Risk factors for unplanned readmissions in paediatric neurosurgery: a systematic review protocol.

INTRODUCTION: Unplanned hospital readmission (UHR) following surgical procedures reflects patient outcomes. While adult readmission studies are abundant, limited research exists in paediatric populations, especially in the context of neurosurgery. METHODS AND ANALYSIS: This protocol outlines a systematic review aimed at identifying reasons for unplanned readmissions (30-day and 90-day readmissions) and risk factors following paediatric neurosurgical procedures. Narrative synthesis, sensitivity analyses, subgroup analyses, and meta-analysis, when appropriate, will be done. ETHICS AND DISSEMINATION: There are no primary data involved and no access to confidential patient information. The findings aim to contribute to refining clinical practice, enhance patient counselling, and optimise healthcare resource utilisation in paediatric neurosurgical care. PROSPERO REGISTRATION NUMBER: CRD42023455779.

Strengthening stroke prevention and awareness in the Philippines: a conceptual framework.

Stroke is a leading cause of mortality and disability worldwide, with low and middle-income countries bearing the greatest burden. This article focuses on stroke prevention and awareness in the Philippines, a country grappling with high stroke incidence and limited healthcare resources. The two-pronged approach presented by the authors aims to address the challenges of stroke care by combining community-based prevention and targeted public awareness campaigns. The community-based stroke prevention component involves personalized risk factor assessments and tailored interventions conducted at local health centers. By identifying modifiable risk factors such as hypertension, diabetes, smoking, and elevated cholesterol levels, healthcare professionals can provide targeted education and interventions to individuals at risk. Additionally, the decentralized targeted stroke awareness campaigns emphasize public education through culturally adapted materials, engagement with local stakeholders, and media campaigns. These initiatives seek to increase awareness of stroke symptoms and prompt presentation in medical facilities. By implementing this comprehensive approach, we aim to mitigate the burden of stroke in the Philippines, improve stroke outcomes, and raise public awareness about stroke recognition and prevention.

E-Smoking out the Facts: The Philippines' Vaping Dilemma.

The Commercial Determinants of Health (CDH) have a major impact on the health of a country's population. The marketing and promotion of products and services by corporations, especially multinational businesses, can significantly impact individuals and communities, both positively and negatively. The vaping epidemic in the Philippines is an example of how commercial influences and government policies, in the context of disinformation, can exacerbate public health issues. The Philippines is facing a rising use of electronic nicotine delivery systems (ENDS) among youth. We conducted a literature review in PubMed and Google Scholar to examine the state of vaping in the Philippines and the lack of research on the health implications of the growing e-cigarette industry. We also discussed the vape bill which lapsed into law - Republic Act 11900, which regulates e-cigarettes and transfers the regulatory power from the Department of Health to the Department of Trade and Industry. We outlined a call to action on three fronts: tailoring national policies, funding research, and improving health education in the youth. Policymakers must prioritize public health gains over economic benefits and consider the impact of their decisions on future generations' health choices.

Students and faculty experiences, perceptions and knowledge on distress during the COVID-19 pandemic: A descriptive cross-sectional study

Background and Objective@#The University of the Philippines Manila (UPM) subcommittee on students in distress was convened during the COVID-19 pandemic to develop “plans, programs and mechanisms” to deal with students experiencing distress and mental health concerns. This study was conducted as one of the activities of the Subcommittee to inform policy to address the following research objective: to describe the experiences, perceptions, and knowledge of both students and faculty members of UP Manila regarding distress.@*Methods@#An online survey tool was created using the results from seven online focus group discussions among 20 faculty of UP Manila. The survey was conducted for one month among faculty and students sampled from the seven colleges of UP Manila and the three extension campuses of the Schools of Health Sciences. The different categories which were consistently perceived as important by both faculty and students as well as those with disparity in the perceptions between faculty and students were described and discussed.@*Results@#A total of 136 faculty (F) and 290 students (S) participated in the study, representing 39% vs 98% (F vs S) of the target sample, respectively. Results showed that among the effects of stressors for students, avoidance of schoolwork (F79 vs S70.3%) and sleep disturbance (F79.4 vs S72.4%), were perceived by both faculty and students as the most frequently perceived response of students to stress.Among the causes of stress, unclear boundaries between school and home (F73.5 vs S63.1%), family duties (F76.5 vs S50.7%), lack of socialization (F89 vs S57.6%), limited recreational activity (F76.5 vs S64.8%), adapting to new ways of socialization (F67.6 vs S53.8%), and internet signal (F99.3 vs S88.3%) were perceived by both faculty and students as the most frequently perceived causes of stress. Among the coping mechanisms, connecting with friends online (F86.8 vs S69.7%), listening to music (F72.8 vs S78.3%), browsing social media (F82.4 vs S81%), viewing movies (F84.6 vs S74.5%), and sleeping or resting (F67.6 vs S84.1%) were perceived by both faculty and students as the most employed by students to cope with stress.Results also show that there were marked disparities in the perceptions of faculty and students. Among the effects of stressors, the largest disparities were in non-performance in academics (F86 vs S51.7%) and academic failure (F76.5 vs S53.8%). Of the causative factors, the largest disparities were in the areas of death (F94.1 vs S14.5%) or sickness in the family (F66.9 vs S0%), family issues (F82.4 vs S24.5%), financial concerns (F89 vs S36.9%), absence of physical connectedness and interaction, (F94.9 vs S23.8%) lack of socialization (F89 vs S57.6%), owning a gadget (F73.5 vs S22.1%), and lack of funds for the internet (F79.4 vs S22.4%).Among the support systems available in the university (psychosocial, academic and wellness activities of the colleges), 70% of the faculty perceived that the students were aware of the support process offered by the university. In contrast, 28% of students were aware of the support services offered to them. @*Conclusion@#This study shows that UP Manila faculty and students perceived stress due to the effects of COVID-19 on teaching, learning, and everyday living. Distress among student respondents was commonly perceived to be caused by family concerns, environmental restrictions, connectivity issues, and experiencing a sense of lack. While support services and mental health programs have been in place within the university, only 28% of students perceive that students in distress were aware of the process in receiving support.

