Clinical Features of Patients Newly Admitted to the Emergency Department of a Psychiatric Hospital with an Emphasis on Physical Examination

Introduction: Many medical diseases and their related signs and symptoms are not identified in routine assessments in emergency departments. Objective: We investigated the prevalence of abnormal findings in physical examination of the patients who were newly admitted to emergency department (ED) of a psychiatric hospital. Methods: We studied 200 patients (143 males, 71.5%) who were recently admitted to the ED of a psychiatric university hospital during a 4-month period in 2018. A thorough physical and neurological examination was performed on each subject. Results: Nearly all of the patients (99.3%) had at least one positive finding in physical (non-neurological) examination and 95% had at least one positive neurological finding. We also found at least one problem in gastrointestinal, respiratory or cardiac system of 22.1%, 24% and 33% of the subjects, respectively. The most frequent findings were in cranial nerve I (30%, more common in substance abuse disorder), and visual acuity (52.6%), as well as recent memory (%68.7), attention (%33.7), orientation to time (%29.5), hypokinetic movements (%28.1, more common in females and psychotic patients), akathisia (41.6%), and skin (%85.1, more common in substance abuse and personality disorders). T wave changes were seen in 31.9% and arrhythmia in 16% of the patients. Conclusions: Abnormal findings in examination of the patients admitted to EDs are very prevalent, but most of the abnormalities are not detected or reported in the routine ward examinations. More emphasis should be placed on the examination of olfactory nerve (especially in patients with substance abuse disorder), cognition (especially in older adults), extrapyramidal system, heart, abdomen and skin (especially in patients with personality disorder) during the first week of admission in a psychiatric emergency setting

Right Lower Extremity Numbness- an Atypical Presentation of Acute Aortic Dissection

Acute aortic dissection (AAD) is one of the most challenging and emergency conditions in the health care system. It`s associated with high mortality. A 55-year-old person was admitted to the emergency department due to numbness of his right leg. The patient had no complaints of chest pain on arrival. However, echocardiography revealed aortic dissection and computed tomography (CT) scan confirmed the diagnosis. The patient was immediately referred to Rajaei hospital for further specialized procedures. He went into the operating room directly and had a successful operation of aortic dissection repair. Rarely AAD has atypical manifestation and may have unusual clinical presentations. Thus, it could cause a delay in establishment of diagnosis of this emergent condition. The purpose of this report was to introduce a rare initial presentation of an atypical aortic dissection

OpenDPD: An Open-Source End-to-End Learning & Benchmarking Framework for Wideband Power Amplifier Modeling and Digital Pre-Distortion

With the rise in communication capacity, deep neural networks (DNN) for digital pre-distortion (DPD) to correct non-linearity in wideband power amplifiers (PAs) have become prominent. Yet, there is a void in open-source and measurement-setup-independent platforms for fast DPD exploration and objective DPD model comparison. This paper presents an open-source framework, OpenDPD, crafted in PyTorch, with an associated dataset for PA modeling and DPD learning. We introduce a Dense Gated Recurrent Unit (DGRU)-DPD, trained via a novel end-to-end learning architecture, outperforming previous DPD models on a digital PA (DPA) in the new digital transmitter (DTX) architecture with unconventional transfer characteristics compared to analog PAs. Measurements show our DGRU-DPD achieves an ACPR of -44.69/-44.47 dBc and an EVM of -35.22 dB for 200 MHz OFDM signals. OpenDPD code, datasets, and documentation are publicly available at https://github.com/lab-emi/OpenDPD.Comment: To be published at the 2024 IEEE International Symposium on Circuits and Systems (ISCAS), Singapor

A new design equation for prediction of ultimate bearing capacity of shallow foundation on granular soils

A major concern in design of structures is to provide precise estimations of ultimate bearing capacity of soil beneath their foundations. Direct determination of the bearing capacity of foundations requires performing expensive and time consuming laboratory tests. To cope with this issue, several numerical models have been presented by researchers. This paper presents the development of a new design equation for the prediction of the ultimate bearing capacity of shallow foundations on granular soils using linear genetic programming (LGP) methodology. The ultimate bearing capacity is formulated in terms of width of footing, footing geometry, depth of footing, unit weight of sand, and angle of shearing resistance. The LGP-based design equation is established using the results of several load tests on real sized foundations presented in the literature. Validity of the model is verified using a part of laboratory data that are not involved in the calibration process. The statistical measures of coefficient of determination, root mean squared error and mean absolute error are used to evaluate the performance of the model. Sensitivity and parametric analyses are conducted and discussed. The proposed model accurately characterizes the ultimate bearing capacity resulting in a very good prediction performance. The LGP model reaches a better prediction performance than the well-known prediction equations for the bearing capacity of shallow foundations

AN INTEGRATED APPROACH FOR SIMULATION AND PREDICTION OF LAND USE AND LAND COVER CHANGES AND URBAN GROWTH (CASE STUDY: SANANDAJ CITY IN IRAN)

