In this retrospective report we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21+4 to 22+5 and treated during their antenatal period, meanwhile the other two were admitted within 1 week postpartum. All of them were in a need of intensive care, one was treated with high flow oxygen therapy, the other four with invasive mechanical ventilation (three with endotracheal intubation and one with extra corporeal membrane oxygenation). Age above thirty, overweight and gestational diabetes are notable factors in the cases presented. At the time of admission, they all presented with symptoms as fever, cough and dyspnea. Chest imaging with computer tomography scan was performed in each case and demonstrated multifocal pneumonic infiltrates in all of them but no pulmonary embolism was confirmed in any. Neither did the echocardiogram indicates any cardiomyopathy. Four of the patients have been discharged from the hospital, with an average of 20 hospital days. One antenatal pregnant woman needed prolonged ECMO therapy, in gestational week 27+3 she went into cardiac arrest, resulting in an urgent c-section on maternal indication. At the time of writing she is still hospitalized. In coherence with other published reports our cases indicate that critically ill pregnant women infected by SARS-Cov-2 may develop severe respiratory distress syndrome requiring prolonged intensive care. The material is limited for conclusions to be taken, more detailed information on symptoms, treatment, and outcomes for pregnant and postpartum women managed in intensive care is therefore needed.

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

The challenge regarding COVID-19 is to prevent complications and fatal evolution. Azithromycin (AZM) and hydroxychloroquine (HCQ) have proven their antiviral effect in vitro. We aimed to assess the efficacy and safety of AZM alone or combined to HCQ, prescribed, at an early stage, in patients with Covid-19, in a primary care setting. Eighty-eight patients received either no or a symptomatic treatment (NST) (n=34) or AZM alone (n=34) or AZM+HCQ (n=20). The efficacy end point was the time to clinical recovery and the safety end point was the occurrence of cardiovascular events. The mean (SD) times to achieve clinical recovery were respectively 25.8 days (11.1), 12.9 days (13.4) and 9.2 days (9.3), showing a statistically significant difference between NST and AZM alone (p<0.0001) or AZM+HCQ (p<0.0001). To improve the evidence level, a case-control analysis was performed on a sample of 57 patients (19/group) matched for age, sex and BMI. The statistical difference between NST and AZM was confirmed (p=0.0149) as well as the difference with AZM+HCQ (p=0.0002). No cardiac toxicity was recorded in any patient. No statistical difference was shown between AZM and AZM+HCQ groups, although the dual therapy tended to be more effective in patients over 50 years, based on an analysis using the cox model. In conclusion, AZM and AZM+HCQ favourably impacted the course of the disease. We need trials, ideally prospective/double blind, to show if a statistical difference can be evidenced with a broader group, and clarify the indications of each treatment depending on initial clinical presentation.

Dental services are significantly impacted by the COVID-19 pandemic. Almost all dental procedures carry a high infection risk for providers and patients due to spread of aerosols. As a consequence, national public health agencies, and dental professional associations have issued guidelines for enhanced infection control, personal protection equipment and limiting care to urgent or emergency services. However, there is no dental service concept for disaster preparedness or response that might be applied. Similarly, pathways to care provision in a post-pandemic future are missing. We propose Safe Aerosol-free, Emergent Dentistry (SAFE Dentistry) as one approach to dental services during and emerging from pandemics. The concept’s starting point is the identification of the most common patient needs. The next step is to replace common treatments relating to the most common needs with alternative interventions with less infection risk because they do not generate aerosols. SAFE Dentistry is innovative, safe, and responds to the requirements of a pandemic and post-pandemic emergence where the risk of disease transmission remains high. SAFE Dentistry thereby ensures continuity of dental services while protecting providers and patients from infectious pathogens. Moreover, SAFE Dentistry allows dental service providers to remain operational and generate income even under pandemic conditions. Implementation and policy options for SAFE Dentistry include universal availability without co-payments by patients and a uniform bundled payment scheme for providers to simplify budgeting, reimbursement and to provide easier administration during a pandemic. Adaptations and adjustments of the concept are possible and encouraged, as long as the principle of avoiding aerosol-generation is maintained.

Nonpharmacological therapeutic interventions in elderly may lead to the reduction of cognitive and depressive symptoms. The aim of the study was to evaluate changes in cognitive functions and mood er or not. in older adults participating in therapy, conducted in the community day-care center (CD-CC). 46 elderly adults (21 M, 25 W) (SG) were examined. The control group (CG) included 45 adults (12 M, 33 W), who participated in the activities of the University of the Third Age (U3A). The following measuring tools were used: Mini-Mental State Examination (MMSE), Clock-Drawing Test (CDT), Verbal Fluency Test (VFT), Digit Span Test (DST), Stroop Color and Word Test (SCWT), Beck's Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS). The intervention consisted of CD-CC 6-month complex therapy. In the SG, compared to the CG, the scores on the: MMSE, CDT, VFT, DST, and SCWT were significantly lower (p<0,05), and BDI was significantly higher (p<0,05). After intervention, the SG and the CG, did not show substantial differences in their scores on the: MMSE, CDT, and BDI. In the SG, a significant improvement (p<0,05) was reported on the: VFT, BDI, and HADS scores. The CD-CC complex therapy can be helpful for the cognitive and emotional elderly functioning.

Among humans, simply looking at infants can activate affiliative and nurturant behaviors. However, it remains unknown whether mere exposure to infants also activates other aspects of the caregiving motivational system, such as generalized defensiveness in the absence of immediate threats. Here, we demonstrate that simply viewing faces of infants (especially from the ingroup) may heighten vigilance against social threats and support for institutions that purportedly maintain security. Across two studies, participants viewed and rated one among several image types (between-subjects design): infants, adult males, adult females, and puppies in Study 1, and infants of varying racial/ethnic groups (including one's ingroup) and puppies in Study 2. Following exposure to one of these image types, participants completed measures of intergroup bias from a range of outgroups that differed in perceived threat, belief in a dangerous world, right-wing authoritarianism and social-political conservatism (relative to liberalism). In Study 1 (United States), stronger affiliative reactions to images of infants (but not adults or puppies) predicted stronger perceptions of a dangerous world, endorsement of right-wing authoritarianism, and support for social-political conservatism (relative to liberalism). Study 2 (Italy) revealed that exposure to images of ingroup infants (compared to outgroup infants) increased intergroup bias against outgroups that are characterized as threatening (immigrants and Arabs) and increased conservatism. These findings suggest a predisposed preparedness for social vigilance in the mere suggested presence of infants e.g., viewing images, even in the absence of salient external threats.

