genes related to osteoblasts differentiation, osteogenesis, osseointegration and reparation of mineralized tissues. Vectors used to link titanium surfaces and miRNAs did not show cytotoxicity or interference with cells’ viability.
Aug 2018 DOI 10.14302/issn.2641-9467.jgrc-18-1936
M. H. MubarakCorresponding author
Four nitrogen forms and four biofertilizer were application as well as their interactions on growth analysis of sugar beet (Beta vulgaris L). The important results could be summarized as follow. Urea treatment achieved maximum increase in Leaf Area Index were 69.71, 81.32 and 166.54 at 120, 140 and 160 day in the 1st season, respectively, The highest one was 160.6 in the 2nd also was ammonium nitrate application at 160 days. Urea treatment inclusion in seeds with ntrobin application resulted the highest values of leaf area index (LAI), crop growth rate (CGR) and leaf area duration (LAD) and in the 1st season. A slight increase was 0.03 g/week in this case was found due to urea treatments as compared with the others treatment at the period from Relative growth rate (RGR3) in the 1st season. Ammonium nitrate treatment achieved the maximum values from Crop Growth Rate was 39.16 g/day in (CGR1), 93.24 and 13.5 g/day in (CGR2) and (CGR3) from urea treatment at the 1st season. The highest net assimilation rate was 0.66 g/dm.week achieved by ntrobin as compared the others treatment whereas, the lowest one 0.11 g.dm /week with the phosphorine application. Ammonium sulphate treatment with (phosphorin + ntrobin) obtained the highest net assimilation rate (NAR) in the 1st season. The highest values from leaf area duration were 0.11, 0.19 and 0.15 dm2/week achieved with urea and ntrobin in the 1st season at (LAD2), (LAD3) and (LAD4). Ammonium nitrate treatment with phosphorin obtained the highest leaf area duration (LAD) in the 2nd season. Generally, it could be recommended that fertilizing sugar beet plants variety Ymer with nitrogen forms inoculated with biofertilizer (ntrobin 600gm/fed) increased the growth of sugar beet plants under sandy soil conditions.
Dec 2017 DOI 10.14302/issn.2997-2086.jfs-17-1846
Amin RuchiCorresponding author
Pediatric Surgery, Children’s Hospital of Wisconsin
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.
Aug 2017 DOI 10.14302/issn.2379-7835.ijn-17-1710
Çöpür MazlumCorresponding author
Associate Professor in Child and Adolescence Psychiatry. Arel University Faculty of Science and Letters Department of Psychology
Background: High number of patients suffering from autism spectrum disorders utilize dietary intervention methods, especially gluten-free/casein-free diet. In contrast with its’ extensive usage no sufficient and consistent data exist to support its’ efficiency and safety. Objective: The main aim of this systematic review is to provide a general look to the efficiency and safety of gluten-free/casein-free diet treatment for autism spectrum disorders. Method: Studies used in this systematic review are gathered from 3 online databases (PubMed, Embase and the Cochrane Library). Inclusion criteria are established for study selection. Articles published in a peer-reviewed article between 1990 and 2016 in English about our topic of interest and conducted with patients under the age of eighteen (18) are selected and further analyzed (“Level of Evidence” and “Grade of Recommendation” criteria are utilized). Results: Even though some studies with high values of “Level of Evidence” claim that gluten-free/casein-free diet is beneficial for patients suffering from autism spectrum disorders, studies with lower risk of bias demonstrate otherwise. Since studies such as case reports and cohort studies may contain bias associated with small sample size, absence of clear assessment methods, lack of randomization and short treatment period we suggest that there is no sufficient data to support gluten-free/casein-free diet treatment. Conclusion: Due to controversial outcomes from studies that have different “Level of Evidence” we speculate that efficiency of gluten-free/casein-free diet might be related to individual genetic differences. Therefore, studies conducted with large study groups could not provide statistically significant data to support this treatment option. Further studies should be conducted, especially in the field of genetics, in order to test our hypothesis.
