In order to achieve its carbon peak and neutrality targets, a high proportion of distributed power sources are connected to the distribution network in China, which greatly increases the risk of distribution network operation. Aiming at the above problems, this paper proposes an active distribution network risk planning model based on multi-source data from carbon capture and power internet of things, and conducts exceeding testing of distribution network based on the stochastic load flow algorithm with semi-invariant and level expansion, calculates the semi-invariant of each order of node state vectors and branch current vectors, and then utilizes the Gram-Charlier level expansion to obtain the exceeding probability density function and probability distribution function of the node voltages and line powers of the distribution network. The probability density function and probability distribution function of the exceeding are obtained using the Gram-Charlier series expansion. Combined with multi-source data, the active distribution network with integrated energy system considering carbon capture is modeled. According to the risk scenario of the distribution network, the nonconvex constraints in the model are simplified by the second-order cone relaxation, and the optimal planning scheme of the distribution network is solved by combining the gurobi solver with the risk index as the first-level objective and the economic benefit as the second-level objective. The simulation results of a coupled network consisting of a 39-node distribution network and an 11-node transportation network verify the effectiveness of the proposed model.

Objectives to assess COVID-19 mortality rates per country population. To determine what if any independent country-specific variables from 9 different databases were correlated. Design population based retrospective cohort study. Setting analysis of global COVID-19 treatment and containment strategies using data from 9 worldwide websites. Participants 108 countries worldwide. Interventions none. Main Outcome Measures were COVID-19 death rates per country population analyzed by univariate and multivariate analysis. The main outcome parameters were to determine if there are any correlations between the percentage of countrywide COVID-19 deaths/population by the countries’ percent vaccinated. Secondary outcome measures include the effect of other independent variables on COVID-19 death rates per country population including: health expenditures per capita, annual income per capita, COVID-19 tests per 1000 people, stringency index (a measure of each countries containment strategies), hydroxychloroquine score (a measure of each countries use), ivermectin score (a measure of each countries use), hypertension, obesity, diabetes, and specific countries and geographic locations. Results COVID-19 vaccination rates ranged from 0-99% in 108 countries. Univariate analysis demonstrates the following independent variables to correlate with COVID-19 deaths/population (correlation coefficient, p value): countrywide COVID-19 vaccination rates (+0.2936, p=0.002); healthcare costs per capita (+0.3212, p=0.0007), income per capita (+0.3051, p=0.0013), COVID-19 tests per 1000 population (+0.6981 p=0.0307); stringency index (+0.3098, p=0.0011); hydroxychloroquine index (-0.1337, p=0.0678); and ivermectin index (-0.1383, p=0.1535). Conclusions Increasing rates of COVID-19 vaccination are associated with increase COVID-19 death rates per country population (p=0.002). Other variables associated include healthcare costs per capita (+0.3212, p=0.0007), income per capita (+0.3051, p=0.0013), COVID-19 tests per 1000 population (+0.6981 p=0.0307); and stringency index (+0.3098, p=0.0011).

Steel reinforcement in concrete has the tendency to corrode and this process can lead to structural damage. FRP reinforcement represents a viable alternative for structures exposed to aggressive environments and has many possible applications where superior corrosion resistance properties are required. The use of FRP rebars as internal reinforcements for concrete, however, is limited to specific structural elements and does not yet extend to the whole structure. The reasons for this relate to the limited availability of curved or shaped reinforcing elements on the market and their reduced structural performance. Various studies, in fact, have shown that the mechanical performance of bent portions of composite bars is reduced significantly under a multiaxial combination of stresses and that the tensile strength can be as low as 25% of the maximum tensile strength that can be developed in the straight part. In a significant number of cases, the current design recommendations for concrete structures reinforced with FRP, however, were found to overestimate the bend capacity of FRP rebar. This paper presents the state-of-the art review of the research works on the strength degradation in curved FRP composites and highlighted the performance of exiting predictive models for the bend capacity of FRP reinforcement. Recent practical predictive model based on the Tsai-Hill failure criteria by considering the material at marcromechanical level is also discussed and highlighted. The review also identifies the challenges and highlights the future directions of research to explore the use of shaped FRP composites in civil engineering applications and the trends for future research in this area.

Urban spatial perception critically influences human behavior and emotional reactions, emphasizing the necessity of aligning urban spaces with human needs for enhanced urban living. However, functionality-based categorization of urban architecture is prone to biases, stemming from disparities between objective mapping and subjective perception. These biases can result in urban planning and designs that fail to cater adequately to the needs and preferences of city residents, negatively impacting their quality of life and the city's overall functionality. In this study, we apply machine learning to elucidate these biases within urban spatial perception research, utilizing a three-step methodology: objective mapping, subjective perception analysis, and perception deviation assessment. Our findings reveal that machine learning can expose hidden patterns within this research field, bearing substantial implications for urban planning and design. Of particular note, the study revealed significant discrepancies in the distribution centroids between commercial buildings and residential or public buildings. This result illuminates the spatial organization characteristics of urban architectural functions, serving as a valuable reference for urban planning and development. Moreover, it uncovers the advantages and disadvantages of different data sources and techniques in interpreting urban spatial perception, paving the way for a more comprehensive understanding of the subject. These findings underscore the importance of integrating both objective mapping and subjective perspectives in urban architectural functionality classification.

Background and Objectives: The Ventilatory Workload Kinetic Index (VWKI) has been proposed as a clinical instrument to evaluate ventilatory balance-imbalance. On the other hand, the regulated application of scales that allow an integral evaluation of the object of study and their subsequent reliability evaluation should be a continuous. The objective was determined the reliability of the VWKI between two evaluators and its applicability in the clinical field of physiotherapy. Materials and Methods: Methodology was divided into three stages: i) induction period, ii) application of the VWKI, and iii) reliability process. Results: The VWKI total score obtained excellent inter-rater reliability (ICC=0.913, p<0.05). The airway resistance (AR) showed moderate inter-rater reliability (ICC=0.528, p<0.05), while the use of accessory musculature (UAM) showed poor inter-rater reliability (ICC=0.483, p<0.05). The physiotherapy care prioritization system, for both evaluator A (EA) and evaluator B (EB), the total VWKI score was significantly higher in priority 1 (p=0.001; p<0.05, respectively). The Total VWKI score by services, it was observed that both EA and EB rated the VWKI significantly higher in the intensive care unit (ICU) than in Medicine and the other services (p=0.001, p=0.0001 and p<0.05, p<0.05, respectively). Conclusions: VWKI have of excellent reliability your the total score. Also, have consistency with the system of prioritization of physiotherapy care, and the ability to determine the severity of respiratory clinical pictures.

The combined use of lasmiditan and triptan is unexplored in medical literature. This study aimed to investigate whether the intake of lasmiditan following triptan improves migraine pain. Following triptan intake, if headache relief was less than 50% at 1 hour, patients took 50 mg lasmiditan within 2 hours of migraine onset. Patients recorded headache intensity and adverse events(AEs) caused by lasmiditan at 1, 2, and 4 hours after intake of additional 50 mg of lasmiditan. A significant reduction in pain scale was observed post 50 mg lasmiditan intake (p < 0.001, t-test). Pain relief was reported for 32 migraine attacks (80%) at 1 hour after additional lasmiditan intake. Although AEs were observed in 63% of the patients who took an additional lasmiditan, most were mild and resolved 1 hour after lasmiditan intake. Our study revealed the significant headache reliefs provided by an additional lasmiditan for patients who did not achieve satisfactory results following initial triptan intake for treating migraine. The AEs associated with this treatment strategy were mild and lasted for a short term. This study suggested that the combination of triptan and lasmiditan is promising for the treatment of migraine and should be studied in a randomized placebo-controlled trial.

AbstractBackground: In digitalization era, health care system was conditioned with the health worker’s ability to adapt media of digital technology. Digital technology media was used to strengthening and fasted the health care for patient and community. Aims: This study aimed to explore the accurate information of health professional utilization digital technology during doing the job at the health facilities in Timor-Leste. Methods: This study was used correctional study with 56 respondents was participated in the study. Was collected the data from 1 to 30 February 2023. Was used questioner of google form based for data collection. Data collection was distributed via online with google form to social media as WhatsApp’s, email and face book and twitter to completed by respondents. The inclusive Criteria are: health professional living in Timor-Leste, to able response the questioner. Was used descriptive analysis in this study. Finding: This study was indicated that majority of health professional was participated in the study as 54,2% man then women have 45,8%. About 100% health professional used hand phone to facilitate their daily activities including related with their work activities. Other side indicated in digital technology tools use are able to use Microsoft word is 78,3%, able to use Microsoft Excel is 76,7% and able to use Power Point is 81,7%. E-mail use about 89,2%, WhatsApp’s use 81,7%, About 74,2% was used zoom/webinars/Google meet application, about 72,5% sad that they were used computer in the work place until now. Around 96.4% need to improve or deepen their knowledge and skills in using ICT in the future to facilitate they are activity. Conclusion: Majority of health professional in Timor-Leste was used the computer, internet, hand phone in daily activities. Majority need to gate the training to improve their knowledge, attitude and psychomotor in the future.

Primary Health Care is crucial in the healthcare system, being the first level of contact with health services for users and patients to take action using the available resources. Patient care units are created to facilitate direct user participation through the circuit of complaints, grievances, and suggestions, allowing the analysis of the population's unmet expectations and needs. To study complaints and grievances regarding the treatment and information received by users in the Santiago and Barbanza healthcare area during the year 2022. A descriptive cross-sectional study was conducted, in which complaints filed by patients in the year 2022 in the Santiago and Barbanza healthcare area were analyzed. A total of 326 users who filed a total of 512 complaints were studied in the year 2022, with 358 (70.0%) related to treatment/information. The mean age was 33.5±16.2 years. 72.4% were women (n=236). A Pearson correlation was performed to establish whether there was a dependence between the number of healthcare visits in both primary care and hospital settings in 2022 and the number of complaints filed in the same year. Pearson correlation coefficient was 0.14; 95% CI (0.02 - 0.27), p=0.012. There is a correlation between the number of consultations and the number of complaints filed. Frequent users are more likely to file a complaint. However, there is no correlation between the number of consultations and the likelihood of filing a complaint regarding treatment/information. Therefore, there seems to be a good relationship between healthcare personnel and users, which impacts patient satisfaction.

Introduction: Family-centered care (FCC) is currently taking a greater role in health care, due to the increasing empowerment of the parental experience. This literature aims to find out the study of the philosophy of child nursing services based on Family Centered CareMethode: The study of this literature through the search of scientific publications ranges from 201 7-2022. The databases used are Pubmed, Science Direct, and Proquest. The literature search was conducted according to the topic with four keyword groups based on Medical Subject Heading (MeSH) and combined with Boolean operators AND, OR and NOT, keywords Child AND Family AND Centered AND Care. Result: The study of the philosophy of child nursing services based on Family Centered Care is conducted based on the study of ontology, epistomotogi and axiology. Family-centered care (FCC) is a philosophy that emphasizes partnerships between parents and health care staff. The FCC's basic principles in neonatal intensive care units (NICs) are unlimited parental presence and parental participation, shared responsibility and decision-making about infant hospital care, and open communication between parents and staff. A family-centered treatment approach has benefits such as maintaining a bond between the child and the family, allowing the family to engage in child care, and minimizing the negative effects of hospitalization on the child and family.Conclusion: FCC is beneficial for nurses in terms of efficiency and effectiveness of time in the care process and increases professional satisfaction. Therefore, the implementation of the FCC is more effective and the satisfaction of clients and families is more increased.

Abstract: Appetite loss is common in older patients and an independent risk factor for sarcopenia, which is associated with high mortality. However, few studies have explored the phenomenon of appetite loss after discharge from the intensive care unit (ICU). Therefore, we aimed to describe the prevalence of appetite loss and the relationship between appetite loss and depression in patients living at home 12 months after intensive care. We conducted a post hoc analysis, which was a published ambidirectional study examining post-intensive care syndrome at 12 months after discharge. We included patients aged > 65 years. The Short Nutritional Assessment Questionnaire (SNAQ) and Hospital Anxiety Depression Scale (HADS) were used for the analysis. Descriptive statistics and a multilevel generalized linear model were used to clarify the relationship between appetite loss and depression. Data from 468 patients were analyzed. The defined appetite loss was 25.4% (95%CI, 21.5–29.4). High severity of depression was an independent factor for high probability of appetite loss (OR, 1.2; 95%CI, 1.14–1.28; p=0.00). Poor appetite is common 12 months after intensive care and is associated with the severity of depression.

