Primary outcome measures used in interventional trials for ankle fractures : a systematic review

Background Ankle fractures cause considerable pain, loss of function and healthcare resource use. High quality randomised controlled trials are required to evaluate the optimal management protocols for ankle fracture. However, there is debate regarding the most appropriate outcome measure to use when assessing patients with ankle fractures. The aim of this systematic review is to identify and summarise primary outcome measure use in clinical trials of non-pharmacological interventions for adults with an ankle fracture. Methods We performed comprehensive searches of the Medline, Embase, CINAHL, AMED and Cochrane CENTRAL databases, as well as ISRCTN and ClinicalTrials.gov online clinical trial registries on 19/06/2019 with no date limits applied. The titles and abstracts were initially screened to identify randomised or quasi-randomised clinical trials of non-pharmacological interventions for ankle fracture in adults. Two authors independently screened the full text of any articles which could potentially be eligible. Descriptive statistics we used to summarise the outcome measures collected in these articles including an assessment of trends over time. Secondary analysis included a descriptive summary of the multi-item patient reported outcome measures used in this study type. Results The searches returned a total of 3380 records. Following application of the eligibility criteria, 121 records were eligible for inclusion in this review. The most frequently collected primary outcome measures in this type of publication was the Olerud Molander Ankle Score, followed by radiographic and range of movement assessments. There was a total of 28 different outcome measures collected and five different multi-item, patient reported outcome measures collected as the primary outcome measure. There was a sequential increase in the number of this type of study published per decade since the 1980’s. Conclusion This review demonstrates the wide range of measurement methods used to assess outcome in adults with an ankle fracture. Future research should focus on establishing the validity and reliability of the outcome measures used in this patient population. Formulation of a consensus based core outcome set for adults with an ankle fracture would be advantageous for ensuring homogeneity across studies in order to meta-analyse trial results

Serum Lipid Profile And Random Blood Glucose of Male And Female Wistar Rats Following Administration of Leptin Hormone After A Dietary Regime

The Leptin hormone is a product of the obesity gene, a key regulator of feeding and energy expenditure.The World Health Organization (WHO) predicts 11.1 million deaths globally and 71% deaths in developing countries due to Coronary Artery Disease (CAD) by 2020 A.D. CAD has been associated with alterations in lipid metabolism, which include hyper-triglyceridemia and significantly reduced HDL-c. The increase in the concentration of cholesterol is attributable to LDL cholesterol because the high density lipoprotein (HDL) cholesterol is typically reduced. The study is aimed at determining the effect of leptin hormone on fasting serum lipid profile, atherogenic index (AI) and Random Blood glucose (RBG) inWistar rats following a diet regime and leptin injection.Fourty (40) Wistar rats (male n=20, female=20), age 9weeks and weighing between 77.2g-123.0g were randomly divided into two (2) groups of 5 rats per sub-group. All groups were maintained ad-libitum on experimental diets and water for a period of 10weeks. Group 1 (A1 and B1) the control received standard rat feed, group 2 (A2 and B2) received high fat diet (margarine, 90%) mixed with some standard rat feed (10%), group 3 (A3 and B3) received protein diet (soya beans, 100%) and group 4 (A4 and B4) received carbohydrate diet (cereal, 100%). The leptin hormone was given intra-peritoneal for a period of two (2) weeks.The resultshowed a significant difference (Plt0.05) in the Tot-c, TG, VLDL-c, LDL-c and RBG in the pre-test and post-test periods, but there was no significant difference (Pgt0.05) for the calculated atherogenic index (AI). There was a significant difference (Plt0.05) and sexual dimorphism for HDL-c and AI respectively and no significant difference (Pgt0.60) for Tot-c, TG, VLDL-c, LDL-c and RBG. It also showed a low LDL-c, low TG, low VLDL-c, low Tot-c and high HDL-c which resulted in a low AI in the male gender. The RBG was increased after the injection of the leptin hormone in all the groups. There was no sexual dimorphism in RBG. The result implies that the male gender is at a lower risk developing coronary artery disease (CAD)

