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Kim, Bong-Jun. "Taiwan February 28 Incident in Korean Media Reports." Korea Association of World History and Culture 70 (March 31, 2024): 123–51. http://dx.doi.org/10.32961/jwhc.2024.03.70.123.
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The 1947 February 28 Incident, which resulted in more than 10,000 casualties, is a seminal event in Taiwan’s modern history. The sharp internal and external divisions that were expressed during the event and its aftermath became the prototype for modern Taiwan’s social conflicts. The Incident also attracted the attention of not only Taiwan but also Korea, which had just been liberated, and Korean media outlets reported the causes and background of the Incident in light of their own experience of colonization. Therefore, an understanding of the narrative and causes of the February 28 Incident can serve as a mirror for understanding the immediate post-liberation situation in East Asian countries with colonial experiences. To this end, this article focuses on Korean media coverage of the February 28 Incident, analyzing the sources, context of the coverage, and perspectives expressed in the commentary. This article explains that the KMT’s misguided policies and responses played a crucial role in the escalation of the incident to the rest of Taiwan, and that internal conflicts and divisions within the KMT contributed to the difficulties in the negotiation process. As commentary in the Korean and Western media has shown, the February 28 Incident cannot be viewed simply as a result of internal contradictions in Taiwanese society, but also provides clues to understanding the effects of Japanese colonial rule, the state of the KMT, and economic insecurity.
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Liao, P. h. "Rewriting Taiwanese National History: The February 28 Incident as Spectacle." Public Culture 5, no. 2 (1993): 281–96. http://dx.doi.org/10.1215/08992363-5-2-281.
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Yang, Ruijie, Junjie Wang, Xile Zhang, et al. "Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Technology." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/392596.
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Objective. To explore the implementation of incident learning for quality management of radiotherapy in a new established radiotherapy program.Materials and Methods. With reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically established for reporting, investigating, and learning of individual incidents. The incidents that occurred in external beam radiotherapy from February, 2012, to February, 2014, were reported.Results. A total of 28 near misses and 5 incidents were reported. Among them, 5 originated in imaging for planning, 25 in planning, and 1 in plan transfer, commissioning, and delivery, respectively. One near miss/incident was classified as wrong patient, 7 wrong sites, 6 wrong laterality, and 5 wrong dose. Five reported incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, and inadequate training contributed to 19, 15, and 12 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4.Conclusion. Effective implementation of incident learning can reduce the occurrence of near misses/incidents and enhance the culture of safety.
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Simon, Preker. "A Tinted Politics of Memory: Anniversaries Caught between Political Camps in Taiwan in 2017." Global Politics Review 4, no. 1 (2018): 67–77. https://doi.org/10.5281/zenodo.1237365.
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ABSTRACT: Thirty years after Taiwan lifted martial law in 1987, Taiwanese society today is open to a re-evaluation of its authoritarian past. Following the beginning of the Tsai presidency in 2016, Taiwan’s quest for a national identity has become more perceivable in its memory culture. The year 2017 marked the 70th anniversary of the February 28 Incident as well as the 80th anniversary of the beginning of the Second Sino–Japanese War. Questions of whether and how to commemorate the 1937 Marco Polo Bridge Incident, as well as the search for historical equivalences are overshadowed by the two large political camps and their respective allies. Third parties such as the CCP or Japan also offer conflicting narratives and seek to influence Taiwan’s historiography, which will ultimately shape Taiwan’s future. More than just vying for the prerogative of the interpretation of memory, these issues also led to a more fundamental question: What should be considered Taiwanese history?
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Paul, James E., Barbara Bertram, Karen Antoni, et al. "Impact of a Comprehensive Safety Initiative on Patient-controlled Analgesia Errors." Anesthesiology 113, no. 6 (2010): 1427–32. http://dx.doi.org/10.1097/aln.0b013e3181fcb427.
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Background Adverse drug events related to patient-controlled analgesia (PCA) place patients at risk. Methods We reviewed all critical incident reports at three tertiary care hospitals dated January 1, 2002, to February 28, 2009. In this longitudinal cohort study, critical incidents attributable to PCA errors were identified, and each incident was investigated. A safety intervention was implemented in February 2006 and involved new PCA pumps, new preprinted physician orders, nursing and patient education, a manual independent double-check, and a formal nursing transfer of accountability. Results A total of 25,198 patients were treated with PCA during this study, and 62 errors were found (0.25%), with 21 (0.08%) involving pump programming. All errors occurred before the safety interventions were put in place. Compared with the preintervention period, the odds ratio of a PCA error postintervention was 0.28 (95% CI = 0.14, 0.53; P < 0.001) whereas the odds ratio of a pump-programming error postintervention was 0.05 (95% CI = 0.001, 0.30; P < 0.001). Programming the wrong drug concentration was the most common programming error (10 of 21). Improper setup of intravenous tubing was also common (8 of 62), with one incident leading to respiratory arrest. Most PCA errors resulted in no harm, but there was negative impact to patients 34% of the time. Conclusion At less than 1%, the incidence of PCA errors is relatively low. Most errors occur during PCA administration. Safety can be improved by addressing equipment, education, and process issues.
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Chiou, Fang-Yi, and Ji Yeon Hong. "THE LONG-TERM EFFECTS OF STATE REPRESSION ON POLITICAL BEHAVIOR AND ATTITUDES: EVIDENCE FROM TAIWAN." Journal of East Asian Studies 21, no. 3 (2021): 427–48. http://dx.doi.org/10.1017/jea.2021.24.
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AbstractThis article examines how violence against citizens affects their political attitudes and behavior in the long run, and how those effects vary over time. We construct and analyze a novel dataset on the victims of Taiwan's February 28 Incident, in 1947, with survey data spanning 1990 to 2017. Our empirical analysis shows that cohorts having directly or indirectly experienced the Incident are less likely to support the Kuomintang Party (KMT), the former authoritarian ruling party responsible for the Incident. They tend to disagree with the key conventional policy stand of the KMT (unification with mainland China), are more likely to self-identify as Taiwanese, and are less likely to vote for KMT presidential candidates. Taiwan's residents who were born in towns with larger number of casualties during the Incident are more likely to reject unification. Finally, the effects are found to vary over the period following democratization.
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Chen-Jung, Lin. "Book Review: Ni-ni-hachi Jiken: “Taiwan-jin” Keisei no Esunoporitikusu (The February 28 Incident: the formation of Taiwanese ethnopolitics)." China Information 18, no. 3 (2004): 507–8. http://dx.doi.org/10.1177/0920203x0401800313.
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Louzon, Victor. "From Japanese Soldiers to Chinese Rebels: Colonial Hegemony, War Experience, and Spontaneous Remobilization during the 1947 Taiwanese Rebellion." Journal of Asian Studies 77, no. 1 (2017): 161–79. http://dx.doi.org/10.1017/s0021911817001279.
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A former part of the Qing Empire, Taiwan was colonized by Japan in 1895 and returned to China, upon Tokyo's defeat, in 1945. Two years later, a revolt broke out against the mainland Chinese authorities and was brutally crushed. This episode, known as the February 28 Incident, has been at the center of memory wars in Taiwan since democratization. Historical accounts have tended to focus on the background causes of the Incident and on the role played by the Taiwanese elite. This article argues that devoting more attention to grassroots participants and their repertoire of action can shed new light on the events. During World War II, many young Taiwanese were mobilized in the Japanese army and paramilitary structures. This experience persisted in collective memory after Japan's defeat. During the revolt, young Taiwanese spontaneously “remobilized” the repertoire of actions and symbols formed during the war, with important consequences.
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Demirel, Tanel. "Turkey's Troubled Democracy: Bringing the Socioeconomic Factors Back in." New Perspectives on Turkey 24 (2001): 105–40. http://dx.doi.org/10.1017/s0896634600003514.
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The advent of democracy in Turkey has been far from tranquil. Since the transition to multiparty politics in 1946, democracy has been interrupted by three military interventions (in 1960, 1971, and 1980)- unless we count as the fourth intervention the more recent incident, euphemistically labeled “the 28 February Process,” in which the military played a crucial role in forcing the resignation of the governing coalition led by the Islamist-oriented Welfare Party (WP). Not only has Turkish democracy followed a cyclical pattern in which breakdowns and transitions succeeded each other, the degree or the quality of democracy that was in place never ceased to attract bitter criticism.
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Der Meer Mohr, Pauline F. M. Van. "Measures to Prevent Collisions with Offshore Installations on the Dutch Continental Shelf." Leiden Journal of International Law 1, no. 2 (1988): 222–30. http://dx.doi.org/10.1017/s092215650000090x.
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1. INTRODUCTIONOn February 1988, the M.S. Cape, a 2,000 ton coaster sailing under the Honduran flag, passed the K14 FA 1 production platform belonging to the Nederlandsche Aardolie Maatschappij (NAM) at a distance of 25 meters. The ship had been drifting because of an engine failure but did not communicate this fact until it had reached an adjacent production platform, by which time it had successfully solved its engine problem. As a result of this incident, the production of gas was halted for some time and the operator of the platform suffered considerable losses. On 28 February 1988, the Swedish ferry M.S. “Vinca Gorthon” entered a field with severe weather conditions, ran into trouble, sent a MAY-DAY call, listed and sunk right on top of a Unocal pipeline, which was damaged. Oil transport through this pipeline had to be stopped immediately. The daily loss suffered by the operator was approximately Dfl.1,5 million.
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Jiang, Wei, and Wei Han. "Analysis of “2·28” KEEPER Chemical Industries Hazardous Chemical Explosion Accident Based on FTA and HFACS." International Journal of Environmental Research and Public Health 15, no. 10 (2018): 2151. http://dx.doi.org/10.3390/ijerph15102151.
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On 28 February 2012, a guanidine nitrate explosion occurred at HEBEI KEEPER Chemical Industries Co., Ltd., China, resulting in 25 deaths, with 4 missing individuals and 46 injured. In order to explore the causal relationship hidden behind this accident, fault tree analysis (FTA) and the Human Factors Analysis and Classification System (HFACS) were used to systematically analyze the incident. Firstly, FTA was used to analyze the causes of the accident in depth, until all the basic causal events causing the guanidine nitrate explosion were identified, and a fault tree diagram of the guanidine nitrate explosion was drawn. Secondly, for the unsafe acts in the basic causal events, the HFACS model was used to analyze the three levels of factors that lead to unsafe acts, including the preconditions for unsafe acts, unsafe supervision, and organizational influences. Finally, based on the analysis results of FTA and HFACS, a complete logic diagram of the causes of the accident was obtained. The FTA and HFACS accident analysis methods allowed for the identification of human factors and the accident evolution process in the explosion accident and provide a reference for accident investigation.
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Dhondt, E. L., and A. Heulot. "(A13) Effective Proactive Outreach among Disaster Relief Workers (DRW) in an Emergency Mortuary (EM)." Prehospital and Disaster Medicine 26, S1 (2011): s3. http://dx.doi.org/10.1017/s1049023x11000264.
