Non-steroidal anti-inflammatory drugs in postoperative hand fracture management:Do they positively or negatively impact recovery?

This editorial explores the impact of non-steroidal anti-inflammatory drugs(NSAIDs)on postoperative recovery in hand fracture patients,amidst shifting pain management strategies away from opioids due to their adverse effects.With hand fractures being significantly common and postoperative pain management crucial for recovery,the potential of NSAIDs offers a non-addictive pain control alternative.However,the controversy over NSAIDs'effects on bone healing—stemming from their Cyclooxygenase-2 inhibition and associated risks of fracture non-union or delayed union—necessitates further investigation.Despite a comprehensive literature search,the study finds a lack of specific research on NSAIDs in postoperative hand fracture management,highlighting an urgent need for future studies to balance their benefits against possible risks.

Drugs used for pain management in gastrointestinal surgery and their implications

Pain is the predominant symptom troubling patients.Pain management is one of the most important aspects in the management of surgical patients leading to early recovery from surgical procedures or in patients with chronic diseases or malignancy.Various groups of drugs are used for dealing with this;however,they have their own implications in the form of adverse effects and dependence.In this article,we review the concerns of different pain-relieving medicines used postoperatively in gastrointestinal surgery and for malignant and chronic diseases.

Impacts of Bad Weathers in Growing Season on Apples and Post-disaster Management Measures

Apple cultivation has special requirements for climatic conditions. The period from May to August is a key period for apple growth.During this period,extreme weather occurs frequently,such as extreme high temperature,strong wind,hail,and floods. This paper introduced these extreme weathers and came up with some corresponding management measures.

Influence of Diesel Engine Intake Throttle and Late Post Injection Process on the Rise of Temperature in the Diesel Oxidation Catalyst

In order to effectively implement DPF(Diesel Particulate Filters)regeneration control,thermal management of exhaust products before and inside Diesel Oxidation Catalyst(DOC)is necessary.In the present study,the Influence of the intake throttle valve and late post injection process on temperature rise inside DOC is analyzed through engine bench tests.The steady experiment results show that adjustment of the intake throttle valve can effectively increase exhaust temperature before DOC;in particular,with intake throttle valve opening at 20%,temperature before DOC can be increased by about 170℃ with respect to the full opening.An increase in the late post injection quantity can produce a significant rise of the temperature inside DOC,however its impact on the exhaust temperature before DOC is relatively limited.As the late post injection quantity increases,Hydrocarbon(HC)emissions also grow;in the present work it is shown that with a proper injection quantity,a considerable temperature increase inside the DOC can be obtained with relatively low HC emission.More specifically,with the intake throttle valve at 30%and DOC reaching ignition temperature as the late post injection quantity is increased,the exhaust temperature after DOC can be made larger than 550℃,adequate for DPF active regeneration.

Improved Management Options for Submergence-Tolerant (Sub1) Rice Genotype in Flood-Prone Rainfed Lowlands of West Bengal

Flash flood or submergence is a common phenomenon in rice growing rainfed lowland areas that seriously affects crop establishment leading to severe yield losses. A few submergence-tolerant rice varieties have been developed by introgressing SUB1 gene into mega rice varieties of South Asia. Two of these, Swarna-Sub1 and Sambha Mahsuri-Sub1, are already released in India for the commercial cultivation. Performance of these varieties can be further enhanced through adoption of appropriate management practices both in nursery and in main field. Two on-station field experiments were conducted using Swarna-Sub1 during the wet season (kharif) of 2011 at Rice Research Station, Chinsurah, Hooghly, West Bengal (India). Results of these experiments revealed that the use of lower seeding density (25 g m-2), application of balanced doses of N-P2O5-K2O @ 80-40-40 kg ha-1 in nursery and transplanting of aged seedlings (44 days) significantly improved plant survival, yield attributing traits and grain yield. An additional N-dose of 20 kg ha-1 at 7 days after receding of flood water resulted in better post-submergence recovery and maximum grain yield. In the on-farm trials conducted at three different locations in West Bengal, nursery raising of seedlings with the application of N-P2O5-K2O @ 80-40-40 kg ha-1, transplanting them at an optimum age (35 days) and application of 20 kg·N ha-1 after 7 days of de-submergence produced maximum grain yield of Swarna-Sub1.

