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We study the response of a quantitative trait to exponential directional selection in a finite haploid population, both at the genetic and the phenotypic level. We assume an infinite sites model, in which the number of new mutations per generation in the population follows a Poisson distribution (with mean Θ) and each mutation occurs at a new, previously monomorphic site. Mutation effects are beneficial and drawn from a distribution. Sites are unlinked and contribute additively to the trait. Assuming that selection is stronger than random genetic drift, we model the initial phase of the dynamics by a supercritical Galton-Watson process. This enables us to obtain time-dependent results. We show that the copy-number distribution of the mutant in generation n, conditioned on non-extinction until n, is described accurately by the deterministic increase from an initial distribution with mean 1. This distribution is related to the absolutely continuous part W+ of the random variable, typically denoted W, that characterizes the stochasticity accumulating during the mutant's sweep. A suitable transformation yields the approximate dynamics of the mutant frequency distribution in a Wright-Fisher population of size N. Our expression provides a very accurate approximation except when mutant frequencies are close to 1. On this basis, we derive explicitly the (approximate) time dependence of the expected mean and variance of the trait and of the expected number of segregating sites. Unexpectedly, we obtain highly accurate approximations for all times, even for the quasi-stationary phase when the expected per-generation response and the trait variance have equilibrated. The latter refine classical results. In addition, we find that Θ is the main determinant of the pattern of adaptation at the genetic level, i.e., whether the initial allele-frequency dynamics are best described by sweep-like patterns at few loci or small allele-frequency shifts at many. The number of segregating sites is an appropriate indicator for these patterns. The selection strength determines primarily the rate of adaptation. The accuracy of our results is tested by comprehensive simulations in a Wright-Fisher framework. We argue that our results apply to more complex forms of directional selection.
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Modelos Genéticos , Herencia Multifactorial , Selección Genética , Mutación , Haploidia , Carácter Cuantitativo Heredable , Genética de Población , FenotipoRESUMEN
Fludarabine (FA) is still considered as a first-line chemotherapy drug for hematological tumors related to B lymphocytes. However, it is worth noting that the non-specific distribution and non-different cytotoxicity of FA may lead to irreversible consequences such as central nervous system damage such as blindness, coma, and even death. Therefore, it is very important to develop a system to targeting delivery FA. In preliminary studies, it was found that B lymphoma cells would specific highly expressing the sialic acid-binding immunoglobulin-like lectin 2 (known as CD22). Inspired by the specific recognition of sialic acid residues and CD22, we have developed a supramolecular prodrug based on polysialic acid, an endogenous biomacromolecule, achieving targeted-therapy of B-cell non-Hodgkin's lymphoma (B-NHL). Specifically, the prepared hydrophobic reactive oxygen species-responsive FA dimeric prodrug (F2A) interacts with the TPSA, which polysialic acid were modified by the thymidine derivatives, through non-covalent intermolecular interactions similar to "Watson-Crick" base pairing, resulting in the formation of nanoscale supramolecular prodrug (F@TPSA). Cell experiments have confirmed that F@TPSA can be endocytosed by CD22+ B lymphoma cells including Raji and Ramos cells, and there is a significant difference of endocytosis in other leukocytes. Furthermore, in B-NHL mouse model, compared with FA, F@TPSA is determined to have a stronger tumor targeting and inhibitory effect. More importantly, the distribution of F@TPSA in vivo tends to be enriched in lymphoma tissue rather than nonspecific, thus reducing the leukopenia of FA. The targeted delivery system based on PSA provides a new prodrug modification strategy for targeted treatment of B-NHL.
