Factor In Recovery Research Articles

Flow-mediated dilation as a marker of endothelial dysfunction in pulmonary diseases: A narrative review

The endothelium is an active and crucial component of vessels and produces several key regulatory factors for the homeostasis of the entire organism. Endothelial function can be investigated invasively or non-invasively, both in the coronary and peripheral circulation. A widely accepted method for the assessment of endothelial function is measurement of flow-mediated dilation (FMD), which evaluates the vascular response to changes in blood flow.In this current review, we describe FMD applications in the clinical setting of different respiratory diseases: acute SARS-COV2 infection, pulmonary embolism; post-acute SARS-COV2 infection, Chronic Obstructive Pulmonary Disease, Obstructive Sleep Apneas Syndrome, Pulmonary Hypertension, Interstitial Lung Diseases.Emerging evidence shows that FMD might be an effective tool to assess the cardiovascular risk in patients suffering from the undermentioned respiratory diseases as well as an independent predictive factor of disease severity and/or recovery.

How to predict the outcome of primary brainstem hemorrhage: Six-year results of a single-center retrospective analysis.

Primary brainstem hemorrhage (PBH) is one of the most fatal intracranial hemorrhages, evaluating the prognosis in the early stage is vital for appropriate therapeutic planning. Our study aimed to identify risk factors for 30-day mortality and 90-day functional recovery of PBH. Data from 63 patients with PBH admitted to Beijing Chaoyang Hospital between 2016 and 2022 were retrieved for this study. We grouped the patients according to 30-day survival or 90-day functional recovery. Independent risk factors of 30-day mortality and 90-day functional recovery were identified by univariate and multivariate logistic regression analyses. 31 patients (49.2%) died within 30 days and 22 patients (34.9%) achieved better functional recovery. By multivariate analysis, Glasgow coma scale <9 on admission and tachycardia were significantly associated with 30-day mortality, while the hematoma volume >5 mL was an independent risk factor for 90-day functional recovery. Initial level of consciousness, tachycardia, massive hematoma were risk factors for prognosis, which must be seriously evaluated for therapeutic planning.

Using the Recovery Capital Model to Explore Barriers to and Facilitators of Recovery in Individuals with Substance Use Disorder, Psychiatric Comorbidity and Mild-to-Borderline Intellectual Disability: A Case Series.

Recovery capital (RC) encompasses the wide range of resources individuals can employ to recover from Substance Use Disorder (SUD). It consists of five subdomains: human, social, cultural, financial, and community RC. Negative recovery capital (NRC) represents the obstacles to recovery. Research on (N)RC in complex multimorbid populations is scarce. This study offers an initial exploration of the viability of (N)RC in three individuals with SUD, psychiatric comorbidities, and an intellectual disability (a triple diagnosis) in inpatient addiction treatment. We collected case file data, ranked recovery goals, and conducted follow-up interviews. The data were subjected to template analysis, using (N)RC domains as codes. All domains were prevalent and relevant, showing dynamic and reciprocal effects, influenced by critical life events acting as catalysts. Notably, during treatment, patients prioritized individual skill development despite challenges in other domains. RC emerges as a valuable concept for mapping recovery barriers and facilitators in individuals with a triple diagnosis, serving as an alternative to the medical model and complementing the biopsychosocial model. It provides a systematic framework to assess critical factors for recovery in complex cases and accordingly align interventions. Future studies should explore the intersections of NRC domains and the dynamic nature of (N)RC to enhance the understanding of the challenges faced by individuals with a triple diagnosis.

