The perplexing postsurgical complication of carotid-jugular fistula: A bitter experience

Background: Vascular injuries occur in approximately 25% of all penetrating neck traumas, with carotid artery injuries being particularly lethal. Penetrating neck injuries are potentially fatal. Vascular injuries occur in approximately 25% of cases, which can lead to the formation of arteriovenous fistulas. Case Description: The authors present a case of delayed open surgery to repair a carotid-jugular fistula that resulted in an unprecedented complication, as well as a brief review of the condition’s diagnosis and treatment options. Conclusion: This case report suggests us that, penetrating neck injuries should be thoroughly evaluated for arteriovenous fistulae. To avoid complications, common carotid-jugular fistulas must be treated as soon as possible. Postoperative complications can be effectively managed with prompt action.

Survival in bladder and upper urinary tract cancers in Finland and Sweden through 50 years

Survival has improved in bladder cancer but few studies have considered extended periods or covered populations for which medical care is essentially free of charge. We analyzed survival in urothelial cancer (UC, of which vast majority are bladder cancers) in Finland and Sweden over a 50-year period (1967–2016) using data from the NORDCAN database. Finland and Sweden are neighboring countries with largely similar health care systems but higher economic resources and health care expenditure in Sweden. We present results on 1- and 5-year relative survival rates, and additionally provide a novel measure, the difference between 1- and 5-year relative survival, indicating how well survival was maintained between these two periods. Over the 50-year period the median diagnostic age has increased by several years and the incidence in the very old patients has increased vastly. Relative 1- year survival rates increased until early 1990s in both countries, and with minor gains later reaching about 90% in men and 85% in women. Although 5-year survival also developed favorably until early 1990s, subsequent gains were small. Over time, age specific differences in male 1-year survival narrowed but remained wide in 5-year survival. For women, age differences were larger than for men. The limitations of the study were lack of information on treatment and stage. In conclusion, challenges are to improve 5-year survival, to reduce the gender gap and to target specific care to the most common patient group, those of 70 years at diagnosis. The most effective methods to achieve survival gains are to target control of tobacco use, emphasis on early diagnosis with prompt action at hematuria, upfront curative treatment and awareness of high relapse requiring regular cystoscopy follow up.

Psychological Problem in Geriatric Age Group

The proper definition of geriatrics is not easy to define. It can be said it is the health care / medical care provided to the elderly age group people of the society. Old/elderly is also preferred over the geriatric term but is not that precise, sixty-five years is said to be the age group coming into the geriatric group, but some of the people do not need any medical care until the age of seventy- seventy years. Biological or physiological impairment, as well as socioeconomic circumstances, can affect functional status. Their functional ability determines the elderly's capacity to stay at home. Doctors should reasonably expect to care for an increasing number of elderly people with complex medical and psychosocial issues. As a result of these challenges and issues, difficult ethical dilemmas may arise. As a result, practitioners should be aware of ethical difficulties that arise frequently when caring for older patients. Poor patient-clinician communication can lead to ethical difficulties; as a result, we present practical guidelines for better communication. People were more likely to develop physical disabilities, despair, and cognitive impairment as they got older, especially those in the 80-89 age bracket. Current data for India's old provide a foreshadowing of a new challenges if programme managers and policymakers do not take prompt action in this area. There is a need to raise awareness of the medical and socioeconomic difficulties that India's elderly confronts and initiatives for improving their quality of life.

The Response of Social Crime Prevention Police to Cyberbullying Perpetrated by Youth in Rural Areas of South Africa

Recently, South Africa has seen a surge in violence, cyberbullying by learners against peers, and online malicious acts against teachers. In response, the South African Department of Basic Education invited the social crime prevention police to intervene. This study reports on the developmental issues contributing to cyberbullying and the police response to this violence in rural schools. An extensive literature review was conducted, and a conceptual framework was developed to guide the study and development of a mobile application. This framework was tested using data collected from focus groups, 8 police officers, 9 teachers, 52 grade-10 learners, and 27 grade-12 learners. The data were analyzed using thematic and quantitative techniques. The findings reveal some developmental issues. For instance, teachers are often targeted by learners online because they fail to take prompt action when learners report cyberbullying incidents. This finding is consistent with the developmental theory which predicts that lack of support would create a permissive context for cyberbullying. In addition, the popularity of cyberbullying has a stronger influence on older, rather than younger, adolescents. Older adolescents are more concerned about gaining popularity than being socially accepted. Recommendations are made which can be useful to schools, learners, and the police force in their fight against cyberbullying.

PneumoniaNet: Automated Detection and Classification of Pediatric Pneumonia Using Chest X-ray Images and CNN Approach

Pneumonia is an inflammation of the lung parenchyma that is caused by a variety of infectious microorganisms and non-infective agents. All age groups can be affected; however, in most cases, fragile groups are more susceptible than others. Radiological images such as Chest X-ray (CXR) images provide early detection and prompt action, where typical CXR for such a disease is characterized by radiopaque appearance or seemingly solid segment at the affected parts of the lung due to inflammatory exudate formation replacing the air in the alveoli. The early and accurate detection of pneumonia is crucial to avoid fatal ramifications, particularly in children and seniors. In this paper, we propose a novel 50 layers Convolutional Neural Network (CNN)-based architecture that outperforms the state-of-the-art models. The suggested framework is trained using 5852 CXR images and statistically tested using five-fold cross-validation. The model can distinguish between three classes: viz viral, bacterial, and normal; with 99.7% ± 0.2 accuracy, 99.74% ± 0.1 sensitivity, and 0.9812 Area Under the Curve (AUC). The results are promising, and the new architecture can be used to recognize pneumonia early with cost-effectiveness and high accuracy, especially in remote areas that lack proper access to expert radiologists, and therefore, reduces pneumonia-caused mortality rates.

