Diarrhea is defined as the passage of loose stools and increase in stool frequency, weight, or volume. Diarrhea is an important health issue since it accounts for 2.5 million deaths in the world each ...year.
Diarrhea can be acute, persistent, or chronic. Acute diarrhea (AD) is usually infectious, caused by viruses, less frequently by bacteria and parasites. The majority of cases of AD are self-limiting and do not require diagnostic workup. The use of diagnostic tests in AD should be limited to patients with signs of severe dehydration, bloody stools, persistent fever and those suffering from immunodeficiencies using immunosuppressive therapy or to cases of suspected nosocomial infection. These patients should be referred to gastroenterologists or infectious disease specialists. Therapy in AD consists of early oral refeeding, antidiarrheal medications, antibiotics, and probiotics. Chronic diarrhea (CD) has diverse etiology. The majority of patients have self-limiting symptoms or functional gastrointestinal disorders. Patients with blood in stool, weight loss, clinical and laboratory signs of anemia, and palpable mass in the abdomen (red flag symptoms) need urgent gastroenterology referral. Therapy in CD is possible when the underlying cause of symptoms is identified.
The general practitioner should identify high-risk patients with AD and/or red flag symptoms for urgent gastroenterology referral.
The paper presents an outline of the advanced theory of thin-walled girders. The improvement includes shear influence on torsion as an extension of shear influence on bending. The analogy between ...bending and torsion is recognized and pointed out throughout the paper. Complete differential equations of coupled flexural and torsional vibrations for a prismatic girder are derived. In addition, the 8 d.o.f. beam finite element, utilizing the energy approach, is constituted with stiffness and mass matrices, and load vectors. The paper describes determining of geometrical properties of multi-cell open cross-sections by employing the strip element method. Numerical procedures for vibration analyses are outlined. Furthermore, dry natural vibrations of a VLCS (Very Large Container Ship) are analysed by 1D FEM model as a prerogative for hydroelastic analyses of these relatively flexible vessels. Influence of transverse bulkheads is taken into account by increasing torsional stiffness of the ship hull proportionally to their deformation energies. Validation of 1D FEM model is checked by correlation analysis with the vibration response of the fine 3D FEM model.
Multi-fragment decays of
129Xe,
197Au and
238U projectiles in collisions with Be, C, Al, Cu, In, Au and U targets at energies between
E
A
= 400
and 1000 MeV have been studied with the ALADIN ...forward-spectrometer at SIS. By adding an array of 84 SiCsI(Tl) telescopes the solid-angle coverage of the setup was extended to
θ
lab = 16°. This permitted the complete detection of fragments from the projectile-spectator source.
The dominant feature of the systematic set of data is the
Z
bound universality that is obeyed by the fragment multiplicities and correlations. These observables are invariant with respect to the entrance channel if plotted as a function of
Z
bound, where
Z
bound is the sum of the atomic numbers
Z
i
of all projectile fragments with
Z
i
⩾ 2. No significant dependence on the bombarding energy nor on the target mass is observed. The dependence of the fragment multiplicity on the projectile mass follows a linear scaling law.
The reasons for and the limits of the observed universality of spectator fragmentation are explored within the realm of the available data and with model studies. It is found that the universal properties should persist up to much higher bombarding energies than explored in this work and that they are consistent with universal features exhibited by the intranuclear cascade and statistical multifragmentation models.
In this work we further refine and improve the neural network based ionospheric characteristic's foF2 predictor, which is actually a neural network autoregressive model with additional input signals ...(NNARX). Our analysis is focused on choice of X parts of NNARX model in order to capture middle and long term dependencies. Daily distribution of prediction error suggests need for structural changes of the neural network model, as well as adaptation of running average lengths used for determination of X inputs. Generalisation properties of proposed neural predictor are improved by carefully designed pruning procedure with additional regularisation term in criterion function. Some results from the NNARX model are presented to illustrate the feasibility of using such a model as ionospheric storm forecasting technique.
Available data suggest that the prevalence of chronic liver disease (CLD) and primary liver cancer is rising in Europe and represents a major public health problem. Predictions are showing that these ...trends will continue to rise in the upcoming years.
