Comparative Cross-sectional Study Research Articles

Volumetric differences in the temporomandibular joint in patients with condylar hyperplasia in active and passive state, SPECT/CT study.

Condylar hyperplasia (CH) is a progressive and deforming disease that modifies anatomy of the temporomandibular joint (TMJ) structures. This study aims to correlate the metabolic bone activity of the condyle measured by SPECT with the volumetry anatomic information from the condyle, fossa and joint space provided by CT images, in patients with CH in active and inactive forms. A cross-sectional comparative study was performed with a set of 116 images from healthy and diagnosed CH patients to compare volumetric measures of the TMJ. Images were acquired through a bone tissue mask using a three-dimensional DICOM reconstruction for SPECT/CT and CBCT images and the Threshold option for segmentation with standardized values for each tissue on the HU scale. there are differences (p<0.01), with greater condylar volume on the affected side in patients with active CH compared to passive CH. The volume of the glenoid cavity shows no differences in either form of CH (p>0.05), however, there were differences for the volume of the joint space on the affected right side of hemimandibular elongation (HE) in the active form. The volume of the mandibular condyle on the affected side in CH cases were larger in HE cases in active and inactive form (p<0.01) compared to healthy patients. Similar results were presented for the glenoid cavity and joint space. Volumetric anatomical evaluation of TMJ structures, as well as information on condylar metabolic activity, can be obtained from SPECT/CT. The study shows a greater condylar volume on the affected side of the CH compared to the contralateral side, but there are more significant differences in the active than in the inactive form.

Evaluation of ophthalmic vascular and neuroretinal alterations in fibromyalgia syndrome: a cross-sectional comparative study.

Fibromyalgia syndrome (FMS) is a prevalent rheumatic disorder, and its pathogenesis includes genetic, neuroendocrine, and autonomic abnormalities, which may impact ocular structures. The aim was to conduct a comparative analysis of the ophthalmic vasculature and the retinal nerve fiber layer (RNFL) thickness between FMS and control groups using optical coherence tomography (OCT) and OCT angiography (OCTA). This cross-sectional comparative study included 43 FMS patients and 40 healthy controls recruited from a tertiary education and research hospital between January 2024 and May 2024. All patients satisfied the 2016 American College of Rheumatology criteria for FMS and consented. OCT and OCTA were used to assess the RNFL thickness and the retinal microvasculature structure. The Fibromyalgia Impact Questionnaire (FIQ) was performed to evaluate disease severity. The study found significantly higher total retinal parafoveal thickness and foveal density in FMS patients (p = 0.017 and p = 0.044, respectively). Nevertheless, there were no significant differences among the groups concerning total retinal foveal thickness, foveal avascular zone characteristics, superficial and deep capillary plexus densities, choriocapillaris flow area, and outer retinal flow area values (p > 0.05). The RNFL thickness in all quadrants did not reveal significant differences between the groups (p > 0.05). Furthermore, there was no significant correlation between FIQ scores and OCTA parameters or RNFL thickness values (p > 0.05). The study revealed slight differences in retinal parafoveal thickness and foveal density in FMS patients, but no substantial vascular or neurodegenerative alterations were observed compared to healthy controls. These data indicate that FMS may not substantially affect ocular structures, contrary to earlier hypotheses.

Metabolic syndrome and associated factors among H. pylori-infected and negative controls in Northeast Ethiopia: a comparative cross-sectional study

BackgroundThe prevalence of metabolic syndrome (MetS) in patients infected with Helicobacter pylori, and the factors associated with it are not well understood. This study evaluates MetS and its associated factors among both H pylori-positive and H pylori-negative individuals in Northeast Ethiopia.MethodsA cross-sectional study was conducted between 1 March 2022 to 30 May 2022. A semi-structured questionnaire was used to collect data on sociodemographic, behavioral, and clinical variables. A total of 228 subjects were randomly selected. Blood and stool samples were collected from each subject to measure fasting blood glucose and lipid profiles, and to identify H. pylori infection. Data were entered into Epi. Data 3.1 and analyzed using SPSS version 25. Logistic regression analysis and the Mann–Whitney U-test were performed to determine associated factors and compare median and interquartile ranges.ResultsOf the 228 participants, 114 were H. pylori positive, and 114 were H. pylori negative. Participants (50.9% female) ranged in age from 18 years to 63 years, with a median age of 31 (IQR, 22, 40) years. The overall prevalence of MetS among the participants was 23.2%. We found a statistically significant association between MetS and fasting blood glucose level (AOR, 15.965; 95% CI, 7.605–33.515, p&amp;lt;0.001). Furthermore, there was a statistically significant difference in the median serum levels of low-density lipoprotein cholesterol (p&amp;lt;0.001), triglycerides (p=0.036), systolic blood pressure (&amp;lt;0.001), and total cholesterol (p&amp;lt;0.001) between H. pylori-positive and H. pylori-negative participants.ConclusionMetS was prevalent among study participants. There was also a statistically significant association between fasting blood sugar and MetS. In addition, systolic blood pressure, total cholesterol, triglycerides, and low-density lipoprotein levels were significantly different between H. pylori-positive and H. pylori-negative individuals.

