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Introduction: Within the context of the coronavirus disease 2019 (COVID-19) pandemic, this study investigated the multifaceted challenges of bacterial infections in cancer patients with COVID-19. It focuses on clinical predictors, resistance patterns, and microbiological characteristics., Methodology: Over 18 months, 112 adult cancer patients with coronavirus infection confirmed by reverse transcription polymerase chain reaction (RT-PCR) were enrolled. Bloodstream and respiratory samples were evaluated for bacterial infection using the Phoenix automation system for definitive species identification. In vitro susceptibility testing followed the Clinical Laboratory Standards Institute (CLSI) M100-Ed30 guidelines., Results: Bacterial infections affected 25.0% of patients, encompassing bacteremia (21.4%) and respiratory tract infections (8.0%). Multivariable analysis identified hypertension, age < 60, and critical COVID-19 as significant predictors for bacterial infections (p-values = 0.024, 0.029, and 0.039, respectively). Most patients received antimicrobial therapy (93.8%), including last-resort carbapenems (52.7%) and colistin (8.9%). Thirty-three bacterial isolates were identified, with secondary infections doubling co-infection rates. Escherichia coli, Klebsiella species, and Staphylococcus aureus were the most common co-infecting species, while Klebsiella, Acinetobacter, and Pseudomonas species were more frequently associated with secondary infections. Alarmingly, 84.8% of isolates displayed high resistance patterns. All isolated S. aureus species were methicillin-resistant, and 62.5% of Gram-negative bacteria were exclusively sensitive to colistin., Conclusions: The dominance of highly transmissible hospital-acquired bacterial species, with increased resistance and extensive antibiotic use in COVID-19 patients, necessitates strict infection control and antimicrobial stewardship. Developing customized antimicrobial strategies for cancer patients with COVID-19 is crucial to managing bacterial infections effectively and improving patient outcomes., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Rasha M Abdel-Hamid, Ahmed Bayoumi, Mona S Abdellateif, Hend A Nooh, Lobna Refaat, Eman Z Kandeel, Safaa S Hassan.)

Background Family presence during resuscitation (FPDR) has been a long-debated topic in medical circles in the last 40 years. Studies usually concentrate on the opinions and responses of the family members of the patients being resuscitated. Only a handful of studies have focussed on the medical practitioner's opinions and beliefs on the topic. Hence, this study aimed to investigate opinions and beliefs regarding FPDR among emergency medicine practitioners (EMPs) in the Kingdom of Saudi Arabia. Methodology This was a self-filled, questionnaire-based study conducted among 450 EMPs across the Kingdom of Saudi Arabia. Proportions and subgroup analyses were conducted with respect to gender, experience, and seniority. EMPs were asked about the number of family members they would allow to attend the resuscitation of a patient under their care in different clinical scenarios. Results A total of 392 (87.1%) EMPs participated in this study. Overall, 64% (n = 250) of EMPs reported that they would not allow FPDR in cases that involved trauma, or if the patient being revived was female. This percentage dropped to about 33% (n = 129) when the patient being resuscitated was a child or in out-of-hospital arrest. The majority of EMPs believed that the decision to allow FPDR was the physician's decision (n = 251, 64.8%) and not the right of the family (n = 133, 34.7%). Moreover, emergency medicine board-certified physicians were more likely to allow FPDR in different cases with 19 (18.5%) in adult arrest cases, 18 (18%) in pediatric cases, and 16 (15.1%) in trauma cases, than non-board-certified practitioners (p = 0.001, 0.007, and 0.031, respectively). Female EMPs were more likely to refuse FPDR than their male counterparts (p < 0.001). Conclusions Approximately, 60-70% of EMPs allowed a member of the family to attend the resuscitation of their loved one. However, this percentage dropped in cases where the patient was a female, or the case was a trauma case instead of a medical case. Most Saudi EMPs believed that FPDR hurts the resuscitating team and might hinder the resuscitation efforts., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee of Armed Forces Hospitals issued approval REC635. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kinsarah et al.)

