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7 mins ago


The study of brain connectomics has led to a rapid evolution in the understanding of human brain function. Traditional localizationist theories are being replaced by more accurate network, or hodologic, approaches that model brain function as widespread processes dependent on cortical and subcortical structures, as well as the white matter tracts (WMTs) that link these areas. Recent surgical literature suggests that WMTs may be more critical to preserve than cortical structures because of the comparably lower capacity of recovery of the former when damaged. Given the relevance of eloquent WMTs to neurologic function and thus quality of life, neurosurgical interventions must be tailored to maximize their preservation. Direct electric stimulation remains a vital tool for identification and avoidance of these critical tracts. Neurosurgeons therefore require proper understanding of the anatomy and function of WMTs, as well as the reported contemporary tasks used during intraoperative stimulation. We review the relevant tracts involved in language, visuospatial, and motor networks and the updated direct electric stimulation-based mapping tasks that aid in their preservation. The dominant-hemisphere language WMTs have been mapped using picture naming, semantic association, word repetition, reading, and writing tasks. For monitoring of vision and spatial functions, the modified picture naming and line bisection tasks, as well as the recording of visual evoked potentials, have been used. Repetitive movements and monitoring of motor evoked potentials and involuntary movements have been applied for preservation of the motor networks.
Recognition of congenital tethered cervical cord in adults and literature review.

Retrospective review of adult onset tethered cervical cord patients (age >20 years).

Three adults were identified; 2 women and 1 man, average age 47 years. The presenting symptoms were neck pain with restricted movement (3), quadriparesis (2), and sensory changes (2). Hyperreflexia was present in all three. Bony abnormalities were mainly bifid cervical spinous processes (3), with Klippel-Feil abnormalities in 1. The neurocutaneous stigmata was seen in 2. Magnetic resonance imaging revealed "limited dorsal myeloschisis" in all 3 patients. The dorsal aspect of the cervical cord extruded into the tract leading to the surface.

Neurocutaneous stigmata should not be considered benign. A missed clinical diagnosis was apparent in all 3 patients; 2 of whom underwent surgery with excellent results. Magnetic resonance imaging can identify the abnormal cervical cord protruding towards the "sinus tract" and allow planning to avert injury to the spinal cord during release.
Neurocutaneous stigmata should not be considered benign. A missed clinical diagnosis was apparent in all 3 patients; 2 of whom underwent surgery with excellent results. https://www.selleckchem.com/products/PF-2341066.html Magnetic resonance imaging can identify the abnormal cervical cord protruding towards the "sinus tract" and allow planning to avert injury to the spinal cord during release.The COVID-19 outbreak has led to fundamental disruptions of health care and its delivery with sweeping implications for patients and physicians of all specialties, including neurosurgery. In an effort to conserve hospital resources, neurosurgical procedures were classified into tiers to determine which procedures have to be performed in a timely fashion and which ones can be temporarily suspended to aid in the hospital's reallocation of resources when equipment is scarce. These guidelines were created quickly based on little existing evidence, and thus were initially variable and required refinement. As the early wave can now be assessed in retrospect, the authors describe the lessons learned and the protocols established based on published global evidence to continue to practice neurosurgery sensibly and minimize disruptions. These operational protocols can be applied in a surge of COVID-19 or another airborne pandemic.
Persons with Down syndrome (DS) require preventive care that addresses their age-/gender- and syndrome-specific needs. Yet, adolescents and adults with DS do not receive these preventive care services as recommended.

To identify factors that predict receipt of age-/gender- and syndrome-specific preventive healthcare among adolescents and adults with DS. We hypothesized that more healthcare encounters and greater medical complexity would increase receipt of preventive care due to more opportunities to complete these activities.

Using Medicaid claims (2006-2010) for California, Colorado, Michigan, and Pennsylvania, we conducted a retrospective cohort study of adolescents and adults with DS (≥12 years old). We modeled receipt of both ≥1 wellness examination and ≥1 thyroid function test (TFT) in 2009-2010 as a function of receipt of those same healthcare activities in 2006-08, adjusting for demographics, key comorbidities, and medical complexity using multivariable logistic regression.

