Hasil untuk "Special situations and conditions"

Arpita Ghosh

Antonina Drzewiecka, Artur Drzewiecki, Oliwia Maciaszek et al.

Introduction and Purpose: Vascular access devices (VADs) are essential for modern inpatient care, yet optimal device selection remains complex due to heterogeneous data on dwell time, indications, and complications. Peripheral options such as midline catheters (MCs) and long peripheral catheters (LPCs) are increasingly proposed as alternatives to peripherally inserted central catheters (PICCs) and central venous catheters (CVCs), particularly for intermediate-duration therapy and in patients with difficult intravenous access (DIVA). The aim of this narrative review is to synthesize current evidence on peripheral and central vascular access, focusing on peripheral intravenous catheters (PIVCs), MCs, LPCs, PICCs, and CVCs, with respect to dwell time, therapeutic indications, and complication rates, including catheter-related bloodstream infections (CRBSI) and thrombosis. State of Knowledge: PIVCs, although most commonly used, have short dwell times and high failure rates, often complicated by phlebitis, infiltration, and occlusion. Midline catheters provide longer dwell times and reduce repeated cannulation but are associated with minor mechanical complications such as superficial thrombophlebitis and occlusion. PICCs and CVCs enable prolonged delivery of vesicant and hyperosmolar therapies but carry higher risks of bloodstream infection and venous thromboembolism. Comparative studies suggest midlines may reduce CRBSI and CLABSI-reportable events relative to PICCs, at the cost of more frequent minor complications. Conclusion: No single VAD is universally optimal. Device choice should integrate therapy duration, infusate characteristics, vascular anatomy, and the balance of infectious, thrombotic, and mechanical risks. MCs and LPCs appear promising for intermediate-duration, peripherally compatible therapies; however, high-quality randomized studies are needed to refine vascular access algorithms and confirm safety signals.

Dominik Kret, Wiktoria Szlachta, Daria Twardowska et al.

Myocardial bridging (MB) of the coronary arteries has long been considered a benign anatomical variant with no significant clinical relevance. However, the development of modern imaging and functional diagnostic methods indicates that its impact on myocardial perfusion may become apparent under conditions of increased hemodynamic load, especially during physical exertion. In the context of sports science, this issue is particularly important, as even subtle coronary flow disturbances can modulate the heart's response to training load and affect exercise tolerance.The aim of this study was to present the current state of knowledge on the anatomy, pathophysiology, clinical picture, diagnosis, and therapeutic management of myocardial bridges, with particular emphasis on their functional significance under conditions of stress typical of physical activity. The article is a narrative review of the literature based on a critical analysis of anatomical, observational, and imaging studies, as well as works devoted to functional assessment and treatment strategies. Available data indicate that MBs are a common structure, but heterogeneous in terms of morphology and hemodynamic significance. Although they remain asymptomatic in most people, in selected cases they may be associated with myocardial ischemia, arrhythmias, and reduced exercise tolerance. Myocardial bridges require individualized clinical and functional assessment, and their presence should not be automatically considered insignificant, especially in the context of exercise capacity assessment.

Taishiro Kamasaki, Hiroshi Otao, Mizuki Hachiya et al.

Background This study investigates factors influencing cane use among older adults and identifies most significant determinants. Methods This study is a cross-sectional study. A total of 160 community-dwelling older adults (mean age, 79±7 years) were included in the analysis. Binomial logistic regression analysis was conducted using the presence or absence of cane use as the dependent variable, and the associated factors were investigated. Results There were 108 participants (mean age, 77±7 years) in the cane-non-using group and 52 (mean age, 83±6 years) in the cane-using group. Factors associated with the presence or absence of cane use were open-eyed one-leg standing time (odds ratio [OR]=0.81; 95% confidence interval [CI], 0.70–0.93; p=0.003) and depressed mood (OR=2.78; 95% CI, 1.31–5.91; p=0.008). Conclusion Older adults with reduced balance ability and depressive mood need to use a cane. This highlights the need to assess balance ability and depressed mood in prescribing a cane to older adults. Appropriate prescription of canes has the potential to enrich the lives of older adults by contributing to their safe range of activities.

