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BACKGROUND: Assessment of the plantar flexion (PF) isokinetic performance has been greatly diverse and based on personal preferences rather than standardized guidelines. OBJECTIVE: To examine the performance of the plantar flexors under different settings including knee joint angle and subject position. METHODS: Thirteen women and 20 men took part in this study. The isokinetic protocol (60∘/s) was set to ankle movement between 10∘ dorsiflexion to 30∘ PF. Participants performed three repetitions of concentric PF in randomly-ordered knee angles; 15∘, 45∘ and 90∘, and in seated and supine positions. Surface electromyography (EMG) data were collected from the Soleus (SOL) and Gastrocnemius. RESULTS: Knee angle impacted the PF moment (P⩽ 0.001–0.026) and work (P⩽ 0.05) measures in both genders. The moment and work measures were significantly less in the 90∘ than those in the 45∘ and 15∘ positions. The 45∘ position had the highest values, particularly in sitting in the male participants. Only the GL EMG data was significantly impacted (P= 0.017) by the subject position. However, the difference was trivial (1.6%). The SOL muscle showed a consistent pattern of increased activity when the knee was in flexion. CONCLUSION: The 45∘ position seems to be optimal for obtaining the highest isokinetic PF scores.

The objective of this investigation was to evaluate the apparent movement of the hallux proximal phalanx in the transverse plane relative to the second metatarsal following hallux valgus surgery. Pre- and postoperative radiographs of a consecutive series of 45 feet undergoing hallux valgus surgery were analyzed. Significant improvements were observed in the first intermetatarsal angle (12.4 vs 7.5 degrees; p.001), hallux valgus angle (24.3 vs 13.4 degrees; p.001), tibial sesamoid position (4.6 vs 2.7; p.001), and second metatarsal-hallux proximal phalanx angle (80.1 vs 84.6 degrees; p.001). No difference was observed in the distance between the second metatarsal bisection and the medial aspect of the tibial sesamoid (31.7 vs 31.5 mm; p = .756) nor between the second metatarsal bisection and medial aspect of the hallux proximal phalanx base (34.6 vs 34.2 mm; p = .592). Significant differences were observed between the second metatarsal bisection and the central aspect of hallux proximal phalanx base (26.5 vs 23.9 mm; p.001) and between the second metatarsal bisection and the lateral aspect of the hallux proximal phalanx base (19.3 vs 15.4 mm; p.001). A statistically significant difference was observed in the change of distance between the second metatarsal bisection and the medial, central, and lateral aspects of the hallux proximal phalanx base (-0.4 vs -2.6 vs -3.9 mm; p = .002). These results indicate that the hallux proximal phalanx does not translocate in the transverse plane following hallux valgus surgery, but instead pivots about the medial aspect of the joint.

Este artículo es el resultado de una investigación que tuvo entre sus objetivos fortalecer las habilidades del pensamiento crítico durante la escritura de textos digitales, bajo ambientes de aprendizaje apoyados por herramientas de la web 2.0 en un grupo de estudiantes de grado once. En el presente artículo se presentan los resultados de la habilidad del pensamiento crítico para el establecimiento de una posición frente a un tema en la escritura digital. El enfoque asumido en el estudio fue mixto; participaron 32 estudiantes, quienes durante 11 sesiones elaboraron producciones digitales que pudieran evidenciar las posiciones frente a determinados temas. Los principales resultados mostraron que es posible fortalecer el establecimiento de la posición frente a un tema en las prácticas de escritura digital

In studies that assessed the accuracy of implant surgical guides, evaluations were based on the placement position of the implant by using a manufactured surgical guide. However, such assessments could involve errors that may occur during implant placement. Therefore, evaluating the 3-dimensional accuracy of the fabrication of the implant surgical guide itself is not enough. In the evaluation method described in this article, location-related information is obtained by connecting a scan body to the sleeve of the surgical guide instead of directly placing the implant. This helps to evaluate the accuracy of the surgical guide without errors in the placement of an implant.

A male patient was scheduled for urgent amputation of his right forearm. His right forearm was stuck inside the insertion slot of a meat grinder, resulting in severe pain to his injured arm. His upper body could not move to sit in a semi-upright position. An endotracheal tube was successfully placed after rapid sequence intubation using a video laryngoscope from behind the patient on the first attempt. This case report is the first documentation of successful anesthetic induction with subsequent endotracheal intubation using a video laryngoscope from behind an injured patient whose upper body was upright with limited positioning.

An asymptomatic twenty-six-year-old woman with repaired tetralogy of Fallot and a bioprosthetic pulmonary valve presented with a large thrombosis occluding most of her right ventricular outflow tract and main pulmonary arteries. Our Pulmonary Embolism Response Team (PERT) was emergently consulted resulting in considerable discussion regarding treatment modality given the large size and high-risk nature of the thrombosis. Ultimately, she was started on a heparin infusion until she could undergo open thrombectomy and pulmonary valve re-replacement. The patient’s asymptomatic presentation despite the considerable clot burden complicated our approach to management but ultimately led to a measured and timely intervention.

