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Minda Abebe,1 Belete Alemu,1 Gudeta Teku,1 Oliyad Eshetu,1 Endeshaw Wale,1 Aschalew Besha,1 Mengistu Yinges Kebede,1 Lamesgen Geta2 1Department of Anesthesia, Collage of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Anesthesia, Collage of Medicine and Health Sciences, Debremarkos University, Debremarkos, EthiopiaCorrespondence: Minda Abebe, Email mindaabebe21@gmail.comBackground: The analgesic effectiveness of a single perioperative dose of dexamethasone is not clearly defined. The administration of systemic medication like dexamethasone, opioids, and non-steroidal anti-inflammatory drugs has a positive effect on the prolongation of postoperative analgesia after cesarean section under spinal anesthesia. A single-dose administration of dexamethasone with moderate to high dose reduces postoperative pain, reduces opioid consumption, and prolongs spinal anesthesia after cesarean delivery.Objective: The aim of this systematic review was to investigate the effectiveness of single intravenous dexamethasone in prolongation of spinal anesthesia for postoperative analgesia in elective cesarean section.Methods: We conducted a search on PubMed, Google Scholar, the Cochrane Library, Hinari, and review articles on the effectiveness of intravenous dexamethasone for extending spinal anesthesia during elective cesarean sections, until June 2023. The searches were conducted by using keyword (IV dexamethasone OR/AND analgesia OR postoperative pain AND cesarean section OR child birth AND prolongation of spinal anesthesia). The articles included describe the analgesic efficacy of dexamethasone for prolongation of spinal anesthesia during cesarean section.Results: A total of 25,384 papers were found using different searching methodologies from different electronic databases. The EndNote reference manager was used to remove duplicates, and 438 articles were selected for screening. Of those, 57 were included for critical evaluation, and 49 were removed with justification. The effectiveness of IV dexamethasone on the prolongation of spinal anesthesia and postoperative analgesia in women undergoing cesarean delivery is the subject of eight RCT studies on 628 parturients that are presented in the chosen journal articles from various countries.Conclusion: Intravenous dexamethasone administration immediately after clamping of the umbilical cord prolongs the duration of spinal block in patients undergoing cesarean sections and has a significant impact on reduction of postoperative pain severity, opioid consumption, and other pain requirements. When high-dose dexamethasone is administered intravenously, it can overcome complications that may arise after severe pain and increase patient satisfaction by extending the duration of postoperative analgesia and sensory block.Keywords: dexamethasone, prolongation, spinal anesthesia, analgesia, caesarean section systematic review

A range of criticisms have been put forward about urban master plans – the most important strategic documents for the planning and management of cities (or towns) – and their quality. The most important of these is about their prolonged processes of preparation, review, and approval as the main hinderance for efficiency and productivity. This pushes plans and programmes away from the realities at the time of approval, and makes them practically ineffective. In response, some urban planning experts are after fundamental changes in the process of preparation, review, and approval of master plans. This research focuses on finding reasons for prolonged processes, because without that all efforts to implement new approaches are doomed to fail, the experience of preparing urban structural-strategic plans in Iran being apoint in the case.To answer the main question of this research, urban planning managers of road and urban development in all provinces of Iran are selected to answer questionnairesdue to their seminal roles in the selection of consulting engineers, preparation, review, approval, communication, and even implementation of the urban master plans. Results show a variety of reasons for prolongation of the process, the most important of which being weaknesses, discordances, non-realisation of potentials, the lack of adequate training of experts, and the absence of experienced consulting engineers involving in preparation of master plans. The weakness of the experts and management bodies of institutions and groups causes problems such as the adoption of piecemeal approaches in master plans, or failures in fulfilling basic requirements for preparation of the plans such as acquiring updated aerial photographs, and as a result, it takes a long time bringingconsultation contracts to a conclusion.

A range of criticisms have been put forward about urban master plans - the most important strategic documents for the planning and management of cities (or towns) - and their quality. The most important of these is about their prolonged processes of preparation, review, and approval as the main hinderance for efficiency and productivity. This pushes plans and programmes away from the realities at the time of approval, and makes them practically ineffective. In response, some urban planning experts are after fundamental changes in the process of preparation, review, and approval of master plans. This research focuses on finding reasons for prolonged processes, because without that all efforts to implement new approaches are doomed to fail, the experience of preparing urban structural-strategic plans in Iran being apoint in the case. To answer the main question of this research, urban planning managers of road and urban development in all provinces of Iran are selected to answer questionnairesdue to their seminal roles in the selection of consulting engineers, preparation, review, approval, communication, and even implementation of the urban master plans. Results show a variety of reasons for prolongation of the process, the most important of which being weaknesses, discordances, nonrealisation of potentials, the lack of adequate training of experts, and the absence of experienced consulting engineers involving in preparation of master plans. The weakness of the experts and management bodies of institutions and groups causes problems such as the adoption of piecemeal approaches in master plans, or failures in fulfilling basic requirements for preparation of the plans such as acquiring updated aerial photographs, and as a result, it takes a long time bringingconsultation contracts to a conclusion. [ABSTRACT FROM AUTHOR]

The distinction between extension (Russian: razvjortyvanie) - a type of prolongation in which the meaning of the expression is preserved - and addition (Russian: dopolnenie), in which the meaning of the expression necessarily changes, was briefly but clearly presented by Permjakov. We are convinced that the consideration of the difference between extension and addition is very useful for phraseological and paremiological theory, as it is inextricably linked to the question of whether prolongation is a variant of an expression (in the case of extension) or a new expression (addition). We present paremias and humorous phrasemes created by addition or extension and highlight the genre differences between them. We also show how the difference between extension and addition can be recognized from the examples of use and explanations of meaning listed in the Slovenian paremiological dictionary. Data on the degree of familiarity of paremia among Slovenian speakers is given on the basis of a survey which was conducted in order to determine the Slovenian paremiological minimum.

