Good Condition Research Articles

Adjuvant non-opioid analgesics decrease in-hospital mortality in targeted patients with acute pancreatitis receiving opioids

Objectives Opioid administration in acute pancreatitis (AP) exacerbates its severity, prompting concerns regarding the increased requirement for intensive care and its potential impact on patient survival. We aimed to elucidate the influence of analgesic patterns on mortality among patients with AP hospitalized in the ICU. Methods We included 784 patients (198 receiving opioid monotherapy and 586 receiving opioid polytherapy) from the Medical Information Mart for Intensive Care database. The primary outcome was in-hospital mortality. Propensity score matching was used to account for baseline differences. We used Kaplan–Meier survival curves and multivariate regression models to indicate survival discrepancies and potential associations. Results Polytherapy group exhibited prolonged hospital survival (79.8 vs. 57.3 days, P < 0.001); polytherapy was associated with decreasing in-hospital mortality adjusted for confounders (HR = 0.49, 95% CI: 0.26–0.92; P = 0.027). Stratification analysis indicated that patients receiving adjunctive acetaminophen had prolonged hospital survival (opioid vs. opioid + acetaminophen, P < 0.001; opioid vs. opioid + NSAIDs + acetaminophen, P = 0.026). Opioid polytherapy benefited patients with APACHE III scores >83 and those with mean oral morphine equivalent >60 mg/day (HR = 0.17, 95% CI: 0.1–0.3, P < 0.001 and HR = 0.32, 95% CI: 0.2–0.52, P < 0.001, respectively). Conclusion Our findings suggest that an opioid-based analgesic regimen offers a survival advantage for patients with AP, particularly those in critical condition or with concerns about opioid use. This approach provides a viable clinical strategy for pain management. Further randomized clinical trials are warranted to validate these results.

Climate-induced risk assessment of the quarantine room in a University Library

Microclimate conditions in conservation spaces such as museums, galleries, storages, archives, and libraries significantly impact the preservation of cultural materials, potentially leading to permanent damage. This study focuses on quarantine rooms, essential for isolating and inspecting incoming collections for infestations or contamination. Despite their importance, systematic microclimate investigations in such spaces have not been conducted until now. In this research, temperature and relative humidity monitoring has been conducted over the past 3 years (i.e., 2021-2022-2023) within the quarantine room of the Norwegian University of Science and Technology (NTNU) University Library (located within the DORA I concrete bunker, Trondheim, Norway). Data analysis revealed stable indoor conditions due to the buffering capacity of the massive building envelope together with climate control system. Specific metrics for the estimation of climate-induced chemical and biological risks on vulnerable artifacts were applied to compute the percentage of time for which thermohygrometric conditions could favour cellulose hydrolysis and biodeteriogens proliferation on a yearly basis. In this way, the study provided a decision-making tool useful to evaluate the best time (in terms of safest temperature and relative humidity conditions) when to introduce incoming collections into the quarantine room, depending on the material they are made of and on the timeframe selected for their isolation.

Analysis of the Use of E-Money, Money Supply, and Gross Domestic Product on Interest Rate

This research aims to examine the effect of a direct relationship between the use of e-money and the circulation of money on interest rates, as well as an indirect effect, namely through the intervening variable gross domestic product. This research method uses a statistical model of path analysis. The sample used was secondary data fetched from the Website of Bank Indonesia (BI) and the Central Bureau of Statistics (BPS), since regulation on electronic payment method was officially issued by Bank Indonesia in May 2009-March 2023. The test results shows that e-money and money supply each, have a significant positive effect on gross domestic product variables. Gross domestic product variables had a negative effect on interest rates. E-money and money supply variables has a negative effect on interest rates, both directly or indirectly through the intervening variable of gross domestic product. Increasing e-money user and money supply, preponderant to gross domestic product, can decrease the interest rate. The results of this research are expected to provide benefits as a prediction of the Indonesian economy in the future, as a result of the issuance of electronic payment instruments. So for the regulators, they can set the right interest rate policy to be able to maintain stable economic conditions. Keywords: electronic money, money supply, gross domestic bruto, interest rate

The Effect of Patient-Specific Variables on the Need for Dental Treatment Under General Anesthesia in Children: A Retrospective Study