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BackgroundFollowing the Buizingen train-crash disaster on February 15, 2010, nineteen dead bodies were evacuated to the morgue of the Military Hospital. According to the hospital's emergency incident management system, the reception plan for the deceased was activated and an EM organized. Aim: To determine the psychological impact of exposure to current death and to evaluate the effect of proactive outreach in DRW deployed in an EM.Methods and ResultsFor five consecutive days 62 hospital staff personnel were involved in the daily activities of an EM: disaster victim identification, autopsies, care for the dead, logistic support and reception and mental relief of the families. Besides a critical incident debriefing on day 5, a postal questionnaire survey of these 62 DRW was conducted, including the Davidson Trauma Scale (DTS) – detecting acute post-traumatic stress reactions/symptoms (ASR/S) – and the Symptom Checklist SCL 90 self-report inventory – measuring primary symptoms and global distress – administered 2, 4 and 7 months following the train-crash. Out of these, 35 (56%) initially responded (informed consent), followed by a return rate of 80% (28/35) and 68% (19/28) respectively. Six out of the 35 participants were identified suffering from acute psychological distress according to DTS and SCL 90 and subsequently followed up in the hospital's dedicated Military Centre for Crisis Psychology. In five of them, normalization of symptoms had occurred by the second inquiry and persisted. Ten months post-event, only 1 patient still needs psychological counseling, whereas 34 demonstrated psychological resilience.ConclusionPrevalence of chronification is low (1/35) compared to literature (5 to 10%). Timely detection of acute distress and proactive outreach may effectively counterbalance chronification in tertiary victims following a critical incident. Education and training should help hospital staff deal with ASR/S and improve coping. Hospitals should support professionals in the most disturbing situations.
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변현정, 정창원, 송은경, 고경아, and 허선주. "Impacts and Conflicts Caused by the Intervention of Foreign Powers After the War - Indirect Causes of the Jeju April 3 Incident and the Taiwan February 28 Incident from the Perspective of Socioeconomic Factors -." 탐라문화 ll, no. 59 (2018): 7–39. http://dx.doi.org/10.35221/tamla.2018..59.001.
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Greene, J. Megan. "Between Assimilation and Independence: The Taiwanese Encounter Nationalist China, 1945–1950. By Steven E. Phillips. [Stanford: Stanford University Press, 2003. 272 pp. $55.00. ISBN 0-8047-4457-2.]." China Quarterly 177 (March 2004): 230–31. http://dx.doi.org/10.1017/s0305741004300123.
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In recent years the sub-field of Taiwan studies has begun to take off and Steven E. Phillips' excellent study of local elite political activities and Nationalist state-building in Taiwan during the highly charged period following the island's retrocession to China is evidence that this process is now extending into the realm of historical research on the Nationalist period. Using a wide array of Chinese, English and Japanese language primary sources, Phillips examines the tensions between local, provincial forces and centralizing, national forces as he traces the question of local self-government through Taiwan's evolution from colony to province to province/nation in the period between 1945 and 1950. He argues that, given the different experiences of Taiwan's elite and the Nationalists, some sort of clash was inevitable, and both groups acted between 1945 and 1950 in ways that were consistent with their past actions and experiences. He further argues that the February 28 incident of 1947 was a turning point after which the Nationalists took over the drive for local self-government in Taiwan and Taiwan's local elite were increasingly politically marginalized.
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Sucipto, Nur Aditia Buana. "DEVELOPMENT OF QUALITY ASSURANCE PROGRAM FOR CONSTRUCTION IN OIL AND GAS COMPANY BY USING STATISTICAL QUALITY CONTROL AND SIX SIGMA." International Journal of Supply Chain, Operation Management and Logistics 3, no. 5 (2022): 01–13. http://dx.doi.org/10.35631/ijscol.35001.
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Stripe Oil Indonesia operated in Sumatera with a production capacity of 200,000 barrels of oil per day and operated over 530 km of pipelines. Many pipelines have already exceeded their design life with some segments more than 50 years with high potential for leaks that have caused production loss. To extend the operating lifetime of existing pipelines, a pipeline repair project was started in 2019 with sleeve installation. Based on factual data, the project team has experienced a delay in the first 2 months of the project. One of the main contributions to the delay was the welding failure that occurred in January 2019. The welding failure has caused a fire incident due to burn-through in the existing pipeline. The root cause analysis of burn-through incidents has been done with the finding of poor welder performance to meet project requirements. The recommendation is to measure the welder’s performance from heat input data records and analyze the rejection rate and capability index. This research demonstrates how Six Sigma methodology using the DMAIC process and Statistical Quality Control can be applied successfully in pipeline repair projects to address issues of reducing defective welds, improving quality performance, and achieving project milestones. The analysis result showed an improvement in quality performance where the defect rate continued to decline as well as the capability index of the welder continued to improve and completed sleeve installation above the target. The project team also managed to achieve the six sigma level. Improvements also occurred in safety performance which achieved zero incidents due to welding failure (burn-through) from February 2019 to December 2020. In terms of business, actual cost savings achieved 28% from the approved budget.
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Heo, Ga Young, Hee Byung Koh, Jung Tak Park, et al. "Sweetened Beverage Intake and Incident Chronic Kidney Disease in the UK Biobank Study." JAMA Network Open 7, no. 2 (2024): e2356885. http://dx.doi.org/10.1001/jamanetworkopen.2023.56885.
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ImportanceAn increasing body of evidence indicates an association between consuming sugar or its alternatives and cardiometabolic diseases. However, the effects of the consumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices on kidney health remain unclear.ObjectiveTo investigate the association of the intake of sugar-sweetened beverages, artificially sweetened beverages, and natural juices with the risk of chronic kidney disease (CKD), and the effect of substituting these beverage types for one another on this association.Design, Setting, and ParticipantsThis prospective, population-based cohort study analyzed data from the UK Biobank. Participants without a history of CKD who completed at least 1 dietary questionnaire were included. The follow-up period was from the date of the last dietary questionnaire until October 31, 2022, in England; July 31, 2021, in Scotland; and February 28, 2018, in Wales. Data were analyzed from May 1 to August 1, 2023.ExposuresConsumption of sugar-sweetened beverages, artificially sweetened beverages, and natural juices.Main Outcomes and MeasuresThe primary outcome was incident CKD. Multivariable Cox proportional hazards models were used to estimate the associations between the 3 beverage types and incident CKD. A substitution analysis was used to evaluate the effect on the associations of substituting one beverage type for another.ResultsA total of 127 830 participants (mean [SD] age, 55.2 [8.0] years; 66 180 female [51.8%]) were included in the primary analysis. During a median (IQR) follow-up of 10.5 (10.4-11.2) years, 4459 (3.5%) cases of incident CKD occurred. The consumption of more than 1 serving per day of sugar-sweetened beverages was associated with higher risk of incident CKD (adjusted hazard ratio [AHR], 1.19 [95% CI, 1.05-1.34]) compared with not consuming sugar-sweetened beverages. The AHR for participants consuming more than 0 to 1 serving per day of artificially sweetened beverages was 1.10 (95% CI, 1.01-1.20) and for consuming more than 1 serving per day was 1.26 (95% CI, 1.12-1.43) compared with consuming no artificially sweetened beverages. By contrast, there was no significant association between natural juice intake and incident CKD (eg, for >1 serving per day: HR, 0.99 [95% CI, 0.87-1.11]; P = .10). Substituting sugar-sweetened beverages with artificially sweetened beverages did not show any significant difference in the risk of CKD (HR, 1.03 [95% CI, 0.96-1.10]). Conversely, replacing 1 serving per day of sugar-sweetened beverage with natural juice (HR, 0.93 [95% CI, 0.87-0.97]) or water (HR, 0.93 [95% CI, 0.88-0.99]) or replacing 1 serving per day of artificially sweetened beverage with natural juice (HR, 0.90 [95% CI, 0.84-0.96]) or water (HR, 0.91 [95% CI, 0.86-0.96]) was associated with a reduced risk of incident CKD.Conclusions and RelevanceFindings from this cohort study suggest that lower consumption of sugar-sweetened beverages or artificially sweetened beverages may reduce the risk of developing CKD.
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Chun-hung, Chen, and Chung Han-hui. "Unfinished Democracy: Transitional Justice in Taiwan." Studia z Polityki Publicznej, no. 4(12) (October 24, 2016): 13–35. http://dx.doi.org/10.33119/kszpp.2016.4.1.
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The article attempts to describe Taiwan’s progress and a difficult position in practicing transitional justice during its democratic process. The first section reviews Taiwan’s democratic progress and the impact on the implementation of transitional justice caused by a regime transition type. The second section describes Taiwan’s authoritarian rule period, from February 28 Incident to the White Terror’s political types of political cases. The third section analyses the reasons for Taiwan’s unfinished transitional justice. The article claims that during Taiwan’s political engineering of transitional justice, compensation for the victims was almost the only act of it and at the same time lacking legal or moral prosecution of the inflictors and the truth discovery. Taiwan has never had an opportunity to reflect on the damage caused by the system of the authoritarian rule, so that many inflictors or cooperators of the system have continued to serve in the democratized government in key positions, which has resulted in the prevailing phenomenon of impunity. Such a handling mode to compensate the victims, not willing to investigate theinflictors and seeking the historical truth, cannot solve the crime left by the authoritarian era alone, but it can also bring about a serious crisis of democratic governance in Taiwan
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Greendyke, William, Alexandra Hill-Ricciuti, Matthew Oberhardt, et al. "1252. A Challenging Burkholderia Outbreak Investigation Across Multiple Units at an Academic Medical Center From June 2017 to February 2018." Open Forum Infectious Diseases 5, suppl_1 (2018): S381. http://dx.doi.org/10.1093/ofid/ofy210.1085.
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Abstract Background Most outbreak investigations involve short-term, geographically localized clusters. However, some organisms can form environmental reservoirs leading to more prolonged, widespread outbreaks. We describe a prolonged outbreak of Burkholderia at our institution. Methods An epidemiological investigation was conducted. Burkholderia isolates were genotyped using pulsed-field gel electrophoresis (PFGE) and recA gene sequencing. Initial isolates were sent to a national reference laboratory for multilocus sequence typing (MLST). Results 32 patients on 12 units (see figure) had ≥1 positive culture for Burkholderia from June 2017 to February 2018. 21 had B. cenocepacia (PFGE pattern A, recA allele 365) and 11 had B. cepacia (PFGE pattern C, recA allele 53). MLST revealed that isolates with recA allele 365 were unique compared with previously identified B. cenocepacia strains. Of 32 patients, 28 (88%) had positive respiratory cultures. Of 32 patients, 3 (9%) had bacteremia. Thirty-day mortality was 4/29 (14%). A case–control study did not reveal a common point source. All surveillance cultures from asymptomatic patients were negative (n = 53). Two of nine sink drains in rooms of cases were positive for an unrelated strain of B. cepacia. Other environmental cultures were negative for Burkholderia (n = 49). Cases continued despite routine interventions (see figure), with some incident cases detected long after potential exposures. Ventilator/respiratory equipment (V/RE) cleaning was investigated. Multiple V/RE interventions were implemented: (1) ensuring a sterilization process for ventilator temperature probes (used in heated humidification) was occurring; (2) using disposable manometers on contact isolation patients; (3) reinforcing ventilator cleaning, including those in radiology suites after use. Conclusion No definitive source of the outbreak was found. New cases continued after reinforcement of basic infection control practices, but subsided after focused attention on V/RE cleaning practices. Control of this outbreak was challenging due to the complexity of a prolonged “latency period” for Burkholderia, difficulty identifying reservoirs, and multiple possible modes of transmission, especially for organisms like Burkholderia that can persist on environmental surfaces and equipment. Disclosures All authors: No reported disclosures.