Background: Nursing services provided by nurses are based on knowledge and competence in the field of nursing science developed in accordance with Client needs, scientific developments, and the demands of globalization. These health services include nursing services that are carried out responsibly, accountably, with quality, and safely by nurses who have obtained registration and permission to practice. Nursepreneur is innovation and courage to take risks and is ready to work hard to achieve goals with optimism. Which has important components namely: 1) quality, 2) role, 3) option and success. The post-pandemic new world, especially in the health care system, continues to grapple with the demands of costs to provide patient care and safety. By using the application of the nursing theory model. Purpose :. Assessing scientific studies on the application of evidence-based intervention in wound care using nursing theory, identifying the important role of telenursing in improving nursing services in Nerspreneurship, Method: literature study Conclusion: Telenursing in nursing focuses on providing nursing care through information technology, such as telephone, computers, and the Internet that can be used to improve treatment outcomes among older people, especially those with low literacy skills and low financial status (Esmaeilpour-BandBoni et al., 2020). The statement from the results of the study refutes that Telenursing is intended for patients who have higher education and middle and upper economic states.

Background: Accreditation is a qualitative assessment aimed at technical-professional quality, but above all, at organizational and measurable aspects through process and outcome checks. Method: There are few references in the literature relating to the accreditation and improvement of the quality and safety of care and treatment in the field of primary care. Clinical Governance must also be applied and certified in the field of primary care. Results: An accreditation system for general medicine is proposed based on a new dynamic model and implement that meets different requirements and assessed on the basis of indicators. Discussion: In the current Italian health system, accreditation of health structures is addressed only to public hospitals and private structures and to providers of services and services, however primary care. GPs / PLS do not have quality and safety guarantee systems or models or systems or public or private accreditation certifications with the SSR and SSN. Conclusion: Given the fundamental importance in the NHS of primary care of MG / PLS as the main and fundamental provider of services to the patient in all his socio-welfare and clinical needs, it is considered essential to think and implement an accreditation system extended to the territorial general practice as already present and in place for all affiliated and provider structures on behalf of the NHS.

Objective: To map the literature pertaining to adult Person-Centered Rehabilitation (PCR).Data Sources: Following our previously published scoping review protocol, data were identified through: three major databases, snowball searches and expert consultation.Study Selection: Two independent reviewers identified English-language papers which addressed adult physical rehabilitation and met one or more of the six pre-defined inclusion categories for PCR content. Data Extraction: Two independent reviewers extracted key characteristics of included papers (e.g. aims, methods, participants). Quantitative methods (descriptive statistics, regression analysis) and qualitative content analyses were used to synthesize the results. Data synthesis: Of 5084 unique records initially screened, 145 papers were included: 111 empirical, including 11 systematic reviews. Empirical papers had data from 13498 clients and 3849 providers, in total. Yearly publications grew exponentially from 2000 to 2017 (r²= 0.65; p<0.01). Publications were unevenly distributed by countries (e.g. United States’ publications per population size was 45 times lower than New Zealand’s). Most papers focused in more than one profession, setting-type or health conditions, respectively 57.2%, 66.2%, and 60.7%. Finally, more than half of the empirical papers (53.2%) studied implementation of PCR approaches, including its effect. Conclusion: This scoping review synthesizes key characteristics and publication trends in the PCR literature, which is mainly empirical and growing exponentially over time. Stakeholders can use the identified trends, gaps, and literature map to guide further PCR research, and both clinical and organizational practices. The high prevalence of papers focused on multiple professions, settings-type, or health conditions reinforces the need for developing a transdisciplinary, trans-service model of PCR, which will be derived from a thematic analysis of this body of literature.

Context: A clinical video telehealth (CVT) program was implemented improve access and quality of dementia care to patients and their caregivers in rural areas. The program was offered as part of an established dementia clinic/geriatric primary care clinic in collaboration with five community-based outpatient clinics (CBOC’s) affiliated with the Tennessee Valley Healthcare System (TVHS) in middle Tennessee. Telehealth support was provided by a physician – social worker team visit. Methods: Telehealth training and equipment were provided to clinic personnel, functioning part-time with other collateral clinical duties. Patients and caregivers were referred by primary care providers and had an average of 1 to 2 CVT encounters originating at their local CBOC lasting 20 to 30 minutes. Clinical characteristics and outcomes of patients and caregivers receiving CVT support were collected by retrospective electronic medical record (EMR) review. Results: Over a 3-year period 45 CVT encounters were performed on patient-caregiver pairs, followed for a mean of 15 (1-36) months. Some 80% patients had dementia confirmed and 89% of these had serious medical comorbidities, took an average of 8 medications, and resided at a distance of 103 (76-148) miles from the medical center. Dementia patients included 33% with late stage dementia, 25% received additional care from a mental health provider, 23% took antipsychotic medications, 19% transitioned to a higher level of care, and 19% expired an average of 10.2 months following consultation. Caregiver distress was present in 47% of family members. Consult recommendations included 64% community-based long-term care services and supports (LTSS), 36% medications, and 22% further diagnostic testing. Acceptance of the CVT encounter was 98%, with 8770 travel miles saved. Conclusion: CVT is well received and may be helpful in providing dementia care and supporting dementia caregivers to obtain LTSS for high-need older adults in rural areas.

Inherited cardiomyopathies are a diverse group of heart muscle diseases caused by genetic mutations that result in structural and functional abnormalities of the myocardium. Understanding genotype-phenotype correlations in these conditions is vital for personalized cardiac medicine, enabling targeted therapeutic strategies and predictive diagnostics. This review explores the major types of inherited cardiomyopathies—hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and restrictive cardiomyopathy (RCM)—and provides detailed insights into how different genetic mutations manifest as clinical features. The integration of multi-omics approaches and advanced disease modeling techniques has enhanced our ability to dissect these correlations. The review also discusses the implications of these findings for personalized medicine, including tailored therapeutic strategies, predictive diagnostics, and future research directions.

Due to the continued deepening of today’s mining projects, there is a need to develop new or improved rockbolts that are strong and yielding and have high energy absorption when exposed to dynamic loading. Impact tests can provide useful information about the dynamic response of rockbolts but most laboratory tests involve high costs in preparation and result validation. Numerical modeling is an alternative that, in addition to complementing laboratory results, can be used to represent the process of deformation and energy absorption of support elements. In this paper the implementation and results obtained from a finite difference (FDM) numerical model are presented. The model functions as a simulation tool to illuminate all the elements that conform the large-scale (1:1) impact test and their behavior and influence on the dynamic response of a threadbar bolt (22 mm nominal diameter). The model was calibrated using published results and based on these results as well as parametric analysis, the response of each component (steel tube, grout, and bolt) could be identified and its behavior in terms of absorbed energy and displacement could be observed. Results show the model can provide important preliminary information to make design decisions about support elements design.

This paper presents an investigation of the oxidation of Alloy X-750 containing 5% Fe in a simulated boiling water reactor (BWR) environment. To mimic the conditions in which the bare metal is exposed to the reactor water the samples were not pre-oxidized. The specimens were exposed for durations ranging from 2 to 840 hours, and the development of the oxide microstructure was mainly studied using electron microscopy. The results showed that the oxide scale consisted of blocky crystals of trevorite on top of a porous inner layer rich in Ni and Cr. After the longest exposure time, the trevorite crystals completely covered the specimen surface. The study further revealed that the speed at which the oxide grew and the metal dissolved both decreased with time. Additionally, the metal thinning process was found to be sub-parabolic. Given the significant variation in iron content in the X-750 specification, the influence of this element on the material's corrosion performance in BWR was examined by comparing the results from this investigation with those from previous work on material containing 8 wt% Fe. The study demonstrated that the oxide growth, metal dissolution and metal thinning were slower in the material with higher Fe content, indicating the importance of this element in limiting the degradation of Alloy X-750 in BWR environments.

Acute vertigo and dizziness are frequent presenting symptoms in patients on the emergency department. With a broad differential diagnosis and symptoms/signs often subtle and transient, the diagnostic approach to the dizzy patient remains challenging. Previous work emphasized the value of combining structured history-taking and a targeted examination focusing on subtle oculomotor signs. Here I review different bedside algorithms proposed for the acutely dizzy patient. Comparing area-under-the-curve ROC-characteristics and sensitivity/specificity, highest diagnostic accuracy was observed for algorithms focusing on subtle oculomotor signs. Both the HINTS+ bedside-exam and the STANDING algorithm have demonstrated higher diagnostic accuracy for identifying strokes than early (<24-48h after symptom-onset) MRI-DWI. Importantly, HINTS and STANDING require moderate training to allow reliable application. Thus, for physicians lacking dedicated training, other approaches are needed. Various scores that rely on vascular risk-factors, clinical symptoms and focal neurologic findings have been proposed (e.g., ABCD2-score, PCI-score, TriAGe+-score). While these scores are more readily applicable for frontline providers, they provide intermediate diagnostic accuracy at best and often lack external validation, thus are an insufficient substitute for algorithms assessing subtle oculomotor findings. Providing dedicated training in HINTS+ or STANDING techniques will be key to improve the diagnostic accuracy and to avoid unnecessary brain imaging.

The world is facing a great technological transformation towards full autonomous vehicles, where optimists predict that by 2030, autonomous vehicles will be sufficiently reliable, affordable and common to displace most human driving. To cope with these trends, reliable perception systems must enable vehicles to hear and see all the surroundings, being light detection and ranging (LiDAR) sensors a key instrument for recreating a 3D visualization of the world in real time. However, perception systems must rely in accurate measurements of the environment. Thus, sensors must be calibrated and benchmarked before being placed on the market or assembled in a car. This article presents an Evaluation and Testing Platform for Automotive LiDAR sensors with the main goal of testing not only commercially available sensors, but also sensor prototypes currently under development in Bosch Automotive Electronics division. The testing system can benchmark any LiDAR sensor under different conditions, recreating the expected driving environment to which such devices are normally subjected. To characterize and validate the sensor under test, the platform evaluates several parameters such as the field of view (FoV), angular resolution, sensor’s range, etc. This project results from a partnership between the University of Minho and Bosch Car Multimedia Portugal, S.A.

We present a simulation library in Python 3 called Lumos. Different optimization routines areimplemented using multiple instruments. Automated measurements are implemented in this librarywhich lead to faster measurements as compared to manual sweeps. We elaborate on the experimentalmethods and also example usage is mentioned.

Appropriate diagnostic testing to identify persons infected with SARS-COV-2 is a vital part of a health system’s ability to control the global pandemic of COVID-19 disease. The primary purpose of this review is to provide an overview of the mass testing strategy implemented throughout the UAE and the overall impact it has made on containing and controlling the spread of the disease. This study describes the mass testing strategy and capacity of the UAE during the pandemic of the new coronavirus SARS-COV-2. The UAE has conducted 15 million polymerase chain reaction (PCR) tests to SARS-COV-2, as of 15 November 2020. The number of tests per day varied from 10,000 by the end of March to 120,000 tests per day in November 2020. The mass testing initiative across the entire UAE forms an integral part of a bigger strategy focusing on testing, tracing contacts and isolating positive cases.

Purpose: Determine the internal consistency and reproducibility test-retest of the Barrier Scale for Cardiac Rehabilitation (BSCR) in Colombian population. Methods: 190 patients (67% men, average age = 65 ± 12 years) completed the scale in two moments, with an average of eight days between applications. Cronbach's Alpha and Intraclass Correlation (ICC) coefficients were calculated. Results: The internal consistency of the Colombian version of the BSCR was good (Cronbach's alpha = 0.85). The ICC of the instrument was 0.69 (95% CI 0.61-0.76), 0.78 (95% CI 0.71-0.84) when used in the interview type, and 0.47 (95% CI 0, 21-0.67) when it was self-completing. Conclusions: The EBRC has an acceptable reliability in the Colombian population, however, its reproducibility decreases when it is self-directed. Identifying barriers using this scale will allow developing strategies to increase participation and adherence to cardiac rehabilitation programs focused on the real needs of patients.

