Number Of Causes Research Articles

Mental health impact of COVID-19 pandemic on therapists at an inpatient rehabilitation facility.

BackgroundHealthcare workers have faced extraordinary work‐related stress in the face of the COVID‐19 pandemic. Physical therapy, occupational therapy, and speech‐language pathology providers at inpatient rehabilitation facilities may represent a distinct at‐risk subgroup for work‐related stress during the pandemic due to the usual nature of their job duties, including close physical contact and extended treatment times.ObjectiveTo evaluate the impact of the COVID‐19 pandemic on work‐related stress and occurrence of depression and anxiety in physical therapists, occupational therapists, and speech‐language pathologists during the first surge of COVID‐19 hospitalizations.DesignCross‐sectional survey.SettingAcademic, freestanding inpatient rehabilitation facility.ParticipantsSurvey responses were collected from 38 therapists.InterventionA 26‐item electronic questionnaire containing a mix of multiple‐choice and open‐ended questions.Main Outcome MeasuresPositive screens for depression or anxiety as measured by the Patient Health Questionnaire‐9 (PHQ‐9) and the General Anxiety Disorder 7‐item (GAD‐7) scale, respectively.ResultsSeven individuals (19%) scored at or above the clinically significant cutoff of 10 on each the PHQ‐9 and GAD‐7, corresponding to increased risk for depression and anxiety. Therapists younger than 30 years old had significantly higher GAD‐7 scores compared to therapists between 30‐39 years old (p < .05). Occupational stress was attributed to a number of causes including concerns for health and safety, unpredictable changes in hospital protocols and work assignments, acquisition of additional work duties, concerns about the ability to provide high‐quality patient care in a restricted environment, and the psychological toll of caring for patients with or recovering from COVID‐19.ConclusionThis cross‐sectional survey highlights the impact of the COVID‐19 pandemic on occupational stress and mental health of therapists working at an inpatient rehabilitation facility during the first surge of COVID‐19 hospitalizations. This research may help institutions identify at‐risk individuals who may benefit from support and guide policy changes to resolve potentially modifiable factors at a systems level.

Unclassified white matter disorders: A diagnostic journey requiring close collaboration between clinical and laboratory services

BackgroundNext generation sequencing studies have revealed an ever-increasing number of causes for genetic disorders of central nervous system white matter. A substantial number of disorders are identifiable from their specific pattern of biochemical and/or imaging findings for which single gene testing may be indicated. Beyond this group, the causes of genetic white matter disorders are unclear and a broader approach to genomic testing is recommended. AimThis study aimed to identify the genetic causes for a group of individuals with unclassified white matter disorders with suspected genetic aetiology and highlight the investigations required when the initial testing is non-diagnostic. MethodsTwenty-six individuals from 22 families with unclassified white matter disorders underwent deep phenotyping and genome sequencing performed on trio, or larger, family groups. Functional studies and transcriptomics were used to resolve variants of uncertain significance with potential clinical relevance. ResultsCausative or candidate variants were identified in 15/22 (68.2%) families. Six of the 15 implicated genes had been previously associated with white matter disease (COL4A1, NDUFV1, SLC17A5, TUBB4A, BOLA3, DARS2). Patients with variants in the latter two presented with an atypical phenotype. The other nine genes had not been specifically associated with white matter disease at the time of diagnosis and included genes associated with monogenic syndromes, developmental disorders, and developmental and epileptic encephalopathies (STAG2, LSS, FIG4, GLS, PMPCA, SPTBN1, AGO2, SCN2A, SCN8A). Consequently, only 46% of the diagnoses would have been made via a current leukodystrophy gene panel test. DiscussionThese results confirm the importance of broad genomic testing for patients with white matter disorders. The high diagnostic yield reflects the integration of deep phenotyping, whole genome sequencing, trio analysis, functional studies, and transcriptomic analyses. ConclusionsGenetic white matter disorders are genetically and phenotypically heterogeneous. Deep phenotyping together with a range of genomic technologies underpin the identification of causes of unclassified white matter disease. A molecular diagnosis is essential for prognostication, appropriate management, and accurate reproductive counseling.