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Linfoma de Células B , Profármacos , Profármacos/química , Profármacos/farmacología , Animales , Ratones , Humanos , Línea Celular Tumoral , Linfoma de Células B/tratamiento farmacológico , Ácidos Siálicos/química , Ácidos Siálicos/farmacología , Lectina 2 Similar a Ig de Unión al Ácido Siálico , Antineoplásicos/farmacología , Antineoplásicos/química , Nanopartículas/química , Medicina de Precisión/métodos , Sistemas de Liberación de Medicamentos/métodos , Ratones Endogámicos BALB C , Especies Reactivas de Oxígeno/metabolismo , Linfoma no Hodgkin/tratamiento farmacológicoRESUMEN
INTRODUCTION: Dialysis adequacy is traditionally calculated from pre- and post-hemodialysis session serum urea concentrations and expressed as the urea reduction ratio, or Kt/Vurea. However, with increasing hemodiafiltration usage, we wished to determine whether there were any differences between standard Kt/Vurea equations and directly measured spent dialysate urea clearance. METHODS: Urea clearance was measured from collected effluent dialysate and compared with various other methods of Kt/Vurea calculation, including change in total body urea from measuring pre- and post-total body water with bioimpedance and the Watson equation, by standard Kt/V equations, and online clearance measurements using effective ionic dialysance (OLC). RESULTS: We compared urea clearance in 41 patients, 56.1% male, mean age 69.3 ± 12.6 years with 87.8% treated by hemodiafiltration. Reduction in total body urea was greater when estimating changes in total body urea, compared to measured dialysate losses of 58.4% (48.5-67.6) vs 71.6% (62.1-78), p < 0.01. Sessional urea clearance (Kt/Vurea) was greater using the online Solute-Solver program compared to OLC, median 1.45(1.13-1.75) vs 1.2 (0.93-1.4), and 2nd generation Kt/V equations 1.3 (1.02-1.66), p < 0.01, but not different from estimated total body urea clearance 1.36 (1.15-1.73) and dialysate clearance 1.36 (1.07-1.76). The mean bias compared to the Solute-Solver program was greatest with OLC (-0.25), compared to second-generation equations (-0.02), estimated total body clearance (-0.02) and measured dialysate clearance (-0.01). CONCLUSION: This study demonstrated that the result from equations estimating urea clearance indirectly from pre- and postblood samples from hemo- and hemodiafiltration treatments was highly correlated with direct measurements of dialysate urea clearance.
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CONCLUSION: There were significant differences between Vwat and Vbis and between Kt/Vwat and Kt/Vbis. Kt/Vwat may underestimate small-solute dialysis adequacy in most cases. Kt/Vbis instead of Kt/Vwat could be accounted for in creating individualized dialysis prescriptions if the patient has no obvious clinical symptoms.
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Diálisis Peritoneal , Urea , Humanos , Composición Corporal , Diálisis Renal/métodos , Análisis EspectralRESUMEN
BACKGROUND: The incidence of total hip arthroplasty (THA) in the United States continues to increase due to its ability to markedly improve patients' quality of life. This study investigated and compared the perioperative and postoperative outcomes of simultaneous (SI-THA) and staged (ST-THA) bilateral THA procedures using an anterior-based muscle-sparing (ABMS) approach. METHODS: This retrospective case control study evaluated perioperative and postoperative outcomes from primary bilateral SI-THA or ST-THA (within 365 days) performed with the ABMS approach by 3 surgeons at a single institution between January 2013 and August 2020. A total of 226 patients (113 in each cohort) were matched based on age, sex, body mass index, and comorbidity score. RESULTS: Compared to the ST-THA group, the SI-THA had shorter anesthesia duration (P < .001) and shorter length of stay (P < .001), but longer length of surgery (P = .002). There was no statistical significance between groups in blood transfusion rates, discharge dispositions, emergency department visits, hospital readmissions, or postoperative complications within one year. CONCLUSIONS: The results of this study demonstrate that SI-THA and ST-THA yield comparable results using the ABMS approach. Our perioperative and postoperative results suggest low rates of complications, emergency department visits, readmissions, and high rates of patient satisfaction scores. Therefore, both SI-THA and ST-THA can be considered by experienced surgeons as treatment for advanced bilateral hip arthritis.
