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1.
Diabetes Res Clin Pract ; 213: 111729, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38844055

RESUMO

AIMS: We aim to analyze trends in mortality rates among adults with diabetic kidney disease (DKD) in the US from 1999 to 2020. METHODS: We queried the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research database for mortality statistics from 1999 to 2020 associated with DKD in adults aged ≥25 years. Age-adjusted mortality rates (AAMRs) were calculated and trends were analyzed using the Joinpoint Regression Program. RESULTS: From 1999 to 2020, a total of 528,430 deaths were reported among adults with DKD. The mortality rates increased over time with males consistently exhibiting higher AAMR than females. NH American Indian or Alaska Native individuals had the highest AAMR, followed by NH Blacks, Hispanics, NH Whites, and NH Asians. The West region had the highest AAMR, followed by the Midwest, South, and Northeast. Rural regions had higher AAMR than urban areas, and mortality rates increased with age. CONCLUSIONS: This study reveals notable disparities in DKD mortality rates across demographic groups and geographic regions. NH American Indians or Alaska Natives, males, elderly individuals, rural residents, and those in the West region were disproportionately affected. Understanding these trends is crucial for developing targeted interventions to reduce DKD-related mortality and address healthcare disparities.

2.
PLoS One ; 19(5): e0302539, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38748657

RESUMO

In recent years, Federated Learning (FL) has gained traction as a privacy-centric approach in medical imaging. This study explores the challenges posed by data heterogeneity on FL algorithms, using the COVIDx CXR-3 dataset as a case study. We contrast the performance of the Federated Averaging (FedAvg) algorithm on non-identically and independently distributed (non-IID) data against identically and independently distributed (IID) data. Our findings reveal a notable performance decline with increased data heterogeneity, emphasizing the need for innovative strategies to enhance FL in diverse environments. This research contributes to the practical implementation of FL, extending beyond theoretical concepts and addressing the nuances in medical imaging applications. This research uncovers the inherent challenges in FL due to data diversity. It sets the stage for future advancements in FL strategies to effectively manage data heterogeneity, especially in sensitive fields like healthcare.


Assuntos
Algoritmos , Diagnóstico por Imagem , Humanos , Diagnóstico por Imagem/métodos , COVID-19/epidemiologia , COVID-19/diagnóstico por imagem , Aprendizado de Máquina , SARS-CoV-2/isolamento & purificação
3.
Curr Probl Cardiol ; 49(5): 102489, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38417475

RESUMO

Cardiovascular disease (CVD) remains a major global health concern, and obesity and diabetes mellitus have been found to be important risk factors. Tirzepatide a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP1) receptor agonist has been shown to have cardioprotective effects. Noteworthy benefits of Tirzepatide include decreased cardiovascular risk factors in people with Type 2 diabetes mellitus (T2DM). In the SURPASS-4 trial, tirzepatide significant decreased blood pressure, body weight, and HbA1c. Furthermore, the SURMOUNT-1 trial demonstrated the effectiveness of tirzepatide in reducing cardiometabolic risk factors in people with obesity without T2DM. Together, the dual receptor agonism improves lipid profiles, increases insulin secretion, reduces inflammation, and promotes endothelial integrity. Tirzepatide shows promise as a comprehensive therapeutic option for managing cardiovascular risk factors in patients with T2DM and obesity. While further studies are needed to assess the long-term cardiovascular benefits, current evidence supports tirzepatide's potential impact on cardiovascular health beyond its antidiabetic properties.


