Search Results (16)

Total gastrectomy with D2 lymphadenectomy for gastric cancer is a complex surgical procedure with a moderate complication rate. Sometimes, some complications may have a misleading onset without a clear clinical presentation and blood test changes. In this case report, hiccups were the main symptom of subdiaphragmatic fluid collection after total gastrectomy. Full article

Hiccups can significantly reduce the quality of life of patients and can occur as a drug side effect. Previous reports have revealed sex-specific differences in the incidence of drug-induced hiccups. However, the pathogenesis of drug-induced hiccups remains unknown, and there is limited evidence on its treatment or prevention. This study examined molecular initiating events (MIEs), which are the starting point of adverse events, to investigate the drug-induced pathways of hiccups. We extracted drugs suspected to cause hiccups using the FDA Adverse Event Reporting System, a large database on adverse drug reactions. Information on drugs suspected to be associated with hiccups was extracted from the overall population and sex-specific subgroups were divided. In each data table, the predicted activity values of nuclear receptors and stress response pathways for each drug were calculated using the Toxicity Predictor, a machine-learning model. Transforming growth factor-beta and antioxidant response elements were considered an independent factor for hiccups in the male and female subgroups, respectively. This report first examined one of the mechanisms of drug-induced hiccups and identified MIEs associated with drug-induced hiccups. The use of an adverse event database and the machine-learning model, Toxicity Predictor, may be useful for generating hypotheses for other adverse effects with unknown mechanisms. Full article

This research is focused on knowledge-based performance drivers, which are often intertwined with intellectual capital (IC); specifically, the value-added intellectual coefficient (VAIC) and its profound influence on labor productivity (LP), with the pivotal inputs of training and research and development (R&D) as moderating, in the realm of small- and medium-sized (engineering) enterprises (SMEs). The aim is to offer this as a sustainable model for practical implementation to empower engineering managers, donors, and policy researchers. The motivation catalyzes more informed decision-making investing in human or structural capital. It attempts to foster sustainable growth and societal stability through job creation within the knowledge-intensive engineering sector of developing countries. Methodologically, the research draws upon statistical analysis, employing Pearson’s correlation, multivariate regression, and model testing executed through specialized statistical software. The World Bank Enterprise Survey Instrument was used to collect data on 213 aviation-related firms. Primary data were collected for the years 2013–2022. Several hypotheses were developed between the variables expected to relate positively, because intellectual capital, training, and research and development should lead to better labor productivity. The findings revealed the critical issue of the misallocated investments in structural capital that this model brought forth. Furthermore, the notable contribution to national intellectual capital (NIC) studies is the significant VAIC value of 4.58 and an impressive labor productivity value of 6.78 within the knowledge-intensive ecosystem of SMEs. More insightful findings were the modest 17% positive variation attributable to the VAIC on LP, accompanied by an absence of significant influence exerted by training and R&D on this relationship. While underscoring the model’s overall validity, this intriguing discovery emphasizes the impact of intangibles on knowledge firms’ overall sustainability calculations, specifically structural capital, which accounts for a substantial 31% of labor productivity. The practical implication is that this model can be used to expose long-term financial performance hiccups through intellectual capital measures. The novelty is employing the labor productivity metric sourced from the engineering literature instead of the customary asset productivity (ATO) ratio from the IC literature. Full article

Current-sensing topology with multi resistors in series has limitations in improving the dynamic range of current acquisition, so a sensing topology with multi resistors in parallel is proposed. The overcurrent state of a parallel shunt circuit cannot be latched, resulting in protection hiccups. A dual threshold-detection circuit is designed to achieve protection state latching and self-recovery. The rectified mean circuit is applied for overcurrent magnitude detection and its validity is proved. But the delay and ripple of the output waveform of the rectified mean circuit may also cause protection hiccups. Combining Fourier series representation, Fourier transform and inverse transform, the time domain expressions of the output of the rectified mean circuit for three common waveforms are obtained. Furthermore, the estimation formulas for the residual ripple amplitude of the three waveforms are derived. In an experiment, the protection hiccup issue in parallel sensing topology was eliminated, while the time constants and hysteresis ratios of the protection circuits were properly set according to theoretical calculation results. With five parallel sensing resistors, the ratio of the maximum to minimum range of the single current channel reaches $1.28\times {10}^4$, which is higher than counterparts with multiple series sensing resistors. The advantages of parallel sensing topology in improving dynamic range are confirmed. Full article

