The Effects of Aerobic Bokashi in the Production of Sweet 16-F1 Watermelon (Citrullus lunatus)

The study aimed to determine the effects of aerobic bokashi on the growth and yield of watermelon (Citrullus lunatus). Specifically, it was intended to determine the response of watermelon in terms of length of vine, girth of vine, days to flowering, weight of fruits, and yield per plot. The study also performed cost and return analysis. The study used a Randomized Complete Block Design (RCBD). The study used 12 experimental plots with 4 treatments and 3 replications. The treatments were the following; Treatment 1: 500 grams (g) of aerobic bokashi per hill, Treatment 2: 1000 grams, Treatment 3 - 1500 grams, and Treatment 4: control. The study was conducted off-season at Dr. Emilio B. Espinosa Memorial State College of Agriculture and Technology (DEBESMSCAT), Mandaon, Masbate, Philippines, from January to March 2021. The result of the study on levels of aerobic bokashi has no significant effect on vine length, vine diameter, days to flower, fruit diameter, and weight of fruits. However, in terms of fruit length and yield, the aerobic bokashi gave significant results. The fruit length and yield per plot were significantly different among the other treatments. This implied that the different levels of boskashi applied will give a different response in terms of fruit length and yield. The most viable result of the cost and return analysis was treatment A. The use of aerobic bokashi in watermelon cost PhP 1,391.00, this investment gave a net income of PhP 1,651.00 and a 118.69 % return on investment

