The task of weakly supervised point cloud semantic segmentation has received widespread attention and also has been widely used in autonomous driving, robotics, and modern industries. Due to the high dimensionality and large volume of point cloud data, many technical difficulties appeal to weakly supervised semantic processing, especially segmentation. However, weakly-supervised schemes usually provide only partial labelling information of the underlying point cloud data and thus need to effectively extract local features, geometric information, and contextual relationships only using these limited labelled data for supervised learning. To improve weakly-supervised semantic segmentation, we propose a novel segmentation network through the boundary-based feature aggregation based on a K-NN algorithm with down-sampling operation, and also introduce the smoothness loss and Siamese loss for effective segmentation. The experiments on public datasets demonstrate that our presented segmentation method exceeds most of the existing fully supervised and weakly-supervised methods in terms of mIoU. Specifically, our network has high segmentation accuracy on the labels of objects with similar geometrical structures, such as ceiling, wall, floor, chair and table, reaching 91.2%, 98.8%, 83.3%, 75.3% and 80.2%, respectively. Extensive experiments also illustrate its robustness, effectiveness, and generalization of the proposed weakly supervised segmentation network.

Femtoscopy is a unique tool to investigate the space-time geometry of the matter created in ultra-relativistic collisions. If the probability density distribution of hadron emission is parametrized, then the dependence of its parameters on particle momentum, collision energy, and collision geometry can be given. In recent years, several measurements came to light that indicated the adequacy of assuming a Lévy-stable shape for the mentioned distribution. In parallel, several new phenomenological developments appeared, aiding the interpretation of the experimental results, or providing tools for the measurements. In this paper we review and discuss some of these advances, phenomenological and experimental.

At present, failure definition and damage characteristic curve (DCC) analysis included in the framework to assess bitumen fatigue cracking performance have an inconsistency in ranking bitumen fatigue behaviour. This study utilized two types of self-healing polymers (STP and IPA1w) to modify the neat asphalt (NA), and research four different types of bitumens: NA, STP-modified bitumen, IPA1w-modified bitumen, and styrene-butadiene-styrene modified bitumen (SBSB), to evaluate the above-mentioned framework. All bitumens were subjected to short-term and long-term aging and tested utilizing the Linear amplitude sweep (LAS) test and simplified viscoelastic-continuum-damage (S-VECD) model. The results showed that the SBSB exhibited the highest numbers of loading cycles (in long-term aging analysis) to reach failure points at 25°C, 28°C, and 31°C which were 2290, 2340, and 2510, respectively. However, this bitumen failed to exhibit the best performance in terms of DCC assessment under the same conditions, confirming the above-mentioned inconsistency. Besides, the current failure criterion could not accurately predict bitumen fatigue behaviour under certain test conditions because two R2 values were below 0.1. As a result, this study proposed a new failure definition and failure criterion to overcome these issues. The proposed failure definition agreed with the DCC analysis to rank bitumen fatigue performance, and the proposed failure criterion showed R2 values higher than 0.9. The new framework presented the modified bitumen containing 0.5% of STP as the asphalt binder with the best fatigue cracking performance, according to the selected test conditions.

In this study, we focus on an abstract form of summation equations, which can be regarded as a particular class of nonlinear difference equations. We investigate sufficient conditions for the existence of discrete almost automorphic solutions by appealing to the fixed point theory and establish a linkage between the existence of discrete almost automorphic solutions and the existence of bounded solutions for the nonlinear difference equations in the spotlight. Consequentially, we propose a discrete counterpart of the Bohr-Neugebauer theorem for the qualitative theory of difference equations.

Based on the teaching material of "Robotics" course, this paper studied the automatic knowledge graph construction, including knowledge points extraction and knowledge point relation extraction. We proposed a new method of extracting the first-level, second-level, and third-level knowledge points as well as their prerequisite relations of knowledge points in the textbook. For the problem of insufficient knowledge of the pre-trained language model in the specific field, methods such as incremental pre-training and optimization of cost functions are employed to integrate subject knowledge into the pre-trained language model, thus improving its effectiveness. To overcome the problem that the traditional method of relationship extraction can not be applied directly to the extraction of teaching materials, a new scheme for knowledge point relationship extraction based on keyword relationship is proposed. The experimental data from textbooks shows that the F1 score of knowledge point extraction reaches 93%, considerably improved compared to the traditional model. Consequently, the knowledge point entity extraction and relationship extraction methods based on the pre-trained model can effectively extract structured information and facilitate the automatic construction of knowledge graphs.

Unmanned aerial vehicles (UAV) have emerged as a solution to day to day survey tasks, allowing users to visualize phenomena in real-time. This paper explores the capabilities of UAV or drones in the collection of accurate, geo-tagged data quickly, including photogrammetry software processes to deliver standardized data output. In order to explore the capabilities of UAV, Gatu Township in Centenary, Muzabani District of Zimbabwe was chosen from the national mapping topographic series. This study demonstrates the efficiency of data collection using drones, generate 2D orthomosaics in real time, so that analysts can easily visualize land cover and identify any changes, map and model large areas to produce data for 2D and 3D models. The recent development of innovative optical image processing has further lowered the costs high resolution topographic surveys.

Most petrochemical plants still maintain a Proportional-Integral-Differential controller(PID) system, which is a feedback control system. However, gradually, the PID system is being extended and introduced to the Advanced Process Controller (APC) system, which is an integrated control system of feedforward and feedback that predicts external influences in advance. In the process of conducting on-site plant tests and calculating APC model parameter for the application of APC systems, a problem arises that Model Parameter are implemented differently depending on the proficiency of APC engineers. To minimize this problem, a technique for estimating APC model parameter without a plant test is required. In order to estimate the APC model parameter, it is necessary to train on dynamic interval data. In this paper, we use statistical techniques such as PELT, Linear Kernel, and Radial Basis Function Kernel of Change Point Detection (CPD) to extract dynamic data with minimum Mean Absolute Error (MAE) from time series data of a real petrochemical plant. Then, the hyper parameter is fixed and the APC model parameter is estimated by learning the dynamic section data. By applying the estimated APC model parameter to the APC Model Tool and measuring the fitting rate, it was confirmed that it is possible to estimate the APC model parameter with excellent control performance without plant test.

We study the Kelvinons: monopole ring solutions to the Euler equations, regularized as the Burgers vortex in the viscous core. There is finite anomalous dissipation in the inviscid limit. However, in the anomalous Hamiltonian, some terms are growing as logarithms of Reynolds number; these terms come from the core of the Burgers vortex. In our theory, the turbulent multifractal phenomenon is similar to asymptotic freedom in QCD, with these logarithmic terms summed up by an RG equation. The small effective coupling does not imply small velocity; on the contrary, velocity is large compared to its fluctuations, which opens the way for a quantitative theory. In the leading order in the perturbation theory in this effective coupling constant, we compute running multifractal dimensions for high moments of velocity circulation, in good agreement with the data for quantum Turbulence and available data for classical Turbulence. The logarithmic dependence of fractal dimensions on the loop size comes from the running coupling in anomalous dimensions. This slow logarithmic drift of fractal dimensions would be barely observable at Reynolds numbers achievable at modern DNS.

Quantum computing has attracted significant interest in the optimization community because it potentially can solve classes of optimization problems faster than conventional supercomputers. Several researchers proposed quantum computing methods, especially Quantum Interior Point Methods (QIPMs), to solve convex optimization problems, such as Linear Optimization, Semidefinite Optimization, and Second-order Cone Optimization problems. Most of them have applied a Quantum Linear System Algorithm at each iteration to compute a Newton step. However, using quantum linear solvers in QIPMs comes with many challenges, such as having ill-conditioned systems and the considerable error of quantum solvers. This paper investigates how one can efficiently use quantum linear solvers in QIPMs. Accordingly, an Inexact Infeasible Quantum Interior Point Method is developed to solve linear optimization problems. We also discuss how we can get an exact solution by Iterative Refinement without excessive time of quantum solvers. Finally, computational results with a QISKIT implementation of our QIPM using quantum simulators are analyzed.

Commonwealth Partnerships for Antimicrobial Stewardship (AMS) uses a health partnership model to establish AMS in Commonwealth countries. The University Hospital of Kwame Nkrumah University of Science and Technology in partnership with Ulster University, in Northern Ireland undertook an AMS project from November 2021 to May 2022. We report on the implementation and its effect on antibiotic use and infections management at the University Hospital. The Global-Point Prevalence Survey (PPS) protocol was used to assess antibiotics use at the hospital at the beginning, midpoint and end of the project. Feedback on each PPS was given to staff to inform behaviour change and improve antibiotic prescribing. Antibiotic use reduced from 65% at baseline to 59.7% at the end of the project. The rate of health-associated infections also reduced from 17.5% at baseline to 6.5%. In addition, the use of antibiotics belonging to the WHO Access group at the hospital was 40% initially but increased to 50% at the project endpoint. Culture and antibiotic susceptibility requests increased from the beginning of the project from 111 total requests to 330 requests over 7 months. The AMS model implemented improved antibiotic use as well as requests for culture and susceptibility test which must be sustained.

Identifying ambient noise-based (ANb) signatures of streams can help in the estimation of their erosive potential (EP) that promotes reverie landslides and soil losses in the fluvial valleys. This is particularly imperative on flooding or rainy days, leading to stronger erosion-prone conditions (colluvium and boulders) of the valley beds inferred from georadar attribute analysis. Developing such research direction can benefit the local communities, as is the case with the Cerrado region of Brazil, where these phenomena have high destructive potential with social, economic, and climatic implications. For the present study, a seasonal stream in the Federal District of Brazil was investigated by ANb monitoring supported by Ground Penetration Radar (GPR) for site characterization. The ANb monitoring was conducted (at a safe distance) with a seismometer over several durations of dry and rainy conditions. The power spectral density (PSDs) was computed as a function of several variables, including weather conditions (rainfall, wind speed, and pressure), time-frequency spectrograms, and ambient noise displacement root mean square (RMS). This analysis also considered the single station horizontal-to-vertical spectral ratio (HVSR), where rain, wind, pressure, river flow and anthropogenic signatures were evident (at selective frequency ranges). Multi-peaks that emerged on the HVSR curve were further analyzed to identify amplitude and frequency changes, and the three peaks shift on average to a lower position during the rainy period. The GPR amplitude and waveform variation features were attributed to the stratigraphy (i.e., the boundary between valid and invalid regions and coherence value) of the floodplain and regions susceptible to erosion (erosion-prone lithological spots). This approach provides the basis for non-destructive monitoring tools enabling the detection of 'seismic signatures' and weak spots of the fluvial channels for improving environmental management.

These days, numerous organizations and Analysis Centers (AC) offer various Ambiguity Resolution (AR) products using various methodologies. To use it for time-frequency transfer, there is no associated study. This paper chooses 16 MGEX stations with external high-precision atomic clocks to constitute 15 international time comparison links and uses AR products data from CNES, SGG, CODE, and PRIDE laboratory, using three ambiguity-fixed strategies, to thoroughly evaluate the effects of various strategies and AR products for high-precision time-frequency transfer. We reach the following results by using the IGS final clock product as a reference and comparing it to ambiguity-float. With various ambiguity-fixed procedures, the time stability STD of time transfer is increased for a single GPS, and the improvement ranges from 10% to 40%. The frequency stability has barely improved; up to 40%, the most notable improvement comes from FCB with GRM products. The time stability STD of combinations has improved after the addition of the Galileo system compared to the single GPS, and the improvement ranges from 2% to 9%. Most strategies have improved, while a few techniques have weakened with the GEC (GPS+Galileo+BDS) combination. We feel that the stability has not significantly increased with the system's increase within short-term stability after comparing multiple groups of linkages.

