The Role Of Age On The Outcome In Patients With Acute Type A Aortic Dissection: A Comparison Study Between Young And Elderly Patients

Acute aortic dissection is considered a lethal disease in the cardiovascular field which requires an emergently surgical intervention. Acute aortic dissection has a mortality rate of about 1% per hour initially, with half of the patients expected to be dead by the 3rd day and almost by 80% by the end of the 2nd week. In this retrospective study we presented the age difference and the postoperative outcome in regard to the postoperative neurological complications in the patients who underwent the surgical treatment of acute type A dissection under deep hypothermia and cardiac arrest with the help of the heart-lung machine. We retrospectively analyzed 368 consecutive patients, who underwent replacement of ascending aorta using deep hypothermic circulatory arrest (DHCA) (18-22 C°) and antegrade cerebral perfusion due to AAAD between 2001 and 2016. The Patients were divided into two groups: those aged 75 years and older [elderly group; 68 (18.5%)] and those younger than 75 years [younger group; 300 (81.5%)]. Our study concluded as a result that surgical treatment of AAAD in elderly patient can be applied safely without increasing risk of neurological complication, however the mortality rate is higher compared to the younger patients but still satisfactory

Misappropriation and instrumentalisation of the Word of God : evil passions in Christian history

First published in French:Détournement et instrumentalisation de la Parole de Dieu, in Journal of Ethics in Higher Education, 2(2023), pp. 99-109. DOI: 10.26034/fr.jehe.2023.4032. © Globethics Publications, 2023

Empirical model-based control for end milling process

The main objective of this research is to develop an empirical model-based control mechanism to maintain a fine surface finish quality by maintaining on-line cutting force values. The proposed model has been developed to present the control model constraints, by varying the machining parameters to control the force output to be constant. To relate the surface finish and the cutting force in the end milling machining process, a design of experiment has been conducted to determine the effect of two different materials (aluminium and steel) and the machining parameters (feed rate, spindle speed) at a predefined depth of cut. Regression model has been applied to derive an empirical relationship of the surface finish and the cutting force versus the machining parameters for the two mentioned materials. These relationships have been applied to develop the proposed mathematical simulation model, in which the cutting force is adjusted to improve the required surface finish for the end milling operation process. The results provide means of greater efficiency by improving the surface quality, minimizing the effect of the process variablity and reducing the error cost in finishing operations

Détournement et instrumentalisation de la Parole de Dieu

Cet article pointe vers les conséquences induites par l’usage d’artifices rhétoriques et l’abus du pouvoir du langage dans l’Église. Ce sont ceux-là même, les responsables d’institutions religieuses, qui censés défendre un service honnête de la Parole, qui souvent laissent se creuser un fossé entre paroles et actions. Une intention louable de servir de manière altruiste autrui est dans ce cas détourné vers des fins égoïstes : comme gagner davantage de notoriété et de moyens financiers ; assouvir un amour immodéré du pouvoir. C’est moins à démasquer des « usurpasteurs » que nous invite l’auteur, mais bien à la relecture patiente des textes. Il n'y a rien de plus beau qu'une bible dont « les pages ont été cornées, marquées et dont la reliure fatiguée raconte l'assidue fréquentation de son propriétaire ». Chaque fois qu'une « bible se détruit par son utilisation, une femme, un homme se construit !

Fading Puppy Syndrome Associated with Toxocara canis Infection

Aim of this work was studying the role of Toxocara canis infection in fading puppy syndrome and evaluating its treatment. Twelve German shepherd puppies suffered from fading puppy syndrome and their dam were presented. The dead puppies (N.=8) were necropsied. On the other hand, living puppies (N.=4) and their dam were examined both clinically and parasitologically. The collected worms from necropsied puppies were parasitologically identified as Toxocara canis and their counts ranged from 48 to 75 per puppy. The live cases were treated by Flubendazole. The parasitological examinations of stool of live puppies and dam revealed eggs identified as Toxocara canis eggs and their counts ranged from 50 to 350 eggs per gram stool. Post-treatment counts of Toxocara canis worms in stool of live puppies and their dam were ranged from 13 to 79 worms per animal. The results of treatment proved the efficacy of Flubendazole for eradication of Toxocara canis. Toxocara canis considers one of the causes of fading puppy syndrome and could be cured by Flubendazole