Acute appendicitis during the recovery phase of dengue hemorrhagic fever: two case reports

BackgroundDengue fever is one of the most common tropical diseases, with high prevalence in many tropical countries including Sri Lanka. Dengue infection can present from subclinical infection to dengue shock syndrome. Further, the disease also shows a variety of atypical presentations and has been reported to mimic a number of causes of acute abdomen.Case presentationThe authors report two children (a 6-year-old Tamil girl and an 8-year-old Muslim girl) who were diagnosed to have acute appendicitis during the early recovery phase of dengue hemorrhagic fever (DHF) and late recovery period of dengue hemorrhagic fever with platelet count of 92 × 103/cumm and 102 × 103/cumm, respectively. Both children were investigated with abdomen ultrasound as they developed severe abdominal pain and tenderness on palpation during the recovery phase, which was felt to be very unusual. Acute appendicitis was diagnosed in one child, while the other child had a ruptured appendicular abscess. Both children were treated with laparoscopic appendectomy and a 7-day course of intravenous antibiotics. Both children were reviewed in 1 month following treatment and had complete recovery.ConclusionAlthough precise pathophysiology and associations of the surgical abdomen with dengue fever remain to be elucidated, there are known factors in dengue fever that can potentially lead to secondary bacterial infections and surgical abdomen. Awareness and increased suspicion by the clinician are paramount to detect such complications early, especially in children who demonstrate unusual clinical features during various stages of dengue infection.

Assessment of intellectual disability in Klinefelter’s Syndrome associated with other Prenatal and Perinatal risk factors. A case report

IntroductionKlinefelter’s syndrome (KS) is considered as a genetic risk factor for intellectual disability and specifically for impairment on verbal skills. Prenatal and perinatal morbidity concurrent with this diagnosis determine the entity and typology of neurodevelopmental deficits.ObjectivesTo describe the intellectual and adaptive functioning of a patient with KS and prenatal and perinatal difficulties, assessed in the Service of Psychiatry, Clinical Psychology and Mental Health at La Paz University Hospital (Madrid).MethodsA descriptive study was conducted of a 6 year and 7-month-old boy with diagnosis of KS (karyotype XXY), extremely low weight at birth (752 gr.), Arnold Chiari type I malformation with post-hemorrhagic hydrocephalus and periventricular leukomalacia, bronchopulmonary dysplasia, intra-atrial septal defect, left kidney agenesis with iatrogenic adrenal insufficiency, and acute ventriculitis due to E. Coli. Neuropsychological evaluation was carried out in October 2021. Leiter-3 scale was selected due to the absence of expressive language; and his parents completed the questionnaire Adaptive Behavior Assessment System-II.ResultsThe nonverbal intelligence quotient was observed in the very low range (full-scale IQ = 69). The result of general adaptive behavior (z = -2.83), showed very high functional disability both in the conceptual, social, and practical domains.ConclusionsThe high number of causes of disability in this patient is consistent with a high degree of functional disability. Efficient evaluation sessions of intellectual performance, adaptive functioning, and necessary supports, due to the absence of expressive language and limited receptive language, are required. A specific neuropsychological evaluation profile should be established for KS.DisclosureNo significant relationships.

Qualitative and Quantitative Analysis of the Causes of Occupational Accidents Related to the Use of Construction Scaffoldings

This article proposes a methodology for classifying occupational accidents involving scaffolding based on the knowledge of the causes that led to their occurrence. Each occupational accident is caused by several causes belonging to three generic groups (technical, organizational, human) occurring in a different configuration. The aim of this research was to determine the qualitative and quantitative structure of the causes of accidents caused by falling from scaffolding. Significant causes were selected from the set of all the causes identified in the analyzed set of accidents. For this purpose, Pareto–Lorenz analysis and the ABC classification were used. Then, a set of significant causes containing technical, organizational and human causes was created, which was the basis for determining the subsets of accidents caused by similar causes. The hierarchical cluster analysis method, the agglomeration clustering technique and the binding of objects using the Ward method were proposed to determine the number of characteristic clusters. Three subsets of accidents with a similar set of causes were obtained. Information on the quality and number of causes in individual subsets was used to estimate the probability of an accident caused by a given set of causes and to assess occupational risk in construction. Calculations were performed using Statistica software.

