Compromised Situation Research Articles

Exploring the Impact of the Synthesis Variables Involved in the Polyurethane Aerogels-like Materials Design.

This research presents a novel approach to synthesising polyurethane (PUR)-based aerogels at the pilot scale, optimizing synthesis variables such as the gelation solvent, solids content, chain extender/isocyanate ratio, and dispersion mode. The solids content (2-11 wt.%) is the parameter with the most influence on the density of the aerogels, with a clear decrease in this property as the solids content decreases. On the other hand, it was demonstrated that minimizing the excess of ethylenediamine (used as chain extender) in relation to the isocyanate is a valuable consideration to improve the thermal conductivity of the aerogel. Related to the chain extender/isocyanate ratio, a compromise situation where the initial isocyanate reacts almost completely is crucial. Fourier-transform infrared spectroscopy was used to conduct such monitoring during the reaction. Once the conditions were optimised, the aerogel showing improved properties was synthesised using ethyl acetate as the gelling solvent, a 3.7 wt.% solids content, an ethylenediamine/isocyanate ratio of 0.20, and sonication as the dispersion mode, attaining a thermal conductivity of 0.030 W m-1 K-1 and a density of 0.046 g cm-3. Therefore, the synthesized aerogel emerges as a promising candidate for use in the construction and automotive industries.

Natural clays as adsorbents for the efficient removal of antibiotic ciprofloxacin from wastewaters: Experimental and theoretical studies using DFT method

Natural clays were used as adsorbent to remove ciprofloxacin from aqueous solutions by adsorption. The textural, structural, and morphological properties were examined, finding low-moderate specific surface area values (9.9–50.1 m2g−1) and a structure coincident with the smectite phase. Adsorption kinetic studies revealed that clay 3 and 4 reached a CIP removal around 70–80 % in 7–8 h. Elovich and pseudo-second-order models were the most suitable to describe the kinetics. The highest equilibrium adsorption capacities (qe = 150.2–193.7 mg g−1) were obtained for clay 1, 3, and 4; the lowest (qe = 30.6 mg g−1) was found for clay 2, which showed the highest-ordered structure. The Freundlich adsorption model led to the best-fitting results. From pH studies, working at solution pH = 4.0 led to the best adsorption results. The estimated thermodynamic parameters suggested that the adsorption process can be considered of physical nature. It was found that the high concentration of CO32– salts in the hospital wastewater effluent enhanced the CIP adsorption capacity, showing a CIP removal of about 95 % for the clay 3. Therefore, the adsorbent with the greatest compromise situation among all the variables was clay 3, presenting the maximum CIP removal after 7 h at pH 4.0, 50 °C and real matrices. The reusability of natural clays can be successfully regenerated by NaOH treatment using the adsorption/desorption process, an indication of its excellent reusability and stability during the regeneration. Finally, DFT molecular studies were performed to clarify the particularities of the adsorption of CIP onto clays.

Oral Candidiasis a common manifestation of xerostomia and chronic renal failure: A report of two case series

Candida species is a natural commensal in the oral cavity in around 53% of the population However, it becomes opportunistic in immune compromised situations and inpatients taking certain medications. The evaluation of risk variables is critical in the management of candidal infection. It is critical to precisely record medical history of the patient in order to know the exact underlying cause. This case report will highlight two candidiasis cases in patients with chronic renal disease and patient on antidepressant therapy.

‘When I get upset about my children’s problem, I can’t concentrate’- International students reflect on their roles as parents while studying in the UK

This article explores international student–parents’reflections about their children’s difficulties as temporary sojourners in UK schools, and the ways in which they attempt to support them in the process of settling down at school. The data is drawn from qualitative research interviews (Richards 2003; Hiller & DiLuzio 2004) with 25 student parents. The emerging themes focus on parents’ attempts to assist their children with academic and linguistic problems and with making and maintaining friendships. A major theme emerges about the role of host schools, and also about the parents’ emotional burden regarding their own compromised situation. The data reflects overall that the first year of sojourn is often more problematic than expected, and thus more research in this area is needed to address how universities interested in internationalisation can best support these student parents. Further, more research is needed into ways in which local schools, including both teachers and learners can best accommodate international children focussing on their unique competencies.