Maf family transcription factors are required for nutrient uptake in the mouse neonatal gut.

There are fundamental differences in how neonatal and adult intestines absorb nutrients. In adults, macromolecules are broken down into simpler molecular components in the lumen of the small intestine, then absorbed. In contrast, neonates are thought to rely on internalization of whole macromolecules and subsequent degradation in the lysosome. Here, we identify the Maf family transcription factors MAFB and c-MAF as markers of terminally differentiated intestinal enterocytes throughout life. The expression of these factors is regulated by HNF4α and HNF4γ, master regulators of enterocyte cell fate. Loss of Maf factors results in a neonatal-specific failure to thrive and loss of macromolecular nutrient uptake. RNA-Seq and CUT&RUN analyses defined an endo-lysosomal program as being downstream of these transcription factors. We demonstrate major transcriptional changes in metabolic pathways, including fatty acid oxidation and increases in peroxisome number, in response to loss of Maf proteins. Finally, we show that loss of BLIMP1, a repressor of adult enterocyte genes, shows highly overlapping changes in gene expression and similar defects in macromolecular uptake. This work defines transcriptional regulators that are necessary for nutrient uptake in neonatal enterocytes.

The association between periodontitis and diabetes among Filipino dental school patients: A retrospective case-control study

Objective@#The association between periodontitis and diabetes mellitus varies based on geographical location, and there are limited investigations on the relationship of the two chronic diseases among Philippine subjects. This study aimed to determine the association between periodontitis and diabetes among Filipino dental school patients. @*Methods@#In this retrospective case-control study, the periodontal conditions and diabetic statuses of all patients who sought treatment at the Dental College’s Oral Medicine clinic within two academic years were reviewed. The prevalence of diabetes among 715 cases of periodontitis was compared to the prevalence among 834 control patients without periodontitis. Odds ratios (OR) were computed using logistic regression analysis, adjusting for age, sex, educational attainment, and smoking status. @*Results@#The overall prevalence of diabetes mellitus for all patients was 3.10%. Patients with periodontitis had a significantly higher prevalence of diabetes at 5.73% compared to control subjects without periodontitis, whose diabetes prevalence was recorded at 0.84% (P<0.001). A significant association was observed between periodontitis and diabetes, with an unadjusted OR=7.19. After logistic regression analysis to control confounding variables, the adjusted OR was found to be 3.05 (95% confidence interval = 1.27 to 7.31; P=0.012). @*Conclusion@#The prevalence and odds of having diabetes are significantly higher among Filipino dental school patients with periodontitis, compared to patients without periodontitis. These results provide evidence to support an association between periodontitis and diabetes mellitus in this representative sample of the Filipino population.