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Krueger, W., D. Feger, A. Friedman, T. Doan, and K. D’silva. "POS1498 COMORBIDITIES AND SAFETY EVENTS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS." Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 1106.1–1106. http://dx.doi.org/10.1136/annrheumdis-2023-eular.2379.
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BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease with multiorgan involvement. High disease activity may drive the development of comorbidities and safety events in SLE.ObjectivesTo assess the prevalence of comorbidities and history of safety events at the time of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) assessment and the incidence of newly diagnosed comorbidities and safety events post-SLEDAI assessment among a prevalent cohort of adult SLE patients ≥18 years old.MethodsThis was a retrospective observational cohort study using the OM1 SLE Registry data from January 2013 to February 2022 (OM1, Inc., Boston, MA). The index date was defined as the first observed or estimated SLEDAI score with ≥12 months of prior data occurring after the first observed SLE diagnosis. The baseline period included all observed time prior to and including the index date. The follow-up period for identifying incident comorbidities and safety events included all available data after the index date. Incidence rates were stratified by disease activity.ResultsAmong 10,837 patients, mean age was 52 years and 92% were female. The most common existing comorbidities were hypertension (44%), fibromyalgia (32%), anemia (29%), dyslipidemia (29%), thyroid disease (26%), obesity (25%), depression (22%), rheumatoid arthritis (22%), anxiety (19%), and Sjögren’s syndrome (18%). History of safety events at baseline most commonly included any infection (11%), abnormal liver function tests, hepatitis, or acute liver injury (ALI) (8%), elevated creatinine or acute kidney injury (AKI) (6%), and any malignancy (5%). Most patients were treated with first-line therapy for SLE (glucocorticoids and/or antimalarials) during follow-up (89%). Use of second-line (methotrexate, azathioprine, leflunomide) and third-line (belimumab, anifrolumab, mycophenolate mofetil, mycophenolic acid, tacrolimus, cyclosporine, voclosporin, rituximab) SLE therapies were less common (29% and 30%, respectively). During follow-up, 36% of patients had no disease activity, 28% had mild activity, 22% had moderate activity, and 14% had severe activity. Greater disease activity was associated with higher rates of incident hypertension, dyslipidemia, anxiety, thyroid disease, end-stage renal disease or dialysis, chronic liver disease/cirrhosis, avascular necrosis, seizures or epilepsy, and Sjögren’s syndrome. The most common incident safety events regardless of disease activity were any infection (30.7 per 1000 person-years [PY]), abnormal liver function tests, hepatitis, or ALI (20.3 per 1000 PY), and elevated creatinine or AKI (17.9 per 1000 PY). Correlation between incident safety events and disease activity varied by outcome.ConclusionMany common comorbidities occur more frequently among patients with higher SLE disease activity. The association between disease activity and the incidence of safety events was less clear. SLE-related systemic inflammation, comorbidities, and effects of SLE treatment (both positive and negative) likely contribute to patients’ risk profiles.Table 1.Incidence Rates per 1000 person-years Stratified by Index SLEDAI ScoreComorbidity or Safety EventNo Activity N=3,919Mild N=3,022Moderate N=2,413Severe N=1,483Hypertension38.038.742.743.3Dyslipidemia31.832.034.335.7Anxiety26.930.932.338.5Thyroid disease23.624.327.229.0End-stage renal disease or dialysis3.23.63.65.3Chronic liver disease3.64.05.05.2Avascular necrosis2.52.93.44.4Seizures or epilepsy5.36.37.18.4Sjögren’s syndrome7.27.88.212.7Abnormal liver function16.322.425.419.2Abnormal kidney function14.420.920.318.0Any infection24.72336.430.6Major adverse cardiovascular events8.19.26.36.6Venous thromboembolism2.34.44.04.6Any malignancy7.04.65.65.2Disease activity cutoffs: No activity (SLEDAI=0), low (SLEDAI=1-5), moderate (SLEDAI=6-10), severe (SLEDAI=11+)AcknowledgementsThe authors would like to thank OM1, Inc. for providing the data and statistical analysis for this project. Financial support for the study was provided by AbbVie. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship.Disclosure of InterestsWhitney Krueger Shareholder of: AbbVie, Employee of: AbbVie, Danielle Feger Shareholder of: AbbVie, Employee of: AbbVie, Alan Friedman Shareholder of: AbbVie, Employee of: AbbVie, Thao Doan Shareholder of: AbbVie, Employee of: AbbVie, Kristin D’Silva Shareholder of: AbbVie, Employee of: AbbVie.
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Adu-Gyamfi, Yaw. "The Gulf War: The Experience of a Department of Anesthesiology in the Management of Scud Missile Casualties." Prehospital and Disaster Medicine 12, no. 2 (1997): 38–42. http://dx.doi.org/10.1017/s1049023x00037389.
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AbstractBackground:The pivotal role of anesthesiologists in the implementation of disaster plans is not widely appreciated.Objective:To describe the role of anesthesiologists as managers in the operating room (OR) especially during hospital disaster management.Methods:On 25 February 1991, King Fahd Hospital of the University in Eastern Saudi Arabia, was alerted, received, triaged, and treated the victims of a Scud missile attack on a United States military barracks which killed 28 and injured more than 100 service personnel.Results:There were 47 males and 15 females admitted to the hospital. Their initial triage categories of injuries were: 1) red, 23; 2) yellow, 27; and 3) green, 7. The flow of patients through the main operating rooms occurred in two peaks: 1) treated within nine hours (60%); and 2) during the next 11 hours (40%). A total 101 units of blood and blood products were consumed.The role of the Chief of Anesthesiology was vital in the dynamics of the situation regarding appropriate deployment of staff and ensuring an orderly throughput of victims in the operating room. He also was required to keep track of resources and supply levels in the operating room, so that he could advise the hospital administration appropriately.Conclusion:The successful management of a large multi-casualty incident, which involved use of the operating rooms, depended upon the efficient coordination of clearly defined functions with the Chief of Anesthesiology Service as the team leader.
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Gumilar, Rimbun Wahyu, Bobby Indra Utama, and Hafni Bachtiar. "Correlation of Colony Lactobacillus spp. with The Incident of Overactive Bladder with OBSS Score at Pauh Primary Health Center Padang." Journal Obgin Emas 5, no. 1 (2021): 56–62. http://dx.doi.org/10.25077/aoj.5.1.56-62.2021.
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Background : Overactive bladder (OAB) is a group of urgent symptoms, with or without urgent incontinence. Research shows that some Lactobacillus spp. can be a sign of a women bladder’s good health; and found a decrease number of Lactobacillus spp. in patients with OAB. This study aims to assess the correlation of Lactobacillus spp. colony with OAB using the OABSS score at Pauh Primary Health Center, Padang.Method : This research is an analytic study with a cross sectional comparative design. The research was conducted from December 2019 to February 2020 at Pauh Primary Health Center. All women aged 20-40 years who came to Pauh Primary Health Center during the study period were included in the study. Pregnant women, having pelvic abnormalities and a history of other urinary tract diseases or having a history of hypertension and diabetes mellitus were excluded in the study. Numerical data are presented in the form of central tendency. Bivariate analysis was performed using the t-independent test if the data distribution was normal and the Kolmogorov-Smirnov test if the distribution of the data was not normally distributed.Result: There were 42 samples consisting of 21 OAB respondents and 21 normal respondents. The age of the respondents in the OAB group was 28 ± 6.8 years, while the normal group was 32 ± 7.3 years (p> 0.05). The number of Lactobacillus spp colonies in the normal group was higher than the OAB group, namely 16,389,670 ± 74,380,427.9 CU / ml compared to 15,229,634 ± 67,553,932.9 CU / ml (p> 0.05).Conclusion: There was no correlation between the number of Lactobacillus Spp colonies and the incidence of Overactive Bladder. It is necessary to do further research regarding other risk factors associated with the incidence of OAB and the causes of the decrease number of Lactobacillus spp colonies in OAB patients and the presence of other microorganisms, especially pathogenic microorganisms. Keywords: overactive bladder, Lactobacillus, OABSS score
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Goodenough, Dana, Carolyn Mackey, Michael Woodworth, Max Adelman, and Scott Fridkin. "Are Patients Preferentially Receiving Oral Vancomycin for Clostridioides difficile Infection in 2018? A Population Perspective." Infection Control & Hospital Epidemiology 41, S1 (2020): s461—s462. http://dx.doi.org/10.1017/ice.2020.1135.
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Background: Historically, metronidazole was first-line therapy for Clostridioides difficile infection (CDI). In February 2018, the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) updated clinical practice guidelines for CDI. The new guidelines recommend oral vancomycin or fidaxomicin for treatment of initial episode of CDI in adults. We examined the changes in treatment of CDI during 2018 across all types of healthcare settings in metropolitan Atlanta. Methods: Cases were identified through the Georgia Emerging Infections program (funded by the Centers for Disease Control and Prevention), which conducts active population-based surveillance in an 8-county area including Atlanta, Georgia (population, 4,126,399). An incident case was a resident of the catchment area with a positive C. difficile toxin test and no additional positive test in the previous 8 weeks. Recurrent CDI was defined as >1 incident CDI episode in 1 year. Clinical and treatment data were abstracted on a random 33% sample of adult (>17 years) cases. Definitive treatment categories were defined as the single antibiotic agent, metronidazole or vancomycin, used to complete a course. We examined the effect of time of infection, location of treatment, and number of CDI episodes on the use of metronidazole only. Results: We analyzed treatment information for 831 adult sampled cases. Overall, cases were treated at 29 hospitals (568 cases), 4 nursing homes (6 cases), and 101 outpatient providers (257 cases). The mean age was 60 (IQR, 34–86), and 111 (13.4%) had recurrent infection. Moreover, ∼28% of first-incident CDI episodes, 8% of second episodes, and 6% of third episodes were treated with metronidazole only. Compared to facility-based providers, outpatient providers were more likely to treat initial CDI episodes with metronidazole only (44% vs 21%; relative risk [RR], 2.1; 95% CI, 1.7–2.7). Treatment changed over time from 56% metronidazole only in January to 10% in December (Fig. 1). First-incident cases in the first quarter of 2018 were more likely to be treated with metronidazole only compared to those in the fourth quarter (RR, 2.76; 95% CI, 1.91–3.97). Conclusions: Preferential use of vancomycin for initial CDI episodes increased throughout 2018 but remained <100%. CDI episodes treated in the outpatient setting and nonrecurrent episodes were more likely to be treated with metronidazole only. Additional studies on persistent barriers to prescribing oral vancomycin, such as cost, are warranted.Funding: NoneDisclosures: Scott Fridkin reports that his spouse receives a consulting fee from the vaccine industry.