Eleonora Di Valentino, Leandros Perivolaropoulos, Jackson Levi Said

The Special Issue on "Modified Gravity Approaches to the Tensions of $Λ$CDM"} in the Universe journal tackles significant challenges faced by the $Λ$CDM model, including discrepancies in the Hubble constant, growth rate of structures, and cosmological anisotropies. These issues suggest foundational cracks in the model, raising questions about the validity of General Relativity, dark energy, and cosmological principles at large scales. This collection brings together leading researchers to delve into Modified Gravity theories as potential solutions. Covering approaches from Scalar-Tensor theories to $f(R,T)$ gravity and beyond, each contribution presents innovative research aimed at addressing the limitations of the $Λ$CDM model. This Special Issue not only highlights the theoretical and empirical strengths of Modified Gravity models but also opens avenues for future investigations, emphasizing the synergy between theoretical advancements and observational evidence to deepen our cosmological understanding.

Roberto Onner Cruz Tapia, Alberto Jose Peraza Labrador, D. M. Guimarães et al.

BACKGROUND Vesiculobullous and macular lesions in the oral mucosa have been reported in patients positive for SARS-CoV-2 infection. Nonetheless, the significance and physiopathology of oral manifestations have not been clearly established in the clinical progression or outcome of the infection. AIM To describe the clinico-pathological oral mucosal lesions in four patients with confirmed SARS-CoV-2 infection. METHODS AND RESULTS Four patients with COVID-19 disease and confirmed by polymerase chain reaction (PCR) presented angina bullosa hemorragica-like lesion, vascular disorder, and nonspecific stomatitis, one patient with histological analysis demonstrated perivascular reactive lymphocitic infliltrate, focal capillary thrombosis, and hemorrhage. According to the discrimination of other local and systemic conditions and the synchronous onset of oral and systemic symptoms, the diagnosis of oral lesions probably associated with COVID-19 was established. CONCLUSION Infection with SARS-CoV-2 may result in oral manifestations with various clinical presentations, which presumably support the hypothesis of thrombi formation and vasculitis; nevertheless, these findings need more evidence and a long-term follow up of patients to accurately establish the significance of the oral mucosa affection in the COVID-19 disease.

Hanan El-Mazahy, Jaidaa Mekky, Noha Elshaer

Abstract Background The COVID-19 pandemic has impacted medical professionals’ job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice. Methods Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice. Results The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%). Conclusions During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.

Lúcio G. Lustosa, David Rudoler, Olga Theou et al.

Aim The purpose of this analysis was to report the prevalence of falls and falls-related injuries among those reporting differ-ent volumes of weekly sedentary time, and to understand the association of sedentary time and falls, accounting for functional fitness. Methods Baseline and first follow-up data from the Canadian Longitudinal Study on Aging (CSLA) were analyzed (n=22,942). Participants self-reported whether they had a fall in the past 12 months (at baseline) and whether they had an injury that was a result of a fall (follow-up). In-home interviews collected self-reported leisure sedentary time using the Physical Activity Scale for Elderly. Functional fitness was assessed using grip strength, timed-up-and-go, and chair rise tests during clinic visits. Results The prevalence of falls was higher among those who reported higher sedentary time. For example, among males aged 65 and older who reported lower sedentary time (<1,080 min/week), the prevalence of falls in the past 12 months (at baseline) was 7.8% compared to 9.8% in those reporting higher sedentary time. The odds of reporting a fall (at baseline) was 21% higher in those who reported higher sedentary time (OR: 1.21; 95%CI: 1.11–1.33) in adjusted models. No associations were found between sedentary time and injuries due to a fall. Conclusions Reporting high volumes of sedentary time may increase the risk of falls. Future research using device-based estimates of total sedentary time and breaks in sedentary time is needed to further elucidate this association.

Akira Harada, Yudai Suwa, Masayuki Harada et al.

Supernova neutrinos are invaluable signals that offer information about the interior of supernovae. Because a nearby supernova can occur at any time, preparing for future supernova neutrino observation is an urgent task. For the prompt analysis of supernova neutrinos, we have developed a new analysis code, ``Supernova Parameter Estimation Code based on Insight on Analytic Late-time Burst Light curve at Earth Neutrino Detector (SPECIAL BLEND)''. This code estimates the parameters of supernova based on an analytic model of supernova neutrinos from the proto-neutron star cooling phase. For easy availability to the community, this code is public and easily runs on web environments. SPECIAL BLEND can estimate the parameters better than the analysis pipeline we developed in the previous paper. By using SPECIAL BLEND, we can estimate the supernova parameters within $10\%$ precision up to $\sim 20\,{\rm kpc}$ and $\sim 60\,{\rm kpc}$ (Large Magellanic Cloud contained) with Super Kamiokande and Hyper Kamiokande, respectively.