A systematic review of the measurement properties of patient reported outcome measures used for adults with an ankle fracture

Background Ankle fractures are painful and debilitating injuries that pose a significant burden to society and healthcare systems. Patient reported outcome measures (PROMs) are commonly used outcome measures in clinical trials of interventions for ankle fracture but there is little evidence on their validity and reliability. This systematic review aims to identify and appraise evidence for the measurement properties of ankle specific PROMs used in adults with an ankle fracture using Consensus Based Standards for the Selection of Health Measurement Instrument (COSMIN) methodology. Methods We searched MEDLINE, Embase and CINAHL online databases for evidence of measurement properties of ankle specific PROMs. Articles were included if they assessed or described the development of the PROM in adults with ankle fracture. Articles were ineligible if they used the PROM to assess the measurement properties of another instrument. Abstracts without full articles and conference proceedings were ineligible, as were articles that adapted the PROM under evaluation without any formal justification of the changes as part of a cross-cultural validation or translation process. Two reviewers completed the screening. To assess methodological quality we used COSMIN risk of bias checklist and summarised evidence using COSMIN quality criteria and a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Two reviewers assessed the methodological quality and extracted the data for a sample of articles. Results The searches returned a total of 377 articles. From these, six articles were included after application of eligibility criteria. These articles evaluated three PROMs: A-FORM, OMAS and AAOS. The A-FORM had evidence of a robust development process within the patient population, however lacks post-formulation testing. The OMAS showed sufficient levels of reliability, internal consistency and construct validity. The AAOS showed low quality evidence of sufficient construct validity. Conclusions There is insufficient evidence to support the recommendation of a particular PROM for use in adult ankle fracture research based on COSMIN methodology. Further validation of these outcome measures is required in order to ensure PROMs used in this area are sufficiently valid and reliable to assess treatment effects. This would enable high quality, evidenced-based management of adults with ankle fracture

Radiological assessment of natural radionuclide contents in soils from Omala, Kogi State, Nigeria.

High purity germanium detector (HPGe) was employed to assess radionuclide contents of 238U, 40K and 232Th in soils obtained from Omala, Kogi State, Nigeria. The activities measured vary from 9.0 to 82.2, 12.3 to 114.86 and below detector limit (BDL) and 349.0 Bq Kg-1 in 238U, 232Th and 40K respectively. Highest activities for the three radionuclides were consistently obtained from soil samples got from Igaliwu. The measured activities were engaged to estimate the absorbed dose, annual outdoor effective dose and gamma index. It was observed from the absorbed dose, annual equivalent dose and the gamma index estimated that soils from Igaliwu, Ijeke-ogene and Bagana were found to be higher than the recommended safe limit for normal background. This suggests that those living or using the soil for construction purposes are exposed to high radiation burden from natural radionuclides

Dynamic simulation of the THAI heavy oil recovery process

Toe-to-Heel Air Injection (THAI) is a variant of conventional In-Situ Combustion (ISC) that uses a horizontal production well to recover mobilised partially upgraded heavy oil. It has a number of advantages over other heavy oil recovery techniques such as high recovery potential. However, existing models are unable to predict the effect of the most important operational parameters, such as fuel availability and produced oxygen concentration, which will give rise to unsafe designs. Therefore, we have developed a new model that accurately predicts dynamic conditions in the reservoir and also is easily scalable to investigate different field scenarios. The model used a three component direct conversion cracking kinetics scheme, which does not depend on the stoichiometry of the products and, thus, reduces the extent of uncertainty in the simulation results as the number of unknowns is reduced. The oil production rate and cumulative oil produced were well predicted, with the latter deviating from the experimental value by only 4%. The improved ability of the model to emulate real process dynamics meant it also accurately predicted when the oxygen was first produced, thereby enabling a more accurate assessment to be made of when it would be safe to shut-in the process, prior to oxygen breakthrough occurring. The increasing trend in produced oxygen concentration following a step change in the injected oxygen rate by 33 % was closely replicated by the model. The new simulations have now elucidated the mechanism of oxygen production during the later stages of the experiment. The model has allowed limits to be placed on the air injection rates that ensure stability of operation. Unlike previous models, the new simulations have provided better quantitative prediction of fuel laydown, which is a key phenomenon that determines whether, or not, successful operation of the THAI process can be achieved. The new model has also shown that, for completely stable operation, the combustion zone must be restricted to the upper portion of the sand pack, which can be achieved by using higher producer back pressure