Hiccups-like contractions, including hiccups, respiratory myoclonus, and diaphragmatic tremor, refer to involuntary, spasmodic, and inspiratory muscle contractions. They have been repeatedly described in mechanically ventilated patients, especially those with central nervous damage. Nevertheless, their effects on patient-ventilator interaction are largely unknown, and even more overlooked is their contribution to lung and diaphragm injury. We describe, for the first time, how the management of hiccup-like contractions was individualized based on esophageal and transpulmonary pressure measurements in three mechanically ventilated patients. The necessity or not of intervention was determined by the effects of these contractions on arterial blood gases, patient-ventilator synchrony, and lung stress. In addition, esophageal pressure permitted the titration of ventilator settings in a patient with hypoxemia and atelectasis secondary to hiccups and in whom sedatives failed to eliminate the contractions and muscle relaxants were contraindicated. This report highlights the importance of esophageal pressure monitoring in the clinical decision making of hiccup-like contractions in mechanically ventilated patients. Full article

Parkinson’s disease (PD) is a chronic, progressive neurological disorder and the second most common neurodegenerative condition. We report three common but overlooked symptoms in PD—hiccups, hypersalivation, and hallucinations—in terms of their prevalence, pathophysiology, and up-to-date evidence-based treatment strategies. Whilst all these three symptoms do occur in many other neurological and non-neurological conditions, early recognition and treatment are paramount. Whilst hiccups affect 3% of healthy people, their rate of occurrence is higher (20%) in patients with PD. Hypersalivation (Sialorrhea) is another common neurological manifestation of many neurological and other neurodegenerative conditions such as motor neuron disease (MND), with a median prevalence rate of 56% (range: 32–74%). A 42% prevalence of sialorrhea is also reported in sub-optimally treated patients with PD. Hallucinations, especially visual hallucinations, are commonly reported, with a prevalence of 32–63% in PD, and a 55–78% prevalence is noted in patients with dementia with Lewy bodies (DLB), followed by tactile hallucinations, which are indicated by a sensation of crawling bugs or imaginary creatures across the skin surface. Whilst mainstay and primary management strategies for all these three symptoms are carried out through history taking, it is also essential to identify and treat possible potential triggers such as infection, minimise or avoid causative (such as drug-induced) factors, and especially carry out patient education before considering more definitive treatment strategies, such as botulinum toxin therapies for hypersalivation, to improve the quality of life of patients. This original review paper aims to provide a comprehensive overview of the disease mechanisms, pathophysiology, and management of hiccups, hypersalivation, and hallucinations in Parkinson’s disease. Full article

Autonomous driving of higher automation levels asks for optimal execution of critical maneuvers in all environments. A crucial prerequisite for such optimal decision-making instances is accurate situation awareness of automated and connected vehicles. For this, vehicles rely on the sensory data captured from onboard sensors and information collected through V2X communication. The classical onboard sensors exhibit different capabilities and hence a heterogeneous set of sensors is required to create better situation awareness. Fusion of the sensory data from such a set of heterogeneous sensors poses critical challenges when it comes to creating an accurate environment context for effective decision-making in AVs. Hence this exclusive survey analyses the influence of mandatory factors like data pre-processing preferably data fusion along with situation awareness toward effective decision-making in the AVs. A wide range of recent and related articles are analyzed from various perceptive, to pick the major hiccups, which can be further addressed to focus on the goals of higher automation levels. A section of the solution sketch is provided that directs the readers to the potential research directions for achieving accurate contextual awareness. To the best of our knowledge, this survey is uniquely positioned for its scope, taxonomy, and future directions. Full article

The Internet of Things (IoT) is a network of sensors that helps collect data 24/7 without human intervention. However, the network may suffer from problems such as the low battery, heterogeneity, and connectivity issues due to the lack of standards. Even though these problems can cause several performance hiccups, security issues need immediate attention because hackers access vital personal and financial information and then misuse it. These security issues can allow hackers to hijack IoT devices and then use them to establish a Botnet to launch a Distributed Denial of Service (DDoS) attack. Blockchain technology can provide security to IoT devices by providing secure authentication using public keys. Similarly, Smart Contracts (SCs) can improve the performance of the IoT–blockchain network through automation. However, surveyed work shows that the blockchain and SCs do not provide foolproof security; sometimes, attackers defeat these security mechanisms and initiate DDoS attacks. Thus, developers and security software engineers must be aware of different techniques to detect DDoS attacks. In this survey paper, we highlight different techniques to detect DDoS attacks. The novelty of our work is to classify the DDoS detection techniques according to blockchain technology. As a result, researchers can enhance their systems by using blockchain-based support for detecting threats. In addition, we provide general information about the studied systems and their workings. However, we cannot neglect the recent surveys. To that end, we compare the state-of-the-art DDoS surveys based on their data collection techniques and the discussed DDoS attacks on the IoT subsystems. The study of different IoT subsystems tells us that DDoS attacks also impact other computing systems, such as SCs, networking devices, and power grids. Hence, our work briefly describes DDoS attacks and their impacts on the above subsystems and IoT. For instance, due to DDoS attacks, the targeted computing systems suffer delays which cause tremendous financial and utility losses to the subscribers. Hence, we discuss the impacts of DDoS attacks in the context of associated systems. Finally, we discuss Machine-Learning algorithms, performance metrics, and the underlying technology of IoT systems so that the readers can grasp the detection techniques and the attack vectors. Moreover, associated systems such as Software-Defined Networking (SDN) and Field-Programmable Gate Arrays (FPGA) are a source of good security enhancement for IoT Networks. Thus, we include a detailed discussion of future development encompassing all major IoT subsystems. Full article