Introduction: An unidentified cluster of pneumonia was identified in Wuhan city of China in the last week of December 2019, named Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2). The current study explored the predictors associated with critical illness and mortality based on symptoms at the time of admission and initial physical examination findings in patients with SARS-CoV-2. Material and methods: A total of 249 records of laboratory-confirmed SARS-COV-2 patients were analyzed. Demographic profile and findings of initial physical examination were collected and analyzed. Bivariate logistic and multivariable stepwise forward regression analysis was used to identify the predictors of critical illness and mortality. Results: A total of 249 records of SARS-COV-2 patients were retrospectively studied, of whom 66 (26.5%) developed a critical illness, and 58 (23.29%) died. The mean age of patients was 45.15 (16.34) years; 171 (68.71%) were men. From 27 potential predictors for developing a critical illness, 15 were reported independent predictors for critical illness, and 13 were for increased risk of mortality. Stepwise forward regression reported dyspnea as a single strongest predictor (OR, 5.800, 95% CI-2.724−12.346; p = 0.001, R2 = 0.272) to develop critical illness. Likewise, the respiratory rate was alone reported as a strong predictor (OR, 1.381, 95% CI- 1.251−1.525; p = 0.000, R2 = 0.329) for mortality. Conclusions: Coronavirus disease is a new challenge to the medical fraternity, leading to significant morbidity and mortality. Knowledge of potential risk factors could help clinicians assess patients' risk with unfavourable outcomes and improve hospitalization decisions in the early stage.

Palaeo weathering during the Cretaceous–Eocene interval is most favorable for bauxitization, i.e., transport and deposition in traps on the karstified surfaces of the Mediterranean karst bauxite belt, including the Parnassos–Ghiona bauxite deposit. Resources of lithium (Li), a critical metal of strategic significance in karst-type bauxite deposits, have attracted significant attention in recent years. Due to the discovery of the Li enrichment in certain karstic bauxite deposits in Europe and particularly in China, this review study is focused on the unexplored Li content in the Parnassos–Ghiona (Greece) bauxite deposit, aiming to improve the understanding of the major controlling factors for their origin and enrichment of critical metals. The presence of thin (up to 50 cm) pyrite-bearing coal seams and carbonaceous facies on top of the Parnassos–Ghiona bauxite deposit, at the transition between B3 (the youngest) bauxite horizon and the occurrence of multicolor bauxite ores reflecting a multistage evolution and changes in the mineralogy and geochemistry, is a common feature with other bauxite deposits in Europe and elsewhere. The organic matter, such as microorganisms in coal layers and carbonaceous layers (derived from plants and algae growing in paleo-mires after a regression of the sea), contains Li, which is derived from seawater, as suggested by a positive correlation with B (a seawater component as well). The available geological, mineralogical, and geochemical data highlight the particular significance of coal layers and carbonaceous layers overlying bauxite bodies as a driving force for redox reactions and as a source of Li in the exploration of karst-type bauxite deposits.

This essay follows a somewhat unconventional approach to writing about Indian dance in the diaspora. I say “unconventional” because it unfolds as a kind of self-reflexive narration of my own journey as a “doubly diasporic” Indian dancer, born in Singapore but having made my career in North America. In essence, I map my own unconventional paths to understanding Indian dance in the diaspora, outside the tired and troublesome idea of “dance as heritage”. The aim of this critical meditation on my own work is to offer up new possibilities for moving Indian dance into progressive conceptual spaces that direct it out of the discursive field of cultural nationalism that frames the idea of “heritage”.

Through an analysis of the Google case, this article shows the need to rethink the critical approach in the field of media and information literacy (MIL), by introducing two little-used theoretical currents: the ethno-semiotic approach and the political economy of communication. The combination of these two approaches provides the keys to understanding contemporary issues and dealing with new live questions. [ABSTRACT FROM AUTHOR]

The longstanding question over whether or not terrorism is a unique form of violence that demands its own unique set of responses is one of the most outstanding theoretical and conceptual problems in the terrorism discourse. The contentious debate has generated and actively sustained a number of competing theories and convictions. Amidst all this, the already convoluted concept of terrorism has become all the more peculiar. The attempts to undermine the uniqueness of terrorism, in particular, pose a serious challenge to the chances of terrorism ever becoming an independent field of academic research. Given the fallout, it becomes necessary to especially reassess the critique that strips terrorism of its uniqueness and distinctiveness. [ABSTRACT FROM AUTHOR]

