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1.
Sci Rep ; 14(1): 15268, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38961084

ABSTRACT

This paper reports the fabrication, characterization, and environmental impact analysis of a super-oleophobic (under water) and super-hydrophilic mesh membrane for oily water treatment. In order to prepare mesh membrane, Titania nanoparticles (NPs) were spray coated on mesh stainless steel followed by calcination at 500 °C. After that, the Titania-coated mesh membrane was characterized using contact angle goniometry (CA), XRD, FE-SEM, EDX and elemental mapping. The FE-SEM, EDX, elemental mapping and XRD results confirmed that the Titania NPs were successfully coated on the surface of mesh membrane. CA results demonstrated that the prepared mesh membrane is super-hydrophilic and super-oleo phobic under water conditions, making it suitable for oil/water separation. Subsequently, life cycle assessment (LCA) was performed to determine the environmental impacts of Titania NPs-coated mesh membrane fabrication process. LCA results indicate that electricity and nitrogen contributed the most toward the eighteen environmental impact categories considered for this study.

2.
Int J Med Inform ; 190: 105538, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38968689

ABSTRACT

BACKGROUND: Intradialytic hypotension (IDH) is one of the most common and critical complications of hemodialysis. Despite many proven factors associated with IDH, accurately predicting it before it occurs for individual patients during dialysis sessions remains a challenge. PURPOSE: To establish artificial intelligence (AI) predictive models for IDH, which consider risk factors from previous and ongoing dialysis to optimize model performance. We then implement a novel digital dashboard with the best model for continuous monitoring of patients' status undergoing hemodialysis. The AI dashboard can display the real-time probability of IDH for each patient in the hemodialysis center providing an objective reference for care members for monitoring IDH and treating it in advance. METHODS: Eight machine learning (ML) algorithms, including Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), K Nearest Neighbor (KNN), Light Gradient Boosting Machine (LightGBM), Multilayer Perception (MLP), eXtreme Gradient Boosting (XGBoost), and NaiveBayes, were used to establish the predictive model of IDH to determine if the patient will acquire IDH within 60 min. In addition to real-time features, we incorporated several features sourced from previous dialysis sessions to improve the model's performance. The electronic medical records of patients who had undergone hemodialysis at Chi Mei Medical Center between September 1, 2020 and December 31, 2020 were included in this research. Impact evaluation of AI assistance was conducted by IDH rate. RESULTS: The results showed that the XGBoost model had the best performance (accuracy: 0.858, sensitivity: 0.858, specificity: 0.858, area under the curve: 0.936) and was chosen for AI dashboard implementation. The care members were delighted with the dashboard providing real-time scientific probabilities for IDH risk and historic predictive records in a graphic style. Other valuable functions were appended in the dashboard as well. Impact evaluation indicated a significant decrease in IDH rate after the application of AI assistance. CONCLUSION: This AI dashboard provides high-quality results in IDH risk prediction during hemodialysis. High-risk patients for IDH will be recognized 60 min earlier, promoting individualized preventive interventions as part of the treatment plan. Our approachis believed to promise an excellent way for IDH management.

3.
Front Pediatr ; 12: 1343045, 2024.
Article in English | MEDLINE | ID: mdl-38962572

ABSTRACT

Background: Bronchiolitis is a respiratory infection of viral origin and is often linked to syncytial respiratory virus. It is the most frequent cause of hospitalisation in children aged under 2 years and sometimes requires transfer to intensive care. Infectious complications may also arise in the short term, and longer-term progression towards asthma is also possible. The occurrence of bronchiolitis in children may affect families in different ways, and may have psychological, organisational, employment-related, and possibly financial consequences. Objective: The aim of the study was to determine the familial and socioeconomic repercussions of bronchiolitis in infants. Setting: Parents with a child with bronchiolitis between January 2021 and May 2022, who were registered at the site of the Association Française de Pédiatrie Ambulatoire (Mpedia site) or at the site of the Malin Programme, which serves families experiencing financial difficulties, were included in the study. Participants: All parents consenting to participate in the study. Results: A total of 2,059 valid questionnaires were retrieved: 1,318 (64%) were obtained from parents through the Mpedia website and 741 (36%) were obtained through the Malin Programme. Parents associated with the Malin Programme had more children, as well as higher rates of unemployment and financial difficulties, and required greater medical assistance. Hospitalisation was necessary in 37% of cases and was comparable between groups. During the illness, moderate to severe anxiety was present in 73% of parents; this percentage rose to 87% if the child required hospitalisation. Many parents reported effects on daily home (84%) and work life (90%), and 60% had taken a leave of absence from work. Conclusion: Beyond the immediate or longer-term medical consequences of bronchiolitis in infants, the illness affects families in multiple ways and can lead to anxiety, as well as changes in day-to-day home and work life. Physicians should have greater awareness of these consequences and should strive to decrease their impact.