In this cohort of 3487 adolescents and adults with DS accessing Medicaid, 17% received both ≥1 wellness examination and ≥1 TFT in 2006-2008, 15% in 2009-2010, and only 7% during both time periods. Despite medical complexity and frequent healthcare interactions, the best predictor of future receipt of these activities was past receipt. State of residence variably impacted receipt of these preventive activities.

Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.
Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.
To investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles.

Cross-sectional study.

This study included 146 participants 47 younger adults (23 men and 24 women; age range 23-44years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86years).

Age (<65years or ≥65years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables.

Older men had a significant positive correlation between tongue pressure and CSA (r=0.

14 mins ago


06-31.26µm (Mean=30.16µm) and 9.42-10.22µm (Mean=9.82), respectively. There was significant difference (P <0.001) between the two groups. https://www.selleckchem.com/products/pbit.html As compared to control groups, both exposure groups have high levels of Superoxide Dismutase and Malondialdehyde and low levels of Glutathione. The finding was statistically significant (P <0.001).

Increased inhalational exposure to air pollutants via working in traffic or coal mines can impose higher oxidative stress and DNA damage among workers as compared to the general population.
Increased inhalational exposure to air pollutants via working in traffic or coal mines can impose higher oxidative stress and DNA damage among workers as compared to the general population.
To determine the association of Upper extremity musculoskeletal disorders and Exposure to Ergonomic risk factors among handicraft workers.

This cross-sectional survey was conducted in a 12 weeks' duration i.e. from November 2018 till January 2019. Nordic musculoskeletal questionnaire was used to determine the frequency of upper limb musculoskeletal disorders. Postural analysis was done using Rapid Upper Limb Assessment (RULA). Data was collected from 100 Handicraft workers and the type of work included Art work (n=18), Ada Work (n=7), botanical arrangement (n=11), Textile, fashion designing and stitching (n=38), Fine arts (n=20), embroidery and knitting (n=6).

The frequency distribution of Rapid upper limb assessment (RULA) score for exposure to risk factors showed that 47 participants were at a high risk and required implementation of change. Most of the participants (n=35) reported pain in neck and shoulder (n=29). The chi square test for association between pain in upper extremity and exposure to risk factors showed that only wrist pain had statistically significant association with overall RULA score (p-value<0.05).

The study concluded that neck and shoulder are more frequently affected among handicraft workers. The frequency of workers who were at high ergonomic risk and required implementation of change in working conditions was high.
The study concluded that neck and shoulder are more frequently affected among handicraft workers. The frequency of workers who were at high ergonomic risk and required implementation of change in working conditions was high.
To find out inter-professional collaboration among speech-language pathologists and nurses in acute care in Pakistan.

This was a cross sectional study which was conducted in all government and private hospitals of Islamabad and Rawalpindi having facility of ICUs after taking consent from authorities. The duration of study was six months from October 2018 to February 2019. A total number of 350 participants (200 nurses, 150 speech language pathologists) working in ICU of different private and government hospitals of Pakistan were included in the study. Standardized questionnaire of " assessment of inter-professioal collaboration scale" (AITCS) was circulated to nurses and speech language pathologists (SLPS) working in ICU with its subscale's partnership, coordination, cooperation and shared decision making on a 5-point likert scale. Data was analyzed using SPSS version 21.Measure of mean was obtained by independent sample t-test. P- Value less than 0.05 was considered as significant.

Statistical analysis There is no significant difference in cooperation.
To compare the efficacy and safety of midazolam-ketamine combination versus fentanyl-propofol combination in pediatric diagnostic colonoscopy.

This is a retrospective study of 68 children undergoing diagnostic gastroenterology with midazolam-ketamine combination (Group-K) or with fentanyl-propofol combination (Group-P) in the pediatric gastroentology department at a Turkish tertiary hospital between January 2015 and June 2017. An intravenous midazolam was administered one minute before ketamine administration in Group K. Intravenous fentanyl was given to Group P, followed by intravenous propofol.

