salvage transjugular intrahepatic portosystemic shunt followed by early transplantation in patients with child c14-15 cirrhosis and refractory variceal bleeding:

Answers

Answer 1

Salvage trans jugular intrahepatic portosystemic shunt that is followed by early transplantation in patients with child c14-15 cirrhosis and refractory variceal bleeding:

What was the aim of this study?

Even though it's still unknown how trans jugular intrahepatic Porto-systemic shunt (TIPS) works to treat variceal hemorrhage that is resistant to sclerotherapy and medicinal intervention.

Research of the outcomes of early salvage TIPS for active, uncontrolled variceal hemorrhage and identification of the precise factors that contribute to mortality.

What methods were used to perform this study?

When it was discovered that 58 individuals had variceal bleeding that had not responded to a combination of sclerotherapy and medicine, Salvage TIPS was given to them as soon as was practical.

23 characteristics were prospectively analyzed to find predictors of death within 60 days after the surgery.

What did the researchers conclude from the study?

Prompt recovery TIPS is an effective technique for stopping active variceal bleeding that is unresponsive to sclerotherapy and drug treatment.

It is impossible to predict the result in a given patient using pre-treatment prognostic indicators that correlate to death.

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Related Questions

Why is prolonged exposure to ultraviolet radiation harmful to the eyes and skin?.

Answers

Answer:

Exposure to UV rays can cause premature aging of the skin and signs of sun damage such as wrinkles, leathery skin, liver spots, actinic keratosis, and solar elastosis. UV rays can also cause eye problems. They can cause the cornea (on the front of the eye) to become inflamed or burned.

3. the nurse needs to administer an iv push medication for a patient who is complaining of pain. the medication is incompatible with the iv fluid that is infusing. what is the nurse’s best initial action?

Answers

The nurse's best initial action is to firstly stop the infusion, flush with 10 mL of 0.9% sodium chloride (NaCl), give the IV pain medicine over the appropriate period of time, flush with another 10 mL of 0.9% sodium chloride(NaCl) at the same rate as the medication was administered, and restart the IV fluids.

What is IV fluid?

In order to treat or prevent dehydration, IV fluids are carefully prepared liquids that are injected into a vein. IV fluids are applied to patients of all ages who are ill, hurt, becoming dehydrated from physical activity or the heat, or who are having surgery. Rehydrating intravenously is a straightforward and with no risk treatment that is commonly used.

Here, the nurse needs to administer an IV push medication for a patient who is complaining of pain. the medication is not compatible with the IV fluid that is infusing. the nurse’s best initial action is to firstly stop the infusion, flush with 10 mL of 0.9% sodium chloride (NaCl), give the IV pain medicine over the appropriate period of time, flush with another 10 mL of 0.9% sodium chloride(NaCl) at the same rate as the medication was administered, and restart the IV fluids.

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The physician ordered a medication, 600,000 units for deep IM injection. The dose on hand is 1,200,000 units per 2 milliliters. How many milliliters will you administer to your patient?

Answers

The volume in millilitres that would be administered is = 1 mL

Calculation of drug dosage

The prescribed dosage of the drug to be given through deep intramuscular route= 600,000 units

On hand dose of the drug available= 1,200,000 units per 2 milliliters.

Therefore to calculate the dose to be given in millilitres;

If 1,200,000 units = 2 milliliters

600,000 units = X millilitres

Make X millilitres the subject of formula,

X millilitres = 2 × 600,000/1,200,000

X millilitres= 1,200,000/1,200,000

X millilitres= 1 mL

Therefore, volume in millilitres that would be administered is = 1 mL

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use radic in a sentece

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I don’t know what radic means but I just used it in a sentence lol

If i took tylenol at about 6 or 7AM in the morning and took one now at 10PM will i be okay?

Answers

No you will not be okay

Explanation:

Hi. How are you. U good?

a client is being admitted to the preoperative holding area for a thoracotomy. preoperative teaching includes what?

Answers

The preoperative teaching should include correct use of incentive spirometry.

What is thoracotomy?

A thoracotomy is a surgical procedure in which a cut is made between the ribs to see and reach the lungs or other organs in the chest or thorax.

What is preoperative teaching?

Preoperative teaching refers to any educational intervention delivered before surgery that aims to improve people's knowledge, health, behaviours and health outcomes.

