Renal dysfunction is a common complication of open-heart surgery: a form of controlled hemorrhagic shock, and successful perioperative management of renal dysfunction depends on recognition of the risk factors and optimal management of factors influencing renal function, including cardiopulmonary bypass, and early detection of renal failure. Changes in renal functional parameters including Ccr, Cosm, CH2O, FENa, and RFI were observed prospectively in forty five patients operated on at Dept. of Thoracic and Cardiovascular Surgery, S.N.U.H., from April to June, 1985. They were 23 males and 22 females with 35 acquired and 10 congenital heart diseases and the mean age and body surface area of them were 38.010.3 years [22-63] and 1.5518 M2[1.151.92] respectively. Followings are the conclusion. 1. The Ccr, representative of renal function, is significantly improved from 90.231.3 ml/min/M2 preoperatively to 101.536.4 ml/min/M2 postoperative and day [P<0.05], and all patients were classified as postoperative renal functional class I of Abel, which representing adequate renal protection during our cardiopulmonary bypass. 2. The Cosm is significantly elevated at immediate postperfusion time and remained high at postoperative one day representing osmotic diuresis at that time, but CH2O shows no significant changes at immediate postperfusion period and is decreased significantly at postoperative one day, representing recovery of renal concentrating ability at that time with decreasing urine flow. 3. The absolute value and changing tendency in FENa and RFI during perioperative period shows no diagnostic reliability on these parameters, but those of CH2O appear to reveal future renal function more accurately than Ccr 4. The depth of hypothermia may be protective upon renal function against the ill effects of prolonged nonpulsatile cardiopulmonary bypass. 5. The depth of the hypothermia, pump time of more than 150 minutes, poor cardiac function, and intraoperative events such as embolism appear to be related with immediate postperfusion renal function. 6. Hemoglobinuria and hemolysis, poor preoperative renal function, history of cardiac surgery, and massive transfusion associated with bleeding appear not to be related with renal dysfunction.
The total asset management system is used for banks or financial institutions for the management of trusteed assets or own assets and it is divided into three systems: the front-office system, the middle-office system and the back-office system by its business areas and functionalities. This kind of asset management system is a huge and complex system handling large data and various financial products, and requires professional knowledges like accounting, financial product specific knowledge, compliance and regulations, etc. It also performs high level computation for NAV calculation and risk measurement on every day Therefore, it needs absolute stability, extendability and efficiency and should handle the frequent change of regulation and products and connectivity with outdoor institutions. In this paper, we report our successful development of such a system and discuss issues regarding its efficient system design and system construction.
This article is concerned about a reason for which Cervantes participates an arabic author named Benengeli and morisco translator in his work instead of christian author. From the multi-cultural point of view, the time in which Don Qujote was published, belongs to the Golden Age. In other words, the society can not be supported by the ideology of Purity of Blood in that the morisco, converso (Christian Jewish) have been permitted to coexist in the name of christian proselyte or New Christian despite of invisible discrimination. An invisible discrimination is based on the prejudice and negative stereotype of Old Christian against the New Christian. Cervantes offers an o open space for readers to participate in the creative reading, giving up the absolute authority of author named Benengeli. The deep-rooted prejudice against morisco or muslim author makes the readers of Don Quijote do reinterpret the contents and have question about his sincerity. This disbelief is partly on the basis of hypothesis that Don Quijote would be passed on orally by an arabic or morisco. Leaving the hypothesis alone, Romance, festival performances of morisco or the aljamia literature in the Iberian Peninsula have the chivalry or knights of the Occident. The chivalry in Romance of morisco means that morisco would seek assimilation into the mainstream of Occidental Christian community. At the same time, morisco would be faced with the dilemma of loss of religious identity. But Taqiyya, islamic doctrine, offsets the dilemma between yearning to assimilate into mainstream and religious conscience of morisco in that Taqiyya permits morisco to convert to Christianity in case that they are in danger of life or the following risk. From this point of view, There is no room for doubt about the fact that Taqiyya contributed to social assimilation or multicultural society of the Iberian Peninsula. It has been a long time since a narrow-minded religious dogma and ideology became a anachronistic relic in multicultural society of Spain such as the Purity of Blood. From a relative viewpoint, Don Quijote provides a ground for the collective intelligence among christian, muslim(morisco) and converso through a liberal community between readers and authors who form a pluralistic society.
Ivaz, Jelena S.;Stojadinovic, Sasa S.;Petrovic, Dejan V.;Stojkovic, Pavle Z.