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Artroplastia de Reemplazo de Cadera , Humanos , Artroplastia de Reemplazo de Cadera/efectos adversos , Estudios Retrospectivos , Estudios de Casos y Controles , Calidad de Vida , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , MúsculosRESUMEN
Objective: The purpose of this case report was to evaluate the effect of telehealth and postpartum care provided to a mother with maternal depression according to Watson's Theory of Human Caring during the pandemic on the improvement in the mother's emotional state and to evaluate the applicability of the model. Methods: Edinburgh Postnatal Depression Scale was administered to eight women who responded to the announcement made on social media, and verbal and written permission was obtained from the mother with the highest scale score. A total of six video calls were made with the mother via WhatsApp, twice a week in the first week after postnatal discharge and once a week in the next 4 weeks, in accordance with the form drawn up according to Watson's Theory of Human Caring. Results: In this study, it was observed that home-based telehealth and postpartum care provided using Watson's Theory of Human Caring, which includes a holistic approach, was very useful, and the care provided according to the model provided a positive improvement in the emotional state of the mother with depression. Conclusions: It was concluded that telehealth and postpartum care is useful in home-based care in extraordinary situations/quarantine conditions such as pandemic; care can also be provided in the form of telehealth service according to Watson's Theory of Human Caring to mothers with depression; and care provides positive improvement in the emotional state of mothers.
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Teoría de Enfermería , Telemedicina , Humanos , Femenino , Embarazo , Madres , Pandemias , Atención PosnatalRESUMEN
AIMS AND BACKGROUND: This study investigated the impact of the Mindful Self-Compassion Program, based on Watson's Theory of Human Caring Model, on the physical and mental health of nursing students. The essence of nursing is care and compassion. While there are studies on compassion in nursing care, nurses' self-compassion is an underrecognized concept in the literature. METHODS: The study employed a randomized controlled design and involved 80 seconds-grade nursing students from a university in Turkey between December 2021 and June 2022. The intervention group received an online program consisting of six weekly sessions, while the control group did not receive any intervention. The data were collected using the Promotive and Protective Health Behaviors Scale, Watson Caritas Self-Rating Score, Brief Resilience Scale, and Self-Compassion Scale before, at the end of, and 5 months after the program. RESULTS: In both the post-test and follow-up test, the intervention group exhibited an increase in health-promoting and protective behaviors, self-care perception, psychological resilience, and self-compassion compared to the control group. CONCLUSION: Therefore, it is recommended to use the program to improve the physical and mental health of individuals in nursing practice areas. Additionally, it would be beneficial to include the program in the nursing education curriculum. Our findings provide evidence supporting the use of the program for nursing students and nurses.
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Empatía , Atención Plena , Estudiantes de Enfermería , Humanos , Estudiantes de Enfermería/psicología , Turquía , Femenino , Masculino , Adulto , Bachillerato en Enfermería , Adulto Joven , Resiliencia PsicológicaRESUMEN
BACKGROUND: Caring for people with schizophrenia is accompanied by challenges that impact caregiver health. We conducted this study to explore the effect of a Caring Science-Based health promotion program on the sense of coherence and well-being among caregivers of persons with schizophrenia. METHODS: This randomized clinical trial with the Solomon four-group design was conducted on 72 caregivers randomly allocated into two intervention and two control groups. A health promotion program based on Watson's theory was performed individually through five face-to-face sessions and a four-week follow-up. Settings were the psychiatric centers of the three educational, specialty, and subspecialty Ibn-e-Sina, Moharary, and Hafez hospitals affiliated with Shiraz University of Medical Sciences (SUMS), south of Iran. The data were collected using a demographic information form, the Sense of Coherence Scale, and the Caregiver Well-Being Scale. One-way ANOVA, chi-square, Kruskal-Wallis, and independent t-test were used to determine the homogeneity at baseline. In the post-test, multiple between-groups and pairwise comparisons were assessed by One-way ANOVA and Tukey's post-hoc. Within-group comparisons were evaluated using paired t-tests. All tests were two-tailed, and the statistical level was considered 0.05. RESULTS: Data analysis showed that the mean scores of caregiver sense of coherence and well-being from pre-intervention to post-intervention were significantly increased in the intervention groups (p < 0.001). At the same time, there were no significant differences in the control groups. CONCLUSION: The health promotion program based on Watson's human caring theory facilitated ongoing intrapersonal, and holistic caring and improved the sense of coherence and well-being in caregivers of persons with schizophrenia. Hence, this intervention is recommended for developing healing care programs. TRIAL REGISTRATION: https://www.irct.ir/trial/55040 : IRCT20111105008011N2 (11/04/2021).