Aim: For pediatric dentists, meeting the dental treatment needs of young children is often a challenge. Behavioral management techniques may be ineffective in underage children or children with special needs. Therefore, general anesthesia (GA) is required for dental rehabilitation of uncooperative children. The aim of this study was to examine the patient population treated under General Anesthesia (GA) in terms of age, gender, ASA Score (American Society of Anesthesiologists Physical Status Classification System), duration of anesthesia, duration of operation and the presence of systemic diseases of the patients. Material and Methods: In this study, 238 patients aged 2-15 years who underwent dental treatment in the General Anesthesia Operating Room of Selçuk University Faculty of Dentistry were included. Patients were divided into 2 groups according to indications for general anesthesia. Medical health status and ASA scores were analysed. Patients were also evaluated according to age, gender, duration of anesthesia and duration of dental treatment. Results: According to results, the mean age (years) and weight (kg) of the patients were 5,4 and 19,7, respectively. The gender distribution of the patients was 125 female (52,55%) and 113 male (47,5%). The number of ASA I patients was 213 (89,6%) and ASA II patients was 25 (10,5%). In terms of duration of anesthesia, 24 patients were treated in less than 60 minutes (min), 132 patients in 60-120 min and 82 patients in 120-180 min. Conclusion: Dental treatment operating rooms with inpatient services can serve more different patient groups.

Urgent Contrast-Enhanced Computed Tomography before Early Colonoscopy in the Management of Colonic Diverticular Bleeding: A Multicenter Randomized Controlled Trial

Introduction: Contrast-enhanced computed tomography (CE-CT) has been gaining attention as an initial investigation in the management of colonic diverticular bleeding (CDB), yet the role of CE-CT other than its diagnostic yield has not been adequately clarified. We aimed to determine whether the use of urgent CE-CT improves identification of stigmata of recent hemorrhage (SRH) in subsequently performed early colonoscopy (≤24 h of arrival) or other clinical outcomes of CDB. Methods: We conducted a randomized, open-label, controlled trial at 23 institutions in Japan. Outpatients with suspected CDB were randomly assigned to undergo either urgent CE-CT followed by early colonoscopy (urgent-CE-CT + early-colonoscopy group) or early colonoscopy alone (early-colonoscopy group). The primary outcome was SRH identification. Secondary outcomes included successful endoscopic hemostasis, early (<30 days) and late (<1 year) rebleeding, length of hospital stay, and transfusion requirements. Results: In total, 240 patients, mostly in a hemodynamically stable condition, were randomized. A contrast extravasation on CE-CT was observed in 20 of 115 patients (17.4%) in the urgent-CE-CT + early-colonoscopy group. SRH was identified in 23 of 115 patients (20.0%) in the urgent-CE-CT + early-colonoscopy group and 21 of 118 patients (17.8%) in the early-colonoscopy group (difference, 2.2; 95% confidence interval [CI], −7.9 to 12.3; p = 0.739). Successful endoscopic hemostasis was achieved in 21 patients in each group (18.3% and 17.8%, respectively) (difference, 0.5; 95% CI, −9.4 to 10.4; p = 1.000). There were also no significant differences between groups in early and late rebleeding, length of hospital stay, and transfusion requirements. Conclusion: The use of urgent CE-CT before early colonoscopy did not improve SRH identification or other clinical outcomes in patients with suspected CDB in a hemodynamically stable condition. The routine use of urgent CE-CT as an initial investigation is not recommended in this population, also considering the low rate of extravasation-positive cases (UMIN registry number, UMIN000026865).

Bayesian Optimization for Controlled Chemical Vapor Deposition Growth of WS2.

We applied Bayesian optimization (BO), a machine learning (ML) technique, to optimize the growth conditions of monolayer WS2 using photoluminescence (PL) intensity as the objective function. Through iterative experiments guided by BO, an improvement of 86.6% in PL intensity is achieved within 13 optimization rounds. Statistical analysis revealed the relationships between growth conditions and PL intensity, highlighting the importance of critical conditions, including the tungsten source concentration and Ar flow rate. Furthermore, the effectiveness of BO is demonstrated by comparison with random search, showing its ability to converge to optimal conditions with fewer iterations. This research highlights the potential of ML-driven approaches in accelerating material synthesis and optimization processes, paving the way for advances in two-dimensional (2D) material-based technologies.