Aug 2017
Zugor VahudinCorresponding author
Department of Urology, University Hospital of Cologne, Germany
Purpose: To show the increased necessity of routine prostate biopsy in men older than 75 years and to identify markers, which reliably indicate the presence of a prostate cancer (PCa), we evaluate several different parameters from elderly patients. Methods: 196 patients over 75 years were included in the study, inclusion criteria for the biopsy were: PSA levels >4 ng/ml and/or a suspicious finding on dig ital rectal examination (DRE). The parameters analyzed included: age, prostate size, PSA levels, DRE findings, American Society of Anesthesiologists (ASA) PCa detection rate, Gleason score, clinically significant PCa detection rate and type of therapy once PCa had been detected (curative intent or palliative intent). Results: PCa was detected in N=115 patients (59%), with 84.3% of them being defined as clinically significant (p<0.05) and 60.8% (p<0.05) as high grade. Only a PSA level > 10 ng/ml with a simultaneous positive DRE finding was a marker for high-grade or significant PCa (p< 0.001) in patients >70 years. Conclusions: Our findings demonstrate that the prevalence of significant and high-grade PCa in the elderly patients is high raised (~60%). We identified two significant markers for patients over the age of 75, namely an increased high PSA level (PSA>10 ng/ml) and positive DRE. The combination of both markers indicates that the patient is suffering under a significant and high-grade PCa. In our opinion, every patient showing a combinational increase of both markers should be biopsied in order to receive an adequate therapy.
Aug 2017 DOI 10.14302/issn.2578-2371.jslr-17-1669
Bagny AklessoCorresponding author
Departement of gastroenterology, University Teaching hospital Campus of Lomé
Aims: To describe the clinical, biological and evolutionary features of mono infected patients treated with tenofovir in Togo. Method: It is a descriptive, prospective study. Patients were treated with Tenofovir Disoproxil Fumarate (TDF). The inclusion criteria were: active chronic HBV (HBs Ag-positive for more than 6 months, high aminotransferases, the HBV –DNA ≥ 2000 IU / ml for HBeAg negative or ≥ 20 000 IU / ml for HBeAg positive and significant fibrosis) and absence of HCV, HDV, or co-infection HIV. Results: Among patients with HBV in our department, only 10.68% were treated with TDF. The mean age of patients was 33.01±9.81years. There was male predominance (68%). The circumstances of discovery were mainly during blood donation (65.3%) and a routine checkup (14.7%). Clinical examination was normal in most of cases (86.7%) apart from hepatomegaly (9.3%) and icterus (4%).) The HBeAg was negative in 89.3%; the average DNA was 7.56 ±8.01 log10 IU/ml. Abdominal ultrasonography was performed in all patients and we found hepatomegaly (18.67%), splenomegaly (10.67%), and ascites (5.3%). The assessment of fibrosis and activity had enabled to find a fibrosis higher or equal to 2 in 12 cases (48%) and an activity higher or equal to 2 in 9 cases (36%). The clinical and virologic outcome was marked by an undetectable viral load (HBV-DNA˂10 IU/l) in 89.3% of the patients after 1 year of treatment. Conclusion: TDF had helped to find out an undetectable viral load in in 89.3% of the patients after one year of treatment.
Aug 2017 DOI 10.14302/issn.2997-2086.jfs-17-1663
Knezevich MichelleCorresponding author
Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Fetal surgery is the newest surgical specialty with a compelling history. The development of fetal surgery began in primates and lambs and, in its most basic form, was first performed in humans in 1965. Since its introduction, the field has expanded and changed dramatically. Several of these changes have involved the ethical aspect of fetal surgery. This field conflicts with the Hippocratic oath mantra of “first do no harm” as one of the patients, the mother, receives no benefit from these procedures. The ethical dilemma resulted in stringent inclusion and exclusion criteria for fetal operations. Initially, fetal surgery was only indicated for life-threatening conditions of the fetus but is now offered in some disease processes to improve quality of life for the child. As the field has matured, it has grown to encompass numerous different types of fetal interventions. Similar to other areas of surgery, the trend has been to migrate from more invasive to less invasive procedures. Currently, some of these therapies are performed entirely percutaneously. Theoretically, this trend would improve outcomes for both the mother and fetus. While this has generally proven true, there are some important exceptions to this rule. Finally, as the field continues to evolve, much research is being performed looking at possible new types of fetal interventions. Some of these procedures, such as fetal stem cell therapy and fetal gene therapy, could change the face of modern medicine.