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Lefter, Nicoleta, Irina Mihaela Abdulan, Alexandra Maștaleru, Maria-Magdalena Leon, and Cristina Rusu. "Demographic Profile and Clinical Characteristics of Adults with Down Syndrome in North-Eastern Romania." Clinics and Practice 14, no. 5 (2024): 1779–89. http://dx.doi.org/10.3390/clinpract14050142.
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(1) Background: Down syndrome is characterized by physical abnormalities, intellectual disability (ID), and specific patterns of other health issues. Additionally, individuals with DS are known to experience premature aging and early onset of certain age-related medical conditions. These conditions are linked to higher incident disability and reduced survival rates compared to the general population. (2) Methods: Between July 2022 and February 2024, we conducted a prospective, observational study in the Cardiovascular Rehabilitation Clinic at Iasi Clinical Rehabilitation Hospital. The study included 28 patients diagnosed with Down Syndrome and a control group. Interdisciplinary interventions were tailored to address the needs of a complex patient, incorporating cardiological, endocrinological, genetical, biological and developmental support. Data on physical health, cognitive development, and psychosocial well-being were collected. (3) Results: Our DS group consisted of 11 (39%) females and 17 (61%) males. Their age ranged from 20 to 55 years with a mean of 28.07 ± 9.51. All patients were unmarried, living in urban areas, without a partner but with family support. In the study sample, 96.4% of participants had three or more comorbidities. (4) Conclusions: The high prevalence of multimorbidity, combined with little medication, contributes to a high level of clinical complexity, which appears to be similar to the one of the older non-trisomic population. As individuals with Down syndrome transition into adulthood, they may require a more comprehensive and holistic approach to their healthcare.
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Nespoli, Luca, Lorenzo Borgognoni, Virginia Caliendo, et al. "Indirect Impact of Pandemic on the Diagnosis of New Primary Melanoma: A Retrospective, Multicenter Study." Journal of Clinical Medicine 14, no. 6 (2025): 2017. https://doi.org/10.3390/jcm14062017.
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Background/Objectives: The indirect impact of the pandemic on the diagnosis and treatment of new primary melanoma has been carefully evaluated in recent years. The aim of the present study was to investigate if the indirect impact of the pandemic in Italy could be detectable also in the second year of the pandemic, as suggested by the characteristics of melanoma at diagnosis. Methods: Retrospective analysis of 1640 diagnoses of cutaneous melanoma in pre-pandemic period and 1292 diagnoses in the pandemic period from 10 centers (from 1 March 2019 to 28 February 2022). Results: Our findings confirmed an indirect impact of the pandemic on characteristics of incident melanoma, also in the second year of the pandemic in Italy (Breslow thickness p < 0.0001, tumor stage p = 0.002, ulceration p = 0.04, SNLB p = 0.03), without statistically significant differences between centers. A statistically significant reduction in the time interval from diagnosis to surgical treatment was observed, but only in centers that had to modify their case mix to address the needs of treating COVID-19 patients (p = 0.0002). Conclusions: Our study confirmed the indirect impact of the pandemic on melanoma characteristics at the diagnosis in the second year of the pandemic in Italy. We also found no differences in melanoma characteristics between hospitals with different organization. Diagnostic delays may be related to a delayed access of the patient to the entire diagnostic pathway, and therefore, especially in the case of a pandemic, policies to support early diagnosis are crucial.
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Jaffe, E. "(P2-8) Analysis of the Performance of Emergency Medical Services Management of 51 Mass-Casualty Incidents in Israel." Prehospital and Disaster Medicine 26, S1 (2011): s137—s138. http://dx.doi.org/10.1017/s1049023x11004523.
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IntroductionBetween February 2002 and January 2004, a total of 51 terrorism-related mass-casualty incidents (MCIs) occurred in Israel.ObjectiveThe objective of this study was to analyze data provided in After Action Reports (AAR) held by Magen David Adom (MDA), after each MCI.MethodsInformation relating to the type of MCI, location, number of ambulances dispatched in five-minute intervals from time of notification, and number of casualties evacuated by urgency in five-minute intervals from the start of the incident was analyzed.ResultsThere were 34 MCIs in 2002, 15 in 2003, and two in 2004. More MCIs (24%) occurred on Wednesdays, and more MCIs occurred during the 05:30–08:59 (18%), 12:00–14:59 (20%), and 17.00–19.59 (24%) time slots. More MCIs occurred in the Jerusalem (24%) area, followed by Tel Aviv (16%). Twenty-six percent of the MCIs resulted from explosions in open areas, 22% in buses, 20% from shootings, and 28% from explosions in semi-closed and closed areas. The mean dispatch time of the first ambulance after notification was 48 seconds. An average of 14.25 ambulances were dispatched in the first five minutes, followed by eight, three, and three in the five-minute slots following. An ANOVA indicated a significant difference in dispatch times by towns/cities (p = 0.05). The average arrival of the first ambulance was 6.4 minutes, and evacuation of the first urgent casualty was 13.6 minutes, the last evacuation was 26.5 minutes after arrival. More urgent casualties (45%) compared to 20% non-urgent were evacuated in first 15 minutes; the majority of non-urgent victims (79%) were evacuated after 16 minutes. The mean number of dispatched ambulances ranged from 37.9 to 26 in urban versus rural areas, respectively. The number of ambulances actually used for evacuation in urban and rural areas was 55% and 44%, respectively.ConclusionsInformation analyzed from AAR is useful for improving Standard Operating Procedures and structuring continuing education interventions for MCIs.
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Nasrulloh, M. Anas, and Abdul Hakim Zakkiy Fasya. "Gambaran Kejadian Sick Building Syndrome (SBS) pada Pegawai Kantor PT. PLN (Persero) UP3 Surabaya Selatan Kota Surabaya." Sehat Rakyat: Jurnal Kesehatan Masyarakat 2, no. 2 (2023): 212–20. http://dx.doi.org/10.54259/sehatrakyat.v2i2.1657.
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One of the health problem phenomena related to indoor air quality is Sick Building Syndrome (SBS). Sick Building Syndrome (SBS) is a collection of symptoms felt by people who are in the building. The purpose of this study is to provide an overview of the impact of the Sick Building Syndrome (SBS) incident. This research is an analytical observational study. Time of research: February - March 2023. PT. PLN (Persero) UP3 Ngagel, South Surabaya, Surabaya City. from the interview results, there were 45% of respondents who experienced at least 12 symptoms from 20 categories of Sick Building Syndrome (SBS) complaints among office employees of PT. PLN (Persero) UP3 South Surabaya, City of Surabaya. Conclusion: Based on the characteristics of the respondents, it can be seen that the working age of the respondents is mostly> 35 years with the most sex, namely men and the dominant working mass is classified as old > 10 years and smoking habits, namely 73% of respondents do not smoke and 28 respondents have good psychosocial conditions and 2 respondents had poor psychosocial conditions. Of all the symptoms of Sick Building Syndrome, (SBS) complaints that are often felt are dry / hoarse throat (36%), dry skin (29%), skin is often reddish, irritated feeling (21%), rash on the skin, red spots ( 29%), Eye irritation (eyes are often watery/red/itchy, etc.) (36%), Runny nose, sneezing (36%), Chest tightness (36%), Flu-like symptoms (50%), Head dizziness, spinning (29%), Frequent headaches (29%), Drowsiness (36%), Chronic fatigue, lethargy (36%).
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Witwer, Medora L., Susan E. Kline, Patricia Ferrieri, et al. "821. Changes in Cleaning Practices and Non-conventional Personal Protective Equipment Use due to SARS-CoV-2 and Association with Increases in Multi-drug Resistant Organism Cases." Open Forum Infectious Diseases 8, Supplement_1 (2021): S503—S504. http://dx.doi.org/10.1093/ofid/ofab466.1017.
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Abstract Background During the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), policy at a Minnesota hospital changed to state that environmental services would not clean rooms of patients with confirmed or suspected SARS-CoV-2 infections, requiring nursing staff to perform these duties. Investigation of a cluster of carbapenem-resistant Enterobacterales (CRE) in patients hospitalized in the same or adjoining rooms on the medical intensive care unit (MICU) raised concern over whether SARS-CoV-2 cleaning practices and non-conventional personal protective equipment (PPE) use led to transmission of multi-drug resistant organisms (MDROs). Methods Infection Prevention conducts passive surveillance for MDRO acquisition in inpatient units. Passive surveillance of SARS-CoV-2 was performed early in the pandemic. Active surveillance SARS-CoV-2 testing on admission was initiated in July 2020 and active surveillance testing for admitted patients every 7 days was initiated in December. Incident cases of vancomycin-resistant Enterococcus (VRE), extended-spectrum-β-lactamase-producing organisms (ESBL), methicillin-resistant S. aureus (MRSA), and CRE were determined for hospitalized patients between March 1, 2020 and February 28, 2021, excluding patients with infection on admission. Rates of hospitalized patients testing positive for SARS-CoV-2 per 100 patient days were compared to rates of patients testing positive for VRE, ESBL, MRSA, and CRE per 100 patient days respectively. The same rate comparisons were completed for the MICU. Using the F-Test Two-Sample to determine variance, the Two-Sample T-test assuming unequal variances was applied to each comparison. Results Correlation was significant between rates of SARS-CoV-2 and VRE (p&lt; 0.005), ESBL (p&lt; 0.005), MRSA (p&lt; 0.005), and CRE (p&lt; 0.005) (Table 1). MICU correlation was significant between rates of SARS-CoV-2 and VRE (p&lt; 0.005), ESBL (p&lt; 0.005), MRSA (p&lt; 0.005), and CRE (p&lt; 0.005) (Table 2). Table 1: Two-sample T-test results assuming unequal variances: Hospital COVID rates per 100 patient days vs. rates of incident positive tests for VRE, ESBL, MRSA, and CRE per 100 patient days Table 2: Two-sample T-test results assuming unequal variances: MICU COVID rates per 100 patient days vs. rates of incident positive tests for VRE, ESBL, MRSA, and CRE per 100 patient days Conclusion The relationships between the rates of SARS-CoV-2 and four MDROs were statistically significant. It can be inferred from this data that changes in hospital cleaning and non-conventional PPE use may have led to an increase in transmission of MDROs in this facility. Disclosures All Authors: No reported disclosures
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Perwiraningtyas, Pertiwi, Ika Cahyaningrum, and Elisabet Masan Leton. "Pemberian Topikal ASI Terhadap Resiko Infeksi Tali Pusat Neonatus: Studi Kasus." Nursing News : Jurnal Ilmiah Keperawatan 8, no. 3 (2024): 202–12. https://doi.org/10.33366/nn.v8i3.3193.
