Martensjochumsen3850
This article describes the development of the Singapore Environmental Assessment Tool (SEAT), a culturally appropriate, usable, reliable, and valid assessment tool designed to evaluate the extent to which the built environment in Singaporean aged care facilities is able to support the provision of high levels of care to people living with dementia.
A multistage sequential mixed methods approach was carried out involving 16 raters in Stage 1 and six raters in Stage 2 using a culturally adapted English version of the Environmental Audit Tool-High Care (EAT-HC) in eight nursing homes. The first stage captured qualitative data on cultural sensitivities and usability of the tool. The SEAT was improved based on the findings, and in the second stage, the usability and psychometric properties of the modified tool were again assessed. Usability was determined by data collected via the System Usability Scale and the Questions to Assess Barriers and Facilitators survey. Psychometric properties were examined by the calculation of percentage agreement, item-level interrater agreement was measured using Fleiss's κ, and Cronbach's α was used to measure the internal consistency of the subscale scores.
The culturally adapted SEAT was found to have an acceptable level of usability and moderate level of reliability among subscales.
The study indicated that the tool is reliable and valid when completed by users with knowledge of dementia-enabling environments. For the tool to be used with confidence education in the application of principles of design to the design of environments for people living with dementia is recommended prior to its use.
The study indicated that the tool is reliable and valid when completed by users with knowledge of dementia-enabling environments. For the tool to be used with confidence education in the application of principles of design to the design of environments for people living with dementia is recommended prior to its use.
Tumor infiltrating lymphocytes (TILs) aid in informing treatment for head and neck squamous cell carcinoma (HNSCC). Nevertheless, little is known about the role of diet on TILs.
Immunohistologic expression of CD4, CD8, CD68, CD103, CD104 and FOXP3 were assessed in tissue microarrays from 233 previously untreated HNSCC patients. Associations between these markers and pretreatment dietary patterns were evaluated using linear regression. Associations between baseline serum carotenoids, tocopherols and TILs were assessed using logistic regression. Cox models evaluated the association between diet and TILs on overall and recurrence-free survival.
Consumption of a Western dietary pattern was associated with lower CD8+ and FOXP3+ infiltrates (p-value0.03 and 0.02, respectively). Multivariable logistic regression models demonstrated significantly higher CD8+ (OR2.21;p-value0.001) and FOXP3+ (OR4.26;p-value<0.0001) among patients with high gamma tocopherol. see more Conversely, high levels of xanthophylls (OR0.12;p-value<0.0001), lycopene (OR0.36;p-value0.0001) and total carotenoids(OR0.31;p-value <0.0001) were associated with significantly lower CD68+. Among those with high CD4+ (HR1.77;p-value0.03), CD68+ (HR2.42;p-value0.004), CD103+ (HR3.64;p-value0.03) and FOXP3+ (HR3.09;p-value0.05), having a high Western dietary pattern increased the risk of overall mortality when compared to a low Western dietary pattern.
Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC.
Dietary patterns and serum carotenoids may play an important role in modifying TILs, and ultimately, outcome after diagnosis with HNSCC.We used a mixed-method design to examine the attributions women in mixed-gender/sex relationships make for their partner's perceived pornography use and whether such attributions covary with women's relationship and sexual satisfaction. A final sample of 199 women completed measures of relationship satisfaction, sexual satisfaction, and their perceptions of partner's pornography use. Participants also completed three open-ended questions assessing their attributions of their partner's perceived pornography use. Qualitative analyses revealed 11 themes in women's attributions of their partner's perceived pornography use; some of the themes reflected on women themselves (e.g., being open-minded and accepting), whereas other themes reflected on the partner (e.g., partner is sexually bored) or the relationship (e.g., strong and trusting relationship). Furthermore, the women made positive, negative, and neutral attributions. Quantitative analyses showed that positive attributions were significantly more frequent than neutral or negative attributions and the latter two categories did not differ significantly from each other. Also, greater frequency of positive and neutral attributions and lower frequency of negative attributions were associated with higher relationship satisfaction and sexual satisfaction. Our results suggest that women make a range of attributions about their partner's pornography use and that this variation relates meaningfully to indices of relationship functioning.The inflammation and immune responses are critical in ischemic stroke and contribute to aggravated brain damage. Ephedrine was reported to play an important role in the control of inflammatory responses. This study was to investigate the repairing effects and potential mechanisms of ephedrine on cerebral ischemic injury in a rat model of focal cerebral ischemia. The rat model of cerebral ischemia/reperfusion injury was established using the middle cerebral artery occlusion (MCAO) method and then rats were treated with ephedrine (5 and 10 mg/kg) for 7 days. The neurobehavioral progression was assessed using the neurological scoring method. The pathology of brain tissue was evaluated by hematoxylin and eosin (H&E) staining. The infarct volume was examined by triphenyltetrazolium chloride (TTC) staining. The apoptosis in ischemic brain tissues was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). Gene quantification and protein expression were detected by real-time PCR and western blot, respectively. Ephedrine treatment significantly alleviated the cerebral ischemia/reperfusion injury, evidenced by decreased neurological deficit score, infarct volume and water content. Ephedrine also decreased autophagy and apoptosis in brain tissues. Moreover, ephedrine treatment significantly reduced inflammatory responses, associating with decreasing the protein expression of p-NF-κB. These results demonstrated neuroprotective properties of ephedrine and highlighted it as a new potential anti-inflammatory agent against injury of cerebral ischemia/reperfusion.
