Although there is clear dose-dependence of pulmonary toxicity caused by inhalation of normobaric oxygen in animal studies, the threshold of toxicity in humans remains largely unknown. The aim of this systematic review of published clinical studies was to establish threshold in terms of total oxygen dose administered under normal pressure by inhalation that causes first clinical signs of toxicity. MEDLINE, EBSCO, The Cochrane Central Register of Controlled Trials (Central), SCIndeks, Scopus, Google Scholar, and ClinicalTrials.gov were searched from their foundation to April 2022. The systematic review was performed according to the pre-registered protocol at PROSPERO. The studies were included if describing toxic effects of normobaric oxygen therapy in humans. In total 11 human studies of poor quality were found, with either experimental or observational design. In none of the analyzed studies did oxygen therapy cause toxic effects on the respiratory tract if the concentration of oxygen in the inhaled air was below 50%, regardless of the rate of administration. The toxic consequences of inhaling oxygen at a concentration of more than 50% occurred only after oxygen was administered for more than 6 hours, at a rate of more than 7 L/min, and were mainly reflected in inflammation of the tracheobronchial mucosa, with epithelial erosions. Normobaric oxygen therapy can have toxic effects in humans if the oxygen concentration in the inhaled air is higher than 50%, if the administration rate is above 7 L/min, and if the application lasts at least 6 hours.
The energy transition towards increased electric power production from renewable energy (RE) resources creates new challenges to ensure the stability of power grids. In conventional power grids voltage fluctuations can be controlled locally. Here, it is explored whether this may be changed by the energy transition. It is well established that the increase of RE resources in power grids increases the amplitude of frequency deviations and the velocity with which these deviations spread throughout the power grid. However, its effect on voltage dynamics and propagation has not been systematically studied. Here, a systematic study is carried out of the transients of voltage amplitude, phase and frequency deviations due to local contingencies in dependence on system inertia, heterogeneity and topology. The 3rd order dynamic power grid model is studied numerically and analytically and compared with real grid simulations for the Nigerian (330 kV) power grid and other grid models, using DigSILENT PowerFactory software. A quantitative analysis of the parametric dependence of the velocity with which a disturbance propagates throughout the grid and of the period of oscillations of the frequency and voltage transients is provided. Beating patterns are found in the transients and are identified as footprints of the location of the fault bus, as caused by multiple reflections of propagating disturbances from the grid boundary. These may result in interarea oscillations. It is confirmed that voltage deviations remain local for realistic ranges of parameters, but that it can propagate by literally surfing on the frequency deviation wave. However, it is found that this no longer holds true when the electrical power in the grid approaches its critical value beyond which no stationary solution exists. Furthermore, time dependent second moments of the geodesic distance weighted with frequency deviations $S_{\delta \omega }(t)$ and voltage deviations $S_{\delta V}(t)$ , respectively are evaluated, confirming a ballistic disturbance propagation in homogeneous model grids. However, in real grid simulations, a linear time dependence of $S(t)$ is observed, indicating a diffusive propagation due to multiple scattering from the inhomogeneities in these power grids.
Background: Medical decision making represent a branch of medical informatics. Our decisions and actions are based not only on relevant information but also on our knowledge of the nature of problem that is being solved. Objective: The aim of this study was to describe and explaine the importance of medical decision making in physician's practice with information technology support. Methods: This is cross-sectional study based on reviewing of apropriate scientific literaure stored in scientific databases like PubMed, PubMed Central, Scopus, Embase, Hinary, etc, Results and Discussion: The reality is that the physician very often makes the decisions on the basis of the incomplete information. Besides that, the value of the available information for the processes of decision making is always relative regarding to the basis on the base of knowledge of the decision carrier. Medical decision making certainly be continuously exposed to it, which is the reason why it could not be of more important. The intricate aspects of medical decision making has been discussed in this article. A decision is a choice varying between several different courses of action that may be pursued. Each decision comes as a result of complex processes which provide two or more options providing results, as well as intro and retrospection, and examination or perspective into the future. As is in everyday life, the principles of decision making are present in medicine as well. Conclusion: Medical decision-making is a process of continuous balancing of concrete risks in which doctors show "loss aversion". Medical decisions are vital - to medical professionals, patients and society. They are difficult, and may provide positive outcomes, or poor complications. They test doctors maximally, and provide insight into the effectiveness of doctors. Doctors do not enter into a “business but social contract” with the patient. Additionally, it may ease and expedite the process of medical decision making, a luxury which was not always present for physicians.
