Catastrophic Condition Research Articles

Health and environmental impacts of Gaza conflict (2023-2024): A review

The war in Gaza, which erupted on October 7, 2023, unleashed unprecedented assaults from the air, sea, and land, affecting the densely populated area of 360 square kilometers housing 2.3 million people. The conflict claimed over 36 000 Palestinian lives, with women and children making up 70% of the casualties, and resulted in more than 80 000 injuries. The devastation was extensive, with over 70% of homes destroyed, along with six universities, numerous hospitals, communication networks, sewage systems, water desalination plants, roads, wells, and other essential infrastructure. Over a million people were displaced from the northern regions to the southern coastal area of Al-Mawasi, which constitutes less than 3% of Gaza's total area, facing dire shortages of water, healthcare, food, and medicine. The collapse of sewage networks and garbage accumulation led to an increase in flies, mosquitoes, insects, and rodents, contributing to the spread of infectious and non-communicable diseases among the displaced population. This research aimed to study the health and environmental impacts of the war in Gaza through data collection, field visits, and photographic documentation. The findings revealed catastrophic conditions, with the destruction of all infrastructure, including buildings, hospitals, universities, mosques, churches, sanitation, water networks, and communications, and the spread of diseases such as intestinal, respiratory infections, and skin infections due to the complete lack of basic life necessities.

A STUDY OF OBSTETRIC HYSTERECTOMY OVER A PERIOD OF 5 YEARS AT CUSMCH

Objectives: The study aimed (1) to determine the indication of obstetric hysterectomy and (2) to determine the fetomaternal outcome. Methods: This is a hospital-based retrospective study carried out in the Department of Obstetrics and Gynecology, C.U.Shah Medical College and Hospital from January 2018 to December 2020. Results: Out of 8881 deliveries during our study period, there were a total of 20 patients who underwent an obstetric hysterectomy, the incidence being 0.2%. Nine cases out of 6871 vaginal deliveries and 11 cases out of 2510 cesarean deliveries required an obstetric hysterectomy. Maximum patients, seven out of 20 were between 31 and 35 years age group followed by six patients between 36 and 40 years and five patients above 41 years. Only two patients were below 30 years of age. Most of the cases (70%) belonged to the lower middle class and 30% were from the upper middle class. About 60% were registered antenatal care (ANC) cases while 40% never visited any health-care facility. Out of 20 patients who underwent an obstetric hysterectomy, 18 patients (90%) were referred from another center while only 2 patients (10%) were admitted at our center. Eleven patients that are 55% delivered outside the institute among which three patients were home delivered by unskilled birth attendants. Nine patients were delivered at our center and among these sseven patients were referred from adjoining primary health-care centers, community health-care centers, and other private hospitals. Our institute being a tertiary hospital, maximum high-risk and complicated deliveries were referred. Conclusion: Obstetric hysterectomy is an unwanted but necessary emergency in obstetrics. It is a life-saving procedure in many catastrophic conditions, although it curtails the future. Good ANC, identification of risk factors, timely referral, and intervention at a well-equipped hospital can reduce obstetric hysterectomies. With the increasing incidence of cesarean deliveries and morbidly adherent placenta, the need for obstetric hysterectomy is increasing. With the improvement of modern obstetrics and modern modalities for the treatment of postpartum hemorrhage and adherent placenta, there is a reduction in the number of obstetric hysterectomies.

