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Purpose: Precooling (PreC) may only benefit performance when thermal strain experienced by an individual is sufficiently high. We explored the effect of mixed-method PreC on 20-km cycling time-trial (CTT) performance under 3 different apparent temperatures (AT). Methods: On separate days, 12 trained or highly trained male cyclists/triathletes completed six 20-km CTTs in 3 different ATs: hot-dry (35 °C AT), moderately hot-humid (40 °C AT), and hot-humid (46 °C AT). All trials were preceded by 30 minutes of mixed-method PreC or no PreC (control [CON]). Results: Faster 2.5-km-split completion times occurred in PreC compared with CON in 46 °C AT (P =.02), but not in 40 °C AT (P =.62) or 35 °C AT (P =.57). PreC did not affect rectal and body temperature during the 20-km CTT. Skin temperature was lower throughout the CTT in PreC compared with CON in 46 °C AT (P =.01), but not in 40 °C AT (P = 1.00) and 35 °C AT (P = 1.00). Heart rate had a greater rate of increase during the CTT for PreC compared with CON in 46 °C AT (P =.01), but not in 40 °C AT (P =.57) and 35 °C AT (P = 1.00). Ratings of perceived exertion (P <.001) and thermal comfort (P =.04) were lower for PreC compared with CON in 46 °C AT only, while thermal sensation was not different between PreC and CON. Conclusion: Mixed-method PreC should be applied prior to 20-km CTTs conducted in hot-humid conditions (≥46 °C AT). Alternatively, mixed-method PreC may be a priority in moderately hot-humid (∼40 °C AT) conditions but should not be in hot-dry (∼35 °C AT) conditions for 20-km CTT. [ABSTRACT FROM AUTHOR]

Driving posture can lead to musculoskeletal pain. Most work focuses on the lower back; therefore, we know little about automobile seat design and neck posture. This study evaluated an automobile driver seat that individualized upper back support to improve head and neck posture. Specifically, we examined the system's impact on anterior head translation with secondary outcomes of spine posture and perceptions of comfort/well-being compared with a control. Forty participants were block randomized to experience either the activated or deactivated version of the same seating system first. Participants completed two 30-minute simulated driving trials, separated by washout, with continuous measures of anterior head translation, spine posture, and pelvis orientation. Perceptions of comfort/well-being were assessed by survey and open-ended questions immediately following each condition. Small, but statistically significant decreases in anterior head translation and posterior pelvic tilt occurred with the activated seat system. Participants reported lower satisfaction with the activated seat system. Order of the 2 seat conditions affected differences in pelvis orientation and participant perceptions of comfort/well-being. An anthropometric-based seat system targeting upper back support can significantly affect head and pelvic posture but not satisfaction during simulated driving. Future work should examine long-term impacts of these posture changes on health outcomes. [ABSTRACT FROM AUTHOR]

This study explores how the motivational framing of a network training program may positively or (inadvertently) adversely impact participants' discomfort with strategic networking and motivation to network. We examine the impact of a "me‐focused" framing (i.e., on the personal career benefits that individuals can accrue through strategic networking) and a "we‐focused" framing (i.e., on the benefits to the team/organization of individuals' strategic networking) compared to a control group in two field‐based quasi‐experiments. In both studies, we found no difference between the two training frames in their effect on the two training outcomes when looking at participants' reactions, on average. However, in the second study, we find that individual differences in the way participants relate to others (i.e., the extent to which they endorse an individual or a collective self‐concept) change the impact of the framing on their discomfort with and motivation to network. The findings highlight the importance of considering the match or mismatch between training framing and self‐concept. In the we‐focused condition, a match was related to decreased networking discomfort, while a mismatch was related to increased discomfort and decreased motivation. In the me‐focused condition, a mismatch was counter‐intuitively related to decreased discomfort. These findings suggest that considering participants' reactions to training (i.e., change in discomfort and motivation), on average, may mask important differences in their response to network‐based training and that tailoring network training to participants' self‐concepts may be an important consideration for human resource management professionals. [ABSTRACT FROM AUTHOR]

