scholarly journals Barriers and Challenges of Implementing Telerehabilitation: A Systematic Review

2021 ◽  
Vol 19 (2) ◽  
pp. 121-128
Author(s):  
Niloufar Rabanifar ◽  
◽  
Kianoush Abdi ◽  
Keyword(s):  
Case Reports ◽  
Rehabilitation Services ◽  
Exclusion Criteria ◽  
Implementation Phase ◽  
Advantages And Disadvantages ◽  
Local Evidence ◽  
Persian Language ◽  
Alternative Approach ◽  
The Usa ◽  
Barriers And Challenges

Objectives: Telerehabilitation (TR) is an alternative approach for providing rehabilitation services in some situations, like Coronavirus Disease 2019 (COVID-19) pandemic. There exist some obstacles, especially during the pre-implementation phase of TR, necessitating an investigation of existing local evidence. This research aimed to investigate the challenges of TR. Methods: Five electronic databases (Scopus, PubMed, Google Scholar, SID, & Magiran) were searched for studies published in English and Persian language from 2011 to February 2021. Search results in all databases provided a total of 598 articles. After reviewing the titles of the articles, we excluded 574 articles as they were duplicated and/or irrelevant. Finally, based on the inclusion and exclusion criteria, 11 articles have remained. Results: Most extracted articles were published in 2020 (n=4). The remaining articles disturbed between 2013 until 2021. These articles were mostly reviews, case reports/series, or qualitative studies and surveys. Geographically, 27% of the final selected papers belonged to the USA, 46% to Asia, and 27% to Europe. Outcomes in studies mostly included TR advantages and disadvantages, facilitators, challenges, and barriers. Discussion: Studies specified numerous challenges for TR implementation. The main challenges in the technologies used in TR were the awareness and culture of individuals and the TR infrastructure. Despite these barriers, TR could be a better treatment selection in some patients. Therefore, it is necessary for health policymakers, and especially rehabilitation managers, technology developers, scientists, and clinicians to cooperatively make serious efforts to remove these barriers.

Bedside Cardiac Pocus in Emergency Setting: A Practice Review

2020 ◽  
Vol 15 ◽  
Author(s):  
Christian Zanza ◽  
Yaroslava Longhitano ◽  
Marco Artico ◽  
Gianmaria Cammarota ◽  
Andrea Barbanera ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Core Curriculum ◽  
Case Reports ◽  
Short Review ◽  
Rapid Identification ◽  
Cochrane Library ◽  
Emergency Setting ◽  
Holistic View ◽  
Questions And Answers ◽  
The Usa

Background: in the last years, ultrasound technology has entered in clinical practice as a tank and today, it has also allowed to no-cardiologists to extend and to deep their medical examination without the needing to call the consultant and having a good profile of diagnostic accuracy. The ultrasound bedside does not replace the consultant but it allows not to perform inappropriate consultations with more savings for hospitals. Objective: The aim was to review recently published literature to inform the clinician about the most up to date management of use bedside echography in emergency setting. In this short review we focused on two types of syndromes, no traumatichypotension and dyspnea, common to the three holistic disciplines of medicine, showing the main and basic questions and answers that ultrasound can give us for rapid identification of the problem Methods: We conducted a systematic review using Pubmed/Medline, Ovid/Willey and Cochrane Library, combining key terms such as “cardiac ultrasound, “cardiac diseases”,“emergency medicine”,“pocus”, “dyspnea”,“ hypotension”. We selected the most relevant clinical trials and review articles (excluding case reports) published in the last 19 years and in our opinion 59 publications appeared the best choice according to the PRISMA statement. In additional papers identified from individual article reference lists were also included. Conclusion: Recent studies have shown promise in establishing best practices for evaluation of heart, lung abdomen and deep vessels At the moment bedside US is widely used in an integrated ultrasound vision just like the holistic view have internal medicine, intensive care and emergency medicine and many medical schools in Europe and the USA are inserting ultrasonography into the core curriculum but we still have to find a standard method for the training program for minimum competence acquisition.

scholarly journals Applicability of Moyers analysis in mixed dentition: A systematic review