Accuracy and reproducibility of UNC-15 and Gram probe #2 in measuring probing pocket depths

@#<p style="text-align: justify;"><strong>Objective.</strong> Second-generation force-controlled periodontal probes were developed to address examiner-related factors in the application of standard forces while probing. However, previous researches comparing the accuracy of first and second-generation probes have failed to yield unequivocal results. This study aimed to determine the accuracy and reproducibility of a first-generation UNC-15 probe and force-controlled Gram probe #2, used by senior and junior dental students in measuring probing pocket depths (PPD).</p><p style="text-align: justify;"><strong>Methods.</strong> Eight senior and eight junior dental students participated in the study. A periodontal model was positioned on a digital balance. Each participant performed probing four times, twice using a UNC-15 and twice employing a Gram probe #2. The order of probe usage was randomly assigned. The PPD and probing forces employed were recorded initially and after a 15-minute interval. Data were analyzed using a t-test at a 0.05 significance level.</p><p style="text-align: justify;"><strong>Results.</strong> Both junior and senior students used significantly higher probing forces (35.3 ± 1.4 and 29.9 ± 2.1 g, respectively) than the standard 25 g when using the UNC-15 probe. The junior students employed accurate forces using the Gram probe while probing both anterior (25.6 ± 1.2 g) and posterior teeth (25.1 ± 0.7 g). In comparison, the seniors used accurate forces (26.0 ± 1.3 g) only while examining anterior teeth. The PPD values obtained by both student groups were comparable to the actual PPD, except for significantly higher measurements (P=0.0003) obtained by juniors when examining posterior teeth using the Gram probe. When assessing the reproducibility of PPD measurements obtained from two examinations, values were reproducible for both juniors and seniors when using the Gram probe and during an inspection of posterior teeth using the UNC-15 probe.</p><p style="text-align: justify;"><strong>Conclusions.</strong> The Gram probe #2 had better reproducibility and yielded forces closer to the standard 25 g. However, more accurate PPD values were obtained with the UNC-15 probe.</p>

Topical treatments for Seborrheic Keratosis: A systematic review

Background@#Seborrheic keratosis is a benign skin tumor removed through electrodessication, cryotherapy, or surgery. Alternative options may be beneficial to patients with contraindications to standard treatment, or those who prefer a non-invasive approach.@*Objectives@#To determine the effectiveness and safety of topical medications on seborrheic keratosis in the clearance of lesions, compared to placebo or standard therapy.@*Methods@#Studies involving seborrheic keratosis treated with any topical medication, compared to cryotherapy, electrodessication or placebo were obtained from MEDLINE, HERDIN, and Cochrane electronic databases from 1990 to June 2018.@*Results@#The search strategy yielded sixty articles. Nine publications (two randomized controlled trials, two non-randomized controlled trials, three cohort studies, two case reports) covering twelve medications (hydrogen peroxide, tacalcitol, calcipotriol, maxacalcitol, ammonium lactate, tazarotene, imiquimod, trichloroacetic acid, urea, nitric-zinc oxide, potassium dobesilate, 5-fluorouracil) were identified. The analysis showed that hydrogen peroxide 40% presented the highest level of evidence and was significantly more effective in the clearance of lesions compared to placebo.@*Conclusion@#Most of the treatments reviewed resulted in good to excellent lesion clearance, with a few well-tolerated minor adverse events. Topical therapy is a viable option; however, the level of evidence is low. Standard invasive therapy remains to be the more acceptable modality.

The effect of sodium bicarbonate abrasives in toothpaste on dental plaque removal: A pilot study

@#<p style="text-align: justify;"><strong>BACKGROUND AND OBJECTIVE:</strong> The role of dental plaque as the etiology of caries and periodontal diseases has long been established. Therefore, plaque control is central to the prevention and management of these oral diseases. Among the different means of self-performed plaque control, brushing is the most essential. Moreover, toothpaste is a common adjunct during tooth brushing, as its abrasive contents are believed to enhance plaque removal. This study aimed to compare the effectiveness of plaque removal when brushing with a sodium bicarbonate abrasive-containing toothpaste, compared to brushing using an abrasive-free toothpaste.</p><p style="text-align: justify;"><strong>METHODS:</strong> Twelve students from the University of the Philippines College of Dentistry participated in the study. The subjects discontinued all oral hygiene measures for a minimum of 48 hours. Using the Modified Bass technique, they performed tooth brushing for two minutes, using either an abrasive-free or abrasive containing toothpaste. Toothpaste allocation was randomized via fishbowl method. Pre-brushing and post brushing plaque scores were recorded using the Turesky modification of Quigley-Hein plaque index. A washout period of 11 days was implemented before crossover to the second round, wherein employed toothpastes were switched. The difference in plaque reduction between the two kinds of toothpaste was analyzed using Wilcoxon signed rank test.</p><p style="text-align: justify;"><strong>RESULTS AND CONCLUSION: </strong>Overall plaque reductions were 75% for the abrasive-free toothpaste and 73% for the abrasive-containing toothpaste. The difference between the toothpaste was statistically insignificant (p=0.48). Therefore, based on the study, brushing with a sodium bicarbonate abrasive-containing toothpaste resulted in similar levels of plaque removal, compared to brushing with an abrasive-free toothpaste. There is insufficient evidence that abrasives in toothpaste result in more effective dental plaque removal. </p>