Tracing the use of focus groups through the communication studies discipline, this manuscript discusses the potential of critical focus groups as an emergent method within the field. Using our own critical focus group work as a grounding thread, we make the case that critical focus groups add a methodological depth to the field, specifically within the sub-disciplines of rhetoric and performance studies. We provide a guide to critical focus groups, a discussion on our use of the method, and offer future possibilities within the changing landscape of communication studies. [ABSTRACT FROM AUTHOR]

The trajectories of people attempting to reduce harmful methamphetamine use are frequently understood within a binary framework of transitioning between states of health and disease. This framework can often be reinforced by service interactions informed by these dominant narratives of recovery and addiction. In this paper, we draw on a critical interactionist analysis of ethnographic fieldwork conducted with people who use methamphetamine, to examine how their experiences could undermine this binary, observing the ways participants experienced growth, change, and progress, without necessarily maintaining abstinence. These findings support a more diverse understanding of drug use trajectories, and we explore the concept of 'living with drug use', similar to how people live with other chronic conditions by finding 'health in illness'. Participant experiences are also interpreted within the context of counter public health, arguing for the recognition and integration of values and goals which are divergent from the implicit aims of public health practice. [ABSTRACT FROM AUTHOR]

This article examines the new social perspective that the digital health transformation issue, which is emerging in the context of artificial intelligence research and applications, is produced through this current interaction of human societies and intelligent machines. By examining this problematic, it is aimed to understand what the current formation of diagnosis and treatment processes means in terms of social change. In order to analyze the main problematic, the subject has been approached in terms of neuroscience research as a theoretical framework. The theoretical framework in question is a perspective that uses the structure of organic neural networks in neuroscience research to develop artificial neural networks in artificial intelligence studies and has social references on connections and interactions. This point of view also constitutes the intellectual basis of the article, which is defined as the interconnected whole of life. A methodical operation has been developed by associating the critical and clinical concepts to clarify this intellectual basis, with the remodeling of the diagnosis and treatment processes that took place in the research aim. Understanding the transformation in health with its new scientific and social conditions is important in order to analyze the digitalized society in terms of medicine. It has been determined that this transformation, which takes place in an interconnectivity-based sociality, is a combination that offers clues of a new sociality in which human and technology come together in terms of digitalization in the field of health. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) can cause acute respiratory failure and acute respiratory distress syndrome (ARDS). The prone position (PP) is widely used in patients with severe hypoxemia due to ARDS as it improves oxygenation. The aim of this study was to investigate whether improvements in gas exchange and lung mechanics with the PPwere associated with survival in ventilated COVID-19 patients. Methods: Fourteen ventilated patients who were placed in the PP were included from May to June 2021. Clinical manifestations and lung mechanics parameters were collected. Results: The overall intensive care unit (ICU) mortality rate was 42.9%. Nonsurvivors were older (p = 0.014) and had higher Charlson comorbidity index (2.1 ± 1.5 vs. 4.8 ± 2.4, p = 0.035) and Sepsis-related Organ Failure Assessment (SOFA) (3.3 ± 1.0 vs. 7.3 ± 3.5, p = 0.019) scores compared to survivors. There was no difference in PaO2/FiO2 (P/F ratio) at baseline between the survivors and nonsurvivors. The improvement in P/F ratio (p = 0.0037) and reduction in driving pressure (Pdrive) (p = 0.046) on the second day after first PP were correlated with lower mortality. Significant predictors of successfully stopping prone treatment included a reduction in Pdrive at the first hour, lower tidal volume (Vt) at the fourth hour, and P/F ratio improvement on the second day after PP. Conclusion: Improvement in P/F ratio and reduction in driving pressure on the second day after PP were correlated with reduced mortality. Three parameters could predict successful resumption of the supine position. [ABSTRACT FROM AUTHOR]

This paper displays a Systemic Functional Linguistic and Critical Discourse Analysis of Boris Johnson's first public speech on COVID-19. Covid-19 is a very dangerous infectious disease caused by the last discovered virus of the Coronavirus strain. This virus began in Wuhan's Chinese city in December 2019. COVID-19 has spread from Wuhan to the rest of the world. It has now turned into a pandemic affecting the whole world. Halliday's (2004) model of systemic functional linguistics (meta-functions), relying on interpersonal and ideational metafunctions, and Van Dijk's ideology and discourse (2000) model depending on the argumentation categories, are the adopted models of analysis. The paper's main objectives are to analyze the speech of Prime Minister Boris critically to uncover the used ideologies to advise, persuade and control the people's beliefs and actions. In addition, this paper aims to identify the interpersonal and ideational meta-functions in the selected speeches of the chosen figure stating their frequencies, then finding out how these features uncover the ideological strategies used to affect all people; Finding the argumentation categories that are used by the prime minister to support the ideas and actions presented. The paper presents a theoretical background of discourse, Critical discourse analysis, dominant, and ideology. Explains the adopted models; Analyzes the speech critically. [ABSTRACT FROM AUTHOR]