The Random Vibrations of the Active Body of the Cultivators

The article continues the exposition of the results obtained in researching an agricultural machine for processing soil, designed for research with applications including exploitation. The MCLS (complex machine for soil tillage) was designed to research the working processes of the instruments intended for soil processing. The MCLS cultivator is a modulated machine (it can work for three working widths: 1, 2, and 4 m, with tractors of different powers) that is designed to use a wide range of working bodies. The experimental data obtained with the structure with a working width of 1 m and the results of their processing within the framework of the theory of random vibrations are presented in this article. The experimental results are analysed as random vibrations of the supports of the active working bodies. As a result, the main characteristics of random vibrations are exposed: the distribution function, the average value, the autocorrelation, and the frequency spectrum. These general results regarding random vibrations are used for several critical applications in the design, execution, and exploitation of some subassemblies and assemblies of agricultural machines of this type. The main applications include estimating the probability of the occurrence of dangerous load peaks, counting and selecting the load peaks that produce fatigue accumulation in the material of the supports of the working bodies, identifying some design deficiencies or defects in the work regime, and estimating the effects of vibrations on the quality of soil processing. All of the outcomes are composed of applications in MCLS research and exploitation. The applications pursue well-known objectives of modelling the working processes of agricultural machines: safety at work, increasing the quality of work, optimising energy consumption, and increasing productivity, all in a broad context to obtain a compromise situation. The material and the method are based on experimental data acquisition, processing, and interpretation.

Establishing a surveillance system on sexual and reproductive health and rights (SRHR) of key populations (KPs) at risk of compromised outcome of SRHR- A protocol for a mixed-method study.

Key populations (KPs) who are at risk of compromised situation of sexual and reproductive health and rights in Bangladesh constitute including males having sex with males, male sex workers, transgender women (locally known as hijra) and female sex workers. Globally, these key populations experience various sexual and reproductive health and rights burdens and unmet needs for ailments such as sexually transmitted infections including Neisseria Gonorrhoea, Chlamydia Trachomatis and human papillomavirus. Most key population focused interventions around the world, including Bangladesh, primarily address human immune deficiency virus and sexually transmitted infections-related concerns and provide syndromic management of sexually transmitted infections, other sexual and reproductive health and rights issues are remained overlooked that creates a lack of information in the related areas. There is currently no systematic research in Bangladesh that can produce representative data on sexual and reproductive health and rights among key populations, investigates their sexual and reproductive health and rights needs, how their needs evolve, and investigate underlying factors of sexual and reproductive health and rights issues that is crucial for informing more sexual and reproductive health and rights-friendly interventions for key populations. Keeping all these issues in mind, we are proposing to establish a sexual and reproductive health and rights surveillance system for key populations in Bangladesh. The sexual and reproductive health and rights surveillance system will be established in Dhaka for males having sex with males, male sex workers and transgender women, and the other in Jashore for female sex workers. The duration will be for 3 years and data will be collected twice, in year one and year two adopting a mixed method repeated cross-sectional design. All key populations 15 years and above will be sampled. Behavioural data will be collected adopting a face-to-face technique and then biological samples will be collected. Those who will be found positive for human papillomavirus, will be referred to a government hospital for treatment. Free treatment will be provided to those who will be found positive for other sexually transmitted infections. In total, 2,240 key populations will be sampled. Written assent/consent will be taken from everyone. Data will be entered by Epi-Info and analysed by Stata. Report will be produced in every year. This surveillance system will be the first of its kind to systematically assess the situation of sexual and reproductive health and rights among selected key populations in Bangladesh. It is expected that this study will provide insights needed for improving the existing sexual and reproductive health and rights intervention modalities for these vulnerable and marginalized key populations.

PROSTHODONTIC MANAGEMENT OF RARE ODONTOGENIC TUMOR (PINDBORG TUMOR) WITH IMPLANT RETAINED MANDIBULAR OVERDENTURE

Pindborg tumour or calcifying epithelial odontogenic tumour (CEOT) is a rare, slow-growing benign tumour occurring most frequently in the posterior part of the mandibular arch. Management ranges from simple enucleation to a segmental resection of the mandible. The latter compromises the jaw foundation for any future prosthetic rehabilitation and warrants jaw reconstruction procedures to improve the retention and stability of the prosthesis. Using mini-implants in such compromised situations is a minimally invasive and cost-effective aid compared to conventional implants. The present case report documents the prosthetic rehabilitation of a patient who underwent mandibular resection for a Pindborg tumour using mini-implants.

