Suchergebnisse

Abstract
Background The global trend toward increased life expectancy because of remarkable improvements in health care quality has drawn increased attention to osteoporotic fractures and degenerative spine diseases. Cement-augmented pedicle screw fixation has been established as the mainstay treatment for patients with poor bone quality. This study aimed to determine the number of patients with cement leakage and pulmonary cement embolism (PCE) as detected on thoracic computed tomography (CT), and to assess the potential risk factors for PCE.
Methods Patients undergoing cement-augmented pedicle screw placement in our institution between May 2008 and December 2020 were included. Data regarding baseline characteristics, complications, and cement leakage rates were collected. Indications for the performance of a postoperative thoracic CT due to the suspicion of PCE were intra- or postoperative complications, or postoperative oxygen supplementation. Moreover, PCE was accidently diagnosed because the thoracic CT was performed for medical reasons other than the suspicion of PCE (tumor staging, severe pneumonia, or exacerbated chronic pulmonary obstructive disease).
Results A total of 104 patients with a mean age of 72.8 years (standard deviation of 6.7) were included. Of 802 screws, 573 were cement augmented. Of the 104 patients, 44 (42.3%) underwent thoracic CT scans to diagnose PCE; additionally, 67 (64.4%) demonstrated cement leakage, of whom 27 developed PCE and 4 were symptomatic. Cement-augmented thoracic screws were a risk factor for PCE (odds ratio: 1.5; 95% confidence interval: 1.2–2.1; p = 0.004).
Conclusions This study showed a high prevalence of cement leakage after cement-augmented pedicle screw insertion, with a relatively frequent incidence of PCE, as tracked by thoracic CT scans. Cement-augmented thoracic screw placement was a unique risk factor for PCE.

Crowd management has attracted serious attention under the prevailing pandemic conditions of COVID-19, emphasizing that sick persons do not become a source of virus transmission. World Health Organization (WHO) guidelines include maintaining a safe distance and wearing a mask in gatherings as part of standard operating procedures (SOP), considered thus far the most effective preventive measures to protect against COVID-19. Several methods and strategies have been used to construct various face detection and social distance detection models. In this paper, a deep learning model is presented to detect people without masks and those not keeping a safe distance to contain the virus. It also counts individuals who violate the SOP. The proposed model employs the Single Shot Multi-box Detector as a feature extractor, followed by Spatial Pyramid Pooling (SPP) to integrate the extracted features to improve the model's detecting capabilities. The MobilenetV2 architecture as a framework for the classifier makes the model highly light, fast, and computationally efficient, allowing it to be employed in embedded devices to do real-time mask and social distance detection, which is the sole objective of this research. This paper's technique yields an accuracy score of 99% and reduces the loss to 0.04%. Doi: 10.28991/esj-2021-SPER-14 Full Text: PDF

Abstract
Background
Pesticides are washed from agricultural fields into adjacent streams, where even short-term exposure causes long-term ecological damage. Detecting pesticide pollution in streams thus requires the expensive monitoring of peak concentrations during run-off events. Alternatively, exposure and ecological effects can be assessed using the SPEARpesticides bioindicator that quantifies pesticide-related changes in the macroinvertebrate community composition. SPEARpesticides has been developed in Central Europe and validated in other parts of Europe, Australia and South America; here we investigated its performance in East African streams.

Results
With minimal adaptations of the SPEARpesticdes index, we successfully characterized pesticide pollution in 13 streams located in Western Kenya. The East African SPEARpesticides index correlated well with the overall toxicity of 30 pesticides (maximum toxic unit = maximum environmental vs. median lethal concentration) measured in stream water (R2 = 0.53). Similarly, the SPEARpesticides index correlated with the risk of surface run-off from agricultural fields (as identified based on ground slope in the catchment area and the width of protective riparian strips, R2 = 0.45). Unlike other bioindicators designed to indicate general water pollution, SPEARpesticides was independent of organic pollution and highly specific to pesticides. In 23% of the streams, pesticides exceeded concentrations considered environmentally safe based on European first tiered risk assessment.

Conclusions
Increasing contamination was associated with considerable changes in the macroinvertebrate community composition. We conclude that pesticides need to be better regulated also in developing countries. SPEARpesticides provides a straightforward and cost-efficient tool for the required monitoring of pesticide exposure in small to medium streams.