Spatial variability of solar quiet fields along 96° magnetic meridian in Africa:results from MAGDAS

We have used chains of Magnetic Data Acquisition System (MAGDAS) magnetometer records of the horizontal (H) and vertical (Z) magnetic field intensities during September 2008 to August 2009 (year of deep minimum) across Africa to study their variability during the quietest international days, which coincidently associated with the sudden stratospheric warming (SSW) event in January 2009. This selection of the most international quiet days is indicative of 80% that are strongly associated with days when unusually strong and prolonged sudden SSW event occurs in January 2009. Interestingly, in January, a significant magnitude depletion of solar quiet (Sq) equivalent current was observed near noon hours around the magnetic equator (Addis Ababa, ABB) compared to any other months along with a consistent significantly reduced value across the Northern Hemisphere and moderate decrease at the Southern Hemisphere. Also, we found that Nairobi and Dar es Salaam at the Southern Hemisphere, which are close to ABB (dip equator), are strongly prone to westward electric field compared to the magnetic equator and Khartoum at the Northern Hemisphere. Significant negative values of MSq(Z) magnitudes observed near noon hours at Hermanus indicate the presence of induced currents that suggest ocean effects along with reversal to significant positive values in the afternoon, which subsided before 1800 LT in almost all the months, indicate stronger influence of ionospheric currents. On seasonal variability of Sq(H), a slight depression at ABB during September equinox is one of the evidences of seasonal Sq focus shift. Latitudinal variability of Sq near-noon hours was also investigated

The longitudinal variability of equatorial electrojet and vertical drift velocity in the African and American sectors

While the formation of equatorial electrojet (EEJ) and its temporal variation is believed to be fairly well understood, the longitudinal variability at all local times is still unknown. This paper presents a case and statistical study of the longitudinal variability of dayside EEJ for all local times using ground-based observations. We found EEJ is stronger in the west American sector and decreases from west to east longitudinal sectors. We also confirm the presence of significant longitudinal difference in the dusk sector pre-reversal drift, using the ion velocity meter (IVM) instrument onboard the C/NOFS satellite, with stronger pre-reversal drift in the west American sector compared to the African sector. Previous satellite observations have shown that the African sector is home to stronger and year-round ionospheric bubbles/irregularities compared to the American and Asian sectors. This study's results raises the question if the vertical drift, which is believed to be the main cause for the enhancement of Rayleigh–Taylor (RT) instability growth rate, is stronger in the American sector and weaker in the African sector – why are the occurrence and amplitude of equatorial irregularities stronger in the African sector

Determinants of utilisation of risk transfer measures among poultry farmers in Ogun state, Nigeria

The poultry industry contributes significantly to the development of Nigeria’s economy. Unfortunately, poultry farmers like other farmers are faced with income fluctuations arising from risks associated with the enterprise. In this study, socio-economic characteristics of poultry farmers, different types of risk faced by the poultry farmers, management strategies employed by the poultry farmers for risk reduction; and the determinant of utilization of risk transfer measures were examined. A total of 186 respondents were selected as the sample size using multistage sampling method. The findings revealed that the average age of the poultry farmers was 45 years, Majority of the poultry farmers were male (87.1%), and married (91.4%). The major types of risk faced by the poultry farmers were fluctuation of input price (1.36), mortality of birds (1.35) and incidence of pest and disease (1.31). Furthermore, the study revealed that the management strategies employed by the poultry farmers for risk reduction were access to credit (1.80), timely administration of drugs and vaccines (1.67) and use of modern production techniques (1.54). From the results, it can be concluded that timely administration of drugs and vaccines, use of modern production techniques, income diversification are the common risk management practices among the poultry farmers. The study therefore recommended that poultry farmers should be encouraged to diversify into other viable income generating activities to increase output and reduce shock of failure. Also, adequate institutional poultry farming, utilization, risk.support should be provided to improve productivit