The novel COVID-19 pandemic prompted an unprecedented Institutional reaction to aggregate existing capacity from silos of research laboratories to establish a multidisciplinary research laboratory for COVID19 testing. In less than two weeks, resources were mobilized from the community to strengthen public health response and epidemic control. Such strengthening of institutional research capacity to support public health response contributes to a natural knowledge transfer, facilitates collaboration, and generates new frontiers for knowledge production that should ultimately lead to professional development and retention of skilled human resources. This report describes the pre-established mechanisms and involvement of the authors that made it possible to set-up a multidisciplinary laboratory in a remarkably short period of time. We also discuss the opportunities and sustainability of multidisciplinary laboratory research post-COVID19. Existing institutional capacity can be repurposed to establish multidisciplinary research laboratories to support the strengthening of basic and clinical translational research capacity in resource limited settings and impact on public health and scientific knowledge for socioeconomic development.

Globally, an approximate of 380,000 patients succumbed to death due to the pandemic COVID-19 which also infected more than six million people since December 2019. Not sparing anyone, COVID-19 infections are widely reported among healthcare professionals, sanitation workers and researchers too while global leaders and various governments are providing their best in defending their citizens against this airborne and contact spread virus. In order to contain the virus and protect millions of lives from this deadly coronavirus, there is a need to have a combination of advanced engineering technology and medical facilities. Application of applied science, engineering and technology diffuse almost every aspect of contemporary living. Grasping the fundamentals to determine humanity's most imperative and forthcoming challenges is essential. Artificial Intelligence, the technology that learns, adapts and reciprocates the actions according to the situations, finds optimum position in the fight against corona virus and acts as a powerful tool against this pandemic. In this research article, the authors discusses how Artificial Intelligence (AI) can be leveraged to fight the deadly virus. The research paper further discusses the efficient utilization of AI across the globe to help in testing, treating and serving the population in these hard times. This manuscript focuses on the potential impact of the process in which AI can be implemented to prevent, test and treat.

In attempting to predict the further course of the novel coronavirus (COVID-19) pandemic caused by SARS-CoV-2, mathematical models of different types are frequently employed and calibrated to reported case numbers. Among the major challenges in interpreting these data is the uncertainty about the amount of undetected infections, or conversely: the detection ratio. As a result, some models include assumptions about the percentage of detected cases among total infections while others completely neglect undetected cases. Here, we illustrate how model projections about case and fatality numbers vary significantly under varying assumptions on the detection ratio. Uncertainties in model predictions can be significantly reduced by representative testing, both for antibodies and active virus RNA, to uncover past and current infections that have gone undetected thus far.

The high environmental impact of conventional methods of cooling and heating has increased the need for renewable energy deployment for covering thermal loads. Towards that direction, the proposed system aims at offering an efficient solar powered alternative, coupling a zeolite-water adsorption chiller with a conventional vapor compression cycle. The system is designed to operate under intermittent heat supply of low-temperature solar thermal energy (<90 °C) provided by evacuated tube collectors. A prototype was developed and tested in cooling mode operation. The results of separate components testing showed that the adsorption chiller was operating efficiently, achieving a maximum coefficient of performance (COP) of 0.65. With respect to the combined performance of the system, evaluated on a typical week of summer in Athens, the maximum reported COP was approximately 0.575, mainly due to the lower driving temperatures at a range of 75 °C. The corresponding mean energy efficiency ratio (EER) obtained was 5.8.

Objective: This paper aims to build an Effort Estimation Model for design, coding and testing Web Applications Based Fuzzy and Practical Models, which will help in optimizing the efforts in software development. Methods/Analysis: Soft computing approach is adopted and applied in the effort estimation and then compared with practical efforts in the development process with interpreting the historical data available for the existing functionalities. Findings: The effort estimation model presented in this paper focuses on the first level estimates published by Project Managers and the second level estimates presented by Project Leaders or Developers for any new requirement or enhancement for a web application built on 3-tier architecture using Microsoft technologies. The model considers the classification of each task as either Low or Medium or High complexity. These tasks pertain to the lowest level parts in bottom-up estimation. Efforts are estimated for designing, coding and unit testing of these tasks and the efforts are summed up to get the effort estimation for the higher level which is a feature to be implemented. Novelty/Improvement: The paper also discusses about the application of the effort estimation model by taking a new requirement as a case study. The first level estimates calculated using the effort estimation model has a variance of about 25% when compared with the actual effort. This variance is very much acceptable considering the fact that the first level estimates can be tolerable up to 35%. The proposed effort estimation tool would help the project managers to efficiently control the project, manage the resources effectively, and improve the software development process and also trade off analyses among schedule, performance, quality and functionality. Fuzzy logic is used to verify the claims made in efforts estimation. It is proposed a new relation between the number of data and efforts value membership for actual data. And converts it into crisp value in the range [0…1] which helps to classify the complexity of the task and subtask in the design, coding and testing phases.

We address Multi-Wall Carbon NanoTubes (MWCNTs) for structural health monitoring in adhesive bonds such as in building structures. MWCNT-loaded composites are employed to sense strain changes under tension load using an AC impedance measurement setup. Different weight percentages of 1, 1.5, 2 and 3 wt.% MWCNT are added to the base epoxy resin using different dispersion times, i.e. 5, 10 and 15 minutes. The equivalent parallel resistance of the specimens is measured by applying an alternating voltage at different frequencies. To determine the mechanical as well as sensory properties, the specimens are subjected to a tensile test with concurrent impedance measurement. Using alternating voltage, a higher sensitivity of the impedance reading can be achieved. Employing these sensors in buildings and combining the readings of a network of such devices can significantly improve the buildings’ safety. Additionally, networks of such sensors can be used to identify necessary maintenance actions and locations.

Recent analyses of cosmic microwave background surveys have revealed hints that there may be a non-trivial running of the running of the spectral index. If future experiments were to confirm these hints, it would prove a powerful discriminator of inflationary models, ruling out simple single field models. We discuss how isocurvature perturbations in multi-field models can be invoked to generate large runnings in a non-standard hierarchy, and find that a minimal model capable of practically realising this would be a two-field model with a non-canonical kinetic structure. We also consider alternative scenarios such as variable speed of light models and canonical quantum gravity effects and their implications for runnings of the spectral index.

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalized, and coordinated intervention under the Value-Based Care approach to address frailty's multidimensional nature in older people. It em-ployed a pre-post randomized controlled design, involving frail individuals over 65 years in Valencia, Spain. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalized care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty and social frailty. The study found signifi-cant improvements in physical frailty, quality of life, reduced health resource use and hospitali-zations, and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalized, comprehensive programs for older individuals with frailty.

This study presents the development and pilot implementation of an assessment and shared deci-sion-making methodology called the Gezamenlijk Inschatten van Zorgbehoeften (GIZ), designed for youth (health) care professionals working with children and families. The three-phase approach included a needs assessment, development of the GIZ methodology, and pilot implementation in a preventive youth health care and youth care setting, involving parents, adolescents, and youth (health) care professionals. The needs assessment produced nine criteria that the GIZ methodology needed to meet. Based on these criteria, the GIZ methodology was developed and described using the Template for Intervention Description and Replication (TIDieR). The pilot implementation demonstrated high client engagement, satisfaction, and feasibility in daily practice. The GIZ ap-proach promotes appropriate support for families by improving the joint assessment and shared decision-making process in youth (health) care. This study supports the implementation of GIZ in youth (health) care practice and highlights the need for further focus on implementation and sus-tainability.

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalised care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of six workshops in different locations of the city to encourage the sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighbourhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their own health and understanding their values and preferences. Qualitative results show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered amongst the reasons to visit health professionals. Some of the conclusions reveal that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognised the benefits of this new approach but required more time and incentives to dedicate the effort needed.

This study examines change detection techniques in dense point clouds for the purpose of Cultural Heritage preservation, with a particular focus on the San Pietro Barisano Bell Tower in Matera, Italy. Dense point clouds, obtained via advanced laser scanning, offer detailed 3D representations of heritage structures, facilitating the precise monitoring changes over time. The investigation uses a variety of change detection algorithms, including the Iterative Closest Point (ICP) algorithm, which is renowned for its robust registration capabilities in aligning point clouds with high accuracy. The combination of ICP with deviation analysis and feature-based methods allows for the effective identification of alterations, including deformations, material loss, and surface degradation. This methodology establishes a comprehensive framework for the monitoring of Cultural Heritage, thereby enabling timely and targeted preservation efforts. The results emphasise the substantial contribution of dense point cloud analysis to the enhancement of heritage management and the safeguarding of vulnerable architectural sites.

This paper proposes a solution for the problem of mobile robot navigation and trajectory interpolation in dynamic environments with large scenes. The solution combines a semantic laser SLAM system that utilizes deep learning and a trajectory interpolation algorithm. The paper first introduces some open-source laser SLAM algorithms and then elaborates in detail on the general framework of the SLAM system used in this paper. Secondly, the concept of voxel is introduced into the occupation probability map to enhance the ability of local voxel maps to represent dynamic objects. Then, in this paper, we propose a PointNet++ point cloud semantic segmentation network combined with deep learning algorithms to extract deep features of dynamic point clouds in large scenes and output semantic information of points on static objects. A descriptor of the global environment is generated based on its semantic information. Closed-loop completion of global map optimization is performed to reduce cumulative error. Finally, T-trajectory interpolation is utilized to ensure the motion performance of the robot and improve the smooth stability of the robot trajectory. The experimental results indicate that the combination of the semantic laser SLAM system with deep learning and the trajectory interpolation algorithm proposed in this paper yields better graph building and loop closure effects in large scenes at SIASUN large scene campus. The use of T-trajectory interpolation ensures vibration-free and stable transitions between target points.

Traditional underground pipeline inspection primarily relies on closed-circuit television (CCTV) systems, capturing visual data of deformations within sewer systems for manual assessment of their types and severity. However, these methods heavily rely on human expertise, which leads to subjective detection with limited accuracy. Moreover, they lack the capability for quantitative analysis of deformation extent, hindering accurate assessments and limiting overall inspection effectiveness. To address these challenges, this paper proposes a method for quantitatively detecting geometric deformations in underground pipe corridors using laser point cloud data. The approach, employing laser scanning with a 3D scanner, enables objective detection of internal pipeline deformations and quantitative assessment of blockage levels. In comparison to traditional CCTV-based methods, this approach offers advantages in objectivity and quantification, thereby improving detection reliability, accuracy, and overall efficiency.

Point-contact spectroscopy has been performed on bulk samples of electron-doped high temperature superconductor Nd2-xCexCuO4-. The samples were characterized by X-ray diffraction and scanning electron microscopy equipped with a wavelength dispersive spectrometer and an electron backscatter diffraction detector. The samples with a Ce content x = 0.15, show the absence of spurious phases and randomly oriented grains, most of which have dimensions of approximately 220 µm2. The low-bias spectra in the tunnelling regime, i.e., high transparency interface, exhibit a gap feature at about ±5 meV and no zero-bias conductance, consistent with the most literature data on oriented samples. The high-bias conductance has also been measured in order to obtain information on the properties of the barrier. A V-shape has been in some cases observed, instead of the parabolic behavior expected for tunnel junctions.

Non-rigid registration presents a significant challenge in the domain of point cloud processing. The general objective is to model complex non-rigid deformations between two or more overlapping point clouds. Applications are diverse and span multiple research fields, including registration of topographic data, scene flow estimation, and dynamic shape reconstruction. To provide context, we begin with a general introduction to the topic of point cloud registration, including a categorization of methods. Next, we introduce a general mathematical formulation for point cloud registration and extend it to address non-rigid registration. A detailed discussion and categorization of existing approaches to non-rigid registration follows. We then introduce our own method where the usage of piece-wise tricubic polynomials for modeling non-rigid deformations is proposed. Our method offers several advantages over existing methods. These advantages include easy control of flexibility through a small number of intuitive tuning parameters, a closed-form optimization solution, and an efficient transformation of huge point clouds. We demonstrate our method through multiple examples that cover a broad range of applications, with a focus on remote sensing applications - namely, the registration of Airborne Laser Scanning (ALS), Mobile Laser Scanning (MLS), and Terrestrial Laser Scanning (TLS) point clouds. The implementation of our algorithms is open source and can be found on GitHub.

