Average Duration Research Articles

Implementation research in the area of early childhood: scoping review

Objective To systematically map implementation research focusing on interventions aimed at early childhood development, its main characteristics and implementation strategies. Methods A scoping review of the global literature was planned and performed in accordance with recommendations of the Joanna Briggs Institute. The search was carried out in nine electronic databases (PubMed, Scopus, Embase, Health System Evidence, Social Systems Evidence, Cochrane, ERIC and CINHAL and VHL) from the beginning of indexing until August 2021. Results The searches mapped 4,105 references, 2,805 of which were unrepeated. After screening, 211 studies were read in full and 82 included. The health sector was the most frequent in interventions, followed by education and social services. Programs aimed at childhood development and strategies focused on parenting, family and nutrition were the main interventions. In total, 89.0% presented children as direct beneficiaries of the strategies. The average duration of interventions was 14.5 months and 25.6% of studies based their methodology on frameworks to analyze the implementation of interventions. Half analyzed adaptations of interventions or programs, while 29.3% cited equity aspects of implementation. Conclusion This scoping review allowed the analysis of a set of interventions aimed at early childhood, demonstrating the potential of implementation research on early childhood development programs, identifying more appropriate strategies to the contexts and the reach of intended objectives, based on incorporation of implementation outcomes.

Assessing postoperative wound infection rates in ultrasound-guided microwave ablation versus conventional surgery for varicose veins.

Varicose veins are the prevalent vascular disorder that has conventionally been managed via risky postoperative wound infections and conventional surgery. While ultrasound-guided microwave ablation (UMA) has gained attention as a minimally invasive alternative, there is still a lack of research examining its comparative effectiveness. A prospective comparative investigation was undertaken in the Zhejiang region of China from January to November 2023, involving 140 patients who had received the diagnosis of primary varicose veins. An equal number of 70 patients underwent UMA and conventional surgery. Exclusion criteria for the study encompassed adult patients aged 18-65, with the exception of those who had undergone prior venous surgery, deep vein thrombosis or peripheral arterial disease. The demographical characteristics, procedural details and complication profiles of patients who developed postoperative wound infections within 30 days were analysed statistically. The outcomes demonstrated that postoperative wound infections were significantly diminished (5.7%) with UMA in comparison to conventional surgery (17.1%). In addition, the average duration of procedures and length of hospital stay for UMA patients were both reduced, although neither of these differences was found to be statistically significant (p > 0.05). Infection management, age and gender distribution of varicose veins were comparable between the two groups (p > 0.05). A significant inverse correlation was observed between the severity of varicose veins and postoperative outcomes, as determined by the regression analysis (p < 0.05). Using UMA to treat varicose veins showed promise as an alternative to conventional surgery, specifically in minimizing the incidence of postoperative wound infections. Additional research and clinical consideration are needed regarding the potential transition toward minimally invasive techniques in treatment of varicose veins, as suggested by these results.

Injuries in male youth football: a one season prospective cohort study of 223 Danish elite players.

This study prospectively investigated injury prevalence, incidence, and burden in male elite under-17 football players (N = 223) during a full season. The players weekly completed a standardized web-based injury survey (OSTRC-H2) and a physical exposure report throughout the study. Average weekly response rate was 89.5%. Football exposure accounted for 52.4% of total physical exposure. On average (±SD), the players participated in individual football, strength, and rehabilitation practices for 1.2 ± 1.5, 3.0 ± .2.1, and 1.9 ± 3.4 h/week, respectively. In total, 742 health problems were reported. Mean weekly prevalence of health problems, injuries and illnesses were 20.1%, 16.5% and 3.8%, respectively. The injury incidence per 1,000 h of football exposure, match play and team practice were 8.28 (95% CI: 7.54-9.08), 16.77 (95% CI: 13.65-20.4), and 7.24 (95% CI: 6.5-8.04), respectively. Sudden-onset and gradual-onset injuries accounted for 36.7% and 43.4% of the total proportion of health problems. Hip/groin injuries had the highest incidence (1.58/1,000 h), whereas knee injuries had the highest burden (20.86 days lost/1,000 h). On average, the players experienced 3.33 health problems (average duration: 7.8 days). On average pr. player, 2.7 (95% CI: 2.2-3.3) wks of football exposure were lost. Sudden and gradual-onset injuries influenced player availability during the season. Health problem prevalence fluctuated markedly, and injury incidence was higher during match play than training. The players had substantial volumes of training beyond football-specific training and matches. Our findings could assist medical and sports science practitioneers in enhancing training and recovery processes to maximize player availability.