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Esquizofrenia , Humanos , Esquizofrenia/terapia , Cuidadores , Promoción de la Salud , Análisis de Varianza , Grupos ControlRESUMEN
Wet air oxidation (WAO) is a clean and eco-friendly technology for dyes removal, but the high operating temperature and pressure limit its practical application. In the present work, an electric field-promoting (EF-promoting) catalytic WAO process is developed to degrade dyes under room condition. The oxidation kinetics of four different types of dyes and their degradation pathways are studied. A kinetic model is constructed by including the exogenous electric field into the Langmuir-Hinshelwood-Hougen-Watson (LHHW) mechanism framework, and quantitative structure-activity relationship (QSAR) analysis is conducted to correlate the kinetic parameters to the physicochemical properties of the dyes. A negative linear relationship is found between the adsorption equilibrium constants of the dyes and their first ionization energies, and their surface reaction rate constants are positively linearly associated to Esum (ELUMO + EHOMO). The degradation pathways of the different dyes are proposed according to the degradation intermediates and the activities of the atoms within the dye molecules. The heteroatoms N and S, and the atom C connecting the aromatic rings are identified as the susceptible sites upon the electrophilic attack of O2. Bond cleavage at these sites gives rise to aromatic fragments which are eventually mineralized via carboxyl acids. The results of this work is helpful for guiding the design and operation of the EF-promoting catalytic WAO process into the treatment of various dye wastewaters.
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Colorantes , Contaminantes Químicos del Agua , Cinética , Colorantes/química , Oxidación-Reducción , Aguas Residuales , Catálisis , Contaminantes Químicos del Agua/químicaRESUMEN
This paper addresses the problem of estimating the conditional survival function of the lifetime of the subjects experiencing the event (latency) in the mixture cure model when the cure status information is partially available. The approach of past work relies on the assumption that long-term survivors are unidentifiable because of right censoring. However, in some cases this assumption is invalid since some subjects are known to be cured, e.g., when a medical test ascertains that a disease has entirely disappeared after treatment. We propose a latency estimator that extends the nonparametric estimator studied in López-Cheda et al. (TEST 26(2):353-376, 2017b) to the case when the cure status is partially available. We establish the asymptotic normality distribution of the estimator, and illustrate its performance in a simulation study. Finally, the estimator is applied to a medical dataset to study the length of hospital stay of COVID-19 patients requiring intensive care.
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COVID-19 , Modelos Estadísticos , Humanos , Simulación por Computador , Análisis de SupervivenciaRESUMEN
This case involved a 17-month-old toddler with Cohen's syndrome and cerebral palsy who had experienced multiple hospitalizations and operations since birth. During hospitalization, the patient suffered from tracheomalacia and poor swallowing and coughing abilities and had experienced two cardiopulmonary resuscitation events, after which a tracheotomy was suggested. Decision-making regarding the tracheotomy placed the mother under tremendous pressure, who was facing both the life-threatening disease of her son and her burden of care. During the nursing care period from 19th September to 6th December 2022, the author identified the main nursing problem as "decision-conflict: decision-making in relation to tracheotomy procedure" and distinguished the nursing process into (1) escape period, (2) conflict period, and (3) coping period after decision-making. Adopting the ten carative factors in Watson's Caring Theory as the core of her care approach, the author was able to establish a mutually trusting relationship with the mother and to understand her needs by means of listening, consistency, and empathy. This involved providing sufficient information and holding family meetings to facilitate communication in combination with palliative medical resources to provide follow-up care support as well as helping the family find meaning in their lives.
