Boundary Effects on the Drag of a Cylinder in Axial Motion at Low Reynolds Number.

This work is an experimental study of the Stokes drag on a right circular cylinder moving with constant velocity through a Newtonian viscous fluid. The cylinder velocity is parallel to its longitudinal axis, and the fluid is bounded on the outside by a fixed coaxial cylindrical tube of circular cross section. The length to diameter ratio of the moving cylinder ranges from 1.0 to 390, the ratio of the width of the annular gap to the cylinder length ranges from 0.0077 to 0.86, and the ratio $\alpha$ of the cylinder diameter to the tube diameter ranges from 0.022 to 0.91. Experimental values of the drag are compared with a theoretical expression which assumes a flow that is entirely axial in the annular region and a drag that is due entirely to the viscous stress on the cylinder side plus the effect of the dynamic pressure difference on the ends of the cylinder. An end correction term is obtained which is found to be proportional to the annular gap width and to the square root of $\alpha$. This term is found to be consistent with previous numerical studies of the narrow gap case and with experimental studies of the wide gap case. Drag values are also presented for the situation in which the bottom of the tube is open to a larger fluid reservoir. A second problem is considered in which a thin circular disk moves broadside through a viscous fluid toward a plane wall that is parallel to the disk. An expression for the Stokes drag is obtained which agrees with the experiment and reduces to known theoretical results at extremes of large and small distances from the disk to the plane

The Impact of Prenatal Exposure to Cocaine on Newborn Costs and Length of Stay

This paper determines newborn costs and lengths of stay attributable to prenatal exposure to cocaine and other illicit drugs, using as a data source all parturients who delivered at a large municipal hospital in New York City between November 18, 1991 and April 11, 1992. We performed a cross-sectional analysis in which multivariate, loglinear regressions were used to analyze differences in costs and length of stay between infants exposed and unexposed prenatally to cocaine and other illicit drugs adjusting for maternal race, age, prenatal care, tobacco, parity, type of delivery, birth weight, prematurity, and newborn infection. Urine specimens, with linked obstetric sheets and discharge abstracts provided information on exposure, prenatal behaviors, costs, length of stay and discharge disposition. Our principal findings show that infants exposed to cocaine and some other illicit drug stay approximately 7 days longer at a cost of $7,731 more than infants unexposed. Approximately 60 percent of these costs are indirect, the result of adverse birth outcomes and newborn infection. Hospital screening as recorded on discharge abstracts substantially underestimates prevalence at delivery, but overestimates its impact on costs.

IS DAYCARE A SAFE PLACE FOR KIDS DURING COVID-19 PANDEMIC? OPINION OF THE LEBANESE MIDDLE TO LOW ECONOMIC STATUS MOTHERS

Purpose: COVID-19 pandemic has negatively impacted the whole society including mothers who struggled between paid work, housework, and full-time childcare. Daycare used to relieve part of this burden. Accordingly, the current study aimed to assess the mothers’ acceptability of sending their children to daycare and the factors that influenced the decision. Subject and Method: A cross-sectional questionnaire-based study was carried out through phone calls in November 2020. Lebanese mothers of children from 0 to 3 years were invited to participate in the study. The questionnaire included demographic data, perception of the ways of COVID-19 transmission, Snyder’s Hope Scale, and acceptability of mothers to send their children to daycare. Data was analysed using SPSS-version 20. Results were considered significant at p-value ≤0.05 with a confidence interval of 95%. Results: Results showed a good knowledge of the way of transmission of SARS-CoV-2. Nevertheless, food and drinks as well as pets were retrieved as a source of transmission in 66.2 and 3.1%, respectively. Mothers average hope reflects their neutrality in agreeing in quarantining and even their disagreement. Accordingly, 62% of the mothers agreed on sending their kids to daycare to overcome their confronted barriers; mainly to go to work. Conclusion: All the results reflect the high burden of raising children without institutional support as well as financial one which the mothers are exposed to during the COVID-19 pandemic. Consequently, daycare must reopen their doors, with special precautions, to relieve the burden on mothers. Moreover, the government must support daycare institutions economically to be affordable to a larger sample of low to middle-income families

Metal Stent Insertion for Malignant Obstruction of a Colostomy

A 47-year-old female with metastatic cervical cancer and diverting colostomy presented with abdominal distention and minimal stool output from her colostomy. A computed tomography (CT) scan revealed a metastatic mass causing partial obstruction at the colostomy level and significant proximal colonic dilation. Her obstruction was relieved by the endoscopic placement of a metal stent through the stoma, with the stent’s distal edge visible externally but not protruding beyond skin level. Two months later, the stent remained patent and did not migrate. This case highlights a viable palliative treatment option for patients who are not operative candidates

