Objective
To determine the prediction ability of the National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), and quick Sequential Organ Failure Assessment (qSOFA) score for the ...prognosis of pulmonary embolism (PE) in the emergency department.
Methods
This retrospective study involved 245 patients with PE. The NEWS, NEWS2, and qSOFA scores were compared according to the hospitalization clinic (ward vs. intensive care unit), hospitalization length (<10 vs. >10 days), severity of embolism (massive vs. submassive), and outcome (discharged vs. died).
Results
The areas under the curve of the NEWS, NEWS2, and qSOFA score for 1-week mortality were 0.854 (sensitivity, 78%; specificity, 73%; cutoff, 7.5; confidence interval, 0.807–0.902), 0.870 (sensitivity, 83%; specificity, 73%; cutoff, 5.5; confidence interval, 0.825–0.915), and 0.789 (sensitivity, 83%; specificity, 51%; cutoff, 0.5; confidence interval, 0.720–0.858), respectively.
Conclusion
The NEWS2 more accurately predicts 1-week mortality than do the NEWS and qSOFA score in patients with PE.
Tannins are polyphenols characterized by different molecular weights that plants are able to synthetize during their secondary metabolism. Macromolecules (proteins, structural carbohydrates and ...starch) can link tannins and their digestion can decrease. Tannins can be classified into two groups: hydrolysable tannins and condensed tannins. Tannins are polyphenols, which can directly or indirectly affect intake and digestion. Their ability to bind molecules and form complexes depends on the structure of polyphenols and on the macromolecule involved. Tannins have long been known to be an "anti-nutritional agent" in monogastric and poultry animals. Using good tannins' proper application protocols helped the researchers observe positive effects on the intestinal microbial ecosystem, gut health, and animal production. Plant tannins are used as an alternative to in-feed antibiotics, and many factors have been described by researchers which contribute to the variability in their efficiencies. The objective of this study was to review the literature about tannins, their effects and use in ruminant nutrition.
The current study was carried out to evaluate the nutritive value of mushroom-uncultivated and -cultivated substrates, and their in vitro gas and methane production. The experiment was conducted in a ...completely randomized design, and analyzed with GLM using SAS 9.4. Analysis of the structural morphology of mushroom-cultivated substrate was performed using a scanning electron microscope. Mushroom cultivation led to lower ether extract, acid detergent fiber, and crude fiber level of substrate (p < 0.05). Mushroom-cultivated substrate showed higher in vitro cumulative gas production (p < 0.05). Moreover, mushroom cultivation led to a higher sample surface, and improved the microorganisms’ access to feed materials, thus stimulating rumen fermentation and increasing methane production (p < 0.05). The organic matter digestibility, metabolizable energy, and net energy lactation values were higher for mushroom-cultivated substrate than uncultivated substrate. The results demonstrate that mushroom-cultivation not only increases the contact surface of cellulose, leading to higher ruminal microorganisms’ access to feedstuff, but could also had higher nutritive value; this material might be used in ruminant ration formulation, to reduce environmental pollution and feed costs.
The chemical composition, in vitro total gas and CH
production and performance of cattle fed on factory black tea waste (
) (BTW), alfalfa (
), sainfoin (
) and white clover (
) was investigated. The ...gas production was quantified at the 24th hour of the incubation process. BTW was found to vary from roughages in chemical composition (
< 0.05). In addition, the roughages differed in terms of nutrient composition and gas production (
< 0.05). In legume roughages, acetic acid (AA), propionic acid (PA), butyric acid (BA), and total volatile fatty acids (TVFA) values ranged from 52.36-57.00 mmol/L, 13.46-17.20 mmol/L, 9.79-12.43 mmol/L, and 79.71-89.05 mmol/L, respectively. In comparison with black tea waste, legume roughages had higher values of AA, PA, BA, and TVFA. Black tea waste contained a higher acetic acid ratio than legume roughages when compared as a percentage. There was a similar ratio of propionic acid to the rate calculated for sainfoin (
) and clover (
), and a similar ratio of butyric acid to the ratio determined for alfalfa (
). The current study shows that the 5.7-6.3% tannin content of black tea waste can be used in ruminant rations with high-quality roughages. Due to the fact that BTW reduces methane emissions from ruminants and eliminates energy waste from them, the environment can be improved. To obtain more reliable results, further animal feeding experiments on legume roughages and BTW are required.