Assuntos
Diabetes Mellitus Tipo 2 , Receptor do Peptídeo Semelhante ao Glucagon 2 , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Polipeptídeo Inibidor Gástrico , Obesidade/complicações , Obesidade/tratamento farmacológico , Peso Corporal
4.
PLoS One ; 19(2): e0289237, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38394176

RESUMO

Rich nature of social media data offers a great opportunity to examine social worlds of its users. Further to wide range of topics being discussed on social media, alcohol-related content is prevalent on social media and studies have found an association between this content and increased consumption of alcohol, cravings for alcohol and addiction. This study analyses social media data to examine social worlds of risky drinking in Victoria, Australia. This study conducted a scoping literature review and two online surveys, one with the general community and the other with health professionals, to determine key words to search for on social media sites. These keywords were used in a social media analytics tool called Talkwalker to generate quantitative and qualitative data on the social media users and their conversations. NVIVO was used for developing categories and themes in a sample of 172 posts. A total of 1,021 results were obtained from Twitter. The main demographic group found to be involved in conversations about drinking alcohol on Twitter was young fathers aged 25-34 years. The culture of alcohol consumption in Victoria for Twitter users is reflective of Australia's drinking culture within which risky drinking, and in particular binge drinking, is normalised.


Assuntos
Mídias Sociais , Humanos , Consumo de Bebidas Alcoólicas/epidemiologia , Comunicação , Fissura , Inquéritos e Questionários , Vitória
5.
Int J Phytoremediation ; 26(4): 557-568, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37705142

RESUMO

This study was designed to investigate the role of Morganella morganii strains in alleviating Cd stress in Arabidopsis seedlings under controlled conditions. Both M. morganii strains ABT3 (ON316873) and ABT9 (ON316874) strains isolated from salt-affected areas showed higher resistance against Cd and possess plant growth-promoting traits such as nitrogen fixation, indole-acetic acid production, ammonia production, phosphate solubilization, and, catalase, gelatinase and protease enzyme production. Plant inoculation assay showed that varying concentration of Cd (1.5 mM and 2.5 mM) significantly reduced Arabidopsis growth, quantum yield (56.70%-66.49%), and chlorophyll content (31.90%-42.70%). Cd toxicity also triggered different associations between lipid peroxidation (43.61%-69.77%) and enzymatic antioxidant mechanisms. However, when both strains were applied to the Arabidopsis seedlings, the shoot and root length and fresh and dry weights were improved in the control and Cd-stressed plants. Moreover, both strains enhanced the resistance against Cd stress by increasing antioxidant enzyme activities [catalase (19.47%-27.39%) and peroxidase (37.50%-48.07%)]that ultimately cause a substantial reduction in lipid peroxidation (27.71%-41.90%). Both strains particularly ABT3 also showed positive results in improving quantum yield (73.84%-98.64%) and chlorophyll content (41.13%-48.63%), thus increasing the growth of Arabidopsis seedlings. The study suggests that PGPR can protect plants from Cd toxicity, and Cd-tolerant rhizobacterial strains can remediate heavy metal polluted sites and improve plant growth.


In order to develop sustainable and effective agricultural techniques in areas polluted with heavy metals, it is important to have a deeper understanding of the characteristics of metal-resistant PGPR. Hence, this study focuses on the efficacy of M. morganii in promoting the growth and increasing the photosynthetic pigments of Arabidopsis seedlings under Cd toxicity.


Assuntos
Arabidopsis , Metais Pesados , Cádmio/toxicidade , Catalase , Antioxidantes , Biodegradação Ambiental , Metais Pesados/toxicidade , Plântula/química , Plantas , Clorofila/análise , Raízes de Plantas/química
6.
IEEE Internet Things J ; 10(5): 3995-4005, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38046398

RESUMO

The awareness of edge computing is attaining eminence and is largely acknowledged with the rise of Internet of Things (IoT). Edge-enabled solutions offer efficient computing and control at the network edge to resolve the scalability and latency-related concerns. Though, it comes to be challenging for edge computing to tackle diverse applications of IoT as they produce massive heterogeneous data. The IoT-enabled frameworks for Big Data analytics face numerous challenges in their existing structural design, for instance, the high volume of data storage and processing, data heterogeneity, and processing time among others. Moreover, the existing proposals lack effective parallel data loading and robust mechanisms for handling communication overhead. To address these challenges, we propose an optimized IoT-enabled big data analytics architecture for edge-cloud computing using machine learning. In the proposed scheme, an edge intelligence module is introduced to process and store the big data efficiently at the edges of the network with the integration of cloud technology. The proposed scheme is composed of two layers: IoT-edge and Cloud-processing. The data injection and storage is carried out with an optimized MapReduce parallel algorithm. Optimized Yet Another Resource Negotiator (YARN) is used for efficiently managing the cluster. The proposed data design is experimentally simulated with an authentic dataset using Apache Spark. The comparative analysis is decorated with existing proposals and traditional mechanisms. The results justify the efficiency of our proposed work.