Probiotics for induction of remission in ulcerative colitis

Background Ulcerative colitis is an inflammatory condition affecting the colon, with an annual incidence of approximately 10 to 20 per 100,000 people. The majority of people with ulcerative colitis can be put into remission, leaving a group who do not respond to first‐ or second‐line therapies. There is a significant proportion of people who experience adverse effects with current therapies. Consequently, new alternatives for the treatment of ulcerative colitis are constantly being sought. Probiotics are live microbial feed supplements that may beneficially affect the host by improving intestinal microbial balance, enhancing gut barrier function and improving local immune response. Objectives To assess the efficacy of probiotics compared with placebo or standard medical treatment (5‐aminosalicylates, sulphasalazine or corticosteroids) for the induction of remission in people with active ulcerative colitis. Search methods We searched CENTRAL, MEDLINE, Embase, and two other databases on 31 October 2019. We contacted authors of relevant studies and manufacturers of probiotics regarding ongoing or unpublished trials that may be relevant to the review, and we searched ClinicalTrials.gov. We also searched references of trials for any additional trials. Selection criteria Randomised controlled trials (RCTs) investigating the effectiveness of probiotics compared to standard treatments or placebo in the induction of remission of active ulcerative colitis. We considered both adults and children, with studies reporting outcomes of clinical, endoscopic, histologic or surgical remission as defined by study authors Data collection and analysis Two review authors independently conducted data extraction and 'Risk of bias' assessment of included studies. We analysed data using Review Manager 5. We expressed dichotomous and continuous outcomes as risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE methodology. Main results In this review, we included 14 studies (865 randomised participants) that met the inclusion criteria. Twelve of the studies looked at adult participants and two studies looked at paediatric participants with mild to moderate ulcerative colitis, the average age was between 12.5 and 47.7 years. The studies compared probiotics to placebo, probiotics to 5‐ASA and a combination of probiotics plus 5‐ASA compared to 5‐ASA alone. Seven studies used a single probiotic strain and seven used a mixture of strains. The studies ranged from two weeks to 52 weeks. The risk of bias was high for all except two studies due to allocation concealment, blinding of participants, incomplete reports of outcome data and selective reporting. This led to GRADE ratings of the evidence ranging from moderate to very low. Probiotics versus placebo Probiotics may induce clinical remission when compared to placebo (RR 1.73, 95% CI 1.19 to 2.54; 9 studies, 594 participants; low‐certainty evidence; downgraded due to imprecision and risk of bias, number needed to treat for an additional beneficial outcome (NNTB) 5). Probiotics may lead to an improvement in clinical disease scores (RR 2.29, 95% CI 1.13 to 4.63; 2 studies, 54 participants; downgraded due to risk of bias and imprecision). There may be little or no difference in minor adverse events, but the evidence is of very low certainty (RR 1.04, 95% CI 0.42 to 2.59; 7 studies, 520 participants). Reported adverse events included abdominal bloating and discomfort. Probiotics did not lead to any serious adverse events in any of the seven studies that reported on it, however five adverse events were reported in the placebo arm of one study (RR 0.09, CI 0.01 to 1.66; 1 study, 526 participants; very low‐certainty evidence; downgraded due to high risk of bias and imprecision). Probiotics may make little or no difference to withdrawals due to adverse events (RR 0.85, 95% CI 0.42 to 1.72; 4 studies, 401 participants; low‐certainty evidence). Probiotics versus 5‐ASA There may be little or no difference in the induction of remission with probiotics when compared to 5‐ASA (RR 0.92, 95% CI 0.73 to 1.16; 1 study, 116 participants; low‐certainty evidence; downgraded due to risk of bias and imprecision). There may be little or no difference in minor adverse events, but the evidence is of very low certainty (RR 1.33, 95% CI 0.53 to 3.33; 1 study, 116 participants). Reported adverse events included abdominal pain, nausea, headache and mouth ulcers. There were no serious adverse events with probiotics, however perforated sigmoid diverticulum and respiratory failure in a patient with severe emphysema were reported in the 5‐ASA arm (RR 0.21, 95% CI 0.01 to 4.22; 1 study, 116 participants; very low‐certainty evidence). Probiotics combined with 5‐ASA versus 5‐ASA alone Low‐certainty evidence from a single study shows that when combined with 5‐ASA, probiotics may slightly improve the induction of remission (based on the Sunderland disease activity index) compared to 5‐ASA alone (RR 1.22 CI 1.01 to 1.47; 1 study, 84 participants; low‐certainty evidence; downgraded due to unclear risk of bias and imprecision). No information about adverse events was reported. Time to remission, histological and biochemical outcomes were sparsely reported in the studies. None of the other secondary outcomes (progression to surgery, need for additional therapy, quality of life scores, or steroid withdrawal) were reported in any of the studies. Authors' conclusions Low‐certainty evidence suggests that probiotics may induce clinical remission in active ulcerative colitis when compared to placebo. There may be little or no difference in clinical remission with probiotics alone compared to 5‐ASA. There is limited evidence from a single study which failed to provide a definition of remission, that probiotics may slightly improve the induction of remission when used in combination with 5‐ASA. There was no evidence to assess whether probiotics are effective in people with severe and more extensive disease, or if specific preparations are superior to others. Further targeted and appropriately designed RCTs are needed to address the gaps in the evidence base. In particular, appropriate powering of studies and the use of standardised participant groups and outcome measures in line with the wider field are needed, as well as reporting to minimise risk of bias

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Structured Integration and Alignment Algorithm: A Tool for Personalized Surgical Treatment of Tibial Plateau Fractures

The planning of the surgical treatment in orthopedics, with the help of three-dimensional (3D) technologies, arouses an increasing scientific interest. Scientific literature describes some semi-automatic reconstructive attempts at fragmented bone fractures, but the matching algorithms presented are likely to improve. The aim of this paper is to develop a new method of aligning fragments of comminutive fractures. We have created a structured integration process and an alignment algorithm integrated in a clinical workflow for personalized surgical treatment of fractures. The provided solution is able to align the surfaces of bone fragments derived from the segmentation process of volumetric tomographic data. Positional uncertainties are eliminated interactively by the user, who selects the corresponding pairs of fracture surfaces. The final matching and the right alignment are performed automatically by the innovative alignment algorithm. The paper solves a challenging problem for the reconstruction of fractured bones, namely the choice of the optimal matching option from the situation in which surface portions of a fracture fragment correspond to multiple high fragments. The method is validated in practice for preoperative planning of a 49-year-old male patient who had a tibial plateau fracture of Schatzker type VI

An Innovative Framework for Sustainable Development in Healthcare: The Human Rights Assessment

