Hasil untuk "Special situations and conditions"

Mohamed R. Zughbur, Yaser Hamam, Ashraf Kagee et al.

Abstract Armed conflicts have a devastating effect on the civilian population, not only by direct violence but also by causing long-lasting psychiatric conditions, such as post-traumatic stress disorder (PTSD), depression, and anxiety, as a result of exposure to traumatic events such as displacement, loss of loved ones, and destruction of homes. The military attack on Gaza, which has been ongoing since October 7, 2023, compounds an environment of continuing fear, uncertainty, and loss, which markedly increases the prevalence of mental health disorders. This study aims to assess the prevalence of anxiety, probable PTSD, and depression in the population of Gaza after one year of continuous war. This study aims to offer a comprehensive perspective on the mental health challenges experienced by the people of Gaza. Data collection was carried out between November 10, 2024, and January 10, 2025. Four hundred five participants completed an online self-reported questionnaire, distributed via emails, social media platforms, and community networks. The survey screened for symptoms of PTSD (PCL-5), anxiety (GAD-7), and depression (PHQ-9), and included items assessing exposure to war-related experiences. The findings indicated alarmingly high rates of mental health symptoms, with 72.7% of participants reporting moderate to severe depression (PHQ-9 ≥ 10), 65% reporting moderate to severe anxiety (GAD-7 ≥ 10), and 83.5% meeting the threshold for probable PTSD (PCL-5 ≥ 33). The mean scores indicated moderate to severe symptom levels for anxiety and depression, with GAD-7 at 13.16 and PHQ-9 at 14.32. The mean PCL-5 score was 48.16, reflecting a substantial burden of PTSD symptoms among participants. A substantial proportion had lost a family member (45.7%), experienced a military siege (82.5%), witnessed someone being killed or injured (80.5%), and reported losing their work due to the conflict (42.7%). Binary logistic regression analysis revealed that losing a family member was significantly associated with moderate or higher levels of depression (OR = 2.395, p = 0.010) and anxiety (OR = 1.929, p = 0.027). Similarly, living in the northern part of the Gaza Strip was significantly associated with moderate or higher levels of depression (OR = 1.755, p = 0.039) and anxiety (OR = 2.395, p = 0.010). The simultaneous presence of any two of the three mental health conditions was statistically significant, with p values for each pairwise association being less than 0.05. The study revealed that the population of Gaza had an extremely high prevalence of diagnosable mental disorders, as determined through validated screening tools for anxiety, depression, and PTSD. These findings have far-reaching implications, emphasizing the urgent need not only for medical and psychosocial support, but more critically, for an end to the ongoing violence that continues to devastate lives and communities.

Zand Elnaz, Zhao Gang

Oocyte cryopreservation is an essential procedure in assisted reproductive technologies, aimed at preserving fertility, particularly for women undergoing IVF treatment or at risk of ovarian damage due to radiation, chemotherapy, or surgery. Despite its growing use, the survival and fertilization rates of cryopreserved oocytes remain suboptimal, largely due to cryo-induced oxidative stress. The generation of Reactive Oxygen Species (ROS) during freezing and thawing causes considerable damage to key cellular components, including proteins, lipids, DNA, and mitochondria. This oxidative stress compromises oocyte quality and reduces developmental potential. To address these challenges, the use of additives - especially antioxidants - has shown significant promise in mitigating oxidative damage. Enzymatic antioxidants such as Superoxide Dismutase (SOD) and Catalase (CAT), along with non-enzymatic antioxidants like glutathione, melatonin, and resveratrol, have demonstrated the ability to neutralize ROS and improve oocyte viability and developmental outcomes. Recent studies highlight the potential of Mitoquinone (MitoQ), a mitochondria-targeted antioxidant, to effectively counteract mitochondrial ROS and enhance cellular defense mechanisms during cryopreservation. This review explores the cellular mechanisms of cryodamage, the role of oxidative stress in oocyte cryopreservation, and the potential of various antioxidant strategies to enhance oocyte survival and function. Developing effective antioxidant supplementation approaches may significantly improve the outcomes of cryopreservation in reproductive medicine.