Using perspectives on language and language learning in Second Language Acquisition (SLA), including the traditional cognitive orientation, sociocultural theory orientation, and critical theoretical orientation as theoretical frameworks, this study critically analyzes 78 papers published from 2014 to 2020 in Chinese as a Second Language-The Journal of the Chinese Language Teachers Association, USA (CSL), a leading journal that is devoted exclusively to the study of Chinese language, culture, and pedagogy. This study investigates how the teaching and learning of Chinese language and culture has been conceptualized and enacted in the field of SLA and explores factors that contributed to frustration, dissatisfaction, or criticisms in this field (e.g., Lantolf and Genung, 2002; Li and Duff, 2008, 2018; Thorne, 2005). Additionally, this study raises awareness of the value of sociocultural and critical perspectives on language teaching and learning (e.g., Douglas Fir Group, 2016; Fairclough, 1992; Halliday and Hasan, 1985; New London Group, 1996; Vygotsky, 1978), suggesting more critical and sociocultural-oriented research to support learning Chinese as a world language in the context of globalization. [ABSTRACT FROM AUTHOR]

This paper aims to determine how to motivate selected students of the Silesian University in Opava, School of Business Administration in Karviná (SU OPF) for the academic year 2020/2021 to develop critical thinking and how to form their factual and value opinions. The theoretical background lies in critical thinking in terms of growth linker, and competence. The methodology used is based on a case study approach to the inventory of ideas and content analysis of respondents' personal opinions. The discussion interprets the effects and criteria for evaluating respondents value opinions and own substantive to implement rational decisions according to the SU OPF study program. The conclusion presents a model and method to develop critical thinking for selected university students and recommends using the Institute of the before second opinion. [ABSTRACT FROM AUTHOR]

Copyright of IUG Journal of Sharia & Law Studies is the property of Islamic University of Gaza and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Christine Montalbetti has published twenty-odd texts at the Éditions P.O.L over the years, beginning with Sa fable achevée, Simon sort dans la bruine, which appeared in 2001. While she has practiced short forms and theater (with several plays produced at the Comédie-Française), her central literary concern has been the novel. Her novels are innovative, engaging, and exceptionally canny constructions. Each of them testifies to a smart, sustained reflection on narrative art, upon its possibilities and its limits, upon its articulative power. Those novels are moreover "critical" in character. That is, they display a broad recognition of the tradition out of which they arise. They invite their reader to share that recognition, and to exercise his or her critical faculties in a very conscious manner. These are generous texts, granted the way in which Christine Montalbetti welcomes her reader into the fictional world, and encourages her or him to participate in a shared meditation on literature and its uses. Her books constitute one of the key sites where contemporary French literature takes full account of its potential and seeks new expressive avenues. [ABSTRACT FROM AUTHOR]

This paper discusses the ECOWAS Conflict Prevention Framework from the perspective of the critical and emancipatory peacebuilding approach. The paper argues that the ECOWAS conflict prevention framework is largely guided by the principles of the liberal peacebuilding model which ignores the 'local' in peacebuilding. The framework represents a complete departure of the sub-regional body, from an emphasis on conflict resolution to transformative conflict prevention with the overarching objective of ensuring human security instead of state security. When subjecting the framework, however, to the philosophies of the critical and emancipatory peacebuilding approach and the social justice frame, one notices that, in its current form, the framework is inadequate to ensure sustainable peace and security within the sub-region. Its over-reliance on the state as the unit of focus together with its adoption of liberal conceptualization of human security, focus on direct violence, top-down approach, low engagement of local communities to ensure local ownership, and the way these have been implemented make it an apparent elite-based policy. For the framework to have an impact in the sub-region, it must be restructured to make it an empowering policy that engages local actors, communities, resources, and knowledge in the transformative conflict prevention agenda of the sub-region. The framework also needs to be anchored on local ownership and agency and must be made to act as an emancipatory and transformative tool aimed at empowering the people of the sub-region as peacemakers, peacebuilders, and transformative leaders. [ABSTRACT FROM AUTHOR]

