scholarly journals Perioperative use of intra-articular steroids during the COVID-19 pandemic

2021 ◽  
Author(s):  
Eric Jou ◽  
Andrew Kailin Zhou ◽  
Jamie Sin Ying Ho ◽  
Azeem Thahir
Keyword(s):  
Risk Of Infection ◽  
Healthcare Burden ◽  
Risks And Benefits ◽  
Financial Benefits ◽  
Potential Risks ◽  
Continued Use ◽  
Almost All ◽  
Medical Guidelines ◽  
Targeted Approach

Abstract Purpose There are growing concerns with the widely used glucocorticoids during the Coronavirus disease-19 (COVID-19) pandemic due to the associated immunosuppressive effects, which may increase the risk of COVID-19 infection and worsen COVID-19 patient outcome. Heavily affecting orthopaedics, the pandemic led to delay and cancellation of almost all surgical cases, and procedures including perioperative intra-articular corticosteroid injections (ICIs) saw similar decreases. However, the benefits of ICI treatments during the pandemic may outweigh these potential risks, and their continued use may be warranted. Methods A literature search was conducted, and all relevant articles including original articles and reviews were identified and considered in full for inclusion, and analysed with expert opinion. Epidemiological statistics and medical guidelines were consulted from relevant authorities. Results ICIs allow a targeted approach on the affected joint and are effective in reducing pain while improving functional outcome and patient quality-of-life. ICIs delay the requirement for surgery, accommodating for the increased healthcare burden during the pandemic, while reducing postoperative hospital stay, bringing significant financial benefits. However, ICIs can exert systemic effects and suppress the immune system. ICIs may increase the risk of COVID-19 infection and reduce the efficacy of COVID-19 vaccinations, leading to important public health implications. Conclusion Perioperative ICI treatments may bring significant, multifaceted benefits during the pandemic. However, ICIs increase the risk of infection, and perioperative COVID-19 is associated with mortality. The use of ICIs during the COVID-19 pandemic should therefore be considered carefully on an individual patient basis, weighing the associated risks and benefits.

Impact of biotechnology on forest ecosystems

1993 ◽  
Vol 69 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Luc C. Duchesne
Keyword(s):  
Forest Management ◽  
Forest Ecosystems ◽  
Gene Conservation ◽  
Forest Biotechnology ◽  
Risks And Benefits ◽  
Genetic Pollution ◽  
Potential Risks ◽  
Integrated Forest Management ◽  
Forest Lands

This paper discusses the potential risks and benefits that may be derived from present and future use of forest biotechnology in Canada. The complementary use of forest biotechnology along with traditional silvicultural programs has the potential to improve the quality of Canadian forests by promoting: increased forest productivity, a reduction of exploitation pressure on forest lands, an increase in gene conservation, and improved forest management. However, these benefits could also be followed by undesirable effects such as pest adaptation to control methods, non-target pest emergence, reduction of biodiversity, and genetic pollution. Measures that could be implemented to circumvent these potentially undesirable effects are discussed. Such measures should be based on a sound understanding of the ecological effects of biotechnology and should promote biotechnology use within programs of integrated forest management.

Physicochemical and bacteriological characterization of hospital effluents and their impact on the environment

2019 ◽  
Author(s):  
Chem Int
Keyword(s):  
Human Health ◽  
Fecal Coliforms ◽  
Chemical Pollution ◽  
Hospital Effluents ◽  
Biological Contaminants ◽  
Almost All ◽  
Direct Discharge ◽  
Significant Chemical

