Hasil untuk "Special situations and conditions"

Loujain Sharif, Khalid Almutairi, Ibrahim Alnasser et al.

Abstract Background Nurses often face significant emotional distress and grief when dealing with patient deaths, especially in acute hospital settings. Despite extensive literature offering guidance on nursing practices for providing optimal care to terminally ill patients and their grieving families, there is a scarcity of empirical research examining nurses’ experiences of grief following patient deaths in Middle Eastern contexts. This study aimed to assess the relationship between grief and coping strategies among nurses experiencing patient death in an acute hospital in Saudi Arabia. Methods A cross-sectional study was conducted using an online survey distributed to nurses at King Fahad Armed Forces Hospital in Jeddah. Data from 382 nurses were analyzed using SPSS software. Descriptive statistics, bivariate analyses, Pearson’s chi-square test, Student’s t-test, one-way ANOVA, and regression analysis were employed to examine the associations between grief levels, coping strategies, and various socio-demographic and professional characteristics. Results Among the participants, 80% were aged 25–40 years, and 50% were married. Most nurses (85.4%) reported normal levels of grief. Coping strategies’ mean scores ranged from 2.60 to 5.52. Grief levels showed significant correlations with nationality, received support, and intervention type. Nurses with high or severe grief levels had significantly higher mean scores for problem-focused, emotion-focused, and avoidant coping strategies (p < 0.001). A significant positive linear correlation was found between total coping scores and total grief scores. Regression analysis indicated that 21.3% of the variance in total coping scores was explained by total grief scores. Conclusions The study highlights that while nurses employ personal coping strategies, there is a need for additional, culturally tailored support to manage grief effectively. Implementing structured support systems may enhance nurses’ coping mechanisms and overall well-being when facing patient deaths.

Kornelia Kaźmierkiewicz, Martyna Chojnacka, Marta Ewelina Lis et al.

Introduction and aim of the study: Neurodegenerative diseases, including Alzheimer's disease, represent a significant health challenge. Therapies are being sought that could delay the development of these diseases and also mitigate their course. Fulvic acid, which is an organic humic compound with antioxidant and anti-inflammatory properties, has attracted increasing interest in the context of treating neurodegenerative diseases. Our study aims to evaluate the effects of fulvic acid on neurodegenerative diseases, mainly Alzheimer's disease, and to determine its therapeutic potential. Materials and methods: The paper is based on an analysis of studies available in databases such as PubMed, Google Scholar, ResearchGate, and other scientific databases. Clinical trials, preclinical studies, and review papers on the use of fulvic acid in the context of Alzheimer's disease were searched. Conclusions: Fulvic acid, due to its anti-inflammatory and neuroprotective abilities, shows promising potential in the treatment of Alzheimer's disease, especially in terms of slowing down the loss of cognitive function and protecting against neurodegeneration. It is advisable to conduct further studies aimed at a more thorough evaluation of the efficacy and safety of fulvic acid in the context of the treatment of Alzheimer's disease and other neurodegenerative diseases.

Hong-ah Chai, Seokbin Yoon, Keumjin Lee

Understanding how air traffic controllers construct a mental 'picture' of complex air traffic situations is crucial but remains a challenge due to the inherently intricate, high-dimensional interactions between aircraft, pilots, and controllers. Previous work on modeling the strategies of air traffic controllers and their mental image of traffic situations often centers on specific air traffic control tasks or pairwise interactions between aircraft, neglecting to capture the comprehensive dynamics of an air traffic situation. To address this issue, we propose a machine learning-based framework for explaining air traffic situations. Specifically, we employ a Transformer-based multi-agent trajectory model that encapsulates both the spatio-temporal movement of aircraft and social interaction between them. By deriving attention scores from the model, we can quantify the influence of individual aircraft on overall traffic dynamics. This provides explainable insights into how air traffic controllers perceive and understand the traffic situation. Trained on real-world air traffic surveillance data collected from the terminal airspace around Incheon International Airport in South Korea, our framework effectively explicates air traffic situations. This could potentially support and enhance the decision-making and situational awareness of air traffic controllers.

Annamaria Canino, Simone Mauro

We prove a multiplicity result for non-constant weak solutions $u \in H^1(Ω)$ for the quasilinear elliptic equation \[ \begin{cases} \displaystyle-\text{div}(A(x,u)\nabla u) + \frac{1}{2} D_sA(x,u)\nabla u \cdot \nabla u = g(x,u) - λu & \text{in } Ω\\ A(x,u)\nabla u \cdot η= 0 & \text{on } \partial Ω\end{cases} \] where $λ\in \mathbb{R}$, $ Ω$ is a bounded lipschitz domain, $ η$ is the outward normal to the boundary $ \partial Ω$, and $g(x,u)$ is a Carathéodory function that satisfies a general subcritical (and superlinear) growth condition. We also prove that any weak solution is bounded under a stronger growth assumption.