The transition from the quantum to the classical world is not yet understood. Here, we take a new approach. Central to this is the understanding that measurement and actualization cannot occur except on some specific basis. However, we have no established theory for the emergence of a specific basis. Our framework entails the following: (i) Sets of N entangled quantum variables can mutually actualize one another. (ii) Such actualization must occur in only one of the 2N possible bases. (iii) Mutual actualization progressively breaks symmetry among the 2N bases. (iv) An emerging "amplitude" for any basis can be amplified by further measurements in that basis, and it can decay between measurements. (v) The emergence of any basis is driven by mutual measurements among the N variables and decoherence with the environment. Quantum Zeno interactions among the N variables mediates the mutual measurements. (vi) As the number of variables, N, increases, the number of Quantum Zeno mediated measurements among the N variables increases. We note that decoherence alone does not yield a specific basis. (vii) Quantum ordered, quantum critical, and quantum chaotic peptides that decohere at nanosecond versus femtosecond time scales can be used as test objects. (viii) By varying the number of amino acids, N, and the use of quantum ordered, critical, or chaotic peptides, the ratio of decoherence to Quantum Zeno effects can be tuned. This enables new means to probe the emergence of one among a set of initially entangled bases via weak measurements after preparing the system in a mixed basis condition. (ix) Use of the three stable isotopes of carbon, oxygen, and nitrogen and the five stable isotopes of sulfur allows any ten atoms in the test protein to be discriminably labeled and the basis of emergence for those labeled atoms can be detected by weak measurements. We present an initial mathematical framework for this theory, and we propose experiments. [ABSTRACT FROM AUTHOR]

As music remains one of the most popular activities of everyday life, this paper builds on critical and popular geopolitics to introduce music as a key endeavour in teaching such topics. The paper attempts to go beyond scrutiny of the popular music by connecting it with the historical strings of geopolitical evolution and their current re-representation. It communicates how music may assist students in understanding geopolitics. Surprised at first by music's relation with geopolitics, students can delve into more complex questions that allow them to scrutinize the forces, institutions and theoretical frameworks that shape geopolitics. Mediated by music, teaching may provide a way to deconstruct geopolitical imaginations and empower students to reflect beyond the texts, and popular contexts. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effectiveness of the CTL-based physics e-module in improving the creative and critical thinking skills of senior high school students. Consequently, an experiment with a pretest-posttest control group design was conducted using two groups of 60 tenth-grade students majoring in Science. The experiment consisted of an assessment of creative and critical thinking skills, as well as test questions. Subsequently, the data obtained from the assessment was analyzed using the ttest and N-Gain, and the results showed that the scores of students' creative and critical thinking skills in the experimental group at the end of the treatment were 81.85 and 81.81. Furthermore, the N-Gain scores for the two skills in the experimental group were 0.60 and 0.59. However, there were significant differences in the levels of creative and critical thinking skills of students using the CTL-based physics e-module with the control group (p=0.000). The experimental group had an average cognitive competence score of 78.50 and a completion rate of 93.34%. The study concluded that the e-module is effective in improving creative and critical thinking skills as well as student learning outcomes in physics education, especially during the aftermath of COVID-19. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The people of the earth have thus entered in varying degrees into a universal community, and it has developed to the point where a violation of rights in one part of the world is felt everywhere.» This paper seeks to comprehensively study the concept of universal jurisdiction (UJ) within the sphere of the Institute of International Law. The paper examines UJ in the twenty-first century and reverts to the nineteenth century. In doing so, the author conveys a consistent critical perspective of UJ; questioning its presumed universal nature.

In this article, we seek to reconceptualize content-based instruction (CBI) curricula and practices from a critical perspective. Further, we propose developing criticality as an essential component of CBI, advocating for an approach we call critical content-based instruction (CCBI). While the importance of CBI has long been recognized, previous discussions predominantly focused on its effectiveness for language learning (and content learning to a lesser degree), and overlooked its fundamental linkage and relevance to broader educational missions. In order to fully maximize the potential of CBI and envision language education as integral to the advancement of society, we argue that a critical approach to CBI should be considered. First, we lay out how CBI came to be and how it has been treated in language pedagogy. We believe CBI is indeed a suitable forum for introducing and implementing a critical perspective because of its original contribution of broadening language education to meet societal needs. Second, we provide an overview of recent discourse surrounding world language education. Based on these reviews, we lastly and most importantly delineate directions for CCBI by presenting examples and possible challenges.