This retrospective study evaluates the effect of a telemedicine program developed in the central Catalan region in lowering the environmental footprint by reducing the emission of atmospheric pollutants thanks to a reduction in the number of hospital visits involving journeys by road. Between January 2018 and June 2019 a total of 12,322 referrals were made to telemedicine services in the primary care centers, avoiding a total of 9,034 face-to-face visits. In total, the distance saved was 192,682 km, with a total travel time savings of 3,779 hours and a total fuel reduction of 11,754 liters with an associated cost of €15,664. This represents an average reduction of 3,248.3 g of carbon dioxide, 4.05 g of carbon monoxide, 4.86 g of nitric oxide and 3.2 g of sulphur dioxide. This study confirms that telemedicine reduces the environmental impact of atmospheric pollutants emitted by vehicles, reducing the number of journeys made for face-to-face visits and can contribute to environmental sustainability.

Background: Level of perceived competence as a basic psychological need could trigger achievement of diabetes self-management goals. Due to lack of a specific data collection tool to measure level of self-competence among Persian speaking patients with diabetes this study was conducted for cross-cultural adaptation and psychometric assessment of the Persian version of Perceived Competence Scale for Diabetes (PCSD-P). Methods: Standard translation/back-translation procedure was carried out to prepare a preliminary draft of the PCSD-P. Content and face validity of the early draft were checked by an expert panel including 15 scholars in the field of health education and promotion as well as nursing education with experience of working and research on diabetes. The final drafted questionnaire was completed by 177 randomly selected patients with type 2 diabetes. Based on the collected data structural validity of the contrived version was appraised using exploratory and confirmatory factor analysis (EFA, CFA). Cronbach's alpha and Intraclass Correlation coefficients (ICC) were used to check the scale’s reliability and internal consistency. ; (3) Results: The estimated measures of Content Validity Index (CVI= 0.95) and Content Validity Ratio (CVR= 0.8) were in the range of acceptable recommended limits. The EFA analysis results demonstrated a single factor solution according to the items’ loadings for the component. The model fit indices i.e. RMSEA= 0.000, CFI=1, TLI=1, GFI= 0.998, NFI= 0.999 RFI= 0.995 confirmed consistency of the hypothesized one-factor solution. Values of the internal consistency and reliability coefficients were also in the vicinity of acceptable range (α= 0.892, ICC=0. 886, P= 0.001). Conclusions: The study findings revealed good internal validity and applicability of the PCSD-P to measure degree of self-competence among Persian speaking type 2 diabetes patients to manage the chronic disease. Due to unrepresentativeness of the study sample future cross-cultural test of PCSD-P on diverse and broader Persian speaking populations is recommended.

Pharmacists and pharmacies are highly visible and accessible to the public and have long been regarded as a source for immunization services in the United States. As international travel continues to increase and grow in popularity in this country, there is a pressing need for expanded access to preventative health services including routine and travel vaccinations and medications for prophylaxis or self-treatment of conditions that may be acquired overseas. In the United States, the scope of pharmacy practice continues to expand and incorporate these preventable health services to varying degrees on a state-by-state level. As a result, pharmacists can help to increase access to and awareness of the need for these services to insure that patients remain healthy while traveling abroad and that they do not acquire a travel-related disease while on their trip. For those pharmacists interested in starting a travel health service, considerations should be undertaken that ensures that they have the necessary training, education, and skill set in order to provide this specialty level of care and that their practice setting is optimally designed to facilitate this service. Outcomes from studies that have evaluated pharmacy-based travel health services are positive, which further supports the role of the pharmacist in this setting. Therefore, the purpose of this paper is to highlight United States pharmacy laws and regulations, pharmacist training, travel clinic considerations, and patient care outcomes from pharmacy-based travel health services.

Malaysia became the centre of international attention when it democratically removed a semi-authoritarian government of 62 years during its 14th general election this year. This electoral success has provided geriatric medicine in Malaysia with the unexpected ageing icon in the oldest prime minister in the world. Political change has led to a wave of optimism for the expansion of geriatric services in Malaysia, which has met with numerous challenges in the last two decades. The number of geriatrics specialists and services had already begun expanding under the previous government. However, existing geriatricians will need to reassess the landscape of delivery and access of care in our rapidly growing ageing population and develop new strategies to truly expand their services. In addition to unrelenting efforts in the recruitment and training of future geriatricians, the steady expansion of the geriatric workforce should take into account the inclusion of geriatric medicine in the undergraduate training curricula of all healthcare professionals. Expansion of geriatric services will also be a cost-effective strategy to reduce the growing national healthcare budget incurred by the growing needs of an ageing population.

The research is carried out to assess factor affecting the health condition of the elderly people in the slum areas in Sylhet City. This research was quantitative type. In Quantitative approach, primary data were collected and used from the randomly selected elderly people in the Sylhet City slum areas. The secondary data were collected from many articles, documents, newspaper, magazine etc. By analyzing the survey data, it is illustrated that the slum dwellers are deprived from the basic needs. Meanwhile, elderly people can‟t fulfill their medical treatment due to their financial condition because of their work incompatibility. This study identifies the factor affecting health condition such as financial condition, lack of knowledge about proper medical facilities, communication gap between the authority and patient, unemployment, and so on. These factors also affect their health situation. Many diseases like asthma, heart disease are occurred. This study also mentions about the livelihood of slum people are so poor in condition. Due to financial condition, aged people can‟t take their proper treatment and their family member can‟t afford it. This study also understands that the people from slum areas are getting concerned about their medical care. They are easily going to the hospital and take their service because of low pricing. On the other hand, people are meanwhile stopped their treatment of financial situation. This study finds the health situation of elderly people at slum areas in metropolitan city and their consciousness.

Background: Ventilator-associated pneumonia (VAP) is among the most common healthcare-associated infections in Pediatric Intensive Care Units (PICUs). Because of the lack of a gold-standard diagnostic test, early diagnosis of VAP is challenging. We investigated whether bronchial biomarkers interleukin-4 (IL-4), plasminogen activator inhibitor-1 (PAI-1) and soluble receptor for advanced glycation end products (RAGE) could contribute in early VAP diagnosis through their fluctuation in time in critically ill pediatric patients. Methods: Bronchial secretions were collected from PICU patients with VAP on days 1 and 6. PAI-1, RAGE and IL-4 levels were measured by ELISA. Protein concentrations between high and low VAP suspicion patients were compared using unpaired Student’s t or Mann–Whitney U tests. Results: Twenty PICU patients, with median age 7.75yrs (range 0.5-15.3), mechanically ventilated for ≥48hrs with increased oxygenation requirements and VAP clinical/laboratory signs were enrolled. They were divided in VAP high-suspicion (n=12) or low-suspicion (n=8) groups based on Clinical Pulmonary Infection Score (cutoff:6). ΡΑΙ-1 και RAGE levels did not differ between high- or low-VAP suspicion groups the 1st or 6th days (p-value&gt;0.05). IL-4 was not detected in bronchial secretions. Conclusion: Bronchial concentrations of IL-4, PAI-1 and RAGE in critically ill children are not correlated with high- or low-VAP suspicion.

