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BACKGROUNDS: The widespread adoption of double eyelid tapes (DET) to achieve the desired double eyelid aesthetic has prompted investigations into their long-term effects. Given the delicate and complex anatomy of the eyelid, concerns have emerged about the impact of DETs on eyelid structure and the outcomes of subsequent surgical procedures. METHODS: A cohort of 267 outpatients from our department was recruited between January 2022 and January 2024 to participate in a survey assessing the usage of double eyelid tape (DET). Eyelid laxity was subsequently tested in all outpatients using the Vertical Lid Pull and Parallel Lid Pull methods. Among all participants, 33 underwent double eyelid surgery, with 22 having a history of excessive DET usage and 11 with no DET usage. Post-operative outcomes, including operation duration, satisfaction levels, and complications were recorded. Additionally excised eyelid skin tissues during surgery underwent Masson's staining and EVG staining to analyze collagen and elastic fibers. RESULTS: Among surveyed outpatients (mean age: 23.79 ± 3.71 years, 99.63% female, mean BMI: 21.56 ± 1.75 kg/m2), 56.55% had oculopathy with ametropia being predominant (53.93%). Hooded eyelids were the most prevalent congenital condition (62.54%). Nearly half (49.44%) used Double Eyelid Tapes (DET) for 1-2 years, with 70.04% experiencing discomfort and 70.79% reporting permanent eyelid shape change. Lid pull measurements showed no significant difference in vertical pulls between DET users and non-users, but parallel pulls varied significantly (p<0.05). Complications like asymmetry, numbness, and hypertrophic scars were exclusive to DET users. Physician evaluations favored non-DET users significantly (p<0.05). Histological analysis revealed an interesting finding that individuals using DET have higher collagen levels and notable changes in skin structure when compared to non-users. CONCLUSIONS: Prolonged use of double eyelid tape (DET) may result in eyelid laxity, impacting ocular health and complicating blepharoplasty procedures. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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This study was conducted to determine the comfort levels and spiritual care needs of gynecologic cancer patients with abdominal drains. The study was conducted with 61 gynecologic cancer patients with abdominal drains at the gynecologic oncology surgery clinic of a state hospital in Turkey. Data were collected using the "Participant Information Form," "Perianesthesia Comfort Questionnaire (PCQ)", and "Spiritual Care Needs Inventory". Kolmogorov-Smirnov test and Mann-Whitney U test were used to analyze the data. It was found that the postoperative comfort of the patients in this study was above a moderate level. Patients who did not need spiritual care, did not fulfil religious rituals regularly and did not receive social support had a high level of comfort in the early postoperative period. Patients with gynecologic cancer were found to have high spiritual care needs. Patients without chronic diseases, possessing a single abdominal drain, familiar with the concept of spiritual care, expressing a need for spiritual care, engaging in regular religious rituals, and enjoying social support were identified as having elevated spiritual care needs. Within the framework of holistic nursing care provided to gynecologic cancer patients with abdominal drains, the results reveal the necessity of spiritual care and the importance of comfort.
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Following a lecture on sexual health and function, occupational therapy students were surveyed regarding their past sex education and their comfort level with the topic of sex. Students indicated a lack of sexual education received from parents/guardians and a prevalence of fear-based education from formal or informal sources. Results reflected a significant increase in students' perceived comfort level with the topic following the lecture from a provider trained and certified in sexual health. As sexuality falls within the domain of occupational therapy, these results suggest a need for comprehensive sex education taught to students by qualified instructors.
