Reduce Recovery Time Research Articles

The 2018 west-central European drought projected in a warmer climate: how much drier can it get?

Abstract. Projections of changes in extreme droughts under future climate conditions are associated with large uncertainties, owing to the complex genesis of droughts and large model uncertainty in the atmospheric dynamics. In this study we investigate the impact of global warming on soil moisture drought severity in west-central Europe by employing pseudo global warming (PGW) experiments, which project the 1980–2020 period in a globally warmer world. The future analogues of present-day drought episodes allow for investigation of changes in drought severity conditional on the historic day-to-day evolution of the atmospheric circulation. The 2018 west-central European drought is the most severe drought in the 1980–2020 reference period in this region. Under 1.5, 2 and 3 ∘C global warming, this drought episode experiences strongly enhanced summer temperatures but a fairly modest soil moisture drying response compared to the change in climatology. This is primarily because evaporation is already strongly moisture-constrained during present-day conditions, limiting the increase in evaporation and thus the modulation of the temperature response under PGW. Increasing precipitation in winter, spring and autumn limits or prevents an earlier drought onset and duration. Nevertheless, the drought severity, defined as the cumulative soil moisture deficit volume, increases considerably, with 20 % to 39 % under 2 ∘C warming. The extreme drought frequency in the 1980–2020 period strongly increases under 2 ∘C warming. Several years without noticeable droughts under present-day conditions show very strong drying and warming. This results in an increase in 2003-like drought occurrences, compounding with local summer temperature increases considerably above 2 ∘C. Even without taking into account a (potentially large) dynamical response to climate change, drought risk in west-central Europe is strongly enhanced under global warming. Owing to increases in drought frequency, severity and compounding heat, a reduction in recovery times between drought episodes is expected to occur. Our physical climate storyline provides evidence complementing conventional large-ensemble approaches and is intended to contribute to the formulation of effective adaptation strategies.

Au modified Nd-doped In2O3 hollow microspheres for high performance triethylamine gas sensor

The Au-modified Nd-doped In2O3 hollow microspheres were prepared by hydrothermal method as well as UV irradiation reduction. Their microstructure and phase structure were characterized by SEM, TEM and XRD. The effect of Nd3+ doping and Au loading were discussed based on the results of XPS, UV–vis, BET. The gas-sensitive measurement reveal the In2O3 loaded with 2 wt% Au and doped with 3 mol% Nd3+ (2 wt% Au/3 mol% Nd–In2O3) exhibited the optimal sensing performance among Au-modified Nd-doped In2O3 nanocomposites. Compared with unmodified In2O3, its sensing properties are improved. The response to 100 ppm triethylamine is 61, 4 times of pure In2O3, along with improved selectivity, declined optimum operation temperature, reduced recovery time and good stability. Using Nd–In2O3 and Au/In2O3 as control samples, the synergetic roles of Nd doping and Au loading in sensing process were discussed. By the cooperation of Nd and Au, more oxygen vacancies, raised electric resistance and increased specific surface area are triggered, which improve the gas-sensitive performance of the sensor. The excellent sensing performance of Au-modified Nd-doped In2O3 nanocomposites makes it a potential sensing material for triethylamine detection.

Model-based observer for vehicle proton exchange membrane fuel cell humidity based on adaptive sliding mode estimation technique

Real-time humidity acquisition for vehicle proton exchange membrane fuel cell (PEMFC) facilitates humidity control to avoid membrane flooding or drying, improving its efficiency and stability. However, due to the frequent changes of actual vehicle conditions and expensive as well as unreliable humidity sensors, it is difficult to obtain real-time water content in PEMFC, which brings obstacles to closed-loop control of humidity. To this end, a model-based observer is proposed to obtain real-time humidity. Specifically, a dimensionless third-order model of relative humidity for PEMFC was established, which includes the dynamic of membrane water content. Based on the proposed model, an adaptive sliding mode convergence algorithm was designed to approach real-time humidity using measurable signals (voltage, current, pressure, flow rate, and temperature). The exploration of proposed adaptive sliding mode observer (ASMO) performance was compared with non-adaptive sliding mode observer (SMO) and classical ASMO by using a real 80 kW commercial fuel system experimental data. The experimental results show that compared with second-order humidity model, proposed third-order humidity model reduced recovery time under small step condition, where 250 s for cathode humidity estimation and 200 s for anode humidity estimation. In addition, under the small step condition, the average error of the three observers was less than 3%, which is accurate for engineering application. Moreover, proposed ASMO had the minimum static error, with 4% for cathode humidity estimation and 9% for anode humidity estimation under large step conditions as well as MAE, MSE, RMSE with 4%, 1.90%, 4.39% for cathode relative humidity estimation, 8.19%, 0.89%, 9.44% for anode relative humidity estimation respectively. The comprehensive results indicate that the proposed ASMO with adaptive parameters tuning has better dynamic performance than non-adaptive SMO as well as classical ASMO in terms of robustness and estimated accuracy.

