A review of clinical trials in dietary interventions to decrease the incidence of coronary artery disease

Of the associations between dietary elements and coronary artery disease (CAD), the greatest body of evidence deals with the beneficial effect of reducing the dietary intake of saturated fatty acids and cholesterol. Furthermore, it is well established, on the basis of convincing evidence, that reduction in serum total cholesterol results in reduction in coronary morbidity and mortality, as well as in regression of other atherosclerotic manifestations.In fact, dietary intervention studies revealed that it is possible to reduce the incidence of coronary death and nonfatal myocardial infarction, as well as manifestations of atherosclerosis in cerebral and peripheral arteries, by reducing dietary intake of saturated fat and cholesterol. In two recently reported dietary interventions the incidence of coronary events, especially coronary mortality, and total mortality were reduced by increased intake of n-3 long-chain polyunsaturated fatty acids and by a modification of the diet toward a Mediterranean-type diet (rich in α-linolenic acid. In addition to those findings, the potential efficacy of the dietary newcomers phytostanol and phytosterol esters on reducing coronary incidence is discussed in the present review

Reasons and risk factors for ninety day re-admission following primary total knee arthroplasty in a high-volume centre

Purpose We aimed to assess the rates, reasons, and risk factors for 90-day re-admissions after total knee arthroplasty (TKA) in a European healthcare setting. Methods We identified all primary elective TKA procedures performed in 2015 at a single high-volume centre. Patients with unplanned re-admissions within 90 days of primary discharge were compared to a 1:4 control cohort of patients having no relevant re-admission. We calculated re-admission rates, recorded the reasons for re-admission, and identified independent predictors of re-admission. Results The 30-day and 90-day unplanned re-admission rates were 6.5% and 8.0%, respectively. The most common reason for re-admission within 90 days was infection (29.6%), followed by knee pain (14.1%), gastrointestinal complications (8.5%), and haematoma (8.5%). Multivariable logistic regression analysis revealed that the following factors were significant independent predictors of re-admission: asthma, psychiatric disease, pre-operative tibiofemoral valgus angle, and pre-operative knee flexion deficit. Conclusions The re-admission rates in our health-care setting were slightly higher than those previously reported. Independent risk factors for re-admissions included pre-operative mechanical axis, range of motion, asthma, and psychiatric disease. Our present results will facilitate the targeting of new subgroups of TKA patients when developing new interventions to further reduce the total re-admission risk after TKA.Peer reviewe

Reply to Comment on Saku et al. : Reasons and risk factors for ninety day re-admission following primary total knee arthroplasty in a high-volume centre

Non peer reviewe

Reasons and Risk Factors for Delayed Discharge After Total Knee Arthroplasty Using an Opioid-Sparing Discharge Protocol

Background: In this study, we aimed to assess the length of hospital stay after total knee arthroplasty in a European healthcare setting. We also aimed to investigate risk factors and reasons for delayed discharge when using an opioid-sparing fast-track protocol. Methods: From our institutional database, we retrospectively identified all primary elective unilateral total knee arthroplasties performed during January to December 2015. Both patient-related and surgery-related variables were collected from our databases. Risk factors were analyzed using multivariable logistic regression analysis. Results: The median length of stay (LOS) was 3 days. Independent risk factors for delayed discharge were higher age, higher American Society of Anesthesiologists score, general anesthesia, surgery performed toward the end of the week, longer duration of surgery, longer stay in the post-anesthesia care unit, and shorter preoperative walking distance. The main reasons for delayed discharge were delayed functional recovery and pain. Conclusion: This study identified several independent risk factors for an LOS longer than 3 days. These risk factors add to the current knowledge on which patients have an increased risk of prolonged LOS, and which patients should be targeted when striving to further reduce the LOS. (C) 2019 Elsevier Inc. All rights reserved.Peer reviewe

Teachers` Heavy Workload and its Effects on Syllabi Coverage in Tanzania Primary Schools: A Case of Kilwa District Council in Lindi Region.