4.
Accid Anal Prev ; 206: 107696, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38964138

ABSTRACT

One of the main objectives in improving the quality of life for individuals with disabilities, especially those experiencing mobility issues such as the elderly, is to enhance their day-to-day mobility. Enabling easy mobility contributes to their independence and access to better healthcare, leading to improvements in both physical and mental well-being. Mobility Scooters have become increasingly popular in recent years as a means of facilitating mobility, yet traffic safety issues such as crash severity have not been adequately investigated in the literature. This study addresses this knowledge gap by employing a hybrid method that combines a machine learning approach using the eXtreme Gradient Boosting (XGBoost) algorithm with Shapley Additive exPlanations (SHAP) and an advanced statistical model called Random Parameters Binary Logit accounting for heterogeneity in means and variances. Analyzing the United Kingdom mobility scooter crash data from 2018 to 2022, the study examined temporal instability using a likelihood ratio test. The results revealed that there was instability over the three distinct periods of time based on the coronavirus (COVID) pandemic, namely, pre-COVID, during COVID, and post-COVID. Moreover, the results revealed that mobility scooter crashes occurring at a give-way or uncontrolled junctions has a random effect on the severity, while factors such as mobility scooter riders aged over 80, rear-end and sideswipe crashes, and crashes during winter months increase the risk of severe injuries. Conversely, mobility scooter riders involved in crashes while riding on the footway are less likely to experience severe injuries. These findings offer valuable insights for enhancing road safety measures that can be utilized to effectively reduce the crash severity of mobility scooter riders.

5.
Article in English | MEDLINE | ID: mdl-38966951

ABSTRACT

Despite incineration is an important emission source of toxic pollutants, such as heavy metals and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), it is still one of the most widely used methods for the management of municipal solid waste. The current paper summarizes the results of a 20-year follow-up study of the emissions of PCDD/Fs by a municipal solid waste incinerator (MSWI) in Sant Adrià de Besòs (Catalonia, Spain). Samples of ambient air, soils and herbage were periodically collected near the facility and the content of PCDD/Fs was analyzed. In the last (2017) survey, mean levels in soil were 3.60 ng WHO-TEQ/kg (range: 0.40-10.6), being considerably higher than the mean concentrations of PCDD/Fs in soil samples collected near other MSWIs in Catalonia. Moreover, air PCDD/F concentrations were even higher than those found in a previous (2014) survey, as they increased from 0.026 to 0.044 pg WHO-TEQ/m3. Ultimately, the PCDD/F exposure would be associated to a cancer risk (2.5 × 10-6) for the population living in the surrounding area. Globally, this information indicates that the MSWI of Sant Adrià de Besòs could have had a negative impact on the environment and potentially on public health, being an example of a possible inappropriate management for years. The application of Best Available Techniques to minimize the emission of PCDD/Fs and other chemicals is critical.