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Inflammation of the umbilical cord is one of the triggers of morbidity and mortality in newborns worldwide. Various preventive and curative efforts are made to reduce this incident. This case study aims to improve the provision of nursing care for newborns with infection risk problems. A case study design was used in this study. The research subjects were selected using the accidental sampling method. The study was conducted on three neonates aged 7 days with the condition that the umbilical cord had not yet come off in the postpartum room of Dr. R. Soedarsono Pasuruan Hospital on February 23-28, 2022. The focus of the problem was the risk of infection. The intervention carried out on the umbilical cord using breast milk. The results of the study showed that the umbilical cords of all babies were wet on the first day. The application was by applying the base of the umbilical cord with a cotton bud that had been given 1-2 drops of breast milk, done 2 times in the morning and evening after bathing. After two days of treatment, the nursing problem of infection risk was resolved. This was indicated by the umbilical cord which tended to be dry and there were no signs of inflammation such as: no redness, odor, pus, edema, and tenderness. The results of this case study serve as a guideline for providing nursing care for newborns, especially those at risk of experiencing inflammation of the umbilical cord. Peradangan yang terjadi pada tali pusat menjadi salah satu pencetus morbiditas dan mortalitas bayi baru lahir di seluruh dunia. Berbagai upaya preventif maupun kuratif dilakukan untuk menekan kejadian tersebut. Studi kasus ini bertujuan sebagai upaya peningkatan pemberian asuhan keperawatan pada bayi baru lahir dengan masalah resiko infeksi. Desain studi kasus digunakan dalam penelitian ini. Subjek penelitian dilakukan dengan metode accidental sampling. Penelitian dilakukan terhadap tiga neonatus usia 7 hari dengan kondisi tali pusat belum terlepas di di ruang nifas RSUD dr. R. Soedarsono Pasuruan tanggal 23-28 Februari 2022. Fokus permasalahan adalah resiko infeksi. Intervensi yang dilakukan pada tali pusat dengan menggunakan ASI. Hasil penelitian menunjukkan tali pusat seluruh bayi dalam keadaan basah pada hari pertama. Penerapannya dengan mengoleskan pangkal tali pusat dengan cotton bud yang sudah diberi tetesan ASI sebanyak 1-2 tetes, dilakukan 2 kali pagi dan sore setelah mandi. Setelah perawatan selama dua hari, masalah keperawatan resiko infeksi teratasi. Hal ini ditandai dengan tali pusat yang cenderung kering dan tidak ada tanda-tanda peradangan seperti: tidak ada kemerahan, berbau, pus edema dan nyeri tekan. Hasil studi kasus ini, menjadi salah satu pedoman dalam pemberian asuhan keperawatan bayi baru lahir khususnya yang beresiko mengalami peradangan pada tali pusat
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Bell, M. "Effect of sowing date on growth and development of irrigated peanuts, Arachis hypogaea L. cv. Early Bunch, in a monsoonal tropical environment." Australian Journal of Agricultural Research 37, no. 4 (1986): 361. http://dx.doi.org/10.1071/ar9860361.
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An experiment was conducted to study the effect of sowing date on the growth and development and commercial yield of Early Bunch peanuts under irrigation in the monsoonal tropical environment of the Ord River Irrigation Area. Sowing dates, which ranged from 7 December to 1 March, represented a wider range than that currently considered optimal for peanuts in this environment. Differences in above-ground dry matter production among sowing dates were primarily the result of differences in cumulative interception of incident light due to different leaf area duration. Later sowings showed progressively slower canopy development, with those in February and March intercepting only 75 and 60% of the cumulative light intercepted by those in December-January. Vegetative development was very responsive to sowing date, with progressive reductions in vegetative dry matter occurring as sowing was delayed between January and March. The proportion of vegetative dry matter as leaf and stem was also affected by sowing date, in that the leaf to stem ratio measured at approximately 75 days after emergence was greater for later sowings. This effect was associated with temperature and photoperiod during the period from emergence to day 75. Pod development was less affected by sowing date than vegetative yield, with accumulation rates and commercial pod yields being reduced by 28 and 31%, respectively, for the final sowing date (1 March). This was the result of a greater proportion of assimilate being partitioned to the reproductive components in later sowings. Pod numbers were more sensitive to sowing date than pod yield, but later sowings tended to compensate for lower pod numbers by having higher average pod weights. Later sowings also tended to have larger sound mature kernels, and this was associated with temperature and photoperiod during kernel development.
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Levine, Stephen Z., Anat Rotstein, Arad Kodesh, et al. "Adult Attention-Deficit/Hyperactivity Disorder and the Risk of Dementia." JAMA Network Open 6, no. 10 (2023): e2338088. http://dx.doi.org/10.1001/jamanetworkopen.2023.38088.
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ImportanceEvidence that adult attention-deficit/hyperactivity disorder (ADHD) is associated with an increased risk of dementia is scarce and inconsistent, and potential sources of bias are untested.ObjectiveTo examine the association between adult ADHD and the risk of dementia.Design, Setting, and ParticipantsThis prospective national cohort study consisted of 109 218 members of a nonprofit Israeli health maintenance organization born between 1933 and 1952 who entered the cohort on January 1, 2003, without an ADHD or dementia diagnosis and were followed up to February 28, 2020. Participants were aged 51 to 70 years in 2003. Statistical analysis was conducted from December 2022 to August 2023.ExposureAdult ADHD was a time-varying covariate, classified as present from the age of the first diagnosis (using the International Classification of Diseases, Ninth Revision, and the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision); otherwise, absent.Main Outcome and MeasuresCox regression models were fitted to quantify the association between adult ADHD and the risk of incident dementia with hazard ratios (HRs) and their 95% CIs unadjusted and in the primary analysis, using inverse probability weights, adjusted for 18 sources of potential confounding. In 14 complementary analyses, subgroup and sensitivity analyses were implemented.ResultsAt the beginning of the follow-up, the sample of 109 218 participants had a mean (SD) age of 57.7 (5.5) years, 56 474 participants (51.7%) were female, and 52 744 (48.3%) were male. During follow-up, 730 participants (0.7%) received a diagnosis of adult ADHD, and 7726 (7.1%) received a diagnosis of dementia. Dementia occurred among 96 of 730 participants (13.2%) with adult ADHD and 7630 of 108 488 participants (7.0%) without adult ADHD. In the primary analysis, compared with the absence of adult ADHD, the presence of adult ADHD was statistically significantly (P &amp;lt; .001) associated with an increased dementia risk (unadjusted HR, 3.62 [95% CI, 2.92-4.49; P &amp;lt; .001]; adjusted HR, 2.77 [95% CI, 2.11-3.63; P &amp;lt; .001]). Twelve of the 14 complementary analyses did not attenuate the conclusions based on the results of the primary analysis. There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication, and evidence of reverse causation was mild.Conclusions and RelevanceIn this cohort study of individuals born between 1933 and 1952 and followed up in old age, adult ADHD was associated with an increased risk of dementia. Policy makers, caregivers, patients, and clinicians may wish to monitor reliably for ADHD in old age.
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Shieh, Albert, Gail A. Greendale, Jane A. Cauley, Carrie A. Karvonen-Gutierrez, and Arun S. Karlamangla. "Prediabetes and Fracture Risk Among Midlife Women in the Study of Women’s Health Across the Nation." JAMA Network Open 6, no. 5 (2023): e2314835. http://dx.doi.org/10.1001/jamanetworkopen.2023.14835.
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ImportanceWhether prediabetes is associated with fracture is uncertain.ObjectiveTo evaluate whether prediabetes before the menopause transition (MT) is associated with incident fracture during and after the MT.Design, Setting, and ParticipantsThis cohort study used data collected between January 6, 1996, and February 28, 2018, in the Study of Women’s Health Across the Nation cohort study, an ongoing, US-based, multicenter, longitudinal study of the MT in diverse ambulatory women. The study included 1690 midlife women in premenopause or early perimenopause at study inception (who have since transitioned to postmenopause) who did not have type 2 diabetes before the MT and who did not take bone-beneficial medications before the MT. Start of the MT was defined as the first visit in late perimenopause (or first postmenopausal visit if participants transitioned directly from premenopause or early perimenopause to postmenopause). Mean (SD) follow-up was 12 (6) years. Statistical analysis was conducted from January to May 2022.ExposureProportion of visits before the MT that women had prediabetes (fasting glucose, 100-125 mg/dL [to convert to millimoles per liter, multiply by 0.0555]), with values ranging from 0 (prediabetes at no visits) to 1 (prediabetes at all visits).Main Outcomes and MeasuresTime to first fracture after the start of the MT, with censoring at first diagnosis of type 2 diabetes, initiation of bone-beneficial medication, or last follow-up. Cox proportional hazards regression was used to examine the association (before and after adjustment for bone mineral density) of prediabetes before the MT with fracture during the MT and after menopause.ResultsThis analysis included 1690 women (mean [SD] age, 49.7 [3.1] years; 437 Black women [25.9%], 197 Chinese women [11.7%], 215 Japanese women [12.7%], and 841 White women [49.8%]; mean [SD] body mass index [BMI] at the start of the MT, 27.6 [6.6]). A total of 225 women (13.3%) had prediabetes at 1 or more study visits before the MT, and 1465 women (86.7%) did not have prediabetes before the MT. Of the 225 women with prediabetes, 25 (11.1%) sustained a fracture, while 111 of the 1465 women without prediabetes (7.6%) sustained a fracture. After adjustment for age, BMI, and cigarette use at the start of the MT; fracture before the MT; use of bone-detrimental medications; race and ethnicity; and study site, prediabetes before the MT was associated with more subsequent fractures (hazard ratio for fracture with prediabetes at all vs no pre-MT visits, 2.20 [95% CI, 1.11-4.37]; P = .02). This association was essentially unchanged after controlling for BMD at the start of the MT.Conclusions and RelevanceThis cohort study of midlife women suggests that prediabetes was associated with risk of fracture. Future research should determine whether treating prediabetes reduces fracture risk.
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Shadman, Mazyar, Sudeep Karve, Sima Patel, et al. "Impact of Ibrutinib Dose Reduction on Duration of Therapy in Patients with Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma." Blood 142, Supplement 1 (2023): 269. http://dx.doi.org/10.1182/blood-2023-181774.