There were statistically no significant differences between the groups as for age, gender, weight, duration of colonoscopy and complications observed during procedure. Ramsay sedation score was significantly higher in Group K. Recovery time and the rate of complications during the recovery of Group-K (23 patients, 65.7%) was significantly higher than that of Group P (8 patients, 24.2%) (p= 0.001).

Colonoscopy procedures can be quite comfortable in children when using the midazolam-ketamine combination. However, adverse effects related to ketamine were observed during recovery.
Colonoscopy procedures can be quite comfortable in children when using the midazolam-ketamine combination. However, adverse effects related to ketamine were observed during recovery.
Subjective memory complaints (SMCs) are suggested to predict dementia at a very early stage. However, association of SMCs with known risk factors of dementia namely diabetes mellitus Type-2 diabetes and hypertension (HTN) remain unexplored which is the main aim of this study. The objective of the study was to investigate the association of SMC with diabetes mellitus type 2 (DM2) and hypertension (HTN).

The associations of diabetes and hypertension, with SMCs has been tested in 500 participants from a tertiary care hospital of Karachi during 2017. Diagnosed cases of diabetes and hypertension were included through convenient sampling. Healthy attendants of patients were interviewed for the reference group. SMCs were assessed through a 14-item SMC questionnaire.

Sample included 114 patients with only diabetes and hypertension each, 103 with both diabetes and hypertension and 169 healthy participants. Compared to healthy adults, persons with diabetes and hypertension had higher SMCs (difference, 0.88, 95% CI 0.22, 1.54) (difference, 1.06, 95% CI 0.40, 1.71) respectively, in fully adjusted models.

Compared to healthy adults of working age-group, persons with diabetes and hypertension were more likely to have SMCs. Assessment and early detection of SMCs in persons with diabetes and hypertension might be informative to provide a window for effective interventions to maintain cognitive health.
Compared to healthy adults of working age-group, persons with diabetes and hypertension were more likely to have SMCs. Assessment and early detection of SMCs in persons with diabetes and hypertension might be informative to provide a window for effective interventions to maintain cognitive health.


Understanding the Risks and Consequences of Ordering Fakes Online
In the age of e-commerce, the web has dramatically changed how consumers shop. While this digital market offers unbelievable convenience and range, it also comes with significant threats, especially when it comes to counterfeit items. This post explores the world of buying fakes online, exploring the reasons that people do so, the possible effects, and how to make educated getting choices.

The Allure of Counterfeit Goods
Counterfeit products are often attractive due to their significantly lower rates compared to their authentic counterparts. From https://securityholes.science/wiki/20_Tools_That_Will_Make_You_Better_At_Buy_Fakes and luxury watches to electronics and cosmetics, counterfeit products can simulate the look of real products carefully enough that they interest an unsuspecting customer. Some of the main factors people choose to order fakes online include:

Expense Savings: Authentic branded products typically come with significant price tags. Counterfeit items supply a more affordable option, making high-end items available to a wider audience.

Stylish Appeal: Many consumers feel the pressure to keep up with trends. Fakes permit them to take part in fashion or tech patterns without the financial problem of purchasing authentic products.

Lack of Awareness: Not all consumers know they are ordering counterfeit goods. Some may wrongly believe they are acquiring legitimate products at a discount rate.

Low Chances of Detection: The digital marketplace offers a certain level of anonymity for both purchasers and sellers, making it easier for counterfeit products to be marketed as genuine.

The Hidden Dangers of Buying Counterfeits
While the initial appeal of ordering fakes online may be strong, it is vital to consider the possible dangers and consequences. The following list lays out the main risks associated with acquiring counterfeit products:

Quality Concerns: Counterfeit products frequently lack the quality that authentic items promise. This might imply lower sturdiness, security risks, and even health threats (as seen in counterfeit cosmetics and medications).

Legal Issues: Engaging in the purchase of counterfeit items might lead to legal repercussions. Depending on the jurisdiction, people might deal with fines or other charges for intentionally buying counterfeit items.

