Typhoid fever presenting as neuropsychiatric oddities:A case report

Rationale:Salmonella is a common etiological agent behind the tropical fever syndrome in the Indian subcontinent.Its prevalence in India remains high due to a lack of proper sanitation services in large parts of the country.Its neuropsychiatric manifestations is rare and the understanding on their pathophysiology is still poor.Patient concerns:A 19-year-old male,presented with a 10-day history of altered mental status,high-grade fever and violent behaviour.2 Days prior to admission,he developed decreased responsiveness and a muttering delirium with self-talking.Diagnosis:Coma vigil secondary to salmonellosis.Interventions:Intravenous ceftriaxone and dexamethasone.Outcomes:The resolution of the coma vigil and the associated Salmonella infection were observed;however,the patient developed residual mutism.Lessons:The atypical presentation of a globally obtunded state followed by mutism in typhoid coma in this case should be brought to the attention of clinicians worldwide.Additionally,the enduring speech limitations and potential psychiatric consequences may be linked to the prolonged duration of the infection.

Gettig Vigilant About Women's Coronary Disease

IN the last year, 41 year-old Huang has suffered more frequently from chest pains and breathlessness, especially when she is tired or angry. These symptoms usually last three to five minutes but can linger for up to an hour or two. Nitroglycerin sometimes helps alleviate the symptoms but not always. No tell-tale abnormal signs show up in Holter, heart supersonic or electrocardiogram checks when the problem is coming on.

Effects of Group Size on Vigilance Behavior of Wintering Common Cranes Grus grus

From January to March 2005, the effects of group size on the vigilance behavior of wintering Common Cranes Grus grus were studied at Lashihai Lake, Yunnan Province, China. We used scan sampling to record the group sizes and the number of vigilant individuals in each group, and focal sampling to record the frequency and duration of individual vigilance behavior. Both the vigilance efforts of groups and individuals significantly decreased as group size increased, but when the group size exceeded 30 individuals, the decrease of group vigilance became not significant （P 〉 0. 05）, and the vigilance duration of adult cranes increased （P 〈 0.01 ）. The vigilance frequency of adults increased （P 〈 0.05） when the size exceeded 50 individuals. Presumably, the maximal group size allowing the lowest vigilance for juvenile cranes was larger than that for adults, and the flocks composed of 20 to 30 individuals represented the optimal group size of wintering Common Cranes by considering only the vigilance behavior. Further research should focus on the synthesized effects of various factors.

肺动脉高压患者肺循环参数不同测量方法的可靠性

目的应用不同方法测量肺动脉高压患者肺循环参数,评价VigilanceⅡ系统连续热稀释法、经胸超声心动图(transthoracic echocardiography,TTE)法预测肺总阻力(total pulmonary resistance,TPR)的可靠性,并评价TTE测量肺动脉压的临床价值。方法选择复旦大学附属中山医院心内科收治的38例肺动脉高压患者(21例有心内分流,17例无心内分流)的TTE及右心导管测量肺循环参数,同时应用VigilanceⅡ系统连续热稀释法、Fick法、TTE法测量TPR,并进行回归相关分析。结果热稀释法、TTE法与Fick法所测量的TPR值之间均有相关性,无心内分流患者的相关性高于有心内分流患者,有心内分流患者TTE法与Fick法测量值之间线性关系无统计学意义,全部患者及无心内分流患者热稀释法、TTE法测得的TPR与Fick法测量值之间的线性关系均有统计学意义。TTE与右心导管测量肺动脉压力值之间有相关性,无心内分流患者之间的相关性高于有心内分流患者。结论 VigilanceⅡ系统连续热稀释法可精确估测无心内分流患者的TPR;TTE能够很好地估测肺动脉压力,可以作为估测无心内分流患者TPR的一种方法,但估测有心内分流患者TPR时要慎重。

基于AHP-TOPSIS法和数据挖掘综合评价新型抑酸药伏诺拉生临床应用的合理性

目的建立伏诺拉生合理性使用评价标准,为临床合理用药提供参考依据。方法以伏诺拉生说明书、临床指南、专家共识为基础,制定伏诺拉生用药评价标准,采用层次分析法(AHP)对评价指标赋权,并通过逼近理想解排序法(TOPSIS法)对某院2021年1月1日至2022年1月31日期间的236例住院患者该药的使用进行合理性评价。构建logistic二元回归模型探讨不合理用药的影响因素,并通过OpenVigiL数据库挖掘该药上市后的不良反应。结果在236个病例中,合理病例71份(占比30.1%),基本合理病例1份(占比0.4%),不合理164份(占比69.5%)。Logistic回归分析发现合并使用抗血小板药物是导致预防用伏诺拉生增加的主因。此外共挖掘到该药的不良反应88种。结论AHP-TOPSIS法可用于伏诺拉生合理性评价,研究结果表明该药存在适应证不适宜、未进行经济学考量、未进行患者教育等不合理现象,同时还应关注该药的不良反应,加大管理力度,以促进临床合理用药。