Clinical characteristics of abruptly increased paediatric patients with Omicron BF.7 or BA.5.2 in Beijing

BackgroundThe coronavirus disease 2019 outbreak has hit Beijing since mid-Nov, 2022, with soaring growth of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. Therefore, it is vital to determine the clinical manifestations of epidemic SARS-CoV-2 strains in paediatric patients.MethodsIn this study, nucleic acid tests (NATs) for SARS-CoV-2 were performed in paediatric outpatients with symptoms of acute respiratory tract infection during 18 Nov–6 Dec, 2022. Half of the outpatients positive for SARS-CoV-2 were randomly selected to screen for other respiratory pathogens, whereas those with low cycle threshold values in SARS-CoV-2 NATs were amplified and sequenced to determine the SARS-CoV-2 variants. Finally, children positive for SARS-CoV-2 with clinical information in detail were enrolled in a follow-up study to identify potential factors significantly associated with long recovery.ResultsAmong 9625 paediatric outpatients tested for nucleic acid of SARS-CoV-2, 733 (7.62%, 733/9625) were identified as SARS-CoV-2 NAT positive, with only three (0.82%, 3/366) co-infected with other pathogens among 366 randomly selected patients, and 71 (62.83%) determined as Omicron subvariant BF.7 and 42 (37.22%) as BA.5.2 among 113 successfully sequenced. Among the 681 patients with complete clinical information, fever was the most common symptom (96.8%). In a follow-up study of 592 patients, 46.96% became asymptomatic on the third day and 65.71% on the fifth day. Only 1.7% of infected children experienced febrile seizures. Combined with abnormal C-reactive protein, a higher percentage of antibiotics administration was observed. More co-living members and longer duration of first symptoms served as independent risk factors for long-term recovery, especially in children vaccinated for SARS-CoV-2.ConclusionsBF.7 and BA.5.2 were the dominate Omicron subvariants and caused milder infections during the SARS-CoV-2 outbreak in Beijing. The number of co-living members and duration of first symptoms were independent risk factors for long-term recovery.

Enhancing resilience against geological hazards and soil erosion through sustainable vegetation management: A case study in Shaanxi Province

As an important component of terrestrial ecosystems, vegetation performs a necessary function in linking the atmosphere, hydrosphere, biosphere as well as soil sphere. The response of vegetation to its driving factors has been a hot research issue that needs to be further explored. Here, the temporal and spatial changes in vegetation cover in Shaanxi Province from 2000 to 2020 was characterized, and the responses to topographic elements, climate factors, geological hazards, and human activities was addressed. The outcomes proved that the average annual vegetation coverage in Shaanxi Province displayed a slight upward trend with a growing rate of 0.0545/10a. Specifically, enhanced vegetation index (EVI) increased significantly in most parts of the study area, while EVI decreased significantly in the border areas of Xi'an and Xianyang. There are differences in the effects of the driving factors on vegetation change during the study period. According to correlation analysis, vegetation was positively associated with temperature and negatively associated with precipitation. In addition, when the elevation was under 2500 m, EVI increased with elevation, while when the elevation used to be above 2500 m, EVI decreased with elevation. Moreover, geological disasters and soil erosion are the major driving factors in the reduction of vegetation cover. Human activities and national policies are the main driving factors for vegetation recovery in the study area. The results of the study are of great significance for ecosystem monitoring and provide a scientific basis for ecosystem restoration.

Older Age, Poor Preoperative Quadriceps Muscle Strength, and Residual Pain as Risk Factors for Poor Quadriceps Muscle Strength Recovery at 1 Year After ACL Reconstruction: A TMDU MAKS Study of 402 Patients.

