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  • Sigmon Pitts posted an update 5 days, 7 hours ago

    [This corrects the article DOI 10.1055/a-1372-4051.].[This corrects the article DOI 10.1055/a-1198-4357.].Following the outbreak of the novel coronavirus (COVID-19) in China in late December 2019, more than 217 countries became almost immediately infected in the resulting pandemic. Consequently, many of them decided to close their educational institutions as a way of preventing the spread of this virus. For many of them, though, the closure made them unable to deliver learning materials to students owing to their inability to provide the right technology for the purpose. To assist with the digitalizing of learning during this time, this study reviews the most common technologies used in the delivery of learning materials, with the experience of most infected countries being considered. Major challenges in online learning are discussed in this study as well. Further, Saudi Arabia was considered as a case study for the effectiveness of distance learning during the 2020 spring semester, where 300 undergraduate students were surveyed on their opinions of distance learning. The responses to the survey indicated that distance learning was effective in providing the required knowledge to the students during the outbreak of COVID-19. The findings showed that although the lack of interaction and poor internet connections were factors affecting comfortable and successful learning of physics and mathematics, 63% of students were satisfied with learning management systems, 75% of students found it easy to understand course materials, and 67% of students found it easy to understand assignments and could deal with them comfortably. The study findings can encourage educational institutions to digitalize their learning materials in the future.

    We aimed to examine the contemporary trends and regional variations in premature mortality due to heart failure across the U.S. from 1999 to 2018.

    For most U.S. census regions, it is unknown whether premature mortality (deaths among persons under age 65) due to heart failure is increasing -or decreasing.

    In this descriptive study, the death certificate data were retrieved from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (WONDER) database and examined from 1999 to 2018 for the underlying cause of death. Age-adjusted mortality rates (AAMR) per 100,000 persons and annual percent change (APC) in rates stratified by census region were calculated using Joinpoint trend analysis software.

    There were 118,116 premature deaths due to heart failure from 1999 to 2018 across the U.S. Of these 52.40% of deaths were reported in the South, 20.30% in the Midwest, 15.10% in the West, and 12.20% in the Northeast. The AAMRs were the highest in the South region (range 3.1-4.9) and the lowest in the Northeast region (range 1.5-1.9). There was an overall decline in mortality across all regions from 1999 till 2011-2012. However, mortality has an upward trajectory throughout all the census regions after 2012.

    This study on nationwide data showed that overall premature mortality due to heart failure declined from 1999 to 2011-2012 followed by an upward trajectory from 2012 to 2018; the explanation for this merits further discovery.

    This study on nationwide data showed that overall premature mortality due to heart failure declined from 1999 to 2011-2012 followed by an upward trajectory from 2012 to 2018; the explanation for this merits further discovery.The present study examines the relationship between smoking and panic, depression, and anxiety over time and across two cultures, using data from the BOOM studies. The relationship between smoking and anxiety disorders, including panic requires further exploration, in order to reconcile inconsistent, contradictory findings and cross-cultural differences. Participants in the present study included 5,416 Chinese university students and 282 German university students. Participants completed surveys assessing smoking, panic, depression, and anxiety. Multiple logistic regressions were used to examine predict later mental health from smoking, as well as later smoking from mental health. In sum, across the regressions, smoking at baseline did not predict higher panic or depression at follow-up in either German or Chinese students. It did predict lower anxiety in German students. Anxiety at baseline, but not depression, predicted increased likelihood of smoking at follow-up in German students. The relationship between smoking and anxiety disorders is one that will require further exploration, in order to reconcile inconsistent, contradictory findings and cross-cultural differences. The present data point to a relationship between anxiety and later smoking, and also to a negative, though small, relationship between smoking and later anxiety in German students, and no prospective relationship in either direction in Chinese students.

    Our understanding of how societal conditions and educational policies influence cognitive development across the life course is improving. We tested the extent to which inequality of educational opportunity (IEO), the country- and cohort-specific correlation of parents’ and their offspring’s length of schooling, offers systematically different opportunities to contribute to cognitive development, which in turn influences cognitive abilities up to older ages.

    A total of 46,972 individuals of three cohorts born 1940-63 from 16 European countries and Israel provided up to six cognitive assessments and information on covariates in the SHARE survey 2004-2017. Individual-level data were linked to indicators of IEO at time of schooling, and economic, health, and human development, provided by World Bank, WHO, and the UN.

    In multilevel (mixed-effects) models with random individual and country-cohort effects and adjusted for a large set of confounders, higher IEO was associated with lower levels of cognitive functioning in men and women. Interaction analyses suggested lower cognitive levels particularly of women who were schooled in higher IEO contexts and had lower educational attainment. Associations with rate of change in cognitive functioning were present only in women, however there was little clinically relevant cognitive decline across the window of observation. Result patterns were mostly consistent after including additional contextual indicators, and in a subsample with childhood information.