Analysis of the Effectiveness of Connectivity Infrastructure Spending in the Bangka Belitung Islands Province

The purpose of this study is to analyze the correlation between APBN and APBD expenditures on the achievement of connectivity indicators. Secondary data sources were obtained from the Directorate of Budget Implementation, the Sintesa application, the OMSPAN and OMSPAN TKD applications, the Ministry of PUPR, and the BPS of the Bangka Belitung Islands Province. Data analysis uses the Pearson correlation method and qualitative descriptive. The results of the study indicate that APBN expenditure is negatively and very strongly correlated with the length of national roads. In addition, APBN expenditure is positively and very weakly correlated with the length of national roads in stable condition and has a moderate positive correlation with the percentage of national road stability. APBD expenditure is very weakly correlated with the length of provincial roads and is moderately correlated with the length of provincial roads in stable conditions and the percentage of stability. Regency/City APBD expenditure also has a very weak correlation and is negatively directed to the total length of district/city roads in the Bangka Belitung Islands Province and has a moderate correlation with the length of district/city roads in stable condition and the percentage of stability. APBN expenditure has a positive and very strong correlation with the length of regional roads and is positively and strongly correlated with the length of regional roads in stable conditions. APBN spending also has a moderate correlation with the percentage of regional road stability. Based on the relationship analysis using Pearson correlation, it was found that the total length of the road has a strong correlation and has a positive relationship with the ADHK GRDP. The Bangka Belitung Islands Province has a higher road stability than the national road stability and road stability in the Sumatra Region.

Integrated FEM-Multibody Co-Simulation of Additively Manufactured Hip Prosthesis containing cracks.

The increase in life expectancy and attention to the quality of life of elderly people spurred the need, in the last decades, to increase the capabilities of medical and surgical techniques. Among these, the development of prosthetic implants has been a staple of biomedical engineering research since the 70’s. In order to satisfy the challenging demands, the latest novelties in industrial engineering are being tested in their applicability to subjects. The 3D printing of metal alloys can produce a highly customizable product, which, after the proper heat treatments, can possess adequate mechanical properties to ensure a satisfactory component life. Defective products are often the results of wrong or absent post-processing treatments which may cause an uncontrolled crack propagation and a premature total failure of the implant. The behavior of such a product, with various critical crack conditions, was investigated by an integrated MBD-FEM co-simulation environment, focused on a femur subjected to total hip replacement. It was concluded that the Stress Intensity Factor (SIF) computed by the model is compatible with the premature failures experienced by patients, and as such, this model opens the possibility for further analyses aimed at understanding the role of defects on the durability of prothesis

Estimation of the Service Life of Approach Slabs of Road Bridges Based on the Statistical Modeling Method

The article discusses the durability and reliability of a separate element – bridge approach slab, which is justified by the need to maintain a satisfactory technical condition of Ukrainian bridges in general and traffic safety on public roads with limited funding during martial law. The scope of the research is forecasting the residual service life of bridge elements (on the example of approach slabs) using probabilistic methods. Approach slabs are designed to smoothly and safely connect the road approach embankment with the bridge to gradually equalize the elastic modulus of the carriageway from a less rigid asphalt pavement on an elastic base to a more rigid one on a reinforced concrete slab. The main defects in the destruction of approach slabs are: changes in the longitudinal profile of the road due to the collapse and subsidence of the soil under the approach slabs; longitudinal and transverse cracks in the asphalt concrete pavement on the bridge approaches; and potholes that lead to an increase in the additional dynamic load on the bridge deck.

Energy-saving mechanism and dynamic characteristics of blade angle adjustment in low head pumping system

To investigate the energy-saving mechanisms and dynamic characteristics of blade angle adjustment, this study proposes a novel research method via simulations, prototype and model testing. For stable conditions, the internal field, the external and energy characteristics of the pumping system with different blade angle are examined. The dynamic characteristics of the pumping system and the blade force characteristics during the adjustment process are also studied. The research results show that, under a certain net head, an appropriate impeller blade angle improves the flow state in the pump and conduits, decreasing the entropy production and providing suitable inlet circulation to reduce the hydraulic loss of outlet conduit, thereby improving the pumping system efficiency by 5–10 percentage points. During the adjustment process, there is an approximate 20-s delay in dynamic characteristics. Additionally, with the increase of the blade angle, the hydraulic torques for blade axis and pump shaft increase, thus increasing the blade adjustment force and shaft power. The adjusting force is found to be underestimated in the adjustment processes of decreasing the blade angle. Achievements of this paper contribute to high efficiency of pumping system and high reliability of blade adjustment devices and pump units.