Effectiveness of community-based interventions for prevention and control of hypertension in sub-Saharan Africa: A systematic review.

Hypertension poses a significant public health challenge in sub-Saharan Africa due to various risk factors. Community-based intervention for prevention and control of hypertension is an effective strategy to minimize the negative health outcomes. However, comprehensive systematic review evidence to inform effective community-based interventions for prevention and control of hypertension in low resource settings is lacking. This study aimed to synthesize the effectiveness of community-based interventions on prevention and control of hypertension in sub-Saharan Africa. A comprehensive search for studies was carried out on PubMed, CINAHL, Web of Science Core Collection, Embase, Scopus, and Google scholar databases. The result of the review was reported according to PRISMA guidelines. Studies published in English language were included. Two independent reviewers conducted critical appraisal of included studies and extracted the data using predefined excel sheet. Experimental, quasi experimental, cohort and analytical cross-sectional studies conducted on adults who have received community-based interventions for prevention and controls of hypertension in sub-Saharan Africa were included. In this systematic review, a total of eight studies were included, comprising of two interventional studies, two quasi-experimental studies, three cohort studies, and one comparative cross-sectional study. The interventions included health education, health promotion, home-based screening and diagnosis, as well as referral and treatment of hypertensive patients. The sample sizes ranged from 236 to 13,412 in the intervention group and 346 to 6,398 in the control group. This systematic review shows the effect of community-based interventions on reduction of systolic and diastolic blood pressure. However, the existing evidence is inconsistence and not strong enough to synthesize the effect of community-based interventions for the prevention and control of hypertension in sub-Saharan Africa. Hence, further primary studies need on the effect of community-based interventions for the prevention and control of hypertension in sub-Saharan Africa. Systematic review registration number: PROSPERO CRD42022342823.

Retinal changes in anemia - A comparative cross sectional study using SD-OCT

Retinal changes in anemia - A comparative cross sectional study using SD-OCT

Assessment of heat stress contributing factors in the indoor environment among vulnerable populations in Klang Valley using principal component analysis (PCA)

Rising global temperatures can lead to heat waves, which in turn can pose health risks to the community. However, a notable gap remains in highlighting the primary contributing factors that amplify heat-health risk among vulnerable populations. This study aims to evaluate the precedence of heat stress contributing factors in urban and rural vulnerable populations living in hot and humid tropical regions. A comparative cross-sectional study was conducted, involving 108 respondents from urban and rural areas in Klang Valley, Malaysia, using a face-to-face interview and a validated questionnaire. Data was analyzed using the principal component analysis, categorizing factors into exposure, sensitivity, and adaptive capacity indicators. In urban areas, five principal components (PCs) explained 64.3% of variability, with primary factors being sensitivity (health morbidity, medicine intake, increased age), adaptive capacity (outdoor occupation type, lack of ceiling, longer residency duration), and exposure (lower ceiling height, increased building age). In rural, five PCs explained 71.5% of variability, with primary factors being exposure (lack of ceiling, high thermal conductivity roof material, increased building age, shorter residency duration), sensitivity (health morbidity, medicine intake, increased age), and adaptive capacity (female, non-smoking, higher BMI). The order of heat-health vulnerability indicators was sensitivity > adaptive capacity > exposure for urban areas, and exposure > sensitivity > adaptive capacity for rural areas. This study demonstrated a different pattern of leading contributors to heat stress between urban and rural vulnerable populations.

Ultrasonographic characteristics of myogenous temporomandibular disorders: A scoping review.