In this study, we investigated Schrödinger–Hirota equation Kerr law in the presence of spatio-temporal dispersion which describes pulse propagation in optical fibers provoked by nonlinear effect and reduced to multi-plane dispersion. We used the Lie symmetry method to reduce the model into the nonlinear ordinary differential equations. Moreover, the unified Riccati equation expansion method was used to obtain optical soliton solutions and other soliton solutions of the model. We obtained dark, kink, singular, and periodic-singular soliton solutions. Obtained results were shown via 3D and contour graphs. Thus, the model was analyzed for the first time with the Lie symmetry method and UREEM. [ABSTRACT FROM AUTHOR]

Algebraic multigrid (AMG) is one of the most widely used solution techniques for linear systems of equations arising from discretized partial differential equations. The popularity of AMG stems from its potential to solve linear systems in almost linear time, that is with an O(n) complexity, where n is the problem size. This capability is crucial at the present, where the increasing availability of massive HPC platforms pushes for the solution of very large problems. The key for a rapidly converging AMG method is a good interplay between the smoother and the coarse-grid correction, which in turn requires the use of an effective prolongation. From a theoretical viewpoint, the prolongation must accurately represent near kernel components and, at the same time, be bounded in the energy norm. For challenging problems, however, ensuring both these requirements is not easy and is exactly the goal of this work. We propose a constrained minimization procedure aimed at reducing prolongation energy while preserving the near kernel components in the span of interpolation. The proposed algorithm is based on previous energy minimization approaches utilizing a preconditioned restricted conjugate gradients method, but has new features and a specific focus on parallel performance and implementation. It is shown that the resulting solver, when used for large real-world problems from various application fields, exhibits excellent convergence rates and scalability and outperforms at least some more traditional AMG approaches. [ABSTRACT FROM AUTHOR]

Methadone is a chiral synthetic opioid primarily used to treat heroin and prescription-opioid addiction: the (R)-enantiomer (Levomethadone) activates the µ-opioid receptor more potently than the (S)-enantiomer, which is a more potent blocker of the hERG potassium channels, resulting in QTc prolongation. The purpose of this retrospective study was to assess the effect of methadone on the QTc interval and to investigate the benefits of Levomethadone. The electrocardiograms of 165 patients taking methadone at various dosages and for different periods of time were examined: the QTc value was manually measured and then adjusted using Bazett's formula. Data analysis revealed a linear association between the dosage of methadone and QTc length; no correlation was found between the QTc value and gender, age, or duration of therapy. In total, 14% of the sample (23 patients) showed a prolongation of the QTc interval (>470 ms in males and >480 ms in females); 10 of the 23 patients with QTc elongation underwent a change of therapy from Methadone to Levomethadone—in 90% of these patients, a normalization in the QTc length was established. This study confirmed the role of methadone, specifically its dosage, in QTc prolongation and the efficiency of Levomethadone as an adequate therapeutic substitute in these circumstances. This study validates the importance of careful electrocardiographic monitoring in methadone-treated patients. [ABSTRACT FROM AUTHOR]

Kelâmın muktezâ-i hâle uygun olması ve zikredilen lafızlar ile mananın birbirine denk olması sözün beliğ olmasının bir gereğidir. Söz bazen muhatabın anlamasını kolaylaştırmak bazen de sözü zihne iyice yerleştirmek gibi sebeplerle uzatılabilmekte ve birçok lafızla daha az anlam ifade edilebilmektedir. Bazen de muhatabın durumu göz önünde bulundurularak etkili bir konuşma yapmak, muhatabı düşünmeye ve araştırmaya sevketmek gibi gayelerle söz kısa bir şekilde ifade edilebilmektedir. Dolayısıyla az sayıda lafız ile birçok mana elde edebilmek için îcâzlı bir anlatıma gidilebilmektedir. Bir sıkıntıyı arz, özür beyanı, taziye, korkutma, tehdit, teşekkür ve istirham yazılarda kendini gösteren îcâzlı anlatım edebî ve kutsal metinlerde de sıklıkla kullanılmıştır. Bu anlatım tarzı bazen cümlenin bazı unsurlarının cümleden çıkarılması yoluyla bazen de hazif yapılmadan elde edilebilmektedir. Kısa ve etkili olduğu için tercih edilen îcâzlı anlatımda vecîz ifadenin kast edilen manayı ifade etmekten yoksun olmaması, tam ve anlaşılır olması, güzel bir beyana sahip olması ve zikredilen lafızda hazfedilmiş olana yönelik bir delilin bulunması şart koşulmuştur. Bir karineye dayalı olarak hazif yapıldığında sözde bir kapalılık olmayacağı için hazif sözün kıymetine zarar vermez, aksine sözü muhatap nezdinde daha etkili hale getirip kalıcı olmasını sağlar. Makamın darlığı, muhatabın meseleye kolayca intibakının sağlanması, sözün ezberinin kolaylaştırılması, muhatap dışındakilerden durumun gizlenmesi, az lafızla çok mananın elde edilmesi, kıymeti ve önemi fazla olana dikkat çekilmesi veya ihtisâr gibi sebeple îcazlı anlatıma gidilebilmektedir. İbareyi yoğun hale getirmesi, güzelleştirip tatlılık vermesi, muhatabın his ve düşünce dünyasını harekete geçirmesi, dikkati asıl önemli olan noktaya çekmesi, bazı hususları dile getirmeden bunların anlaşılmasını muhatabın yorumuna bırakarak ifadelerde anlamsal genişlik meydana getirmesi ve bütün bunların yanı sıra lafza görsel bir güzellik katması îcazlı ifadelerin büyük bir kıymete sahip olduğunu göstermektedir. Bu sebeple itnâb, müsavât ve îcazlı anlatımlardan her birisi yerine göre bir değere sahipken insanlar üzerindeki inkâr edilemez etkisinden dolayı bunlardan en kıymetlisinin îcâzlı anlatım olduğu söylenebilir. Îcâzlı anlatımı bütün yönleriyle ele aldığımız bu çalışmayla Kur’ân âyetleri örnekliğinde mesele derinlemesine araştırılarak îcâzın farklı türleri, îcâzlı anlatımın sebepleri, şartları ve kıymetinin ortaya koyulması amaçlanmaktadır.