Poor postoperative quadriceps muscle strength recovery after anterior cruciate ligament reconstruction (ACLR) leads to delayed return to sports and lower patient satisfaction. The purpose of this study was to examine factors that affect quadriceps muscle strength 1 year after ACLR. It was hypothesized that older age, poor preoperative quadriceps muscle strength, and residual pain would be risk factors for poor quadriceps muscle strength recovery. Case-control study; Level of evidence, 3. Included were patients from multiple institutions who underwent primary ACLR using autologous hamstring tendon grafts between August 1, 2013, and March 31, 2018, and who had at least 1 year of follow-up data. Patients with past ligamentous injuries in the affected knee, previous injuries or operations in the contralateral knee, accompanying ligament injuries of grade 2 or 3, or inflammatory or other types of osteoarthritis were excluded. Patients were categorized as having muscle strength ≥80% (good strength recovery) or <80% (poor strength recovery) compared with the contralateral leg at 1 year postoperatively. Multivariate logistic regression analysis was performed to investigate the factors influencing postoperative quadriceps muscle strength. In addition, a categorical analysis was conducted based on factors extracted by the multivariate logistic regression analysis. A total of 402 patients were included. Multivariate logistic regression analysis revealed that age at surgery (P = .020), preoperative quadriceps muscle strength (P = .006), and postoperative Knee injury and Osteoarthritis Outcome Score (KOOS)-Pain score (P = .002) were significantly associated with quadriceps muscle strength at 1 year postoperatively. The odds of poor muscle strength recovery according to categorical analysis were 5.0-fold higher for patients aged >40 versus ≤20 years, 4.2-fold higher for those with preoperative quadriceps muscle index <60% versus ≥80%, and 7.7-fold higher for those with a postoperative KOOS-Pain score of <85 versus 100. Older age, poor preoperative quadriceps muscle strength, and low postoperative KOOS-Pain score were risk factors for poor quadriceps muscle strength 1 year after primary ACLR. Surgical indications, including age, preoperative active rehabilitation, and pain control, should be considered for optimization of postoperative quadriceps muscle strength recovery.

Fear of sin and fear of God: Scrupulosity predicts women's daily experiences of mental contamination following sexual trauma.

Mental contamination refers to feelings of dirtiness in response to thoughts, images, or memories. Mental contamination is frequently reported after sexual trauma and is associated with symptoms of posttraumatic stress disorder (PTSD). Differences in individuals' views about morality and purity may influence the severity of mental contamination, though this has been studied primarily outside of samples assessed for trauma and/or PTSD. The present study addressed this gap by investigating scrupulosity as a prospective predictor of daily sexual trauma-related mental contamination and PTSD symptoms. Participants included 40 adult women with a history of sexual trauma and current sexual trauma-related mental contamination who completed baseline diagnostic interviews and questionnaires followed by two assessments every day for 2 weeks. The results indicate that scrupulosity was positively correlated with PTSD symptom severity and sexual trauma-related mental contamination at baseline. Scrupulosity was also a prospective predictor of increased daily sexual trauma-related mental contamination, B = 0.19, SE = 0.07, p = .010, but not daily PTSD symptoms, B = -0.10, SE = .08, p = .198. The findings indicate that scrupulosity may be an important factor in understanding recovery from sexual assault.

Peripheral Parenteral Nutrition and Activities of Daily Living in Hospitalized Older Frail Patients.

Frail older adults require nursing care following hospitalization for acute illnesses. Frailty is reversible, and appropriate nutritional management and rehabilitation during hospitalization are essential. However, optimal nutritional management for patients who are unable to obtain adequate nutrition via oral intake has not been established. We aimed to determine whether peripheral parenteral nutrition (PPN) promotes the recovery of activities of daily living (ADLs) in frail older patients. This was a retrospective, observational cohort study conducted at the General Medicine Department of Aomori Prefectural Central Hospital in Aomori, Japan. The primary outcome was recovery of the Barthel index (BI) from the beginning of rehabilitation to discharge, and the secondary outcomes were the proportion of patients transferred for rehabilitation and the nutritional status. In total, 342 patients hospitalized during the period of April 2018 to January 2022 were included, of whom 127 (37.1%) received PPN and 215 (62.9%) did not. Contrary to our expectations, recovery of the BI was lower in the PPN group than that in the non-PPN group (12.2 (95% confidence interval (CI): 8.5-16.0) vs. 22.4 (18.8-23.0); p < 0.01). Multivariable analysis revealed PPN as an independent risk factor for poor BI recovery (mean difference = -7.3 (95% CI = -12.7 to -1.9)). Nutritional management through PPN for frail older adults may not improve physical activity.The nutritional management of frail patients with inadequate oral intake remains challenging.

Impact of Endolymphatic Hydrops and Semicircular Canal Dysfunction on the Incomplete Recovery of Acute Low-Frequency Sensorineural Hearing Loss.