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This study verified typing performance on smartphones of public transportation passengers using subjective assessments of comfort and difficulty and objective assessments of the number of errors and typing speed. Three frequency values (5, 10, and 15 Hz), two magnitudes (0.6 and 1.2 m/s2) and two types of operating systems (Android and IOS) were adopted. Tests without vibration were applied to analyse the residual effect of vibration. The results showed that vibration significantly influences comfort. The higher the frequency, the less errors and the faster the typing speed. In the magnitude analysis, the increase caused a greater number of errors and greater difficulty. In both assessments, the discomfort was proportional to the increase in frequency or magnitude and the number of errors was inversely proportional to the typing speed. Finally, the IOS operating system showed worse comfort when compared to Android, although no significant differences were observed for the objective assessment. Practitioner summary: Public transportation passengers are exposed to WBV while typing on smartphones. The results showed that vibration influences comfort, the number of errors and the typing speed. Therefore, manufacturers should be aware of the level of vibration that vehicles are exposed to in order to provide more performance to the user. Abbreviations: WBV: whole-body vibration; PID: proportional-integral-derivative; RMS: root mean square; HLM: hierarchical linear modeling; OLS: ordinary least squares; STH: seat-to-head.
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Teléfono Inteligente , Vibración , Humanos , Transportes , Vibración/efectos adversosRESUMEN
BACKGROUND: Cutaneous histopathologic diagnoses in children often differ from those in adults. Depending on practice setting, these specimens may be evaluated by dermatopathologists or pediatric pathologists. We sought to determine whether comfort level with pediatric dermatopathology is associated with prior training, pediatric dermatopathology exposure during fellowship, career duration, or specimen subtype. METHODS: We surveyed dermatopathologists and pediatric pathologists practicing in the United States. Training and practice variables were evaluated by multivariable regression for association with comfort level. RESULTS: Of the 156 respondents, 72% were dermatopathologists (response rate 11.6%) and 28% were pediatric pathologists (response rate 9.3%). Dermatopathologists reported higher comfort overall (P < .001); this was also true for inflammatory dermatoses and melanocytic neoplasms (P < .001). Thirty-four percent and 75% of dermatopathologists and pediatric pathologists, respectively, reported lower comfort with pediatric skin specimens than their usual cases. Pediatric pathologists were 28% more likely to refer these cases to colleagues. Among dermatopathologists, dermatology-trained were more comfortable than pathology-trained colleagues interpreting inflammatory dermatoses (P < .001). CONCLUSIONS: Pathologists' comfort with pediatric dermatopathology varied significantly based upon prior training, career duration, and specimen subtype. These results suggest opportunities for improving education in this domain.
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Competencia Clínica/estadística & datos numéricos , Dermatólogos/estadística & datos numéricos , Patólogos/estadística & datos numéricos , Manejo de Especímenes/psicología , Niño , Estudios Transversales , Becas , Humanos , Melanocitos/patología , Melanoma/patología , Pediatría/tendencias , Derivación y Consulta , Autoeficacia , Piel/patología , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/patología , Neoplasias Cutáneas/patología , Encuestas y Cuestionarios , Estados UnidosRESUMEN
The purpose of this study was to describe current genetic counseling practice in the United States following a non-invasive prenatal testing (NIPT) result positive for a sex chromosome abnormality (SCA). Screening for SCAs can be confounded by confined placental mosaicism, natural loss of the X chromosome from maternal cells during aging, and undiagnosed maternal SCA or copy number variant (CNV). Furthermore, with the exception of 45,X, individuals with SCAs usually have no ultrasound or postnatal findings. This makes follow-up for unresolved positive NIPT necessary; however, there are currently no clinical guidelines. This study used a cross-sectional design with an anonymous questionnaire to survey 176 genetic counselors. The majority of prenatal respondents always offered diagnostic testing (>88%) and anatomy ultrasound (~90%), but the percent consistently offering maternal karyotype (22%-52%) and postnatal evaluation (28%-87%) varied. Maternal karyotype was offered more often when NIPT was positive for 45,X or 47,XXX and patients had normal prenatal diagnostic testing (p < 0.02) or declined testing (p < 0.02). Offer of postnatal evaluation was more likely when diagnostic testing was declined (p < 0.001). The majority of pediatric providers always offered a postnatal karyotype for the newborn (>72%) but the percent offering maternal karyotype (6%-46%) varied widely. With the current inconsistencies, many newborns with undiagnosed SCAs who could benefit from growth hormone therapy, early intervention, and/or targeted surveillance may be missed. Therefore, there is a need for professional guidelines to help improve the consistency of clinical care for patients with NIPT results positive for SCAs.
