High-Risk NAFLD among Patients with Irritable Bowel Syndrome: Frequency and Effect on Disease Severity

Background Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disease that can change a patient's quality of life and impair their daily activities. Non-alcoholic fatty liver disease (NAFLD), on the other hand, has become a widespread condition as the global obesity rates rises. The prevalence of NAFLD has reached up to 25% of the adolescent population. The etiology of both diseases is still not clearly understood. The mechanism linking the two seemingly similar diseases could be immune system activation and tissue inflammation; thus, the goal of our study was to see if there was a common link between them and to examine NAFLD prevalence and severity in IBS patients. Our study included 150 patients who have symptoms of IBS with different degrees of severity. IBS was diagnosed according to modified ROME IV criteria. Patients were examined to see if they had NAFLD based on abdominal ultrasonography and NAFLD fibrosis score calculation. Results Our current study showed that regarding evaluating the association of IBS with NAFLD, there was a highly statistically significant association between both diseases. Furthermore, there was a high statistical significant association between higher grades of NAFLD and lipid profile parameters. Conclusion Patients with IBS had a higher frequency of NAFLD. In addition, a significant association was noted between IBS severity and increased NAFLD grades.

Mechanisms and possibilities for the emergence of extreme floods in arid zones (Tiznit plain - Morocco): ميكانزمات واحتمالات نشأة الفيضانات المتطرفة بالمناطق الجافة (سهل تزنيت - المغرب)

In Morocco, the dynamics of change in rainfall patterns have been underway for decades. It is characterized by increasingly frequent and violent hydrological and climatic events (floods and droughts). This work aims to study the peculiarities and mechanisms of the appearance of floods in the watershed of the Oudodou wadi (Province of Tiznit - southwestern Morocco) and conduct a frequency analysis of the extreme hydrological events associated with floods to estimate their probabilities and their return periods. In addition to the diagnosis of natural factors in the area studied and their relationship to the emergence of floods, the methodological approach adopted is divided into two stages. The first, known as historical, is based on the study of 8 flooding cases (1942 - 2014) and the delimitation of threatened areas through the representations of residents. The second step focused on analyzing the frequencies of extreme hydrological events to determine their severity and return periods. Analysis of the results showed that flood thresholds are always associated with the strength and concentration of rainfall, giving them a sudden behavior like summer floods. To guide the interventions of actors in the field, the areas threatened by flooding have been identified according to their degrees of severity. The recurrence of the flows was modeled using the GAMMA law which makes it possible to estimate the probability of occurrence of extreme events (floods) and the instantaneous flows corresponding to the return periods of 2, 5, 10, 20, 50 and 100 years. Biannual and five-year hydrological events correspond to instantaneous flows of 120 and 331 m3/s, while exceptional or even very exceptional cases have a return period of more than 50 and 100 years and correspond to instantaneous flows of 912 and 1035 m3/s.

Venezuelan Aspect of “Emerging Partnership” between Turkey and Latin America: Factors, Dynamics and Risks

The article provides an analysis of Turkish-Venezuelan relations amid Turkey-Latin American ties enhancing. In 2015-2019, this way of intercontinental cooperation has reached a peak. This was reflected in the intensification of trade and economic relations, as well as in the strengthening of diplomatic ties. The author analyzes the causes and international factors of the ongoing rapprochement. The analysis is carried out by tracking the trajectory of the changes in Turkey's foreign policy from the perspective of its gradual departure from the pro-Western course. The main emphasis is placed on the evolution and current stage of the Turkish-Venezuelan relations. After periods of recession and boom by 2016 relations between Venezuela and Turkey had come into a turning point. In recent years, their bilateral partnership has been markedly distinguished on the background of Ankaras relations with other states of the region. Venezuela has a record frequency of interstate official visits and a high degree of mutual understanding with the Turkish leadership on fundamental issues. The author carried out a comparative analysis of the two states political and historical special characteristics. The author comes to the conclusion that the format of Turkish-Venezuelan partnership is built on the basis of responding to common to the two states current external challenges. Both states are under sanctions pressure, although with a varying degrees of severity; both economies are experiencing crisis moments. These factors contribute to the development of economic interaction between the states on a mutually beneficial basis. For Venezuela, its economic cooperation with Turkey is a significant factor mitigating the negative effects of the permanent economic crisis. The supply of Turkish foodstuffs helps to reduce a food shortage, while Ankara's purchases of Venezuelan gold contribute to the replenishment of the Venezuelan budget with currency assets. We can talk about the existing geostrategic partnership, which has, if not long-term, then medium-term potential.