The relationship between living things and their respective environments highly dependent on body temperature regulation. The human capacity to effectively thermoregulate evolved at a time when the environmental temperature was likely around 25°C during the Eocene epoch, some ~ 50-60 million years ago. This effectively meant that homeothermy settled on a core temperature balance point of ~ 37°C. When Homo split from chimpanzee around 5 million years ago the Earth was entering a cooling period where the balance point temperature was always well above that of the environment and body heat balance could be maintained. Following this cooling period, the Earth’s rewarming by 7 °C took over approximately 5,000 years, whereas the current estimates indicate 0.7 °C over the past 100 years; ten times the rate of ice-age-recovery warming, or 20 times faster compared with the last 2 million years. As such, if the predicted continued rise in global temperature continues, and surface temperature reaches values where heat load cannot be dumped as the body temperature balance point is at or near the environmental temperature, areas of the Earth would become inhospitable. This effectively means that we will need to deal with both physiological and behavioral limitations since our ability to adapt will be limited by a thermoregulatory strategy that evolved over millions of years for a different kind of environment, not one that is predicted to change rapidly over the next century. This paper outlines the basis on which Homo settled on a thermoregulatory balance point and what limitations this presents for us in the future.

Urban scene point cloud pose significant challenges for registration due to its large data volume, similar scenarios and dynamic objects. In this paper, we propose PCRMLP, a model for urban scene point cloud registration that achieves comparable registration performance to prior learning-based methods. Compared to previous works which focus on extracting features and estimating correspondence, the model estimates the transformation implicitly from concrete instances. An instance-level urban scene representation method is introduced to extract instance descriptors via semantic segmentation and DBSCAN, which enable the model to obtain robust instance features, filter dynamic objects and estimate transformation in a more logical manner. Then a lightweight network consisting of MLPs is employed to obtain transformation in an encoder-decoder manner. We validate the approach on KITTI dataset. Experimental results demonstrate that PCRMLP can obtain a satisfactory coarse transformation from instance descriptors just in 0.0028s. With a subsequent ICP refinement module, the proposed method achieves higher registration accuracy and computational efficiency than prior learning-based works.

For the symmetrical mixture model and mixture test area, the lattice point set is used to partition, and then the corresponding test statistics can be constructed. In this paper, we first proposes the partition methods under the lattice point sets and obtains several sub-simplexes without common interior points. Furthermore, we present the method for constructing a uniform design on the simplex using the center points of these sub-simplexes. The designs satisfy the uniformity of maximum distance deviation and provide good results for the mean square error deviation. Finally, the uniformity test on the mixture region is considered and illustrated by examples.

Bubble (point defect) – a precursor of fuzz or under dense nanostructure formation is crystal lattice defect. Suitable selection of crystal lattice which inhibit Frenkel pair generation and intrinsically promotes self- interstitial solid solution strengthening contributes effectively towards making plasma facing material. For this, interstitial sites, their size, amount / fraction, positions, tendency of occupation and diffusion parameters (e.g. activation energies (Q), activation volumes) are determined. Fcc iron carbon alloys (austenitic stainless steels AISI / SAE 321, fcc structure, Pearson code cF4, space group Fm3̅m) are proposed as suitable candidates. Along with their room temperature fcc structure having 12 interstitial positions (4 octahedral, 6 coordination sites and 8 tetrahedral, 4 coordination sites / unit cell) to allow insertion of self (iron) atoms, they have excellent corrosion resistance, thermal conductivity, and non- magnetic properties. After their melting, casting, and machining to required dimensions and geometry, stabilizing heat treatment is applied to precipitate all carbon as TiC and prevent formation of Cr23C6 (sensitization). This resist heat and surface degradation and yield excellent architecture which not onlyinhibit Frankel pair generation but will also allow bulk assimilation or surface annihilation (loop punching) of this lattice point defect. A superior thermal, fluid, and structural design augment above. A second choice is presented as Co base superalloys owing to same fcc crystal structure and excellent properties (such as strength, dimensional stability, oxidation resistance) at high temperature.

A novel approach has been suggested to use isoelectric points of viral and human proteins to quickly identify proteins that are effective in not allowing virus particles to attach to human receptor cells by virtue of their electrical charge. The method has been applied to SARS CoV-2 to suggest potentially important human proteins that can be suitable for making anti-viral drugs.

Theoretical analysis into the energetics of a novel putative electromagnetic field propulsion device by the author, found that it was able to impart momenergy to the ground state of the electromagnetic field; some rest-energy of the craft was converted to kinetic energy of the craft. Electrical analysis showed that the propulsor was always a net electrical load – if the device accelerated from one frame, then deaccelerated to the original frame, both processes would consume electrical work. The aim of this paper is to look further into this sinking of high-grade electrical energy into the field ground state and to show that an even more pernicious form of 2^nd Law of Thermodynamics exists.

If an algebra of type $A$ contains a subalgebra which is also an algebra of type $B$, then it is a Smarandache $B$-type $A$-algebra provided the subalgebra of type $B$ contains at least two elements. This generalizes the notion of Smarandache group, where the group of order $\geq 2$ is a subsemigroup of a semigroup. In this paper we investigate a number of such pairings and we deduce a number of conclusions as a consequence.

This paper is devoted to change-point detection using only the ordinal structure of a time series. A statistic based on the conditional entropy of ordinal patterns characterizing the local up and down in a time series is introduced and investigated. The statistic requires only minimal a priori information on given data and shows good performance in numerical experiments.

Sequential hypothesis test and change-point detection when the distribution parameters are unknown is a fundamental problem in statistics and machine learning. We show that for such problems, detection procedures based on sequential likelihood ratios with simple one-sample update estimates such as online mirror descent are nearly second-order optimal. This means that the upper bound for the algorithm performance meets the lower bound asymptotically up to a log-log factor in the false-alarm rate when it tends to zero. This is a blessing, since although the generalized likelihood ratio (GLR) statistics are optimal theoretically, but they cannot be computed recursively, and their exact computation usually requires infinite memory of historical data. We prove the nearly second-order optimality by making a connection between sequential analysis and online convex optimization and leveraging the logarithmic regret bound property of online mirror descent algorithm. Numerical and real data examples validate our theory.

We generalize the point information gain (PIG) and derived quantities, i.e., point information gain entropy (PIE) and point information gain entropy density (PIED), for the case of the Rényi entropy and simulate the behavior of PIG for typical distributions. We also use these methods for the analysis of multidimensional datasets. We demonstrate the main properties of PIE/PIED spectra for the real data on the example of several images, and discuss further possible utilizations in other fields of data processing.

We introduce the notion of generalized contraction on dualistic partial metric spaces. A fixed point theorem for mappings satisfying above mentioned contraction is obtained. Some consequences of our result are obtained. We construct an example to demonstrate the effectiveness of our result among the corresponding results in partial metric spaces. Our results provide substantial generalizations and improvements of several well known results existing in the comparable literature. We discuss an application of our fixed point results to show the existence of solution of functional equations.

Thurstonian scaling, i.e., Thurstonian discriminal distance δ or d' can be used as a sensory measurement index to measure and monitor food sensory difference/similarity between test and control samples due to potential food contamination. It can be obtained from any one of the sensory discrimination methods. Thurstonian scaling is theoretically independent of methods or scales used for its estimation. This paper discusses statistical inference including estimations and tests of hypothesis for d'. Ten basic sensory discrimination methods including 6 forced-choice methods and 4 methods with response bias are used in this paper to estimate d' values and their variances. Statistical tests are conducted based on the estimated d' values and their variances. The statistical tests include difference testing and equivalence/similarity testing for individual d' values for test and control samples and for two or multiple d' values for test samples. Application and significance of Thurstonian scaling for sensory discrimination methods is discussed generally. R codes for estimations and tests for d' values are provided in the paper.

With the continuous development of 3D city modeling, traditional close-range photogrammetry is limited by complex processing procedures and incomplete 3D depth information, making it unable to meet high-precision modeling requirements. In contrast, the integration of LiDAR and camera in mobile measurement systems provides a new and highly effective solution. The LiDAR can quickly and accurately acquire the 3D spatial coordinates of target objects, while optical imagery contains abundant color information. If the two can be integrated, they can play an important role in multiple fields such as streetscape modeling, archaeology and digital city, etc. Currently, integrated mobile measurement systems commonly require cameras, lasers, POS and IMU, thus the hardware cost is relatively expensive and the system integration is complex. Therefore, in this paper we propose a simple ground mobile measurement system composed of a LiDAR and a GoPro camera without a POS system, providing a more convenient and reliable way to automatically obtain 3D point cloud data with spectral information. The automatic point cloud coloring based on video images mainly includes four aspects: (1) Establishing models for radial distortion and tangential distortion to correct video images. (2) Establishing a registration method based on normalized Zernike moments to obtain the exterior orientation elements. Normalized Zernike moments are region-based shape descriptors that can reflect the features of images in multiple dimensions even for low-quality video images. The results show that registration based on normalized Zernike moments provides a good result, with an error accuracy of 0.5-1 pixel, which is far higher than registration based on a collinearity equation. (3) Establishing adjacent video image relative orientation based on essential matrix decomposition and nonlinear optimization. This involves uniformly using the SURF algorithm with distance restriction and RANSAC to select corresponding points, which can improve the reliability of the corresponding points. The results indicate that the accuracy of the relative orientation method is high. Moreover, this method can converge to good results for stereo image pairs with large rotation angles and displacement amounts. Therefore, relative orientation based on essential matrix decomposition and nonlinear optimization has good applicability. (4) The video imagery suffers from significant motion blur and boundary distortion. Therefore, a point cloud coloring method based on Gaussian distribution with central region restriction is adopted. Only pixels within the central region are considered valid for coloring. Then, the point cloud is colored based on the mean of the Gaussian distribution of the color set. Experimental results show that the coloring accuracy between the video imagery and point cloud data is high, meeting the accuracy requirements of applications such as tunnel detection, street-view modeling and 3D urban modeling.

An explanation of the origin of dark matter is suggested in this work. The argument is based on symmetry considerations about the concept of mass. In the Wigner's view, the rest mass and the spin of a free elementary particle in flat space-time are the two invariants that characterize the associated unitary irreducible representation of the Poincar\'e group. The Poincar\'e group has two and only two deformations with maximal symmetry. They describe respectively the de Sitter (dS) and Anti de Sitter (AdS) kinematic symmetries. Analogously to their shared flat space-time limit, two invariants, spin and energy scale for de Sitter and rest energy for Anti de Sitter, characterize the unitary irreducible representation associated with dS and AdS elementary systems. While the dS energy scale is a simple deformation of the Poincaré rest energy and so has a purely mass nature, AdS rest energy is the sum of a purely mass component and a kind of zero-point energy derived from the curvature. An analysis based on recent estimates on the chemical freeze-out temperature marking in Early Universe the phase transition quark-gluon plasma epoch to the hadron epoch supports the guess that dark matter energy might originate from an effective AdS curvature energy.

