Nevin Manimala

Heliyon. 2023 Jul 28;9(8):e18784. doi: 10.1016/j.heliyon.2023.e18784. eCollection 2023 Aug.

ABSTRACT

This article presents a study on the tensile properties of knitted fabrics commonly employed in polymeric matrix textile composites. The key mechanical parameters investigated include stress (Pa), strain, Young’s modulus (Pa), and work of rupture (J). The knitted fabrics were developed using the Cixing Knitting System software and subsequently manufactured using a double jersey (electronic) flat knitting machine. The primary objective of this research was to explore the impact of various factors on the mechanical behavior of these knitted fabrics. The factors studied were wale and course directions, float stitch density, loop length (cm), and the type of synthetic knitting yarns used (100% polyester and 100% polyamide) along with different combinations of knitting yarns (100% cotton and 67% polyester/33% cotton hybrid). The adopted ASTM D 5034 standard, Response Surface Methodology (RSM), and Analysis of Variance (ANOVA) were employed to evaluate the mechanical performance of these fabric structures. The findings of the study revealed that the statistical adjustment of the data set for stress, strain, Young’s modulus, and work of rupture in knitted fabric structures significantly reduced the standard deviations for mechanical responses. This information holds particular significance as it pertains to the frequent use of these knitted fabric structures as reinforcement in textile-reinforced composite materials. Overall, this study sheds light on the mechanical behavior in structures of knitted fabrics used in polymeric matrix composites, providing valuable insights for the design and optimization of advanced textile-based materials.

PMID:37560668 | PMC:PMC10407213 | DOI:10.1016/j.heliyon.2023.e18784

Heliyon. 2023 Jul 22;9(8):e18126. doi: 10.1016/j.heliyon.2023.e18126. eCollection 2023 Aug.

ABSTRACT

BACKGROUND: Obstetric fistula among women of reproductive age is a significant public health issue in developing countries, including Sub-Saharan Africa. However, the pooled awareness of obstetric fistula among women of reproductive age in Sub-Saharan Africa and its variation between countries have not yet been studied. Hence, the review aims to assess variability and awareness of obstetric fistula among women of reproductive age in Sub-Saharan African Countries.

METHOD: Articles were searched using different electronic databases, such as PubMed, Web of science, science direct (Scopus), Google scholar, and HINARI and manual search without regard to publication date. A random-effects model was used to ascertain the pooled prevalence of obstetric fistula awareness among women of reproductive age in Sub-Saharan Africa. Publication bias was checked by using funnel plot and Egger’s test at a 5% level of significance. I² test statistics was performed to evaluate heterogeneity among included studies. In addition, to identify the possible reason for the potential heterogeneity between the studies, sub-group and meta-regression analyses were conducted. A sensitivity analysis was performed to determine the impact of individual research on the overall results. The data were extracted by using Microsoft excel and analyzed using statistical software STATA/SE version 17.

RESULT: A total of 22 studies with 79,693 women of reproductive age were included in this systematic review and meta-analyses. In Sub-Saharan Africa, the pooled prevalence of awareness towards obstetric fistula among women of reproductive age was 40.85% (95% CI: 33.48, 48.22%). Analysis of the subgroups by specific countries revealed significant variation. The highest awareness of obstetric fistula was found among Tanzanian women of reproductive age (61.10%, 95% CI: 55.87-66.33%), whereas the lowest awareness was found in research from the Gambia (12.80%, 95% CI: 12.20-13.40%).The likelihood of obstetric fistula awareness were lower by a factor of 0.424 among studies with sample sizes greater than 3542 (β = -0.424 (95% CI: -0.767 to 0.081), p -value <0.05).

CONCLUSION: According to the current review, there is a low level of awareness about obstetric fistula among women of reproductive age in sub-Saharan Africa, and the results of the sub-group analysis by country showed wide variations. Therefore, we emphasize the need for country-specific public health initiatives to raise awareness about obstetric fistula among women of reproductive age, which could reduce the risk of delayed treatment.

PMID:37560629 | PMC:PMC10407677 | DOI:10.1016/j.heliyon.2023.e18126

Orthop J Sports Med. 2023 Jul 20;11(7):23259671231183416. doi: 10.1177/23259671231183416. eCollection 2023 Jul.

ABSTRACT

BACKGROUND: Regular walking in different types of footwear may increase the mediolateral shear force, knee adduction moment, or vertical ground-reaction forces that could increase the risk of early development of knee osteoarthritis (OA).

PURPOSE: To compare kinematic and kinetic parameters that could affect the development of knee OA in 3 footwear conditions.

STUDY DESIGN: Controlled laboratory study.