Jan 2017 DOI 10.14302/issn.2470-5020.jnrt-16-1415
W. Schrock JonCorresponding author
Associate Professor, Emergency Medicine Case Western Reserve University
Objectives: Computed tomography angiography (CTA) provides early assessment of cerebral vasculature in ED patients presenting with Acute Ischemic Stroke (AIS). Prior studies using 4 row detector CT scanners have suggested that results may be used to determine who receives thrombolytics (tPA). We sought to evaluate the rate of normal CTA and the use of tPA in AIS patients with and without blockages using modern CT technology. Patients and Methods: We conducted a retrospective cohort study of all code stroke patients presenting to our ED over a 3 year period. Inclusion criteria included an ED and neurology diagnosis of AIS with a CTA performed at presentation. All patients had a NIHSS score recorded at presentation and underwent imaging using a 64 row detector scanner with 50cc of non-ionic contrast. Demographic, imaging, and clinical data were collected. Modified Rankin Scores (mRS) were assigned at hospital discharge. Good clinical outcome was defined as a mRS of 0-2. Data are reported as frequencies and medians with interquartile ranges (IQR) as appropriate. Rates of tPA use were evaluated using χ2 testing. Rates of good outcomes were evaluated using odds ratios. Results: A total of 205 subjects met inclusion for analysis of which 103 (50%) were male and 109 (54%) had no blockage on CTA. The median NIHSS score and mortality rates were 14 (IQR 8-19), 14 (14%) with CTA blockage, and 4 (IQR 2-7), 2 (2%) for those without. Of those AIS with a blockage on CTA 46 (48%) were treated with tPA including 29 who were treated with intra-arterial therapy as well while only 13 (13%) of patients without a blockage were treated with tPA. Post tPA bleeding occurred in 12 (13%) patients with blockage on CTA and in 0 patients without blockage. Use of tPA was significantly more frequent in patients with a blockage on CTA, P <0.001. Conclusion: More than half of our AIS patients presenting through our ED have no blockage on CTA. Inter-rater reliability among neuroradiologists evaluating for large vessel occlusion appears to be very good. Patients with AIS and no blockage on CTA have less severe strokes and are less likely to receive tPA. Given the new guidelines recommending endovascular treatment for AIS we expect more emergency departments to begin performing CTA.
