Successful Treatment of Testicular Failure Type IV Without Micro-Testicular Epididymal Sperm Extraction: A Case Report

Objective: Sperm donation and hormonal therapy with micro-Testicular Epididymal Sperm Extraction (TESE) for infertility from testicular failure might not always be available in some contexts. We report a successful embryo transfer from the patient-by ‘cumulative sperm collection’ strategy. Case report: A 42 year-old male presented with non-obstructive azoospermia from testicular failure. Hormonal treatments were given along with the patient-initiated ‘cumulative sperm collection’ strategy, which eventually resulted in 17 sperms retrieved. Twelve mature oocytes were selected for intracytoplasmic sperm injection (ICSI) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. Another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: Seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. The second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section. Conclusion: At a center without micro-TESE availability, successful embryo transfer for testicular failure type IV could be achieved by hormonal therapy plus a ‘cumulative sperm collection’ strategy.

TATALAKSANA GAGAL NAFAS AKUT AKIBAT EDEM PARU AKUT PADA PASIEN DENGAN HIPERTENSI

Gagal nafas merupakan kondisi kegagalan fungsi sistem respirasi dalam pertukaran gas di mana PaO2 < 60 mmHg dan/ PaCO2 > 50 mmHg. Telah dilakukan tindakan kepada seorang pasien laki-laki berusia tujuh puluh satu tahun dengan berat badan 70kg yang di bawa ke IGD RSUD Kota Dumai dengan keadaan penurunan kesadaran. Dari alloanamnesa terhadap keluarga pasien, diketahui sebelumnya pasien mengeluhkan sesak nafas yang muncul tiba-tiba. Pasien memiliki riwayat penyakit jantung yang diketahui sejak 6 bulan terakhir dan hipertensi tidak terkontrol. Pasien didiagnosis dengan respiratory failure type 1 et causa cardiogenic pulmonary oedem. Saat di ICU, saturasi O2 pasien turun menjadi 77% sehingga pasien diberikan bagging untuk bantuan nafas kemudian saturasi O2 naik menjadi 90%, kemudian pasien mengalami apneu, asistol dan arteri karotis tidak teraba sehingga dilakukan RJP kompresi: ventilasi 30:2 dengan total 15 siklus dan pasien mengalami ROSC. Pasien kemudian dipasang intubasi dan dibantu ventilator, saturasi O2 menjadi 99%. Sebelumnya pasien diberikan midazolam 15mg di dalam 50ml NaCl melalui syringe pump dan fentanyl 2 ampul dalam 50cc NaCl 50ml melalui syringe pump. Kemudian, pola nafas tidak efektif dan keadaan umum memburuk, ventilator diubah menjadi mode PCAC kemudian pernafasan kembali adekuat dan hemodinamik pasien stabil. Kemudian pada pasien dilakukan weaning ventilator.

Evaluation of Impact of the Operational and Technical Factors on Downtime of Municipal Buses Based on a Linear Regression Model

The objective of this study was to assess the effect of selected operational and technical factors on downtime of vehicles. The sample consisted of buses from a municipal transport company (Poland). Estimation of parameters of a linear regression model was performed. Month of failure (downtime event) and its type were used as predictors. Failures were divided into three categories: events related to the company’s operations, including vehicle failures (1) and other (organizational) problems (2), as well as failures caused by external factors unrelated to the operations of the transport company (3). The downtime was found to be significantly associated with failure type and month of failure. A linear regression model of downtime with a reduced number of impact factors, taking into account two main failure types and two main periods of their occurrence during the year, was developed.

Machine Learning to Predict Medical Devices Repair and Maintenance Needs

Products often experience different failure and repair needs during their lifespan. Prediction of the type of failure is crucial to the maintenance team for various reasons, such as realizing the device performance, creating standard strategies for repair, and analyzing the trade-off between cost and profit of repair. This study aims to apply machine learning tools to forecast failure types of medical devices and help the maintenance team properly decides on repair strategies based on a limited dataset. Two types of medical devices are used as the case study. The main challenge resides in using the limited attributes of the dataset to forecast product failure type. First, a multilayer perceptron (MLP) algorithm is used as a regression model to forecast three attributes, including the time of next failure, repair time, and repair time z-scores. Then, eight classification models, including Naïve Bayes with Bernoulli (NB-Bernoulli), Gaussian (NB-Gaussian), Multinomial (NB-Multinomial) model, Support Vector Machine with linear (SVM-Linear), polynomial (SVM-Poly), sigmoid (SVM-Sigmoid), and radical basis (SVM-RBF) function, and K-Nearest Neighbors (KNN) are used to forecast the failure type. Finally, Gaussian Mixture Model (GMM) is used to identify maintenance conditions for each product. The results reveal that the classification models could forecast failure type with similar performance, although the attributes of the dataset were limited.

