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1.
J Assoc Physicians India ; 72(3): 14-17, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38736110

RESUMO

BACKGROUND: Exudative pleural effusions are commonly encountered in clinical practice, but in about one-fourth of cases, etiology remains elusive after initial evaluation. Medical thoracoscopy with semirigid thoracoscope is a minimally invasive procedure with high diagnostic yield for diagnosing pleural diseases, especially these undiagnosed exudative pleural effusions. In tubercular endemic areas, often, these effusions turn out to be tubercular, but the diagnosis of tubercular pleural effusion is quite challenging due to the paucibacillary nature of the disease. Although culture is the gold standard, it is time-consuming. Cartridge-based nucleic acid amplification test (CBNAAT) is a novel rapid diagnostic test for tuberculosis (TB) and has been recommended as the initial diagnostic test in patients suspected of having extrapulmonary TB (EPTB). MATERIALS AND METHODS: We conducted a prospective observational study of 50 patients with undiagnosed pleural effusion admitted to our tertiary care hospital. The primary aim of the study is to evaluate the diagnostic performance of CBNAAT on thoracoscopic guided pleural biopsy and compare it with conventional diagnostic techniques like histopathology and conventional culture. RESULTS: Of 50 undiagnosed pleural effusions, TB (50%) was the most common etiology. The overall diagnostic yield of semirigid thoracoscopy in this study was 74%. Our study showed that CBNAAT of pleural biopsies had a sensitivity of 36% only but a specificity of 100%. The sensitivity of CBNAAT was not far superior to the conventional culture. CONCLUSION: Tuberculosis (TB) is a common cause of undiagnosed pleural effusion in our set-up. CBNAAT testing of pleural biopsy, though, is a poor rule-out test for pleural TB, but it may aid in the early diagnosis of such patients.


Assuntos
Técnicas de Amplificação de Ácido Nucleico , Derrame Pleural , Toracoscopia , Tuberculose Pleural , Humanos , Derrame Pleural/diagnóstico , Toracoscopia/métodos , Estudos Prospectivos , Índia , Feminino , Técnicas de Amplificação de Ácido Nucleico/métodos , Masculino , Pessoa de Meia-Idade , Tuberculose Pleural/diagnóstico , Adulto , Sensibilidade e Especificidade , Biópsia/métodos , Pleura/patologia , Idoso
2.
Paediatr Anaesth ; 34(5): 405-414, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38363011

RESUMO

BACKGROUND: Dexmedetomidine is a selective α2-adrenergic agonist originally approved for sedation of adults in the intensive care unit and subsequently approved for procedural sedation in adults undergoing medical procedures. Dexmedetomidine is widely used off-label for procedural sedation in children. AIMS: To evaluate efficacy and safety of monotherapy dexmedetomidine for magnetic resonance imaging procedural sedation of children ≥1month-<17years across three ascending doses. METHODS: Randomized, double-blind, dose-ranging study of procedural sedation recruited patients at USA and Japanese sites from February 2020 to November 2021. Patients were stratified into Cohort A (≥1month-<2years) or Cohort B (≥2-<17years). Cohort A loading doses/maintenance infusions: 0.5 mcg/kg/0.5 mcg/kg/h, 1.0 mcg/kg/1.0 mcg/kg/h, and 1.5 mcg/kg/1.5 mcg/kg/h. Cohort B loading doses/maintenance infusions: 0.5 mcg/kg/0.5 mcg/kg/h, 1.2 mcg/kg/1.0 mcg/kg/h, and 2.0 mcg/kg/1.5 mcg/kg/h. Primary endpoint was percentage of overall patients completing MRI without rescue propofol at the high versus low dose. Key secondary endpoint was percentage in each age cohort who did not require propofol at the high versus low dose. RESULTS: One hundred twenty-two patients received high- (n = 38), middle- (n = 42), or low-dose (n = 42) dexmedetomidine. A greater percentage completed MRI without propofol rescue, while receiving high- versus low-dose dexmedetomidine (24/38 [63.2%] vs. 6/42 [14.3%]) (odds ratio: 10.29, 95% confidence interval: 3.47-30.50, p < .001). Similar results were seen in both age cohorts. The most common adverse events were bradypnea, bradycardia, hypertension, and hypotension, and the majority were of mild-to-moderate severity. CONCLUSIONS: Dexmedetomidine was well tolerated. The high dose was associated with meaningfully greater efficacy compared with lower doses. Based on these results, the recommended starting dose for procedural sedation in children ≥1month-<2years is loading dose 1.5 mcg/kg/maintenance infusion 1.5 mcg/kg/h; children ≥2-<17years is loading dose 2.0 mcg/kg/maintenance infusion 1.5 mcg/kg/h.