"Just Because I Don't Conform to Societal Norms": A Qualitative Study of Transgender People's Experiences of Domestic Violence and Coping Methods.

Background Transgender people experience violence in various forms, primarily domestic violence. The aim of this study was to examine transgender people's experiences of domestic violence and their coping methods. Materials and methods This study was conducted using the phenomenological method, one of the five basic qualitative research methods, with 20 transgender participants who applied to Ondokuz Mayıs University, Samsun, Turkey, to start the gender-affirming treatment process. The participants comprised 19 transgender men and 1 transgender woman. A semi-structured interview form was used for data collection. The average interview duration was 75.7 minutes. Audio recordings were used in the interviews, which were then transcribed. The obtained data set was subjected to content analysis. Results As a result of the content analysis, three themes emerged: being a transgender individual and the family, experiences of domestic violence, and methods of coping. According to the study results, the participants had experienced domestic violence of different dimensions, primarily psychological violence. Defined gender roles and societal expectations were determined to trigger violent behaviors. The most frequently used coping methods were giving a direct reaction, seeking instrumental-social support, and ignoring the incidents. Conclusion Our findings demonstrated that transgender people experience domestic violence at a high rate and that transphobic behaviors are triggered by societal norms. Our results are particularly noteworthy for clinicians regarding the importance of family support and accurate information for transgender people and the coping methods they use most.

Incidence on cost and duration of therapy for potential infections in post-operative traumatic wounds with prosthetic devices, previously treated and untreated with antibacterial gels at San Giuliano hospital ASLNaples 2 north

IntroductionBacterial infections associated with implanted biomaterials represent the most significant complication in orthopedics, constituting the leading cause of failure in primary hip and knee prostheses. Prevention of infections associated with implanted biomaterials should simultaneously focus on at least two objectives: inhibition of biofilm formation and minimization of suppression of the local immune response. Some technologies proposed for this purpose in clinical practice have already demonstrated strong evidence of antibacterial efficacy, safety, and resistance. The time is ripe for further development and experimentation of these technologies in a clinical setting.Materials and MethodsThe study involved observing wounds in the 6 months following treatments (Follow Up). The aim was to evaluate the cost-benefit aspects in patients treated with defensive antibacterial gels during orthopedic interventions for prostheses and/or synthesis at the San Giuliano Hospital, ASL Napoli 2 North. The goal was to assess the effectiveness of the treatment applied to patients undergoing orthopedic interventions for prostheses and/or orthopedic synthesis. The wounds of treated and untreated patients were compared six months post-surgery, along with the costs incurred by the National Health Service (NHS) and the respective benefits obtained for treated and untreated patients. The observational and retrospective study spanned six months and involved a cohort of 60 patients from the orthopedic department and outpatient clinic of San Giuliano Hospital, ASL Napoli 2, undergoing post-traumatic interventions. The cohort was divided into two groups: Group A (gA) included 30 operated patients whose wounds or devices used were treated with decontamination gels to prevent infections, while Group B (gB) consisted of 30 patients operated on but not treated with any such device. The study involved a six-month observation of the two groups, evaluating the possible occurrence of infections, their duration (until complete healing, including any complications), and the average cost of therapy required for treatment (monitoring the use of drugs, supplies, and devices). A scale of values was then set up based on the average cost incurred and the average duration of treatment for each of the 4 levels of the scale.ResultsAt the end of the period, 30 patients from Group A and 30 from Group B were observed. Within Group A, 2 patients reported infections, placing them in the first two levels of the scale. In Group B, 8 patients required treatment for infections, placing them at different levels of the scale based on the treatment received and its associated cost. The economic impact is high and varies depending on the breadth of usage indications, such as applying the device alone or as a carrier in association with antibiotics for all subjects undergoing primary and revision arthroplasty or osteosynthesis surgical procedures, or only for a fraction of them (e.g., patients at risk of infections, subjects undergoing prosthesis re-implantation, osteosynthesis of traumatic exposed fractures, etc.).ConclusionsManaging an infection that develops after an orthopedic intervention for prostheses and/or synthesis leads patients to seek long term medical check-ups and specialized nursing assistance. The total costs for treating the 10 infected patients show that the overall expenditure for the 8 in Group B is much higher than that for the total of 2 in Group A, both because of the fivefold increase in numbers and the milder and more treatable nature of infections in the two patients in Group A. Even when considering the costs related to the use of antibacterial gels on wounds or prosthetic devices/osteosynthesis, the economic savings are significant considering the cost of pharmacological treatments for infections and their potential complications.