Retrospective case series.
Patient with metastatic cancer frequently require spinal operations for neural decompression and stabilization, most commonly thoracic vertebrectomy with reconstruction. Objective of the study was to assess economic aspects associated with use of cement versus expandable cage in patients with single level thoracic metastatic disease. We also looked at the differences in the clinical, radiological, complications and survival differences to assess non-inferiority of PMMA over cages.
The electronic medical records of patients undergoing single level thoracic vertebrectomy and reconstruction were reviewed. Two groups were made PMMA and EC. Totals surgical cost, implant costs was analyzed. We also looked at the clinical/ radiological outcome, complication and survival analysis.
96 patients were identified including 70 one-level resections. For 1-level surgeries, Implant costs for use of cement-$75 compared to $9000 for cages. Overall surgical cost was significantly less for PMMA compared to use of EC. No difference was seen in clinical outcome or complication was seen. We noticed significantly better kyphosis correction in the PMMA group.
Polymethylmethacrylate cement offers significant cost advantage for reconstruction after thoracic vertebrectomy. It also allows for better kyphosis correction and comparable clinical outcomes and non-inferior to cages.
Polymethylmethacrylate cement offers significant cost advantage for reconstruction after thoracic vertebrectomy. It also allows for better kyphosis correction and comparable clinical outcomes and non-inferior to cages.
The aim of this paper was to synthesize the experimental research on factors that affect takeover performance during conditionally automated driving.
For conditionally automated driving, the automated driving system (ADS) can handle the entire dynamic driving task but only for limited domains. When the system reaches a limit, the driver is responsible for taking over vehicle control, which may be affected by how much time they are provided to take over, what they were doing prior to the takeover, or the type of information provided to them during the takeover.
Out of 8446 articles identified by a systematic literature search, 48 articles containing 51 experiments were included in the meta-analysis. Coded independent variables were time budget, non-driving related task engagement and resource demands, and information support during the takeover. Coded dependent variables were takeover timing and quality measures.
Engaging in non-driving related tasks results in degraded takeover performance, particularly if it has overlapping resource demands with the driving task. Weak evidence suggests takeover performance is impaired with shorter time budgets. Current implementations of information support did not affect takeover performance.
Future research and implementation should focus on providing the driver more time to take over while automation is active and should further explore information support.
The results of the current paper indicate the need for the development and deployment of vehicle-to-everything (V2X) services and driver monitoring.
The results of the current paper indicate the need for the development and deployment of vehicle-to-everything (V2X) services and driver monitoring.The Na+-taurocholate cotransporting polypeptide (NTCP) acts as the major hepatic basolateral uptake system, and plays a key role in balancing bile flow. The anti-tuberculosis drugs rifampin (RFP) can affect bile flow causing liver injury, while tanshinone IIA (TAN IIA) has the effect of protecting liver. This study aimed to investigate the effects of RFP and TAN IIA on the NTCP expression and activity, and explore the potential connections. Herein, we established sandwich-cultured primary rat hepatocytes, and quantified mRNA and protein levels of NRF2 and NTCP after treatment with RFP (10, 25, or 50 μM) or co-treatment with TAN IIA (5, 10, or 20 μM) for 12, 24, 48 h (n = 3). NTCP activity was assessed by measuring the initial uptake rates of known substrates taurocholate (TCA) (n = 3) after treatment with different concentrations of RFP, TAN ⅡA for 12, 24 and 48 h. We found that RFP had inhibition effects on NRF2, NTCP mRNA and protein expression, and co-administration of TAN IIA could reverse RFP inhibition. TCA cellular accumulation was significantly decreased by RFP (39.1%), and TAN IIA could significantly induce TCA uptake of NTCP (2.9-fold at 48 h). The TCA uptake activity was correlated with the NTCP mRNA expression, confirming the role of RFP or TAN IIA on NTCP expression and activity is synchronous, and we can predict NTCP activity by detecting its mRNA expression. In conclusion, our work will enrich the significance of NTCP in the liver protection, and provide theoretical basis for TAN IIA to prevent RFP induced cholestatic liver injury.