Improvement of bioactivity with dual bioceramic incorporation to nanofibrous PCL scaffolds

Bone tissue injuries, diseases or related clinical interventions require bone tissue engineering (BTE) approaches for regeneration of large bone defects, especially for compromised situations. Most BTE applications in literature focused on composites of polymers with a single type of bioceramic. However, native bone matrix has various inorganic components. Accordingly, this study aimed to investigate the use of dual bioceramics in BTE scaffolds prepared by wet-electrospinning of Poly-caprolactone (PCL) and bioceramics; hydroxyapatite (HA), carbonated hydroxyapatite (CHA) and akermanite (AKR). After physicochemical characterizations of single and dual bioceramic-discs, it was found that AKR component should be at most 10% and thus, fibrous 3D composite scaffolds (PCL/HA; PCL/CHA; PCL/90HA/10AKR; PCL/90CHA/10AKR) were prepared. Scaffolds were then compared for degradation, swelling and microstructure properties. PCL/CHA, PCL/HA/AKR and PCL/CHA/AKR scaffolds improved apatite formation and presence of CHA, AKR or both in scaffolds increased Ca/P precipitation compared to HA involving scaffolds. Specifically, when two bioceramics were introduced, there was a noticeable increase in mineralization. No significant weight change was detected for scaffolds after two weeks of incubation. Presence of bioceramics in scaffolds significantly reduced swelling of PCL scaffolds with PCL/90HA10AKR and PCL/90CHA10AKR having higher swelling results than PCL/HA and PCL/CHA, respectively. Additionally, scaffolds with dual bioceramics (90HA10AKR, 90CHA10AKR) had higher cell proliferation for bone cells (Saos-2). In terms of osteogenic activity all groups showed increased ALP activity at 14 days compared to 7 days with PCL/CHA scaffolds having the highest value. Results suggests that newly developed PCL/90HA10AKR and PCL/90CHA10AKR composites hold potential for bone tissue engineering applications.

Effects of Cognitive Loading on Pilots and Air Traffic Controller Performance: Implications for Neural Dynamics and Cognitive Flow

The digitized environment in aviation operations has seen marked growth and expansion as new technologies arrive and are implemented. The flight deck and air traffic control functions are two areas where growth is particularly robust. Previous work has identified the effects of compounded cognitive loading and SHELL interfaces in these work environments, and the potential consequences when relief or collaborative resource management is not employed effectively. This paper examines the relationship of cognitive loading in the context of cognitive flow to identify potential areas where neural metrics might aid in a better understanding of the dynamics to determine thresholds of overload. Application of the Triple-Network Model of neural regulation dynamics and Polyvagal Theory are explored for potential relationships to compromised situation awareness and working memory constraints. Conclusions indicate that when cognitive flow is disrupted, cognitive processing loads on working memory expand exponentially and rapidly reach a plateau that inhibits safe performance. Implications suggest a more focused effort in systems and training to address neural metrics and cognitive processing rates.

Fear of Falling Avoidance Behavior in Parkinson's Disease: Most Frequently Avoided Activities.

Fear of falling avoidance behavior (FFAB) is common in Parkinson's disease (PD). The objectives of the study are to determine what activities are most avoided due to FFAB among people with PD and whether any associations exist with demographic factors or fall history. Cross-sectional analysis of 174 individuals with PD using the Modified FFAB Questionnaire. Walking in dimly lit, unfamiliar places, and different surfaces, lifting and carrying objects, walking in crowded places, recreational/leisure activities, and going up/downstairs were most avoided. Fallers reported more FFAB (ps < .029). FFAB for certain activities was associated with increased or decreased odds of falling. Individuals with PD avoid walking in compromised situations and engaging in recreational/leisure activities due to FFAB. While excessive FFAB may increase the odds of falling, protective forms may be associated with decreased odds. Targeting FFAB among individuals with PD may increase safe participation in meaningful occupations in the home and community.

