Borrelia Ocular Infection: A Case Report and a Systematic Review of Published Cases

<b><i>Introduction:</i></b> Lyme borreliosis can cause many diverse manifestations, also ocular disease where the diagnosis of ocular borreliosis is challenging. The primary aim was to report on the evidence of <i>Borrelia spirochetes</i> in the ocular tissue in presumed ocular borreliosis. <b><i>Methods:</i></b> A systematic review of pathological eye conditions was performed where <i>Borrelia</i> has been suspected in relevant ocular tissue, together with a case report of diagnosed uveitis with polymerase chain reaction (PCR)-confirmed <i>Borrelia afzelii</i> in the vitreous. The evidence for clinical and laboratory diagnosis was evaluated systematically. As a secondary aim, the treatment of ocular <i>Borrelia</i> infection was also evaluated for confirmed cases. <b><i>Results:</i></b> Thirteen includable studies were found, and after the removal of case duplicates, eleven unique cases were extracted. Apart from the present case report, 4 other cases reported strong evidence for the detection of <i>B. spirochetes</i> in ocular tissue. Four cases presented reasonable evidence for assumed detected <i>Borrelia</i>, while three additional cases showed only weak diagnostic credibility that <i>Borrelia</i> was detected. <b><i>Conclusion:</i></b> This systematic review, including all reported cases and our case report, supports evidence of ocular infection of <i>Borrelia</i> species. Furthermore, in case of suspicion of infection and seronegativity, it is justified to look for <i>Borrelia</i> in eye tissue samples. In addition, microscopy without using PCR is not sufficient to confirm the diagnosis of borreliosis on ocular tissue. In the articles studied, there was no unambiguous recommendation of treatment.

The Application of Salutogenesis in Birth, Neonatal, and Infant Care Settings

In this chapter, the relation of salutogenesis to maternity care is discussed by giving a critical overview of studies in perinatal care, primarily measuring and promoting parental sense of coherence (SOC) and well-being.An overview is given on salutogenic approaches to neonatal and infant service provision. Important aspects of and salutogenic interventions for parent–child attachment in the first year of a child’s life are examined. Parents’ and caregivers’ relationship with their infants and newborns plays a critical role in shaping the emotional, cognitive, and social development of their child. Different interventions of early support to optimize parenting capacity and their impact are also discussed.Although the chapter focuses only on examples of salutogenic approaches based on reasonable evidence, there is a growing awareness of the value of salutogenic approaches to the provision of maternity care, and to facilities and services to enhance parenting and well-being in infancy and early childhood. Research gaps are identified, and suggestions for the direction of future research are outlined.

H-Wave® Device Stimulation: A Critical Review

Pain treatments have historically centered on drugs, but an “opioid crisis” has necessitated new standards of care, with a paradigm shift towards multi-modal pain management emphasizing early movement, non-narcotics, and various adjunctive therapies. Electrotherapies remain understudied and most lack high-quality clinical trials, despite a desperate need for effective adjunctive options. A systematic search of human clinical studies on H-Wave® device stimulation (HWDS) was conducted as well as a comprehensive review of articles articulating possible HWDS mechanisms of action. Studies unrelated to H-Wave were excluded. Data synthesis summarizes outcomes and study designs, categorized as pre-clinical or clinical. Pre-clinical studies demonstrated that HWDS utilizes a biphasic waveform to induce non-fatiguing muscle contractions which positively affect nerve function, blood and lymph flow. Multiple clinical studies have reported significant benefits for diabetic and non-specific neuropathic pain, where function also improved, and pain medication usage substantially dropped. In conclusion, low- to moderate-quality HWDS studies have reported reduced pain, restored functionality, and lower medication use in a variety of disorders, although higher-quality research is needed to verify condition-specific applicability. HWDS has enough reasonable evidence to be considered as an adjunctive component of non-opioid multi-modal pain management, given its excellent safety profile and relative low cost. Level of Evidence: III.

The impact of hospital accreditation on the quality of healthcare: a systematic literature review

Background Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation. Methods We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes. Results We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures. Conclusion There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.

Calculation of transient temperature and rated capacity of three-phase induction motor under different working systems

This paper aims to propose a method to determine the temperature rise and rated capacity of induction motors under different working systems. A dynamic mathematical model, a 3D temperature field model, and finite element method are used to analyze the electromagnetic loss and transient temperature rise, respectively. The influence of the motor starting process on the temperature rise is taken into account, which resolves the complex loading of transient heat source. The maximum allowable running times for the motor operating with different overloads are determined. The relationship between the motor output power and the allowable running time is obtained, and it provides a basis to determine the rated capacity of motor under S2 working system. The relationship between the motor output power and the temperature rise under different load duration rates is also obtained and provides reasonable evidence to determine the rated capacity of the motor under S3-working system.