Dahlia Saba, Dominic Groß

In this article, we investigate small-signal frequency and DC voltage stability of hybrid AC/DC power systems that combine AC and DC transmission, conventional machine- based generation, and converter-interfaced generation. The main contributions of this work are a compact frequency domain representation of hybrid AC/DC systems and associated stability conditions that can be divided into conditions on the individual bus dynamics and conditions on each DC network. The bus- level conditions apply to a wide range of technologies (e.g., synchronous generators, synchronous condensers, grid-forming renewables and energy storage). Moreover, the system-level conditions establish that hybrid AC/DC systems combining a wide range of devices are stable independently of the network topology provided that the frequency response of converters on each DC network is sufficiently coherent relative to the network coupling strength. Additionally, we develop and validate a novel reduced- order damper winding model for multi-machine systems.

Alice Sharples, Rob Duffield, Jarrod Wade et al.

Introduction Rugby league is a physically demanding sport that necessitates considerable nutritional intake, focusing on quality and type, in order to optimize training and competition demands. However, rugby league athletes are reported to have inadequate nutrition intake to match these demands. Some factors that may determine an athlete’s nutrition intake have been reported in other sports, including (but not limited to, knowledge, time, cooking skills, food costs, income, belief in the importance of nutrition, body composition goals, and family/cultural support). However, these potential factors are relatively unexplored in rugby league, where a range of personal (age, body composition) or social (ancestry) influences could affect nutritional intake. Further exploration of these factors is warranted to understand the knowledge, attitudes and behavior underlying rugby league athletes’ nutritional intake that can provide practitioners with a more detailed understanding of how to approach nutrition behaviors and attitudes in rugby league athletes.Objectives The primary aim was to describe the nutrition behaviors and knowledge of rugby league athletes. A secondary aim was to compare nutrition knowledge and behavior based on age, body composition and self-identified ancestry.Methods Fifty professional rugby league athletes anonymously completed a seventy-six-question online survey. The survey consisted of three sections : 1) sports nutrition knowledge, 2) attitudes toward nutrition on performance , and 3) nutrition behaviors. All participants completed the online survey without assistance using their own personal device, with data entered via REDCap during pre-season. Nutrition knowledge was compared based on age (years), body composition (body fat percentage (%)) and ancestral groups (Pasifika, Aboriginal and/or Torres Strait Islander (ATSI) and Anglo- European).Pearson correlation was used for the relationship between nutrition knowledge, age and body composition. An Analysis of Covariance (ANCOVA) was used to determine nutrition knowledge differences between ancestral groups with age and body composition as covariates. Attitudes and behaviors were compared based on age groups (<20, 20–24 and >25 y), ancestry and body composition. Attitudes and behaviors were analyzed by Pearson correlation for body composition, one-way ANOVA for age groups and ANCOVA for ancestry with covariates age and body composition.Results Overall athletes’ nutrition knowledge score was reported as 40 ± 12% (overall rating “poor”). Nutritional behaviors were significant for body composition, as those with lower body fat percentage had higher intakes of vegetables and dairy products (p = 0.046, p = 0.009), and ate more in the afternoon (lunch p = 0.048, afternoon snack p = 0.036). For ancestry, after adjustment for both age and body composition, Pasifika athletes were more inclined to miss breakfast and lunch compared to their Anglo-European (p = 0.037, p = 0.012) and ATSI (p = 0.022, p = 0.006) counterparts and ate more fruit than Anglo-Europeans (p = 0.006, p = 0.016). After adjustment for body composition, ATSI athletes also viewed the impact of nutrition on mental health and well-being significantly lower than Pasifika (p = 0.044).Conclusion These findings suggest differences exist within rugby league athletes based on ancestral backgrounds and body composition for nutrition attitudes, behaviors and knowledge. Such outcomes could be used when designing nutrition education interventions, with consideration given to these factors to optimize long-term positive behavior change.

