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Pathophysiology of Advanced Heart Failure
پاتوفیزیولوژی نارسایی پیشرفته قلب-2021 The pathophysiologyof advanced heart failure (HF) can be characterized asa complex interplay ofdysregulated mechanisms comprising impaired hemodynamics, neurohormonal and proinflammatory
activation, dysfunctional cardiorespiratory reflex control, and inadequate energy handling, all of which
ultimately lead to multiorgan dysfunction; at the later stage of HF, numerous comorbidities, whose underlying pathophysiologiesoftenamplifyHFprogression,tendtodominatetheclinicalpicture and therapeutic approach, and some of these mechanisms have been identified as therapeutic targets in HF.
Blockade of the renin-angiotensin-aldosterone system (preferably with an angiotensin receptorneprilysin inhibitor, but alternatively with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers together with mineralocorticoid receptor antagonist) and sympathetic nervous system (with b-blockers) is now considered a fundamental element of pharmacologic therapy for all patients with advanced HF and reduced ejection fraction. Autonomic modulation (vagal nerve stimulation or baroreflex stimulation) in advanced HF tends to benefit functional variables (qualityof life,NewYork HeartAssociation class, 6-minutewalking distance), whereas improvement in the outcomes (total mortality, HF hospitalizations) still remains uncertain. Fluid overload with central and/or peripheral congestion characterize the clinical picture of advanced HF and is the main reason for hospital admission in these patients; distinction of different clinical patterns of congestion with different underlying mechanisms may improve the management of fluid overload in advanced HF. Recent clinicaltrials have shown that the following novel therapiestargeting impairedpathophysiologic pathways in advanced HF seem to improve patients’ outcomes: (1) vericiguat, a soluble guanylate cyclase stimulator; (2) omecamtiv mecarbil, a selective cardiac myosin activator; (3) sodium-glucose cotransporter 2 inhibitors; (4) ferric carboxymaltose, for patients with concomitant iron deficiency. Better understanding of the pathophysiology underlying HF progression may allow characterization of novel mechanisms that can be targeted in order to revert to a natural pathway of HF development and progression. |
مقاله انگلیسی |
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Empathy in phenomenological research: Employing Edith Steins account of empathy as a practical and ethical guide
همدلی در تحقیقات پدیدارشناسی: استفاده از گزارش ادیت استاین از همدلی به عنوان راهنمای عملی و اخلاقی-2021 An ‘affective turn’ has come about in philosophy of mind debates and the notion of empathy is increasingly
influential. This could usefully extend into psychological research, particularly in counselling and psychother-
apy. Edith Stein’s account of empathy bridges gaps between individual psychological experience, embodied
interpersonal emotionality, and our collective social moral order. Her philosophy provides ethical and practical
guidance for researchers who seek to understand the meaning of what their participants experience in the flow of
intersubjectivity and situated living. Researchers can thereby avoid positioning them as ‘different,’ ‘deviant,’ or
‘dysfunctional.’ Methodologies are recommended, based on Stein’s account. keywords: یکدلی | ادیت استین | پدیده شناسی | Empathy | Edith stein | Phenomenology |
مقاله انگلیسی |
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Brain activity during walking in older adults: Implications for compensatory versus dysfunctional accounts
فعالیت مغز در طول پیاده روی در بزرگسالان سالمند: پیامدهای جبران خسارت در برابر حسابهای ناکارآمد-2021 A prominent trend in the functional brain imaging literature is that older adults exhibit increased brain
activity compared to young adults to perform a given task. This phenomenon has been extensively stud-
ied for cognitive tasks, with the field converging on interpretations described in two alternative accounts.