2013 ◽  
Vol 18 (6) ◽  
pp. 100-105 ◽  
Author(s):  
Mariana de Aguiar Bulhões Galvão ◽  
Gladys Cristina Dominguez ◽  
Sérgio Thomaz Tormin ◽  
Alex Akamine ◽  
André Tortamano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Clinical Case ◽  
Case Reports ◽  
Mixed Dentition ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Theoretical Probability ◽  
Study Population ◽  
Mixed Dentition Analysis

INTRODUCTION: Moyers analysis is widely used for analyzing mixed dentition, however, the accuracy of its theoretical probability tables has been recently questioned. Taking into consideration the fact the mixed dentition analysis is of paramount importance to precisely determine the space needed for alignment of canines and premolars, this research aimed at objectively assessing in the literature such an important step for orthodontic diagnosis. METHODS: A computerized search involving articles published on PubMed and Lilacs between 1990 and September, 2011 was conducted in accordance with the method described in the Cochrane 5.1.0 handbook. RESULTS: The research resulted in a sample composed of 629 articles. The inclusion criteria were: Articles using the Moyers analysis with a sample greater or equal to 40 patients. Conversely, the exclusion criteria were: Dental casts of patients with syndromes or oral cleft, researches conducted with a literature review, only, or clinical case reports and researches conducted before 1990. For this systematic review, 19 articles were selected. CONCLUSION: Based on the literature available, we can conclude that the Moyers mixed dentition analysis must be carefully used, since the majority of the articles analyzed showed that the probability of 75% was not as accurate as expected, leading to the need of adapting the probability levels depending on the study population.

scholarly journals Presenting Psychiatric and Neurological Symptoms and Signs of Brain Tumors before Diagnosis: A Systematic Review

2021 ◽  
Vol 11 (3) ◽  
pp. 301
Author(s):  
Fatima Ghandour ◽  
Alessio Squassina ◽  
Racha Karaky ◽  
Mona Diab-Assaf ◽  
Paola Fadda ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neurological Symptoms ◽  
World Health ◽  
Exclusion Criteria ◽  
Comprehensive Description ◽  
Brain Tumor Diagnosis ◽  
Health Organization ◽  
Symptoms And Signs

Brain tumors can present with various psychiatric symptoms, with or without neurological symptoms, an aspect that complicates the clinical picture. However, no systematic description of symptoms that should prompt a neurological investigation has been provided. This review aims to summarize available case reports describing patients with brain tumors showing psychiatric symptoms before brain tumor diagnosis, in order to provide a comprehensive description of these symptoms as well as their potential relationship with delay in the diagnosis. A systematic literature review on case reports of brain tumors and psychiatric symptoms from 1970 to 2020 was conducted on PubMed, Ovid, Psych Info, and MEDLINE. Exclusion criteria comprised tumors not included in the World Health Organization (WHO) Classification 4th edition and cases in which psychiatric symptoms were absent or followed the diagnosis. A total of 165 case reports were analyzed. In a subset of patients with brain tumors, psychiatric symptoms can be the only manifestation or precede focal neurological signs by months or even years. The appearance of focal or generalized neurological symptoms after, rather than along with, psychiatric symptoms was associated with a significant delay in the diagnosis in adults. A timely assessment of psychiatric symptoms might help to improve early diagnosis of brain tumors.

Methylene blue is not contraindicated to treat hemodynamic instability in pediatric and neonate patient

2021 ◽  
Vol 17 ◽  
Author(s):  
Walusa A. Gonçalves-Ferri ◽  
Agnes A.S. Albuquerque ◽  
Patricia Martinez Evora ◽  
Paulo R.B. Evora
Keyword(s):  
Methylene Blue ◽  
Side Effects ◽  
Infusion Rate ◽  
Case Reports ◽  
Hemodynamic Instability ◽  
Exclusion Criteria ◽  
Old Patients ◽  
Randomized Clinical Study ◽  
Dose Infusion ◽  
Administration Timing