METHODS: A total of 40 asymptomatic participants performed walking trials in the laboratory at self-selected walking speeds under barefoot (BF), minimalistic (MF), and neutral (NF) footwear conditions. Knee joint parameters were described using discrete point values, and continuous curves were evaluated using statistical parametric mapping. A 3 × 1 repeated-measures analysis of variance was used to determine the main effect of footwear for both discrete and continuous data. To compare differences between footwear conditions, a post hoc paired t test was used.

RESULTS: Discrete point analyses showed a significantly greater knee power in NF compared with MF and BF in the weight absorption phase (P < .001 for both). Statistical parametric mapping analysis indicated a significantly greater knee angle in the sagittal plane at the end of the propulsive phase in BF compared with NF and MF (P = .043). Knee joint moment was significantly greater in the propulsive phase for the sagittal (P = .038) and frontal planes (P = .035) in BF compared with NF and MF and in the absorption phase in the sagittal plane (P = .034) in BF compared with MF and NF. A significant main effect of footwear was found for anteroposterior (propulsion, ↑MF, NF, ↓BF [P = .008]; absorption, ↑BF, MF, ↓NF [P = .001]), mediolateral (propulsion, ↑MF, NF, ↓BF [P = .005]; absorption, ↑NF, MF, ↓BF [P = .044]), and vertical (propulsion, ↑NF, BF, ↓MF [P = .001]; absorption, ↑MF, BF, ↓NF [P < .001]) ground-reaction forces. Knee power showed a significant main effect of footwear (absorption, ↑NF, MF, ↓BF [P = .015]; propulsion, ↑MF, NF, ↓BF [P = .039]).

CONCLUSION: Walking in MF without sufficient accommodation affected kinetic and kinematic parameters and could increase the risk of early development of knee OA.

PMID:37560612 | PMC:PMC10406632 | DOI:10.1177/23259671231183416

Adv Med Educ Pract. 2023 Aug 3;14:837-844. doi: 10.2147/AMEP.S419333. eCollection 2023.

ABSTRACT

BACKGROUND AND AIMS: This study evaluates the use of virtual anatomy dissection (Anatomage Table) in teaching anatomy for Jordanian medical students. The study also highlights any gender differences in students’ perception on this method of teaching anatomy.

METHODS: This is a cross-sectional questionnaire-based study that was carried out on medical students enrolled in Al-Balqa Applied University, a Jordanian public university. A group of expert anatomists designed a questionnaire that investigates the students’ perceptions and attitudes toward using virtual anatomy dissection. The questionnaire also investigated student’s opinions and expectations on the impact of using this method on the academic achievement of students.

RESULTS: The findings of the study showed that most students agreed that Anatomage Table helped them better understand (64.3%) and memorize (64%) anatomy lectures. In addition, most students were interested in using this learning method in lab groups (72.3%). However, the didactic approach that combined anatomical models and the Anatomage Table was preferred over the unilateral approach that included only the Anatomage Table (80.5% vs 30.2%, p<0.001, r=0.9). Of note, there was a statistically significant difference between males and females in their preference for Anatomage Table (p<0.001), and in their perceptions on the impact of Anatomage Table on understanding of lectures (p<0.001) and memorization of anatomical structures (p=0.004).

CONCLUSION: The Anatomage Table is a powerful teaching and learning method in undergraduate medical education. Its application to Al-Balqa Applied University has proven to be effective so far. It can be used to overcome the problems facing anatomical education in the college of medicine in Al-Balqa Applied University and perhaps other universities in Jordan, but this needs better cooperation between universities and stakeholders to provide adequate funding for this method.

PMID:37560611 | PMC:PMC10406572 | DOI:10.2147/AMEP.S419333

Adv Med Educ Pract. 2023 Aug 4;14:845-857. doi: 10.2147/AMEP.S417649. eCollection 2023.

ABSTRACT

OBJECTIVE: The purpose of this study was to examine the application of faculty to stimulate the critical thinking and deep analysis of their students through instructional practice including lecture design, assessment structure, and assignment instructions.

METHODS: Faculty from multiple different health colleges at Saudi Arabia were asked to respond to survey items about the activities they use in their classrooms with regards to designing lectures, assessment structures, and instructional assignments. A correlation analysis was performed to determine if the level of applied critical thinking and deep analysis that is stimulated by faculty members were statistically related between designing lectures, assessment structure, and instructional assignments. An analysis of variance (ANOVA) was also performed to determine if there were significant differences based on the demographic characteristics of the participants and level of applied critical thinking and deep analysis.

RESULTS: A correlational analysis revealed that the mean score for designing lectures was 67.276, following by a mean score of 65.233 for instructional assignment and 64.688 for assessment structure. The result of the ANOVA showed that there was a significant difference in the perceptions of the participants between designing lectures, assessment structure, and instructional assignment (p<0.05).