Objectives To develop and validate a prediction model for 28-day in-hospital mortality among adult patients critically ill with COVID-19 in the UK. Design Observational cohort study. Setting 287 adult critical care units in England, Wales and Northern Ireland, of which 260 admitted at least one eligible patient. Participants 10,933 patients with confirmed COVID-19 of whom 10,401 were eligible (excluding 532 patients with a duration of critical care less than 24 hours and 1 patient with unknown 28-day outcome): 8,666 development (March-April 2020) and 1,735 temporal validation (May-August 2020). Main outcome measures 28-day in-hospital mortality from start of critical care. Results Two models were developed using 14 patient level predictors selected from 30 candidate predictors, with and without adjustment for calendar time. In the temporal validation data, the model discrimination was maintained (c index 0.78) but calibration was poor, particularly for the model not adjusted for calendar time (ratio of observed to predicted mortality 0.74 versus 0.88 for the model adjusted for calendar time). Conclusions We developed and validated a prediction model for 28-day in-hospital mortality for patients critically ill with COVID-19. Although absolute predictions were inaccurate due to changing outcomes, the models will support risk-adjustment in analyses and monitoring changes in risk-adjusted outcome over time.

In the following article, we estimate the Renunciation of Healthcare Services-RHS in Italian regions in the context of the Environmental, Social and Governance-ESG model during the period 2004-2022. The data were acquired from the ISTAT-BES dataset. The data were analyzed using the following econometric techniques: Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Square-WLS,. Results show that RHS tends to growth with the E-Component, is negatively associated to the S-Component, and positively associate with the G-Component within the ESG model. Furthermore, a clusterization with the unsupervised k-Means algorithm is presented and the results are discussed with a confrontation between optimal and suboptimal k values optimized with the Silhouette Coefficient. Finally, a confrontation among eight different machine-learning algorithms is performed to predict the future value of RHS. Outcomes show that the Simple Regression Tree is the best predictive algorithm and that the level of RHS is predicted to growth on average of 4.4% for the Italian regions. Results are critically discussed.

Heel pain in the “funnel-shaped” space between the calcaneus, talus, and talocalcaneonavicular and subtalar joints may be representative of Sinus Tarsi syndrome. The pain is often characterized by a burning, numbness, or tingling sensation that can stem from strains and tears on the ligaments in that area. Injury treatment typically includes balance training, muscle exercises, bracing, foot orthosis, and non-steroidal anti-inflammatory drugs (NSAIDs). This study presents Wharton Jelly (WJ) tissue allografts as an alternative intervention for patients who fail standard-care treatments. WJ targets tissue defects, unlike other therapies, which aim to reduce swelling and symptomatic pain. This study includes five female patients who have previously failed standard-of-care treatment. Each received extracorporeal pulse-activated therapy (EPAT), WJ, laser therapy, and an orthotic. After an average of 80 days, the cohort had an overall 85.29% improvement in pain. The study's limitations include a small cohort size and a non-blinded design. Given the significant improvement in pain, WJ tissue allograft, combined with other techniques, presents an optimal patient care plan for tissue defects associated with Sinus Tarsi syndrome when standard-of-care treatments fail. These results provide evidence for a more extensive, randomized study to define dosage protocols further and confirm safety and efficacy.

In this article, we analyse the ESG determinants of the “Elderly People Treated in Integrated Home Care”-EPIHC in the Italian regions between 2004 and 2022. We used data from the ISTAT-BES database. We used different econometric techniques i.e.: Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS and Weighted Least Squares-WLS. The results show that the EPIHC is positively associated with “Nurses, midwives, and Soil sealing by artificial cover" and negatively associated with "Museum heritage density and relevance" and "Trust in law enforcement agencies and firefighters fire". Furthermore, we have applied a k-Means algorithm with the Silhouette Coefficient and we find the presence of two clusters. Finally, we propose a confrontation among eight different machine-learning algorithms and we find that Linear Regression is the best predictive algorithm.

In the following article, it is presented an investigation of the determinants of Beds for High-Care Specialties-BHCS in the Italian regions in the context of Environmental, Social and Governance-ESG approach. Data from ISTAT-BES for 20 countries in the period 2004-2021 are been used. Different econometric techniques have been applied i.e.: Pooled Ordinary Least Squares, Panel Data with Fixed Effects, Panel Data with Random Effects, Dynamic Panel at 1 stage. Furthermore, a cluster analysis performed with a k-Means algorithm optimized with the Silhouette Coefficient indicated the presence of three clusters. Finally, eight different machine-learning algorithms are analysed to predict the future value of BHCS. The results show that the Artificial Neural Network-ANN algorithm is the best algorithm. The future value of BHSC is expected to growth on average of 4.88% for the analysed regions.

The following article presents an analysis of the impact of the Environmental, Social and Governance-ESG determinants on Hospital Emigration to Another Region-HEAR in the Italian regions in the period 2004-2021. The data are analysed using Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Squares-WLS, and Dynamic Panel at 1 Stage. Results show that HEAR is negatively associated to E, positively to S and negatively associated to the G within the ESG model. The data were subjected to clustering with a k-Means algorithm optimized with the Silhouette coefficient. The optimal clustering with k=2 is compared to the sub-optimal cluster with k=3. The results suggest a negative relationship between the resident population and hospital emigration at regional level. Finally, a prediction is proposed with machine learning algorithms classified based on statistical performance. The results show that the Artificial Neural Network-ANN algorithm is the best predictor. The ANN predictions are critically analyzed in light of health economic policy directions.

In the following article, we analyse the determinants of the number of physicians in the context of ISTAT BES-Benessere Equo Sostenibile data among twenty Italian regions in the period 2004-2022. We apply Panel Data with Random Effects, Panel Data with Fixed Effects, and Pooled OLS-Ordinary Least Squares. We found that the number of Physicians among Italian regions is positively associated, among others, to “Trust in the Police and Firefighters”, “Net Income Inequality”, and negatively associated, among others, to “Research and Development Intensity” and “Soil waterproofing by artificial cover”. Furthermore, we apply the k-Means algorithm optimized with the Silhouette Coefficient and we find the presence of two clusters. Finally, we confront eight different machine-learning algorithms to predict the future value of physicians and we find that the PNN-Probabilistic Neural Network is the best predictive algorithm.

