system operations

Catholic hospitals and health systems have proliferated and succeeded in American healthcare; they now operate four of the largest health systems and serve nearly one in six hospital patients. Like other religious entities that Wuest and Last write about in this issue, in their article Church Against State, they have benefited by and supported the long reach of conservative efforts to undermine the administrative state.

Narcotic Detection Dogs (NDDs) are essential tools in the fight against drug trafficking, acting with high precision and improving efficiency at border posts. When trained efficiently, these dogs can detect a great variety of compounds, such as cocaine, marijuana and its derivatives, and synthetic drugs, among others. Most of the knowledge on canine detection processes and efficiency has been determined in experimentally controlled conditions, but narcotic seizures detected by dogs in realistic anti-drug operations have not yet been critically determined in a Country with continental dimensions such as Brazil...

OBJECTIVE: This study was conducted to develop a comprehensive nomogram for individuals with choroidal melanoma (CM) to determine their cancer-specific survival (CSS). METHODS: Data of individuals with CM, diagnosed between 2004 and 2015, were accessed at the Surveillance, Epidemiology, and End Results (SEER) database. The selected individuals were randomly categorized into a training and validation cohort. Multivariate Cox regression analysis was applied to screen the relevant variables...

This study describes the non-bracket oblique traction-hoisting construction strategy for cable-truss structures, which is to assemble the upper and lower radial cables, hoop cables, sling cables, and compression rods without stress at a low altitude, then hoist the cable-strut system to a high altitude by oblique traction of the upper radial cables through the jack fixed on the upper radial anchorage nodes, and finally actively tension the lower radial cables to achieve the designed shape and prestress level of the entire structure...

More accurate sun position estimation could transform the design and operation of solar power systems, weather forecasting services, and outdoor augmented reality systems. Although several image-based approaches to sun position estimation have been proposed, their performance is significantly affected by momentary disruptions in cloud cover because they use only a single image as input. This study proposes a deep learning-based sun position estimation system that leverages spatial, temporal, and geometric features to accurately regress sun positions even when the sun is partially or entirely occluded...

Background: Spinal cord stimulation (SCS) is a treatment for chronic intractable pain powered by an implantable pulse generator that may be rechargeable or not rechargeable (NR). It is performed in 2 stages (a trialing phase followed by permanent device implantation) and necessitates 2 hospitalizations, which may increase infection risk. Objective: This analysis explores the cost impact of improvements in battery longevity and the adoption of 1-step (direct-to-implant [DTI]) SCS implantation. Methods: Since 2019, 3 leading NR-SCS devices have been launched: Device A (2019), Device B (2020), and Device C (2021)...

INTRODUCTION: Laparoscopy in gallbladder cancer (GBC) has a possible role in staging, radical cure, and palliation in gallbladder cancer. However, a few studies have advocated the use of laparoscopic approach and concluded the safety of this approach. This present study was undertaken to determine the safety and feasibility between open and laparoscopic cholecystectomy in patients with the non-metastatic GBC. MATERIALS AND METHODS: A systematic database search was performed in MEDLINE, Embase, and Google Scholar for relevant articles...

BACKGROUND: Operable triple-negative breast cancer (TNBC) is an unfavorable subtype of breast cancer, which usually requires an aggressive perioperative systemic treatment. When TNBC presents as a second primary cancer after cured acute leukemia, its management might be challenging. CASE PRESENTATION: We present a case report of a young postmenopausal woman with an operable TNBC who had a history of the B-cell acute lymphoblastic leukemia (B-ALL) and graft versus host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT)...

CMOS-compatible materials for efficient energy harvesters at temperatures characteristic for on-chip operation and body temperature are the key ingredients for sustainable green computing and ultralow power Internet of Things applications. In this context, the lattice thermal conductivity (κ) of new group IV semiconductors, namely Ge1- x Sn x alloys, are investigated. Layers featuring Sn contents up to 14 at.% are epitaxially grown by state-of-the-art chemical-vapor deposition on Ge buffered Si wafers...

KDM2B, a histone lysine demethylase, is expressed in a plethora of cancers. Earlier studies from our group, have showcased that overexpression of KDM2B in the human prostate cancer cell line DU-145 is associated with cell adhesion, actin reorganization, and improved cancer cell migration. In addition, we have previously examined changes of cytosolic Ca2+ , regulated by the pore-forming proteins ORAI and the Ca2+ sensing stromal interaction molecules (STIM), via store-operated Ca2+ entry (SOCE) in wild-type DU-145...