To identify the available evidence on the ultrasonographic characteristics of masticatory muscles in subjects with myogenous TMD, as well as the potential use of ultrasonography as a diagnostic and treatment assessment outcomes tool. An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'ultrasonography', 'ultrasound', 'masseter', 'temporal', 'masticatory muscles', 'temporomandibular disorders', 'temporomandibular joint disorders'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria. Thirteen articles were included for analysis: one comparative cross-sectional study, five case-control studies, six clinical trials and one randomised clinical trial. Main ultrasonographic characteristic assessed were local cross-sectional dimension and intramuscular ultrasonographic appearance. Retrieved studies reported the use ultrasonography for diagnosis or treatment assessment purposes showing heterogeneous results. For diagnosis purposes, the results of local cross-sectional dimension are not consistent; therefore, its diagnostic value for myogenous TMD diagnosis is weak. However, more homogeneous results were observed for intramuscular ultrasonographic appearance showing a higher prevalence of type-II pattern in myogenous TMD subjects than non-TMD subjects. On the other hand, for treatment assessment purposes, muscles were observed thinner after treatment compared to pre-treatment. Also, results of intramuscular ultrasonographic appearance show disappearance or reduction of anechoic areas, higher prevalence of type-II pattern and significant distinction of echogenic bands were observed after treating TMD subjects. Ultrasonography cannot be considered as a diagnostic instrument, but maybe as a complementary tool for treatment assessment of myogenous TMD subjects, even though future research is required to confirm its utility.

Disparities in satisfaction among insured and uninsured adult outpatient department service users in Southern Ethiopia, 2022: a comparative cross-sectional study

BackgroundPatient satisfaction is a critical measure of the quality of healthcare services provided by healthcare facilities. However, very few studies, particularly in Ethiopia, which includes the study area, have specifically examined these discrepancies among people who use outpatient care. In this study, satisfaction levels and associated factors were compared between insured and uninsured patients receiving outpatient services at public health institutions in Hadiya Zone, southern Ethiopia.MethodsA facility-based comparative cross-sectional study design was employed on 630 patients using multistage and systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire. Results of the analysis were presented in text, tables, and graphs as appropriate. Multivariable logistic regression was used to predict associations between predictors and the outcome variable. Statistical significance was declared at p-value < 0.05.ResultsOverall, 344(55.48%) patients were satisfied with the service they received, of which 206(65.8%) out of 313 with a 95% CI [60.7–71.2%] were insured and 138(44.95%) out of 307 with a 95% CI [39.4–5.1%] were uninsured. Among insured patients, factors associated with higher satisfaction included having a family size less than five members [AOR = 3.3, 95% CI; 1.5, 7.4], perceived fair waiting time to be seen[AOR = 2.35, 95% CI; 1.02, 5.5], perceived short waiting time to be seen[AOR = 8.12, 95% CI; 1.6, 41.3], having all ordered laboratory tests available within the facility[AOR = 7.89, 95% CI; 3.5, 17.5], having some ordered laboratory tests within the facility[AOR = 2.97, 95% CI; 1.25, 7.01] having all prescribed medications available within the facility[AOR = 16.11, 95% CI; 6.25, 41.5], having some prescribed medications available within the facility[AOR = 13.11, 95% CI; 4.7, 36.4]. Among non-insured patients, factors associated with higher satisfaction included urban residency, a fair and short perceived time to be seen, having ordered laboratory tests within the facility, and having prescribed drugs within the facility.ConclusionThis study identified lower overall satisfaction, particularly among uninsured patients. Enrollment in the CBHI program significantly impacted satisfaction, with both groups reporting lower levels compared to enrollment periods. Access to essential services, wait times, and socio-demographic factors identified as associated factors with patient satisfaction regardless of insurance status.

Dietary inflammation, sleep and mental health in the United Kingdom and Japan: A comparative cross-sectional study.