Concurrent daytime and nighttime heatwaves in the late 21st century over the CORDEX‐East Asia phase 2 domain using multi‐GCM and multi‐RCM chains

AbstractThe adverse impacts of extreme heat on human health when a concurrent daytime and nighttime heatwave (CDNHW) occurs are greater than when daytime or nighttime heatwaves occur individually, because of the reduced recovery time from heat exposure. This study projects increases in CDNHW over the whole of East Asia under two Representative Concentration Pathway scenarios (RCP2.6 and RCP8.5) and two Shared Socioeconomic Pathway scenarios (SSP1‐2.6 and SSP5‐8.5). The daily maximum and minimum temperatures, which are used to define a CDNHW, are calculated of 3‐hourly temperatures of 25 km horizontal resolution produced by 12 general circulation model and regional climate model chains participating in the Coordinated Regional Climate Downscaling Experiment East Asia phase 2 project. In Historical simulation (1981–2005), occurrence period and occurrence rate of CDNHW from April to September area‐averaged in East Asia are 10.9 days and 0.9%, respectively. In projections for the future (2071–2100), occurrence period and occurrence rate of CDNHW will be 3 weeks and 3.7% (RCP2.6), 2 months and 20.5% (RCP8.5), 2 months and 15.6% (SSP1‐2.6), and 3 months and 45.7% (SSP5‐8.5). In addition, it is expected that the CDNHW intensity will increase, and the spatial extent of CDNHW will be extended. Although a CDNHW lasting less than 3 days is the most common, the proportion of CDNHWs lasting more than 10 days, compared to the total CDNHW frequency, will increase to 1.2% (RCP2.6), 7.2% (RCP8.5), 6.1% (SSP1‐2.6), and 17.3% (SSP5‐8.5) from 0.2% (Historical). Both occurrence rate and intensity of CDNHW will increase to a relatively large extent in Indochina, East and West China, and India. If the current greenhouse gas emissions continue, East Asia will experience unprecedented heat stress because the frequency and intensity of CDNHWs, which rarely occur during present‐day, will increase significantly over all regions by the end of the 21st century.

A Comparative Study of Post-Operative Outcomes for Off-Pump and On-Pump Coronary Artery Bypass Grafting

Introduction: Coronary artery bypass grafting (CABG) is a common surgical procedure for the management of coronary artery disease. Off-pump (OPCAB) and on-pump (ONCAB) CABG have been compared in various studies, but limited data exists for the Bangladeshi population. The present study was conducted to shed further light on the topic relative to the Bangladeshi demographic. Methods: This retrospective observational study conducted at the Department of Cardiac Surgery, National Institute of Cardiovascular Disease, Dhaka, Bangladesh, over a 1.5-year period from April 2019 to September 2020 compared the outcomes of OPCAB and ONCAB in a Bangladeshi population, analyzing the demographic and clinical characteristics, operative characteristics, early postoperative outcomes, and recovery parameters of 34 patients undergoing either OPCAB (n=17) or ONCAB (n=17). Result: The two groups were well-matched in terms of demographic and clinical characteristics, with no significant differences in age, gender, BMI, or comorbidities. The OPCAB group had a significantly shorter total operative time (180.4 ± 26.8 min vs. 195.3 ± 31.2 min, P < 0.05). Early postoperative outcomes were similar between the two groups (P > 0.05 for all comparisons), while the OPCAB group had a significantly shorter hospital stay (7.8 ± 1.8 days vs. 9.2 ± 2.1 days, P < 0.05), mechanical ventilation time (9.1 ± 3.8 hours vs. 12.6 ± 4.5 hours, P < 0.05), and time to ambulation (3.8 ± 0.9 days vs. 4.5 ± 1.0 days, P < 0.05). Conclusion: Our study suggests that OPCAB may be a viable alternative to ONCAB for selected patients in the Bangladeshi population, offering potential benefits in terms of reduced recovery times and resource utilization. Further large-scale, randomized controlled trials are needed to confirm these findings and assess the long-term outcomes and cost-effectiveness of OPCAB compared to ONCAB.

