Seventh Month Research Articles

Near Complete Biliopancreatic Segment Necrosis: A Rare and Unknown Entity Observed After Roux-en-Y Gastric Bypass-A Case Report.

Roux-en-Y gastric bypass is one of the common bariatric surgery procedures performed worldwide. Necrosis of the biliopancreatic or Roux limbs in the late period after RYGB is a rarely observed condition, the most common causes of which are postoperative adhesion, inflammatory entities, volvulus, intussusception, and internal herniations. The goal of surgical treatment is the removal of the necrotic segment and the reconstruction of biliopancreatic or gastric drainage. Here, we present a rare case in which a patient developed complete necrosis of the third and fourth segments of the duodenum and proximal jejunal limb in the postoperative seventh month after undergoing Roux-en-Y gastric bypass surgery. Necrosis occurring after RYGB surgery often affects the Roux limb, though necrosis of the biliopancreatic limb is extremely rare. The goal of surgery is to remove the necrotic segment and reconstruct the drainage. An area of ischemia is often observed in the jejunum, while a large ischemic area was noted in the present case that encompassed the third and fourth parts of the duodenum. Although in general necrosis of the Roux limb occurs due to volvulus, intussusception, or internal herniation following RYGB surgery, it must be taken into account that necrosis of the jejunal, duodenal, or complete biliopancreatic segment may occur in cases in which the underlying etiology cannot be exactly revealed.

Identification of sodicity-tolerant banana varieties to harness the salt-affected ecosystem

"Salt Affected Soils" (SAS) refers to a category of soils that contain either an excess of soluble salts or exchangeable sodium. Soils are divided into four categories: normal, saline, sodic, and saline-sodic, based on the electrical conductivity (EC), pH and exchangeable sodium percentage (ESP) measurements. At the Horticultural College and Research Institute for Women in Trichy, fifteen genotypes of bananas were assessed for growth, yield, and physiological parameters in a saline-sodic environment. Four replications of the field experiment were set up in RBD and evaluated for three years. The growth physiological and biochemical characters were recorded in the seventh month after planting (MAP), and the bunch characters were recorded at harvest time. FHIA 1 (83.4%), Saba (81.0%) and Karpooravalli (78.0%) had the highest relative water content. The highest yield was recorded in FHIA-1 (23.5 kg), Saba (22.2 kg), Udhayam (22.5 kg) and Karpooravalli (22.0 kg). The sodicity injury symptoms in the leaves were evaluated using a scoring technique, and the genotypes FHIA-1(1.0) Saba recorded the lowest score for sodicity damage. A significant negative correlation was observed between salt injury degree and leaf K+/Na+. So, the varieties that maintain higher K+/Na+ ratio in leaf and root are salt tolerant. The general ranking of the banana varieties for salt tolerance was FHIA 1 > Saba > Karpooravalli > Bangrier > Ash Monthan > Veneetu Mannan > Udhayam. A comparative field trial for the 15 banana types showed that Saba, FHIA-1 and Karpooravalli could withstand sodic conditions in the field in terms of bunch characteristics, biochemical parameters, and plant growth. Grand Naine, Rasthali and CO 1 were vulnerable to sodicity stress. Regardless of cultivar, sodicity stress increased the days needed for shooting and harvest.

Effect of birth type and sex on growth performance, wither height, humerus-radius bone dimensions, humerus-ulna growth plate width and selected hormone profile in growing Gurcu goat kids.

In this study, the effects of sex and birth type on growth performance, withers height (WH), radiographic measurements and selected hormone profiles in Gurcu goat kids were investigated. Twenty kids (single female=5, single male=5, twin female=5, twin male=5) were included in the study. Body weight (BW), WH, radiographic measurements (humerus length [HL], radius length [RL], proximal humerus epiphyseal plate width [HEP] and distal ulna epiphyseal plate width [UEP]) and biochemical analysis (for serum calcitonin, free triiodothyronine [FT3], free thyroxine [FT4], growth hormone [GH] and insulin-like growth factor-I [IGF-I]) were performed at 1, 3, 5, 7, 9 and 12 months of age. BW was significantly higher in males starting from the seventh month compared to females (p<0.05). HL was higher in males at seventh (p=0.009) and ninth (p=0.033) months, whereas RL was lower in twins at the third month (p=0.021). UEP was wider in males at seventh (p=0.008) and ninth (p=0.036) months. Closure of HEP was observed in 65% of kids by the 12th month. Calcitonin was lower in twins at third (p=0.045) and fifth (p=0.006) months, with changes observed due to group and time effects (p<0.05), whereas other hormones only changed with time (p<0.05). Positive correlations were observed between BW, WH, HL, RL and IGF-I. There was a negative correlation between BW, WH, HL, RL, IGF-I and HEP, UEP, calcitonin, FT3, FT4, GH. Sex and birth type in Gurcu goat kids may have an impact on growth performance, radiographic measurements and certain hormonal profiles.