It is difficult to automatically recognize defects using digital image processing method in X-ray radiograph that tested from lap joint of unequal thickness plates. The continuous change of the wall thickness for the lap joint workpiece brings about the very different gray levels in X-ray background image. Besides, due to the shape and fixturing of the workpiece, the distribution of the weld seam in the radiograph is not vertical and results in an existence of a certain angle with the vertical direction. This makes it difficult for automatic defect detection and localization. In this paper, a method of X-ray image correction based on invariant moments is presented to solve the problem. In addition, an automatic defect detection method combined of image noise suppression, background removal, image segmentation and mathematical morphology is introduced. The results show that the proposed method can effectively recognize the gas pores in lap joint of unequal thickness and it is suitable for automatic detection.

The effect of spanwise wing non-planarity, implemented in conjunction with a Gurney flap is presented. Testing was undertaken in a low speed wind tunnel using a rectangular wing with an aspect ratio of 3. The outer 1/3 of the wing was non-planar which took the form of dihedral or a circular arc. A 2% high Gurney flap was implemented such that it could extend over the entire span, or the planar inboard section. Loads were measured using a sting balance. The data shows that non-planarity increases the maximum lift coefficient and the wing’s lift curve slope. Gurney flap lift modulation was enhanced in the presence of non-planarity. The addition of Gurney flaps caused a greater minimum drag coefficient increment for the non-planar wings. The Gurney flaps reduced the lift dependent drag of the wings; however, the minimum drag coefficient was observed to increase. The Gurney flaps reduced the maximum lift to drag ratio (L/D) for the non-planar wings; however, the flat wing showed a small L/D increment with flap addition.

The overall contribution of otolith receptors to eye movements, postural control and perceptual functions is the basis for clinical testing of otolith function. With such wide range of contributions, it is important to recognize that the functional outcomes of these tests may vary depending on the specific method employed to stimulate the hair cells. In this article, we review common methods used for clinical evaluation of otolith function and how different aspects of physiology may affect the functional measurements in these tests. We compare the properties and performance of various clinical tests with the emphasis on the newly-developed video ocular counter roll (vOCR), measurement of ocular torsion on fundus photography, and subjective visual vertical or horizontal (SVV/SVH) testing.

This research work has been based on a previous study by the authors that characterized the behavior of a polyimide-coated FBG sensor in a structural monitoring system. Sensors applied to structural health monitoring are affected in the presence of a state of multidirectional strains simultaneously. The previous study observed the influence of transverse strain (ε_y) while keeping longitudinal strain constant (ε_x), where the direction x is the direction of the optical fiber. The present study developed an experimental methodology which has consisted of carrying out a campaign of biaxial tests on cruciform specimens with three embedded FBG sensors coated with polyimide, acrylate and ORMOCER®. Applying the Strain–Optic Theory as reference, a comparison of the results obtained with the different coatings has been studied. This experimental work has done it possible to study the influence of transverse strain (ε_y) in the longitudinal measurement of each of the FBG sensor and the influence of the coating material. Finally, the calibration procedure as well as the strain sensitivity factor K for each sensor has been defined.

The APIS Breast Cancer Subtyping Kit is an mRNA-based assessment of the three biomarkers routinely assessed in all newly diagnosed breast cancers (BC), estrogen receptor (ER), progesterone receptor (PR), and HER2 as well as an additional four genes that create a novel proliferation signature, MKI67, PCNA, CCNA2, KIF23. Taken together the data is used to produce a molecular sub-type for every sample. The kit was evaluated against the current standard protocol of immunohistochemistry (IHC) and/or in situ hybridization (ISH) in breast cancer patients. The data was presented at the weekly breast Multidisciplinary Team (MDT) meeting. 98 consecutive cases of pre-operative breast cancer core biopsies and two core biopsy of nodal metastases yielding 100 cases were assessed. IHC and APIS Results were available for 100 and 99 cases. ER was concordant in 97% cases, PR in 89% and HER2 results were concordant with IHC/ISH in 100% of the cases. Ki-67 IHC was discordant in 3% cases when compared with MK167 alone but discordant in 24% when compared with the four gene proliferation signature. In conclusion, our study, indicates that the APIS Breast Cancer Subtyping Kit is highly concordant when compared to the results produced for ER/PR/HER2 by IHC and/or ISH. The assay could play a role in the routine assessment of newly diagnoses Breast Cancer (BC) specimens.

The issue of optimising the initial stand density (ISD) of tree plantations has high practical importance. The objective of this study was to nondestructively evaluate the influence of the initial stand density of Scots pine plantations located in the European part of the Russian Federation on wood basic density (BD), moisture content (MC), ultrasound velocity (UV), latewood content, and drilling resistance (DR). 45-year-old trees with stand densities of 500, 1000, 3000, 5000, and 10000 trees/ha were tested by a 5-cm-long core sample for gravimetric MCGM and BD, by PULSAR-2.2 for UV along the height (UVH) and through the tree trunk diameter (UVD), by the IML-RESI PD-400 tool for DR, and by GANN HT 85T for MC based on the electrical resistance method (MCERM). A significant influence of ISD was found on DBH, UVD, MCGM, and MCERM. ISD had no significant impact on BD, UVH, and DR. The wood BD ranged from 356 to 578 kg/m-3, with a mean value of 434±3.3 kg/m-3, and was restricted by the soil and environmental factors. DBH and 70% MCERM were good indicators of tree vitality. Linear correlations between DBH and MCERM (R2=0.67), DBH and MCGM (R2=0.74), DR and BD (R2=0.71), and the two-factor model MCGM=f(DBH, BD), (R2=0.76) were found.

Alternative food sources are essential in both low-resource settings or during emergencies like abrupt sunlight reduction scenarios. Seaweed presents a promising option but requires investigation into the viability of unconventionally sourced ropes for harvesting. As such, a low-cost reliable method to test the tensile strength of rope is needed to validate alternative materials for use in harvesting seaweed. Unfortunately, commercial rope testing jigs alone range in price from several thousand to tens of thousands of dollars. To fill this need, this article reports on an open-source design for tensile strength rope testing hardware. The hardware design focuses on using readily available parts that can be both sourced from a hardware store and manufactured with simple tools to provide for the greatest geographic accessibility. The jig design, which can be fabricated for CAD$20 is two to three orders of magnitude less expensive than commercially available solutions. The jig was built and tested using a case study example investigating denim materials (of 1 5/8”, 3 1/4", 4 7/8”, 6 1/2", and 8 1/8” widths) as a potential alternative rope material for seaweed farming. Denim demonstrated strength up to 1.65kN for the widest sample and the jig demonstrated sufficient strength and stiffness for operating at forces below 4kN. The results are discussed and areas for future improvements are outlined to adapt the device to other circumstances and increase the strength of materials that can be tested.