Identifying strategies and techniques for the Egyptian medium and large size contractors to respond to economic hardship

There are numerous challenges and problems facing the construction industry in Egypt as a result of several economic influences and sovereign decisions, which are listed below: 1) The Central Bank of Egypt (CBE) increased the value of the US dollar against the Egyptian pound in the official market to reach USD/EGP 8.85 in March 14th, 2016. 2) Egypt’s parliament approved the value added tax (VAT) in September 8th, 2016. 3) The Egyptian Pound exchange rate liberalization in: November 3rd, 2016. 4) Hike in the value of projects\u27 funding since November 3rd, 2016. 5) Fuel prices increased following the Central Bank of Egypt\u27s decision to float the Egyptian Pound in November 4th, 2016. Many construction companies have shut down and left the market since 2016. The closure of these companies happened, as they did not acquire the experience and the managerial skills to deal with the economic hardship. They did not respond with the suitable techniques and strategies that will enable them to survive during this period of instability. This research identifies adequate strategies and techniques to be implemented by the first category contractors registered in the Egyptian Federation for Construction and Building Contractors that could enable them to survive during such economic conditions. The identification process is processed through two different methods. First, companies in other countries that have passed by similar conditions have been analyzed in order to identify the strategies and techniques they have used in order to survive. Second, interviews with experts in the Egyptian market have been conducted in order to identify the strategies implemented by their companies as a response to such economic instability. Furthermore, the strategies previously identified and applied in foreign markets are presented to those experts in order to study their applicability and efficiency if used in Egypt. A framework was developed in order to assist the construction companies in choosing the suitable techniques to their company size, through identifying the top ranked strategies and techniques that should be adopted by the company based on the parameters given to the framework. This framework has been verified by studying the financial statements of two companies, the first one has implemented almost all the top ranked strategies, and the other one has implemented only few strategies and techniques from the top tanked strategies. The figures concerning 2017 have been analyzed in respect to 2016, in order to visualize the effects of the strategies on the companies\u27 financials. The framework has been also validated through experts\u27 interviews. These experts have used and tested the framework and have rated through an interview its applicability and effectiveness. Furthermore, the experts have given few comments and recommendations in order to enhance the framework

Prevalence and Evaluation of Three Acaricides of Canine Sarcoptic Mange

Sarcoptes scabiei var canis infest different dog breeds and human. Three hundred ninety five dogs were clinically and parasitologically examined for the detection of Sarcoptes scabiei var canis. Twenty four infested dogs were classified into three groups (8 dogs per group), each group was treated separately with ivermectin oral tablets (Ivactin®) or selamectin pour on(Revolution®) or doramectin injection (Dectomax®). The prevalence of Sarcoptes scabiei var canis in totally examined dogs was 6.08%. The prevalence was highest in German Shepherd dogs and lowest in St. Bernard dogs. Three acaricides have the same successful treatment rate (100%) at the fourth weeks post treatment. It could be concluded that ivermectin tablets is the cheapest and easiest to administer and more preferable to be used for treatment of Sarcoptes scabiei var canis infested dogs

Age-Associated Changes in Voltage-Gated Sodium Channels Within the Right Atrium Predispose the Elderly to Atrial Fibrillation