犬肺动脉高压模型连续热稀释法的应用

背景:以往小动物肺动脉高压模型有创测压方法一般根据生物信号采集系统的压力波形图引导,采用右心导管法进行压力测定;由于设备技术和动物体积的限制无法应用肺动脉导管测定心输出量及肺血管阻力。目的:在脱氢野百合碱诱导建立犬肺动脉高压模型中利用Swan-Ganz七腔漂浮导管和Vigilance系统根据连续热稀释法测定心输出量、肺血管阻力,肺动脉压力,探讨连续心排量法在肺动脉高压动物模型中的应用价值。方法:10只比格犬随机分成2组:实验组用脱氢野百合碱右心房注射的方法建立肺动脉高压的动物模型,对照组右心房注射二甲基酰胺做对照;在用药前,用药后8周使用漂浮导管和Vigilance系统分别测定两组犬右心房收缩压、右心室收缩压、肺动脉收缩压、平均肺动脉压力、肺毛细血管楔压及心输出量。结果与结论:实验组用药后肺血管阻力显著上升(P=0.00),实验组用药后心输出量显著减少(P<0.05)。使用连续热稀释法测定肺血管阻力和心输出量较传统的间断热稀释法更准确稳定。利用漂浮导管和Vigilance系统根据连续热稀释法原理在脱氢野百合碱诱导的犬肺动脉高压模型中进行肺血管阻力和心输出量测定,该方法具有准确稳定、可重复操作和对实验模型创伤小的优点。

Suitable distance to observe Red-crowned Cranes:a note on the observer effect

In order to assess the effect of the observer distance on the behavior of Red-crowned Cranes (Grus japonensis),we studied their time budgets with a gradient of observer distances in Yancheng,China from December 2008 to March 2009.Observer distance was classified into four levels,i.e.,＜ 200 m,200-300 m,300-400 m and ＞ 400 m.The results indicated that cranes increased their vigilance when the observer was less than 300 m away.A safe distance for the observer was often as far as or more than 300 m.Cranes increased scan frequency when observers were within 200 m,whereas they prolonged the duration of their scan when observers were between 200 m and 300 m away,indicating two distinct vigilant strategies,given the observer distance.We suggest an observer distance of at least 300 m,in order to minimize the observer effect.

Policy Framework for Community and State Policing in Combating Rising Security Challenges in Nigeria

Viability of decentralizing policing in Nigeria had been on the front burner of security discourse since Nigeria returned to democratic governance in 1999.Valid points had been put forward by both those in support and those in opposition.The Community Policing Department of the Nigeria Police had remained more of an administrative unit with little impact beyond the Police Community Relations Committee activities.Rising cases of herdsmen attacks of various communities,terrorist insurgency in the North-East,kidnappings across the different geo-political zones had resulted in the need to interrogate the efficacy of effective community policing and state policing as viable options to combating rising security challenges.The study adopted qualitative method,and being a library research relied entirely on secondary data.Sources of data included journals,relevant textbooks,newspapers,magazines,and materials downloaded from internet.The paper argues that the traditional security agencies had failed to effectively combat the many security challenges that Nigeria faces.The combination of the official security agencies and the military had failed to effectively combat insecurity in the country.The local vigilante groups on the other hand had made valuable inroad in curtailing some of the security challenges including terrorist insurgency as a result of their knowledge of the terrain.The paper concludes that to effectively combat the many security challenges,there is a need for new policy framework at the federal and state levels that would decentralize policing and give legal backing for collaboration between the official security agencies under the federal government and state security outfits including the vigilante.