6.
Clin Transl Oncol ; 2024 Jul 05.
Article in English | MEDLINE | ID: mdl-38967738

ABSTRACT

OBJECTIVE: To examine the impact of a combined craniocaudal approach on pain and complications during laparoscopic D3 lymph node dissection in clients diagnosed with right colon cancer (RCC). METHODS: 100 RCC patients were divided into Group A and Group B. Both groups underwent laparoscopic D3 lymph node dissection, with Group A undergoing an intermediate approach and Group B undergoing a combined head and tail approach. Two groups of patients' perioperative (surgical time, intraoperative blood loss, number of lymph node dissection) indicators, postoperative recovery (postoperative exhaust time, postoperative hospital stay, drainage tube removal time) indicators, perioperative pain level (VAS scores 1, 3, and 5 days following surgery), and incidence of complications (vascular injury, intestinal obstruction, anastomotic bleeding, incision infection), and the therapeutic efficacy [CEA, CA19-9] indicators were compared. RESULTS: Clients in the B team had substantially shorter operating times and considerably fewer intraoperative hemorrhage than those in the A team. The VAS grades of clients in the B team were considerably lower than those in the A team the day following surgery. Clients in the B team experienced vascular injury at a substantially lower rate than those in the A team. The overall incidence rate of problems did not differ statistically significantly between the A team and the B team. Following therapy, teams A and B's CEA and CA19-9 levels were considerably lower than those of the same team prior to therapy. CONCLUSION: Combined craniocaudal technique can significantly reduce intraoperative bleeding, postoperative pain, and the risk of sequelae from vascular injuries.

7.
Environ Int ; 190: 108871, 2024 Jul 03.
Article in English | MEDLINE | ID: mdl-38972115

ABSTRACT

Previous studies on the relationship between urban form and air quality: (1) report mixed results among specific aspects of urban spatial structure (e.g., urban expansion, form, or shape) and (2) use primarily cross-sectional approaches with a single year of data. This study takes advantage of a multi-decade, longitudinal approach to investigate the impact of urban spatial structure on population-weighted concentrations of PM2.5 and NO2. Based on fixed-effect regression models for 481 urban areas in the United States spanning from 1990 to 2015, we found significant associations between various aspects of urban spatial structure and air quality after controlling for meteorological and socio-economic factors. Our results show that population density, compact urban form, circularity, and green space are associated with lower concentrations. Conversely, higher rates of urban expansion, industrial area, and polycentricity are associated with higher concentrations. For large cities (total population: 180,262,404), we found that increasing key factors from each urban spatial structure category (i.e., greenness, population density, compactness, circularity) by a modest 10% results in 10,387 (12,376) fewer deaths for PM2.5 (NO2). We recommend that policymakers adopt comprehensive strategies to increase population density, compactness, and green spaces while slowing urban expansion to reduce the health burden of air quality in US cities.

8.
Adv Mater ; : e2405183, 2024 Jul 07.
Article in English | MEDLINE | ID: mdl-38973222

ABSTRACT

Biological materials relying on hierarchically ordered architectures inspire the emergence of advanced composites with mutually exclusive mechanical properties, but the efficient topology optimization and large-scale manufacturing remain challenging. Herein, this work proposes a scalable bottom-up approach to fabricate a novel nacre-like cement-resin composite with gradient brick-and-mortar (BM) structure, and demonstrates a machine learning-assisted method to optimize the gradient structure. The fabricated gradient composite exhibits an extraordinary combination of high flexural strength, toughness, and impact resistance. Particularly, the toughness and impact resistance of such composite attractively surpass the cement counterparts by factors of approximately 700 and 600 times, and even outperform natural rocks, fiber-reinforced cement-based materials and even some alloys. The strengthening and toughening mechanisms are clarified as the regional-matrix densifying and crack-tip shielding effects caused by the gradient BM structure. The developed gradient composite not only endows a promising structural material for protective applications in harsh scenarios, but also paves a new way for biomimetic metamaterials designing.