Abstract Background The postoperative length of hospital stay (PLOS) is an important indicator of surgical quality. We identified perioperative factors that affect prolonged PLOS (PPLOS) after laparoscopic colorectal cancer resection, which is the preferred surgical approach for colorectal cancer, the third most common cancer. Methods This study was a secondary analysis of a randomized trial (clinicaltrials.gov ID: NCT03160144) that included 280 patients who underwent laparoscopic colorectal cancer resection. The primary outcome was a PPLOS, defined as a PLOS that was longer than the median PLOS. Baseline, anesthetic, surgical, and postoperative management factors were included in the univariate and multivariate analyses to identify factors influencing PPLOS. Results The median PLOS was 10 days, and 117 patients had a PPLOS. We identified six influencing factors for PPLOS: preoperative pulse oxygen saturation

Background: Cervical cerclage reduces the risk of preterm birth in women at high-risk of preterm birth and probably reduces risk of perinatal deaths. Objectives: To study obstetric and neonatal outcomes in antenatal patients with transvaginal cervical cerclage. Methods: This is an ambidirectional cohort study conducted in Government Medical college, Thrissur for 2 years on 42 antenatal women who underwent transvaginal cervical cerclage. After written informed consent, data was collected using a semi structured questionnaire at first visit or at time of cerclage and followed up until removal and delivery, all antepartum, intrapartum and neonatal events until discharge were listed. Results: Cervical cerclage in total had a fetalsalvage rate of 73.8%.Elective cerclage had 95.3% take home baby rate, while emergency cerclage had only 50% fetal salvage rate. Comparing Mc Donald and Modified Shirodkar technique, though the latter is associated with more prolongation of gestational age, the difference was not statistically significant. Cerclage was not found to have any maternal complications in this study. Conclusion: Overall cervical cerclage in indicated cases offers good obstetric outcomes in terms of mean prolongation of gestational age at delivery and improved take home baby rates. It is advisable to screen pregnancies at risk of cervical insufficiency and to offer elective cerclage as it gives better results when compared to emergency cerclage. [ABSTRACT FROM AUTHOR]

This paper investigates Arabic terms used as equivalents for English consonants and vowels. The Arabic terms, namely harf sakin (consonants) and harakat (vowels), are specifically tailored for the study of Arabic linguistic items. In bilingual dictionaries, Arabic terms do not truly reflect the linguistic realities represented by English vowels and consonants. The aim of the study is therefore to identify the linguistic realities that the Arabic terms represent within the Arabic linguistic environment. A sketch of contrastive analysis of vowels and consonants in English and Arabic helps in clarifying the linguistic meanings, which are absent from bilingual dictionaries. The findings of the study show that Arabic lexical equivalents are simply sense- indicators and thus not sufficient, as the totality of the conceptual meaning of the item is not provided in bilingual dictionaries. The study concludes by briefly discussing some of the study's implications for translators and other dictionary users. [ABSTRACT FROM AUTHOR]

Background: Immediate delivery is an established concept for preventing life-threatening complications in mothers with HELLP syndrome; however, it is associated with preterm births. Methods: Cases of HELLP syndrome diagnosed at the university hospitals of Halle and Magdeburg (Germany) were analyzed retrospectively. Each patient of the treatment group was administered 64 mg of methylprednisolone (MP) intravenously for 10 days, with the dosage being reduced by 50% every other day in patients from Halle (n = 65). Almost immediate delivery was performed in the control groups (n = 45, Halle; n = 28, Magdeburg). Results: Pregnancies in the treatment group were prolonged by 4 days (median 1–55 days). The platelet counts increased from 76,060 ± 22,900/μL to 117,430 ± 39,065/μL in the MP group compared with an increase from 66,500 ± 25,852/μL to 83,430 ± 34,608/μL in control group 1 and from 78,890 ± 19,100/μL to 131,080 ± 50,900/µL in control group 2 (p < 0.001). Severe neonatal complications were significantly reduced in the treatment group (p < 0.05): sepsis, 9.25% vs. 24%; ventilation, 44.6% vs. 46.5%; and infant death, 1.6% vs. 8.6%. Conclusions: In a selected collective of patients with HELLP syndrome, prolongation of pregnancy using MP treatment improved maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Honeydew honey represents about 60% of the annual honey production, mainly pine and fir honey, in Europe and more than 70% of the annual honey production in Greece. Pine honey produced from the honeydew secretions of Marchalina hellenica (Coccoidea: Marchalinidae) is the main category of honeydew honey in Greece, representing about 60% of the annual honey production. In the past, the rate of honeydew production by Marchalina hellenica was believed to be regular and steady every year. However, beekeepers have noted a decrease in the quantity of honeydew in recent years. Therefore, the establishment of a forecasting model of honeydew flow will be of great benefit to beekeepers, honey bees, and the rural economy. In the present work, we employ the Cumulative Logit Model to prove that temperature, and more specifically the number of cold days in February, is a significant parameter to the life cycle of Marchalina hellenica and construct a statistically significant forecasting model. [ABSTRACT FROM AUTHOR]

It is a requirement for the word to be eloquent that the sentence should be in accordance with the muqtadā al-hal (as occasion requires) and the words mentioned and the meaning should be equivalent to each other. Sometimes the word can be extended for reasons such as making it easier for the interlocutor to understand, and sometimes placing the word in the mind well, and many words may mean less. Sometimes, the word can be expressed in concisely, to make an effective speech, taking into account the situation of the collocutor, and prompting the collocutor to think and research. Therefore, an ījāz (concision) expression can be used to obtain many meanings with a few words. Expression with ījāz, which manifests itself in writings, apologizing, condolence, intimidation, threat, thanks and forgiveness, has also been frequently used in literary and sacred texts. This style of expression can sometimes be obtained by removing some elements of the sentence (hazf), and sometimes by without removing the sentence elements. In ījāz expression, which is preferred because it is short and effective, the ījāz expression should not be far from expressing the meaning to be given, it should be complete and understandable, and it should have a beautiful expression. Since there will be no complexity in the sentence when words are removed based on a clue, removing the words from the sentence does not harm the value of the sentence. It is possible to use ījāz narration for reasons such as ensuring the interlocutor's adaptation to the issue easily, hiding the situation from others, obtaining more meaning with few words, drawing attention to or briefly explaining what is more valuable and important. Intensifying the expression, beautifying it and giving it sweetness, activating the world of feeling and thought of the interlocutor, drawing attention to the issue that is most important, for semantics width in the expressions by leaving the understanding of them to the interpretation of the interlocutor without mentioning some points, and adding a visual beauty to the wording, besides all these, idiomatic sentences proves to be of great value. For this reason, while each of the expressions with the itnāb (prolixity), musāwāt (equating) and ījāz has a value according to its place, it can be said that the most valuable one is the one with ījāz due to its undeniable effect on people. In this study, in which we deal with all aspects of ījāz narration, it is aimed to reveal the different types of ījāz, the reasons, conditions and value of ījāz by examining the issue in the example of Qur'anic verses. [ABSTRACT FROM AUTHOR]

