Postpartum sacral stress fracture: a case report

BACKGROUND: Stress fractures are classified as insufficiency and fatigue fractures. Insufficiency fractures occur when normal stresses are placed on bone with decreased mineralization and elastic resistance; whereas fatigue fractures occur when abnormal forces are applied to normal bone. CASE PRESENTATION: We report a case of postpartum bilateral sacral fracture in the absence of documented osteoporosis in a 30 year old Lebanese female, thus satisfying the classification of fatigue fractures. Clinical presentation was mainly low back pain, pelvic pain, and abnormal gait. CONCLUSIONS: This case stresses the importance of including sacral fractures in the differential diagnosis of patients presenting with similar symptoms during pregnancy or the postpartum period

Pregnancy in a Woman with Homozygous Familial Hypercholesterolemia Not on Low-Density Lipoprotein Apheresis

Pregnancy in women with homozygous familial hypercholesterolemia (FH) has been rarely reported and might pose risks on the mother and her fetus. Although most reported cases remained on low-density lipoprotein (LDL) apheresis, there are no clear guidelines regarding the management of this entity. We report the first case of an uncomplicated pregnancy in a 24-year-old homozygous FH woman who was not maintained on LDL apheresis. FH expresses a wide variability in the phenotype, and management of homozygous FH cases who desire to become pregnant should be individualized based on preconceptional assessment with frequent antenatal follow-up. Decisions on management should be made after weighing the risks versus benefits of LDL apheresis

A graph based approach to trace models composition

International audienceA model driven engineering process involves different and heterogeneous models that represent various perspectives of the system under development. The model composition operation allows combining those sub-models into an integrated view, but remains a tedious activity. For that, traceability information must be maintained to comprehend the composition effects and better manage the operation itself. Against this context, the current paper describes a framework for model composition traceability. We consider the traces generation concern as a crosscutting concern where the weaving mechanism is performed using graph transformations. A composition specification case study is presented to illustrate our contribution

‘Unsolvable within existing regimes’: Using a Systems Thinking Approach to Co-design for Data Governance in Cities

Despite people’s significant role in generating data in cities, their involvement in data governance (DG) remains limited, failing to address the inherent complexity of DG and undermining their ’right to the city’. We propose a collaborative systems thinking approach as a scoping tool for co-design, enabling researchers and designers to involve people in co-creating an understanding of the systemic structures underpinning DG in cities and developing prototypes and solutions informed by these structures. Using causal loop diagrams, we facilitated the development of a conceptual model of DG. Participants, representing diverse perspectives, created individual causal loop diagrams that were merged into a collaborative causal loop diagram (C-CLD). This C-CLD was employed in an interactive workshop to identify intervention points and develop targeted solutions. Our findings demonstrate how C-CLDs can accommodate multiplicity, foster agonism, and enable participants to challenge political dimensions and existing systemic structures. Moreover, the engagement process revealed the complexity of DG in the city, as perceived by the collective of participants, resulting in three key submodules that highlight tensions between citizen sensitisation to data collection, the private sector’s role in fulfilling citizens’ needs, and the struggles faced by local governments. This work draws on and extends HCI research that engages with systems thinking ontologies, contributing to an HCI that includes the political, moves beyond solutionism, and advances social justice-oriented approaches

Role of ultrasonography in pregnancies complicated by gestational diabetes: A review

This review is to better clarify the role of ultrasonography during pregnancies complicated with gestational diabetes mellitus (GDM). It will focus on the effect of GDM on pregnancy, and the use of ultrasound modality to estimate fetal size and accordingly the mode of delivery. It will also shed light on how this technology can be used to improve our understanding of the pathophysiology of this diagnosis and hopefully improve the maternal-fetal outcome. © 2019 LWW. All right reserved

Self-based Learning Compared to Didactic Learning for Basic Medical or Surgical Technical Skills

This randomized controlled study compared self-based learning (SBL) to didactic learning (DL) in teaching medical students medical and surgical skills. Self-based learning is at least as good as didactic learning in teaching medical students. The skills used were IV line insertion and simple interrupted suture. Sixty-four consenting second year medical students were randomly divided into two groups of 32 students each. For the IV line insertion activity, Group 1 was given a short didactic lecture on IV line insertion and Group 2 received a self-based learning task. Both groups were assessed a week later for IV line insertion on a dummy. Then the two groups were crossed over, where Group 2 attended a short didactic lecture and Group 1 underwent a self-based learning task on simple interrupted suturing. Both groups were assessed a week later using a suturing pad model. Statistical analysis of data, collected from assessment forms and questionnaires, was done using χ2 test (chi-square test). The results showed that there was no significant difference between the two groups in terms of their performance assessment, for both skills. However, student satisfaction significantly differed between the two groups with the SBL group expressing higher overall satisfaction in both activities. Self-based learning should be integrated in medical curricula since its comparable to didactic learning in terms of students’ performance and leads to higher student satisfaction