The NIH has published treatment guidelines for treating COVID-19 patients in the hospital. However, as of this writing, there are no established protocols for treating COVID-19 positive patients in primary care. Accordingly, this investigator has taken on the task of reviewing the medical literature to be able to propose evidence-based protocols for treating COVID-19 positive patients in primary care. The CDC is advising people to do nothing when they find out they are positive for COVID-19 unless they have symptoms.
The evidence from the literature irrefutably shows COVID-19 infection evokes a massive and deadly hyperinflammatory response called the “Cytokine storm” and that Cytokine levels in the blood have a predictive value in identifying an impending Cytokine storm. With such data primary care providers can effectively lower Cytokine levels and prevent critical illness and death.
Accordingly, this paper presents identification of the problem of not having standard practices in primary care for people who are positive for COVID-19 and not knowing who is at risk. Moreover, the evidence shows that knowing vitamin D levels and correcting deficiencies can go a long way in reducing Cytokine levels. Additionally, the literature review presents evidence that undeniably shows the stark possibility that many of the COVID-19 related deaths can be prevented by identifying who is at risk for the Cytokine storm and other complications and providing early treatment even before symptoms appear.
Multiple studies have investigated the relationship between androgenetic alopecia and cardiovascular disease, including studies that have identified elevated rates of cardiovascular disease in patients with vertex hair loss, vertex and frontal hair loss, early onset hair loss and rapidly progressive hair loss. In addition, increased risks for hypertension, excess weight, abnormal lipids, insulin resistance, carotid atheromatosis and death from diabetes or heart disease have been reported in this population. Studies investigating an association between androgenetic alopecia and metabolic syndrome have yielded conflicting findings. Distinct guidelines for the detection and prevention of cardiovascular disease in individuals with androgenetic alopecia have not been established. In addition to the traditional risk factors for developing cardiovascular disease, included in the definition of the metabolic syndrome, several skin diseases have recently been shown to be markers of conditions relating to the patient’s overall health. Physicians should be aware of the possible connection between relatively frequent skin diseases, such as psoriasis and hair growth disruptions, including androgenetic alopecia and female pattern hair loss and cardiovascular disease. This review is concentrated on the association between insulin resistance, type 2 diabetes, abdominal fat, cardiovascular disease and hair growth disruptions as an early indicator of these underlying conditions. We have investigated the importance of robust primary clinical treatment measures to address the manifestation of hair loss due to a disruption caused by metabolic syndrome as an effective means to alleviate further stress induced hair loss, which can exacerbate the underlying cause.
Pain is a complex phenomenon which is unpleasant. Different cosmetic procedures are associated with varying degrees of pain. Various modalities are adopted to decrease the severity of pain. The commonly used is the administration of analgesics (opioid or non-steroidal). The pain is carried to the brain by pain fibres. There are various theories about the pain [1,2]. Many attempts have been undertaken to find the modalities which decrease the perception of pain by the brain. The famous ‘gate theory’ was proposed in 1965 by Melzack et al. [3]. It was proposed that the pain experience can be reduced by the activation of nerve fibres that conduct non-toxic stimuli. The theory suggested that the stimulation of larger diameter fibres (A-beta) can close a neural ‘gate’ to nocioceptive signals and can reduce the perception of the pain. The ‘gate’ is proposed to lie within the spinal cord/brainstem and inhibits the transmission of nocioceptive action potentials to higher centres in the central nervous system [4]. The “post-synaptic inhibitory and fascilitatory mechanism” provide a basis for explaining the pain reducing strategies such as rubbing the painful area or applying cold or vibration to decrease the perception of the pain. Various topical irritants used in a few ‘magic’ creams also work on the same principle.
Every effort is made to decrease the perception of pain in cosmetic surgery procedures especially hair restoration. A surgeon who can perform a hair restoration without pain has an edge over his competitors. The potential patients undergoing hair restoration are very anxious about the pain level to be perceived during the procedure. Vibration anaesthesia is becoming increasing used in hair restoration to decrease pain perception. Various recent studies have demonstrated the effective use if vibrations to decrease the pain of local anaesthesia injections [5,7]. The pain of the injection has basically two components; the first is the actual needle prick and second is the discomfort felt due to the tissue stretch by the local anaesthetic drugs [8].
The following study was conducted to compare the pain level of ring block in the patients undergoing hair restoration with and without the use of vibration
Einstein’s special and general relativity revolutionized physics. The predictions of general relativity are Strong Lensing, Weak Lensing, Microlensing, Black Holes, Relativistic Jets, A Gravitational Vortex, Gravitational Waves, The Sun Delaying Radio Signals, Proof from Orbiting Earth, Expansion of the universe. The density of the universe determines the geometry and fate of the universe. According to Freedman’s equations of general relativity published in 1922 and 1924, the geometry of the universe may be closed, open and flat. It all depends upon the curvature of the universe also. Various results of Cosmic Microwave Background Radiation (CMBR), NASA’s Wilkinson Microwave Anisotropy Probe (WMAP), and ESA’s Planck spacecraft probes found that our universe is flat within a margin of 0.4% error. In this short work, by applying the laws of quadratic equations, we attempt to show that OUR UNIVERSE IS FLAT.