The transition from Building Information Modelling (BIM) to Heritage Building Information Modelling (H-BIM) is intended to pursue an adequate knowledge of the artefact that is to be preserved, progressively replacing the traditional methods of the restoration and structural reinforcement projects with new tools for managing both existing information and new interventions. The aim of the paper is to show the application of the H-BIM method to a stone pavement road located in the Archaeological Site of Pompeii. In detail, starting from a Laser Scanner based survey, juxtaposed by coordinated points georeferenced through a total station, points clouds were handled by means of several BIM-based tools to perform the road design process, starting from the digital elevation model (DEM) to the corridor representation. Subsequently, a visual programming application based on Python language was adopted to update corridor information by means of the object property set. As preliminary results, a tool, complete with graphical and non-graphical information, is proposed to be used in conservation, maintenance and restoration project.

In this article, we are interested in a new generic class of nonlocal fractional impulsive differential inclusions with linear sectorial operator and Lipschitz multivalued function in the setting of finite dimensional Banach spaces. By modifying the definition of PC-mild solutions initiated by Shu, we succeeded to determine new conditions that sufficiently guarantee the existence of the solutions. The results are obtained by combining techniques of fractional calculus and fixed point theorem for contraction maps. We also characterize the topological structure of the set of solutions. Finally, we provide a demonstration to address the applicability of the theoretical results.

This work assesses sea-level rise using three different models created on Free and Open-Source Software for Geographic Information System (FOSS4GIS). Based on regional projections of Special Report on Climate Change and Oceans and Cryosphere (SROCC) of the Intergovernmental Panel on Climate Change (IPCC), the models were applied to a case of study on Rio Grande do Sul coast – Brazil under different sea-level rise scenarios by the end of this century. The End Point Rate for QGIS (EPR4Q), calculates a shoreline projection using End Point Rate method. The Uncertainty Bathtub Model (uBTM), analyses the sea-level rise impact by the uncertainty of sea-level projec-tions and vertical error of the Digital Elevation/Terrain Model (DEM/DTM). The Bruun Rule for Google Earth Engine Model (BRGM) predicts the shoreline position with sea-level rise, using topographic and bathymetric data from Unmanned Aerial Vehicles (UAV) and Coastal Modelling System (SMC – Brazil), respectively. The results indicated a maximum shoreline retreat for 2100 of -502 m and -1727 m using EPR4Q and BRGM, correspondingly. The uBTM using the land-use of Mapbiomas showed a maximum of 44.57 km2 of urban area impacted by the sea-level flood. This research highlights the possibility of performing coastal management analysis in GIS environ-ment using non-commercial software.

The urgent need to improve performance in the construction industry has led to the adoption of many innovative technologies. 3D laser scanners are amongst the leading technologies being used to capture and process assets or construction project data for use in various applications. Due to its nascent nature, many questions are still unanswered about 3D laser scanning, which in turn contribute to the slow adaptation of the technology. Some of these include the role of 3D laser scanners in capturing and processing raw construction project data. How accurate is the 3D laser scanner or point cloud data? How does laser scanning fit with other wider emerging technologies such as Building Information Modelling (BIM)? This study adopts a proof-of-concept approach, which in addition to answering the afore-mentioned questions, illustrates the application of the technology in practice. The study finds that the quality of the data, commonly referred to as point cloud data is still a major issue as it depends on the distance between the target object and 3D laser scanner’s station. Additionally, the quality of the data is still very dependent on data file sizes and the computational power of the processing machine. Lastly, the connection between laser scanning and BIM approaches is still weak as what can be done with a point cloud data model in a BIM environment is still very limited. The aforementioned findings reinforce existing views on the use of 3D laser scanners in capturing and processing construction project data.

In this paper, Lyapunov-Razumikhin technique, design of state-dependent switching laws, a fixed point theorem and variational methods are employed to derive the existence and the unique existence results of (globally) exponentially stable positive stationary solution of delayed reaction-diffusion cell neural networks under Dirichlet zero boundary value, including the global stability criteria \textbf{in the classical meaning}. Next, sufficient conditions are proposed to guarantee the global stability invariance of ordinary differential systems under the influence of diffusions. New theorems show that the diffusion is a double-edged sword in judging the stability of diffusion systems. Besides, an example is constructed to illuminate that any non-zero constant equilibrium point must be not in the phase plane of dynamic system under Dirichlet zero boundary value, or it must lead to a contradiction. Next, under Lipschitz assumptions on active function, another example is designed to prove that the small diffusion effect will cause the essential change of the phase plane structure of the dynamic behavior of the delayed neural networks via a Saddle point theorem. Finally, a numerical example illustrates the feasibility of the proposed methods.

The high transmissibility and replication of SARS-CoV-2 have been attributed to enhanced protein functions which are dependent on protein folding. Our in silico study endeavored to scrutinize SARS-CoV-2 ORF1ab by analyzing the conserved folding patterns of its transcribed proteins. Accordingly, the findings indicated that SARS-CoV-2 ORF1ab shares domain-specific fold-fingerprints with a spectrum of unrelated organisms. Closer observation revealed slight changes in folding patterns engendered with small variation in the intrinsic amino acid sequence. By correlating with the evolvability-potential of RNA-viruses and COVID-19 pandemic, we hypothesize that SARS-CoV-2 could undergo fast recombination with the host, SARS-CoV-2 minor variants and other viral species resulting in a reservoir of SARS-CoV-2 quasispecies. It is highly possible that natural selection will cause a future emergence of evolved SARS-CoV-2-descendants. Nonetheless, we hope that this insightful study will assist in elucidating SARS-CoV-2 protein functionalities, development of vaccines, and the possibility and nature of future emergence.

The study was conducted in north wollo, south wollo and orimiya zone, in Eastern Amhara with an aim to assess the resource potential of Acacia seyal in the selected sites. The data from the selected sites were collected using point center quarter method. A total of 90 quadrates from nine study areas with plot size 50m*50m, (22.5ha) were systematically located along each transect, 100 m apart, and was spatially captured with the aid of GPS. At every sampling point, four quadrants (90 degrees) were created, using the transect line and a line perpendicular to it. Species composition Acacia seyal structure and its regeneration status, at points along transects were taken to analyze diversity and target species structure of the sites. The highest and least density of Acacia seyal ha^-1 were attained by Mehale mecharie (148) and Alene sefer (52). The highest shannon weiner diversity and species richness was observed in Alene sefer(Kemessie). Acacia seyal structure in all study sites showed an inverted J shape except lastie gerdao (Gubalafeto). Therefore, Acacia seyal deserves immediate conservation and appropriate management measures in order to get sustainable product and services from the species. Based on the results, awareness creation on the values and management of Acacia seyal, study on the management options of Acacia seyal for firewood, fuel wood, charcoal production and also investigation of gum production techniques of Acacia seyal for the sustainable use of the resource are recommended.

Advancement in physics often results from analyzing numerical data and then creating a theoretical model that can explain and predict those data. In the field of lens design, the reverse is true: longstanding theoretical understanding is being overtaken by more powerful numerical methods.

In a wireless network, locations of base stations (BSs)/access points (APs)/sensor nodes can be modeled based on stochastic processes, e.g., a Poisson point process (PPP) or a deterministic pattern planned ahead by providers. While deterministic deployment does not provide tractable interference analysis in general, PPP yields tractable analysis for interference. However, PPP allows APs to be deployed very close to each other and gives pessimistic results compared to the field measurements. In this study, in order to address this issue, Lloyd’s algorithm, which functions as a bridge between random and structural APs deployments, is investigated for analyzing coverage probability in a network. The link distance distribution is modeled as a mixture of Weibull distributions and its parameters are obtained by using the expectation-maximization (EM) algorithm for each iteration of Lloyd’s algorithm. The link distance distribution is further utilized for calculating the coverage probability approximately by exploiting the tractability of PPP.

In factory automation systems, hybrid wired/wireless networks are often deployed to connect devices of difficult reachability such as those mounted on mobile equipment. A widespread version of these networks makes use of Access Points (APs) to implement wireless extensions of Real--Time Ethernet (RTE) networks via the IEEE 802.11 Wireless LAN (WLAN). Unfortunately, APs may introduce random delays in packet forwarding, mainly related to the their internal behaviors (e.g. code processing times) that negatively impact on the whole performance of the automation systems. Consequently, the knowledge of these delays represent a crucial design information. This paper presents an original and effective method to measure the delays introduced by APs, exploiting a hybrid loop-back link and a simple set-up with moderate instrumentation requirements. The method, which requires an initial calibration by means of a reference AP, has been successfully tested on some commercial APs. As it will be shown, the proposed measurement procedure is general and, as such, can be profitably adopted in even different scenarios.

In this paper, an extensive study on the operation, control and performance of a hybrid photovoltaic and wind turbine (PV-WT) system is presented. The study includes the operation of the hybrid systems under different weather conditions which are reflected on a change in the wind speed and irradiance. Various loading conditions are investigated such a change in active and reactive power demands for static and dynamic loads. The performance of the hybrid system is examined via MATLAB/SIMULINK simulations.

This paper proposes a novel single-stage buck-boost three-Level neutral-point-clamped (NPC) inverter with two independent dc sources coupled for the grid-tied photovoltaic (PV) application, which can effectively solve the unbalanced operational conditions generally appeared between two coupled independent PV sources induced by the unequal irradiation and temperature distribution. The proposed control scheme can simultaneously guarantee the maximum power point (MPP) operation of both PV sources and maintain the output waveform quality. Compared to the traditional two-stage PV inverter, the proposed NPC inverter could reduce the PV array voltage requirement and dc-link capacitors’ voltage rating, meanwhile show the advantage in operational efficiency. MATLAB simulations and the captured experimental results are presented to show the performance of the proposed three-level inverter.

For multi-sensor integrated systems, such as a mobile mapping system (MMS), data fusion at sensor-level, i.e., the 2D-3D registration between optical camera and LiDAR, is a prerequisite for higher level fusion and further applications. This paper proposes a line-based registration method for panoramic images and LiDAR point cloud collected by a MMS. We first introduce the system configuration and specification, including the coordinate systems of the MMS, the 3D LiDAR scanners, and the two panoramic camera models. We then establish the line-based transformation model for panoramic camera. Finally, the proposed registration method is evaluated for two types of camera models by visual inspection and quantitative comparison. The results demonstrate that the line-based registration method can significantly improve the alignment of the panoramic image and LiDAR datasets under either the ideal spherical or the rigorous panoramic camera model, though the latter is more reliable.

