Southern Journal of Applied Forestry最新文献

Introduction: Permanent arteriovenous fistula and graft are considered the best options for hemodialysis in end-stage renal disease patients. Temporary access using the internal jugular or femoral veins is the feasible option in acute cases of dialysis and if permanent access is unavailable. Occasionally, however, these access sites are unusable after consecutive blockage of the upper and lower extremities veins. A transhepatic or translumbar approach might be the only unconventional way to ensure a sufficient blood flow for adequate dialysis.

Method: Retrospective data on all transhepatic catheters (THCs) in patients at the King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia were collected. The catheters were inserted over a 10-year period (2009-2019). A minimum of 1 year of follow-up from the last catheter insertion was considered for analysis.

Results: A total of 12 patients had THCs with a mean age of 42.5 ± 12.2 and pre-insertion mean dialysis duration of 130.0 ± 72.9 months. All catheters were functional from the start with no immediate complications. A total of 35 catheter replacements over guidewires were made with a median of 2.0 catheters (range of 0-10). The mean blood flow was 300 ± 30 ml/minute with a mean Kt/v of 1.4 ± 0.4. The median initial (primary) device service interval was 68 (range 6-1531 days) and the median total access site service interval was 392 (range 76-2698 days). Catheter complications included catheter migration, thrombosis, and bloodstream infection occurring at a rate of 0.12, 0.18, and 0.046 per 100 catheter days respectively.

Conclusions: Transhepatic catheters provide safe, feasible access in patients with exhausted vascular access. Patients who undergo THC insertion should be worked up for innovative permanent vascular access or urgent transplantation utilizing unconventional vascular techniques to avoid death due to lack of access.

Background: India is the second-largest country in the world with an estimated 77 million people living with diabetes. Persons with diabetes reported lower quality of life when compared to non-diabetes persons. There are significant associations between poor health-related quality of life (HRQoL) and adverse health outcomes among diabetes people. However, evidence documenting the same in India is scarce.

Aims: To assess the health-related quality of life and its determinants among diabetic patients in rural Kerala, India.

Methods: We conducted a community-based cross-sectional study among 425 adults type-2 diabetic patients from rural Kerala. The World Health Organization Quality of Life questionnaire was used to measure HRQoL. Multiple logistic regression analysis was used to study the association between HRQoL and independent variables.

Results: More than half of the respondents were men (52%), and 45% were older adults (≥60 years). Poor quality of life was reported by 38% of the respondents. Medium [Odds ratio (OR):4.70, 95%CI: 2.61-8.46] and low socio-economic status (SES) group (OR: 4.59, CI: 2.43-8.66) had poorer HRQoL compared to the higher SES group. Those with multi-morbidity (OR: 2.91, CI: 1.63-5.19), unemployed (OR: 2.54, CI: 1.46-4.42), and less educated (OR: 2.28, CI: 1.34-3.88) and older adults (OR: 2.11, CI: 1.28-3.45) were more likely to have poor HRQoL compared to their counterparts.

Conclusion: More than one-third of the diabetes patients in rural Kerala reported poor HRQoL. The study also identified age, socio-economic status, education, and occupation as the important predictors of HRQoL among diabetes patients. The findings highlighted the need for assessing HRQoL as part of the routine management of diabetes care in similar settings.

Diffeomorphic registration using optimal control on the diffeomorphism group and on shape spaces has become widely used since the development of the large deformation diffeomorphic metric mapping (LDDMM) algorithm. More recently, a series of algorithms involving sub-Riemannian constraints have been introduced in which the velocity fields that control the shapes in the LDDMM framework are constrained in accordance with a specific deformation model. Here, we extend this setting by considering, for the first time, inequality constraints in order to estimate surface deformations that only allow for atrophy, introducing for this purpose an algorithm that uses the augmented Lagrangian method. We prove the existence of solutions of the associated optimal control problem and the consistency of our approximation scheme. These developments are illustrated by numerical experiments on simulated and real data.