One account interprets over-activation in older adults as reflecting neural dysfunction (increased brain
activity – indicates poorer performance), whereas another interprets it as neural compensation (in-
creased brain activity - supports better performance). Here we review studies that have recorded brain
activity and walking measurements in older adults, and we categorize their findings as reflecting either
neural dysfunction or neural compensation. Based on this synthesis, we recommend including multiple
task difficulty levels in future work to help differentiate if and when compensation fails as the locomo-
tion task becomes more difficult. Using multiple task difficulty levels with neuroimaging will lead to a
more advanced understanding of how age-related changes in locomotor brain activity fit with existing
accounts of brain aging and support the development of targeted neural rehabilitation techniques. keywords: فعالیت مغز | پیاده روی | سالخورده | جبران خسارت | اختلال عملکرد | کنترل عصبی | Brain activity | Walking | Aging | Compensation | Dysfunction | Neural control |
مقاله انگلیسی |
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The role of nature of knowledge and knowledge creating processes in knowledge hiding: Reframing knowledge hiding
نقش ماهیت دانش و دانش ایجاد فرآیندهای در مخفی کردن دانش: بازسازی دانش پنهان کردن دانش-2021 Knowledge hiding research has traditionally focused on the ways in which knowledge is hidden in the context of
interactions between employees. This study advances knowledge hiding research by highlighting the benefits of
moving away from the dyadic level of analysis to a multilevel analysis across individuals, groups, and organi-
zations. We also elaborate how knowledge hiding is influenced both by the nature of knowledge and by the
modes of knowledge creation in organizations. We propose a theoretical framework that juxtaposes the nature of
knowledge – tacit vs. explicit and component vs. architectural – against the four modes – socialization, exter-
nalization, combination, and internalization – of the knowledge creating process in organizations. The frame-
work developed in our study also enables us to identify four distinct root causes of knowledge hiding in
organizations – functional bias, misaligned incentives, dysfunctional resource allocations, and value
incongruence. keywords: پنهان کردن دانش | یادگیری سازمانی | مدیریت دانش | Knowledge hiding | Organizational learning | Knowledge management |
مقاله انگلیسی |
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Concurrent validity of a custom computer vision algorithm for measuring lumbar spine motion from RGB-D camera depth data
اعتبار همزمان یک الگوریتم بینایی ماشین سفارشی برای اندازه گیری حرکت ستون فقرات کمری از داده های عمق دوربین RGB-D-2021 Using RGB-D cameras as an alternative motion capture device can be advantageous for biomechanical spine motion assessments of movement quality and dysfunction due to their lower cost and complexity. In this study, we evaluated RGB-D camera performance relative to gold-standard optoelectronic motion capture equipment. Twelve healthy young adults (6M, 6F) were recruited to perform repetitive spine flexion-extension, while wearing infrared reflective marker clusters placed over their T10-T12 spinous processes and sacrum, and motion capture data were recorded simultaneously by both systems. Custom computer vision algorithms were developed to extract spine angles from depth data. Root mean square error (RMSE) was calculated for continuous Euler angles, and intra class correlation coefficients (ICC2,1) were calculated between minimum and maximum angles and range of motion in all movement planes. RMSE was low (RMSE ≤ 2.05◦ ) and reliability was good to excellent(0.849 ≤ ICC2,1 ≤ 0.979) across all movement planes. In conclusion, the proposed algorithm for tracking 3Dlumbar spine motion during a sagittal movement task from one RGB-D camera is reliable in comparison to gold- standard motion tracking equipment. Future research will investigate accuracy and validity in a wider variety of movements, and will also investigate the development of novel methods to measure spine motion without using infrared reflective markers. Keywords: RGB-D cameras | Computer vision | Depth camera | Low back pain | Movement quality |
مقاله انگلیسی |
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Implementation of a standardized voiding management protocol to reduce unnecessary re-catheterization - A quality improvement project
اجرای یک پروتکل استاندارد مدیریت تخلیه برای کاهش دوباره کاتتریزاسیون غیر ضروری - یک پروژه بهبود کیفیت-2020 Objective. To design and implement a standardized postoperative voiding management protocol that accurately
identifies patients with urinary retention and reduces unnecessary re-catheterization.
