What Global Censorship Studies Tell us About Hong Kong’s Media Future

China imposed a new National Security Law on its Special Administrative Region (SAR) of Hong Kong in mid-2020. The deployment of this legal weapon, combined with other actions of local authorities that have grown noticeably more irritable and vindictive, means that Hong Kong media no longer enjoy the freedom from government restrictions that they had been accustomed to. Hong Kong has thus joined the ranks of the many societies with media environments that are semifree and semi-closed. These societies’ experiences indicate that arrests and bans, while attracting the most attention, are not what inflict the most damage in the long run. As alarming as the on-going legal actions are, citizens’ access to information and ideas is more likely to be restricted by less spectacular and coercive means, including economic carrots and sticks that encourage a culture of self-censorship. Such an environment requires new mindsets and skillsets among journalists

Perceptions of Academic Librarians in Sri Lanka about Faculty Status and Teaching Information Literacy (IL)

Academic librarians working in higher education institutions in Sri Lanka have been enjoying faculty status for the last forty years. The study explores their self-identity, and their perceptions about the teaching role. In total, there are 140 academic librarians working in universities in Sri Lanka. A survey was conducted among them. An analysis of thirty one responses revealed that a significant number of respondents consider themselves as professionals rather than faculty member. A section of the academic librarians believes that the society does not recognize teaching by librarians. Another section generally opines that librarians are reluctant to take up the task of teaching, but the survey found out that 80% of respondents voluntarily teach at their institutions. It was also found that, as reported by many other studies, the academic programs that many of them had attended in library schools did not provide enough training for teaching jobs

Outcome in women with previous caesarean section in a secondary care hospital in rural South India

Background: Caesarean section has become increasingly the common method of delivery. From 1980 to 2001 the rate in UK has increased from 9% to 21% of all births. The aim of the study was to find out the outcome of delivery in women with previous cesarean section, the mode of delivery, maternal and fetal outcome of labour and various factors which influence the mode of delivery.Methods: 150 women with one previous caesarean section who attended the antenatal clinic and fit the inclusion criteria were enrolled in the study.Results: Success rate of VBAC was 30.5% among those included in trial of labour after caesarean section (TOLAC). 60.7% of the enrolled women underwent elective repeat caesarean section of which 54.9% were at the patients’ request. Favorable Bishop’s score (p= 0.0002) and previous cesarean section for breech (p=0.191) are positively associated with VBAC. Incidence of maternal complications in the study was 10.67% and 2.5% babies had an Apgar <7 at 5 minutes. There was no maternal or neonatal mortality.Conclusions: The VBAC rate in the study is 30.5% in carefully selected patients for trial of scar with the existing litigation pressure. TOLAC can be judiciously implemented in carefully chosen patients even in rural health setting equipped with required facilities. Patient’s participation in the decision making has brought down the VBAC rate which is reflected by the increased repeat elective cesarean section done at patients’ request (54.9%). Factors such as prior vaginal delivery, favorability of the cervix, indication of previous cesarean section, onset of labour and birth weight are highly significant in deciding the success of VBAC and can be used to improve VBAC rates in practice

Effectiveness of Platelet-Rich Fibrin with Decalcified Freeze-Dried Bone Allograft Compared to Decalcified Freeze-Dried Bone Allograft Alone in Mandibular Grade–II Furcation Defects: A Quasi-Experimental Study

Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade–II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects

STUDY OF PRESCRIBING PATTERN AND USE OF ANTIBIOTIC IN THE MANAGEMENT OF WOUND INFECTION

Objective: The main objective of the study is to estimate the demographic details of patients with various wound infection and to observe the variousorganism causing infections and also to analyze the prescribing pattern of antibiotic used in wound infection.Methods: This is a prospective observational study to evaluate the prescribing pattern of antibiotics in the Department of Surgery. The study wasconducted for 4 months (April 2016-July 2016), the information was collected from the case sheets, and the data were analyzed using Microsoft Excel.Results: In this study, males were higher than females consisting of 64.5% of the total sample size. In wound infection, diabetic foot ulcer wasfound to be a major problem. It can be observed that antibiotics were prescribed for all of the patients with cefotaxime being prescribed the most asmonotherapy. Cefotaxime+metronidazole were commonly prescribed as dual therapy. Multivitamins, antiulcerants were other major drugs providedin the supportive care. With reference to the culture sensitivity test, the major organism isolated was Staphylococcus aureus.Conclusion: An important consideration is needed in prescribing antibiotic therapy. The utilization of culture sensitivity studies are limited andmost antibiotic selection is empirical, so proper evaluation and monitoring is needed by the health-care professionals to select the appropriate one topromote the rational use of antibiotics.Keywords: Diabetic foot ulcer, Wound sepsis, Burns, Surgical site infection, Antibiotics.Â

Endothelin-1–Mediated Alteration of Metallothionein and Trace Metals in the Liver and Kidneys of Chronically Diabetic Rats