Diet has been repeatedly shown to affect mental and sleep health outcomes. However, it is well known that there are cross-cultural differences in dietary practices as well as the prevalence of mental and sleep health outcomes. Given that the dietary inflammatory potential of diets has been linked to mental and sleep health outcomes, in the current study we sought to assess the inflammatory status of habitual diets and examine its relationship with mental and sleep health outcomes in both the United Kingdom and Japan. Our aim was to determine if the associations between the dietary inflammation index (DII) score and these health outcomes could elucidate any potential cross-cultural differences in health. Online survey data was collected from 602 participants (aged 18-40 years) in the United Kingdom (n = 288) and Japan (n = 314). Participants self-reported their dietary intakes, as well as current mental health and sleep patterns. The DII score was calculated (score range - 2.79 to 3.49) We found that although participants in the United Kingdom reported better overall mental wellbeing, participants in Japan reported less severe depression, anxiety and stress and better subjective sleep quality, less sleep disturbances and daytime dysfunction, despite sleeping shorter, and a better adherence to an anti-inflammatory diet. Moreover, across the United Kingdom and Japan, adherence to more anti-inflammatory diets predicted higher levels of subjective sleep quality, fewer sleep disturbances, less use of sleep medicine and less daytime dysfunction. In conclusion, there are several differences between mental and sleep health outcomes in the United Kingdom and Japan, which could be attributable to the inflammatory potential of respective regional diets. Future studies are warranted to examine the mental and sleep health benefits of adhering to anti-inflammatory traditional Japanese diets in clinical and subclinical cohorts.

Evaluation of immunophenotypic alterations of peripheral blood lymphocytes and their sub-sets in uncomplicated P. Falciparum infection

BackgroundMalaria is a life-threatening parasitic disease typically transmitted through the bite of an infected Anopheles mosquito. There is ample evidence showing the potential of malaria infection to affect the counts of lymphocyte subpopulations in the peripheral blood, but the extent of alteration might not be consistent in all geographical locations, due to several local factors. Although Ghana is among the malaria-endemic countries, there is currently no available data on the level of alterations that occur in the counts of lymphocyte subpopulations during P. falciparum malaria infection among adults.AimThe study was to determine the immunophenotypic alterations in the level of peripheral blood lymphocytes and their subsets in adults with uncomplicated P. falciparum malaria infection and apparently healthy participants.MethodsThe study was a cross-sectional comparative study conducted in two municipalities of the Volta region of Ghana. Blood samples were collected from study participants and taken through serology (P. falciparum/Pan Rapid Diagnostic Kits), microscopy (Thick and thin blood films) and Haematological (Flow cytometric and Full blood count) analysis.ResultsA total of 414 participants, comprising 214 patients with malaria and 200 apparently healthy individuals (controls) were recruited into this study. Parasite density of the malaria patients ranged from 75/µL to 84,364/µL, with a mean of 3,520/µL. It was also observed that the total lymphocytes slightly decreased in the P. falciparum-infected individuals (Mean ± SD: 2.08 ± 4.93 × 109/L) compared to the control group (Mean ± SD: 2.47 ± 0.80 × 109/L). Again, there was a significant moderate positive correlation between parasite density and haematocrit levels (r = 0.321, p < 0.001). Apart from CD45 + T-cells, more people in the control group had normal values for the lymphocyte subsets measured compared to the malaria patients.ConclusionsFrom the results obtained, there was high parasite density among the malaria patients suggestive of high intensity of infection in the case group. The malaria patients again showed considerable haematological alterations in lymphocyte sub-sets and the parasite density appeared to be strongly associated with CD4 + T-cell reduction. Also, the parasite density significantly associated with decreasing haematocrit levels. This indicates that lymphocyte subset enumeration can be used to effectively support malaria diagnosis.

Gut Microbiota and Clinical Manifestations in Thai Pediatric Patients with Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder potentially linked to gut dysbiosis. This comparative cross-sectional study profiled the gut microbiota in 24 treatment-naïve Thai children diagnosed with ADHD and 24 healthy ones matched by age and gender (median age: 7 years). Fecal microbial compositions were genetically analyzed using 16s rRNA gene amplicon sequencing. The study findings indicated no statistically significant differences in microbial diversity between groups, although Firmicutes and Actinobacteria appeared dominant in both groups. Moreover, ADHD patients exhibited enrichment in Alloprevotella, CAG-352, Succinivibrio, and Acidaminococcus genera, while healthy controls had higher levels of Megamonas, Enterobacter, Eubacterium hallii, and Negativibacillus genera. Spearman correlation analysis demonstrated a significant positive association between CAG-352 and inattention and hyperactivity/impulsivity scores, whereas the Eubacterium hallii group and Megamonas exhibited negative correlations with these symptomatology domains. Beta-carotene intake was associated with the Eubacterium hallii group and Succinivibrio: likewise, vitamin B2 intake was associated with Alloprevotella. Additional research should aim to elucidate the underlying mechanisms influencing clinical biomarkers that signify alterations in specific gut microbiome profiles linked to ADHD.