Thus, the preoperative teaching should include correct use of incentive spirometry which usually begins before surgery to familiarize the patient with its correct use.

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which safety intervention would the nurse include in a plan of care for a client with somatic disorder who reports loss of vision

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Answer:

The nurse would include a safety intervention for the client with somatic disorder who reports loss of vision, such as keeping the client's bed in a low position, providing the client with a bedside commode, and keeping the client's environment free of obstacles.

Explanation:

We know this is the answer because, as stated in the question, the client is experiencing loss of vision which means, among other things, that they have a decreased ability to see. Therefore, it is important to make sure that they are in a safe environment where they are not at risk of falling or injuring themselves.

which roles is the nurse demonstrating when recognizing a problem and collecting data to sufficiently support the need for policy updates?

Answers

The roles that the nurse demonstrates when recognizing a problem and collecting data to sufficiently support the need for policy updates is change agents.

Who is a change agent?

This exemplifies the advocate-in-nursing position. When nurses identify a problem and gather data to support it in order to change policy, they are conducting research. Nurses are acting in the capacity of change agents when they investigate issues and gather information to support the need for change.

Change agents standardize and streamline the decision-making process by connecting corporate goals with operational and cultural concerns. Change agents have an entrepreneurial mindset and a strong sense of accountability; they desire to advance and motivate others to do the same.

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a nurse is assessing a neonate during the first 24 hours after birth. which finding would the nurse recognize as normal?

Answers

The nurse would recognize the body temperature of 97.9° to 99.7° F (36.5° to 37.5° C) as a normal finding.

What is a neonate?

A newborn baby is called a neonate. When the child is under 28 days of age or the first 4 weeks of their life, they are called neonates. This period of the first 4 weeks is also called as neonatal period.

This temperature that is taken of a neonatal is to determine whether the child is under normal body conditions or not. The baby may have a fever if they have a body temperature of 38°C or above. This mostly happens in the body of a baby in order to fight germs.

The immune system of the body increases the temperature to help get rid of the germs without causing any harm to the body itself.

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a nurse is assessing a client with multiple myeloma. due to this condition, what will this client be at risk for?

Answers

A client assessed and diagnosed to be having multiple myeloma will be at risk for serious bone pains or even bone fractures

This goes to say that such patient will a very painful risk of pathologic bone fractures

Healthcare assessment

Healthcare care assessment can simply be defined as those assessments, care, intervention and check ups which the healthcare professionals usually look out for in patients with with health conditions. The aim and objective of this assessment is to improve the well being of clients.

So therefore, a client assessed and diagnosed to be having multiple myeloma will be at risk for serious bone pains or even bone fractures

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WILL GIVE BRAINLIEST!!!!

What type of recording do you think would be the most useful to crime investigators? Why?

Answers

Answer:

photographs

Explanation:

they actually show the crime scene, and it’s not all blurry like a security camera video. They still count as evidence. Also security camera videos can be edited and the security cams themselves could be taken down or disabled. But a camera (regular) won’t have any of these. Some of the, even work without internet.

Answer:

High quality video would likely be the best in many cases.

Explanation:

Most currently available security cameras are fairly high resolution, cooler, and have audio capabilities.

how would the nurse respond to an alcohol recovery program sponsor requestiong to read hisor her client. quiazlet

Answers

Following nursing ethics, the nurse should not allow the sponsor to review the record.

What ethics should the nurse follow?Ethics are moral rules that oversee how the individual or a organization will act or respond to a situation.Nursing ethics is the applied discipline that tends to the ethical principle of nursing practice. Moral qualities are fundamental for all medical services laborers. Ethical practice is an establishment for medical caretakers, who deal with moral issues day to day.There are four fundamental principles of ethics: autonomy, beneficence, justice, and non-maleficence. Every patient has the option to settle on their own choices in view of their own convictions and values (autonomy).Medical services laborers have an obligation to cease from abuse, limit hurt, and advance great towards patients (beneficence).All patients reserve a privilege to be dealt with fairly and similarly by others (justice).Patients reserve an option to no damage. Non-maleficence expects that attendants try not to hurt patients.

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prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. kannel 1998

Answers

An irregular heart rhythm that starts in the upper (Atria) of heart is known as Atrial fibrillation.