Safety and Health at Work
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v.12
no.4
/
pp.479-489
/
2021
Background: During 2011, a study was undertaken to assess safety conditions in Serbian underground coalmines by analysis of injury data. The study covered all Serbian coalmines, identified week spots from the aspect of safety, and recommended possible courses of action. Since then, Serbia has made changes to safety and health legislation; all coalmines introduced new preventive measures, adopted international standards, and made procedures for risk management. After 10 years a new study has been performed to analyze the impact of these changes. Materials and methods: In this study, the injuries that have occurred in the Serbian underground coal mines over the last 20 years were analyzed. Statistical data analysis was performed by IBM SPSS Statistics v23. The injuries that occurred in the last ten years were compared with the results of the previous study (2000-2009). The average values of injury rates for both periods were compared for each of the categories (severity, age, body part, qualification), and the results were presented as absolute difference or percentile difference. Results: The results showed reduction in the number of injuries in the category of 20-30 years old workers, where the new training procedures for workers, which were set by mandatory legal regulations, certainly contributed. They also showed an increase in the number of injuries in the category of old workers, which indicates that the law did not have a positive effect on this category. Conclusion: The total number of injuries is still high; therefore, it is necessary to introduce mechanization and automation in mines and have a better policy for older workers who retire later nowadays.
Ramos, Salvador;Arredondo, Cesar;Reinoso, Eduardo;Leonardo-Suarez, Miguel;Torres, Marco A.
Earthquakes and Structures
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v.20
no.1
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pp.71-86
/
2021
This paper focuses on the development and assessment of the expected damage for the rocking response of rigid anchored blocks, with irregular geometry and non-uniform mass distribution, considering the site conditions and the seismicity of Mexico City. The non-linear behavior of the restrainers is incorporated to evaluate the pure tension and tension-shear failure mechanisms. A probabilistic framework is performed covering a wide range of block sizes, slenderness ratios and eccentricities using physics-based ground motion simulation. In order to incorporate the uncertainties related to the propagation of far-field earthquakes with a significant contribution to the seismic hazard at study sites, it was simulated a set of scenarios using a stochastic summation methods of small-earthquakes records, considered as Empirical Green's Function (EGFs). As Engineering Demand Parameter (EDP), the absolute value of the maximum block rotation normalized by the body slenderness, as a function of the peak ground acceleration (PGA) is adopted. The results show that anchorages are more efficient for blocks with slenderness ratio between two and three, while slenderness above four provide a better stability when they are not restrained. Besides, there is a range of peak intensities where anchored blocks located in soft soils are less vulnerable with respect to those located in firm soils. The procedure used in here allows to take decisions about risk, reliability and resilience assessment of different types of contents, and it is easily adaptable to other seismic environments.
Kim, Selin;Jeong, Wonjeong;Jang, Sung-In;Park, Eun-Cheol;Park, Sohee
Safety and Health at Work
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v.12
no.1
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pp.96-101
/
2021
Background: Many studies have reported noticeable increases in the proportion of employees working either relatively short or relatively long hours. Such trends have been accompanied by an increasing concern regarding work hour mismatches defined as a discrepancy between actual and preferred work hours. The aim of this study was to investigate association between work hour mismatch and depression. Methods: Data regarding work hour mismatches for 47,551 adults were extracted from the 2017 Korean Working Conditions Survey. The World Health Organization-Five Well-Being Index was used to measure depression. Multiple logistic regression analyses were performed to examine the association between work hour mismatch and depression. Results: Men and women workers with work hour mismatch were more likely to have depression [underemployed males: odds ratio (OR) = 1.30, 95% confidence interval (CI) = 1.14-1.49, overemployed males: OR = 1.28, 95% CI = 1.18-1.40; underemployed females: OR = 1.37, 95% CI = 1.20-1.56, overemployed females: OR = 1.12, 95% CI = 1.02-1.23]. Underemployed workers, workers who worked more than 52 hours per week, and workers with a high income level, all had higher ORs for depression. The greater the discrepancy between actual and preferred work hours, the higher OR for depression among both underemployed and overemployed workers. Conclusions: A difference between actual and preferred work hours was associated with depression. Underemployed workers had a higher risk of depression than that of overemployed workers. As a work hour mismatch negatively affected workers' mental health, it is important to reduce work hours mismatches as well as shorten the absolute number of work hours.
Bond, Evalina S.;Soteropulos, Carol E.;Poore, Samuel O.