In the research of steam turbine rotor, start-up optimization is a very key research problem. A series of start-up optimization research can greatly improve the start-up efficiency of steam turbine and the safety performance of the unit. The start-up optimization of steam turbine is inseparable from the analysis of the start-up process of steam turbine and the mathematical model of the startup process of steam turbine unit, because the optimization of steam turbine unit can be regarded as a function to find the optimal solution. This paper analyzes the start-up process of 300 MW steam turbine, analyzes the start-up process of steam turbine unit through the data used in the actual power plant, and gives the mathematical model of cold start-up of steam turbine according to the start-up process of steam turbine, so as to further study the start-up optimization of steam turbine. Finally, the optimization model is determined by several key parameters, which are three weight coefficients α1,α2,α3, the actual damage value Di and damage limit value Dlim, and the start-up time ti and total start-up time t0 of each stage.
Objective: In primary care, during treatments, nurses may need to wear surgical masks, namely for control of infection contamination, or to minimize unpleasant odors. The goal of this study is to inspect the effect of nurses wearing the mask on patient perception of the nurse-patient relation.
Methods: A pre-post-test, control-experimental group design was employed with 60 patients treated in family health units. Patients responded to the Patient Satisfaction Questionnaire III (PSQ-III) regarding nurses’ communication, interpersonal manner, technical quality, as well regarding general satisfaction with the encounter. An additional question asked both patients and nurses how long they felt that the visit lasted.
Results: Results show that nurses wearing the surgical mask had significantly negative effects in all dimensions of PSQ-III and increased the perceived visit duration among both nurses and patients.
Conclusion: When a previous relationship exists, nurses wearing the surgical mask in primary care in Portugal negatively affects patient satisfaction with both the patient-nurse relation and the nurses’ technical quality.
Practice implications: Is important the nurse understand this impact to discuss with the colleagues the best strategy to minimize the negative impact to the patient- family nurse relation and manager this situation in the best way to the patient.
Plasma stability is the biggest challenge facing the nuclear fusion industry. One of the best methods of stability study is magnetohydrodynamic (MHD) equations, which has two linear and nonlinear states. Usually linear stability analysis is used to describe the MHD state, which is obtained by linearizing nonlinear equations. The reactor under study is the W7-X reactor, which is an optimal example of a stellaratoric system.
The question raised in this research is how to create suitable conditions for the formation of plasma and heat transfer produced by the melting reaction. Many efforts have been made in this direction, but still the record holder for plasma state maintenance belongs to the international ITER project and around 1000. However, IPP researchers at the Max Planck Institute in Germany (maker of the W7-X reactor) predicted that by 2020 they would produce a pulse of 30 minutes.
The numerical method is used to investigate the stability of the reactor. In this paper, boundary conditions were expressed in terms of resistance wall. With the help of the mathematical Matlab software, magnetic field values were obtained from experimental reports extracted from the Max Planck Institute for various values of β. From the values obtained, it was concluded that the appropriate field value is β = 5 according to the ideal MagnetoHydroDynamic state and the interval defined by the Max Planck Institute.
COVID-19 created a public health crisis shutting down many normal day-to-day activities and adversely affecting life, as we know it. Not only did this affect vulnerable, senior populations and people with poorly managed diabetes and hypertension [1-4], it displaced nursing students from clinical experiences putting them at risk of not graduating. Given the projected shortages of RNs in 2030, in California alone of 44,500 FTEs [5], this delay would have added a ripple effect increasing already dire predictions. This displacement created an emergency and with the aid of the Board of Registered Nursing, Assembly Bill 2288 [6] passed allowing student nurse clinical experience requirements to be revised to help meet graduation requirements.
Dear reader, isn’t it time to turn things around and allow TIME to take its rightful place? In a nutshell, I believe Time should be considered as the primary energy that has created the whole material world and governs the continuous changes in it. In my article “An Intelligent Cosmos: Philosophy of Science”, I discuss that this primary creative energy is, more generally, the Dark Energy in our Universe. I believe that Dark Energy probably has a variety of specific manifestations, and I assume that one of those manifestations is Time.
This article is a continuation of my article “An Intelligent Cosmos: Philosophy of Science”
In this work the statistical and squeezing properties of light-driven by sub-harmonic generation with two-mode coherent light are studied. With interaction Hamiltonian of both two-mode coherent and sub harmonic generation, we have driven master equation of system under consideration. From the master equation, the solution of the C-number Langevin equation is derived. It helps us to solve quadrature variance, quadrature squeezing, mean, and variance of photon number for light produced by sub-harmonic generation with the two-mode coherent light state. And the result shows that; the squeezing occurs in plus quadrature with the maximum squeezing of 87%. The photon statistics of the system under consideration is subpoissonian in which both mean & variance are increasing as kappa increase.
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