scholarly journals Status Epilepticus Mortality Risk Factors and a Correlation Survey with the Newly Modified STESS

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1570
Author(s):  
Tzu-Hsin Huang ◽  
Ming-Chi Lai ◽  
Yu-Shiue Chen ◽  
Chin-Wei Huang
Keyword(s):  
Status Epilepticus ◽  
Predictive Accuracy ◽  
Positive Impact ◽  
Mortality Rates ◽  
Underlying Disease ◽  
Clinical Practices ◽  
Predictive Capacity ◽  
Prediction Of Mortality ◽  
The Status ◽  
Prediction Of Prognosis

Background: Status epilepticus (SE) is a neurological emergency and is usually associated with significant morbidity and mortality rates. Several clinical scales have been proposed to predict the clinical outcome of such incidents, including the Status Epilepticus Severity Score (STESS), the modified STESS (mSTESS), and the Encephalitis-Nonconvulsive Status Epilepticus-Diazepam Resistance-Image Abnormalities-Tracheal intubation (END-IT). Nevertheless, there is still a need for a more practical and precise predictive scale. Methods: This is a retrospective cohort study which examines data from patients with SE in our Department of Neurology between 2009 and 2020. Based on the outcome of each case, the patients were divided into survivor and non-survivor groups. We analyzed the independent factors and adjusted the STESS to achieve a better prediction of prognosis. The predictive accuracy of our new STESS scale was then compared with that of the mSTESS and the END-IT. Results: Data on a total of 59 patients were collected, with 6 of them classified as non-survivors. The effects of the variables of age, sex, underlying disease(s), and type(s) of antiepileptic drug (AED) use showed no significant differences between the survivor and non-survivor groups. Importantly, the number of AEDs used in the first week and the use of thiobarbiturates predicted non-survival. We adjusted the STESS to create the newly modified STESS (nSTESS), which showed a better predictive capacity than the STESS, the mSTESS, and the END-IT. Conclusions: Our adjustment of the STESS with the addition of the factors “number of AEDs within the first week” and “use of thiobarbiturates”, could have a positive impact on the prediction of mortality rates compared with currently used scales. This nSTESS could potentially be useful in clinical practices, for the early prediction of outcomes for patients with SE.

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

scholarly journals Status epilepticus from GABABR antibody positive encephalitis due to de novo mixed small cell and adenocarcinoma of the prostate

2020 ◽  
Vol 13 (11) ◽  
pp. e238172 ◽  
Author(s):  
Christopher Kwan ◽  
Aaron Sia ◽  
Cullen O'Gorman
Keyword(s):  
Status Epilepticus ◽  
De Novo ◽  
Locally Advanced ◽  
Small Cell ◽  
Gamma Aminobutyric Acid ◽  
Transrectal Biopsy ◽  
The Status ◽  
Adenocarcinoma Of The Prostate ◽  
Receptor Antibodies

We present a case study of a 67-year-old man who presented with a new onset of recurrent tonic-clonic seizures. He had tested positive to gamma-aminobutyric acid B receptor antibodies in his blood and cerebrospinal fluid, and subsequent CT imaging and transrectal biopsy confirmed the presence of a locally advanced mixed small cell and Gleason 9 adenocarcinoma of the prostate. His seizures remained resistant to treatment with multiple antiepileptic drugs, including sodium valproate, clobazam, topiramate, carbamazepine, phenytoin and lacosamide. He progressed to status epilepticus, which required intravenous immunoglobulin and steroids, followed by plasma exchange 1 week later. The status epilepticus was refractory and required multiple admissions to the intensive care unit.

scholarly journals Serum lactate level predicts 6-months mortality in hospitalized patients with decompensated cirrhosis

2019 ◽  
Author(s):  
Yue Zhang ◽  
Yuan Nie ◽  
Si-Zhe Wan ◽  
Cong Liu ◽  
Xuan Zhu
Keyword(s):  
Lactate Level ◽  
Multivariate Analyses ◽  
Predictive Accuracy ◽  
Roc Curves ◽  
Serum Lactate ◽  
Meld Score ◽  
Decompensated Cirrhosis ◽  
Serum Lactate Level ◽  
Initiation Of Therapy ◽  
Prediction Of Prognosis