The reasons for short-term, incomplete recovery of some acute low-frequency sensorineural hearing loss (ALFHL) are unclear. We investigated the impact of endolymphatic hydrops and semicircular canal dysfunction on the incomplete recovery of ALFHL. The impact of electrocochleography (EcochG), caloric test, video head impulse test (vHIT), cervical vestibular-evoked myogenic potential (cVEMP), and ocular vestibular-evoked myogenic potential (oVEMP) results on the incomplete recovery of 86 patients with ALFHL was analyzed. The correlation between a high abnormal rate of vestibular-evoked myogenic potential (VEMP) and aural fullness, dizziness, and level of hearing loss was also examined. Abnormal oVEMP with an odds ratio (OR) of 6.071 (P = .002) and EcochG with an OR of 5.919 (P = .005) were independent risk factors for incomplete recovery in ALFHL, but abnormal cVEMP, caloric test, and vHIT were not independent risk factors for ALFHL. There was no correlation between a high abnormal rate of VEMP and aural fullness, dizziness, or level of hearing loss in ALFHL. Abnormal oVEMP and EcochG values rather than caloric test and vHIT were risk factors for incomplete recovery of ALFHL, which may be related to the difficulty of successfully treating utricular and cochlear hydrops. High abnormal rate of VEMP was not correlated with hearing loss level, aural fullness, or dizziness in ALFHL. Abnormal oVEMP and EcochG values can indicate poor short-term prognosis of ALFHL.

Development Of Halal Value Chain As A Manifestation For Economy Recovery In Post Covid-19

The Covid-19 phenomenon that significantly affects the economic sector has forced all countries in the world to rise up and make recovery efforts. One of the efforts that is currently attracting attention is strengthening the halal industrial sector, which during the Covid-19 pandemic has been recognized for its success in maintaining economic stability. Halal Value Chain is a strategy used by the halal industry in an effort to recover the economy, the significance of the application of halal value chain in economic activities can give birth to a business model that can be an example for the halal industry and become a competitive advantage. This study aims to provide a comprehensive presentation on the dynamics of halal industry acceleration and halal value chain principles in the recovery of the economic sector after the Covid-19 pandemic. This research uses qualitative methods using a literature review approach from several studies. Based on research that has been carried out, it was found that the solutions offered by the halal industry through the halal value chain have proven to be one of the success factors in economic recovery after the Covid-19 pandemic, halal value chain is not just a concept that has been universally applied but is a need for the world community, because the application of the halal value chain ecosystem in the industrial sector is not only profit-oriented, however, the use of halal products and services aims to provide comfort, safety and certainty for the community.&#x0D; Keyword: Halal Value Chain, Halal Industry, Economy Recovery.

Prognostic factors for visual recovery after successful large macular hole surgery using the inverted flap technique

The goal of our study is to describe the functional results and preoperative factors predicting visual recovery after successful inverted flap technique and closure of large full-thickness macular holes (FTMH) and to evaluate the correlations between microstructural foveal changes and final visual acuity. Retrospective, descriptive, analytical study including 80eyes of 78patients with large FTMH; operated by inverted flap technique with successful closure of the macular hole after surgery. All eyes underwent a full preoperative ophthalmic examination and macular B-scan SD-OCT. We performed the classic inverted flap technique for all patients. Postoperatively, all patients were examined at 7days, 1, 3, 6, 9 and 12months after surgery. SD-OCT was performed for all patients on each follow-up. Preoperatively, best-corrected visual acuity (BCVA), FTMH size and basal hole diameter were the main outcome measures. Postoperatively, BCVA, macular thickness, integrity of the external limiting membrane (ELM) and ellipsoid zone (EZ) were recorded. Mean age was 62±8.42years with female predominance. Mean size of the FTMH was 692.59μm, and mean basal hole diameter was 1436.06μm. Mean BCVA improved from 1.06±0.491 LogMAR preoperatively to 0.52±0.32 at 9months following surgery (P<0.001). At 9months, the ELM was absent, partial or fully restored in 6.67, 10 and 83.33% respectively. The EZ was absent, partial or fully restored in 6.67, 33 and 63.33% respectively. ELM regeneration always preceded EZ regeneration at every point of follow-up. Final BCVA was statistically correlated with initial hole size (P=0.006, OR=1.056; CI [1.016-1.098]) and mean symptom duration prior to surgery (P=0.001. OR=0.987; CI [0.976-0.998]). Analysis of the ROC curve demonstrated that a hole diameter>478.5μm and symptom duration>5weeks were correlated with non-improvement of visual acuity, with 81.3% sensibility and 18.7% specificity. We report tomographic microstructural foveal changes and functional results following successful large idiopathic FTMH surgery using the classic inverted flap technique. Preoperative parameters such as initial FTMH diameter and mean symptom duration prior to surgery are crucial prognostic factors influencing final visual results.