9.
Article in English | MEDLINE | ID: mdl-38973333

ABSTRACT

The introduction of invasive species has become an increasing environmental problem in freshwater ecosystems due to the high economic and ecological impacts it has generated. This systematic review covers publications from 2010 to 2020, focusing on non-native invasive freshwater bivalves, a particularly relevant and widespread introduced taxonomic group in fresh waters. We collected information on the most studied species, the main objectives of the studies, their geographical location, study duration, and type of research. Furthermore, we focused on assessing the levels of ecological evidence presented, the type of interactions of non-native bivalves with other organisms and the classification of their impacts. A total of 397 publications were retrieved. The studies addressed a total of 17 species of non-native freshwater bivalves; however, most publications focused on the species Corbicula fluminea and Dreissena polymorpha, which are recognised for their widespread distribution and extensive negative impacts. Many other non-native invasive bivalve species have been poorly studied. A high geographical bias was also present, with a considerable lack of studies in developing countries. The most frequent studies had shorter temporal periods, smaller spatial extents, and more observational data, were field-based, and usually evaluated possible ecological impacts at the individual and population levels. There were 94 publications documenting discernible impacts according to the Environmental Impact Classification for Alien Taxa (EICAT). However, 41 of these publications did not provide sufficient data to determine an impact. The most common effects of invasive bivalves on ecosystems were structural alterations, and chemical and physical changes, which are anticipated due to their role as ecosystem engineers. Despite a considerable number of studies in the field and advances in our understanding of some species over the past decade, long-term data and large-scale studies are still needed to understand better the impacts, particularly at the community and ecosystem levels and in less-studied geographic regions. The widespread distribution of several non-native freshwater bivalves, their ongoing introductions, and high ecological and economic impacts demand continued research. Systematic reviews such as this are essential for identifying knowledge gaps and guiding future research to enable a more complete understanding of the ecological implications of invasive bivalves, and the development of effective management strategies.

10.
J Palliat Med ; 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38973555

ABSTRACT

Background: Postgraduate fellowship training for nurse practitioners (NP) in palliative care can ameliorate workforce shortages; however, currently there are few NP fellowships and little evidence about outcomes, such as retention in hospice and palliative nursing, job satisfaction, or professional contributions. Objective: To describe the impact of palliative care fellowship training on the careers of NP alumni. Methods: A survey was electronically distributed to all NP alumni of an interprofessional palliative care fellowship since adult and pediatric nursing cohorts were added (2009-2022). Results: Most respondents still worked in hospice and/or palliative care; a majority of them engaged in professional activities beyond clinical work and reported high career satisfaction. Alumni endorsed multiple benefits of postgraduate fellowship except for post-fellowship compensation. Conclusions: NP palliative care fellowship alumni reported multiple career benefits including job satisfaction, professional accomplishment, and ongoing employment at their training institutions.

11.
Transpl Int ; 37: 12469, 2024.
Article in English | MEDLINE | ID: mdl-38952482

ABSTRACT

Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources.


Subject(s)
Drug Resistance, Multiple, Bacterial , Organ Transplantation , Humans , Organ Transplantation/adverse effects , Transplant Recipients , Anti-Bacterial Agents/therapeutic use , Prevalence , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , Developing Countries
12.
Surg Obes Relat Dis ; 2024 May 27.
Article in English | MEDLINE | ID: mdl-38955647

ABSTRACT

BACKGROUND: The COVID-19 pandemic had affected the health systems across the world since early 2020 with a concern about access to medical care during the first wave of COVID-19 pandemic. OBJECTIVES: The objective of this study was to examine how the COVID-19 pandemic influenced patient selection, approach type, and postoperative outcomes in elective bariatric surgery. SETTING: United States. METHODS: Data from the MBSAQIP database for the years 2016-2020 were queried. Wilcoxon rank-sum test and Fisher's exact test were employed for continuous and categorical variables, respectively. Postoperative outcomes within 30 days were assessed separately and based on the Clavien-Dindo (CD) classification of III-V. χ2 test and logistic regression were used to compare outcomes between procedure and approach types, as well as surgical operation periods. RESULTS: A total of 741,620 patients underwent robotic and laparoscopic sleeve gastrectomy and Roux-en-Y gastric-bypass. The cases performed in 2020 exhibited lower comorbidities and postoperative complications compared to prepandemic years, regardless of the approach type. Notably, the proportion of White patients decreased during the pandemic, while there was an increase in the number of African American and Hispanic patients who had bariatric surgery. CONCLUSIONS: Patients who underwent bariatric surgery during the COVID-19 pandemic appeared to be healthier with fewer comorbidities and experienced fewer adverse postoperative outcomes compared to those who had surgery prior to the pandemic. This study highlights the limited access to bariatric surgery for high-risk patients during the pandemic.