Assuntos
Dexmedetomidina , Propofol , Adolescente , Criança , Humanos , Agonistas de Receptores Adrenérgicos alfa 2 , Sedação Consciente/métodos , Hipnóticos e Sedativos , Imageamento por Ressonância Magnética , Recém-Nascido , Lactente , Pré-Escolar
3.
iScience ; 27(3): 108794, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38384854

RESUMO

Elevated serine peptidase inhibitor, Kazal type 1 (SPINK1) levels in ∼10%-25% of prostate cancer (PCa) patients associate with aggressive phenotype, for which there are limited treatment choices and dismal clinical outcomes. Using an integrative proteomics approach involving label-free phosphoproteome and proteome profiling, we delineated the downstream signaling pathways involved in SPINK1-mediated tumorigenesis and identified tyrosine kinase KIT as highly enriched. Furthermore, high to moderate levels of KIT expression were detected in ∼85% of SPINK1-positive PCa specimens. We show KIT signaling orchestrates SPINK1-mediated oncogenesis, and treatment with KIT inhibitor reduces tumor growth and metastases in preclinical mice models. Mechanistically, KIT signaling modulates WNT/ß-catenin pathway and confers stemness-related features in PCa. Notably, inhibiting KIT signaling led to restoration of AR/REST levels, forming a feedback loop enabling SPINK1 repression. Overall, we uncover the role of KIT signaling downstream of SPINK1 in maintaining lineage plasticity and provide distinct treatment modalities for advanced-stage SPINK1-positive patients.

4.
Eur J Med Res ; 29(1): 36, 2024 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-38185694

RESUMO

INTRODUCTION AND OBJECTIVE: There is a paucity of data on patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) and a decompensated diabetic state, diabetic ketoacidosis (DKA). Therefore, we aimed to investigate the outcomes of patients with MINOCA presenting with or without DKA. METHODS: We conducted this retrospective propensity score-matched analysis from January 1, 2015, to December 4, 2022. The patients with a principal admission diagnosis of ST-Elevation MI (STEMI) and discharge labeled as MINOCA (ICD-10-CM code 121.9) with DKA were analyzed. We performed a comparative analysis for MINOCA with and without DKA before and after propensity score matching for primary and secondary endpoints. RESULTS: Three thousand five hundred sixty-three patients were analyzed, and 1150 (32.27%) presented with DKA, while 2413 (67.72%) presented as non-DKA. The DKA cohort had over two-fold mortality (5.56% vs. 1.19%; p = 0.024), reinfarction (5.82% vs. 1.45%; p = 0.021), stroke (4.43% vs. 1.36%; p = 0.035), heart failure (6.89% vs. 2.11%; p = 0.033), and cardiogenic shock (6.43% vs. 1.78%; p = 0.025) in a propensity score-matched analysis. There was an increased graded risk of MINOCA with DM (RR (95% CI): 0.50 (0.36-0.86; p = 0.023), DKA (RR (95% CI): 0.46 (0.24-0.67; p = 0.001), and other cardiovascular (CV) risk factors. CONCLUSION: DKA complicates a portion of MINOCA and is associated with increased mortality and major adverse cardiovascular events (MACE).


Assuntos
Diabetes Mellitus , Cetoacidose Diabética , Infarto do Miocárdio , Humanos , Cetoacidose Diabética/complicações , MINOCA , Pontuação de Propensão , Estudos Retrospectivos
6.
Lung India ; 41(1): 55-59, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38160460

RESUMO

Antiviral combinations have been proposed as treatment for influenza in order to increase the antiviral activity by action at different sites of action as well as obviate the emergence of drug resistance to the commonly used antiviral agents like oseltamivir. Nitazoxanide has been found to exhibit anti-influenza viral activity with clinical benefit in a previous study. We recruited 242 cases of SARI, among whon 67 were confirmed to have influenza viral infection. In a randomized blinded fashion, 34 patients received a combination of nitazoxanide and oseltamivir whereas 33 cases received oseltamivir alone. Clinical parameters were followed in both groups and the nasal swabs were re-tested on day 6 for influenza positivity and the cycle threshold (CT) values. No significant differences were observed in terms of time for resolution of fever, other symptoms, and SOFA scores. Nine patients succumbed during the course of the illness that included three in the oseltamivir group and six in the combination group. All but one of those who expired had an underlying co-morbid illness. Our preliminary data suggest that the addition of nitazoxanide does not improve outcomes in hospitalized patients with influenza. Larger studies are recommended for statistically robust conclusions.