: The present review was carried out to describe publications on the use of methylene blue (MB) in pediatrics and neonatology, discussing dose, infusion rate, action characteristics and possible benefits for a pediatric patient group. The research was performed on the data sources PubMed, BioMed Central, and Embase (updated on Aug 31, 2020) by two independent investigators. The selected articles included human studies that evaluated MB use in pediatric or neonatal patients with vasoplegia due to any cause, regardless of the applied methodology. The MB use and 0 to18-years-old patients with vasodilatory shock were the adopted criteria. Exclusion criteria were the use of MB in patients without vasoplegia and patients ≥ 18-years-old. The primary endpoint was the increase in mean arterial pressure (MAP). Side effects and dose were also evaluated. Eleven studies were found of which 10 were case reports and 1 was a randomized clinical study. Only two of these studies were with neonatal patients (less than 28 days-old), reporting a small number of cases (1 and 6). All studies described positive action of MB on MAP, allowing the decrease of vasoactive amines in several of them. No severe side effects or death related to the use of the medication was reported. The maximum dose used was 2 mg/kg, but there was no consensus on the infusion rate and drug administration timing. Finally, no theoretical or experimental basis sustains the decision to avoid MB in children claiming it can cause pulmonary hypertension. The same goes for the concern of a possible deleterious effect on inflammatory distress syndrome.

scholarly journals MANAGEMENT AND OPERATION MODELS IN ELECTRICAL CHARGING INFRASTRUCTURE (EXAMPLE OF KEY COUNTRIES: USA AND CHINA)

2021 ◽  
pp. 94-108
Author(s):  
Леонид Вячеславович Калимуллин ◽  
Денис Константинович Левченко
Keyword(s):  
Developed Countries ◽  
Practical Experience ◽  
Infrastructure Management ◽  
Electric Transport ◽  
Charging Infrastructure ◽  
Advantages And Disadvantages ◽  
State Initiatives ◽  
The Usa ◽  
Characteristic Features ◽  
Russian Model

Несмотря на существующие государственные инициативы, одним из факторов, сдерживающих развитие электротранспорта в России, является низкий уровень развития электрозарядной инфраструктуры. В данном контексте актуально изучить успешный опыт построения и внедрения моделей функционирования электрозарядной инфраструктуры и управления ею на примере наиболее развитых по данному направлению стран. Целью статьи является исследование моделей функционирования инфраструктуры для электромобилей и управления ею, применяемых в США и Китае, выявление характерных особенностей, преимуществ и недостатков с целью формирования наиболее оптимальных условий для построения российской модели электрозарядной инфраструктуры. Элементы научной новизны заключаются в обобщении и систематизация практического опыта применения моделей функционирования электрозарядной инфраструктуры и управления ею. Despite existing state initiatives, one of the factors limiting the development of electric transport in Russia is the low level of development of electric charging infrastructure. In this context, it is relevant to study the successful experience of building and implementing models for the management and operation of electric charging infrastructure on the example of the most developed countries in this area. The purpose of the article is to study models of infrastructure management and functioning for electric vehicles used in the USA and China, to identify characteristic features, advantages and disadvantages in order to form the most optimal conditions for building a Russian model of electric charging infrastructure. Elements of scientific novelty are the synthesis and systematization of practical experience in the application of models of control and operation of electric charging infrastructure.

scholarly journals Faringoezofaginių (Cenkerio) divertikulų chirurginis gydymas

2004 ◽  
Vol 2 (4) ◽  
pp. 0-0
Author(s):  
Romaldas Rubikas ◽  
Paulius Gradauskas ◽  
Diana Samiatina
Keyword(s):  
Case Reports ◽  
Surgical Care ◽  
Posterior Wall ◽  
Upper Esophageal Sphincter ◽  
Patient Death ◽  
Main Method ◽  
Advantages And Disadvantages ◽  
Zenker Diverticulum ◽  
Prevertebral Fascia ◽  
Esophageal Sphincter