Effect of Tissue Pedicle Position on Postoperative Recovery From Severe Auricular Laceration.

Postoperative recovery from severe auricular lacerations varies significantly. However, few studies have sought to clarify the risk factors associated with the prognosis of severe auricular lacerations, and little attention has been paid to the intraoperative management of severe auricular lacerations and early postoperative intervention. The purpose of this study was to analyze the risk factors that may affect the prognosis of severe auricular lacerations. Case data and imaging data of patients with severe auricular lacerations treated in our department between January 2018 and September 2022 were collected. A total of 90 patients (90 severe auricular lacerations) were included in the analysis and were divided into good group (68 cases) and poor group (22 cases) according to postoperative recovery, which was defined as poor postoperative recovery when postoperative auricular blood supply disorders required interventional treatment or second stage plastic surgery. The percentage of ventral tissue pedicles in the poor recovery group was 77.3% ( P <0.001). The proportion of ventral tissue pedicle was significantly higher in the poor postoperative group than in the good postoperative group, and ventral tissue pedicle [odds ratio (OR)=12.22, P =0.002] was an independent risk factor for poor postoperative recovery from severe auricular laceration. The prognosis of patients with severe auricular lacerations differs between the different tissue pedicle locations, and prophylactic treatment of patients with ventral tissue pedicles is beneficial. In addition, patients with ventral tissue pedicles should be informed in advance of their increased risk of surgical failure.

Chronic fatigue and recovery among nurses working two-shift and three-shift rotations

BackgroundShift patterns influence nurses’ work and rest conditions. Limited information is available about the nurses' recovery, fatigue, and their associated factors considering shift patterns. AimThis study explored the association between fatigue and recovery and factors associated with recovery and chronic fatigue among nurses working a three-shift (8 hour shifts) or two-shift (more than 12 hour shifts) rotations in Japan. MethodsThis cross-sectional secondary analysis included 807 nurses from a previous questionnaire survey. Fatigue (acute and chronic) and intershift recovery were measured using the Occupational Fatigue Exhaustion Recovery Scale. FindingsIntershift recovery was significantly lower among nurses working a three-shift rotations compared to nurses working a two-shift rotations. Nurses aged ≥40 years tended to experience severe chronic fatigue working in the two-shift rotations. In both shift patterns, overtime hours and low sleep quality were associated with lower intershift recovery and higher chronic fatigue. In the three-shift rotations, having children and being activity-oriented in leisure time were associated with higher intershift recovery and lower chronic fatigue. In the two-shift rotations, activity orientation was significantly associated with lower chronic fatigue. DiscussionsThe three-shift rotations influenced nurses’ intershift recovery more than the two-shift rotations. Regardless of shift patterns, managers must restrict overtime and encourage nurses to maintain sleep quality, family roles, and leisure activities. Moreover, considering nurses’ age while selecting and organising shift patterns may prevent chronic fatigue. ConclusionFatigue management based on the characteristics and associated factors of fatigue and recovery for each shift pattern revealed in this study prevents chronic fatigue, which may contribute to the retention of nurses.