In this paper, we propose a method for the generation of simulation test scenarios for autonomous driving. Based on the requirements of standard regulatory test scenarios, we can generate virtual simulation scenarios and functional scenario libraries for autonomous driving, which can be used for simulation verification of different ADAS functions. Firstly, the design operation domain (ODD) of the functional scenario is selected and the weight values of the ODD elements taken are calculated; then a combination test algorithm based on parameter weights is improved to generate autonomous driving virtual simulation test cases for the ODD elements, which can effectively reduce the number of generated test cases compared with the traditional combination test algorithm; then the traffic participant elements under each test case are Then, the values of the subelements under the traffic participant element in each test case are sampled and clustered to obtain hazard specific scenarios. Finally, the specific scenarios are applied to the automatic emergency braking (AEB) system on the model-in-the-loop (MIL) testbed to verify the effectiveness of this scenario generation method.

A friction loss model for brake testing platform is constructed to revise the braking force test results, which can largely improve the accuracy of automotive brake performance testing. Specifically, the influence of tire pressure, vehicle axle load, placement angle and vehicle speed on the friction loss is tested and analyzed on a wheelbase adjustable automotive anti-force brake testing platform. The friction loss model for the platform is constructed based on the defined relative slip and placement angle, which is validated through actual tests on four types of vehicles. The results showed that the maximum relative error between the values of the model calculated simulation and the measured was 2.2%, indicating the friction loss model is valid and can provide a basis for revising the braking force of automotive brake. Meanwhile, the maximum braking force increases from 3982 N to 4772 N, increased by 19.8%, when the placement angle increased from 36.9° to 47.0°. Accordingly, in order to improve the accuracy of detection results of the automotive anti-force rolling brake testing platform, the friction loss caused by the change in the placement angle should be revised, and then braking rate of the vehicle should be judged according to GB 7258-2017 and GB 38900-2020.

With the continuous development of digital transformation and upgrading of Chinese construction enterprises, it is becoming increasingly important to measure their digital level, find the problems in the enterprise transformation process, and identify the key factors of enterprise digital capacity enhancement. This paper constructs a construction enterprise digital transformation maturity evaluation model from six first-level indicators and 20 second-level indicators, including digital strategy, digital business application, digital technology capability, data capability, digital organization capability, and change management. Digital maturity is divided into five levels: business management, process operation, intelligent construction, intelligent scene application, and industrial ecological collaboration. A detailed process of digital maturity evaluation based on the method of Analytic Hierarchy Process (AHP)-Decision Testing and Evaluation Laboratory (DEMATEL) is then developed. A questionnaire survey of 25 experts is used to weight the various parameters in the model, which is then demonstrated with an example construction enterprise. The model comprehensively reflects digital levels under the background of the digital economy. Its application will help understand the advantages and disadvantages enterprises face in their digital transformation to enable targeted measures to improve their digital transformation capabilities and efficiency, enhance their core competitiveness of enterprises, and promote the development of digital transformation in the construction industry.

Abstract Introduction: With the containment of the COVID-19 pandemic in Côte d'Ivoire, efforts were made to seamlessly integrate COVID-19 vaccination into the national immunization program. A collaborative initiative involving UNICEF, WHO, GAVI, and partner organizations resulted in the creation of the COVID-19 Vaccine Integration Mapping Tool. This paper presents a case study documenting the field testing of the Integration Mapping Tool and assessing the integration of COVID-19 vaccination within primary healthcare and routine immunization in Côte d'Ivoire. The study aims to describe the pilot process, gather feedback on tool usefulness and challenges, and establish integration priorities through roadmap development. Methods: Under the guidance of the Ministry of Health and Universal Coverage Cabinet, a workshop was conducted with participants from major health programs to field test the tool. Data analysis was performed using Excel, and the results were presented through tables, heat maps, and line graphs. Results: The first-of-its-kind field test of the Integration Mapping Tool in Cote d'Ivoire showcased its potential to bring key partners together to discuss the current state of integration, to improve transparency about resource allocation resource allocation, and enhance data management for the successful incorporation of COVID-19 vaccination into existing immunization systems. The integration of COVID-19 vaccines in Côte d'Ivoire showed a moderate level of progress, with improvement needed in resource allocation, payment systems, targeting of highest risk groups and vaccine administration. Support should be increased for target population identification, distribution points, quality of care mechanisms, and health personnel training. Health information systems and access to essential medicines were relatively satisfactory. Integration into existing programs, intersectoral collaboration, national health strategy, communication strategy, community participation, and data utilization require improvement. The post-workshop satisfaction survey gave the tool a score of .7 out of 10. Early lessons from Côte d'Ivoire provide guidance for enhancing integration, focusing on data-driven decision-making, collaboration, stakeholder engagement, and effective leadership. Conclusion: The successful field test of the Integration Mapping Tool (IMT) in Côte d'Ivoire marks a groundbreaking milestone, exemplifying the transformative potential of innovative tools in immunization practices. The IMT's application sets a precedent for seamless COVID-19 vaccination integration worldwide, emphasizing data-driven decision-making, collaboration, timing, and leadership. The pilot exercise's success in Côte d'Ivoire was attributed to political commitment, well-facilitated workshops, assessments, and the fact that the team in CI had previously already developed some initial integration plan.

In ancient buildings, timber members could need specific on-site interventions, including reinforcement or repair, sometimes inserting of reinforcing material into grooves routed in the original sound wood. Grooves number, positions and dimensions, and strengthening materials may differ, according to the desired increase of bending stiffness and strength. The Modulus-of-Elasticity (MOE) of each beam is of key importance, but the incisions can affect it, net of the reduction of the removed wood. In this study 12 old beams were accurately measured and their static and dynamic MOEs calculated before and after the grooves processing, to simulate the operations of typical reinforcing interventions. One groove was routed along the length of each beam and deepened progressively by three steps. Tests have showed how the MOE is affected by the groove depth, decreasing up to one third. The paper proves how the weakening effect of grooves on-site can be assessed with dynamic MOE and roughly predicted by means of visual survey. Grooves need for strengthening beams, must be carefully evaluated because of the variation of the actual mechanical properties, net to lost wood.

