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Subarachnoid haemorrhage (SAH) is a rare yet consequential medical emergency that may mimic an acute myocardial infarction (MI). SAH causes enhanced sympathetic activity, culminating in the development of neurogenic stunned myocardium (NSM), which presents as ST-segment deviations, prolonged QT intervals, T-wave inversions or Q-waves. Reperfusion therapy is contraindicated for SAH because of an increased risk of bleeding and death. Therefore, a prompt diagnosis is crucial. Here, we report a unique case of massive SAH presenting as diffuse ST-segment deviation simulating an acute MI. Our patient was brought to the emergency department after a cardiac arrest and died on day 2 of admission.

Autoimmune Hepatitis (AIH) is a progressive form of chronic hepatitis, with periods of remissions and exacerbations. Diagnosis includes abnormally high levels of immunoglobulins and multiple autoantibodies. Clinical presentation is variable, with a spectrum extending from asymptomatic cases to fulminant liver failure. Symptoms include abdominal pain, malaise, fatigue, and small joint arthralgia. We present a case of a 36-year-old male with a past medical history of alcohol dependence and acute pancreatitis who was diagnosed with AIH. There is limited data regarding patients with concomitant AIH and pancreatitis. Our patient presented with AIH with secondary acute on chronic pancreatitis, in the absence of additional autoimmune manifestations. The mechanism of AIH remains poorly understood; however, there is an association between the HLA gene and AIH. Genetic studies have shown HLA-DRB1*0301 and HLA-DRB1*0401 as primary and secondary genotypes susceptible to AIH, as well as genetic variants with CARD10 and SH2B3. Products secondary to metabolism of ETOH such as alcohol dehydrogenase, malondialdehyde, and acetaldehyde, can lead to development of autoantibodies. Additional research is indicated to evaluate the relationship between AIH and acute pancreatitis.

Sinistral portal hypertension (SPH), also known as segmental portal hypertension, is a complication of pancreatic disorders and an extremely rare cause of upper gastrointestinal (GI) bleeding. SPH is observed in patients without cirrhosis and arises from splenic vein thrombosis. Unmitigated backflow of blood may cause gastric venous congestion and ultimately GI hemorrhage. Herein, we report a rare case of massive hematemesis due to SPH in a male patient with a history of chronic pancreatitis and pancreatic pseudocyst. Our patient was successfully treated with endoscopic necrosectomy followed by open splenectomy, distal pancreatectomy, and partial gastric resection.

Familial Mediterranean fever (FMF) is a hereditary disorder characterized by episodes of fever, polyserositis, or cutaneous inflammation. The FMF attacks last 1–3 days and have no apparent triggers. Recurrent deposition of the serum amyloid A (SAA) protein in the gut can cause intractable diarrhea, dysmotility, and recurrent abdominal pain. Gastrointestinal amyloidosis is a rare, but serious, complication of FMF. In this case report, we describe a rare case of chronic diarrhea and recurrent abdominal pain due to FMF-induced gastrointestinal amyloidosis.

Panniculitis is an inflammatory process localized to subcutaneous tissue, with etiologies including infection, malignancy, external insults, enzymatic destructive processes, and inflammatory disorders. The incidence of panniculitis manifesting as necrosis of subcutaneous fat tissue associated with pancreatic diseases is low, which may encompass associated periarthritis with bone necrosis and panniculitis (Pancreatitis, panniculitis and polyarthritis syndrome). Pancreatitis, panniculitis and polyarthritis syndrome is considered to derive from the systemic activity of enzymes within the pancreas, which leads to disturbances within the microcirculatory system, and fat necrosis of medullary bone marrow; however, the exact pathophysiology remains unknown. Here, we present a case of a 53-year-old male with a history of chronic pancreatitis who presented with lower abdominal pain found to have osteolytic pelvic lesions considered to be panniculitis secondary to pancreatitis. Our patient provided an interesting clinical picture given his alcohol use disorder, and lytic lesions which lead the team initially towards a malignant etiology of panniculitis such as myeloma; however, given his negative studies, it was presumed his panniculitis was derived from his chronic pancreatitis. Overall, additional literature is warranted regarding the extensive workup of lytic bone lesions that present in patients who have acute vs chronic pancreatitis.

The carotid sinus-arterial baroreflex is essential in maintaining blood pressure (BP) regulation. Afferent baroreflex failure (ABF) can present with labile changes in BP within seconds and can be secondary to neck surgery or radiation. We present here the first case, to our knowledge, of ABF precipitated by thyroidectomy, in a patient with active COVID-19 pneumonia, causing difficult control of severely labile BP in a critical care unit. Contributing factors included her critical illness state with upregulation of IL-6 leading to pituitary-adrenal axis alteration, her thyroidectomy further exacerbating autonomic dysfunction, as well as downregulation of ACE2 via COVID-19 infection. Management was achieved with a combination of midodrine and clonidine catered to specific BP thresholds. Additional research with a multidisciplinary approach is warranted to fully optimize the treatment of ABF in patients with neck surgery and or inflammatory conditions such as COVID-19.