Alcohol-related liver disease, nonalcohol fatty liver disease, and viral hepatitis B and hepatitis C are the leading causes of liver cirrhosis and primary liver cancer in Europe. Drug-induced liver injury represents a major cause of acute hepatitis, while liver transplantation is the second most common solid organ transplantation in the world. Patients with CLD have increasing rates of hospitalization, longer hospital stays, and more adverse outcomes compared to the other chronic conditions. Direct targeting of risk factors can prevent complications of advanced liver disease and improve outcome. Patients with CLD should be referred to a hepatologist for assessment of the stage of liver disease, for specific treatment and screening for hepatocellular carcinoma. Moreover, patients with unknown etiology of abnormal liver blood tests should be referred to a hepatologist for assessment of liver disease, as well as for prevention and treatment of complications of cirrhosis and/or portal hypertension. Key Messages: CLD is amenable to prevention and treatment, while disease management strategies need to improve in order to reduce the burden of liver disease and deaths due to end-stage liver diseases.
The paper is related to investigation of coupled horizontal flexural and torsional vibrations of container vessels. Differential equations of coupled vibrations of a prismatic beam with open ...cross-section are derived. The equations are solved analytically by direct integration and by variational method. In the former case, the frequency equation is reduced to a polynomial of the fourth order. In the latter case, beam deflection and twist angle are assumed in the form of series of natural modes of uncoupled vibrations of free beam with suspended warping. The variational method manifests very fast convergence and high accuracy. Application of the developed methods is illustrated in the case of a prismatic pontoon with cross-section of a container vessel. The same numerical example is used for checking 1D FEM mathematical model and code developed for analyses of real structures of container vessels with variable cross-sections. In addition, correlation analysis of 1D and 3D FEM results is done to validate the accuracy of the former.
Indices of motor recovery and the fracture risk were estimated in patients examined after stroke and suffering from osteoporosis or osteopenia. Our study included 57 patients (29 with osteoporosis ...and 28 with osteopenia) who received treatment at a rehabilitation clinic. The average age of patients was 69.62 ± 9.86 years. The data were based on anamneses, questionnaires, and bone mineral density (BMD) measured by the DXA method. The fracture risk was assessed by applying the FRAX index. The functional status was evaluated by the Barthel index (BI), and motor recovery was evaluated by the Signe Brunnström scale (SB). The prevalent impairment was left-sided hemiparesis (n = 30; 52.63%). Most patients with stroke and a reduced BMD (42, 73.68%) had low and intermediate risk estimates, while 15 (26.31%) patients had a high risk of major osteoporotic fractures. Patients with stroke and osteopenia had a significantly higher risk for major osteoporotic fractures, compared to patients with osteoporosis (P < 0.001). Concerning the hip fracture, more patients with a reduced BMD (34, 59.65%) had a lower fracture risk than those with an intermediate (15, 26.31%) or high risk (8, 14.03%). The majority of patients had significantly higher scores on the SB scale in lower segments of the extremities. No statistically significant difference in motor recovery between left- and right-sided patients with stroke and reduced BMD was found (P ˃ 0.01). Thus, an association between the high risk level for major osteoporotic fractures and osteopenia was found. Patients with right-sided hemiparesis and osteopenia had more significant reduction in the BMD on the femur, when compared to patients with left-sided hemiparesis. Patients with stroke and an increased fracture risk require preventive individual therapeutic programs in order to avoid fractures.
Differential equations of coupled flexural and torsional vibrations of a prismatic beam are derived. The equations are solved analytically by the direct integration and the Ritz method. In the former ...case, the frequency equation is reduced to a polynomial of the third order. In the latter case, beam response is assumed in the form of series of natural modes of uncoupled vibrations of free beam. The Ritz method shows very fast convergence and high accuracy. Beside natural frequencies and natural modes, modal stiffness and modal mass are also determined. Application of the developed procedures is illustrated for the case of an elastic barge. In addition, barge vibrations are analysed also by the finite element method utilizing beam model. The intention is to check the reliability of 1D FEM model in hydroelastic analysis of large container ships, where structural model is coupled with 3D hydrodynamic model based on the radiation–diffraction theory.
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