MONITORING THE GEODYNAMICS OF NATURAL AND MAN-MADE RISKS OF ALMATY

The purpose of the article is to solve the problems of drawing up a map, its presentation, processing, analysis in order to comprehensively assess the regional system of natural and artificial threats of the Almaty region. By solving these problems, you can consider ways to easily resolve the upcoming conflicts and problems. It can be prevented by making predictions about natural and man-made problems. The root of natural and man-made catastrophic conditions of Almaty region are natural disasters characteristic of mountainous regions. We will take into account the conditions of seasonal mudslides and earthquakes. Since Almaty region is a region located in a mountainous zone, there are a lot of earthquake foci. Tectonic movements often occur. In order to prevent major natural disasters, it is necessary to carry out special monitoring work. From this point of view, the compilation of Geodynamic maps, the study of the Earth’s crust, the identification and differentiation of earthquake foci come to the rescue. With this, major disasters can be prevented. The article compiled a map of natural and man-made conditions of the Almaty region. In the process of creating a map, using GIS data, we created a map in the ArcGIS application. We received data from the GIS through a special platform, processing space surveys using a program. We received the data on the basis of SRTM space survey. By studying the dynamics of changes for each year, by comparing maps, you can make conclusive forecasts. Collecting data through free platforms helps to create rational solutions. It is possible to monitor, update,store,and edit the database of information using maps. In the article, a complete study of the region’s region was carried out, the importance was given to the rational, effective use of GIS data.

Recent achievements in nonlinear dynamics, synchronization, and networks.

This Focus Issue covers recent developments in the broad areas of nonlinear dynamics, synchronization, and emergent behavior in dynamical networks. It targets current progress on issues such as time series analysis and data-driven modeling from real data such as climate, brain, and social dynamics. Predicting and detecting early warning signals of extreme climate conditions, epileptic seizures, or other catastrophic conditions are the primary tasks from real or experimental data. Exploring machine-based learning from real data for the purpose of modeling and prediction is an emerging area. Application of the evolutionary game theory in biological systems (eco-evolutionary game theory) is a developing direction for future research for the purpose of understanding the interactions between species. Recent progress of research on bifurcations, time series analysis, control, and time-delay systems is also discussed.

Anatomical Feasibility of Endobentall Strategies for Management of Acute type A Aortic Dissection.

This study assesses the feasibility of acute type A dissections treatment with a dedicated aortic root endograft concept and introduces a new aortic classification. Acute type A aortic dissection (ATAAD) remains a catastrophic aortic condition with perioperative mortality ranging from 12% and 20%. Total Aortic root endovascular repair, "Endobentall concept", has been explored as an alternative but only documented on case report. Imaging study of all consecutive patients treated in three French centers were achieved. The study introduces an adapted aortic classification to report entry tear locations. Measurements included aortic annulus mensuration, coronary height, and several aortic lengths. Two treatment concepts were described "fenestrated Endobentall" and "branched Endobentall". Patients were eligible to the "fenestrated endobentall" design if their aortic root dimensions fitted the Edwards Sapien® and Corevalve Medtronic® instruction for use. Eligibility for the "branched Endobentall" required meeting the criteria for a "fenestrated Endobentall" and having a left coronary main stem length exceeding 5mm. "Branched Endobentall" was mandatory when the entry was located in the aortic root. A total of 250 CT scans for acute type A aortic dissection were reviewed, 116 were finally included for analysis. The primary entry tear was found in the aortic root in 9% of patients, and in 31% of cases, it was located within the first centimeter distal to the sinotubular junction (STJ). 63.7% of the patients were eligible for an Endobentall procedure, even 73.3% when considering extended criterion. Fenestrated Endobentall accounted for 2/3 of cases. In our study, 63.7% of patients with aortic type A dissections are deemed eligible to an "Endobentall repair", increasing to 73.3% when considering extended anatomical criteria.

Innovative Strategies in 3D Bioprinting for Spinal Cord Injury Repair.

Spinal cord injury (SCI) is a catastrophic condition that disrupts neurons within the spinal cord, leading to severe motor and sensory deficits. While current treatments can alleviate pain, they do not promote neural regeneration or functional recovery. Three-dimensional (3D) bioprinting offers promising solutions for SCI repair by enabling the creation of complex neural tissue constructs. This review provides a comprehensive overview of 3D bioprinting techniques, bioinks, and stem cell applications in SCI repair. Additionally, it highlights recent advancements in 3D bioprinted scaffolds, including the integration of conductive materials, the incorporation of bioactive molecules like neurotrophic factors, drugs, and exosomes, and the design of innovative structures such as multi-channel and axial scaffolds. These innovative strategies in 3D bioprinting can offer a comprehensive approach to optimizing the spinal cord microenvironment, advancing SCI repair. This review highlights a comprehensive understanding of the current state of 3D bioprinting in SCI repair, offering insights into future directions in the field of regenerative medicine.