Methods. A postoperative voiding management protocol was designed and implemented in patients undergoing
major, inpatient, non-radical abdominal surgery with a gynecologic oncologist. No patients had epidural
catheters. The implemented quality improvement (QI) protocol included: 1) Foley removal at six hours postoperatively;
2) universal bladder scan after the first void; and 3) limiting re-catheterization to patientswith bladder
scan volumes N150 ml. A total of 96 patients post-protocol implementation were compared to 52 patients preprotocol.
Along with baseline demographic data and timing of catheter removal,we recorded the presence or absence
of urinary retention and/or unnecessary re-catheterization and postoperative urinary tract infection rates.
Fishers exact test and students t-tests were performed for comparisons.
Results. The overall rate of postoperative urinary retention was 21.6% (32/148). The new voiding management
protocol reduced the rate of unnecessary re-catheterization by 90% (13.5% vs 2.1%, p = 0.01), without
overlooking true urinary retention (23.1% vs 20.8%, p = 0.83). Additionally, there was a significant increase in
hospital-defined early discharge prior to 11:00 AM (4.0% vs 22.0%, p = 0.022). There was no difference in the
postoperative urinary tract infection rate between the groups (p=1.00). Risk factors associatedwith urinary retention
included older age (p b 0.01), use of medications with anticholinergic properties (p b 0.01), and
preexisting urinary dysfunction (p b 0.01).
Conclusions. Implementation of this new voiding management protocol reduced unnecessary recatheterization,
captured and treated true urinary retention, and facilitated early hospital discharge Keywords: Quality improvement | Bladder voiding | Urinary retention | Postoperative management | Gynecologic Oncology surgery | Urinary tract infection |
مقاله انگلیسی |
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Paradigm shift to implement SDG 2 (end hunger): A humanistic management lens on the education of future leaders
تغییر پارادایم برای اجرای SDG 2 (پایان گرسنگی): یک لنز مدیریت انسانی در آموزش رهبران آینده-2020 This article argues that new paradigms of leadership, as well as leadership education, are required to more effectively work towards the implementation of SDG 2 – end hunger. It draws on the philosophically rooted concept of Humanistic Management as a lens to examine the relationship between SDG 2, the human right to food and reasons for the persistence of hunger in the world. The status quo and current approaches are presented in detail as dysfunctional, with an emphasis on the role of the WTO regulations, intellectual property rights schemes and negotiation processes. It is suggested that in order to develop future leaders who tackle global issues like this persistence of hunger in more promising and more responsible ways, business schools need to look beyond responsible management education. In this vein, Humanistic Management is also discussed as a platform for the advocated paradigm shift. It is highlighted through which stages business schools could transform their educational approach and provision accordingly. |
مقاله انگلیسی |
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اجرای یک پروتکل استاندارد مدیریت خالی سازی جهت کاهش میله گذاری دوباره غیرضروری – یک پروژه بهبود کیفیت
سال انتشار: 2020 - تعداد صفحات فایل pdf انگلیسی: 7 - تعداد صفحات فایل doc فارسی: 19 هدف: طراحی و اجرای یک پروتکل استاندارد مدیریت پساعملی خالی سازی که بیمارانی با نگه داشتن ادرار را به صورت دقیق شناسایی می کند و میله گذاری ضروری دوباره را کاهش می دهد.
