The Impact of Selenium Supplementation on Trauma Patients—Systematic Review and Meta-Analysis

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: “trace element”, “selenium”, “copper”, “zinc”, “injury”, and “trauma”. Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I2 = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I2 = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): −0.324, 95% CI: −0.382, −0.265, p < 0.001; heterogeneity, I2 = 0%) and lesser hospital length of stay (SMD: −0.243, 95% CI: −0.474, −0.012, p < 0.001; heterogeneity, I2 = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.

A Meta-Analysis in Assessing Oxidative Stress Using Malondialdehyde in Oral Submucous Fibrosis

Objective This study aims to evaluate the oxidative stress marker Malondialdehyde (MDA) in oral submucous fibrosis with available literature. Materials and Methods We conducted a literature search electronically in PubMed (MeSH), Science Direct, Scopus, and Google Scholar using specific keywords. Results A systematic search in PubMed, Science Direct, and Google Scholar identified 334 articles. Of these, four were duplicate reports, and three were animal studies. After reading the abstracts of the collected articles, 288 articles were excluded for the following reasons: low quality, not relevant to the research question, or did not meet the inclusion criteria. The remaining 46 articles were chosen for full-text assessment. Finally, the present qualitative synthesis included 23 articles for evaluation. The selected studies in MDA analysis in a random-effects model showed higher heterogeneity (Q = 477.636, p < 0.001, I2 = 95.394%). The standard difference in mean MDA concentration between oral submucous fibrosis (OSMF) and healthy subjects was estimated as 2.73 nmol/mL (95% confidence interval: 2.08–3.38). Conclusion The selected studies showed significantly higher MDA levels in various biological samples of patients with OSMF. Therefore, further studies are needed to estimate oxidative stress levels by using different biomarkers in OSMF to direct future therapy.

Skipping the doctor: evidence from a case with extended self-certification of paid sick leave

This paper examines the impact of a policy reform in a municipality in Norway that extended to workers the right to self-certify sickness absence from work. After the reform, workers were no longer obliged to obtain a certificate from a physician to receive sickness benefits. They could call in sick directly to their line leader and had to engage in a counselling program organized by the employer. To estimate the effect of this reform, we contrast the change in sickness absence among employees who were granted the extended right to self-certify absence with absence among employees who had to obtain a physician’s certificate to be entitled to sickness benefits. We use both a standard difference-in-differences method and the synthetic control method to estimate the effect of the reform. We can rule out large positive effects on absence after the reform, with strong evidence that the policy change actually resulted in a reduction in absence for female workers.

Does Mandatory Disclosure Matter? The Case of Nonprofit Fundraising

Do donors seek out potentially adverse information about organizations making fundraising appeals? Do they react when it is readily available? Do they draw negative inferences when critical information is not available? To answer these questions, we consider previously unexamined large-scale natural experiments involving U.S. charitable organizations—tax-exempt organizations that file Internal Revenue Service (IRS) Form 990. Using standard difference-in-differences designs, we find that donors penalize organizations with high fundraising costs when there is mandatory disclosure or involuntary disclosure by a third-party reporter. Organizations with lower fundraising costs fundraise more successfully in the presence of these disclosures. The contrast with donors’ behavior when such information is not available suggests that donors do not draw correct inferences when potentially consequential information is not disclosed. Disclose-on-request requirements, in contrast, apparently do not have any significant impact on donors’ or organizations’ behavior. We then sketch implications for the regulation of donations to charities and their modern cousins, such as crowdfunding and social enterprise organizations.

Analysis of Glycemic Improvement in Hemodialysis Patients Based on Time in Range, Assessed by Flash Glucose Monitoring

<b><i>Introduction:</i></b> This study aimed to investigate the application value of “time in ranges (TIRs)” in dialysis patients with diabetes and summarize the experience of optimizing glycemic control by flash glucose monitoring (FGM) system. <b><i>Methods:</i></b> In this monocentric 2-week pilot study, FGM was applied for 14 days in 57 type 2 diabetes mellitus medically stable patients under maintenance hemodialysis to determine their glycemic improvement. The diagnostic value of TIR versus HbA1c in detecting glucose fluctuations and levels was evaluated using receiver operating characteristic analysis. <b><i>Results:</i></b> Average glucose exhibited stronger association with TIR (<i>r</i> = −0.785, <i>p</i> &#x3c; 0.001) than HbA1c (<i>r</i> = 0.644, <i>p</i> &#x3c; 0.001), and mean amplitude of glycemic excursion (MAGE) had the same conclusion (<i>r</i> = −0.568, <i>p</i> &#x3c; 0.001 for TIR vs. <i>r</i> = 0.423, <i>p</i> = 0.016 for HbA1c). TIR exhibited a higher area under curve than HbA1c in detecting significant derangements in glucose fluctuation, using a 14-day average FGM-derived coefficient of variation &#x3e;36% as the reference standard (difference between areas: 0.237; 95% CI 0.092–0.383, <i>p</i> = 0.001). We found a significant improvement in TIR (58.38 ± 19.42 vs. 46.45 ± 24.42 mmol/L, <i>p</i> &#x3c; 0.001) and a significant decline in MAGE (median 5.64 vs.7.42 mmol/L, <i>p</i> &#x3c; 0.001) compared to the baseline without deterioration of time spent in hypoglycemia. <b><i>Conclusion:</i></b> TIR seems to be feasible and clinically useful for AGP analysis in dialysis patients with diabetes, and FGM can be used to improve glycemic control.