Cerebral microangiopathy according to magnetic resonance imaging of the brain in patients undergoing longterm programmed hemodialysis

Introduction. Cerebral microangiopathy (CMA), being the leading cause of vascular cognitive impairment and strokes, has a number of causes, among which chronic kidney disease (CKD) and programmed hemodialysis (HD) are the least studied.Purpose of the study: to determine the frequency of CMA neuroimaging markers and risk factors for its development in patients receiving renal replacement therapy for a long time using the programmed HD.Material and methods: the study involved 70 patients who had been on programmed HD for 10 months or more. Clinical neurological examination, laboratory tests and brain MRI were performed. The analysis of CMA neuroimaging markers was carried out in accordance with the STRIVE recommendations. Cerebral Small Vessel Disease Score (CSVDS) was used to quantify the overall severity of MR imaging markers of CMA.Results. Among 70 examined (29 men and 41 women) aged 53.0 ± 14.2 years, average HD experience – 70.0 ± 39.5 months, the main clinical manifestations of CMA were cognitive impairment (82.9%, n = 58), emotional disorders (61.4%, n = 43), sleep disorders (38.6%, n = 27), pseudobulbar syndrome (17.1%, n = 12), walking disorders (8.6%, n = 6), acute lacunar syndromes (7.1%, n = 5) and pelvic dysfunction (4.3%, n = 3). CMA neuroimaging markers of varying severity were found in 100% of cases. Expansion of perivascular spaces (100%, n = 70) and white matter hyperintensities (81.4%, n = 57) prevailed in the structure of CMA imaging markers. Cortical atrophy (67%, n = 47), cerebral microbleeds (47%, n = 33), asymptomatic lacunae (35.7%, n = 25) and minor subcortical infarctions (2.9%, n = 3) were less common. Mild CMA (1–2 points on the CSVDS scale) was determined in 38 patients (54.3%), severe CMA (3–4 points on the CSVDS scale) – in 32 patients (45.7%). The presence of uncontrolled arterial hypertension (OR 1.85, p &lt; 0.05), intradialysis hypertension (OR 2.8, p &lt; 0.05), dialysis vegetative polyneuropathies (OR 2.75, p &lt; 0.05), type 2 diabetes mellitus (OR 5.7, p &lt; 0.05) and the experience of programmed HD (more than 50 months) (OR 3.1, p &lt; 0.05) were prognostic signifi cance for the development of severe CMA in dialysis patients.Conclusion. All patients with end-stage CKD who have been on programmed HD for a long time are shown to undergo the brain MRI in order to timely diagnose CMA imaging markers and possible correction of therapy.

Avascular Necrosis of Femoral Head Diagnosed by 99mTc MDP Bone Scan Incorporated with SPECT- A Case Report

Avascular necrosis (AVN) may be defined as cellular death of bone components due to the lack of blood supply resulting in joint damage and loss of joint function. This condition may arise from a number of causes i.e. both traumatic and non-traumatic. Diagnosis of the disease at an early stage and deliberate management can prevent the unwanted complications like femoral head collapse and severe arthritis and may save the bone. Although diagnosis of AVN is primarily dependent on radiological investigations, the incremental value and vital role of 99mTc-methylene diphosphonate (99mTc-MDP) single-photon emission computed tomography (SPECT) over planar bone scintigraphy permits more accurate localization of lesions and provide pertinent information to recognize the disease at initial stage for better management. We present a case of unexplained low back pain in a young woman who was diagnosed as having avascular necrosis of both femoral heads by 99mTc-MDP bone scan incorporated with SPECT Bangladesh J. Nuclear Med. 23(1&amp;2): 55-58, 2020