Comparison of Postoperative Wound Infection in Controlled Diabetic and Non-Diabetic Patients in Elective Operations

Background: Diabetes mellitus (DM) is a systemic disease that alters the metabolism of blood sugar. Poorly controlled diabetes or hyperglycaemia is associated with an array of micro-vascular, macro-vascular, and neuropathic complications. There is a widely held belief that infections are usually more frequent and severe in diabetic patients. Diabetes prevalence is increasing in the developed &amp; developing countries, and the appropriate management of patients with diabetes has become increasingly important for the prevention of hospital-acquired infections. Postoperative wound infection continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques. There is little information regarding postoperative wound infection in controlled diabetic patients undergoing elective operation. Objectives: The aim of our study was to evaluate the postoperative wound infection in controlled diabetic and non-diabetic patients in elective operations. Materials &amp; method: This cross sectional comparative study was conducted in Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of October 2011 to March 2012. A total seventy three patients with controlled diabetics and seventy three non-diabetics were selected. Inclusion criteria were patients undergoing clean and cleancontaminated elective operations. Un-controlled diabetes, patient undergoing contaminated and dirty operation, patient with tuberculosis, jaundice, uraemia, having cortico-steroids /chemoradiation and operated for malignancies were excluded. After preoperative preparation specific operation was done. All patients were followed up for 30 days of post operative period for development of any postoperative wound infection. All information recorded in data collection sheet. Data was processed and analysed with the help of computer program SPSS-16 and Microsoft excel. Quantitative data expressed as mean and standard deviation and qualitative data as frequency and percentage. Result: The patients of diabetic group [31 male, 42 female; mean age, 44.5 (SD 8.2) years] and non-diabetic group [40 male, 33 female; mean age, 43.1 (SD 9.4) years] were similar in age and sex (p&gt;0.05 each). The rate of postoperative wound infection after elective abdominal surgery was 7.5% [in controlled diabetic group was 12.3% and that of non-diabetic group was 2.7% (p&lt;0.05)] and the patients of diabetic group were 5.0 times more likely to develop wound infection as compared to that of non-diabetic group (OR=4.992; 95% of CI=1.040–23.971) in clean and clean contaminated elective abdominal surgery. The length of postoperative hospital stay was significantly more in diabetic group than that of non-diabetic group (8.2 (SD ± 2.9) vs 6.8 (SD ± 3.2) days; p&lt;0.01). Conclusion: Postoperative wound infection was higher in controlled diabetic patients than that of non-diabetic. These results support the consideration of diabetes as an independent risk factor for SSIs after elective surgery. Continued efforts are needed to improve surgical outcomes for diabetic patients. J Dhaka Med Coll. 2022; 31(2) : 226-231

Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study.

The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361.

Literacy and Attitude Toward Suicide Among Doctors and Nurses: A Cross-Sectional Comparative Study

Literacy and Attitude Toward Suicide Among Doctors and Nurses: A Cross-Sectional Comparative Study

Low thiamine status in adults following low-carbohydrate / ketogenic diets: a cross-sectional comparative study of micronutrient intake and status.

