Case Files Research Articles

Pregnancy Outcome Among Grand Multiparous Women at Delta State University, Oghara, Nigeria

Abstract Background: Grand multiparity presents a significant challenge to the obstetrician, especially in developing countries, including Nigeria. Objective: To determine the incidence and complications associated with grand multiparity at the Delta State University Teaching Hospital (DELSUTH), Oghara, Delta State, Nigeria. Materials and Methods: A retrospective descriptive study of grand multiparous women in DELSUTH between July 1, 2014, and June 30, 2023. Data retrieved from the hospital records and case files were analyzed. Results: The results revealed that during the period under review, the incidence of grand multiparity was 7.8% (146 grand multiparous women in 1874 deliveries). The majority (79.1%, n = 106) were para 5 and 6 (mean age: 37 ± 4.2 years). They were mostly farmers (49.3%) and housewives (17.9%) with a primary level of education (41.8%). Fifty-one percent (51.5%) were booked. Anemia (30.6%) and hypertensive disorders (12.7%) were the most common complications in the antenatal period, whereas hypertensive disorders (14.2%) were the most common complications seen during labor. The majority (61.9%) of the women had vaginal delivery. There was one case of maternal mortality (0.7%). The majority of the babies were of normal birth weight (57.3%, n = 82). One hundred and thirty-one of the babies (91.6%) were live births, whereas 8.4% (n = 12) suffered perinatal death. Conclusion: This study concludes that grand multiparity contributes to maternal and perinatal morbidity and mortality in Oghara, Nigeria.

Retinal thickness and macular microvascular changes seen on optical coherence tomography angiography (OCTA) in patients with sickle cell retinopathy in a tertiary care eye hospital

PurposeTo report retinal thickness values and macular vascular flow characteristics identified by optical coherence tomography angiography (OCT-A) in patients with various sickle cell genotypes in a population from sub-Saharan Africa. DesignRetrospective, observational study. MethodsThis is a single-institution case series of adult patients with various sickle cell genotypes who presented to the Eye Foundation Hospital Lagos between January 2022 and December 2023. Case files of patients were reviewed, and macular OCT and OCT-A images analyzed quantitatively for macular thickness, areas of flow loss, size of foveal avascular area, parafoveal flow, as well as vascular density in both the superficial and deep vascular plexi. The findings were compared by sickle cell genotype and comparisons made with age matched normal patients. ResultsA total of 38 eyes of 19 patients’ records were reviewed, and 35 eyes met the inclusion criteria; 16 eyes of 9 age and gender matched controls were included. The mean central foveal thickness (CFT) was 242.4 μm ± 33.3 μm among patients’ eyes, while a mean CFT of 236.1 μm ± 10.1 μm was measured among controls (p = 0.312). A smaller mean FAZ area of 0.270 mm2 ± 0.116 mm2 was seen among the control eyes compared to a mean of 0.314 mm2 ± 0.206 mm2 among patients’ eyes (p = 0.439). The mean flow area was larger among control eyes with 0.849 mm2 ± 0.647 mm2 compared to a mean flow of 0.822 mm2 ± 0.471 mm2 among patients’ eyes (0.868). The mean superficial foveal vessel density was greater among control eyes (19.30 ± 4.58) compared to patient eyes (18.77 ± 7.78) (p = 0.765). The mean deep foveal vessel density was greater among controls (35.30 ± 8.36) than among patients (34.06 ± 9.30) (p = 0.650). The difference between eyes of SC (53.37 ± 5.13) patients and SS (47.94 ± 8.44) patients in the deep temporal perifoveal VD was statistically significant (p = 0.035). ConclusionThe retina in eyes with sickle retinopathy and that of controls tends to be thickest in the nasal quadrant, then the superior, then inferior, and then thinnest in the temporal quadrant. Macular vessel density in both the superficial and deep capillary plexi was thicker among controls compared to eyes with sickle cell retinopathy. Among patients’ eyes, the deep capillary vessel density in the temporal perifoveal quadrant was greater among SC patients compared to SS (p = 0.035).

A 10-year retrospective analysis of sudden unexpected death in the young investigated at Salt River Mortuary, Cape Town.