세종대 풍수학에 대한 인식과 그 실상 - 세종 15년(1433) ‘풍수학’ 설치 과정을 중심으로

This paper aims to explore the actual state of geomancy (pungsu, 風水) in the early 15th century and examine perceptions of geomancy from various perspectives by investigating the process of establishing the “Pungsuhak (風水學)” organization. In the seventh month of the 15th year of King Sejong (世宗)'s reign (1433), a debate arose in the court over the auspicious site of Gyeongbok-gung (景福宮) Palace, initiated by the geomancer Choi Yang-seon (崔揚善). This led to a geomantic debate in the court, reigniting the controversy over the mountain pass next to Heolleung (獻陵), which had been raised but remained unresolved in the 12th year of Sejong's reign (1430). Despite opposition from his officials, King Sejong ordered scholars from the Jiphyeonjeon to study geomantic texts to resolve the issues. He formalized the scholars' research duties by assigning them official titles and establishing the “Pungsuhak” organization. The establishment of “Pungsuhak” faced considerable opposition. The key points of contention were threefold: first, that geomancy should not be discussed in royal lectures; second, that geomancy was not a subject worthy of the king's personal study; and third, that the Jiphyeonjeon should not be engaged in the study of geomancy. King Sejong countered these objections by citing Zhu Xi (朱熹)'s example, arguing that discussing geomancy was not beyond the scope of a Confucian scholar's duties, and he proceeded with the research through the “Pungsuhak” organization. At the time, two other organizations oversaw geomancy: the Seoun-gwan (書雲觀), an administrative body, and the Yin-Yang Studies (陰陽學) of the Ten Schools (十學), an organization responsible for education and examinations. However, when the geomantic debate arose, Sejong chose not to utilize these existing organizations but instead established the “Pungsuhak” organization, entrusting the scholars of Jiphyeonjeon with the study of geomancy. Consequently, the geomancy departments within the Seoun-gwan and Yin-Yang Studies remained in a disadvantaged position.

Surgical management strategies for unstable sacral fractures: Case series and surgical guideline

IntroductionUnstable sacral fractures usually have posterior pelvic and spinopelvic instability, which usually be classified as AO type C. There are many controversial points concerning the management of these fractures due to their rarity. Herein, we retrospectively review cases of this injury and propose a surgical guideline. Case presentationA 37-year-old female experienced back pain after a motor vehicle accident. Diagnostic imaging revealed an AO type C1 sacral fracture, Isler subtype 2a (case No. 7). Preoperative CT scan and CT reconstruction images showed a longitudinal fracture with a simple intraarticular fracture of the left S1 superior facet. Although the patient sustains a lumbosacral facet joint injury, the lumbosacral motion seems preservable after healing. The triangular osteosynthesis was chosen because it provides both transverse plane and vertical plane stability. The patient was allowed to continue weight-bearing ambulation after the operation. To maintain lumbosacral motion, the spinopelvic rod was removed in the postoperative seventh month. DiscussionThe unstable sacral fracture might have instability in both the vertical and transverse planes. The fixation construct should provide both vertical and transverse stability. Regarding vertical fixation, it might cost a loss of lumbosacral motion, which the treating surgeon has to consider. The lumbosacral injury is sometimes trivial, and long-term lumbosacral motion is expectable. So, permanent spinopelvic fixation is not necessary. The patient's character is also an important factor. Whether the patient needs or does not need early progressive weight bearing after the operation determines the fixation method. ConclusionUnstable sacral fractures are rare conditions usually resulting from a high-energy injury. We have proposed a surgical management strategy for this group of fractures with an optimal fixation method based on three factors: 1) fracture morphology, 2) lumbosacral integrity, and 3) concomitant injury.

Associations of hypertension and antenatal care-seeking with perinatal mortality: A nested case-control study in rural Bangladesh.