Primary amyloidosis of the conjunctiva and eyelid is a rare and often misdiagnosed condition. It is characterized by the deposition of insoluble amyloid fibrils, which are misfolded proteins, in the body. Amyloidosis can be systemic or localized with different types of amyloid fibril proteins identified using mass spectrometry. Ocular involvement in amyloidosis can lead to corneal dystrophies, glaucoma, vitreous opacities, and other symptoms. Diagnosis involves clinical examination and histopathological assessment...

A 73-year-old woman was referred to a National Centre for Peripheral Nerve Injury with a post-operative left radial nerve degenerative lesion following open reduction and internal fixation of a proximal third humerus fracture using radiolucent Arthrex FiberTape® Cerclage as an adjunct to plating to improve stability. Intra-operative photographs illustrate compression of the radial nerve under the cerclage construct. Use of radiolucent cerclage for humerus fractures is increasing with modern systems capable of withstanding an ultimate load of 4300 N...

We present case series of simultaneous surgery for coexisting cardiac and non-cardiac pathologies to evaluate the feasibility of the treatment. The retrospective analysis included 27 patients aged between 28 and 74 years. The most often heart diseases were coronary arterial disease and valve defects, and the most often heart surgery was coronary artery bypass grafting. The non-cardiac diseases included neoplasms in the abdominal cavity, urinary system, and chest organs. The average duration of surgery was 277 ± 87 minutes, blood loss 285 ± 182 ml...

PURPOSE: The objective of this study is to evaluate the accuracy of an augmented reality (AR) system in improving guidance, accuracy, and visualization during the subxiphoidal approach for epicardial ablation. APPROACH: An AR application was developed to project real-time needle trajectories and patient-specific 3D organs using the Hololens 2. Additionally, needle tracking was implemented to offer real-time feedback to the operator, facilitating needle navigation...

OBJECTIVE: Our aim was to develop a nomogram that integrates clinical and radiological data obtained from computed tomography (CT) scans, enabling the prediction of chronic hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH). METHOD: A total of 318 patients diagnosed with subarachnoid hemorrhage (SAH) and admitted to the Department of Neurosurgery at the Affiliated People's Hospital of Jiangsu University between January 2020 and December 2022 were enrolled in our study...

Capitellum fractures represent fewer than 1% of elbow fractures. Most commonly, these fractures occur secondary to either axial loading with the elbow fully extended or direct impact to the lateral aspect of the elbow. Numerous classification systems exist, with many types and subtypes. Since capitellum fractures are uncommon and fracture type varies widely, there is a lack of consensus with regard to treatment recommendations. We present a case series of seven patients with capitellum fractures, who presented between January 2016 and August 2020 to Addenbrooke's Hospital (Cambridge, the United Kingdom)...

One of the challenges in the transfer of heat during the mechanical machining process is the coolant substance used in the internal cooling method which is generally liquid water or a water-based coolant. This limits the heat transfer capacity insofar as the thermal conductivity of liquid water is concerned. The other difficulty is the requirement for an external mechanical system to pump the coolant around the internal channel, providing efficient transfer of the accumulated thermal energy. This study proposes a novel method to address this issue by using liquid gallium which provides the means to transfer the excess heat generated during the cutting process by integrating the design into an aluminium oxide insert...

The feasibility of a synergistic endogenous partial denitrification-phosphorus removal coupled anammox (SEPD-PR/A) system was investigated in a modified anaerobic baffled reactor (mABR) for synchronous carbon, nitrogen, and phosphorus removal. The mABR comprising four identical compartments (i.e., C1-C4) was inoculated with precultured denitrifying glycogen-accumulating organisms (DGAOs), denitrifying polyphosphate-accumulating organisms, and anammox bacteria. After 136 days of operation, the chemical oxygen demand (COD), total nitrogen, and phosphorus removal efficiencies reached 88...

Nursing information systems are becoming increasingly prevalent in our medical institutions. However, changes in the social environment and imbalances between the demands of caregivers and care recipients mean that current nursing information systems are inadequate in terms of quality and operational needs. This article was written to provide insights into opportunities to leverage technology to further promote care quality by applying a "data, information, knowledge, and wisdom" system development structure to develop intelligent technology products that equitably meet the needs of patients, caregivers, and nursing processes...

The rapid development of technology in recent years has not only transformed everyday life but also profoundly impacted the fields of healthcare and caregiving. Approaches to care that are technology-based and human-centered may be used to provide care services that are more efficient, accurate, and personalized and that, ultimately, improve our quality of life and overall health. First, intelligent health monitoring systems can generate customized health management plans based on individual health conditions and needs, allowing chronic diseases to be managed more effectively and helping prevent disease onset...