7.
Nanoscale Adv ; 5(22): 6216-6227, 2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-37941957

RESUMO

Applications: the study of highly advanced hybrid nanofluids has aroused the interest of academics and engineers, particularly those working in the fields of chemical and applied thermal engineering. The improved properties of hybrid nanoliquids are superior to those of earlier classes of nanofluids (which are simply referred to as nanofluids). Therefore, it is essential to report on the process of analyzing nanofluids by passing them through elastic surfaces, as this is a typical practice in engineering and industrial applications. Purpose and methodology: the investigation of hybrid nanoliquids was the sole focus of this research, which was conducted using a stretched sheet. Using supporting correlations, an estimate was made of the improved thermal conductivity, density, heat capacitance, and viscosity. In addition, the distinctiveness of the model was increased by the incorporation of a variety of distinct physical limitations, such as thermal slip, radiation, micropolarity, uniform surface convection, and stretching effects. After that, a numerical analysis of the model was performed, and the physical results are presented. Core findings: the results of the model showed that it is possible to attain the desired momentum of hybrid nanofluids by keeping the fluidic system at a uniform suction, and that this momentum may be enhanced by increasing the force of the injecting fluid via a stretched sheet. Surface convection, thermal radiation, and high dissipative energy are all great physical instruments that can be used to acquire heat in hybrid nanofluids. This heat acquisition is significant from both an applied thermal engineering perspective and a chemical engineering perspective. The features of simple nano and common hybrid nanoliquids have been compared and the results indicate that hybrid nanofluids exhibit dominant behavior when measured against the percentage concentration of nanoparticles, which enables them to be used in large-scale practical applications.

8.
PLoS One ; 18(11): e0286823, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37967095

RESUMO

What are the effects of parenting styles on academic performance and how unequal are these effects on secondary school students from different gender and socioeconomic status families constitute the theme of this paper. A cross-sectional and purposive sampling technique was adopted to gather information from a sample of 448 students on a Likert scale. Chi-square, Kendall's Tau-c tests and hierarchical multiple regression analyses were used to determine the extent of the relationship among the variables. Chi-square and Kendall's Tau-c (Tc) test results established that the socioeconomic status of the respondent's family explained variation in children's academic performance due to parenting style; however, no significant difference was observed in the academic performance of students based on gender. Furthermore, hierarchal multiple regression analysis established that the family's socioeconomic status, authoritative parenting, permissive parenting, the interaction of socioeconomic status and authoritative parenting, and the interaction of socioeconomic status and permissive parenting were significant predictors (P<0.05) of students' academic performance. These predictor variables explained 59.3 percent variation in the academic performance of children (R2 = 0.593). Results of hierarchal multiple regression analysis in this study ranked ordered the most significant predictors of the academic performance of children in the following order. Family socioeconomic status alone was the strongest predictor (ß = 18.25), interaction of socioeconomic status and authoritative parenting was the second important predictor (ß = 14.18), authoritative parenting alone was third in importance (ß = 13.38), the interaction of socioeconomic status and permissive parenting stood at fourth place in importance (ß = 11.46), and permissive parenting was fifth (ß = 9.2) in influencing academic performance of children in the study area. Children who experienced authoritative parenting and were from higher socioeconomic status families perform better as compared to children who experienced authoritarian and permissive parenting and were from low socioeconomic status families.