Introduction: The position and pose measurement of the rehabilitation robot plays a very important role in patient rehabilitation movement, and the non-contact real-time robot position and pose measurement is of great significance. Rehabilitation training is a relatively complicated process, so it is very important to detect the training process of the rehabilitation robot in real time and accuracy. The method of the deep learning has a very good effect on monitoring the rehabilitation robot state. Methods: The structure sketch and the 3D model of the 3-PRS ankle rehabilitation robot are established, and the mechanism kinematics is analyzed to obtain the relationship between the driving input - the three slider heights - and the position and pose parameters. The whole network of the position and pose measurement is composed of two stages: (1) measuring the slider heights using the CNN based on the robot image and (2) calculating the position and pose parameter using the BPNN based on the measured slider heights from the CNN. According to the characteristics of continuous variation of the slider heights, a regression CNN is proposed and established to measure the robot slider height. Based on the data calculated by using the inverse kinematics of the 3-PRS ankle rehabilitation robot, a BPNN is established to solve the forward kinematics for the position and pose. Results: The experimental results show that the regression CNN outputs the slider height and then the BPNN accurately outputs the corresponding position and pose. Eventually, the position and pose parameters are obtained from the robot image. Compared with the traditional robot position and pose measurement method, the proposed method has significant advantages. Conclusion: The proposed 3-PRS ankle rehabilitation position and pose method can not only shorten the experiment period and cost, but also get excellent timeliness and precision. The proposed approach can help the medical staff to monitor the status of the rehabilitation robot and help the patient rehabilitation in training. Discussion: The goal of the work is to construct a new position and pose detection network based on the combination of the regression convolutional neural network (CNN) and the back propagation neural network (BPNN). The main contribution is to measure the position and pose of the 3-PRS ankle rehabilitation robot in real time, which improves the measurement accuracy and the efficiency of the medical staff work.

The Manila clam (Ruditapes philippinarum) is the second most exploited bivalve in the world but remains threatened by diseases and global changes. Their associated microbiota play a key role in their fitness and acclimation capacities. This study aimed at better understanding the behavior of clam digestive glands and extrapallial fluids microbiota at small, but contrasting spatial and temporal scales. Results showed that environmental variations impacted clam microbiota differently according to the considered tissue. Each clam tissue presented its own microbiota, and showed different dynamics according to the intertidal position and sampling period. Extrapallial fluids microbiota was modified more rapidly than digestive glands microbiota, for clams placed on the upper and lower intertidal position, respectively. Clam tissues could be considered as different microhabitats for bacteria as they presented different responses to small-scale temporal and spatial variabilities in natural conditions. These differences underlined a more stringent environmental filter capacity of the digestive glands.

BACKGROUND: Few studies have investigated the variations in body composition and performance in Japanese collegiate American-football players. OBJECTIVE: To clarify what characterizes competitors at the highest levels – in the top division or on the starting lineup – we compared players’ body compositions and performance test results. METHODS: This study included 172 players. Each player’s body composition and performance (one-repetition maximum bench press, one-repetition maximum back squat, and vertical jump height) were measured; power was estimated from vertical jump height and body weight. Players were compared according to status (starter vs. non-starter), position (skill vs. linemen), and division (1 vs. 2). Regression analysis was performed to determine characteristics for being a starter. RESULTS: Players in higher divisions and who were starters were stronger and had more power, greater body size, and better performance test results. Players in skill positions were relatively stronger than those in linemen positions. Vertical jump height was a significant predictor of being a starter in Division 1. CONCLUSION: Power and vertical jump may be a deciding factor for playing as a starter or in a higher division.

Summary External levator advancement is commonly performed for involutional blepharoptosis repair; however, it is difficult to predict the postoperative upper eyelid position (UEP) accurately in blepharoptosis surgery. The purpose of this study was to determine the factors that influence postoperative UEP following surgery for involutional blepharoptosis. We retrospectively studied 40 Japanese women (80 eyelids) who underwent bilateral external levator advancement surgery. We used digital analysis software to measure the UEP and the eyebrow position from straight-gaze view photographs. Statistical analysis was performed to determine the correlation between postoperative UEP and related factors, including age, levator function, amount of levator advancement, anatomical fixed position, and preoperative and intraoperative UEP. We also compared UEP changes in mild, moderate, and severe ptosis groups. Levator function affected both preoperative and postoperative UEP. The amount of levator advancement and the anatomical fixation position on the aponeurosis did not affect the postoperative UEP. However, both preoperative (r = 0.49) and intraoperative (r = 0.55) UEPs affected the postoperative UEP. In cases of severe ptosis, there was significant re-drooping after surgery, while in cases with mild ptosis, the intraoperative eyelid position was maintained or slightly elevated. In involutional blepharoptosis, the degree of preoperative and intraoperative UEP contributed to the postoperative eyelid position. These data suggested that the levator muscle function is a major contributing factor in the pathogenesis of involutional blepharoptosis.