We hypothesized that social jetlag would be associated with prolonged sleep duration on weekends and irregularities in wake-up time and/or bedtime on weekdays. In total, 1,200 Japanese male college students were included in this study. Participants completed an eight-day sleep diary in which they recorded their wake-up time, bedtime, and sleep duration every day for a week. Mean wake-up time, bedtime, and sleep duration, standard deviations in wake-up time and bedtime, the coefficient of variation in sleep duration, social jetlag, and chronotype were calculated over seven nights. Multiple regression was used to explore the factors influencing social jetlag. Stepwise selection analysis was performed to analyze the parameters identified on multiple regression analysis. The mean chronotype of the included participants was 5.3 ± 1.5; their mean social jetlag value was 1.1 ± 1.0. The mean wake-up time, bedtime, and sleep duration values were 8.5 ± 1.1, 25.0 ± 1.1, and 7.5 ± 1.1 h, respectively. Multiple regression analysis showed five indicators exerting a statistically significant influence on social jetlag. The standard deviation in wake-up time was adopted as the first factor in the stepwise selection analysis. These results show that social jetlag is associated with not only prolonged sleep duration on weekends but also irregularities in wake-up time during the week. [ABSTRACT FROM AUTHOR]

Abstract Background The impact of radiotherapy interruption due to the Spring Festival holidays in China on the survival of patients with nasopharyngeal carcinoma (NPC) is unclear. Methods Nontrial patients with locoregionally advanced NPC receiving radiotherapy plus induction chemotherapy (IC) and/or concurrent chemotherapy (CC) were included (N = 5035) and divided into two groups based on the Spring Festival-induced radiotherapy interruption. Kaplan–Meier curves for overall survival (OS) and failure-free survival (FFS) were compared between rival groups. Impact of the timing of radiotherapy interruption (during or outside the Spring Festival) on survival was investigated in a propensity score-matched dataset. We adopted ordination correspondence analysis to determine the cut-off of radiotherapy prolongation for prognostic prediction, and accordingly performed subgroup analysis based on delayed days and chemotherapy details. Individual patient data of three phase III NPC trials (NCT00677118, NCT01245959, NCT01872962) were used for validation (N = 1465). Results Radiotherapy interruption was most frequently observed between December to January of the following year. Significantly lower OS and FFS were associated with the Spring Festival-induced interruption of radiotherapy (P = 0.009 and 0.033, respectively), but not that interruption of IC. In two matched comparison groups, the timing of radiotherapy interruption during the Spring Festival was more likely to lead to a decrease in FFS than outside the Spring Festival (P = 0.046), which was not observed in the validation using clinical trial data or in the subgroup analysis based on the 5-day delayed time. The absence of CC and the accumulated dose of cisplatin

It is well known that the prolongation of an almost complex structure from a manifold $ M $ to the tangent bundle of order $ r $ on $ M $ is also an almost complex structure if it is integrable. The general quadratic structure $ F^2 = \alpha F+\beta I $ is a generalization of an almost complex structure where $ \alpha = 0, \; \beta = -1. $ The purpose of this paper is to characterize a metallic structure defined by the general quadratic structure $ F^2 = \alpha F+\beta I, \; \alpha, \beta\in \mathbb{N} $, where $ \mathbb{N} $ is the set of natural numbers. We show that the $ r $-lift of the metallic structure $ F $ in the tangent bundle of order $ r $ is also a metallic structure. Furthermore, we deduce a theorem on the projection tensor in the tangent bundle of order $ r $. Moreover, prolongations of $ G $-structures immersed in the metallic structure to the tangent bundle of order $ r $ and 2 are discussed. Finally, we construct examples of metallic structures that admit an almost para contact structure on the tangent bundle of order 3 and 4.

Background: The postoperative length of hospital stay (PLOS) is an important indicator of surgical quality. We identified perioperative factors that affect prolonged PLOS (PPLOS) after laparoscopic colorectal cancer resection, which is the preferred surgical approach for colorectal cancer, the third most common cancer. Methods: This study was a secondary analysis of a randomized trial (clinicaltrials.gov ID: NCT03160144) that included 280 patients who underwent laparoscopic colorectal cancer resection. The primary outcome was a PPLOS, defined as a PLOS that was longer than the median PLOS. Baseline, anesthetic, surgical, and postoperative management factors were included in the univariate and multivariate analyses to identify factors influencing PPLOS. Results: The median PLOS was 10 days, and 117 patients had a PPLOS. We identified six influencing factors for PPLOS: preoperative pulse oxygen saturation < 96% (odds ratio [OR], 3.09 [95% confidence interval (CI) 1.38–6.92]; P = 0.006), distant tumor metastasis (OR, 0.34 [95% CI 0.13–0.91]; P = 0.031), the Miles procedure or left hemicolectomy (OR, 4.51 [95% CI 1.67–12.18]; P = 0.003), perioperative surgical events (OR, 2.44 [95% CI 1.25–4.76]; P = 0.009), postoperative albumin infusion (OR, 2.19 [95% CI 1.14–4.19]; P = 0.018), and postoperative early ambulation (OR, 0.35 [95% CI 0.18–0.68]; P = 0.002). Further stratified analysis showed that postoperative albumin infusion might be a risk factor for PPLOS, even in patients with a preoperative albumin level < 40 g/L (OR, 2.29 [95% CI 0.98–5.34]; P = 0.056) or duration of surgery ≥ 3 h (OR, 2.52 [95% CI 1.08–5.87]; P = 0.032). Conclusions: A low preoperative pulse oximetry reading, complex surgical procedures, perioperative surgical events, and postoperative albumin infusion may be risk factors for PPLOS after laparoscopic colorectal cancer resection, whereas distant tumor metastasis and postoperative early ambulation might be protective factors. The association between postoperative albumin infusion, a modifiable factor, and PLOS or clinical outcomes warrants further investigation. [ABSTRACT FROM AUTHOR]

This essay will argue against William Caplin’s concept of cadence and will disprove his allegation about an unquestionable lack of interior cadence in the sentence of Schoenberg. Another subject of criticism will be the assumption expressed by Caplin and other theorists that functional prolongation always negates cadence.