Assuntos
Desempenho Acadêmico , Poder Familiar , Humanos , Criança , Estudos Transversais , Estudantes , Classe Social
9.
Heliyon ; 9(11): e21107, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37928015

RESUMO

The magnetohydrodynamic (MHD) rotating flow that occurs across a stretching surface has numerous practical applications in a variety of domains. These fields include astronomy, engineering, the material sciences, and space exploration. The combined examination of magnetohydrodynamics rotating flow across a stretching surface, taking into consideration fluctuating viscosity and nanoparticle aggregation, has significant ramifications across several different domains. It is essential for both the growth of technology and the attainment of deeper insights into the complicated fluid dynamics to maintain research in this field. Given the aforementioned motivation, the principal aim of this study is to examine the effects of variable viscosity on the bidirectional rotating magnetohydrodynamic flow over a stretching surface. Aggregation effects on nanoparticles are used in the analysis. Titania (TiO2) is taken nanoparticle and ethylene glycol as base fluid. The nonlinear ordinary differential equations and the boundary conditions that correspond to them can be transformed into a dimensionless form by using a technique called similarity transformation. To get a numerical solution to the transformed equation, the Runge-Kutta 4th order (RK-4) method is utilized, and this is done in conjunction with the shooting method. The impact of various leading variables on dimensionless velocity, the coefficients of temperature, skin friction and local Nusselt number are graphically represented. Velocity profiles in both direction increases with increasing values of φ. The Nusselt number increases with increasing values of the radiation and temperature ratio parameters. When a 1 % volume fraction of nanoparticles is introduced, the Nusselt number exhibits a 0.174 % increase for the aggregation model compared to the regular fluid in the absence of radiation effects. When the aggregation model is used with a 1 % volume fraction of nanoparticles, the skin friction increases by 0.1153 % in the x direction and by 0.1165 % in the y direction compared to the regular fluid. Tables show the variation in Nusselt numbers, as well as a comparison of the effects of nanoparticle's aggregation model without and with radiation. Moreover, the numerical results obtained were compared with previously published data, demonstrating a satisfactory agreement. We firmly believe that this finding will have extensive implications for engineering and various industries.

10.
Cureus ; 15(9): e46031, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37900380

RESUMO

Hepatic artery aneurysms (HAA) and pseudoaneurysms are rare vascular abnormalities, that can lead to significant morbidity and mortality if left untreated. We present a case report of a 78-year-old lady with a hepatic artery aneurysm who initially presented with upper gastrointestinal bleeding (UGIB) and biliary obstruction and was treated by trans-arterial embolization. Recovery was complicated by glue embolisation leading to obstructive jaundice and biliary sepsis. This case highlights the importance of having a high index of suspicion for HAA and pseudoaneurysm when initial investigations including oesophago gastro duodenoscopy (OGD) are negative. Although rare, glue embolization should be considered in patients who present with obstructive jaundice and abdominal pain.

11.
Nanoscale Adv ; 5(21): 5819-5828, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37881707

RESUMO

Nanofluids are referred to as nanometer suspensions in standard nanometer-sized fluid transfer. In this study, our focus was to examine the flow and transmission of heat through a non-parallel walled channel of nanofluids. For this purpose, we used the thermal transport in H2O composed of Al2O3 and γ-Al2O3 nanomaterials within the convergent/divergent channel for stretching/shrinking parameters. The flow was considered two-dimensional and unsteady. As a result, the flow of an unstable fluid, including various nanoparticles, was modeled within the convergent/divergent channel. A suitable similarity transformation was used to convert the complicated coupled system of differential equations into a non-dimensional form. For numerical solutions, the complicated system of equations was first transformed into a set of first-order differential equations using the shooting method. The Runge-Kutta (RK-4) method was then used to solve the reduced first-order equations. To comprehend the flow pattern and temperature and velocity profile deviations caused by dimensionless parameters, a graphical investigation was performed. Graphs were also used to investigate the variation in the velocity and temperature profiles for various emerging factors.

12.
Cells ; 12(18)2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37759470

RESUMO

Cellular biomolecular condensates, termed ribonucleoprotein (RNP) granules, are often enriched in messenger RNA (mRNA) molecules relative to the surrounding cytoplasm. Yet, the spatial localization and diffusion of mRNAs in close proximity to phase separated RNP granules are not well understood. In this study, we performed single-molecule fluorescence imaging experiments of mRNAs in live cells in the presence of two types of RNP granules, stress granules (SGs) and processing bodies (PBs), which are distinct in their molecular composition and function. We developed a photobleaching- and noise-corrected colocalization imaging algorithm that was employed to determine the accurate positions of individual mRNAs relative to the granule's boundaries. We found that mRNAs are often localized at granule boundaries, an observation consistent with recently published data. We suggest that mRNA molecules become spontaneously confined at the RNP granule boundary similar to the adsorption of polymer molecules at liquid-liquid interfaces, which is observed in various technological and biological processes. We also suggest that this confinement could be due to a combination of intermolecular interactions associated with, first, the screening of a portion of the RNP granule interface by the polymer and, second, electrostatic interactions due to a strong electric field induced by a Donnan potential generated across the thin interface.