Healthcare providers are investing considerable resources for the development of quality management systems in hospitals. Contrary to these efforts, the number of tools that allow the evaluation of implementation efforts and the results of quality, security and sustainable development is quite limited. The purpose of the study is to develop a reference framework for quality and sustainable development in healthcare, Sanitary-Quality (San-Q) at the micro system level, which is compatible with applicable national and international standards in the field. The research method consisted of the study of literature, identification and analysis of good sustainability practices in healthcare, which allowed identification of the areas of the new San-Q framework: quality, economic, environmental, social, institutional and healthcare. These areas are incorporated into the core topics of social responsibility mentioned by ISO26000. A total of 57 indicators have been defined that make up the new reference framework. The evaluation format of the indicators is innovative through a couple of values: completion degree–significance. In the experimental part of the research, a pilot implementation of the San-Q framework at an emergency hospital was performed, the results recorded in terms of responsibility for human rights being presented. The conclusions of the study reveal the innovative aspects of the framework that facilitate the development of a sustainability strategy promoted through performance indicators, the results obtained after evaluation being useful in establishing a reference level of sustainability but also in developing sustainability policies

The Environmental Sustainability Assessment of an Orthopedics Emergency Hospital Supported by a New Innovative Framework

Due to their high consumption of resources and enormous amount of generated waste, healthcare systems are not considered to be sustainable. Given the constant changes in internal needs, improvement of this state cannot be achieved only through policies, strategies, and interventions administered from the outside. Thus, it is necessary to design tools that, through their constant application, facilitate the sustainable development of health institutions. The objective of this research is to develop and validate in practice an innovative framework for assessing the sustainability of healthcare facilities that is compatible with hospital accreditation legislation and other community frameworks. The research is limited to the study of environmental sustainability and its results are validated in a healthcare facility with an orthopedic profile. The research method consists of defining the domains of the new innovative framework, collecting the latest medical practices related to environmental sustainability, designing indicators related to environmental responsibility and a matrix of indicators, followed by its validation in practice at an emergency hospital. The new innovative framework is organized in three areas, including environmental, economic, and social sustainability, to which is added organizational capacity along with management and provision of sustainable healthcare services. It contains 57 indicators, of which 8 are dedicated to the environmental area. The indicators are described in detail together with evaluation grids structured by the coupled degrees of importance and achievement. The practical implementation of the innovative framework at the County Emergency Clinical Hospital of Targu Mures highlights its added value by promoting sustainability strategies together with continuous quantification of the organization’s sustainability level

An Investigation for Future Practice of Elective Hip and Knee Arthroplasties during COVID-19 in Romania

Background and Objectives: Elective arthroplasty in Romania has been severely affected by the COVID-19 pandemic, and its effects are not quantified so far. The aim of this paper is to determine the impact of COVID-19 on arthroplasty interventions and how they varied in Romania. Materials and Methods: We performed a national retrospective analysis of patients who underwent primary and revision elective hip and knee interventions at the 120 orthopedic-traumatology hospitals in Romania that are registered in the National Endoprosthesis Registry from 1 January 2019 to 1 September 2022. First, we examined the monthly trend in the number of surgeries for seven categories of arthroplasties. We calculated the percentage change in the average number of cases per month and compared them with other types of interventions. We then examined the percentage change in the average monthly number of arthroplasty cases, relative to the number of COVID-19 cases reported nationwide, the influence of the pandemic on length of hospital stay, and the percentage of patients discharged at home who no longer follow recovery protocols. Finally, we calculated the impact of the pandemic on hospital revenues. Results: There was an abrupt decrease in the volume of primary interventions in hip and knee patients by up to 69.14% with a low degree of patient care, while the average duration of scheduled hospitalizations increased. We found a 1–2-day decrease in length of hospital stays for explored arthroplasties. We saw an increasing trend of home discharge, which was higher for primary interventions compared to revision interventions. The total hospital revenues were 50.96% lower in 2020 compared to 2019, and are currently increasing, with the 2022 estimate being 81.46%. Conclusions: The conclusion of this study is that the COVID-19 pandemic severely affected the volume of arthroplasty of the 120 hospitals in Romania, which also had unfavorable financial implications. We proposed the development of new procedures and alternative clinical solutions, as well as personalized home recovery programs, to be activated if necessary, for possible future outbreaks