Background: After deep brain stimulation (DBS), hiccups as a complication may lead to extreme fatigue, sleep deprivation, or affected prognosis. Currently, the causes and risk factors of postoperative hiccups are unclear. In this study, we investigated the risk factors for hiccups after DBS of the subthalamic nucleus (STN) for Parkinson’s disease (PD) under general anesthesia. Methods: We retrospectively included patients who underwent STN DBS in the study, and collected data of demographic characteristics, clinical evaluations, and medications. According to the occurrence of hiccups within seven days after operation, the patients were divided into a hiccups group and non-hiccups group. The potentially involved risk factors for postoperative hiccups were statistically analyzed by logistic regression analysis. Results: A total of 191 patients were included in the study, of which 34 (17.80%) had postoperative transient persistent hiccups. Binary univariate logistic regression analysis showed that male, higher body mass index (BMI), smoker, Hoehn and Yahr stage (off), preoperative use of amantadine, hypnotic, Hamilton anxiety scale and Hamilton depression scale scores, and postoperative limited noninfectious peri-electrode edema in deep white matter were suspected risk factors for postoperative hiccups (p < 0.1). In binary multivariate logistic regression analysis, male (compared to female, OR 14.00; 95% CI, 1.74–112.43), postoperative limited noninfectious peri-electrode edema in deep white matter (OR, 7.63; 95% CI, 1.37–42.37), preoperative use of amantadine (OR, 3.64; 95% CI, 1.08–12.28), and higher BMI (OR, 3.50; 95% CI, 1.46–8.36) were independent risk factors for postoperative hiccups. Conclusions: This study is the first report about the risk factors of hiccups after STN DBS under general anesthesia for PD patients. The study suggests that male, higher BMI, preoperative use of amantadine, and postoperative limited noninfectious peri-electrode edema in deep white matter are independent risk factors for postoperative hiccups of STN-DBS for PD patients. Most hiccups after STN-DBS for PD patients were transient and self-limiting. Full article

Introduction: Among the less common symptoms associated with the SARS-CoV-2 infection the attention is drawn by a persistent hiccup that was recently quoted in the literature. Case report: We present the case of a 46-year-old Caucasian male patient hospitalized in the Infectious Diseases Clinic of the Academic Emergency Hospital Sibiu, Romania with laboratory confirmation of SARS-CoV-2 infection with a positive result of real-time reverse transcriptase–polymerase chain reaction (RT-PCR) assay from nasopharyngeal swabs, that during the disease course developed persistent hiccup associated with the administration of cortisone therapy, dexamethasone. A decision to stop the treatment with cortisone preparations was made, with the disappearance of the hiccup after 36 h. Conclusions: From our experience, other cases of SARS-CoV-2 infection that we managed during these months of the pandemic, with mild or severe forms of the disease, showed hiccup under treatment with dexamethasone, an event also described in other medical conditions under the same treatment and improved at its cessation or when replaced by methylprednisolone. Full article

An improved low-power hiccup-mode technology for short-circuit protection is proposed in this paper, which can effectively suppress short-circuit currents and greatly minimize the power dissipation of hiccup mode. The circuit can start normally after the short circuit is recovered, and there is no voltage overshoot. At the same time, the proposed pre-charge circuit can effectively suppress the large initial inrush current in the pre-charge stage. These technologies are used in a Peak-Current-Mode-Control (PCMC) Pulse-Width-Modulation (PWM) DC-DC boost converter designed with a 0.35 standard CMOS process. Compared with the conventional structure, the post-simulation results show that the initial inrush current during the start-up phase in the proposed structure is reduced by about 90%. When the output short circuit occurs, the inductor current drops to approximately zero and the power dissipation of the converter is very low at this time. The converter repeatedly detects the state of the output load after a period of about 24 ms. Eventually, the converter will restart after the short circuit is recovered and there is no voltage overshoot. Full article