13.
J Geriatr Cardiol ; 20(8): 596-601, 2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37675260

RESUMO

BACKGROUND: Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis. The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome (ACS). METHODS: This was a prospective observational study of 601 older adult patients (age > 60 years) with ACS who underwent percutaneous coronary intervention over two years (2017-2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters. RESULTS: The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio (NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio (PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio (OR) = 0.85, P = 0.021], hematocrit (OR = 0.91, P = 0.018), NLR (OR = 1.10, P = 0.001) and PLR (OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR (OR = 1.096, 95% CI: 1.006-1.15, P = 0.035) was an independent predictor of 30-day mortality. CONCLUSIONS: For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count.

14.
PLoS One ; 18(9): e0276133, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37682884

RESUMO

Robotics and artificial intelligence have played a significant role in developing assistive technologies for people with motor disabilities. Brain-Computer Interface (BCI) is a communication system that allows humans to communicate with their environment by detecting and quantifying control signals produced from different modalities and translating them into voluntary commands for actuating an external device. For that purpose, classification the brain signals with a very high accuracy and minimization of the errors is of profound importance to the researchers. So in this study, a novel framework has been proposed to classify the binary-class electroencephalogram (EEG) data. The proposed framework is tested on BCI Competition IV dataset 1 and BCI Competition III dataset 4a. Artifact removal from EEG data is done through preprocessing, followed by feature extraction for recognizing discriminative information in the recorded brain signals. Signal preprocessing involves the application of independent component analysis (ICA) on raw EEG data, accompanied by the employment of common spatial pattern (CSP) and log-variance for extracting useful features. Six different classification algorithms, namely support vector machine, linear discriminant analysis, k-nearest neighbor, naïve Bayes, decision trees, and logistic regression, have been compared to classify the EEG data accurately. The proposed framework achieved the best classification accuracies with logistic regression classifier for both datasets. Average classification accuracy of 90.42% has been attained on BCI Competition IV dataset 1 for seven different subjects, while for BCI Competition III dataset 4a, an average accuracy of 95.42% has been attained on five subjects. This indicates that the model can be used in real time BCI systems and provide extra-ordinary results for 2-class Motor Imagery (MI) signals classification applications and with some modifications this framework can also be made compatible for multi-class classification in the future.


Assuntos
Algoritmos , Inteligência Artificial , Humanos , Teorema de Bayes , Modelos Logísticos , Eletroencefalografia
15.
J Nanobiotechnology ; 21(1): 332, 2023 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-37716974

RESUMO

OBJECTIVES: This study investigated whether exosomes from LPS pretreated bone marrow mesenchymal stem cells (LPS pre-MSCs) could prolong skin graft survival. METHODS: The exosomes were isolated from the supernatant of MSCs pretreated with LPS. LPS pre-Exo and rapamycin were injected via the tail vein into C57BL/6 mice allografted with BALB/c skin; graft survival was observed and evaluated. The accumulation and polarization of macrophages were examined by immunohistochemistry. The differentiation of macrophages in the spleen was analyzed by flow cytometry. For in vitro, an inflammatory model was established. Specifically, bone marrow-derived macrophages (BMDMs) were isolated and cultured with LPS (100 ng/ml) for 3 h, and were further treated with LPS pre-Exo for 24 h or 48 h. The molecular signaling pathway responsible for modulating inflammation was examined by Western blotting. The expressions of downstream inflammatory cytokines were determined by Elisa, and the polarization of macrophages was analyzed by flow cytometry. RESULTS: LPS pre-Exo could better ablate inflammation compared to untreated MSC-derived exosomes (BM-Exo). These loaded factors inhibited the expressions of inflammatory factors via a negative feedback mechanism. In vivo, LPS pre-Exo significantly attenuated inflammatory infiltration, thus improving the survival of allogeneic skin graft. Flow cytometric analysis of BMDMs showed that LPS pre-Exo were involved in the regulation of macrophage polarization and immune homeostasis during inflammation. Further investigation revealed that the NF-κB/NLRP3/procaspase-1/IL-1ß signaling pathway played a key role in LPS pre-Exo-mediated regulation of macrophage polarization. Inhibiting NF-κB in BMDMs could abolish the LPS-induced activation of inflammatory pathways and the polarization of M1 macrophages while increasing the proportion of M2 cells. CONCLUSION: LPS pre-Exo are able to switch the polarization of macrophages and enhance the resolution of inflammation. This type of exosomes provides an improved immunotherapeutic potential in prolonging graft survival.