Methadone is a chiral synthetic opioid primarily used to treat heroin and prescription-opioid addiction: the (R)-enantiomer (Levomethadone) activates the µ-opioid receptor more potently than the (S)-enantiomer, which is a more potent blocker of the hERG potassium channels, resulting in QTc prolongation. The purpose of this retrospective study was to assess the effect of methadone on the QTc interval and to investigate the benefits of Levomethadone. The electrocardiograms of 165 patients taking methadone at various dosages and for different periods of time were examined: the QTc value was manually measured and then adjusted using Bazett’s formula. Data analysis revealed a linear association between the dosage of methadone and QTc length; no correlation was found between the QTc value and gender, age, or duration of therapy. In total, 14% of the sample (23 patients) showed a prolongation of the QTc interval (>470 ms in males and >480 ms in females); 10 of the 23 patients with QTc elongation underwent a change of therapy from Methadone to Levomethadone—in 90% of these patients, a normalization in the QTc length was established. This study confirmed the role of methadone, specifically its dosage, in QTc prolongation and the efficiency of Levomethadone as an adequate therapeutic substitute in these circumstances. This study validates the importance of careful electrocardiographic monitoring in methadone-treated patients.

Polymers are currently of interest as drug delivery systems. The use of polymeric forms of medicinal substances will eliminate or reduce the disadvantages of traditional drugs. The purpose of this work was to assess the ability to prolong the action of polyvinyl alcohol in relation to the drug release when going from dilute to more concentrated solutions. It was established that an increase in the viscosity of the polymer in solution caused by an increase in its concentration results not only in a slowdown in the diffusion of drugs from the polymer solution, but also in a significant decrease in the amount of drugs firmly fixed on the polymer matrix. Since it is the adduct of the polyvinyl alcohol-drug interaction that provides the slow release of the drug from the polymer solution, a decrease in its amount leads to the fact that no enhancement of the prolonging action is observed. It is claimed that when moving from solutions to polymer films, the rate of drug release is also determined by the structure of the polymer matrix. The lower the density of the polymer film, the greater the diffusion coefficient of the drug release from the film. Thus, in the course of evaluating the ability to prolong the action of polyvinyl alcohol, it was shown that using some prolongation techniques, it is possible to achieve targeted regulation of the rate of drug release from polymer dosage forms.

Background: The impact of radiotherapy interruption due to the Spring Festival holidays in China on the survival of patients with nasopharyngeal carcinoma (NPC) is unclear.Methods: Nontrial patients with locoregionally advanced NPC receiving radiotherapy plus induction chemotherapy (IC) and/or concurrent chemotherapy (CC) were included (N = 5035) and divided into two groups based on the Spring Festival-induced radiotherapy interruption. Kaplan-Meier curves for overall survival (OS) and failure-free survival (FFS) were compared between rival groups. Impact of the timing of radiotherapy interruption (during or outside the Spring Festival) on survival was investigated in a propensity score-matched dataset. We adopted ordination correspondence analysis to determine the cut-off of radiotherapy prolongation for prognostic prediction, and accordingly performed subgroup analysis based on delayed days and chemotherapy details. Individual patient data of three phase III NPC trials (NCT00677118, NCT01245959, NCT01872962) were used for validation (N = 1465).Results: Radiotherapy interruption was most frequently observed between December to January of the following year. Significantly lower OS and FFS were associated with the Spring Festival-induced interruption of radiotherapy (P = 0.009 and 0.033, respectively), but not that interruption of IC. In two matched comparison groups, the timing of radiotherapy interruption during the Spring Festival was more likely to lead to a decrease in FFS than outside the Spring Festival (P = 0.046), which was not observed in the validation using clinical trial data or in the subgroup analysis based on the 5-day delayed time. The absence of CC and the accumulated dose of cisplatin < 200 mg were related to the negative influences of the Spring Festival-induced radiotherapy interruption on FFS (P = 0.002) and OS (P = 0.010), respectively.Conclusions: The poor survival of patients with NPC is associated with the Spring Festival-induced interruption of radiotherapy. We recommend that these patients receive adequate doses of cisplatin concurrently with radiotherapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the biomarker(s) that could affect the decision for immediate or delayed delivery in severe preeclampsia. Methods Data on serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatinine, blood urea nitrogen (BUN), uric acid (UA) and platelet counts from 134 cases were collected and analysed. Results Higher UA levels were seen in case with immediate delivery. Higher stillbirth was seen in cases with delayed delivery. Conclusion UA levels could be a potential management biomarker for immediate or delayed delivery in severe preeclampsia. However, the higher risk of stillbirth must be considered in delayed delivery.

Background: Immediate delivery is an established concept for preventing life-threatening complications in mothers with HELLP syndrome; however, it is associated with preterm births. Methods: Cases of HELLP syndrome diagnosed at the university hospitals of Halle and Magdeburg (Germany) were analyzed retrospectively. Each patient of the treatment group was administered 64 mg of methylprednisolone (MP) intravenously for 10 days, with the dosage being reduced by 50% every other day in patients from Halle (n = 65). Almost immediate delivery was performed in the control groups (n = 45, Halle; n = 28, Magdeburg). Results: Pregnancies in the treatment group were prolonged by 4 days (median 1–55 days). The platelet counts increased from 76,060 ± 22,900/μL to 117,430 ± 39,065/μL in the MP group compared with an increase from 66,500 ± 25,852/μL to 83,430 ± 34,608/μL in control group 1 and from 78,890 ± 19,100/μL to 131,080 ± 50,900/µL in control group 2 (p < 0.001). Severe neonatal complications were significantly reduced in the treatment group (p < 0.05): sepsis, 9.25% vs. 24%; ventilation, 44.6% vs. 46.5%; and infant death, 1.6% vs. 8.6%. Conclusions: In a selected collective of patients with HELLP syndrome, prolongation of pregnancy using MP treatment improved maternal and neonatal outcomes.

