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OBJECTIVES:. Accurate classification of disorders of consciousness (DoC) is key in developing rehabilitation plans after brain injury. The Coma Recovery Scale—Revised (CRS-R) is a sensitive measure of consciousness validated in the rehabilitation phase of care. We tested the feasibility, safety, and impact of CRS-R-guided rehabilitation in the ICU for patients with DoC after acute hemorrhagic stroke. DESIGN:. Retrospective cohort study. SETTING:. This single-center study was conducted in the neurocritical care unit at the University of Maryland Medical Center. PATIENTS:. We analyzed records from consecutive patients with subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (ICH), who underwent serial CRS-R assessments during ICU admission from April 1, 2018, to December 31, 2021, where CRS-R less than 8 is vegetative state/unresponsive wakefulness syndrome (VS/UWS); CRS-R greater than or equal to 8 is a minimally conscious state (MCS). INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Outcomes included adverse events during CRS-R evaluations and associations between CRS-R and discharge disposition, therapy-based function, and mobility. We examined the utility of CRS-R compared with other therapist clinical assessment tools in predicting discharge disposition. Seventy-six patients (22 SAH, 54 ICH, median age = 59, 50% female) underwent 276 CRS-R sessions without adverse events. Discharge to acute rehabilitation occurred in 4.4% versus 41.9% of patients with a final CRS-R less than 8 and CRS-R greater than or equal to 8, respectively (odds ratio [OR] 13.4; 95% CI, 2.7–66.1; p < 0.001). Patients with MCS on final CRS-R completed more therapy sessions during hospitalization and had improved mobility and functional performance. Compared with other therapy assessment tools, the CRS-R had the best performance in predicting discharge disposition (area under the curve: 0.83; 95% CI, 0.72–0.94; p < 0.0001). CONCLUSIONS:. Early neurorehabilitation guided by CRS-R appears to be feasible and safe in the ICU following hemorrhagic stroke complicated by DoC and may enhance access to inpatient rehabilitation, with the potential for lasting benefit on recovery. Further research is needed to assess generalizability and understand the impact on long-term outcomes.

Organic Rankine Cycle (ORC) is one of the alternative technologies for generating electricity from low to medium level heat sources. ORC operates at low temperatures and pressures using two types of organic working fluids. The organic working fluids as the refrigerants were chosen in the ORC system instead of water, which is suitable for high pressure and temperature applications. Since the performance and configuration of the ORC system rely on its working fluids, the selection of the working fluid for the ORC system becomes crucial. The system utilizes low-temperature heat sources as a supply of heat energy that flows through the evaporator and is then received by the working fluid to operate the cycle. In this study, two dry type working fluids, namely butane (R600) and isobutane (R600a), were used to thermally design an ORC to recover geothermal waste heat. The working fluids were designed using mathematical calculations based on thermodynamic laws. The results revealed that a slightly higher thermal efficiency value was achieved when using R600 as the working fluid, which was 12.8% compared to R600a.

International students comprise over 50% of the graduate student population in the life sciences in the US, over 70% of whom are Asian. Research that aims to understand international students' experiences has often treated Asian students as a monolith, discounting significant cultural and historical differences between regions in Asia that may affect students' motivations for pursuing graduate degrees, their experiences in graduate school, and their identities as scientists in training. To begin to understand the experiences of SAI students as they transition to PhD programs in the sciences, we conducted an exploratory study in which we interviewed 10 SAI students and 12 US native students during the first six months of their doctoral programs. We performed a content analysis of the interview data with the aim of identifying factors that shaped students' doctoral transitions. We then selected factors that were distinctive to SAI students. Finally, we carried out an interpretative phenomenological analysis to understand and describe the following factors that SAI students experienced as influencing their doctoral transitions: prior exposure to research; opportunities for networking; challenges with and affordances for acculturation; attitudes toward and understanding of mental health issues; financial affordances and constraints of pursuing a PhD, and barriers to communication. The results of this work have the potential to be useful to graduate programs seeking to ease SAI students' transition to doctoral programs.