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Background : Ibrutinib (Ibr) has demonstrated a significant progression-free survival and overall survival benefit compared to chemotherapy in multiple phase 3 studies in patients with previously untreated and relapsed/refractory chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). Patients with CLL/SLL who continue treatment with single-agent Ibr experience better survival outcomes than those who discontinue treatment within the first 2 years. Adverse events (AEs) may be managed, and treatment outcomes are optimized through Ibr dose reduction (DR). Recent real-world data have shown that patients with a DR after an AE had longer time to next treatment (TTNT) than those without a DR and that this trend was consistent among patients with cardiac and noncardiac AEs (Shadman et al, EHA 2023). Here we continue to evaluate the impact of DR on real-world outcomes using data from electronic medical records (EMRs). Aims: This study estimates the real-world impact of DR following an AE among patients with CLL/SLL. Methods : Previously untreated adults diagnosed with CLL/SLL on or after February 12, 2013), who were treated with 420 mg single-agent Ibr on or after Feb 12, 2014 (Ibr approval date) were analyzed using EMRs from the ConcertAI database (February 12, 2013−May 1, 2022). Patients were included if they had a cardiac or noncardiac AE after single-agent Ibr initiation at 420 mg per day without any DRs/escalations prior to first AE occurrence (index date). Patients were excluded if they received an antineoplastic agent ≤6 months prior to starting first-line (1L) Ibr, an antineoplastic agent or combination therapy within 28 days of Ibr use, second-line therapy within 30 days of index, hematopoietic stem cell transplant, CYP3A inhibitor during 1L Ibr or before start of the second-line, an experimental therapy in clinical trials, or were diagnosed with other malignancies for which Ibr is indicated within 6 months prior to Ibr initiation. Demographics, clinical characteristics, and TTNT were described following AE occurrence among patients with and without DRs. A DR was defined as a dose lower than 420 mg per day on or after the date of first AE post-Ibr initiation, per pharmacy records. Cardiac AEs included atrial fibrillation, ischemic heart disease, heart failure, hypertension, and cardiomyopathy. Noncardiac AEs included febrile neutropenia, anemia, neutropenia, pancytopenia, thrombocytopenia, diarrhea, abdominal pain, musculoskeletal pain, rash, and pneumonia. TTNT sensitivity analyses requiring next-line treatment to occur ≥180 days after 1L initiation or considering a switch to another BTKi or death as censoring events were also conducted. Results : Overall, 522 patients were included in the analysis; 420 patients (80%) without a DR and 102 patients (20%) with a DR. Patients with a DR were slightly older than those without (median age: 74.5 vs 70 years); a lower proportion of women had a DR compared with men (43% vs 57%). Among patients with and without a DR, the median time to the first incident AE was 42 days and 65 days, respectively. Among patients with a DR, 68 (67%) were able to resume the full 420 mg per day Ibr dose after DR. Mean time between Ibr initiation and end of 1L Ibr treatment was significantly longer in patients with a DR compared with those without (553 days vs 464 days; P = 0.012). Fewer patients with DR had a next treatment (47%) than those without a DR (55%). Median TTNT was significantly longer in patients with DR (27 months, 95% CI: 21, 44) compared with those without (18 months, 95% CI: 15, 20) ( P = 0.007) (Figure). TTNT results were similar in each sensitivity analysis. Summary/Conclusion : Among patients with CLL/SLL treated with 1L Ibr, those with doses reduced after experiencing an AE remained on 1L Ibr longer compared with those who did not have the dose reduced. Ibr dose adjustments may support patients with CLL/SLL remaining on 1L Ibr longer.
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Sirajuddin, Achmad Daengs GS, Megasari Gusandra Saragih, Elfitra Desy Surya, and Marcos R. B. Sandoval. "Communicating about sustainability on @greenpeaceid." Jurnal Studi Komunikasi (Indonesian Journal of Communications Studies) 6, no. 3 (2022): 739–52. http://dx.doi.org/10.25139/jsk.v6i3.4518.
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Environmental challenges are critical issues that the entire international community is currently dealing with. The number of incidents of factory waste disposal, climate change, and biodiversity extinction all represent a significant threat to all creatures' survival. As a result, Greenpeace, as an environmental group, continues to work to stop the ongoing natural damage. This study aims to find out the sustainable communication model on the Greenpeace social media site. From January 1, 2022, to February 28, 2022, Krippendorff content analysis via Instagram @greenpeaceid was used. Based on the data analysis that has been carried out, sustainability communication on the Instagram @greenpeaceid social media site for the period January 1, 2022, to February 28, 2022, is more dominant in producing posts that contain the benefits of messages that invite people to care about environmental balance.
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Parasuraman, Ganeshkumar, Mogan Kaviprawin, Manikandanesan Sakthivel, et al. "Epidemiology of Coronavirus Disease 2019 during the Second and Third Wave in Chennai, India: An Analysis of the Coronavirus Disease 2019 Surveillance System, February 2021–February 2022." Indian Journal of Public Health 68, no. 1 (2024): 60–65. http://dx.doi.org/10.4103/ijph.ijph_821_23.
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Abstract Introduction: Analysis of the coronavirus disease 2019 (COVID-19) surveillance system in the first wave indicated that the data-driven approach helped in resource allocation and public health interventions. Objectives: We described the epidemiology of COVID-19 cases in Chennai, Tamil Nadu, India, from February 2021 to February 2022. Materials and Methods: We analyzed the COVID-19 surveillance data from Chennai City, Tamil Nadu, India’s Greater Chennai Corporation. We described the deidentified line list of COVID-19 cases and deaths by months, zones, age, and gender. We estimated the incidence of COVID-19 cases per million population, test positivity rate (TPR), and case fatality ratio (CFR). Results: Of the 434,040 cases reported in Chennai from February 1, 2021, to February 28, 2022, 53% were male. The incidence per million peaked in May 2021 (19,210) and January 2022 (15,881). Age groups more than 60 years reported maximum incidence. Southern region zones reported higher incidence. Overall TPR was 5.8%, peaked in May 2021 (17.5%) and January 2022 (15.1%). Over half of the 4929 reported deaths were in May 2021 (56%). Almost half of the deaths were 61–80 years (52%), followed by 41–60 years (26%). Overall CFR was 1%, which peaked in June 2021 (4%). Conclusion: We conclude that Chennai city experienced a surge in COVID-19 due to delta and omicron variants. Understanding descriptive epidemiology is vital for planning the public health response, resource allocation, vaccination policies, and risk communication to the community.
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Дашкевич, А. М., and Н. Д. Коломиец. "Characteristics of the Epidemic Process of COVID-19 in the Republic of Belarus." Клиническая инфектология и паразитология 13, no. 1 (2024): 70–80. http://dx.doi.org/10.34883/pi.2024.13.1.035.
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Цель. Оценка проявлений эпидемического процесса COVID-19 среди населения Республики Беларусь в период с февраля 2020 г. по май 2022 г. Материалы и методы. Проведен ретроспективный анализ случаев COVID-19 в Республике Беларусь с начала регистрации (28 февраля 2020 г.) по 8 мая 2022 г. Для оценки динамики выявления новых случаев COVID-19 использовали статистические данные, опубликованные Министерством здравоохранения Республики Беларусь. Результаты. За весь период наблюдения (с 28 февраля 2020 г. по 8 мая 2022 г.) в Республике Беларусь зарегистрировано 982 654 случая заболевания, среднее значение уровня заболеваемости составило 91,4 случая на 100 тыс. населения. Заключение. Развитие эпидемического процесса COVID-19 в Республике Беларусь носило волнообразный характер: в анализируемый период отмечено 4 подъема заболеваемости, отличающихся продолжительностью, показателями, пиковыми уровнями заболеваемости и численностью вовлеченного населения, что обусловлено циркуляцией различных вариантов SARS-CoV-2, изменением иммунной структуры населения, масштабным проведением вакцинации населения, а также реализацией иных санитарно-противоэпидемических мероприятий по предупреждению распространения COVID-19. Purpose. Assessment of the manifestations of the epidemic process of COVID-19 among the population of the Republic of Belarus in the period from February 2020 to May 2022. Materials and methods. A retrospective analysis of COVID-19 cases in the Republic of Belarus was carried out from the beginning of registration (February 28, 2020) to May 8, 2022. To assess the dynamics of identifying new cases of COVID-19, we used statistical data published by the Ministry of Health of the Republic of Belarus. Results. For the entire observation period (from February 28, 2020 to May 8, 2022) 982,654 cases of the disease were registered in the Republic of Belarus, the average incidence rate was 91.4 cases per 100 thousand population. Conclusion. The development of the COVID-19 epidemic process in the Republic of Belarus was characterized by a wave-like nature: during the analyzed period, 4 rises in the incidence rate were noted, differing in duration, indicators, peak incidence levels and the number of the involved population, which is due to the circulation of various variants of SARS-CoV-2, changes in the immune structure of the population, large-scale vaccination of the population, as well as the implementation of other sanitary and anti-epidemic measures to prevent the spread of COVID-19.
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Akhmetzhanov, Andrei R., Kenji Mizumoto, Sung-Mok Jung, Natalie M. Linton, Ryosuke Omori, and Hiroshi Nishiura. "Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February–March 2020." Journal of Clinical Medicine 10, no. 11 (2021): 2392. http://dx.doi.org/10.3390/jcm10112392.
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Following the first report of the coronavirus disease 2019 (COVID-19) in Sapporo city, Hokkaido Prefecture, Japan, on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized due to having mild or no symptoms during the initial months of the outbreak. We therefore aimed to predict the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo city using data on cases diagnosed outside these areas. Two statistical frameworks involving a balance equation and an extrapolated linear regression model with a negative binomial link were used for deriving both estimates, respectively. The estimated cumulative incidence in Hokkaido as of 27 February was 2,297 cases (95% confidence interval (CI): 382–7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo city as of 28 February was estimated at 2233 cases (95% CI: 0–4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating a higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases helped to inform the public health response at the beginning of the pandemic and provided insight into the possible scope of undetected transmission for future assessments.
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Skilbrei, Ove T., and Vidar Wennevik. "The use of catch statistics to monitor the abundance of escaped farmed Atlantic salmon and rainbow trout in the sea." ICES Journal of Marine Science 63, no. 7 (2006): 1190–200. http://dx.doi.org/10.1016/j.icesjms.2006.05.005.
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Abstract Catch statistics and scale samples were collected from a gillnet fishery targeting escaped farmed salmonids between 1 October and 28 February each year from 2001 to 2004 in Hordaland County, western Norway. Fish were classified into different groups, or escape incidents, using catch per unit effort (cpue) and size distribution of the catch from different geographical subregions. Reported escape incidents of both rainbow trout and salmon appeared to be followed by peaks in the cpue lasting four to six weeks, but a large proportion of the catch of escaped salmon appeared to stem from unreported, small-scale escape events. The wide size-range of fish caught suggests that the escapees originated from different escape incidents, and the variability between regions suggests that most catches were of local origin. Genetic comparisons among three groups of escapees indicated that DNA profiling may facilitate identification in monitoring programmes of escapees originating in different genetic groups. A low incidence of wild fish was found in the catches. Provided the conservation status of local wild salmonid stocks is taken into account, a fishery targeting escaped farmed salmonids may reduce the numbers of escapees, thus lowering the risk of introgression with wild salmon populations and removing potential sources of sea lice. Information on the relative abundance of escapees in the sea would also be provided by a fishery targeting escapees.
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Sharma, Avinash, and Rhian Isaac. "P34 The intravenous use of strong potassium chloride in paediatric intensive care (PICU)." Archives of Disease in Childhood 108, no. 5 (2023): 19.1–19. http://dx.doi.org/10.1136/archdischild-2023-nppg.33.