一种利用信任管理的关于无线计算的安全框架

PKI和RBAC利用分布式信任管理在普遍计算环境中提供了一种高度柔性的增强性安全模式,在对PKI和RBAC进行改进的基础上,提出了一种主要应用于无线计算系统的安全框架Vigil。

Improved de-interleaving algorithm of radar pulses based on dual fuzzy vigilance ART

As a core part of the electronic warfare(EW) system,de-interleaving is used to separate interleaved radar signals. The de-interleaving algorithm based on the fuzzy adaptive resonance theory(fuzzy ART) is plagued by the problems of premature saturation and performance improving dilemma. This study proposes a dual fuzzy vigilance ART(DFV-ART) algorithm to address these problems and make the following improvements. Firstly, a correction method is introduced to prevent the network from prematurely saturating;then, the fuzzy vigilance models(FVM) are constructed to replace the conventional vigilance parameter, reducing the error probability in the overlapping region;finally, a dual vigilance mechanism is introduced to solve the performance improving dilemma. Simulation results show that the proposed algorithm could improve the clustering accuracy(quantization error dropped60%) and the de-interleaving performance(clustering quality increased by 10%) while suppressing the excessive proliferation of categories.

Vigilance behavior of Pyrenean chamois Rupicapra pyrenaica pyrenaica:Effect of sex and position in the herd

The Pyrenean chamois Rupicapra pyrenaica pyrenaica is a mountain-dwelling ungulate with an extensive presence in open areas. Optimal group size results from the trade off between advantages （a reduction in the risk of predation） and disadvantages （competition between members of the herd） of group living. In addition, advantages and disadvantages of group living may vary depending on the position of each individual within the herd. Our objective was to study the effect of central vs. peripheral position in the herd on feeding and vigilance behavior in male and female Pyrenean chamois and to ascertain if a group size effect existed. We used focal animal sampling and recorded social interactions when a focal animal was involved. With males, vigilance rate was higher in the central part of the group than at the periphery, probably due to a higher density of animals in the central part of the herd and a higher probability of being disturbed by conspecifics. With females, vigilance rate did not differ according to position in the herd. Females spent more time feeding than males, and males showed a higher frequency of the vigilance behavior than females. We did not observe a clear relationship between group size and vigilance behavior. The differences in vigilance behavior might be due to social interactions

Epidemic spreading in scale-free networks including the effect of individual vigilance

In this paper, we study the epidemic spreading in scale-flee networks and propose a new susceptible-infected- recovered （SIR） model that includes the effect of individual vigilance. In our model, the effective spreading rate is dynamically adjusted with the time evolution at the vigilance period. Using the mean-field theory, an analytical result is derived. It shows that individual vigilance has no effect on the epidemic threshold. The numerical simulations agree well with the analytical result. Purthermore, we investigate the effect of individual vigilance on the epidemic spreading speed. It is shown that individual vigilance can slow the epidemic spreading speed effectively and delay the arrival of peak epidemic infection.

Comparison of novel tools with traditional cognitive tests in detecting delirium in elderly medical patients

BACKGROUND Efficient detection of delirium and comorbid delirium-dementia is a key diagnostic challenge.Development of new,efficient delirium-focused methods of cognitive assessment is a key challenge for improved detection of neurocognitive disorders in everyday clinical practice.AIM To compare the accuracy of two novel bedside tests of attention,vigilance and visuospatial function with conventional bedside cognitive tests in identifying delirium in older hospitalized patients.METHODS 180 consecutive elderly medical inpatients(mean age 79.6±7.2;51%female)referred to a psychiatry for later life consultation-liaison service with delirium,dementia,comorbid delirium-dementia and cognitively intact controls.Participants were assessed cross-sectionally with conventional bedside cognitive tests[WORLD,Months Backward test(MBT),Spatial span,Vigilance A and B,Clock Drawing test and Interlocking Pentagons test]and two novel cognitive tests[Lighthouse test,Letter and Shape Drawing test(LSD)-4].RESULTS Neurocognitive diagnoses were delirium(n=44),dementia(n=30),comorbid delirium-dementia(n=60)and no neurocognitive disorder(n=46).All conventional tests had sensitivity of>70%for delirium,with best overall accuracy for the Vigilance-B(78.3%),Vigilance-A(77.8%)and MBT(76.7%)tests.The sustained attention component of the Lighthouse test was the most distinguishing of delirium(sensitivity 84.6%;overall accuracy 75.6%).The LSD-4 had sensitivity of 74.0%and overall accuracy 74.4%for delirium identification.Combining tests allowed for enhanced sensitivity(>90%)and overall accuracy(≥75%)with the highest overall accuracy for the combination of MBT-Vigilance A and the combined Vigilance A and B tests(both 78.3%).When analyses were repeated for those with dementia,there were similar findings with the MBTVigilance A the most accurate overall combination(80.0%).Combining the Lighthouse-SA with the LSD-4,a fail in either test had sensitivity for delirium of 91.4 with overall accuracy of 74.4%.CONCLUSION Bedside tests of attention,vigilance and visuospatial ability can help to distinguish neurocognitive disorders,including delirium,from other presentations.The Lighthouse test and the LSD-4 are novel tests with high accuracy for detecting delirium.