    Findings suggest that IEO is able to substantially influence cognitive development with long-lasting impacts. Lower-educated women of the cohorts under investigation may have been particularly vulnerable to high-inequality educational contexts.

    Findings suggest that IEO is able to substantially influence cognitive development with long-lasting impacts. Lower-educated women of the cohorts under investigation may have been particularly vulnerable to high-inequality educational contexts.The ongoing COVID-19 pandemic has spotlighted the role of America’s overcrowded prisons as vectors of ill health, but robust analyses of the degree to which high rates of incarceration impact population-level health outcomes remain scarce. In this paper, we use county-level panel data from 2927 counties across 43 states between 1983 and 2014 and a novel instrumental variable technique to study the causal effect of penal expansion on age-standardised cause-specific and all-cause mortality rates. We find that higher rates of incarceration have substantively large effects on deaths from communicable, maternal, neonatal, and nutritional diseases in the short and medium term, whilst deaths from non-communicable disease and from all causes combined are impacted in the short, medium, and long run. These findings are further corroborated by a between-unit analysis using coarsened exact matching and a simulation-based regression approach to predicting geographically anchored mortality differences.

    Climate change is leading to an increased number of natural disasters. Children from low- and middle-income countries are disproportionately affected. The impacts of exposure to multiple natural disasters on the development of children are not well understood. The Philippines had 6.5 million people affected by natural disasters in 2018 and is therefore an ideal country in which to study the cumulative effects of natural disasters on human development.

    We used wave 1 (2016-17) of the Longitudinal Cohort Study on the Filipino Child, a nationally representative cohort study of 4952 10-year-old children, to examine the impact of natural disasters. For caregivers, we examined mental health, family violence, and food insecurity. For children, we examined exposure to violence and stunting. We used random effects models to estimate the associations between natural disasters and children’s development outcomes and caregivers’ outcomes, after adjusting for neighbourhood, demographic, and geographic variables. Disasis the first national study to document that cumulative measures of natural disasters had small, but wide-ranging, impacts on children and their caregivers. Further research is needed to identify factors that will protect populations who are at risk of high levels of natural disasters to ensure the optimal development of children.

    The Philippines Project, The Australian National University.

    The Philippines Project, The Australian National University.

    Surgical management of Extraarticular Distal-third diaphyseal Humerus Fracture (EADHF) poses a dilemma in terms of surgical approach, implant selection and position of the implant due to the availability of various pre-contoured implants and plate configurations. PF-06826647 Various studies have described a modified application of anatomic locking plates as a satisfactory method of fixation in the surgical management of EADHF.

    This report discusses the modified application of anatomic Distal Medial Tibial locking Plate (DMTP) as an alternative strategy in fixation of an acute extraarticular distal-third diaphyseal fracture of the humerus in a 45-years-old female patient. Bony union was achieved successfully without any malalignment and the patient showed a full recovery with an excellent clinical and outcome at 2-years follow-up.

    In EADHF, the use of 3.5mm DMTP is advantageous as it offers rigid fixation by insertion of more number of 3.5mm locking bicortical screws and stability in both columns. This promotes biological fracture healing, low rate of complication, early return to work with improvement in clinical function. Therefore, we recommend that pre-contoured 3.5mm DMTP can be successfully used as an alternative fixation choice for the treatment of EADHF.

    In EADHF, the use of 3.5 mm DMTP is advantageous as it offers rigid fixation by insertion of more number of 3.5 mm locking bicortical screws and stability in both columns. This promotes biological fracture healing, low rate of complication, early return to work with improvement in clinical function. Therefore, we recommend that pre-contoured 3.5 mm DMTP can be successfully used as an alternative fixation choice for the treatment of EADHF.

    Native hip dislocations are most commonly seen after high energy trauma. While there are documented cases of hip dislocation with associated stroke, we present a case of posterior hip dislocation in the context of acute longitudinal transverse myelitis due to a rare presentation of SARS-CoV-2.

    A 60-year-old male presented with bilateral lower limb weakness with a shortened internally rotated left leg. Plain radiographs revealed a posteriorly dislocated native left hip and MRI of the spine showed acute longitudinal transverse myelitis of the cervical and thoracic regions. His nasopharyngeal swab was positive for SARS-CoV-2. His hip was reduced, and he was treated with intravenous steroids. His neurological symptoms improved with follow-up MRI showing resolution of the transverse myelitis.

    This case illustrates a classic orthopaedic emergency in the context of a rare presentation of SARS-CoV-2, and the vigilance that orthopaedic doctors must have when examining patients with lower limb neurological deficit.