Betrearon Sileshi, Seifu Gizaw, Belay Merkeb et al.

<h4>Background</h4>Brucellosis is a neglected zoonotic disease often contracted through contact with animals and consumption of unpasteurized dairy products. Despite being the most common cause of non-malarial acute febrile illness brucellosis is often misdiagnosed in healthcare setups. The global incidence of Brucella infection is reported to be over 2 million cases annually. In Ethiopia, there are varying reports on the prevalence of brucellosis, and just a few researches have been undertaken on the prevalence among febrile patients. Therefore, this study aimed to determine sero-prevalence of human brucellosis and associated factors among febrile patients attending Moyale Primary Hospital in southern Ethiopia.<h4>Methods</h4>Cross-sectional study was conducted on 293 febrile patients attending Moyale Primary Hospital. We used convenience sampling technique. Blood specimen was collected and screened for Brucella antibody using Rose-Bengal plate test and ELISA was used for confirmation of Brucella infection. We used a questionnaire to collect socio-demographic data and to assess associated factors (S1 Table). Bivariate and subsequent multivariable logistic regression was performed to explore associated factors with the prevalence of human brucellosis.<h4>Results</h4>The sero-prevalence of human brucellosis in this study was 13% (95% CI: 9.5, 16.5). Majority of the study participants (58.7%) were rural dwellers; 54.6% were male and the age range was from 5 to 80 years (mean = 24.17, SD = ±15.9). Higher number of sero-prevalence was seen among rural residents (19.8%) and male participants (14.40%). Drinking unpasteurized camel milk (AOR = 11.62, 95% CI: 3.85, 17.13; P = 0.000) and rural residence (AOR = 7.21, 95% CI: 2.48, 15.90; P = 0.000) were significantly associated with brucellosis. Consumption of pasteurized milk was shown to have protective effect (AOR = 6.12, 95% CI: 1.26, 29.76; P = 0.025) against brucellosis.<h4>Conclusion</h4>The current study showed 13% point prevalence of human brucellosis among febrile patients attending Moyale Primary Hospital. Consuming unpasteurized milk, particularly unpasteurized camel milk, and rural residence was significantly associated with Brucella infection. Awareness creation about the zoonotic nature of brucellosis and the role of unpasteurized milk in the transmission of the disease is important to control human brucellosis.

LakKumar Fernando, Randee Kastner, Pujitha Wickramasinghe et al.

<h4>Background</h4>Outbreaks of dengue can overburden hospital systems, drastically reducing capacity for other care. The 2017 dengue serotype 2 (DENV-2) outbreak in Sri Lanka coincided with vaccination in an ongoing phase 3 efficacy trial of a tetravalent dengue vaccine, TAK-003 (NCT02747927). Here, we present data on the efficacy of TAK-003 following two doses of the vaccine administered 3 months apart in participants aged 4-16 years in Sri Lanka. In addition, we have used the 2017 outbreak dynamics to model the potential impact of TAK-003 on virologically confirmed dengue (VCD) cases and hospitalizations during an outbreak situation.<h4>Methodology/principal findings</h4>Modeling was performed using an age-structured, host-vector, spatial and stochastic transmission model, assuming 65% vaccine coverage and 30 days until initiation of vaccination. Efficacy of TAK-003 against VCD and hospitalized VCD cases was based on data against DENV-2 from the first year of the phase 3 trial. Vaccine efficacy and safety findings in Sri Lanka were in line with those of the overall trial population. The efficacy estimates in Sri Lanka up to the first 12 months after the second dose of TAK-003 were 94.7% and 95.7% against VCD and hospitalized VCD cases, respectively. Modeling of the trial data over an extended geographic area showed a substantial reduction in cases and a flattening of outbreak curves from TAK-003 use. The baseline vaccination scenario (initiation at 30 days, 65% target coverage, vaccine effective at 14 days, 70% hospitalization rate, VE of 95% for VCD and 97% for hospitalized VCD, and 47% for asymptomatic) resulted in a 69.1% reduction in VCD cases and 72.7% reduction in VCD hospitalizations compared with no vaccination. An extreme high scenario (vaccination initiated at Day 15, 80% coverage rate, baseline VE) resulted in 80.3% and 82.3% reduction in VCD and VCD hospitalizations, respectively. Vaccine performance, speed of vaccination campaign initiation, and vaccine coverage were key drivers in reducing VCD cases and hospitalizations.<h4>Conclusions/significance</h4>Overall, the study and modeling results indicate that TAK-003 has the potential of meaningful utility in dengue outbreaks in endemic areas.

