Penasandoval6329

An adequate number of pain domains was assessed by the Brief Pain Inventory (BPI), Short Form-BPI (SF-BPI), and McGill Pain Questionnaire (MPQ). The SF-BPI was the only PROM to demonstrate adequate content validity and at least a low-level of evidence for sufficient internal consistency, resulting in a Class A recommendation (the best performing instrument, recommended for use).

SF-BPI is the best currently available PROM to assess postpartum pain. However, it fails to assess several important domains and only just met the criteria for a Class A recommendation. Future studies are warranted to develop, evaluate, and implement a new PROM designed to specifically assess postpartum pain.

SF-BPI is the best currently available PROM to assess postpartum pain. However, it fails to assess several important domains and only just met the criteria for a Class A recommendation. Future studies are warranted to develop, evaluate, and implement a new PROM designed to specifically assess postpartum pain.This paper concentrates on a simple and robust control method for the discrete time nonlinear systems to fulfill the requirement of predefined accuracy. A sliding mode control method is designed by introducing equivalent dynamic linearization technique according to the input/output (I/O) information merely. A square-root type error transformation method is presented for the tracking error to be restricted within a preassigned zone. The performance of presented control method is demonstrated through experiments on a nonlinear system. Experiment results show that the presented control method has a superior tracking accuracy compared with PID controller and model-free adaptive control (MFAC).The COVID-19 outbreak is an epidemic disease caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). When a new virus emerges, generally, little is known about it, and no vaccines or other pharmaceutical interventions are available. In the case of a person-to-person transmission virus with no vaccines or other pharmaceutical interventions, the only way to control the virus outbreak is by keeping a sustained physical distancing between the individuals. However, to adjust the level of the physical distancing accurately can be so complicated. Any level above the necessary can compromise the economic activity, and any level below can collapse the health care system. This work proposes a controller to keep the number of hospitalized individuals below a limit, and a new group-structured model to describe the COVID-19 outbreak. The proposed controller is robust to the uncertainties in the parameters of the model and keeps the number of infected individuals controlled only by adjusting the social distancing level. Numerical simulations, to show the behavior of the proposed controller and model, are done.This research extends the design of adaptive passivity-based controllers (APBC), proposing a normalized APBC (NAPBC) for nonlinear dynamical systems with a direction of control unknown. The plant also has an accessible single-input and a single-output, smooth behavior, linear explicit parametric dependence, and unknown parameters. The proposed method can handle unknown control direction through an alternate and more straightforward method than Nussbaum gains, having two fewer parameters. We present the stability proof of the controlled system. Besides, the proposed NAPBC expands the tuning method for normalized fixed gains or time-varying gains, reducing the trial and error procedure. Finally, we apply the proposed methodology step by step to a conical tank-scale pilot plant. Comparative experimental results show the proposed NAPBC has better indexes ISI, Ess, MO, IAE, and Ts.

To evaluate the experience and perceptions of reproductive endocrinology and infertility fellowship applicants and program directors (PDs) regarding the current and future use of web-based interviews (WBIs).

Cross-sectional study.

Nationwide cohort.

Reproductive endocrinology and infertility fellowship applicants and PDs participating in the 2020 application cycle.

Anonymous survey sent to applicants and PDs.

Descriptive study evaluating the experience and satisfaction of applicants and PDs with WBIs.

Forty-six percent of applicants and eligible PDs responded to our survey. Most applicants and PDs responded that WBIs were adequate for conveying a sense of a program's strengths, faculty, diversity, clinical training, and research opportunities, but less than half responded that WBIs were adequate in providing a sense of the program's clinical site and facilities. After WBIs, both applicants (73%) and PDs (86%) were able to rank with confidence. The cost of WBIs was significantly lower for both applicants (median $100) and programs (median $100) than the costs previously reported for in-person interviews. The applicants interviewed at more programs than they would have if the interviews were on-site, and Zoom was the highest rated platform used. Most applicants and PDs responded that WBIs were an adequate substitute, and that they should continue after the coronavirus disease 2019 pandemic. Furthermore, most of the PDs were planning to continue to use WBIs in some capacity.

Both applicants and PDs had favorable experiences with and perceptions of WBIs, and most endorse the continued use of this interview modality. BAY-985 chemical structure The findings of this study can help guide and optimize future WBI practices.

Both applicants and PDs had favorable experiences with and perceptions of WBIs, and most endorse the continued use of this interview modality. The findings of this study can help guide and optimize future WBI practices.

To evaluate the use of a web-based application that assists in medication management during invitro fertilization (IVF) treatment.

Multicenter randomized controlled trial.

University hospitals.

Women undergoing IVF.

Subjects were recruited to assess quality of life during IVF and were randomly assigned to use either the OnTrack application to assist with medication management or conventional medication management. Surveys were administered at four time points.