Background: Everyday, doctors and individuals in the field of healthcare must make calculated decisions which have important consequences, impacting patients on the individual level, and communities and nations on a more global level. Healthcare professionals must at times make these choices with limited information, resources, and knowledge, and yet is is expected that these decisions are highly calculated and accurate. Objective: The aim of this study was to describe and explaine the importance of medical decision making in physician's practice. Methods: It is cross-sectional study based on reviewing of apropriate scientific literaure stored in scientific databases like PubMed Central Scopus, Embase, Hinary, etc, Results and Discussion: Medical decision making certainly be continuously exposed to it, which is the reason why it could not be of more important. The intricate aspects of medical decision making has been discussed in this article. A decision is a choice varying between several different courses of action that may be pursued. Each decision comes as a result of complex processes which provide two or more options providing results, as well as intro and retrospection, and examination or perspective into the future. As is in everyday life, the principles of decision making are present in medicine as well. In the world of biomedicine, decisions may rely on the available systems of information provided to the decision maker through medical documentation. Additionally, it may ease and expedite the process of medical decision making, a luxury which was not always present for physicians. Conclusion: Medical decision making is highly important to doctors and patients alike, as well as the broader population. Medical decisions are vital - to medical professionals, patients and society. They are difficult, and may provide positive outcomes, or poor complications. They test doctors maximally, and provide insight into the effectiveness of doctors. And finally, from the presented strategy, we can conclude that the mathematical models provides support in diagnosis and therapeutic selection in patients with heart damage by cardiovascular diseases and its helped to pysician, as decision maker, to decide which and when appropriate decision will be used. In health care, shared decision-making is increasingly embraced and recommended. It is important to involve patients in health care decisions, to communicate with them, and to provide patient-centered care, however formal models and evaluations in cardiovascular care are still in their infancy.
Background: Consuming a diet rich in natural foods that include oilseed products containing bioactive compounds and a diverse array of fatty acids is not just a dietary choice; it is a critical element of maintaining human health. Objective: This paper aims to review the current state of knowledge on minor bioactive compounds in vegetable cold pressed oils, these are substances that are found in small amounts in vegetable cold pressed oils. Methods: Intended as an indispensable resource, this review is designed to empower medical professionals in the fields of integrative medicine, nutrition, and dietetics. Results and Discussion: Cold-pressed oils extracted from various plant sources have emerged as vital allies in the battle against inflammation-related diseases, offering a versatile range of valuable compounds. These compounds contribute to the oils' multifaceted properties, which encompass potent anti-inflammatory, antioxidant, and anticancer effects, greatly enhancing their nutritional significance. This brief review delves deep into the intricate composition of cold-pressed oils, with a specific focus on the often overlooked but highly influential minor bioactive compounds, including phytosterols, phospholipids, tocols, phenols, squalene and pigments. Intended as an indispensable resource, this review is designed to empower medical professionals in the fields of integrative medicine, nutrition, and dietetics. It equips them with a wealth of knowledge to guide consumers in making informed choices when incorporating cold-pressed oils into their dietary plans, tailored to their individual health needs.. Conclusion: This paper highlights the importance of cold-pressed oils as a source of various minor bioactive compounds that have the potential to promote human health and prevent or manage a range of diseases. The findings presented in this paper serve as a valuable resource for medical professionals in the field of integrative medicine, nutrition, and dietetics, as well as for consumers looking to make informed choices about their dietary and health needs.
Background: Radiotherapy is one of the primary treatment options in cancer management, together with surgery and chemotherapy. Radiation therapy is technologically complex discipline involving professionals with various specialties, and using high energy radiation in treatment of wide range of different cancer types. Technical complexity, increasing number of patients, large workload, and delivery of radiation therapy treatment with lack of human, technical and financial resources in low and middle income countries creates environment with great potential to develop incidents. Emerging need of modern radiation therapy is to develop preventive approach to risk management i to improve the patient safety. Objective: The objective of this research is to identify and assess risk associated with radiation therapy practice in Bosnia and Herzegovina. Methods: An anonymous, voluntary electronic on-line radiation therapy incident reporting system (IRS) was created. IRS consists of four sections containing questions about working environment, incident occurrence, root causes and contributing factors, and incident severity assessment. Data collected using IRS were used to create taxonomy of incidents in radiation therapy. Risk assessment was made using Risk Matrix method. Research was made using the data collected from first 60 incidents reported to IRS. Results: Based on probability and frequency of incident occurrence and severity of consequences, it was assessed that 41.7% of incidents had low risk level (L), 50% of incidents had moderate risk level (M), and 8.3% of incidents had high risk level (H). Radiation therapy risk profile based on risk assessment results clearly shows that incidents with low frequency, low occurrence probability, but high consequences severity level have highest level of risk. Conclusion: The results of this research confirm that the electronic on-line radiation therapy IRS allows the identification and classification of the most significant risk factors in radiotherapy and prevention of serious incidents occurrence.