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Asesoramiento Genético , Pruebas Genéticas/métodos , Diagnóstico Prenatal/métodos , Aberraciones Cromosómicas Sexuales , Estudios Transversales , Variaciones en el Número de Copia de ADN , Femenino , Humanos , Recién Nacido , Cariotipificación , Mosaicismo , Embarazo , Estados UnidosRESUMEN
Comfort level in the human body is an index that is always difficult to evaluate in a general and objective manner. Therefore, building owners and managers have been known to adjust environmental physical parameters such as temperature, humidity, and air quality based on people's subjective sensations to yield satisfactory feelings of comfort. Furthermore, electricity consumption could be reduced by minimizing unnecessary use of heating and cooling equipment based on precise knowledge of comfort levels in interior spaces. To achieve the aforementioned objectives, this study undertook the following four tasks: first, providing visualization and smart suggestion functions to assist building managers and users in analyzing and developing plans based on the demands of space usage and electrical equipment; second, using Internet of Things technology to minimize the difference between real situations and those simulated in building information modeling (BIM); third, accurately evaluating interior environment comfort levels and improving equipment operating efficiency based on quantized comfort levels; and fourth, establishing a persuasive workflow for building energy saving systems. Through developing this system, COZyBIM will help to enhance the satisfactions of comfort level in interior space and operate energy consuming equipment efficiently, to reach the target of energy saving.
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OBJECTIVE: ClearVoice is a single-microphone noise reduction algorithm in Advanced Bionics cochlear implant(CI) systems with the aim to improve performance in background noise. The present study investigated a hypothesised increased effect of ClearVoice if combined with a structural increase of maximum comfort stimulation levels (M-levels) in the CI fitting. DESIGN: We tested performance with ClearVoice (Medium) in four conditions, defined by combined settings of ClearVoice off/on and with/without 5% increase of M-levels. The main outcome measures were the Acceptable Noise Level (ANL) and the speech reception threshold in continuous background noise (SRTn). STUDY SAMPLE: Participants were 16 experienced cochlear implant recipients with Advanced Bionics implants and a Naida Q70 processor. RESULTS: The ANL significantly improved by using either ClearVoice or an increase of M-levels. Combining both settings gave the largest improvement in ANL. For the SRTn, we found a small, but significant interaction between ClearVoice and an increase of M-levels, implying that ClearVoice improved speech understanding slightly, but only if combined with a 5% increase of M-levels. CONCLUSIONS: Optimal profit from ClearVoice is obtained if combined with a structural 5% increase of M-levels.
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Implantación Coclear/instrumentación , Implantes Cocleares , Audición , Ruido/efectos adversos , Enmascaramiento Perceptual , Personas con Deficiencia Auditiva/rehabilitación , Procesamiento de Señales Asistido por Computador , Percepción del Habla , Estimulación Acústica , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Comprensión , Estimulación Eléctrica , Humanos , Percepción Sonora , Persona de Mediana Edad , Personas con Deficiencia Auditiva/psicología , Estudios Prospectivos , Diseño de Prótesis , Inteligibilidad del Habla , Prueba del Umbral de Recepción del HablaRESUMEN
OBJECTIVE: To evaluate the validity and efficacy of a transient noise reduction algorithm (TNR) in cochlear implant processing and the interaction of TNR with a continuous noise reduction algorithm (CNR). DESIGN: We studied the effects of TNR and CNR on the perception of realistic sound samples with transients, using subjective ratings of annoyance, a speech-in-noise test and a noise tolerance test. STUDY SAMPLE: Participants were 16 experienced cochlear implant recipients wearing an Advanced Bionics Naida Q70 processor. RESULTS: CI users rated sounds with transients as moderately annoying. Annoyance was slightly, but significantly reduced by TNR. Transients caused a large decrease in speech intelligibility in noise and a moderate decrease in noise tolerance, measured on the Acceptable Noise Level test. The TNR had no significant effect on noise tolerance or on speech intelligibility in noise. The combined application of TNR and CNR did not result in interactions. CONCLUSIONS: The TNR algorithm was effective in reducing annoyance from transient sounds, but was not able to prevent a decreasing effect of transients on speech understanding in noise and noise tolerance. TNR did not reduce the beneficial effect of CNR on speech intelligibility in noise, but no cumulated improvement was found either.