All humans will experience the process of birth, old age, illness, and death. However, when faced with life-sustaining decisions, the families of patients are often faced with medical decisions as surrogates. In recent years, the families of patients have started to value the importance of the right to palliative care, although this often requires lengthy discussions. Therefore, this study explored the predictability of factors that affect the feeling experienced by patients’ families when signing Do-Not-Resuscitate Consent. This study used a cross-sectional study and interviewed 90 family members using a structural questionnaire. The study hypotheses were tested using a t-test, one-way analysis of variance, product–moment correlation, and hierarchical regression analysis. Attribute variables of family members, such as gender and whether they live with the patient, are predictors that affect the family member’s feeling experience when signing Do-Not-Resuscitate Consent. The emotional support from medical professionals to family members helps the family member to express their negative feelings on signing Do-Not-Resuscitate Consent; more informational support information provided to family members by medical professionals can alleviate negative feelings felt by family members when signing Do-Not-Resuscitate Consent. This study identified that family members’ knowledge about Do-Not-Resuscitate acquired from medical professionals is relatively low. It is suggested that critical care units regularly conduct training on hospice palliative care, implement standard care procedures of hospice palliative care at critical care units, and provide detailed medical information about advanced decisions to family members so as to reduce their emotional stress. This will ensure that intensive care units can also achieve the goal of critically ill hospice palliative care.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

As the penetration of renewable energies increases, their acceptance of the power grid system is becoming an important issue. In the case of South Korea, a 22.9kV transformer is frequently utilized to reduce the power loss of the generated renewable energy transmission, so the power quality at the point of common connection (PCC) is inevitably influenced by the nonlinearity of the transformer and the uncertainty of the inductance and resistance of the transmission line. In this paper, we present a point of common connection voltage-modulated direct power control (PCCVM-DPC) system that enhances power quality at the PCC. First, we present the mathematical dynamics of active and reactive power at the PCC side, which contains the step-up transformer’s nonlinearity, the grid voltage harmonics, and the parameter uncertainties. By analyzing the disturbance terms of the PCCVM-DPC system, we present the disturbance observer (DOB) for the PCCVM-DPC system. To assess the efficacy of our approach, we perform comparative studies of the PCCVM-DPC without DOB and PCCVM-DPC with DOB by constructing the simulation environment based on the commercial step-up transformer and ESS inverter datasheet. We have validated that the active and reactive power control performance of the PCCVM-DPC with DOB outperforms the PCCVM-DPC without DOB from the observation that the current total harmonic distortion reduced by more than 40% compared to the PCCVM-DPC without the DOB.

Petrochemical plants use on-stream inspection more often to detect and monitor the corrosion on the equipment and piping system. Compared to ultrasonic thickness gauging and pulse-echo A-scan, phased array corrosion mapping has better coverability and can scan a large area to detect general and localized corrosion. This paper's objective is to obtain documentary evidence on the accuracy of corrosion detection from 30°C to 250°C on A36 low-carbon steel by carrying out simulation experiments every 10°C steps. A minimum of three sets of phased array corrosion mapping data in each temperature were collected to study and evaluate the detectability. The data evidence could enhance the confidence level of the plant's end users to use the phased array mapping in the future during an inspection. The experiments were found to be insufficiently thorough despite addressing the initial concerns, leaving more area for discussion in further studies, such as expanding the investigation to thicker carbon steel, stainless steel, and wedge materials.

Burnout represents a concern for all healthcare providers, particularly those specializing in emergency medical care for whom burnout outcomes have been well-documented. What remains unknown is the effect of burnout on redeployed medical specialists during the COVID-19 pandemic from an appointment-centered practice to emergency care directed by public health considerations. This research aims to identify and assess the burnout responses of fourteen medical specialties noted in searched returns of the four most cited articles published since 2020 about non-emergency physicians regarding their burnout brought on by the unanticipated need for them to provide emergency care during the recent pandemic. The hypothesis is that medical specialists accustomed to planning for emergency possibilities in their appointment-centered practice would demonstrate the least burnout regarding COVID-19-related emergencies. Considering coping as a process based on Lazarus's research, comparing and ranking the COVID-19 emergency responses across the various normally appointment-centered medical specialties in their employed coping strategies determines the outcome. With the hypothesis supported, suggested interventions for future pandemics—when these specialists are, again, redeployed to emergency care directed by public health considerations—are those coping strategies identified as most effective in reducing burnout while maintaining the viability of the medical specialty and excellent patient care.

Stroke is a global leading cause of death and disability. Knowledge of related guidelines is crucial for Emergency Department (ED) staff, influencing early diagnosis and timely treatment. We investigated Greek-Cypriot ED healthcare professionals' (nurses and physicians) knowledge in recognizing and managing stroke. A descriptive cross-sectional study spanned November 2019 to April 2020, encompassing four private and seven public EDs in the Republic of Cyprus. The data were collected through a self-reported questionnaire developed by the research team, consisting of 37 questions. Eight questions focused on sociodemographic and employment characteristics, 28 assessed knowledge in stroke recognition and management (each item was equally weighted without deliberate prioritization), and one question addressed self-assessment of knowledge in stroke care. 255 nurses [Response Rate (RR): 74.1%] and 26 physicians (RR: 47.3%) completed the questionnaire. The average correct response rate was 12.9 out of 28 statements (SD: 4.2), with nurses and physicians scoring 12.6 (SD: 4.1) and 15.7 (SD: 4), respectively. Work experience significantly influenced stroke knowledge, with all groups demonstrating superiority over those with less than one year of experience. Participants with previous training scored an average of 1.45 additional correct answers while educational attainment did not significantly influence stroke knowledge. Investigating stroke knowledge among Emergency Department nurses and physicians in the Republic of Cyprus revealed significant deficits. The study stresses targeted interventions, including, education, yearly examinations, workshops with hands-on training, and repeated training, to address these gaps and enhance the overall stroke care capabilities of the healthcare professionals.

Alzheimer’s disease and related dementias (ADRD) remain a public health challenge in developing counties. We developed a needs-based essential care service package (ECSP) for care planning of persons living with dementia (PLWD) using a cross-sectional survey among PLWD in institutions in six cities in China (n= 1,299). Face-to-face interviews were conducted with caregivers of PLWD by trained staff between 2018 and 2019. Care service needs and utilization by the level of cognitive impairment were summarized. The average age of PLWD was 80.7 years. 76% of participants had severe cognitive impairment. The needs-based ECSP with 30 service items would be sufficient in supporting care services of PLWD in China, of which seven items are core care. The selection plan for ECSP at different levels is designed as “General Care Services + Selective Care Services”, in which service items for low-, mid-and high-level care for PLWD are 7+3, 7+6, and 7+10, respectively. The findings provide the first large-scale data on service needs and utilization of PLWD in mainland China. The ECSP for PLWD advanced in the paper was a practicable and effective quantitative management means. It is deserved to application in a large scale.

Currently, many manufacturing industries use machine learning, artificial intelligence, robotics, and blockchain technologies as process-streamlining instruments of industry 4.0. Before implementing industry 4.0 tools in any process of a manufacturing industry's supply chain, it is essential to evaluate their adaptability. In this paper, the adaptability of industry 4.0 procurement tools to an oil and gas-related manufacturing company's procurement process is evaluated to determine the company's level of maturity. The active participation of participants is evaluated to determine the level of maturity of the main procurement process areas. The results identified the areas of the procurement process that can be improved by implementing the suggested industry 4.0 tools and techniques.

One of the main challenges in geodetic deformation analysis is to infer whether the geometry of some engineering structures or zones of natural hazards has changed from their initial state or not. The pillar that supports such an analysis is tightly based on the fundamentals of statistical hypothesis testing. The null hypothesis model indicates that no displacement has occurred. It is tested against a class of alternative models, which stipulate different displacement patterns. In this contribution, we present an innovative geodetic displacement detection which integrates combinatorial analysis and likelihood ratio tests into a sequential procedure for the case where the differences between observations of two epochs are in play. This framework is applied and investigated to two test scenarios: a synthetic and a real simulated trilateration network. From a statistical point of view, our approach is rigorous, because the alternative model can identify simultaneously more than one unstable point. In addition, the relationship between the unknown parameters and the observations is always linear, even if the problem manifests itself as non-linear. Consequently, we avoid a potential loss of statistical test power due to the model linearization. In addition, the proposed method controls the false positive rate efficiently. One of the problems that arise here is also related to the selection of the maximum number of points to be considered in the test procedure ( ). Here, we provide an innovative methodology based on rank computation of the design matrices to define , which can even be extended to the problem of outlier detection. Determining avoids the problem of having non-separable models in identifying unstable points. The algorithms and data are available in the repository.

Globally, the use of whole-cell matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in clinical microbiology laboratories has increased considerably. With the rapid growth of artificial intelligence technology, there is an increasing number of areas devoted to solving problems by implementing machine learning-based methods. Applying the use of artificial intelligence to the analysis of the massive amount of information obtained in the mass spectrum derived from MALDI-TOF MS should be a breakthrough in clinical microbiology. Specifically, it would facilitate a more rapid and accurate strain typing or antibiotic susceptibility test (AST) based on whole-cell MALDI-TOF MS spectra, and hence, it is a promising solution. Even though the reproducibility of peaks could result in some critical problems, computational methods have been developed to address this issue. Therefore, clinical microbiologists are able to perform strain typing or an AST as smoothly and easily as identifying species by using MALDI-TOF MS and artificial intelligence.

The plate heat exchanger (PHE) is a component that provides heat to be transferred from hot water to domestic cold water without mixing them with high efficiency. Over the lifetime of the PHE, cyclic pressures act on the brazing points and the plates, and this may lead to fatigue failure. The fatigue behaviour of the PHE, designed by using copper-brazed 316L stainless steel, was investigated in this study. First, the fatigue tests under the load ratio R = 0.1 were performed on the Vibrophore 100 testing machine to obtain the S-N curve of the analysed brazed joint. Based on the obtained experimental results, an appropriate material model of the analysed brazed joint has been created, which was validated with numerical calculation in the framework of a program code Ansys. A validated material model was then used for the subsequent numerical analysis of PHE. In order to carry out a numerical calculation using the finite element method (FEM), a 3D model of the heat exchanger was created based on the previous scanning of PHE-geometry. Thereafter, the geometry was parameterised, which allowed us to perform parametric simulations (monitoring different responses depending on the input geometry). Numerical simulations were carried out in the framework of the Ansys software, whereby the obtained results were analysed, and the responses were appropriately characterised according to previously determined load cases.

Evaluating mutation testing behavior can help decide whether refactoring successfully maintains the expected initial test results. Moreover, manually performing this analytical work is both time-consuming and prone to errors. This paper extends an approach to assess test code behavior and proposes a tool called MeteoR. This tool comprises an IDE plugin to detect issues that may arise during test code refactoring, reducing the effort required to perform evaluations. A preliminary assessment was conducted to validate the tool and ensure the proposed test code refactoring approach is adequate. By analyzing not only the mutation score but also the generated mutants in the pre- and post-refactoring process, results show that the approach is capable of checking whether the behavior of the mutants remains unchanged throughout the refactoring process. This proposal represents one more step toward the practice of test code refactoring. It can improve overall software quality, allowing developers and testers to safely refactor the test code in a scalable and automated way.

It is generally accepted that the human abdominal wall is comprised of skin, subcutaneous tissues, muscles and their aponeuroses, and the parietal peritoneum. Understanding these layers and their mechanical properties provides valuable information to those designing procedural skills trainers, supporting surgical procedures (hernia repair), and engineering-based work (in silico simulation). However, there is little literature available on the mechanical properties of the abdominal wall in layers or as a composite. This work characterizes the tensile properties of the human abdominal wall by layer and as a partial composite. Tissues were collected from fresh-never-frozen and fresh-frozen cadavers and tested in uniaxial tension at a rate of 5 mm/min until failure. Stress-strain curves were created for each sample, and the values for elastic moduli, ultimate tensile strength, and strain at failure were obtained. The experimental outcomes from this study demonstrated variation of tensile properties within and between tissues. The data also suggest that the tensile properties of composite abdominal walls are not additive. Ultimately, this body of work contributes to a deeper comprehension of these mechanical properties and will serve to enhance patient care, refine surgical interventions, and assist with more sophisticated engineering solutions.

Since the first published genome sequence of Trypanosoma cruzi in 2005, there has been tremendous technological advance in genomics, reverse genetics, and assay development for this elusive pathogen. However, there is still an unmet need for new and better drugs to treat Chagas disease. Here we introduce a T. cruzi assay strain that is useful for drug research as well as basic studies in host-pathogen interaction. Trypanosoma cruzi STIB980 is a strain of discrete typing unit TcI that grows well in culture as axenic epimastigotes or intracellular amastigotes. We have evaluated the optimal parameters for genetic transfection and constructed derivatives of T. cruzi STIB980 that express reporter genes for fluorescence- or bioluminescence-based drug efficacy testing, as well as a Cas9-expressing line for CRISPR/Cas9-mediated gene editing. The genome of T. cruzi STIB980 was sequenced by combining short-read Illumina with long-read Oxford Nanopore technologies. The latter served for the primary assembly, the former to correct mistakes and fill the gaps. This resulted in a high-quality nuclear haplotype assembly of 28 Mb in 400 contigs, containing 10,043 open-reading frames with a median length of 1077 bp. We believe that T. cruzi STIB980 is a useful addition to the antichagasic toolbox, and propose that it can serve as a DTU TcI reference strain for drug efficacy testing.