Madona Tito-Betancur, Renzo Felipe Carranza Esteban, Calixto Tapullima-Mori et al.

Introducción: La salud financiera, determinada en buena parte por el salario, está estrechamente relacionada a la salud global del individuo y su familia. Por ello se tuvo como objetivo evaluar la producción científica sobre salud financiera en la base de datos Scopus: periodo 2011 - 2022. Método: Scoping review en la que se analizaron manuscritos publicados en revistas indexadas en la base de datos Scopus entre los años 2011 - 2022. Para la búsqueda se utilizó descriptores tales como financial obligations, financial inclusion, family economy, financial education, financial literacy, financial wellness y financial stress. Se realizó una síntesis narrativa. Resultados: Se incluyeron 6 940 manuscritos, de los cuales el 82,0% eran artículos originales. Se observó un crecimiento constante del número de artículos a lo largo del periodo de estudio, especialmente a partir de 2016, con un incremento del 860% en 2022 (n = 1429) respecto a 2011 (n=165). Estados Unidos fue el país con mayor producción científica. Las revistas con mayor número de publicaciones fueron Sustainability (Suiza) y el Journal of Financial Counseling and Planning (EEUU). Entre los descriptores de mayor impacto se encuentran la inclusión financiera a través del uso de la tecnología, estrés financiero, educación financiera y salud financiera. Conclusiones: La investigación sobre salud financiera ha tenido un aumento significativo. El nuevo conocimiento sobre el tema es impulsado por autores e instituciones de Estados Unidos en su mayoría, y finalmente, se evidencian tendencias de estudio relacionadas a la inclusión y educación financiera.

Yufeng Lin, Rich Kerswell

In this note, we discuss a poorly known alternative boundary condition to the usual Neumann or `stress-free' boundary condition typically used to weaken boundary layers when diffusion is present but very small. These `diffusion-free' boundary conditions were first developed (as far as the authors know) in 1995 (Sureshkumar & Beris, J. Non-Newtonian Fluid Mech., vol 60, 53-80, 1995) in viscoelastic flow modelling but are worthy of general consideration in other research areas. To illustrate their use, we solve two simple ODE problems and then treat a PDE problem - the inertial wave eigenvalue problem in a rotating cylinder, sphere and spherical shell for small but non-zero Ekman number $E$. Where inviscid inertial waves exist (cylinder and sphere), the viscous flows in the Ekman boundary layer are $O(E^{1/2})$ weaker than for the corresponding stress-free layer and fully $O(E)$ weaker than in a non-slip layer. These diffusion-free boundary conditions can also be used with hyperdiffusion and provide a systematic way to generate as many further boundary conditions as required. The weakening effect of this boundary condition could allow precious numerical resources to focus on other areas of the flow and thereby make smaller, more realistic values of diffusion accessible to simulations.

Qiuping Li, Xiujiao Xia

Judith H. J. Urlings, Ramona Backhaus, Hilde Verbeek et al.

Abstract Background Nursing homes were disproportionally affected by the COVID-19 pandemic. Vaccination was considered critical for the normalization of daily live of nursing home residents. The present study investigates the impact of the prolonged COVID-19 pandemic and the effect of vaccinations on the daily lives of residents and staff in Dutch nursing homes. Setting and participants The sample consisted of 78 nursing homes that participated in the Dutch national pilot on nursing home visits after the COVID-19 pandemic. One contact person per nursing home was approached for participation in this mixed-methods cross-sectional study. Methods Data was collected twice through questionnaires in April and December 2021. Quantitative questions focused on recent COVID-19 outbreaks, progress of vaccination, effects of vaccination on daily living in the nursing home and burden experienced by staff. Open-ended questions addressed the prolonged effect of the pandemic on residents, family members and staff. Results The overall vaccination rate of residents across nursing homes appeared to be high among both residents and staff. However, daily living in the nursing home had not returned to normal concerning personal interactions, visits, the use of facilities and work pressure. Nursing homes continued to report a negative impact of the pandemic on residents, family members and staff. Conclusions Restrictions to the daily lives of residents in nursing homes were stricter than restrictions imposed on society as a whole. Returning to a normal daily living and working was found to be complex for nursing homes. With the emergence of new variants of the virus, policies strongly focusing on risk aversion were predominantly present in nursing homes.