Abstract Background The prediction of prognosis is an important part of management in decompensated cirrhosis (DeCi) patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in DeCi patients.Methods We performed a single-center, observational, retrospective study of 456 DeCi patients extracted from hospitalization. Univariate and multivariate analyses were used to determine whether lactate was independently associated with the prognosis of DeCi patients. The AUROC was calculated to assess the predictive accuracy compared with existing scores.Results Serum lactate level was significantly higher in nonsurviving patients than in surviving patients. Univariate and multivariate analyses demonstrated that lactate was a risk-independent factor 6-months mortality (odds ratio: 1.412, P=0.001). ROC curves were drawn to evaluate the prediction efficiencies of lactate for 6-months mortality (AUROC: 0.716, P<0.001). Based on our patient cohort, the new scores (MELD+ lactate score, Child-Pugh+ lactate score) had good accuracy for predicting 6-months mortality (AUROC=0.769, P<0.001; AUROC= 0.766, P<0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001).Conclusion Serum lactate at admission may be useful for predicting 6-months mortality in DeCi patients, and the predictive value of the MELD score and Child-Pugh score were improved by adjusting lactate. Lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.

scholarly journals Can Functional Performance Predict Long-Term Mortality Post Hip Fracture in Older Adults (65–100 Years of Age)?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 268-268
Author(s):  
Rashmita Bajracharya ◽  
Denise Orwig ◽  
Jay Magaziner ◽  
Jack M Guralnik
Keyword(s):  
Hip Fracture ◽  
Grip Strength ◽  
Performance Measures ◽  
Gait Speed ◽  
Functional Performance ◽  
Underlying Disease ◽  
Prediction Of Mortality ◽  
Hazard Ratios ◽  
Long Term Mortality

Abstract Functional performance measures (grip strength, Short Physical Performance Battery (SPPB), and 3-meter gait speed) represent underlying disease progression and predict mortality. However, there is little information regarding whether these measures assessed at 2-months post-hip fracture predict long-term mortality (10-year follow-up). To address this gap, a longitudinal analysis of Baltimore Hip Studies-7 cohort, with mortality verified by National Death Index, was conducted. Mean difference in 2-month functional performance measures (n=242, men n=121, female n=121) among those who survived and did not survive over 10 years was determined using t-test. Prediction of mortality by these measures, overall and by sex, was estimated using cox proportional hazard models, for which Hazard ratios (HR) with 95% confidence intervals (CI) were estimated. We found that, gait speed [0.47(standard deviation,SD=0.39) versus 0.31(SD=0.27)] and SPPB score [4.89(SD=3.31) versus 2.83(SD=2.24)] were significantly higher at 2 months among those surviving compared to those who did not. Adjusting for covariates, functional performance predicted long-term mortality in men and women. Increase in gait speed by 0.1m/s predicted 15% decrease in mortality for men [HR=0.85(0.55-0.96)] and 17% for women [HR=0.83 (0.74-0.93)]. Increase in SPPB by 1 unit predicted decrease in mortality by 14% for men [HR=0.86(0.77-0.95)] and 17% for women [HR=0.83(0.74-0.93). Increase in grip strength by 1 kg predicted 5% decrease in mortality for men [HR=0.94(0.92-0.97)] and 9% for women [HR=0.90(0.86-0.95)]. Functional performance measured at 2-months post-hip fracture predicted long-term mortality. Those with poor functional performance at 2-months can be referred for further assessment to optimize their care to promote survival.

scholarly journals The Impact and Empirical Analysis of the Development Level of E-commerce Industry on China’s Export Trade

2021 ◽  
Vol 235 ◽  
pp. 02046
Author(s):  
Chun Feng ◽  
Fei Lei ◽  
Zhijun Luo
Keyword(s):  
High Efficiency ◽  
Positive Impact ◽  
Low Cost ◽  
Status Quo ◽  
Export Trade ◽  
Empirical Methods ◽  
Existing Problems ◽  
Development Level ◽  
The Status ◽  
The Impact

With its advantages of low cost and high efficiency, e-commerce is not only favored by ordinary consumers, but also effectively promotes SMEs to find business opportunities and win the market. This article starts with the development scale of China’s e-commerce industry and the status quo of export trade, and measures the overall index of China’s e-commerce industry development level from 2008 to 2018 through empirical methods to analyze its impact on China’s export trade. The results show that the development level of the e-commerce industry has a significant positive impact on China’s export trade. Finally, it analyzes the existing problems in the development of China’s e-commerce industry.