Low-carbohydrate diets (LCD) are popular for weight loss but lack evidence about micronutrient sufficiency in real-life use. This study assessed the intake and biochemical status of selected micronutrients in people voluntarily following LCDs. A cross-sectional study was conducted (2018-20) among 98 adults recruited as self-reporting either LCD (n = 49) or diets not restricting carbohydrates (controls; n = 49). Diets were assessed using the 130-item EPIC-Norfolk food-frequency questionnaire. Red-blood-cell thiamine diphosphate (TDP) was measured for thiamine status using HPLC. Plasma magnesium, zinc, copper, and selenium were measured using inductively coupled plasma mass spectrometry. Between-group biomarker comparisons were conducted using ANCOVA and adjusted for age, sex, body mass index (BMI), and diabetes status. LCD-followers (26% male, median age 36 years, median BMI 24.2 kg/m2) reported adhering to LCDs for a median duration of 9 months (IQR 4-36). The most followed LCD type was 'their own variations of LCD' (30%), followed by ketogenic (23%), 'palaeolithic' (15%), and Atkins diets (8%). Among controls, 41% were male (median age 27 years, median BMI 23kg/m2). Median macronutrient intakes for LCD vs control groups were carbohydrate 16%Energy (E) vs. 50%E; protein 25%E vs. 19%E; and fat 55%E vs 34%E (saturated fat 18%E vs. 11%E). Two-thirds of LCD followers (32/49) and half of the controls (24/49) reported some use of dietary supplements (p = 0.19). Among LCD-followers, assessing from food data only, 21 (43%) failed to meet the reference nutrient intake (RNI) for thiamine (vs.14% controls, p = 0.002). When thiamine from supplementation (single- or multivitamin) was included, there appeared to be no difference in thiamine intake between groups. Still, red-blood-cell TDP was lower in LCD-followers than controls (407 ± 91 vs. 633 ± 234 ng/gHb, p < 0.001). Three LCD-followers were thiamine-deficient (RBC thiamine < 275 ng/gHb) vs. one control. There were no significant differences in dietary intakes or plasma concentrations of magnesium, zinc, copper, and selenium between groups. Following LCDs is associated with lower thiamine intake and TDP status than diets without carbohydrate restriction, incompletely corrected by supplement use. These data, coupled with a lack of RCT evidence on body weight control, do not support recommending LCDs for weight management without appropriate guidance and diet supplementation.

The effects of individual and cultural factors on digital inclusion in European countries: a two-level regression analysis

PurposeWith digitisation, a new kind of inequality has emerged in society between people and groups of people. A lack of digital inclusion creates challenges for the economic and social development of society and citizen participation. This study analyses how the country-level cultural factors defined by Hofstede are associated with citizens' digital skills and internet usage and how they moderate the effects of age, gender, educational level and income level.Design/methodology/approachThis comparative cross-sectional study examines digital inclusion in 22 European countries. Data from the European Social Survey (N = 37,602) are analysed using a two-level regression analysis.FindingsThe study found significant effects of demographic and socio-economic factors and country-level indulgence on digital skills and internet usage. In addition, the study shows that a high value on the indulgence index moderates the negative effect of age.Originality/valueThe digital divide has been studied widely with regard to individual-level influencing factors and international comparisons. The significance of Hofstede’s cultural dimensions in terms of digitisation and digital divides has also been confirmed in previous studies. However, there is a lack of analysis combining the effects of country-level culture and individual-level demographic and socio-economic factors on citizens' digital skills and internet usage. Generally, the research emphasises the significance of national culture in digital inclusion and especially in supporting the digital inclusion of older adults.

Linear Measurement of Females' Vocal Fold Across Different Ages

Abstract Background One of the most complex oragns of the human body is the larynx so Understanding its morphology is an important step toward understanding the detailed laryngeal anatomy, and physiology. Different studies have described the linear measurements of the larynx in different measuring methods. but no studies have been structured to describe vocal fold length in vivo in females at different stages of their lives.The vocal instrument is comprised of the vibratory body, the respiratory power source and the oropharyngeal resonating chambers. Voice is characterized by its intensity, frequency, and harmonics. The harmonics are hormonally dependent. Aim of the Work The aim of this study is to screen the membranous vocal fold length in different ages throughout females’ life and if it is affected by hormonal changes in their lives or not. Study Design a comparative cross-sectional study. Patients and Methods This comparative cross-sectional study was carried out on 120 Egyptian Arabic speaking apparently healthy females at the outpatient clinic of the Units of Phoniatrics, ENT Department of both Ain Shams University Hospitals and Zagazig University Hospitals. Results It was obvious that female’s larynx is affected by age and sex hormones that is reflected on the laryngeal structure and function. Although the results showed non significant relation between the length of the membranous part to aging this may be due to small sample size that could not reflect that difference. Conclusion The vocal imprint is characteristic to each individual. It reveals personality and translates emotions. The voice evolves with age. It bears both the scars of life, as well as its joys and pleasures. Nevertheless, the human voice remains intangible and a fertile field for future research in the cycle of life.