Improvement of Osteoporosis Screening among Inflammatory Bowel Disease Patients at Gastroenterology Fellows’ Clinics

Introduction Individuals with inflammatory bowel disease (IBD) have an increased risk of osteoporosis compared to the general population. We aimed to improve the osteoporosis screening rate in the IBD patient population of the gastroenterology (GI) fellows' continuity clinics. Methods Baseline preintervention data were collected on patients seen from July through September of 2018. Four simplified criteria for osteoporosis screening were extrapolated from 3 national guidelines. Among patients who met any of these criteria, we determined the baseline screening rate. Fellows were then educated with a didactic session and handout material, and a standardized template was incorporated into clinic notes. Following this intervention, screening rates were reassessed from December 2018 through February 2019. Results During the preintervention phase, fellows saw 80 patients with IBD. Dual-energy X-ray absorptiometry (DEXA) scan was obtained in 44% of IBD patients who qualify for screening at the county hospital clinic compared to 21% of veterans' clinic IBD patients. In the postintervention period, screening rates remarkably improved to 100% in the county hospital clinic and to 75% in the veterans' clinic. Overall, the screening rate increased by 56% (P < 0.001). Conclusions A large percentage of IBD patients at risk for osteoporosis did not have appropriate bone mass density testing. Educating GI fellows and adding a template to clinic notes were effective in significantly improving the number of patients at risk of osteoporosis to receive appropriate screening test, a DEXA scan. Similar educational interventions should be considered for providers caring for IBD patients to prevent complications of osteoporosis in these patients

Establishing a sorting protocol for healthcare databases

Background: Health information records in many countries, especially developing countries, are still paper based. Compared to electronic systems, paper-based systems are disadvantageous in terms of data storage and data extraction. Given the importance of health records for epidemiological studies, guidelines for effective data cleaning and sorting are essential. They are, however, largely absent from the literature. The following paper discusses the process by which an algorithm was developed for the cleaning and sorting of a database generated from emergency department records in Lebanon.Design and methods: Demographic and health related information were extracted from the emergency department records of three hospitals in Beirut. Appropriate categories were selected for data categorization. For health information, disease categories and codes were selected according to the International Classification of Disease 10th Edition.Results: A total of 16,537 entries were collected. Demographic information was categorized into groups for future epidemiological studies. Analysis of the health information led to the creation of a sorting algorithm which was then used to categorize and code the health data. Several counts were then performed to represent and visualize the data numerically and graphically.Conclusions: The article describes the current state of health information records in Lebanon and the associated disadvantages of a paper-based system in terms of storage and data extraction. Furthermore, the article describes the algorithm by which health information was sorted and categorized to allow for future data analysis using paper records

Azithromycin plus chloroquine: combination therapy for protection against malaria and sexually transmitted infections in pregnancy

INTRODUCTION: The first-line therapy for the intermittent preventive treatment of malaria in pregnancy (IPTp) is sulphadoxine-pyrimethamine (SP). There is an urgent need to identify safe, well-tolerated and efficacious alternatives to SP due to widespread Plasmodium falciparum resistance. Combination therapy using azithromycin and chloroquine is one possibility that has demonstrated adequate parasitological response > 95% in clinical trials of non-pregnant adults in sub-Saharan Africa and where IPTp is a government policy in 33 countries. AREAS COVERED: Key safety, tolerability and efficacy data are presented for azithromycin and chloroquine, alone and/or in combination, when used to prevent and/or treat P. falciparum, P. vivax, and several curable sexually transmitted and reproductive tract infections (STI/RTI). Pharmacokinetic evidence from pregnant women is also summarized for both compounds. EXPERT OPINION: The azithromycin-chloroquine regimen that has demonstrated consistent efficacy in non-pregnant adults has been a 3-day course containing daily doses of 1 g of azithromycin and 600 mg base of chloroquine. The pharmacokinetic evidence of these compounds individually suggests that dose adjustments may not be necessary when used in combination for treatment efficacy against P. falciparum, P. vivax, as well as several curable STI/RTI among pregnant women, although clinical confirmation will be necessary. Mass trachoma-treatment campaigns have shown that azithromycin selects for macrolide resistance in the pneumococcus, which reverses following the completion of therapy. Most importantly, no evidence to date suggests that azithromycin induces pneumococcal resistance to penicillin