Sudden unexpected death in the young (SUDY) is defined as the rapid, unsuspected demise of an apparently healthy individual between the ages of one and 40 years. There is a gap in research pertaining to this population in a South African context. This retrospective study aimed to explore the burden, scope of post-mortem investigation, and risk factors of SUDY admissions to Salt River Mortuary (SRM) in Cape Town between 1 January 2010 and 31 December 2019. Medico-legal case files pertaining to SUDY cases from SRM were reviewed. SRM received a total of 34 601 admissions in the 10-year period; of which 1 997 (5.77%) were SUDY cases. Nearly two-thirds (62.59%) of the SUDY admissions were male. The leading cause of death was pneumonia (17.11%), and the most prevalent organ system implicated in cause of death was the pulmonary system (45.19%). At least 32.46% of SUDY cases were infectious-related, with varying degrees of confidence. A large proportion of cases had no history of acute or chronic illness (45.43%), and no family history of illness (56.66%). In total, 52 potential candidates were identified for a molecular autopsy, of which 47 have stored biological samples for future investigations. This study advocates for the routine performance of post-mortem ancillary microbiological and toxicological testing in cases of SUD, considering the large burden of infectious disease and substance abuse in South Africa. The retention of biological samples in undetermined or non-specific natural cases is also urged, to allow for cause of death determination on a molecular level.

A refugee history perspective

This article draws upon ongoing research in refugee history and specifically a close examination of confidential individual case files in the archives of the UNHCR to explore aspects of the cultural representation of refugees in different sites of population displacement in the modern world. Reflections by Roland Barthes and Abdulrazak Gurnah FBA provide the starting point to consider visual culture and cultural representation in efforts to assist refugees, such as the UN campaign for World Refugee Year in 1959–1960. No less significant have been the efforts by refugees themselves to make themselves heard in relation to the international refugee regime. The article ends with a plea for scholars and refugees to engage in the co-production of knowledge about population displacement and its consequences. (This article is published in the thematic collection `The arts and humanities: rethinking value for today—views from Fellows of the British Academy’, edited by Isobel Armstrong.)

Owner satisfaction and prognosis for return to work after pancarpal arthrodesis in working dogs in the United Kingdom: a retrospective study (2011–2020)

BackgroundPancarpal arthrodesis (PCA) is a commonly performed procedure in the UK. However, it is not known whether working dogs in the UK and other European countries with carpal injuries that have undergone unilateral PCA are able to return to working ability as determined by the owner. Medical records from a referral hospital in the UK were reviewed retrospectively for cases of working dogs treated using unilateral PCA. Case files and radiographs were retrospectively analysed for cause of injury, diagnosis, and complications. The ability of the dog to work after surgery and owner satisfaction with the outcome were assessed using telephone questionnaire.Results50% (5/10, 50%) owners stated their dog could perform normal duties, 4/10 (40%) could perform most duties with some allowances. Outcome was not as good for dogs working on steep, uneven fell terrain. 80% (8/10, 80%) owners rated the level of post-operative lameness as unaffected with a normal gait. 90% (9/10, 90%) owners were either very satisfied or satisfied with the outcome of the procedure, and 90% owners stated the financial investment was worthwhile.ConclusionsUnilateral PCA carries a good prognosis for working dogs with high owner satisfaction. Caution should be advised for dogs expected to work on steep, uneven fell terrain.

Proses Peradilan terhadap Pelaku Pengulangan Tindak Pidana Pencurian Ringan di Pengadilan Negeri Pulau Punjung: Studi Kasus Putusan Nomor: 8/Pid.C/2020/PN Plj

The judicial process for perpetrators of repeat crimes of light theft should be processed using a regular examination or short examination, while at the Pulau Punjung District Court, cases of repeat crimes of light theft are processed using a speedy examination. The aim of writing this thesis is to understand the judicial process regarding the examination of perpetrators of repeat crimes of petty theft at the Pulau Punjung District Court, as well as to determine the Judge's obstacles in deciding the speedy trial process in case Number: 8/Pid.C/2020/PN Plj at the District Court Pulau Punjung. This legal research is empirical juridical research, namely research that uses field object data or is based on actual conditions. The results of writing this thesis show that: the judicial process for examining perpetrators of repeat crimes of petty theft at the Pulau Punjung District Court has not been effective, especially in case Number: 8/Pid.C/2020/PN Plj which is still being processed using a quick examination process, where the process Rapid examinations can only be carried out in cases of minor criminal offenses which are not repetitions of criminal acts (recidivism), the examination process for repetitions of minor criminal acts should be carried out using ordinary and short examination procedures. The judge's obstacles in deciding the speedy examination process in this case were the lack of accuracy in handing over the case files at the time of registration where one of the defendants was a repeat criminal, as well as the lack of communication and coordination between law enforcement agencies, namely investigators and prosecutors.