Breast biomechanics, exercise-induced breast pain (EIBP) and performance effects in female athletes are established. Wearing sports bras during exercise reduces breast movement and EIBP. Despite the prevalence of female equestrians, little investigation of breast movement during horse riding exists, yet excessive breast movement, embarrassment and EIBP are reported. Breast movement relative to the torso is linked to EIBP, associated with magnitude and direction of forces generated. Equestrians may experience novel breast and upper-body movement patterns in response to large vertical excursions of the horse. This study aimed to establish relative vertical breast displacement (RVBD), EIBP and positional changes in three support conditions: ‘no support’, ‘low support’ and ‘high support’. Thirty-eight female equestrians rode a Racewood™ Equine Simulator in each breast support condition in medium walk, medium trot (sitting) and medium canter. Trials were filmed and analysed using Quintic® Biomechanics V29. Significant reductions in RVBD (P

The author considers the position of Iran regarding the Afghan armed conflict (1978-1979) before the Soviet troops entered Afghanistan, as well as the consistent evolution of this position and the involvement of Iran in internal Afghan events. The author relies mainly on documentary sources, but also attracts scientific works in Russian and English (including the works of Iranian authors). According to the author, the analysis and study of Irans position on Afghanistan and the evolution of this position deserve a separate article because, firstly, the religious factor began to especially influence Irans foreign policy after the events of the Islamic Revolution of 1979; secondly, for the two years chosen for consideration in an article in Iran, the political regime has radically changed, and it is useful to consider the transformation of Irans foreign policy from the reign of the shah to the theocratic regime. In the first part of the article, the author analyzes the position of the Shah of the Iranian regime regarding the April Revolution of 1979 and the political changes that took place in Afghanistan after the revolution. The second part is devoted to the policy of Iran with respect to Afghanistan in 1979, and in this part the author argues that the Herat rebellion, which took place in March 1979, became the main trigger for transforming Irans attitude towards Afghanistan from a wait-and-see attitude to active involvement. The author also notes, that Irans policy towards Afghanistan in 1978-1979 developed sequentially, despite the radical transformation of power in Iran itself during this period.

© 2021, Springer Nature Switzerland AG.Purpose: Sleep apnea is a multifactorial illness which can be differentiated in various physiological phenotypes as a result of both anatomical and non-anatomical contributors (e.g., low respiratory arousal threshold, high loop gain). In addition, the frequency and duration of apneas, in the majority of patients with OSA, are influenced by sleeping position. Differences in characteristics between non-positional patients (NPP) and positional patients (PP) suggest another crucial phenotype distinction, a clinical phenotype focusing on the role of sleeping position on sleep apnea. Since this clinical phenotype distinction has therapeutic implications, further research is necessary to better understand the pathophysiology behind this phenotypic trait and to improve management of PP. Therefore, we suggest a standardized framework that emphasizes the role of sleeping position when reporting clinical and research data on sleep apnea. Methods: We identified 5 key topics whereby a standardized framework to report on the role of sleeping position would be of added value: (1) sleep study data, (2) anatomical, morphological and physiological factors, (3) drug-induced sleep endoscopy (DISE) findings, (4) sleep apnea management, and (5) effectiveness versus efficacy of positional therapy in sleep apnea management. We performed a literature search to identify evidence to describe and support the rationale behind these 5 main recommendations. Results: In this paper, we present the rationale behind this construct and present specific recommendations such as reporting sleep study indices (disease severity) and sleep time spent in various sleeping positions. The same is suggested for DISE findings and effect of treatment. Sleep study indices (disease severity), anatomical, morphological, and physiological factors in sleep apnea patients should be reported separately for PP and NPP. Conclusion: Applying these suggestions in future research will improve patient care, assist in better understanding of this dominant phenotype, and will enhance accurate comparisons across studies and future investigations.

Introduction The purpose of this study was to analyze the treatment effects after molar distalization using modified C-palatal plates with and without second molar eruption and, to evaluate the three-dimensional position of the molars during long-term retention using cone-beam computed tomography. Methods The study sample comprised 74 third molars in 42 patients. Twenty-seven adolescent patients (mean age, 12.6 years) having 48 maxillary third molars were divided into 2 groups according to the eruption of their second molars: 15 patients with second molar eruption (group 1) and 12 patients without second molar eruption (group 2). Pretreatment, posttreatment, and long-term data (mean, 5.2 years) from cone-beam computed tomography were scanned and compared with control groups. Results There was less tipping movement of the first and second molars (0.94° and 3.22°) and distal tipping movement of the third molars (8.91°) in group 1 than in group 2 (4.36°, 7.39°, and 3.08°, respectively), but the treatment time was shorter and the positional change of the third molars was insignificant in group 2. In the long-term, the second molars fully erupted after distalization in group 2, and there was no difference in the third molar position between group 1, group 2, and the control group, except for the vertical position of the third molars in group 1. Conclusions In the long-term, the second molars fully erupted after distalization, and the third molars were in a favorable position. Therefore, these findings suggest that clinicians do not need to extract developing third molars before distalization in adolescents.