Assuntos
Exossomos , NF-kappa B , Camundongos , Animais , Camundongos Endogâmicos C57BL , Lipopolissacarídeos/farmacologia , Proteína 3 que Contém Domínio de Pirina da Família NLR , Medula Óssea , Transdução de Sinais , Aloenxertos
16.
Heart Lung Circ ; 32(9): 1057-1068, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37532601

RESUMO

BACKGROUND: Innovative models of health care that involve advanced technology in the form of a digital hospital are emerging globally. Models include technology such as machine learning and smart wearables, that can be used to integrate patient data and improve continuity of care. This model may have benefits in situations where patient deterioration must be detected quickly so that a rapid response can occur such as cardiopulmonary settings. AIM: The purpose of this scoping review was to examine the evidence for a digital hospital model of care, in the context of cardiac and pulmonary settings. DESIGN: Scoping review. DATA SOURCES: Databases searched were using PsycInfo, Ovid MEDLINE, and CINAHL. Studies written in English and containing key terms related to digital hospital and cardiopulmonary care were included. The Joanna Briggs Institute methodology for systematic reviews was used to assess the risk of bias. RESULTS: Thirteen (13) studies fulfilled the inclusion criteria. For cardiac conditions, a deep-learning-based rapid response system warning system for predicting patient deterioration leading to cardiac arrest had up to 257% higher sensitivity than conventional methods. There was also a reduction in the number of patients who needed to be examined by a physician. Using continuous telemonitoring with a wireless real-time electrocardiogram compared with non-monitoring, there was improved initial resuscitation and 24-hour post-event survival for high-risk patients. However, there were no benefits for survival to discharge. For pulmonary conditions, a natural language processing algorithm reduced the time to asthma diagnosis, demonstrating high predictive values. Virtual inhaler education was found to be as effective as in-person education, and prescription error was reduced following the implementation of computer-based physician order entry electronic medical records and a clinical decision support tool. CONCLUSIONS: While we currently have only a brief glimpse at the impact of technology care delivery for cardiac and respiratory conditions, technology presents an opportunity to improve quality and safety in care, but only with the support of adequate infrastructure and processes. PROTOCOL REGISTRATION: Open Science Framework (OSF: DOI 10.17605/OSF.IO/PS6ZU).

17.
Nanotechnology ; 34(46)2023 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-37549667

RESUMO

The present article describes the impact of variable thermal conductivity on the flow of ternary hybrid nanofluid with cylindrical shape nanoparticles over a stretching surface. Three nanoparticles combine in base fluid polymer. The assumption made will be used to model an equations. Modeled equations are in the form of a system of partial differential equations are difficult to solve can be converted to system of an ordinary differential equations, through resemblance substitutions, and will be solved numerically. Numerical scheme of Runge-Kutta order four is coupled with the shooting method to solve the resulting equations. The graphs in the study illustrate how physical quantities, such as magnetic field, injection/suction, nanoparticles volume fraction, and variable thermal conductivity, affected the velocity, skin friction, temperature, and local Nusselt number. The velocity profiles deflate as the volume fraction rises. While the temperature rises with an increase in the volume fraction of nanoparticles for both injection and suction, the velocity profiles also decline as the injection and suction parameter increases. Furthermore, as the magnetic field increases, the temperature profile rises while the velocity profile falls. The temperature curves increase as thermal conductivity increases. Finally, as the magnetic field is strengthened, the Nusselt number and skin friction decrease. The combination of mathematical modeling, numerical solution techniques, and the analysis of physical quantities contributes to the advancement of knowledge in this ternary hybrid nanofluid.