CXCR6-based immunotherapy in autoimmune, cancer and inflammatory infliction

T cells, including both CD4+ and CD8+ T cells, play a pivotal role in mediating various inflammation and immune disorders. A long-standing challenge in T cell-based immunotherapy is to precisely inactivate or delete the pathogenic T cells in inflammation and autoimmune diseases, or to selectively expand the immunocompetent T cell in tumor or other immune compromised situations, without inducing global immunosuppression or zealous immune activation respectively. To achieve this, a specific marker is needed to differentiate the pathogenic or immunocompetent T cell among the rests. Indeed, recent progress of immunology strongly suggests that CXC chemokine receptor 6 (CXCR6, CD186) is such a kind of marker. Here, we review the emerging role of CXCR6 as a novel target for immunotherapy and discuss the underlying mechanism. We propose that CXCR6-based immunotherapy will play a significant role in autoimmune, nonalcoholic steatohepatitis (NASH), tumor, coronavirus disease 2019 (COVID-19) and even ageing-related inflammatory infliction.

Short-term mechanical circulatory support in elderly patients.

Age over 70years seems to confer poor prognosis for patients under mechanical circulatory support (MCS). Advanced age is usually a relative contraindication. Our objective was to assess the impact of age on survival of patients with short-term MCS. Retrospective analysis of ≥70-year-old patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP® due to cardiogenic shock and other situations of hemodynamic instability in a referral hospital (elderly group), compared with younger patients (<70years). We analyze factors associated with survival in elderly group. Out of 164 short-term MCS implants from 2013 to October 2020, 45 (27.4%) correspond to ≥70-year-old patients (73.3% VA-ECMO; 26.7% Impella CP®), 80% as bridge to recovery and 15.6% for high-risk percutaneous coronary intervention (PCI). We found no significant differences in complications developed between both groups. Survivals at discharge (40% vs. 43.7%, p=0.403) and at follow-up (median 13.6 [30] months) were similar in elderly and young patients (35.6% vs. 37.8%, log-rank p=0.061). Predictive factors of mortality in elderly patients were peripheral artery disease (p=0.037), higher lactate (p=0.003) and creatinine (p=0.035) at implant, longer cardiac arrest (p=0.003), and worse post-implantation left ventricular ejection fraction (p=0.003). Patients with indication of MCS for high-risk PCI had higher survival compared to other indications (p=0.013). Short-term MCS with VA-ECMO or Impella CP® in elderly patients may be a reasonable option in hemodynamic compromise situations as bridge to recovery or elective high-risk PCI, without a significant increase in complications or mortality. Age should not be an absolute contraindication, but careful selection of candidate patients is necessary.

Evaluation of Insertion Torque and Initial Stability of Single Thread Implants versus Double and Triple Thread Implants: An Animal Study

Aim: This study aimed to evaluate the insertion torque and initial stability of single thread implants versus double and triple thread implants. Methods: Forty two osteotomies were prepared in fresh bovine bone. The implants used in this study were 3 types according to the thread lead design,single thread implant, double and triple thread implants (n=14). Implants were inserted in bone blocks until reaching insertion torques (30 Ncm, 40Ncm and 50Ncm) then calibration of the part of implant inserted within bone was performed. The primary stability was assessed via resonance frequency analysis using the Osstell ISQ device. The removal torque of each implant is measured at torque 50N/cm. intergroup and intragroup comparisons were performed. The significance level was set at p ≤ 0.05 for all tests. Results: Regarding , implant insertion torque the highest value was found in single thread group followed by double thread group, while the lowest value was found in triple thread group. Primary stability results and removal torque revealed that, the highest value were found in triple thread group, followed by double thread group, while the lowest value were found in single thread group and there was a significant difference between different groups (p < 0.001) in all measured outcomes. Conclusions: When primary stability is a concern, as in low bone quality, double and triple threaded implants can provide greater primary stability and insertion torque. Double threaded implants combine optimum insertion speed and high primary stability and insertion torque in compromised situations.