13.
Front Public Health ; 12: 1386667, 2024.
Article in English | MEDLINE | ID: mdl-38957207

ABSTRACT

Healthcare quality in low- and middle-income countries poses a significant challenge, contributing to heightened mortality rates from treatable conditions. The accreditation of health facilities was part of the former health reform in Mexico, proposed as a mechanism to enhance healthcare quality. This study assesses the performance of hospital accreditation in Mexico, utilizing indicators of effectiveness, efficiency, and safety. Employing a longitudinal approach with controlled interrupted time series analysis (C-ITSA) and fixed effects panel analysis, administrative data from general hospitals in Mexico is scrutinized. Results reveal that hospital accreditation in Mexico fails to enhance healthcare quality and, disconcertingly, indicates deteriorating performance associated with increased hospital mortality. Amidst underfunded health services, the implemented accreditation model proves inadequately designed to uplift care quality. A fundamental redesign of the public hospital accreditation model is imperative, emphasizing incentives for structural enhancement and standardized processes. Addressing the critical challenge of improving care quality is urgent for Mexico's healthcare system, necessitating swift action to achieve effective access as a benchmark for universal healthcare coverage.


Subject(s)
Accreditation , Quality of Health Care , Mexico , Accreditation/standards , Humans , Quality of Health Care/standards , Quality Improvement , Hospitals/standards , Interrupted Time Series Analysis , Hospital Mortality , Longitudinal Studies
14.
S Afr Fam Pract (2004) ; 66(1): e1-e13, 2024 Jun 06.
Article in English | MEDLINE | ID: mdl-38949448

ABSTRACT

BACKGROUND:  Epidermolysis bullosa (EB) is a rare, incurable genodermatosis that presents with blistering and skin fragility. Complications can be localised or generalised, limited to the skin or have systemic effects resulting in death. Caring for a child with this painful condition can have a profound effect on the quality of life of parents and the family. There is currently no published research on the lived experience of parents caring for a child with EB in a resource-limited environment in Africa. METHOD:  This qualitative research used interpretative phenomenological analysis with the aim of understanding the lived experiences of parents caring for children with EB. Semi-structured interviews were conducted with 13 participants between May 2022 and October 2023. Guba's framework of trustworthiness was used to ensure rigour. RESULTS:  Seven experiential themes with associated sub-themes were identified. The themes were (1) grappling with understanding EB, (2) the psychological experience, (3) living with the responsibility, (4) barriers to feeling supported, (5) changing relational dynamics, (6) experience of healthcare professionals and (7) parental needs. CONCLUSION:  Parents caring for children with EB face emotional, physical, psychosocial and financial challenges. Addressing parents' needs and concerns will go a long way in decreasing this burden. A biopsychosocial approach with an awareness of cultural context is essential for family-centred holistic EB care.Contribution: This is the first study in Africa that focussed on the lived experiences of parents caring for a child with EB.


Subject(s)
Epidermolysis Bullosa , Parents , Qualitative Research , Quality of Life , Humans , Epidermolysis Bullosa/psychology , Epidermolysis Bullosa/therapy , Parents/psychology , Male , Female , Child , Adult , Interviews as Topic , Middle Aged , South Africa , Child, Preschool , Perception
15.
Int Urogynecol J ; 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38951165

ABSTRACT

INTRODUCTION AND HYPOTHESIS: The objective was to study the incidence of urinary incontinence (UI), associated risk factors and quality of life (QOL) in postpartum women. METHODS: A prospective study was conducted with 406 postpartum women at Rajavithi Hospital and followed up over the phone between June 2020 and September 2021. Inclusion criteria were singleton pregnant women aged 18-45 years, and gestational age ≥ 37 weeks. Baseline characteristics (age, body mass index, birthweight, gestational age, parity, delivery type, smoking, and alcohol and caffeine intake) were recorded. UI was defined as a score ≥ 16.7% using the Urogenital Distress Inventory. Incontinence-related QOL was evaluated using the Incontinence Impact Questionnaire: a score of ≥ 70 indicated poor QOL. Outcomes were assessed during the postpartum period at 2 days, 6 weeks, 3 months, and 6 months. Multivariate logistic regression was used to analyze risk factors for UI. RESULTS: The incidence of self-reported UI at 2 days, 6 weeks, 3 months, and 6 months postpartum were 39%, 3%, 1%, and 0% respectively. Caffeine consumption during pregnancy was only a risk factor for UI (adjusted RR 1.61, 95%CI 1.27-2.05, p < 0.001) after adjusting for age, BMI, birthweight, parity, delivery type, alcohol, smoking, and pelvic floor exercise. Three women with UI had poor QOL, whereas all women without UI reported a good QOL. CONCLUSION: In our study sample, urinary incontinence was found in one-third of women during the early postpartum period, but for most women symptoms improved with the first 6 weeks and all resolved at 6 months. In this study, caffeine consumption during pregnancy was the only risk factor for UI.