China's Post and Telecommunications Service

In 1994, the handling capacity and business volume of China’s posts and telecommunications fulfilled the target of the Eighth Five-Year Plan (1991-1995) a year ahead of schedule and that of quadrupling the business volume during the period of 1980-2000 six years in advance. 1. The comprehensive communications capacity further enhanced with the construction of the telecommunication mains transmission network mainly composed of optical fibre cables is now in place. Seven

Oxytocin versus Methylergometrine in the Active Management of Third Stage of Labour

Objective: To compare the efficacy of Oxytocin versus Methylergometrine in active management of third stage of labour in reducing risk of postpartum hemorrhage. Methods: This study was carried out by randomly assigning into two groups with 150 women in each group.?Group 1 included patients who received injection Oxytocin 10 IU intramuscular within one minute of the birth of the baby. Injection?Methylergometrine?(0.2 mg) was given intravenously at the delivery of anterior shoulder of the baby to women in Group 2. Outcome measures were the duration of third stage, blood loss, pre and post-delivery hematocrit, side effects and incidence of PPH. Statistical analysis was done using Chi square test, Fischers test, Mann Whitney test, and t test. p < 0.05 was considered significant. Results: Mean duration of third stage of labour, mean blood loss, post-delivery fall in hematocrit and need for additional uterotonics were significantly less in the Group 2. However side effects like nausea, vomiting and rise in blood pressure were significantly higher in women in Group 2 (p = 0.000). Conclusion: Methylergometrine is more effective than Oxytocin in reducing the duration of third stage of labour and blood loss but has significant side effects like nausea, vomiting and rise in blood pressure.

Improving Rice-Based Cropping Pattern Through Soil Moisture and Integrated Nutrient Management in Mid-Tropical Plain Zone of Tripura, India

An experiment was conducted in three fallow paddy fields situated on the mid-tropical plain zone of a northeastern Indian state （Tripura） to provide rice fallow management options using leftover soil moisture and nutrients. The three experimental fields were managed by growing rice under the system of rice intensification as the rainy season crop and then groundnut, lentil, rapeseed and potato as the post-rainy season crops. Fertilization under the integrated nutrient management system and lifesaving irrigation at critical stages of each post-rainy season crop were provided. Results showed that the field water use efficiency values were 5.93, 2.39, 2.37 and 59.76 kg/（hm2.mm） and that the yield of these crops increased by approximately 20%, 34%, 40% and 20% after applying two lifesaving irrigations in groundnut, lentil, rapeseed and potato, respectively. Therefore, fallow paddy field can provide possible profitable crops during the post-rainy season by utilizing the residual moisture and minimum supplemental irrigation under improved nutrient management practices.

Difficulties and Countermeasures of Enterprise＇s Post Internship Management

Relative policies, enterprise＇ s human resources management theories and colleges＇ internship management systems were reviewed, the difficulties of enterprise＇ s post internship management were analyzed and countermeasures were put forward from the perspective of colleges in order to lower enterprise＇ s risk, foster internship work to carry out smoothly and realize the benefits of college, enterprise and students.

Standardizing Management of Post-Dural Puncture Headache in Obstetric Patients: A Literature Review

Post-dural puncture headache continues to be a significant cause of morbidity in parturients. Despite being a common complication faced by many anesthesiologists, there is a lack of consensus regarding its management. Many still use traditionally taught treatments such as strict bed rest and aggressive hydration despite lack of evidence for their usage. Few are using newly tested treatments such as gabapentin and ACTH despite being proven effective in randomized controlled trials. Furthermore, when and how the epidural blood patch should be used is contentious between different practitioners. This review aims at answering what is the best strategy to manage post-dural puncture headache and proposes an evidence-based practice guideline.

Evaluation of the post-fire erosion and flood control works in the area of Cassandra(Chalkidiki, North Greece)

We quantified morphological and hydrographical characteristics of two drainage basins（Chanioti and N. Skioni） on Cassandra peninsula of Chalkidiki（North Greece）, and evaluated the effectiveness of post-fire flood and erosion control works. The drainage basins were chosen because of their severe damage by fire, post-fire potential for erosion and flood due to the steep relief, and the importance of the area for residential and tourism development. The first measures taken in the area after the fire were salvage cutting of burned trees, a total ban on grazing, and construction of three types of works, log erosion barriers（LEBs）, log check dams and contour branch barriers. Almost all necessary post-fire works were completed in both catchments but many construction failures were recorded. Approximately 75 % of the LEBs and45 % of the contour branch barriers functioned properly,while the remainder failed. Nearly 80 % of the log dams were sedimented to 0–20 % of the dam height, 14.3 %were 20–40 % filled and 5.9 % collapsed. Despite these failures, peak discharge declined by 10.5 % in Chanioti and 20.4 % in N. Skioni catchment. The main reasons for works failures were the rush of construction and the limited supervision of workers, which resulted in floods during the years that followed.

