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The heat generated during the cutting processes significantly influences the manufacturing accuracy. For many machining tasks, the use of cooling lubricant is essential to achieve the necessary cooling and lubricating effect in the cutting zone. A reduction of a coolant supply due to resource-efficient or ecological efforts has an impact on the temperature field in the cutting tool and clamping system, which affects the thermal behavior of the frame structure and can cause its thermo-elastic deformations leading to machining inaccuracies. In this paper, the multi-phase CFD model for simulation of liquid coolant flow around the cutting tool was developed. The effect of rotation of the cutting tool causing turbulences was taken into account and the simulation of coolant flow was based in Eulerian approach as a continuous flow. Furthermore, this paper considers the modification of the simulation model for thermal simulations of the influence of coolant flow on the temperature field of the cutting tool and clamping system. [ABSTRACT FROM AUTHOR]

Introduction: Central line-associated bloodstream infections (CLABSI) are prevalent and preventable hospital-acquired infections associated with high morbidity and costs. Disparities based on race, ethnicity, and hospital factors remain underexplored. This study compares cost, length of stay, and mortality for adults with CLABSI by race-ethnicity, hospital location-teaching status, and geographic region in the United States using data from the National Inpatient Sample (NIS) database from 2016 to 2020., Methods: The hospitalization cohort included adults diagnosed with CLABSI, excluding those with primary CLABSI diagnoses, cancer, immunosuppressed states, or neonatal conditions. Primary outcomes were in-hospital mortality, length of stay, and hospital costs, adjusted to mid-year 2020 US dollars. Independent variables included race-ethnicity, hospital location-teaching status, and geographic region. All analyses accounted for NIS sampling design., Results: From 2016 to 2020, there were approximately 19,835 CLABSI hospitalizations. The overall in-hospital mortality rate was 9.1%, with a median hospital stay of 16.9 days and median cost of $44,810. Hispanic patients experienced significantly higher mortality, longer length of stay, and higher costs compared to non-Hispanic Black and White patients. Urban teaching hospitals had longer stays and higher costs than rural and urban non-teaching hospitals. Regionally, the Northeast and West had higher costs and longer stays than the Midwest and South, but mortality rates did not differ significantly., Conclusion: This study highlights significant disparities in CLABSI outcomes based on demographic factors. Addressing these disparities is crucial for improving CLABSI management and healthcare equity. Further research should explore the underlying causes of these differences to inform targeted interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dix, Belleville, Mishra, Walters, Millner, Jabbar and Tauseef.)

Background: The fecal immunochemical test (FIT) is widely used in colorectal cancer (CRC) screening, but limited data exist for its application in individuals at above-average risk for CRC who complete surveillance colonoscopies., Aim: To assess the accuracy, acceptability, and effectiveness of FIT in the interval between surveillance colonoscopies, for predicting advanced neoplasia (advanced adenoma or CRC) at the next colonoscopy., Methods: Individuals enrolled in an Australian surveillance program were included. Diagnostic accuracy was determined for 614 individuals completing a two-sample FIT (OC-Sensor) ≤ 3 months preceding surveillance colonoscopy. 386 Individuals were surveyed to assess acceptability of interval FIT. Additionally, a retrospective analysis was performed on 7331 individuals offered interval FIT between colonoscopies, where a positive FIT (≥ 20 µg hemoglobin/g feces) triggered an early colonoscopy. Associations between interval FIT results and advanced neoplasia were determined using regression analysis., Results: FIT detected CRC and advanced adenoma with sensitivities of 60.0% (3/5) and 27.1% (35/129), respectively. Most (89.1%, 344/386) survey respondents preferred completing interval FIT every 1-2 years. The detection rate of interval FIT for advanced neoplasia decreased with increasing FIT completion. Individuals returning a positive FIT had a higher risk of advanced neoplasia than those who did not complete FIT. Positive interval FIT reduced time-to-diagnosis for CRC and advanced adenoma by a median of 30 and 20 months, respectively., Conclusion: Interval FIT was well accepted and enabled earlier detection of advanced neoplasia in individuals at above-average risk of CRC. Given that interval FIT predicts advanced neoplasia, it may be used to personalize surveillance colonoscopy intervals., (© 2024. The Author(s).)