Phase angle as an indicator of physical activity in patients with stable chronic obstructive pulmonary disease

ObjectivesPhase angle (PhA) reflects cell membrane integrity and vitality and is an indicator of sarcopenia. PhA is associated with physical function in patients with stable chronic obstructive pulmonary disease (COPD). To our knowledge, the association between PhA and physical activity (PA) has not been investigated. Therefore, the aim of this study was to investigate whether PhA reflects PA in patients with COPD. MethodsThis single-center, cross-sectional, observational study included 103 patients with stable COPD (87 men; mean age, 74.7 ± 8.1 y; mean forced expiratory volume in 1s %predicted value, 58.9 ± 20.4%). PhA was measured by bioelectrical impedance analysis. Patients were stratified into low (n = 54) and high (n = 49) PhA groups based on median values (4.3° ± 0.6° and 5.4° ± 0.5°, respectively). PA was calculated as the average daily duration of high-intensity light PA (HLPA; 2.0–2.9 metabolic equivalents [METs] of PA) and moderate- to vigorous-intensity PA (MVPA; >3 METs). Correlation and multivariate analyses using multiple regression analysis were performed to confirm the association between PhA and PA. ResultsThe high-PhA group demonstrated greater HLPA (104.4 [16.5–332.5] versus 131.3 [61.1–328.7] min, P = 0.005) and MVPA (19.5 [4.7–96.0] versus 46.6 [8.9–139.3] min, P < 0.001) than the low-PhA group. PhA was positively correlated with HLPA (r = 0.32, P < 0.001) and MVPA (r = 0.49, P < 0.001). MVPA (β = 0.178, P = 0.029) and HLPA (β = 0.158, P = 0.026) were associated with PhA independent of age, sex, body mass index, respiratory function, muscle strength, skeletal muscle mass index, and 6-min walking distance. ConclusionIn patients with COPD, PhA may reflect PA as well as muscle function.

Increased incidence of vibriosis in Maryland, U.S.A., 2006–2019

BackgroundVibrio spp. naturally occur in warm water with moderate salinity. Infections with non-cholera Vibrio (vibriosis) cause an estimated 80,000 illnesses and 100 fatalities each year in the United States. Climate associated changes to environmental parameters in aquatic ecosystems are largely promoting Vibrio growth, and increased incidence of vibriosis is being reported globally. However, vibriosis trends in the northeastern U.S. (e.g., Maryland) have not been evaluated since 2008. MethodsVibriosis case data for Maryland (2006–2019; n = 611) were obtained from the COVIS database. Incidence rates were calculated using U.S. Census Bureau population estimates for Maryland. A logistic regression model, including region, age group, race, gender, occupation, and exposure type, was used to estimate the likelihood of hospitalization. ResultsComparing the 2006–2012 and 2013–2019 periods, there was a 39% (p = 0.01) increase in the average annual incidence rate (per 100,000 population) of vibriosis, with V. vulnificus infections seeing the greatest percentage increase (53%, p = 0.01), followed by V. parahaemolyticus (47%, p = 0.05). The number of hospitalizations increased by 58% (p = 0.01). Since 2010, there were more reported vibriosis cases with a hospital duration ≥10 days. Patients from the upper eastern shore region and those over the age of 65 were more likely (OR = 6.8 and 12.2) to be hospitalized compared to other patients. ConclusionsLong-term increases in Vibrio infections, notably V. vulnificus wound infections, are occurring in Maryland. This trend, along with increased rates in hospitalizations and average hospital durations, underscore the need to improve public awareness, water monitoring, post-harvest seafood interventions, and environmental forecasting ability.