Different aspects of biochar addition on semi-dry anaerobic digestion of organic fraction of municipal solid waste in continuous mode

This study investigated the use of biochar, derived from a wood gasifier, in semi-dry anaerobic digestion of organic fraction of municipal solid waste (OFMSW). The experiment was conducted in three phases, without biochar and changing the hydraulic retention time (HRT) from 50 to 15 days until first acidification condition (on pH = 6.5), with biochar at an optimal concentration of 30 g/L in HRT= 20–10 day. Also, countermeasures for the acidified reactor with biochar during the dormancy period were investigated. The results demonstrated that adding biochar led to a rapid recovery of the acidified reactor, improved stability parameters, and removed foaming as a disturbance. Biochar addition (30 g/L) enhanced the organic loading rate (OLR) up to 11 kgVS/m3.day with an HRT of 20 days leading to specific methane production of 383 L/kgVS and a volumetric production increase of biomethane by 85 %. However, at higher OLRs with HRT of 10 days, acidification condition resurfaced leading to homogeneous foaming. Excess adding of biochar did not have significant treatment effects but necessitated a no-feeding period (about 45 days) and gentle stirring with long intervals for stable conditions. Overall, the use of biochar along with the OFMSW biogas plant was demonstrated to enhance production efficiency.

Ostial left main disease tackled with a percutaneous coronary intervention using a second-generation drug-eluting stent: A case report

Abstract: The hospital emergency admitted a middle-aged male who had previously undergone stenting in the left anterior descending (LAD) and right coronary arteries due to severe central chest pain radiating to both arms. A two-dimensional color Doppler echocardiogram showed septal hypokinesia, and coronary angiography showed a 70% ostial left main (LM) stenosis. The LAD coronary artery had a patent stent, but the mid-right coronary artery had a totally occluded stent. The chest pain increased during coronary angiography, and the patient consented to percutaneous coronary intervention (PCI) with a second-generation drug-eluting stent. The patient was discharged in a stable condition. The evolution and the current approach of PCI compared to coronary artery bypass grafting surgery for LM coronary disease based on randomized trials are discussed.

Research on the Flicker Effect in Modern Light Sources Powered by an Electrical Network

Disruptions in power quality have a negative impact on many energy consumers. These include lighting, where interference manifests itself, among others, in the form of light flickering. The article presents phenomena accompanying the operation of modern light sources against the background of exemplary results of studies on the flicker of conventional light sources, such as incandescent or fluorescent lamps. The flickering effect of light generated in modern lamps can occur under stable voltage conditions in the supply network. The main subjects of the conducted research were solid-state light sources—light-emitting diode (LED) lamps, currently available on the lighting market. To assess the effects of these phenomena, it is necessary to use measures other than those traditionally used. The method used allows for the measurement of flicker resulting from both power supply disturbances and the properties of modern light sources. Using the developed measurement system, it is possible to record temporal changes in flicker coefficients resulting from, for example, changing supply voltage conditions. Due to the possibility of flickering light from sources offered by different manufacturers, as shown by research, it is advisable to carry out measurements at the place of use of the lighting.

Dobutamine-induced transient cardiomyopathy during dobutamine stress echocardiography

Abstract: Takotsubo cardiomyopathy is a syndrome characterized by transient left ventricular (LV) dysfunction in the absence of significant coronary artery disease. We report a rare case of dobutamine-induced transient cardiomyopathy during dobutamine stress echocardiography, whose coronary angiography was suggestive of noncritical coronary artery disease. The patient was managed conservatively and was discharged after 7 days in a hemodynamically stable condition with improved LV function. Anticoagulation was not pursued due to improvement in LV function. We also herein aim to review the epidemiology, various accepted mechanisms of etiopathogenesis, clinical features, complications, diagnostic criteria, and currently practiced guidelines on the management of stress-induced cardiomyopathy.