16.
J Appl Clin Med Phys ; : e14403, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38952067

ABSTRACT

PURPOSE: This study aimed to clarify the dosimetric impact of the respiratory motion of the liver on stereotactic body radiation therapy (SBRT) for spine metastasis and examine the utility of introducing beam avoidance (beam-off at specific gantry angles). METHODS: A total of 112 consecutive patients who underwent SBRT for spine metastasis between 2018 and 2024 were examined. Overall, 15 patients who had lesions near the liver dome were included in this study. Retrospective treatment plans were generated using computed tomography (CT) images acquired during inhalation and exhalation to evaluate the dosimetric impact of respiratory motion of the liver. The dose difference (DD) and relative value (DD%) were evaluated using the dose-volume histogram (DVH) metrics, planning target volume Dmax, D95%, spinal cord D0.035 cc, and esophagus D2.5 cc. The magnitude of the liver movements was evaluated based on differences of liver size Lave at the isocentric axial plane between the inspiratory and expiratory CT images. RESULTS: The DD in almost all DVH metrics tended to increase when the liver moved away from the target during inhalation: For example, Mean ± $ \pm $ a standard deviation (SD) DD in PTV D95% for the treatment plan incorporating beam avoidance and those without beam avoidance was 0.5 ± $\pm$ 0.3 and 0.9 ± $ \pm $ 0.6 Gy, respectively. The spinal cord D0.035 cc for those shows 0.4 ± $ \pm $ 0.2 and 0.7 ± $ \pm $ 0.7 Gy, respectively. The treatment plans without beam avoidance also showed moderate or strong correlations between Lave and DD for almost all DVH metrics. No correlation was seen in the beam avoidance plan. The spinal cord D0.035 cc revealed approximately 1 Gy or +4% in DD when Lave was < -4 cm. CONCLUSIONS: Respiratory motion of the liver dome can cause substantial dosimetric discrepancies in the dose delivered to the spinal cord, although the extent depends on patient variables. Dose assessment should be performed for determining the appropriate means of respiratory management, such as breath-hold. Alternatively, beam avoidance effectively mitigates the impact.

17.
Vet Anaesth Analg ; 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38960765

ABSTRACT

OBJECTIVE: To characterize the extent of the impact of the COVID-19 pandemic on aspects of the anesthesia residency experience from the perspective of American College of Veterinary Anesthesia and Analgesia (ACVAA) mentors and trainees. This includes the residency interview process, didactic training and availability and variety of clinical cases for resident learning. STUDY DESIGN: Cross-sectional, online, anonymous voluntary survey. SAMPLE POPULATION: A total of 58 respondents, representing 30 residency program mentors and 28 residents. METHODS: Surveys were distributed by email to 94 residency program mentors and 70 residents, representing programs and residents registered with the ACVAA during the years of 2019-2021. Anonymous links to an online survey were provided via a link embedded in the email. Questions included perceived impacts (-5 to +5 scale) on didactic and clinical training, case distribution, workload, residency application and selection process, and mental health. Responses were summarized with descriptive statistics [median (IQR) or mean ± SD]. RESULTS: The overall survey response rate was 31.9% (30/94) and 40.0% (28/70) for resident program mentors and residents, respectively. There was a negative perceived impact on overall residency training reported: -1.0 (IQR -2.0 to 0) for program mentors and -1.5 ± 1.5 for residents. The reported perceived impact of travel limitations on case log completion was -2.0 (IQR -4.0 to -1.0) for program mentors and -2.4 ± 2.0 for residents. Program mentors and residents had incongruent feelings on the impact of the pandemic on work hours, with residents reporting a perceived increase in work hours [+2.1 ± 2.1 versus 0 (IQR -1.0 to 0)]. CONCLUSIONS: Residency program mentors and residents generally agreed that the COVID-19 pandemic had negatively impacted multiple aspects of residency interview and training process. A broader, objective analysis of veterinary anesthesia training programs is required to fully elucidate the scale of the impact on veterinary anesthesia training.