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Teoría de Enfermería , Traqueostomía , Femenino , Humanos , Preescolar , Lactante , Empatía , Relaciones Enfermero-PacienteRESUMEN
UV light is a tool associated with the denaturation of cellular components, DNA damage, and cell disruption. UV treatment is widely used in the decontamination process; however, predicting a sufficient UV dose by using traditional methods is doubtful. In this study, an in-house UVC apparatus was designed to investigate the process of the inactivation of five indicator bacteria when the initial cell concentrations and irradiation intensities varied. Both linear and nonlinear mathematical models were applied to predict the inactivation kinetics. In comparison with the Weibull and modified Chick-Watson models, the Chick-Watson model provided a good fit of the experimental data for five bacteria, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus faecalis, and Bacillus subtilis. The specific death rate (kd) significantly increased when the irradiation intensity (I) increased from 1.41 W/m2 to 3.02 W/m2 and 4.83 W/m2 (P < 0.05). Statistical analysis revealed no significant difference in the kd values among the groups of tested Gram-positive bacteria, Gram-negative bacteria, and B. subtilis spores, but the kd values differed among groups (P < 0.05). The death rate coefficient (k) varied from species to species. The k values of the tested Gram-positive bacteria were higher than those of the Gram-negative bacteria. The thick peptidoglycan layer in the Gram-positive membrane was responsible for UVC resistance. The high guanine-cytosine (GC) content in bacteria also contributed to UV resistance due to the less photoreactive sites on the nucleotides. This investigation provides a good understanding of bacterial inactivation induced by UVC treatment. IMPORTANCE Prevention and control measures for microbial pathogens have attracted worldwide attention due to the recent coronavirus disease 2019 pandemic. UV treatments are used as a commercial control to prevent microbial contamination in diverse applications. Microorganisms exhibit different UV sensitivities, which are often measured by the UV doses required for decreasing the number of microbial contaminants in the logarithmic order. The maximum efficacy of UV is usually observed at 254 nm (residing in the UVC range of the light spectrum). UV technology is a nonthermal physical decontamination measure that does not require any chemicals and consumes low levels of energy while leaving insignificant amounts of chemical residues or toxic compounds. Therefore, obtaining the microbial death kinetics and their intrinsic parameters provided in this study together with the UV photoreaction rate enables advancement in the design of UV treatment systems.
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COVID-19 , Descontaminación , Bacterias/efectos de la radiación , Desinfección/métodos , Bacterias Gramnegativas/efectos de la radiación , Bacterias Grampositivas/efectos de la radiación , Humanos , Modelos Teóricos , Rayos UltravioletaRESUMEN
Multivariate recurrent event data are frequently encountered in biomedical and epidemiological studies when subjects experience multiple types of recurrent events. In practice, the event type information may be missing due to a variety of reasons. In this article, we consider a semiparametric additive rates model for multivariate recurrent event data with missing event types. We develop the augmented inverse probability weighting technique to handle event types that are missing at random. The nonparametric kernel-assisted proposals for the missing mechanisms are studied. The resulting estimator is shown to be consistent and asymptotically normal. Extensive simulation studies and a real data application are provided to illustrate the validity and practical utility of the proposed method.
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Proyectos de Investigación , Simulación por Computador , Humanos , ProbabilidadRESUMEN
Base pairing in RNA are significantly rich and versatile due to the potential non-canonical base pairing amongst nucleotides. Not only that, one base in RNA can pair with more than one bases simultaneously. This opens up a new dimension of research to detect such types of base-base pair networks in RNA and to analyze them. Even if a base do not form a pair, it may have significant extent of [Formula: see text]-[Formula: see text] stacking overlap that can stabilize the structures. In this work, we report a software tool, called BPNet, that accepts a mmCIF or PDB file and computes the base-pair/[Formula: see text]-[Formula: see text] contact network components using graph formalism. The software can run on Linux platform in both serial and parallel modes. It generates several information in suitable file formats for visualization of the networks. This paper describes the BPNet software and also presents some interesting results obtained by analyzing several RNA structures by the software to show its effectiveness.
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Biología Computacional , ARN , Emparejamiento Base , Enlace de Hidrógeno , Conformación de Ácido Nucleico , ARN/químicaRESUMEN
INTRODUCTION: In low-flow home daily dialysis (HDD), the dialysis dose is evaluated from the total body water (TBW). TBW can be estimated by anthropometric methods or bioimpedance spectroscopy. METHODS: A multicentric cross-sectional study of patients in HDD for >3 months was conducted to assess the correlation and the difference between the anthropometric estimate of TBW (Watson-TBW) and the bioimpedance estimate (BIS-TBW) and to analyse the impact on the dialysate volume prescribed. RESULTS: Forty patients from 10 centres were included. The median BIS-TBW and Watson-TBW were 35.1 (29.1-41.4 L) and 36.9 (32-42.4 L), respectively. The 2 methods had a good correlation (r = 0.87, p < 0.05). However, Bland-Altman analysis showed an overestimation of TBW with Watson's formula, with a bias of 2.77 L. For 4, 5, or 6 sessions per week, the use of Watson-TBW increases the dialysate prescription per week by 100 L, 45 L, or 10 L, respectively, over our entire cohort. There is no increase in the volume of dialysate prescribed with the 7 sessions per week schedule. CONCLUSION: BIS-TBW and Watson-TBW estimation have a good correlation; however, Watson's equation overestimates TBW. This overestimation is negligible for a prescription frequency of >5 sessions per week.