In this study, we used the large number of cases in the FDA adverse-event reporting system (FAERS) database to investigate risk factors for drug-induced hiccups and to explore the relationship between hiccups and gender. From 11,810,863 adverse drug reactions reported between the first quarter of 2004 and the first quarter of 2020, we extracted only those in which side effects occurred between the beginning and end of drug administration. Our sample included 1454 adverse reactions for hiccups, with 1159 involving males and 257 involving females (the gender in 38 reports was unknown). We performed univariate analyses of the presence or absence of hiccups for each drug and performed multivariate analysis by adding patient information. The multivariate analysis showed nicotine products to be key suspect drugs for both men and women. For males, the risk factors for hiccups included older age, lower body weight, nicotine, and 14 other drugs. For females, only nicotine and three other drugs were extracted as independent risk factors. Using FAERS, we were thus able to extract new suspect drugs for drug-induced hiccups. Furthermore, this is the first report of a gender-specific analysis of risk factors for hiccups that provides novel insights into drug-induced hiccups, and it suggests that the mechanism responsible is strongly related to gender. Thus, this study can contribute to elucidating the mechanism underlying this phenomenon. Full article

Thrombocytopenia and impaired platelet function are known as intrinsic drawbacks of cardiac surgery and extracorporeal life supports (ECLS). A number of different factors influence platelet count and function including the inflammatory response to a cardiopulmonary bypass (CPB) or to ECLS, hemodilution, hypothermia, mechanical damage and preoperative treatment with platelet-inhibiting agents. Moreover, although underestimated, heparin-induced thrombocytopenia is still a hiccup in the perioperative management of cardiac surgical and, above all, ECLS patients. Moreover, recent investigations have highlighted how platelet disorders also affect patients undergoing biological prosthesis implantation. Though many hypotheses have been suggested, the mechanism underlying thrombocytopenia and platelet disorders is still to be cleared. This narrative review aims to offer clinicians a summary of their major causes in the cardiac surgery setting. Full article

Curcuma amada Roxb. (Zingiberaceae), commonly known as mango ginger because its rhizome and foliar parts have a similar aroma to mango. The rhizome has been widely used in food industries and alternative medicines to treat a variety of internal diseases such as cough, bronchitis, indigestion, colic, loss of appetite, hiccups, and constipation. The composition of the volatile constituents in a fresh rhizome of C. amada is not reported in detail. The present study aimed to screen and characterize the composition of volatile organic compound (VOC) in a fresh rhizome of three C. amada (ZO45, ZO89, and ZO114) and one C. longa (ZO138) accessions originated from Myanmar. The analysis was carried out by means of headspace solid-phase microextraction (HS-SPME) coupled with gas chromatography-time-of-flight-mass spectrometry (GC-TOF-MS). As a result, 122 VOCs were tentatively identified from the extracted 373 mass spectra. The following compounds were the ten most highly abundant and broadly present ones: ar-turmerone, α-zingiberene, α-santalene, (E)-γ-atlantone, cuparene, β-bisabolene, teresantalol, β-sesquiphellandrene, trans-α-bergamotene, γ-curcumene. The intensity of ar-turmerone, the sesquiterpene which is mainly characterized in C. longa essential oil (up to 15.5–27.5%), was significantly higher in C. amada accession ZO89 (15.707 ± 5.78^a) compared to C. longa accession ZO138 (0.300 ± 0.08^b). Cis-α-bergamotene was not detected in two C. amada accessions ZO45 and ZO89. The study revealed between-species variation regarding identified VOCs in the fresh rhizome of C. amada and C. longa. Full article

Nonsurgical approaches involving bronchoscopic lung volume reduction (BLVR) have been developed in the last decade. One of these, the BLVR coil procedure, is a treatment option for patients with homogeneous and heterogeneous end-stage emphysema and a forced expiratory volume in 1 second (FEV₁) of 15–45%. This treatment decreases hyperinflation and improves lung function, the quality of life, and exercise capacity. It is very important to prepare patients for treatment, premedications, anesthesia applications, intubation, post-procedure follow-up and treatments. Further, it has been observed that various complications can develop during and after the procedure. Generally, the observed and reported complications are chronic obstructive pulmonary disease (COPD) exacerbation, chest pain, mild bleeding, pneumonia, pneumothorax, and respiratory failure. Rarely, aspergillus cavitation (coil-related aspergilloma), bronchopleural fistula and penetration into the pleural space, bronchiectasis, coil-associated inflammatory response and opacities, and hiccups are observed. Common complications are usually mild or moderate, while the rare ones can be life-threatening (except hiccup), so early diagnosis and treatment are necessary. However, patients treated with BLVR have lower mortality rates than untreated patients with similar morbidity. Based on the findings of this review, we can estimate that premedication one day before and just before the procedure may reduce potential complications. Some medical centers apply and recommend 30-day macrolide treatment after the procedure. New generation supraglottic devices may be preferred to avoid complications due to endotracheal intubation. Moreover, further research is needed to identify risk factors, prevent potential complications, and a common consensus is required for routine preventive treatment. Full article