Competing Interests: Disclosure: ASR has received consulting fees from Analog Devices and is on the Cardiac Failure Review editorial board; this did not influence acceptance. MD received expenses for attending American College of Cardiology Conference 2022. JL has received grants from AstraZeneca and Volumetrix, and consulting fees from Abbott, Alleviant, AstraZeneca, Axon, Bayer, Boston Scientific, Cordio, CVRx, Edwards Lifesciences, Medtronic, Merck, Vascular Dynamics, VWave and Whiteswell. All other authors have no conflicts of interest to declare.

The Family-centered Function Focused Care (Fam-FFC) intervention, is a nurse-family care partnership model aimed to improve the physical and cognitive recovery in hospitalized persons living with Alzheimer's Disease Related Dementias (ADRD) while improving the care partner's experiences. Discussions of patients' needs and preferences between nurses and the patient's close family members have been found to be useful in preventing excessive stress in persons with dementia, while lessening the anxiety of care partners. However, the efficacy of dementia-specific interventions is influenced in part by the degree to which the interventions are flexible and sensitive to the patient's and care-partner's condition, needs, and preferences, including cultural preferences. Therefore, the purpose of this study is to assess the cultural appropriateness of Fam-FFC using the Ecological Validity Model (EVM). This qualitative, descriptive study included 28 consented care partners drawn from a sample of 455 dyads enrolled in the Fam-FFC intervention. An interview guide was created based on the EVM. Participants provided demographic data. Thematic analysis was conducted to analyze transcribed interviews. The majority of the sample was female (79%), Non-Hispanic (96%) and half were married. One-half of the sample represented Black care partners and one-half were White. Seventy-nine percent lived with their family member with ADRD. Three major themes were identified from the thematic analysis including Care Partner Identity, Care Partner Preferences, and Goals of Care for functional recovery of their family member living with dementia. In this study care partners wanted more social services as well as home care that supported not just physical needs but also social and recreational needs. Findings from the study offer guidance on improving the Fam-FFC intervention including strengthening education and resources on partner self-care., Competing Interests: Declaration of conflict of interestThe author(s) declare no potential conflicts of interest regarding the research, authorship, and/or publication of this article.

Introduction: There is a paucity of literature comparing patients receiving bedside placed percutaneous endoscopic gastrostomy (PEG) versus fluoroscopic-guided percutaneous gastrostomy tubes (G-tube) in an intensive care unit (ICU) setting. This study aims to investigate and compare the natural history and complications associated with PEG versus fluoroscopic G-tube placement in ICU patients., Methods: All adult patients admitted in the ICU requiring feeding tube placement at our center from 1/1/2017 to 1/1/2022 with at least 12-month follow up were identified through retrospective chart review. Adjusting for patient comorbidities, hospital factors, and indications for enteral access, a 1-to-2 propensity score matched Cox proportional-hazards model was fitted to evaluate the treatment effect of bedside PEG tube placement versus G-tube placement on patient 1-year complication, readmission, and death rates. Major complications were defined as those requiring operative or procedural intervention., Results: This study included 740 patients, with 178 bedside PEG and 562 fluoroscopic G-tube placements. The overall rate of complication was 22.3% (13% PEG, 25.2% G-tube, P = 0.003). The major complication rate was 11.2% (8.5% PEG, 12.1% G-tube, P = 0.09). Most common complications were tube dysfunction (16.7% PEG; 39.4% G-tube; P = 0.04) and dislodgement (58.3% PEG; 40.8% G-tube). After propensity score matching, G-tube recipients had significantly increased risk for all-cause (HR 2.7, 95% CI 1.56-4.87, P < 0.001) and major complications (HR 2.11, 95% CI 1.05-4.23, P = 0.035). There were no significant differences in 1-year rates of readmission (HR 0.90, 95% CI 0.58-1.38, P = 0.62) or death (HR 1.00, 95% CI 0.70-1.44, P = 0.7)., Conclusions: The overall rate of complications for ICU patients requiring feeding tube in our cohort was 22.3%. ICU patients receiving fluoroscopic-guided percutaneous gastrostomy tube placement had significantly elevated risk of 1-year all-cause and major complications compared to those undergoing bedside PEG., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Reliable functionality in anomaly detection in thermal image datasets is crucial for defect detection of industrial products. Nevertheless, achieving reliable functionality is challenging, especially when datasets are image sequences captured during equipment runtime with a smooth transition from healthy to defective images. This causes contamination of healthy training data with defective samples. Anomaly detection methods based on autoencoders are susceptible to a slight violation of a clean training dataset and lead to challenging threshold determination for sample classification. This paper indicates that combining anomaly scores leads to better threshold determination that effectively separates healthy and defective data. Our research results show that our approach helps to overcome these challenges. The autoencoder models in our research are trained with healthy images optimizing two loss functions: mean squared error (MSE) and structural similarity index measure (SSIM). Anomaly score outputs are used for classification. Three anomaly scores are applied: MSE, SSIM, and kernel density estimation (KDE). The proposed method is trained and tested on the 32 × 32-sized thermal images, including one contaminated dataset. The model achieved the following average accuracies across the datasets: MSE, 95.33%; SSIM, 88.37%; and KDE, 92.81%. Using a combination of anomaly scores could assist in solving a low classification accuracy. The use of KDE improves performance when healthy training data are contaminated. The MSE+ and SSIM+ methods, as well as two parameters to control quantitative anomaly localization using SSIM, are introduced.