One of the growing areas in the west of Iran is Sanandaj city, the center of Kordestan province, which requires the investigation of the city's growth and the estimation of land degradation. Today, the combination of remote sensing data and spatial models is a useful tool for monitoring and modeling land use and land cover (LULC) changes. In this study, LULC changes and the impact of Sanandaj city growth on land degradation in geographical directions during the period 1989 to 2019 were investigated. Also, the accuracy of three models, artificial neural network-cellular automata (ANN-CA), logistic regression-cellular automata (LR-CA), and the weight of evidence-cellular automata (WOE-CA) for modeling LULC changes was evaluated, and the results of these models were compared with the CA-Markov model. According to the results of the study, ANN-CA, LR-CA, and WOE-CA models, with an accuracy of more than 80%, are efficient and effective for modeling LULC changes and growth of urban areas

Microseismicity and seismotectonics of the South Caspian Lowlands, NE Iran

This paper is concerned with the microseismicity and seismotectonics of the eastern South Caspian Sea region, where the East Alborz mountains descend to meet the South Caspian Lowlands of NE Iran. To better understand the present-day tectonics and seismicity of this region, which includes the cities of Gorgan and Gonbad-e-Qabus (combined population 500 000), we installed a temporary local seismic network across the area for 6 months between 2009 and 2010. We analysed the seismicity and focal mechanisms together with data from the permanent networks of the Institute of Geophysics, University of Tehran (IGUT) and the International Institute of Earthquake Engineering and Seismology (IIEES), based in Tehran. Microseismicity is focused primarily on the Shahrud fault system, which bounds the east Alborz range to the south. Relatively few earthquakes are associated with the Khazar thrust fault, which bounds the north side of the range. A cluster of shallow microseismicity (<15 km depth) occurs 40 km north of the Khazar fault (within the South Caspian Lowlands; SCL), an area typically thought to be non-deforming. This area coincides with the location of three relatively deep thrust earthquakes (M_w 5.3–5.5) which occurred in 1999, 2004 and 2005. Inversion of teleseismic body waveforms allows us to constrain the depth of these earthquakes at 26–29 km. Although significant sedimentation throughout the SCL obscures any expression of recent fault activity at the surface, focal mechanisms of well-located events from the shallow cluster of micro-seismicity show a significant component of left-lateral strike-slip motion (assuming slip occurs on NE–SW fault planes, typical of active faults in the region), as well as a small normal component. Inversion of traveltimes for well-located events in our network yields a velocity structure for the region, and a Moho depth of 41 km. The pattern of deep thrust and shallow normal seismicity could be explained by bending of the rigid South Caspian crust as it underthrusts the East Alborz mountains and Central Iran. Late Quaternary reorganization of drainage systems in the SCL may be the result of shallow normal fault activity within the SCL

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Improving EAP-TLS performance using cryptographic methods

This study is conducted to study and compare two types of Extensible Authentication Protocol-Transport Layer Security (EAP-TLS) in order to provide an alternative technique using robust cryptographic methods. Alternative EAP-TLS uses Elliptic Curve Digital Signature Algorithm (ECDSA) and Secure Hash Algorithm (SHA-256) to provide robust security and high performance. The alternative method and employed mechanisms are fully described, and compared to main EAP-TLS method. The results show the alternative algorithm provides strong security, high speed, and more efficiency with approximately same level of memory usage compared to main EAP-TLS

Surveying the quality of prehospital emergency services for the elderly falls 2017

INTRODUCTION: Falls are the most common cause of injuries in elderly population. This study aimed to determine the quality of prehospital emergency services (EMS) for the elderly falls in 2017. MATERIALS AND METHODS: This cross-sectional study was carried out at the Pre-hospital Emergency Center of Kashan in 2017. The sample consisted of elderly people who had reported fall incidents in EMS. The questionnaire consisted of 7 areas with 54 items. Data collected by descriptive and inferential statistics of Friedman and Mann–Whitney were analyzed by SPSS v. 16 software. RESULTS: The number of elderly people was 150 (58% female) and the average age was 68.22 ± 6.75 years. Most falls (88.65%) occurred at home. The average performance scores (between 0 and 2) were as follows: assessment of the scene of the incident (1.51), primary assessment of the elderly (1.46), airway management (1.64), circulation management (1.78), fixation (1.82), secondary and continuous assessment (1.59), and patient transfer (1.68). It was found that secondary assessment and transfer of the male patients were significantly higher in quality than female patients (P < 0.05). CONCLUSIONS: In this research, the quality of care in all areas was reported to be desirable. It is recommended that the weaknesses of each area are investigated and the necessary strategies are taken into account such as staff training, changes in data collection forms, and training for the elderly

Paradigms of Interaction Between Culture and Politics

Political thought as a normative knowledge seeks a good society and the means for its realization. Accordingly, every intellectual paradigm introduces us a social and individual situation which is the best. This model, itself requires a dramatic change in the culture and flourishes it. In another words, there is a necessary relationship between the elements of political thought and the culture in every society. This relationship is twofold, so it is impossible to indicate whether which aspect is the first. So every paradigm feeds some special elements into the current culture of society, while there is it feedback. It is important that political thought goes in search of condition for cultural flourishing which is according whit the criteria of good society. This paper focuses on most important paradigm in political thought history and shows the trend in which indicates the relationships between political thought and culture. This trend looks at human beings as "citizen", then "the individual"; and in the modem era, paradigms of "critical modem", "postmodern", and "communitarian" has a key role in prospering the realm of culture