Alejandro Passeggi, Fabio Armando Tal

This work investigates topological chaos for homeomorphisms of the open annulus, introducing a new set of sufficient conditions based on points with distinct rotation numbers and their topological relation to invariant continua. These conditions allow us to formulate classic methods for verifying annular chaos in a finitely verifiable version supported on basic properties of the map. The results pave the way for simple computer-assisted proofs of chaos in a wide range of annular maps, including many well known examples, and we present these proofs for some analytic families, demonstrating the effectiveness of the method. On the theoretical side, one of the consequences of the established conditions permits the proof of a folkloric conjecture about the relation between topological entropy and rotation sets.

Merlin Christ, Fabian Haiden, Yu Qiu

We develop a unified approach for identifying spaces of stability conditions of triangulated categories arising from weighted marked surfaces with moduli spaces of quadratic differentials. This approach is based on the notion of a perverse schober (perverse sheaf of triangulated categories) and their triangulated categories of global sections. Under suitable conditions on the perverse schober, we identify mixed-angulations and their flips with finite-length hearts and their tilts, which then leads to the identification of moduli spaces. As an application we obtain a generalization of the results of Bridgeland--Smith to quadratic differentials with arbitrary singularity type (zero/pole/exponential).

Alex P Salam, Alexandre Duvignaud, Marie Jaspard et al.

Ribavirin is currently the standard of care for treating Lassa fever. However, the human clinical trial data supporting its use suffer from several serious flaws that render the results and conclusions unreliable. We performed a systematic review of available pre-clinical data and human pharmacokinetic data on ribavirin in Lassa. In in-vitro studies, the EC50 of ribavirin ranged from 0.6 μg/ml to 21.72 μg/ml and the EC90 ranged from 1.5 μg/ml to 29 μg/ml. The mean EC50 was 7 μg/ml and the mean EC90 was 15 μg/ml. Human PK data in patients with Lassa fever was sparse and did not allow for estimation of concentration profiles or pharmacokinetic parameters. Pharmacokinetic modelling based on healthy human data suggests that the concentration profiles of current ribavirin regimes only exceed the mean EC50 for less than 20% of the time and the mean EC90 for less than 10% of the time, raising the possibility that the current ribavirin regimens in clinical use are unlikely to reliably achieve serum concentrations required to inhibit Lassa virus replication. The results of this review highlight serious issues with the evidence, which, by today standards, would be unlikely to support the transition of ribavirin from pre-clinical studies to human clinical trials. Additional pre-clinical studies are needed before embarking on expensive and challenging clinical trials of ribavirin in Lassa fever.

Stephanie L. Boudreau, P.T., D.P.T., Laura L. Mattes, P.T., D.P.T., O.C.S., Natalie A. Lowenstein, B.S. et al.

Participation of female athletes in sports at all levels continues to grow exponentially, as well as the injuries they experience during play. A literature review does outline return to sport guidelines, yet few studies address the potential need for differences between male and female athletes. This commentary is a review of the literature that outlines various sports that involve both male and female overhead athletes and potential differences in upper-extremity injuries and strengths and weaknesses between sexes. This information proposes the potential need to customize return-to-sport guidelines and screens that include recommendations for overhead female athletes within their specific sport, following both injury as well as surgical intervention. Level of Evidence: V.

Fernando L. Pagan, Yasar Torres‐Yaghi, Michaeline L. Hebron et al.