Age differences in the prosecution of child abuse cases.

Evidence in child abuse cases can be scarce and is often centred around the child's testimony. However, child testimony varies with the child's development. Here, an overview of suspects, case decisions and court verdicts from a cohort of children is presented, stratified across children aged 0-3, 4-7, 8-11, and 12-15 years. Children seen at the Department of Forensic Medicine, Aarhus University, Denmark, in 2001-2013 were analysed, including all case files from the police, courts and healthcare services. A total of 647 cases were presented. The most frequent suspect was the child's parents. The police referred to the prosecutor in 69% of all cases, and 37% were tried in court. The lowest proportion of cases of tried cases was found among children aged 0-3 years (20%) and the highest among children aged 8-11 years (57%). Across ages, no corroborating evidence, the accused's refusal of guilt and no case to pursue (insufficient strong evidence) were the most frequent reasons for case closure. Cases relating to children aged 0-3 years were frequently dismissed because the fault could not be placed, whereas cases relating to children aged 12-15 were frequently rejected because of lacking evidence of compulsion (non-consent). Results show variations across ages regarding children tried in court and case dismissal. A dedicated child court may be considered to ensure equal access to justice. Questioning during the forensic examination and the use of psychologists may strengthen the available evidence. These materials have received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints made evident from the materials belong to the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund. Not relevant.

FP6.9 - Improving Compliance & Implementation of the STAR Score at a tertiary level hospital in India: A continuous process

Abstract Aim To perform an audit to check the Quality and compliance of Surgical documentation using STAR Score at a tertiary hospital in India. Method A total of 90 case files were studied and assessed in detail from all surgical departments. The “STAR: Surgical tool for auditing records” tool was used to collect data accordingly. The results were compared with standard guidelines and further analyzed. A series of departmental training and implementation meetings were carried out. Three cycles were carried out and a re-audit was performed at the end of every cycle. Result The overall compliance score of the hospital was found to be 74%. While the departments of General surgery and orthopaedics showed a higher rate of compliance, each constituting 82%, Neurosurgery showed the least compliance at 62%. It was also seen that the maximum percentage of missing information constituted anaesthetic records and subsequent entries. At the end of 3 cycles, a considerable improvement was observed, with the compliance rate improving to 98% in all departments. Conclusion We believe that compliance and implementation of the STAR Score is mandatory, as it can significantly improve the quality of documentation and can be implemented universally.

A multi-state evaluation of extreme risk protection orders: a research protocol

BackgroundExtreme Risk Protection Orders (ERPOs) are civil court orders that prohibit firearm purchase and possession when someone is behaving dangerously and is at risk of harming themselves and/or others. As of June 2024, ERPOs are available in 21 states and the District of Columbia to prevent firearm violence. This paper describes the design and protocol of a six-state study of ERPO use.MethodsThe six states included are California, Colorado, Connecticut, Florida, Maryland, and Washington. During the 3-year project period (2020–2023), ERPO case files were obtained through public records requests or through agreements with agencies with access to these data in each state. A team of over four dozen research assistants from seven institutions coded 6628 ERPO cases, abstracting 80 variables per case under domains related to respondent characteristics, events and behaviors leading to ERPO petitions, petitioner types, and court outcomes. Research assistants received didactic training through an online learning management system that included virtual training modules, quizzes, practice coding exercises, and two virtual synchronous sessions. A protocol for gaining strong interrater reliability was used. Research assistants also learned strategies for reducing the risk of experiencing secondary trauma through the coding process, identifying its occurrence, and obtaining help.DiscussionAddressing firearm violence in the U.S. is a priority. Understanding ERPO use in these six states can inform implementation planning and ERPO uptake, including promising opportunities to enhance safety and prevent firearm-related injuries and deaths. By publishing this protocol, we offer detailed insight into the methods underlying the papers published from these data, and the process of managing data abstraction from ERPO case files across the multi-state and multi-institution teams involved. Such information may also inform future analyses of this data, and future replication efforts.RegistrationThis protocol is registered on Open Science Framework (https://osf.io/kv4fc/).