Sweet dreams, bright futures: the relationship between sleep duration and health, income and education

PurposeTo examine the relationship between sleep duration and health, income, and education.MethodsSleep, demographic, income, education and wellness data from 49,365 participants aged 18 years and older were sourced from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a cross-sectional telephone survey conducted by state health departments with technical and methodological assistance provided by the Centers for Disease Control and Prevention. Self-reported sleep duration was assessed as well as self-perceptions of health and wellness.ResultsIndividuals with average daily sleep durations between 7 and 9 h reported significantly better physical and mental wellness as compared to those who reported fewer than 7 h or more than 9 h of sleep per day (p < 0.001). Similarly, individuals reporting adequate sleep duration of 7–9 h per day also reported the highest self-ratings of overall health and life satisfaction (p < 0.001), the highest levels of income, and the greatest percentage of 4-year college degrees of the three sleep duration groups.ConclusionThis study suggests that adequate sleep is associated with better health, higher income, and higher education. Whether adequate sleep resulted in, or was a result of, better health, higher income and higher education, a relationship between them is clear.

Soliton molecules order control and their propagation features in an anomalous dispersion optical fiber

We report the experimental generation of soliton molecules (SM) with a controlled number of pulses in an all-fiber erbium laser. The change in the number of pulses (from 7 to 18 coupled states) occurred without changing time- separation between pulses. The ability to increase or decrease the number of pulses is repeatable and easily controlled by changing the pump power in both directions without changing the output characteristics of the reported regime. The average pulse duration was < 0.5 ps at full width at half maximum with a time interval between pulses of ∼ 4.7 ps.We also experimentally and numerically studied the evolution of soliton molecules regime with N = 23 during propagation along a standard telecommunication fiber with anomalous dispersion. In this case, we observed the appearance of a dispersive wave, which led to a rapid broadening of the pulses and the subsequent decay of the SM.

Transforaminal lumbar interbody fusion with a tantalum cage: lumbar lordosis redistribution and sacral slope restoration with a modified posterior technique

BackgroundTransforaminal lumbar interbody fusion (TLIF), a commonly used procedure in spine surgery, has the advantage of a lower incidence of nerve lesions compared to the posterior lumbar interbody fusion (PLIF) technique. The intersomatic arthrodesis has always been carried out with a single tantalum cage normally used for PLIF. Tantalum is a metal that is particularly used in orthopedic surgery. It has a modulus of elasticity similar to marrow and leads to high primary stability of the implant.Materials and methodsOur study was a retrospective monocentric observational study evaluating clinical and radiological outcomes of tantalum cages in a modified TLIF technique with posterior instrumentation and autologous and/or homologous posterolateral bone grafting. The aim of the study was to evaluate clinical outcomes and the increase in or redistribution of lumbar lordosis. The intersomatic arthrodesis was always carried out with a single tantalum cage normally used for PLIF to reduce the neurological risk. We retrospectively studied 105 patients who were treated with a modified unilateral TLIF approach by two surgeons between 2013 and 2018. We evaluated the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for back pain, global lumbar lordosis, lordosis of L4–sacrum, segmental lordosis of functional motion units that underwent arthrodesis, pelvic tilt, pelvic incidence, and the sacral slope in 77 patients. All patients were suffering from grade III or IV Pfirrmann, instability, or foraminal post-laminectomy stenosis and/or grade I–II degenerative spondylolisthesis or low-grade isthmic spondylolisthesis. They had no significant sagittal imbalance, with a sagittal vertical axis (SVA) of < 5 mm. The average follow-up duration was 30 months.ResultsWe achieved excellent clinical results, with only four cases of failure (5.2%). Moreover, we noticed a statistically significant redistribution of lumbar lordosis, with an average percentage increase in L4–S1 lordosis equal to 19.9% (P < 0.001), an average increase in the L4–S1/Lumbar lordosis (LL) ratio from 0.53 to 0.63 (P < 0.001), and a mean percentage increase in sacral slope equal to 7.6% (P < 0.001).Conclusion Thanks to the properties of tantalum, our modified single-portal TLIF technique is a valid surgical solution to obtain a solid arthrodesis and restore the correct lumbar lordosis distribution while reducing neurological complications and the number of failures.Level of evidence: 4Trial registration statement: retrospective observational study, no trial registration.