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Algoritmos , Implantes Cocleares , Pérdida Auditiva/psicología , Inteligibilidad del Habla/fisiología , Percepción del Habla/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Implantación Coclear , Femenino , Pérdida Auditiva/cirugía , Humanos , Masculino , Persona de Mediana Edad , Ruido , Enmascaramiento PerceptualRESUMEN
In this study, passenger comfort and the air pollution status of the micro-environmental conditions in an air-conditioned bus were investigated through questionnaires, field measurements, and a numerical simulation. As a subjective analysis, passengers' perceptions of indoor environmental quality and comfort levels were determined from questionnaires. As an objective analysis, a numerical simulation was conducted using a discrete phase model to determine the diffusion and distribution of pollutants, including particulate matter with a diameter < 10 µm (PM10), which were verified by experimental results. The results revealed poor air quality and dissatisfactory thermal comfort conditions in Jinan's air-conditioned bus system. To solve these problems, three scenarios (schemes A, B, C) were designed to alter the ventilation parameters. According to the results of an improved simulation of these scenarios, reducing or adding air outputs would shorten the time taken to reach steady-state conditions and weaken the airflow or lower the temperature in the cabin. The airflow pathway was closely related to the layout of the air conditioning. Scheme B lowered the temperature by 0.4 K and reduced the airflow by 0.01 m/s, while scheme C reduced the volume concentration of PM10 to 150 µg/m3. Changing the air supply angle could further improve the airflow and reduce the concentration of PM10. With regard to the perception of airflow and thermal comfort, the scheme with an airflow provided by a 60° nozzle was considered better, and the concentration of PM10 was reduced to 130 µg/m3.
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Aire Acondicionado/estadística & datos numéricos , Contaminación del Aire Interior/análisis , Contaminación del Aire/estadística & datos numéricos , Vehículos a Motor/estadística & datos numéricos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminación del Aire Interior/estadística & datos numéricos , Monitoreo del Ambiente , Humanos , Material Particulado/análisis , Temperatura , VentilaciónRESUMEN
OBJECTIVE: This study aimed to investigate the relationship between perceived comfort level with moral distress and moral sensitivity among oncology nurses METHODS: This is a descriptive-correlational study on 210 oncology nurses. The samples were selected through the convenience method from September 2020 to February 2022 in the oncology centers of Ahvaz, Iran. Data were collected via a demographic form, Lutzen's Modified Moral Sensitivity Questionnaire, Corley's Moral Distress Scale, and Kolcaba's Nurses Comfort Questionnaire (NCQ). Data were analyzed using SPSS V24, descriptive statistics, Independent t, Mann-Whitney-U, Kruskal-Wallis, Pearson's correlation coefficient, ANOVA, and linear regression tests. RESULTS: Nurses experienced a moderate level of perceived comfort (67.91 ± 8.75), moral sensitivity (58.4 ± 13.3), and moral distress (57.54.8 ± 8.9). Moral sensitivity was significantly inversely related to the intensity of moral distress (P < .001). A statistically significant relationship was found between nurses' perceived comfort level with frequency of distress (P < .001) and moral sensitivity (Pâ¯=â¯.046). Moral distress explained 13.8% of changes in perceived comfort level (R2â¯=â¯0.138, Fâ¯=â¯6.51, sig < 0.001, Râ¯=â¯0.371). CONCLUSION: Nurses' perceived comfort level, moral sensitivity, and moral distress were at a moderate level and intercorrelated. It is suggested that factors contributing to moral distress should be eliminated. Also, moral sensitivity should be refined as a decisive factor. IMPLICATION FOR NURSING PRACTICE: Oncology nurses are exposed to morally distressing situations that may be a source of discomfort. This study guides nurses, managers, planners, and policymakers to identify the contributing factors and use strategies and solutions to enhance nurses' perceived comfort level.