A risk prediction model for postoperative recovery of closed calcaneal fracture: a retrospective study

ObjectiveTo explore the risk factors for postoperative recovery of closed calcaneal fracture and develop a prediction model.MethodsWe retrospectively enrolled patients with closed calcaneal fracture from January 1, 2017 to December 31, 2020. Patients treated from 2017 to 2019 were selected as a training cohort and those in 2020 as a validation cohort. The outcome variable was the postoperative recovery evaluated by the Creighton-Nebraska calcaneal fracture scoring system. Multivariate logistic regression analysis was used to screen the risk factors of postoperative recovery. A risk prediction model was constructed in the training cohort and the corresponding nomogram was drawn. The model was validated internally using bootstrapping and externally by calculating the performance in the validation cohort.ResultsA total of 659 patients with closed calcaneal fracture met the inclusion and exclusion criteria, which were divided into the training cohort (n = 509) and the validation cohort (n = 150). 540 cases (81.9%) patients recovered well after calcaneal fracture surgery. According to multivariate logistic regression analysis, female (OR = 2.525, 95% CI 1.283–4.969), > 60 years (OR = 6.644, 95% CI 1.243–35.522), surgery within 8–14 days after fracture (OR = 2.172, 95% CI 1.259–3.745), postoperative infection (OR = 4.613, 95% CI 1.382–15.393), and weight-bearing time longer than 3 months after surgery (4–6 months, OR = 2.885, 95% CI 1.696–4.907; 7–12 months, OR = 3.030, 95% CI 1.212–7.578; > 12 months, OR = 15.589, 95% CI 3.244–74.912) were independent risk factors for postoperative recovery of calcaneal fractures. The C-indices were 0.750(95% CI 0.692–0.808) in the training cohort and 0.688(95% CI 0.571–0.804) in the external validation cohort, and the C-index of internal validation was 0.715. The Hosmer–Lemeshow test showed good fitting of the model (all P > 0.05), which was consistent with the results of the calibration plots. Decision Curve Analysis indicated that the clinical effectiveness was the best when the threshold probability was between 0.10 and 0.45.ConclusionsPatients with female, > 60 years, surgery within 8–14 days after fracture, postoperative infection, and weight-bearing time longer than 3 months after surgery are more likely to have poor postoperative recovery. The risk prediction of fracture patients through this model might be translated into clinical guidance and application.Trial registration This study was registered on the Chinese Clinical Trial Registry (Registration number: ChiCTR-EPR-15005878).

Spatio-temporal characteristics and driving factors of flash drought recovery: From the perspective of soil moisture and GPP changes

Flash drought recovery is significant to evaluate the impact of flash drought and the resilience of ecosystem. However, the definition of flash drought recovery stage and its mechanism remain unclear, with limited research in this area. This study proposes the definitions of flash drought recovery stage based on soil moisture change and gross primary productivity (GPP) change. The spatio-temporal characteristics, driving factors and differences between two identifications are investigated in Xiang River Basin (XRB) and Wei River Basin (WRB), two typical humid and semiarid basins in China. The main results are as follows: (1) XRB has a slightly longer recovery time and a higher recovery rate in terms of soil moisture-based definition, while GPP-based definition shows similar recovery times for both basins, with WRB having a higher recovery rate. (2) Based on soil moisture-based definition, the recovery time and recovery rates of different flash drought events in the same basin vary greatly, while most flash drought events in both basins recover within 2*8 days in terms of GPP-based definition. (3) Under both definitions, regions with relatively higher precipitation, lower average temperature and lower solar radiation tend to have higher recovery rates and shorter recovery time. Besides, grasslands tend to recover more quickly from flash drought than forests with GPP-based definition. (4) The recovery stage with soil moisture-based definition begins with the changes in associated meteorological variables, while the recovery stage with GPP-based definition begins 8 to 2*8 days after the changes of meteorological variables occur. This study proposes preliminary definitions for the recovery stage of flash drought and reveals the mechanism underlying the flash drought recovery, which are crucial for understanding the evolution of flash drought and reducing the risks resulting from it.