Background:
The treatment of benign paroxysmal positional vertigo (BPPV) has not been well studied. Many clinicians are indifferent about canalith reposition maneuvers and frequently prefer medical ...treatments.
Objectives:
We aimed to detect efficacy of Epley maneuver in relieving symptoms of benign paroxysmal positional vertigo patients diagnosed in emergency department and if medical treatments are useful in patients whose symptoms were not relieved.
Methods:
The study was conducted as a prospective cohort study in the emergency department of a tertiary hospital. Patients who were over 18 years of age and presented to emergency department with complaints of vertigo symptoms and nausea and had a positive Dix–Hallpike test were included in the study. Patients’ demographic data, possible etiological factors, affected ear, and benign paroxysmal positional vertigo diagnosis in the history were recorded on the study data form. The European Evaluation of Vertigo scale and the Visual Analogue Scale (VAS) score of nausea and vertigo symptoms were graded and recorded for each patient before and after treatment.
Results:
Ninety patients were included in the study in total. Epley maneuver was carried out to all patients. Vertigo symptoms VAS (VASd) score (p < 0.001), nausea and vomiting VAS (VASnv) score (p < 0.001), and European Evaluation of Vertigo scale score (p < 0.001) of all patients showed a statistically significant decrease after Epley maneuver. A combination of dimenhydrinate and metoclopramide helped to reduce VASd (p = 0.048), VASnv (p = 0.031), and European Evaluation of Vertigo scale scores (p = 0.001) at a statistically significant level more than dimenhydrinate treatment alone.
Conclusions:
Epley maneuver may be applied to every patient with benign paroxysmal positional vertigo. Dimenhydrinate and/or metoclopramide helps to control patients’ symptoms whose symptoms remain despite Epley maneuver.
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•A phononic crystal linear waveguide is employed for size-based particle sorting.•Millimeter-sized particles in air are sorted according to either radius or density.•Contact-free ...fractionation is achieved in a compact manner.•Separation of glass beads with 0.5 mm and 1.0 mm radii is experimentally shown.
A two-dimensional phononic crystal linear defect waveguide is utilized for size-based sorting of millimeter-sized solid particles in the air through acoustic radiation force. The waveguide channels ultrasonic waves at 20 kHz, as calculated through Finite-Element Method simulations. Spherical solid particles released from rest at the top of the vertically aligned waveguide experience the combined effect of the acoustic radiation, gravity, and drag forces. When the particles are released from the symmetry plane of the waveguide, they follow straight paths where the ones with radii smaller than a threshold value are trapped at the waveguide nodal planes, whereas larger particles are let pass through. This requires input sound pressure levels between 173 dB and 177 dB. Moreover, such particles can also be differentiated with respect to density. Alternatively, the release of particles with a slight offset from the symmetry center induces unbalanced acoustic radiation potential, and thus uneven radiation force, resulting in the initiation of horizontal displacement whose extent depends on particle radius. Thus, both simulation results and experimental findings suggest that this scheme can be employed in size-based particle separation. Sorting of spherical glass particles with 0.5 mm and 1.0 mm radii are experimentally demonstrated for low ultrasonic transducer acoustic power output up to 90 W. The proposed approach can be utilized in applications where contact-free separation of airborne particles is required.
In this paper, the numerical approximation of unsteady convection–diffusion–reaction equations with finite difference method on a special grid is studied in the convection or reaction-dominated ...regime. We extend the method 19 which was designed for multidimensional steady convection–diffusion–reaction equations to unsteady problems. We investigate two possible different ways of combining the discretization in time and in space (where the sequence of the discretizations is interchanged). Discretization in time is performed by using Crank–Nicolson and Backward-Euler finite difference schemes, while for the space discretization we consider the method 19. Numerical tests are presented to show good performance of the method.
