The Causes of Acute Fever Requiring Hospitalization in Geriatric Patients: Comparison of Infectious and Noninfectious Etiology

Introduction. Infectious diseases may present with atypical presentations in the geriatric patients. While fever is an important finding of infections, it may also be a sign of noninfectious etiology. Methods. Geriatric patients who were hospitalized for acute fever in our infectious diseases unit were included. Acute fever was defined as presentation within the first week of fever above 37.3°C. Results. 185 patients were included (82 males and 103 females). Mean age was 69.7 ± 7.5 years. The cause of fever was an infectious disease in 135 and noninfectious disease in 32 and unknown in 18 of the patients. The most common infectious etiologies were respiratory tract infections (n = 46), urinary tract infections (n = 26), and skin and soft tissue infections (n = 23). Noninfectious causes of fever were rheumatic diseases (n = 8), solid tumors (n = 7), hematological diseases (n = 10), and vasculitis (n = 7). A noninfectious cause of fever was present in one patient with no underlying diseases and in 31 of 130 patients with underlying diseases. Conclusion. Geriatric patients with no underlying diseases generally had infectious causes of fever while noninfectious causes were responsible from fever in an important proportion of patients with underlying diseases

The outcome of kidney transplants with multiple renal arteries

BACKGROUND: The use of grafts with multiple renal arteries has been considered a relative contraindication because of the increased incidence of vascular and urologic complications The aim of this study is to determine whether the kidney grafts with multiple arteries have any adverse effect upon post-transplant graft and patient survival. METHODS: We reviewed the records of 225 adult kidney transplants done consecutively at our institution. Twenty-nine patients (12.8%) had grafts with multiple renal arteries. We analyzed the incidence of post-transplant hypertension and vascular complications, mean creatinine levels, patient and graft survival. In 17 cases reconstruction was done as conjoined anastomosis between two arteries of equal size, and in 6 cases as end-to-side anastomosis of smaller arteries to larger arteries. Multiple anastomoses were performed in 6 cases. RESULTS: In one patient postoperative bleeding occurred. Mean systolic blood pressures, creatinine levels at first year and last follow-up and complication rates were all in acceptable ranges. There was no significant difference in graft and patient survival between multiple and single renal artery allografts. CONCLUSION: Although the kidney grafts with multiple renal arteries have been considered a relative contraindication because of the increased risk of complications, in our study allografts with multiple arteries were used successfully in kidney transplantation

Identification of phantom movements with an ensemble learning approach

Phantom limb pain after amputation is a debilitating condition that negatively affects activities of daily life and the quality of life of amputees. Most amputees are able to control the movement of the missing limb, which is called the phantom limb movement. Recognition of these movements is crucial for both technology-based amputee rehabilitation and prosthetic control. The aim of the current study is to classify and recognize the phantom movements in four different amputation levels of the upper and lower extremities. In the current study, we utilized ensemble learning algorithms for the recognition and classification of phantom movements of the different amputation levels of the upper and lower extremity. In this context, sEMG signals obtained from 38 amputees and 25 healthy individuals were collected and the dataset was created. Studies of processing sEMG signals in amputees are rather limited, and studies are generally on the classification of upper extremity and hand movements. Our study demonstrated that the ensemble learning-based models resulted in higher accuracy in the detection of phantom movements. The ensemble learning-based approaches outperformed the SVM, Decision tree, and kNN methods. The accuracy of the movement pattern recognition in healthy people was up to 96.33%, this was at most 79.16% in amputees. 2022 The Author(s)This study is supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under grant no. EEEAG-117E579. The data that support the findings of this study are available on request from the principle investigator of the project EEEAG-117E579, Akhan Akbulut, PhD. The data are not publicly available due to the confidential information that could compromise the privacy of research participants. Open Access funding provided by the Qatar National Library.Scopus2-s2.0-8513934593

A variable-fractional order admittance controller for pHRI

In today’s automation driven manufacturing environments, emerging technologies like cobots (collaborative robots) and augmented reality interfaces can help integrating humans into the production workflow to benefit from their adaptability and cognitive skills. In such settings, humans are expected to work with robots side by side and physically interact with them. However, the trade-off between stability and transparency is a core challenge in the presence of physical human robot interaction (pHRI). While stability is of utmost importance for safety, transparency is required for fully exploiting the precision and ability of robots in handling labor intensive tasks. In this work, we propose a new variable admittance controller based on fractional order control to handle this trade-off more effectively. We compared the performance of fractional order variable admittance controller with a classical admittance controller with fixed parameters as a baseline and an integer order variable admittance controller during a realistic drilling task. Our comparisons indicate that the proposed controller led to a more transparent interaction compared to the other controllers without sacrificing the stability. We also demonstrate a use case for an augmented reality (AR) headset which can augment human sensory capabilities for reaching a certain drilling depth otherwise not possible without changing the role of the robot as the decision maker

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Valorization of Boron Mine Tailings in Alkali-Activated Mortars

Mine tailings cause significant storage and environmental problems because a large amount of tailings containing potentially numerous hazardous contaminants is generated during mining operations. Therefore, the utilization of mine tailings in different sectors should be taken into consideration to minimize the storage efforts and environmental pollution problems. In this two-stage study, the alkali activation opportunity of waste clay containing boron (WCB) discarded from boron mine production was investigated. In the first stage of this study, alkali activation of WCB calcined at different temperatures between 500 degrees C and 800 degrees C was investigated under steam-curing conditions. It was found that a calcination temperature of at least 700 degrees C is necessary to initiate the alkali activation of WCB, whereas the maximum compressive strength value was obtained at 800 degrees C. Subsequently, the effects of alkaline activator solution type (sodium hydroxide and sodium silicate) and quantity on the development of engineering properties of alkali-activated WCB mortars, such as compressive and flexural strength, water sorptivity, and drying shrinkage, were investigated by using WCB calcined at 800 degrees C. Furthermore, X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA/DTA), and scanning electron microscopy with energy dispersive spectroscopy (SEM/EDS) analyses were carried out on the hardened paste mixtures. The minimum activator concentration for alkali activation of calcined WCB was 6% Na2O by weight of WCB with a minimum silicate modulus (Ms=SiO2/Na2O) of 1.2. A compressive strength value up to 38 MPa along with acceptable water absorption characteristics and drying shrinkage values can be obtained from alkali activation of calcined WCB at 800 degrees C. NaOH activator was not as effective as sodium silicate activator in activating WCB, even in high dosages