Quality of life (QOL) is based on their perception of their position in life in respect to their goals, expectations, standards, and concerns, as well as their culture and value systems, their workflow and workplace situations while it influences quality of services. In this study we aim to report on dental and nursing academians’ QOL and well-being at the end of the third year of the COVID-19 pandemic. The World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) tool, recording Physical, Psychological, Social and Environmental dimensions of QOL, was used. The WHOQOL-BREF was modified on a spiritual, coaching/mentoring approach in a two-step designing and validated procedure. The modified SHQOL-BREF (Spiritual Healthcare version) designed for this study, was uploaded, and filled in online during April-June 2023. Staff (N=120, 75% female) of both departments of Dentistry (44.2%) and Nursing (55.8%) of the National and Kapodistrian university of Athens, participated in anonymity. QOL in terms of physical health was reported at a higher level (M=72.2 points) compared to social relationships (M=69 points), psychological health (M=65 points) and environment (M=59 points) (scores reported in 0-100 score). Overall QOL was rated at 66 points while satisfaction from health at 72 points. Job satisfaction (M1=3.2) and spirituality (M2=3.0) were reported at a medium level in a 5-point scale, while personal beliefs and values were reported at a high level (M3=4.0). Participants age presented a significant, moderate to strong effect on physical health [F(3,97)=2.89, p<.05, η2p=.08] and on environment [F(3,97)=2.80, p<.05, η2p=.08] and marital status on social relationships [F(1,97)=9.66, p<.05, η2p=.09]. Married participants reported consistently higher levels of QOL compared to single participants, for all age groups. Department had a significant moderate effect on social relationships (F(1,97)=5.10, p<.05, η2p=.05) and education a significant moderate to strong effect on psychological health (F(2,97)=3.74, p<.05, η2p=.07). PhD level participants in both departments presented higher levels of psychological health compared to lower educational levels. Also, participants from the department of Dentistry reported higher levels of social relationships QOL in all educational groups, compared to the department of Nursing. Strategic planning on sustainability and QOL initiatives should be introduced after the COVID-19 pandemic for dental and nursing academic personnel to promote resilience and QOL scores.

Introduction: Emotional intelligence plays a critical role in nursing leadership, influencing organizational dynamics and patient care. However, there is limited understanding of the impact of Emotional Intelligence on leadership in Primary Health Care in the Greek context. Methods: A longitudinal experimental design assessed the effects of an educational intervention on EI and leadership among Greek Primary Health Care nurses. Questionnaires, including the Wong and Law Emotional Intelligence Scale (WLEIS) and Multifactor Leadership Questionnaire - form 5x (MLQ), were administered pre- and post-intervention. Results: The intervention group exhibited significant improvements in Emotional Intelligence and adoption of transformational leadership styles compared to the control group. Tables highlighted nuanced changes in leadership dynamics post-intervention. Conclusions: Educational interventions effectively enhance nurses' Emotional Intelligence and influence leadership styles, emphasizing the need for tailored professional development programs in nursing education.

Introduction: Hospitalization in a COVID-19 unit represents a significant source of stress and psychological distress for patients. Our study aims to determine the factors of psychological distress in the therapeutic and psychosocial management of patients hospitalized with a COVID-19 infection. Methods: This cross-sectional study was carried out over 8 months at the COVID-19 zone of the CHU HASSAN II of FES. 99 patients were evaluated within days of diagnosis by psychometric scales of anxiety, depression, and post-traumatic stress. In the course of this follow-up, we found the presence of psychological impacts in these patients, and we tried to find correlating factors between the occurrence of psychiatric disorders and the set of factors related to sociodemographic data, hospitalization course and treatments taken, as well as family support. Results: 35% of patients had scores in favor of post-traumatic stress disorder, 37% of the patients had definite depression and 50% had anxiety. Post-traumatic stress, depression, and anxiety were correlated with sociodemographic factors, hospitalization, treatments received, and length of stay. Conclusion: The prevalence of anxiety-depressive disorders and post-traumatic stress disorder was high in patients with COVID-19, hence the interest in providing psychological and psychosocial care in the emergency department.

Objective: The long-term care insurance (LTCI) system was introduced in 2000 to provide financial support for long-term care services to older adults. What is known on this topic report focuses on a comparative analysis of how the LTCI system has affected older people in Japan. Methods: We obtained data from the literature about the LTCI system, compared and analysed the collected articles, and concluded. Results: The LTCI system has improved access to long-term care services, with more older adults receiving care than before the system’s implementation. This service has improved the quality of life for many elderly individuals who require assistance with daily activities. Furthermore, the LTCI system has alleviated the financial burden of long-term care services since the insurance covers a large portion of the costs. It has made older adults maintain their independence and dignity, as they can afford the necessary care without relying solely on their savings or burdening their families. Conclusions: Japan’s LTCI system has positively impacted older adults by improving access to long-term care services and alleviating financial burdens. However, challenges such as increasing demand and variations in service quality need to be addressed to ensure the system effectively supports older people in Japan.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

Humming is probably more effective than speech improving mothers' cardiorespiratory function and infants' self-regulation. We intend to understand the effects of: 1) maternal humming vs. speech on preterm infants’ physiological parameters; 2) maternal humming vs. speech on mothers’ physiological parameters; 3) humming melodic contours and of the lengthening of the final note on preterm infants’ physiological parameters. This study was designed as a single group repeated measure, using microanalytical methodology (ELAN software), with a protocol (silent baseline / speech or humming / silence / humming or speech / silence) applied to preterm dyads (N = 36). Audio and video observations were recorded. Infants’ and mothers’ heart rate (HR) and O2 saturation were observed once a minute. Proportion of O2 saturation relative to HR (Prop. O2 saturation/HR) was estimated for both partners during protocol. We found an infants’ HR mean significantly lower during humming (p = .028), a significantly higher Prop. O2 saturation/HR during humming for infants (p = .027) and for mothers (p = .029). The duration of sinusoidal contours together with the lengthening of the final note predict infants’ Prop. O2 saturation/HR. Musical features of humming seem to improve the physiological stability of preterm infants during kangaroo care.

Pressure ulcers carry a significant risk in clinical practice and require effective preventive measures. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity and skin moisture. Their analysis allows nursing professionals to predict the risk levels of pressure ulcer and make informed decisions about patient care. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. The approach proposed aims to support nursing professionals in making timely decisions regarding the appropriate preventive interventions according to the risk levels of pressure ulcers, thus improving patient outcomes and healthcare costs. The usefulness and effectiveness of the models presented make them a valuable resource for nursing care in the prevention of pressure ulcers.

Osteoarthritis (OA) poses a growing challenge for the aging population, especially in hip and knee joints, contributing significantly to disability and societal costs. Conventional clinical evaluations, typically performed in controlled settings, face difficulties in capturing the dynamic characteristics of rehabilitation and functioning in real-life scenarios. The study assessed the use of automated unsupervised evaluations in the rehabilitation process for patients after hip and knee replacements. We analyzed data from 1144 individuals who used a digital application after surgery, activity data were collected using the Garmin Vivofit 4. Several parameters such as the Peak 6-Minute Consecutive Cadence (P6MC) and Peak 1-Minute Cadence (P1M) were computed and analyzed on a daily basis. The results indicated that cadence measurements, specifically, can effectively differ among individuals with hip and knee conditions as well as the recovery process. Moreover, these metrics demonstrated a high level of responsiveness in monitoring the progress of recovery, surpassing the effectiveness of simply measuring the total number of steps taken. The study highlighted the capacity of technology-driven, patient-centered rehabilitation to improve accuracy, tailor therapy to individual patients, and increased patient involvement. This research also highlighted the significance of automated, unsupervised assessments in enhancing rehabilitation results for OA patients following hip and knee replacement, as tele-rehabilitation becomes increasingly important.

Post-extubation dysphagia (PED) can lead to serious health problems in critically ill patients. Contrasting its high incidence rate of 12.4% reported in a recent observational study, many ICUs lack routine bedside screening, likely due to limited awareness. This study aimed to establish baseline data on the current approaches and the status of perceived best practices in PED screening and treatment, as well as to assess awareness of PED. A nationwide cross-sectional, online survey was conducted in all fourteen adult ICUs in the Republic of Cyprus in June 2018, with a 100% response rate. Over 85% of ICUs lacked a standard screening protocol for PED. The most commonly reported assessment methods were cough reflex testing and the water swallow test. Treatment approaches included muscle strengthening exercises without swallowing and swallowing exercises. Only 28.6% of ICUs acknowledged PED as a common issue. The study identified significant gaps in awareness and knowledge regarding PED screening and treatment in Greek-Cypriot ICUs. Urgent implementation of comprehensive dysphagia education programs within the units is necessary, and interdisciplinary collaboration among nurses, intensivists, and speech and language therapists is crucial to improve the quality of care provided.

(1) Background: Mobile health (mHealth) solutions can become means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. Aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to provide personalized surgical experiences to qualified patients, along with the associated problems and opportunities. (2) Methods: A survey-based analysis was conducted on patients who were prescribed the use of a specific care management platform and underwent primary Robotic total knee arthroplasty (rTKA) between January 2021 and February 2023. (3) Results: Patients registered on the platform who have undergone primary Robotic TKA (rTKA) were considered. The mean age of registered patients is 68,6 years. The male (M) / female (F) ratio is 45.1% / 54.9%. The patients interviewed were at an average distance of 485 days from the intervention, with a standard deviation of 187.5. The survey highlighted appreciation for the App and its features but limits in its use and in its perception from the patients. All these data were evaluated according to the Wald principles and strategies to improve patient recruitment, enhance adherence, and create a comprehensive patient journey for optimized surgical experiences were analyzed. (4) Conclusions: This patient care platform may have the potential to impact surgical experiences by increasing patient engagement, facilitating remote monitoring, and providing personalized care. There is the need to emphasizes the importance of integrating the recruiting process, improving adherence strategies, and creating a comprehensive patient journey within the platform

The contemporary landscape of eHealth is characterized by major concerns related to electronic medical records (EMRs). In an EMR, critical patient health information gets its own repository, which is the core of the eHealth system. Notably, the EMR not only retrieves health information generated in ambulatory clinical settings but also includes court-generated records. These overlapping records assume the role of a foundational data source for a comprehensive electronic health record (EHR). This scholarly review sheds light on recent trends in medical records and associated challenges, while at the same time providing insights into Saudi Arabia’s targeted approaches to healthcare delivery. Additionally, the talk expands to include a description of blockchain technology and its underlying conceptual framework. This demonstration positions blockchain technology as a promising approach that requires consideration for future use in the healthcare system.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions of how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. Twenty patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size suggesting, each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) (https://osf.io/9np8v/) prior to recruiting the first participant.

High-flow Nasal Cannula (HFNC) oxygen therapy is gaining traction globally as a treatment for respiratory failure. There are several physiological benefits and there may be a growing patient preference for HFNC. In this narrative review, we aim to outline the basic mechanisms of HFNC, who can use it and review the literature regarding its utility both in the critical care setting, as well as in the home setting for chronic hypercapnic respiratory failure with an emphasis on Chronic Obstructive Pulmonary Disease (COPD). The role of non-pharmacological interventions like non-invasive ventilation (NIV) and HFNC in the prevention of hospital readmissions following acute exacerbations of COPD (AECOPD) is an area of increasing importance because randomised controlled trials and systematic reviews have found measures like nurse-led predischarge bundles to be clinically ineffective and to have a high cost per quality adjusted life year. This review therefore considers the evidence of NIV vs HFNC in the context of AECOPD and the application of HFNC at home in the prevention of AECOPD. We also look at applications of HFNC in specific settings, such as in the peri-operative period, emergency department, acute (mainly Critical Care) setting including in immunocompromised patients and palliative care.

In this work we present a study of impact of textile materials used in health care facilities on microbial colonization of textile surfaces. Polypropylene yarns doped with silver phosphate glass and zinc pyrithione were prepared and used for production of bed sheets and clothing for healthcare personnel. Subsequently measurements of airborne particles and viable microorganisms on given textiles were conducted in a private surgery clinic during 3 weeks comparing the counts of viable microorganisms before and after replacing of staff clothing and bedding on examination and surgical bed with said polypropylene cloth. In this study a significant reduction of viable airborne fungi and viable microorganisms on monitored textiles was observed by multiple methods.