Background Several serious complications are associated with the lithotomy position, including well-leg compartment syndrome and peroneal nerve paralysis. The aims of this study were to identify risk factors for the intraoperative elevation of lower leg pressure and to evaluate the effectiveness of monitoring external pressure during surgery for preventing these complications. Methods The study included 106 patients with a diagnosis of sigmoid colon or rectal cancer who underwent elective laparoscopic surgery between June 2019 and December 2020. We divided the posterior side of the lower leg into four parts (upper outside, upper inside, lower outside, lower inside) and recorded the peak pressure applied to each area at hourly intervals during surgery (called "regular points") and when the operating position was changed (e.g., by head-tilt or leg elevation; called "points after change in position"). When the pressure was observed to be higher than 50 mmHg, we adjusted the position of the leg and re-recorded the data. Data on postoperative leg-associated complications were also collected. Results The pressure was measured at a total of 1125 points (regular, n = 620; after change of position, n = 505). The external pressure on the upper outer side of the right leg (median, 36 mmHg) was higher than that on any other area of the lower leg. The pressure increase to more than 50 mmHg was observed not only during the change of position (27.5%) but also during regular points (22.4%). Bodyweight, strong leg elevation, and low head position were identified as factors associated with increased external pressure. There have been no compression-related complications in 534 cases at our institution since the introduction of intraoperative pressure monitoring. Conclusions Several risk factors associated with increased external pressure on the lower leg were identified. Intraoperative pressure monitoring might help reduction of pressure-related complications, needing further and larger prospective data collections.

Background: The birth of the baby is an exceptional experience for the mother and the whole family. It is crucial that the women’s opinions during maternity care are valued, especially during labor or childbirth, is a crucial factor inproviding respectful maternity care. Aims: This study aims to identify barriers to adapting an upright position during the second stage of labor in Madinah and what are the strategies necessary to overcome these barriers. Methods: A qualitative study was performed at Maternity and Children Hospital,Madinah (MMCH), Saudi Aribia, The study sample consisted of a non- probability convenience sampling of 18 health care clinicians. Data collection was done through face-to-face semi-structured interviews with the consenting healthcare providers. Results: The following core themes emerged: policy, safest way, doctors setthe rules, midwives’ hesitancy to assume responsibility, uncooperative, uninformed women, and the way forward. Conclusion: This study concludes that irrespective of all the evidence supporting the upright position in the second stage of labor, many healthcare providers continue to practice the lithotomy position in accordance with the cultural and routine norms. Many healthcare providers prefer the lithotomy position for their own convenience, disregarding other birth positions as well as the women’s preferences and desires.

Objective:Position changes in patients requiring critical care aimed to mobilise secretions, prevent compression wounds and decrease the risk of ventilator-related pneumonia. This study aimed to investigate the effects of supine, left lateral, right lateral and Fowler positions on the respiratory and cardiac parameters with the CO2 rebreathing technique using non-invasive cardiac output monitor.Materials and Methods:Forty patients aged 18-65 years who were on invasive mechanical ventilator support and had a hospitalisation time >24 h were included in the study. Cardiac output was monitored with non-invasive cardiac output monitor. Patients were assisted on supine, left lateral, right lateral and Fowler positions. Respiratory and hemodynamic parameters of patients were measured at these positions with 1-h intervals.Results:A significant difference was found among the measurements when the mean arterial pressure values measured at different times at the left lateral position were compared. Similarly, a significant difference was noted among SpO2 values measured at the supine position at different times. However, this difference was not clinically significant. No significant differences were found within the groups as regards to other respiratory and cardiac parameters.Conclusion:Position changes did not lead to a clinically significant change on respiratory mechanics, hemodynamic parameters and oxygenation in patients with stable hemodynamic who were on mechanical ventilator support.

Most pancreatic neuroendocrine tumors (NETs) are detected incidentally and arise in the endocrine tissues. NETs can secrete hormones and result in clinical syndromes. However, between 50 and 75 percent of pancreatic NETs are nonfunctioning. Ultrasonography shows a well-circumscribed mass with a smooth margin and round or oval hypoechoic shape. A 38-year-old woman visited our hospital with mild upper abdominal discomfort. We visualized an oval hypoechoic mass with inner hyperechogenicity after water intake in the stomach and position change. The patient underwent surgery, and the mass was diagnosed as pancreatic NET.