Archives of Plastic Surgery
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v.49
no.3
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pp.324-331
/
2022
Prior abdominal liposuction can be viewed as a relative or absolute contraindication to abdominally based autologous breast reconstruction given concerns for damaged perforators and scarring complicating intraoperative dissection. This systematic review aims to explore the outcomes of abdominally based breast reconstruction in patients with a history of abdominal liposuction. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided literature search was conducted using PubMed, Scopus, and Web of Science from the earliest available date through June 2020. Deep inferior epigastric perforator, muscle-sparing transverse rectus abdominis musculocutaneous (TRAM), superficial inferior epigastric artery, and pedicled TRAM flaps were included for evaluation. Complications included total or partial flap loss, fat necrosis, seroma, delayed wound healing, and donor site complications. After inclusion criteria were applied, 336 non-duplicate articles were screened, yielding 11 for final review, representing 55 flaps in 43 patients. There was no instance of total flap loss, eight (14.5%) flaps developed partial loss or fat necrosis, three (5.4%) flaps had delayed wound healing, and two (4.6%) patients had donor site complications. Most authors (8/11) utilized some type of preoperative imaging. Doppler ultrasonography was the most used modality, and these patients had the lowest rate of partial flap loss or flap fat necrosis (8%), followed by those without any preoperative imaging (10%). In conclusion, this review supports that patients undergoing abdominally based autologous breast reconstruction with a history of abdominal liposuction are not at an increased risk of flap or donor site complications. Although preoperative imaging was common, it did not reliably decrease complications. Further prospective studies are needed to address the role of imaging in improving outcomes.
de Oliveira, Larissa Bertacchini;de Souza, Luana Mendes;de Lima, Fabia Maria;Fhon, Jack Roberto Silva;Puschel, Vilanice Alves de Araujo;Carbogim, Fabio da Costa
Safety and Health at Work
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v.13
no.2
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pp.255-260
/
2022
Background: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the importance of implementing strategic management that prioritizes the safety of frontline nurse professionals. In this sense, this research was aimed at identifying factors associated with the illness of nursing professionals caused by COVID-19 according to socio-demographic, clinical, and labor variables. Methods: A cross-sectional study was conducted in three Brazilian university hospitals with 859 nursing professionals, which include nurses, technicians, and nursing assistants, between November 2020 and February 2021. We present data using absolute and relative frequency. We used Chi-square test for hypothesis testing and multiple logistic regression for predictive analysis and chances of occurrence. Results: The rate of nursing professionals affected by COVID-19 was 41.8%, and the factors associated with contamination were the number of people in the same household with COVID-19 and obesity. Being a nurse was a protective factor when the entire nursing team was considered. The model is significant, and its variables represent 56.61% of the occurrence of COVID-19 in nursing professionals. Conclusion: Obesity and living in the same household as other people affected by COVID-19 increases the risk of contamination by this new coronavirus.
da Costa, Joao Cordeiro;Manso, Maria Conceicao;Gregorio Susana;Leite, Marcia;Pinto, Joao Moreira
Tuberculosis and Respiratory Diseases
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v.85
no.4
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pp.349-357
/
2022
Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.
Moon, Da Hye;Kim, Jeeyoung;Lim, Myoung Nam;Bak, So Hyen;Kim, Woo Jin
Tuberculosis and Respiratory Diseases
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v.84
no.3
/
pp.188-199
/
2021
Background: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increased prevalence in the elderly. Telomeres are repetitive DNA sequences found at the end of the chromosome, which progressively shorten as cells divide. Telomere length is known to be a molecular marker of aging. This study aimed to assess the relationship between telomere length and the risk of COPD, lung function, respiratory symptoms, and emphysema index in Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) cohort. Methods: We extracted DNA from the peripheral blood samples of 446 participants, including 285 COPD patients and 161 control participants. We measured absolute telomere length using quantitative real-time polymerase chain reaction. All participants underwent spirometry and quantitative computed tomography scan. Questionnaires assessing respiratory symptoms and the COPD Assessment Test was filled by all the participants. Results: The mean age of participants at the baseline visit was 72.5±7.1 years. Males accounted for 72% (321 participants) of the all participants. The mean telomere length was lower in the COPD group compared to the non-COPD group (COPD, 16.81±13.90 kb; non-COPD, 21.97±14.43 kb). In COPD patients, 112 (75.7%) were distributed as tertile 1 (shortest), 91 (61.1%) as tertile 2 and 82 (55%) as tertile 3 (longest). We did not find significant associations between telomere length and lung function, exacerbation, airway wall thickness, and emphysema index after adjusting for sex, age, and smoking status. Conclusion: In this study, the relationship between various COPD phenotypes and telomere length was analyzed, but no significant statistical associations were shown.
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