Risk factors associated with short-term complications in mandibular fractures: the MANTRA study—a Maxillofacial Trainee Research Collaborative (MTReC)

Abstract Introduction Complications following mandibular fractures occur in 9–23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders. In this paper, we use a collaborative snapshot audit to document novel risk factors and confirm established risks for complications following the treatment of mandibular fractures. Methods The audit was carried out by 122 OMFS trainees across the UK and Ireland (49 centres) over 6 months, coordinated by the Maxillofacial Surgery Trainees Research Collaborative. Variables recorded included basic demography, medical and social history, injury mechanism and type, management and 30-day outcome. Results Nine hundred and forty-seven (947) patients with fractured mandibles were recorded. Surgical management was carried out in 76.3%. Complications at 30 days occurred 65 (9%) of those who were managed surgically. Risk factors for complications included male sex, increasing age, any medical history, increasing number of cigarettes smoked per week, increasing alcohol use per week, worse oral hygiene and increased time from injury to presentation. Discussion We have used a large prospective snapshot audit to confirm established risk factors and identify novel risk factors. We demonstrate that time from injury to presentation is confounded by other indicators of poor health behaviour. These results are important in designing trial protocols for management of mandibular fractures and in targeting health interventions to patients at highest risk of complications. </jats:sec

Barriers towards widespread adoption of V2G technology in smart grid environment: From laboratories to commercialization

A new era of transportation has experienced electrification and undergoes notable changes in the last few decades. The concern about environmental friendly technology carries almost a huge expansion prospect to electric vehicles (EVs). Whereas plug-in hybrid electric vehicles (PHEVs) are recognized as a feasible term in the line of vehicular technology in the smart electric grid to lessen the dependency on fossil fuels and greenhouse gas (GHG) emissions related to conventional vehicles (CVs). The development of vehicle-to-grid (V2G) strategies establishes win?win situations for the PHEV participation without additional infrastructure cost, reduction of generation, operational and PHEV user cost, reduction of environmental pollution. Together with the expansion of the smart grid technologies, the V2G power allocation problems need to be addressed. More originally, this chapter measures substantial, though often overlooked, social barriers to the wider use of PHEVs (a likely precursor to V2G) and implementation of a V2G transition. This chapter has given an idea that the only important barriers facing the greater use of PHEVs and V2G systems are technical. Instead, it provides a broader assessment situating such ?technical? barriers alongside more subtle impediments relating to social and cultural values, business practices, and political interests. Thus, this research study recognizes probable socio-technical obstacles towards widespread adoption of V2G in smart grid and governs that if sustainability problems affect consumer decision to adopt V2G to charge their PHEVs. The current study delivers valuable understanding about the perception among technology fanatics associated with knowledge expansion and improved fortified to sort out the numerous alterations among V2G and PHEVs. Finally, the outcomes of this chapter can guide policy makers to implement V2G technology successfully. Moreover, the chapter illuminates the policy implication of such barriers, which emphasizes what policy makers need to achieve towards V2G technology adoption in smart grid environment while integrating electric vehicles engineering with consumer preference. ? Springer International Publishing AG, part of Springer Nature 2018.Scopu

Antibody Response and Disease Severity in Healthcare Worker MERS Survivors

We studied antibody response in 9 healthcare workers in Jeddah, Saudi Arabia, who survived Middle East respiratory syndrome, by using serial ELISA and indirect immunofluorescence assay testing. Among patients who had experienced severe pneumonia, antibody was detected for >18 months after infection. Antibody longevity was more variable in patients who had experienced milder disease

Antibody Response and Disease Severity in Healthcare Worker MERS Survivors

We studied antibody response in 9 healthcare workers in Jeddah, Saudi Arabia, who survived Middle East respiratory syndrome, by using serial ELISA and indirect immunofluorescence assay testing. Among patients who had experienced severe pneumonia, antibody was detected for >18 months after infection. Antibody longevity was more variable in patients who had experienced milder disease

Test-based De-isolation in COVID-19 Immunocompromised patients: Ct value versus SARS-CoV-2 viral cultures

Background Immunocompromised patients with coronavirus disease 2019 (COVID-19) have prolonged infectious viral shedding for more than 20 days. A test-based approach is suggested for de-isolation of these patients. Methods The strategy was evaluated by comparing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load (cycle threshold (Ct) values) and viral culture at the time of hospital discharge in a series of 13 COVID-19 patients: six immunocompetent and seven immunocompromised (five solid organ transplant patients, one lymphoma patient, and one hepatocellular carcinoma patient). Results Three of the 13 (23%) patients had positive viral cultures: one patient with lymphoma (on day 16) and two immunocompetent patients (on day 7 and day 11). Eighty percent of the patients had negative viral cultures and had a mean Ct value of 20.5. None of the solid organ transplant recipients had positive viral cultures. Conclusions The mean Ct value for negative viral cultures was 20.5 in this case series of immunocompromised patients. Unlike those with hematological malignancies, none of the solid organ transplant patients had positive viral cultures. Adopting the test-based approach for all immunocompromised patients may lead to prolonged quarantine. Large-scale studies in disease-specific populations are needed to determine whether a test-based approach versus a symptom-based approach or a combination is applicable for the de-isolation of various immunocompromised patients