Abstract: Iltifat (shifting) speech act is distinctive and considered unique style of Arabic. It has potential errors when it is translated into Indonesian. Therefore, translation of iltifat speech act into another language can be an important issue. The objective of the study is to know translation procedures/techniques and ideology required in dealing with iltifat speech act. This research is directed at translation as a cognitive product of a translator. The data used in the present study were the corpus of Koranic verses that contain iltifat speech act along with their translation. Data analysis typically used descriptive-evaluative method with content analysis model. The data source of this research consisted of the Koran and its translation. The purposive sampling technique was employed, with the sample of the iltifat speech act contained in the Koran. The results showed that more than 60% of iltifat speech act were translated by using literal procedure. The significant number of literal translation of the verses asserts that the Ministry of Religious Affairs tended to use literal method of translation. In other words, the Koran translation made by the Ministry of Religious Affairs tended to be oriented to the source language in dealing with iltifat speech act. The number of the literal procedure used shows a tendency of foreignization ideology. Transitional pronouns contained in the iltifat speech act can be clearly translated when thick translations were used in the form of description in parentheses. In this case, explanation can be a choice in translating iltifat speech act.

Introduction: Acute focal bacterial nephritis is an underdiagnosed condition. It clinically resembles acute pyelonephritis. If unrecognized and undertreated, it may progress into complications (kidney abscess and scars). Contrast-enhanced computed tomography (CT) reveals specific images of the disease and is considered the gold standard to make the diagnosis. Case Report: A 63-year-old male patient with solitary kidney presented with symptoms compatible with acute pyelonephritis. Kidney ultrasound was not conclusive. Because of persisting high-grade fever not resolving after 48 hours of antibiotics, a contrast-enhanced CT was then performed, and the diagnosis of acute focal bacterial nephritis was made. A repeat CT after three weeks of intravenous (IV) antibiotics showed marked improvement of the intrarenal lesions, and a fourth week of IV antibiotics was dispensed.Conclusion: Diagnosing acute focal bacterial nephritis is important (particularly in a patient with solitary kidney). This will dictate the therapy duration. Unlike acute pyelonephritis, acute focal bacterial nephritis requires at least three weeks duration of antibiotics to avoid progress into further complications.

Background Statistical process control (SPC) is utiled in manufacturing and service applications. It is used to monitor the behavior of the process, also to discover and solve the issues in internal systems. SPC allows immediate corrective actions to prevent defects and maintain process stability. There are two types of control charts are available in the literature: variable control charts and attribute control charts. Methods The use of attribute control charts for two positively skewed distributions such as power function distribution and weighted power function distribution is discussed in this research paper. We compared the behavior of both types of control charts and presented the results in form of tables. Results We conclude that control charts under a weighted power function distribution perform better than control charts using a power function distribution. Furthermore, these results will help in the early detection of errors that enhance the process reliability of the telecommunications and financing industries.

There is a recognised lack of women participating in engineering and STEM in most western countries. However, it is desirable for engineering cohorts to have a broad diversity. Hence, girls need to be encouraged into all engineering fields, but especially those traditionally dominated by men such as civil, mechanical and software engineering. A number of factors influence students' critical career decisions. In particular, teachers influence their students in a number of different ways, some overt and others subliminal, including influencing students' self-image and belief in capability. Students between the ages of 11-13 years often develop images of themselves that can exclude them from careers in technology related careers such as engineering. This study conducted structured interviews with 20 initial teacher education students and two of their lecturers. The interviews considered the students experiences in their own career selection, the reasons one may encourage someone to consider engineering, and the participants of engineering and engineering practice. Interpretation of interview transcriptions indicated that most final year teacher-education students held either limited or stereotypical views of engineering. Participants thought of engineers as mainly for men or "country-type" girls who were good at maths and science. Most recognised the practical nature of engineering, some the academic nature. There was little recognition of the social and empathetic characteristics required. These outcomes imply a gap in understanding that may cause teachers to rely on their gender prejudice, rather than the skills beneficial in the career when providing career advice to potential engineers.