Un-Compromised Credibility: Social Media based Multi-Class Hate Speech Classification for Text: A Review

Abstract: Hate speech is a crime that has been on the rise in recent years, not just in face-to-face contacts but also online. This is due to a number of causes. On the one hand, due of the anonymity given by the internet and social networks in particular, people are more likely to engage in hostile behaviour. People's desire to voice their thoughts online, on the other side, have increased, adding to the spread of hate speech. Governments and social media platforms can benefit from detection and prevention techniques because this type of prejudiced speech can beimmensely destructive to society. We contribute to a solution to this dilemma by giving a systematic review of research undertakenin the subject through this survey. This challenge benefited from the use of several complicated and non-linear models, and CAT Boost performed best due to the application of latent semantic analysis (LSA) for dimensionality reduction. Keywords: Multi-Class Hate Speech, Natural Language Processing, Hate Speech Classification, Social Media Micro blogs, Multi-Class Hate SpeechDataset.

Factors Associated with Major Errors on Death Certificates.

The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor errors according to the contribution to the process of determining the cause of death. Death certificates were classified into two groups with major errors (ME group) and without major errors (non-ME group). General characteristics of the death certificates, the main cause of death (cancer, cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, genitourinary disease, intentional self-harm, external causes, and other causes), the number of causes of deaths written on the death certificate, and major and minor errors were investigated. The ME group had 127 cases out of 548 death certificates. The number of causes of deaths written on the death certificates and the total number of errors were higher in the ME group than in the non-ME group. Cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and other diseases as causes of deaths had higher risks of major errors on death certificates than cancer as a cause of death. The group with cancer as a cause of death had the lowest incidence of major errors and fewer causes of deaths. To reduce major errors, continuous education and feedback are needed for those who are qualified to issue a death certificate.

Identification of plants releasing isoprene causing smog

The accessibility of water is most important component for plant productivity and growth. Water stress is a major threat for the agriculture system of Pakistan. The change in climate causes the change in the patterns of rainfall which may cause the extreme events. The main cause of climate change is the concentration of carbon dioxide in the air and global warming. A change in environment overall takes place by a number of causes but the most important cause of all these changes is isoprene.1 Water scarcity causes high isoprene emission from plants. The dominant volatile organic compound which is released from vegetation is Isoprene (2-methyl-1,3,-butadiene). Isoprene produced by few herbaceous plant species and many woody trees. The emission of these volatiles like isoprene has an indirect effect on climate change and cause smog formation. The examination found that isoprene responds with human made nitrogen oxide to make particulate issue. In light of the presence of nitrogen oxides, it is engaged with creating the negative impacts on climate and human wellbeing. The research investigates current knowledge about the presence of isoprene emissions within the plant kingdom under drought stress conditions. Eucalyptus, Kachnar, Mulberry and Conocarpus are few species which are able to produce isoprene. The pot experiment was designed to identify isoprene emission within these plants. The plants were exposed to decrease Fractional Transpirable Soil Water FTSW. Various VOCs emission was increase under stress conditions. The isoprene emission rate is high under mild drought stress but decline under severe drought stress. Other parameters like stomatal conductance, photosynthesis, internal CO2 were also observed.

A stochastic approach to evaluating the economic impact of disruptions in feedstock pipelines on downstream production

Reliability of feedstock supply is an important consideration for enhancing the safety and continuous operation of chemical plants. A critical component of the chemical and refining sectors is the extensive pipeline network which transports natural gas and hydrocarbon liquids from producing areas to refineries and chemical plants. Incidents involving spills or releases and shutdowns of those pipeline can occur due to a number of causes including corrosion, equipment malfunction, and excavation damage. These incidents involve economic, environmental, and safety consequences such as the cost of asset damage, lost commodities, cleanup requirement, and operational disruption. In this work, an appropriately developed stochastic framework is presented to determine the disruption impact of pipeline incidents on downstream chemical production. Incident data are statistically analyzed to determine meaningful distributions for incident rates, spill/release quantities, and pipeline shutdown durations. A case study on the production of propylene via three different pathways (crude oil, propane, and natural gas) is presented to illustrate the methodology and underline the variability of the process production impact due to variations in risk occurrence characteristics. Using specific process chemistry and mass balances, more precise risk profiles for the product shortfall and cost of lost sales can be generated.