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Agua Corporal , Diálisis Renal , Composición Corporal , Estudios Transversales , Soluciones para Diálisis , Impedancia Eléctrica , Hemodiálisis en el Domicilio , HumanosRESUMEN
BACKGROUND: The Swedish Watson Dysphagia Scale (S-WDS) has been used to assess dysphagia in patients with eosinophilic esophagitis (EoE) but has not been validated for this patient group. The aim of this study was to validate the S-WDS for adult patients with EoE. METHODS: Ninety-seven Swedish adult patients with EoE and 97 controls without dysphagia filled out the S-WDS, the Swedish Eosinophilic Esophagitis Activity Index (S-EEsAI) and a set of supplementary questions. The reliability of the S-WDS was evaluated using Cronbach's alpha, Pearson correlation of items and total score, and test-retest analysis (n = 29). Validity was investigated using Spearman correlations of the S-WDS items, S-EEsAI domains and a self-assessment score, and by investigating floor and ceiling effects. RESULTS: The Cronbach's alpha of the S-WDS was 0.77 and all items demonstrated moderate to strong correlation to the S-WDS score (r = 0.40-0.81) indicative of sufficient reliability of the instrument. In addition, the test-retest results reflected excellent reliability with an intraclass correlation coefficient of 0.85 for the S-WDS score. Adequate validity of the instrument was demonstrated, the S-WDS score correlated moderately with the self-assessment score and with 4/6 S-EEsAI domains, and strongly with the remaining two domains. Floor effects were more common for liquids and soft-textured foods and ceiling effects increased with increasing food consistency. The S-WDS scores of the patient group were significantly different from those of the nondysphagia control group (P < 0.001). CONCLUSION: The S-WDS instrument is an appropriate and valid instrument for assessment of dysphagia in patients with EoE.
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Trastornos de Deglución , Esofagitis Eosinofílica , Adulto , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/etiología , Esofagitis Eosinofílica/complicaciones , Esofagitis Eosinofílica/diagnóstico , Humanos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , SueciaRESUMEN
BACKGROUND: Total hip arthroplasty (THA) using a minimally invasive (MI) approach is a commonly performed procedure, and several approaches are now being used clinically. The MI anterolateral (MIAL) approach is one of the MI approaches used in clinical practice. Whether the MIAL approach is superior to non-MI approaches remains controversial. To resolve this controversy, we performed a systematic review and a meta-analysis of results of THA procedures that used the MIAL approach. We assessed whether the MIAL approach was superior to the lateral transmuscular (LT) approach in terms of operative time, operative blood loss, radiological parameters, and clinical outcomes. METHODS: We performed a methodical search for all literature published on PubMed, Web of Science, and the Cochrane Library, and pooled data using the RevMan software. A p value < 0.05 was considered statistically significant. We calculated the mean differences (MD) for continuous data with 95% confidence intervals (CI) for each outcome. RESULTS: This meta-analysis included 6 studies. Pooled results indicated no statistically significant differences between the groups in terms of operative time (MD = 5.13, 95% CI -2.49 to 12.75, p = 0.19), cup abduction angle (MD = 1.64, 95% CI -1.32 to 4.60, p = 0.28), and cup anteversion angle (MD = 0.75, 95% CI -1.09 to 2.59, p = 0.43). Operative blood loss was significantly greater in those who underwent THA via the MIAL approach than those who underwent THA via the LT approach (MD = 68.01, 95% CI 14.69 to 121.33, p = 0.01). The postoperative Harris hip score (HHS) assessed at the time of final follow-up was significantly higher in those who underwent THA via the MIAL approach than those who underwent THA via the LT approach (MD = 1.41, 95% CI 0.50 to 2.33, p = 0.002). CONCLUSION: We conclude that the MIAL approach is superior to the LT approach in terms of clinical outcomes. LEVEL OF EVIDENCE: Level â ¡.