Epidemiologic pattern and factors associated with adverse outcomes of diabetic ketoacidosis in medical intensive care units of a tertiary care centre in India

AimDiabetic ketoacidosis (DKA) is a dreadful complication of diabetes mellitus characterized by a biochemical triad of hyperglycemia, ketosis, and metabolic acidosis. The clinic-epidemiologic pattern and outcomes of DKA in the Indian subcontinent are largely unexplored, yet understanding them is crucial for optimizing management strategies. MethodsA total of 138 patients admitted with a DKA diagnosis were reviewed retrospectively over two years. Patient demographics, clinical history, laboratory findings, precipitating factors, and intensive care management were extracted from case files. Clinical outcomes were classified as either discharge or death. Data analysis was performed using SPSSv29. ResultsThe mean age of the patients was 41.54 (16) years; 77 (55.79 %) were female, 56.52 % had type 1, 23.19 % had type 2, and 20.29 % had pancreatic diabetes. Non-compliance with infection (21.02 %), and pancreatitis (21.01 %) were common DKA triggers. Severity was assessed by pH, anion gap, and bicarbonate levels. The overall mortality rate was 11.59 %. Factors significantly associated with mortality included age >60 years, >3 previous DKA episodes, hypokalaemia, elevated serum creatinine, and altered sensorium. ConclusionThese findings emphasize the importance of demographics and risk factors in assessing DKA mortality risk, aiding early identification and targeted interventions for high-risk patients.

Obstructed Labor at a Tertiary Hospital in Nigeria: A Six-Year Review

Introduction: Unlike most developed countries, obstructed labor with a dead fetus is still a reality in many developing countries, and it is a well-known cause of maternal and perinatal morbidity and mortality. Objective: To highlight the characteristics of patients presenting with obstructed labor at a tertiary hospital and determine fetomaternal outcomes. Methodology: A retrospective descriptive study of 45 cases of obstructed labor that were managed in a tertiary hospital from January 2009 to December 2014. Relevant information was extracted from patients’ case files, and the data obtained were analyzed. Results: Obstructed labor constituted 0.75% of all deliveries. All patients were referred in, and thirty (2/3) of them were nulliparous, while 25 (55.6%) were between the ages of 16 and 25. Forty-one (91.1%) of the patients were delivered by emergency caesarean section, while four patients had exploratory laparotomy with uterine repair and bilateral tubal ligation. Thirty-eight (84.5%) of the babies weighed between 2.6-4kg and five (11.1%) weighed more than 4kg. Most of the patients, 91.1%, had prolonged hospital stay with 25% staying over 3 weeks postpartum before being discharged. Eight (17.8%) suffered severe birth asphyxia, and there were five perinatal and two maternal mortalities. The commonest complication was puerperal sepsis. Conclusion: The study showed obstructed labor remains a cause of perinatal and maternal morbidity and mortality. Effective use of partographs in the peripheral centers, where all the women came from, would ensure early referral before labor became obstructed.

Ectopic Pregnancy at a Tertiary Hospital in Nigeria: A Six-Year Review

Introduction: Ectopic pregnancies, though a disease of vagaries, its diagnosis remains essentially clinical; hence, a review of sociodemographic characteristics, risk factors, and clinical features will help determine the pattern of presentation. Objective: To highlight the characteristics that best predict ectopic pregnancy. Methodology: A retrospective descriptive analysis of 128 cases of ectopic pregnancy that were managed in a tertiary hospital from January 2009 to December 2014. Relevant information was extracted from patients’ case files, and the data obtained were analyzed. Results: Ectopic pregnancies constituted 4% of all gynecological admissions and 2.1% of all pregnancies occurring commonly in the age group 25–29 years. The commonest clinical presentations were lower abdominal pain (94.5%), amenorrhea (64%), and vaginal bleeding (53.9%). The majority (44.5%) of the women had a history of previous induced abortions. Sixty-nine patients had their diagnosis made clinically, and there was no maternal mortality. Conclusion: Lower abdominal pain in the presence of amenorrhea is a good predictor of ectopic pregnancy. Other symptoms that might be helpful in diagnosing ectopic pregnancy are a previous history of induced abortion and vaginal bleeding. This, however, needs further research.