Injury prevention strategies at the 2019 FIFA Women's World Cup display a multifactorial approach and highlight subjective wellness measurements

ObjectiveTo report the injury prevention programs utilised by top-level female footballers competing internationally. MethodsAn online survey was administered to physicians of the 24 competing national teams at the 2019 Federation Internationale de Football Association (FIFA) Women's World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies, and (4) reflection on their World Cup experience. ResultsFollowing responses from 54% of teams, the most common injuries encountered included muscle strains, ankle sprains, and anterior cruciate ligament ruptures. The study also revealed the most important injury risk factors during the FIFA 2019 World Cup. Intrinsic risk factors include accumulated fatigue, previous injury, and strength endurance. Extrinsic risk factors include reduced recovery time between matches, congested match schedule, and the number of club team matches played. The 5 most used tests for risk factors were flexibility, joint mobility, fitness, balance, and strength. Monitoring tools commonly used were subjective wellness, heart rate, minutes/matches played, and daily medical screening. Specific strategies to limit the risk of an anterior cruciate ligament injury included the FIFA 11+ program and proprioception training. ConclusionThe present study revealed multifactorial approaches to injury prevention strategies for women's national football teams at the FIFA 2019 World Cup. Challenges to injury prevention program implementation reflect time limitations, schedule uncertainties, and varying club team recommendations. Level of evidenceIV.

PO-01-090 ABLATION OF TYPICAL RIGHT ATRIAL FLUTTER THROUGH THE ARM: EVALUATION OF SAFETY, FEASIBILITY, AND EFFICACY – THE ARM AFLUTTER STUDY

Typical atrial flutter ablation (AFLA) has become a common procedure usually performed through the femoral vein. Case reports have described ablation via the arm which may allow for a safer procedure and reduced recovery time. We aimed to evaluate the safety, feasibility, and efficacy of AFLA via the Arm approach (AA) vs Femoral approach (FA). Patients were randomly assigned 1:1 to either FA or AA for EP study and AFLA. The primary endpoint was length of recovery time after the procedure. The secondary endpoints were success rates for achieving bidirectional block across the cavotricuspid isthmus, procedure complications, and recurrence rates of atrial flutter at 1 month follow-up. Outcomes with continuous variables were compared between groups using a Mann Whitney U test. Categorical outcomes were compared between groups using a chi-square analysis or Fisher’s exact test. Patients (N=16; aged 64.4±11.3yr; 81.3% Male) were randomized to either AA (n=7) or FA (n=9). There were no significant differences in baseline patient characteristics or medications at the time of ablation. With regard to the primary endpoint, recovery time was significantly less in AA (median, IQR=137.0, 27.0 min) compared to FA (median, IQR=265.0, 49.0 min; P=.004, U=4.00). Bidirectional block was achieved for all patients in both groups, however time to achieve bidirectional block was longer in AA (median, IQR=73.0, 65.0 min) compared to FA (median, IQR=37.0, 31.0 min; P=.026, U=10.50). There were no complications in either group, and there were no recurrences of atrial flutter at 1 month follow-up. In a small sample, AFLA from the arm was a feasible, safe approach with shorter recovery time to discharge without recurrence at 1 month. Achieving bidirectional block required more time in AA compared to FA likely due to operator learning curve, and lack of appropriately designed sheaths and catheters for use in the arm. Results from these data will be confirmed in a larger, adequately powered study with 6 and 12 month follow-up.

Research on Triode Based High Re-Frequency Ultrafast Electrical Pulse Generation Technology