Financial Loss: While counterfeit products might look like a deal, buyers often end up losing money when these products fail to perform. Refunds can be difficult to secure, particularly when purchasing from unregulated online platforms.

Support for Criminal Activity: The counterfeit items market is frequently linked to arranged criminal offense, putting money into unlawful ventures and undermining the economy by impacting real organizations.

Unfavorable Environmental Impact: Counterfeit production often occurs in uncontrolled environments that do not stick to ecological standards, thus contributing to contamination and waste.

Spotting Counterfeit Products Online
To reduce the threats associated with ordering fakes, it's vital to know how to recognize genuine items when going shopping online. Here are some tips for finding counterfeit items:

Tips for Identifying Counterfeit Products:
Buy from Reputable Retailers: Always buy from widely known and trustworthy sellers. This helps make sure the credibility of the products.

Research study the Brand: Familiarize yourself with the brand's main website. This can provide you insight into current items, prices, and authorized sellers.

Inspect Product Details: Look for inconsistencies in product descriptions, images, and product packaging. Authentic products usually have specific functions or markings that counterfeit variations might lack or misrepresent.

Read Reviews: Customer evaluations can supply valuable insight. Search for feedback regarding item authenticity and quality.

Major Price Discrepancies: If an offer appears too great to be true, it most likely is. Beware of items listed at considerably lower prices than their retail value.

Trust Your Instincts: If something feels off about a website or item, trust your gut and prevent completing the purchase.

The Legal Landscape Surrounding Counterfeit Goods
As the concern of counterfeiting continues to rise, governments worldwide are taking procedures to address the problem. Numerous laws are in place aimed at combating counterfeit goods. Here are some essential legal elements to comprehend:

Copyright Laws: Companies hold trademarks and copyrights for their logo designs and designs. Buying counterfeit goods can infringe on those rights, leading to possible legal action versus the purchaser.

Customer Protection Laws: Certain jurisdictions have laws safeguarding consumers from fraudulent sales practices, including the sale of counterfeit goods. These laws can enforce charges on sellers.

Online Marketplace Regulations: Many popular online markets have guidelines and policies to restrict the sale of counterfeit products. It's necessary for customers to comprehend these policies before purchasing.



Conclusion
Buying fakes online might appear like a fast and easy way to save money or stay up to date with trends, but the hidden dangers and repercussions are considerable. From quality concerns and financial losses to legal consequences and ethical issues, the choice to buy counterfeit products requires careful thought.

For those looking to shop responsibly, making the effort to research products, acknowledge quality indications, and pick trusted sellers can help combat the temptation of counterfeit products. Eventually, making notified acquiring choices advantages not simply the individual customer however likewise the wider market economy.

Frequently Asked Questions about Ordering Fakes Online
Q1: Is it prohibited to buy counterfeit products?
A: While laws differ by country, purchasing counterfeit goods can lead to legal repercussions, especially if you knowingly buy them.

https://opensourcebridge.science/wiki/3_Ways_In_Which_The_Buy_Counterfeit_Money_Discreetly_Influences_Your_Life : How can I inform if an online seller is offering counterfeit items?
A: Look for seller evaluations, inspect their return policy, and research study the products completely. Be cautious of prices that appear too great to be real.

Q3: What should I do if I mistakenly buy a counterfeit product?
A: Contact the seller to request a refund. If you encounter difficulties, you may need to report the problem to your payment provider and local consumer protection company.

Q4: Are counterfeit items damaging?
A: Yes, many counterfeit products-- specifically cosmetics and electronic devices-- can posture safety and health dangers due to bad materials and producing requirements.

By being vigilant and notified, customers can prevent the pitfalls connected with buying fakes online and, in the process, support authentic brands and a healthy market.

Videos

On this episode of The Cost of Everything we take a closer look at the cosmetics industry and how the market is controlled by only a few corporate players. Could this be the reason cosmetics seem to have an unnaturally high mark-up? Host Christy Ai speaks with professor Delphine Horvath about the cost of producing a single cosmetic and where the incredible mark-ups are really coming from.

Circles

Sorry, no results were found.