Maternal hypertension may be an underrecognized but important risk factor for perinatal death in low resource settings. We investigated the association of maternal hypertension and perinatal mortality in rural Bangladesh. This nested, matched case-control study used data from a 2019 cross-sectional survey and demographic surveillance database in Baliakandi, Bangladesh. We randomly matched each pregnancy ending in perinatal death with five pregnancies in which the neonate survived beyond seven days based on maternal age, education, and wealth quintile. We estimated associations of antenatal care-seeking and self-reported hypertension with perinatal mortality using conditional logistic regression and used median and interquartile ranges to assess the mediation of antenatal care by timing or frequency. Among 191 cases and 934 matched controls, hypertension prevalence was 14.1% among cases and 7.7% among controls. Compared with no diagnosis, the probability of perinatal death was significantly higher among women with a pre-gestational hypertension diagnosis (OR 2.90, 95% CI 1.29, 6.57), but not among women with diagnosis during pregnancy (OR 1.68, 95% CI 0.98, 2.98). We found no association between the number of antenatal care contacts and perinatal death (p = 0.66). Among women with pre-gestational hypertension who experienced a perinatal death, 78% had their first antenatal contact in the sixth or seventh month of gestation. Hypertension was more common among rural women who experience a perinatal death. Greater effort to prevent hypertension prior to conception and provide early maternity care to women with hypertension could improve perinatal outcomes in rural Bangladesh.

Functional and pasting properties of aerial yam starch at different harvesting periods

The impact of the harvesting period (sixth, seventh and eighth month) on functional and pasting properties of starches from Tob2857 and Tob3059 cultivars of aerial yam was investigated. Matured yam bulbils were further classified into two; matured ripe bulbils (MRB) and matured unripe bulbils (MUB) based on their peel colours at harvest. Starch content, amylose, resistant starch (RS), pasting and morphological characteristics of starches were evaluated using standard methods. RS (5.11-12.37%), amylose (14.88-20.15%) and solubility (1.16-3.98%) were higher in MUB than MRB starches and varied with the harvesting period. Pasting profiles revealed that peak, hot, break down, cold paste and set back viscosities, respectively ranged thus; (261.50-528.92 RVU), (269.00-458.38 RVU), (16.95-70.54 RVU), (304.14-576.79 RVU) and (71.42-118.41 RVU). Pasting time and temperature ranged from 4.68-5.92 min and 84.18-88.26 oC, respectively. The swelling power (0.53-9.85%) varied significantly between the cultivars and ripeness of the bulbils. The starch granules showed similar shapes (ovo-triangular-oblong) and granule size (16.80-32.34 µm) varied significantly with the harvesting period. The variation in functionality of aerial yam starch cultivars at different harvesting periods in this study could be exploited for the postharvest valorization of aerial yam starches.

Evaluating the Injection of Platelet-Rich Plasma on Second Lower Molars Protraction: A Randomized Controlled Clinical Trial.

Background The use of platelet-rich plasma (PRP) in dentistry was entered several decades ago, yet its clinical use in orthodontics still requires further investigation. The aim of this study was to evaluate the possible effects of local injection of PRP on the rate and typeof mandibular second molar protractionmovement compared with the comparator (no PRP) group. Material and methods Eighteen patients aged between 17 and 25 years were randomly allocated in a split-mouth study design to receive PRP injections on one sideimmediately before the start of molar protraction (PRP group), while the other side received only saline solution (comparator group). Eligibility criteria included bilaterally extracted mandibular first molars casesand indicated mandibular second molars protraction. The primary outcome of the study consisted of measuring the rate of molar protraction from the beginning of protraction (T0) to the end of the seventh month (TF), using a digital gauge. The secondary outcome included measuring the typeof second molar protraction movement between T0 and TFby lateral cephalometric images. Randomization of the intervention side was performed by picking out opaque sealed envelopes. The blinding of the principal investigator was impossible but blinding of the patient was achieved by injection of saline. Analyses were done using paired samples T-test to compare the changes in all variables between T0 and TF. The level of significance was taken at a P-value < 0.05. Results No significant difference was detected between the PRP and comparator groups in the rate of second lower molar protraction during seven months (0.56±0.07 mm per month in the comparator group, whereas, was 0.6±0.11 mm per month in the PRP group). Molar protraction parameters in both groups showed second lower molars moving by controlled tipping closer to bodily movement (Root Movement:Crown Movement≈0.8). Conclusions Platelet-rich plasma (PRP) is ineffective in accelerating the rate of orthodontic tooth movement (OTM) during molar protraction, and it has no effect on the type of tooth movement. In addition, the mechanics that we used (6 mm power arm in combination with miniscrews) are effective in mandibular second molar protraction by controlled tipping closer to bodily movement.