This study was carried out to determine the effects of addition of humate, probiotic, and their combination into diets on performance, egg quality, and yolk fatty acid composition of hens during the ...second laying period. Lohmann LSL white layers (
n
= 192), 46 weeks of age, were randomly divided into 4 groups and fed with basal diet (control, C), 0.3% humate (H), 0.3% probiotic (P), 0.15% humate + 0.15% probiotic (HP) for 18 weeks. Feed consumption and egg production were determined daily, egg weight was measured biweekly, and body weights were recorded at the beginning and the end of the experiment. Also, 12 egg samples from each group were randomly collected to determine the egg quality every 30 days. Laying performance, yolk color, and fatty acid composition were significantly (
P
< 0.05 and
P
< 0.01) affected by addition of humate, probiotic, and their combination into diets of layers. The HP group had higher cracked egg yield and feed conversion ratio values than control and H and P groups. Except for egg yolk color, the other egg quality parameters such as shape index, shell strength, shell thickness, albumen index, yolk index, and Haught unit were not affected by treatment (
P
< 0.05 and
P
< 0.01). The egg yolks of treatment groups had less stearic acid than those of control group. In conclusion, supplementation of humate and probiotic into the diets of laying hens increased monounsaturated fatty acids in yolk and improved feed conversion ratio and egg yolk color.
In this paper, we consider low-rank approximations for the solutions to the stochastic Helmholtz equation with random coefficients. A Stochastic Galerkin finite element method is used for the ...discretization of the Helmholtz problem. Existence theory for the low-rank approximation is established when the system matrix is indefinite. The low-rank algorithm does not require the construction of a large system matrix which results in an advantage in terms of CPU time and storage. Numerical results show that, when the operations in a low-rank method are performed efficiently, it is possible to obtain an advantage in terms of storage and CPU time compared to computations in full rank. We also propose a general approach to implement a preconditioner using the low-rank format efficiently.
Geçmişi ilk insanlara kadar uzanan şiddet olgusu, bireysel ve toplumsal unsurlar barındırması bakımından karmaşık bir yapıya sahiptir. Herhangi bir canlıya bireysel ya da toplu zarar vermeyi ...amaçlayan, kasıtlı olarak yapılan eylemler şeklinde tanımlayabileceğimiz şiddet; tarih boyunca insan ile özdeşleştirilen bir eylem olarak varlığını devam ettirmiştir. Temelinde bireyin duygusal açıdan baskı altına alınması olan psikolojik şiddet, şiddet türleri içerisinde günlük hayatımızda en çok rastladığımız türlerden biridir. Fiziksel şiddet gibi görünür olmadığı için çoğu zaman fark edilmeyen bu şiddet unsurları, edebi ürünlerde değişik işlevler üstlenerek farklı şekillerde vücut bulmuşlardır. Oğuzların günlük hayatından düşmanla mücadelesine kadar geniş bir konu yelpazesinin yanı sıra Türk’ün düşünce yapısını, ideallerini, zaaflarını çarpıcı şekilde dile getiren Türk kültür ve edebiyat tarihi açısından önemli bir yere sahip olan Dede Korkut Hikâyelerinde de psikolojik şiddet unsurları farklı işlevlerle kendine yer bulmuştur. Birçok hikâyede olan ile olması istenen, otorite ile halk arasında fikir ayrılıklarına sebep olmuştur. Halkın otoriteye boyun eğmesi ve anlaşma yolunu seçmesi huzursuzluğu sona erdirmiş, aksi durumlar ise huzursuzluğun çatışmaya dönmesine sebep olup otoritenin daha katı önlemler almasına -dolayısıyla şiddet eylemlerinin baş göstermesine- zemin hazırlamıştır. Bu çalışmada Dirse Han Oğlu Boğaç Han anlatısında psikolojik şiddet unsurları, var olan toplumsal düzenin bozulmasıyla ortaya çıkan kaosun kişiler üzerindeki etkisi ve kahramanların bu baskıyla mücadelesi bağlamında incelenecektir.
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