Sustainable development

2014 ◽  
Vol 32 (4) ◽  
pp. 315-330 ◽  
Author(s):  
Michelle C. Brennan ◽  
Alison J. Cotgrave
Keyword(s):  
Sustainable Development ◽  
Construction Industry ◽  
Positive Impact ◽  
Successful Implementation ◽  
Content Type ◽  
Current State ◽  
The Status ◽  
The Many ◽  
The Uk ◽  
Industry Professionals

Purpose – Despite the surge of interest in construction sustainability and the many Government initiatives encouraging reform in the UK construction industry (CI), the prevalence of sustainable development (SD) in the industry is still largely lagging behind that of other industries. Given the amount of focus and activity identified nationally in this area, the purpose of this paper is to investigate the reasons why this is not being translated into action and to seek counsel from industry professionals as to how they believe change can be achieved with a particular focus on how they believe higher education institutions (HEIs) can contribute. Design/methodology/approach – An explorative, qualitative study using three focus groups was of construction professionals. Findings – Despite a lack of action, many in industry support sustainability and actively attempt to engage in sustainable practices but a number of barriers preclude successful implementation. Government initiatives are having a positive impact, with participants believing that both Government and HEIs are imperative in driving the sustainability agenda forward. Research limitations/implications – Whilst limited in scale, this paper highlights the current state of the CI in relation to SD and evidences that progress is being made albeit slowly. The findings may help both Government and HEIs alongside industry in achieving how this can be overcome. Originality/value – Previous research in this area has generally adopted a quantitative approach. Adopting a qualitative approach provides a more in depth view as to why the status quo remains with regards to SD in the CI.

Abstract P79: Characteristics, Management and Outcomes of Patients with Acute Coronary Syndrome: A Comparison Between the Global Registry of Acute Coronary Events (GRACE) and the Gulf Registry of Acute Coronary Events (Gulf RACE)

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Hamza H Awad ◽  
Mohammad Zubaid ◽  
Alawi A Alsheikh-Ali ◽  
Gordon FitzgGerald ◽  
Frederick A Anderson ◽  
...  
Keyword(s):  
Middle East ◽  
Hospital Mortality ◽  
Treatment Strategies ◽  
Mortality Rates ◽  
Clinical Practices ◽  
Unique Region ◽  
Coronary Syndrome ◽  
Coronary Events ◽  
Global Registry ◽  
Arab Middle East

Background: Developing countries have been under-represented in multinational cardiovascular registries despite playing an important role in global cardiovascular burden. The Arab Middle East is a unique region of the developing world where little is known about the characteristics, clinical practices, and hospital outcomes of patients hospitalized with an ACS. The objective of this study was to compare ACS patients hospitalized in the Arab Middle East to patients enrolled in a multinational ACS registry. Methods: The study sample consisted of patients (pts) recruited in 2007 with a confirmed diagnosis of ACS, including 4,445 from the Global Registry of Acute Coronary Events (GRACE) and 6,706 from the Gulf Registry of Acute Coronary Events (Gulf RACE). Results: The average age in Gulf RACE was nearly a decade younger than GRACE (56 vs 66 years). Patients in Gulf RACE were significantly more likely to be male (5,071(76%) vs 3,072(69%)), smoke (2,452(37%) vs 1,217(28%)), be diabetic (2,745(41%) vs 1,181(27%)) and have a STEMI (2,619(39%) vs 1,504(34%)), while less likely to be hypertensive (3,364(55%) vs 2,929(66%)) compared to pts in GRACE. Patients in Gulf RACE had a significantly higher odds of receiving aspirin (6,563(98%) vs 4,181(94%)) and statins (6,079(91%) vs 3,574(81%)) and significantly lower likelihood of being treated with ACE inhibitors or ARBs (4,618(69%) vs 3,574 (81%)), β-blockers (4,361(65%) vs (3,858 (87%)) and clopidogrel (3,605(54%) vs 3,274(73%)) during hospitalization. The reperfusion strategy of choice among eligible STEMI patients was thrombolysis in Gulf RACE (1,415(84%) vs 297(24%)), while in GRACE it was PCI (805(66%) vs 139(8%)). While overall unadjusted in-hospital mortality rates were not significantly different between Gulf RACE and GRACE (247(3.7%) vs 167(3.8%)), age stratified rates were higher for Gulf RACE across all strata. After adjustment for additional potential confounders, there were no significant differences in hospital mortality of pts enrolled in the two registries. All P<0.01 Conclusions: Despite differences in demographics, clinical characteristics, and treatment strategies, short-term mortality rates are comparable between ACS pts enrolled in registries from different geographic settings.