Background: Shared housing for adults with intellectual disabilities with staff support, is a common housing model internationally. We explored an overlooked aspect of group homes, namely the extent to which they enable a sense of 'feeling at home' for residents. Method: A diverse group of 19 housemates participated in a photovoice study. Participants took photos in their homes and discussed them in individual interviews and in groups. Data was analysed using reflexive thematic analysis. Results: Residents' experience of home was multi‐dimensional. 'Feeling at home' related to home as a site of identity cultivation (personal home); physical comfort or 'misfitting' (physical home) and home as the locus of key relationships (social home). Conclusion: Achieving a sense of 'feeling at home' requires engagement in practices of home‐making. Many of our participants required support from staff to engage in these practices. For some housemates their experience of home was conditional and precarious. [ABSTRACT FROM AUTHOR]

In this study, we investigated factors related to subjective outdoor thermal comfort in the Ancient Ming Dynasty Walled City in Xi'an, China. Environmental data were collected from study sites by microclimate monitoring. Survey locations, demographics, psychological characteristics, thermal sensation vote (TSV), and thermal comfort vote (TCV) data were collected from 639 individuals in a questionnaire survey. Generalized linear regression analysis and path analysis were used to understand the associations between the TSV, environmental and psychological factors, and TCV. We found that green space locations, higher age, and greater subjective well-being and environmental satisfaction were associated with increased TCV. The universal thermal climate index was associated with TCV, and this association could have been affected by the individual's psychological state. Our findings suggest that environmental factors and psychological factors had non-negligible effects on the subjective thermal comfort of individuals located in an open urban area with historical and cultural significance. [ABSTRACT FROM AUTHOR]

Pelvic Floor Muscle Training (PFMT) is the first primary solution to improve urinary incontinence (UI) symptoms, but many challenges stems from certain PFMT-related practices. Exploring PFMT experience will help to increase treatment satisfaction, enjoyment, and empowerment. Hence, the aim of this study was to investigate the experience of pelvic floor muscle training (PFMT) in Italian people with UI. A qualitative semi-structured interview study was conducted. The interviews' transcriptions were analysed using a constructionist epistemology lens and adopting the "Reflexive Thematic Analysis". Sixteen Italian participants (Women N = 10, Men = 6) with UI who experienced PFMT were interviewed. Four themes were generated: (1) 'Learn to Control the Unconscious Consciously' as participants learned to control continence through active exercises; (2) 'Starting PFMT, Changing Mind' as they realised they can have an active role in managing their condition; (3) 'Into the unknown intimacy', as they bridged the gap in their (mis)understanding of the pelvic floor area, overcoming the discomfort linked to intimacy; (4) The Importance of Not Being Alone in this Process', as the participants emphasised the paramount role of the physiotherapists in the healing process. To conclude, in people with UI, PFMT enhanced pelvic floor knowledge and understanding, fostering awareness, positive mindset, and symptom relief. The physiotherapist's pivotal role as an educator and empathetic guide in exercise programs, along with a preference for active exercises. Overall, our results proved that PFMT has positive consequences in people's beliefs and mindset about and in the management of UI. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to compare long‐ and short‐term frequent attenders' (FAs) perceptions of patient‐centredness and to assess the equivalence of the factor structure of patient‐centred primary care (PCPC) instrument for long‐ and short‐term FAs. Methods: A cross‐sectional survey of long‐term (n = 234) and short‐term (n = 261) FAs within the primary healthcare of one city in Finland. The data collected in January–July 2020 via 'the 36‐item PCPC instrument' were analysed using Pearson's chi‐squared test, Mann–Whitney U‐test, Cronbach's alpha, and multigroup confirmatory factor analysis (MGCFA). Results: Long‐term FAs had worse perceptions of patient‐centredness than short‐term FAs across all subscales: patients' preferences, physical comfort, coordination of care, continuity and transition, emotional support, access to care, information and education, and family and friends. The MGCFA indicated a good fit for the predicted eight‐factor model. Conclusions: Long‐term FAs' care needs are currently not being met, indicating the need for considering how the way healthcare services are arranged and care is provided affects prolonged and high care needs. Various dimensions of patient‐centredness need to be addressed when developing not only FAs' care but also wider service paths. A distinction should be made between long‐ and short‐term frequent attendance when identifying and addressing FAs' service needs. [ABSTRACT FROM AUTHOR]