Background: Diabetic ketoacidosis (DKA) is the most common acute hyperglycemic complication of diabetes. According to a recent report DKA affects approximately 8 per 1000 diabetics annually. It is associated with significant morbidity and mortality, with a worldwide mortality rate of 2-10%. Objective: The aim of the work was to assessment of QTc interval prolongation among patients with DKA. Patients and methods: This prospective observational cohort study included 100 patients who were diagnosed with DKA. The mean age of patients was 37.29±11.63 years, and 53% of them were males. All patients were subjected to detailed history taking, full clinical examination, laboratory investigations and 12-lead ECG. Results: Frequency of Prolonged QTmaxc amongst studied patients was 59%. Mean QTmaxc declined significantly after treatment to be 414.6±44.1ms compared to 482.45±63.56ms before treatment with p<0.0001 and Frequency of prolonged QTmaxc was significantly decreased with treatment from 59% to 20%. Anion gap was significantly higher for Prolonged QTmaxc patients compared to normal QTmaxc patients p<0.0001. While ABG (PH, HCO3) were significantly lower for Prolonged QTmaxc patients compared to normal QTmaxc patients p<0.0001. Logistic regression revealed that anion gap was significant independent risk factor for QTmaxc prolongation while. Conclusion: patients with DKA have a potential risk of QTmaxc interval prolongation due to acidosis regardless electrolytes abnormalities, and associated with a relative risk of 1.732-fold for mortality. Carful measuring of anion gap at time of admission can be used in diagnosis and prediction of occurrence of prolonged QTmaxc with high sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background: Several reports linked the use of repurposed drugs such as hydroxychloroquine (HCQ), azithromycin, lopinavir/ritonavir, and favipiravir with QT interval prolongation in patients with SARS-CoV2 infection. Little is known about the risk factors for QT interval prolongation in this population. We sought to describe the prevalence and identify the main risk factors associated with clinically significant corrected QT (QTc) prolongation in this population. Methods: We conducted a retrospective analysis of critically ill patients who were admitted to our intensive care unit (ICU), had at least one electrocardiogram performed during their ICU stay, and tested positive for SARs-CoV-2. Clinically significant QTc interval prolongation was defined as QTc >500 milliseconds (ms). Results: Out of the 111 critically ill patients with SARS-CoV-2 infection, QTc was significantly prolonged in 47 cases (42.3%). Patients with a clinically significant QTc prolongation had significantly higher proportions of history of cardiac diseases/surgery (22 [46.8%] vs. 10 [15.6%], P <.001), hypokalemia (10 [21.3] vs. 5 [7.8%], P =.04), and male gender (95% vs. 82.8%, P =.036) than patients with QTc ≤500 ms, respectively. A total of 46 patients (41.4%) received HCQ, 28 (25.2%) received lopinavir/ritonavir, and 5 (4.5%) received azithromycin. Multivariate logistic regression analysis showed that a history of cardiac disease was the only independent factor associated with clinically significant QTc prolongation (P =.004 for the likelihood-ratio test). Conclusion: The prevalence of clinically significant QTc prolongation in critically ill patients with SARS-CoV-2 infection was high and independent of drugs used. Larger prospective observational studies are warranted to elucidate independent risk factors associated with clinically significant QTc prolongation in this study population. [ABSTRACT FROM AUTHOR]

Given a coalgebra D , a commutative algebra A , a commutative A -algebra B and a measuring ψ : D ⊗ A → B , we define an algebra [ D ] (A , ψ) B that generalizes the symmetric algebra over the module of Kähler differentials Sym B (Ω B / A 1). We show that the spectrum of [ D ] (A , ψ) B is isomorphic to a prolongation space as defined by Moosa and Scanlon, providing a direct construction of the latter. These prolongation spaces generalize those of Gillet, Rosen and Vojta. The universal prolongations of differential and difference kernels can also be recovered from our generalized differentials. When D is moreover a bialgebra, our generalized differentials provide a unified approach to the prolongations of commutative rings, unifying the well-known constructions in the differential and difference case. [ABSTRACT FROM AUTHOR]

Reducing the environmental burden and assessing the safety of plastics are huge global challenges. However, standard test data on the ready biodegradability of plastics are limited. We evaluated the ready biodegradability of 8 biodegradable plastics using Organisation for Economic Co‐operation and Development (OECD) test guideline 301F with nonspecific bacteria and examined the effects of prolonging the test duration to a maximum of 90 d. Cellulose used as a potential reference material for plastics was not comparable to the reference material of OECD test guideline 301, but it may be improved by using a test concentration lower than the typical test concentration (100 mg/L). Of the 8 plastics examined, polyamide 4, poly(3‐hydroxybutyrate‐co‐3‐hydroxyhexanoate), polycaprolactone, and poly(butylene succinate adipate; PBSA) were biodegraded by >60% by day 28 and considered to show ready biodegradability. Poly(3‐hydroxybutyrate; PHB), poly(3‐hydroxybutyric acid‐co‐3‐hydroxyvaleric acid; PHBV), and poly(butylene succinate; PBS) were biodegraded but did not fulfill the ready biodegradability criteria. Because the typical test concentration is considered to have negative effects on biodegradation and calculation of biodegradation percentage, using a lower concentration may result in PHB, PHBV, and PBS fulfilling the ready biodegradability criteria. Poly(d,l‐lactide; PLA) was not biodegraded. The biodegradation of PBS and PBSA was noted to vary depending on the used inoculum and/or particle size. For the 7 plastics except PLA, the percentage biodegradation on day 60 was larger than that on day 28, indicating that a longer test period could be useful for evaluating the environmental persistence of plastics. In tests in which the plastics were not biodegraded by day 60, no marked biodegradation was observed by day 90. Environ Toxicol Chem 2021;40:2443–2449. © 2021 SETAC [ABSTRACT FROM AUTHOR]

Based on the group analysis of differential equations, we consider the symmetry properties of equations with fractal derivatives defined within the framework of Fα-calculus. Analogs of the prolongation of transformations of independent and dependent variables are discussed. The infinitesimal invariance of equations with fractal derivatives is studied on an example of the Lie symmetries of the one-dimensional diffusion equation with a fractal time derivative. [ABSTRACT FROM AUTHOR]