The high-repeat frequency ultrafast electrical pulse generation technology is mainly based on ultrafast switching devices combined with ultrafast circuits to generate electrical pulses with repetition frequencies of several kilohertz and a rise-time of nanoseconds or even picoseconds. This technology is the basis for several research studies and is one of the key technologies that has received wide attention from various countries. The problems to be solved are high re-frequency ultrafast high-voltage pulse generation and ultra-broadband ultrafast pulse transport and circuit stability applicability, which include circuit conduction mechanism research, pulse generation time improvement and recovery time reduction. By studying the avalanche transistor high-voltage transient conduction characteristics and reducing the loss in the carrier transport process, the influence of each parameter on the output is determined, and the key factors to enhance the circuit performance are identified. This paper designs a new high-repetition frequency ultrafast electric pulse generation (UPG) circuit using pure electronics components, which consists of combining avalanche transistor model 2N2222 with a hybrid Marx structure at the same time in the pulse circuit to add filtering, fast recovery diodes and pulse cutoff and other matching techniques to make its output more stable, which can obtain higher output frequency, faster rise-time and narrower pulse widths. It has been tested that a high re-frequency ultrafast high-voltage electrical pulse signal with a pulse repetition frequency of 200 kHz, a leading edge of 800 ps, a half-high pulse width of 5 ns, an amplitude of 1.2 kV and jitter of less than 5% can be generated at the load with a 50 Ω load at the output. The signal can be applied in the fields of ultrafast diagnosis, information countermeasures and nuclear electromagnetic radiation research.

Adolescents With More Oculomotor and Vestibular Signs of Sport-Related Concussion Benefit from Aerobic Exercise: An Exploratory Analysis.

Abstract Early targeted heart rate (HR) aerobic exercise has been shown to reduce the duration of recovery from sport-related concussion (SRC) as well as the incidence of persistent post-concussive symptoms (PPCS). It is not known, however, if more severe oculomotor and vestibular presentations of SRC benefit from a prescription of aerobic exercise. The current study is an exploratory analysis of two published randomized controlled trials that compared aerobic exercise within 10 days of injury with a placebo-like stretching intervention. Combining the two studies yielded a larger sample size to stratify severity of concussion based on the number of abnormal physical examination signs present at the initial office evaluation, which were confirmed with self-reported symptoms and recovery outcomes. The most discriminant cut-off was between those who had ≤3 oculomotor and vestibular signs and those who had >3 signs. Aerobic exercise (hazard ratio = 0.621 [0.412, 0.936], p = 0.023) reduced recovery times even when controlling for site (hazard ratio = 0.461 [0.303, 0.701], p < 0.001), severity (hazard ratio = 0.528 [0.325, 0.858], p = 0.010) and the interaction term of intervention and severity (hazard ratio = 0.972 [0.495, 1.909], p = 0.935). Adolescents who presented with >3 signs and were assigned to the placebo-like stretching group had a PPCS incidence of 38%, which was the highest of all subgroups (aerobic exercise and ≤3 findings: 8%; stretching and ≤3 findings: 11%; aerobic exercise and >3 findings: 21%). This exploratory study provides pilot evidence that prescribed sub-symptom threshold aerobic exercise treatment early after SRC may be effective for adolescents with more oculomotor and vestibular physical examination signs and should be validated in future adequately powered trials.

Design of the Novel Single Incision, Free Motion Laparoscopic Surgical System

Abstract Laparoscopic surgery is a common minimally invasive surgery that uses specialized tools to access the abdominal cavity and pelvic regions via small incisions called ports. Compared to open surgery, laparoscopy's small incision size better protects a patient's health and reduces recovery time. However, restricted rotation of the tools around chosen port locations can limit a surgeon's mobility while operating. To address this, the novel single incision, free motion (SIFM) laparoscopic surgical system was created, and its design was explored through three experiments. Experiment 1 analyzed different permanent magnetic configurations to optimize the magnetic force between a tool on the inside of the abdominal wall and an external tool. The chosen configuration was a single-pole external magnet, coupled to an axially magnetized internal magnet. Experiment 2 analyzed the experimental and theoretical forces applied by the internal tool. The tool was able to provide sufficient cutting forces at 26.1 mm of separation between the tools. Experiment 3 measured the precision of the tool's end effector which was controlled by a stepper motor-powered cable system. The tool's end effector rotates no more than 1 deg about the y-axis and no more than 2 deg about the x-axis. The SIFM system combines the health benefits of minimally invasive laparoscopic surgery, with the free motion and ease of open surgery.