Tolerance of disturbance by humans in long-time resident and recent colonist urban doves

Background: A critical trait for successful urban dwelling by birds is the ability to tolerate high levels of disturbing stimulation by humans. If such tolerance is partly acquired gradually after colonization, species with a long history of residence in cities are likely to be more tolerant of such stimulation than recent urban colonists, but this has not often been tested.Methods: We tested whether introduced Rock(Columba livia) and Spotted(Streptopelis chinensis) Doves, historically long-term residents of Melbourne, Australia, were more tolerant of disturbance by humans than the very recent colonist, the native Crested Pigeon(Ochyphaps lophotes) by comparing the Flight Initiation Distances(FID) and time allocations to vigilance during foraging of all three species in urban Melbourne. That all three species are members of the Columbiformes reduces the possibility that any species differences in tolerance are simply phylogenetic in origin.Results: Flight initiation distance was shorter in Rock Doves than in the other two species, which did not differ in approachability by a human. Rock Doves retreated from an approaching human mainly by walking a relatively short distance, Crested Pigeons mainly by running a relatively short distance and Spotted Doves primarily by flying a comparatively long distance. The time allocation to anti-predator vigilance of Rock Doves was smaller than that of the other two species, whose allocations were similar.Conclusions: The very recent colonist of eastern Melbourne, the Crested Pigeon, was not the least tolerant of disturbance by humans of the three related species. Natural selection for tolerance therefore probably cannot entirely explain the pattern of tolerance evident among these urban dove species and behavioural flexibility is probably involved. Length of residency in a city is not an infallible guide to a species' level of tolerance of disturbance by humans.

Saltmarsh vegetation and social environment influence flexible seasonal vigilance strategies for two sympatric migratory curlew species in adjacent coastal habitats

Background:Animals need to adjust their vigilance strategies when foraging between physically contrasting veg-etated and non-vegetated habitats.Vegetated habitats may pose a greater risk for some if vegetation characteristics function as a visual obstruction but benefit others if they serve as protective shelter.Variation in group size,presence of similar species,along with variation in environmental conditions and anthropogenic disturbance can also influence vigilance investment.Methods:In this study,we quantified the vigilance behaviour of two large-bodied,sympatric migratory curlew species-Far Eastern Curlew(Numenius madagascariensis)and Eurasian Curlew(N.arquata)-in vegetated Suaeda salsa saltmarsh and non-vegetated mudflat habitat in Liaohekou National Nature Reserve,China.We used linear mixed models to examine the effects of habitat type,season,tide time,flock size(conspecific and heterospecific),and human disturbance on curlew vigilance investment.Results:Both species spent a higher percentage of time under visual obstruction in S.salsa habitat compared to mudflat habitat but in response,only Far Eastern Curlew increased their percentage of vigilance time,indicating that visual obstruction in this habitat is only a concern for this species.There was no evidence that S.salsa vegetation served as a form of cryptic background colouration since neither species decreased their vigilance effect in S.salsa habitat in spring compared to the autumn migration season.The effect of curlew social environment(i.e.flock size)was habitat dependent since percentage of vigilance time by curlews in saltmarsh increased with both the number of individual curlews and number of other birds present,but not in mudflat habitat.Conclusions:We conclude that both migratory curlew species exhibit a flexible vigilance adjustment strategy to cope with the different environmental and social conditions of adjacent and sharply contrasting coastal habitats,and that the trade-off between the risks of foraging and the abundance of prey may be a relatively common phenom-enon in these and other shorebird populations.