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AimIncorrect use of strong potassium is listed as a ‘Never Event’,1a largely preventable patient safety incident if national2or healthcare provider guidance is followed. Local guidance for the use of strong intravenous (IV) potassium is available for paediatric intensive care, with multiple considerations to follow before it should be considered. This audit investigates the use of strong IV potassium in a Paediatric Intensive Care Unit (PICU) against the current PICU specific safety guidance. The aims being to assure and provide direction to improve compliance and patient safety.MethodAudit standards were adapted from hospital guidelines on the use of IV strong potassium in PICU. Data points were set using these audit standards, and a standardised data collection form was piloted before being finalised. Data were collected during a 12 hour window each day over a total of 20 days. Patients were identified through entries in the potassium section of the PICU IV infusion chart. Data were analysed using excel.ResultsNineteen out of 31 patients (61%) had their serum potassium measured within 2 hours of administration. Nineteen patients requiring IV strong potassium had increased urine output, with 11 of these (58%) having diuretic therapy review. Nine out of 28 patients (32%) had been prescribed a potassium sparing diuretic (PSD), with 3 patients excluded due to a recent serum potassium > 4.5 mmol/L. Of the patients not given a PSD, reasons included unintentional omission, being previously crossed off the chart and not re-prescribed, and a high urine output. Patients on IV maintenance fluids or parenteral nutrition could have their contents optimised. Optimisation of the potassium content in IV maintenance fluids or parenteral nutrition was missed with only 3 out of 13 patients (23%) on IV maintenance and 2 out of 9 patients on PN having the potassium content increased. Fifteen patients from the total of 31 (48%) were tolerating enteral feeds and should have been given oral potassium supplements where possible, as there was no clinical need or urgency to opt for IV.ConclusionSeveral steps detailed in PICU IV potassium guidance could reduce the need for IV strong potassium if followed to a greater extent, reducing the risks of using strong IV potassium. Relaunching the guideline and further education is required; with particular emphasis on the use of PSDs, optimising the potassium content of IV maintenance and parenteral nutrition, reviewing diuretic therapy, and oral potassium supplementation. Reminding prescribers that use of enteral potassium in patients tolerating enteral feeds should be considered prior to electing for the IV route. Education regarding the omission of PSD in patients with high urine output is required. Time savings could be made by following the guideline as IV strong potassium requires several safety checks and is time consuming to prepare. Following the relaunch of the guideline a re-audit is needed to measure whether the interventions have improved compliance and reduced the unnecessary risks of strong IV potassium use.3ReferencesNHS Improvement. Never Events list 2018 (updated February 2021). London, 2021. Available from: https://www.england.nhs.uk/publication/never-events/National Patient Safety Alert. ‘Potassium solutions: risks to patients from errors occurring during intravenous administration.’ NPSA 2002.Rhodes LA, Wall KM, Abernathy SL,et al. Decreasing IV potassium in pediatric cardiac intensive care: quality improvement project.Pediatr Crit Care Med2016;17:772–8.
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Abdo, M. G., W. M. El Amin, E. A. G. Khalil, and M. M. Mukhtar. "Antimony-resistant Leishmania donovani in eastern Sudan: incidence and in vitro correlation." Eastern Mediterranean Health Journal 9, no. 4 (2003): 837–43. http://dx.doi.org/10.26719/2003.9.4.837.
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A longitudinal study was done in a leishmaniasis -endemic region in eastern Sudan during the period November 2001-February 2003 to determine the incidence of failure of sodium stibogluconate treatment. We studied 820 confirmed visceral leishmaniasis patients. All were treated with sodium stibogluconate, 20 mg/kg body weight for at least 28 days. Parasites were isolated from lymph node aspirates from 22 participants identified as relapsed patients. All isolates were typed as Leishmania donovani based on polymerase chain reaction [PCR] amplification of parasite kDNA. Six parasites showed in vitro resistance to sodium stibogluconate using murine J774 macrophage amastigote testing method. The resistant isolates showed different restriction profiles when the amplified kDNA PCR products were digested with ALU1 restriction enzyme, indicating that resistance was mediated by different parasite clones
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Rey-Rodriguez, Marta M., MA Vazquez-Gamez, Mercè Giner, et al. "Incidence, morbidity and mortality of hip fractures over a period of 20 years in a health area of Southern Spain." BMJ Open 10, no. 9 (2020): e037101. http://dx.doi.org/10.1136/bmjopen-2020-037101.
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ObjectiveTo evaluate the incidence of osteoporotic hip fracture in the Macarena Health Area (Seville).Setting and participantsThis was a prospective observational study that collected all osteoporotic hip fractures that occurred between March 2013 and February 2014 at the Clinical Unit of Traumatology and Orthopaedics. All cases collected during the first 6 months of the study were followed for 1 year after the occurrence of the event.Outcome measuresWe evaluated the incidence of osteoporotic hip fractures in the Macarena Health Area (Seville) from 1 March 2013 to 28 February 2014, and we compared the incidence with that in 2 previous studies carried out with the same methodology in 1994 and 2006. Furthermore, we calculated the morbidity and degree of disability 1 year after the fracture occurred and determined mortality and the associated factors.ResultsThe overall incidence was 228 per 100 000 individuals/year (95% CI 204.5 to 251.6), and the incidence was higher in women than in men. In women, the incidence rate decreased in all age groups over time, while in men, the incidence rate increased. The mortality rate 1 year after the episode was 27.2%. The factors associated with overall mortality were a body mass index below 25 kg/m2, renal failure and low plasma proteins.ConclusionsOur results show a high incidence of osteoporotic hip fracture that is increasing in men, and in men it is associated with a higher mortality than in women. There is room to improve the modifiable factors associated with mortality and the available rehabilitation interventions to reduce the disability associated with these fractures.
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Padelli, Mael, Papa Gueye, Diane Guilloux, et al. "Soluble urokinase plasminogen activator receptor levels are predictive of COVID-19 severity in Afro-Caribbean patients." Biomarkers in Medicine 16, no. 3 (2022): 169–77. http://dx.doi.org/10.2217/bmm-2021-0669.
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Aim: To investigate association between soluble urokinase plasminogen activator receptor (suPAR) plasma levels at admission and incidence of complications in COVID-19 patients. Patients & methods: We considered Afro-Caribbean patients (n = 64) admitted to the hospital between 1 February 2020 and 28 February 2021. Primary outcome was time from the hospital admission until intensive care unit care or death. Results: Primary outcome (hazard ratio, HR [95%CI]) was associated with higher CT scan severity score (3.18 [1.15–8.78], p = 0.025), National Early Warning Score (NEWS2; 1.43 [1.02–2.02], p = 0.041) and suPAR (1.28 [1.06–2.06], p = 0.041). Kaplan–Meier analysis indicated patients with suPAR level above 8.95 ng/ml had a worse outcome (7.95 [3.33–18.97], p < 0.001). Conclusion: Our study suggests that COVID-19 patients with increased baseline suPAR levels are at a high risk of complications.
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Braga, Moisés Heleno Vieira, Gervásio Teles C. de Carvalho, Rafael Augusto Castro Santiago Brandão, Franklin Bernardes Faraj de Lima, and Bruno Silva Costa. "Early shunt complications in 46 children with hydrocephalus." Arquivos de Neuro-Psiquiatria 67, no. 2a (2009): 273–77. http://dx.doi.org/10.1590/s0004-282x2009000200019.
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OBJECTIVE: To determine the causes of early shunt complications in 46 children with hydrocephalus. METHOD: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007. RESULTS: Thirteen (28%) patients presented complications, which were due to infection in 9 (69%) and to malfunction of the shunt system in 4 (31%).The mean number of surgical procedures performed on patients who presented complications was 2.8 per patient, with a total of 46 surgeries in this group. All patients with infectious complications were identified during their hospital stay. CONCLUSIONS: Infection was the most common complication. The infection rate was proportional to the length of hospital stay. All patients with hydrocephalus due to tumors or myelomeningocele presented complications. A higher incidence of infections was observed in children older than 2 years.
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Yu, Guo-pan, Qifa Liu, Jing SUN, et al. "Effect of Antithymocyte Globulin Dosage for Prophylactic Gvhd On Epstein-Barr Virus Reactivation and Diseases in Allogeneic Hematopoietic Stem Cell Transplantation." Blood 120, no. 21 (2012): 4486. http://dx.doi.org/10.1182/blood.v120.21.4486.4486.
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Abstract Abstract 4486 Background: Antithymocyte globulin (ATG) is one of the main risk factors for Epstein-Barr virus (EBV) reactivation and disease in allogeneic hematopoietic stem cell transplantation (allo-HSCT), however, whether there is a correlation between ATG dose and EBV reactivation is unsure. Aim of this single-center prospective study is to explore the relationship between ATG dose and EBV reactivation in allo-HSCT. Methods: Ninety-nine patients with hematologic malignancies underwent allo-HSCT and administration of ATG for graft versus host disease (GVHD) prophylaxis were enrolled in this study in Nanfang hospital from February 2008 to February 2012. Sixty-one patients were unrelated donor transplants, thirty-eight were HLA-mismatched related donor transplants. GVHD prophylactic regimen was cyclosporine A+Methotrexate+ATG. According to donors' HLA matching, we chose three dosage groups of prophylactic ATG: low dose group with ATG dose of 5.0∼6.0mg/kg (n=28), medium dose group with ATG dose of 7.0∼8.0mg/kg (n=55), and high dose group with ATG doses of ≥10mg/kg (n=16). The levels EBV-DNA in plasma were regularly monitored by quantitative real-time polymerase chain reaction (RQ-PCR). Results: With a median follow-up of 21 (range, 1–50) months post allo-HSCT, the cumulative incidence of EBV viremia and EBV-associated diseases was 17.6% (5/28) and 17.6% (5/28) in low dose group, respectively, with 32.7% (18/55) and 29.1% (16/55) in medium dose group, respectively, with 50.0% (8/16) and 31.3% (5/16) in high dose group, respectively. There were statistical significances of the incidence (χ2□□9.555, P=0.008). Logistic regression models showed that ATG prophylaxis was one of the main risk factors for EBV infection (RR=16.728, P=0.000) while bivariate correlation analysis presented that the incidence of EBV reactivation was positively correlated with ATG prophylaxis dosage (rpearman = 0.452, P = 0.000). The cumulative incidence of high degree (II∼IV°) aGVHD was 35.7% (10/28) in low dose group, with 39.6% (21/53) in total and 50.0% (6/12) in relapsed leukemia with HLA-mismatched related transplantation in medium dose group, with 68.8% (11/16) in high dose group. There were not statistical significances of the incidence (χ2□□6.971, P=0.137). Conclusion: EBV reactivation might be positively correlated with ATG prophylaxis dosage. According to donors' HLA matching, reducing ATG prophylaxis dose appropriately could prevent EBV reactivation in allo-HSCT without increasing high degree aGVHD. Disclosures: No relevant conflicts of interest to declare.
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Akhtar, K. P., I. A. Khan, M. R. Kazmi, R. I. Hassan, and B. Fatima. "Preventive Control of Powdery Mildew Disease of Mango." Journal of Agricultural and Marine Sciences [JAMS] 4, no. 1 (1999): 23. http://dx.doi.org/10.24200/jams.vol4iss1pp23-28.