Romaldas Rubikas, Paulius Gradauskas, Diana SamiatinaKauno medicinos universiteto Torakalinės chirurgijos klinika,Eivenių g. 2, Kaunas, LT-50009El. paštas: [email protected] Įvadas / tikslas Ryklės ir stemplės sandūros užpakalinėje sienoje virš ryklės apatinio sutraukiamojo raumens, musculus constrictor pharyngis inferior, atsiradęs gleivinės maišelis vadinamas faringoezofaginiu arba Cenkerio (vok. Zenker) divertikulu. Pagrindinė jo atsiradimo priežastis yra stemplės viršutinį rauką (angl. upper esophageal sphincter) sudarančių raumenų veiklos, maistui slenkant rykle, koordinacijos sutrikimas. Dažniausiai vartojami du šios ligos chirurginio gydymo metodai – divertikulo rezekcija ir viršutinio stemplės rauko įpjova su divertikulo fiksacija vertikalioje padėtyje. Retrospektyvaus tyrimo tikslas – ištirti ankstyvuosius pooperacinius rezultatus, įvertinti klinikoje vartotų faringoezofaginio divertikulo chirurginio gydymo metodų pranašumus ir trūkumus. Pacientai ir metodai Nuo 1990 iki 2004 metų nuo faringoezofaginio divertikulo operuoti 58 ligoniai. Divertikulo rezekcija atlikta 43, o stemplės viršutinio rauko įpjova ir divertikulo fiksacija – 15 ligonių. Duomenys surinkti iš ligos istorijų. Rezultatai Po divertikulo rezekcijos gydymo trukmė (10,6 ± 4,6 dienos) buvo statistiškai reikšmingai (p = 0,004) ilgesnė negu po stemplės viršutinio rauko įpjovos bei divertikulo fiksacijos (6,3 ± 1,6 dienos). Po divertikulo rezekcijos dviem (4,6%) ligoniams susidarė stemplės fistulė. Viena ligonė (2,3%) nuo šios komplikacijos mirė. Po stemplės viršutinio rauko įpjovos ir divertikulo fiksacijos sunkių pooperacinių komplikacijų nebuvo. Išvada Stemplės viršutinio rauko įpjova ir divertikulo fiksacija yra sudėtingesnė operacija, palyginti su rezekcija, tačiau dėl reikšmingų pranašumų laikytina pagrindiniu šios ligos chirurginio gydymo metodu. Reikšminiai žodžiai: faringoezofaginis (Cenkerio) divertikulas, rezekcija, fiksacija, stemplės viršutinis raukas, įpjova Surgical treatment of pharyngoesophageal (Zenker) diverticula Romaldas Rubikas, Paulius Gradauskas, Diana Samiatina Background / Objective Pharyngoesophageal (Zenker) diverticulum is a mucosal pouch presenting posterolateral to the hypopharynx just above the level of the cricopharyngeal muscle, i. e. in the main part of the upper esophageal sphincter. The primary pathway in the pathogenesis of Zenker diverticulum appears to be failure of coordinated relaxation of the upper esophageal sphincter at the time a food bolus reaches that position in the hypopharynx. Surgical care of this disease involves mainly two methods: resection of the diverticulum and myotomy of the cricopharyngeal with esophageal muscles combined with diverticulum suspension to the prevertebral fascia or posterior wall of the pharynx. The aim of this retrospective study was to analyse postoperative results and reveal advantages and disadvantages of both these methods. Patients and methods From 1990 to 2004, 58 patients were operated on due to Zenker diverticulum. Resection of the diverticulum, myotomy and diverticulum suspension were performed for 43 and 15 patients, respectively. Perioperative data were collected from case reports. Results Hospital stay was shorter (p = 0.004) in patients who underwent myotomy and diverticulum suspension than in those who had resection of the diverticulum (10.8 ± 4.6 days versus 6.3 ± 1.6 days). Esophageal fistula occurred in two (4.6%) cases after resection of the diverticulum. This complication caused one (2.3%) patient death. There were no severe postoperative complications following myotomy and diverticulum suspension. Conclusion Myotomy and diverticulum suspension is technically more complicated than its resection. However, myotomy and diverticulum suspension have significant clinical advantages and, therefore, should be recommended as the main method for the surgical care of Zenker diverticulum. Keywords: pharyngoesophageal (Zenker) diverticulum, resection, suspension, upper esophageal sphincter, myotomy