روشها: یک پروتکل پساعملی مدیریت خالی سازی در بیمارانی که عمل جراحی شدید، بستری شدن و وریدهای شکمی غیر ریشه ای را تحمل می کنند با یک تومورشناس زنان طراحی و اجرا شد. هیچ بیماری میله اپیدورالی نداشت. پروتکل بهبود کیفیت اجرا شده شامل موارد زیر بود: 1) حذف صدا در شش ساعت به صورت پساعملی؛ 2) اسکن عمومی مثانه پس از اولین خالی سازی؛ و 3) کاهش میله گذاری دوباره برای بیمارانی با حجم اسکن مثانه ای بیشتر از 150 میلی لیتر. درکل اجرای پساپروتکل 96 بیمار با پیش- پروتکل 52 بیمار مقایسه شد. درکنار داده های جمعیتی مبنا و زمان سنجی حذف میله گذاری، ما حضور یا عدم حضور نگه داشتن ادرار یا میله گذاری دوباره غیرضروری و نرخ عفونت پساعملیاتی دسته تارهای ادراری را ثبت کردیم. آزمایش واقعی فیشر و آزمایش های t دانشجویی برای مقایسه ها انجام شد.
نتایج: نرخ کلی نگه داشتن ادرار پس از عمل جراحی برابر با 6/21% (148/32) بود. پروتکل جدید مدیریت خالی سازی، نرخ میله گذاری دوباره غیرضروری را تا 90 درصد (5/13 درصد دربرابر ½ درصد، 01/0 = p)، بدون چشم پوشی از نگه داشتن واقعی ادرار (1/23% دربرابر 8/20%، 83/0 = p) کاهش داد. به علاوه، افزایش قابل توجهی در ترخیص زودتر از زمان تعریف شده توسط بیمارستان قبل از ساعت 11 قبل از ظهر وجود داشت (40% دربرابر 22%، 022/0 = p). هیچ تفاوتی در نرخ عفونت تارهای ادراری پسا از عمل بین گروهها وجود نداشت (1 = p). عوامل خطر درکنار نگه داشتن ادرار شامل سن بالا (01/0>p)، استفاده از داروهایی با ویژگی های استیل کولین (01/0>p) و عملکرد غیرمعمول ادرارِ ازقبل موجود می شود.
نتیجه گیری ها: اجرای این پروتکل مدیریتی جدید خالی سازی، میله گذاری دوباره غیرضروری را کاهش داد، نگه داشتن ادرار واقعی را به دست داد و ترخیص بیمارستانی پیشین را تسهیل کرد.
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مقاله ترجمه شده |
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Proteome Homeostasis Dysfunction: A Unifying Principle in ALS Pathogenesis
اختلال عملکرد هموستاز پروتئین: یک اصل واحد در پاتوژنز ALS-2020 Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease
but currently has no effective treatment. Growing evidence suggests that proteome
homeostasis underlies ALS pathogenesis. Protein production, trafficking,
and degradation all shape the proteome. We present a hypothesis that proposes
all genetic lesions associated with ALS (including in mRNA-binding proteins)
cause widespread imbalance to an already metastable proteome. The impact
of such dysfunction is felt across the entire proteome and is not restricted to a
small subset of proteins. Proteome imbalance may cause functional defects,
such as excitability alterations, and eventually cell death. While this idea is a unifying
principle for all of ALS, we propose that stratification will appear that might
dictate the efficacy of therapeutics based on the proteostasis network. |
مقاله انگلیسی |
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The Evolution-Driven Signature of Parkinson’s Disease
امضای محور تکامل بیماری پارکینسون-2020 In this review,we approach Parkinson’s disease (PD) in the context of an evolutionary
mismatch of central nervous system functions. The neurons at risk have hyperbranched
axons, extensive transmitter release sites, display spontaneous spiking,
and elevated mitochondrial stress. They function in networks largely unchanged
throughout vertebrate evolution, but now connecting to the expanded human cortex.
Their breakdown is favoured by longevity. At the cellular level, mitochondrial dysfunction
starts at the synapses, then involves axons and cell bodies. At the behavioural
level, network dysfunctions provoke the core motor syndrome of parkinsonism
including freezing and failed gait automatization, and non-motor deficits including
inactive blindsight and autonomic dysregulation. The proposed evolutionary reinterpretation
of PD-prone cellular phenotypes and of prototypical clinical symptoms
allows a new conceptual framework for future research |
مقاله انگلیسی |