Liquid effluents discharged by hospitals may contain chemical and biological contaminants whose main source is the different substances used for the treatment of patients. This type of rejection can present a sanitary potentially dangerous risk for human health and can provoke a strong degradation of diverse environmental compartments mainly water and soils. The present study focuses on the quality of the liquid effluents of Hassani Abdelkader’s hospital of Sidi Bel-Abbes (West of Algeria). The results reveal a significant chemical pollution (COD: 879 mgO2/L, BOD5: 850 mgO2/L, NH4+ : 47.9 mg/l, NO2- : 4.2 mg/l, NO3- : 56.8 mg/l with respect to WHO standard of 90 mgO2/L, 30 mgO2/L, 0.5 mg/l, 1 mg/l and 1 mg/l respectively). However, these effluents are biodegradable since the ratio COD/BOD5 do not exceeded the value of 2 in almost all samples. The presence of pathogen germs is put into evidence such as pseudomonas, the clostridium, the staphylococcus, the fecal coliforms and fecal streptococcus. These results show that the direct discharge of these effluents constitutes a major threat to human health and the environment.

An Ayurvedic Visual Rehabilitation In Lebers Congenital Amaurosis - Prospective Case Study

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Vidhyasri M ◽  
Dr. S. M. Pasha
Keyword(s):  
Marked Improvement ◽  
Clinical Case ◽  
Treatment Plan ◽  
Visual Disability ◽  
Visual Rehabilitation ◽  
Potential Risks ◽  
The Subject ◽  
Slow Frequency

Introduction: This is the case report of child who was diagnosed with LCA reported with complaints of large-amplitude, slow-frequency, roving nystagmus, frequent tendency to press on his eyes, enopthalmos, with completely normal ophthalmoscopic examination with normal appearing optic nerve and retina and has a non recordable ERG; considering this condition under the lines of Vataja Nanatmaja Vyadhi treatment was structured to render effective visual rehabilitation which showed marked results. Methods: 4 years old male child who was diagnosed with lebers congenital amaurosis was brought by his parents to Eye OPD, GAMC, Bengaluru. The presentation of this case includes bibliographic review of the subject, presentation of a clinical case and description of the importance of Ayurvedic prespective of handling of these patients. Results: The child showed improvement in fixing for light and also nystagmus showed marked improvement and there were considerable behavioural changes observed. Discussion: It is important to deepen the environment of the disease to know the possible implications in Ayurvedic management, recognize the magnitude of visual disability that our patient presents for the establishment of the treatment plan and provide an integral care of excellence in an interdisciplinary way in favor of visual rehabilitation of our patients and also help to restore quality of life with no potential risks of side effects.

Transformative Learning in Mastery-Oriented CS0 Course

2021 ◽  
pp. 234763112110072
Author(s):  
Srinivasan Lakshminarayanan ◽  
N. J. Rao ◽  
G. K. Meghana
Keyword(s):  
Transformative Learning ◽  
First Year ◽  
Guided Discovery ◽  
Engineering Programs ◽  
Transformative Experiences ◽  
Significant Difference ◽  
Cognitive Levels ◽  
Almost All ◽  
Core Course

The introductory programming course, commonly known as CS1 and offered as a core course in the first year in all engineering programs in India, is unique because it can address higher cognitive levels, metacognition and some aspects of the affective domain. It can provide much needed transformative experiences to students coming from a system of school education that is dominantly performance-driven. Unfortunately, the CS1 course, as practiced in almost all engineering programs, is also performance-driven because of a variety of compulsions. This paper suggests that the inclusion of a course CS0 can bring about transformative learning that can potentially make a significant difference in the quality of learning in all subsequent engineering courses. The suggested instruction design of this course takes the advantage of the unique features of a course in programming. The proposed CS0 course uses “extreme apprenticeship” and “guided discovery” methods of instruction. The effectiveness of these instruction methods was established through the use of the thematic analysis, a well-known qualitative research method, and the associated coding of transformative learning experiences and instruction components.