Abstract Introduction Bosutinib, a dual Abelson/Src inhibitor, was investigated in individuals with dementia with Lewy bodies (DLB). Methods A single site, randomized, double‐blind, placebo‐controlled study of the effects of oral bosutinib, 100 mg once daily for 12 weeks on primary safety and pharmacokinetics and secondary biomarker outcomes. Results Twenty‐six participants were randomized and included male and female (12:1) in the bosutinib arm and all male (13) in the placebo arm. The average age was 72.9 ± 8.1 (year ± standard deviation). There were no serious adverse events and no dropouts. Bosutinib was measured in the cerebrospinal fluid (CSF) and inhibited Abelson. Bosutinib reduced CSF alpha‐synuclein and dopamine catabolism. Discussion Bosutinib is safe and well tolerated and penetrates the blood–brain barrier to inhibit Abelson and reduce CSF alpha‐synuclein and dopamine catabolism, suggesting that bosutinib (100 mg) may be at or near the lowest effective dose in DLB. These results will guide adequately powered studies to determine the efficacy of a dose range of bosutinib and longer treatment in DLB. Highlights Bosutinib is a dual Abl/Src inhibitor that penetrates the blood brain barrier Bosutinib is safe and tolerated in individuals with dementia with Lewy bodies Bosutinib engages its target via inhibition of Abl and Src Bosutinib reduces CSF alpha‐synuclein and attenuates breakdown of dopamine Bosutinib improves activities of daily living in dementia with Lewy bodies

Serge Hamoudou, Jacky Kumar, David London

In particle physics, the modern view is to categorize things in terms of effective field theories (EFTs). Above the weak scale, we have the SMEFT, formed when the heavy new physics (NP) is integrated out, and for which the Standard Model (SM) is the leading part. Below $M_W$, we have the LEFT (low-energy EFT), formed when the heavy SM particles ($W^\pm$, $Z^0$, $H$, $t$) are also integrated out. In order to determine how low-energy measurements depend on the underlying NP, it is necessary to compute the matching conditions of LEFT operators to SMEFT operators. These matching conditions have been worked out for all LEFT operators up to dimension 6 in terms of SMEFT operators up to dimension 6 at the one-loop level. However, this is not sufficient for all low-energy observables. In this paper we present the momentum-independent matching conditions of all such LEFT operators to SMEFT operators up to dimension 8 at tree level.

Marlon M. Mencia FRCS, Shamir O. Cawich DM, Nemandra Sandiford MSc, FRCS (Tr & Orth)

Background: Prosthetic joint infection (PJI) is the second most common cause for revision following hip hemiarthroplasty (HHA) resulting in a mortality rate of 5.6%. The treatment of PJI is both challenging and controversial, without general consensus on best practice. In an attempt to avoid surgery, patients are commonly prescribed antibiotics, reducing the chance of detecting a microorganism, and culture negative infections are reported to occur in up to 21% of all PJI. Two stage revision is arguably the gold standard treatment but frequently these patients are too frail to undergo such extensive procedures. Some surgeons have attempted to avoid this by leaving well fixed implants undisturbed, effectively performing a partial single-stage revision. Case Presentation: A previously well 83 -year-old female patient presented with a gradual onset of increasing pain and difficulty walking. Just over 1 year prior to this presentation she fell at home and underwent an uncomplicated bipolar hemiarthroplasty. Clinical examination as well as serological and radiological investigations were suspicious for a periprosthetic infection. Her rapidly deteriorating clinical picture required prompt surgical intervention. In theater the patient underwent a single stage partial exchange arthroplasty leaving the well cemented femoral stem undisturbed. Although multiple samples were taken, no microorganism was identified. The patient has been followed up for 1 year and remains well, with no recurrence of infection. Her inflammatory markers have returned to normal and radiographs demonstrate no evidence of loosening of the total hip replacement. Conclusion: The burden of infection following hip hemiarthroplasty is likely to parallel the predicted increase in hip fractures. The combination of physiologic frailty, osteoporosis and multiple medical comorbidities are pertinent factors for consideration in the development of a treatment strategy. A partial single stage revision THR performed by an experienced arthroplasty surgeon, along with expertly led antimicrobial therapy may be considered in carefully selected patients.