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization's conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

Introduction: In conflict affected countries, healthcare delivery remains a huge concern. Pakistan is one country engulfed with conflict spanning various areas and time spans. We aimed to explore the effect of conflict on provision of reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH&N) services and describe the contextual factors influencing the prioritization and implementation in conflict affected areas of Pakistan (Balochistan and FATA).Method: We conducted a secondary quantitative and a primary qualitative analysis. For the quantitative analysis, we stratified the various districts/agencies of Balochistan and FATA into the conflict categories of minimal-, moderate- and severe based on accessibility to health services through a Delphi methodology with local stakeholders and implementing agencies and also based on battle-related deaths (BRD) information from Uppsala Conflict Data Program (UCDP). The coverage of RMNCAH&N indicators across the continuum of care were extracted from the demographic and health surveys (DHS) and district health information system (DHIS). We conducted a stratified descriptive analysis and multivariate analysis using STATA version 15. The qualitative data was captured by conducting key informant interviews of stakeholders working in government, NGOs, UN agencies and academia. All the interviews were audiotaped which were transcribed, translated, coded and analyzed on Nvivo software version 10.Results: The comparison of the various districts based on the severity of conflict through Delphi process showed that the mean coverage of various RMNCAH&N indicators in Balochistan were significantly lower in severe- conflict districts when compared to minimal conflict districts, while there was no significant difference between moderate and severe conflict areas. There was no reliable quantitative data available for FATA. Key factors identified through qualitative analysis, which affected the prioritization and delivery of services included planning at the central level, lack of coordination amongst various hierarchies of the government and various stakeholders. Other factors included unavailability of health workforce especially female workers, poor quality of healthcare services, poor data keeping and monitoring, lack of funds and inconsistent supplies. Women and child health is set at a high priority but capacity gap at service delivery, resilience from health workers, insecurity and poor infrastructure severely hampers the delivery of quality healthcare services.Conclusion: Conflict has severely hampered the delivery of health services and a wholesome effort is desired involving coordination amongst various stakeholders. The multiple barriers in conflict contexts cannot be fully mitigated, but efforts should be made to negate these as much as possible with good governance, planning, efficiency and transparency in utilization of available resources.

Background and Objective: Scorpion sting and snakebite are the important problems in some area such as Iran that must be addressed. This study was to investigate temporal pattern of scorpion sting and snakebite incidence in patients referred to Masjedsoleiman's main hospital, during 24 months from 21 March 2008 to 20 March 2009. Materials and Methods: It was an analytical study to scrutiny of monthly and seasonal procedure of scorpion sting and snakebite. Data were analyzed by SPSS and Minitab. To identify the goodness of fit model for monthly and seasonal incidence of scorpion sting and snakebite, autoregressive integrated moving average (ARIMA) models were used to explore time series analysis. Results: Of all 9457scorpion sting and snake-bite cases in patients referring to hospital, 45% (n=4253) were men. Mean age of them was 28.26±0.36 years. Significant numbers (27%) of these patients had 21-30 years old, and were bitted in urban (93%), at their home (99.7%). The auto regression suggested that monthly average incidents model have a moving average. The analyses through Anderson- Darling test provide evidence that the distribution of residuals was normal (P= 0.125). Conclusion: Weather variables can be as the predictors of scorpion sting and snake-bite incidence for Masjedsoleiman. REFERENCESREFERENCES1- Bahloul M, Rekik N, Chabchoub I, Chaari A, Ksibi H, Kallel H, et al. Neurological complications secondary to severe scorpion envenomation. Medical science monitor: international medical journal of experimental and clinical research. 2005; 11(4):CR196-202.2- Ozkan O, Carhan A. The neutralizing capacity of Androctonus crassicauda antivenom against Mesobuthus eupeus scorpion venom.Toxicon. 2008; 52(2):375-9.3- Ghaderi H, Shariati Z, Ghodoosi A, Ziyaee M. Scorpion bites in the north-western of Khuzestan province from May 2002 to December 2003. Hayat. 2006; 12(2): 73-8.4- Jalali A, Vatan Pour H, BagheriKhalili M, Ayatollahi SAM, KamaliNejad M. 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The Indian crested porcupine (Hystrix indica) is a vertebrate pest of agricultural lands and forest. The study was aimed to report the damage to local crops by the Indian crested porcupine (Hystrix indica) in the Muzaffarabad District. A survey was conducted to identify the porcupine-affected areas and assess the crop damage to the local farmers in district Muzaffarabad Azad Jammu and Kashmir (AJK) from May 2017 to October 2017. Around 19 villages were surveyed, and a sum of 191 semi-structured questionnaires was distributed among farmers. Crop damage was found highest in village Dhanni where a porcupine destroyed 175 Kg/Kanal of the crops. Regarding the total magnitude of crop loss, village Danna and Koomi kot were the most affected areas. More than half (51.8%) of the respondents in the study area suffered the economic loss within the range of 101-200$, and (29.8%) of the people suffered losses in the range of 201-300$ annually. Among all crops, maize (Zea mays) was found to be the most damaged crop ranging between 1-300 Kg annually. In the study area, porcupine also inflicted a lot of damages to some important vegetables, including spinach (Spinacia oleracea), potato (Solanum tuberosum) and onion (Allium cepa). It was estimated that, on average, 511Kg of vegetables are destroyed by porcupine every year in the agricultural land of Muzaffarabad. It was concluded that the Indian crested porcupine has a devastating effect on agriculture which is an important source of income and food for the local community. Developing an effective pest control strategy with the help of the local government and the Wildlife department could help the farmers to overcome this problem.