Timely initiation of complementary feeding and associated factors among mothers having children aged 6 to 24 months in North-West Ethiopia: a comparative cross-sectional study

BackgroundThe timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory.ObjectiveTo compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6–24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021.MethodsA community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant.ResultsThe prevalence of timely initiation of complementary feeding among urban and rural mothers was 69.8% with (95% CI: 66%, 74%) and 51.9% with (95% CI: 48- 56%) respectively. Urban residence [AOR = 1.39, 95% CI: (1.02–1.94)], had antenatal care visits [AOR = 0.24 (95%CI: (0.13, 0.44)], had post natal care checkups [AOR = 0.44, 95%CI: (0. 27- 0.72)] and being a governmental employee [AOR = 2.82; 95% CI: (1.91–6.1)] were factors associated with timely initiation of complementary feeding among urban mothers. Whereas in rural settings: institutional delivery [(AOR = 2.21, CI: 1.35–3.65)], post natal care checkups [(AOR = 0.53, CI: (0.36–0.77)] being daily laborer [AOR = 3.47; 95% CI: (1.78–6.75)] were associated with timely initiation of complementary feeding.ConclusionThe prevalence of timely introduction of complementary feeding in children aged 6–24 months is still low in the study areas. There was also disparity between urban and rural mothers in which urban mothers practiced better.

Sleep Disorders Linked to Quality of Life in a Sample of Egyptian Policemen a Comparative Study between Shift Workers and Non-Shift Workers

Abstract Background Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. Aim and Objectives To compare quality of life, occupational stress level, between shift &amp;non shift workers policemen working at El-Agouza Police Hospital. Subjects and Methods This was a cross-sectional comparative study conducted on 64 policemen working in 6 different Police department recruited from sleep clinic neuropsychiatry department at EL-Agouza Police Hospital serving police officers in El-Nile street, Giza, Egypt. Result Occurrence of sleep disorders was significantly higher in the shift workers compared to the non-shift worker group (p &amp;lt; 0.01). Conclusion In the current population-based study of police officers, poor sleep quality was more prevalent among officers who were engaged in shift work. The findings are consistent with prior evidence that night shift carried the greatest risk of poor sleep quality because night-shift officers have to make some adaptations that compensate for their natural circadian patterns.

Elevation in Liver Enzymes as a Predictor for COVID-19 Severity

Abstract Background The coronavirus disease 2019 (COVID-19) started in December of 2019 as a cluster of pneumonia cases of unclear etiology in Wuhan city of Hubei province in China. Later, it was found to be caused by a coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease rapidly spread throughout the world, becoming a pandemic, and as of April, 2022, there were more than 500 million cases worldwide with more than 6 million deaths. It is postulated that the virus enters the human body by binding to the angiotensin-converting enzyme receptor-2 (ACE-2) with the help of spike protein on its cell membrane. Aim of the Work To compare the serum liver chemistries such as hepatic transaminases to evaluate whether they can predict severity and mortality in COVID-19. Patients and Methods A comparative cross-sectional study for 6 months in Ain-Shams University hospitals, we studied 100 hospitalized patients with confirmed COVID-19 by RT- PCR for SARS- CoV-2. They included 70 patients with non-severe COVID-19 and 30 patients with severe COVID- 19 on hospital admission. This classification was based on the quick COVID-19 severity index (qCSI) and CT- severity index. Results The results of our study showed that levels of inflammatory markers such as CRP, serum ferritin, d-dimer, and procalcitonin were significantly higher in the severe group when compared to the non-severe group. This could be an indicator of a more intense inflammatory state in patients with severe COVID- 19 admitted to ICU. Our study showed that 40% of the severe group admitted to the ICU passed away. In our study, the median levels for ALT, AST at admission were 51 and 46 U/L, respectively, which are considered higher than the upper limit of normal levels. Our study showed that during hospitalization, the group of patients with severe COVID-19 who were admitted to ICU had significantly higher prevalence of abnormal ALT levels when compared to the non- severe group (86% versus 32%, respectively). Conclusion Our study showed that patients with severe COVID-19 have significantly higher levels of AST and ALT and that, on admission, patients with abnormal ALT and AST levels have significantly higher odds for developing severe COVID-19 compared to patients with normal levels. We confirm the importance of monitoring liver enzymes in hospitalized patients with COVID-19 as patients with abnormally elevated AST and ALT are more expected to progress to severe COVID- 19 which have prognostic implications in the COVID-19 disease course.