SUSTAINABLE PERFORMANCE OF PLAYERS IN THE GLOBAL AVIATION INDUSTRY IN THE LIGHT OF MULTI-FACTOR ANALYSIS OF ONLINE REPUTATION

The issue of reputation management in terms of increasing sustainable performance and competitiveness is rapidly developing and undoubtedly is the most important tool in the business area. The study analyzes the reputation of 10 companies with the largest share in the aviation market that were selected on the basis of one of the most widely-used measures of airline size - passenger-kilometer (RPKs) as presented by the International Air Transport Association. The aim is to point out online reputation tools and present ways to improve the performance and competitiveness of analyzed subjects by managing several digital metrics that create this reputation. For this purpose, was applied a modified multi-factor analysis of the overall online reputation sentiment. The research results provide business units with reasonable evidence to proactively implement and invest in reputation management approach because such approach should have a positive impact on their sustainable performance dimensions and further enhance strategic competitiveness.

Conflict Data Fusion in a Multi-Agent System Premised on the Base Basic Probability Assignment and Evidence Distance

The multi-agent information fusion (MAIF) system can alleviate the limitations of a single expert system in dealing with complex situations, as it allows multiple agents to cooperate in order to solve problems in complex environments. Dempster–Shafer (D-S) evidence theory has important applications in multi-source data fusion, pattern recognition, and other fields. However, the traditional Dempster combination rules may produce counterintuitive results when dealing with highly conflicting data. A conflict data fusion method in a multi-agent system based on the base basic probability assignment (bBPA) and evidence distance is proposed in this paper. Firstly, the new bBPA and reconstructed BPA are used to construct the initial belief degree of each agent. Then, the information volume of each evidence group is obtained by calculating the evidence distance so as to modify the reliability and obtain more reasonable evidence. Lastly, the final evidence is fused with the Dempster combination rule to obtain the result. Numerical examples show the effectiveness and availability of the proposed method, which improves the accuracy of the identification process of the MAIF system.

Natural Antioxidant Application on Fat Accumulation: Preclinical Evidence

Obesity represents one of the most important challenges in the contemporary world that must be overcome. Different pathological consequences of these physical conditions have been studied for more than 30 years. The most nagging effects were found early in the cardiovascular system. However, later, its negative impact was also investigated in several other organs. Damage at cellular structures due to overexpression of reactive oxygen species together with mechanisms that cause under-production of antioxidants leads to the development of obesity-related complications. In this view, the negative results of oxidant molecules due to obesity were studied in various districts of the body. In the last ten years, scientific literature has reported reasonable evidence regarding natural and synthetic compounds’ supplementation, which showed benefits in reducing oxidative stress and inflammatory processes in animal models of obesity. This article attempts to clarify the role of oxidative stress due to obesity and the opposing role of antioxidants to counter it, reported in preclinical studies. This analysis aims to clear-up different mechanisms that lead to the build-up of pro-oxidants during obesity and how various molecules of different origins hinder this phenomenon, behaving as antioxidants.

Factors Predicting the Success of Adhesiolysis Using a Steerable Catheter in Lumbar Failed Back Surgery Syndrome: A Retrospective Study

Failed back surgery syndrome (FBSS) is a commonly encountered disease after lumbar surgery. There are many cases where it is difficult to choose a treatment because no specific cause can be found. Nevertheless, according to recent reports, adhesiolysis has shown reasonable evidence. However, considering its poor cost-effectiveness, adhesiolysis cannot be used as the first line of treatment. FBSS patients often suffer from chronic pain; accordingly, they become frustrated when this treatment produces a poor response. Therefore, before the procedure, the target group must be selected carefully. We sought to identify the pre-procedure factors predicting the effect of adhesiolysis in FBSS. A total of 150 patients were evaluated and analyzed retrospectively. Of these 150 patients, 69 were classified as responders three months after the procedure (46%). The outer diameter of the catheter during the procedure and grade of foraminal stenosis were correlated with the procedure effect. In conclusion, of the 2.1 mm diameter of the catheter, 1.7 mm of it was used during the procedure, and the milder the foraminal stenosis, the greater the pain reduction effect was three months after the procedure.

Extent of Integration in Agriculture Supply Chain: The Public Sector Stakeholders perspective

Purpose: Integrating network factors (i.e. Actors, Activities, and Resources), help organizations in achieving superior supply chain performance. Despite reasonable evidence on positive relationship between SCI and SCP, there exists sufficient contradiction on universal integration of chains. This paper is a qualitative exploratory study, which based on the network perspective intends to explore the current and required levels of supply chain integration among actors, activities, and resources in the agriculture supply chain of Pakistan. Design/Methodology/Approach: The data was collected through in depth semi-structured interviews from public sector stake holders of agriculture sector (i.e. From Thirteen wings of Ministry of Agriculture) across Pakistan. The current and required extent of supply chain integration was measured at three levels, i.e. strategic (long-term), tactical (medium-term) and operational (short-term) as suggested by (Childerhouse & Towill, 2011). Findings: The research results indicate that the relationship between supply chain integration and supply chain performance is a contextual phenomenon and significantly varies among Network factors. This study and its findings are expected to add into the literature of supply chain integration and its impact on supply chain performance.