Clinical Outcome of a New Surgical Technique for the Treatment of Peri-Implant Dehiscence in the Esthetic Area. A Case Report

This study describes the clinical and esthetic outcome of n apical surgical treatment on peri-implant soft tissue dehiscence in an implant with a poor prognosis in the esthetic area. The patient presented a compromised situation of clinical attachment loss both in the 1.2 implant and in the adjacent teeth. A biphasic approach consisted firstly of a connective tissue graft accessed by apical and then, 11 months later, a palatal flap technique plus a connective tissue graft. After 20 months of healing, surgical approaches without vertical releasing incisions showed a gain in recession reduction over the implant ranging from 0.3 to 2.7 mm (CI 95%), in addition to a gain in width (2 mm) and thickness (2.3 mm) of the keratinized mucosa. With respect to the white esthetic score, 4 points were gained, and with respect to the pink esthetic score, 3 points were gained. With the use of the apical approach technique and the palatal flap technique, satisfactory results are obtained in the treatment of recessions on implants, improving the amount of keratinized mucosa and the esthetic result in an objective manner in the anterior area.

The effect of antimicrobial photodynamic therapy in the osseointegration of immediately implants placed in a more compromised healing situation such as ligature‐induced periodontitis in dogs

The effect of antimicrobial photodynamic therapy in the osseointegration of immediately implants placed in a more compromised healing situation such as ligature‐induced periodontitis in dogs

Optimizing complex full arch rehabilitation by initial provisional and final CAD/CAM suprastructures

Background: The concepts to treat patients with failing dentition show a high variation. Depending on remaining bone volume the placement of a reduced number of implants without major grafting or the reconstruction of the atrophied jaw by intensive grafting procedures is recommended. All these cases require a reestablishment of the chewing and speech function. Most of the patients are adapted to the compromised situation for many years. After an ideal reconstruction quite often functional disorders appear. Aim/Hypothesis: Various procedures are recommended to reestablish the vertical dimension and to design the lingual appearance of implant borne prosthesis. Can CAD/CAM technologies improve the prosthetic workflow to minimize clinical problems like chipping, screw loosening, framework fractures and speech problems? Materials and Methods: A retrospective analysis of 30 cases which received a removable prosthesis during the healing phase of the implants was performed regarding the possible functional and technical problems of the final superstructure. 12 patients received two stage grafting procedures (TSG) with removable prosthesis TSG. 18 patients were treated with local grafting procedures and simultaneous implant placement (SIP). 15 (5 TSG, 10 SIP) patients received the final fabrication of the suprastructure consequently after implant impression taking within a period of 4.2 ÷ 4.5 week (Group A). The other 15 patients received a CAD/CAM milled provisional superstructure after impression taking within a period of 2.8 ± 3.8 weeks (Group B). These provisional suprastructures were used between 6 and 32 weeks. Results: Patients of group A had to wait longer after second stage surgery to receive a suprastructure with a higher number of consultations to adapt the bite and the vertical. In two cases the framework need to be redone, due to changes between initial bite registration and final try in of the restorations. 5 patients required a remounting after the final delivery with the discomfort of missing the implant borne prosthesis for a least one day. Patients of group A showed a higher occurrence of chipping and relining to improve speech function. Patient of Group B received the necessary adaptation of the provisional suprastructure always chairside without a absende of the restoration. After the adaptation phase the appointments for the final fabrication were reduced, due to the possibility to use the CAD/CAM data of the initial impression taking and matching of the data of the adapted provisional suprastructure. Conclusions and Clinical Implications: The use of a CAD/CAM produced provisional fixed prosthesis improves the digital work flow for the final suprastructure. The patients receive a restoration shortly after second stage surgery. Adaptation are much easier to be performed and corrections on the final restorations are not necessary. Due to the adaptation period significantly less chipping were observed. The use of CAD/CAM technologies allows cost effective prosthetic rehabilitation with a high patient satisfaction. Keywords: full arch rehabilitation, provisional suprastructure, CAD/CAM technologie, Improvement workflow, digital workflow

A Novel Design Modification to Improve Flexural Strength of Zirconia Framework: A Comparative Experimental In Vitro Study.

