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BackgroundMethodsResultsConclusionWith the increasing cases of TBI cases in the elderly population taking anticoagulants for comorbidities, there is a need to better understand the safety of new anticoagulants and how to manage anticoagulated TBI patients.A meta-analysis using a random-effect model was conducted to compare the effect of preinjury use of DOACs and VKAs on the outcomes following TBI.From 1951 studies, 49 studies with a total sample size of 15,180 met our inclusion criteria. Our meta-analysis showed no difference between preinjury use of DOACs or VKAs on ICH progression, in-hospital delayed ICH, delayed ICH at follow-up, and in-hospital mortality, but using DOACs was associated with a lower risk of immediate ICH (OR = 0.58; 95% CI = [0.42; 0.79]; p < 0.01) and neurosurgical interventions (OR = 0.59; 95% CI = [0.42; 0.82]; p < 0.01) compared to VKAs. Moreover, patients on DOACs experienced shorter length of stay in the hospital than those on VKAs (OR = -0.42; 95% CI = [−0.78; −0.07]; p = 0.02).We found a lower risk of immediate ICH and surgical interventions as well as a shorter hospital stay in patients receiving DOACs compared to VKA users before the head injury. [ABSTRACT FROM AUTHOR]

This paper introduces a new structure of a multi-level inverter (MLI) to generate high-level AC voltages using a low number of switches with a quasi-sine waveform. The small number of driver circuits utilised in bidirectional switches is a salient characteristic of this inverter. Also, the number of conducting switches at each voltage level is low in this structure. This results in lower conduction losses of the switches. The proposed topology can be used as the cascaded structure with different approaches to select the value of voltage sources. Power losses are discussed for the proposed structure. To compare the proposed multi-level inverter and demonstrate its superiority, a comparison has been made with some recently presented topologies. According to the comparison results, the advantage of the proposed structure is producing high voltage levels with a smaller number of switches and driver circuits. To prove the suitable performance of the proposed MLI, a 21-level symmetric and 37-level asymmetric inverter containing 14 switches are designed and simulated in the MATLAB/Simulink program. A laboratory prototype for each of these inverters is implemented. The experimental results finely verify the simulations. Besides, an accurate comparison with recently introduced multilevel inverters has been carried out to confirm the effectiveness and superiority of the proposed structure. [ABSTRACT FROM AUTHOR]

The Valsalva maneuver and its modifications have been utilized across several conditions in medicine; however, there have been difficulties in its application. Thus, at the University of Texas Health Science Center in San Antonio, we designed and patented an affordable and accessible device that mimics Valsalva called "Forced Inspiratory Suction and Swallow Tool (FISST). In this review, we discuss the premise for the design of FISST, based on applications of the law of conservation energy, the continuity equation, and Bernoulli's principle. We then detail the mechanism by which FISST stimulates hiccup cessation by increasing negative inspiratory pressure when drinking through the apparatus, causing diaphragmatic contraction and disruption of the hiccup reflex. We then detail the efficacy and future applications of FISST in addressing other pathologies. FISST has been used to address hiccups by utilizing its reverse-Valsalva effect to increase parasympathetic stimulation by increasing vagal tone. In a prospective study that we conducted on a cohort of 249 hiccup subjects worldwide, this tool achieved 92% effectiveness. Additionally, several cases, including a published case report, have found FISST successful in terminating supraventricular tachycardias (SVT). FISST may be further utilized in diagnosing or addressing various upper airway pathologies and should be explored further. [ABSTRACT FROM AUTHOR]

Posterior reversible encephalopathy syndrome (PRES) is a neurological condition with a wide range of symptoms, including visual disturbances, headache, vomiting, seizures, and altered consciousness. This review describes the pathophysiology of PRES, as well as the clinical, diagnostic, and therapeutic intervention during pregnancy. The gold standard for diagnosis of PRES is Magnetic Resonance Imaging (MRI), helping to differentiate it from other similar conditions. The aim of this paper is to review the principal aspects of PRES, general care, blood pressure control, and seizures prevention while avoiding potential injuries to the mother and fetus in the event of pregnancy. We concluded that PRES can be effectively treated and reversed if prompt diagnostic action is made, and adequate care is initiated. [ABSTRACT FROM AUTHOR]