The aim of this study was to develop a physical activity advisory system supporting the correct implementation of sport exercises using inertial sensors and machine learning algorithms. Specifically, three mobile sensors (tags), six stationary anchors and a system-controlling server (gateway) were employed for 15 scenarios of the series of subsequent activities, namely squats, pull-ups and dips. The proposed solution consists of two modules: an activity recognition module (ARM) and a repetition-counting module (RCM). The former is responsible for extracting the series of subsequent activities (so-called scenario), and the latter determines the number of repetitions of a given activity in a single series. Data used in this study contained 488 three defined sport activity occurrences. Data processing was conducted to enhance performance, including an overlapping and non-overlapping window, raw and normalized data, a convolutional neural network (CNN) with an additional post-processing block (PPB) and repetition counting. The developed system achieved satisfactory accuracy: CNN + PPB: non-overlapping window and raw data, 0.88; non-overlapping window and normalized data, 0.78; overlapping window and raw data, 0.92; overlapping window and normalized data, 0.87. For repetition counting, the achieved accuracies were 0.93 and 0.97 within an error of ±1 and ±2 repetitions, respectively. The archived results indicate that the proposed system could be a helpful tool to support the correct implementation of sport exercises and could be successfully implemented in further work in the form of web application detecting the user's sport activity.

Perfectly coated surfaces are an essential quality feature in the automotive and consumer goods industries. They are the result of an optimized, controlled coating process. Because entire assemblies could be rejected if Out-of-Specification (OOS) parts are installed, this has a severe economic impact. This paper presents a novel, line-integrated multi-camera system with intelligent algorithms for anomaly detection on small KTL-coated aluminum parts. The system also aims to automatize the previously used human inspection to a sophisticated and automated vision system that efficiently detects defects and anomalies on coated parts.

This paper presents a new approach to the structural integration of piezoceramics into thin-walled steel components for condition-monitoring applications. The procedure for integrating the sensors into metal components is described, and their functionality is experimentally examined with a 2 mm-thick steel sheet. The signal quality of the produced sensors is investigated in a frequency range from 100 Hz to 50,000 Hz and is compared with the results of piezo patches and strain gauges under the same conditions. The results show that due to a higher signal-to-noise ratio and a better coherence, the structurally integrated piezoceramics and the piezo patches are more qualified sensors for vibration measurement in the examined frequency range than the strain gauges. The measurements also indicate that the patches provide higher amplitudes for the frequency range up to 20 kHz. Beyond that, up to 40 kHz, the integrated sensors supplied higher amplitudes. The better signal quality in different frequency ranges as well as the different manufacturing and application methods can be interpreted as an advantage or disadvantage depending on the boundary conditions of the condition-monitoring system. In summary, structural integrated piezoceramics extend the options of monitoring technology.