The issue of pedestrian-level wind environments around high-rise buildings is closely related to the comfort and safety of human settlements. In this paper, we study the effects of different wind direction angles and spacing ratios on the wind environment at pedestrian heights around buildings arranged in an equilateral triangle configuration. Three-dimensional steady-state numerical simulation was employed, with the standard k-ε model selected as the turbulence model. Wind speed ratios and different area ratio parameters are used to quantitatively express the degree and range of influence of wind speed by buildings. The results show that the maximum wind speed ratio at the corner of a building is greatly affected by the wind direction angle, with 45°, 135°, and 157.5° being the unfavorable wind direction angles. Conversely, the area ratio of different areas is greatly affected by the spacing ratio. As the spacing ratio increases, the mutual interference effect between buildings weakens, resulting in a better pedestrian wind environment. Owing to the unique layout of the building group, different degrees of ventilation corridors are formed among the three buildings. The wind speed amplification effect in the corridors is more significant, and the areas with poor wind environments are concentrated in these corridors. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Firefighters operating in hot environments face challenges from protective garments that restrict heat dissipation, resulting in increased core temperature, thermal discomfort, and performance decline. Cooling vests represent a viable solution. The study aim was to compare effectiveness of the same amount of cooling power to the upper body (UB) or whole body (WB) in alleviating thermoregulatory and physiological stress, enhancing cognitive function, and reducing ratings of thermal discomfort and exertion, during 60 min of exercise in a hot environment (40°C, 40% relative humidity) while wearing firefighter turnout gear. METHODS: E ight healthy individuals (27.5 ± 3 y) participated in three conditions with either no cooling (Control) or active cooling with a liquid perfused shirt (UB cooling), or with a liquid perfused shirt and pants (WB cooling). In each trial, subjects performed three sets of 15 min of stepping (20 steps · min-1) and 5 min of rest. RESULTS: Both cooling strategies were beneficial compared to having no cooling at all. Subjects could only complete two exercise bouts during Control, but they completed all three bouts with active cooling. WB cooling provided an advantage over UB cooling for core and skin temperature, and thermal comfort and sensation. The advantage in minimizing the increase in core temperature was only evident during the third exercise bout. DISCUSSION: A ctive cooling is advantageous under these conditions. WB cooling provided some benefits vs UB cooling during heavy intensity exercise; however, it is uncertain whether these benefits would be observed during light-to-moderate exercise, which more likely reflects an actual firefighting scenario. [ABSTRACT FROM AUTHOR]

Background: Postoperative thirst is one of the most intense, common and easily ignored subjective discomforts in patients after gynecological surgery. This study aimed to investigate whether early oral hydration on demand in the postanesthesia care unit (PACU) after gynecological laparoscopy under general anesthesia can appease postoperative thirst and increase patient comfort. Methods: Participants were randomized into the intervention and control groups. Patients in the intervention group were allowed to achieve early oral hydration on demand in the PACU if they were evaluated as fully conscious, with stable vital signs, grade 5 muscle strength, and well-recovered cough and swallowing reflex. However, the total amount of water intake throughout the entire study should not exceed 0.5mL/kg. During the study, the frequency of water intake, the total amount of water intake and adverse events were accurately recorded. The control group was managed according to the routine procedures and began to drink water 2 h after anesthesia. The intensity of thirst and subjective comfort in patients were assessed using the visual analog scale (VAS) when they entered and left the PACU. Results: No statistically significant differences were identified in age, height, weight, body mass index, pre-operative fasting time, duration of surgery, intraoperative fluid intake, intraoperative blood loss, intraoperative urine volume, and thirst intensity and subjective comfort scores between the groups before intervention (P > 0.05). After intervention, the VAS score for thirst intensity in the intervention group significantly decreased (P < 0.05), and the VAS score for subjective comfort in the intervention group significantly increased (P < 0.05). No adverse events were detected in both groups during the entire study. Conclusion: Early oral hydration on demand in the PACU can safely and effectively relieve postoperative thirst in patients, and improve patient comfort after gynecological laparoscopy. Trial registration: This single-center, prospective, randomized controlled trial was registered at the Chinese Clinical Trial Center on April 27, 2023. The registration number of this study is ChiCTR2300070985. [ABSTRACT FROM AUTHOR]