Mental illness vs mental retardation

Mental illness and mental retardation are completely two different terms and with two different concepts in them and cannot be used interchangeably. Mental illness can be caused by number of causes like genetic causes, environmental causes and chemical imbalances in the brain. While mental retardation in the imbalance in normal development of the brain in an individual by which it can be categorized into mild Estimates of the prevalence of comorbidity of psychiatric disorders and mental retardation in community and clinical populations range from 14.3 to 67.3 percent. Mental illness can be described when behaviour of individuals is inappropriate, irrational, or unrealistic in most physical, or in mental illness the person’s behaviour is not normal. Mental disorder can be caused by physical, psychological or environmental factors, or a com- bination of all three. While mental illness is not level of intelligence, it is possible for a person to be both mentally ill and retarded.

Computed-Tomography as First-line Diagnostic Procedure in Patients With Out-of-Hospital Cardiac Arrest.

BackgroundMortality after out-of-hospital cardiac arrest (OHCA) with return of spontaneous circulation (ROSC) remains high despite numerous efforts to improve outcome. For patients with suspected coronary cause of arrest, coronary angiography is crucial. However, there are other causes and potentially life-threatening injuries related to cardiopulmonary resuscitation (CPR), which can be detected by routine computed tomography (CT).Materials and MethodsAt Hannover Medical School, rapid coronary angiography and CT are performed in successfully resuscitated OHCA patients as a standard of care prior to admission to intensive care. We analyzed all patients who received CT following OHCA with ROSC over a three-year period.ResultsThere were 225 consecutive patients with return of spontaneous circulation following out-of-hospital cardiac arrest. Mean age was 64 ± 13 years, 75% were male. Of them, 174 (77%) had witnessed arrest, 145 (64%) received bystander CPR, and 123 (55%) had a primary shockable rhythm. Mean time to ROSC was 24 ± 20 min. There were no significant differences in CT pathologies in patients with or without ST-segment elevations in the initial ECG. Critical CT findings qualifying as a potential cause for cardiac arrest were intracranial bleeding (N = 6), aortic dissection (N = 5), pulmonary embolism (N = 17), pericardial tamponade (N = 3), and tension pneumothorax (N = 11). Other pathologies were regarded as consequences of CPR and relevant for further treatment: aspiration (N = 62), rib fractures (N = 161), sternal fractures (N = 50), spinal fractures (N = 11), hepatic bleeding (N = 12), and intra-abdominal air (N = 3).ConclusionEarly CT fallowing OHCA uncovers a high number of causes and consequences of OHCA and CPR. Those are relevant for post-arrest care and are frequently life-threatening, suggesting that CT can contribute to improving prognosis following OHCA.

Prevention of Fraud with Real Estate in the Residential Sector in Ukraine at the Present Stage

The real estate market in Ukraine is increasing the pace of its development every day, especially in large cities, and accordingly, in parallel with such active development, several ways of acquiring, alienating, and obtaining real estate objects are being improved. However, it is quite difficult to investigate specific volumes of fraud, since most of these phenomena still are latent, and as a result, the prevention measures taken do not give the desired results, so the issue under study is truly relevant for the scientific plane. The purpose of this study is to analyse the most common manifestations of fraudulent actions in the housing sector, their determinants in Ukraine, as well as to identify effective measures to prevent criminal offences of this category and implement them in the legal reality of the country. The study uses the general dialectical method of scientific knowledge of real phenomena, their connections, as well as the Aristotelian method. The theoretical framework of this study comprises the works of Ukrainian and foreign scientists on a comprehensive study of this adverse phenomenon and the development of effective counteraction to it in the current conditions. Based on the conducted research, the main ways of committing a criminal offence and measures that can prevent fraud with real estate in the housing sector are studied and highlighted. Statistical data on the number of registered criminal offences related to fraud in the field of property in recent years and the indicator are presented the ratio of the number of latent acts. The article examines the current state of national legislation in the field of prevention of crimes in the housing sector and identifies areas for improving the mechanism regulating this institution in Ukraine. Proposals have been made to eliminate a number of causes that contribute to this phenomenon today. The practical significance of scientific work lies in the fact that the studied scientific provisions, generalisations, conclusions, and recommendations have both theoretical and applied significance, which can later be used in research activities and the educational process