In the present study, the role of endothelin-1 (ET-1) on alterations of hepatic and renal metallothionein (MT) and trace metals (Zn, Cu, and Fe) were investigated in streptozotocin (STZ)- induced diabetic rats. Diabetic rats, age- and sex-matched controls, as well as control and diabetic animals on a dual ETA/ETB receptor blocker, bosentan, were investigated after 6 months of follow-up. MT was measured by cadmium-heme assay. Metals were measured by atomic absorption spectrometer. ET-1 mRNA was analyzed by reverse transcriptase–polymerase chain reaction (RT-PCR) technique. Hepatic and renal ET-1 mRNA was increased in diabetic rats as compared to control rats, along with an increase in both hepatic and renal MT proteins. The increased hepatic MT protein level was associated with decreases in hepatic Cu and Fe, whereas increased renal MT was associated with increases in renal Cu and Fe accumulation. Zn levels were unaltered in both organs in diabetic rats. Bosentan treatment partially prevented the increase in MT levels in both liver and kidney, along with reduced serum creatinine and increased urinary creatinine levels. Further bosentan treatment corrected the increased Cu and Fe levels in the kidney in diabetic rats, but reduced hepatic Cu and Fe levels. No significant effects of bosentan treatment on nondiabetic rats were observed. The data suggest that the possible effects of ET antagonism in diabetes may be mediated via changes in MT and trace metals

Use of low dose misoprostol for induction of labour in a secondary hospital setting: a retrospective cohort study of a unique induction protocol

Background: Induction of labour is a procedure often used in pregnant women where there are clear medical indications. There are various modalities of induction of labour which differ in outcomes and complications. Our aim was to look at how effective our protocol using misoprostol was in achieving delivery within 24 hours of the start of induction, the induction delivery interval, Caesarean section rates and its indications using Robsons classification, uterine hyperstimulation with FHR changes and oxytocin augmentation and its duration. Methods: This was a retrospective study which looked at the mode of induction and outcomes of women during the period from 1st February, 2021 to 31st July,2021. Results: There were 2574 deliveries in the period February 1st, 2021 to July 31st, 2021. We found more nulliparous women and obese women in the induced group. The main indication for induction was past dates and the mean induction to delivery interval among the women being induced was 32 hours (SD: 22.58). There were significantly higher women who experienced PPH and Caesarean sections were 2.100 (1.577- 2.793) times higher among women who were induced. Conclusions: Induction protocols need to be developed taking into consideration the advantages as well as complications associated with it and then tailor it according to infrastructure and personnel available

Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness

Introduction Adrenal incidentalomas are lesions that are incidentally identified while scanning for other conditions. While most are benign and hormonally non-functional, around 20% are malignant and/or hormonally active, requiring prompt intervention. Malignant lesions can be aggressive and life-threatening, while hormonally active tumours cause various endocrine disorders, with significant morbidity and mortality. Despite this, management of patients with adrenal incidentalomas is variable, with no robust evidence base. This project aimed to establish more effective and timely management of these patients. Methods We developed a web-based, electronic Adrenal Incidentaloma Management System (eAIMS), which incorporated the evidence-based and National Health Service–aligned 2016 European guidelines. The system captures key clinical, biochemical and radiological information necessary for adrenal incidentaloma patient management and generates a pre-populated outcome letter, saving clinical and administrative time while ensuring timely management plans with enhanced safety. Furthermore, we developed a prioritisation strategy, with members of the multidisciplinary team, which prioritised high-risk individuals for detailed discussion and management. Patient focus groups informed process-mapping and multidisciplinary team process re-design and patient information leaflet development. The project was partnered by University Hospital of South Manchester to maximise generalisability. Results Implementation of eAIMS, along with improvements in the prioritisation strategy, resulted in a 49% reduction in staff hands-on time, as well as a 78% reduction in the time from adrenal incidentaloma identification to multidisciplinary team decision. A health economic analysis identified a 28% reduction in costs. Conclusions The system’s in-built data validation and the automatic generation of the multidisciplinary team outcome letter improved patient safety through a reduction in transcription errors. We are currently developing the next stage of the programme to proactively identify all new adrenal incidentaloma cases

Transport of organic solvents through natural rubber/nitrile rubber/organically modified montmorillonite nanocomposites

International audienceThe article describes the transport phenomenon of some commonly used laboratory organic solvents which differ in their solubility parameter value through polymer blend nanocomposites membrane prepared by melt mixing. The three solvents that were used are hexane, toluene and xylene which differed widely in their solubility parameter values. The motivation for the study was to know the effect of solubility parameter on the diffusion transport properties of NR/NBR (natural rubber/nitrile rubber) blends. The solvent uptake, diffusion, sorption and permeation constants were investigated and were found to decrease with organically modified montmorillonite (OMt) content at lower loading. The mode of transport through NR/NBR nano-composites was found to be anomalous. The difference in solubility parameter value greatly influenced the transport properties. The dependence of various properties on OMt content was supported by morphological analysis data. The effect of blend ratio, solvent size and OMt loading on the diffusion of aromatic and aliphatic solvents through NR/ NBR blend systems were investigated. The swelling coefficient values also decreased upon the addition of fillers indicating the presence of hindered path for solvents to diffuse into the polymer matrix. The better reinforcement at lower filler loading was confirmed from the cross-link density values and mechanical properties. The transport data obtained were applied to mathematical models for predicting the diffusion behaviour through nanocomposite membranes and to elucidate the physical mechanism of transport