A Vision for Digitizing Judicial Processes and Integrating Artificial Intelligence in Pakistan’s Judiciary: Enhancing Efficiency and Upholding Judicial Integrity

The judiciary, as the cornerstone of justice and the rule of law, is at a pivotal juncture to harness the transformative power of digital technology and artificial intelligence (AI) to enhance its operations. This essay outlines a comprehensive approach for digitizing judicial processes in Pakistan, incorporating AI integration by drawing parallels with successful international model. The focus is on the need for systemic change to ensure efficiency, transparency, and accessibility in the legal system. Current challenges include a lack of proper implementation of the rule of law, prolonged trials, and low public confidence. Traditional methods of case filing are manual and paper-based, leading to inefficiencies. The essay proposes a step-by-step transformation starting from e-filing to the digitization of the entire lifecycle of a case, aiming to modernize Pakistan’s judiciary. AI can aid in legal research, evidence standards, and sentencing, offering predictive capabilities and streamlining routine case management. Ethical considerations and the need for human judicial discretion are emphasized to balance AI’s assistance with maintaining judicial integrity and fairness. This digital transformation can restore public trust and efficiency in Pakistan’s judiciary, paving the way for a modern, digital legal system. Keywords: Technological Integration in Courts, Predictive Analytics in Law, Transparency in Judicial Processes, Judicial Modernization, Artificial Intelligence in Judiciary, Digital transformation, AI and Legal Ethics, Case Management Systems, E-Filing, Legal Tech Innovation, AI in Legal Research, Efficiency in Judiciary, AI and Evidence Standards, AI in Sentencing, Legal Information Systems

Suspect race affects defense attorney evaluations of preidentification evidence.

When an officer places a suspect in an identification procedure and the witness identifies the suspect, it falls on attorneys to make decisions that reflect the strength of that identification. The factor that most affects the strength of identification evidence is the likelihood that the suspect is guilty before being subjected to the procedure, which scholars refer to as the prior probability of guilt. Given large racial disparities in exonerations based on eyewitness misidentifications, the current work examined whether defense attorneys are less sensitive to prior evidence of guilt when the defendant is Black as opposed to White. We predicted that when the defendant's race was described as White rather than Black, attorneys' judgments would be more sensitive to variations in the evidence that would influence the base rate of guilt. We also predicted that attorneys would rate the case as stronger when the victim's race was described as White rather than Black. We gave 316 defense attorneys case files (modeled after the New York Police Department's style) that varied the strength of the preidentification evidence (strong vs. weak), the race of the defendant (Black vs. White), and the race of the victim (Black vs. White). Attorneys made judgments that were sensitive to the base rate of guilt, but self-report measures demonstrated that they did not understand the extent to which the base rate of guilt influences the reliability of eyewitness evidence. Participants also rated the strength of the preidentification evidence as stronger for Black than for White defendants. Although attorneys are intuitively sensitive to the strength of preidentification evidence, they lack conscious awareness of how a suspect's prior probability of guilt affects likelihood of a mistaken identification, which may have implications for their ability to make race-neutral evaluations of preidentification evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The treatment and diagnostic plan for chronic myeloid leukemia in Libyan oncology centers

Background: CML is one of the best understood diseases from the aspect of its cytogenetic abnormalities and the molecular mechanisms involved. CML was the first human disease in which a specific abnormality of the karyotype, the Philadelphia (Ph) chromosome, could be linked to a malignant disease. Later on, it was shown that the Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, which produces the BCR-ABL fusion oncogene. Accordingly, in this study; we are going to determine whether the team workers in Libyan oncology centers actually following these steps of guidelines as it has been used internationally or there are some differences and special circumstances prevent them to apply the guidelines. Objectives: The present study aimed to explore the methods and plans used for diagnosis and treatment of CML patients in Libyan oncology centres and to confirm the most effective methods in diagnosis and treatment of CML by using a statistical analysing of some special data related to a well investigated cases by making a comparison between those plans. Methods: 173 and 153 CML patient files who has registered in Sabratha oncology institute and Misurata oncology institute -which are both considered as the main oncology centers in Libya- during the last sixteen years were investigated. Then, ten CML case files have randomly chosen from total CML patient files (51) and (78) cases from both oncology institutes which represents (35% and 45%) of all cases respectively (Male and Female, five from each institute). All results of laboratory investigations (CBC, biochemistry profiles, blood film, bone marrow, cytogenetic and molecular analysis) have been recorded and statistically analyzed to know the hematological, cytogenetic and molecular responses during the treatment period. CML patients chosen were at varying disease stages (chronic, accelerated, and blastic phases). The drugs used for treatment included 500 mg of Hydroxyurea, 400 mg, 600 mg and 800 mg of Glivec, and 600 mg of Tasigna in rare cases. Results and conclusion: The study has indicated the existence of a clear deficiency gap represented in a widespread lack of many capabilities such as the lack of some devices, equipments, operating materials and qualified experts. Moreover, the study has confirmed that the treatment plan has modified depending on the results of the complete blood count (CBC) only during all periods of the treatment without achieving other important investigation used for treatment follow up such as bone marrow aspiration, blood film examination, cytogenetic examination and molecular diagnostic. This study-as the first study dealing with this important topic- clarified many shortcomings of the diagnostic and treatment plan followed in both oncology institutes. As a recommendation, it is necessary to apply all international standard steps of the diagnosis and treatment in particular.