ASSESSMENT OF SERUM PROLACTIN IN HYPOTHYROIDISM INFERTILE FEMALES, IN WHITENILESTATE, SUDAN

Background: Thyroid dysfunction is a public health problem in White Nile State in Sudan. It is majorly caused by iodine deficiency. Hyperprolactinemia, the clinical condition associated with infertilityis resulted from a number of causes. Objectives: This study aimed to assess the relationship between thyroid hormone and prolactin serum level in Sudanese hypothyroidism infertile females. Material and Method: One hundred Sudanese females with hypothyroidism were compared with eightys healthy control. Blood samples were collected after an overnight fasting. Serum TSH, T3, T4 were analyzed using fully automated immunoassay analyzer system (AIA)TOSOH BIOSCINCEAIA360. Prolactin is measured using i-CHROMATM. Results: Hypothyroidism patients showed increased prolactin levels. Prolactin is increased in 40% of hypothyroidism patients.Also, TSH levels were significantly positively correlated with prolactin levels. Conclusion:The serum prolactin levels were increased in hypothyroidism infertile patients.

Analysis of electric vehicles

Electric vehicles (EVs) are gaining popularity as a result of a number of causes, including lower prices and have gained concern due to changing climatic conditions. This study focuses on changes to be brought in electrical vehicle considering the recent trends in battery technology, new techniques for charging the vehicles and provides new opportunities for research. More specifically, an examination of the global market condition for electric vehicles (EVs) and their future prospects is conducted. Battery being one of the most important parts of electric vehicles, the paper provides a comprehensive overview of various technologies of batteries. We also go over many EV charging standards that are available, as well as the pros and cons of each.

Hypokalemic paralysis due to distal renal tubular acidosis type 1 in patient of mucormycosis on amphotericin B: a case report

A 42-year-old male patient who is a known case of DM and mucormycosis on treatment presented with sudden onset difficulty in moving all 4 limbs followed by decreased depth of respiration for 4 hours. The patient was known case of DM for 10 years and was on OHA for the same, he had history of biopsy diagnosed rhino mucormycosis 4 months ago and was on treatment for the same. On initial examination the tone was hypotonic in all4 limbs along with power of 3+, respiration was shallow and patient was bedridden unable to stand on his own, he was ambulatory 6 days before presenting to hospital. Potassium-1.7 mEq/l, ABGA pH-7.18, HCO3-10 Meq/l, urine osmolality 220 mOsm/l, urine pH-7.0, potassium-to-creatinine rstio (K/Cr)-3.9 mEq/ml, urine K-22 mEq/ml. Distal RTA (dRTA) is the classical form of RTA, being the first described. Distal RTA is characterized by a failure of H+ secretion into lumen of nephron by the alpha intercalated cells of the medullary collecting duct of the distal nephron. This failure of acid secretion may be due to a number of causes, and it leads to an inability to acidify the urine to a pH of less than 5.3. This case study enumerates the potentially dangerous side effects of amphotericin B in patients which can precipitate RTA type 1 leading to severe hypokalaemia and acidosis, thus all patients receiving amphotericin B should be cautiously warned regarding side effect of hypokalaemia and prophylactic potassium syrup supplementation may be given in predisposed patients.

The Progress of Patients with Blunt Abdominal Trauma Depending on the Number of the Damaged Organs.