FEATURES OF THE STRUCTURE OF THE EAR TUBE IN THE PRENАTAL PERIOD OF HUMAN DEVELOPMENT

They were irregular in ten cases, rectangular in nine cases, and triangular in three cases. It has been established that the size and shape of the auditory tube in prematurely born children do not have defi nitive dimensions and its location diff ers from that in newborns. The pharyngeal openings of the auditory tubes are at the level of the hard palate and, in newborns, above the level of the hard palate. The tympanic openings from the lower part of the anterior wall of the tympanic cavity in fetuses of the seventh month of intrauterine development move completely to the upper part of it and open into the supratympanic space in fetuses of the tenth month. The identifi ed features are important in improving the technology and adequacy of surgical treatment and manipulations in prematurely born children.The structure and syntony of the auditory tube were studied in 35 human fetuses of the seventh to tenth months of intrauterine development and 11 corpses of newborns. In the fetuses of the seventh month, the shape of the tympanic openings of the auditory tubes was irregular in eight cases, triangular in three cases, and rectangular in eleven cases. The drum holes shift to the top even more. They had an irregular shape in nine cases and a rectangular shape in fi ve. In the tenth month, the tympanic openings of the auditory tubes move to the upper part of the anterior wall of the tympanic cavity and open into the supratympanic space. They had an irregular shape in ten cases, and in six cases we observed a rectangular shape of them. The tympanic openings of the auditory tubes in newborns are located in the upper part of the anterior wall of the tympanic cavity and open into the supratympanic space. They were irregular in ten cases, rectangular in nine cases, and triangular in three cases. It has been established that the size and shape of the auditory tube in prematurely born children do not have defi nitive dimensions and its location diff ers from that in newborns. The pharyngeal openings of the auditory tubes are at the level of the hard palate and, in newborns, above the level of the hard palate. The tympanic openings from the lower part of the anterior wall of the tympanic cavity in fetuses of the seventh month of intrauterine development move completely to the upper part of it and open into the supratympanic space in fetuses of the tenth month. The identifi ed features are important in improving the technology and adequacy of surgical treatment and manipulations in prematurely born children.

Topography and dimensions of the auditory tube at the end of the fetal period

Introduction. Otitis media in premature newborns and term newborns is a serious problem due to the immaturity of the organs and systems of these children and the difficulty of their adaptation. This often leads to the development of pathological changes in the hearing organ and the need for surgical intervention. The aim - to find out the topographic and anatomical features of the auditory tube at the end of the fetal period to improve technologies and the adequacy of surgical treatment. Material and methods. The study was performed on 35 human fetuses of 231.0-375.0 mm parietococcygeal length (PCL) and 11 neonatal cadavers. In the course of the study the following methods were used: thin dissection of the middle ear and adjacent areas under the control of a binocular loupe; macro- and microscopy; morphometry; macro photography with digital camera "OLIMPUS μ 1000 All-weather 10.0 MPix". Results. It has been established that the size and shape of the auditory tube in premature babies do not have definitive dimensions and its location differs from that in term newborns. The pharyngeal openings of the auditory tubes are located at the level of the hard palate, and in term newborns - above the level of the hard palate. The tympanic openings from the lower part of the anterior wall of the tympanic cavity in fetuses of the seventh month of intrauterine growth completely move to its upper part and open into the supratympanic space in fetuses of the tenth month. Conclusions. The defined features of the development of the auditory tube at the end of the fetal period are important for the improvement of technologies and the adequacy of surgical treatment and manipulations in premature babies and term newborns. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution indicated in the work. No conflict of interests was declared by the authors.

Evaluation of the relationship between restless legs syndrome, mental status, and sleep disorders among Moroccan women during their third trimester of pregnancy.

