Impact of Social Distancing on Geriatric Hip Fractures Among Jordanian Population During COVID-19 Pandemic.

Background: There were serious concerns about delivering the care and support to the elderly population in Jordan during the full lockdown period. In turn, this raised concerns about how this group of population will care for themselves and if this change in the situation will increase the risk of falls and related geriatric hip fractures. Hip fractures are a significant cause of morbidity and mortality in the geriatric population. Jordan has been affected by the coronavirus disease, COVID-19; pandemic like other parts of the world. The Jordanian authorities acted early to prevent the infection from spread, and lockdown along with social distancing measures were implemented early and enforced. Even though these measures successfully slowed the spread of the virus, some concerns were raised about the delivery of care by the family and caregivers to Jordanian geriatric population. Objective: We studied the effect of lockdown and social distancing in Jordan on hip fracture incidence among the geriatric population during the lockdown period. Methods: This retrospective observational study was conducted at two Jordanian Royal Medical Services (JRMS) hospitals, King Hussein Medical Center and Prince Rashid Hospital. Patients who were treated surgically for traumatic hip dislocation during lockdown (15th March to 30th April 2020) were compared with patients during the corresponding period in 2019 regarding the incidence of geriatric hip fractures. Results: The lockdown group included 102 trauma patients, 68 patients (66.7%) had geriatric hip fractures. On the other hand, the non-lockdown group included 144 patients, 45 (31.3%) had hip fractures. Thus, the proportion of patients with geriatric hip fractures in the lockdown group was significantly higher than the non-lockdown group (P=0.034). However, the geriatric hip fractures male to female ratio were the same in lockdown and non-lockdown groups (1:1.5). Conclusion: During the complete lockdown and social distancing due to COVID-19, the epidemiology of surgically treated fractures changed; there is a decrease in the total number of trauma patients and an increase in the proportion of geriatric hip fractures.

Concentrations of homocysteine in follicular fluid and embryo quality and oocyte maturity in infertile women: a prospective cohort.

Homocysteine is one of the components of follicular fluid (FF), so that any disruptions in its concentration may affect oocyte development. The aim of this study was to determine the relationship between FF homocysteine concentration and embryo quality, oocyte maturity, and pregnancy rate. Oocytes and embryos of 44 infertile women were categorised into different groups based on their maturity and quality, respectively. FF homocysteine levels, oocyte maturity, embryo quality, and pregnancy status were measured. A significant association was observed between the levels of FF homocysteine ​and oocyte maturation rate (p = .00). The concentration of FF homocysteine was higher than 9.8 µm/L in women with oocyte maturation < 80%. Most of the good quality embryos belonged to homocysteine levels < 9.8 µm/L. Decreased FF homocysteine concentrations can significantly improve the oocyte maturation rate and embryo quality. Aging may be an indirect factor contributing to decreased embryo quality and oocyte maturation through increasing FF homocysteine levels.IMPACT STATEMENTWhat is already known on this subject? It has been demonstrated that homocysteine is one of the components of follicular fluid (FF), but no information is available about the link between its concentration in FF and oocyte development.What do the results of this study add? The data indicated that decreased FF homocysteine concentrations at a younger age may remarkably improve the oocyte maturity and embryo quality of infertile patients undergoing assisted reproductive treatment (ART).What are the implications of these findings for clinical practice and/or further research? Based on the findings and considering the ease of measuring serum homocysteine and its direct correlation with FF homocysteine, homocysteine level measurement is recommended in patients who are candidates for infertility treatment in order to estimate oocyte maturation rate, embryo quality, and ART outcomes. Future studies are suggested to investigate patients with PCOS, endometriosis, and male factor infertility.

Importance of direction of vibration on the onset of Soret-driven convection under gravity or weightlessness.

This paper considers the influence of the direction of vibration on the stability threshold of two-dimensional Soret-driven convection. The configuration is an infinite layer filled with a binary mixture, which can be heated from below or from above. The limiting case of high-frequency and small-amplitude vibration is considered for which the time-averaged formulation has been adopted. The linear stability analysis of the quasi-mechanical equilibrium shows that the problem depends on five non-dimensional parameters. These include the thermal Rayleigh number (Ra(T)), the vibrational parameter (R), the Prandtl number (Pr), the Lewis number (Le), the separation ratio (S) and the orientation of vibration with respect to the horizontal heated plate (alpha). For different sets of parameters, the bifurcation diagrams are plotted Ra(c) = f(S) and k(c) = g(S), which are the critical thermal Rayleigh and the critical wave numbers, respectively. Our results indicate that, relative to the classical case of static gravity, vibration may affect all regions in Ra(c)-S stability diagram. In the case of mono-cellular convection, by using a regular perturbation method, a closed-form relation for the critical Rayleigh number is found. Several physical situations in the presence or in the absence of gravity (micro-gravity) are discussed.