Clinical assessment of the pelvic floor muscles (PFMs) in a standing position may provide a more valid representation of PFM function experienced by patients in daily life than assessment in the lying position. The primary aim of this study was to examine PFM function in a standing versus a lying position in parous women with any type of urinary incontinence and/or pelvic organ prolapse. In this exploratory cross-sectional study, participant symptom status was determined using the Australian Pelvic Floor Questionnaire. Pelvic floor muscle function was assessed in standing and lying positions with a randomised order of testing. The primary outcome measure was vaginal squeeze pressure (VSP) using intra-vaginal manometry. Secondary outcomes included vaginal resting pressure, total PFM work and digital muscle testing. The difference between PFM function in a standing position compared with a lying position was analysed using paired t test or Wilcoxon’s signed rank test. Vaginal squeeze pressure assessed with manometry was higher in a standing than in a lying position (p = 0.001): standing (mean [SD]) 24.90 [12.67], lying 21.15 [14.65]. In contrast, PFM strength on digital muscle testing was lower in a standing position than in a lying position. This study has demonstrated that PFM function in a standing position is different from that in a lying position in women with pelvic floor dysfunction. Whether the higher VSP observed in a standing position reflects a true difference in strength between positions, or a higher pressure reading due to incorrect PFM contraction technique in a standing position is uncertain. Further research with larger cohorts and a measurement tool that can accurately distinguish a rise in intra-vaginal pressure from PFM contraction rather than increasing intra-abdominal pressure is required to confirm this difference, and the clinical significance of any difference.

Background. The problem of diagnostics and treatment of malignant neoplasms of the lungs is urgent. Verification of a malignant process in the case of peripheral localization of a neoplasm in the lung using ultrasound bronchoscopy ranges from 30 to 85%. To improve the efficiency of ultrasound bronchoscopy, a modified biopsy technique for ultrasound bronchoscopy was developed and introduced into clinical practice at the Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine. The essence of the modified technique is that it becomes possible for ultrasound visual control over the passage and deployment of biopsy forceps in real time. The technique was patented, patent for invention RU №2719666 C1 was issued. Aim. To clarify the information content of ultrasound bronchoscopy using a modified technique. Materials and methods. On the basis of the endoscopic Department of Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine in 2019 and 2020, ultrasound bronchoscopy using this technique was performed on 40 patients with suspected peripheral malignant neoplasm of the lungs. The diagnosis of malignant neoplasm was verified in 67.5% of cases. Using the standard biopsy technique, the probability of verification of lung malignant neoplasms in 2019 and 2020 was 57.7%. Thus, the modified biopsy technique made it possible to increase the verification probability by 9.8%. The modified technique is relatively safe, complications during the procedure were detected in 2 patients (in 3.8% of cases) and were successfully treated conservatively. During and after the procedure, the patients were monitored and monitored. The ultrasound bronchoscopy according to the modified technique was satisfactorily tolerated by the patients. Results. The period of examination of patients when using this technique does not increase. The technique replaces more invasive diagnostic procedures. Conclusion. The use of the modified technique will improve the information content of ultrasound bronchoscopy, shorten the examination time for patients and accelerate the appointment of special treatment methods.

UDK: 597.551.2(497) Sabanejewia balcanica is a fish species that belongs to Cobitidae family and it is the endemic of the Balkan Peninsula. It is present in the tributaries of the Danube and Aegean waters. Systematics of this species has experienced certain changes that are related to the systemic instability of the entire Cobitidae family, so there has been a change in the name of the genus of this species. The genus Sabanejewia was separated from the genus Cobitis in the last century, but this name was generally used much later. According to data of the IUCN Red List of Threatened Species, this species is still not endangered, but is assigned a status of least concern (LC). Sabanejewia balcanica is in the Annex II of the Habitats Directive and Annex III of the Bern Convention which basically require the protection of this species and its habitats. In the proposal to create a red list of fauna of the Federation of Bosnia and Herzegovina, has been concluded that there is not enough information on the population characteristics of this species. The aim of this article is to present data on exploration of Sabanejewia balcanica in the Balkan area as well as Bosnia and Herzegovina, thereby contributing to the determination of its status of vulnerability and protection of its natural habitats.

Post-mortem movement relating to the disarticulation or positional change of entire limbs is relevant to a forensic investigator when examining a deceased person. Understanding that the position a ...

The head elevation position increased mortality, decreased MAP, and showed no significant change in CePP.