A Clustering-tree Topology Control Based on the Energy Forecast for Heterogeneous Wireless Sensor Networks

How to design an energy-efficient algorithm to maximize the network lifetime in complicated scenarios is a critical problem for heterogeneous wireless sensor networks (HWSN). In this paper, a clustering-tree topology control algorithm based on the energy forecast (CTEF) is proposed for saving energy and ensuring network load balancing, while considering the link quality, packet loss rate, etc. In CTEF, the average energy of the network is accurately predicted per round (the lifetime of the network is denoted by rounds) in terms of the difference between the ideal and actual average residual energy using central limit theorem and normal distribution mechanism, simultaneously. On this basis, cluster heads are selected by cost function (including the energy, link quality and packet loss rate) and their distance. The non-cluster heads are determined to join the cluster through the energy, distance and link quality. Furthermore, several non-cluster heads in each cluster are chosen as the relay nodes for transmitting data through multi-hop communication to decrease the load of each cluster-head and prolong the lifetime of the network. The simulation results show the efficiency of CTEF. Compared with low-energy adaptive clustering hierarchy (LEACH), energy dissipation forecast and clustering management (EDFCM) and efficient and dynamic clustering scheme (EDCS) protocols, CTEF has longer network lifetime and receives more data packets at base station. © 2014 Chinese Association of Automation.

Irritable bowel syndrome in children:Current knowledge, challenges and opportunities

Irritable bowel syndrome(IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS.

Uterotonic drugs use for post partum hemorrhage: An audit of the third stage of labor management

Objectives: Worldwide the use of uterotonic drugs has significantly reduced maternal mortality from postpartum hemorrhage. The objective is to audit the use of uterotonics in the active management of the third and fourth stages of labor. Methods: Personal data, diagnostic clinical information, blood loss and uterotonics administered were extracted from a cohort of 634 consecutive parturient. Trend in Shock Index (Pulse Rate/Systolic Blood Pressure) and 48 hours hematocrit changes were computed and analyzed. Results: There were 422 vagina deliveries and 212 caesarean sections. Primiparous mothers were 141 (34.2%), while grand multiparous mothers were 14 (3.4%). The mean visually estimated postpartum blood loss 165.9 ± 80 ml. There was no significant difference in the mean blood loss between the three parity groups of parturient [P = 0.09]. Fourteen parturient (3.44%) had blood loss ≥500 ml. The value of Shock Index (Pulse Rate/Systolic Blood Pressure) in the study ranged between 0.43 and 1.38. Logistic regression analysis of the variables associated with the switch between the three regimens of uterotonic drugs, showed a significant positive correlation between VEBL and uterotonic drugs administered [Pearson correlation = 0.130, P-value = 0.008]. In addition, there was a significant negative correlation between uterotonic drugs administered and Shock Index at 30 minutes and 2 hours postpartum. The correlation coefficient between VEBL and regimens of uterotonic drugs used was positive and significant (P = 0.019). Conclusion: Visually estimated blood loss, with shock are the main Triggers involved in switching between uterotonic drugs regimens used in active management of PPH. Shock index calculation is vital in management decision. We advocate training of all birth attendants on VEBL.

Long-term forest management after wildfire(Catalonia,NE Iberian Peninsula)