This paper presents the development of an underwater crack detection system for structural integrity assessment of submerged structures, like offshore oil and gas installations, underwater pipelines, underwater foundations for bridges, dams etc. Focus is on use of machine learning based approaches. First a detailed literature review of state of the current methods for underwater surface crack detection is presented highlighting challenges and opportunities. An overview of image augmentation approach for creation of underwater optical effects is also presented. Experimental results using standard network based machine learning approach, used for surface crack detection in onshore environment, is presented. Series of Test cases are presented where existing networks performance are improved using augmented images for underwater conditions. The experimental results demonstrate the effectiveness and accuracy of the proposed system in detecting cracks in underwater structures. The system has the potential to improve the safety and reliability of underwater structures and prevent catastrophic failures.

This paper proposes an optimal trading algorithm based on a novel application of the conventional Control Engineering (CE). We consider a fundamental CE concept, namely, the feedback control and apply it to the Algorithmic Trading (AT). The concrete feedback control strategy is designed in a form of the celebrated Proportional-Integral-Derivative (PID) model. The highly fluctuating nature of the modern financial markets has led to the adoption of a model-free realisation of the generic PID framework. The control theoretical methodology we propose is combined with the advanced statistics for the historical market data. We obtain a specific log-normal probability distribution function (pdf) associated with the specific quantities associated with the available stock data. The empirical log-normal pdf mentioned above makes it possible the necessary PID gains optimization. For this aim, we apply the data-driven optimization approaches and consider the corresponding Monte Carlo solution procedure. The optimized PID trading algorithm we propose is also studied in the Fourier analysis framework. This equivalent frequency domain representation involves a new concept in the financial engineering, namely, the "stock market energy" concept. For the evaluation, we implement the proposed PID optimal trading algorithm and develop a Python based prototype software. We finally apply the corresponding prototype software to a dataset from the Binance BTC / USDT stock market. The experimental result illustrates the implementability of the proposed optimal PID trading scheme and also shows the effectiveness of the proposed CE methods in the modern AT.

Scientific, technical and bioinformatics advances have made it possible to establish analytics-based molecular biosimilarity for the approval of biosimilars. If the molecular structure and other product- and process-related attributes are comparable within the limits of testing then a biosimilar candidate would have safe safety and efficacy as its reference products. The current model of animal and human testing becomes redundant since all of these studies have much lower sensitivity and reproducibility in confirming biosimilarity. The recent AI-based protein structure prediction model has confirmed that the 3D structure can be predicted from the amino acid sequence, reducing the need for structural analysis; however, the new test methods based on MS are millions of times more sensitive and accurate. While the regulatory agencies have begun waiving animal testing and, in some cases, clinical efficacy testing, removing clinical pharmacology profiling brings a dramatic paradigm shift, reducing development costs without compromising safety and efficacy. Also shared is a list of 160+ products ready to enter as biosimilars. Major actions from regulatory agencies and developers are required to make this paradigm shift.

Ayurveda as a healthcare system has survived for thousands of years but continues to be dogged by reported lack of efficacy of the treatments in clinical trials. The reported lack of efficacy could be due to a real lack of efficacy (which then contradicts the survival of Ayurveda as a functional medical system enjoying considerable public patronage) or could be attributed to inadequacies in the efforts towards evidence generation or in a larger context the overall scientific conduct of research in Ayurveda. In an effort towards better evidence generation, there is an immediate need for standardizing the design, conduct and reporting of clinical trials of Ayurveda but it is a daunting task. For this effort to benefit the scientific endeavors of Ayurveda researchers, it should allow the researchers to be able to apply Ayurveda’s multi-component, individualized and inherently holistic approach. Statistical principles can benefit this effort. Statistical hypothesis testing (SHT) is central to these statistical principles and also aligns well with conventional scientific principles of evidence generation. Although there are challenges with SHT, good practitioners engaged in it do much more than just apply the mathematical theory behind it. As a particular example, lot of time in clinical trial designing is spent in addressing biases and designing trials prudently by minimizing the effect of such biases. SHT can benefit such an effort objectively. There is a need for Ayurveda researchers to engage deeply and mindfully about biases in study design in order to gain scientific validity and acceptability. The article highlights issues that arise in Ayurveda research, and discusses few ways of dealing with these issues using statistical principles.

Alternating current field measurement (ACFM) testing is one of promising techniques in the field of non-destructive testing with advantages of the non-contact capability and the reduction of lift-off effects. In this paper, a novel crack detection approach is proposed to reduce the effect of the angled crack (cack orientation) by using rotated ACFM techniques. The sensor probe is composed of an excitation coil and two receiving coils. Two receiving coils are orthogonally placed in the centre of the excitation coil where the magnetic field is measured. It is found that the change of the x component and the peak value of the z component of the magnetic field when the sensor probe rotates around a crack follows a sine wave shape. A customised accelerated finite element method solver programmed in MATLAB is adopted to simulate the performance of the designed sensor probe which can significantly improve the computation efficiency due to the small crack perturbation. The experiments have also been carried out to validate the simulations. It is found that the ratio between the z and x components of the magnetic field remains stable under various rotation angles. It shows the potential to estimate the depth of the crack from the ratio detected by combining the magnetic fields from both receiving coils (i.e., the x and z components of the magnetic field) using the rotated ACFM technique.

3D-printed aluminium alloy fabrications made by selective laser melting (SLM) offer a promising route for the production of small series of custom-designed heat exchangers with complex geometry and shape and miniature size. Alloy composition and printing parameters need to be optimized to mitigate fabrication defects (pores and microcracks) and enhance the part performance. The deformation response needs to be studied with adequate characterization techniques at relevant dimensional scale capturing the peculiarities of micro-mechanical behavior relevant to the particular article and specimen dimensions. Purposefully designed Al-Si-Mg 3D-printable RS-333 alloy was investigated with a number of microscopy techniques including in situ mechanical testing with a Deben Microtest 1 kN stage integrated and synchronized with Tescan Vega3 SEM to acquire high resolution image datasets for Digital Image Correlation (DIC) analysis. Dog bone specimens were 3D-printed in different orientation of gauge zone cross-section with respect to the fast laser beam scanning and growth directions. This corresponds to varying local conditions of metal solidification and cooling. Specimens show variation in mechanical properties, namely, Young’s modulus (65…78 GPa), yield stress (80–150 MPa), ultimate tensile strength (115–225 MPa) and elongation at break (0,75–1,4 %). Furthermore, the failure localization and character was altered with the change of gauge cross-section orientation. DIC analysis allowed correct strain evaluation that overcame the load frame compliance effect and helped to identify the unevenness of deformation distribution (plasticity waves) that ultimately resulted in exceptionally high strain localization near the ultimate failure crack position.