The year 2015 was exceptional in terms of arrival of refugees both in Austria and Germany. About 600,000 persons crossed Austria on their way to Germany and other EU-destinations, about 90,000 filed an application for international protection in Austria and more than 476,000 asylum applications were made in Germany. In both countries, the regular accommodation system could not handle the high numbers of refugees and emergency camps were hastily put up, often aligned with an outstanding engagement of the civil society. Since then, most emergency shelters have been closed down and the public mentality has turned from enthusiasm to skepticism. Many refugees have also made sobering experiences as they found themselves 'stuck in reception': While both Austria and Germany aim at quick decisions and seek to keep the liminal period of reception as short as possible, in practice administrative and legal procedures often take more time. Against this backdrop, the article analyses the experiences of refugees whose asylum application has been pending for more than six months or who found themselves in a prolonged state of reception as they cannot return to their countries of origin. Departing from a comparative overview of the politics of dispersal as well as the multilevel systems of reception in Austria and Germany, the article sets out to examine how refugees deal with their long-term reception constellation and the lack of capabilities that it entails. [ABSTRACT FROM AUTHOR]

The problematic in tonality and tonal composition are not tied to harmony or counterpoint, but are the result of their combination. In the more elaborate compositions, harmony and counterpoint have very well defined functions, thus resulting a set of clear basic principles in composition development. One of these principles consists in the idea that, harmonic progressions are the structure of the composition and the contrapuntal progressions and chords are the ones that enrich and create the flow of it. [ABSTRACT FROM AUTHOR]

This paper studies the concept of prolongational controllability for control affine system with piecewise constant controls. The purpose is to show the relationship between the controllability by prolongations and the notion of weak uniform attraction, presenting criteria for controllability and controllability by prolongations. The central result assures that a control affine system is controllable by prolongations if and only if each state point is a global weak uniform attractor. For systems with nonextensive semi-orbits, the controllability by prolongations coincides with the usual one; in this case, the system is controllable if and only if each state point is a weak attractor. In particular, for invariant control affine system on Lie group, a necessary and sufficient condition for the system to be controllable is the identity of the group to be a weak attractor. [ABSTRACT FROM AUTHOR]

The efficacy and the effectiveness of anxiety disorder treatments have been proven. However, the desired results are not always achieved. Studying the factors that interfere with the natural course of the treatments could help to correct and to adapt them. Two of these factors are the unnecessary prolongation of treatments and their premature termination. As expected, the duration of the treatment depends on the nature of the problem and the existence of comorbid problems, however treatments that are too ambitious (an excess of techniques) or combined with pharmacological treatments (increasing sessions by up to 21%) also have a longer duration. Premature termination is around 30-35% and patients “announce” the dropout by displaying poorer task performance and more irregular attendance from the beginning. More than 50% of the therapeutic dropout occurs before the eighth session and 80% of successful treatments are completed before the 20th session

Zoë Zuilhof, Sandhaya Norris, Claude Blondeau, Pierre Tessier, Pierre Blier Department of Psychiatry, University of Ottawa, The Royal Ottawa Institute of Mental Health Research, Ottawa, ON, Canada Introduction: This study investigated if optimized dose regimens of escitalopram and bupropion combination from treatment initiation can be superior to either drug alone in speed of onset, remission rate, and maintenance of therapeutic efficacy.Methods: Patients from a single site (N=85) within a larger double-blind 12-week trial (N=245) showed a lower dropout rate (14% vs 40%) and used higher doses; therefore, this cohort was analyzed separately. Uniquely at this single site, after 12 weeks, non-remitters on a single drug received the other one in addition and combination non-remitters underwent a switch of escitalopram for duloxetine for a 6-week period. Escitalopram could be given up to 40 mg/day and bupropion up to 450 mg/day. A 6-month prolongation was then implemented in remitters, maintaining the double-blind design throughout. Remission was defined as ≤7 on the 17-item Hamilton Rating Scale for Depression, as in the initial publication.Results: At week 2, combination treatment was superior in remission rate (5/28) compared with both bupropion (0/26) and escitalopram monotherapies (0/31; P=0.03 and P=0.02, respectively). The week 12 remission rate of combination treatment showed a higher rate (15/28) relative to bupropion monotherapy (7/26; P=0.04), but not statistically different from escitalopram monotherapy (11/31; P=0.13). The 6-week augmentation produced remission in 7/21 monotherapy non-remitters and 0/6 in the switch group (P=0.13). Remission was sustained in 28/31 patients enrolled in the 6-month maintenance.Conclusion: These results suggest that combination of escitalopram and bupropion from treatment initiation is superior to either monotherapy in speed of onset. The addition of a second drug in non-remitters can lead to additional remissions, as shown with other combinations of medications. Treatment prolongation using optimized regimens leads to low relapse rates. Keywords: antidepressant, escitalopram, bupropion, action onset, augmentation, prolongation

The paper introduces Laplace-type operators for functions defined on the tangent space of a Finsler Lie algebroid, using a volume form on the prolongation of the algebroid. It also presents the construction of a horizontal Laplace operator for forms defined on the prolongation of the algebroid. All the Laplace operators considered in the paper are also locally expressed using the Chern-Finsler connection of the algebroid.

This essay will argue against William Caplin’s concept of cadence and will disprove his allegation about an unquestionable lack of interior cadence in the sentence of Schoenberg. Another subject of criticism will be the assumption expressed by Caplin and other theorists that functional prolongation always negates cadence. [ABSTRACT FROM AUTHOR]

Objective: To investigate the biomarker(s) that could affect the decision for immediate or delayed delivery in severe preeclampsia.Methods: Data on serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatinine, blood urea nitrogen (BUN), uric acid (UA) and platelet counts from 134 cases were collected and analysed.Results: Higher UA levels were seen in case with immediate delivery. Higher stillbirth was seen in cases with delayed delivery.Conclusion: UA levels could be a potential management biomarker for immediate or delayed delivery in severe preeclampsia. However, the higher risk of stillbirth must be considered in delayed delivery. [ABSTRACT FROM AUTHOR]

The Mal'tsev product of two varieties of similar algebras is always a quasivariety. We consider the question of when this quasivariety is a variety. The main result asserts that if V is a strongly irregular variety with no nullary operations and at least one non-unary operation, and S is the variety, of the same type as V , equivalent to the variety of semilattices, then the Mal'tsev product V ∘ S is a variety. It consists precisely of semilattice sums of algebras in V . We derive an equational base for the product from an equational base for V . However, if V is a regular variety, then the Mal'tsev product may not be a variety. We discuss various applications of the main result, and examine some detailed representations of algebras in V ∘ S . [ABSTRACT FROM AUTHOR]