This study addressed the grand raised research question asking, what have been the pros and cons of teachers’ over workload trend concerning the syllabi coverage in relation to pupils’ literacy performance in the studied schools? Its general objective was to examine teachers’ perceptions on excess workload effects on timely syllabus/i content completion in studied public primary schools in studied district council. Its research approach was qualitative and triangulated case study design. Its sample size was 42 research participants, whose units of analysis were: primary school district officers, head teacher and subject teachers. The data were collected through triangulated qualitative methods by: interviews guide and an opinionnare. The analysis was done by: sorting, categorising, comparing, and tabulation. Among findings were: that teachers’ over workload exists in studied schools it is not a whim. The overload trend overlaps the stipulated policy standards for pupil-teacher ratio in studied schools. The exceeding number of pupils translates into shortage of teachers, triggering teachers to rush in covering the required syllabi content timely. The observed trend prompts teachers to feel guilty and stress in effort to cover the syllabi on arrival of quality assurance team. Majority of pupils remain with low acquired knowledge and skills in taught courses. The studied participants applauded governments’ efforts, though still much is desired to increase employment of qualified teachers close to provisional ratio. It is recommended to do a comparative study on the same studied problem in other districts of Lindi. Keywords: Over workload, Syllabi coverage, Effect

A Consultation Phone Service for Patients With Total Joint Arthroplasty May Reduce Unnecessary Emergency Department Visits

Background: Different measures for reducing costs after total joint arthroplasty (TJA) have gained attention lately. At our institution, a free-of-charge consultation phone service was initiated that targeted patients with TJA. This service aimed at reducing unnecessary emergency department (ED) visits and, thus, potentially improving the cost-effectiveness of TJAs. To our knowledge, a similar consultation service had not been described previously. We aimed at examining the rates and reasons for early postdischarge phone calls and evaluating the efficacy of this consultation service. Methods: During a 2-month period, we gathered information on every call received by the consultation phone service from patients with TJAs within 90 days of the index TJA procedure. Patients were followed for 2weeks aftermaking a call to detectmajor complications and self-initiated EDvisits. Datawere collected fromelectronic medical charts regarding age, gender, type of surgery, date of discharge, and length of hospital stay. Results: We analyzed 288 phone calls. Calls were mostly related to medication (41%), wound complications (17%), and mobilization issues (15%). Most calls were resolved in the phone consultation. Few patients (13%) required further evaluation in the ED. The consultation service failed to detect the need for an ED visit in 2 cases (0.7%) that required further care. Conclusion: The consultation phone service clearly benefitted patients with TJAs. The service reduced the number of unnecessary ED visits and functioned well in detecting patients who required further care. Most postoperative concernswere related to prescribed medications, wound complications, and mobilization issues. (c) 2017 Elsevier Inc. All rights reserved.Peer reviewe

Modernin IoT-laitteen tietoturvaongelmat ja -ratkaisut

Tiivistelmä. Tässä kandidaatintyössä perehdytään IoT-laitteissa piileviin tietoturvaongelmiin ja niiden ratkaisuihin. Työssä käydään läpi yleisimmät IoT-laitteita kohtaavat haavoittuvuudet, niihin johtaneet syyt sekä niiden aiheuttamat seuraukset. Lisäksi työssä esitellään jo markkinoilla olevia älykkäillä ominaisuuksilla varustettuja tietoturvalaitteita, joiden on tarkoitus vastata juuri IoT-laitteiden tietoturvaongelmiin. Varsinaisena työnä tuotettiin Raspberry Pi alustaa käyttäen samoja tietoturvaominaisuuksia sisältävä sulautettu järjestelmä sekä mobiilisovellus järjestelmän tarkkailuun. Sulautettu järjestelmä sisältää pythonilla kirjoitetun Paketinsuodatuspalomuurin IP-osoitteiden suodatukseen ja estämiseen, sekä REST-palvelimen tiedonvälitykseen Raspberry Pi:n ja mobiilisovelluksen välillä.Security problems and solutions of a modern IoT device. Abstract. This bachelor’s thesis takes a closer look on the security problems and solutions of a modern IoT device. Thesis covers most common vulnerabilities in IoT design, reasons behind, and consequences that follow. In addition, thesis showcases some of the devices intended specially for IoT security that have already reached the markets. This thesis also includes design process for a Rasberry Pi based embedded system, that includes same functionality as commercial security devices and a mobile application to monitor the embedded system. System consists of packet-filtering type firewall, written in python, to capture and block unwanted packets and of REST-server to transfer information between firewall and mobile application

Treatment of medial-sided injuries in patients with early bicruciate ligament reconstruction for knee dislocation