Cache-Based Matrix Technology for Efficient Write and Recovery in Erasure Coding Distributed File Systems

With the development of various information and communication technologies, the amount of big data has increased, and distributed file systems have emerged to store them stably. The replication technique divides the original data into blocks and writes them on multiple servers for redundancy and fault tolerance. However, there is a symmetrical space efficiency problem that arises from the need to store blocks larger than the original data. When storing data, the Erasure Coding (EC) technique generates parity blocks through encoding calculations and writes them separately on each server for fault tolerance and data recovery purposes. Even if a specific server fails, original data can still be recovered through decoding calculations using the parity blocks stored on the remaining servers. However, matrices generated during encoding and decoding are redundantly generated during data writing and recovery, which leads to unnecessary overhead in distributed file systems. This paper proposes a cache-based matrix technique that uploads the matrices generated during encoding and decoding to cache memory and reuses them, rather than generating new matrices each time encoding or decoding occurs. The design of the cache memory applies the Weighting Size and Cost Replacement Policy (WSCRP) algorithm to efficiently upload and reuse matrices to cache memory using parameters known as weights and costs. Furthermore, the cache memory table can be managed efficiently because the weight–cost model sorts and updates matrices using specific parameters, which reduces replacement cost. The experiment utilized the Hadoop Distributed File System (HDFS) as the distributed file system, and the EC volume was composed of Reed–Solomon code with parameters (6, 3). As a result of the experiment, it was possible to reduce the write, read, and recovery times associated with encoding and decoding. In particular, for up to three node failures, systems using WSCRP were able to reduce recovery time by about 30 s compared to regular HDFS systems.

Moving Microgrid Hierarchical Control to an SDN-Based Kubernetes Cluster: A Framework for Reliable and Flexible Energy Distribution

Software Defined Networking (SDN) is a communication alternative to increase the scalability and resilience of microgrid hierarchical control. The common architecture has a centralized and monolithic topology, where the controller is highly susceptible to latency problems, resiliency, and scalability issues. This paper proposes a novel and intelligent control network to improve the performance of microgrid communications, solving the typical drawback of monolithic SDN controllers. The SDN controller's functionalities are segregated into microservices groups and distributed through a bare-metal Kubernetes cluster. Results are presented from PLECS hardware in the loop simulation to validate the seamless transition between standard hierarchical control to the SDN networked microgrid. The microservices significantly impact the performance of the SDN controller, decreasing the latency by 10.76% compared with a monolithic architecture. Furthermore, the proposed approach demonstrates a 42.23% decrease in packet loss versus monolithic topologies and a 53.41% reduction in recovery time during failures. Combining Kubernetes with SDN microservices can eliminate the single point of failure in hierarchical control, improve application recovery time, and enhance containerization benefits, including security and portability. This proposal represents a reference framework for future edge computing and intelligent control approaches in networked microgrids.

Endoscopic Resection for Vascular Anomalies in Children: A New Standard.

To report an innovative endoscopic surgery for subcutaneous vascular malformations and intramuscular fibro-adipose vascular anomaly (FAVA) at our center. Historically, open surgical resection has been the treatment of choice. Recent advances in minimally invasive surgery have led to the successful application of endoscopic resection techniques for the surgical management of diseases of soft tissue. Patients who underwent endoscopic resection of vascular anomalies were included in this retrospective review. Data were extracted from our Vascular Anomalies Center database between September 2019 and October 2022, including sex, age, symptoms, diagnosis, sites of surgery, previous treatment, surgery, and follow-up. There were 13 females and 15 males in the current study, with ages ranging from 1 to 17 years. The diagnoses included microcystic lymphatic malformation (LM) (n = 8), Klippel-Trénaunay syndrome (n = 7), venous malformation (n = 6), FAVA (n = 6), and mixed cystic LM (n = 1). Surgical sites included the lower extremity (n = 24), abdominal wall (n = 2), upper extremity (n = 1), and thoracic wall (n = 1). Five patients had an intramuscular lesion (FAVA). The endoscopic technique used 2 or 3 small ports in a gas inflation manner. Surgery included thrombectomy, radical resection, and debulking of vascular anomalies. Postoperative sclerotherapy with bleomycin was performed through a drainage tube in 6 patients with microcystic LM. Technical success was obtained in 27 patients. The conversion to open surgery was performed in one patient owing to the deep location of the lesion. No wound-related complication was observed. Endoscopic surgery is a minimally invasive, effective, and safe treatment for subcutaneous vascular malformations and intramuscular FAVA. This approach can set a new standard that minimizes wound complications and reduces recovery time in patients undergoing resection for benign soft-tissue lesions.

Advances in Endoscopic Ultrasound (EUS)-Guided Liver Biopsy.