Sep 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1196
Singh Nayyar AbhishekCorresponding author
Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Background and Context: Autologous bone grafts require a second surgical exposure to harvest the graft with a significant risk of post-operative complications and donor site morbidity. Employment of allografts potentially eliminates donor site morbidity but carries the potential of causing foreign body immune reactions with a high rate of rejection and failures. Hence, Alloplasts have emerged as novel materials to overcome the drawbacks of autogenous and allogenous bone grafts. Today’s advanced dentistry is enterprising a putty form of calcium phosphosilicate (CPS) into several aspects of reconstructive domain of dentistry including the sinus augmentation procedures, osseous regeneration of periodontal bone defects, cystic cavity defects and alveolar socket preservation. This eccentric multifaceted study was planned as an honest effort on the path of proving the efficiency of CPS as an alloplastic bioactive graft material and aimed at quantitative evaluation of regenerated bone radiographically using Cone Beam Computed Tomography (CBCT) scans following sinus augmentation procedures. Materials and Methods: A total of 20 sinus augmentations were carried-out in 17 patients satisfying the criteria (inclusion and exclusion) requiring placement of implants in atrophic maxilla and in other situations of anatomic constraints. The graft material used was calcium phosphosilicate (CPS) putty (Nova bone dental putty, Novabone products, Alachua, Fla). The residual bone height was recorded using CBCT scans and a computer based software where the measurements were made from the crest of the ridge till the sinus floor lining. The patients were assessed clinically at immediate post-operative, 1 week, 1 month, 3 months and 6 months follow-up recalls post-operatively. Radiographic assessment for bone height was done pre-operatively and at 6 months follow-up recall post-operatively using Cone Beam Computer Tomography scans. Results: The post-treatment bone height (11.76+0.97mm) was found to be significantly higher than the pre-treatment bone height (6.8 +0.70mm) in indirect sinus augmentation procedures (t=14.4, p<0.005). In case of direct sinus augmentation group also, the post-treatment bone height (11.27 +0.71mm) came-out to be significantly higher than the pre-treatment bone height (2.44 +0.81mm) (t=32.17, p<0.005). The post-treatment bone grafted sinus floor measurements (1107.6 + 155.6mm) were also found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (412+ 65.5mm) (t=16.6, p<0.001) in case of indirect sinus augmentation procedures. Similarly, the post-treatment bone grafted sinus floor measurements (1169.6+136.7mm) were found to be significantly higher than the original sinus floor measurements of bone density (Grayscale values) (416.4+ 0.70mm) (t=17.9, p<0.001) in case of direct sinus augmentation group. Conclusion: Calcium Phosphosilicate (CPS) was accepted well at the recipient sites without any complications demonstrating its efficiency and reliability in sinus augmentation procedures.
Apr 2016 DOI 10.14302/issn.2470-5020.jnrt-16-980
Stein MarcoCorresponding author
Department of Neurosurgery, Justus Liebig University Giessen, Germany
Spontaneous intracerebral hemorrhage (ICH) is one of the leading causes of death worldwide. In randomized trials on surgical therapy inclusion of the very old was limited by the recruitment process. This study was performed to evaluate the age limits in published surgical trials on ICH, and to determine how upper age limits effect the inclusion of men and women in these and future trials on the basis of a large cohort of ICH patients in central Europe. The Hessian stroke registry, a state-wide prospective stroke databank, was used to analyze upper age limits and sex differences for patients with the diagnosis of ICH (ICD-10: I61.0 to I61.9) who were admitted between January 2010 and December 2012. Sex differences were calculated at different age cutoffs, and the proportions of potentially excluded sex-specific patients from surgical trials on ICH were calculated. Overall, 5184 patients with the diagnosis of spontaneous ICH were identified. A total of 2457 (47.4%) patients were female and 2727 (52.6%) patients were male. Mean age was 72.3 ± 13.6 years. Female patients were significantly older compared to male patients (74.9 ± 13.5 years vs. 69.9 ± 13.2 years; p<0.001). With an upper age limit of 70, 75, and 80 years, 3437 patients (66.3%), 2664 patients (51.4%), and 1765 patients (34.0%) were excluded, respectively. Upper age limits in surgical trials on ICH could lead to the exclusion of a significant portion of patients from studies. This should be noted when transferring conclusions from these trials into clinical practice.
Jun 2015 DOI 10.14302/issn.2381-862X.jwrh-14-546
M. Haas DavidCorresponding author
Department of OB/GYN, Indiana University School of Medicine, Indianapolis, IN
Objective: To assess the efficacy of bupropion therapy for hypoactive sexual desire disorder (HSDD) in women. Methods: A systematic review was performed utilizing the standard databases. Data were abstracted for study quality, characteristics, and outcomes. Due to the small number of studies and lack of consistently reported outcomes, a meta-analysis was not performed. Results: Two studies (289 women) met inclusion criteria. While one study had low risk of bias, the other had areas of high risk of bias. Both trials reported improvement in sexual function domains with treatment ranging from 12 weeks to 112 days. Conclusions: Despite two trials demonstrating benefit with bupropion treatment for premenopausal women with HSDD, the evidence is limited and not of adequate quality to recommend the therapy. More trials are needed in this area.