Aaron T. Seaman, Julia H. Rowland, Samantha J. Werts et al.

Introduction: Cancer rates increase with age, and older cancer survivors have unique medical care needs, making assessment of health status and identification of appropriate supportive resources key to delivery of optimal cancer care. Comprehensive geriatric assessments (CGAs) help determine an older person’s functional capabilities as cancer care providers plan treatment and follow-up care. Despite its proven utility, research on implementation of CGA is lacking.Methods: Guided by a qualitative description approach and through interviews with primary care providers and oncologists, our goal was to better understand barriers and facilitators of CGA use and identify training and support needs for implementation. Participants were identified through Cancer Prevention and Control Research Network partner listservs and a national cancer and aging organization. Potential interviewees, contacted via email, were provided with a description of the study purpose. Eight semi-structured interviews were conducted via Zoom, recorded, and transcribed verbatim by a professional transcription service. The interview guide explored providers’ knowledge and use of CGAs. For codebook development, three representative transcripts were independently reviewed and coded by four team members. The interpretive process involved reflecting, transcribing, coding, and searching for and identifying themes.Results: Providers shared that, while it would be ideal to administer CGAs with all new patients, they were not always able to do this. Instead, they used brief screening tools or portions of CGAs, or both. There was variability in how CGA domains were assessed; however, all considered CGAs useful and they communicated with patients about their benefits. Identified facilitators of implementation included having clinic champions, an interdisciplinary care team to assist with implementation and referrals for intervention, and institutional resources and buy-in. Barriers noted included limited staff capacity and competing demands on time, provider inexperience, and misaligned institutional priorities.Discussion: Findings can guide solutions for improving the broader and more systematic use of CGAs in the care of older cancer patients. Uptake of processes like CGA to better identify those at risk of poor outcomes and intervening early to modify treatments are critical to maximize the health of the growing population of older cancer survivors living through and beyond their disease.

Hideki Maeda

We study energy conditions for non-timelike thin shells in arbitrary $n(\ge 3)$ dimensions. It is shown that the induced energy-momentum tensor $t_{μν}$ on a shell $Σ$ is of the Hawking-Ellis type I if $Σ$ is spacelike and either of type I, II, or III if $Σ$ is null. Then, we derive simple equivalent representations of the standard energy conditions for $t_{μν}$. In particular, on a spacelike shell or on a null shell with non-vanishing surface current, $t_{μν}$ inevitably violates the dominant energy condition. If the surface pressure on the null shell is vanishing in addition, $t_{μν}$ is of type III and violates all the standard energy conditions. Those fully general results are obtained without imposing a spacetime symmetry and can be used in any theory of gravity. Lastly, several applications of the main results are presented in general relativity in four dimensions.

Hideto Iwata

In 2001, M.Rekos described the analytic behavior for a function $f(z)$ connected with the Euler totient function for Im$z > 0$ (see (1.2)) imitating the previous research of [1] and [3]. In the present paper, for Im$z > 0$ we describe the analytic behavior of the generalized function $f(z,F)$ (see (2.1)), where the function $F$ belongs to the subclass of the Selberg class which has a polynomial Euler product and satisfies some special conditions.

Tyler J. Gregory, P.T., D.P.T., Samuel A. Rauchwarter, P.T., D.P.T., S.C.S., Michael D. Feldman, M.D.

Dry needling is most commonly used in the subacute and chronic phases of an injury; therefore, it is imperative to understand the use of dry needling in the acute phases of an injury. There are four main reasons to use dry needling during the acute phase of injury: to relieve pain, decrease edema, increase range of motion and flexibility, and increase strength and power. Dry needling can be used pregame, postgame, during half time or an intermission, or following an injury. Although further research is needed, acute dry needling can be used to bolster athletes’ health and possibly improve sports performance.

Dirk Pauly, Michael Schomburg

We show that the biharmonic Hilbert complex with mixed boundary conditions on bounded strong Lipschitz domains is closed and compact. The crucial results are compact embeddings which follow by abstract arguments using functional analysis together with particular regular decompositions. Higher Sobolev order results are also proved. This paper extends recent results of the authors on the de Rham and elasticity Hilbert complexes with mixed boundary conditions and results of Pauly and Zulehner on the biharmonic Hilbert complex with empty or full boundary conditions.