The nursing process in clinical practice can be assessed using standardized language systems. The purpose is to find evidence on the effectiveness of the nursing process with standardized terminology using NANDA International, Nursing Interventions Classification, and Nursing Outcome Classification improving diag-nostic accuracy, nursing interventions, health outcomes, and people’s satisfaction. A systematic review was carried out in Medline and PreMedline, Embase, The Cochrane Library, CINAHL, SCI-EXPANDED, SSCI and Scielo and LILACS including randomized clinical trials, quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with Grading of Recommendations Assessment, Development and Evaluation Methodology. 17 studies were included with variability in the level and certainty of evidence. According to outcomes, 6 evaluated improvements in diagnostic accuracy and 11 evaluated improvements in individual health outcomes. No studies evaluated improvements in intervention efficacy or population satisfaction. There is a need to increase studies with rigorous methodologies that address diagnostic accuracy and indi-viduals’ health outcomes using NANDA International, Nursing Interventions Classification, and Nursing Outcome Classification; as well as implementing studies that evaluate the use of these terminologies for improvements in the efficacy of nurses' interventions and population satisfaction with the nursing process.

Extracts of Cordyceps militaris which possess the bioactive capacity such as antimicrobial activity and DPPH-free radical scavenging capacity, are applied to the serum product. This finished serum product has been evaluated the in vitro bioactivity and the stability with expect to find out a good extract with a suitable percentage used for serum product as natural materials on preservatives and antioxidation.

The COVID-19 pandemic and associated lockdown measures have been associated with substantial disruptions to health care services, including screening for human immunodeficiency virus (HIV) and management of people living with HIV (PLWH). Methods: Data from 3265 patients were examined in a retrospective cohort study. We compared outpatient follow-up for PLWH, the number of new patients, treatment adherence, hospitalizations, and deaths during the “pandemic period” (March 2020 to February 2021) to the “pre-pandemic period” (the equivalent timeframe in 2019) and the “post-pandemic period” (March to September 2021). Results: During the pandemic period, the number of new patients seen at the HIV clinic (116), as well as the requested viral load tests (2414), decreased significantly compared to the pre-pandemic (204 and 2831, respectively) and post-pandemic periods (146 and 2640, respectively)(p<0.01 for all the comparisons). However, across the three study periods, the number of drug refills (1385, 1330, 1411, respectively), the number of patients with undetectable viral loads (85%, 90%, 93%, respectively), and the number of hospital admissions among PLWH remained constant. Conclusions: Despite the COVID-19 pandemic impact, our findings show stability in the retention of clinical care, adherence to treatment, and viral suppression of PLWH, with no significant impact on hospitalization rates and all-cause mortality.

Background: dementia is a significant health issue worldwide. Mild cognitive impairment (MCI) can transform into dementia over time. General practitioners may be the first to notice the cognitive deficit, so they may need a screening test in the event of suspicion, which they must be able to use under great time pressure. We examined the usability of the Hungarian Test Your Memory (TYM-Hun) self-administered dementia test in general practice, and with the results of the received tests, we tried to draw conclusions regarding the population. Methods: In the four Hungarian cities with medical universities, general practitioners filled out 368 questionnaires with their clients over 50 years of age. Results: the total scores of the test showed a significant correlation with education and the type of occupation, while a significant negative correlation with age. We found the clock drawing test and recall indicates cognitive decline the earliest. Based on the TYM-Hun results, the prevalence levels for MCI and dementia are slightly higher in Hungary than globally. Conclusion: the test can sensitively indicate MCI and early-stage dementia as a screening test, and two of its subtests can raise the possibility of cognitive impairment at an earlier age than the others.

Introduction. The main task of the study was to measure the workload of nurses in the care of a patient with a developmental defect–congenital diaphragmatic hernia (CDH)–in the neonatal intensive care unit, which was evaluated on the basis of standardized tools Therapeutic Intervention Scoring System (TISS–28), Nine Equivalents of Nursing Manpower use Score (NEMS) and Nursing activities Score (NAS). Methods. Retrospective study. The workload was measured using TISS–28, NEMS and NAS tools. Descriptive statistics were used to analyze the data, and a single-sample test was used to verify the research hypotheses. Results. The sample consisted of medical records of 33 patients; 592 observations were analyzed. Studies prove the need for research on the workload of nurses in neonatal intensive care units. A patient with CDH should receive nursing care as required. Conclusion. It is necessary to implement a model for measuring the workload of nurses in neonatal intensive care units, taking into account the evaluation of work and its optimization.

The COVID-19 pandemic has led to numerous delays in cancer-related care and cancer-specific screening, but the extent is not fully understood. For those that experience a delay or disruption in care, health related self-management is required to re-engage in care pathways and the role of health literacy in this pathway has not been explored. The purpose of this analysis is to (1) report the frequency of self-reported delays in cancer treatment and preventative screening services at an academic, NCI-designated center during the COVID-19 pandemic and (2) investigate cancer-related care and screening delays among those with adequate and limited health literacy. A cross-sectional survey was administered from an NCI-designated Cancer Center with a rural catchment area during November 2020 through March 2021. Nearly 19 percent of participants were categorized as having limited health literacy. Twenty percent of those with a cancer diagnosis reported a delay in cancer-related care; and 23-30% of the sample reported a delay in cancer screening. In general, the proportions of delays among those with adequate and limited health literacy were similar with the exception of colorectal cacner screening. There was also a notable difference in the ability to re-engage in cervical cancer screening among those with adequate and limited health literacy. Thus, there is a role for those engaged in cancer-related education and outreach to offer additional navigation resources for those at risk to cancer-related care and screening disruptions. Future study is warranted to investigate the role of health literacy on cancer care engagement.

This study examines demographic factors which may influence opinions concerning medical students’ self-care and substance use behaviors as a means of providing insights into how future doctors view these issues compared to Australian doctors and members of the public. We conducted national, multicenter, prospective, on-line cross-sectional surveys using hypothetical scenarios to three cohorts- Australian medical students, medical doctors, and the public. Participants’ responses were compared for the different contextual variables within the scenarios and the participants’ demographic characteristics. In total 2,602 medical students, 809 doctors and 503 members of the public participated. Compared with doctors and the public, medical students were least tolerant of alcohol intoxication, and most tolerant of using stimulants to assist with study, and cannabis for anxiety. Doctor respondents more often aligned with the public’s opinions on the acceptability of the medical students’ behaviors. Although opinions are not equivalent to behaviour, Australian students’ views on the acceptability for cannabis to help manage anxiety, and inappropriate use of prescription-only drugs are concerning; these future doctors will be responsible for prescribing drugs and managing patients with substance abuse problems. However, if current Australian medical student’s opinions on alcohol misuse persist, one of the commonest substance addictions amongst doctors may decrease in future.

The personalist ethics of Edith Stein and her feminist thought are intrinsically interrelated. This unique connection constitutes perhaps the main novelty of Stein’s ethical thought that makes her a forerunner of some recent developments in feminist ethics, particularly ethics of care. A few scholars noticed the resemblance between Stein’s feminist personalism and care ethics, yet none of them have properly explored it. This paper offers an in-depth discussion of the overlaps and differences between Stein’s ethical insights and the core ideas of care ethics. It argues that both Stein and care ethicists relocate a certain set of practices, values and attitudes from the periphery to the center of ethical reflection. This includes relationality, emotionality and care. The paper finally argues that it is plausible and fruitful to read Stein’s advocacy of ‘woman’s values and attitudes’ in a critical feminist way, rather than as an instance of essentialist difference feminism.

The aim was to analyze the coping strategies used by primary health care (PHC) professionals. A cross-sectional, descriptive-analytical study was conducted with professionals working in primary health care units in São José do Rio Preto, a large city in the interior of São Paulo, Brazil. For data collection we used an instrument developed by the researchers, containing sociodemographic and professional variables, as well as the Problem Coping Modes Scale (EMEP). We evaluated 333 PHC professionals. A difference was observed between the scores of the four coping strategies (p<0.001), with the highest score for the problem-focused strategy (3.8) and the lowest score for the emotion-focused strategy (2.4). Physicians had the lowest scores in coping strategies focused on religious practices/fantastical thinking (p<0.001) and pursuit of social support (p=0.045), while community health agents had the highest scores in these coping strategies). Professionals working in PHC have different coping strategies for the problems and stressful situations experienced in the work environment. These strategies can involve more positive attitudes focused on confrontation and problem solving, to emotional responses that involve attitudes of avoidance and denial that involve attitudes of avoidance and denial of the problem.

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing symptoms do not readily triggers an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p<.001) and emergency admission (IRR 4.24; p<.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assignment_group=-.881; p<.001) and in the quality of life (βSlope. Assignment_group=1.739; p<.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.

Multicomponent training is recommended for people with dementia living in long-term care homes. Nevertheless, evidence is limited and people with severe dementia are often excluded from trials. Hence, the aim of this study was to investigate (1) the feasibility and (2) the requirements regarding a multicomponent training for people with moderate to severe dementia. The study was conducted as an uncontrolled single arm pilot study with a mixed methods approach. 15 nursing home residents with a mean age of 82 years (range: 75-90 years; female: 64%) with moderate to severe dementia received 16 weeks of multicomponent training. Feasibility and requirements of the training were assessed by a standardized observation protocol. Eleven participants regularly attended the intervention. The highest active participation was observed during gait exercises (64%), the lowest during strength exercises (33%). It was supportive if exercises were task-specific or related to everyday life. This study confirms that a multicomponent training for the target group is (1) feasible and well accepted. To enhance active participation (2) individual instructions and the implementation of exercises related to everyday life is required. The effectiveness of the adapted training should be tested in future randomized controlled trials.

Background: Care home residents have complex healthcare needs but may have faced barriers to accessing hospital treatment during the first wave of the COVID-19 pandemic. Objective: To examine trends in the number of hospital admissions for care home residents during the first months of the COVID-19 outbreak. Methods: Retrospective analysis of a national linked dataset on hospital admissions for residential and nursing home residents in England (257,843 residents, 45% in nursing homes) between 20 January 2020 and 28 June 2020, compared to admissions during the corresponding period in 2019 (252,432 residents, 45% in nursing homes). Elective and emergency admission rates, normalised to the time spent in care homes across all residents, were derived across the first three months of the pandemic between 1 March and 31 May and primary admissions reasons for this period were compared across years. Results: Hospital admission rates rapidly declined during early March 2020 and remained substantially lower than in 2019 until the end of June. Between March and May, 2,960 admissions from residential homes (16.2%) and 3,295 admissions from nursing homes (23.7%) were for suspected or confirmed COVID-19. Rates of other emergency admissions decreased by 36% for residential and by 38% for nursing home residents (13,191 fewer admissions in total). Emergency admissions for acute coronary syndromes fell by 43% and 29% (105 fewer admission) and emergency admissions for stroke fell by 17% and 25% (128 fewer admissions) for residential and nursing home residents, respectively. Elective admission rates declined by 64% for residential and by 61% for nursing home residents (3,762 fewer admissions). Conclusions: This is the first study showing that care home residents’ hospital use declined during the first wave of COVID-19, potentially resulting in substantial unmet health need that will need to be addressed alongside ongoing pressures from COVID-19.