Impact of brand anthropomorphism on ethical judgment: the roles of failure type and loneliness

Purpose This paper aims to investigate whether anthropomorphized (i.e. humanized) brands are judged less negatively for competence failures than for moral lapses and how these ethical judgments impact negative word-of-mouth (NWOM) intentions of less-lonely and more-lonely consumers. Design/methodology/approach Two scenario-based experiments were conducted, involving a total of 1,375 US mechanical turk (Amazon consumer panel) participants. Findings Findings show that brand humanization has an impact on ethical judgments only for less-lonely consumers. More specifically, for less-lonely consumers, a humanizing strategy backfires when the failure is moral but helps the brand when the failure is competence-related. On the other hand, more-lonely consumers judge the situation less negatively overall, and this effect is not impacted by the anthropomorphization strategy. Process tests indicate that these judgments indirectly affect consumers’ intention to spread NWOM following negative events. Research limitations/implications Future research could examine the specific process for lonely consumers (i.e. the role of empathy) and manipulate the size of the negative events (i.e. consumer perceptions of moderate vs extreme failures). Practical implications Brand managers need to consider their specific situations, as anthropomorphization can have both positive and negative effects depending on the consumers and the failure type (moral vs competence). Originality/value Extant research indicates that a humanizing strategy backfires when the market has negative information about the brand. This research introduces types of negative information, as well as consumers’ loneliness as moderators and contributes to the literature in branding, business ethics and word-of-mouth.

Analysis of the Frequency and Onset Time of Hyponatremia/Syndrome of Inappropriate Antidiuretic Hormone Induced by Antidepressants or Antipsychotics

Background Hyponatremia and syndrome of inappropriate antidiuretic hormone (SIADH) is a potentially fatal adverse effect of antidepressants (ADs) and antipsychotics (APs), although its frequency and onset time have not been well documented. Objective To analyze the frequency and onset time of AD- or AP-induced hyponatremia/SIADH. Methods We used plural data-mining techniques to search the US Food and Drug Administration Adverse Event Reporting System (FAERS) database for reports on hyponatremia/SIADH induced by psychotropic drugs from January 2004 to June 2020. For each item, we assessed the reporting odds ratio, 95% CI, median onset time, and Weibull distribution parameters. Results We identified 36 422 reports related to hyponatremia/SIADH. Signals were detected for all psychotropic drugs that we analyzed, except for clozapine. The median onset time of total AD-induced hyponatremia/SIADH was shorter than that of AP. For all ADs and APs except clozapine, hazards were considered to be the early failure type. In contrast, the hazard of clozapine was considered to be the random failure type. The limitations of this study included several reporting biases and the presence of confounding variables, particularly age. Conclusion and Relevance Most ADs and APs were found to be associated with a risk for hyponatremia/SIADH. In addition, sufficient attention should be paid to signs of hyponatremia/SIADH in the early phase when most ADs and APs are administered. These data are potentially useful for determining AD- or AP-induced hyponatremia/SIADH in the early stage and for preventing its further aggravation into a serious condition.

PH, CRP as Prognostic Indicators for the Success of Treatment with Non-invasive Ventilation in Patients with Chronic Respiratory Failure Type II