Toothpick ingestion is a medical emergency requiring urgent intervention. Swallowed toothpicks can cause intestinal perforation, bleeding, or damage to the surrounding organs. Herein, we describe a unique case of a geriatric patient with a history of peptic ulcer disease who presented to the emergency department for the evaluation of abdominal pain and nausea. Gastric wall thickening concerning for a gastric neoplasm was observed on a computed tomography (CT) scan of the abdomen and pelvis. An esophagogastroduodenoscopy (EGD) revealed an embedded toothpick with a contained gastric perforation, and the foreign body was retrieved with a grasper device. Given the rare presentation, nonspecific symptoms, inability to recall, and often inconclusive imaging, a high index of suspicion is needed for early diagnosis and treatment of toothpick ingestion.

Cerebral venous sinus thrombosis (CVST) is a rather uncommon disorder. CVST is potentially lethal, therefore early detection and treatment is critical. CVST has been linked to pregnancy and puerperium, while COVID-19 infection has been linked to a hypercoagulable state. CVST can be difficult to detect and treat due to the wide range of neurological manifestations, especially in patients with hypercoagulability. The goal of this study is to conduct a literature review and present a unique case of a pregnant woman with CVST who had left hemiplegia and headache. After 6 months of treatment in the hospital, the patient's hemiplegia was fully resolved. Here, we discuss the treatment of CVST in pregnant women who have a suspected past COVID-19 infection.

Abstract The desire to enhance connectivity and communication while simplifying data used to improve and optimize products and processes has driven many organizations within developed countries to invest heavily in implementing intelligent technologies for manufacturing. These technologies promise to enhance global manufacturing capabilities while sustaining demands by integrating equipment and frameworks in advanced economies for future production systems. On the other hand, many small and medium enterprises (SMEs) within developing countries have shown apprehension and mistrust toward the emerging technologies associated with Industry 4.0. This article provides a comprehensive review of SMEs' readiness within developing countries to implement the novel technologies falling within the Industry 4.0 realm. Such techniques include intelligent manufacturing systems, cyber‐physical systems, and other crucial technological tools for improved connectivity and communication within manufacturing and production systems. Analysis of the literature shows that many SMEs within developing countries are experiencing delays in introducing intelligent manufacturing and digitizing factories due to a lack of knowledge and communication issues. These firms lag in embracing the transformation to equipment and systems that can communicate with future‐oriented technologies and introduce intelligent devices and machines into production processes. This article explores challenges, identifies gaps and suggests the potential solutions to address the readiness of SMEs toward Industry 4.0 in developing countries, through a systematic summary and integrative analysis of the findings from the literature.

In a passive radar system, localizing a target in Cartesian space is achieved by using one of the following bistatic geometries: multiple non-cooperative transmitters with one receiver, one non-cooperative transmitter with multiple receivers, or one non-cooperative transmitter with one receiver. In this paper, we propose a new method for localizing a target in Cartesian space by passive radar having the bistatic geometry “one non-cooperative transmitter and one receiver”. This method depends on using two consecutive particle filters for estimating and analyzing the Doppler frequency and time delay of the target’s echo signal. The theoretical analysis of the proposed method is presented, and its efficiency is verified by simulating the passive radar system with a Digital Video Broadcasting-Terrestrial (DVB-T) transmitter.

Passive radar is a bistatic radar that detects and tracks targets by processing reflections from non-cooperative transmitters. Due to the bistatic geometry for this radar, a target can be localized in Cartesian coordinates by using one of the following bistatic geometries: multiple non-cooperative transmitters and a single receiver, or a single non-cooperative transmitter and multiple receivers, whereas the diversity of receivers or non-cooperative transmitters leads to extra signal processing and a ghost target phenomenon. To mitigate these two disadvantages, we present a new method to estimate Cartesian coordinates of a target by a passive radar system with a single non-cooperative transmitter and a single receiver. This method depends on the ability of the radar receiver to analyze a signal-to-noise ratio (SNR) and estimate two arrival angles for the target’s echo signal. The proposed passive radar system is simulated with a Digital Video Broadcasting-Terrestrial (DVB-T) transmitter, and the simulation results show the efficiency of this system compared with results of other researches.

The subject matter of the article is a model of calculating the user similarity coefficients of the recommendation systems. The urgency of the development is determined by the need to improve the quality of recommendation systems by adapting the time characteristics to possible changes in the similarity coefficients of users. The goal is the development of the improved model of user similarity coefficients calculation for recommendation systems to optimize the time of forming recommendation lists. The tasks to be solved are: to investigate the probability of changing user preferences of a recommendation system by comparing their similarity coefficients in time, to investigate which distribution function describes the changes of similarity coefficients of users in time. The methods used are: graph theory, probability theory, radioactivity theory, algorithm theory. Conclusions. In the course of the researches, the model of user similarity coefficients calculating for the recommendation systems has been improved. The model differs from the known ones in that it takes into account the recalculation period of similarity coefficients for the individual user and average recalculation period of similarity coefficients for all users of the system or a specific group of users. The software has been developed, in which a series of experiments was conducted to test the effectiveness of the developed method. The conducted experiments showed that the developed method in general increases the quality of the recommendation system without significant fluctuations of Precision and Recall of the system. Precision and Recall can decrease slightly or increase, depending on the characteristics of the incoming data set. The use of the proposed solutions will increase the application period of the previously calculated similarity coefficients of users for the prediction of preferences without their recalculation and, accordingly, it will shorten the time of formation and issuance of recommendation lists up to 2 times.