The normal cycle of electrical impulses in heart is interrupted if person have atrial fibrillation

What are the types of atrial fibrillation?

There are three types of atrial fibrillation, and these are Persistent A fib, Paroxysmal A fib, Long standing persistent A fib.long Standing persistent A fib lasts more than a Year and sometimes hard to treat.Persistent A fib lasts more than one week, and it needs treatment.Paroxysmal A fib lasts less than one week and generally stops on its own treatment.

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select the correct answer. which type of stretching must be done under the supervision of a coach or a trainer?

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Dynamic stretching is a type of stretching that must be done under the supervision of a coach or a trainer.

Stretching that is movement-based is called dynamic stretching. It achieves a stretch by working the muscles directly. Due to the fact that the stretch posture is not maintained, it differs from conventional "static" stretching. By warming up the muscles and loosening the muscular fibers, dynamic stretching increases flexibility. As your muscles warm up, the fibers lengthen and loosen, enabling you to extend the stretch further.

Dynamic stretching improves muscle and joint mobility, which may aid in injury prevention. Dynamic hamstring exercises were found to increase range of motion and decrease passive stiffness in a recent study. These elements are linked to a lower incidence of hamstring strains, one of the most frequent injuries sustained during exercise.

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a client will have bowel surgery in the morning. the health care provider orders 500 ml of golytly po starting at 5 pm this evening. what would this amount be in liters?

Answers

A client will have bowel surgery in the morning. The health care provider orders 500 ml of golytely starting at 5 pm this evening. In liters its 1/2 liter.

What is Golytely?

GoLytely (polyethylene glycol 3350 and electrolytes)  is a laxative solution used as medicine for adults to clean the colon prior a colonoscopy or barium enema X-ray examination. It cleans our colon by causing us to have diarrhea (loose stools). Cleaning our colon is done so that the inside of our colon is visible more clearly to healthcare provider during your colonoscopy. This medication contains minerals that are passed from the body in the stool to replace electrolytes.

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sandy liu, a cardiac care unit nurse, notices that a few of her patients are suffering from inadequate pain control. currently, a patient who needs pain medication must call the front desk, which then calls the nurse, who then goes to the patient’s room to find out what he or she needs. sandy finds out that a hospital in the next county has a simpler process: patients can send a text message directly to the nurse to request pain medication. sandy goes to her manager and suggests that they form a team to work on improving pain control and test this change to improve care in the cardiac care unit within the next three months. what improvement project phase is sandy looking to embark on?

Answers

Sandy has uncovered a new possibility and is looking into the possibility of doing a test.

The new method is put through its paces during the piloting procedure, which entails doing it in a single location before being meticulously improved.

It's possible that implementation and expansion will occur later, but that will depend on how well the pilot goes. Option B

This is further explained below.

What is cardiac care unit?

Generally, A coronary care unit, also known as a cardiac intensive care unit, is a ward at a hospital that specializes in the care of patients who have suffered from heart attacks, angina pectoris, cardiac dysrhythmia, and a variety of other cardiac disorders that call for ongoing monitoring and treatment.

In conclusion,  Sandy has identified a previously unconsidered option and is now investigating the feasibility of doing an experiment.

The new approach is put through its paces during the piloting stage, which comprises carrying it out in a single area before being painstakingly worked upon.

During this time, the method is evaluated for its effectiveness.

Implementation and growth are both possibilities in the future; however, their occurrence will be contingent on how successful the pilot project is.

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complete question

Sandy Liu, a cardiac care unit nurse, notices that a few of her patients are suffering from inadequate pain control. Currently, a patient who needs pain medication must call the front desk, which then calls the nurse, who then goes to the patient's room to find out what he or she needs. Sandy finds out that a hospital in the next county has a simpler process: Patients can send a text message directly to the nurse to request pain medication. Sandy goes to her manager and suggests that they form a team to work on improving pain control and test this change in the cardiac care unit.

What improvement project phase is Sandy looking to embark on?

(A) Innovation

(B) Pilot

(C) Implementation

(D) Spread

hey guys What is oxymetholone Half life and can you calculate its Ke ?​

Answers

Answer:Anabolic steroid

It can treat certain types of anemias.