Electromagnetic sensors have been used for inspecting small surface defects of metals. Based on the eddy-current thin-skin regime, a revised algorithm is proposed for a triple-coil drive-pickup eddy-current sensor scanning over long surface crack slots (10 mm) with different rotary angles. The method is validated by the voltage measurement of the designed EC sensor scanning over a benchmark (ferromagnetic) steel with surface defects of different depths and rotary angles. With an additional sensing coil for the designed EC sensor, the defect angle (or orientation) can be measured without spatially and coaxially rotating the excitation coil. By referring to the voltage change (due to the defect) diagram (voltage sum versus voltage different) of two sensing pairs, the rotary angle of the surface crack is retrieved with a maximum residual deviation of 3.5 %.

For the electromagnetic eddy current testing, various methods have been proposed for reducing the lift-off error on the measurement of samples. In this paper, instead of eliminating the measurement error caused by the lift-off effect, an algorithm has been proposed to directly measure the lift-off distance between the sensor and non-magnetic conductive plates. The algorithm is based on a sample-independent inductance (SII) feature. That is, under high working frequencies, the inductance is found sensitive to the lift-off distance and independent of the test piece under an optimal single high working frequency (43.87 kHz). Furthermore, the predicted lift-off distance is used for the thickness prediction of the non-magnetic conductive samples using an iterative method. Considering the eddy current skin depth, the thickness prediction is operated under a single lower frequency (0.20 kHz). As the inductance has different sensitivities to the lift-off and thickness, the prediction error of the sample thickness is different from that of the lift-off distance. From the experiments on three different nonmagnetic samples – aluminium, copper, and brass, the maximum prediction error of the lift-off distance and sample thickness is 1.1 mm and 5.42 % respectively at the lift-off of 12.0 mm.

This report describes the collection of a large dataset (6930 measurement) on dimensional error in the fused deposition modeling (FDM) additive manufacturing process for full-density parts. Three different print orientations were studied, as well as seven raster angles (0°, 15°, 30°, 45°, 60°, 75°, and 90°) for the rectilinear infill pattern. All measurements were replicated ten times on ten different samples to ensure a comprehensive dataset. Eleven polymer materials were considered: acrylonitrile butadiene styrene (ABS), polylactic acid (PLA), high-temperature PLA, wood-composite PLA, carbon-fiber-composite PLA, copper-composite PLA, aluminum-composite PLA, high-impact polystyrene (HIPS), polyethylene terephthalate glycol-enhanced (PETG), polycarbonate, and synthetic polyamide (nylon). The samples were ASTM-standard impact testing samples, since this geometry allows the measurement of error on three different scales; the nominal dimensions were 3.25mm thick, 63.5mm long, and 12.7mm wide. This dataset is intended to give engineers and product designers a benchmark for judging the accuracy and repeatability of the FDM process for use in manufacturing of end-user products.

Continuous ultrasonic in-situ monitoring for industrial applications is difficult owing to the high operating temperatures in industrial fields. It is expected that ultrasonic transducers consisting of CaBi4Ti4O15(CBT)/Pb(Zr,Ti)O3(PZT) sol-gel composite could be one solution for ultrasonic nondestructive testing (NDT) above 500 C because no couplant is required and CBT has a high Curie temperature. To verify the high temperature durability, CBT/PZT sol-gel composite films were fabricated on titanium substrates by spray coating, and the CBT/PZT samples were tested in a furnace at various temperatures. Reflected echoes with a high signal-to-noise ratio were observed up to 600 C. A thermal cycle test was conducted from room temperature to 600 C, and no significant deterioration was found after the second thermal cycle. To investigate the long-term high-temperature durability, a CBT/PZT ultrasonic transducer was tested in the furnace at 600 °C for 36 h. Ultrasonic responses were recorded every 3 h, and the sensitivity and signal-to-noise ratio were stable throughout the experiment.

Dietary supplements are widely embraced by cancer patients seeking complementary and integrative approaches to their care. Unfortunately, many patients do not discuss supplement use with physicians, often due to perceptions of physician indifference or negativity toward supplements. This communication gap exposes patients to unreliable information sources and, potentially, unnecessary risk. As the healthcare landscape evolves, patients increasingly value physicians who recognize their pivotal role in shaping healthcare decisions. This patient-centered perspective emphasizes the provision of evidence-based information tailored to individual needs, open discussions on potential risks, and shared decision-making. It underscores the importance of respecting patient autonomy, offering alternative options, documenting preferences, and ensuring ongoing support while coordinating with the healthcare team. To address these needs, healthcare providers should transform their perspectives and become expert guides who embrace patients as informed, empowered participants. This approach prioritizes open dialogue that considers both facts and uncertainties regarding dietary supplement use, allowing for mutually informed decision-making. Here, we review the literature and present a practical approach emphasizing open discussions, transparency, and respect for patient autonomy. Following this approach, healthcare providers can empower patients to navigate the complexities of dietary supplement use in the context of cancer care, ultimately safeguarding patient safety and well-being.

Hydrogen and carbon monoxide over-equilibria have been found computationally in kinetic dependencies of methane reforming catalytic reactions (steam and dry reforming) using conditions of the conservatively perturbed equilibrium (CPE) phenomenon, i.e. at the initial equilibrium concentration of hydrogen or carbon monoxide.  The influence of pressure, temperature, flow rate and composition of the initial mixture on the position of the CPE point (the extremum point) was investigated in a wide domain of parameters. It is demonstrated that the CPE phenomenon significantly increases the product concentration (H2 and CO) at the reactor length which is significantly less than the reactor length required to reach the equilibrium. The CPE-point was interpreted as the “turning point” in kinetic behavior.  Recommendations on the temperature and pressure regimes are different from the traditional ones related to the Le Chatelier’s law. Obtained results provide valuable information on optimal reaction conditions for complex reversible chemical transformations, offering potential applications in chemical engineering processes.

In this article, we consider a class of nonsmooth interval-valued multiobjective semi-infinite programming problems with vanishing constraints (in short, NIMSIPVC). We introduce the VC-Abadie constraint qualification (in short, VC-ACQ) for NIMSIPVC and employ it to establish Karush-Kuhn-Tucker (in short, KKT)-type necessary optimality conditions. Related to NIMSIPVC, we formulate interval-valued vector Lagrange type dual and scalarized Lagrange type dual problems. Subsequently, we establish weak, strong, and converse duality results relating NIMSIPVC and corresponding dual problems. In addition, we introduce the notions of saddle points for interval-valued vector Lagrangian and scalarized Lagrangian of NIMSIPVC. Moreover, we establish the saddle point optimality criteria for NIMSIPVC. Various non-trivial examples are provided to demonstrate the validity of established results. To the best of our knowledge, optimality conditions, Lagrange type duality, and saddle point optimality criteria for NIMSIPVC have not been investigated yet via Clarke subdifferentials.