Hand Scrubbing and Donning of Sterile Surgical Gloves: An Observational Clinical Audit of Novice Dental Surgeons.

Background The most critical factors in the satisfactory recovery of a patient post-surgery are obedience to sterilization and aseptic protocol.Using aseptic principles, the standard hand scrubbing and gloving procedure prevents contamination of the surgical site and aids in infection control. Methods Eighty dental interns were observed during minor oral surgical procedures for hand scrubbing and donning sterile surgical gloves, following the steps and guidelines providedby World Health Organization (WHO). The dental interns were evaluated, and in order to enhance their understanding of hand scrubbing and donning surgical gloves, desensitization programs were conducted through lectures using PowerPoint presentations. After one week, the participants were observed and evaluated again. This program made the participants aware of asepsis and infection control in clinical practice. Results Prior to intervention, only 37.14% of young dental surgeonsperformed proper conventional hand hygiene practices. After the intervention, this percentage increased to 62.142%, indicating a significant improvement. Regarding the donning of sterile surgical gloves, 43.75% of participants followed the standard steps before the intervention. After the intervention, the percentage raised to 86.25% indicating substantial growth. Conclusion Observations before and after the evaluation demonstrated significant changes in the acceptance rates for the fundamental criteria of hand hygieneand donning sterile surgical gloves. Adhering to both procedures according to WHO guidelines will help to reduce the risk of infections and raise awareness about asepsis in the practice among youngdental surgeons.

Demographic and clinical profile of an inception cohort of road trauma survivors

BackgroundRoad trauma is a major public health concern, often resulting in reduced health-related quality of life and prolonged absenteeism from work even after so-called ‘minor’ injuries that do not result in hospitalization. This manuscript compares pre-injury health, sociodemographic characteristics and injury details between age, sex, and road user categories in a cohort of 1,480 road trauma survivors.MethodsThis was a prospective observational inception cohort study of road trauma survivors recruited between July 2018 and March 2020 from three trauma centres in British Columbia, Canada. Participants were aged ≥ 16 years and arrived in a participating emergency department within 24 h of involvement in a motor vehicle collision. Data were collected from structured interviews and review of medical records.ResultsThe cohort of 1,480 road trauma survivors included 280 pedestrians, 174 cyclists, 118 motorcyclists, 683 motor vehicle drivers, and 225 passengers. Median age was 40 (IQR = [27, 57]) years; 680 (46%) were female. Males and younger patients were significantly more likely to report better pre-injury physical health. Motorcyclists and cyclists tended to report better physical health and less severe somatic symptoms, whereas pedestrians and motor vehicle drivers reported better mental health. Injury severity and hospital admission rates were higher in pedestrians and motorcyclists and lower in motorists. Upper and lower extremity injuries were most common in pedestrians, cyclists and motorcyclists, whereas neck injuries were most common in motor vehicle drivers and passengers.ConclusionsIn a large cohort of road trauma survivors, overall injury severity was low. Motorcyclists and pedestrians, but not cyclists, had more severe injuries than motorists. Extremity injuries were more common in vulnerable road users. Future research will investigate one-year recovery outcomes and identify risk factors for poor recovery.

Persisting symptoms common but inability to work rare: a one-year follow-up study of Finnish hospitalised COVID-19 patients

Background Difficulties in recovery persisting for months have been reported in patients with severe COVID-19. Our aim was to investigate respiratory and overall recovery one year after hospital discharge. Methods Finnish patients hospitalised due to COVID-19 during the first wave of the pandemic were recruited to a survey of symptoms, quality of life (RAND-36), work status, and health care use one year after hospital discharge. Patients with lung function test and chest x-ray results available from 3-6 months after hospital discharge underwent spirometry and a chest x-ray at one year. Results Ninety-six patients responded to the one-year survey, 32 underwent spirometry and 32 a chest x-ray. Of those working full-time before COVID-19, median duration of sick leave was 40 days and 10% had not returned to work at one year. Health-care service use related to COVID-19 after discharge was reported by 79%, 50% using primary care, 34% occupational health care and 32% specialist care, respectively. Tiredness, fatigue, and physical difficulties increased in follow-up (p = 0.022–0.033). Quality of life did not change. Chest x-ray abnormalities decreased in follow-up, with an abnormal chest x-ray in 58% at 3–6 months and 25% at one year. A restrictive spirometry pattern was more common at one year (16 vs. 34%, p = 0.014). Conclusions Prolonged symptoms are common, some patients have decreased lung function, and a small minority of patients still have not returned to work one year after severe COVID-19. This calls for further research into the underlying causes and risk factors for prolonged recovery.