​Feed Quality Test, Prevalence of Aflatoxin Contamination in Dairy Feed and Raw Milk in Oromia Special Zone Surrounding Finfinne, Ethiopia

Background: The study was attended in Oromia special zone around Finfinne with the objective to asses feed quality composition, detect and quantify the amount of aflatoxine (AFM1) in raw cow’s milk and AFB1 in home-mixed feed of dairy. Methods: For this purpose, 90 milk and 90 samples of feed from dairy farmers were collected. Analysis for AFM1 and AFB1 was conducted by high-performance liquid chromatography. Result: The study discovered that the occurrence of AFM1 in all samples of milk and detection level ranged from 0.02 ppb to 0.08 ppbL. Overall, 64 (71.1%) out of a total of 90 milk samples contained less than or equal to 0.05 ppb of AFM1. Moreover, 26 (28.9%) milk samples exceeded 0.05 ppb. All the feed samples were contaminated with AFB1 minimum 12.67 ppb and a maximum of 45.67 ppb. Overall, out of a total of 90 feed samples collected, about 66 (73.3%) contained AFB1 at a level less than or equal to 20 ppb. At the same time, 34 (26.7%) of the feed samples contained AFB1 at a level exceeding 20 ppb. The linear regression displayed that the significant associations between the presence of AFB1 in the feed and the levels of adulteration in AFM1 in milk. The level of aflatoxin pollution found during this study in milk and feed ought to prompt action to spot appropriate interventions. These results recommend that risk mitigation should focus on reducing aflatoxin impurity in raw materials feed which can ultimately minimize AFM1 in milk.

THE LEGAL REFLECTIONS ON ABORTION THROUGH THE PRISM OF THE CHILD’S RIGHT TO LIFE

Abortions represent one of the most controversial issues in contemporary society. Some states have adopted restrictive legislation on interruption of pregnancy to diminish the number of abortions performed annually. Other states have adopted abortion-on-demand rules guaranteeing women free access to abortions. Based on the statistical dates, the problem of interruption of pregnancy remains a crucial one and requires prompt action undertaken by the state. This article is dedicated to the analysis of measures undertaken by the state to reduce the number of abortions and stimulate population growth. This study highlights the effectiveness of remedies taken by some states, e.g. the USA, and presents a multitude of measures that states regulated in national law.

Prompt action on Russian torture may not limit damage

Headline RUSSIA: Prompt action on torture may not limit damage

Excellence and Customer Delight in Services Marketing

Innovation, differentiation, and e-adoption are imperative for companies to sustain in the competition. It is difficult to innovate and differentiate physical products. Service companies gain in importance because of higher scope of innovation and differentiation with the help of e-adoption. The importance of innovation in services, initiatives taken by service companies, and the roles of e-adoption and technology as enablers to achieve excellence and customer delight are discussed. The initiatives include a strategic orientation, commitment from the top management, maintaining high standards, having profit tiers, monitoring service performance, and prompt action on customer complaints. The study focuses on the differentiation incorporated in services, adoption of the internet, and the roles of the internet in the differentiation of services. The study discusses about those companies which excel in providing superior services and analyses the strategies adopted by them. Proper implementation and execution of strategies enable companies to delight customers and achieve excellence.

What Bots Can (and Can’t) Do? (Model of Protest and Counter-Protest Political Mobilization)

Despite the increasing interest among scholars in the effect of Internet bots, or automated social media accounts, on the processes of political communication and mobilization in the online sphere, the extent of bots’ effectiveness and the specific mechanisms of their use remain largely understudied. The deficit of the overarching conceptual understanding and concrete results is arguably due to researchers’ aspiration to solve a problem in the empirical way, without attempting to combine data analysis with mathematical and computational modeling. Having analyzed the existing models on the topic, the authors offer their own model that is based on the spiral-of-silence theory. The key features of the model that set it apart from the existing ones are the following: a) taking into account differences in the types of motivation and costs associated with expressing protest and loyalist sentiments; b) including “partner effect” into the spiral-ofsilence mechanism; c) employing a neurological decision-ma king scheme according to which the same stimulus can prompt action and be a deterrent. On the basis of a series of computational experiments with the model, the authors demonstrate that bots are more effective in mobilizing opposition members when an individual motivated for political participation refrains from it because his local social community does not share his views. In this case, the emergence of a like-minded partner bot can destroy the spiral of silence created by this community and encourage this individual to openly express his position. On the contrary, when mobilizing loyalists, bots are most effective in relation to poorly motivated individuals. The model elaborated by the authors not only allows us to evaluate bots’ effects in a new way, but it also sheds light on how people make decisions in the framework of political communication and mobilization in social networks.