A better understanding of diseases progress in tissues vest on the accurate understanding of tissues under mechanical loading. Also, development of therapies for injuries may depend on the available mechanical data for soft tissues. In this study, the raw data of biaxial tensile testing of sclera soft tissue is presented in this paper. Biaxial mechanical testing of soft tissues presents details understanding of how soft tissues behave when compared to uniaxial testing. Biomechanical properties of soft tissues are vital in the development of accurate computational models. Reliable computational models of studying mechanisms of diseases depends mainly on the accurate and more details mechanical behavior of soft tissues. These accurate and detailed computational models may be utilized to further develop the understanding and therapies of various diseases. The mechanical tensile testing was conducted on the passive sheep sclera. Engineering stress vs strain of several samples of the sheep sclera are further presented determined from force and displacement experimental data. The goal of this paper is to make available biaxial data of sheep sclera soft tissue that can be further utilized.

The use of multi-gene panels for germline testing in breast cancer enables the estimation of cancer risk and guides risk-reducing management options for tested individuals and their family members. We performed an analysis in our clinical database to identify breast cancer patients undergoing genetic testing with positive reports. We reviewed positive results with respect to the different levels of information provided in the reports; risk estimation and management, cascade family testing, information from secondary findings and actionable information for treatment decision-making. A total of 415 positive test reports were identified with 57.1%, 18.1%, 10.8% and 13.5% of individuals having pathogenic/likely pathogenic variants in high (BRCA1, BRCA2, PALB2, PTEN, TP53), moderate (ATM, CHEK2, NBN), low (BARD1, BRIP1, CHEK2, MLH1, MSH2, MSH6, NF1, RAD51C) and with insufficient evidence for breast cancer risk genes (FANCA, FANCM, NBN, MRE11, PMS2, RAD50, RAD51B, XRCC2, MUTYH), respectively. 6.7% of individuals were double heterozygotes with two pathogenic variants. Germline findings in 92% of individuals are linked to evidence-based treatment information and receive risk estimates for predisposition to breast and/or other cancer types. The use of germline findings for treatment decision making expands the indication of genetic testing to include individuals that could benefit from targeted treatments.

In this paper, a non-destructive test to diagnose wear of blade´s compressor of a gas turbine is reported. Gas turbine was operating in Campeche City, Mexico, in a very aggressive environment, where the entry of solid particles is unavoidable. The objective was to reduce cost of maintenance in this equipment. Analysis on a blade of gas turbine was performed, which was in operation on an offshore platform. Compressor blade was exposed to a severe damage by the impact of particles and environmental pollutants such as salts, sands and sulphurs. In first stage of this analysis, a visual inspection with a borescope was performed, which has the ability to illuminate dark internal areas, with a bright light for visual examination and/or make a photographic reproduction in semi-annual maintenance cycles. Images analysis was used to determine the typical failure modes. In a second stage, a tribological characterization was carried out. Chemical composition of the material of blades was obtained. Scanning electron microscopy (SEM) was used to measure roughness and evaluate degradation of surfaces of blades after 30,000 service hours. The points, where peak stresses were calculated, correspond to those places in witch corrosion and some irregular scratches similar to plowing action, was observed. These are the points in which failures take place. Results showed wear modes were originated by a severe stinging action. Also, large craters, similar to those observed in solid particle erosion, were developed by at normal impact. In the same way it could be found some localized areas with a witch corrosion and irregular scratches similar to plowing action, was observed. These are the points in which failures take place.

This work investigates the influence of strain rate on the stress/strain behaviour of Scalmalloy. This material is an aluminium-scandium-magnesium alloy, specifically developed for additive manufacturing. The bulk yield stress of the material processed by Selective Laser Melting is approximately 340 MPa which can be increased by heat-treating to approximately 530 MPa. These numbers, combined with the low mass density of 2.7 g/cm3, make Scalmalloy an interesting candidate for lightweight crash-absorbing structures. As this application is inherently dynamic, it is of interest to study the loading rate sensitivity, which is difficult to predict: Al-Sc alloys exhibit classic strain rate sensitivity with an increased yield stress at elevated strain rates. However, Al-Mg alloys are known to show the contrary effect, they exhibit less strength as strain rate is increased. To answer the question how these effects combine, we study the dynamic behaviour at four different strain rates ranging from 10−3 /s to 1000 /s using servo-hydraulic and Split-Hopkinson testing methods. The resulting data is analysed in terms of strain rate sensitivity of tensile strength and failure strain. A constitutive model based on a simplified Johnson-Cook approach is employed to simulate the tensile tests and provides good agreement with the experimental observations.

SARS-CoV-2 continues to widely circulate in populations globally. Underdetection is acknowledged and is problematic when attempting to capture the true prevalence. Seroprevalence studies, where blood samples from a population sample are tested for SARS-CoV-2 antibodies that react to the SARS-CoV-2 virus, are a common method for estimating the proportion of people previously infected with the virus in a given population. However, obtaining reliable estimates from seroprevalence studies is challenging for a number of reasons, and the uncertainty in the results is often overlooked by scientists, policy makers and the media. This paper reviews the methodological issues that arise in designing these studies, and the main sources of uncertainty that affect the results. We discuss the choice of study population, recruitment of subjects, uncertainty surrounding the accuracy of antibody tests themselves, and the relationship between antibodies and infection over time. Understanding these issues can help the reader to interpret and critically evaluate the results of seroprevalence studies.

Regional mechanics of the heart is vital in the development of accurate computational models for the pursuit of relevant therapies. Challenges related to heart dysfunctioning are the most important sources of mortality in the world. For example, myocardial infarction (MI) is the foremost killer in sub-Saharan African countries. Mechanical characterisation plays an important role in achieving accurate material behaviour. Material behaviour and constitutive modelling are essential for accurate development of computational models. In most cases previously, the mechanical properties of the heart myocardium were assumed to be homogeneous. The main objective of this paper is to determine the mechanical material properties of healthy porcine myocardium in three regions, namely left ventricle (LV), mid-wall/interventricular septum (MDW) and right ventricle (RV). The biomechanical properties of the pig heart RV, LV and MDW were characterised using biaxial testing. The biaxial tests show the pig heart myocardium behaves non-linearly, heterogeneously and anisotropically. In this study, it was shown that RV, LV and MDW may exhibit slightly different mechanical properties. Data presented here may be helpful in regional tissue mechanics, especially for the understanding of various heart diseases and development of new therapies.

The paper is focused on the examination of the internal quality of joints created in a multi-material - additive manufacturing process. The main part of the work focuses on experimental production and non-destructive testing of restrained joints of modified PLA (polylactic acid) and ABS (Acrylonitrile butadiene styrene) 3Dprinted on RepRap 3D device that works on the "open source" principle. The article presents the outcomes of non-destructive materials test in the form of the data from the Laser Amplified Ultrasonography, microscopic observations of the joints area and tensile tests of the specially designed samples. The samples with designed joints were additively manufactured of two materials: specially blended PLA (Market name – PLA Tough) and conventionally made ABS. The tests are mainly focused on the determination of the quality of material connection in the joints area. Based on the results obtained, the samples made of two materials were compared in the end to establish which produced material joint is stronger and have a lower amount of defects.

The relative dislocation density of aluminum and copper samples is quantitatively measured using linear Resonant Ultrasound Spectroscopy (RUS). For each metallic group, four samples were prepared with different thermomechanical treatments in order to induce changes in their dislocation densities. The RUS results are compared with Nonlinear Resonant Ultrasound Spectroscopy (NRUS) as well as Second Harmonic Generation (SHG) measurements. NRUS has a higher sensitivity by a factor of two to six and SHG by 14% to 62%. The latter technique is, however, faster and simpler. As main a result we obtain a quantitative relation between the changes in the nonlinear parameters and the dislocation density variations, which in a first approximation is a linear relation between these differences. We also present a simple theoretical expression that explains the better sensitivity to dislocation content of the nonlinear parameters with respect to the linear ones. X-Ray diffraction measurements, although intrusive and less accurate, support the acoustics results.

Model-based image reconstruction has brought improvements in terms of contrast and spatial resolution to imaging applications such as magnetic resonance imaging and emission computed tomography. However, their use for pulse-echo techniques like ultrasound imaging is limited by the fact that model-based algorithms assume a finite grid of possible locations of scatterers in a medium -- which does not reflect the continuous nature of real world objects and creates a problem known as off-grid deviation. To cope with this problem, we present a method of dictionary expansion and constrained reconstruction that approximates the continuous manifold of all possible scatterer locations within a region of interest. The expanded dictionary is created using a highly coherent sampling of the region of interest, followed by a rank reduction procedure based on a truncated singular value decomposition. We develop a greedy algorithm, based on the Orthogonal Matching Pursuit (OMP), that uses a correlation-based non-convex constraint set that allows for the division of the region of interest into cells of any size. To evaluate the performance of the method, we present results of 2-dimensional ultrasound image reconstructions with simulated data in a nondestructive testing application. Our method succeeds in the reconstructions of sparse images from noisy measurements, providing higher accuracy than previous approaches based on regular discrete models.

Flare stacks are a key element in the safety of petrochemical and refinery industries; the correct operating conditions thereof must be ensured through a schedule for the periodic reviewing of all parts thereof. Advances in Non-Destructive Testing (NDT) in recent years and the application thereof to this field allow reliable, objective information to be obtained. This article describes and groups together the main applicable NDT techniques, analysing their advantages and disadvantages, updated with the new possibilities offered by unmanned aircraft or drones.

Empirically based modeling is an essential aspect of design for a wave energy converter. These models are used in structural, mechanical and control design processes, as well as for performance prediction. The design of experiments and methods used to produce models from collected data have a strong impact on the quality of the model. This study considers the system identification and model validation process based on data collected from a wave tank test of a model-scale wave energy converter. Experimental design and data processing techniques based on general system identification procedures are discussed and compared with the practices often followed for wave tank testing. The general system identification processes are shown to have a number of advantages. The experimental data is then used to produce multiple models for the dynamics of the device. These models are validated and their performance is compared against one and other. While most models of wave energy converters use a formulation with wave elevation as an input, this study shows that a model using a hull pressure sensor to incorporate the wave excitation phenomenon has better accuracy.

This paper investigates the integration of artificial intelligence (AI) and robotics in healthcare, highlighting the potential of autonomous humanoid robots to replicate compassionate care while centering on ethical and safety concerns related to reliability, quality, and empathy. It reviews the benefits, challenges, and ethical considerations of deploying humanoid robots in care settings, including user acceptance and technological limitations, and questions their ability to genuinely simulate compassion. Through multisensory simulations of human-robot interactions (HRIs) using agent-based modeling, the study reveals complex dynamics among patients, robots, and healthcare systems, suggesting that advanced robot designs can enhance personalized sensing with quantum and neuromorphic information processing. Additionally, it analyzes the philosophical implications of robotic nursing care, advocating for a posthumanist perspective that recognizes nonhuman caring agencies, and concludes with recommendations for future research to improve communication and humanize the capabilities of robots in caregiving.

Objectives: Evaluate the performance of diagnostic measures (sensitivity and specificity) of the intrinsic capacity (IC) construct recommended by the WHO ICOPE guidelines by domain and by age group. Study design: This cross-sectional study included 164 community-dwelling elderly (95 women and 69 men). The participants completed the assessment of the 5 domains of IC (cognition, psychological, vitality, locomotion and sensory). In addition, they were assessed for activities of daily living (ADL), instrumental activities of daily living (IADL), frailty and urinary incontinence. Main outcomes measures: Descriptive statistics were used to summarize the intrinsic capacity and identify which domains were compromised. Comparisons between three or more samples were made by 1-way ANOVA with Bonferroni post-test and those with two samples by the t-test or Mann-Whitney test for quantitative variables. Chi-square test was used for qualitative variables. The sensitivity and specificity of each domain and each domain by age group were evaluated using the ROC curve. Results: Participants with a decline in IC were older, worse ADL, IADL and mental function, low gait speed, and higher depression scores. In addition, people with a decline in IC had frailty, urinary incontinence. Other issues related to the decline in CI were self-reported non-practice of physical activities and level of schooling.The evaluation of each domain did not prove to be a good screening tool (sensitivity or specificity &lt; 80%, but both values &gt; 50%). When the analyses were separated by domain and age group, good performance was found in the psychological (69-69 years and ≥80 years), vitality (≥80 years) and sensory (≥80 years) domains. Conclusions: The ICOPE screening tool performed well in terms of diagnostic measures when applied by domain and age group.