Comparing packing and non-packing of the abscess cavity post incision and drainage of perianal abscess: A meta-analysis

Background: Pain is a very important factor in patient recovery and satisfaction. Following incision and drainage of perianal abscess, wound packing has been found to be very painful. The aim of this study is to compare packing the wound and not packing the wound after incision and drainage (I&amp;D) of perianal abscess, taking into account recurrence rate, rate of occurrence of perianal fistula as well as post-operative pain. Materials and Method: Standard medical electronic databases were searched with the help of a local librarian and relevant published randomised controlled trials (RCT) were shortlisted according to the inclusion criteria. The summated outcome of post-operative pain score, recurrence rate, and rate of occurrence of perianal fistula was evaluated using the principles of meta-analysis on RevMan 5 statistical software. Result: Three RCTs on 490 patients undergoing I&amp;D of perianal abscess were found suitable for this meta-analysis. In the random effects model analysis, the post operative pain score was statistically lower in NPG [risk ratio 0.66, 95%, CI (0.36, 0.97), Z=4.25, P=0.0001]. There was no heterogeneity [Tau2=0.15; chi2=9.32; df=6; I2=36 %; p=0.16] between the studies, however, statistically it was not significant. In addition, there was no statistical difference between the 2 groups in terms of recurrence of perianal abscess or the occurrence of perianal fistula [risk ratio 0.64, 95%, CI (0.31, 1.31), Z=1.23, P=0.22], [risk ratio 1.41, 95%, CI (0.89, 2.23), Z=1.47, P=0.14] respectively. Conclusion: Not packing the wound post I&amp;D of perianal abscess is associated with significantly reduced VAS pain scores, which may result in improved recovery and patient satisfaction and has no effect on recurrence rate or the occurrence of perianal fistula. However, more RCTs recruiting a greater number of patients are required to endorse these findings.

The influence of disturbance scale on the natural recovery of biological soil crusts on the Colorado Plateau.

Up to 35% of global drylands have experienced degradation due to anthropogenic impacts, including physical disturbances like trampling and soil removal. These physical disturbances can result in the loss of soil communities known as biological soil crusts (biocrusts) and the important functions they provide, such as soil stability and fertility. The reestablishment of biocrust organisms after disturbance is determined by many factors, including propagule availability, climate, and vascular plant community structure. The role of these factors in natural recovery may be intensified by the extent (or size) of a disturbance. For example, large disturbances can result in reduced propagule availability or enhanced erosion, which impact both the dispersal and establishment of biocrust organisms on disturbed soils, leading to a slower natural recovery. To test how disturbance extent impacts biocrust's natural recovery, we installed four disturbance extents by completely removing biocrust from the mineral soil in plots ranging from 0.01 m2 to 1 m2 and measured productivity and erosion resistance. We found that small disturbance extents did not differ in chlorophyll a content, total exopolysaccharide content, or soil stability after 1.5 years of natural recovery. However, the concentration of glycocalyx exopolysaccharide was higher in the smallest disturbances after the recovery period. Our results indicate that disturbances <1 m2 in scale recover at similar rates, with soil stability returning to high levels in just a few years after severe disturbance. Our findings align with prior work on biocrust natural recovery in drylands and highlight the opportunity for future work to address (1) cyanobacteria, moss, and lichen propagule dispersal; (2) rates and mechanisms of biocrust succession; and (3) the role of wind or water in determining biocrust colonization patterns as compared to lateral growth.