Low Morbidity and Mortality of Status Epilepticus in Children

PEDIATRICS ◽  
1989 ◽  
Vol 83 (3) ◽  
pp. 323-331
Author(s):  
Joseph Maytal ◽  
Shlomo Shinnar ◽  
Solomon L. Moshé ◽  
Luis A. Alvarez
Keyword(s):  
Status Epilepticus ◽  
Age Groups ◽  
Neurologic Disease ◽  
Neurologic Disorder ◽  
Patients Âgés ◽  
Symptomatic Group ◽  
Younger Age ◽  
The Status ◽  
Neurologic Sequelae ◽  
History Of

In an ongoing study of status epilepticus, 193 children with status epilepticus of varying causes have been followed up for a mean period of 13.2 months. Of these, 97 patients were recruited prospectively. The patients' ages ranged from 1 month to 18 years (mean, 5.0 years). The cause of the status epilepticus was classified as idiopathic in 46 cases, remote symptomatic in 45, febrile in 46, acute symptomatic in 45, and progressive neurologic in 11. The mortality and incidence of sequelae following status epilepticus was low and primarily a function of etiology. Seven children died within 3 months of having the seizure. New neurologic deficits were found in 17 (9.1%) of the 186 survivors. All of the deaths and 15 of the 17 sequelae occurred in the 56 children with acute or progressive neurologic insults. Only two of the 137 children with other causes sustained any new deficits (P &lt; .001). Duration of the status epilepticus affected outcome only within the acute symptomatic group (P &lt; .05). Neurologic sequelae occurred in 29% of infants younger than 1 year of age, 11% of children 1 to 3 years of age, and 6% of children older than 3 years of age. However, this was a reflection of the greater incidence of acute neurologic disease in the younger age groups. Within each cause, age did not affect outcome. Of the 193 children, 61 (32%) had a history of prior unprovoked seizures. Of the 125 surviving children with no history of prior unprovoked seizures, 37 (30%) had subsequent unprovoked seizures. It is concluded that the morbidity of aggressively treated status epilepticus in children, in the absence of an acute neurologic insult or progressive neurologic disorder, is low.

Multi-Dimensional Factors Impacting on E-Government Adoption in Botswana, Mozambique, and Malawi

2013 ◽  
pp. 58-71
Author(s):  
Kelvin Joseph Bwalya ◽  
Tanya Du Plessis ◽  
Chris Rensleigh
Keyword(s):  
Positive Impact ◽  
Base Stations ◽  
African Countries ◽  
Ict Skills ◽  
Government Services ◽  
Left Behind ◽  
Literature Reviews ◽  
The World ◽  
The Status ◽  
The Impact

With widespread adoption of ICT usage in public service delivery platforms (e-Government) throughout the world, African countries have vowed not to be left behind in this marathon. Robust e-Government adoption depends on the strategy employed to implement it. This paper presents the different initiatives that have been employed to promote e-Government development and development in Botswana, Mozambique and Malawi thereby showing the impact of such initiatives on overall e-Government agenda. Using extensive document and literature reviews, this paper further intends to investigate the status of e-Government implementation in these three countries and understand the multi-dimensional factors that dictate adoption and use of e-Government services. The paper has found that deliberate fiscal ICT policies, trust of e-applications, availability of ICT infrastructures such as appropriate mobile phone and base stations technology, usability of ICT platforms, and relevant ICT skills of ordinary citizens have a lasting positive impact on people’s intention to engage in e-Government.

Virtual Reality and Learning in an African University Environment

2011 ◽  
Vol 1 (1) ◽  
pp. 36-49
Author(s):  
Kelvin Joseph Bwalya
Keyword(s):  
Higher Education ◽  
South Africa ◽  
Virtual Reality ◽  
Case Studies ◽  
Positive Impact ◽  
University Environment ◽  
The Status ◽  
E Learning ◽  
Education Model ◽  
User Centric

Incorporating Virtual Reality aesthetics and semantics can contribute towards transforming the education landscape in both the developed and developing world. This can be realized by VR’s capacity to enable the design of more vibrant and dynamic/interactive multimedia applications that are user centric. VR has a positive impact on e-Learning, which is an emerging education model in Africa. This paper uproots the different initiatives, experiences, and challenges that have been met by various endeavors to employ VR as a tool for education, especially in African universities. Using exploratory approaches, two universities in South Africa and Botswana are reviewed as case studies in order to ascertain the status of VR use in higher education in Africa. The paper finds that the potential of VR education is evident in Africa but needs to be unearthed.

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