Analysis of morbidity in hospitals

The article presents an analysis of morbidity in hospitals and the average length of stay by disease classes and individual nosology in Russia for the period from 2016 to 2021. The aim of the work was to analyze the indicators of morbidity in hospitals among the adult population of Russia for the period 2016-2021. Statistical and analytical research methods were used in the work. The data on the number of discharged adult patients (18 years and older) from medical organizations providing inpatient care as well as on the number of bed-days discharged were used from the federal statistical observation form № 14 'Information about the activities of units of medical organizations providing care in inpatient settings' for 2016-2021. The morbidity in hospitals rate decreased from 205.5 to 196.0 per 1000 people of the corresponding age, the average duration of stay in a hospital bed decreased from 11.7 to 10.6 days. The downward trend in morbidity in hospital is traceable for almost all classes of diseases. Since 2020, due to the pandemic of the new coronavirus infection COVID-19 and the reprofiling of most hospitals to infectious diseases hospitals, there has been a change in the structure of morbidity in hospital in adult patients by disease class.

Groote Schuur Hospital neurosurgical intensive care unit: A 2-year review of admission characteristics.

At Groote Schuur Hospital (GSH), the neurosurgical intensive care unit (NsICU) is a 6-bed unit headed by a specialist neurosurgeon with extensive experience in neurocritical care, working in close collaboration with intensivists from the Division of Critical Care. There is currently no detailed analysis of the demographics, diagnosis and management of patients admitted to the NsICU at GSH. To provide a detailed descriptive analysis of the demographics, diagnosis and management of patients admitted to the NsICU at GSH from 1 January 2020 to 31 December 2021. A retrospective descriptive analysis was done of patients who received treatment in the NsICU from 1 January 2020 to 31 December 2021. A total of 685 patients were admitted to the unit over a 2-year period, with a male preponderance (68.2%). The average age was 42.5 (standard deviation (SD) 17.2) years. The most common neurosurgical diagnoses were traumatic brain injuries (39.6%), brain tumours (22.6%) and aneurysmal subarachnoid haemorrhages (9.9%). Emergency admissions comprised 76.6% of the total and 86.7% of patients were admitted postoperatively. Three hundred and seventy-two patients (54.3%) required mechanical ventilation, 132 (19.3%) required both an intracranial pressure (ICP) monitor and brain tissue oxygenation monitor, 86 (12.5%) needed placement of an external ventricular drain, 50 (7.3%) needed placement of a tracheostomy tube and 16 (2.3%) needed placement of an ICP monitor only. The average duration of stay was 5.5 (1.3) days and NsICU mortality over 2 years was 11.1%. The NsICU at GSH manages predominantly male trauma patients and a significant number of admitted patients require specialised invasive intracranial monitoring. This is the first in-depth analysis of patients managed in a dedicated neurosurgical intensive care unit in South Africa. The work defines the patient population, neurosurgical pathologies and service level requirements that would likely be encountered by teams building a similar service.

Epilepsy phenotype and its reproducibility after lateral fluid percussion-induced traumatic brain injury in rats: Multicenter EpiBioS4Rx study project 1.

This study was undertaken to assess reproducibility of the epilepsy outcome and phenotype in a lateral fluid percussion model of posttraumatic epilepsy (PTE) across three study sites. A total of 525 adult male Sprague Dawley rats were randomized to lateral fluid percussion-induced brain injury (FPI) or sham operation. Of these, 264 were assigned to magnetic resonance imaging (MRI cohort, 43 sham, 221 traumatic brain injury [TBI]) and 261 to electrophysiological follow-up (EEG cohort, 41 sham, 220 TBI). A major effort was made to harmonize the rats, materials, equipment, procedures, and monitoring systems. On the 7th post-TBI month, rats were video-EEG monitored for epilepsy diagnosis. A total of 245 rats were video-EEG phenotyped for epilepsy on the 7th postinjury month (121 in MRI cohort, 124 in EEG cohort). In the whole cohort (n = 245), the prevalence of PTE in rats with TBI was 22%, being 27% in the MRI and 18% in the EEG cohort (p > .05). Prevalence of PTE did not differ between the three study sites (p > .05). The average seizure frequency was .317 ± .725 seizures/day at University of Eastern Finland (UEF; Finland), .085 ± .067 at Monash University (Monash; Australia), and .299 ± .266 at University of California, Los Angeles (UCLA; USA; p < .01 as compared to Monash). The average seizure duration did not differ between UEF (104 ± 48 s), Monash (90 ± 33 s), and UCLA (105 ± 473 s; p > .05). Of the 219 seizures, 53% occurred as part of a seizure cluster (≥3 seizures/24 h; p >.05 between the study sites). Of the 209 seizures, 56% occurred during lights-on period and 44% during lights-off period (p > .05 between the study sites). The PTE phenotype induced by lateral FPI is reproducible in a multicenter design. Our study supports the feasibility of performing preclinical multicenter trials in PTE to increase statistical power and experimental rigor to produce clinically translatable data to combat epileptogenesis after TBI.