Aim: Reporting 3 year outcomes of a community shared care scheme run by specialised independent prescribing (IP) optometrists for stable glaucoma and ocular hypertension (OHT) patients in West Kent, England. Purpose: Shared Care Schemes for glaucoma exist to alleviate the burden on Hospital Eye Services (HES) glaucoma clinics. We studied the effectiveness of community care by highly trained and qualified IP optometrists in terms of disease stability and referral rate into HES.Methods: Retrospective longitudinal review of 200 eyes with stable early to moderate stage glaucoma and OHT followed-up in two specialist optometry practices. Outcome measures included visual field mean deviation (VFMD), intraocular pressure (IOP), changes to treatment and referral rate into HES. Inclusion criteria included all patients with OHT and glaucoma (open angle and primary angle closure) referred for community follow-up. Incomplete data sets were excluded.Results: Mean age 71yrs (range 28 - 93yrs) and equal male: female ratio. n= 159 at year 3. The results for both outcomes showed no significant change from baseline at 12 or 24-month time points. However, a significant change from baseline at 36 months was observed for both outcomes: mean reduction of 0.7 mmHg in IOP, and a mean reduction of 0.3 dB in VFMD. There was a statistically significant change in the number of drops used at 36 months (p=0.001). 11 patients had a change in medication within 3 years. One patient was referred back to HES for uncontrolled IOP and consideration of trabeculectomy.Conclusion: Community follow-up of stable cases of glaucoma and OHT by highly qualified IP optometrists was safe, with stability of disease maintained and few referrals back to HES.

Patients with heart failure have difficulty in self-care management, as daily monitoring and recognizing symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate self-care management and quality of life changes on patients with heart failure and assessed by a pilot study, for three months, to sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p<.001) and emergency admission (IRR 4.24; p<.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (βSlope. Assign-ment_group=-.881; p<.001) and in the quality of life (βSlope. Assignment_group=1.739; p<.001). This study supports that a nurse-led program on symptom recognition and fluid restriction can have a positive impact on self-care behaviours and quality of life in patients with heart failure.

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3rd April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range and gender groups. 1082 participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders and age ranges should be considered in order to improve health recommendations and adherence to guidelines. It would also be crucial to identify vulnerable groups to promote the adoption of health behaviors that may help in the development of effective public health strategies. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.

This paper reports on in-depth qualitative interviews conducted with 69 disabled people in England and Scotland, and with 28 key informants from infrastructure organisations in the voluntary and statutory sectors, about the impact of COVID-19, and measures taken to control it. Participants were recruited through voluntary organisations. As with everyone, the Pandemic has had a huge impact: we discuss the dislocations it has caused in everyday life; the failures of social care; the use of new technologies; and participants’ view on leadership and communication. We conclude with suggestions for urgent short term and medium term responses, so that the United Kingdom and other countries can respond better to this and other pandemics, and build a more inclusive world.

Migraine is one of the leading causes of disability worldwide [1,2]and patients with acute migraine frequently present to emergency departments (ED)[3]. The current literature suggests that ED treatment of migraine headache varies across institutions [4-7]. Considering this, we conducted a scoping review to summarize trends in medication prescribing patterns for acute migraine treatment in the ED setting. Trends were evaluated for factors influencing treatment choices, with particular attention placed on opioids and migraine specific therapy. This scoping review was based on the Arksey and O'Malley methodological framework[8]and included studies published between 1 January 2000 until 31 May 2020. 14 publications met the inclusion criteria. The most common classes of medication prescribed were often anti-emetics or Non-steroidal anti-inflammatory drugs (NSAID), but rates varied between studies. There was a concerning trend towards an underutilization of triptans and overutilization of opiates. The use of specific clinical goals of treatment (e.g. two-hour pain free freedom response) was also not evident. Additionally, 88% (n=8) of the 9 studies commenting on adherence to hospital or evidence-based guidelines stated that practices were non-adherent. Overall, the reviewed literature reveals treatment practices for acute migraine in the ED are heterogeneous and deviate from established international recommendations.

Laryngopharyngeal reflux (LPR) is a prevalent disease in the general population and may have acute or chronic clinical presentation. LPR may be misdiagnosed in primary care medicine regarding the lack of gastroesophageal reflux disease symptoms and the lack of findings at the gastrointestinal endoscopy. Depending on the physician field of expertise and experience, LPR may be clinically over- or under-diagnosed. The management of LPR is possible in primary care medicine but primary care physician has to consider some red flags that requires to address the patient to otolaryngologist or gastroenterologist. The use of patient-reported outcome questionnaire such as reflux symptom score-12 and the consideration of some oral and pharyngeal findings visualized through the mouth opening may help the primary care physician to evaluate the LPR findings at the diagnosis time and throughout treatment. In this review, we provide a practical algorithm of management of LPR for primary care physician or other specialists that cannot perform fiberoptic examination. In this algorithm, physician has to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and red flags. Physician may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the complaint severity of the patient. In case of prescription of medication, proton pump inhibitors and alginate have to be considered in association to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.

Designed by a group of ME/CFS researchers and health professionals, the European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE) has received funding from the European Cooperation is Science and Technology (COST) (https://www.cost.eu/cost-actions/what-are-cost-actions/ ) - COST action 15111 - from 2016 to 2020. The main goal of the Cost Action was to assess the existing fragmented knowledge and experience on health care delivery for people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in European countries, and to enhance coordinated research and health care provision in this field. We report on the recommendations for clinical diagnosis, heath services and care for people with ME/CFS in Europe, as prepared by the group of clinicians and researchers from 22 countries and 55 European health professionals and researchers, who have been informed by people with ME/CFS (https://www.cost.eu/actions/CA15111/#tabs|Name:overview).

Rationale: Examining trends in patient characteristics, processes of care and outcomes, across an epidemic, provides important opportunities for learning. Objectives: To report and explore changes in admission rates, patient characteristics, processes of care and outcomes for all patients with COVID-19 admitted to intensive care units (ICUs) in England, Wales and Northern Ireland. Methods: Population cohort of 10,287 patients with COVID-19 in the Case Mix Programme national clinical audit from 1 February to 2 July, 2020. Analyses were stratified by time period (pre-peak, peak, post-peak) and geographical region. Multivariable logistic regression was used to estimate differences in 28-day mortality, adjusting for patient characteristics over time. Main results: Admissions to ICU peaked simultaneously across regions on 1 April, with ongoing admissions peaking ten days later. Compared with pre- and post-peak periods, patients admitted during the peak were slightly younger but had greater respiratory and renal dysfunction. Use of invasive ventilation and renal replacement reduced over time. Twenty-eight-day mortality reduced from 43.5% (95% CI 41.6% to 45.5%) pre-peak to 34.3% (95% CI 32.3% to 36.2%) post-peak; a difference of −8.8% (95% CI: −5.2%, −12.3%) after adjusting for patient characteristics. London experienced the highest admission rate and had higher mortality during the peak period but a greater reduction in post-peak mortality. Conclusion: This study highlights changes in patient characteristics, processes of care and outcomes, during the UK COVID-19 epidemic. After adjusting for the changes in patient characteristics and first 24-hour physiology, there was substantial improvement in 28-day mortality over the course of the epidemic.

Introduction: Dental health problems including dental plaque are common health problems affecting people of different age groups globally. Air-polishing is a safe tooth polishing technique used by dental professionals for stain and plaque removal and as preventive procedure for dental health. Here we report the technical improvisation of existing air-polishing technique by supplementing cannabinoid powder into the classic polishing powder for effective removal of supragingival and subgingival plaque and inhibition of plaque forming bacteria. Methods: The cannabidiol (CBD) powder was added to the tooth polishing powder (AIR-N-GO, classic) at 1% (wt/wt) ratio. The study was conducted on 12 patients, of which 6 received regular polishing treatment and 6 received CBD-supplemented polishing treatment. The dental plaque samples were collected before and after each treatment and subjected to in vitro microbiological analysis and the colony forming units (CFU) were analyzed using automated colony counter. Results: Based on in vitro microbiological analysis, the average CFU of interdental space samples collected from post-CBD-supplemented polishing treatment was significantly reduced (linear fold change between 3.9-18.4) compared to that of post-regular polishing (linear fold change between 1.0-2.6) treatment. Conclusions: CBD-supplemented polishing powder can help in effective removal and killing of dental plaque bacteria during the polishing treatment. CBD powder can be added as enhancing supplement to the existing polishing powders.

Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.

Due to its devastating consequences, late life depression is an important public health problem. The aim of the study was the analysis of variables which may potentially influence risk of depression (GDS-SF). Furthermore, the aim was to study possible mediating effect of given variables on the relationship between the total protein concentration and risk of depression in older-adults with chronic diseases, and physical function impairment. The research sample included a total of 132 older adults with chronic conditions and physical function impairments, remaining under a long-term care in residential environment. Negative linear correlation was observed between patients’ physical functionality, total protein concentration, concentration of HDL cholesterol, arm circumference, and the risk of depression. Considerably stronger relationship was observed between total protein concentration, and GDS-SF, in elderly suffering from sensory dysfunction (b = −6.42, 95% CI = −11.27; −1.58). The effect of the mediation between depression risk is correlated to total protein concentration in blood serum, and the mediators are probably low function impairment and low levels of 25 (OH)D vitamin. Cohort control research is suggested to confirm the hypothesis.

This study was undertaken to investigate and analyze noise pollution in a large Chinese governmental hospital’s medical intensive care unit and compare to the WHO guidelines.This cross-sectional study was conducted in a MICU at a public governmental teaching hospital in Fujian province between July and August of 2017. A WENSN® WS1361 Integrated Sound Level Meter (China) was used for continuous every five seconds one week noise levels recording. After this measurement, the decibel meter was used for recording different location of isolation rooms and open bays, including occupied and unoccupied patient, and recording sound events occurs in the ICU to identify sources of noise. Peak and average noise levels were obtained from the meter, and data were downloaded from the WS1361 into a laptop computer. The measured mean equivalent sound pressure levels (L) and standard Aeq deviation over one week period were 66.64±7.57 dB(A), with acute spikes reaching 119.7 dB(A), the average sound level for a 24 hour period in a work day was 68.03±5.07 dB(A). These are higher than the current daytime environmental noise limit of 40-45 decibels in China and WHO. Mean work day noise was significantly louder than weekend time, there was a significant difference in work days and weekend (t=16.85;P=0.000).There was a statistical difference between the day time and night time shifts (t=34.67;P=0.000). The isolation rooms were significantly quieter than the open-bay rooms(t=46.15; p=0.00), sound levels in the occupied and unoccupied rooms also had significant difference(t=17.26; P=0.000).Two types of noise resources, including twenty kinds sources were identified and measured, mean noise levels ranged from of 61.33 to 79.21 dB(A). This study shows noise levels in intensive care units were exceeded the recommended. The study of the influence of noise on patient and staff is needed, and noise reduction strategies must be conduct in ICU.

Comprehensive geriatric assessment, defined as an interdisciplinary assessment and development of an overall plan of treatment and follow-up, has become a fundamental part of clinical geriatric care. Since the 1970s, the Veterans Administration has encouraged the development of geriatric evaluation and management programs. Evolution of geriatric evaluation and management has occurred over time and many VA medical centers have transferred inpatient geriatric evaluation programs to long-term care Community Living Centers (CLC) and outpatient settings. Availability of resources and trained personnel across the continuum of care as well as administrative facilitation of collaboration between care components are critical to the efficient utilization of geriatric services. Facilities may need to prioritize their resources and utilize the most effective and relevant elements of geriatric evaluation and management according to patient population needs, available space, resources, and institutional priorities.

The rapid growth rate of the elderly population is a serious current issue in most countries, affecting them economically through needed medical treatment and healthcare planning. The priority concern is how to reduce the number of elderly people requiring long-term healthcare and raise the number who are able to live independently. This study executed a behavior assessment of elderly person’s self-reported use of electric scooters and analyzed their degree of acceptance of these assisted living tools, partly through a related factor analysis of our survey instrument. We used this questionnaire survey as our research method, applying SPSS22 software for factor analysis that revealed five survey facets.