Mehran Falahchai, Yasamin Babaee Hemmati, M. Hasanzade

Abstract Aim The level of preparedness of the healthcare system plays an important role in management of coronavirus disease 2019 (COVID‐19). This study attempted to devise a comprehensive protocol regarding dental care during the COVID‐19 outbreak. Methods and result Embase, PubMed, and Google Scholar were searched until March 2020 for relevant papers. Sixteen English papers were enrolled to answer questions about procedures that are allowed to perform during the COVID‐19 outbreak, patients who are in priority to receive dental care services, the conditions and necessities for patient admission, waiting room and operatory room, and personal protective equipment (PPE) that is necessary for dental clinicians and the office staff. Conclusion Dental treatment should be limited to patients with urgent or emergency situation. By screening questionnaires for COVID‐19, patients are divided into three groups of (a) apparently healthy, (b) suspected for COVID‐19, and (c) confirmed for COVID‐19. Separate waiting and operating rooms should be assigned to each group of patients to minimize the risk of disease transmission. All groups should be treated with the same protective measures with regard to PPE for the dental clinicians and staff.

José Ernesto Picado Ovares

Resumen Objetivos Comparar los tipos de asistencia domiciliar geriátrica y paliativa para determinar cuál obtiene mejores resultados en los pacientes con demencia avanzada. Métodos El presente es un estudio de cohorte retrospectiva. Se incluyeron pacientes con demencia avanzada ingresados al programa de Atención Comunitaria Geriátrica de un hospital geriátrico público de Costa Rica en el periodo entre enero de 2018 y junio de 2019. Ellos se dividieron en dos grupos dependiendo del equipo especializado que realizó la atención domiciliaria y se analizaron sus características sociodemográficas y clínicas. Posteriormente, se analizaron los datos generados de los registros médicos sobre consultas de emergencia, hospitalización, lugar de defunción y costo de la visita generados por cada paciente entre junio de 2018 y diciembre de 2019. Se compararon 192 pacientes con demencia avanzada Global Dementia Scale 7 visitados por el equipo geriátricos especializado domiciliar con 19 de visitados por el equipo de cuidados paliativos especializado domiciliar del Hospital Geriátrico Nacional. Resultados Se analizaron 226 datos generados (192 por el programa de geriatría y 34 por el de paliativos). Los que recibían atención domiciliaria por un equipo paliativo tenían menos probabilidades de acudir a la sala de emergencias y morir en un centro de salud en comparación con aquellos que reciben atención domiciliaria por un equipo geriátrico, con un costo menor. Conclusiones El programa de cuidado paliativo especializado domiciliar reduce las consultas de emergencia, la muerte en el domicilio y los costos de atención en pacientes con demencia avanzada en comparación con el programa geriátrico.

Elise Piraux, Gregory Reychler, Louise Maertens de Noordhout et al.

Abstract Background Substantial postoperative complications occur after tumor resection for esophagogastric cancers. Physical prehabilitation programs aim to prepare patients for surgery by improving their functional status with the aim of reducing postoperative complications. This systematic review aims to summarize the effects of physical prehabilitation programs on exercise capacity, muscle strength, respiratory muscle function, postoperative outcomes, and health-related quality of life and to determine the optimal design of such a program to improve these outcomes in esophagogastric cancer patients undergoing tumor resection. Methods A systematic literature review was conducted using PubMed, The Cochrane Library, Scopus, and PEDro databases to identify studies evaluating the effects of physical prehabilitation program on exercise capacity, muscle strength, respiratory muscle function, postoperative complications, length of hospital stay, mortality, and health-related quality of life in patients with esophagogastric cancer awaiting surgery. Data from all studies meeting the inclusion criteria were extracted. The quality of each selected study was determined using the Downs and Black checklist. Results Seven studies with 645 participants were included. The preoperative exercise program consisted of respiratory training alone in three studies, a combination of aerobic and resistance training in two studies, and a combination of respiratory, aerobic, and resistance training in two studies. Training frequency ranged from three times a day to twice a week and each session lasted between 20 and 75 min. Four studies were of fair quality and three of good quality. Some studies reported improvements in maximal inspiratory pressure, inspiratory muscle endurance, postoperative (pulmonary) complications, and length of hospital stay in the preoperative exercise group compared to the control group. Conclusion This systematic review reports the current evidence for physical prehabilitation programs in patients with esophagogastric cancer awaiting surgery. However, due to the limited number of randomized controlled trials, the significant heterogeneity of exercise programs, and the questionable quality of the studies, higher quality randomized controlled trials are needed. Trial registration PROSPERO Registration Number: CRD42020176353 .