Studies of post-fire soil status in Mediterranean ecosystems are common;however,few have examined the effects of long-term forest management after a wildfire on physicochemical soil properties.Here,we analyzed differences in soil properties attributable to long-term postfire management and assessed the sustainability of these management practices in relation to the soil properties.The study area is located in Odena in the northeast region of the Iberian Peninsula consisted of the control forest(burned more than 30 years ago),low density forest(LD;burned in a wildfire in 1986 and managed in 2005)and high density forest(HD;burned in a wildfire in 1986 and no managed).For soils from each plot,we measured soil water repellency,aggregate stability,total nitrogen(TN),soil organic matter(SOM),inorganic carbon(IC),pH,electrical conductivity,extractable calcium,magnesium,sodium,potassium(K),phosphorus,aluminum(Al),manganese(Mn),iron(Fe),zinc,copper,boron,chrome,silicon and sulfur and calculated the ratios of C/N,Ca+Mg/(Na+K)^1/2,Ca/Al and Ca/Mg.Significant differences were found in TN,IC,SOM,pH,K,Al,Mn,Fe and C/N ratio(p<0.05).All soil properties were found to have largely recovered their pre-fire values.Soils were affected by the post-fire management practices implemented 20 years after the fire,as reflected in their respective physicochemical properties,so that soil properties at the control and LD sites are more similar today than those at the control and HD sites.Thus,sustainable forest management can overcome soil degradation in areas affected by wildfire in the medium-and long-term by improving soil properties.

Application of CVAM-based management accounting in mobile telecommunication enterprises

CVAM-based management accounting emphasizes that enterprises should make efforts not only to provide goods or service to customers but also to create value for customers. In practice, customer value should be measured reasonably first. Then according to its condition, enterprise can apply the CVAM-based management accounting method by improving management quality, perfecting costing planning, brand operation and business innovation to create value for customers thus achieving increase of corporate value as well as social value.

Analysis of Post-Consumer Solid Textile Waste Management among Households in Oyo State of Nigeria

This research work viewed issues relating to post-consumers’ solid textile waste management among households from a sociological perspective. The study was carried out in Oyo state of Nigeria. It specifically identified sources of post-consumer solid textiles waste, assessed waste management practices in the study area and, examined knowledge of respondent’s on impact of post-consumers solid textile waste on the environment. Eight Local Government Areas were randomly selected from the state and, multistage random sampling procedure was applied in selecting 880 households for the study. Solid wastes generated by each of this household were collected twice a week. Sensitive and micro-census calibrated scale machine and weighing balance was employed in taking weight of the sorted textile wastes. Calibrated cylinder of radius 10 cm and height 40 cm was used in taking volume of the shredded waste. Mean value of post-consumer solid textile waste generated by individual was 0.11 kg ± 0.08, of volume 354 cm3 per day. Major identified waste disposal systems practiced by the respondents were open land surface dumping and open air burning. The respondents (100%) strongly agreed that, wastes are often discards indiscriminately in the street by individuals. Level of awareness on danger created by poor waste disposal system among 78% of the respondents was low. None of the respondents have training on waste management neither is there any accessible training center in the studied area. Part of procedures to solve environmental problems can be by raising levels of awareness of individual household’s, markets and institutional sectors on danger posed by poor handling of textile wastes to life and the environment, and be trained on waste management techniques. A functional and practically ideal waste management scheme should be established by the various organs of government mostly at the Local Government Area levels, and some investors could also be encouraged in instituting such schemes. Research institutes in the country should develop appropriate technologies and trainings on waste management. Apart from salvaging the environment, such schemes will also provide job to cushion poverty mitigation in Nigeria.

Content Validity of a Self-Management Behavior Assessment Tool for Adult Post-Renal Transplant Recipients Using a Modified Delphi Method

Background: Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. Objective: This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. Methods: A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. Conclusions: The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.

Effectiveness of Clinical Pharmacist Directed-Diabetes Management

Objective: The main aim of the study is predominately utilizing clinical pharmacist in the provision of continuing diabetic education programs to emphasize and re-emphasize the importance of risk factors, prevention, adherence to medication and behavioral changes to prevent recurrences of the disease, their progression, and ultimately minimize hospitalization. Specific goals are to improve clinical outcomes for patients with diabetes—to maintain optimal plasma glucose concentrations Fasting, Postprandial Plasma Glucose, and Glycated Hemoglobin. Study design: A prospective interventional study in the Outpatient General Medicine Department, for a period of six months from October 2018 to March 2019. Results: HbA1c levels were reduced from baseline by &minus;1.107 ± 0.8634, Fasting Plasma Glucose levels and Postprandial blood glucose levels were reduced from baseline by &minus;24.2218 ± 5.70352 and &minus;30.1891 ± 1.40592 respectively. Conclusion: A trained clinical pharmacist by providing diabetes education and care can significantly reduce hyperglycemia, thereby improving the quality of life in diabetes patients and ultimately reducing health care costs associated with these morbidities.