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Background: The Roma minority, Europe's largest ethnic minority, experiences significant disparities in living conditions and health outcomes compared to the non-Roma populations across the continent. Despite extensive documentation of the socio-economic challenges faced by the Roma, there is a notable lack of comparative research. Methods: This study aims to fill this gap by examining the differences in socio-economic characteristics, living conditions, and self-reported health status between Roma (R) and non-Roma (nR) women in in Hungary (HU), Romania (RO), and Slovakia (SK), providing a cross-country comparative analysis. Utilizing simple and multiple binary logistic models, our research analysed data collected from September 2020 to March 2022, involving 322 Roma and 294 non-Roma women in Hungary, 258 Roma and 183 non-Roma women in Romania, and 146 Roma and 163 non-Roma women in Slovakia. Results: Findings indicate significant associations between increased age (R:OR = 1.04[1.02,1.06], p < 0.001), (nR:OR = 1.04[1.02,1.05], p < 0.001) lower financial situation (R:OR = 2.05[1.01,4.18], p = 0.048) (nR:OR = 1.67[1.01,2.77], p = 0.047), and basic education level (R:OR = 3.60[1.29,10.08], p = 0.015) (nR:OR = 3.64[1.77,7.51], p < 0.001) with the likelihood of poor health status across both groups in Hungary. In Romania, increased age (OR = 1.04[1.02,1.06], p < 0.001) and basic education level (OR = 5.24[2.29,11.99], p < 0.001) were particularly predictive of poor health among non-Roma, while in Slovakia, age (OR = 1.05[1.02,1.07], p < 0.001) was a significant factor for Roma, and intermediate education level (OR = 2.68[1.16,6.20], p = 0.021) was for non-Roma. The study also found that a higher number of children (HU:OR = 1.35[1.12,1.63], p = 0.002), (RO:OR = 1.57[1.25,1.96], p < 0.001) and problems with housing comfort (RO:OR = 4.83[2.19,10.62], p = 0.015) and wall conditions (RO:OR = 2.81[1.22,6.46], p < 0.001) significantly impacted the health status of non-Roma women in Hungary and Romania. Conversely, an increase in household size was associated with a better health status among Roma women in Hungary (OR = 0.88[0.79,0.99]) and Slovakia (OR = 0.78[0.61,0.99]). Conclusion: By offering a novel comparative analysis, this study highlights the critical need for focused attention on the health disparities faced by Roma women, particularly those in a multiply disadvantaged situation due to their ethnic and socio-economic status.
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Disparidades en el Estado de Salud , Romaní , Humanos , Femenino , Eslovaquia , Hungría , Rumanía/etnología , Romaní/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Factores Socioeconómicos , Grupos Minoritarios/estadística & datos numéricos , Anciano , Estado de SaludRESUMEN
In recent years, due to the prevalence of virtual reality (VR) and human-computer interaction (HCI) research, along with the expectation that understanding the process of establishing sense of ownership, sense of agency, and limb heaviness (in this study, limb heaviness is replaced with comfort level) will contribute to the development of various medical rehabilitation, various studies have been actively conducted in these fields. Previous studies have indicated that each perceptual characteristics decrease in response to positive delay. However, it is still unclear how each perceptual characteristic changes in response to negative delay. Therefore, the purpose of this study was to deduce how changes occur in the perceptual characteristics when certain settings are manipulated using the avatar developed in this study. This study conducted experiments using an avatar system developed for this research that uses electromyography as the interface. Two separate experiments involved twelve participants: a preliminary experiment and a main experiment. As observed in the previous study, it was confirmed that each perceptual characteristics decreased for positive delay. In addition, the range of the preliminary experiment was insufficient for the purpose of this study, which was to confirm the perceptual characteristics for negative delay, thus confirming the validity of conducting this experiment. Meanwhile, the main experiment showed that the sense of ownership, sense of agency, and comfort level decreased gradually as delay time decreased, (i.e., this event is prior to action with intention, which could not be examined in the previous study). This suggests that control by the brain-machine interface is difficult to use when it is too fast. In addition, the distribution of the most strongly perceived settings in human perceptual characteristics was wider in regions with larger delays, suggesting this may lead to the evaluation of an internal model believed to exist in the human cerebellum. The avatar developed for this study may have the potential to create a new experimental paradigm for perceptual characteristics.