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Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Cadera/métodos , Pérdida de Sangre Quirúrgica , Humanos , Tempo Operativo , Periodo Posoperatorio , Radiografía , Resultado del TratamientoRESUMEN
INTRODUCTION: There is controversy about the role of minimally invasive surgery (MIS) for total hip arthroplasty (THA). The present study aimed to investigate whether a MIS approach has a positive impact on the outcome of THA via the Watson-Jones anterolateral approach. Clinical scores and radiological findings of minimally and standard invasive exposures were evaluated and compared. METHODS: The present study was conducted according to the STROBE statement. Patients operated between 2017 and 2018 in two different orthopaedic institutions was performed. Patients with symptomatic coxarthrosis reducing considerably patient's quality of life were asked to participate in the present study. Patients were divided into two THA groups: MIS and standard invasive surgery (SIS). Surgical procedures were performed in by two experienced surgeons via the Watson-Jones approach. RESULTS: Data from 140 patients were collected (70 patients for each group) at two years follow-up. Leg length discrepancy was greater in the MIS cohort (P = 0.01). The Stiffness subscale of the WOMAC score resulted minimally increased in the SIS group (P = 0.03). The overall WOMAC score and the other subscales resulted similar between the two groups. Femoral offset, acetabular offset, cup orientation, cup inclination, VAS resulted similar between the two cohorts. Only a case of revision in the SIS group was reported. CONCLUSION: THA via the Watson-Jones approach achieves short terms excellent results. Surgery performed via a MIS approach does not provide any superior outcome compared to the SIS in terms of radiographic findings and clinical scores at two years follow-up.
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Artroplastia de Reemplazo de Cadera , Osteoartritis de la Cadera , Artroplastia de Reemplazo de Cadera/métodos , Estudios de Cohortes , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Osteoartritis de la Cadera/diagnóstico por imagen , Osteoartritis de la Cadera/cirugía , Calidad de Vida , Estudios RetrospectivosRESUMEN
This study aims to investigate the experiences of survivors of COVID-19 in Turkey. The research questions and results are structured according to Watson's Theory of Human Caring. The study was conducted using a descriptive qualitative research design. The phenomenological method was used to explore the experiences of survivors of COVID-19. A total of 34 survivors of COVID-19 were included in the study. Data were collected using semistructured and open-ended questions online and via telephone interviews between February and March 2020. Data were evaluated using thematic analysis and descriptive analysis. Six main themes and 25 subthemes were defined that describe the experiences of survivors of COVID-19 regarding the illness: (a) denial and adaptation, (b) fear, (c) feeling of hopelessness, (d) preventions, (e) meaning attribution, and (f) metaphors about COVID-19. Information from this research may be used by healthcare professionals to develop new strategies for the care of survivors of COVID-19. Moreover, it can be said that Watson's Theory of Human Caring is suitable for monitoring the psychosocial development of patients with COVID-19.
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COVID-19 , Teoría de Enfermería , Humanos , Investigación Cualitativa , Autoimagen , SobrevivientesRESUMEN
AIM: This study aimed to explain the feelings and experiences of nurses who survived COVID-19 in their care and recovery processes, based on Watson's theory of human caring. BACKGROUND: The COVID-19 pandemic was an extraordinary time when nurses both took care of their patients and dealt with their illness by catching the disease themselves. In this process, nurses who contracted the disease experienced the fear of transmitting the disease to their relatives. METHOD: A qualitative descriptive research design was used in this study. The sample consists of 15 nurses selected by the convenience sampling method and diagnosed with COVID-19 and recovered. The data were collected in face-to-face interviews using the individual in-depth interview method through a semi-structured interview form. A thematic analysis was performed on the data according to the 10 carative factors of Watson's theory of human caring. RESULTS: It was determined that the spiritual and professional difficulties experienced by nurses who recovered from COVID-19 during the disease and symptom management process were the fear of death, infecting their family members and losing them, and the importance of life. CONCLUSION: It is considered that care practices based on Watson's theory of human caring will be beneficial in the management of these processes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses diagnosed with COVID-19 should be supported by the nursing management during their illness so that their negative experiences will not be repeated. Watson's theory of human caring can help eliminate this sense of fear and loss.