The accurate identification of bacterial infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, along-side cost and accessibility issues. Consequently, there's a pressing need for a marker that is economically feasible, rapid, and reliable. Presepsin (PSP), also known as soluble CD14 subtype (sCD14-ST), has emerged as a promising biomarker for early sepsis diagnosis. PSP, derived from soluble CD14, reflects the activation of monocytes/macrophages in response to bacterial infec-tions. It has shown potential as a marker of cellular immune response activation against patho-gens, with plasma concentrations increasing during bacterial infections and decreasing post-antibiotic treatment. Unlike traditional markers such as procalcitonin (PCT) and C-reactive protein (CRP), PSP specifically indicates monocyte/macrophage activation in bacterial infections. While limited studies in critical illness have explored PSP's role in sepsis, its diagnostic accuracy varies with threshold values, impacting sensitivity and specificity. Recent meta-analyses suggest PSP's diagnostic potential for sepsis, yet its standalone effectiveness in ICU infection management remains uncertain. This review provides a comprehensive overview of PSP's utility in ICU set-tings, including its diagnostic accuracy, prognostic value, therapeutic implications, challenges, and future directions.

Aim: The aim of the study is to analyze quantitatively the scientific literature covering nursing studies on patient safety. Method: The Web of Science database is queried in this retrospective bibliometric analysis to identify relevant publications. The study themes, contributing journals, countries, institutions, and authors were evaluated quantitatively. Thus, a total of 5470 publications concerning patient safety in nursing were included and analyzed. Findings: The number of studies conducted increased every year from 1992 to 2023. While the country whose articles receive the most citations (31072) is the United States of America (USA), Turkey is ranked as last with the lowest number of citations (581). Journal of Clinical Nursing, with 338 articles, appeared to have the highest number of publications, Chaboyer W. appeared to have the highest number of citations with a total of 1426 and 45 publications. The countries that have the strongest international cooperation for research in this field are the USA, England, Australia and China. Results: After examining the literature in the field of patient safety in nursing through bibliometric analysis, it is seen that themes such as patient safety, medication errors, nursing care, nursing, education, systematic review, quality care and leadership were emphasized as important considerations.

The study investigated the impact of traditional medicine on life expectancy in Nasarawa State, Nigeria. The study adopted a quantitative research approach. Purposive or judgmental sampling was used to elucidate the data set used for the study. Cross-sectional data were gathered with the help of a well-designed questionnaire from a total of three hundred and fifty-seven (357) respondents who were available for the survey. The data set collected was analysed using descriptive and linear regression using Ordinary Least Squares (OLS). From the results, 53%, 87%, and 56% were male, below 50 years old, and in the low-income class, respectively, suggesting that the bulk of the respondents under investigation were male, young, and had rather modest incomes. Also, 53% were married, and all had one form of formal education. 67% of respondents acknowledge using traditional medicine; however, the majority of respondents preferred Orthodox medical care over alternative kinds of care. Traditional medicine (TM) and factors that contribute to the advancement of traditional medicine (FITM) have a negative impact on life expectancy, according to the regression analysis. On the other hand, TM has no statistically significant impact on life expectancy, despite FITM having a statistically significant effect at the 5% level. All available data, however, indicates that TM and FITM have an impact on life expectancy, either directly or indirectly. Based on the results, this study concluded that traditional medicine has the potential to significantly increase life expectancy in Nasarawa State and throughout Nigeria. The study recommends that traditional health professionals, stakeholders, and concerned government agencies should put efforts in place to improve and promote modern traditional medicine among the people, especially its effectiveness and medicinal quality, increase its accessibility to people, and efficiently regulate its prices to increase its affordability for low-income earners.

The second external cause of death from unintentional injuries is falls in people over 60, a worldwide public health problem. Associated factors are identified early in Primary Health Care. Thus, we analyze professional narratives about older adults/old age and the organization of services in the presence of fall-inducing frailty. A structured narrative was applied under the following stages: understanding the context; setting/plot/character analysis; and interpretive synthesis. Data were collected from August to November 2022, distributing 21 health professionals in three Narrative Focus Groups. In the analyses, the collective conceptions dialogued with Bourdieu’s Epistemology of field, habitus, and capital. Among the results, technical and common sense representations of older adults were simultaneously observed, along with the belief of old age as a problematic life stage. Care is centered on the installed disease/ailment. Encouraging autonomy and self-care emerges in integrative health practices, which older adults underestimate. Professionals access the lives of older adults according to their habitus, which, in turn, is structured (structuring) in the disputes for installed capital. Thus, the care provided disregards subjectivities and symbolic systems associated with falls.

(1) Background: There is not much research about obesity in nursing homes although knowledge will help us to develop customized treatment plans and prevention strategies, which may help to decrease the burden for all persons involved. The objective of conducting this study was to describe the prevalence of obesity and the association between obesity and care problems in nursing home patients. (2) Methods: This study is a secondary data analysis of data collected in an annually performed cross-sectional study called “Nursing Quality Measurement 2.0”. A standardized and tested questionnaire was used to collect data. (3) Results: 1236 nursing home patients took part and 16.7% of them were obese. The multivariate logistic regression analysis results show that urinary incontinence is significantly associated with the presence of obesity (OR 2.111). The other care problems of pressure injuries, fecal and double incontinence, physical restraints, falls and pain were not associated with obesity. (4) Conclusion: The results indicate that, in the nursing home setting, health care staff should pay special attention to the patients’ nutritional and continence status and help patients maintain a normal, healthy weight. Conducting more studies with larger sample sizes is recommended, as this will allow differentiation among different obesity classes.

(1) Background: Our paper aimed to examine the ways in which the care centers for the elderly acted and adapted during the pandemic period, by taking into account the opinions of the beneficiaries, of the employees and of the managers of those centers. (2) Methods: in order to conduct the research we used a mixed-method approach. Considering the quantitative research, we applied a questionnaire to 430 institutionalized elderly from Timis county, Romania. Considering the qualitative analysis, we conducted interviews with 31 institutionalized elderly, with 7 employees and 4 managers. (3) Results: most institutionalized elderly were mainly satisfied with their life in the care centers, the main difficulties they had were: the impossibility of being close to loved ones, and the difficulty of adapting to the living conditions within the center, and the elderly were satisfied with the interactions they had with the staff of the care centers. (4) Conclusions: the research conducted provides a view on the lifestyle of the elderly from care centers during the pandemic, it highlights the struggles of the elderly and it can be used as a point of reference for the further improvement of the lifestyle of the elderly within the care centers.

Background: To identify and appraise the impacts and effectiveness of counseling interventions based on the 5A model on indicators of physical activity in adults. Methods: In May, 2022, a systematic review was carried out. Searches were performed in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science. To avoid potential losses searches also were made in Google Scholar and in reference lists. Assessment of studies, data extraction and synthesis took place independently by two researchers. Results: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, being women in the majority of the samples. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the “daily number of steps” indicator. Conclusions: counseling based on the 5A model did not reflect significant findings in relation to physical activity. Considering that behavior change for many people is neither a simple nor a quick process and that the 5A model is promising for other behavioral indicators, we indicate the need to carry out new intervention studies, with an expanded focus in relation to themes related to physical activity (e.g., types, dos-es, risks, benefits, identification of barriers and assessment) and, in parallel, the offer of practices in the Primary Health Care setting.

Family-Centered Care (FCC) as a philosophy is defined as a care provider that emphasizes and involves the important role of the family. However, there are several obstacles in implementing family center care for children where parents have different perceptions from health workers. Parents are angry when they are involved in a job they consider to be a nurse's job and the attitude of nurses prevents parents from participating. This difference in perception causes the implementation of Family Center Care (FCC) has not been carried out optimally, this has an impact on discomfort during treatment. Along with the not yet optimal implementation of family center care when providing care to children, further discussion is needed regarding the philosophy of child nursing with a family center care approach. The reasons for the importance of implementing family center care include building a collaborative system, focusing on family strengths and resources.

OBJETIVES: During the COVID-19 pandemic, the risk of collapse of the health system created great difficulties. We will demonstrate that Intermediate Respiratory Care Units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important in patients with SARS-CoV-2 pneumonia. METHODS: A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. RESULTS: 991 patients were admitted, 56 to the IRCU (of the 81 a critical care unit). Mean age was 65 years (SD 12.8), Barthel Index 75 (SD 8.3), Charlson 3.1 (SD 2.2), HTN 27%, COPD 89% and obesity 24%. Significant relationship (p <0.05) with higher mortality of the following: fever greater than or equal to 39oC [OR 5.6; 95% CI (1.2-2.7); p = 0.020], protocolized pharmacological treatment [OR 0.3; 95% CI (0.1-0.9); p = 0.023] and IOI [OR 3.7; 95% CI (1.1-12.3); p = 0.025]. NIMV showed less of a negative impact [OR 1.8; 95% CI (0.4-8.4); p = 0.423] than IOI. The total cost of the IRCUs amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. CONCLUSION: The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.

(1)Background: When the COVID-19 pandemic arrived, changes had to be made to several management aspects at our Pediatric Oncology Center. We investigated how the families per-ceived these changes. (2) Methods: Two questionnaires were developed at the Pediatric Oncology Unit of the Istituto Nazionale dei Tumori in Milan, to explore how the pandemic has affected the experience of patients who had been or were being treated at our hospital, and their families. These were administered to three samples of individuals. (3) Results: Between July and October 2020, 120 questionnaires were administered to parents of patients. The impact of school closures and the impossibility of attending sports and social activities outside the hospital were regarded as im-portant. 77.5% of parents judged the social distancing to have affected their children. Regarding the changes introduced in the management of the ward and outpatient clinic, most parents’ opinions were positive. Differences in the opinions expressed by Groups 2 and 3 were statistically significant on the topic of relationships on the ward and staff workload. The aspect most negatively affected by the pandemic was the support that patients’ parents were able to give each other. Regardless of whether patients were treated before the pandemic or after the first lockdown, their parents of all indicated a strong degree of satisfaction with the care received, and with the organizational ar-rangements. (4) Conclusions: The results of our study point us in the right direction to further improve our daily work and better respond to the needs of our patients and their families.

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

Abstract: The study aimed to determine the factors associated with the avoidance of dental preventive care in adolescents and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia has been initiated during the years 2015/2016. The data were collected using two separate standardized questionnaires: (i) the questionnaire for adolescents (n=515) and (ii) the questionnaire for parents (n=681). The study group consisted of 57 adolescents (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group consisted of 458 adolescents (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents (21.4%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were observed as the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents were not visiting either dental preventive care but also pediatric preventive care (AOR=5.14; 95%CI=2.40, 10.99). Divorced mothers and mothers with household income lower than 900 € had significantly higher dental care avoidance in their children. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%; p&lt; .05). The results of the study can be used as an educational intervention steps focusing on the influence of parental and adolescent behavior in dental preventive care.

