Factors associated with long-term mechanical ventilation in patients undergoing cardiovascular surgery.

BACKGROUND: One of the main therapy for coronary artery disease is surgery. Prolonged mechanical ventilation in patients with cardiac surgery is associated with high mortality. This study aimed to determine the factors related to long-term mechanical ventilation (LTMV) in patients undergoing cardiovascular surgery. METHODS: The present study was a descriptive-analytical study in which the records of 1361 patients who underwent cardiovascular surgery and were on a mechanical ventilator during 2019-2020 at the Imam Ali Heart Center in Kermanshah city were examined. The data collection tool was a three-part researcher-made questionnaire including demographic characteristics, health records, and clinical variables. Data analysis was done using descriptive and inferential statistical tests and SPSS Version 25 software. RESULTS: In this study, of the 1361 patients, 953 (70%) were male. The results indicated that 78.6% of patients had short-term mechanical ventilation, and 21.4% had long-term mechanical ventilation. There was a statistically significant relationship between the history of smoking, drug use, and baking bread with the type of mechanical ventilation (P < 0.05). Also, based on the regression test, some parameters, such as the history of respiratory conditions, could predict the prolongation of mechanical ventilation. Creatinine levels before surgery, chest secretions after surgery, central venous pressure after surgery, and the status of cardiac enzymes before surgery also affect this issue. CONCLUSION: This study investigated some factors related to prolonged mechanical ventilation in patients undergoing heart surgery. For optimizing the care and therapeutic measures, It is suggested, healthcare workers have a detailed assessment on patients with factors such as the history of baking bread, history of obstructive pulmonary disease, history of kidney disease, use of an intra-aortic pump, number of respirations and systolic blood pressure 24 h after surgery, creatinine level 24 h after surgery, chest secretions after surgery, and the amount of pre-operative ejection fraction and cardiac enzymes (CK-MB).

A novel compartmental model to capture the nonlinear trend of COVID-19.

The COVID-19 pandemic took the world by surprise and surpassed the expectations of epidemiologists, governments, medical experts, and the scientific community as a whole. The majority of epidemiological models failed to capture the non-linear trend of the susceptible compartment and were unable to model this pandemic accurately. This study presents a variant of the well-known SEIRD model to account for social awareness measures, variable death rate, and the presence of asymptomatic infected individuals. The proposed SEAIRDQ model accounts for the transition of individuals between the susceptible and social awareness compartments. We tested our model against the reported cumulative infection and death data for different states in the US and observed over 98.8% accuracy. Results of this study give new insights into the prevailing reproduction number and herd immunity across the US.

Endovascular correction of an infantile intracranial venous outflow obstruction.

The authors report on the case of a 7-year-old boy who presented with a reduced level of activity, macrocephaly, prominent scalp veins, and decreased left-sided visual acuity. Imaging workup demonstrated generalized cerebral volume loss, bilateral chronic subdural hematomas, absent left sigmoid sinus, hypoplastic left transverse sinus, and severe focal weblike stenosis of the right sigmoid sinus. Right sigmoid sinus angioplasty and stent insertion was performed, with an immediate reduction in the transduced intracranial venous pressure gradient across the stenosis (from 22 to 3 mm Hg). Postprocedural diminution of prominent scalp and forehead veins and spinal venous collateral vessels was followed by a progressive improvement in visual acuity and physical activity over a 1-year follow-up period, supporting the efficacy of angioplasty and stent insertion in intracranial venous outflow obstruction. There are multiple potential causes of intracranial venous hypertension in children. Development of dural sinus stenosis in infancy may be one such cause, mimicking the clinical presentation of other causes such as vein of Galen malformations. This condition can be ameliorated by early endovascular revascularization.

Formalization of Generalized Constraint Language: A Crucial Prelude to Computing With Words.

The generalized constraint language (GCL), introduced by Zadeh, serves as a basis for computing with words (CW). It provides an agenda to express the imprecise and fuzzy information embedded in natural language and allows reasoning with perceptions. Despite its fundamental role, the definition of GCL has remained informal since its introduction by Zadeh, and to our knowledge, no attempt has been made to formulate a rigorous theoretical framework for GCL. Such formalization is necessary for further theoretical and practical advancement of CW for two important reasons. First, it provides the underlying infrastructure for the development of useful inference patterns based on sound theories. Second, it determines the scope of GCL and hence facilitates the translation of natural language expressions into GCL. This paper is an attempt to step in this direction by providing a formal syntax together with a compositional semantics for GCL. A soundness theorem is defined, and Zadeh's deduction rules are proved to be valid in the defined semantics. Furthermore, a discussion is provided on how the proposed language may be used in practice.