Adoption Archives: Documents, Subjecthood, and the Possibility of Justice

This essay turns to adoption archives as a key site for imagining justice in both law and literature, taking South Korea’s history of transnational adoption as its focus. Adoptees are made through documents: case files, consent forms, advertisements and brochures, applications, home studies, and certificates that render them into adoptable subjects. On the one hand, these archives hold the promise of recovery, containing information needed to contextualize oneself and find one’s first families. Yet these documents also pose interpretive difficulties through their opacities, omissions, and fabrications, not to mention their lack of access. This essay proposes that efforts towards justice for Korean adoptees must proceed from a robust understanding of adoption archives: a knowledge that involves the complicated legal, ethical, and interpretive problems that surround these documents, as well as the difficult affective and intellectual relationships adoptees have with institutional record-holders as well as with the documents themselves. As a step towards this fuller reckoning, this essay provides a description and theorization of adoption archives in relation to foundational and recent developments in archive theory. It then outlines the legal histories and frameworks surrounding Korean adoption archives as they exist today, while also attending to the practical experiences of adoptees in accessing their records. Finally, it turns to recent literary works on Korean adoption that center adoption documents, exploring how literature provides a productive space for exploring the complexity of the archive. Ultimately, the essay proposes that archives matter not just as a source of violence or recovery, or as an unrecoverable origin, but rather through their representational forms and their implications for the adoption imagination.

Reliability of Continuous Noninvasive Hemoglobin Monitoring in Healthy Participants During En Route Care Training.

Current standards for hemoglobin monitoring during air transports of U.S. combat wounded are invasive and intermittent. Fielded pulse co-oximeters can noninvasively measure total hemoglobin, but this parameter is not currently utilized. The primary objective of this study was to assess the percentage of vital sign measurements with successful capture of total noninvasive hemoglobin measurement using spectrophotometry-based technology for Hb (SpHb) measurements in healthy participants during training flights. Secondary objectives were to assess the feasibility of a novel electronic data capture mechanism from usual patient movement items and perform a pilot analysis of SpHb changes in healthy participants during transitions from ground to air transport. We conducted a feasibility study enrolling healthy participants who had hemodynamic monitoring during usual U.S. Air Force Critical Care Air Transport (CCAT) flight training exercises from 2022 to 2023. Usual CCAT monitoring equipment and currently used Masimo Rainbow® pulse co-oximeters had the capability to measure SpHb. After each training exercise, the study team wirelessly downloaded case files from patient monitors utilizing the Battlefield Assisted Trauma Distributed Observation Kit (BATDOKTM) Case Downloader application. We then calculated point and precision estimates for the percentage of time for successful SpHb capture during the exercise and compared this to pulse oximetry (SpO2) capture. An a priori precision analysis for percentage of flight-time with successful SpHb data capture and descriptive statistics were performed. This study received Exempt Determination by the 59th Medical Wing IRB. We analyzed 26 records with mean monitoring durations of 94.5 [59.3-119.9] minutes during ground phases and 78.0 [59.9-106.5] minutes during flight phases. SpHb measures were successfully captured for 97.7% (n = 4,620) of possible ground measurements and 97.2% (n = 3,973) of possible in-flight measurements compared to 99.5% ground and 98.2% in-flight capture for SpO2. Mean intervals of missing SpHb data were 2 ± 5 minutes on the ground and 4 ± 6 minutes in-flight. Mean SpHb increased by 0.93 ± 0.96 g/dL during the ground phase, but had minimal changes during ascent, cruising altitude or descent. The BATDOKTM Case downloader completed transfer for all files. Masimo Rainbow® SpHb pulse co-oximeters reliably captured continuous, noninvasive hemoglobin measurements using usual CCAT patient movement items in healthy participants during both ground and flight training. The BATDOKTM Case Downloader successfully imported case files from CCAT patient monitors. Mean SpHb measures had a small increase during the ground phase of monitoring followed by minimal changes when transitioning to flight altitude.