Recent years have seen the emergence of endoscopic-ultrasound-guided liver biopsy (EUS-LB) as an effective alternative to traditional (percutaneous or transjugular) liver biopsy techniques. Comparative studies have demonstrated that both endoscopic and non-endoscopic approaches are similar in terms of diagnostic adequacy, accuracy, and adverse events; however, EUS-LB offers the advantage of reduced recovery time. Additionally, EUS-LB enables the sampling of both lobes of the liver as well as the advantage of portal pressure measurements. However, EUS-LB may be argued to have a high cost, although this procedure can be cost-effective if bundled with other endoscopic procedures. Approaches utilizing EUS-guided liver therapy, such as the administration of chemotherapeutic agents and EUS elastography, are in development, and their optimal integration into clinical care is likely to emerge in the coming years. In the present review, we evaluate the available literature on EUS-LB indications, contraindications, variations in needle biopsy techniques, comparative outcomes, advantages and disadvantages, and future trends and perspectives.

Effects of Multidisciplinary Specialized Nursing Care on the Short and Long-term Postoperative Quality of Life in Patients with Pancreatic Cancer: A Randomized Controlled Trial

Objective: To analyze the effects of multidisciplinary specialized nursing care on the short and long-term postoperative quality of life in patients with pancreatic cancer. Methods: This is a randomized controlled trial. In this study, 88 patients with pancreatic cancer who were treated at our hospital between January 2021 and January 2022 were recruited and allocated 1:1 either to receive into routine nursing care (n=44, routine group) or interdisciplinary specialist nursing care (n=44, study group). The outcome measures in both groups included surgery-related indices, short and long-term quality of life, and adverse responses. Results: There were no participants who dropped out of this study due to treatment intolerance, nor were there any additional participants. Patients in the study group had significantly shorter recovery time from gastrointestinal function, bed rest and hospital stay than those in the conventional group (P&lt;0.05). Before the intervention, there was no significant difference in the quality of life between the two groups (P&gt;0.05); 3 months and 1 year after the intervention, the quality of life of patients in the study group was higher than that of patients in the conventional group (P&lt;0.05). The overall incidence of adverse reactions was significantly lower in the study group than in the conventional group (P&lt;0.05). Conclusion: Multidisciplinary specialized nursing care produces an ideal clinical outcome for postoperative patients with pancreatic cancer. It substantially reduces recovery time, boosts short and long-term postoperative quality of life, and diminishes the incidence of adverse reactions in patients. This protocol merits clinical application.

A 24 V to 1 V integrated dual-charging path dual-inductor hybrid converter for improved step-up load transient response

This paper proposes a dual-charging-path dual-inductor hybrid converter that can charge two inductors simultaneously to improve the step-up load transient response. The proposed scheme only introduces one additional switch and capacitor to form a dual charging path during step-up load transient response. All power switches are integrated using 5 V transistors with 0.25 μm HV BCD process. Using type-3 PWM control combined with a fast load transient detector, simulation results show that the proposed circuit achieves 55.4% voltage drop and 23.6% recovery time reduction compared to the conventional DIH converter for load transient step from 20 mA to 4 A.

Managing business continuity in the Arctic: Experiences from mining.

This article presents a model for business continuity capacity, which shows how organizations can analyze possible gaps in their business continuity capability and thereby increase their capacity to recover value-adding critical activities. Using an example of a flooded mine on Svalbard, the study investigated how the mining company Store Norske Spitsbergen Coal Company (SNSK), with considerable experience with similar events and an excellent safety record, could fail to manage a well-known event and reduce recovery times of its critical activities. The analysis explored how experience in safety and incident management does not necessarily mean that these abilities are transferable to a new but similar event. The study sought to answer the research question: To what extent does SNSK's systematic work with safety, and experience with flooding events, improve business continuity capacity? In the Arctic, emergency response can take hours or days to arrive after the event. A structured recovery system can support pre-existing platforms aimed at safety, to include the critical activities needed to ensure an organization's overall survival. Systematic work can improve performance and make the organization engage in a virtuous cycle by implementing management structures, risk identification systems, competency development, and processes for the in situ evaluation of hazards. However, as seen here, the organization needs to pay attention to changes that could affect risk assessments and threat levels well-known events. These insights can be utilized by other organizations seeking synergy when strengthening their safety and business continuity performance.

Utility of CRISPR/Cas mediated electrochemical biosensors.

