Kyedkorsgaard0349

In the Netherlands, there is an increasing need for collective forms of housing for older people. Such housing bridges the gap between the extremes of living in an institutionalised setting and remaining in their own house. The demand is related to the closure of many residential care homes and the need for social engagement with other residents. This study focuses on housing initiatives that offer innovative and alternative forms of independent living, which deviate from mainstream housing arrangements. It draws on recent literature on healthcare 'rebels' and further develops the concept of 'rebellion' in the context of housing. The main research question is how founders dealt with challenges of establishing and governing 'rebellious' innovative living arrangements for older people in the highly regulated context of housing and care in the Netherlands. Qualitative in-depth interviews with 17 founders (social entrepreneurs, directors and supervisory board members) were conducted. Founders encountered various obstacles that are often related to governmental and sectoral rules and regulations. Their stories demonstrate the opportunities and constraints of innovative entrepreneurship at the intersection of housing and care. The study concludes with the notion of 'responsible rebellion' and practical lessons about dealing with rules and regulations and creating supportive contexts.To improve healing of pressure ulcer wounds, it is important to optimize the conditions of the area surrounding the wound. Negative pressure wound therapy (NPWT) promotes wound healing, however, the removal of NPWT can cause pain or focal bleeding, delaying wound healing or causing infection. In this study, we reviewed the efficacy of the lipidocolloid non-adherent dressing (Urgotul®) as a wound contact layer. A total of 38 patients from the same facility who applied NPWT from April 2016 to October 2019 were included and divided into two groups; NPWT with the lipidocolloid non-adherent dressing (group 1, experimental group, 19 patients) and NPWT only (group 2, control group, 19 patients). The condition of the wound was examined prior to NPWT application, at one week, and again at three weeks after application. No significant differences were found between groups for general characteristics, bacterial culture or photo analysis. However, when comparing groups based on the time of examination, there was a significant reduction of the wound size in group 1 (p = 0.001) but not in group 2 (p = 0.082). Therefore, the current study finds that using the lipidocolloid non-adherent dressing as a wound contact layer in NPWT stimulates healing by shrinking the size of the pressure ulcer wound.Background A machine learning (ML) system is able to construct algorithms to continue improving predictions and generate automated knowledge through data-driven predictors or decisions. Objective The purpose of this study was to compare six ML methods (random forest (RF), logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, and sigmoid SVM) of predicting falls in nursing homes (NHs). Methods We applied three representative six-ML algorithms to the preprocessed dataset to develop a prediction model (N = 60). We used an accuracy measure to evaluate prediction models. Results RF was the most accurate model (0.883), followed by the logistic regression model, SVM linear, and polynomial SVM (0.867). Conclusions RF was a powerful algorithm to discern predictors of falls in NHs. For effective fall management, researchers should consider organizational characteristics as well as personal factors. Recommendations for Future Research To confirm the superiority of ML in NH research, future studies are required to discern additional potential factors using newly introduced ML methods.The growing importance of bio-based products, combined with the desire to decrease the production of wastes, boosts the necessity to use wastes as raw materials for bio-based products. A waste material with a large potential is spent sugar beets, which are mainly used as animal feeds or fertilizers. After hydrothermal treatment, the produced chars exhibited an H/C ratio of 1.2 and a higher heating value of 22.7 MJ/kg, which were similar to that of subbituminous coal and higher than that of lignite. Moreover, the treatment of 25 g/L of glucose and 22 g/L of fructose by heating up to 160 °C led to a possible application of spent sugar beets for the production of 5-hydroxymethylfurfural. In the present study, the maximum concentration of 5-hydroxymethylfurfural was 3.4 g/L after heating up to 200 °C.Cyclic wetting and drying processes have been considered as important factors that accelerate the weathering process and have deteriorative effects on rock properties. In the present study, a fully nondestructive and noninvasive testing approach utilizing micro-CT and ultrasonic wave velocity tests was employed to investigate the microstructure of slate under wetting and drying cycles. We studied variations in the physical properties, including the dry weight and the velocities of P- and S-waves versus the number of wetting and drying cycles. The internal microstructural distributions were visualized and quantified by the 3D reconstruction and hybrid image segmentation of CT images. The degree of deterioration caused by wetting and drying cycles was reflected by exponential decreases of physical properties, including dry weight and velocities of the P- and S-waves. Parameters relating to the microfracture diameter, volume, etc. were quantified. The nondestructive and noninvasive testing approach utilizing micro-CT and ultrasonic wave velocity tests has potential for the detection and visualization of the internal microstructure of rock under wetting and drying cycles.African animal trypanosomosis are parasitic diseases caused by several protozoa of the genus Trypanosoma, transmitted by hematophagous insects, essentially tsetse flies, but also, less frequently by Tabanidae and Stomoxidae. They are geolocated in a part of the continent and affect livestock animals and carnivores; dogs are especially sensitive to them. They do not seem to present a zoonotic risk. Despite the chemical prevention with trypanocides for French military working dogs on mission in Côte d'Ivoire, a fatal case induced by Trypanosoma congolense in France after returning from Abidjan raises the question of an imported secondary focus. The clinical case was developed and the causative agent was confirmed by microscopy and PCR methods. The three necessary pillars to create a secondary potential focus are present the parasite introduction in a new territory, the presence and the propagation vectors, and their proximity with sensitive species.Effective traffic sign recognition algorithms can assist drivers or automatic driving systems in detecting and recognizing traffic signs in real-time. This paper proposes a multiscale recognition method for traffic signs based on the Gaussian Mixture Model (GMM) and Category Quality Focal Loss (CQFL) to enhance recognition speed and recognition accuracy. Specifically, GMM is utilized to cluster the prior anchors, which are in favor of reducing the clustering error. Meanwhile, considering the most common issue in supervised learning (i.e., the imbalance of data set categories), the category proportion factor is introduced into Quality Focal Loss, which is referred to as CQFL. TAK-779 chemical structure Furthermore, a five-scale recognition network with a prior anchor allocation strategy is designed for small target objects i.e., traffic sign recognition. Combining five existing tricks, the best speed and accuracy tradeoff on our data set (40.1% mAP and 15 FPS on a single 1080Ti GPU), can be achieved. The experimental results demonstrate that the proposed method is superior to the existing mainstream algorithms, in terms of recognition accuracy and recognition speed.