Medication surplus, incidence of medication errors, amount of patient-initiated communication, and patient satisfaction.

A total of 153 women participated. The average number of portal messages and telephone calls was similar between groups. Twelve patients in the control group (12/69, 17.4%) and 8 patients in the case group (8/72, 11.1%) made medication errors. There were similar amounts of medication surplus in the two groups. The estimated cost of medication waste was $2,578 ± $2,056 in the control group and $2,554 ± $1,855 in the case group. Patient satisfaction was similar between the two groups.

Use of a web-based application did not decrease medication errors, medication surplus, or patient-initiated messages. Many patients had a medication surplus, which can be an area of cost reduction during IVF.

Clinicaltrials.gov NCT03383848.

Clinicaltrials.gov NCT03383848.

To review the diagnosis and management of 3 variations of incomplete müllerian duct fusion and reabsorption.

Narrated video delineating the surgical management of 3 müllerian anomalies; this video was deemed exempt from review by the institutional review board of the Mayo Clinic.

Tertiary care academic medical center.

This video focuses on 3 müllerian anomalies complete septate uterus with a single septate cervix (septate uterus unicollis); complete septate uterus with duplicated cervix (septate uterus bicollis); and complete duplication of the uterus and cervix (uterine didelphys).

Magnetic resonance imaging (MRI), cervical septoplasty, operative hysteroscopy, and uterine septoplasty.

Several variations of uterine malformations exist. In our practice, we differentiate complete septate uteri as either unicollis or bicollis via MRI and vaginal examination. The bicollis presentation can be identified on MRI by the "lambda sign," which is seen as the 2 cervices that diverge as they enter the vagina. d by different degrees of disruption in embryogenesis. MRI with vaginal gel and vaginal examination are tools to help classify the anomaly and guide surgical management.

To identify modifying genes that explains the risk of fragile X-associated primary ovarian insufficiency (FXPOI).

Gene-based, case/control association study, followed by a functional screen of highly ranked genes using a Drosophila model.

Participants were recruited from academic and clinical settings.

Women with a premutation (PM) who experienced FXPOI at the age of 35 years or younger (n = 63) and women with a PM who experienced menopause at the age of 50 years or older (n = 51) provided clinical information and a deoxyribonucleic acid sample for whole genome sequencing. The functional screen was on the basis of Drosophila TRiP lines.

Clinical information and a DNA sample were collected for whole genome sequencing.

A polygenic risk score derived from common variants associated with natural age at menopause was calculated and associated with the risk of FXPOI. Genes associated with the risk of FXPOI were identified on the basis of the P-value from gene-based association test and an altered level of fecundity when knocked down in the Drosophila PM model.

The polygenic risk score on the basis of common variants associated with natural age at menopause explained approximately 8% of the variance in the risk of FXPOI. Further, SUMO1 and KRR1 were identified as possible modifying genes associated with the risk of FXPOI on the basis of an untargeted gene analysis of rare variants.

In addition to the large genetic effect of a PM on ovarian function, the additive effects of common variants associated with natural age at menopause and the effect of rare modifying variants appear to play a role in FXPOI risk.

In addition to the large genetic effect of a PM on ovarian function, the additive effects of common variants associated with natural age at menopause and the effect of rare modifying variants appear to play a role in FXPOI risk.

Von Hippel-Lindau disease (VHL) is a rare cause of hereditary bilateral Pheochromocytomas (PHEO). Traditionally, treatment has been total adrenalectomy due to a lifetime risk of developing new tumors. Limited data exists on the surgical management of bilateral PHEO in children with VHL. We reviewed our experience with laparoscopic partial adrenalectomy for bilateral PHEO.

A retrospective review was performed of patients undergoing adrenalectomy for PHEO in children with VHL from 2004 to 2019.

Eight children with VHL diagnosed with bilateral PHEO underwent 16 adrenalectomies (10 synchronous, 5 metachronous, 1 for recurrence). Median age at diagnosis was 13 [range 8-17] years with a median tumor size of 2.3 [range 0.5-7.7]cm. Of 16 adrenalectomies, all were performed laparoscopically, 14 were partial adrenalectomies; 2 patients required a contralateral total adrenalectomy due to size and diffuse multinodularity. There were no postoperative complications. No patients required corticosteroid replacement at the end of the study period. Two patients had new ipsilateral tumors identified after a median follow up of 5 [range 4-6] years with one undergoing repeat partial adrenalectomy. There were no mortalities in the study period.

Partial adrenalectomy for bilateral PHEO in patients with VHL is safe and does not compromise outcomes. When technically feasible, laparoscopic partial adrenalectomy should be considered as a primary surgical approach for children with VHL.

Level IV - Case series with no comparison group.

Level IV - Case series with no comparison group.