Setting up a successful nurse-led intravitreal injections service: pearls from Swindon

2020 ◽  
Vol 29 (20) ◽  
pp. 1178-1185
Author(s):  
Hani Hasan ◽  
Sunil Mamtora ◽  
Nimish Shah
Keyword(s):  
Nurse Practitioners ◽  
Positive Impact ◽  
Training Model ◽  
Training Programme ◽  
Intravitreal Injections ◽  
Nurse Training ◽  
Financial Benefits ◽  
Hands On ◽  
Number Of Injections

The demand for performing intravitreal injections has increased in recent years, prompting the need for more nurse training in their administration. The Great Western Hospitals NHS Trust in Swindon has developed a structured nurse training programme and now has 8 independent nurse injectors trained to undertake injections independently; nurse practitioners now contribute upwards of 85% of the total number of injections. The authors have also demonstrated the financial benefits of using injection assistant devices and shown the positive impact such devices have on training. In September 2019, the authors organised the first course to offer nurses and doctors hands-on experience in administering injections, using the Swindon training model to provide participants with a structured approach to learn how to perform intravitreal injections safely. Nurses made up 96% of participants; the remainder were doctors and managers; 6% had never performed an intravitreal injection; of units where they had, disposable drapes and a speculum were used in 71% of these. The number of injections performed per session at participants' units at the time they attended the course was: 17 or more injections=46%, 13–14=39%, and 11–12=15%. The course was rated 8.9/10 overall for content, with 85% very likely to recommend it to colleagues. All participants indicated that using the Swindon model made them feel confident to deliver injections safely. The authors demonstrated that using a structured training protocol and intravitreal assistant device improves the quality of nurse training and increases confidence in administering intravitreal injections.

scholarly journals Noise at the time of COVID 19: The impact in some areas in Rome and Milan, Italy

Noise Mapping ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 248-264
Author(s):  
Rosa Maria Alsina Pagès ◽  
Francesc Alías ◽  
Patrizia Bellucci ◽  
Pier Paolo Cartolano ◽  
Ilaria Coppa ◽  
...  
Keyword(s):  
Sound Pressure ◽  
Traffic Noise ◽  
Motor Vehicles ◽  
Acoustic Environment ◽  
Commercial Activities ◽  
Real Time Traffic ◽  
Italian Regions ◽  
Almost All ◽  
The Impact

AbstractThe COVID-19 pandemic was confirmed in Italy at the end of January 2020, when the first positive cases for the virus were identified. At the beginning of March, the virus had spread to all Italian regions and on 10 March 2020 the lockdown phase began, limiting the movement of people and prohibiting almost all commercial activities, businesses and non-essential industries. As a result, millions of people were forced to stay at home, causing a drastic drop in traffic volume, which significantly changed the acoustic environment and air quality of cities. On 4 May 2020, the lockdown was partially lifted and activities were progressively reopened. Therefore, traffic gradually started to increase and, consequently, the noise emitted by motor vehicles. This behaviour was confirmed by the data collected by the DYNAMAP system, an automatic platform developed within the LIFE DYNAMAP project, providing real time traffic noise maps in terms of sound pressure levels and impacts at receivers (people and dwellings exposed to noise level bands). In this paper traffic and non-traffic-related noise events in the cities of Rome and Milan from March to May 2020 are analysed and compared to the corresponding values in 2019 to evaluate the effects of the lockdown period.

scholarly journals Research Regarding the Quality of Lambs Carcass Resulted from Tsigaia Purebred Compared with Hybrids of Tsigaia Ewes Crossed with Blanc du Massif Central Rams

2017 ◽  
Vol 74 (1) ◽  
pp. 7
Author(s):  
Mihai Marian BORZAN ◽  
Dana PUSTA ◽  
Liviu BOGDAN ◽  
Alexandra TABARAN ◽  
Attila MATE ◽  
...  
Keyword(s):  
Body Weight ◽  
Chemical Composition ◽  
Massif Central ◽  
Live Body Weight ◽  
Almost All ◽  
Qualitative Characteristics

Abstract: The research aims to compare some qualitative characteristics of purebred Tsigaia lambs and Tsigaia crossed with Blanc du Massif Central lambs. The criteria assessed were: chemical composition of purebred and Tsigaia crossed meat, the live body weight, the slaughtering performance, the weight of different carcass cut. For almost all criteria chosen the crossed individuals registered better results.