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OBJECTIVE: Use of video in patient education is becoming widespread due to its low cost, time management, ease of application, and permanent learning. The study aimed to investigate the effect of video training on the symptom burden, comfort level, and quality of life of patients undergoing hemodialysis treatment. METHODS: In this clustered randomized controlled trial, the patients were randomly assigned to groups by lottery method according to hemodialysis treatment days and sessions. Individuals in the intervention group(n = 26) were screened one episode of the training video in each session for three episodes per week for 12 weeks. Individuals in the control group(n = 22) received only conventional hemodialysis without video training. RESULTS: At the third and fourth measurement times, in intervention group, mean scores of symptom burden decreased compared to baseline (respectively:40,12 ± 21,63; 22,31 ± 14,08;21,54 ± 16,78), mean scores of comfort level increased (respectively:102,42 ± 13,45; 111,42 ± 8,00;115,04 ± 9,73)(p < 0.05), while there was no significant difference in control group(p > 0.05). This study observed a statistically significant difference between quality of life scale scores individuals in intervention group(p < 0,05). CONCLUSION: It was concluded that video training delivered to patients undergoing hemodialysis treatment decreased symptom burden of patients and increased their comfort level, and quality of life. PRACTICE IMPLICATIONS: Video training can be utilized in the educational program of hemodialysis patients.
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Educación del Paciente como Asunto , Calidad de Vida , Diálisis Renal , Grabación en Video , Humanos , Femenino , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto/métodos , Adulto , Anciano , Fallo Renal Crónico/terapia , Fallo Renal Crónico/psicología , Comodidad del Paciente , Carga SintomáticaRESUMEN
INTRODUCTION: The maximum comfort level (MCL), threshold level (THR) and electrical impedance change in the postoperative period of the cochlear implant for months until they stabilize. The objective of this article is to establish the variation during 5 post-surgical years of impedance, and its relationship with MCL in unilaterally implanted adults. METHODS: Retrospective study over 5 years, with 78 adult patients implanted with MED-EL in a tertiary hospital from the year 2000 to 2015. The variation in impedance, MCL and the relationship between them were analyzed in basal (9-12), medial (5-8) and apical electrodes (1-4), performing an inferential ANOVA analysis of repeated measures with comparisons between consecutive times, corrected with Bonferroni criteria. RESULTS: 33 men (42.3%) and 45 women (57.7%), with a mean age of 52.7±14.6 years. "Stability" was considered the time of follow-up without statistically significant differences between one visit and the next. Changes in impedance in medial electrodes ceased to be statistically significant at 3 months, and in apicals at 6 months, with mean values of 5.84 and 6.43kΩ. MCL stabilized at 2 years in basal and apical electrodes, and at 3 years in medial, with mean values of 24.9, 22.7, and 25.6qu. There was a correlation between MCL and impedance in medium electrodes up to 3 months and in apical ones up to one year. CONCLUSIONS: Electrical impedance drops significantly in medial and apical electrodes up to 3 and 6 months. MCL increases significantly up to two years. Impedance is related to MCL up to 6 months.