Background: Non-invasive mechanical ventilation (NIMV) provides an alternative option to the initiation of invasive mechanical ventilation in patients with acute respiratory failure, avoiding the associated adverse events. Objective: the present study aimed to assess the outcome of the patients who were initially treated with NIMV and identify the prognostic predictive value of PH and CRP for NIMV failure. Materials and methods: This was observational analytical study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from January 2019 to January 2020. Adult patients with the diagnosis of acute on chronic respiratory failure type 2 were enrolled in the study. Results: A total of 67 patients with acute on chronic respiratory failure type 2 were included in the study. The median age was 63 years and 62.7% were male. The patients in the PH group (7.20-7.25) presented higher rates of mortality and admission to intensive care unit (ICU) which represented 25% and 50% respectively. The NIMV failure rate was 22.4%. Frequency of patients with PH≤ 7.31, ΔPH ≤ 0.04, or CRP ≥53.5 were higher in NIMV failure group; (33.3% vs. 3.8%, p: 0.001), (46.7% vs. 23.1% -, p: 0.03), and (53.3% vs. 32.7%, p: 0.04) respectively. Independent predictors for NIMV failure were: PH≤ 7.31(OR 3.3[0.6-7.8], p:0.01) and ΔPH ≤ 0.04(OR 2.1[1.1-3.9], p: 0.02). Conclusion: NIMV is an effective treatment for hypercapnic respiratory failure. Identification independent predictors for NIMV failure may be useful to avoid the possible complications.

Comprehensive Analysis of Antibiotic-induced Agranulocytosis Using the Japanese Adverse Drug Event Report Database

Although infrequent, drug-induced agranulocytosis can be stimulated by antibiotics. Here, we analyzed the Japanese Adverse Drug Event Report database to identify profiles of antibiotic-induced agranulocytosis. Ten of 60 antibiotics showed signals for agranulocytosis; the reporting odds ratios (95% confidence intervals) for ampicillin/sulbactam, amikacin, cefmetazole, cefozopran, clindamycin, ciprofloxacin, imipenem/cilastatin, kanamycin, teicoplanin, and vancomycin were 2.65 (1.79–3.80), 2.49 (1.91–4.34), 4.48 (2.27–6.92), 2.77 (1.88–3.95), 1.64 (1.04–2.47), 2.01 (1.40–2.82), 2.78 (2.11–3.60), 6.05 (2.16–13.7), 2.05 (1.31–3.07), and 3.54 (2.73–4.54), respectively. The median times-to-onset of agranulocytosis for ampicillin/sulbactam, cefmetazole, cefozopran, clindamycin, imipenem/cilastatin, kanamycin, teicoplanin, and vancomycin were 20, 6, 10, 16, 12, 3, 18, and 13 days, respectively. The 95% confidence intervals of the Weibull shape parameter β for these antibiotics were over and excluded 1, indicating that the antibiotics were the wear out failure type. These findings provided insights into the characteristics of antibiotic-induced agranulocytosis.

Influence of Post-Core and Crown Type on the Fracture Resistance of Incisors Submitted to Quasistatic Loading

The aim of this paper was to evaluate the fracture resistance and failure type of maxillary incisor teeth, rebuilt with various types of post-core restorations and full crowns made of either direct conventional particulate filler composite (PFC, G-aenial Anterior, GC, Tokyo, Japan) or indirect CAD/CAM restorations (composite Cerasmart 270 and glass ceramic LiSi Block from GC). One hundred (n = 10/group) central incisors were cut and divided into 10 experimental groups restored with different approaches. In approach A, teeth were restored with a core build-up composite (Gradia Core, GC) for a core and full crown of PFC. Approach B had teeth restored using composite core and prefabricated fiber posts, and a complete crown of either PFC or CAD/CAM. Approach C contained teeth restored with a core of short fiber-reinforced composite (everX Flow, GC) and prefabricated fiber posts, and a complete crown of either PFC or CAD/CAM. In approach D, the teeth had a core of short fiber-reinforced composite only, and a complete crown of either PFC or CAD/CAM restorations. The root canals were prepared, and when posts were used, they were luted with either a dual-cure resin cement (LinkForce, GC) or everX Flow. As the control, sound teeth (n = 10) were used. Restorations were quasi-statically loaded until fracture. Failure type was visually investigated. The interface between the fiber post and luting cement was investigated using SEM, before and after completion of the loading test. The data were analyzed by analysis of variance (p = 0.05) followed by Tukey’s test. None of the restorative approaches restored the fracture load strength of intact teeth (p < 0.05). Restorations with additional fiber posts (Approaches B and C) had higher load-bearing capacity (p < 0.05) than restorations without fiber posts (Approaches A and D). Restorations that had short fiber-reinforced composite cores with or without fiber posts presented more repairable failures. Using short fiber-reinforced composite as post-luting and core build-up material with conventional fiber posts proved to be a promising method to strengthen severely damaged incisors.