This article takes an approach to explaining the behavioral manifestations of the decision making in US companies’ offer of health insurance that is grounded not only on their cost minimizing behavior, but also in a humanness dimension based on the African concept of Ubuntu. In this way, we define an Ubuntu based Random Utility modeling framework, describing the choice process as a tripartite decision making, and implemented using a nationally representative random sample of 1,061 American companies from the Dunn and Bradstreet Business data, supplied by Survey Sampling International to the Associated Press-NORC Center for Public Affairs Research. The results from the three sequentially implemented specifications showed that the relationship between management culture and health plan offering strategy is dependent on other relevant co-variates, which when left out, leads to the problem of omitted variables bias. However, when all variables are included but assumed to enter the relationship exogenously, this results in management culture not having any statistically significant effect on companies' decisions about scope of health plan offering. When the exogeneity assumption is relaxed through a recursively Bivariate Probit model, the system of two equations produces a highly significant management culture effect. In fact, in this later case we see that companies with groups and formal committee management culture are 1.58 times less likely to choose a multiple plan strategy over a single plan strategy, hence failing to show the more wholesome plan offering that would theoretically prevail under Ubuntu style management.

Research on fall and movement detection with wearable devices has witnessed promising growth. However, there are few publicly available datasets, all recorded with smartphones, that prevent authors to evenly compare their new proposals. Here, we present a dataset of falls and activities of daily living (ADL) acquired with a self-developed device composed of two types of accelerometer and one gyroscope. It consists of 19 ADL and 15 fall types performed by 23 young adults, 15 ADL types performed by 14 healthy and independent participants over 62 years old, and data from one participant of 60 years old that performed all ADL and falls. These activities were selected based on a survey and a literature analysis. We test the dataset with widely used feature extraction and a simple to implement threshold based classification, achieving up to 96~\% of accuracy in fall detection. An individual activity analysis demonstrates that most errors coincide in a few number of activities where algorithms could be focused on. Finally, validation tests with elderly people significantly reduced the fall detection performance of the tested features. This validates findings of other authors and encourages to develop new strategies with this new dataset as benchmark.

The notion of Critical Point Theory has extensive application in the filed of Partial Differential Equations, one of which is studying the existence and commenting on the uniqueness and multiplicity (in case when the solution is not unique) of weak solutions to Elliptic PDEs under certain boundary conditions.\par This article provides a brief survey about specific concepts like : differentiation on Banach Spaces, maxima and minima and its applications to PDEs. Furthermore, we've discussed the notion of defining a weak topology on Banach Spaces, before introducing the Variational Principle and its applications.\par The epilogue of the article primarily deals with results which studies the existence of weak solutions to Dirichlet Boundary Value Problems under specific conditions. The most notable aspect of this article is the proof of \textit{Rabinowitz's Saddle Point Theorem} using the method of \textit{Brouwer Degree}. Readers who are highly motivated in pursuing research in any of the topics relevent to the contents of this paper will surely find the \texttt{References} section to be extremely resourceful.

In the digital age, 3D as-built monitoring of structures and buildings is becoming increasingly important. It provides the basis for automated quality control and progress monitoring through as-built and as-planned model- comparisons, as well as 3D modelling for automated repair, refurbishment and reuse in existing construction. Especially for 3D model-based manufacturing processes such as additive manufacturing, efficient as-built monitoring is essen- tial to ensure the quality and accuracy of buildings and products. Therefore, three different 3D scanning devices have been evaluated for 3D as- built monitoring of concrete structures with different characteristics: An indus- trial handheld laser scanner commonly used in automotive and mechanical en- gineering, a mobile device with lidar for commercial public use, and a terrestri- al laser scanner commonly used for surveying. The devices were tested on 3D printed, cast, and assembled structures of different sizes and geometries. The scan results are compared to the as-planned models based on their dimen- sional distances using Cloud-to-Cloud Comparison (C2C). The results show that the applicability is highly dependent on the size, geometric complexity and surface texture of the concrete structures. While small and flat structures can be captured completely and with micrometer accuracy using the handheld industri- al laser scanner, terrestrial laser scanners are suitable for capturing large struc- tures and environments. The handheld, photogrammetry-based mobile device has demonstrated the broadest applicability for concrete structures. The accura- cy and coverage of the point cloud results were respectively high. Therefore, photogrammetry-based scanning with advanced mobile devices is a cost- effective, fast and portable alternative for 3D as-built monitoring and data ac- quisition of a wide range of concrete structures.

Global pose refinement is a significant challenge within Simultaneous Localization and Mapping (SLAM) frameworks. For LIDAR-based SLAM systems, pose refinement is integral to correcting drift caused by the successive registration of 3D point clouds collected by the sensor. A divergence between the actual and calculated platform path characterizes this error. In response to this challenge, we propose a linear, parameter-free model, which uses a closed circuit for global trajectory corrections. Our model maps rotations to quaternions and uses Spherical Linear Interpolation (SLERP) for transitions between them. The intervals are established from the constraint set by the Least Squares (LS) method on rotation closure and are proportional to the circuit's size. Translations are globally adjusted in a distinct linear phase. Additionally, we suggest a coarse-to-fine pairwise registration method, integrating Fast Global Registration and Generalized ICP with multiscale sampling and filtering. The proposed approach is tested on three varied datasets of point clouds, including Mobile Laser Scanners and Terrestrial Laser Scanners. These diverse datasets affirm the model's effectiveness in 3D pose estimation with substantial pose differences and efficient pose optimization in larger circuits.

This is the second paper in a cycle investigating the exact solution of loop equations in decaying turbulence. We perform numerical simulations of the Euler ensemble, suggested in the previous work, as a solution to the loop equations. We designed novel algorithms for simulation, which take a small amount of computer RAM so that only the CPU time grows linearly with the size of the system and its statistics. This algorithm allows us to simulate systems with billions of discontinuity points on our fractal curve, dual to the decaying turbulence. For the vorticity correlation function, we obtain \textbf{quantum fractal laws} with regime changes between universal discrete values of indexes. The traditional description of turbulence with fractal or multifractal scaling laws does not apply here. The measured conditional probabilities of fluctuating variables are smooth functions of the logarithm of scale, with statistical errors being negligible at our large number of random samples $T = 167,772,160$ with $N = 200,000,000$ points on a fractal curve. The quantum jumps arise from the analytical distribution of scaling variable $X = \frac{\cot^2(\pi p/q)}{q^2}$ where $\frac{p}{q}$ is a random fraction. This distribution is related to the totient summatory function and is a discontinuous function of $X$. In particular, the energy spectrum is a devil's staircase with tilted uneven steps with slopes between $-1$ and $-2.03$. The logarithmic derivative of energy decay $n(t)$ as a function of time is jumping down the stairs of universal levels between $1.50$ and $1.53$. The quantitative verification of this quantization would require more precise experimental data.

Object detection is important in many applications, such as autonomous driving. While 2D images are lack of depth information and are sensitive to environmental conditions, 3D point cloud can provide accurate depth information and a more descriptive environment. However, sparsity is always a challenge in single-frame point cloud object detection. This paper introduces a two-stage proposal-based feature fusion method for object detection using multiple frames. The proposed method, called proposal features fusion (PFF), utilizes a cosine-similarity approach to associate proposals from multiple frames and employs an attention weighted fusion module to merge features from these proposals. It allows for feature fusion specific to individual objects and offers lower computational complexity while achieving higher precision. The experimental results on the nuScenes dataset demonstrate the effectiveness of our approach, achieving a mAP of 46.7%, which is 1.3% higher than the state-of-the-art 3D object detection method.

The multiobjective optimization problem is a key research direction in the field of optimization. Based on the multivariant optimization algorithm (MOA), this paper puts forward a multiobjective multivariant optimization algorithm (MMOA). A good point set is adopted for population initialization and to ensure the homogeneity of the initial solution set and avoid prematurity; global atoms are acquired by non-dominated sorting and an external archiving strategy; a nonlinear search radius is designed to balance global and local searches and enhance the convergence precision of the algorithm. Levy Flight and Sine chaotic mapping are introduced to redesign the update formula for local atoms, increase the convergence rate of the algorithm, and boost the optimization efficiency. Comparative experiments are conducted between MMOA and NSGA-II, MOEA/D, NSWOA, MOGWO, NSMFO on multiobjective test functions and an engineering example. The simulation results show that MMOA has superior convergence and diversity to the other five algorithms.

Recently, federated learning (FL) has been receiving great attention as an effective machine learning method to avoid the security issue in raw data collection as well as to distribute the computing load to edge devices. However, even though wireless communications is a essential part for implementing FL in edge networks, there have been a few works that analyze the effect of wireless networks on FL. In this paper, we investigate FL in small-cell networks where multiple base stations (BSs) and users are located according to homogeneous Poisson point process (PPP) with different densities. We comprehensively analyze the effects of geographic node deployment on the model aggregation in FL on the basis of stochastic geometry-based analysis. We derive the closed-form expressions of coverage probability with tractable approximations and discuss the minimum required BS density for achieving a target model aggregation rate in small-cell networks. Our analysis and simulation results provide insightful information for understanding the behaviors of FL in small-cell networks, and it can be exploited as a guideline for designing the network facilitating the wireless FL.

The nature of the fracture and fragmentation process of concrete medium under blast loading is the transformation process of the medium from continuum to discontinuity, coupled with the significant rate correlation of concrete medium, its mechanical behavior presents a high degree of complexity. Problems such as grid distortion and even negative volume are often encountered in the finite element method and others when solving this problem, while the material point method can effectively avoid these problems. In addition, the widely used HJC concrete constitutive model does not take into account the segmented characteristics of the calculation function for dynamic increasing factor. Therefore, in this paper, firstly, the calculation function for dynamic increasing factor in the HJC concrete model is modified by SHPB experiment, and the improved HJC concrete model is proposed; secondly, the material point method simulation program is developed, and the improved HJC concrete model is embedded into the simulation program; finally, the simulation program is verified by numerical examples, and the results show that the developed simulation program can better simulate the fracture and fragmentation process of concrete medium under blast loading, especially the pulverization characteristics of the medium in the near zone of the load.

In this paper, we report orthogonal fuzzy versions of some celebrated iterative mappings. We provide various concrete conditions on the real valued functions J,S:(0,1]→(−∞,∞) for the existence of fixed-points of (J,S)-fuzzy iterative mappings. We obtain many fixed point theorems in orthogonal fuzzy metric spaces. We apply (J,S)-fuzzy version of Banach fixed point theorem to show the existence and uniqueness of the solution. We support these results with several non-trivial examples and applications to Volterra-type integral equations and fractional differential equations.

In order to study the movement characteristics of fuel in the fuel tank during aircraft maneuvering, this paper conducts numerical simulations of a typical wing fuel tank using the finite point set method based on certain boundary conditions and excitation. The results show that the finite point set method can capture the complex phenomena of fuel free surface fluctuations, surging, rolling and breaking, as well as the change in center of gravity caused by fuel movement. Under aircraft acceleration and pitch angle excitation, fuel will generate sustained impact pressure on the fuel tank wall. The velocity attenuation of fuel flowing through the baffle communication hole is fast, and the flow resistance and energy dissipation of the communication hole buffer the impact of fuel on the fuel tank wall.

The Amoebic Self Theory is a concept of the social psychology, which postulates that humans have a psychological boundary. As the authors of the concept propose [1], the function of the boundary is to allow psychological separation of one from the others. In this study, we examined how sen-sitivity to violation of the boundary, measured by an amoebic self scale, is connected with differ-ent types of procrastination sensu lato, measured by seven procrastination subscales. Only two of the seven procrastination aspects, i.e. the preference for pressure and outcome satisfaction, were negatively and significantly related to the spatial-symbolic domain of the amoebic self scale. The other purpose of this research was to examine the connection between the students’ grade point average (GPA) and scores obtained in the procrastination subscales. Only the non-adaptive aspect of procrastination predicted significantly the GPA. That is an important detail, because pointing out the gap between one’s self-opinion and the real, non dependent of the opinion, academic achievement. All these findings were considered in the academic context and consequences of these results were discussed.

