Renal complications of lipodystrophy: A closer look at the natural history of kidney disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/1/cen13732_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/2/cen13732.pd

Development and mechanical modeling of Si1-XGex/Si MQW based uncooled microbolometers in a 130 nm BiCMOS

This paper presents the development of process integration and mechanical modeling of a Si1-xGex/Si MQW based uncooled micro-bolometer. The recent progress on layer transfer based integration scheme of Si1-xGex/Si based micro-bolometer into a 130 nm BiCMOS process is presented. The two important parts of the process integration, namely the layer-transfer and stress compensation of the arms are studied. The initial successful results on layer transfer and the FEM modeling for the stress compensation of the thin and narrow arms of the bolometer is presented. Finally, the developed FEM model is compared with the fabricated cantilevers. The results show that the developed FEM model has a very good matching with the experimental results; thus very convenient to use for the FEM modeling of the full bolometer structure

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Nursing Responsibilities And Non-Pharmacological Approaches In Delirium Management

Delirium is a common clinical syndrome; characterized by rapid onset and fluctuating symptoms during the day. A decrease in functional capacity, an increase in length of stay at the hospital, and an increase in mortality are negative results seen in delirious patients. Therefore, patients should be assessed at least once a day in terms of delirium that may develop due to underlying factors. Because delirium monitoring does not contribute to improvement in delirium itself, delirium prevention and treatment methods are needed. Non-pharmacological approaches include re-orientation, reduction of environmental stimuli, early mobility, providing hydration and sleep hygiene. Frequently used nonpharma-cological approaches in delirium management are easy to implement, cost effective and directly related to nursing care. However, few studies document information about which approaches are used or the content and effects of these approaches. This review aims to discuss non-pharmacological approaches used in the management of delirium and the nursing responsibilities based on recent literature.WoSScopu

A karyological study on taxa of Coronopus DC section of Plantago L. genus (Plantaginaceae) in Turkey

WOS: 000358644500002In this study the chromosome number and morphology of five taxa of the Coronopus D.C. section - Plantago coronopus subsp. coronopus L., P. coronopus subsp. commutata (GUSS.) PLGER, P. crassifolia FORSSKAL, P. maritima L., and P. holosteum SCOP. (Plantaginaceae) - in Turkey were investigated using karyological techniques. The seeds of taxa were collected from natural habitats. The chromosome numbers are determined for four taxa (P. coronopus subsp. coronopus, P. coronopus subsp. commutata, P. crassifolia and P. maritima) as 2n = 4x =20 and one taxon (P. holosteum) as 2n = 2x = 12. The chromosome numbers and karyotype analysis of the species are reported for the first time for Turkey