Atrial Fibrillation (AF) is the most common cardiac arrhythmia worldwide with sufferers of the condition facing significant morbidity and mortality. Ageing alone is identified as the most significant risk factor for developing the arrhythmia. As such, an ageing global population has, and will continue to give rise to a marked prevalence of AF, placing enormous pressure on healthcare systems around the world. Ionic remodelling of sodium channels has been observed in animal studies with regards to the ageing process which drive the arrhythmogenic pathology, with parallel observations made with regards to AF. This study will examine, and potentially unify, the narratives of ionic remodelling in AF and ageing, focusing specifically on the expression of two voltage-gated sodium channel (VGSC) isoforms within the human heart; Nav1.5 & Nav1.8. The former being the native cardiac isoform and principal driver for phase 0 of the action potential, and the latter a neuronal isoform implicated in pathological late currents which predispose the cardiomyocyte to electrical instability. This study involved sampling human right atrial appendage from patients undergoing routine cardiac surgery at Castle Hill Hospital. With increasing age, expression of Nav1.5 declined with a Pearson’s correlation coefficient of -0.25. Comparing the extremes in age of these samples, protein expression was decreased by 18.8% in the older group (P=0.18). The inverse trend was noted with regards to Nav1.8 with a positive correlation of +0.259. When comparing the extremes of age an increase of 32% was observed (P=0.039). These results suggest that the ageing process remodels the human heart in a manner which diminishes the capacity for sodium ion influx critical for conduction during action potential upstroke, meanwhile upregulating ion channels which enhance the aberrant late currents. To investigate the ionic landscape of cardiac tissue in AF, patients with the arrhythmia were matched on age with patients in sinus rhythm. AF patients were found to have significantly reduced expression of Nav1.5 (P=<0.05). These results suggest that the loss of native cardiac sodium channels may be a key step in the pathophysiology of cardiac arrhythmia in humans, and a process in which the ageing heart undergoes which underpins development of AF. In order to investigate the precise mechanics modulating the ionic redistribution observed, this study examined the role JNK may have as a potential regulator of sodium channel expression in the human heart. JNK has been suggested as having a strong influence in the expression of other ion channel proteins-specifically Cx43. Total expression of JNK was found to be 56 % greater in the oldest population compared to younger patients (P=0.05). Examination of the direct role increased levels of JNK may have on VGSC expression was investigated using pharmacological manipulation of this pathway through Anisomycin (JNK activator) and SP600125 (JNK inhibitor). Subjectively, it has been noted that inhibition of JNK markedly reduced the expression of Nav1.8, whereas upregulation of this protein seemed to increase the density of expression of the neuronal isoform

Big Data Affirmative Action

As a vast and ever-growing body of social-scientific research shows, discrimination remains pervasive in the United States. In education, work, consumer markets, healthcare, criminal justice, and more, Black people fare worse than whites, women worse than men, and so on. Moreover, the evidence now convincingly demonstrates that this inequality is driven by discrimination. Yet solutions are scarce. The best empirical studies find that popular interventions—like diversity seminars and antibias trainings—have little or no effect. And more muscular solutions—like hiring quotas or school busing—are now regularly struck down as illegal. Indeed, in the last thirty years, the Supreme Court has invalidated every such ambitious affirmative action plan that it has reviewed. This Article proposes a novel solution: Big Data Affirmative Action. Like old-fashioned affirmative action, Big Data Affirmative Action would award benefits to individuals because of their membership in protected groups. Since Black defendants are discriminatorily incarcerated for longer than whites, Big Data Affirmative Action would intervene to reduce their sentences. Since women are paid less than men, it would step in to raise their salaries. But unlike old-fashioned affirmative action, Big Data Affirmative Action would be automated, algorithmic, and precise. Circa 2021, data scientists are already analyzing rich datasets to identify and quantify discriminatory harm. Armed with such quantitative measures, Big Data Affirmative Action algorithms would intervene to automatically adjust flawed human decisions—correcting discriminatory harm but going no further. Big Data Affirmative Action has two advantages over the alternatives. First, it would actually work. Unlike, say, antibias trainings, Big Data Affirmative Action would operate directly on unfair outcomes, immediately remedying discriminatory harm. Second, Big Data Affirmative Action would be legal, notwithstanding the Supreme Court’s recent case law. As argued here, the Court has not, in fact, recently turned against affirmative action. Rather, it has consistently demanded that affirmative action policies both stand on solid empirical ground and be well tailored to remedying only particularized instances of actual discrimination. The policies that the Court recently rejected have failed to do either. Big Data Affirmative Action can easily do both