L. Borsten, A. Marrani, C. N. Pope et al.

This special feature, dedicated to Michael J. Duff FRS on the occasion of his 70th birthday, concerns topics in 'Quantum gravity, branes and M-theory'. These three intertwining subjects have been central to Duff's work; indeed many of his contributions have come to define significant aspects of what we actually mean by these terms. From the discovery of Weyl anomalies to recognising superstrings in 10 dimensions as a special case of membranes in an 11-dimensional M-theory, Duff's insights have shaped major developments across these themes. So it is an apposite setting for such a celebration and we are delighted to be able to include in this collection contributions from many of the pioneers of quantum gravity, branes and M-theory. The breadth of these topics has placed little constraint on the multiplicity of ideas appearing in these pages, from astrophysical black holes to chaotic condensed matter. Again, this is fitting as Duff's scientific remit spans a remarkable diversity of motifs, from the fundamentals of M-theory to entanglement in quantum information.

Micheal Mathavavisakan Nicholas GnanaSekar, Indhira Kandaiyan

The concept of a single server retrial queueing system with delayed repair and feedback under a working vacation policy, along with the asymmetric transition representation, is discussed in this article. In addition, consumers are entitled to balk and renege in some situations. The steady-state probability generating function for system size and orbit size is derived by using the approach of supplementary variables. Discussions include key metrics of the system and a few significant special conditions. Moreover, the impact of system parameters is examined through the analysis of some numerical examples.

B. Etzold, A. Fechter

ABSTRACT Conventional understandings of protracted displacement are limited by a number of shortcomings. They imply the stasis of protracted situations; the passivity and disconnection of vulnerable groups who need external support; and immobility of people ‘stuck’ in places. Moreover, solutions to protracted displacement are based on the priorities of states and defined by the perspectives of humanitarian organisations. In contrast, this special issue seeks to advance scholarly and policy debates in order to advocate for more nuanced understandings and genuinely supportive practices of refugees and internally displaced persons (IDPs). This is realised through the framework of social figurations of displacement, documenting how these evolve over time, and highlighting the structural forces that perpetuate conditions of displacement. Articles in this special issue demonstrate the agency, resilience and transformative power that lies in displaced persons’ everyday practices. They foreground the role of multiple mobilities in displacement situations, unsettling the politicised concept of protracted displacement as an example of governance techniques that are geared towards locking the lives of forcibly displaced people in space and in time, rendering the displaced populations controllable. Recognising their mobility and connectivity can become a basis to continuously circumventing and challenging these.

Yi Xiao, Xinqing Wang, Peng Zhang et al.

Deep learning is currently the mainstream method of object detection. Faster region-based convolutional neural network (Faster R-CNN) has a pivotal position in deep learning. It has impressive detection effects in ordinary scenes. However, under special conditions, there can still be unsatisfactory detection performance, such as the object having problems like occlusion, deformation, or small size. This paper proposes a novel and improved algorithm based on the Faster R-CNN framework combined with the Faster R-CNN algorithm with skip pooling and fusion of contextual information. This algorithm can improve the detection performance under special conditions on the basis of Faster R-CNN. The improvement mainly has three parts: The first part adds a context information feature extraction model after the conv5_3 of the convolutional layer; the second part adds skip pooling so that the former can fully obtain the contextual information of the object, especially for situations where the object is occluded and deformed; and the third part replaces the region proposal network (RPN) with a more efficient guided anchor RPN (GA-RPN), which can maintain the recall rate while improving the detection performance. The latter can obtain more detailed information from different feature layers of the deep neural network algorithm, and is especially aimed at scenes with small objects. Compared with Faster R-CNN, you only look once series (such as: YOLOv3), single shot detector (such as: SSD512), and other object detection algorithms, the algorithm proposed in this paper has an average improvement of 6.857% on the mean average precision (mAP) evaluation index while maintaining a certain recall rate. This strongly proves that the proposed method has higher detection rate and detection efficiency in this case.

Peter N-Jonaam Mahama, Amos Tiereyangn Kabo-Bah, Justine I. Blanford et al.