Videos

On this episode of The Cost of Everything we take a closer look at the cosmetics industry and how the market is controlled by only a few corporate players. Could this be the reason cosmetics seem to have an unnaturally high mark-up? Host Christy Ai speaks with professor Delphine Horvath about the cost of producing a single cosmetic and where the incredible mark-ups are really coming from.

Posts

7 mins ago


The study of brain connectomics has led to a rapid evolution in the understanding of human brain function. Traditional localizationist theories are being replaced by more accurate network, or hodologic, approaches that model brain function as widespread processes dependent on cortical and subcortical structures, as well as the white matter tracts (WMTs) that link these areas. Recent surgical literature suggests that WMTs may be more critical to preserve than cortical structures because of the comparably lower capacity of recovery of the former when damaged. Given the relevance of eloquent WMTs to neurologic function and thus quality of life, neurosurgical interventions must be tailored to maximize their preservation. Direct electric stimulation remains a vital tool for identification and avoidance of these critical tracts. Neurosurgeons therefore require proper understanding of the anatomy and function of WMTs, as well as the reported contemporary tasks used during intraoperative stimulation. We review the relevant tracts involved in language, visuospatial, and motor networks and the updated direct electric stimulation-based mapping tasks that aid in their preservation. The dominant-hemisphere language WMTs have been mapped using picture naming, semantic association, word repetition, reading, and writing tasks. For monitoring of vision and spatial functions, the modified picture naming and line bisection tasks, as well as the recording of visual evoked potentials, have been used. Repetitive movements and monitoring of motor evoked potentials and involuntary movements have been applied for preservation of the motor networks.
Recognition of congenital tethered cervical cord in adults and literature review.

Retrospective review of adult onset tethered cervical cord patients (age >20 years).

Three adults were identified; 2 women and 1 man, average age 47 years. The presenting symptoms were neck pain with restricted movement (3), quadriparesis (2), and sensory changes (2). Hyperreflexia was present in all three. Bony abnormalities were mainly bifid cervical spinous processes (3), with Klippel-Feil abnormalities in 1. The neurocutaneous stigmata was seen in 2. Magnetic resonance imaging revealed "limited dorsal myeloschisis" in all 3 patients. The dorsal aspect of the cervical cord extruded into the tract leading to the surface.

Neurocutaneous stigmata should not be considered benign. A missed clinical diagnosis was apparent in all 3 patients; 2 of whom underwent surgery with excellent results. Magnetic resonance imaging can identify the abnormal cervical cord protruding towards the "sinus tract" and allow planning to avert injury to the spinal cord during release.
Neurocutaneous stigmata should not be considered benign. A missed clinical diagnosis was apparent in all 3 patients; 2 of whom underwent surgery with excellent results. https://www.selleckchem.com/products/PF-2341066.html Magnetic resonance imaging can identify the abnormal cervical cord protruding towards the "sinus tract" and allow planning to avert injury to the spinal cord during release.The COVID-19 outbreak has led to fundamental disruptions of health care and its delivery with sweeping implications for patients and physicians of all specialties, including neurosurgery. In an effort to conserve hospital resources, neurosurgical procedures were classified into tiers to determine which procedures have to be performed in a timely fashion and which ones can be temporarily suspended to aid in the hospital's reallocation of resources when equipment is scarce. These guidelines were created quickly based on little existing evidence, and thus were initially variable and required refinement. As the early wave can now be assessed in retrospect, the authors describe the lessons learned and the protocols established based on published global evidence to continue to practice neurosurgery sensibly and minimize disruptions. These operational protocols can be applied in a surge of COVID-19 or another airborne pandemic.
Persons with Down syndrome (DS) require preventive care that addresses their age-/gender- and syndrome-specific needs. Yet, adolescents and adults with DS do not receive these preventive care services as recommended.

To identify factors that predict receipt of age-/gender- and syndrome-specific preventive healthcare among adolescents and adults with DS. We hypothesized that more healthcare encounters and greater medical complexity would increase receipt of preventive care due to more opportunities to complete these activities.