7.
PLoS One ; 18(12): e0296111, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38096185

RESUMO

[This corrects the article DOI: 10.1371/journal.pone.0287755.].

8.
Vasc Biol ; 5(1)2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37931411

RESUMO

Platelets have a pivotal role in maintaining cardiovascular homeostasis. They are kept docile by endothelial-derived mediators. Aberration in haemostatic balance predisposes an individual to an elevated risk of a prothrombotic environment. Anti-platelet therapy has been a key component to reduce this risk. However, understanding how these medications affect the balance between the activation and inhibition of platelets is critical. There is no evidence that a key anti-platelet therapy - aspirin, may not be the most efficacious medicine of choice, as it can compromise both platelet inhibition and activation pathways. In this review, the rationale of aspirin as an anti-thrombotic drug has been critically discussed. This review looks at how recently published trials are raising key questions about the efficacy and safety of aspirin in countering cardiovascular diseases. There is an increasing portfolio of evidence that identifies that although aspirin is a very cheap and accessible drug, it may be used in a manner that is not always beneficial to a patient, and a more nuanced and targeted use of aspirin may increase its clinical benefit and maximize patient response. The questions about the use of aspirin raise the potential for changes in its clinical use for dual anti-platelet therapy. This highlights the need to ensure that treatment is targeted in the most effective manner and that other anti-platelet therapies may well be more efficacious and beneficial for CVD patients in their standard and personalized approaches.

9.
PLoS One ; 18(10): e0286573, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37796857

RESUMO

Given the recent trends in the MPPT converters in PV systems, which have been researched extensively to improve design, modified closed-loop converter technology based on SoC is presented here. This paper aims to provide detailed information on the modern-day solar Maximum Power Point Tracking (MPPT) controller and Battery Management System (BMS). Most MPPT controller examination researched in the past is suitable only for fixed-rated battery capacity, which limits the converter capability and applications. The proposed paper uses the distributed energy management control technique to dispatch multi-battery charging based on the State of Charge (SoC). The converter construction is modified here as per the prerequisite of the model. The system hardware is developed and tested using Atmega2560 low power RISC based high-performance microcontroller. The batteries' SoC level and State of Health (SoH) are calculated using embedded sensors and communication platforms through the IoT platform and Global System Monitoring (GSM) technology. The GSM and IoT technology ensure that the different batteries are monitored periodically, and any irregularities are immediately addressed through the distributed energy management control technique. This ensures a safe, reliable, and effective charging of multiple batteries with increased accuracy, thereby maximizing battery life and reducing operational costs.


Assuntos
Fontes de Energia Elétrica , Energia Solar , Eletricidade , Fenômenos Físicos , Tecnologia
10.
PLoS One ; 18(10): e0292587, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37819992

RESUMO

Coronavirus disease (COVID-19), which has caused a global pandemic, continues to have severe effects on human lives worldwide. Characterized by symptoms similar to pneumonia, its rapid spread requires innovative strategies for its early detection and management. In response to this crisis, data science and machine learning (ML) offer crucial solutions to complex problems, including those posed by COVID-19. One cost-effective approach to detect the disease is the use of chest X-rays, which is a common initial testing method. Although existing techniques are useful for detecting COVID-19 using X-rays, there is a need for further improvement in efficiency, particularly in terms of training and execution time. This article introduces an advanced architecture that leverages an ensemble learning technique for COVID-19 detection from chest X-ray images. Using a parallel and distributed framework, the proposed model integrates ensemble learning with big data analytics to facilitate parallel processing. This approach aims to enhance both execution and training times, ensuring a more effective detection process. The model's efficacy was validated through a comprehensive analysis of predicted and actual values, and its performance was meticulously evaluated for accuracy, precision, recall, and F-measure, and compared to state-of-the-art models. The work presented here not only contributes to the ongoing fight against COVID-19 but also showcases the wider applicability and potential of ensemble learning techniques in healthcare.