Valentina Anita Carriero, Aldo Gangemi, Andrea Giovanni Nuzzolese et al.

In this paper, we present an Ontology Design Pattern for representing situations that recur at regular periods and share some invariant factors, which unify them conceptually: we refer to this set of recurring situations as recurrent situation series. The proposed pattern appears to be foundational, since it can be generalised for modelling the top-level domain-independent concept of recurrence, which is strictly associated with invariance. The pattern reuses other foundational patterns such as Collection, Description and Situation, Classification, Sequence. Indeed, a recurrent situation series is formalised as both a collection of situations occurring regularly over time and unified according to some properties that are common to all the members, and a situation itself, which provides a relational context to its members that satisfy a reference description. Besides including some exemplifying instances of this pattern, we show how it has been implemented and specialised to model recurrent cultural events and ceremonies in ArCo, the Knowledge Graph of Italian cultural heritage.

Dirk Pauly, Michael Schomburg

We show that the de Rham Hilbert complex with mixed boundary conditions on bounded strong Lipschitz domains is closed and compact. The crucial results are compact embeddings which follow by abstract arguments using functional analysis together with particular regular decompositions. Higher Sobolev order results are proved as well.

M. Herrero, Ana Martínez-Pampliega, Irati Alvarez

ABSTRACT Family communication is central to adjusted family functioning, which may be of special relevance to limit the impact of divorce on children. The present study aims to examine positive family communication as a facilitator of family adaptation to divorce, its impact on children’s maladjustment, and the role of coparenting. A cross-sectional study was carried out with 309 parents with high interparental-conflict. The expected model was tested using path analysis. We observed that: 1) positive family communication was related to parents’ greater psychological adjustment to the divorce and fewer socioeconomic consequences of the divorce on children and indirectly to children’s lower anxiety/depression and aggressiveness; 2) supportive coparenting was a protective factor against socioeconomic consequences, but a risk factor in situations of high conflict. These results highlight positive family communication in family adaptation and children’s well-being. Furthermore, findings differentiate the divorce conditions in which coparenting may or may not be appropriate.

Liyong Wang, P. Sun, Minzhao Xie et al.

Great changes have taken place in automation and machine vision technology in recent years. Meanwhile, the demands for driving safety, efficiency, and intelligence have also increased significantly. More and more attention has been paid to the research on advanced driver-assistance system (ADAS) as one of the most important functions in intelligent transportation. Compared with traditional transportation, ADAS is superior in ensuring passenger safety, optimizing path planning, and improving driving control, especially in an autopilot mode. However, level 3 and above of the autopilot are still unavailable due to the complexity of traffic situations, for example, detection of a temporary road created by traffic cones. In this paper, an analysis of traffic-cone detection is conducted to assist with path planning under special traffic conditions. A special machine vision system with two monochrome cameras and two color cameras was used to recognize the color and position of the traffic cones. The result indicates that this novel method could recognize the red, blue, and yellow traffic cones with 85%, 100%, and 100% success rate, respectively, while maintaining 90% accuracy in traffic-cone distance sensing. Additionally, a successful autopilot road experiment was conducted, proving that combining color and depth information for recognition of temporary road conditions is a promising development for intelligent transportation of the future.

Man Hung, R. Moffat, Gagandeep Gill et al.

AIMS Little evidence exists to confirm that better oral health is associated with better overall health and well-being. The present study aimed to examine the impact of oral health on the overall health of the population greater than 65-year old in the entire United States. METHODS AND RESULTS Data from National Health and Nutrition Examination Survey (NHANES) 2015-2016 were used. Variables included demographics and perceptions of oral health and overall health and well-being. Weighted prevalence estimates were calculated using mean, standard deviation, and percentage as appropriate. Chi-square tests and logistic regressions were performed to examine the association of oral health with physical health, mental health, general health, and systemic disease conditions. Analyses showed statistically significant relationships between oral health, physical, mental and general health, energy levels, work limitation, depression, and appetite. Out of the 10 systemic diseases being investigated, six of them were directly related to oral health outcome. CONCLUSION This study provided strong empirical evidence that oral health is directly associated with different disease conditions and contributes largely to an individual's general health, particularly in the elderly. In the current landscape of patient-centered and value-based care, addressing the oral health needs of the elderly, who generally find themselves with limited access to care, should be a priority.