“Defendendo a paz social”: entre a naturalização e o racismo em decisões de decretação de prisão preventiva.

This study aimed to analyze the arguments mobilized by judges to justify the issuance of preventive detention orders and to observe the existence of a relationship between these arguments and class and race factors. The methodology used was the documentary analysis of interlocutory decisions converting flagrant arrests into preventive detentions, referring to charges of theft and robbery that occurred between 2015 and 2018 in the metropolitan region of Salvador, Brazil. A total of 322 interlocutory decisions to decree preventive detention were analyzed, retrieved from the case files of Salvador Prison/BA, a unit for temporary detainees. At the end of the research, it was concluded that, among the justifications in force in Article 312 of the Code of Criminal Procedure, 100% of the decisions analyzed were based on the category of guaranteeing public order, understood as social harmony offended by the dangerousness of the prisoner. This dangerousness is expressed by the concepts of criminal recidivism and modus operandi. It was also concluded that these arguments reproduce class and race stereotypes, since they use mechanisms to naturalize the group most affected by the net of the criminal justice system (young black men), depriving them of the enjoyment of citizenship and protection of fundamental rights.

Clinical audit of cases and outcomes of patients admitted to the intensive care unit at Kamuzu Central Hospital, Lilongwe, Malawi

In 2016, a new, improved and modern intensive care unit was constructed at Kamuzu Central Hospital in Lilongwe, Malawi. Having been operational for about 4 years, there has not been a systematic audit to gauge its performance. Therefore, this quantitative retrospective cohort study aimed at investigating the performance of the intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi. We analysed the patterns of admission through 250 clinical cases and their respective outcomes spanning from 1st January 2019 to 31st December 2019 using STATA. Descriptive and inferential statistics were computed. We also had a follow-up discussion with the Head of the unit to better understand the unit’s functioning. Out of the 250 admissions, we evaluated 249 case files. About 30.8% of all patients were referred from the main operating theatre, and 20.7% from the casualty (emergency medicine). Head injury (26.7%) and peritonitis (15.7%) were the commonest causes of admission. The overall mortality was 52.2% with more females (57.5%) dying than males (47.9%). Head injury and peritonitis had the highest contribution to the mortality accounting for 25.3% and 16.9% of all deaths respectively. In conclusion, despite the new unit registering an improved performance compared to the old unit’s 2012 mortality of 60.9%, the current mortality rate of 52.2% generally reflects a suboptimal performance. The intensive care unit is still grappling with a number of challenges that need immediate attention including few working beds, shortage of critical care specialists and nursing staff and lack of standard admission criteria.

The Implementation of Information Technology within the Supreme Court of the Republic of Indonesia to Facilitate the Handling of Case Files

A case settlement between the party who is the victim and the party who is the perpetrator is known as case dispute resolution. The process of resolving a case can take one of two forms: through litigation (in the court) or non-litigation (outside of court). Using methods from a literature review, the purpose of this study is to examine how digital justice is affected by technology and innovation in law enforcement. The application of information technology to increase the effectiveness and efficiency of time in handling case files, particularly at the Supreme Court of the Republic of Indonesia, has changed the way law enforcement operates in the ever-growing digital era. These technological developments include big data analysis, artificial intelligence, and digital forensic technology. Indonesia. This study's problem formulation is as follows: 1) How are cases resolved in court? 2) How are efforts to speed up the resolution of cases in court according to PERMA Number 4 of 2020 concerning Electronic Administration and Trial of Criminal Cases in Court? Legal behavioral products, such as reviewing laws, are used in normative case studies in normative legal research methods (normative law study). The issuance of PERMA Number 4 in 2020 will accelerate the resolution of cases in court through administrative procedures and electronic broadcasting. This could increase the effectiveness and efficiency of broadcasting principles and reduce the broadcasting of cases in court, particularly given the existence of PERMA Number 1 in 2019.