Explanation: half 50

hope this helped! Brainlist? plz

If vaccination for meningococcal meningitis is required of all entering college students, this would be an example of which type of intervention?.

Answers

If vaccination for meningococcal meningitis is required of all entering college students, this would be an example of a Primary intervention—obligation.

An intervention is a precautionary measure or a treatment that is taken so that a disease can be treated or prevented.

Primary intervention s such a type of intervention that is taken even before a disease or injury has taken place. A primary intervention may include a certain kind of precautionary measure taken, a medicine, or a vaccination done to prevent a disease before it has occurred. If a primary intervention is termed obligatory, then it means that it is obligatory for a person to take that treatment plan.

The college students above have an obligation to take vaccination for meningococcal meningitis. There hasn't been any infection caused by the microorganisms yet but still, the measure is recommended by the college officials as an obligatory primary intervention to eradicate infections caused by this microorganism. Hence. the correct option is primary intervention- obligation.

Other options, such as secondary intervention, are not correct as any kind of secondary intervention is taken at the onset of a disease to prevent further worsening of the situation.

Although a part of your question is missing, you might be referring to this question:

If vaccination for meningococcal meningitis is required of all entering students, this would be an example of which type of intervention?

Select one:

a. Primary Intervention - Education

b. Primary Intervention - Obligation

c. Secondary Intervention - Education

d. Secondary Intervention - Motivation

e. Tertiary Intervention - Education

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can chronic pelvic pain in men be treated with myofascial trigger point release and paradoxical relaxation training? fitzgerald

Answers

Yes, Chronic pelvic pain in men can be treated with myofascial trigger point release and paradoxical relaxation training.

What is pelvic pain?

Pelvic pain means pain or discomfort in the lowest part of the abdomen and pelvis, ranging from a sharp jab to a dull ache.

Intense myofascial trigger point stimulation and concurrent paradoxical relaxation training are beneficial for males with chronic pelvic pain that is resistant to conventional treatment. Patients can lessen pain and dysfunction by learning how to self-administer trigger point release and maintain pelvic muscle relaxation. The success rate of this therapy technique should be increased through improved clinical phenotyping and the identification of individuals with soreness in the pelvic muscles.

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global burden of cardiovascular diseases and risk factors, 1990–2019: update from the gbd 2019 study

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Ischemic heart disease (IHD) and stroke are the primary causes of death and disability worldwide. Cardiovascular diseases (CVDs) are another important cause of disability. Using data from the Global Burden of Disease (GBD) Study 2019, this report examines the scope of the overall CVD burden, including the 13 underlying causes of cardiovascular mortality and the 9 associated risk factors.

GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, produced estimates for 204 countries and territories from 1990 to 2019 using all population-level data sources on incidence, case fatality, prevalence, mortality, and health risks.

The prevalence of all CVD cases virtually doubled from 271 million cases in 1990 to 523 million cases in 2019 (95% UI: 497 to 550 million cases), while the number of CVD deaths progressively rose from 12.1 million cases in 1990 to 18.6 million cases (95% UI: 17.1 to 19.7 million cases) in 2019. Years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI: 24.9 to 43.6 million) throughout that time period, with the global trends for disability-adjusted life years (DALYs) and years of life lost also rising dramatically. Almost all nations outside of high-income nations continue to see an increase in the burden of CVD, and frighteningly, the age-standardized rate of CVD has started to climb in several places where it was previously dropping in high-income nations. If the world is to accomplish the objectives of Sustainable Development Goal 3 and achieve a 30% decrease in early mortality attributable to noncommunicable illnesses, it must concentrate on adopting current cost-effective policies and initiatives.

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Weight control, aggression, impulsivity, and psychological depression have all been associated with.

Answers

associated with serotonin pathways

the nurse is caring for a client following an aneurysm coiling procedure. the nurse documents that the client is experiencing korsakoff syndrome. which set of symptoms characterizes korsakoff syndrome?

Answers

The set of symptoms that characterizes korsakoff syndrome are psychosis, disorientation, delirium, insomnia, and hallucinations.

Interventional neuroradiology is being used to treat aneurysms as a result of technological advancements. In certain patients, endovascular procedures may be utilized to occlude the aneurysm itself using coils or another method by occluding the blood flow from the artery that supplies it.