Objective: This is to determine whether health beliefs regarding colorectal cancer (CRC) screening could predict discomfort with a change to CRC surveillance proposing regular faecal immunochemical tests (FIT) instead of colonoscopy., Methods: Eight hundred individuals enrolled in a South Australian colonoscopy surveillance programme were invited to complete a survey on surveillance preferences. Responses were analysed using binary logistic regression predicting discomfort with a hypothetical FIT-based surveillance change. Predictor variables included constructs based on the Health Belief Model: perceived threat of CRC, perceived confidence to complete FIT and colonoscopy (self-efficacy), perceived benefits from current surveillance and perceived barriers to FIT and colonoscopy., Results: A total of 408 participants (51%) returned the survey (complete data n = 303; mean age 62 years, 52% male). Most participants (72%) were uncomfortable with FIT-based surveillance reducing colonoscopy frequency. This attitude was predicted by a higher perceived threat of CRC (OR = 1.03 [95% CI 1.01-1.04]), higher colonoscopy self-efficacy (OR = 1.34 [95% CI 1.13-1.59]) and lower perceived barriers to colonoscopy (OR = 0.92 [95% CI 0.86-0.99])., Conclusions: Health beliefs regarding colonoscopy and perceived threat of CRC may be important to consider when changing CRC surveillance protocols. If guideline changes were introduced, these factors should be addressed to provide patients reassurance concerning the efficacy of the alternative protocol., (© 2022 John Wiley & Sons Ltd.)

The pathological changes of ubiquitination and deubiquitination following myocardial infarction (MI) and chronic heart failure (CHF) have been sparsely examined. We investigated the expression of muscle-specific E3 ubiquitin ligases and deubiquitinases in MI and CHF. Therefore, mice were assigned to coronary artery ligation for 3 days or 10 weeks as well as for sham operation (each n = 10). Expression of E3 ligases (MAFBX, MURF1, CHIP, ITCH, MDM2) and deubiquitinases (A20, CYLD, UCH-L1, USP14, USP19) was determined. After MI and in CHF, the mRNA expression of MURF1, CHIP and MDM2 (all p < 0.05) was decreased. Protein expression analyses revealed that ITCH expression decreased in CHF ( p = 0.01), whereas MDM2 expression increased in MI ( p = 0.02) and decreased in CHF ( p = 0.02). Except for USP19 mRNA expression that decreased at 3 days and 10 weeks (both p < 0.01), the expression of other deubiquitinases remained unaffected after MI and CHF. The expression of myocardial E3 ligases is differentially regulated following MI, raising the question of whether an upstream regulation exists that is activated by MI for tissue protection or whether the downregulation of E3 ligases enables myocardial hypertrophy following MI.

Human-induced deforestation and soil erosion were environmental stressors for the ancient Maya of Mesoamerica. Furthermore, intense, periodic droughts during the Terminal Classic Period, ca. Common Era 830 to 950, have been documented from lake sediment cores and speleothems. Today, lakes worldwide that are surrounded by dense human settlement and intense riparian land use often develop algae/cyanobacteria blooms that can compromise water quality by depleting oxygen and producing toxins. Such environmental impacts have rarely been explored in the context of ancient Maya settlement. We measured nutrients, biomarkers for cyanobacteria, and the cyanotoxin microcystin in a sediment core from Lake Amatitlán, highland Guatemala, which spans the last ∼2,100 y. The lake is currently hypereutrophic and characterized by high cyanotoxin concentrations from persistent blooms of the cyanobacterium Microcystis aeruginosa Our paleolimnological data show that harmful cyanobacteria blooms and cyanotoxin production occurred during periods of ancient Maya occupation. Highest prehistoric concentrations of cyanotoxins in the sediment coincided with alterations of the water system in the Maya city of Kaminaljuyú, and changes in nutrient stoichiometry and maximum cyanobacteria abundance were coeval with times of greatest ancient human populations in the watershed. These prehistoric episodes of cyanobacteria proliferation and cyanotoxin production rivaled modern conditions in the lake, with respect to both bloom magnitude and toxicity. This suggests that pre-Columbian Maya occupation of the Lake Amatitlán watershed negatively impacted water potability. Prehistoric cultural eutrophication indicates that human-driven nutrient enrichment of water bodies is not an exclusively modern phenomenon and may well have been a stressor for the ancient Maya., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)