Hershini Bhana Young. Falling, Floating, Flickering: Disability and Differential Movement in African Diasporic Performance

Young’s Falling, Floating, Flickering investigates aesthetic archives and repertoires of Black differential movement. Examining how bodies “fall, crawl, float, and spasm” (13) to form communities and aesthetic “condition[s] of possibility” amid catastrophic conditions (11), Young centres the Global South and the world-making of Black conjoined flesh in critical disability studies.

Comprehensive evaluation of Chinese herbal compound prescriptions for postoperative spinal cord injury: A network meta-analysis of randomized controlled trials

BackgroundSpinal cord injury (SCI) is a catastrophic condition associated with spinal nerve damage, which can lead to complete or partial loss of sensory and motor functions. Chinese herbal compound prescriptions (CHCP) have shown varying degrees of therapeutic effects on spinal cord injuries. However, there is a significant lack of clinical evidence-based research to substantiate these effects. PurposeThis study aims to thoroughly assess the viability of CHCPs in postoperative SCI through network meta-analysis. MethodsComputer searches were conducted across multiple databases, including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM, from their inception until May 2024. The meta-analysis adhered to the PRISMA guidelines and was registered in the PROSPERO database (CRD42023462686). A network meta-analysis was performed using the BUGSnet software package via R. Study design: A network meta-analysis of randomized clinical trials (RCTs). ResultsA total of 26 RCTs involving 1848 patients were ultimately included. The network meta-analysis revealed the effectiveness in improving ASIA motor score as follows: “HQGZD” > “Other Decoctions” > “BYHWD” > “TDHXD” > “THCQD” > “Surgery”. For ASIA sensory score, the effectiveness ranking was: “HQGZD” > “Other Decoctions” > “BYHWD” > “TDHXD” > “THCQD” > “Surgery”. Additionally, the experimental group had a higher ADL score compared to the control group, with a statistically difference [SMD = 1.08, 95 % CI = (0.88, 1.27), p < 0.05]. The experimental group had fewer adverse events compared to the control group, with a statistically difference [RR = 0.41, 95 % CI (0.22, 0.78), p < 0.05]. ConclusionThe findings suggest that CHCP can mprove postoperative ASIA motor and sensory scores, enhance ADL scores, and reduce adverse events following SCI surgery. Specifically, combining surgery with Huangqi Guizhi Wuwu Decoction or Buyang Huanwu Decoction may provide superior therapeutic effects in SCI treatment. Integrating CHCP into postoperative care for SCI patients may offer potential benefits.

Carboxymethyl cellulose/quaternized chitosan hydrogel loaded with polydopamine nanoparticles promotes spinal cord injury recovery by anti-ferroptosis and M1/M2 polarization modulation

Spinal cord injury (SCI) represents a catastrophic neurological condition resulting in long-term loss of motor, autonomic, and sensory functions. Recently, ferroptosis, an iron-regulated form of cell death distinct from apoptosis, has emerged as a potential therapeutic target for SCI. In this study, we developed an injectable hydrogel composed of carboxymethyl cellulose (CMC), and quaternized chitosan (QCS), loaded with modified polydopamine nanoparticles (PDA NPs), referred to as CQP hydrogel. This hydrogel effectively scavenged reactive oxygen species (ROS), prevented the accumulation of Fe2+ and lipid peroxidation associated with ferroptosis, and restored mitochondrial functions in primary neuronal cells. When administered to animal models (rats) with SCI, the CQP hydrogels improved motor function by regulating iron homeostasis, inhibiting ferroptosis, and mitigating oxidative stress injury. Both in vitro and in vivo studies corroborated the capacity of CQP hydrogels to promote the shift from M1 to M2 polarization of microglia/macrophages. These findings suggest that CQP hydrogels, functioning as a localized iron-chelating system, have potential as biomaterials to enhance recovery from SCI by targeting ferroptosis and modulating anti-inflammatory macrophages activity.