REPORT OF MEASLES OUTBREAK INVESTIGATION IN DAN MANAU COMMUNITY OF BAKURA LGA, ZAMFARA STATE, NORTHWEST NIGERIA

Background: Measles is a disease that belongs to the RNA virus of the genus Morbillivirus within the family paramyxoviridae, and its infection accounts for many deaths particularly in children. Objective: The study’s aim to establish the existence of the measles outbreak at Dan Manau village in Bakura LGA, Zamfara State. Methods: Both descriptive and analytical studies were used in the outbreak investigation. In the descriptive analysis a 2-tiered standard case definition (suspected and confirmed) were used: Suspected case: any person with fever and rash or any person in whom a clinician suspects measles Confirmed case: A suspected measles case that has serological confirmation test of recent measles virus infection using measles IgM antibodies ELISA method and had not received measles vaccination in the 30 days preceding the specimen collection. Result: A total of 169 cases and 34 deaths were reported with Case Fertility Rate (CFR) of 20.1%. Male shows a high prevalence of 100 (59.1%) than female 69(40.9%). Most of the cases were less than 3 years old. The majority (85%) of the cases were < 5years old. It was also noted that (68%) of the cases were 0-36months old. Nevertheless, the age groups most affected were 13-24 months (26%). The occurrence of the cases peaked at week 10 with smaller peaks at weeks 6, 14, 16 and 19 respectively. Blood samples from 5valunteer suspected cases were analyzed using Enzymes Linked Immunosorbent Assay (ELISA). Serological tests of the above samples were conducted at the WHO accredited laboratory in Kaduna State reveal 3 positive IgM out 5 with a prevalence of 3(60%) Vaccination with one dose of measles vaccine was lower among the positive cases 38(39%) than the Negative cases 68(68%). Although the odd of this association was less than 1, it was statistically significant (P < 0.05). Conclusions: Measles outbreak is still a common occurrence during the hot session in most communities with poor utilization of routine immunization services. The impact on the community morbidity and mortality rates is high due to some factors like delay in reporting, inadequate local response capacity, weak surveillance system, and weak laboratory services

Djelovanje per- i polifluoroalkilnih tvari na okolišne i ljudske mikroorganizme i njihov potencijal za bioremedijaciju

Utilised in a variety of consumer products, per- and polyfluoroalkyl substances (PFAS) are major environmental contaminants that accumulate in living organisms due to their highly hydrophobic, lipophobic, heat-resistant, and non-biodegradable properties. This review summarizes their effects on microbial populations in soils, aquatic and biogeochemical systems, and the human microbiome. Specific microbes are insensitive to and even thrive with PFAS contamination, such as Escherichia coli and the Proteobacteria in soil and aquatic environments, while some bacterial species, such as Actinobacteria and Chloroflexi, are sensitive and drop in population. Some bacterial species, in turn, have shown success in PFAS bioremediation, such as Acidimicrobium sp. and Pseudomonas parafulva.Budući da se koriste u izradi raznih potrošačkih proizvoda, per- i polifluoroalkilne tvari (engl. per- and polyfluoroalkyl substances, krat. PFAS) veliki su zagađivači okoliša koji se nakupljaju u živim organizmima zbog svoje izrazite hidrofobičnosti, lipofobičnosti, otpornosti na topline i biološke nerazgradljivosti. Ovaj članak donosi sažeti pregled njihova djelovanja na populacije mikroba u tlu, vodnim i biogeokemijskim sustavima te na humanom mikrobiomu. Pojedini su mikrobi neosjetljivi na zagađenje PFAS-om, čak i napreduju, poput bakterije Escherichia coli i proteobakterija u tlu i vodi, a osjetljive su pojedine bakterijske vrste, poput rodova Actinobacteria i Chloroflexi, pa im se smanjuje populacija u takvom okružju. Neke su se, pak, bakterije pokazale uspješnima u bioremedijaciji, poput vrsta Acidimicrobium sp. i Pseudomonas parafulva