PURPOSE To study the changes of hyoid position in infants with Robin sequence before and after mandibular distraction osteogenesis, and to explore the related factors. MATERIAL AND METHODS Twenty-six infants with Robin sequence underwent bilateral mandibular distraction osteogenesis from May 2016 to April 2020. Three-dimensional computed tomography data of patients before and after surgery were analyzed with Materialise Mimics 17.0. Changes in the three-dimensional position of the hyoid bone were studied. RESULTS The angle between the long axis of the tongue body and hard palate plane, and the angle between the long axis of the tongue body and mandibular plane were significantly decreased after surgery than before surgery. The hyoid bone-cranial base vertical distance, hyoid bone-mental point distance, and hyoid bone-epiglottis distance were significantly increased after surgery. The differences in the above-mentioned data were statistically significant (P

In this study we propose a portable tool to monitor and monitor patients at risk of Alzheimer's. The aim of this research was design and make a useful tool to determine the position and condition of Alzheimer's sufferers. The research stages consisted of designing hardware, software and testing the whole tool. The patient's condition find out by an accelerometer sensor was used which read the values of the x, y, and z axes to determine the condition of patient normal or falling. This tool also have a panic button which use by the patient if he did not know his position and forget the way to go home and SMS notification will be sent to the colleague when this button was pressed. The results of the test show the device can send an SMS notification of the patient's position when the supervisor sends a sms "GPS ON” and the navigation module can determine the location of the position. The distance between reading position of the GPS module to the test point in average was 2.39 meters. Generally speaking, the tool can working properly.

Background: Crohn’s disease (CD) is a chronic inflammatory disorder affecting the gastrointestinal tract with disease behaviour based on the depth and severity of mucosal injury. Cumulative injury can result in complications including stricture formation and penetrating complications which often require surgical resection of diseased segments of the intestine resulting in significant morbidity. Accurate assessment of disease activity and appropriate treatment is essential in preventing complications. Summary: Treatment targets in the management of CD have evolved with the advent of more potent immunosuppressive therapy. Targeting the resolution of sub-clinical inflammation and achieving mucosal healing is associated with the prevention of stricturing and penetrating complications. Identifying non-invasive modalities to assess mucosal healing remains a challenge. Key Messages: Mucosal healing minimizes the risk of developing disease complications, prolongs steroid-free survival, and reduces hospitalization and the need for surgical intervention.

PURPOSE Adequate patient positioning is of paramount importance in neurosurgery. Complications related to the position are common and make up for more than 16% of the claims towards anaesthesiologists and neurosurgeons. This paper aims to provide the anaesthesiologist with a practical guide to avoid common pitfalls related to the patient positioning process. METHOD We performed a systematic review of the medical literature for the identification, screening, and inclusion of articles. The bibliographic search was conducted on June 1st, 2021 by two of the authors. In this review, we included articles indexed by MEDLINE, Cochrane Library, or Google Scholar. RESULTS We retrieved a total of 5706 unique papers from our initial search. However, after the initial screening, 5363 papers were removed is not related to our research leaving a total of 343 papers. We examined the full text of all the 343 articles including 68 of them in the final qualitative analysis. DISCUSSION In this review we examine the most common neurosurgical positions: supine, sitting, lateral, park-bench, prone, jack-knife, and knee-chest. For each of them, the proper positioning and related complications are described. Particular attention is given to the prevention and management of these complications, providing a practical guide for clinicians.

The study aimed at introducing a digital method of locating the osteotomy position of the zygomatic arch during surgery and analyze the accuracy of this method. Patients with a prominent zygomatic bone who underwent zygomatic arch osteotomy and reduction in the orthognathic surgery department of our hospital were selected. Preoperative and postoperative computed tomography (CT) data of the patients were imported into modeling and analysis software Mimics 23.0 in DICOM format to construct 3D models of the zygomatic bone and zygomatic arch region. The data were obtained by locating the simulated osteotomy position of the zygomatic arch before the surgery, applying the digitally modeled osteotomy position of the zygomatic arch during the surgery, and locating the actual osteotomy position of the zygomatic arch after the surgery. The accuracy of the experimental method was verified by matching the preoperative simulation data with the postoperative osteotomy data. A Wilcoxon rank sum test was performed to compare the 20 cases’ osteotomy positions obtained by preoperative simulation with the actual postoperative position. There was no significant difference in zygomatic arch osteotomy position between the preoperative simulation and the real postoperative position (Z=-1.867, P=0.062). The digital method to locate the zygomatic arch osteotomy seems to show an acceptable accuracy to achieve the proper osteotomy position and, therefore, should adopted whenever appropriate.