The current epidemiological transition makes us wonder how the parallel of infectious diseases (IDs) might be at the end of each passing year. Yet, the surveillance of these IDs continues to focus on high-profile diseases of public health importance without keeping track of the broad spectrum of the IDs we face. Here, we presented the prevalence of the broad spectrum of IDs in Ghana. Data from the annual reports on Gold Coast now Ghana, Global Infectious Diseases and Epidemiology Network (GIDEON), and the District Health Information Management System II (DHIMS2) databases were examined for records of ID prevalence in Ghana. Using the IDs from these databases, the paper assessed the epidemiological transition, pathogen-host interactions, spatiotemporal distribution, transmission routes, and their potential areas of impact in Ghana. The topmost ID recorded in health facilities in Ghana transitioned from yaws in the 1890s to malaria in the 1950s through 2020. We then presented the hosts of a pathogen and the pathogens of a host, the administrative districts where a pathogen was found, and the pathogens found in each district of Ghana. The highest modes of transmission routes were through direct contact for bacteria and airborne or droplet-borne for viral pathogens. From GIDEON, 226 IDs were identified as endemic or potentially endemic in Ghana, with 42% cited in peer-reviewed articles from 2000 to 2020. From the extent of risk of endemic or potentially endemic IDs, Ghana faces a high risk of ID burden that we should be mindful of their changing patterns and should keep track of the state of each of them.

Fujun Hou

`Rank and Yank' is practiced in many organizations. This paper is concerned with the condtions for none to be whipped by `Rank and Yank' when the evaluation data under each criterion are assumed to be ordinal rankings and the majority rule is used. Two sufficient conditions are set forth of which the first one formulates the alternatives indifference definition in terms of the election matrix, while the second one specifies a certain balance in the probabilities of alternatives being ranked at positions. In a sense, `none to be whipped' means that the organization is of stability. Thus the second sufficient condition indicates an intrinsic relation of balance and organization stability. In addition, directions for future research are put forward.

F. J. Corpas, L. A. Del Río, J. Palma

Plant peroxisomes are subcellular compartments involved in many biochemical pathways during the life cycle of a plant but also in the mechanism of response against adverse environmental conditions. These organelles have an active nitro-oxidative metabolism under physiological conditions but this could be exacerbated under stress situations. Furthermore, peroxisomes have the capacity to proliferate and also undergo biochemical adaptations depending on the surrounding cellular status. An important characteristic of peroxisomes is that they have a dynamic metabolism of reactive nitrogen and oxygen species (RNS and ROS) which generates two key molecules, nitric oxide (NO) and hydrogen peroxide (H2 O2 ). These molecules can exert signaling functions by means of post-translational modifications that affect the functionality of target molecules like proteins, peptides or fatty acids. This review provides an overview of the endogenous metabolism of ROS and RNS in peroxisomes with special emphasis on polyamine and uric acid metabolism as well as the possibility that these organelles could be a source of signal molecules involved in the functional interconnection with other subcellular compartments.

H. Husaini, Happy Fitria

Success a management cannot be separated from management principles which formed the basis and the value of the management itself. Principles in management should be resilient, it needs to be considered in accordance with the special conditions and situational change. The general notion of management is an activity to achieve the goals that have been determined (getting things done through the effort of other people). Effective leadership is based on those they lead (conditions and situations). The leadership in Islamic educational institutions will be very effective in accordance with the conditions and situations that arise at the time. There is no effective leadership style but with the situation and the growing conditions. In the management of Islamic educational institutions must have some component of the right to produce a proper and prudent performance include planning, organizing, actuating, dan controlling.

Víctor Ernesto González Velázquez, Lázaro Roque Pérez, Elys María Pedraza Rodríguez et al.