Summary: The regular operation of the subway negatively impacts the occupants of super high‐rise multi‐tower buildings located on over‐depot (MBLO), causing undesirable vibrations. To save engineers time and computational cost, an improved one‐dimensional impedance model of super high‐rise MBLO is established to predict undesirable vibration in the design phase and devise measures to enhance human comfort. The stiffness factor of the thick plate of a large chassis is introduced, and the impedance relationships of coupled beam and floor based on the equivalence of mass and bending stiffness are considered for an improved one‐dimensional impedance model. The vibration response of multi‐story buildings and super high‐rise MBLO is predicted by an improved one‐dimensional impedance model and compared with field measurements and experimental results, respectively. The results show that the vibration transmission law of super high‐rise MBLO can be more accurately predicted when the stiffness factor of thick plates and the impedance relationships of coupled beam and floor are adopted in an improved one‐dimensional impedance model of super high‐rise MBLO. [ABSTRACT FROM AUTHOR]

Aims: This study aims to describe the experiences of women with gynaecological cancer regarding family‐oriented care (FOC) and how they rated their health‐related quality of life (HRQoL) using a 15D instrument (15D©). Design: A cross‐sectional mixed‐method study. Methods: The data were collected by electronic surveys of two Finnish cancer associations from gynaecological cancer patients (n = 53). The qualitative data were analysed using thematic analysis. The HRQoL answers were analysed statistically using IBM SPSS Statistics (Version 27). Results: The results emphasized that FOC is not yet part of the care process. Furthermore, comprehensive encounters are lacking, and the experience of being a woman is forgotten during the care process. The results of the HRQoL analysis suggest that distress and the discomfort and symptoms of cancer patients are perceived as significant factors affecting their quality of life during different phases of treatment. Family status also has an impact on perceived quality of life, whereby those living alone gave worse ratings for the depression and vitality dimensions. Conclusion: In part, the quantitative and qualitative data supported each other, but the descriptions provided a more comprehensive view of issues that affect women in a more multidimensional way, such as sexual health issues. More research on the effectiveness of FOC is needed to develop the capacity for effective healthcare. Implications for the Profession and/or Patient Care: This study was able to identify important areas for improvement in clinical practice from the perspective of patients and their families. Reporting Method: This study was prepared and reported according to the STROBE checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

This study introduces a method to reduce the thermal conductivity and boost cement clinker corrosion resistance in sintered magnesia using ZnO-modified additives. Solid-solution modified sintered magnesia was prepared at 1700 °C, and the impact of ZnO on the sintering properties, room-temperature strength, thermophysical properties, and corrosion resistance was assessed. ZnO addition enhanced the densification, grain size, and strength of sintered magnesia due to activated sintering from the ZnO and MgO solid-solution reaction at high temperatures. Additionally, ZnO addition improved the thermal stability and thermal shock resistance of sintered magnesia in a high-temperature environment. However, excessive ZnO led to incomplete diffusion, impeding grain growth and degrading the properties of magnesia. The thermal conductivity significantly decreased compared to the unmodified sample, particularly at 1000 °C with 4 mol% ZnO addition. Moreover, ZnO improved the corrosion resistance due to increased grain size and densification, with 4 mol% ZnO yielding the best results. [ABSTRACT FROM AUTHOR]

Empathy plays an important role in nursing so that the patients are provided with quality care and are satisfied with the services provided. Saudi Arabian patient interactions, including initial exploring, tend not to be formulaically initiated as in other countries. In this current study, the researcher aimed to highlight the critical role of nurse introductions in creating a desirable patient experience in the inpatient centers of Ministry Of Health hospitals in Saudi Arabia. This study was a cross-sectional secondary data analysis using the National Health Links/Presses Ganey surveys for every quint between the period 2021 and 2022. The methodology comprised an in-depth analysis of the Patient Experience Management Program (PXMP) survey that was involved as the uniform survey concluded by the Health Links/PressGaney. During the analysis, however, the results were found to have significant differences as 71.3% of the patients had a very good impression of their overall patient experience. This was specifically designed to address specific issues such as personal characteristics. The results of this study contribute to the understanding of what drives the nurses-patient interactions and forge the need for enhancing the way nurses are introduced to their patients to increase the average level of satisfaction of patients in the Ministry Of Health hospitals in Saudi Arabia. This study recommends that Saudi nurses should be trained to establish rapport in their interactions with patients as this promotes patient-centeredness and subsequently patients' experiences and care outcomes. [ABSTRACT FROM AUTHOR]

