OBJECTIVES: Since the International Labour Organization (ILO) serves as the primary authority on work-related matters, this study is focused on analyzing the ILO's policies regarding the acknowledgment of COVID-19 infections as occupational diseases. It also investigates how States can recognize COVID-19 as such a disease while delving into the connection between the disease or injury and the occupation itself.
METHODOLOGY: This study utilizes a doctrinal methodology, focusing on legal research. This approach employs an applied (expository) research method and discusses the topic from a professional constituency perspective, as proposed by Arthurs in 1983.
RESULT: The findings indicate that the ILO does not explicitly mention the pandemic or COVID-19 infection as an occupational disease in its list. However, it does include "infectious-related diseases" or "work that carries a particular risk of contamination" as occupational or work-related diseases, which can logically be interpreted as encompassing COVID-19 infection as an occupational or work-related disease.
RECOMMENDATION: As the ILO sets guiding principles for its member States, this study recommends that the ILO should establish clear and comprehensive guidelines for member States to recognize COVID-19 infections or any future pandemics as occupational diseases.
CONCLUSION: This study will serve as a valuable resource for policymakers who intend to enact or amend national legislation to align with the ILO. Furthermore, it will assist relevant stakeholders in taking necessary actions based on the study's findings.
OBSERVATION: We report a rare case of a neonate with transient abnormal myelopoiesis and tumor lysis syndrome, complicated with concomitant heart failure due to an underlying atrioventricular septal defect. Hyperhydration was contraindicated due to heart failure. The patient was managed conservatively with full recovery.
CONCLUSION: Tumor lysis syndrome should be suspected in neonates with transient abnormal myelopoiesis with electrolyte abnormalities. Treatment options should be considered carefully for their risks and benefits.
OBJECTIVE: To assess the responsiveness of the measure of cervical JPE after a 4-week home-based neck proprioceptive training intervention in people with CNP.
DESIGN: An observational study to assess the responsiveness of the measure of cervical JPE.
METHODS: The JPE test was assessed in people with CNP before and after 4 weeks of neck proprioception training. JPE was assessed as participants performed neck joint position sense tests for flexion, extension, right rotation, and left rotation in sitting and standing which were performed in a random order. Both the absolute and constant JPE were assessed. The intervention consisted of neck repositioning exercises as well as movement sense exercises. Cohen's d effect size was used to assess the internal responsiveness of the JPE test. The Pearson's correlation was used to assess the change of scores of the laser pointer and measures from inertial measurement units (IMUs) (external responsiveness).
RESULTS: After 4 weeks of proprioception training, JPE assessed in sitting reduced from 2.69◦-3.57◦ to 1.88◦-1.98◦ for flexion, extension, and right rotation with large effect sizes (Cohen's d range: 1.25-2.00). For left rotation, JPE reduced from 3.23◦ to 1.9◦, and the effect size was close to being large (Cohen's d: 0.79). When assessed in standing, JPE reduced from 3.49◦-4.52◦ to 1.5◦-2.33◦ with large effect sizes (Cohen's d range: 0.89-1.25) for flexion, extension, right rotation, and left rotation. Large effect sizes were not observed for the constant JPE when assessed in either sitting or standing. The assessment of the external responsiveness revealed weak correlations between the change of scores obtained from the laser pointer and the IMUs for all movements, apart from the constant JPE in sitting for left rotation, which showed a strong correlation (r = 0.7).
CONCLUSION: The results of this study showed that the measure of the JPE has sufficient internal responsiveness, however, the external responsiveness was inadequate. Further research is advised.
METHODS: Both eyes of patients with myopic MNV diagnosed with fluorescein angiography (FA), SD OCT and OCTA were assessed by unmasked investigators. The images were deidentified and randomised before graded by masked investigators, who determined the presence of active myopic MNV by using SD OCT together with OCTA without FA and by FA alone, respectively. The findings of masked investigators were compared with unmasked investigators.
RESULTS: 213 eyes of 110 patients comprising 499 imaging episodes were eligible for grading. For diagnosing new-onset myopic MNV without FA, combined use of SD OCT and OCTA had a sensitivity of 0.94, specificity of 0.84 and area under the curve (AUC) of 0.92. FA had a sensitivity of 0.52 (p<0.01), specificity of 0.80 (p=0.38) and AUC of 0.66 (p<0.01). For recurrent myopic MNV, the combination of SD OCT and OCTA had a sensitivity of 0.98, specificity of 0.78 and AUC of 0.88. FA had a sensitivity of 0.50 (p=0.04), specificity of 0.76 (p=0.85) and AUC of 0.63 (p=0.01). Myopic traction maculopathy was more frequently associated with recurrent myopic MNV (p<0.01).
CONCLUSION: SD OCT with dense volumetric scan was highly sensitive for diagnosing myopic MNV. The addition of OCTA improved the diagnostic specificity without FA. Monitoring of the longitudinal changes on SD OCT and judicious use of FA is a reliable surveillance strategy for myopic MNV.