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has become increasingly popular. Several reports have emphasized the safety and efficacy of this new approach. However, there is no report on functional voice outcomes, including voice pitch change after TOETVA.

The functional voice outcomes of patients undergoing TOETVA were compared with those of patients undergoing conventional thyroidectomy. A total of 82 consecutive patients were included in the study 44 underwent thyroid lobectomy via TOETVA (transoral group) and 38 underwent thyroid lobectomy via the classic cervical approach (open group). Thyroidectomy-related voice questionnaire (TVQ), perceptual voice analysis, fiberoptic laryngoscopic and videolaryngostroboscopic examinations, and acoustic analysis were carried out before and one month after surgery. The changes in these values after surgery and the differences between the transoral and open groups were analyzed.

We found no significant postoperative change in voice workups in either group. The mean high pitch decreased (from 367.91 ± 120.98 to 325.80 ± 100.86 Hz,

= 0.069) in the transoral group, but statistical significance was not attained. Clinically significant changes in pitch (postoperative change in speaking fundamental frequency, ΔSFF ≥ 12) after surgery were evident in seven (15.91%) patients in the transoral group and eight (21.05%) patients in the open group without significant difference (

= 0.579).

This is the first study to assess functional voice outcomes (including pitch) after TOETVA compared with conventional open surgery. TOETVA was associated with good voice outcomes without any significant drop in pitch.

This is the first study to assess functional voice outcomes (including pitch) after TOETVA compared with conventional open surgery. TOETVA was associated with good voice outcomes without any significant drop in pitch.There is an under-recognized role of the aryl hydrocarbon receptor (AhR) in co-ordinating the entry and pathophysiology of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that underpins the COVID-19 pandemic. The rise in pro-inflammatory cytokines during the 'cytokine storm' induce indoleamine 2,3-dioxygenase (IDO), leading to an increase in kynurenine that activates the AhR, thereby heightening the initial pro-inflammatory cytokine phase and suppressing the endogenous anti-viral response. Such AhR-driven changes underpin the heightened severity and fatality associated with pre-existent high-risk medical conditions, such as type II diabetes, as well as to how racial discrimination stress contributes to the raised severity/fatality in people from the Black Asian and Minority Ethnic (BAME) communities. The AhR is pivotal in modulating mitochondrial metabolism and co-ordinating specialized, pro-resolving mediators (SPMs), the melatonergic pathways, acetyl-coenzyme A, and the cyclooxygenase (COX) 2-prostaglandin (PG) E2 pathway that underpin 'exhaustion' in the endogenous anti-viral cells, paralleling similar metabolic suppression in cytolytic immune cells that is evident across all cancers. The pro-inflammatory cytokine induced gut permeability/dysbiosis and suppression of pineal melatonin are aspects of the wider pathophysiological underpinnings regulated by the AhR. This has a number of prophylactic and treatment implications for SARS-CoV-2 infection and cancers and future research directions that better investigate the biological underpinnings of social processes and how these may drive health disparities.