Although they are rare, postoperative problems can happen. Korsakoff syndrome, forgetfulness, and other psychiatric problems are examples of potential consequences (disorder characterized by psychosis, disorientation, delirium, insomnia, hallucinations, and personality changes). The illness Creutzfeldt-Jakob causes myoclonus and severe dementia.

Tremor, stiffness, and bradykinesia are the three hallmark symptoms of Parkinson's disease. Huntington illness causes dementia and progressively uncontrollable choreiform (dance-like) motions.

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Ordered:3 mg
Available:1.5 mg/tablet
How many tablets should be given?
Ordered:1000mg
Available:250 mg/tablet
How many tablets should be given?

Answers

Answer:

For me

Explanation:

The first one is 2 tablets

The second one is 4 tablets

The requested and available amounts must be compared in order to determine how many tablets should be administered. The first illustration shows a 3mg order and a 1.5mg tablet supply. As a result, since 3 mg/1.5 mg equals two tablets, the patient should receive two.

What is the second illustration to it ?

In the second illustration, 1000 mg are requested, and 250 mg are offered each tablet. As a result, since 1000mg/250mg equals four tablets, the patient should receive that number of tablets.

It's crucial to keep in mind that when determining how many tablets should be administered, the requested and available amounts must be compared.

Using 1.5 mg/tablet tablets, administer 3 mg:

= 3 mg x 1.5 mg/tablet, total number of tablets

Tablets = 2 tablets in total.

As a result, 2 pills should be administered.

To provide 1000 mg using pills containing 250 mg:

There are 1000 mg in each pill, divided by 250 mg.

4 pills total, please.

As a result, 4 pills should be administered.

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ed has been diagnosed with alzheimer's disease. he is taking an experimental medication. this medicine is designed to: please choose the correct answer from the following choices, and then select the submit answer button. answer choices increase the level of acetylcholine. decrease the level of dopamine. decrease the level of acetylcholine. increase the level of dopamine.

Answers

The medicine for Alzheimer's disease is specifically designed to increase the level of acetylcholine.

What is acetylcholine?

Acetylcholine is a neurotransmitter (i.e. a chemical messenger) released by motor neurons present in the nervous system, and acetylcholinesterase enzymes that break down acetylcholine can be used as medicine for Alzheimer's disease.

In conclusion, the medicine for Alzheimer's disease is specifically designed to increase the level of acetylcholine.

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middle-aged woman has sought care from her primary provider and undergone diagnostic testing that has resulted in a diagnosis of MS. What sign or symptom is most likely to have prompted the woman to seek care

Answers

Fatigue is typically one of the earliest symptoms of MS

the client with asthma has loud wheezing and signs of an impending asthma attack. which intervention should the nurse implement first?

Answers

The nurse should give an inhaled beta-2 adrenergic agonist.
For the treatment of respiratory conditions such bronchial asthma and chronic obstructive pulmonary disease, beta-2 adrenergic agonists are a staple (COPD).

At least every four hours, check the patient's vital signs and breathing patterns. Use auscultation to listen for breath sounds. to aid in making a precise diagnosis and track the success of medical therapy. One of the key symptoms of asthma is wheezing.Bronchospasm can be treated or avoided by using the short-acting beta2 agonists (albuterol, levalbuterol, metaproterenol, and pirbuterol). By inhaling aerosolized or nebulized versions of these drugs, the bronchial smooth muscles are routinely given these medications.

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what actions should the nurse educator take to address this? (select all that apply. one, some, or all options may be correct.)

Answers

Answer:

Could you list the options please?

Explanation:

Describe the difference between supination & pronation, circumduction & rotation, contraction & relaxation,
adduction & abduction.

Answers

Answer:

Explanation:

Supination and pronation are used to describe the up or down orientation of your hand. When your palm or forearm faces up, it’s supinated. When your palm or forearm faces down, it’s pronated.

Circumduction is when the limb moves in a circle and rotation is when the limb turns around its long axis, like using a screwdriver.

Contraction is when you flex/activate your muscle so it stiffens, and relaxation is when your muscle is at rest.

Abduction is movement away from the midline of the body, and adduction is a movement towards the midline of the body

Answer:

Supination means that when you walk, your weight tends to be more on the outside of your foot. Pronation means that when you walk, your weight tends to be more on the inside of your foot. An easy way to remember the difference is that supination has the term “up” in it.