CONSEQUENCES OF CHILDREN SWALLOWING FOREIGN BODIES IN THE FORM OF MAGNETIC BALLS

The authors draw attention to dangerous children's toys – magnetic balls (MB). When MB is swallowed in the gastrointestinal tract (GIT), they can connect with each other in chains or are attracted to each other through the intestinal wall, forming necrosis and perforation of hollow organs at the junction. The authors cite four clinical cases of patients aged 2 to 8 years with varying degrees of severity of pathology caused by magnetic foreign bodies in GIT, from spontaneous discharge of foreign bodies during vomiting to multiple perforations of GIT.

Type, effects and cause of injuries suffered by workers in the sawmill industry of El Salto, Durango, Mexico

Introduction: Sawmill work is a dangerous occupation because it involves handling materials and equipment that exposes workers to many risks that can affect their health and safety.Objective: To identify injuries, parts of the body affected and agents that cause accidents in sawmill workers in the region of El Salto, Durango.Materials and methods:A structured survey was applied to 300 workers in 26 sawmills and pallet mills to determine typology, damages and cause of injuries suffered in the last five years.Results and discussion: In the sawmills of El Salto, the most important positions are occupied by people of older age and work experience, regardless of their level of schooling; they have suffered one to five accidents in the last five years and only 32 % have received occupational safety training. The most frequent injuries were caused by hits and crushing body parts of assistants (57 %), open wounds in operators (16 %) and sprains (15 %). The mechanisms causing these injuries were getting stuck by moving objects (30 %), hitting against moving objects (23.3 %), falling objects (14.3 %) and false moves (13.7 %). Fingers were the most affected (35 %) due to a hit and by getting stuck. Conclusions: Safety training is limited, leading to 95 % of workers with injuries with different degrees of severity. It is necessary to implement actions to reduce the risk of accidents and injuries.

Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries

Peripheral artery diseases are a worldwide medical and social problem. Approximately 30 % of patients with critical limb ischemia will undergo amputations and 25 % will die after 1 year. These patients require reconstructive and angioplastic interventions to preserve the limb. The aim of the study is to compare the effectiveness of different endovascular surgical technologies in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries. Materials and methods. Among 243 endovascular interventions, 51 patients were presented with multilevel steno-occlusive lesions of the infrarenal aortic arteries as a result of atherosclerosis obliterans. 42 patients (82.4 %) had two-level lesions and 9 (17.6 %) had three-level lesions. Results. Among 42 patients with a two-level lesion, 29 (56.9 %) ones had femoral arterial segment affection in combination with tibial artery affection. 13 (25.5 %) patients suffered from the lesion of the iliac segment in combination with the affection of the femoral segment arteries. In 9 (17.6 %) patients the lesions of three or more levels were determined: an iliac segment in combination with femoral and popliteal arteries – in 4 patients, and in 2 patients there were lesions of the femoral, popliteal and tibial segments, in 3 patients there was a lesion of the iliac, femoral, popliteal and tibial-foot segments in different degrees of severity. 7 balloon angioplasties and 13 stenting procedures were performed in two and three-level lesions in which the iliac arterial segment was affected. Only balloon angioplasty was used to revascularize the infraingvinal arterial segments. In the early postoperative period, the complications included thrombosis appeared in 6 patients. It was possible to restore the blood flow and save the limb only in 3 persons. For the other 3 ones, the attempts to restore the patency of the arteries were unsuccessful and resulted in the amputation of the lower extremity. Mortality in the early postoperative period was 3.9 % (2 death due to myocardial infarction). Conclusions. The persons with multilevel steno-obstructive lesions of the infrarenal aortic arteries are the most difficult category of patients with CLI. The surgical method of choice for patients with multilevel steno-occlusive lesions is the endovascular angioplasty with or without stenting.