18.
Nutr Neurosci ; : 1-12, 2024 Jul 06.
Article in English | MEDLINE | ID: mdl-38970803

ABSTRACT

OBJECTIVES: Rosmarinus officinalis L. (rosemary) is a fragrant plant of the mint family, broadly known as a nourishment flavoring agent; it is additionally utilized in conventional people cures for its anti-inflammatory, diuretic, and antibacterial properties. Intense cognitive impacts from devouring plant-based flavonoids can be measured with electroencephalography (EEG), which records unconstrained brain movement. Brain activity can be evaluated amid independent states or whereas performing attentional assignments. This study aimed to determine the impact of rosemary consumption on cognitive consequences. METHODS: Twenty volunteers took part in the study. EEG was taken for each volunteer twice, before drinking rosemary extract and around one hour after drinking it. EEG information was recorded with a Micromed recording framework inspecting rate of 512 Hz. EEG signals were prepared to be utilized in EEGLAB, an open-source toolbox within the MATLAB environment. The information obtained after the EEG recording was compared with the preliminary EEG information. RESULTS: The signal's power spectral density in theta, delta, and beta frequency bands modestly increased in males and females. Even though there was a significant increase in power at the alpha frequency band in both sexes, this increment was not specific channel-wise. DISCUSSION: The obtained data are consistent with the expected results and similar studies conducted, suggesting that the consumption of rosemary is beneficial for cognitive function in the short term. It is anticipated that forthcoming long-term studies will support the existing data.

19.
Eur J Epidemiol ; 2024 Jul 06.
Article in English | MEDLINE | ID: mdl-38971917

ABSTRACT

Here we introduce graphPAF, a comprehensive R package designed for estimation, inference and display of population attributable fractions (PAF) and impact fractions. In addition to allowing inference for standard population attributable fractions and impact fractions, graphPAF facilitates display of attributable fractions over multiple risk factors using fan-plots and nomograms, calculations of attributable fractions for continuous exposures, inference for attributable fractions appropriate for specific risk factor → mediator → outcome pathways (pathway-specific attributable fractions) and Bayesian network-based calculations and inference for joint, sequential and average population attributable fractions in multi-risk factor scenarios. This article can be used as both a guide to the theory of attributable fraction estimation and a tutorial regarding how to use graphPAF in practical examples.

20.
Front Pharmacol ; 15: 1416029, 2024.
Article in English | MEDLINE | ID: mdl-38983909

ABSTRACT

The global impact of drug shortages on healthcare systems is a concerning issue that needs urgent attention. These shortages not only jeopardize patient care, public health, and healthcare delivery but also pose distinct challenges for pediatric populations due to their specific medication requirements and vulnerabilities. It is imperative to address this issue to safeguard the health and wellbeing of this specific age group. This review Gaimed to conduct a systematic analysis of strategies for addressing drug shortages in pediatric care from 2014 to 2024. The search included five databases: PubMed, Reaxys, Embase, Scopus, and Science Direct, using the keywords "drug shortage" and "pediatric". The final protocol was developed following the guidelines outlined in the " The PRISMA 2020 statement: An updated guideline for reporting systematic reviews". In total, 234 publications were identified. After screening the search results and applying inclusion and exclusion measures, a total of 27 original research papers were included. The primary finding indicates that a comprehensive approach rooted in risk management can significantly mitigate drug shortages in pediatric settings. This approach should address underlying causes such as manufacturer and delivery challenges and focus on prevention through enhanced forecasting and vigilant shortage monitoring. The most prevalent response involved seeking alternative treatment options. It is imperative to implement institutional and national guidelines, foster communication, and provider education, and minimize waste to effectively mitigate drug shortages in pediatric settings.

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