Nov 2014 DOI 10.14302/issn.2379-8572.joa-14-418
Califano LuigiCorresponding author
Department of Audiology and Phoniatrics “G. Rummo” Hospital, Benevento, Italy
This double-blind randomized studyevaluates the efficiency of the Quick Liberatory Rotation maneuver (QLR) in solving signs and symptoms of Posterior Canal BPPV in a short time follow-up comparing the efficiency of QLR vs. a sham maneuver (“Fake QLR”).The study was performed at an input-output tertiary center for balance disorders.From January to September 2012, 200 patients with signs and symptoms of Posterior Canal BPPV respected the inclusion criteria in the study. The diagnosis was based on observation with binocular infrared videonystagmoscopy of the paroxysmal torsional and upbeat nystagmus evoked through the Dix-Hallpike test (DHT). Patients were divided in two groups, 100 in the group treated by QLR (Group 1) and 100 in the control group treated by “Fake QLR” (Group 2). Before the treatment, they self-evaluated a Visual Analogue Score on their vertiginous complaints (V-VAS). Patients were controlled one hour after the treatment by a blinded examiner about the first phase of the study through DHT, the Straight head-hanging positioning test and the Head Roll test in supine position and assessed again with V-VAS. Patients with a persisting positive Dix- Hallpike test were subsequently treated through QLR. The main outcome measure is the number of patients treated through QLR or “Fake QLR” with a negative DHT one hour after the first treatment. At the post-procedure check, 79 patients from Group 1 presented a negative DHT with little or no subjective symptoms, whereas all the patients of Group 2 presented persistence of a positive DHT. The presence of the secondary nystagmus during QLR (“liberatory” nystagmus) was significantly correlated with a negative DHT at the post-procedure control. In Group 1 pre- and post-treatment V-VAS differences were significant; post-treatment V-VAS differences were significant in Group 1 vs. Group 2. In a short time follow-up QLRis an effective treatmentfor Posterior Canal BPPV when compared to a sham maneuver.
Aug 2014 DOI 10.14302/issn.2329-9487.jhc-13-313
A. Hammond DraytonCorresponding author
University of Arkansas for Medical Sciences, Little Rock, Arkansas
Objective: Ablation of foci within the atria has been shown to resolve symptoms of atrial fibrillation and atrial flutter. However, no standard has been established for anticoagulation after the procedure. Enoxaparin has been well described in the literature as a means to provide anticoagulation after ablation procedures. The only enoxaparin doses previously studied were 0.5 mg/kg and 1 mg/kg, both given every 12 hours. The purpose of the study was to compare the incidence of a major bleed or vascular complication in patients who received enoxaparin doses between 0.5 mg/kg and 1 mg/kg every 12 hours with patients who received either 0.5 mg/kg or 1 mg/kg every 12 hours. Methods: This IRB-approved, single-center, retrospective, cohort study included subjects greater than 18 years of age who received an atrial fibrillation or atrial flutter ablation procedure and at least one dose of enoxaparin post-ablation. Results: There were 119 subjects who satisfied the inclusion criteria. The primary outcome, incidence of major bleeding or vascular complication, did not demonstrate a statistically significant difference between groups (p = 0.92). The incidences were 4.8% with enoxaparin ≥ 1 mg/kg, 3% with enoxaparin between 0.5 mg/kg and 1 mg/kg, and 3.2% with enoxaparin ≤ 0.5 mg/kg. No subject experienced an ischemic stroke or transient ischemic attack within 28 days of a cardiac ablation procedure. Conclusion: Significant increases in major bleeding or vascular complications may not exist with an intermediate dose of enoxaparin provided after a cardiac ablation procedure.