Patient Safety Incidents in Operating Rooms Reported in the Past Five Years (2017-2021) in Korea.

Patient safety incidents in the operating room require special attention because they can cause catastrophic and irreversible conditions in patients. Although patient safety incidents have different characteristics, there may be similarities and patterns of risk factors that may be common. Therefore, this study analyzed factors associated with the PSIs by analyzing data from the Korean Patient Safety Reports from 2017 to 2019. The "Patient Safety Incidents Data from 2017 to 2021" systematically collected by the Korea Institute for Healthcare Accreditation, include patient safety incident reports from medical institutions. Data on 1140 patient safety incidents in the operating room were analyzed. They included patients' gender and age, Hospital size, Incident seasons, incident time, Incident reporter, incident type, Medical department, and Incident severity. The Incident severity was analyzed by dividing it into three stages: near miss, adverse event, sentinel event, which are applied by domestic medical institutions. The highest number of OR patient safety incidents were related to surgery and anesthesia. On analyzing the probability of adverse events based on near misses, the significant variables were patient gender, incident reporter, incident type, and Medical department. Additionally, the factors that were likely to precipitate sentinel events based on near misses were patient gender, incident time, reporter, and incident type. To prevent sentinel events in Patient safety incidents, female and during night shifts are required to pay close attention. Moreover, it is necessary to establish a patient safety reporting system in which not only all medical personnel, but also patients, generally, can actively participate in patient safety activities.

Transcutaneous auricular vagal nerve stimulation for consciousness recovery in patients with prolonged disorders of consciousness (TAVREC): study protocol for a multicenter, triple-blind, randomized controlled trial in China

IntroductionProlonged disorders of consciousness (pDoC) are a catastrophic condition following brain injury with few therapeutic options. Transcutaneous auricular vagal nerve stimulation (taVNS), a safe, non-invasive intervention modulating thalamo-cortical connectivity and...

Air in the portal vein: Not so dangerous in certain situations. A case report of portal vein air due to cow milk allergy

Background: Air in the portal vein in ultrasound reports is worrisome for the clinician as it might indicate bowel wall disintegration. However, with the advent of ultrasound technology, detection of subtle findings became possible and more benign causes of the portal vein are encountered in the clinical practice. Case: A benign case was presented in this report. The patient was an example of mucosal integrity disruption due to cow milk allergy. Conclusion: Although portal vein air is traditionally an ominous sign and should alert the clinician about catastrophic conditions, the clinician should also be aware of more benign etiologies.before taking radical actions.

Seepage-induced passive earth pressure modification of retaining structures considering composite failure surface

Waterfront and submarine retaining structures are normally exposed to catastrophic seepage conditions under the effect of tidal and occasionally heavy rainfall effect, resulting in a decreased passive earth thrust and thus the higher risk of instability of retaining structures. To examine the effect of seepage flow on the magnitude and distribution of passive earth thrust, this paper assumes a composite curved-planar failure surface and presents a modified method of passive earth pressure considering the seepage flow effect. The flow field and pore pressure are firstly solved by the two-dimensional (2D) Laplace equation using the Fourier series expansion. The effective reaction force acting on the composite failure surface is then obtained using a modified Kötter equation. Compared to conventional methods based on limit equilibrium, the present method facilitates a straightforward assessment of both the magnitude and distribution of passive earth thrust without the prior assumption of the application point. The outcomes highlight that the passive earth thrust decreases with the ratios of permeability coefficients. The greater effective friction angle and a smaller ratio of permeability coefficients result in the lower application point of the passive earth thrust.

Extravehicular activity on the lunar surface: Mapping mitigation risk consequence for crew needing assistance or rescue

The lunar environment presents unique challenges for human health and safety over the course of performing Extravehicular Activities (EVAs) during early Artemis missions. Medical conditions leading to an injured EVA crewmember needing assistance or rescue were analysed and correlated to established, defined consequence categories. Catastrophic conditions were identified, and three mitigation strategies were analysed to determine if there was a potential change in consequence with their application. Risk consequence across the mitigations were compared with each other and the original risk without mitigations. Mitigations were further evaluated in a broader context with prospective preventions to understand the design and risk trade space associated with an early Artemis EVA.