Rays are usually caught for their high-value fins, but their flesh is also in demand in Philippine tribal areas. Compared to other commercial marine fish in the local market of Bongao, Tawi-Tawi, Philippines, stingrays are not very expensive, but they are high in protein. Fish flakes are a popular snack food made from intermediate moisture fish. This study evaluated sweet and spicy fish flakes made using dried stingray meat with the aid of white cane vinegar (T1) and water (T2) as pre-treatments. The newly developed fish flakes were evaluated by 100 panelists, particularly faculty and students. The results showed that the color, odor, texture, and general acceptability scores of sweet and spicy dried fish flakes did not differ significantly (P>0.05) between the two treatments. However, the taste scores showed a significant difference (P<0.05) in terms of sweetness. The sweetness score of sweet and spicy dried fish flakes pre-treatment with water (4.33 ± 0.09) was significantly higher than those pre-treatment with vinegar (3.99 ± 0.09). Moreover, the sensory quality scores suggest that either of the two treatments can be used to formulate this new fishery product. However, this new product requires further analysis, especially on shelf life, proximate and microbial analyses.

Irfan Ullah,1 Assad Ullah,2 Sher Ali,3 Petra Poulova,4 Ahsan Akbar,5 Muhammad Haroon Shah,6 Alam Rehman,7 Muhammad Zeeshan,8 Fakhr E Alam Afridi3 1Reading Academy, Nanjing University of Information Science and Technology, Nanjing, People's Republic of China; 2School of Economics, Henan University, Kaifeng, People's Republic of China; 3Department of Economics, Islamia College Peshawar, Peshawar, Pakistan; 4Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, 500 03, Czech Republic; 5International Business School, Guangzhou City University of Technology, Guangzhou, 510080, People's Republic of China; 6College of International Students, Wuxi University, Wuxi 214105, Jiangsu, People's Republic of China; 7Faculty of Management Sciences, National University of Modern Languages, Islamabad, Pakistan; 8College of Business Administration, Liaoning Technical University, XingCheng, Liaoning Province, 125105, People's Republic of ChinaCorrespondence: Ahsan AkbarInternational Business School, Guangzhou City University of Technology, Guangzhou, 510080, People's Republic of ChinaEmail akbar@gcu.edu.cnObjective: The provision of healthcare facilities remains high on the manifesto of various political parties in Pakistan and healthcare spending has witnessed a significant surge in the last two decades that is expected to positively influence health outcomes in the country. Therefore, this research aims to explore the effects of healthcare expenditures on the actual health status of the masses in Pakistan for the period 1995Q1 to 2017Q1.Methods: We apply the Quantile Autoregressive Distributed Lag (QARDL) approach for estimation purposes. This is the most recent and emerging estimation technique in time series analysis.Results: Our findings confirm that public healthcare spending significantly impacts health outcomes in Pakistan both in the short-run and long-run. Public healthcare spending improves life expectancy and reduces death rate and infant mortality.Conclusion: The study concludes that public healthcare is the main focus of the current regime. It is noticed that spending on healthcare significantly contributes to the health outcomes in Pakistan. These efforts by the government significantly promote life expectancy and drop down the mortality ratio in the country. Based on these notable facts, the government should allocate sufficient resources towards the latest healthcare technologies and equipment to optimize health outcomes in the country.Keywords: healthcare spending, health outcomes, healthcare technologies, Quantile cointegration, QARDL, Pakistan