Physiological changes associated with thermoregulation can influence the kinetics of chemicals in the human body such as alveolar ventilation (VA) and redistribution of blood flow to organs. In this study, the influence of heat stress on various physiological parameters was evaluated in nine male volunteers during sessions of exposure to wet-bulb globe temperatures (WBGT) of 21, 25, and 30 °C for 4 h. Skin and core temperatures and more than 20 cardiopulmonary parameters were measured. Liver, kidneys, brain, skin, and muscles blood flows were also determined based on published measurements. Results show that most subjects (eight out of nine) have been affected by the inhalation of hot and dry air at the WBGT of 30 °C. High respiratory rates, superficial tidal volumes, and low VA values were notably observed. The skin blood flow increased by 2.16-fold, whereas the renal blood flow and liver blood flow decreased by about by 11% and 18%, respectively. A complete set of key cardiopulmonary parameters in healthy male adults before and during heat stress was generated for use in physiologically based pharmacokinetic modeling. A toxicokinetic studies are ongoing to evaluate the impact of heat stress on the absorption, biotransformation and excretion rates of volatile xenobiotics.

Purpose:Residual fragments following retrograde intrarenal surgery can lead to future stone episodes. The lower pole of the kidney presents a unique challenge as it is the most difficult location f...

At the beginning of the nineties of the last century, one of the most prominent Arab problems appeared ‎in the Middle East, which was represented by Iraq‏’‏s invasion of Kuwait, which was the most prominent ‎event at all levels, regional and international, given the great political and strategic changes that the ‎invasion provoked in the region and the difference in attitudes and consensus at other times, ‎including‏ ‏It was necessary for us to study and analyze the position of one of the most important Arab ‎countries in the region, which is the Syrian position on the issue of Iraq‏’‏s invasion of Kuwait and its ‎repercussions, and the Syrian government‏’‏s attempt to settle that conflict by adopting various effective ‎ways to contain the crisis and prevent the dispersal of the Arab nation with its focus on finding a ‎peaceful solution to avoid the countries of the region from possible future dangers‏. ‏It cannot be ‎controlled later, which is what prompted it to go along with all the Arab and international resolutions ‎that condemned that invasion. That is why it sought to announce its position on the issue of the ‎invasion clearly and transparently, and on several occasions, it did not deviate from its national and ‎Arab principles until the date of the liberation of Kuwait and the resolution of the crisis and its end‎‎. Keywords: Iraq, Syria, Invasion, Security Council, Saudi Arabia, Arab League, Kuwait

Background: Pectoralis minor tightness has been thought to affect the scapular position. Despite the wide implementation of doorway stretch in clinical practice owing to its apparent effectiveness in stretching the pectoralis minor, limited studies have investigated its influence on the glenohumeral rotational range of motion (ROM). This study aimed to examine the acute effects of doorway stretch on the glenohumeral rotational ROM and the correlation between the scapular position and ROM. Materials and Methods: In total, 34 male high-school baseball players participated in this study. Outcomes included the pectoralis minor muscle length, glenohumeral rotational ROM, and scapular position. The distance between the sternocostal joint of rib 4 and the coracoid process was measured as the pectoralis minor length. Internal and external rotation ROM with the shoulder abducted at 90° were measured. The scapular position was defined by the following two measurements: the distance between the surface and the posterolateral corner of the acromion as well as the scapular index. The participants performed doorway stretch by abducting and externally rotating the shoulder at 90° and flexing the elbow at 90°. The outcomes were compared before and after stretching. Furthermore, the correlation between these changes was investigated. Results: Pectoralis minor muscle length and glenohumeral internal rotation ROM was significantly higher after stretching than before, and the scapular position also significantly changed (P

Both seating arrangement and position have been one the problematic topic in educational studies, particularly in higher education. There is a large body of studies on the seating arrangement; however, an architectural design studio is specialized in different activities and interaction that challenges the classical form of arrangement. For this reason, the students arrange, rearrange, and disarrange the seating arrangement and position in the studio. This study aimed to investigate the relationship between the viewpoints of the students with seating arrangement positions to find out the students’ preferences to select seating positions. Both quantitative and qualitative methods were applied to analyze data. The Likert questionnaire with fifteen criteria analyzed variables through chi-square, mode, and the graphical analysis illustrated important aspects of the seating arrangements in the department of architecture, the University of Rwanda. The findings addressed that students preferred to use a U-shaped classroom and studio and five statistical criteria supported the association between the viewpoint of students and seating arrangement including the trend to personalize the position, to teamwork activity, to sit close lecturers, to enhance their position. Although other criteria statistically did not associate with the seating arrangement, the cross-tabulation table address that the rear seats in the studio were more preferable for students due to the visual corridor to the front, monitoring, and eye contact.