Assuntos
Big Data , COVID-19 , Humanos , COVID-19/diagnóstico , Ciência de Dados , Instalações de Saúde , Aprendizado de Máquina
11.
Cureus ; 15(8): e44146, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37753045

RESUMO

Background Falls among the adult population are a major global health concern with severe repercussions for individuals and healthcare systems. The purpose of this study was to investigate the prevalence and associated risk factors of falls in hospitalized patients in order to improve hospital care for elderly adults. Materials and methods The research was conducted at two institutions of tertiary care in Abbottabad, Pakistan. After extensive screening and obtaining informed consent, a total of 210 participants aged 50 and older were enrolled in the study. Mental status, history of falls, ambulation/elimination status, vision, gait/balance, systolic blood pressure, medication use, and predisposing diseases were evaluated using the Long Term Care Fall Risk Assessment Form. Additionally, the Dynamic Gait Index was utilized to evaluate various aspects of gait. Results 58.6% of participants reported a history of falls in the previous year, according to the findings. BMI, imbalance, vertigo, and fear of falling were significantly associated with an increased risk of falls in older individuals. The Long-Term Care Fall Risk Assessment, the Montreal Cognitive Assessment (MoCA), the Dynamic Gait Index (DGI), and the Mini-BESTest scores revealed that patients with a history of falls had inferior functional and cognitive outcomes. Falls were more common among individuals with a robust BMI, especially men. Conclusions The study results highlight the multifactorial nature of falls in the adult population and the need for targeted interventions to address modifiable risk factors. To enhance hospital care for high-risk patients, proactive fall prevention strategies, including regular risk assessments and individualized interventions, should be implemented. This study provides important insights into the prevalence and causes of accidents among hospitalized patients, particularly in developing nations such as Pakistan. ​​​​​​.

12.
PLoS One ; 18(7): e0287755, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37471397

RESUMO

The pandemic has significantly affected many countries including the USA, UK, Asia, the Middle East and Africa region, and many other countries. Similarly, it has substantially affected Malaysia, making it crucial to develop efficient and precise forecasting tools for guiding public health policies and approaches. Our study is based on advanced deep-learning models to predict the SARS-CoV-2 cases. We evaluate the performance of Long Short-Term Memory (LSTM), Bi-directional LSTM, Convolutional Neural Networks (CNN), CNN-LSTM, Multilayer Perceptron, Gated Recurrent Unit (GRU), and Recurrent Neural Networks (RNN). We trained these models and assessed them using a detailed dataset of confirmed cases, demographic data, and pertinent socio-economic factors. Our research aims to determine the most reliable and accurate model for forecasting SARS-CoV-2 cases in the region. We were able to test and optimize deep learning models to predict cases, with each model displaying diverse levels of accuracy and precision. A comprehensive evaluation of the models' performance discloses the most appropriate architecture for Malaysia's specific situation. This study supports ongoing efforts to combat the pandemic by offering valuable insights into the application of sophisticated deep-learning models for precise and timely SARS-CoV-2 case predictions. The findings hold considerable implications for public health decision-making, empowering authorities to create targeted and data-driven interventions to limit the virus's spread and minimize its effects on Malaysia's population.


Assuntos
COVID-19 , Aprendizado Profundo , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , África , Ásia , Previsões
13.
J Pak Med Assoc ; 73(5): 1123-1126, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37218250

RESUMO

Alveolar soft part sarcoma is a very rare malignant neoplasm of peripheral muscular, adipose or neural tissue. Its occurrence, as a primary intracranial tumour, is even rarer. To the best of our knowledge, only nine cases of primary intracranial alveolar soft part sarcoma exist in English scientific literature. We attempt to write a comprehensive review on this poorly understood intracranial malignancy, with no evident systemic lesions, such as in the case of our 22 years old patient. In addition to absent definitive proof of benefit of radiologic or chemotherapeutic management, we highlight the role of surgery as the primary treatment. Younger patients with this tumour may have a worse prognosis than elderly patients.