The 3D reconstruction method using RGB-D camera has a good balance in hardware cost, point cloud quality and automation. However, due to the limitation of inherent structure and imaging principle, the acquired point cloud has problems such as a lot of noise and difficult registration. This paper proposes a three-dimensional reconstruction method using Azure Kinect to solve these inherent problems. Shoot color map, depth map and near-infrared image of the target from six perspectives by Azure Kinect sensor. Multiply the 8-bit infrared image binarization with the general RGB-D image alignment result provided by Microsoft to remove ghost images and most of the background noise. In order to filter the floating point and outlier noise of the point cloud, a neighborhood maximum filtering method is proposed to filter out the abrupt points in the depth map. The floating points in the point cloud are removed before generating the point cloud, and then using the through filter filters out outlier noise. Aiming at the shortcomings of the classic ICP algorithm, an improved method is proposed. By continuously reducing the size of the down-sampling grid and the distance threshold between the corresponding points, the point clouds of each view are continuously registered three times, until get the complete color point cloud. A large number of experimental results on rape plants show that the point cloud accuracy obtained by this method is 0.739mm, a complete scan time is 338.4 seconds, and the color reduction is high. Compared with a laser scanner, the proposed method has considerable reconstruction accuracy and a significantly ahead of the reconstruction speed, but the hardware cost is much lower and it is easy to automate the scanning system. This research shows a low-cost, high-precision 3D reconstruction technology, which has the potential to be widely used for non-destructive measurement of crop phenotype.

In the wake of the current SARS-CoV-2 pandemic devastating the world, it is imperative to elucidate the comparative genomics of geographically-diverse strains of this novel coronavirus to gain insights into its microevolution, pathogenesis and control. Here we explore the molecular nature, genome-wide frequency, and gene-wise distribution of mutations in three distinct datasets encompassing 68 SARS-CoV-2 RNA-genomes altogether. While phylogenomic analysis revealed parallelism between the evolutionary paths charted by distinct quasispecies clusters of the virus, occurrence of mutations across genomes was found to be non-random. Whereas deletion mutations are extremely scarce and insertions totally absent, of all the instances of single nucleotide substitution detected, the overwhelming majority were transition mutations with cytidine to uridine being the most prevalent type. Propensity of this transition could be attributed to hydrolytic deamination mediated by ultra-violet irradiation or bisulfite reagent, both of which find wide usage as sterilizer/disinfectant. Transversions, albeit few and predominated by the guanosine to uridine form, were found concentrated in loci encoding the structural proteins of the virus, so might confer versatile tissue-colonization potentials. Mutation frequency of the three distinct genome-sets ranged narrowly between 0.07-1.08 × 10^-4 nucleotides positions mutated per nucleotide aligned. Gene-wise mapping of the global mutations illuminated the highly conserved nature of the genes encoding the non-structural proteins Nsp7, Nsp8 (two essential cofactors of the viral RNA-dependent RNA-polymerase) and Nsp9 (Nsp8-interacting single-strand RNA-binding protein), plus the envelope protein E (involved in SARS-CoV-2 assembly, budding and pathogenesis). These mutation-free genomic loci and/or their protein products could be potent targets for future drug designing/targeting.

The characterization of thin-film solar cells is of huge importance for obtaining high open-circuit voltage and low recombination rates from the interfaces or within the bulk of the main materials. Among the many electrical characterization techniques, the two- and four-wire probe using the Cascade instrument is of interest since the resistance of the wires, and the electrical contacts can be excluded by the additional two wires in 4-wire probe configuration. In this paper, both two and four-point probes configuration are employed to characterize the CIGS chalcogenide thin-film solar cells. The two-wire probe has been used to measure the current-voltage characteristics of the cell which results in a huge internal resistance. Therefore, the four-wire connection is also used to eliminate the lead resistance to enhance the characterization’s accuracy. The load resistance in the two-wire probe diminishes the photogenerated current density at smaller voltage ranges. In contrast, the proposed four-wire probe collects more current at higher voltages due to enhanced carrier collection efficiency from contact electrodes. The current conduction mechanism is also identified at every voltage region represented by the value of the ideality factor of that voltage region. It is observed that a long time given to the charge collection results in increased current density at a higher voltage. According to the results and device characteristics, a novel double-diode model is suggested to extract the saturation current density, shunt and series resistances and the ideality factor of the cells. These cells are shown to be efficient in terms of low recombination at the interfaces and with lower series resistance as the quality of the materials is in its most possible conductive form. The measured internal resistance and saturation current density and ideality factor of the two measurement configuration is measured and compared.

The akimotoite--majorite--bridgmanite (Ak--Mj--Bm) triple point in MgSiO3 has been measured in large-volume press (LVP; COMPRES 8/3 assembly) and laser-heated diamond anvil cell (LHDAC). For the LVP data, we calculated pressures from the calibration by Leinenweber (2012). For the LHDAC data, we conducted \textit{in situ} determination of pressure at high temperature using the Pt scale by Dorogokupets and Dewaele (2007) at synchrotron. The measured temperatures of the triple point are in good agreement between LVP and LHDAC at 1990-2000 K. However, the pressure for the triple point determined from the LVP is 3.9+/-0.6~GPa lower than that from the LHDAC dataset. The triple point determined through these experiments will provide an important reference point in the pressure-temperature space for future high-pressure experiments and allow mineral physicists to compare the pressure--temperature conditions measured in these two different experimental methods.

Deformation flows are flows incorporating shear, strain and rotational components. These flows are ubiquitous in the geophysical flows, such as the ocean and atmosphere. They appear near almost any salience, such as isolated coherent structures (vortices and jets), various fixed obstacles (submerged obstacles, continental boundaries). Fluid structures subject to such deformation flows may exhibit drastic changes in motion. In this review paper, we focus on the motion of a small number of coherent vortices embedded in deformation flows. Problems involving isolated one and two vortices are addressed. When considering a single-vortex problem, the main focus is on the evolution of the vortex boundary and its influence on the passive scalar motion. Two vortex problems are addressed with the use of point vortex models, and the resulting stirring patterns of neighbouring scalars are studied by a combination of numerical and analytical methods from the dynamical system theory. Many dynamical effects are reviewed with emphasis on the emergence of chaotic motion of the vortex phase trajectories and the scalars in their immediate vicinity.

In this paper, we established the existence of PC-mild solutions for non local fractional impulsive functional integro-differential equations with finite delay. The proofs are obtained by using the techniques of fixed point theorems, semi-group theory and generalized Bellman inequality. In this paper, we have used the distributed characteristic operators to define the mild solution of the system. Results obtained here improve and extend some known results.

This article describes the use of the PI ProcessBook software tool for visualization and indirect monitoring of occupancy of SHC rooms from the measured operational and technical quantities for monitoring of daily living activities for support of independent life of elderly persons. The proposed method for data processing (predicting the CO₂ course using neural networks from the measured temperature indoor T_i (°C), temperature outdoor T_o (°C) and the relative humidity indoor rHi (%)) was implemented, verified and compared in MATLAB SW tool and IBM SPSS SW tool with IoT platform connectivity. Within the proposed method, the Stationary Wavelet Transform de noising algorithm was used to remove the noise of the resulting predicted course. In order to verify the method, two long-term experiments were performed, (specifically from February 8 to February 15, 2015, from June 8 to June 15, 2015) and two short-term experiments (from February 8, 2015 and from June 8, 2015). For the best results of the trained ANN BRM within the prediction of CO₂, the correlation coefficient R for the proposed method was up to 90%. The verification of the proposed method confirmed the possibility to use the presence of persons of the monitored SHC premises for rooms ADL monitoring.

Background: Positive person-centered attributes of inpatient rehabilitation need to be identified from the patient perspective to be further developed and sustained. Purpose: To identify which attributes patients openly evoke as being great care experiences, using an open appreciative inquiry during the inpatient rehabilitation stay. Methods: Qualitative secondary analysis of appreciative patient comments during a bedside patient experience rounding, facilitated by a neutral party. Two independent analysts employed an inductive, summative form of content analysis. Results: Among 150 patients rounded, 122 provided categorizable appreciative accounts. Over two thirds of the patients (67.2%) focused on “staff attributes” in their great-experience accounts. Those attributes were mostly interpersonal such as being “attentive & caring - beyond clinical duty” and being “encouraging (but not too hard) & reassuring”. These interpersonal staff attributes were reported with words showing deep levels of personal significance or patient appreciation. Beyond staff attributes, the perceived quality of the “patient care” (31.1%) and opportunities for “leisure and social activities” (9.0%) were also frequently evoked. Amenities like food or costumer service were the least evoked, rarely so as an exclusive attribute (0.8% for each). Conclusions: The human(e) factor, especially the interpersonal qualities of staff, emerged as greatly appreciated from the patient experience perspective during inpatient rehabilitation. These experiences help identify which person-centered attributes of care might be further developed and sustained.

As the global population faces an increasing prevalence of physical disabilities, the challenge of motor rehabilitation has become increasingly urgent. Considering that approximately 15% of the global population lives with some form of disability, with a significant number having motor disa-bilities that greatly impact their quality of life, the integration of robotic technologies into rehabili-tation processes offers an opportunity for significant improvement in functional recovery and pa-tient autonomy. This analysis aims to evaluate the progress and challenges encountered in imple-menting robotic technology for the rehabilitation of patients with physical disabilities, highlighting the potential of emerging technologies such as exoskeletons, assisted training devices, and brain-computer interface systems in facilitating motor recovery. By examining relevant clinical studies, the analysis demonstrates the varied effectiveness of robotic therapies compared to traditional re-habilitation methods, while also highlighting the need for ongoing research to optimize care prac-tices and address challenges related to cost, accessibility, and treatment personalization. In con-clusion, robotic technologies represent a promising direction in motor rehabilitation, with the po-tential to revolutionize the care of patients with physical disabilities, significantly improving quali-ty of life and social integration.

Colonoscopy, essential for diagnosing and treating colorectal cancer, relies on effective bowel preparation to inspect the colonic mucosa fully. Traditional education methods include printed instructions and verbal explanations, but these may not ensure clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. Using the outpatient’s Android mobile device, the mobile health care model is provided as a nursing guide to assist in bowel preparation for colonoscopy. This single-blinded, randomized trial en-rolled patients for colonoscopy at a Northern Taiwan gastroenterology center. Eligible patients were physically and mentally healthy and could communicate in Chinese. The study tested the ColonClean app during bowel preparation. After the procedure, endoscopists rated the prepara-tion quality using the Aronchick Scale. Data analysis with SPSS software (version 25.0) evaluated if the app significantly improved bowel preparation compared to those who did not use it. Forty patients were recruited for both the control (conventional method) and experimental (conven-tional method plus ColonClean app) groups. In the experimental group, endoscopists assessed bowel preparation quality; all achieved at least "Fair," with 75% receiving "Excellent" or "Good" ratings. The ColonClean App enhanced bowel preparation quality more effectively than tradi-tional nursing guidance.