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Oidium mangiferae Berthet was found to be associated With the powdery mildew disease of mango. The air- borne conidia are released from the old tissue harboring the dormant fungal hyphae under favorable weather conditions, which produce the disease. Proper forecasting of release of airborne innoculum significantly reduced the required number of sprays needed for chemical control. Spore traps were used to monitor the concentration of airborne conidia during the months of February, March and April 1996 and l997. Daily temperature and relative humidity were noted and the spore counts from the spore traps were correlated to the meteorological data. There was a positive trend between rising temperature, lowering relative humidity and number of spores in the air alter a low temperature, high humidity and cloudy spell of weather. The maximum spore occurrences were noted around 25°C and relative humidity of 40-60%. It took 5-8 days for the emergence of disease symptoms after the first detection of airborne conidia. Ten fungicides were tested on three mango varieties (Langra, Dashehari, and Anwar Retol). The preventive sprays at the stage of first detection of air born conidia were effective in controlling the disease. Optimal timing of two sprays of fungicide were sufficient to provide preventive control (>90%). The susceptibility of inflorescence varied with its developmental stage. Proper forecasting reduced the number of sprays from 7 to 2 or 3. There was no varietal difference in incidence of the disease or response to fungicide applications. During the course of this study, we identified seedling plants which consistently showed resistance to powdery mildew.
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Iqbal, Muhardani, Blondina Marpaung, and Andi Raga Ginting. "Relationship Between Protein Tyrosine Phosphatase Non-Receptor Type 22 1858>C Gene Polymorphism with Rheumatoid Arthritis Disease Activity Score-28." International Journal of Research and Review 10, no. 2 (2023): 663–68. http://dx.doi.org/10.52403/ijrr.20230280.
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Background: Rheumatoid arthritis (RA) is one of the systemic inflammatory autoimmune diseases. A number of previous studies showed the potency of Protein Tyrosine Phosphatase Non-Receptor Type 22 (PTPN22) 1858c>T gene polymorphism with the incidence of rheumatoid arthritis. Objective: To know the relationship of PTPN22 1858C>T gene polymorphism with disease activity score-28 (DAS-28) in rheumatoid arthritis patients at H. Adam Hospital Medan. Method: 69 rheumatoid arthritis patients were conducted in this study by consecutive sampling who were treated at H. Adam Malik General Hospital, Medan from February-August 2022. The PTPN22 gene polymorphism was genotyped using polymerase chain reaction. Results: Majority of the subject in the study was female, around 65 people (94.2%). The mean age of the subjects was 42.35 ± 12.28 years old. The most ethnic group was Batak with 34 people (49.3%). Mean DAS-28 score was 3.45 ± 0.79. All CC genotypes and C alleles were found in 69 (100%) subjects. Statistical analysis found no correlation between PTPN22 1858C>T gene polymorphism and DAS-28 score with p value <1.0 Conclusion: PTPN22 1858C>T gene polymorphism has no significant relationship DAS-28 in rheumatoid arthritis. Keywords: PTPN22 1858C>T gene polymorphism, Disease Activity Index-28, rheumatoid arthritis
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Flores-Alanis, Alejandro, Zeus Saldaña-Ahuactzi, Israel Parra-Ortega, et al. "Clinical Characteristics of Coronavirus Disease (COVID-19) in Mexican Children and Adolescents." Viruses 14, no. 10 (2022): 2162. http://dx.doi.org/10.3390/v14102162.
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Background: We analyzed the demographic, clinical, and diagnostic data of children and adolescents in Mexico, from the first case of coronavirus disease (COVID-19) to 28 February 2022. Methods: Using the open databases of the Ministry of Health and a tertiary pediatric hospital, we obtained demographic and clinical data from the beginning of the COVID-19 pandemic until 28 February 2022. In addition, quantitative reverse-transcription polymerase chain reaction outputs were used to determine the viral load, and structural protein-based serology was performed to evaluate IgG antibody levels. Results: Of the total 437,832 children and adolescents with COVID-19, 1187 died. Of these patients, 1349 were admitted to the Hospital Infantil de Mexico Federico Gómez, and 11 died. Obesity, asthma, and immunosuppression were the main comorbidities, and fever, cough, and headache were the main symptoms. In this population, many patients have a low viral load and IgG antibody levels. Conclusion: During the first 2 years of the COVID-19 pandemic in Mexico, children and adolescents had low incidence and mortality. They are a heterogeneous population, but many patients had comorbidities such as obesity, asthma, and immunosuppression; symptoms such as fever, cough, and headache; and low viral load and IgG antibodies.
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Subahan, SKF, Raghavendra Kumar Gunda, JNS Kumar, et al. "A PROSPECTIVE OBSERVATIONAL STUDY ON PREVALENCE AND INCIDENCE OF ANAEMIA AMONG GESTATIONAL WOMEN." Journal of Applied Pharmaceutical Sciences and Research 7, no. 1 (2024): 50–54. http://dx.doi.org/10.31069/japsr.v7i1.09.
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Objective: This observational study aims to determine the prevalence and incidence of anaemia in pregnant women in the city of narsaraopeta, India. Methods and Methodology: Information on total of 130 pregnant women who attended to ANCs from September 2023 to February 2024 were taken. Information about age, parity, educational status, no. of abortions, type of family, socioeconomic factors, dietary habits, were collected by using pre-designed questionnaire, and patient clinical data form. In this study we used a simple randomised sampling technique to select subjects. Results: The study encompassed 130 patients from government and private ANC (Antenatal Care) care hospitals in Narasaraopet over six months. Pregnant women were predominantly aged 19-23 (49.62%) and 24-28 (37.40%). The distribution based on trimesters revealed 23.26% in the first trimester, 36.43% in the second, and 36.43% in the third. Regarding previous delivery types, graduates constituted 24.43%, illiterates 31.30%, and primary education holders 44.27%. The distribution based on the severity of anemia showed variations across follow-ups, with a significant proportion in the moderate category. Additionally, the occupation-wise distribution depicted a high percentage of housewives (65.54%) and varied percentages among others. Conclusion:. Anaemia prevalence is highest in the third trimester, persisting across follow-up periods, with a significant proportion in the 19-28 age group, highlighting challenges in managing anaemia during pregnancy.
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Yang, Quanhe, Xin Tong, Mary G. George, Anping Chang, and Robert K. Merritt. "COVID-19 and Risk of Acute Ischemic Stroke Among Medicare Beneficiaries Aged 65 Years or Older." Neurology 98, no. 8 (2022): e778-e789. http://dx.doi.org/10.1212/wnl.0000000000013184.
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Background and ObjectivesFindings of association between coronavirus disease 2019 (COVID-19) and stroke remain inconsistent, ranging from significant association to absence of association to less than expected ischemic stroke among hospitalized patients with COVID-19. The current study examined the association between COVID-19 and risk of acute ischemic stroke (AIS).MethodsWe included 37,379 Medicare fee-for-service (FFS) beneficiaries aged ≥65 years diagnosed with COVID-19 from April 1, 2020, through February 28, 2021, and AIS hospitalization from January 1, 2019, through February 28, 2021. We used a self-controlled case series design to examine the association between COVID-19 and AIS and estimated the incidence rate ratios (IRRs) by comparing incidence of AIS in risk periods (0–3, 4–7, 8–14, 15–28 days after diagnosis of COVID-19) vs control periods.ResultsAmong 37,379 Medicare FFS beneficiaries with COVID-19 and AIS, the median age at diagnosis of COVID-19 was 80.4 (interquartile range 73.5–87.1) years and 56.7% were women. When AIS at day of exposure (day = 0) was included in the risk periods, IRRs at 0–3, 4–7, 8–14, and 15–28 days following COVID-19 diagnosis were 10.3 (95% confidence interval 9.86–10.8), 1.61 (1.44–1.80), 1.44 (1.32–1.57), and 1.09 (1.02–1.18); when AIS at day 0 was excluded in the risk periods, the corresponding IRRs were 1.77 (1.57–2.01) (day 1–3), 1.60 (1.43–1.79), 1.43 (1.31–1.56), and 1.09 (1.01–1.17), respectively. The association appeared to be stronger among younger beneficiaries and among beneficiaries without prior history of stroke but largely consistent across sex and race/ethnicities.DiscussionRisk of AIS among Medicare FFS beneficiaries was 10 times (day 0 cases in the risk period) as high during the first 3 days after diagnosis of COVID-19 as during the control period and the risk associated with COVID-19 appeared to be stronger among those aged 65–74 years and those without prior history of stroke.Classification of EvidenceThis study provides Class IV evidence that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with increased risk of AIS in the first 3 days after diagnosis in Medicare FFS beneficiaries ≥65 years of age.
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Reviani, Nia, and Christine Handayani Tampubolon. "The Influence of a History of Anemia during Pregnancy on Stunting Incidents." International Journal of TROPICAL DISEASE & Health 46, no. 3 (2025): 29–36. https://doi.org/10.9734/ijtdh/2025/v46i31634.
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Stunting is a form of growth failure (growth faltering) due to the accumulation of insufficient nutrition that lasts for a long time from pregnancy to 24 months of age. Children are classified as stunted if their Z-score is < -2 SD (stunted) and < – 3 SD (severely stunted). Based on data from the Indonesian Nutrition Status Survey (SSGI), in 2022 Sumedang Regency was known as the highest stunting incidence in West Java Province, which is reported to be above 20% every year. Among 26 sub-districts in Sumedang Regency, Rancakalong District has the highest prevalence. This study aims to describe the incidence of stunting in children under five in the Rancakalong Health Center from August 2022 - February 2023. The design of this study is observational analytic with a retrospective case-control approach. The sample used in this study was 55 toddlers with the total sampling method. The results of the analysis found that 17 children (30.9%) were included in the stunting category and 28 mothers (50.9%) with stunting toddlers had a history of anemia during pregnancy. P value=0.002 (<0.05). This study concludes that there is a significant association between a history of maternal anemia and the incidence of stunting in toddlers.
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Yunir, Em, Tri Juli Edi Tarigan, Eni Iswati, et al. "Characteristics of Diabetic Foot Ulcer Patients Pre- and During COVID-19 Pandemic: Lessons Learnt From a National Referral Hospital in Indonesia." Journal of Primary Care & Community Health 13 (January 2022): 215013192210897. http://dx.doi.org/10.1177/21501319221089767.
Full textAbstract:
Background: Diabetic foot ulcer (DFU) is one of the most terrifying diabetic complications for patients, due to the high mortality rate and risk for amputation. During the COVID-19 pandemic, many diabetic patients limited their visits to the hospital, resulting in delays for treatment especially in emergency cases. Objective: This study aimed to compare the characteristics of patients with DFU pre- and during COVID-19 pandemic period. Methods: This study was a retrospective cohort study using foot registry data. We compared our patients’ characteristics pre-COVID-19 pandemic period (1 March 2019-28 February 2020) and during COVID-19 pandemic period (1 March 2020-28 February 2021). Results: Cohorts of 84 and 71 patients with DFU pre- and during COVID-19 pandemic period, respectively, were included in this study. High infection grade (66.7% vs 83.1%, P = .032), osteomyelitis event (72.6% vs 87.3%, P = .04), leukocyte count (15 565.0/μL vs 20 280.0/μL, P = .002), neutrophil-to-lymphocyte ratio (7.7 vs 12.1, P = .008), waiting time-to-surgery (39.0 h vs 78.5 h, P = .034), and number of major amputation (20.2% vs 39.4%, P = .014) were significantly higher during the COVID-19 pandemic period. Conclusion: During the COVID-19 pandemic, patients with DFU had more severe infection, higher proportion of osteomyelitis, longer waiting time for getting surgical intervention, and higher incidence of major amputation.