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Implantación Coclear , Implantes Cocleares , Masculino , Adulto , Humanos , Femenino , Persona de Mediana Edad , Anciano , Impedancia Eléctrica , Estudios Retrospectivos , Umbral AuditivoRESUMEN
OBJECTIVE: To determine the effect of cluster nursing on pressure ulcer prevention and comfort of orthopedic patients. METHODS: A total of 124 orthopedic inpatients admitted to the Seventh Affiliated Hospital of Sun Yat-sen University from July 2018 to June 2021 were retrospectively analyzed. Among them, 66 cases received cluster nursing who were assigned into the observation group and the other 58 cases received routine nursing and were assigned into the control group. The incidence of pressure ulcers, the degree of pressure the ulcer, quality of life-brief (QOL-BREF), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) scores of the two groups at 7 days after surgery were compared, and the comfort score and nursing satisfaction of the two groups were evaluated and compared. The expression and predictive value of serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in patients with pressure ulcers before operation were analyzed via enzyme-linked immunosorbent assay (ELISA). The levels of IL-6 and TNF-α were compared between the two groups before and after nursing. RESULTS: After nursing, the observation group had significantly lower IL-6, TNF-α, SAS score, and SDS scores than the control group, and showed significantly higher QOL-BREF score, nursing satisfaction and comfort scores than the control group. In addition, the observation group showed a significantly lower incidence of pressure ulcers and a significantly lower severity level than the control group after nursing. Patients with pressure ulcers showed significantly higher serum IL-6 and TNF-α levels before surgery, and receiver operating characteristic curve (ROC) showed that IL-6 and TNF-α had certain value in forecasting the occurrence of pressure ulcers. CONCLUSION: Cluster nursing can substantially lower the incidence of pressure ulcers in hospitalized orthopedic patients and improve their comfort.
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Background and Aims: The use of lidocaine aerosol for pediatric tonsil and adenoidectomy has been reported less frequently. We hope to improve the perioperative comfort of pediatric patients undergoing these procedures by applying lidocaine aerosol. Methods: A total of 122 pediatric patients receiving tonsil and adenoidectomy were randomly divided into a lidocaine aerosol group (Group L) and a saline group (Group C), with 61 patients in each group; 2.4% alkaline lidocaine aerosol and saline were sprayed in the pharynx before induction. Our primary outcome were the incidence and rate ratio (RR) of postoperative pharyngeal complications (oropharyngeal dryness, dysphagia, hoarseness, and sore throat) and the pharyngeal comfort score, the latter of which was assessed by the occurrence of the above complications (yes = 0 point, none = 1 point). The secondary outcomes included preoperative and intraoperative blood pressure and heart rate, the incidence of choking during the induction period, the intraoperative opioid dosage, and the pain level and depth of sedation at 2, 6, and 24 h postoperatively. Statistical software used in this study included PASS15.0, SPSS 26.0, and GraphPad Prism 9.3.1, and statistical methods used included the t-test, the χ² test, the Mann-Whitney U test, and the repeated measures analysis of variance. Results: The incidence and RR of postoperative pharyngeal complications such as oropharyngeal dryness (RR: 0.667, 95% confidence interval [CI]: 0.458-0.970, p = 0.03), dysphagia (RR: 0.333, 95% CI: 0.114-0.976, p = 0.03), hoarseness (RR: 0.647, 95% CI: 0.433-0.967, p = 0.03), and sore throat (RR: 0.727, 95% CI: 0.547-0.967, p = 0.03) were significantly lower in Group L than in Group C at 2 h postoperatively, and the incidence and RR of postoperative sore throat was significantly lower in Group L than in Group C at 6 h postoperatively (RR: 0.717, 95% CI: 0.547-0.942, p = 0.01). The postoperative pharyngeal comfort scores were significantly higher in Group L than in Group C at all postoperative time points (p < 0.05). The Ramsay sedation score was significantly higher (p < 0.01) and FLACC (face, legs, activity, crying, and consolability) score was significantly lower (p < 0.01) in Group L than in Group C at 2 h postoperatively. In Group C, the blood pressure and heart rate significantly faster at all time points immediately after intubation and afterward, except at the end of surgery (p < 0.05). Conclusions: In pediatric tonsil and adenoidectomy, the application of lidocaine aerosol before induction can reduce the incidence of postoperative pharyngeal complications, improve the child's postoperative pharyngeal comfort, and better realize perioperative "comfort medical treatment."