Hospital Night Shift and Its Effects on the Quality of Sleep, the Quality of Life, and Vigilance Troubles among Nurses

Introduction: The exposure to shift works, and especially to night shift, goes against the circadian rythmicity of the social man, which brings about a multitude of disruptive effects on health. In a hospital environment, such night shift is necessary so as to ensure the continuity of care. Sleep and vigilance disorders related to this work mode are frequent and often pose adaptation problems. The objective of this study is to detect the harmful effects of night shift on sleep, vigilance and the quality of life of nurses in Farhat Hached Teaching Hospital in Sousse. Material and Methods: It is a cross-sectional study carried out among two groups of nurses: one group performing a fixed night work and the other one working permanently during the day at Farhat Hached Teaching Hospital in Sousse. Data collection is mainly based on validated questionnaires evaluating sleep quality (Pittsburg sleep quality index), daytime sleepiness (Epworth sleepiness scale), sleep typology (Horne and Ostberg questionnaire), and the quality of life (SF-12). An objective evaluation of vigilance was realized by the study of reaction time and error rates to different tasks of “Super lab” software. Results: 50 night and 50 day nurses have been colligated. Both groups were age- and gender-matched. Sleep quality mean index was significantly higher among night nurses in comparison with day nurses (10.2 ± 5.9 versus 6.76 ± 5.16). After multivariate analysis, sleep quality was significantly correlated to age, department, schedule and the choice of schedule. Night shift was not related to daytime sleepiness. The objective analysis of vigilance showed that the reaction time to different tasks exploring the attentional mechanisms, as well as errors rate, were significantly more important among the night group. The mental score of the quality of life was significantly higher among day nurses. However, such difference was not significant with regard to physical score. Conclusion: The findings of our study highlight not only the alteration of the health and the well being of paramedical staff secondary to night shift, but also a possible threat to safety care lavished by these teams, which involves the necessity to undertake preventive measures on an individual and collective scale.

Definition of spatial positions within foraging Greater White-fronted Geese flocks from an individual's perspective:Cost-benefit dynamics change with the distance to flock edge

The costs and benefits of group living are not evenly distributed among individuals that occupy different spatial positions within a group(central or peripheral).However,the definitions of central and peripheral positions may artificially mask the true dynamics of cost and benefit of individuals.Using wintering foraging Greater Whitefronted Geese(Anser albifrons)flocks as our study system,we measured individual spatial position within a flock as distance to the flock edge.First,we tested the effects of distance to edge on the antipredation cost and foraging benefit of individual goose using generalized linear mixed models(GLMMs).Flock size and number of neighbors and their interactions with distance to edge were included as fixed effects in GLMMs.Then we used piecewise regression to determine the threshold value of distance to edge to classify central and peripheral individuals.Our results indicated distance to edge significantly affected percent of time spent on vigilance(vigilance time),percent of time spent on foraging(foraging time)and intake rate(pecks/min),whereas other factors had no effects.We found that the critical distance that predicted changes in behavior was around 2.5 m.Birds 2.5 m or less from the edge of the group were more vigilant,and had less efficient foraging than more central individuals.Behavioral differences between central and peripheral individuals were more easily detected when the birds were classified by the method introduced in this study than by the traditional minimum convex polygon method.Our research provides researchers a dichotomous classification scheme that places individuals into peripheral and central positions from an individual's perspective.

ART-2 neural network based on eternal term memory vector:Architecture and algorithm

Aimed at the problem that the traditional ART-2 neural network can not recognize a gradually changing course, an eternal term memory (ETM) vector is introduced into ART-2 to simulate the function of human brain, i.e. the deep remembrance for the initial impression.. The eternal term memory vector is determined only by the initial vector that establishes category neuron node and is used to keep the remembrance for this vector for ever. Two times of vigilance algorithm are put forward, and the posterior input vector must first pass the first vigilance of this eternal term memory vector, only succeeded has it the qualification to begin the second vigilance of long term memory vector. The long term memory vector can be revised only when both of the vigilances are passed. Results of recognition examples show that the improved ART-2 overcomes the defect of traditional ART-2 and can recognize a gradually changing course effectively.

Humorous Communication and Comprehension:Manipulation and Epistemic Vigilance

This paper takes an integrative approach to the communication and comprehension of humor from the perspectives of the humorist’s manipulation and the recipient’s vigilance informed by relevance theory.It is proposed that,in order to communicate humor,the humorist manipulates the recipient’s expectation of relevance in the setup and in the punchline in two different but related ways:misleading and guiding.It is also proposed that,in order to comprehend and appreciate humor,the recipient exercises vigilance against his/her own shallow processing in the setup and exercises vigilance for special cognitive effects in the punchline.On this approach,humorous communication and comprehension is viewed as an interaction between manipulation and epistemic vigilance.Strategies of manipulation and vigilance are described,and some essential issues arising from the relevance-theoretic approach to humor are reconsidered with some implications drawn.This paper contributes to enhancing the explanatory power of relevance theory for the communication and comprehension of humor.