The pneumatic tourniquet is widely used in orthopedic surgery; however, it may causea series of complications. Some investigators have used ultrasound-guided methods tofind lower tourniquet pressures that permit the operation to proceed while mitigatingcomplications. Studies have shown that a tourniquet can damage patients� pulmonaryventilation function. It remains unclear, however, whether setting the pressure of thetourniquet under the guidance of ultrasound can reduce injury to pulmonaryventilation function in patients undergoing lower limb surgery. A total of 100 patientswho required tourniquet for lower limb surgery were divided into two groups (n = 50each): control and ultrasound-guided. In the ultrasound-guidance group, the optimaltourniquet pressure was the pressure at which popliteal artery blood flow disappearedon imaging. Pneumatic tourniquet pressure was set using traditional methods in thecontrol group. At specified time points (immediately after tourniquet inflation [T0], 1h after tourniquet inflation [T1], and 0.5 h [T2], 2 h [T3], 6 h [T4] and 24 h [T5] aftertourniquet deflation), several parameters were measured, including mean arterialpressure (MAP), heart rate (HR), plasma malondialdehyde (MDA) and superoxidedismutase (SOD) concentration, partial pressure of arterial blood oxygen (PaO2),partial pressure of arterial CO2 (PaCO2), and calculated respiratory index (RI),alveolar artery blood oxygen partial pressure difference (PA�aDO2) and arterialblood/alveolar oxygen partial pressure ratio (A/a ratio). In both groups, MAP waslower, and HR was more rapid at T2 than at T0. Compared with T0, PaO2 and the a/Aratio decreased, and PA-aDO2 and RI ratio increased at T4 in both groups. Comparedwith T0, the concentration of MDA was higher and the concentration of SOD waslower at T3�T5 in the control group. In the ultrasound-guided group, theconcentration of MDA was higher and the concentration of SOD was lower at T3�T5than at T0. Compared with the control group, in the ultrasound-guided group MAPincreased and HR decreased at T2?the ratio of PaO2 and a/A increased, while the ratioof PA-aDO2 and RI decreased at T4 and the concentration of MDA decreasedsignificantly, the concentration of SOD increased significantly at T3�T5. Therefore,patients in whom tourniquet pressure was set using ultrasound exhibited more stableMAP and HR, and less dysfunction in pulmonary ventilation compared with thetraditional method of pressure setting. A possible mechanism is that this methodreduces the consumption of the oxygen free radical scavenging agent (SOD), thusreducing lipid peroxide reactions (MDA) and reduces lipid peroxide injury in theprocess of limb ischemia-reperfusion injury caused by the tourniquet.

Background: One of the most relevant complications of diabetes mellitus is the diabetic neuropathy (DN), which might be related to alterations of the postural stability. \nObjective: The objectives of this study were to evaluate the DN relation with alterations in the postural control, to describe and to analyze the methods of measurement of postural control.\nMethods: a systematic review of the literature including case control studies related to postural control and DN was carried out on the electronic data bases Pub Med, Scopus, Web of Science, EMBASE, Central Cochrane, Cinahl and Lilacs, using the descriptors: diabetic neuropathy, balance alterations, postural stability and their synonyms. The data analyzed included: clinical characteristics, methods and results of balance evaluations. The quality of the studies was evaluated using the instrument STROBE.\nFindings: The total number of studies found was 5,686. From these, 22 were selected for analysis, totaling 1,175 participants, and within that group 421 presented DN. Most studies showed that the postural oscillation in those participants was over 30% in relation to the control group, regardless of the method used to measure stability. When comparing methods, the most practical method used to measure postural stability was the Berg Balance Scale (BBS).\nInterpretation: Association between DN and postural stability alteration was found. Due to the inexistence of a standard to evaluate and measure this alteration, factors such as applicability and cost-benefit relation should be considered when choosing the most suitable measurement method. PROSPERO (CRD42020163466).

In this paper, which is metaphilosophical and not historiographic, it is about finding in Georges Canguilhem\'s work valid elements to elaborate a critique of transhumanist ideology. The originality of Canguilhem\'s proposal resides first of all in placing himself outside the field of bioethics, opting instead for a biological philosophy or a philosophy of medicine. Secondly, it maintains a \"technophilic\" position, which roots technique in the normative movement of life. Finally, Canguilhem defends a non-essentialist conception of life, understood as contingent variation and as an evaluative activity.