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Polymer polyvinylpyrrolidone (PVP) can be described as the main coating. After heating and curing, it is able to build a strong adhesion to the latex catheter for creating a durable and effective hydrophilic coating. In this study, we aim to explore the advantages and disadvantages of the new super lubricath latex catheter PVP coating compared with the common latex catheter. 148 patients who participated in the study were completely randomly divided into two groups, the observation group and the control group. When the urinary catheter was incubated, indwelling in subjects' body, and removed from the subjects, the researchers accordingly recorded the subjects' comfort feedback, device safety evaluation and the patient's vital signs, relevant blood and urine examination index, electrocardiogram (ECG) changes and recorded various adverse events. PVP super lubricath coating latex catheter offered better comfort, less damage to the urethra, and no significant disadvantage in safety compared to regular latex catheters, improving quality of care and patient satisfaction compared to regular latex urinary catheters.
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OBJECTIVE: To investigate emergency clinicians' comfort level in assessing neurological emergencies and to identify opportunities to foster enhanced training of clinical neurology in the emergency room. DESIGN: Internet-based survey. SETTING: University teaching hospitals and private referral centers. SUBJECTS: One hundred and ninety-two emergency and critical care specialists and resident trainees (ECC) and 104 neurology specialists and resident trainees (NEUR) in clinical practice. INTERVENTIONS: An internet-based survey was distributed via veterinary professional organizations' listserves and message boards and responses were collected between March and April 2020. ECC completed a survey evaluating stress levels associated with neurological emergencies, confidence with neurological examinations, and neuroanatomical localization. NEUR completed a similar survey to report their perception of their ECC colleagues' confidence in the assessment of neurological cases. Chi-square and Mann-Whitney U-tests were used to compare categorical responses and confidence scores between groups. P < 0.002 was considered significant. MEASUREMENTS AND MAIN RESULTS: Fifty-two percent of ECC found neurological emergencies slightly challenging, whereas 85% of NEUR found them moderately to extremely challenging for ECC (P < 0.0001). ECC's median self-reported confidence score in performing a neurologic examination on a scale of 0-100 was 75 (interquartile range [IQR], 27), while NEUR reported a median ECC confidence of 44 (IQR, 25; P < 0.0001). Median self-reported ECC confidence in localizing intracranial, spinal, and neuromuscular disease was 67 (IQR, 40), 88 (IQR, 21), and 60 (IQR, 37), respectively, which was significantly higher than median NEUR-reported ECC confidence of 35 (IQR, 38), 51 (IQR, 31), and 18 (IQR, 20), respectively (all P < 0.0001). Following case transfer, 34% of ECC received NEUR feedback in >75% of cases. CONCLUSIONS: Noticeable discrepancies between ECC and NEUR perceptions of ECC clinical confidence were seen, while no firm evidence of neurophobia could be inferred. Improvements in interdepartmental communication and teaching of clinical neurology may be warranted.
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Urgencias Médicas , Internado y Residencia , Animales , Urgencias Médicas/veterinaria , Servicio de Urgencia en Hospital , Encuestas y Cuestionarios , PercepciónRESUMEN
To address the problem of ambiguity and one-sidedness in the evaluation of comprehensive comfort perceptions during lower limb exercise, this paper deconstructs the comfort perception into two dimensions: psychological comfort and physiological comfort. Firstly, we designed a fixed-length weightless lower limb squat exercise test to collect original psychological comfort data and physiological comfort data. The principal component analysis and physiological comfort index algorithm were used to extract the comfort index from the original data. Secondly, comfort degrees for each sample were obtained by performing K-means++ to cluster normalized comfort index. Finally, we established a decision tree model for lower limb comfort level analysis and determination. The results showed that the classification accuracy of the model reached 95.8%, among which the classification accuracy of the four comfort levels reached 95.2%, 97.3%, 92.9%, and 97.8%, respectively. In order to verify the advantages of this paper, the classification results of this paper were compared with the classification results of four supervised classification algorithms: Gaussian Parsimonious Bayes, linear SVM, cosine KNN and traditional CLS decision tree.