Background: To study and compare the effects of clear aligners without brackets and traditional fixed aligners in orthodontic treatment. Methods: The samples were collected from January 2022 to April 2023. The control group (n = 26) received orthodontic treatment using traditional fixed appliances. The research group (n = 20) received orthodontic treatment using the clear aligners without brackets. Compare the therapeutic effects and related evaluation indicators between two groups. Results: The total effective ratio was compared between the 2 groups, and the study group was greater(P < 0.05). After treatment, the detected values of the periodontal condition indicators (plaque index, debris index, and gingival bleeding index), serum inflammatory factors (CRP, IL-6 and TNF-α) of the two groups, were less than before, also were all less than the control group. (P < 0.05). After therapy, in comparison of the control group, the value of mastication efficiency, comfort and psychological evaluation, sleep indicators and the points of the four dimensions of life quality in the study group was greater, and the detection results were obviously greater than before(P < 0.05). Conclusion: In the orthodontic therapy of sufferers with malocclusion, compared with the traditional fixed appliance, the clear aligners without brackets can enhance the treatment effects, improve the periodontal condition and masticatory function, and reduce the inflammatory responses, so that patients can feel more comfortable, thereby improving their psychology, sleep and quality of life. In the future, with the continual advancement of technology and people's pursuit of beauty, the application of clear aligners without brackets in orthodontic treatment will become more and more extensive. The continuous introduction of new materials and new technologies will further improve the effects and comfort of the clear aligners without brackets, reduce treatment time and discomfort, and also reduce patients' resistance to aligners, bringing patients a better treatment experience. [ABSTRACT FROM AUTHOR]

Purpose: Family physicians are increasingly more likely to encounter transgender and gender-diverse (TGD) patients requesting gender-affirming care. Given the significant health inequities faced by the TGD community, this study aimed to assess changes in military-affiliated clinicians' perspectives toward gender-affirming care over time. Methods: Using a serial cross-sectional survey design of physicians at the 2016 and 2023 Uniformed Services Academy of Family Physicians conferences, we studied participants' perception of, comfort with, and education on gender-affirming care using Fisher's Exact tests and logistic regression. Results: Response rates were 68% (n = 180) and 69% (n = 386) in 2016 and 2023, respectively. Compared to 2016, clinicians in 2023 were significantly more likely to report receiving relevant education during training, providing care to >1 patient with gender dysphoria, and being able to provide nonjudgmental care. In 2023, 26% reported an unwillingness to prescribe gender-affirming hormones (GAH) to adults due to ethical concerns. In univariable analysis, female-identifying participants were more likely to report willingness to prescribe GAH (OR = 2.6, 95%CI = 1.7-4.1) than male-identifying participants. Willingness to prescribe was also associated with ≥4 h of education (OR = 2.2, 95%CI = 1.1-4.2) compared to those with fewer than 4 h, and those who reported the ability to provide nonjudgmental care compared to those who were neutral (OR = 0.09, 95%CI = 0.04-0.2) or disagreed (OR = 0.11, 95%CI = 0.03-0.39). Female-identifying clinicians were more likely to agree additional training would benefit their practice (OR = 5.3, 95%CI = 3.3-8.5). Conclusions: Although military-affiliated family physicians endorsed more experience with and willingness to provide nonjudgmental gender-affirming care in 2023 than 2016, profound gaps in patient experience may remain based on the assigned clinician. Additional training opportunities should be available, and clinicians unable to provide gender-affirming care should ensure timely referrals. Future research should explore trends across clinical specialties. [ABSTRACT FROM AUTHOR]