The platelet count, a component of the full blood count, has been identified as a useful diagnostic marker for cancer in primary care. The reference range for the platelet count is 150 to 400 or 450 × 109/l; this range does not account for natural variation in platelet count by age and sex. This study used three primary care cohorts from England Canada, and Australia. Patients aged 40 years and over with a full blood count were included and stratified by age (in 10-year bands), sex, (male/female), and platelet count group. Cancer incidence within one year of test date was estimated from linked registry data. In all three countries there was a clear upwards trend in cancer incidence with increasing platelet count, for both sexes and at all age groups. Lung and colorectal were the most common sites. These results have important implications for the international application of this work; analysis of local health datasets will be crucial to determine appropriate thresholds. Appropriate upper thresholds will depend on local populations, healthcare needs, and priorities. Further research is needed to assess the likely impact of new recommendations on the healthcare system, on cancer outcomes, and patient benefit.

Abstract: Comorbidities of patients may be related to the duration of mechanical ventilation, survival, and Candida isolation during intensive care unit (ICU) stay. To examine the frequency of Candida isolation and significant comorbidities in the surgical intensive care unit (ICU) in Osijek University Hospital, Croatia, the data from the electronic database from May 2016 to June 30, 2023, were analyzed. In a cross-sectional study examining 15,790 microbiological samples, different strains of Candida were observed in 581 samples from 236 patients. The control group was 160 consecutive patients from March-May 2019, and 161 in the same months of 2020 (pre- and post-COVID-19). Comorbidities, duration of mechanical ventilation and survival were compared. Patients with isolated Candida were more often non-elective, had significantly more heart, kidney, liver diseases and sepsis (P<0.001). The duration of mechanical ventilation was 9.2 [2.2-9.24], 96 [24-146], 160 [19.5-343] and 224 [73.5-510] hours in controls, and patients with Candida albicans, non-albicans, and in patients with ³2 Candidas isolated. The mortality was significantly higher and reached 42% in patients with Candida isolated, while in the control group, it was 19% (P<0.001). In a multivariate analysis adjusted for patient’s age, SAPS II score, days of ICU, and type of admission, only sepsis was independent predictor of mortality (OR = 2.27).

Background: Since 2010, Burkina Faso has developed and initiated community-based management of childhood illnesses. Following the increased presence of community health workers and the adoption of free community health care, this study aims to assess community satisfaction with curative care administered by community health workers. Methodology: It was a descriptive and analytical cross-sectional study. Data were collected in the health districts of Boussé and Boussouma from 20 February to 30 March 2023 for quantitative data and from 12 to 30 January 2024 for qualitative data using a questionnaire (household survey) and an interview grid (focus groups). Analyses were conducted using SPSS IBM 25 and Nvivo 14. Results: Households benefit from oral curative care when using CHWs, but are not satisfied with the temporal accessibility of these community health workers. Temporal accessibility and awareness during care have a significant influence on household satisfaction. Conclusion: Curative care by community health workers is effective, but its use could be improved by addressing the unavailability of community health workers, inputs and better communication during care.

Management of sarcomas in specialist centers delivers significant benefits. In much of the world specialists are not available and development of expertise is identified as a major need. However the terms ‘specialist’ or ‘expert’ center are rarely defined. Our objective is to offer a definition for patient advocates and a tool for healthcare providers to underpin improving the care of people with sarcoma. SPAGN developed a discussion paper for a workshop at the SPAGN 2023 Conference, attended by 75 delegates. A presentation to the Connective Tissue Oncology Society (CTOS) and further discussion led to this paper. Core Principles were identified that underlie specialist sarcoma care. The primary principle is the multi-disciplinary team discussing every patient, at first diagnosis and during treatment. Principles for optimal sarcoma management include accurate diagnosis followed by safe, high-quality treatment, with curative intent. These Principles are supplemented by Features describing areas of healthcare, professional involvement, and service provision and identifying further research and development needs. These allow for variations because of national or local policies and budgets. We propose the term ‘Sarcoma Intelligent Specialist Network’ to recognize expertise wherever it is found in the world. This provides a base for further discussion and local refinement.

The number of long-term cancer survivors increases continually. Understanding their needs is crucial to ensure an adequate follow-up. The aim of our study was to summarize the current literature concerning needs and what in-fluences these needs. A Scoping review of systematic reviews was conducted according to the recommendations of the Joanna Briggs Institute (JBI). Four electronic databases were searched. Of 414 retrieved papers, 11 met the eligi-bility criteria. Needs were aggregated into six domains (health-related information, health system, mental, practical, relationship and physical) and 15 categories. The lack of adequate information and the lack of access and/or conti-nuity of supportive care were the most prominent needs. Female gender, younger age, a low level of family and/or social support, and higher educational level were identified as risk factors. Employment and relationship status can affect the needs both in a positive or negative way. The weeks or months after the end of the treatments are partic-ularly critical and needs can be emphasized during this period. Cancer survivors could also leave positive changes. The variety of needs affects the quality of life of cancer survivors. The current Swiss healthcare system is not de-signed to support these people. Needs assessments should be systematically provided to ensure a better awareness on the part of health professionals and to allow an individual, holistic, and integrated follow-up.

The fetal splenic artery pulsatility index (PI) is a parameter that reflects fetal well-being and has been used as a predictor of adverse pregnancy outcomes. The aim of this study was to investigate the predictive value of splenic artery PI in GDM class A1 cases for NICU admission. In this prospective case controlled study, only sixty single pregnancy cases diagnosed with gestational diabetes mellitus class A1 were evaluated. Fetal splenic artery Doppler parameters Peak systolic velocity (PSV), Pulsatility index (PI), Resistivity index (RI) and End diastolic velocity (EDV) were measured in all cases. The rate of re-quirement of need of neanoatal intensive care unit was noted. In cases with need fetal intensive care, fetal splenic PI index was found to be statistically significantly lower than in healthy cases without it (0.94 ± 0.29 vs. 1.70 ± 0.53, respectively, p

Background: This study aimed to develop and evaluate a dietary self-care promotion program for hemodialysis patients based on Hurley's self-efficacy model. Methods: The needs of hemodialysis patients were identified, and an online community-based dietary self-care promotion program was developed with expert evaluations. 44 hemodialysis patients were randomly assigned to an experimental group (n=22) and a control group (n=22). The program was applied to the experimental group for four weeks. Before and after the intervention, as well as four weeks after the intervention, dietary self-efficacy, dietary self-care behavior, interdialytic weight gain, serum phosphorus, and serum potassium were assessed in both groups. Results: Significant differences over time and between groups were observed in dietary self-efficacy, interdialytic weight gain, serum phosphorus, and serum potassium. The interaction between time and group was also significant. While no significant differences were found over time in dietary self-care behavior, significant group differences and interaction effects between time and group were identified. Conclusions: The results indicate that the dietary self-care promotion program using an online community for hemodialysis patients is more effective in enhancing dietary self-efficacy and dietary self-care behavior compared to conventional treatment. This suggests the clinical applicability of the proposed dietary self-care promotion program.

Nowadays, healthcare-associated infections (HAIs) represent a major global public health problem and the burden of these infections is high. In order to reduce the incidence of HAIs and to prevent the spread antibi-otics resistant organisms is mandatory to develop surveillance systems. We undertook a retrospective case-control study of all patients presenting HAIs admitted in Intensive Care Unit (ICU) in order to assess risk factors associated with death among patients with HAIs. Patients admitted to Intensive Care Unit who died were more likely to present an infection with a multidrug resistant bacteria, an infection with Acineto-bacter baumannii, and to suffer from acute myocardial infarction. Among the patients enrolled in the study, a higher probability of death was also observed in association with certain gram-negative pathogens: Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. The longer the patient remains admitted in ICU, the higher the risk of getting an infection that can often become fatal. Acquiring a noso-comial infection also increases the length of hospitalization which will lead to increased financial damage.

Purpose of the study: to reveal how the transfusion and the refraining from it affects the neuro-vascular unit in the congenital heart defects correction with cardiopulmonary bypass. Materials and methods: in vitro research, we formed a model of a neurovascular unit, which contains neu-rons, astrocytes and endothelial cells. This cellular model was cultivated in hypoxia conditions with the oxygen saturation levels of 1, 2, 3, 4%. In addition, this unit was cultivated with the pa-tient's serum adding in two different groups - with minimal and maximal levels of system in-flammatory response that we estimated by IL-6 level. Results: We found that during incubation in hypoxic conditions, the level of transendothelial resistance changed in groups with oxygen levels of 1% and 2% only after 4 hours. When we cultivated neurovascular unit cells with patients' sera, we found a minimal level of transendothelial resistance at 4 hours that increased after 24 hours. Permeability analysis showed that its level significantly decreased in the 1% and 2% oxygen group at 60- and 90-minutes relative to the control group. Conclusion: the system inflammatory response has more expressed but less long effect on the neurovascular unit model than hypoxia.

Objective: To evaluate the effect of care bundles on treatment compliance and intestinal barrier function in patients with refractory septic shock in the intensive care units (ICUs). Methods: In this retrospective study, the clinical data of 94 patients with refractory septic shock admitted to our hospital between June 2020 and April 2022 were collected. Patients with routine nursing were included in the routine group, and those with care bundles were assigned to the care bundles group, with 47 cases in each group. Outcome measures included nursing efficiency, treatment compliance, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE II) score, intestinal barrier function, inflammation factor level, treatment outcome and complications. Results: Care bundles resulted in significantly higher nursing efficiency and treatment compliance versus routine care (P<0.05). Patients receiving care bundles showed significantly higher SOFA scores and APACHE II scores than those receiving routine care (P<0.05). Intestinal fatty-acid binding protein (I-FABP), diamine oxidase (DAO), lactate, endotoxin, and intestinal dysfunction scores in the care bundles group were significantly lower than those in the conventional group after treatment (P<0.05). Care bundles were associated with significantly lower levels of procalcitonin (PCT) and hypersensitive C-reactive protein (hsCRP), shorter time to symptom relief, ICU treatment time, and duration of mechanical ventilation, and lower 28-d morbidity and mortality versus routine care (P<0.05). Patients in the care bundles group had a significantly lower incidence of complications than those in the routine group (P<0.05). Conclusion: Care bundles effectively enhance treatment compliance, improve intestinal barrier function and treatment outcomes, reduce the inflammatory response, and decrease the risk of SOFA score, APACHE II score, and complications in patients with refractory septic shock.

Objective: To evaluate the effect of care bundles on treatment compliance and intestinal barrier function in patients with refractory septic shock in the intensive care units (ICUs). Methods: In this retrospective study, the clinical data of 94 patients with refractory septic shock admitted to our hospital between June 2020 and April 2022 were collected. Patients with routine nursing were included in the routine group, and those with care bundles were assigned to the care bundles group, with 47 cases in each group. Outcome measures included nursing efficiency, treatment compliance, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHE II) score, intestinal barrier function, inflammation factor level, treatment outcome and complications. Results: Care bundles resulted in significantly higher nursing efficiency and treatment compliance versus routine care (P<0.05). Patients receiving care bundles showed significantly higher SOFA scores and APACHE II scores than those receiving routine care (P<0.05). Intestinal fatty-acid binding protein (I-FABP), diamine oxidase (DAO), lactate, endotoxin, and intestinal dysfunction scores in the care bundles group were significantly lower than those in the conventional group after treatment (P<0.05). Care bundles were associated with significantly lower levels of procalcitonin (PCT) and hypersensitive C-reactive protein (hsCRP), shorter time to symptom relief, ICU treatment time, and duration of mechanical ventilation, and lower 28-d morbidity and mortality versus routine care (P<0.05). Patients in the care bundles group had a significantly lower incidence of complications than those in the routine group (P<0.05). Conclusion: Care bundles effectively enhance treatment compliance, improve intestinal barrier function and treatment outcomes, reduce the inflammatory response, and decrease the risk of SOFA score, APACHE II score, and complications in patients with refractory septic shock.