Improvement of the method of diagnostics and treatment of injuries and diseases of the maxillofacial region

This study aims to describe and apply a special endolift device in the treatment of various injuries to the zygomatic-orbital-facial complex as a means of forming an endoscopic space. A patented technique of creating an endoscopic area using an endolift device in the field of maxillofacial surgery, registered under the number 2082 dated 31.07.2018 in the Kyrgyz Republic, on the example of a clinical case, was presented. The endolift is a metal two-piece device that consists of a horizontal round mini plate up to 10 mm in diameter and a perpendicularly located hollow tube up to 4 mm in diameter in the centre of the plate with two holes at the top. The method of endoscopic space formation using endolift was used in 15 patients with various traumas to the maxillofacial region. An example of a clinical case is presented by patient J.B., 36 years old, who underwent endoscopic minimally invasive surgery to reconstruct a mandibular fracture. The course of the operation included a small incision in the submandibular region, soft tissue separation, skeletonization of the jaw, and the formation of a tunnel, for the endolift. The endolift was inserted into the tunnel and an endoscope was inserted through it for visualisation. After alignment of the bone fragments and fixation with a miniplate through the endolift, the wound was sutured, and a dressing was applied. There were no complications during or after surgery in all 15 cases of surgery. Patients were discharged 3 days after the operation in satisfactory condition. The sutures were removed on the 7th day. Functional and cosmetic results were evaluated as satisfactory. The use of this method of treatment ultimately determines the degree of effectiveness, safety, and quality of life of the performed manipulations for patients, especially in countries with low levels of economic development.

Results of the Mycological Investigation of the Shoot System of "Irinovsky Oak" Tree (Leningrad Oblast, Russia).

The wild nature monument "184-year-old oak tree in the village of Irinovka" (Leningrad oblast, Russia), better known in local historical literature as "Irinovsky Oak," was officially opened in 2013. It is represented by a separate pedunculate oak tree (Quercus robur), planted in 1829 and preserved in satisfactory condition at 194 years of age. This paper presents data from a survey of the shoot system of the tree investigated. A total of 12 fungal species were registered (Cladosporium herbarum, Colpoma quercinum, Coryneum depressum, Diatrypella quercina, Erysiphe alphitoides, Hyphoderma setigerum, Laetiporus sulphureus, Mar-chandiomyces corallinus, Peniophora quercina, Trichoderma viride, Sphaerulina quercicola, Vuilleminia comedens). The lichenicolous species Marchandiomyces corallinus was reported as a new find to the Leningrad oblast. It was shown that the shoot system of the tree investigated is associated with a complex of Quercus robur-adapted and coadapted species, among which such necrotrophs as Sphaerulina quercicola and Coryneum depressum and such pathogenic saprotrophs as Vuilleminia comedens and Colpoma quercinum, as well as saprotrophs (Diatrypella quercina, Peniophora quercina), dominated. This species complex ensures a continuous process of the crown's thinning.

A modified perturb and observe MPPT algorithm with zero steady state oscillation for single-phase grid-connected transformerless solar inverter

ABSTRACT This paper proposes a modified perturb and observe (P&O) algorithm to improve the performance of maximum power point tracking in a grid-connected solar inverter. The proposed method eliminates the steady state oscillations in photovoltaic panel voltage under stable irradiance conditions there by enhancing its performance. It also retains the simplicity of conventional P&O algorithm and introduces only one additional step of checking the quantum of power change to bypass the perturbations. A cascaded multi-loop control structure is adopted to achieve the objectives and retain the ability to respond to changing environmental conditions. The proposed and conventional P&O algorithms along with a designed 1 kW single-phase grid-connected transformerless solar inverter are simulated in PSIM to perform a comparative study. Furthermore, the proposed algorithm is validated experimentally on the developed solar inverter prototype.