Influence of out-of-plane fiber waviness and different environmental conditionings on mechanical and morphological characteristics of fiber glass/epoxy laminates

The use of structural polymeric composites constitutes an interesting option in the area of wind turbine blade manufacturing. Nevertheless, thick composite components may present out-of-plane waviness in their fibers, compromising the service life of the wind blades. In this context, the present study aims to study the influence of out-of-plane waviness in the fibers with different degrees of severity as well as to verify the effect of fiber glass/epoxy resin composites immersion in distilled water and saline solution in their tensile strength (σmax), modulus of elasticity (E), and deformation at break (єrup), analyzing the reinforcement/matrix interface changes. The results showed that the increase in severity promoted, in general, a statistically significant deterioration in σmax of the samples exposed to the same environmental conditioning. The conditioning led to a decrease in E and an increase in єrup, attributed to the deterioration of the interface and the plasticization of the polymeric matrix, respectively, as evidenced by fractographic analysis. The effect of severity on the єrup and σmax properties was only noticed in laminates exposed to environmental conditioning, due to water sorption favoring the deterioration of the matrix/reinforcement interface, intensifying the deleterious effect of out-of-plane waviness of fibers.

Objective Laryngoscopic Measures From Older Patients With Voice Complaints and Signs of Aging

Purpose The purpose of this study was to use objective measures of glottal gap, bowing, and supraglottic compression from selected images of laryngoscopic examinations from adults over 60 years of age with voice complaints and signs of aging to test current hypotheses on whether degree of severity impacts treatment recommendations and potential follow-through with treatment. Method Records from 108 individuals 60 years or older with voice complaints and signs of aging were reviewed. Three objective measures (normalized glottal gap area [NGGA], total bowing index, and normalized true vocal fold width) were derived. Each measure was subsequently divided into three categories by severity: absence, small degree, or large degree. Nonparametric statistics tested associations between severity and treatment recommendations as well as potential follow-through. Results Noninvasive treatments (observation/voice therapy) were marginally associated with no glottal gap ( p = .09). More invasive treatments (injection/bilateral thyroplasty) were associated with glottal gaps being present ( p = .026), but bilateral thyroplasty recommendations were not significantly associated with the largest gaps. Treatment modalities were not characterized by specific severity categories for any of the objective measures. No significant differences were found for any of the three objective measures between those who followed through with recommended treatment and those who did not. Discussion Results demonstrated some support for current hypotheses on how degrees of severity of objective measures relate to treatment recommendations. Of the three measures, NGGA appears to be more informative regarding treatment recommendations and follow-through, but due to low power, larger sample sizes are needed to confirm clinical relevance.

COVID-19 Country Strategies Counteraction: A System Analysis Experience

Introduction. The article discusses the features of the regulation of counteraction measures in the initial period of the pandemic. When choosing the object of the study, the authors proceeded from the assumption that the effectiveness of responding to COVID-19 threats is related to the capabilities of public administration systems to be adaptive and respond promptly to changes in the situation. The authors focused on studying the process of adaptation of management systems to a new type of threat, for this purpose the situation in countries with maximum and minimum mortality rates was studied. Methods and materials. The methodology is based on the use of the Evidence-based policy principle, implemented through desk research and event analysis. The chosen methodology made it possible to identify a number of typical response strategies based on attempts of “suppression and deterrence”, “mitigation and struggle”, “support and assistance”, expressed in lockdowns of varying degrees of severity. Analysis. Typical measures in the political sphere include the creation of government crisis response headquarters and the development of national plans to combat the epidemic. Most of the damage received by States during the COVID-19 pandemic is due to underestimation of the situation and risks of biological safety, lack of experience in responding. Results. Conclusions were drawn about the economic and political consequences of the implementation of state strategies, their impact on national security. In particular, it was noted that administrative measures (China) give a quick effect with great complexity of implementation, but most states prefer to balance between the necessary restrictions and maintaining the viability of economies. As a result, the final conclusion was made that the practice of crisis management should become an integral part of government responses to shocks in the future.