Developing and Implementing Ch. VII O&M Programs at CCGT Plants: Case Studies

2021 ◽  
Author(s):  
Peter Jackson ◽  
Robert Rosario ◽  
Andreas Fabricius ◽  
Anita Johny ◽  
Alexandria Wholey
Keyword(s):  
High Temperature ◽  
High Energy ◽  
Piping System ◽  
Inspection Planning ◽  
Accelerated Corrosion ◽  
Advantages And Disadvantages ◽  
Effective Implementation ◽  
Creep Fatigue ◽  
The Usa ◽  
High Temperature Steam

Abstract We will present the results from several projects from the USA and other jurisdictions where ASME B31.1 Ch. VII O&M Covered Piping System (CPS) Programs have been implemented at several types of natural gas-fired CCGT plants. Common elements of programs for different plants will be summarized as well as plant-specific considerations for high energy piping condition assessment for newer plants. Pros and cons between a common program for a thermal fleet and plant-specific programs will be discussed including advantages and disadvantages of each approach. Effective implementation of parts of the Nonmandatory Appendix V guidance within the CPS Program will be described and recommendations for best practices. A brief overview of degradation-specific mechanisms for high energy piping and approaches for planninng/scheduling NDE inspections will be described. This overview will include: creep, fatigue, corrosion (erosion-corrosion - E/C and flow accelerated corrosion - FAC) as well as mechanisms that are commonly responsible for high energy piping leaks, failures and repairs including thermal quench cracking of HRSG interstage, terminal desuperheaters and turbine bypass attemperators. A brief summary of Gr. 91 inspection planning in Ch. VII O&M Programs will also be included as well as corrosion under insulation (CUI) and common inspection scopes for high temperature steam drains. Resolution of constant force and variable spring pipe supports on high pressure/high temperature piping that are not accommodating thermal expansion as per their engineering design can be evaluated using pre-outage pipe stress models and data obtained from field walkdowns to support rapid decisions for repair/replacement in the field. Finally, experiences with long term scheduling the need for adaptive management of the CPS Programs will be summarized with typical management oversight actions described for effective implementation.

Heroin (diamorphine)

1967 ◽  
Vol 5 (3) ◽  
pp. 11-12
Keyword(s):  
Morphine Dependence ◽  
Advantages And Disadvantages ◽  
The Usa ◽  
Important Drug

Although heroin (diamorphine) was first manufactured from morphine at St. Mary’s Hospital in 1874, its advantages and disadvantages in comparison with morphine itself are still in dispute. It was originally introduced into medicine as a remedy for cough and morphine dependence in 1898. Indeed morphine addicts readily exchange morphine for heroin but of course this does not represent a cure. Heroin is now the more important drug of addiction although its manufacture has been banned in the USA since 1924, as well as in most other countries. An attempt to do the same in Britain in 1953 failed in a welter of propaganda and counter-propaganda which did nothing to establish its value objectively.

Enterprise Systems Education

2011 ◽  
pp. 339-357
Author(s):  
Frank Lin ◽  
Tony Coulson
Keyword(s):  
Higher Education ◽  
Enterprise Systems ◽  
Enterprise System ◽  
Small Companies ◽  
Education Industry ◽  
Alternative Approach ◽  
Major Player ◽  
The Usa

SAP and Oracle (including PeopleSoft and J.D. Edwards) are the major enterprise systems vendors in the marketplace. Yet most of the universities within the USA, Canada, and Ger-many that have an enterprise system curriculum integrate SAP’s enterprise systems. As a result of the recent PeopleSoft merger, Oracle is becoming a major player in the education industry. Oracle enterprise systems are not only suitable for large and medium companies but also small companies. Oracle enterprise systems are appealing alternatives for institutions to consider in regard to integrating enterprise systems into their curricula. Thus, we are going to introduce this global application vendor’s Oracle Academic Initiative, Enterprise System and its related education — Oracle University’s practice. An alternative approach to delivering enterprise system education, developed through experience and literature, using Oracle E-business Suite in higher education is discussed.

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