Background: Monk healers provide an accessible and popular service in Southeast Asia, but little is known on the substance use status of their clients. This investigation intended to assess and compare the rate and correlates of substance use disorders in two different treatment settings (monk healers=MH and primary health care=PHC) in Thailand. Methods: In a cross-sectional study, 1024 patients (591 of MH and 613 of PHC) responded to screening measures of the “World Health Organization Alcohol, Smoking, and Substance Involvement Screening Test Lite”, and two common mental disorders (major depression and generalized anxiety disorder) from November 2018 to February 2019. Logistic regression was used to estimate the determinants of any substance use disorder in the MH and PHC setting. Results: The prevalence of substance use disorder was higher in MH clients than PHC patients: any substance use disorder 11.7% (95% Confidence Interval-CI: 9.3%-14.5%) vs 5.4% (95% CI: 3.9%-7.5%), tobacco use disorder 7.6% (95% CI: 5.7%-9.9%) vs 2.5% (95% CI: 1.5%-4.0%), alcohol use disorder 10.0% (95% CI: 8.4%-13.6%) vs 4.3% (95% CI: 3.0%-6.3%), any drug use disorder 4.2% (95% CI: 2.8%-6.1%) vs 0.3% (95% CI: 0.08%-1.3%), and any past three months drug use 8.2% (95% CI: 6.2%-10.7%) vs 1.5%, 95% CI: 0.8%-2.8%). In adjusted logistic regression analysis, among MH clients, male sex (Adjusted Odds Ratio-AOR: 9.52, 95% Confidence Interval-CI: 5.06-17.92) was positively, and were married (AOR: 0.32, 95% CI: 0.16-0.61) and high social support (AOR: 0.40, 95% CI: 0.16-0.99) were negatively associated with any substance use disorder. Among PHC patients, male sex (AOR: 7.05, 95% CI: 2.99-16.63) was positively and age (AOR: 0.95, 95% CI: 0.92-0.98) was negatively associated with any substance use disorder. Conclusion: The proportion of substance use disorders among MH attendees was more than twice that of PHC attenders in Thailand, calling for collaboration in controlling substance use disorders between the two treatment systems.

Introduction: Type 2 diabetes (T2D) is a major driver of health care costs, thus treatments enabling T2D reversal may reduce expenditures. We examined the impact of a T2D continuous care intervention (CCI) on health care utilization. Previous research documented that CCI, including individualized nutrition supported by remote care, simultaneously reduced hemoglobin A1c and medication use and improved cardiovascular status after two years; however, the impact on utilization is unknown. Methods: This study used four years of data (two years pre-intervention, two years post-intervention) from the Indiana Network for Patient Care (INPC) health record. Two methods estimated the impact of CCI on utilization. First, an interrupted time series (ITS) including only CCI participants (n=193) compared post-intervention utilization to expected utilization had the pre-intervention trend persisted. Deviation from the trend was estimated non-parametrically for each 6-month interval after the implementation of CCI . Second, a 1:3 matched comparator group (n=579) was constructed and used for a difference-in-differences (DiD) analysis. The primary outcome was annualized outpatient encounters. Secondary outcomes included emergency encounters and hospitalizations. Results: In two years prior to intervention, CCI participants had a mean of 5.77 annualized encounters (5.62 outpatient, 0.04 hospitalizations, 0.11 emergency). The CCI group showed a reduction in outpatient utilization after intervention. In ITS analysis, 1.6 to 1.9 fewer annualized outpatient encounters occurred in each 6-month interval post-intervention relative to expected utilization based on pre-intervention trends (p<0.01 each 6-month period; 28-33% reduction). The DiD analysis suggested a larger reduction; 5 fewer annualized outpatient encounters in the quarter after intervention, diminishing to 2.5 fewer after 2 years (p<0.01 each quarter). The study was underpowered to draw conclusions about hospitalization and emergency encounters due to the limited number of CCI patients and the rarity of encounters. Conclusions: Outpatient encounters were significantly reduced for a T2D patient population up to 2 years after receiving an individualized intervention supporting nutrition and behavior change through remote care.

This study aimed to know the conditioning factors of the transition process to the self-care of women diagnosed with HIV/AIDS. This qualitative study was carried out from June to September 2015 with seven seropositive women, users of a specialized service in sexually transmitted diseases in the municipality of Imperatriz, Maranhão State, Brazil. For the data collection, an individual interview was used, and data analysis was performed by content analysis delineated by Hsieh and Shannon (2005). The resources that influence the self-care in the transition process of women with HIV/AIDS are represented by personal conditioning factors, such as the meaning they attribute to the living with the disease, personal attitudes and cultural beliefs, socioeconomic status, preparation and knowledge about the disease, and by conditioning factors found in the community and society. The transition theory can provide important insights about the resources present in the adaptation process of women diagnosed with HIV so that they can perform their self-care satisfactorily.

INTRODUCTION Recently there has been a significant increase in age in the United States. It is necessary to better understand the physiological and surgical needs of these patients in order to optimize outcomes. The vast majority of procedures performed in adult patients are low-risk operations, such as laparoscopic cholecystectomy. Our aim is to investigate the outcomes, including length of stay, morbidity, mortality, re-admission and discharge disposition of the elderly population (>80) undergoing low-risk operations in our tertiary community hospital. METHODS A retrospective chart review was done at a tertiary community hospital. The time frame utilized was 2011-2015. Patients were excluded only on the basis of their age (< 80) at the time of operation. RESULTS There were a total of 30 patients who underwent laparoscopic cholecystectomy from 2011 to 2015. 21 patients (70%) were female and 9 (30%) were male. No patients were converted to an open procedure. The average age was 86.4 years and average ASA classification prior to surgery was 2.88. Higher ASA class, specifically those that were class III/IV were more likely to have an increased length of stay that was statistically significant. Overall age greater than 80 was an independent risk factor for transfer to a higher level of care upon discharge (SNF, LTAC, etc.), a surrogate marker for physical decompensation following surgery. CONCLUSIONS Routine surgery, such as the laparoscopic cholecystectomy, effects the elderly population in a more substantial way, and early recognition coupled with increased education for physicians regarding geriatric patients can help to reduce length of stay, morbidity, and overall physical and mental deconditioning.

Pharmacists’ roles in providing patient care remain limited in Indonesia, hence this study aimed to determine the preparedness of pharmacy graduates from one university in Indonesia to deliver patient care. Pharmacy graduates (both registered pharmacists [104] and recent graduates eligible for registration [45]) were sent a validated self-administered survey. The survey sought their perceptions about whether they had acquired 16 patient care related attributes. Further, it sought their opinion on the desirability of having those attributes. Data were analysed using SPSS version 22.0. Sixteen of 104 (15.4%) registered pharmacists and 40 of 45 (88.9%) recent pharmacy graduates participated in the study. More than 50% of participants in both groups were female and most participants were aged in their 20s. Of the recent pharmacy graduates the majority perceived they had at least partially acquired four of 16 list attributes. Male and female recent graduates had significantly different beliefs about their leadership ability (p=0.004). In comparison, most registered pharmacists perceived they had 10 out of the 16 listed attributes. The findings of this study suggested that pharmacy graduates should be better prepared to deliver patient care, and that curriculum redesign with expansion of experiential learning is required.

The FDA has concluded that a biosimilar candidate capable of demonstrating pharmacodynamic biomarkers in a healthy subject need not be tested for clinical efficacy in patients, regardless of if the biomarker correlates with clinical response. Since monoclonal antibodies (mAbs) do not trig-ger pharmacodynamic response, they can be substituted with robust functional disqualifying them for this waiver that can be overcome by allowing comparison of functional properties that eventually result in clinical response. This suggestion is based on the FDA's preference for more sensitive testing methods. However, clinical efficacy testing in patients is the least sensitive method, as confirmed by statistical modeling, a fact that regulatory agencies need to admit. In this paper, I present a logical and rational argument to establish the biosimilarity of products that do not have pharmacodynamic biomarkers based on their orthogonally proven functional bio-similarity. This understanding will significantly lower the development cost of biosimilars, a goal that the FDA outlined in all its guidance. Keywords: biosimilarity 1; biosimilars 2; pharmacodynamic biomarkers 3; monoclonal antibodies 4; FDA 5; clinical efficacy testing in healthy subjects 6; clinical efficacy testing in patients 7; functional assays 8; receptor binding 9.

Acute myeloid leukemias (AMLs) are heterogeneous hematologic cancers that occur prevalently in older patients as the result of a complex pathobiology. The clinical outcomes of older patients with AML, often unsuitable for intensive chemotherapy and allogeneic stem cell transplantation, are generally disappointing. However, recent advances in understanding molecular pathogenesis and other biological mechanisms recognized in AML development and progression have changed the treatment approach, especially for this particularly vulnerable category of patients. Indeed, non-intensive biologically tailored approaches, such as combining venetoclax with hypomethylating agents, have changed the therapeutic paradigm in this field. Moreover, other promising compounds and treatment strategies are currently under advanced clinical development. This article delves into the latest biological understanding and therapeutic advances in the clinical management of older AML patients into new conceptual frameworks that progressively transform the clinical practice in this challenging setting.

Background: Carers (or care partners) of adults in LTC contribute substantially to the health and well-being of their loved ones by providing physical care, emotional support, and companionship. Despite their critical role, little is known about how caregivers have been impacted by the pandemic. The purpose of this study was to explore the lived experiences of caregivers of people living in long-term care (LTC) homes during the initial phases of the COVID-19 pandemic and potential supports and resources needed to improve caregivers’ quality of life.Design: An interpretive descriptive approach that incorporated photovoice method was used. Methods: Using purposive sampling strategy, six family carers in Ontario, Canada were recruited between September and December 2021. Over a four-week period, caregivers took pictures depicting their experience of the pandemic that were shared in a virtual focus group. Visual and text data were analyzed using thematic analysis with an inductive approach.Findings: Caregivers expressed feelings of frustration, confusion, and joy. Emerging themes included: (i) feeling like a “criminal” amidst visitor restrictions and rules; (ii) experiencing uncertainty and disappointment in the quality of care of long-term care homes; (iii) going through burnout; and (iv) focusing on small joys and cherished memories.Conclusions: The combination of visual and textual methods provided unique insight into the mental distress, isolation, and intense emotional burdens experienced by caregivers during the pandemic. Impact: Our findings underscore the need for LTC organizations to work in unison with caregivers to optimize the care of residents and support mental health of caregivers.

Salvia miltiorrhiza (SM) contains the tanshinones, a compound with various pharmacological effects, and has been extensively studied as a pharmaceutical material. However, conventional methods for extracting tanshinones face challenges such as environmental hazards and high cost. In this study, we aimed to effectively extract tanshinones from SM using cloud point extraction (CPE) with lecithin, a natural surfactant. By optimizing various extraction conditions including the solid-to-liquid ratio, lecithin concentration, NaCl concentration, pH, and equilibrium temperature, the optimal extraction efficiency was achieved using 20 mL of solvent per 1 g of sample, 3% lecithin (w/v), 2% NaCl (w/v), pH 6, and room temperature (25 ± 2°C). The CPE method, which minimizes the use of organic solvent and is eco-friendly demonstrated improvements in extraction efficiency, with a 4.55% increased for dihydrotanshinone I, 8.32% for cryptotanshinone, 15.77% for tanshinone I, and 6.81% for tanshinone IIA compared to the conventional water extraction method. These results suggest that CPE is promising, environmentally friendly, and efficient approach for extracting hydrophobic components from pharmacologically active materials such as SM, with potential applications across various fields of natural product extraction.

Recently, attention mechanisms have developed into an important tool for performance improvement of deep neural networks. In computer vision, attention mechanisms are generally divided into two main branches: spatial and channel attention. Both attention categories have their own advantages. The fusion of both attentions achieves higher performance, on the cost of the computational load. This paper introduces an innovative and lighter n-shifted sigmoid channel and spatial attention (CSA) module to reduce the computational cost and to improve the 3D scene relevant features selection. To validate the proposed attention module, 3D scene object detection in the deep Hough voting point sets is considered as the testing application. The proposed attention module with its piecewise n-shifted sigmoid activation function improves the network’s learning and generalization capacity which effectively predict bounding box parameters directly from 3D scenes and detect objects more accurately. This advantage is achieved by selectively attending to more relevant features of the input data. When used in the deep Hough voting point sets, the proposed attention module outperforms state-of-the-art 3D detection methods on the sizable SUNRGBD dataset. Experiments conducted showed an increase of 12.02 mean accuracy precision (mAP) when compared to the celebrated VoteNet (without attention). It also got 9.92 mAP higher compared to the MLVCNet, and 10.32 mAP higher than the Point Transformer. The proposed model not only decreases the sigmoid vanishing gradient problem but also brings out valuable features by fusing channel-wise and spatial information while improving accuracy results in 3D object detection.