Restless legs syndrome (RLS) is a motor disorder encountered during pregnancy and leads to psychological and sleep impairments. The latter seems to be non-restorative and its occurrence alters the quality of life of pregnant women. The objective of this study was to evaluate the prevalence of RLS and its relationship with both anxio-depressive symptoms and sleep disorders among a population of Moroccan pregnant women during their third trimester of pregnancy. A cross-sectional study was conducted in a population of pregnant women in their third trimester (n=178) admitted to two health facilities in the city of Marrakech: Youssef Ibn Tachafine and Oasis. The face-to-face questionnaire was used to collect data including demographic and clinical characteristics, the four diagnostic criteria of RLS, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS). Patients were divided into two groups RLS+ (women with RLS) and RLS- (women without RLS). The prevalence of RLS was 59.5%; this syndrome was more common in the ninth month (74.15%) compared with the seventh and eighth months. Sleep impairment, including sleep efficiency, was significantly higher in RLS+ than RLS- (P-value 0.05). Anxiety but not depression is significantly increased in RLS+ compared to RLS- (48.11% versus 38.8%, P = 0.000). There were no significant differences between RLS+ and RLS- in terms of socio-demographic and other clinical characteristics. RLS is encountered during the prenatal period, with a higher prevalence in the last trimester. During this stage of pregnancy, women suffering from RLS were vulnerable to anxiety and sleep disorders. Prevention and early diagnosis of RLS could be a proactive healthcare management leading to better health outcomes and better conditions of pregnancy, which precedes childbirth.

The Effectiveness of an Education Intervention based on Self-Care Model on Depressive Symptoms among adolescents with Type 1 Diabetes Mellitus

Introduction: Over the past years, evidence has shown a high prevalence of depression among Type 1 Diabetes Mellitus (T1DM) patients. This interventional study was performed to decrease depressive symptoms using education based on the self-care model in Kiambu County, Kenya.&#x0D; Methodology: The study was conducted from January to August 2021 at diabetic clinics of Thika Level 5 Hospital (TL5H) and Kiambu Level 5 Hospital (KL5H). The study employed a pre-test post-test non-equivalent quasi-experimental study design. There were 96 adolescents with T1DM obtained by stratified random sampling, and assigned into experimental (48 respondents) and control group (48 respondents). Depressive symptoms were evaluated in the first and seventh months using the Center for Epidemiology Studies Short Depression (CES-D) scale. Paired sample T-test and Independent sample T-test were used to analyze data.&#x0D; Results: The results of the Independent sample T-test showed that there was a statistically significant difference in the mean score difference of depressive symptoms at postintervention (t = -2.968, df = 94, p = 0.004), but no statistically significant difference in the mean score difference of depressive symptoms at baseline (t = -1.100, df = 86, p =0.274). The result of the paired sample T-test revealed that there was a statistically significant difference in the mean score difference of depressive symptoms in the intervention group (t = -4.374, df = 47, p = &lt;0.001), but no statistically significant difference in the mean score difference of depressive symptoms in the control group (t= -1.304, df = 47, p =0.199).&#x0D; Conclusions: Education intervention based on the self-care model is an effective program that can improve depressive symptoms. In addition, the education intervention based on the self-care model needs to be implemented continuously to prevent diabetes-related complications and improve depressive symptoms among diabetic patients.

Ecophysiological responses of bromelias in the restinga in simulated climate change scenarios.

We investigated the ecophysiological responses of the bromeliads Aechmea nudicaulis and Vriesea procera, seeking to assess their suitability to survive in a climate change scenario (optimistic scenario RCP 2.6 of the IPCC, 2021) in a Restinga environment. To carry out this investigation, we used open-top chambers (OTC). During a period of nine months (June 2022 to February 2023), the bromeliads A. nudicaulis and V. procera were subjected to the following treatments: treatment T: plants transplanted to the environmental conditions of the bare sand of the restinga and subjected to the microclimatic conditions of the OTC's; control C: plants transplanted to the environmental conditions of the bare sand of the restinga. The ecophysiological variables height, rosette diameter, relative water content, specific leaf area and total weight of the plants were evaluated. In addition, dead plants were counted. The OTC's showed an average increase in temperature and VPD (Vapor Pressure Deficit) of 1.6°C and 0.5 Kpa, respectively, and an average reduction in RH (relative humidity) of 5.3%. The results of this study indicated that the increase in local temperature that occurred between the sixth and seventh months evaluated (November and December) created limiting conditions that exceeded the tolerance capacity of the bromeliads studied. Furthermore, the climatic conditions of the OTCs intensified the damage that occurred in the plants, verified here by the reductions in the values ​​of the ecophysiological attributes evaluated in the bromeliads studied. In addition, the high mortality rate (above 50%) reinforces the idea that the climatic conditions of the OTC's induced the bromeliads studied to a senescence process. Therefore, these results are important, as they indicate that even the most optimistic climate change scenario (IPCC 2021 RCP 2.6) can harm the growth and development of these bromeliads, which are essential for the structure and functioning of Restinga communities.