Application of a discrete time (DT) sliding mode controller (SMC) in the control structure of the primary controller of a three-phase LCL grid inverter is presented. The design of the inverter side current control loop is performed using a DT linear model of the grid inverter with LCL filter at output terminals. The DT quasi-sliding mode control was used due to its robustness to external and parametric disturbances. Additionally, in order to improve disturbance compensation, a disturbance compensator is also implemented. Also, a specific anti-windup mechanism has been implemented in the structure of the controller to prevent large overshoots in the inverter response in case of random disturbances of grid voltages, or sudden changes in the commanded power. The control of the grid inverter is realized in the reference system synchronized with the voltage of the power grid. The development of the digitally realized control subsystem is presented in detail, starting from theoretical considerations, through computer simulations to experimental tests. The experimental results confirm good static and dynamic performance.
Background: Acute pancreatitis (AP) is an acute inflammatory illness of the pancreas representing a true question in diagnostic process. Laboratory markers of the hepatobiliary tract such as liver transaminases with pancreatic enzymes give a true hint of a hidden diagnosis together with urea, creatinine and creatine kinase (CK). Objective: This clinical study aims to show whether there is any correlation between alpha-amylase and CK or their ratio examining hospitalized patients with AP diagnosis. Methods: From total number of 99 patients with a clinical picture of AP, 71 patients in this retrospective analysis (including both genders) were included according to the presence of two biochemical markers in collected laboratory analysis at admission and 72 hours later on a laboratory check-up: CK and alpha-amylase. Results: The median CK value of AP cases was 92 (41.75 – 207.25) in the acute period and 73 (37 – 159) after 72h staying in the hospital without statistical significant (p=0.521; p<0.05). However, there was a statistically significant correlation between the parameters of CK at admission and creatine kinase after 72h staying in the hospital. The median value of CK/Amylase ratio in the acute period was 0.168 (0.069 – 0.532) and 0.386 (0.12 – 1.12) after 72 hours of staying in the hospital. There was a statistically significant difference between values of CK/amylase ratio in these two groups (p=0.000; p<0.01). Conclusion: In conclusion, a connection between CK and alpha-amylase needs to be elucidated in further studies and its existence must be researched both in physiological and pathophysiological conditions, and it is two-way and very complex. This study helped us obtain significant information about the perspective of AP in the potential relation to other non-standard laboratory markers for some diseases
Allegations about the number of German soldiers engaged in Yugoslavia was one of the pillars of the narrative about the "People's Liberation War". This issue, however, was never given a proper historiographical treatment in the socialist period. It would have shown that the number of units in Yugoslavia depended on external factors (events on major fronts and broader strategic deliberations) at least to the same extent as on internal ones (guerrilla danger), that the occupation contingent was of highly heterogeneous nature, and that large numbers are not always synonymous for combat quality. This research, based almost entirely on unpublished primary sources, will attempt to provide a comprehensive account of the strength and quality of the German occupation contingent in the second half of the war. The original plan to hold the country with a symbolic force of 2 to 4 divisions was shattered already in the summer of the same year by the outbreak of the uprising in occupied Serbia and the NDH. From the early 1942 to mid-1943, anywhere from 4 to 7 divisions were engaged in anti-guerrilla duties, and from the summer of 1943 until the arrival of the Red Army in the late autumn of 1944, from 5 to 9 divisions (parts of the divisions that were nominally responsible for securing the coast, yet in practice constantly engaged against the Partisans, not counted). In the final phase of the war, almost the entire German contingent consisting of 11 to 15 divisions (including those stationed in Slovenia) ended up fighting the regular Yugoslav army. Apart from the divisions, dozens of independent combat battalions were involved in these operations. In the worst case, a large percentage of all these units could have been used to secure the rear areas of the main fronts, and a smaller percentage could be used directly against the Allied armies. Although, in general, these formations were of lower combat value, there is no doubt that their deployment to a secondary theater of war such as the Yugoslav one was to the detriment of the German war effort.
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