Using Medicaid claims (2006-2010) for California, Colorado, Michigan, and Pennsylvania, we conducted a retrospective cohort study of adolescents and adults with DS (≥12 years old). We modeled receipt of both ≥1 wellness examination and ≥1 thyroid function test (TFT) in 2009-2010 as a function of receipt of those same healthcare activities in 2006-08, adjusting for demographics, key comorbidities, and medical complexity using multivariable logistic regression.

In this cohort of 3487 adolescents and adults with DS accessing Medicaid, 17% received both ≥1 wellness examination and ≥1 TFT in 2006-2008, 15% in 2009-2010, and only 7% during both time periods. Despite medical complexity and frequent healthcare interactions, the best predictor of future receipt of these activities was past receipt. State of residence variably impacted receipt of these preventive activities.

Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.
Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.
To investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles.

Cross-sectional study.

This study included 146 participants 47 younger adults (23 men and 24 women; age range 23-44years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86years).

Age (<65years or ≥65years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables.

Older men had a significant positive correlation between tongue pressure and CSA (r=0.

14 mins ago


06-31.26µm (Mean=30.16µm) and 9.42-10.22µm (Mean=9.82), respectively. There was significant difference (P <0.001) between the two groups. https://www.selleckchem.com/products/pbit.html As compared to control groups, both exposure groups have high levels of Superoxide Dismutase and Malondialdehyde and low levels of Glutathione. The finding was statistically significant (P <0.001).

Increased inhalational exposure to air pollutants via working in traffic or coal mines can impose higher oxidative stress and DNA damage among workers as compared to the general population.
Increased inhalational exposure to air pollutants via working in traffic or coal mines can impose higher oxidative stress and DNA damage among workers as compared to the general population.
To determine the association of Upper extremity musculoskeletal disorders and Exposure to Ergonomic risk factors among handicraft workers.

This cross-sectional survey was conducted in a 12 weeks' duration i.e. from November 2018 till January 2019. Nordic musculoskeletal questionnaire was used to determine the frequency of upper limb musculoskeletal disorders. Postural analysis was done using Rapid Upper Limb Assessment (RULA). Data was collected from 100 Handicraft workers and the type of work included Art work (n=18), Ada Work (n=7), botanical arrangement (n=11), Textile, fashion designing and stitching (n=38), Fine arts (n=20), embroidery and knitting (n=6).

The frequency distribution of Rapid upper limb assessment (RULA) score for exposure to risk factors showed that 47 participants were at a high risk and required implementation of change. Most of the participants (n=35) reported pain in neck and shoulder (n=29). The chi square test for association between pain in upper extremity and exposure to risk factors showed that only wrist pain had statistically significant association with overall RULA score (p-value<0.05).

The study concluded that neck and shoulder are more frequently affected among handicraft workers. The frequency of workers who were at high ergonomic risk and required implementation of change in working conditions was high.
The study concluded that neck and shoulder are more frequently affected among handicraft workers. The frequency of workers who were at high ergonomic risk and required implementation of change in working conditions was high.
To find out inter-professional collaboration among speech-language pathologists and nurses in acute care in Pakistan.

This was a cross sectional study which was conducted in all government and private hospitals of Islamabad and Rawalpindi having facility of ICUs after taking consent from authorities. The duration of study was six months from October 2018 to February 2019. A total number of 350 participants (200 nurses, 150 speech language pathologists) working in ICU of different private and government hospitals of Pakistan were included in the study. Standardized questionnaire of " assessment of inter-professioal collaboration scale" (AITCS) was circulated to nurses and speech language pathologists (SLPS) working in ICU with its subscale's partnership, coordination, cooperation and shared decision making on a 5-point likert scale. Data was analyzed using SPSS version 21.Measure of mean was obtained by independent sample t-test. P- Value less than 0.05 was considered as significant.

Statistical analysis There is no significant difference in cooperation.
To compare the efficacy and safety of midazolam-ketamine combination versus fentanyl-propofol combination in pediatric diagnostic colonoscopy.