The training and registration of psychiatric/mental health nurses has a contested past in Canada. One of the consequences of the professional jostling between psychiatry and nursing for control over this area is the unusual circumstances of Canada having two education systems for this specialty. To understand why the schism has taken place and the impact it has had on psychiatric/mental health nursing, the authors have undertaken a critical review of the ontological and epistemological assumptions of these two pedagogical approaches. This review reveals that while the approaches share much in common, groups from both the east and the west receive different levels of mental health-related curriculum within their training. While it could be argued that psychiatric/mental health nursing practice is different enough to warrant its own framework for the preparation of specialist practitioners, there is no clear answer as to whether one of the current models should be implemented over the other. In this context, this paper argues that it is important that psychiatric nurses advocate for a future for the speciality in Canada.

Abstract Introduction This study aimed to assess the experience of providing futile care among intensive care unit nurses and to examine the moderating effect of spiritual beliefs on job dissatisfaction related to the sense of futile care among nurses in Intensive Care Units. Materials and methods The study had two phases. The first phase was a qualitative study. Twenty-two semi-structured interviews were conducted. In the second phase, we employed a cross-sectional design. The data from 236 nurses were collected using nurses’ perceptions of futile care questionnaire, Minnesota Satisfaction Questionnaire, and Spirituality and Spiritual Care Rating Scale. Results The main theme of the qualitative phase was a feeling of self as a useful tool in God’s hand. Sub-themes were providing care while knowing it is futile, not knowing the patient destiny, having hope for care to be fruitful, experiences patient recovery, acting to be a part of God’s plan. Futile care and job experience were two predictors of low job satisfaction. Spiritual well-being had a moderating effect and increased job satisfaction. Conclusions Futile care can decrease job satisfaction, while spiritual well-being can reduce its negative effect. Supporting spiritual aspects of nursing care can decrease turn-over intention among nurses.

Introduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >18 years of age were included. The primary variables of interest, ferritin, CRP, and D-dimers, for each patient throughout hospitalization were recorded. Primary clinical outcomes of length of stay in ICU and survival were recorded. Demographics: age, gender, BMI, and nationality. Ferritin, CRP, and D-dimers were recorded daily if available for the whole ICU stay, and all other variables were recorded on admission day to ICU. Results: The sample includes 235 records. More than 95% of patients have all markers on the day of admission to ICU were ferritin (median 1,278; IQR 1,424), D-dimer 1.21 (3.4), and CRP 129.5 (121). Daily average levels of markers were different from their admission day level: ferritin 1,395 (1,331), D-dimer 3.11 (5.52), and CRP 107 (75.8). Multiple logistic regression analysis determined that average CRP during the stay was the only predictor of survival. Discussion: Data on markers utilization to detect the acute phase of inflammation help clinicians focus on the opportunity window for intensive treatment. Conclusion: Average CRP during the stay in ICU is higher than CRP on admission. Average CRP is the only factor that predicts survival.

Introduction: Bloodstream infections are one of the leading causes of mortality and morbidity. Time to positive blood culture may be reflective of the severity of infection. We aim to study the impact of time to positivity (TTP) of blood culture upon clinical outcome. Methods: Data from blood cultures for 17 months duration reviewed. Outcome measures included in-hospital mortality and length of stay in ICU (LOSICU). TTP was determined for each sample. Demographics (age, gender, BMI, and nationality), APACHE-2 score for severity of illness, comorbid conditions, and other confounding factors were recorded. Results: One hundred and one patients with 346 positive blood cultures with mean age of 62 and mean APACHE-2 score of 18.9 + 9.7 (mean +SD) with overall observed mortality of 61%. Median TTP was 20.2 h with quartiles cutoff Q1 = 15.3, Q2 = 20.2, Q3 = 28, and range 8–104 h. Only APACHE-2 scores predict LOSICU. TTP is not a significant predictor for mortality or LOSICU. Discussion: Data on TTP of blood cultures have a complex interaction with clinical outcomes. Conclusion: TTP of blood cultures does not predict mortality or length of stay in ICU.

