Menstrual disturbances in perimenopausal women: What's best?

It's best to start with nonsteroidal anti- inflammatory drugs (NSAIDs), which effectively reduce heavy menstrual bleeding (strength of recommendation [SOR]: B, systematic review of randomized clinical trials [RCTs]). Perimenopausal women with heavy bleeding not controlled by NSAIDs, or other forms of dysfunctional uterine bleeding, can benefit from continuous, combined hormonal therapy with estrogen and progestin; hormonal therapy with estrogen and a cyclical progestin; or a cyclical progestin alone (SOR: B, RCTs and a systematic review of RCTs). Intrauterine devices (IUDs) containing levonorgestrel also effectively reduce bleeding and may avoid surgical intervention (SOR: B, systematic review of RCTs)

Recursiveness, Switching, and Fluctuations in a Replicating Catalytic Network

A protocell model consisting of mutually catalyzing molecules is studied in order to investigate how chemical compositions are transferred recursively through cell divisions under replication errors. Depending on the path rate, the numbers of molecules and species, three phases are found: fast switching state without recursive production, recursive production, and itinerancy between the above two states. The number distributions of the molecules in the recursive states are shown to be log-normal except for those species that form a core hypercycle, and are explained with the help of a heuristic argument.Comment: 4 pages (with 7 figures (6 color)), submitted to PR

Intelligent control system of metal vacuum sputtering process on the basis of application of multi-agent system

A vacuum sputtering process comprises evaporation of the material and subsequent vapor condensation on the substrates. Getting required and repeatable quality of coatings is challenging task. It depends on capabilities of equipment, type of evaporator, interaction evaporator with the evaporating substance and deposition process. Sputtering process parameters are determined by the ability evaporator to maintain a certain temperature evaporated substance for a long time. Controlling operations sequence of pumping and heating depends on achieving optimum vacuum conditions, in spite of used pumping method. The control system must foresee and identify emerging cracks or damage of the system components. This paper focuses on the development of intelligent control system vacuum process on the agent-based approach. © IDOSI Publications, 2013

Effect of Palliative Care–Led Meetings for Families of Patients With Chronic Critical Illness: A Randomized Clinical Trial

Family caregivers of patients with chronic critical illness experience significant psychological distress

Priority setting for pandemic preparedness and response:A comparative analysis of COVID-19 pandemic plans in 12 countries in the Eastern Mediterranean Region

Background: The COVID-19 pandemic has significantly disrupted health systems and exacerbated pre-existing resource gaps in the Eastern Mediterranean Region (WHO-EMRO). Active humanitarian and refugee crises have led to mass population displacement and increased health system fragility, which has implication for equitable priority setting (PS). We examine whether and how PS was included in national COVID-19 pandemic plans within EMRO.Methods: An analysis of COVID-19 pandemic response and preparedness planning documents from a sample of 12/22 countries in WHO-EMRO. We assessed the degree to which documented PS processes adhere to twenty established quality parameters of effective PS.Results: While all reviewed plans addressed some aspect of PS, none included all quality parameters. Yemen’s plan included the highest number (9) of quality parameters, while Egypt’s addressed the lowest (3). Most plans used evidence in their planning processes. While no plans explicitly identify equity as a criterion to guide PS; many identified vulnerable populations - a key component of equitable PS. Despite high concentrations of refugees, migrants, and IDPs in EMRO, only a quarter of the plans identified them as vulnerable.Conclusion: PS setting challenges are exacerbated by conflict and the resulting health system fragmentation. Systematic and quality PS is essential to tackle long-term health implications of COVID-19 for vulnerable populations in this region, and to support effective PS and equitable resource allocation

Parasitoses et mycoses des régions tempérées et tropicales

En parfaite cohérence avec le programme du deuxième cycle des études de médecine et les Épreuves Classantes Nationales, cet Abrégé \u27 Connaissances et pratique \u27 aborde les connaissances fondamentales en parasitologie et mycologie. - La partie \u27 Connaissances \u27 est divisée en trois sections : parasitoses, ectoparasitoses et mycoses. Les items du programme de DCEM2-DCEM4 sont clairement identifiés au début de chaque chapitre et dans un tableau récapitulatif inséré en début d\u27ouvrage. Le contenu, clair et didactique, est étayé par une très riche iconographie (avec plus de 200 illustrations en noir et en couleur) : cycles, cartes, schémas, photographies de pathologies et imageries. Enfin, chaque chapitre se conclut par un encadré Points clés résumant les éléments indispensables à connaître pour réussir les ECN. - La partie \u27 Pratique \u27, composée d\u27une trentaine de dossiers cliniques avec des corrections commentées, offre un véritable outil d\u27auto-évaluation et d\u27entraînement. - Pour cette deuxième édition, les membres de l\u27ANOFEL ont participé à la mise à jour de l\u27ensemble des items. Le nombre des illustrations a été augmenté, des tableaux récapitulatifs des traitements et des étiologies parasitaires ou fongiques par grands symptômes ont été ajoutés et les dossiers cliniques ont été renouvelés