Assuntos
Antineoplásicos , Neoplasias Encefálicas , Sarcoma Alveolar de Partes Moles , Humanos , Feminino , Idoso , Adulto Jovem , Adulto , Sarcoma Alveolar de Partes Moles/diagnóstico por imagem , Sarcoma Alveolar de Partes Moles/cirurgia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/terapia , Redação
14.
Diagnostics (Basel) ; 13(10)2023 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-37238188

RESUMO

Ovarian cancer ranks as the fifth leading cause of cancer-related mortality in women. Late-stage diagnosis (stages III and IV) is a major challenge due to the often vague and inconsistent initial symptoms. Current diagnostic methods, such as biomarkers, biopsy, and imaging tests, face limitations, including subjectivity, inter-observer variability, and extended testing times. This study proposes a novel convolutional neural network (CNN) algorithm for predicting and diagnosing ovarian cancer, addressing these limitations. In this paper, CNN was trained on a histopathological image dataset, divided into training and validation subsets and augmented before training. The model achieved a remarkable accuracy of 94%, with 95.12% of cancerous cases correctly identified and 93.02% of healthy cells accurately classified. The significance of this study lies in overcoming the challenges associated with the human expert examination, such as higher misclassification rates, inter-observer variability, and extended analysis times. This study presents a more accurate, efficient, and reliable approach to predicting and diagnosing ovarian cancer. Future research should explore recent advances in this field to enhance the effectiveness of the proposed method further.

15.
Cureus ; 15(3): e36398, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37090353

RESUMO

Background Skin and soft tissue swellings (SSTS) frequently present in dermatology, plastic surgery, and general surgery departments. While a general surgeon can take care of excisable lesions, people typically seek plastic surgery for cosmetic reasons. According to the signs and symptoms, soft tissue and skin lesions must be removed, and it is crucial to maintain cosmesis following their removal. Objective The aim of this article is to describe the clinical and histopathological types, sites, laterality, and postoperative complications of SSTS. Material and methods This retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, Lahore General Hospital, Lahore, Pakistan in November 2022. We studied admitted patients from July 1, 2020 to June 30, 2022 for SSTS excision. Data on patients' demographics, associated features of SSTS, and their postoperative complications was gathered using Google Docs-generated proforma and sent to a statistician for the computation of results via a Microsoft Excel-generated spreadsheet. Results Out of the total 60 patients, 66.7% of the lesions were found in women. The mean age at presentation came out to be 34.16±17.42 years. Nevi with 16.7% were the most common SSTS in our study. The most common site of presentation of SSTS was the scalp and face in 63.3% of cases. Fever was the most frequently encountered post-excision complication in 40% of patients. Conclusion A comprehensive history, clinical examination, signs and symptoms, and the histology of the lesion, all play a crucial role in the management of such swellings. Surgery was the definitive treatment option for SSTS. There were very few major complications in a handful of patients.