Nesfatin-1 enhances vascular smooth muscle calcification through facilitating BMP-2 osteogenic signaling

Vascular calcification (VC) arises from the accumulation of calcium salts in the intimal or tunica media layer of the aorta, contributing to higher risk of cardiovascular events and mortality. Despite this, the mechanisms driving VC remain incompletely understood. We previously described that nesfatin-1 functioned as a switch for vascular smooth muscle cells (VSMCs) plasticity in hypertension and neointimal hyperplasia. In this study, we sought to investigate the role and mechanism of nesfatin-1 in VC. The expression of nesfatin-1 was measured in calcified VSMCs and aortas, as well as in patients. Loss- and gain-of-function experiments were evaluated the roles of nesfatin-1 in VC pathogenesis. The transcription activation of nesfatin-1 was detected using a mass spectrometry. We found higher levels of nesfatin-1 in both calcified VSMCs and aortas, as well as in patients with coronary calcification. Loss-of-function and gain-of-function experiments revealed that nesfatin-1 was a key regulator of VC by facilitating the osteogenic transformation of VSMCs. Mechanistically, nesfatin-1 promoted the de-ubiquitination and stability of BMP-2 via inhibiting the E3 ligase SYTL4, and the interaction of nesfatin-1 with BMP-2 potentiated BMP-2 signaling and induced phosphorylation of Smad, followed by HDAC4 phosphorylation and nuclear exclusion. The dissociation of HDAC4 from RUNX2 elicited RUNX2 acetylation and subsequent nuclear translocation, leading to the transcription upregulation of OPN, a critical player in VC. From a small library of natural compounds, we identified that Curculigoside and Chebulagic acid reduced VC development via binding to and inhibiting nesfatin-1. Eventually, we designed a mass spectrometry-based DNA-protein interaction screening to identify that STAT3 mediated the transcription activation of nesfatin-1 in the context of VC. Overall, our study demonstrates that nesfatin-1 enhances BMP-2 signaling by inhibiting the E3 ligase SYTL4, thereby stabilizing BMP-2 and facilitating the downstream phosphorylation of SMAD1/5/9 and HDAC4. This signaling cascade leads to RUNX2 activation and the transcriptional upregulation of MSX2, driving VC. These insights position nesfatin-1 as a potential therapeutic target for preventing or treating VC, advancing our understanding of the molecular mechanisms underlying this critical cardiovascular condition.

Gullian Barre syndrome secondary to heat stroke: a case report.

Heat waves are increasingly common in subcontinent countries, including Pakistan. Heat stroke (HS) is a critical condition resulting from extreme temperatures, often culminating in multiorgan dysfunction. Clinical manifestations of heat-related emergencies can include altered mentation, fever, and profound weakness. We present a compelling case of a previously healthy 49-year-old male who developed altered mentation, fever, and acute kidney injury following intense physical exertion amidst a severe heat wave. Although initially managed as heat stroke, the patient soon exhibited dysarthria, palatal weakness, and bilateral lower limb weakness with areflexia, prompting a detailed neurological assessment. Electromyography and nerve conduction studies revealed the acute motor-sensory axonal neuropathy (AMSAN) variant of Guillain-Barré Syndrome (GBS), an uncommon but severe sequel of heat stroke. GBS, an autoimmune disorder, typically presents with ascending bilateral lower limb flaccid paralysis, often following an acute infectious trigger. Treatment with plasmapheresis led to remarkable neurological recovery. This case represents the first documented instance of heat stroke-induced GBS in Pakistan, highlighting both the distinctive clinical features and the therapeutic complexities of this rare condition.

Challenges in the Valorization of Green Waste in the Central European Region: Case Study of Warsaw

Expanding green areas in cities results in growth in green waste generation. This study presents the findings of an investigation into green waste from selective collection in a large Central European city (Warsaw, Poland), which can be identified as a valuable biomass resource. The research objective was to identify the properties of garden waste from single-family housing to determine valorization opportunities, emphasizing the utilization of GW as a source of energy. The research yielded several findings, including a notable degree of variability in fuel properties, including moisture content (CV = 30%), lower heating value (CV = 14.3%), and ash content (CV = 62.7/56.2%). The moisture content suggests composting, while the fertilizing properties indicate suitability for anaerobic digestion. The instability of the fuel properties, coupled with the elevated levels of chlorine, sulfur, and moisture, constrains the use of garden waste in thermal processes and alternative fuel production. Pyrolysis could be a viable approach for green waste feedstock, offering value-added products depending on the processing conditions and pre-treatment. Nevertheless, implementing a selective collection system is a critical condition for the optimal utilization of bio-waste, facilitating the quality and property control of green and food waste. This is essential for their effective processing, including energy recovery, thereby contributing to the efficient valorization of biomass.