Asphaltene-resin-paraffin deposition (ARPD) is a complicated and prevalent issue in oil and gas industry, impacting the efficiency, integrity of petroleum extraction, production, transportation and processing systems. Considering all witnessed ARPD problems in Azerbaijan oil fields, this paper proposed a chemical method and optimized the type and the concentration of chemical inhibitors. And then the effect of selected chemical reagent on inhibiting the ARPD amount and thus en-hancing oil recovery was detected by reservoir simulation during both waterflooding and CO2 flooding production. Three new chemical compounds (namely, Chemical-A, Chemical-B and Chemical-C) were examined in laboratory conditions and their impact on rheological properties of high-paraffin oilfield samples of Azerbaijan (X, Y and Z) were investigated. Experimental results show that Chemical-C with concentration of 600 g/t has the best efficiency for alleviating the problems. After adding Chemical-C to the crude oil, the freezing point of oil is decreased from 12 °C to (-4) °C, ARPD amount is declined from 0.185 to 0.016 g and oil effective viscosity is reduced from 16.2 mPa·s to 3.1 mPa·s. It is determined that for water and CO2 flooding, higher injection pressure resulted in reduced asphaltene precipitation. Adding selected ARPD inhibitor, the oil recovery for waterflooding can increase from 52% to 62%, while it can rise from 55% to 68% for CO2 flooding.

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&lt;.05, η2p=.08] and on environment [F(3,97)=2.80, p&lt;.05, η2p=.08] and marital status on social relationships [F(1,97)=9.66, p&lt;.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&lt;.05, η2p=.05) and education a significant moderate to strong effect on psychological health (F(2,97)=3.74, p&lt;.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.

Chronic wounds have a significant impact on patients' quality of life, necessitating the management of pain, infection, bleeding, and emotional challenges. Debridement, which involves the removal of nonviable tissue, is crucial for promoting wound healing. In addition to surgical methods, cost-effective alternatives such as local solutions and ointments with biological properties have been explored. The use of natural compounds with anti-inflammatory, antibacterial, and collagen-synthesizing abilities holds promise for wound healing. This study aimed to assess the safety and effectiveness of a wound-healing ointment containing bioactive ingredients derived from medicinal plants (extracts, essential oils, and vegetable oils). Pre-clinical tests were conducted following standardized protocols. The chemical composition of the ointment was characterized using Fourier transform infrared (FTIR) spectroscopy to gain insights into its synergistic action. FTIR analysis revealed similarities between the product's spectrum and that of bioactive compounds. The in vitro tests demonstrated that all formulations of the ointment induced no cell death, DNA damage, or acute toxicity in cell cultures. No lethal dose was observed, indicating the safety of the ointment at all concentrations. In vivo preclinical analyses demonstrated no adverse responses being effective in the healing process, similar to the gold standard (Silver Sulfadiazine). The regenerative ointment displayed excellent biocompatibility and bioactivity in vitro and in vivo studies, contributing to the development of innovative and sustainable wound management therapies.

Background/Objectives: Successfully weaning patients with prolonged mechanical ventilation (PMV: ≥21 days) from ventilators is a challenging process, and proper nutritional support is a crucial factor in this process. Previous studies have highlighted the significance of higher albumin levels and increased daily protein intake in predicting successful weaning among PMV patients. However, the importance of calorie intake in patients with PMV has remained unclear. Methods: This retrospective study included 1,038 adult patients (age >18 years) who underwent endotracheal intubation or tracheostomy and required mechanical ventilation for >21 days. Baseline characteristics, nutritional variables, disease severity, management factors and patient outcomes (hospital stay and duration of ventilator use) were analyzed between the weaning-failure and weaning-success sub-cohorts and factors associated with successful weaning were identified. Results: The participants had mean APACHE II score of 18 and a Day 1 SOFA score of 4.9 and the successful weaning rate was 70%. Multivariate logistic regression analysis revealed that higher albumin and hemoglobin levels, the absence of shock, less positive fluid status, and higher calorie intake were associated with a higher successful weaning rate; an average calorie intake higher than 25 kcal/kg/day during respiratory care center (RCC) stay predicted better successful ventilator weaning. Conclusions: Higher daily calorie intake in the RCC is associated with more successful ventilator weaning, and an average intake exceeding 25 kcal/kg/day is recommended for optimizing the weaning process.

Background: Family and Community Nurse specialists are advocates of a holistic model of care in multidisciplinary primary care teams. The study aimed to describe and understand the experiences and perceptions of family and community nurse specialists with regard to their employment situation in primary care teams in Spain; Methods: A Qualitative descriptive study was conducted. Eighteen family and community specialist nurses from different autonomous communities in Spain participated. Individual interviews and a focus group were conducted; Results: The results showed two themes and four sub-themes: 1) Current work situation of the Family and Community Nursing specialist: a) The lack of social and work recognition, and b) The advantages of working with Family and Community Nursing specialists; and 2) Support network and system of rejection: a) Systematic ambivalence towards Family and Community Nursing and b) Need for institutional support. Conclusions: Their inclusion in primary care teams fosters the nurse-patient bond, increases and/or maintains patient quality of life and promotes patient health empowerment. However, there is a great lack of knowledge on the part of society and health administrations regarding the functions of these nurses.

Patients who survived critical COVID-19 frequently reported post-acute sequelae of COVID-19 (PASC) such as psychosomatic and neurocognitive health problems. The goal of this study was to identify clinical risk factors and other predictors for such long-term consequences in severely ill COVID-19 patients. Adult COVID-19 intensive care unit (ICU) survivors from August 2020 to May 2021 were enrolled. A broad range of clinical, laboratory and chest computed tomography (CT) data was collected during ICU stay. The association between ICU predictors and psychosomatic, respiratory and neurocognitive assessments 12 months after ICU discharge was analyzed using univariate regression analysis. In 17 patients (mean age 58.9 ± 11.4 years), laboratory markers (CRP, lymphocytes, hemoglobin), ICU severity (SOFA, SAPS II, need for mechanical ventilation), complications (ARDS), and lung CT data (ground-glass opacity) were promising predictors of depressive and anxiety symptoms, fatigue, and sleep problems. Recovery of psychosomatic health such as fatigue, depression and anxiety correlated with lower levels of inflammation and high hemoglobin levels. ARDS, mechanical ventilation and worse SOFA and SAPS II scores were further risk factors for depressive and anxiety symptoms. Our study identified novel associations such as pulmonary ground-glass opacity being positively associated with depression, anxiety, fatigue, and insomnia levels.

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.