Introduction: Blunt abdominal trauma (BAT) is one of the most common traumatic emergencies and is associated with significant morbidity and mortality, which is associated with a number of causes despite improvements in their management. This study aims to assess 308 cases of BAT and their management depending on the number of Injured organs.&#x0D; Material and Methods: The study has a retrospective character and it has been realized within the period of time from January 20016 to December 2018. In our study are included 308 trauma cases admitted at the University Hospital of Trauma in Tirana Albania. All recorded data were grouped as follows; Demographic data, trauma mechanism, admission time in hospital, the mode of management…&#x0D; Results: The sample of the population was chosen by chance which means that this study is included all trauma cases presented at the emergency department and hadn’t any study limitation. In our study, based on the mechanism of trauma, motor vehicle accident [191(62%)] was the most common mechanism of injury, and most of the patients in our study were male [231(75%)], female [77 (25%)] with an M:F ratio of 3:1. The spleen [118 (38.3%)] was the most damaged organ after BAT, and the most common surgical procedure performed was splenectomy [53 (35.5%)]. The majority of traumatized patients presented to the Emergency Department in stable hemodynamic condition [145 (47.1%)]&#x0D; Conclusions: The progress of patients with BAT has a close relationship with The number of injured organs. The number and presence of EAI organs were important which worsen patient conditions and influence at the prognosis. The time of hospitalization of patients has a lot to do with the result. Early diagnosis and prompt treatment can save many lives.

Clinical aspects of cervical spine traumatic injury biomechanics

Cervical spine trauma is one of the most serious injuries of the human musculoskeletal system, as structural disorders of the cervical spine lead to neurological disorders due to damage to the spinal cord and/or its roots or create conditions when instability poses a significant potential threat to anatomical integrity and functional capacity of the spinal canal structures. A lot of classifications of traumatic injuries of the cervical spine have been developed, they are based on the biomechanics of injury, but none of them is generally accepted and universal. Failures to develop a system that could clearly determine the causal relationship between the effects of the traumatic agent and the traumatic bone changes are due to a number of causes. Extensive clinical material accumulated over the years of study of traumatic changes in the cervical spine allowed identifying the main criteria that determine the nature and degree of traumatic injuries. These include the parameters of traumatic action and individual characteristics of the victims, in particular physiological indicators and the presence of comorbidities. In this review, we present a brief description of the main clinical factors influencing the biomechanics of traumatic cervical spine injury (nature, direction and intensity of traumatic action, age of a patient, muscle condition and initial curvature of the cervical spine, as well as some comorbidities: degenerative changes of the spine, osteoporosis, connective tissue diseases, congenital malformations). These criteria are of practical importance that allows using the collected information not only in theoretical but also in applied aspects.

A MatchedCase-Control: Effect of Early Initiation of Breast Feeding, Exclusive Breastfeeding, and Infectious Diseases on Stunting Incidence during the Covid-19 Pandemic in Balangan Regency

Background: The Covid-19 pandemic is thought to affect a number of causes of stunting, including exclusive breastfeeding, early breastfeeding initiation, and illness exposure. Objectives: This study aims to investigate the effect of early initiation of breastfeeding, exclusive breastfeeding, and infectious diseases on stunting during the Covid-19 pandemic. Methods: The study was conducted in 6 stunting focus location villages in 2 subdistricts in Balangan Regency in June 2022. Children aged 6-23 months, both stunted and normal, served as the case samples in thecase-controlresearch design. Utilizing the Lemeshow formula, 66 samples with a 1:2 comparison were selected using asimple random samplingtechnique. In thecaseandcontrolgroups, the characteristics were equalized based on gender and age. Statistical analysis was conducted using thechi-square testandbinary logistic regression. Results: early initiation of breastfeeding (p=0.001, OR=6.806, CI=2.185-21.201), exclusive breastfeeding (p=0.021, OR=4.080, CI=1.363-12.209) and infectious diseases (p=0.000, OR=12.244, CI=3.118-48.086). Infectious diseases had the most influence on the incidence of stunting during the Covid-19 pandemic, proved by the magnitude of the OR value. Conclusions: During the Covid-19 pandemic, the rate of stunting was influenced by early breastfeeding initiation, exclusive breastfeeding, and infectious diseases.