<strong>Background:</strong> cutaneous malignant melanoma is the most lethal skin tumor, so it is important to know the risk factors for mortality in patients who suffer from it. <br /><strong>Objective:</strong> to determine the prognostic factors of mortality in patients with cutaneous malignant melanoma diagnosed and treated at the Celestino Hernández Robau Teaching University Hospital between January 2010 and December 2015. <br /><strong>Method:</strong> a retrospective cohort analytical observational study was carried out. The population consisted of all patients with cutaneous malignant melanoma diagnosed and treated at the Hospital in the study period (N = 142), and the sample was 112 patients. The variables analyzed were: age, sex, skin color, histological subtype, Breslow index, Clark level, mitotic index, lymph node involvement, distant metastasis, ulceration, topographic location, clinical stage, type of treatment, and lactate dehydrogenase levels blood at diagnosis. The Odds Ratio (OR) and its confidence intervals (CI) were determined for the statistically significant factors. The area under the ROC curve was evaluated for the quantitative variables and a multivariate analysis was performed using Binary Logistic Regression. It was a reliability of 95 %. <br /><strong>Results:</strong> the multivariate analysis identified as prognostic factors of mortality the Breslow index with a C statistic of 0.849 (CI: 0.770–0.923), the Clark V level (OR: 1.246; CI: 0.985-1.870), mitotic index ≥ 6mm2 (OR: 12.408; CI: 9.012-14.897), lymph node involvement ≥ 2 nodes (OR = 6.316; CI = 4.541-8.291), metastasis to lung or other viscera (OR: 6.206; CI: 4.342-8.001), tumor location on the head, neck or trunk (OR: 9.720; CI: 7.684-12.546), ulceration (OR: 0.528; CI: 0.120-0.856), non-surgical treatment (OR: 8.311; CI: 7.098-9.366) and the LDH value in blood ≥333 IU / l (OR: 18.905; CI: 14.750-21.053). <br /><strong>Conclusions:</strong> the prognostic factors of mortality in patients with a diagnosis of cutaneous malignant melanoma were the Breslow index, the Clark level, the mitotic index, lymph node involvement, metastases to the lung or other viscera, the location of the tumor in the head, neck or trunk, the presence of ulceration, non-surgical treatment and the highest values of LDH in blood.

Rupak Desai, Tarang Parekh, Jilmil Raina et al.

Recent reports proposing a potential association of influenza virus infection with cardiovascular diseases like Takotsubo syndrome (TTS) warrant a literature review to elucidate the demographics, clinical presentation, and outcomes in these cases. A thorough literature search was performed until March 2020. We systematically discussed TTS cases reported following influenza infection or flu vaccination and related outcomes. Ten patients (7 women/3 men) were identified who displayed diagnostic and clinical signs of TTS after influenza infection or flu-like illness and influenza (flu) vaccination. Of 10 cases reviewed (mean age 77.0 ± 11.7 years), 7 (70%) were females, of whom 71.4% (n = 5) were above 60 years of age. Seven patients had influenza A, one patient had influenza B, and two patients had received a flu vaccination. Total 70% of cases reported the flu-like event as a triggering event for TTS and, all of them occurred within 5 days of symptoms onset or vaccination. The classical apical ballooning pattern, elevated cardiac enzymes, ST-segment/T-wave changes on electrocardiogram, and reduced left ventricular ejection fraction were present in a majority of the cases. Only one patient died during the course due to cardiac arrest whereas 6 cases (60%) reported at least one cardiopulmonary complication. Physicians should remain vigilant about an infrequent association of TTS and consequent cardiopulmonary complications in influenza virus infection especially in aged patients with prevalent cardiovascular risk factors. The overall prognosis of influenza-associated TTS while looks promising, there is a need for larger studies to find more conclusive evidence.

Fariba Askarian

Background: Sports Investments is one of the most unique sports events, in the country dealing both with collectors and dealers.Aim: The purpose of this study was to compare the sports investment o Iran in 2016 and 1998. Therefore, we estimate the value of the sports investment sector and share of total investment, GDP, GDSP and compare with 1998 in Iran.Materials and Methods: In this study, national accounts were used. Most of the basic data fare available in a decentralized manner in the Statistics Center and the Program and Budget Organization of Iran. Due to achieving real changes in sports investment between 1998 and 2016, prices in 1998 was considered as the base year and were considered. Then using the price index of the desired years, the effects of inflation were eliminated and growth real was calculated.Results: The results indicate that investment in sport in 1998 was 360 billion Rials, which is 0.43% of total investment, 0.1% GDP, and 26.2% of GDSP. Also, investment in sport in 2016 was 15449 billion Rials, which is 0.46% of total investment, 0.11% GDP and, 73.38% of GDSP. Investment in sport in 2016 compared to 1998 had 2347% real growth.Conclusion: Although, investment in sport in 2016 compared to 1998 has grown, but it is very small compared to the total investments. Results also show the major share of the public sector and the low participation of the private sector.