16.
Environ Res ; 222: 115314, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-36738770

RESUMO

The critical challenge being faced by our current modern society on a global scale is to reduce the surging effects of climate change and global warming, being caused by anthropogenic emissions of CO2 in the environment. Present study reports the surface driven adsorption potential of deep eutectic solvents (DESs) surface functionalized cerium oxide nanoparticles (CeNPs) for low pressure CO2 separation. The phosphonium based DESs were prepared using tetra butyl phosphoniumbromide as hydrogen bond acceptor (HBA) and 6 acids as hydrogen bond donors (HBDs). The as-developed DESs were characterized and employed for the surface functionalization of CeNPs with their subsequent utilization in adsorption-based CO2 adsorption. The synthesis of as-prepared DESs was confirmed through FTIR measurements and absence of precipitates, revealed through visual observations. It was found that DES6 surface functionalized CeNPs demonstrated 27% higher adsorption performance for CO2 capturing. On the contrary, DES3 coated CeNPs exhibited the least adsorption progress for CO2 separation. The higher adsorption performance associated with DES6 coated CeNPs was due to enhanced surface affinity with CO2 molecules that must have facilitated the mass transport characteristics and resulted an enhancement in CO2 adsorption performance. Carboxylic groups could have generated an electric field inside the pores to attract more polarizable adsorbates including CO2, are responsible for the relatively high values of CO2 adsorption. The quadruple movement of the CO2 molecules with the electron-deficient and pluralizable nature led to the enhancement of the interactive forces between the CO2 molecules and the CeNPs decorated with the carboxylic group hydrogen bond donor rich DES. The current findings may disclose the new research horizons and theoretical guidance for reduction in the environmental effects associated with uncontrolled CO2 emission via employing DES surface coated potential CeNPs.


Assuntos
Cério , Nanopartículas , Dióxido de Carbono , Solventes Eutéticos Profundos , Cério/química , Solventes/química
17.
Cureus ; 15(1): e33703, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36793815

RESUMO

Internet pornography provides explicit content in various forms and can progress from habit to addiction. The consumption of online porn has risen due to the general use of current technology. The main reasons people consume it are sexual arousal and sexual enhancement. We planned this review study to identify the reasons for online pornography utilization, the mechanisms involved in its addiction, and its physiological, emotional, behavioral, social, and substance abuse effects. After a detailed literature search using PubMed Central and Google Scholar, four case studies and nine original articles from 2000 to 2022 were included. The main findings of the literature demonstrated that watching porn was most frequently done out of boredom, for sexual gratification, and to pick up new fashion and behavior ideas from these movies. In all facets of the users' lives, negative consequences were seen. Due to the explosion of new technologies, online pornography has risen to an alarming level, which has very injurious effects on societies and individuals. Therefore, it is high time to get rid of this addiction to protect our lives from its harmful effects.

18.
Cureus ; 15(1): e33932, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36819375

RESUMO

Background Endoscopic variceal ligation (EVL) is a surgical intervention that can work well to curb variceal bleeding in people with liver cirrhosis. However, it could make ulcer bleeding worse and be fatal in some cases. The widespread use of proton pump inhibitors (PPI) in cirrhotic individuals with variceal bleeding is empirical rather than based on scientific data. According to many studies, PPIs reduce the size of post-EVL ulcers. This study aimed to see if PPI use could reduce rebleeding after endoscopy therapy in cirrhotic patients with variceal bleeding. Methodology A retrospective cross-sectional study was conducted at a tertiary care hospital from August 2019 to September 2021. Cirrhotic patients with bleeding gastroesophageal varices (GEVs) who had undergone EVL at the same hospital were enrolled in the study. Medical records were organized, and the sample was divided into two groups based on whether or not PPI was given. Both PPI and non-PPI patients had their endoscopic findings, initial hemostasis outcomes, rebleeding rates, bleeding-related mortality rates, and treatment-related comorbidities compared. Results A total of 46 patients were selected for the study and divided into two groups (PPI group n=28 and non-PPI group n=18). The majority of the patients were males. The PPI group had a mean age of 58.6 ±7.8 years, whereas the non-PPI group had a mean age of 53.6 ±4.4 years. Hepatitis B virus (HBV) infection was the most prevalent cause of cirrhosis in both groups. After endoscopic treatment, three patients (16%) in the non-PPI group suffered a variceal hemorrhage. Bleeding-related fatalities and the time it took for the bleeding to stop varied significantly between the two groups. History of variceal bleeding (relative risk (RR)=1.45; 95% confidence interval (CI), 1.60-7.67; p=0.02), presence of gastric varices (RR=2.23; 95% CI, 2.56-9.832; p=0.035), and not administering PPIs (RR =7.542; 95% CI, 3.98-29.13; p=0.008) were linked with rebleeding. The presence of red concurrent esophageal varices (RR=6.37; 95% CI, 0.562-15.342; p=0.002) and failure to provide PPIs (RR=2.3; 95% CI, 1.621-25.64; p=0.04) were linked with post-EVL bleeding in a multivariate analysis. Conclusions Proton pump inhibitors reduce the occurrence of early bleeding and adverse events after EVL in cirrhotic patients. Not prescribing PPIs and the presence of GEVs were substantially related to a higher risk of bleeding during preventative EVL. Not initiating PPI medication immediately was the sole predictor of bleeding complications in patients who had undergone EVL without gastric varix treatment. To lower the risk of post-EVL ulcer bleeding, we recommend PPI use in patients undergoing EVL.