PPSM architecture synthesizes multiplier blocks with low hardware requirement suitable for implementation as part of full parallel finite impulse response (FIR) filters is presented in this paper. FIR digital filters are widely used in DSP by the virtue of its stability, linear phase, fewer finite precision error and efficient implementation. In this paper, new reconfigurable architectures of low complexity FIR filters are proposed, namely programmable shifts method. The Methods can be modified by replacing the adder architecture by using carry save adder instead of normal adder architecture. The proposed architectures offer 12% of area and power reductions and compared to the best existing reconfigurable FIR filter implementations in the literature and the proposed architectures have been implemented and tested on Spartan-3 xc3s200-5pq208 field-programmable gate array (FPGA) and synthesized.

One of the methods for improving meat products and improving quality of the products is reduction of their negative effects on health. On the other hand, improving physicochemical and organoleptic properties of the meat products can be effective in this regard. The main objective of the present study is to assess effects of rice bran protein on physical-sensory properties of German sausage. Main results of the study were applying of rice bran protein concentrate in formulation of produced treatments in amount of 50gr/5kg, 100gr/5kg, 150gr/5kg and 200gr/5kg, which provides desirable output.

A Mobile Ad-hoc Network (MANET) facilitates construction of multiple paths due to connectivity issues between nodes. The nodes generally have high rate of mobility, this results in their movement away from their transmission range. Determination of the communication path in such a scenario becomes difficult. Many diversified protocols are available to find the path for communication between nodes. Even after the determination of communication path, a path found to communicate, may break before the transmission begins or during the transmission. This means that a permanent path between any source and destination does not exist. Uninterrupted connectivity is a minimum requirement for many applications and is a challenge with MANET. Hence finding a reliable route itself is still under research in MANET environment. In this paper an algorithm named “TIME ACCOUNT BASED AODV (TABA)” is proposed to improve path construction and retention using AODV protocol.

In the Iranian culture and context, family members prefer to provide care to the elderly in family, therefore determining the importance of family\'s caring behaviors related to the elderly in Iranian families is necessitate. \nAim: The purpose of this qualitative study was to describe and explore the experiences of Iranian family members providing care to elderly people at their own homes. \nMethod: Semi-structured interviews were held with 11 family members providing care to elderly at their own homes chosen using purposeful sampling. Thematic analysis was conducted for data analysis.\nResults: Following the analysis of data three major themes of individual skills, sacrifice and forbearing were extracted as the desired outcomes of aged caring in the family.\nConclusion: Aged care outcomes in the family follow the perception of family members from aged care phenomenon as well as their value and faith related fundamentals. Conduction of qualitative research with phenomenological approach is recommended to discover the perception of families from aged care meaning in the family by nurses.

Orthogonal Frequency Division Multiplexing (OFDM) is a multicarrier modulation scheme used in high speed communication systems. OFDM system is being extensively used in several broadband communication systems like Wireless local area network (WLAN), Worldwide interoperability for Microwave access (Wi-Max), Digital video broadcasting (DVB) and Digital audio broadcasting (DAB). However, the limiting factor remains the occurrence of high Peaks in OFDM signals, when transmitted through power amplifier causes in-band and out-of-band distortion and increase in Bit error rate (BER). The most popular quantification metric of envelope variation of OFDM signal is the Peak-To- Average Power Ratio (PAPR). The reduction in PAPR is desirable in order to obtain power efficiency of the amplifier. This paper proposes an efficient Adjacent Phase Sequence Matrix (APSM) method that is based on special matrices (Circulant, Riemann, Hilbert and Hadamard) for optimizing PAPR of OFDM signals. The proposed technique does not require the transmission of side information to the receiver for original phase recovery. Further, the proposed technique reduces computational and phase search complexity. The proposed scheme has been analyzed with random data, image and audio input to validate multimedia requirements. The results show that the proposed scheme offers better PAPR reduction and BER performance.

The higher education institutions, which are more and more characterized by a stronger competition, must learn to apply scientific management and marketing principles, in order to enhance their competitiveness. Students, on the one hand, and employers, on the other hand, have increasing expectations in terms of learning outcomes. This paper aims to present the main findings of a pilot-study, conducted to assess the willingness of employers to engage in a long term relationship with the universities in order to express their views on the competencies provided to graduates by the study programs in business and economics. Additionally, this pilot-study seeks to adjust the methodology of a more complex research that universities in the field of business and economics must conduct to identify the employers’ needs and expectations on the issues that define the learning outcomes.