A Low-Cost Mobile-Based Augmented Reality Neuronavigation System for Retrosigmoid Craniotomy

BACKGROUND AND OBJECTIVES: The correct positioning of the transverse-sigmoid sinus junction (TSSJ) during retrosigmoid craniotomy (RC) is crucial for enhancing surgical efficiency and preventing complications. An augmented reality technology may provide low-cost guidance for the TSSJ position. The authors aimed to investigate the clinical application of a self-developed mobile augmented reality navigation system (MARNS) for TSSJ positioning during RC and present their findings. METHODS: This observational research enrolled patients who underwent RC at Fujian Provincial Hospital from May 2023 to June 2023. All patients had their TSSJs located by MARNS. The surgical incision and skull “keyhole” for drilling were determined separately based on the projections of TSSJ on the 3-dimensional model displayed by MARNS. This method was assessed using matching error, positioning time, integrity of the bone flap, incidence of transversal sigmoid sinus injury, and other complications. RESULTS: Seven patients diagnosed with acoustic neuroma, trigeminal neuralgia, and hemifacial spasm were enrolled in this study. The MARNS system exhibited a matching error with an average magnitude of 2.88 ± 0.69 mm. The positioning procedure necessitated an average duration of 279.71 ± 27.29 seconds. In every instance, the inner edge of the TSSJ was precisely identified and exposed while the bone flap was successfully formed and maintained an average integrity of 86.7%. CONCLUSION: This study demonstrated the efficacy of MARNS in the precise placement of the TSSJ during RC procedures. It offers advantages for convenience, cost-effectiveness, and reliability for neurosurgical navigation.

Robot-assisted liver resections in locally advanced intrahepatic cholangiocarcinoma

Aim. To evaluate the immediate results of robot-assisted liver resections in locally advanced intrahepatic cholangiocarcinoma.Materials and methods. The research methodology involved the analysis of intraoperative and direct results of robotassisted liver resections from 2015 to June 2023.Results. Total of 89 patients with intrahepatic cholangiocarcinoma underwent surgery. Open liver resection was performed in 59 cases (66.3%), laparoscopic resection – in 22 cases (24.7%), robot-assisted resection – in 8 cases (8.9%). The share of massive liver resections accounted for 83%. The average duration of robot-assisted liver resection amounted to 545 (327–640) minutes, blood loss volume – 300 (100–750) ml, number of resected lymph nodes – 7 (5–11), resection margin width – 6 (5–14) mm. All patients underwent extensive resection with elements of vascular or biliary resection. Severe complications developed only in half of the patients. No deaths or liver failures were reported. The average duration of hospital stay after surgery amounted to 11 (6–15) days.Conclusion. Robot-assisted liver resections expand the indications for minimally invasive surgeries in intrahepatic cholangiocarcinoma due to patients with locally advanced forms. Satisfactory immediate results justify further accumulation and evaluation of the experience of such interventions.

Long-term Results of Developmental Hip Dysplasia Under Therapy With Pavlik Harness.