ABSTRACTAim:Zirconia-based restoration is successfully replacing metal ceramic restorations in posterior areas. Although higher mechanical properties of zirconia, their use in compromised situation is questionable. Hence, there is a need to modify the design which to strengthen the framework. The aim of this in vitro study was to evaluate the influence of lingual collar design on the flexural strength of CAD/CAM-fabricated posterior three-unit zirconia framework.Materials and Methods:A mandibular metallic stainless steel master mold is designed for a three-unit fixed partial denture framework. All CAD-milled 20 samples are divided into two groups based on the design. Group A––with collar (10 samples) and Group B––without collar (10 samples), tested using universal testing machine to calculate the mean fracture load and flexural strength.Statistical Analysis Used:Descriptive statistics and independent sample t test were used to find the difference between the groups, and simple linear regression was used to find the relationship between load and displacement between the groups.Results:The result of the mean flexural strength for Group A was 11328.06 ± 3770MPa and for Group B was 7633.95 ± 3196MPa; the mean fracture strength observed for Group A was 1274.04 ± 424MPa and for Group B was 858.80 ± 359MPa. A statistically significant difference was observed in flexural strength between Groups A and B (P < 0.05).Conclusion:Zirconia framework with connector dimension of 7 mm2 with lingual collar design can be successfully incorporated in compromised situation where an ideal connector dimension of 9 mm2 cannot be placed.

Who achieves the efficiency? A new approach to measure “local energy efficiency”

Abstract The basic idea of this paper is that an efficient energy planning requires a deepened awareness of the state of place. By considering the complexity of this issue - that involves both production, consumption, impacts on the environment and policy aspects - a multidimensional analysis should be implemented. The aim of the study is to propose an innovative approach for achieving increased efficiency energy by reducing the existent differential among the local areas. The approach consists of two main steps: i) the building of LEEI (Local Energy efficiency Index) and further four sub-indexes - designed by using a Principal Component Analysis - for assessing the level of local efficiency; ii) the measurement of the distance between the score achieved in the ranking by each observation and a threshold calculated as best compromise situation - realized by using a redrafted Sen Index. This methodology has been tested on a sample of 20 Italian provinces. The findings allow to provide information to policy makers concerning the overall energy efficiency of an area through a vertical comparison among the observation; while the four sub-indexes offer specific indication about the multidimensionality of the analysed phenomenon. This final step helps to offer punctual information for a future allocation to the regions, for a financial resource programming on the bases of the real weakness.

Electricity theft detection framework based on universal prediction algorithm

&lt;span lang="EN-GB"&gt;Electricity theft has caused huge losses over the globe and the trend of its perpetuation constantly evolve even as smart technologies such as smart meters are being deployed. Although the smart meters have come under some attacks, they provide sufficient data which can be analysed by an intelligent strategy for effective monitoring and detection of compromised situations. So many techniques have been employed but satisfactory result is yet to be obtained for a real-time detection of this electrical fraud. This work suggests a framework based on Universal Anomaly Detection (UAD) utilizing Lempel-Ziv universal compression algorithm, aimed at achieving a real-time detection in a smart grid environment. A number of the network parameters can be monitored to detect anomalies, but this framework monitors the energy &lt;a name="_Hlk725881"&gt;&lt;/a&gt;consumption data, rate of change of the energy consumption data, its date stamp and time signatures. To classify the data based on normal and abnormal behaviour, Lempel-Ziv algorithm is used to assign probability of occurrence to the compressed data of the monitored parameters. This framework can learn normal behaviours of smart meter data and give alerts during any detected anomaly based on deviation from this probability. A forced aggressivemeasure is also suggested in the framework as means of applying fines to fraudulent customers.&lt;/span&gt;

Utilidad y fiabilidad de la ecografía clínica en medicina familiar: ecografía del cuello y ecografía en urgencias

Ultrasound is a very useful tool for diagnosis and to handle a great sort of daily affaires. The family Doctor, as general specialist, must be competent to carry out almost all kind of wealthy situations that can potentially affect to his population. Because of that, with this tool in his hand, the Doctor can get a higher level of quality in the efficiency of the assistant procedure. This is the last paper of a serial dedicated to show the different applications of clinical ultrasound, in which most of them have been reviewed, such as abdominal, nephrourological, musculoskeletal, cardiac or pulmonary focused ultrasound. We want to finalize with scenarios like neck pathology or applications in urgencies in which we can provide the definitive data to get the right diagnosis orientation, the clinic use, or even patient live, such as the patient under deep vein thrombosis in lower members, thoracoabdominal trauma, hemodynamic compromise situation or cardiac arrest.