The principles of prolongation and linear progression give us a comprehension of music from a broader perspective, of general architecture, as an organic scheme of the whole. Such an understanding of music helps us to avoid, in interpretation, considering each note as having the same degree of importance in a musical phrase. Also, a proper division of the musical works into fragments according to prolongations and harmonic progressions is a genuine help in the process of obtaining fluency and correct phrasing. The analysis is necessary because only in this way can the musical ideas be understood and performed. [ABSTRACT FROM AUTHOR]

Classical music is governed by rules that manage the relation between notes and the dynamic element that states its tempo and rhythm. Musical analysis represents the process of understanding the composer's aims when creating a work and can be used as an intermediary depiction of it for purposes like expressive performance or music comparison. Melody is one of the most elementary features of music, consisting in a series of notes stringed together. The melodic line of a musical work is a sequence of sounds that structure a melody. Melodic analysis regards the stylistic features of a musical phrase. [ABSTRACT FROM AUTHOR]

Background: Cirrhotic cardiomyopathy is chronic cardiac dysfunction in cirrhotic patients with no previous structural heart disease. QT prolongation is one of the most important cardiac alterations related to cirrhosis. Objective: This study was aimed to evaluate QT interval duration among compensated and decompensated chronic Hepatitis C (Ch HCV) cirrhotic patients and to detect its relation to biochemical changes in cirrhosis and its effect on patients' outcome. Patients and Methods: A cross sectional study was conducted on 52 Ch HCV patients divided into two groups according to presence of signs of decompensation. Patients underwent clinical, laboratory and electrocardiographic evaluation. Cirrhosis severity was classified according to the Child-Pugh score. The QT interval in lead II (QTII), maximum QT (QTmax), heart rate corrected QTmax (msillisecond) obtained manually using by a 12-lead electrocardiogram. Results: Decompensated patients had non-significantly lower values of QTII and QT max. There was significant difference between both groups regarding QT maxc. 80.8% versus 38.5% of decompensated and compensated patients had prolonged QTC. There was significant relation between child class and QT parameters. There was significant relation between QT maxc prolongation and serum Albumin, sodium, ammonia, Urea, AFP and APACHE-II. There was significant relation between outcome and both QT max and QT maxc. Cutoff of QT max n predicting mortality was≥435 with sensitivity 80% and specificity 69%. QT maxc cutoff ≥508 predicted mortality with sensitivity 80% and specificity 84%. Conclusion: A prolonged QT maxc was prevalent among cirrhotic patients and this positively correlated with disease severity and high mortality. [ABSTRACT FROM AUTHOR]

I give a short review of the theory of twisted symmetries of differential equations, emphasizing geometrical aspects. Some open problems are also mentioned. [ABSTRACT FROM AUTHOR]

Hearing and representing melodic and harmonic elaboration lies at the heart of tonal analysis. We sometimes disagree about what exactly is ornamental or how tones are prolonged, but our widespread collective understanding of passing tones, neighbor tones, suspensions, and the like underscores the important notion that some notes are more structurally important than others. This article proposes ways to read ornamentation in atonal music, recasting ornamental categories gesturally and pragmatically instead of (or in addition to) tonally and metrically. [ABSTRACT FROM AUTHOR]

Background: Atrial electromechanical delay (AEMD) is the time interval between the beginning of P wave on surface electrocardiography and starting of the late diastolic wave on tissue Doppler imaging. We investigated the prolongation of AEMD, echocardiographic changes, and correlation of these findings with neutrophil-to-lymphocyte ratio (NLR) in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods: The study consisted of 105 (49 females and 56 males; mean age: 65.1 ± 9) patients with COPD exacerbation and 104 (21 females and 83 males; mean age: 64.8 ± 9.6) stable COPD outpatients. Demographics, body mass index, pulmonary function tests, and transthoracic echocardiography of the patients were evaluated. Echocardiography was performed in the first 6 h for stable COPD outpatients and in the first 24 h for COPD exacerbation patients. Diameters of right ventricle (RV), left ventricle (LV) and left atrium, aortic root diameters, left ventricular ejection fraction (LVEF), Emax, Amax, Emax/Amax, tricuspid annular plane systolic excursion (TAPSE), Ea, Aa, Ea/Aa, Emax/Ea, and tricuspid regurgitation velocity (TRV) were evaluated. AEMD measurements were obtained from lateral/tricuspid, lateral/mitral, and septal annulus from apical four-chamber views with tissue Doppler imaging and corrected for heart rate. Complete blood count including NLR was also assessed. Results: The mean age of patients in exacerbation period (65.1 ± 9) was higher than the stable group (64.8 ± 9.6). RV basal and mid diameters (P < 0.001), Amax (P < 0.001), Ea tricuspid (P = 0.040), Aa tricuspid (P < 0.001), TRV, and systolic pulmonary artery pressure (P < 0.001) were higher; TAPSE and tricuspid Emax/Amax (P < 0.001) were significantly lower in patients with COPD exacerbation. LV end-diastolic diameter (P = 0.002) and LVEF (P = 0.005), Emax/Amax mitral (P < 0.001), Ea/Aa mitral (P < 0.001), and Ea/Aa septal (P < 0.001) were significantly lower; Amax mitral (P = 0.002), Aa mitral (P < 0.001), Aa septal (P < 0.001), and systolic motion mitral (P = 0.011) were significantly higher in patients with exacerbation. AEMD lateral/tricuspid (P < 0.001), lateral/mitral (P < 0.001), and septal (P < 0.001) were significantly higher in patients with COPD exacerbation. Neutrophil and lymphocyte count (P < 0.001) and NLR (P = 0.003) were significantly higher in the acute group. A weak correlation of NLR with LV end-diastolic diameter (P = 0.003; r = 0.357), Emax/Ea mitral (P = 0.019; r = 0.285), Emax tricuspid (P = 0.045; r = −0.244), and systolic motion septal (P = 0.003; r = 0.352) was detected in patients with stable COPD. Conclusion: In COPD exacerbation patients, prolongation of AEMD intervals was determined. Acute period of COPD may trigger atrial dysrhythmias including atrial fibrillation and flutter, multifocal atrial tachycardia, premature beats, and both systolic and diastolic dysfunctions frequently.