CONCLUSION: The participants applied critical thinking and deep analysis when they design their lectures more than assessments and instructional assignments. They had the flexibility to stimulate critical thinking during the lecture activities. In contrast, this flexibility was limited when they were structuring the assessment as they had instructions to consider and were required to provide a rubric with unified key answer which is a mandatory requirement from the assessment department. This is due to the nature of high level of critical thinking answers that lead to high subjectivity in student responses.

PMID:37560610 | PMC:PMC10408665 | DOI:10.2147/AMEP.S417649

Surg Neurol Int. 2023 Jul 7;14:235. doi: 10.25259/SNI_409_2023. eCollection 2023.

ABSTRACT

BACKGROUND: Continuous electroencephalograms (cEEGs) are often used in the neurosurgical intensive care unit (NSICU) to detect subclinical seizures (SCSs) in patients with altered mental status (AMS). This retrospective study evaluated the efficacy of this approach for improving patient outcomes.

METHODS: We reviewed the records of 100 patients admitted to the NSICU between 2015 and 2020 who underwent continous electroencephalograms (cEEG) during workup of unexplained AMS. Patient outcomes were classified as positive (discharged), neutral (transfer of care), or negative (dead). Incidence of SCSs on cEEG and association with patient outcomes was analyzed with Chi-square analysis and relative risk (RR).

RESULTS: For the 99 included patients, median age was 62 years and 43% were female. About 15.2% had a known or newly diagnosed brain tumor. Outcomes were positive in 22 patients, neutral in four, and negative in 73. SCSs were detected in 15 patients, of whom 12 died, two were discharged, and one whose care was transferred. Chi-square association between SCS and outcome (P = 0.59) and RR of death associated with SCS diagnosis (1.1) was not significant.

CONCLUSION: We found a lower incidence of SCSs (15.2%) than reported in the literature. In the absence of clinically evident seizures, continous cEEGs performed in the NSICU to determine the etiology of AMS did not yield an improvement in patient outcomes, and patients diagnosed and treated for SCS did not have statistically decreased risk of death. In summary, electroencephalogram monitoring for SCS is important but should not delay diagnosis and treatment of other, potentially life-threating etiologies of AMS.

PMID:37560585 | PMC:PMC10408650 | DOI:10.25259/SNI_409_2023

Interdiscip Perspect Infect Dis. 2023 Aug 1;2023:1035113. doi: 10.1155/2023/1035113. eCollection 2023.

ABSTRACT

BACKGROUND: Bacterial urinary tract infections are important public health problems in children. This study was conducted to identify the bacterial agents of urinary tract infections and antibiogram patterns in children.

METHODS: A hospital-based cross-sectional study including 220 children was carried out between November 15, 2021, and March 10, 2022. Simple random sampling was used to enroll participants. The sociodemographic and clinically pertinent information was gathered using a semi-structured questionnaire. Every participant in the study who was ≤15 years old gave clean-catch midstream urine. Urine samples were inoculated onto a cystine lactose electrolyte-deficient agar using a calibrated inoculating loop with a 0.001 ml capacity and then incubated aerobically for 24 hours at 37°C. Subculturing for significant bacteriuria was done on MacConkey and blood agar. Gram staining, biochemical assays, and colony characteristics were used for bacterial identification. The disc diffusion method developed by Kirby and Bauer was used for antimicrobial susceptibility testing. SPSS software version 25 was used for data entry and analysis. To find the risk factors, bivariate and multivariate logistic regression analyses were performed. An association was deemed statistically significant if the p value at the 95 percent confidence interval was less than 0.05.

RESULTS: In this study, the majority (50.5%) of the study participants were males. The mean age of the study participants was 6 ± 0.91 years. It was found that 31.8% of children had urinary tract infections. The most prevalent urinary pathogens among the isolates were E. coli (27.1%) and S. aureus (18.6%). Approximately 56% of the participants were infected with multidrug-resistant pathogens. Additionally, compared to children who have never had a urinary tract infection, children with a history of infection had 1.04 (95 percent confidence interval (CI): 0.39, 2.75) times higher risk of infection.

CONCLUSION: This study has shown an alarming increase in the prevalence of pediatric urinary tract infections which warrants further investigation into multidrug-resistant bacterial infection.

PMID:37560543 | PMC:PMC10409584 | DOI:10.1155/2023/1035113

Circ J. 2023 Aug 9. doi: 10.1253/circj.CJ-23-0318. Online ahead of print.