BACKGROUND Endotracheal intubation for the purpose of providing anaesthesia was first described by William Mc Ewan. Jackson1 stressed the importance of anterior flexion of the lower cervical spine, in addition to obvious extension of the atlanto-occipital joint. Sniffing position has been commonly advocated as a standard head positioning for direct laryngoscopy which is achieved by flexion of the neck on chest and extension of the head at the atlanto-occipital joint. Present study was designed to evaluate the glottis view and ease of intubation achieved with direct laryngoscopy in the sniffing position with that of 25 degree backup position in a study group of 100 patients divided in 2 groups of 50 each. METHODS This study is a controlled comparative study. Controlled trial in 50 consecutive patients in each group [Group I and Group II] was conducted on patients who underwent elective surgery under general anaesthesia. Inclusion Criteria - General anaesthesia with endotracheal intubation, Aged 18 to 60 years, American society of Anaesthesiologists (ASA) grades I and II. Exclusion Criteria - Patients with body mass index more than 30 kg/m2. 1. Bucked teeth. 2. Restricted neck movement. 3. Inter-incisor gap less than 35 mm. 4. Thyro-mental distance less than 6 mm. 5. Patients with risk of regurgitation and aspiration. 6. Pharyngeal pathology. 7. Limitation of anterior and posterior movement of mandible 8. Pregnant patients Groups wereGroup I – Sniffing position Group II– 25 degree back up position RESULTS The glottis visualization was assessed by Cormack Lehane grading which revealed that glottis view was better in 25 degree backup position than sniffing position. CONCLUSIONS In our prospective randomized study in a series of 50 patients undergoing general anaesthesia in SIMS & RC, intubation difficulty scale (IDS) score was better in 25 degree backup position than sniffing position. It implies glottis view is better in 25 degree backup position than sniffing position. KEYWORDS Sniffing Position, 25 Degree Backup Position, Laryngoscopy

Stereotypes created by society toward women still can be found around. Women could not be leaders, could not have a decent job, did not have to have high education, and their position only to please their family. In this research the researcher is discussing about stereotypes that happened towards women. By using Barbara Walter's theory, where it is portrayed how men find women should be under their position whether in work position or in general, this study is examined. The method used in this research is qualitative method, where the data taken from sentences or conversations from the novel On the Come Up by Angie Thomas. The results of this study indicate the main character is not following the stereotypes that society has created. It can be concluded that she is not the ideal type based on societal stereotypes.

Background: Crohn’s disease is a progressive inflammatory bowel disease. Persistent untreated inflammation can cumulatively result in bowel damage in the form of strictures, fistulas, and fibrosis, which can ultimately result in the need for major abdominal surgery. Mucosal healing has emerged as an attractive, yet ambitious goal in the hope of preventing long-term complications. Summary: Clinical remission is an inadequate measure of disease activity. Noninvasive markers such as fecal calprotectin, CRP, or small bowel ultrasound are useful adjunct tools. However, endoscopic assessment remains the cornerstone in building a treatment plan. Achieving complete mucosal healing has proved to be an elusive goal even in the ideal setting of a clinical trial. Key Messages: Aiming for complete mucosal healing in all patients may result in overuse of medications, higher costs, and potential side effects of aggressive immunosuppressive treatment. More practical goals such as relative or partial healing, for example, 50% improvement in inflammation and reduction in size of ulcers, ought to be considered, particularly in difficult-to-treat populations.

Предложен способ определения рефлексивной позиции устойчивости у будущих военных специалистов. На основе изучения специфики служебно-боевой деятельности и особенностей профессиональной подготовки в военном вузе выделены составляющие, необходимые для защиты от воздействия информационных провокаций. Рассмотрены возможности диагностики рефлексивной позиции устойчивости к информационным провокациям по личностному и групповому критериям, оказывающим взаимное влияние на подготовку к выполнению учебных и служебно-боевых задач. По итогам анализа результатов исследования определены необходимые составляющие рефлексивной позиции устойчивости к информационным провокациям у будущих офицеров. The article proposes a method of determining the reflexive position of stability in future military specialists. Based on the study of the specifics of service and combat activities and the peculiarities of professional training, the military university identified the components necessary to protect against the influence of information provocations. Possibilities of diagnostics of reflexive position of resistance to information provocations according to personal and group criteria having mutual influence on preparation for performance of educational and service-combat missions are considered. Based on the analysis of the results of the study, the necessary components of a reflexive position of resistance to information provocations among future officers were determined.

Purpose Disfluencies associated with stuttering generally occur in the initial position of words. This study reviews data from a school-age child with an atypical stuttering profile consisting predominantly of word-final disfluencies (WFDs). Our primary goals were to identify patterns in overt features of WFDs and to extend our understanding of this clinical profile by focusing on aspects of stuttering that lie beneath the surface. Method Analyses explored the patterns and distributions of the child's observable stuttering behaviors, in addition to his awareness, perceptions, and subjective experience of stuttering. Results Findings indicated that the WFD profile consists of relatively consistent and distinct overt features. We also found that, in many ways, the child perceived the impact of his disfluencies much like other children who stutter, even though his disfluencies manifested in a less common form. Conclusion Findings suggest the need for increased awareness of the varied forms stuttering may take in order to ensure accurate diagnosis, clear communication to clients and parents, and timely access to appropriate intervention.