Electrochemical biosensors represent a class of sensors that employ biological materials as sensitive elements, electrodes as conversion elements, and potential or current as detection signals. The integration of CRISPR/Cas systems into electrochemical biosensors holds immense potential, offering enhanced versatility, heightened sensitivity and specificity, reduced recovery time, and the ability to capture and identify analytes at low concentrations. In this review, we provided a succinct summary of the fundamental principles underlying electrochemical biosensors and CRISPR/Cas systems, and new progress of electrochemical biosensors based on CRISPR/Cas systems in virus, bacteria, and cancer detections. Besides, we discussed its pros and cons, present gaps, potential problem-solvers, and future prospects. To sum up, CRISPR/Cas mediated electrochemical biosensors will surely benefit us a lot in the detection of cells and microorganisms, and of course in other promising fields.

Case Report and Literature Review: A Severe Case of Pyoderma Gangrenosum Approached with Regenerative Medicine

Pyoderma gangrenosum (PG) is a challenging autoinflammatory neutrophilic dermatoses (ND) condition characterized by painful skin alterations leading to ulceration and tissue necrosis. Regenerative medicine (RG) offers promising strategies for addressing these challenges. Diverse therapies including mesenchymal stem cells (MSC), MSC-exosomes, tilapia skin grafts with fibroblast growth factors (FGF), and antioxidants like Vitamin C (VitC), have demonstrated effectiveness in promoting wound healing, reducing inflammation, and restoring tissue function. This paper offers comprehensive insights into the pathogenesis, epidemiology, and conventional treatment approaches for PG, while also providing a concise review of pertinent RM therapies. In this case report, a severe case of PG is managed with a combination of RM therapies, with remarkable results. A 73-year-old patient experienced persistent ulceration, pain, and edema despite conventional treatments. The administration of IV (Intravenous) MSCs, MSC-exosomes, tilapia skin graft, FGF, and VitC resulted in significant improvement in wound healing, pain reduction, and inflammation control. This case demonstrates the potential use of RM therapies in managing complex dermatological conditions like PG. The integration of regenerative approaches provides hope for patients with challenging conditions, potentially leading to enhanced outcomes and reduced recovery times. As PG remains a difficult-to-treat condition, RM holds promise as a valuable alternative therapy option for patients facing these severe dermatoses conditions.

Perception and practices of depth of anesthesia monitoring and intraoperative awareness event rate among Jordanian anesthesiologists: a cross-sectional study

BackgroundIntraoperative awareness is the second most common complication of surgeries, and it negatively affects patients and healthcare professionals. Based on the limited previous studies, there is a wide variation in the incidence of intraoperative awareness and in the practices and attitudes toward depth of anesthesia (DoA) monitoring among healthcare systems and anesthesiologists. This study aimed to evaluate the Jordanian anesthesiologists’ practice and attitudes toward DoA monitoring and estimate the event rate of intraoperative awareness among the participating anesthesiologists.MethodsA descriptive cross-sectional survey of Jordanian anesthesiologists working in public, private, and university hospitals was utilized using a questionnaire developed based on previous studies. Practice and attitude in using DoA monitors were evaluated. Anesthesiologists were asked to best estimate the number of anesthesia procedures and frequency of intraoperative awareness events in the year before. Percentages and 95% Confidence Intervals (95%CI) were reported and compared between groups using chi-square tests.ResultsA total of 107 anesthesiologists responded and completed the survey. About one-third of the respondents (34.6%; 95% CI 26.1–44.2) had never used a DoA monitor and only 6.5% (95% CI 3.1–13.2) reported using it as a “daily practice”. The use of a DoA monitor was associated with experience and type of health sector. However, 81.3% (95% CI 66.5–83.5) believed that currently available DoA monitors are effective for DoA monitoring and only 4.7% (95%CI 1.9–10.8) reported it as being “invalid”. Most respondents reported that the main purpose of using a DoA monitor was to prevent awareness (86.0%; 95%CI 77.9–91.4), guide the delivery of anesthetics (63.6%; 95%CI 53.9–72.2), and reduce recovery time (57%; 95%CI 47.4–66.1). The event rate of intraoperative awareness was estimated at 0.4% among participating anesthesiologists. Most Jordanian hospitals lacked policy intending to prevent intraoperative awareness.ConclusionsMost anesthesiologists believed in the role of DoA monitors in preventing intraoperative awareness, however, their attitudes and knowledge are inadequate, and few use DoA monitors in routine practices. In Jordan, large efforts are needed to regulate the use of DoA monitoring and reduce the incidence of intraoperative awareness.