Mathematical Analysis and Numerical Solution of a Model of HIV with a Discrete Time Delay

We propose a mathematical model based on a set of delay differential equations that describe intracellular HIV infection. The model includes three different subpopulations of cells and the HIV virus. The mathematical model is formulated in such a way that takes into account the time between viral entry into a target cell and the production of new virions. We study the local stability of the infection-free and endemic equilibrium states. Moreover, by using a suitable Lyapunov functional and the LaSalle invariant principle, it is proved that if the basic reproduction ratio is less than unity, the infection-free equilibrium is globally asymptotically stable. In addition, we designed a non-standard difference scheme that preserves some relevant properties of the continuous mathematical model.

Optimal control problem of variable-order delay system of advertising procedure: Numerical treatment

<p style='text-indent:20px;'>This paper presents an optimal control problem of the general variable-order fractional delay model of advertising procedure. The problem describes the flow of the clients from the unaware people group to the conscious or bought band. The new formulation generalizes the model that proposed by Muller. Two control variables are considered to increase the number of customers who purchased the products. An efficient nonstandard difference approach is used to study numerically the behavior of the solution of the mentioned problem. Properties of the proposed system were introduced analytically and numerically. The proposed difference schema maintains the properties of the analytic solutions as boundedness and the positivity. Numerical examples, for testing the applicability of the utilized method and to show the simplicity, accuracy and efficiency of this approximation approach, are presented with some comprising with standard difference methods.</p>

Assessment Of Efficacy of Lab-Based Learning In Enhancing Critical Thinking And Creative Thinking Among Learners

With technological innovations happening at workplaces, 21st century organizations demand competencies in thinking creatively and critically. These two skills will potentially help prospective employees become confident individuals, concerned citizens, self-directed learners, and active professionals. In this context, it becomes imperative to overhaul the lecture-based and banking model of the traditional pedagogical approach in order to impart such skills among undergraduate and graduate students. To address this issue, a lab-based teaching-learning method focused on problem-solving and design thinking was introduced at OAMK Labs in Finland. This study assesses the efficacy of lab-based learning in enhancing creativity and critical thinking among students from engineering, management, and science backgrounds of Kathmandu University, Nepal. The study was conducted in a workshop setting using a randomized control trial (RCT) where participants were divided into control and treatment groups. Participants in treatment group took part in a design thinking workshop that applied lab-based learning pedagogy, while those in the control group were given some reading material on improving creativity and critical thinking. Standard tests on both critical and creative thinking in a pre- and post-stages were administered to both groups. Data was analyzed using standard Difference-in-Differences technique. The results showed that while the level of critical thinking improved significantly, among the learners in treatment group alone, the creativity level in the post-stage increased significantly among learners in both groups. Results validated the efficacy of lab-based teaching-learning in addressing the need for critical and creative thinking skills among learners. Keywords: critical thinking, creativity, lab based learning, innovation, higher education, Difference-in-Differences

Event-related potentials in a two-choice oddball task of impaired behavioral inhibitory control among males with tendencies towards cybersex addiction

Background and aimsImpaired behavioral inhibitory control (BIC) is known to play a crucial role in addictive behavior. However, research has been inconclusive as to whether this is also the case for cybersex addiction. This study aimed to investigate the time course of BIC in male individuals with tendencies towards cybersex addiction (TCA) using event-related potentials (ERPs) and to provide neurophysiological evidence of their deficient BIC.MethodsThirty-six individuals with TCA and 36 healthy controls (HCs) were given a Two-Choice Oddball task that required them to respond differently to frequent standard stimuli (images of people) and infrequent deviant stimuli (pornographic images) within 1,000 ms. Electroencephalography (EEG) was recorded as the participants performed the task.ResultsDespite the similarity of standard stimuli between the groups in terms of reaction times (RTs), the RTs of the TCA group to deviant stimuli were much slower than those of the HC group. The behavioral difference was accompanied by group differences in the averaged amplitudes of N2 (200–300 ms) and P3 (300–500 ms) components in the deviant-standard difference wave. More specifically, compared to the HC group, the TCA group demonstrated smaller N2 and P3 amplitude differences for deviant than standard stimuli.Discussion and conclusionsIndividuals with TCA were more impulsive than HC participants and shared neuropsychological and ERP characteristics of substance use disorder or behavioral addictions, which supports the view that cybersex addiction can be conceptualized as a behavioral addiction.

The Efficiency And Safety Of Dexamethasone For Pain Relief Followed Lumbar Decompression And Fusion: A Systematic Review And Meta-Analysis

Background: This meta-analysis was to evaluate the safety and efficiency of dexamethasone for pain relief followed lumbar decompression and fusion.Methods: Two reviewers have independently searched 3 electronic databases (PubMed, EMBASE and Cochrane Library) up to Jun, 2019 without restrictions on language and publication. After testing for heterogeneity between studies, data were aggregated for random-effects models when necessary. The results of dichotomous outcomes were expressed as relative risks (RRs) with a 95% confidence intervals (CIs). For continuous variable, mean and standard difference (SD) were applied for assessment. Meta-analysis was performed using Stata 12.0 software.Results: Seven RCTs and one retrospective study including 958 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of visual analogue scale (VAS) scores at 24 hours of movement (SMD=0.44, 95% CI: 0.67 to 0.21, P < 0.001). Dexamethasone group was associated with a lower opioids consumption at 24 hours (SMD=0.601, 95% CI: 0.93 to 0.28, P < 0.001), less occurrence of nausea and vomiting (RR=0.52, 95% CI: 0.40 to 0.67, P < 0.001), shorter length of hospital stay (SMD = 0.207, 95% CI: 0.396 to 0.017, P = 0.003).Conclusion: In our meta-analysis of 8 reliable studies, we found that intravenous dexamethasone could significantly reduce postoperative pain scores and opioids consumption within the 24 hours followed lumbar decompression and fusion. Furthermore, patients could gain functional exercise early and the length of stay in hospital was significantly shorten. More researches were needed to confirm these conclusions.