Object counting is an active research area that gained more attention in the past few years. In smart cities, vehicle counting plays a crucial role in urban planning and management of the Intelligent Transportation Systems (ITS). Several approaches have been proposed in the literature to address this problem. However, the resulting detection accuracy is still not adequate. This paper proposes an efficient approach that uses deep learning concepts and correlation filters for multi-object counting and tracking. The performance of the proposed system is evaluated using a dataset consisting of 16 videos with different features to examine the impact of object density, image quality, angle of view, and speed of motion towards system accuracy. Performance evaluation exhibits promising results in normal traffic scenarios and adverse weather conditions. Moreover, the proposed approach outperforms the performance of two recent approaches from the literature.

Transient liquid phase bonding (TLP) of AZ31 samples has been investigated using Cu coatings and Cu coatings with Sn interlayer. Copper coatings were used for one set of the bonds, and a combination of Cu coatings and Sn interlayer was used for the other set of bonds. The bonding temperature was fixed at 520 °C, and various bonding times were applied. This study shows that the bonds produced using only Cu coatings have shown weaker bonds compared to the bonds made using Cu coatings and Sn interlayer. The Cu2Mg particles were detected at the joint region of both bonds made by Cu coatings and Cu coatings with Sn interlayer by X-ray diffraction (XRD). However, it has been observed that the joint region was dominated by solid solution which is rich in Mg. Sn interlayer was not contributed to the intermetallic compound (IMC) at the joint region, and therefore it was diffused away through the Mg matrix. Within the joint interface, a slight increase of micro-hardness was observed compared to Mg base metal alloy. This was attributed to the formation and presence of IMC’s within the joint region. It was noticed that the presence of the Sn interlayer improved the joint strength by reducing the pores at the joint region. Pores were clearly observed for those bonds made using Cu coatings—especially for region where the fracture occurs; this was accomplished by scanning electron microscope (SEM).

Background: The factors influencing nurses' knowledge of delirium in acute care settings have not been fully investigated in Saudi Arabia. Therefore, this study aimed to investigate these factors among nurses in acute care settings in the northern region of Saudi Arabia. Methodology: A cross-sectional study was conducted using a convenience sample of 234 acute care nurses at the main public hospitals in the Hail region of Saudi Arabia. Data were collected using a structured, self-administered questionnaire, from November 2023 to February 2024. Multiple linear regression was used to identify factors of knowledge about delirium. Results: Of the acute care nurses, 7.3% had a good level of overall knowledge about delirium, while 66.1% and 26.6% showed poor and moderate levels, respectively. Most nurses (78.2%) had poor knowledge of delirium assessment. Significantly higher scores on delirium assessment were observed for nurses who reported receiving in-service training on delirium (P = 0.006) and when a clear job description was applied (P = 0.031), whereas significantly higher scores on knowledge about risk factors were observed for those who had previous experience in caring for delirious patients (P < 0.001), received educational sessions on delirium (P = 0.001), and participated in training on delirium care (P < 0.001). Lack of previous experience in caring for delirious patients and participation in delirium care training were significant factors for lower knowledge about delirium scores (CI=− 5.750 --1.200, P < 0.001). Conclusion: In-service training, daily clinical discussion, availability of instructional materials, and specific training on delirium significantly influence nurses' knowledge about delirium, particularly regarding delirium assessment and early recognition. Enhancing these factors could improve nurses' knowledge and the care and management of patients complaining of delirium in acute care settings. [ABSTRACT FROM AUTHOR]

The impact of job demands on job performance is not always straightforward but relies on whether employees are burned out or engaged. Although such relationships were established previously based on job demands–resources (JD-R) theory in Western developed countries, evidence from Eastern developing countries is very limited. During the peak of COVID-19, this study was conducted to examine the impact of job demands on nurses' job performance via the mediating role of work burnout and work engagement. By employing the tenets of the JD-R theory, the theory was tested through collecting data from 202 nurses who were working in Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. The findings disclosed that work burnout was negatively related to job performance, and work engagement was positively related to job performance. Unexpectedly, job demand had a negative relationship with work burnout and a positive relationship with work engagement. However, work burnout and work engagement mediated the relationship between job demand and job performance. A discussion of the findings, contributions, implications, limitations and future directions is provided. [ABSTRACT FROM AUTHOR]