Divinizing Nature for Sustainable Global Growth: The Indian Perspective

The recent catastrophic climate conditions and the spate of wildfires, floods, cyclones, etc. on an unparalleled scale sweeping most parts of the globe has sent mankind in a tizzy. Despite numerous summits and conferences of world leaders and the action plans continue to make headlines even though the real effect on the ground seems suspect. Faultlines flagged include the seemingly unsustainable global market economy, high-level consumerism, widespread deforestation, emissions from ever-burgeoning number of automobiles and fossil-fuel fed industries, use of chemicals, building of big dams, etc. While all this is true, the real change has to come about in human attitude to nature. From the urge to exploit nature, it has to be of an interdependence based on respect for the natural elements and creatures because these maintain balance and provide congenial environment for life. My paper analyses the situation and concludes that for this to happen, we need to involve heart and soul as much as the mind. Our native cultures existing since ages and finding expression in ancient as also contemporary literatures provide an answer to tackle the fearsome scenario facing us, and this is to treat nature not just as a living being, but rather a divine being.

Pediatric acute liver failure: Current perspective in etiology and management.

Pediatric acute liver failure (PALF) is a catastrophic clinical condition with very high morbidity and mortality without early detection and intervention. It is characterized by the acute onset of massive hepatocellular injury that releases circulating inflammatory mediators, resulting in metabolic disturbances, coagulopathy, hepatic encephalopathy and multi-organ failure. The etiological spectrum is dominated by hepatotropic viruses, drug-induced liver injury, metabolic and genetic disorders and immune-mediated diseases. Unlike adults, indeterminate causes for acute liver failure constitute a considerable proportion of cases of acute liver failure in childrenin the west. The heterogeneity of age and etiology in PALF has led to difficulties in developing prognostic scoring. The recent guidelines emphasize prompt identification of PALF, age-appropriate evaluation for hepatic encephalopathy and laboratory evaluation with careful monitoring. Current therapy focuses on supporting the failing liver and other organs, pending either spontaneous recovery or liver transplantation. Targeted therapy is available for a select group of etiologies. Liver transplantation can be lifesaving and a plan for the same should beorganized, whenever indicated. The aim of this review is to define PALF, understand its etiopathogenesis, address the challenges encountered during the management and update the latest advances in liver transplantation and non-transplant treatment options in PALF.

Discrete element analysis on impact failure mechanism of “Zhengzhou 7.20” catastrophic flood for coal gangue railway subgrade

Limited research has been conducted on the failure mechanism of coal gangue railway subgrade structures during catastrophic flood disasters, including the impact of varying flood impact heights and load sizes. This study investigates the process and mechanism of coal gangue railway subgrade failure in the coal mining subsidence area, in conjunction with the “7.20” catastrophic flood in Zhengzhou. First, various factors such as impact forms, impact height, flow velocity, water depth, and wave height are considered, and a wave-water flow coupling calculation method is proposed to determine the catastrophic flood load acting on inclined slopes. The maximum impact load calculated is then applied to simulate the impact process of the catastrophic flood using Particle Flow Code 2D. As the flood-related parameters increase, the maximum impact load on the subgrade slope also increases, leading to the breakdown of the subgrade and causing fatal damage. Finally, the failure process of the coal gangue railway subgrade under the impact and scour of a catastrophic flood is divided into three stages: erosion weakening, potential failure surface formation, and overall failure. The main failure mechanisms of each stage are revealed. These research result findings offer valuable insights for the design of railway subgrade reinforcement under catastrophic flood conditions.