Intestinal Tuberculosis with Enterocutaneus Fistula: A Rare Case

Introduction: Enterocutaneous fistula is a common postoperative complication. The incidence of enterocutaneous fistula as a complication of intestinal tuberculosis is quite rare, so we are interested in reporting this case. Case Report: 32-year-old male presented with history of abdominal pain and fecal matter coming out from an opening in umbilical region for the past 1 month. Patient have history of laparotomy exploration 7 months ago and histopathology showed intestinal tuberculosis. Currently, patient was undergoing TB treatment with anti-tubercular treatment (ATT) for the seventh month. Physical examination showed fistulous opening 2x2 cm over the scar of previous laparotomy. Laboratory examination revealed leukocytosis shift to the left and hypoalbuminemia. Chest X-ray showed active pulmonary tuberculosis. Abdominal CT with with contrast showed localized ileus consist of sentinel loop and suggestive intestinal tuberculosis. Diagnosis of tubercular enterocutaneus fistula arising of as a post-operative complication was made. Patient was given intravenous fluids, antibiotics, antitubercular treatment, and wound care. Patient responded well to conservative management. Discussion: Intestinal tuberculosis (TB) is the sixth most common site of extrapulmonary tuberculosis which can occur primary or secondary. Enterocutaneus fistula (ECF) is a rare complication of intestinal TB and can be managed based on whether the output is low or high. Conservative management can be done through administration of intravenous fluids, antibiotics, antitubercular treatment, and wound care

The Use of Free Fibula Flap in Different Extremities and Our Clinical Results.

Background and objectives Plastic, orthopedic, otolaryngology, and oromaxillofacial surgery specialists rely on fibula grafts to solve reconstructive problems. The aim of this study is to discuss the use and results of vascular fibula flaps in the treatment of bone and soft tissue defects in various regions with different etiologies. Materials and methods In our clinic, we treated 32 patients with osteocutaneous fibular flaps due to bone and soft tissue defects of different etiologies and varying anatomical regions. In our study, age, gender, side, cause of injury, surgical technique, treatment results, and complications were evaluated for each patient. Results Of the 32 patients, 25 were male, and 7 were female. The average age is 37.2 (27-56). The mean bone defect size was 10.45 cm. Bone defect occurred in eight patients due to osteomyelitis, eleven patients due to gunshot wounds, nine patients due to pseudoarthrosis, and four patients due to a giant cell tumor. We applied osteocutaneous fibula flap in 27 patients and vascularized fibular flap in five patients. Bone union could not be achieved in four patients, and bone grafting was performed as a secondary surgery. Local infection occurred in five patients, and their treatment was completed with debridement and antibiotic administration. Wound complications occurred in three patients at the donor site, which were treated with debridement and skin grafting. The mean duration of radiological union was three months, and complete union was achieved in the seventh month. Conclusions We have shown in our case series that free vascularized fibula transfer has gained an important place in the field of skeletal reconstruction and is a reliable method for various bone reconstructions.

Appraisal of long-term responsiveness of normalized difference vegetation index to climatic factors using multiscale time–frequency decomposition in an arid environment

An arid climate is a unique condition that has a significant impact on the growth of crops and natural vegetation. The normalized difference vegetation index (NDVI) is a crucial remotely sensed measurement of greenness due to its strong correlation with crop and vegetation growth and productivity. In the present study, the spatiotemporal dynamics of NDVI were analyzed from 2000 to 2021 in the segment of the arid western plain zone of Rajasthan, India. NDVI time-series data, as well as data related to climatic factors, viz., precipitation, soil moisture, evapotranspiration, and 2-m air temperature, were collected from Giovanni, the Goddard Earth Science dataset. The Mann–Kendall (MK) trend test and Sen’s slope depicted the long-term continuous time–frequency trend, while Karl Pearson’s correlation analysis depicted the significant relationship between all the factors except 2-m air temperature. The seasonal and mean monthly results of all the factors except 2-m air temperature showed considerable coherence with NDVI. The multiscale time–frequency decomposition or wavelet analysis depicted the fifth to the seventh month and the ninth to the 15th month of the cycle, showing the significance of the cropping pattern and the natural vegetation growth cycle. The cross-wavelet analysis further depicted important coherence, leading, and lagging phases among climatic factors and NDVI. Our research provided significant insights into the long-term variability and coherence of various climatic factors with NDVI that are applicable on regional and global scales.