The Pavlik harness is a commonly used treatment for developmental dysplasia of the hip (DDH) of types IIc or worse, based on the Graf classification. This study aimed to assess the long-term follow-up outcomes after treating DDH with the Pavlik harness. Between 1995 and 2006, ultrasound screening was conducted on 7372 newborns within the first days of life. Among them, 203 dysplastic hips in 152 patients, whose sonograms were Graf type IIc or worse, were treated with Pavlik harness. Treatment was discontinued if the measurement indicated Graf type Ia/b. More than 20 years later (mean: 20.46y), patients were invited for clinical evaluation (Oxford Hips Score, Schulthess Hip Score, Harris Hip Score) and radiologic examination (center-edge angle according to Wiberg and the Severis classification, the rate of roofing of the femoral head via the Reimers migration percentage, and the Sharp angle). Of the 152 patients, 60 (39.5%) participants with 80 (39.4%) affected hips (57.7% type IIc, 7.9% type D, and 15.6% type IIIa/b) were reexamined. The average follow-up duration was 20.5 years, with a maximum of 25.9 years. According to the Severin's classification, only 2 (3.77%) patients, each with one affected hip, showed slight residual dysplasia. The Reimer's migration percentage indicated an average of almost 90% canopy cover in the patient collective studied. No avascular necrosis was found, and the Sharp angle showed an average of almost 38 degrees. Only 4 participants with each one affected hip showed residual dysplasia according to the Sharp angle. The clinical results were quite satisfying, as none of the patients experienced hip pain that significantly limited their everyday activities or sports engagement, requiring medical attention before this study.Conclusions:Conservative therapy of DDH (Graf type IIc, D, III) with the Pavlik harness has demonstrated very good therapeutic success and a very low rate of residual dysplasia (2.81%). Both the radiologic and clinical outcomes were highly satisfactory. Level IV.

Relation of Iron Deficiency Anemia in Pre-Menopause Women with Calcium and Vitamin D Levels at Teaching Hospital

Background: Iron deficiency anemia (IDA) is a common condition influenced by various factors, such as age, symptom duration, and other biochemical markers. Premenopausal women often experience premenstrual syndrome (PMS), which is frequently associated with reduced blood levels of calcium and vitamin D. Given the worldwide public health concern of osteoporosis, understanding lifetime preventive measures is crucial. Methods: This study aimed to explore the relationship between IDA and various clinical characteristics in 161 participants. We evaluated parameters including age, symptom duration, and levels of calcium and vitamin D to identify potential associations with IDA. Data for the 161 patients were collected using a predesigned proforma, as approved by the ethics committee. The Chi-square test was employed to determine statistical significance, with a P-value threshold set at 0.05. Results: The average age of participants was 38.6 years, with the majority (58.4%) reporting symptoms for an average duration of 58.4 months. Among them, 54% had confirmed cases of IDA. However, there was no significant age-related correlation with IDA. Notably, a strong correlation was observed between IDA and low vitamin D levels, which were present in 79.8% of the patients. Conversely, no significant relationship was found between calcium levels and IDA. Conclusion: Current research underscores the complex interplay between IDA and various clinical factors. Low vitamin D levels appear to be strongly linked with IDA, whereas age and symptom duration are not reliable indicators of the condition. This emphasizes the importance of considering multiple factors in the diagnosis and treatment of IDA, particularly focusing on the potential role of vitamin D in its pathogenesis. Further prospective studies are needed to confirm and expand upon these findings, potentially leading to improved treatment and diagnostic strategies for patients with IDA.

Prevalence of exposure to household cooking oil fumes in women aged 40 years and older in China, 2019

Objective: To understand the prevalence of exposure to household cooking oil fumes in women ≥40 years old. Methods: The data were from Chronic Obstructive Pulmonary Disease (COPD) Surveillance in China during 2019-2020, which selected permanent residents ≥40 years old from 125 counties (districts) in 31 provinces (autonomous regions and municipalities) across the country by multi-stage stratified cluster random sampling method. The relevant demographic information and cooking oil fumes were collected by face-to-face interview. Our study served 37 164 women with complete cooking practice information as the subject. After complex sample weighting, we analyzed the prevalence of cooking oil fumes exposure in women from cooking time, kitchen characteristics, and Self-reported cooking oil fumes exposure. Results: In 2019, 83.9% (95%CI: 82.1%-85.7%) and 4.5% (95%CI: 3.8%-5.2%) of Chinese women ≥40 years old cooked daily and often, respectively. The average daily cooking duration is 1.8 hours/day, 31.1% of women who cooked daily more than 2.0 hours, and the average cumulative cooking years of cooking women were 32.8 years. 79.3% of cooking women used ventilation devices, and 3.2% cooked in the living room. 8.9% and 7.2% of cooking women in south China and northwest China cooked in the living room, significantly higher than in other regions (P=0.036). The self-reported exposure rate to cooking oil fumes was 81.0% (95%CI: 79.3%-82.7%). Rural, older, lower education level and women engaged in agriculture had a higher proportion of cooking daily, average daily cooking duration, cumulative cooking years, the proportion of cooking in the living room, and rate of self-reported cooking oil fumes exposure, but a lower proportion of using ventilation devices during cooking (P<0.001). Conclusions: The exposure to household cooking oil fumes was serious in Chinese women, and some women still did not take any ventilation measures when cooking. More attention should be paid to the exposure to home cooking oil fumes and its health hazards in women, especially those with lower socioeconomic status.