In the humanist philosophy of Richard Rorty, the existence and concept of nihilism is used to scrutinize the theory of irony. Nihilism and the humanitarian crisis of cruelty underpin Rorty’s philosophical thinking. One of his basic ideas is how humans have a particular attitude in perceiving reality, which can be found in terms of irony. This term provides a humanist grounding for coping with humanitarian issues in the present day, in this regard functioning as a frame for understanding put forward by Rorty within human selfhood. This literature review is based on both primary and secondary sources, with the formers referring to books written by Rorty, while the latter comprises information from books, journals, articles, and research papers discussing Rorty and human philosophy, especially existentialism. The research steps undertaken were data collection, classification, description, and analysis, and methodological elements were interpretation, heuristics, compilation, and reflection. The results provide an understanding of the use of Rorty’s word, “irony,” a consequence of humans tending to overlook their position as human beings. Humans are apparently ironic for seeing things critically, yet are capable of taking steps in any conditions. The meaning of irony can be understood as humans in the present day acting for others (in a social context). The virtue of ironists is conscious thought that may exist regarding the presence of others inside themselves, with language simply being an intermediary, functioning as a tool for dialectical needs. Humans construct history by considering three things that can be classified as morality, language, and socially constructed basic investigations.

Currently the UK does not have a specific anti-cyberterrorism law, instead relying on existing anti-terrorism laws to deal with cyberterrorism. This approach raises a number of problems insofar as it can lead to legislative uncertainty and unpredictability, as well as impacting on carrying risks of over-criminalisation, a lack of counterbalance, violation of principles of proportionality and arbitrariness. In light of these problems, this article aims to offer a critical evaluation of the UK's existing legal responses to cyberterrorism with reference to the rule of law and basic human rights principles, mainly focusing on the vague and overly broad definition of terrorism, a tendency towards criminalising a wide range of terrorism precursor offences online, pre-emptive strategies and aggravated punishment of cyberterrorism. Based on this analysis, the article argues that applying the extension of existing anti-terrorism laws to combat low-risk cyberterrorism activities runs the risk of exacerbating harms to the values of the rule of law. [ABSTRACT FROM AUTHOR]

Background: Inhaler technique errors can affect the disease outcome through reduced deposition of medication in the lungs with certain errors were more likely to deter the optimum drug from reaching the lung. The objective of this study was to evaluate the pressurized metered-dose inhaler (pMDI) critical technique errors among asthma and COPD patients, and to investigate the predictors of those errors. Methods: A cross-sectional, observational, and multi-centered study conducted in 3 major hospitals in the state of Penang, Malaysia. Asthma and COPD patients aged 18 years or older consented to the study were consecutively recruited if they were at least on 1 pMDI without mouthpiece spacer or facemask space. Direct observation of the patient's technique was recorded using a standard checklist and certain steps in the checklist were pre-determined as critical steps. The number of patients missed or incorrectly performed the steps including the critical steps were documented. Using logistic regression, the factors associated with the critical errors were determined, and the correlation was evaluated between age and pMDI knowledge score with critical inhalation steps score. Results: Of 209 patients observed, only less than half (40.7%) could perform all the critical pMDI steps correctly. Low education level was the only factor associated with critical inhaler errors. The increased knowledge of their inhaled medication was found to positively correlate with the correct critical inhalation steps. The critical errors also increase with the increased age of patients. Conclusion: The majority of the study population make inhalation error particularly in critical steps. Training and education intervention programs may help patients with lower education level, as well as those of advanced age and lack of knowledge of their inhaled medication because those populations are at a greater risk of committing critical errors in their use of pMDI. [ABSTRACT FROM AUTHOR]

Many patients are being released from hospitals without follow up and thorough assessment of their recovery.Iraq is one of the countries that were hit hard by this novel disease, but till now there is little literature on the sequelae of this illness after recovery. The aim of our study is to assess the prevalence of post covid 19 syndrome and the characteristics of post covid 19 symptoms. A cross sectional study using interview based questionnaires of 165 recovered covid 19 subjects (mean age 37±14)and 67% of them were female. The prevalence of post covid 19 in the study sample was (66.7%), out of them (52.7%) reported acute post covid 19 symptoms, (18.2%) reported long post covid symptoms, and (29.1%) reported persistent post covid 19 symptoms. The most frequently reported symptom was fatigue (29%) followed by hair loss (23%) and anosmia/ parosmia (21.2%). All of the patients who were in critical condition during the illness developed post covid 19 syndrome. So a prolonged follow up of the recovered patients seems necessary, regardless of their initial clinical presentation. [ABSTRACT FROM AUTHOR]