Breastfeeding in primiparous women – expectations and reality: a prospective questionnaire survey

BackgroundBreastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers.MethodsIn this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life).ResultsA total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants’ sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05).ConclusionsBreastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour.Trial registrationThe study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).

Discharge prescribing and subsequent opioid use after traumatic musculoskeletal injury.

To investigate the effects of discharge opioid supply after surgery for musculoskeletal injury on subsequent opioid use. Instrumental variables analysis of retrospective administrative data. Data were acquired on 1039 patients treated operatively for a musculoskeletal injury between 2011 and 2015 at 2 level I trauma centers. State registry data were used to track all postoperative opioid prescription fills. Discharge surgical resident was identified for each patient. We categorized residents in the top one-third of opioid prescribing as high-supply residents and others as low-supply residents, with adjustment for service attending physician and month. The primary outcome was subsequent opioid use, defined as new opioid prescriptions and cumulative prescribed opioid supply 7 to 8 months after injury. On average, patients of high-supply residents received an additional 96 morphine milligram equivalents (MME) at discharge (95% CI, 29-163 MME; P < .01), or 16% more, compared with patients of low-supply residents, which is equivalent to an additional 2-day supply at a typical dosage. In the seventh or eighth month after surgery, patients of high-supply residents received a greater total MME volume than patients of low-supply residents (difference, 13.0 MME; 95% CI, 3.1-22.9 MME; P < .01) despite receiving a greater cumulative supply of opioid medications through the sixth month after surgery. After surgery for musculoskeletal injury, patients discharged by residents who prescribe greater supplies of opioid pain medications received higher supplies of opioids 7 to 8 months after surgery than patients discharged by residents who tend to prescribe less. Thus, limiting postoperative supplies of opioid pain medication may help reduce chronic opioid use.

Strategi Komunikasi Muhammadiyah dalam Menebar Dakwah Kultural Persfektif Muhammad Abu Fatah Al-Bayanuni (Studi Kasus: Muhammadiyah Bangun Purba Deli Serdang)

In this study the authors wanted to know the Communication Strategy of the Muhammadiyah Bangun Purba Branch Leaders in spreading cultural da'wah. The author uses Muhammad Abu Fatah Al-Bayanuni's Da'wah Strategy Theory, including: Athifiy Da'wah Strategy, Aqliy Strategy, and Hissiy Method. In this study the authors used descriptive qualitative research. In collecting data the authors used three techniques, namely: participant observation, in-depth interviews, and documentation. Data validity technique with credibility test. Data analysis techniques using the Miles &amp; Huberman model. Muhammadiyah Bangun Purba Branch Manager has its own communication strategy in spreading cultural da'wah, in carrying out the tradition of the Seven Months of Pregnancy, it is more advisable for Persyarikatan residents to Al-Quran recitations during the pregnancy process without having to enter the seventh month of pregnancy. Whereas in the Tahlilan tradition of Sending Prayers for people who have died, the Muhammadiyah Bangun Purba Branch Leader forbade it to be carried out, Muhammadiyah Bangun Purba members prioritize the nature of respecting and maintaining friendship. To show the existence that Muhammadiyah is not anti-art culture, currently the Branch Manager Muhammadiyah Bangun Purba has a dance and Martial Arts studio, Tapak Suci.

Korrekciós tréning a Magyar Táncművészeti Egyetem klasszikus balett szakirányának első évfolyamaiban

At the beginning of the academic year all students newly admitted to the classical ballet dancer training course of The Hungarian Dance University are assessed by the Child Development and Therapy Centre called Bárányfelhő. After the assessment of their motor and neurodevelopment, children can have special skills development training integrated in their curriculum. Between the 33 children assessed in September 2020 the most significant differences were found in cross-body movements and the independent use and coordination of the upper and lower extremities. In the seventh month following the evaluation, the ballet masters of these classes reported development in concentration, coordination, balance, attention, as well as the independent use of the limbs and proprioception in these children. The skills development training has got a compound effect: as students` coordination skills improve, they gain more success and, as a result, they become more self-confident. This kind of specific skills development at the Hungarian Dance Academy does not only fill a gap in professional dancer training but it is also unique regarding professional dancer courses.