Successful pregnancy outcome via in-vitro fertilization and laparoscopic resection of non-communicating rudimentary horn pregnancy containing early pregnancy: a case report

BackgroundNon-communicating rudimentary horn pregnancy (NCRHP) lead to life-threatening condition for both mother and fetus. Early diagnosis of NCRHP and laparoscopic resection is important to prevent catastrophic conditions. However, delayed diagnosis until the second or third trimester makes it difficult to accurately diagnose between NCRHP and bicornuate uterine pregnancy, as both conditions present uterine rupture and massive hemoperitoneum. Furthermore, these rare cases are challenging in pregnancy trials and associated with adverse outcomes in subsequent pregnancies.Case presentationA 31-year-old gravida 1 para 0 Korean woman visited our infertility center with a confirmed positive urine pregnancy test after timed intercourse. Before she was scheduled to have timed intercourse, a unicornuate uterus with a non-communicating right uterine horn was suspected based on an ultrasound scan and hysterosalpingography during the initial infertility workup. A gestational sac was observed in the right non-communicating rudimentary horn at 5 weeks of gestation. Serum beta-human chorionic gonadotropin (b-hCG) level was 2052.0mIU/mL. An elective laparoscopic resection of the right rudimentary horn containing a gestational sac, along with ipsilateral salpingectomy, was performed with no adverse event. After 3-month of recovery period and three cycles of conceptional trials involving timed intercourse and intrauterine insemination, in-vitro fertilization (IVF) was performed using the antagonist protocol, and successful pregnancy was confirmed. The patient had been hospitalized from 21 + 6 weeks to 35 + 6 weeks of gestation, underwent cerclage placement and tocolytics with corticosteroid treatment. She delivered an early-term male baby by cesarean section.ConclusionIn this rare case, the successful pregnancy achieved through IVF following the appropriate management of NCRHP under laparoscopy underscores the critical importance of early diagnosis and intervention in cases of NCRHP. Timely identification and management of NCRHP are vital to prevent the occurrence of catastrophic conditions and to enhance the prognosis of a successful pregnancy through assisted reproductive technology (ART). Therefore, a high index of suspicion for NCRHP is important and employs a range of diagnostic modalities.

Acute limb ischemia due to left brachial artery occlusion in a 40-year-old female patient: a case report

Acute upper limb ischemia (ALI) due to brachial artery occlusion is a rare but catastrophic condition that poses a significant threat to limb viability and can result in limb amputation or death. Accurate diagnosis and timely intervention are crucial to avoid catastrophic consequences. Literature on ALI due to brachial artery occlusion is scant and usually related to atrial fibrillation. We report a 40-year-old female presented with sudden onset left upper limb pain, change in color, and neurological deficits in the last three days. A color Doppler ultrasound revealed a complete occlusion of the left brachial artery with echogenic thrombosis suggestive of ALI. The patient urgently underwent a thrombectomy with an uneventful outcome. In conclusion, even though ALI due to brachial artery occlusion is rare, a heightened level of suspicion, precise diagnosis, and timely management are essential to prevent any fatal consequences.

MONITORING THE GEODYNAMICS OF NATURAL AND MAN-MADE RISKS OF ALMATY

The purpose of the article is to solve the problems of drawing up a map, its presentation, processing, analysis in order to comprehensively assess the regional system of natural and artificial threats of the Almaty region. By solving these problems, you can consider ways to easily resolve the upcoming conflicts and problems. It can be prevented by making predictions about natural and man-made problems. The root of natural and man-made catastrophic conditions of Almaty region are natural disasters characteristic of mountainous regions. We will take into account the conditions of seasonal mudslides and earthquakes. Since Almaty region is a region located in a mountainous zone, there are a lot of earthquake foci. Tectonic movements often occur. In order to prevent major natural disasters, it is necessary to carry out special monitoring work. From this point of view, the compilation of Geodynamic maps, the study of the Earth's crust, the identification and differentiation of earthquake foci come to the rescue. With this, major disasters can be prevented. The article compiled a map of natural and man-made conditions of the Almaty region. In the process of creating a map, using GIS data, we created a map in the ArcGIS application. We received data from the GIS through a special platform, processing space surveys using a program. We received the data on the basis of SRTM space survey. By studying the dynamics of changes for each year, by comparing maps, you can make conclusive forecasts. Collecting data through free platforms helps to create rational solutions. It is possible to monitor, update,store,and edit the database of information using maps. In the article, a complete study of the region's region was carried out, the importance was given to the rational, effective use of GIS data.