This is a retrospective study of 68 children undergoing diagnostic gastroenterology with midazolam-ketamine combination (Group-K) or with fentanyl-propofol combination (Group-P) in the pediatric gastroentology department at a Turkish tertiary hospital between January 2015 and June 2017. An intravenous midazolam was administered one minute before ketamine administration in Group K. Intravenous fentanyl was given to Group P, followed by intravenous propofol.

There were statistically no significant differences between the groups as for age, gender, weight, duration of colonoscopy and complications observed during procedure. Ramsay sedation score was significantly higher in Group K. Recovery time and the rate of complications during the recovery of Group-K (23 patients, 65.7%) was significantly higher than that of Group P (8 patients, 24.2%) (p= 0.001).

Colonoscopy procedures can be quite comfortable in children when using the midazolam-ketamine combination. However, adverse effects related to ketamine were observed during recovery.
Colonoscopy procedures can be quite comfortable in children when using the midazolam-ketamine combination. However, adverse effects related to ketamine were observed during recovery.
Subjective memory complaints (SMCs) are suggested to predict dementia at a very early stage. However, association of SMCs with known risk factors of dementia namely diabetes mellitus Type-2 diabetes and hypertension (HTN) remain unexplored which is the main aim of this study. The objective of the study was to investigate the association of SMC with diabetes mellitus type 2 (DM2) and hypertension (HTN).

The associations of diabetes and hypertension, with SMCs has been tested in 500 participants from a tertiary care hospital of Karachi during 2017. Diagnosed cases of diabetes and hypertension were included through convenient sampling. Healthy attendants of patients were interviewed for the reference group. SMCs were assessed through a 14-item SMC questionnaire.

Sample included 114 patients with only diabetes and hypertension each, 103 with both diabetes and hypertension and 169 healthy participants. Compared to healthy adults, persons with diabetes and hypertension had higher SMCs (difference, 0.88, 95% CI 0.22, 1.54) (difference, 1.06, 95% CI 0.40, 1.71) respectively, in fully adjusted models.

Compared to healthy adults of working age-group, persons with diabetes and hypertension were more likely to have SMCs. Assessment and early detection of SMCs in persons with diabetes and hypertension might be informative to provide a window for effective interventions to maintain cognitive health.
Compared to healthy adults of working age-group, persons with diabetes and hypertension were more likely to have SMCs. Assessment and early detection of SMCs in persons with diabetes and hypertension might be informative to provide a window for effective interventions to maintain cognitive health.


Understanding the Risks and Consequences of Ordering Fakes Online
In the age of e-commerce, the web has dramatically changed how consumers shop. While this digital market offers unbelievable convenience and range, it also comes with significant threats, especially when it comes to counterfeit items. This post explores the world of buying fakes online, exploring the reasons that people do so, the possible effects, and how to make educated getting choices.

The Allure of Counterfeit Goods
Counterfeit products are often attractive due to their significantly lower rates compared to their authentic counterparts. From https://securityholes.science/wiki/20_Tools_That_Will_Make_You_Better_At_Buy_Fakes and luxury watches to electronics and cosmetics, counterfeit products can simulate the look of real products carefully enough that they interest an unsuspecting customer. Some of the main factors people choose to order fakes online include:

Expense Savings: Authentic branded products typically come with significant price tags. Counterfeit items supply a more affordable option, making high-end items available to a wider audience.

Stylish Appeal: Many consumers feel the pressure to keep up with trends. Fakes permit them to take part in fashion or tech patterns without the financial problem of purchasing authentic products.

Lack of Awareness: Not all consumers know they are ordering counterfeit goods. Some may wrongly believe they are acquiring legitimate products at a discount rate.

Low Chances of Detection: The digital marketplace offers a certain level of anonymity for both purchasers and sellers, making it easier for counterfeit products to be marketed as genuine.

The Hidden Dangers of Buying Counterfeits
While the initial appeal of ordering fakes online may be strong, it is vital to consider the possible dangers and consequences. The following list lays out the main risks associated with acquiring counterfeit products:

Quality Concerns: Counterfeit products frequently lack the quality that authentic items promise. This might imply lower sturdiness, security risks, and even health threats (as seen in counterfeit cosmetics and medications).