ABSTRACT

BACKGROUND: The HELT-E₂S₂score, which assigns 1 point to Hypertension, Elderly aged 75-84 years, Low body mass index <18.5 kg/m², and Type of atrial fibrillation (AF: persistent/permanent), and 2 points to Extreme Elderly aged ≥85 years and previous Stroke, has been proposed as a new risk stratification for strokes in Japanese AF patients, but has not yet undergone external validation.Methods and Results: We evaluated the prognostic performance of the HELT-E₂S₂score for stroke risk stratification using 2 large-scale registries in Japanese AF patients (n=7,020). During 23,241 person-years of follow-up (mean follow-up 1,208±450 days), 287 ischemic stroke events occurred. The C-statistic using the HELT-E₂S₂score was 0.661 (95% confidence interval [CI], 0.629-0.692), which was numerically higher than with the CHADS₂score (0.644, 95% CI 0.613-0.675; P=0.15 vs. HELT-E₂S₂) or CHA₂DS₂-VASc score (0.650, 95% CI, 0.619-0.680; P=0.37 vs. HELT-E₂S₂). In the SAKURA AF Registry, the C-statistic of the HELT-E₂S₂score was consistently higher than the CHADS₂and CHA₂DS₂-VASc scores across all 3 types of facilities comprising university hospitals, general hospitals, and clinics. However, in the RAFFINE Study, its superiority was only observed in general hospitals.

CONCLUSIONS: The HELT-E₂S₂score demonstrated potential value for risk stratification, particularly in a super-aged society such as Japan. However, its superiority over the CHADS₂or CHA₂DS₂-VASc scores may vary across different hospital settings.

PMID:37558457 | DOI:10.1253/circj.CJ-23-0318

BMJ Open. 2023 Aug 9;13(8):e069308. doi: 10.1136/bmjopen-2022-069308.

ABSTRACT

INTRODUCTION: Armed conflicts have significant negative impacts on the entire healthcare system in general and HIV care system in particular. Sub-Saharan Africa is suffering from a disproportionate double burden of armed conflict and HIV infection. Nevertheless, the impact of the armed conflict on the HIV treatment outcomes in conflict settings in sub-Saharan Africa has not been thoroughly and systematically synthesised. This protocol outlines a review that aims to summarise the available evidence on the impact of armed conflict on HIV treatment outcomes in sub-Saharan Africa.

METHODS AND ANALYSIS: A systematic review of all quantitative studies that assess the impact of armed conflicts on HIV treatment outcomes will be conducted. The systematic search will start with a preliminary search of Google Scholar, followed by implementation of the full search strategy across five databases (MEDLINE, PubMed, CINAHL, SCOPUS and Web of Science) and the screening of titles and abstracts then relevant full texts. Bibliographies will be reviewed to identify additional relevant studies. We will include studies conducted in sub-Saharan Africa that were published in English between 1 January 2002 and 31 December 2022. Methodological validity of the included studies will be assessed using standardised critical appraisal instruments from the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument. Data will be extracted using standardised JBI instruments and analysed through narrative synthesis, and meta-analyses and regression. Heterogeneity will be assessed using I² and Χ² tests.

ETHICS AND DISSEMINATION: Since this study will not involve gathering primary data, formal ethical approval is not required. Journal publications, conference presentations and a media release will be used to share the study findings.

PROSPERO REGISTRATION NUMBER: CRD42022361924.

PMID:37558447 | DOI:10.1136/bmjopen-2022-069308

BMJ Open. 2023 Aug 9;13(8):e066644. doi: 10.1136/bmjopen-2022-066644.

ABSTRACT

INTRODUCTION: Indian Council of Medical Research (ICMR), New Delhi has established a nationwide registry ‘Indian Registry for Venous Thromoembolism Disorder (i-RegVeD)’ for real-time analytics of sociodemographic profile of patients, disease patterns, management strategies, treatment choices and outcomes of patients with venous thromboemobolism (VTE). The purpose is to generate evidence on VTE in order to fill the gaps in the knowledge of the disease across various demographic regions.

METHODS AND ANALYSIS: This prospective hospital-based registry will be a continuous data collection process on the occurrence and characteristics of VTE from the 16 hospital sites pan India. This process would include obtaining clinical profiles, risk factors, diagnostic tests, treatment and outcome information of patients collected from medical records through an active method of data abstraction and data capture mechanism guided by an online web-based tool.

ETHICS AND DISSEMINATION: At centralised programme management unit, the study protocol was approved by the Institutional Ethics Committees (IEC) named ICMR-Central Ethics Committee on Human Research and similarly each of the participating site has obtained the ethical approval by their respective IECs. The results from this study will be disseminated publicly on the study website (https://iregved.icmr.org.in) as well as through scientific meetings and publications.

PMID:37558443 | DOI:10.1136/bmjopen-2022-066644