18.
Heliyon ; 9(6): e17538, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37408888

RESUMO

It is still not quite apparent how suspended nanoparticles improve heat transmission. Multiple investigations have demonstrated that the aggregation of nanoparticles is a critical step in improving the thermal conductivity of nanofluids. However, the thermal conductivity of the nanofluid would be greatly affected by the fractal dimension of the nanoparticle aggregation. The purpose of this research is to learn how nanoparticle aggregation, joule heating, and a heat source affect the behavior of an ethylene glycol-based nanofluid as it flows over a permeable, heated, stretched vertical Riga plate and through a porous medium. Numerical solutions to the present mathematical model were obtained using Mathematica's Runge-Kutta (RK-IV) with shooting technique. In the stagnation point flow next to a permeable, heated, extending Riga plate, heat transfer processes and interrupted flow phenomena are defined and illustrated by diagrams in the proposed mixed convection, joule heating, and suction variables along a boundary surface. Data visualizations showed how different variables affected temperature and velocity distributions, skin friction coefficient, and the local Nusselt number. The rates of heat transmission and skin friction increased when the values of the suction parameters were raised. The temperature profile and the Nusselt number both rose because of the heat source setting. The increase in skin friction caused by changing the nanoparticle volume fraction from φ=0.0 to φ=0.01 for the without aggregation model was about 7.2% for the case of opposing flow area (λ=-1.0) and 7.5% for the case of aiding flow region (λ=1.0). With the aggregation model, the heat transfer rate decreases by approximately 3.6% for cases with opposing flow regions (λ=-1.0) and 3.7% for cases with assisting flow regions (λ=1.0), depending on the nanoparticle volume fraction and ranging from φ=0.0 to φ=0.01, respectively. Recent findings were validated by comparing them to previously published findings for the same setting. There was substantial agreement between the two sets finding.

19.
Micromachines (Basel) ; 14(4)2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37421050

RESUMO

This paper presents a deep neural network (DNN) based design optimization methodology for dual-axis microelectromechanical systems (MEMS) capacitive accelerometer. The proposed methodology considers the geometric design parameters and operating conditions of the MEMS accelerometer as input parameters and allows to analyze the effect of the individual design parameters on the output responses of the sensor using a single model. Moreover, a DNN-based model allows to simultaneously optimize the multiple output responses of the MEMS accelerometers in an efficient manner. The efficiency of the proposed DNN-based optimization model is compared with the design of the computer experiments (DACE) based multiresponse optimization methodology presented in the Literature, which showed a better performance in terms of two output performance metrics, i.e., mean absolute error (MAE) and root mean squared error (RMSE).

20.
Heliyon ; 9(7): e17673, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37449139

RESUMO

The transfer of heat is a phenomenon that is significant in a variety of contexts due to the different ways in which it may be utilized in industrial settings. To increase the rate at which heat is transferred, carbon nanotubes (CNTs), which can either be single-wall or multi-walled, are suspended in base fluids, and the resulting mixture is referred to as a "nanofluid. This study looks at how heat transfers through nanofluids that are suspended in carbon nanotubes with different lengths and radii over a stretching surface. It also looks at how changing viscosity and joule heating affect motion. Water is taken as base fluid. This study looks at both carbon nanotubes with one wall and those with more than one. The flow is governed by a series of partial differential equations, which, to control the flow, are transformed into a series of nonlinear ordinary differential equations. Similarity transformation is used to convert the obtained nonlinear ordinary differential equations and accompanying boundary conditions into a form that is dimensionless. To numerically solve the transformed equation, RK-4 with shooting method is used. Graphs and in-depth discussions are used to look at how velocity and temperature profiles are affected by the leading variables. The expression for skin friction and local Nusselt number are written down and graphs show how these two numbers change for different parameter values. The temperature profile goes down when the viscosity parameter goes down, but the velocity profile goes up. When the magnetic parameter goes up, the velocity profile f'(η), goes down, but the velocity profile g(η) and temperature θ(η) both go up at the same time. The rate of heat transfer increases with the addition of φ and S. When the suction parameter (S = 2.1) with 1% of φ is used, it is reported that rate of heat transfer increases by 1.135% for Single walled and 1.275% for Multi Walled carbon nanotubes. To determine whether or not the proposed numerical model is legitimate, a comparison is made between the current results and those that have previously been published.

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