The Corona virus disease 2019 (COVID-19) pandemic has affected surgical practice around the world. While several abdominal emergencies can be managed effectively and safely using minimally invasive surgery (MIS), the safety of using MIS amid the COVID-19 pandemic has been debated. MIS, including laparoscopy and robotic surgery, is considered an aerosol-generating procedure and some recent research demonstrated possible spread of the virus through aerosol. This review assessed the available evidence on the safety of MIS in the COVID-19 era, explored the possible precautions to be taken when using MIS to prevent exposure of the operating team to infection, and highlighted the recommendations of several surgical societies in this regard. Electronic databases, Google Scholar, and pre-print archives were searched for evidence on airborne transmission of COVID-19 and the safety of MIS amid the COVID-19 pandemic. Recommendations of recognized surgical societies were also searched. The available evidence was summarized in a narrative manner. Limited data on the possibility of airborne transmission of COVID-19 were found. The studies that reported on the presence of the SARS-COV-2 in the air samples of patients with COVID-19 had conflicting results. Several precautions to minimize the presumed risk of exposure of the operation room staff to COVID-19 were devised. According to the available evidence and recommendations of different surgical societies, MIS may be used in the treatment of acute abdominal emergency. However, considerable caution should be taken to avoid the presumed risk of aerosolization of the virus particles during the procedure, which may expose the operating staff to the risk of COVID-19. [ABSTRACT FROM AUTHOR]

Background: Hope has a contextual dimension and experiences of hope seem to be an important part of everybody's life irrespective of changing and challenging health conditions. However, less focus has been placed on the similarities and differences in the experiences of hope among patients and family caregivers in different contexts of suffering and health, such as the nursing contexts of acute and critical care, rehabilitation and long‐term care and prevention and health promotion. Aim: This paper focuses on experiences of hope and hoping in different clinical nursing contexts, based on a meta‐synthesis of seventeen empirical studies on hope and hoping. These studies highlight experiences of hope and advance our theoretical and clinical understanding of the phenomenon. Methodological framework: This study on hope and hoping from seventeen empirical research studies was based on a meta‐synthesis, by clarifying and modifying the essence of hope and hoping, aiming to identify the unique conditions in the different clinical contexts. Results: A new understanding of the empirical findings emerged from the text: Hope means transformation and hope is indispensable in the acute and critical nursing context, and hope as an inner flame and hope as a lighthouse related to rehabilitation and long‐term care. Hope means pushing limits and expanding hope was experienced in the context of prevention and health promotion. Conclusions: According to the findings, dimensions of hope and hoping were always present but also influenced by contextual suffering and losses. Implications for practice: Hope means metaphorically a lighthouse, meaning a bright and shining centre, which must be promoted and protected in patients and their families. [ABSTRACT FROM AUTHOR]

Considering time interval models, which can describe a large class of models including timed event graphs and P-time event graphs, a general aim is to control the system such that it follows a one-periodic behavior starting from an initial state with a minimal or maximal cycle time. The aim of this article is the optimization of the time durations in order to achieve a given rate of production when the quantity of resources (number of pallets, machines, and so on), usually represented by the initial marking, is assumed to be a fixed datum. A prior step is the determination of the critical subsystems, whose variations can influence these optimal values and affect the obtainment of the relevant trajectories and the noncritical subsystems leading to time margins. Two approaches are proposed in that aim. A first technique is based on an adaptation of the classical Martínez and Silva’s algorithm, where each solution gives a critical subsystem, while a second approach checks each inequality of the system by an optimality verification. Using this partition of the subsystems and particularly exploiting the time margins corresponding to idle times of machines, the approach allows an optimization of the noncritical time durations when the extremum cycle times and the resources are the constant parameters of the problem. In this article, the definition of P-time event graphs is generalized by introducing the model of time supervisor place, which restricts the time behavior of a set of places. The approach is applied to a plant bakery composed of two production lines. [ABSTRACT FROM AUTHOR]