Explanation:

incidence and predictors of perioperative atrial fibrillation in burn intensive care unit patients following burn surgery

Answers

Incidence and predictors of perioperative atrial fibrillation for the burn intensive care unit patients following a burn surgery.

What is Atrial Fibrillation?

Atrial fibrillation is a well-known side effect of heart surgery. It has been associated with greater inpatient and long-term mortality. There hasn’t been much research on atrial fibrillation in persons with severe burns after a burn surgery. The purpose of this study was to examine the prevalence, contributing causes, and prognosis of atrial fibrillation in patients with severe burns who underwent burn surgery.

Methods of Atrial Fibrillation

The participants in this study were over the age of 18 and had a 30% burned total body surface area (TBSA). Atrial fibrillation was ruled out in patients who had it on their preoperative ECG or in their historical medical records. Data from 214 patients’ medical records were reviewed retrospectively.

Atrial fibrillation, which was associated with both complete thickness and TBSA%, was a rather infrequent complication when badly burned patients were brought in for surgery.

The importance of maintaining ideal electrolyte and fluid balance as well as avoiding sympathetic activation is supported by the fact that every single one of our patients had one of the risk factors for atrial fibrillation.

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infection control is foremost for all health care providers. which example best interferes with the chain of infection?

Answers

The action that best interferes with the chain of infection is to inform family members not to visit clients when they are sick.

What is chain of infection?

The term chain of infection has to do with the route that an infection passes as it continues to infect organisms starting from the primary host. When a person gets sick, the illness may be communicable thus it could spread by contact.

As such, a person who is sick with such a disease has to stay away from making contacts with people. Thus, the action that best interferes with the chain of infection is to inform family members not to visit clients when they are sick.

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Erick, Mia, and Isabelle golfed 9 holes. Erick scored 10 more than Mia, and Isabelle scored 16 less than twice Mia's score. Use the drop-down menus to complete the statements about the expression that represents the scenario.What does the expression x + x + 10 + 2x 16 represent from the given scenario?What does the variable in the expression represent?What is the expression in simplified form?What is the constant in the simplified expression? Josh and Shira do not come to school on Yom Kippur, the Jewish Day of Atonement. It's a day of forgiveness and reflection. Josh and Shira will participate in fasting and prayer at their local synagogue. Which first amendment right are Josh and Shira exercising? Which type of cell is found in the hypodermis? Which cells carry nutrients from food to the rest of the cells in the body?Responsesblood cellsstomach cellsnerve cellsmuscle cells The drafters( writers) of the Articles of Confederation were most concerned about how a strong central government could potentially abuse their power towards the citizensA.TrueB.False The best way to avoid negative peer pressure is to __________. a. hang out with people that have bad reputations b. scream "no" and run away whenever you feel pressure c. hang out with friends that share your values and support you d. be aggressive with others so that they leave you alone please select the best answer from the choices provided. a b c d BRAINLIST IF RIGHTWhich type of dwelling was used in the Plains? Please help me!! This was due today ahhhh I give brain please help Which choice best symbolizes of the law of the jungle in "Law of the Jungle"?A. the rights of the individualB. violence and chaosC. the codes of societyD. the way societies crumble Please help help Solve for all values of x in simplest form, |x - 2| - 1 = 2 please help asap!!!! Barbara photographs a bird. The bird measures 8.6 cm tall in the photo and is actually 52.4 cm tall. Approximately how long is the bird's beak if it measures 1.1 cm in the photo? A hammer strikes a nail with a 8 N force for 0.018 seconds. Calculate the impulse of the hammer. Write the steps in detailOn how to solve an angle bisectorproblem, please use complet sentences. Can animal wildlife protection be an amendment, or do amendment have to affect humans? GIVING BRAINIESTThe time it takes to travel a fixed distance varies inversely with the speed traveled. If it takes Pam 1.5 hours to bike to her fishing spot at 9 miles per hour (how long will it take her if she rides at 12 miles per hour? One pyruvate will produce ______.A) 1 carbon dioxide waste moleculeB) 1 ATP moleculeC) 1 NADH molecule that moves to the electron transport chainD) 4 NADH waste molecules What is the solution to the given system of equationsY= 4x-28Y= 1.5x - 18-12,44,-127,07.5,2