Purpose In knee dislocation with bicruciate ligament and medial side injury (KDIIIM), treatment method of medial side injuries is controversial. The purpose of this study was to evaluate the outcomes of non-operative treatment of proximal and midsubstance and operative treatment of distal avulsion medial collateral ligament (MCL) ruptures in patients with early bicruciate reconstruction. Methods One-hundred and forty-seven patients with a knee dislocation and bicruciate ligament injury (KDII-KDV) were identified. Sixty-two patients had KDIIIM injury. Of these, 24 patients were excluded and 13 were lost to follow-up. With a minimum of 2 years of follow-up, IKDC2000 (subjective and objective), Lysholm and Tegner scores and stress radiographs were recorded. Results Twenty-five patients were available for follow-up: 18 had a proximal or midsubstance grade-III MCL rupture (proximal MCL group) and 7 had a distal MCL avulsion (distal MCL group). In the proximal MCL and distal MCL groups, respectively, median IKDC2000 subjective scores were 80 (range 57-99) and 62 (range 39-87), and median Lysholm scores were 88 (range 57-99) and 75 (range 40-100). The median medial opening (side-to-side difference) was 2.4 mm (range 0.1-9.2) in the proximal MCL group and 2.5 mm (range 0.2-4.8) in the distal MCL group. Conclusion We found acceptable recorded outcomes in patients who underwent non-operative treatment of proximal and midsubstance grade-III MCL rupture and operative treatment of distal MCL avulsion with early bicruciate ligament reconstruction.Peer reviewe

Nanoparticle release from anionic nanocellulose hydrogel matrix

Nanocellulose hydrogels have been shown to be excellent platforms for sustained delivery of drug molecules. In this study, we examine the suitability of anionic nanocellulose hydrogels for the sustained release of various nanoparticles. Systems releasing nanoparticles could produce applications especially for therapeutic nanocarriers, whose life-times in vivo might be limited. Micelles, liposomes and DNA origami nanostructures were incorporated into the nanocellulose hydrogels, and their release rates were measured. Two different hydrogel qualities (with 1% and 2% mass of fiber content) were used for each nanoparticle formulation. We showed that the drug release rates depend on nanoparticle size, shape, and charge. Smaller particles with neutral charge were released faster from 1% hydrogels than from 2% hydrogels. Nanoparticles with cationic labeling were retained in both hydrogels, whereas for the neutral nanoparticles, we were able to determine the cut-off size for released particles for both hydrogels. Rod-shaped DNA origami were released rapidly even though their length was above the cut-off size of spherical particles, indicating that their smaller radial dimension facilitates their fast release. Based on our results, anionic nanocellulose hydrogels are versatile platforms for the sustained release of the chosen model nanoparticles (liposomes, micelles, and DNA origami). Alternatively, for the tightly bound nanoparticles, this could lead to nanoparticle reservoirs within hydrogels, which could act as immobilized drug release systems.Peer reviewe

PENGARUH SISTEM INFORMASI AKUNTANSI TERHADAP KINERJA KARYAWAN BADAN USAHA MILIK DESA (BUMDesa) DI KABUPATEN MANGGARAI TIMUR

ABSTRACT In the era of government now the village plays an important role where the village is the front guard to identify any problems that exist in society.  One way for the village to prosper the community is to establish a Village-Owned Enterprise (BUMDesa).  This study aims to determine whether there is an influence of the accounting information system on the performance of BUMDesa employees / administrators in East Manggarai Regency.  This research uses a mix method.  This research was conducted at 12 BUMDesa in East Manggarai Regency.  The results of this study indicate that the accounting information system has a positive effect on employee / management performance in East Manggarai Regency.  The magnitude of the influence of the accounting information system on performance is 29.8%.  The results of the interviews also showed the same results where from the elaboration of each indicator the researchers concluded that the accounting information system affected the performance of BUMDesa employees/administrators in East Manggarai Regency.   Keywords: Accounting Information System, Performance of Employees, Village Owned EnterprisesABSTRAK Di era pemerintahan sekarang desa memainkan peranan yang penting dimana desa menjadi garda terdepan untuk mengidentifikasi setiap persoalan yang ada dalam masyarakat. Salah satu cara desa untuk mensejahterakan masyarakat adalah dengan mendirikan Badan Usaha Milik Desa (BUMDesa). Penelitian ini bertujuan untuk mengetahui apakah terdapat pengaruh dari sistem informasi akuntansi terhadap kinerja karyawan/pengurus BUMDesa di Kabupaten Manggarai Timur. Penelitian ini menggunakan mix method. Penelitian ini dilakukan pada 12 BUMDesa yang ada di Kabupaten Manggarai Timur. Hasil penelitian ini menunjukan bahwa sistem informasi akuntansi berpengaruh positif terhadap kinerja karyawan/pengurus  di Kabupaten Manggarai Timur. Besarnya pengaruh dari sistem informasi akuntansi terhadap kinerja adalah sebesar 29,8%. Hasil wawancara juga menunjukan hasil yang sama dimana dari penjabaran setiap indikator peneliti dapat menyimpulkan bahwa sistem informasi akuntansi berpengaruh terhadap kinerja karyawan/pengurus BUMDesa di Kabupaten Manggarai Timur. Katakunci: Sistem Informasi Akuntansi, Kinerja Karyawan, BUMDes