scholarly journals Impact of Demerger on Shareholders’ Wealth

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Ranjit SINGH ◽  
Amalesh BHOWAL ◽  
Varun BAWARI
Keyword(s):  
Value Creation ◽  
Stock Exchange ◽  
Specific Character ◽  
Average Price ◽  
Share Prices ◽  
The Subject ◽  
Time Specific ◽  
Almost All ◽  
Total Wealth

Purpose – The purpose of this paper is to investigate the change in the level of the wealth of the shareholders’ before the demerger and after the demerger.Design/methodology/approach – In the present study the data relating to share prices has been taken from the official website of Bombay Stock Exchange. Here the average of the six months price of the demerged company before demerger and average six months price or the average price upto 31st of July, 2007 has been collected of demerged and resultant company after demerger. Findings – It is found that after demerger there is increase in the total wealth of the shareholders in almost all the cases.Research limitations/implications – Given the nature of this study, generalizations cannot be made as the study is conducted in a bullish market. The time specific character of the subject matter is an opportunity for future longitudinal research.Practical implications – Presently de-mergers are creating enormous wealth for shareholders. It is because of the negative synergy. Due to the demerger this negative synergy is removed and the value is unlocked. However, Investors should differentiate between genuine attempts at value creation and de-mergers undertaken to create hype around the stocks. Stay away from dubious companies that want to manipulate prices. Investors should focus on the quality of management and corporate governance record of the companyOriginality/value – The study is the first of its kind and hence original in nature.Article Type: Research paperKeyword(s): Demerger, Demerged Company, Resultant Company, Negative Synergy, Shareholders Wealth.

scholarly journals Sedation During Neurocritical Care

2019 ◽  
Vol 06 (02) ◽  
pp. 056-061 ◽  
Author(s):  
Nieves Vanaclocha ◽  
Vicente Chisbert ◽  
Vicent Quilis ◽  
Federico Bilotta ◽  
Rafael Badenes
Keyword(s):  
Therapeutic Strategy ◽  
Neurocritical Care ◽  
Clinical Evidence ◽  
Deep Sedation ◽  
Clinical Prognosis ◽  
Daily Interruption ◽  
Risks And Benefits ◽  
Potential Risks ◽  
Volatile Agents ◽  
Sedative Agents

AbstractSedation is an essential therapeutic strategy in the care of neurocritical patients. Intravenous sedative agents are the most widely used, with promising alternatives (dexmedetomidine, ketamine, and volatile agents) to propofol and midazolam arising. Studies designed to evaluate superiority and avoid biases are required. A neurological awakening test is safe in most patients. Potential risks and benefits of limiting deep sedation and daily interruption of sedation in these patients remain unclear. The aim of this review was to report recent clinical evidence on sedation in this subgroup of patients, focusing on its effects on clinical prognosis.

scholarly journals Update on Data Reuse in Health Care

2017 ◽  
Vol 26 (01) ◽  
pp. 24-27 ◽  
Author(s):  
C. Safran
Keyword(s):  
Clinical Data ◽  
Legal Framework ◽  
Data Reuse ◽  
Policy Initiatives ◽  
Clinical Databases ◽  
Real World Evidence ◽  
Policy Frameworks ◽  
Potential Risks ◽  
Barriers To Use

Summary Objective: Reuse of clinical data has broad use in clinical, research, governmental, and business settings. This summary provides an update on the benefits, barriers to use with large clinical databases, policy frameworks that have been formulated, and challenges. Methods: This report highlights some recent publications on the diverse uses of clinical data and some policy initiatives to promote reuse. It also contains the opinions of the author. Results: Although many examples of the benefits of data reuse have been documented, this summary also reviews why the quality of clinical data needs to be the focus of future informatics work. Conclusion: The promise of reusing data outweighs potential risks, but concerns about privacy and the need to modernize our legal framework will be necessary to realize the full benefits of real-world evidence.

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