Legal Issues: Engaging in the purchase of counterfeit items might lead to legal repercussions. Depending on the jurisdiction, people might deal with fines or other charges for intentionally buying counterfeit items.

Financial Loss: While counterfeit products might look like a deal, buyers often end up losing money when these products fail to perform. Refunds can be difficult to secure, particularly when purchasing from unregulated online platforms.

Support for Criminal Activity: The counterfeit items market is frequently linked to arranged criminal offense, putting money into unlawful ventures and undermining the economy by impacting real organizations.

Unfavorable Environmental Impact: Counterfeit production often occurs in uncontrolled environments that do not stick to ecological standards, thus contributing to contamination and waste.

Spotting Counterfeit Products Online
To reduce the threats associated with ordering fakes, it's vital to know how to recognize genuine items when going shopping online. Here are some tips for finding counterfeit items:

Tips for Identifying Counterfeit Products:
Buy from Reputable Retailers: Always buy from widely known and trustworthy sellers. This helps make sure the credibility of the products.

Research study the Brand: Familiarize yourself with the brand's main website. This can provide you insight into current items, prices, and authorized sellers.

Inspect Product Details: Look for inconsistencies in product descriptions, images, and product packaging. Authentic products usually have specific functions or markings that counterfeit variations might lack or misrepresent.

Read Reviews: Customer evaluations can supply valuable insight. Search for feedback regarding item authenticity and quality.

Major Price Discrepancies: If an offer appears too great to be true, it most likely is. Beware of items listed at considerably lower prices than their retail value.

Trust Your Instincts: If something feels off about a website or item, trust your gut and prevent completing the purchase.

The Legal Landscape Surrounding Counterfeit Goods
As the concern of counterfeiting continues to rise, governments worldwide are taking procedures to address the problem. Numerous laws are in place aimed at combating counterfeit goods. Here are some essential legal elements to comprehend:

Copyright Laws: Companies hold trademarks and copyrights for their logo designs and designs. Buying counterfeit goods can infringe on those rights, leading to possible legal action versus the purchaser.

Customer Protection Laws: Certain jurisdictions have laws safeguarding consumers from fraudulent sales practices, including the sale of counterfeit goods. These laws can enforce charges on sellers.

Online Marketplace Regulations: Many popular online markets have guidelines and policies to restrict the sale of counterfeit products. It's necessary for customers to comprehend these policies before purchasing.



Conclusion
Buying fakes online might appear like a fast and easy way to save money or stay up to date with trends, but the hidden dangers and repercussions are considerable. From quality concerns and financial losses to legal consequences and ethical issues, the choice to buy counterfeit products requires careful thought.

For those looking to shop responsibly, making the effort to research products, acknowledge quality indications, and pick trusted sellers can help combat the temptation of counterfeit products. Eventually, making notified acquiring choices advantages not simply the individual customer however likewise the wider market economy.

Frequently Asked Questions about Ordering Fakes Online
Q1: Is it prohibited to buy counterfeit products?
A: While laws differ by country, purchasing counterfeit goods can lead to legal repercussions, especially if you knowingly buy them.

https://opensourcebridge.science/wiki/3_Ways_In_Which_The_Buy_Counterfeit_Money_Discreetly_Influences_Your_Life : How can I inform if an online seller is offering counterfeit items?
A: Look for seller evaluations, inspect their return policy, and research study the products completely. Be cautious of prices that appear too great to be real.

Q3: What should I do if I mistakenly buy a counterfeit product?
A: Contact the seller to request a refund. If you encounter difficulties, you may need to report the problem to your payment provider and local consumer protection company.

Q4: Are counterfeit items damaging?
A: Yes, many counterfeit products-- specifically cosmetics and electronic devices-- can posture safety and health dangers due to bad materials and producing requirements.

By being vigilant and notified, customers can prevent the pitfalls connected with buying fakes online and, in the process, support authentic brands and a healthy market.

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