19.
Cureus ; 15(1): e33838, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36819420

RESUMO

Background and objective Testicular cancer is the commonest of all types of cancer males are affected with. Testicular cancer, when diagnosed early, has one of the best prognoses. However, in Pakistan, early detection is hindered by religious and sociocultural norms, lack of education, and awareness deficit. Testicular self-examination (TSE) can significantly facilitate early detection of the condition and decrease associated mortality rate. This study aimed to acquire the frame of mind regarding testicular cancer (TC) and testicular self-examination (TSE) among the male outdoor patients of Lahore General Hospital, Lahore. Materials and methods After ethical considerations, elaborated literature review and consequent pilot study were done to develop a bilingual questionnaire. Following patient consent, answers to a set of questions were noted down by the authors. A 90-second bilingual, motivational video was displayed and an educational pamphlet on the same topic was also handed over. Afterward, another survey was conducted to grasp the comprehension, satisfaction, and willingness to spread the message. Results About 92% of the subjects had not heard of or performed TSE and 58.3% mentioned lack of education as the reason for not knowing the method. Eighty-two percent patients had never heard of TC. Post-education, 100% patients claimed that their knowledge of the subject improved and 97% were ready to teach other male relatives. Conclusion The results indicate that the population's lack of awareness regarding testicular self-examination and testicular cancer is alarming. Most subjects did not know the age group, risk factors, presentation, and early prevention of testicular cancer.

20.
Environ Res ; 218: 114905, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36442522

RESUMO

CO2 sequestration into coalbed seams is one of the practical routes for mitigating CO2 emissions. The adsorption mechanisms of CO2 onto Malaysian coals, however, are not yet investigated. In this research CO2 adsorption isotherms were first performed on dry and wet Mukah-Balingian coal samples at temperatures ranging from 300 to 348 K and pressures up to 6 MPa using volumetric technique. The dry S1 coal showed the highest CO2 adsorption capacity of 1.3 mmol g-1, at 300 K and 6 MPa among the other coal samples. The experimental results of CO2 adsorption were investigated using adsorption isotherms, thermodynamics, and kinetic models. Nonlinear analysis has been employed to investigate the data of CO2 adsorption onto coal samples via three parameter isotherm equilibrium models, namely Redlich Peterson, Koble Corrigan, Toth, Sips, and Hill, and four parameter equilibrium model, namely Jensen Seaton. The results of adsorption isotherm suggested that the Jensen Seaton model described the experimental data well. Gibb's free energy change values are negative, suggesting that CO2 adsorption onto the coal occurred randomly. Enthalpy change values in the negative range established that CO2 adsorption onto coal is an exothermic mechanism. Webber's pore-diffusion model, in particular, demonstrated that pore-diffusion was the main controlling stage in CO2 adsorption onto coal matrix. The activation energy of the coals was calculated to be below -13 kJ mol-1, indicating that adsorption of CO2 onto coals occurred through physisorption. The results demonstrate that CO2 adsorption onto coal matrix is favorable, spontaneous, and the adsorbed CO2 molecules accumulate more onto coal matrix. The observations of this investigation have significant implications for a more accurate measurement of CO2 injection into Malaysian coalbed seams.


Assuntos
Dióxido de Carbono , Carvão Mineral , Dióxido de Carbono/análise , Adsorção , Termodinâmica , Temperatura , Cinética
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