Epidemiological characteristics of public health emergency events of varicella in China, 2006-2021

Objective: To understand the epidemiological characteristics of public health emergency events (PHEE) of varicella in China from 2006 to 2021 and related response performances. Methods: The data of varicella PHEE in 31 provinces of China from 2006 to 2021 were collected through the Public Health Emergency Management Information System, Microsoft Excel 2019 software and SPSS 26.0 statistical software were used to conduct descriptive epidemiological, statistical analysis on the time, area, location distribution, scale and epidemic management. Results: A total of 11 443 PHEE involving 341 048 related cases were reported from 2006 to 2021, with an annual attack rate of 1.78%-3.80% and a total attack rate of 2.33% (341 048/14 624 042). The number of PHEE and related cases of varicella decreased from 1 107 (35 349) in 2007 to 262 (6 884) in 2012 (Z=-2.40, P<0.001), then increased year by year to 1 318 (42 649) in 2019 (Z=2.58, P<0.001), with a significant decline since 2020. The varicella PHEE in China presents the seasonal characteristics,the peak is from April to June and from October to December, respectively. The sub-peak of varicella PHEE in eastern China generally appears 1-2 months earlier than in central and western China. Varicella PHEE reports are mainly distributed in eastern China, the attack rate is relatively high in western China, school-reported varicella PHEE was 88.26% of the total reports (10 099/11 443). The epidemic scale of varrcella PHEE typically range from 10 to 29 cases per year among the given outbreaks. The M (Q1, Q3) of average number of cases, average duration, and average reporting interval of PHEE were 23 (16,35), 20 (14, 26) days, and 9 (5,19) days, respectively, and the reporting interval was positively correlated with the duration (r=0.854, P<0.001). Conclusions: The varicella PHEE in China from 2006 to 2021 has not been effectively controlled. Schools are the key places to prevent and control varicella PHEE. Improving the sensitivity of varicella PHEE monitoring, strengthening the timely disposal of varicella epidemic, and promoting varicella vaccination are effective measures to prevent and control varicella PHEE.

Inferior Petrosal Sinus Sampling Tumor Lateralization and the Surgical Treatment of Cushing Disease: A Meta-Analysis and Systematic Review

To determine whether accurate inferior petrosal sinus sampling (IPSS) tumor lateralization is associated with improved clinical outcomes following the surgical treatment of Cushing disease. The presented study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data regarding patient demographics, IPSS tumor lateralization, and postoperative endocrinologic outcomes were abstracted and pooled with random effects meta-analysis models. Additional meta-regression models were used to examine the association between the accuracy of IPSS tumor lateralization and postoperative outcomes (recurrence/persistence or remission/cure). Statistical analyses were performed using the Comprehensive Meta-Analysis software (significance of P < 0.05). Seventeen eligible articles were identified, yielding data on 461 patients. Within average follow-up duration (∼59months), the rate of correct IPSS tumor lateralization was 69% [95% confidence interval: 61%, 76%], and the rate of postoperative remission/cure was 78% [67%, 86%]. Preoperative IPSS tumor lateralization was concordant with magnetic resonance imaging lateralization for 53% of patients [40%, 66%]. There was no significant association between the rate of correct IPSS tumor lateralization and postoperative remission/cure among study-level data (P= 0.735). Additionally, there was no association among subgroup analyses for studies using stimulatory agents during IPSS (corticotropin-releasing hormone or desmopressin, P= 0.635), nor among subgroup analyses for adult (P= 0.363) and pediatric (P= 0.931) patients. Limited data suggest that the rate of correct IPSS tumor lateralization may not be positively associated with postoperative remission or cure in patients with Cushing disease. These findings bring into question the utility of IPSS tumor lateralization in the context of preoperative planning and surgical approach rather than confirming a pituitary source.