PURPOSE: The purpose of this pilot clinical study was to compare casts generated from a conventional definitive impression with casts generated from an altered cast impression using a 3-dimensional (3D) analysis software program.
MATERIAL AND METHODS: Three partially edentulous participants with mandibular Kennedy Class I were enrolled, and impressions were made with the 2 techniques and poured in stone. The casts were scanned, aligned, and superimposed by using a 3D analysis software program. Surface deviations were measured to evaluate the differences in displacement induced by the impression on the tissue surface. Five observations were made in 4 different areas on each partially edentulous side. Means from these observations were generated, and the Wilcoxon and Mann Whitney tests were performed for all data to assess the differences between the right and left sides in the same participant and among the 3 participants (α=.05).
RESULTS: The casts made from the altered cast impression had an overall mean ±standard deviation displacement of -0.05 ±1.25 mm on the right and left sides of the mandibular buccal shelf area. Moreover, the greatest overall difference of about 0.45 ±0.41 mm occurred on the lingual slope of the residual ridge, and the differences in the other areas were 0.10 ±0.99 mm (crest of the residual ridge) and 0.16 ±0.66 mm (buccal slope of the residual ridge). The overall differences varied statistically between significance and nonsignificance for the same participant and among the 3 participants.
CONCLUSIONS: A digital comparative analysis of the conventional and altered cast methods of recording the bilateral distal extension areas in partially edentulous participants showed that the altered cast method exhibited more displacement on the buccal vestibule or buccal shelf area compared with other examined areas. The differences between the 2 impression methods in the displacement values among the examined areas were minimal and in close proximity, and such differences may lack clinical significance.
METHODS: This single-blinded, randomized controlled trial was conducted in a single emergency department. Patients with acute long bone fractures and numerical rating scale (NRS) pain scores ≥ 6 following an initial dose of intravenous morphine were assigned to receive either a LDK (0.3 mg/kg) over 15 min or intravenous MOR at a dose of 0.1 mg/kg administered over 5 min. Throughout a 120-min observation period, patients were regularly evaluated for pain level (0-10), side effects, and the need for additional rescue analgesia.
RESULTS: A total of 58 subjects participated, with 27 in the MOR group and 31 in the LDK group. Demographic variables and baseline NRS scores were comparable between the MOR (8.3 ± 1.3) and LDK (8.9 ± 1.2) groups. At 30 min, the LDK group showed a significantly greater mean reduction in NRS scores (3.1 ± 2.03) compared to the MOR group (1.8 ± 1.59) (p = 0.009). Similarly, at 60 min, there were significant differences in mean NRS score reductions (LDK 3.5 ± 2.17; MOR mean reduction = 2.4, ± 1.84) with a p-value of 0.04. No significant differences were observed at other time intervals. The incidence of dizziness was higher in the LDK group at 19.4% (p = 0.026).
CONCLUSION: Short infusion low-dose ketamine, as an adjunct to morphine, is effective in reducing pain during the initial 30 to 60 min and demonstrated comparability to intravenous morphine alone in reducing pain over the subsequent 60 min for acute long bone fractures. However, it was associated with a higher incidence of dizziness.
TRIAL REGISTRATION: NMRR17318438970 (2 May 2018; www.nmrr.gov.my ).
RESULTS: Clostridiales isolates were profiled for their ability to perform 57 enzymatic reactions and produce short-chain fatty acids (SCFAs) and hydrogen sulfide, revealing that these bacteria were capable of a range of activities associated with metabolism and host response. Consistent with this finding, monocolonization of mice with individual isolates identified bacteria that were potent inducers of regulatory T-cell (Treg) differentiation in the colon. Comparisons between variables revealed by these studies identified enzymatic properties correlated with Treg induction and Trichuris egg hatching.
CONCLUSION: We identified Clostridiales species that are sufficient to induce high levels of Tregs. We also identified a set of metabolic activities linked with Treg differentiation and Trichuris egg hatching mediated by these newly isolated bacteria. Altogether, this study provides functional insights into the microbiotas of individuals residing in a helminth-endemic region. Video Abstract.
METHODS: To construct a practical value framework for traditional non-pharmacological therapies, a scoping review methodology was adopted to identify the evaluation domains and obstacles. A search, screening, and analysis process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Evidence was retrieved from scientific databases and HTA agencies' websites.
RESULTS: The search strategy identified 5 guidelines records and 17 acupuncture HTA reports. By synthesizing the valuable reports of CPM and acupuncture evaluation in representative countries, this study found that Mainland China was promoting the comprehensive value assessment of CPM, whereas the United Kingdom, Singapore, Canada, the United States, and Malaysia had carried out the HTA evaluation of acupuncture for various conditions among which chronic pain was the most common. UK and Singapore applied the HTA results to support acupuncture reimbursement decisions. Three domains, including safety, effectiveness, and economy, were commonly adopted. The identified biggest challenge of evaluating traditional non-pharmacological therapies is the scarce high-quality clinical evidence.
CONCLUSIONS: This study identified value domains and issues of traditional therapies, and pointed out future research implications, to promote the development value framework of traditional therapies.