Neide Canana

Abstract Background It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions. Methods Cost information was collected retrospectively from the provider perspective, and both economic and financial costs were calculated. A “one-way” deterministic sensitivity analysis was performed. Results The average economic costs totaled US$117,351.34, with an average economic cost per household sprayed of US$16.35, and an average economic cost per person protected of US$4.09. The average financial cost totaled US$69,174.83, with an average financial cost per household sprayed and per person protected of US$9.84 and US$2.46, respectively. Vehicle, salary, and insecticide costs were the greatest contributors to overall cost in the economic and financial analysis, corresponding to 52%, 17%, and 13% in the economic analysis and 21%, 27%, and 22% in the financial analysis, respectively. The sensitivity analysis was adapted to a range of ± (above and under) 25% change. There was an approximate change of 14% in the average economic cost when vehicle costs were decreased by 25%. In the financial analysis, the average financial cost was lowered by 7% when salary costs were decreased by 25%. Conclusions Altogether, the current cost analysis provides an impetus for the consideration of targeted IRS operationalization within the available governmental budget, by using locally-available human resources as spray operators to decrease costs and having IRS rounds be correctly timed to coincide with the build-up of vector populations.

Behailu Merdekios, Myrthe Pareyn, Dagimawie Tadesse et al.

In most low-resource settings, microscopy still is the standard method for diagnosis of cutaneous leishmaniasis, despite its limited sensitivity. In Ethiopia, the more sensitive molecular methods are not yet routinely used. This study compared five PCR methods with microscopy on two sample types collected from patients with a suspected lesion to advise on optimal diagnosis of Leishmania aethiopica. Between May and July 2018, skin scrapings (SS) and blood exudate from the lesion spotted on filter paper (dry blood spot, DBS) were collected for PCR from 111 patients of four zones in Southern Ethiopia. DNA and RNA were simultaneously extracted from both sample types. DNA was evaluated by a conventional PCR targeting ITS-1 and three probe-based real-time PCRs: one targeting the SSU 18S rRNA and two targeting the kDNA minicircle sequence (the 'Mary kDNA PCR' and a newly designed 'LC kDNA PCR' for improved L. aethiopica detection). RNAs were tested with a SYBR Green-based RT-PCR targeting spliced leader (SL) RNA. Giemsa-stained SS smears were examined by microscopy. Of the 111 SS, 100 were positive with at least two methods. Sensitivity of microscopy, ITS PCR, SSU PCR, Mary kDNA PCR, LC kDNA PCR and SL RNA PCR were respectively 52%, 22%, 64%, 99%, 100% and 94%. Microscopy-based parasite load correlated well with real-time PCR Ct-values. Despite suboptimal sample storage for RNA detection, the SL RNA PCR resulted in congruent results with low Ct-values. DBS collected from the same lesion showed lower PCR positivity rates compared to SS. The kDNA PCRs showed excellent performance for diagnosis of L. aethiopica on SS. Lower-cost SL RNA detection can be a complementary high-throughput tool. DBS can be used for PCR in case microscopy is negative, the SS sample can be sent to the referral health facility where kDNA PCR method is available.

L. Marchini, R. Ettinger, T. Caprio et al.

Alzheimer's disease and related disorders (ADRD) are among the age-associated chronic conditions that are most challenging to health care systems around the globe, as patients with dementia require full-time, intensive care for multiple years. Oral health care is negatively impacted by cognitive decline, and consequently poor oral health is common among people with ADRD. Poor oral health status is linked with many undesirable consequences for the well-being of people with ADRD, from excruciating local pain to life-threatening conditions, as aspiration pneumonia. In this paper, the authors provide an update on the most current concepts about Alzheimer's disease epidemiology, etiology, and management, current oral health care for patients with Alzheimer's disease, oral health promotion strategies for this population, as well as current research and future direction for improving oral health care for patients with Alzheimer's disease. It concludes that oral health care should be included in the patient's routine health care as early as possible in the progression of Alzheimer's disease for preventing rapid oral health deterioration. Establishing oral hygiene routines and providing dental treatment that is customized to the patients' individual needs and disease stage are important to achieve good oral health outcomes and prevent quality of life decline.

Theresa Southam

na