Intensive Care Unit (ICU) patients not only require life-sustaining treatments but also the preservation of their psychological well-being and dignity, and ICU nurses face heavy work pressure, focusing more on life-sustaining treatments for patients, while the patient's psychological experiences are often overlooked. This article aims to explore the issue of nurse-led patient dignity preservation in the ICU from China. Reflection is a process of deep thinking and examining one's actions, experiences, perspectives, or emotions. It involves retrospectively reviewing, analyzing, and evaluating past events to gain insights, understanding, and personal growth. Through reflection, individuals can consider whether their actions align with their values and goals and whether they can learn valuable lessons from them. This article discusses the preservation of patient dignity in the ICU from China based on Taylor's Emancipatory Reflection Model, which involves four steps: constructing, deconstructing, confronting, and reconstructing. The process of reflection incorporates theories such as Maslow's Hierarchy of Needs, Comfort Theory, and the style of Paternalistic Decision-making. This study is of great significance in enhancing Chinese nurse's attention to patient dignity, improving the inpatient experience of ICU patients, and enhancing the quality of nursing practice by critically examining current nursing practices in China and providing improvement recommendations. [ABSTRACT FROM AUTHOR]

Machine acoustics is an important area of research impacting the quality and comfort of human life. With increased levels of electrification and the wider use of electric motors, the contribution of motor drives towards quieter acoustic systems becomes increasingly important. This paper presents a novel acoustic improvement method involving the use of acoustic waves generated from High Frequency Injection to perform Active Noise Control. Although High Frequency Injection has been used widely in the domain of sensorless motor control, its acoustic generation process has been so far perceived as a negative by‐product. This paper presents the analysis and experimental results from the application of the proposed method to the Helicopter Electro‐Mechanical Actuation System. Considering the extensive use of motor drives in a number of industries, the proposed practice of High Frequency Injection Active Noise Control can have a significant impact to future applications. [ABSTRACT FROM AUTHOR]

Green urban squares are essential in densely built neighborhoods and enhance their quality of life. Investment in the greening of urban areas will have a beneficial impact, particularly regarding human thermal comfort. Smaller than parks, squares can be easily spread over the cities and should be part of any neighborhood. While the cooling effect of green squares during hot summer days is increasingly well established, microclimatic assessments during all seasons are still missing. This study aimed to determine whether it is possible to identify an optimal greenery design that maximizes human thermal comfort, as indexed by physiological equivalent temperature (PET), in temperate climates across all seasons. This study employed a "research by design" methodology, utilizing the micrometeorological simulation model ENVI-met to analyze the impact of greenery on PET improvement across different seasons. The objective was to identify the most effective combination of greenery for PET improvement. To achieve these objectives, two urban squares in Munich, Germany were selected. This selection was based on the assumption that typical greening practices, exemplified by the presence of trees, shrubs, and grass, would significantly impact urban squares and their microclimatic effects on human thermal comfort. The small square with a grass surface underneath trees, Alpenplatz, is highly influenced by the surrounding buildings, affecting the sky view factor (SVF), a crucial aspect of the urban environment. Marstallplatz, an open, large square that is not highly affected by urban morphology, was analyzed through simulation scenarios combining grass, shrubs, and trees. The results demonstrate that hot summer days are of primary concern for climate-sensitive urban square design in order to avoid health risks and thus need to be prioritized without compromising comfort for cold days. To attend to both needs, increasing the number of deciduous trees for shading during the day and the amount of grass to enhance air cooling at night are particularly effective. Nevertheless, microclimate design for the spring and autumn periods must also be considered, with the provision of adaptable opportunities for sheltered and sun-exposed spaces. [ABSTRACT FROM AUTHOR]

Introduction: Animal‐assisted and nature‐based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal‐assisted and nature‐based activities on a farm as a complementary intervention for young adults with autism and social withdrawal. Methods: The participants were aged 18–30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12‐week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants' characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis. Consumer and community involvement: The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective. Findings: The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants' experiences from the activity generated three categories, "Being in a meaningful context", "Creating a comfort zone" and "Developing structure in everyday life", and each of these included sub‐categories. Conclusion: The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non‐verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention's timeframe of 12 weeks was experienced as too short for long‐lasting change. [ABSTRACT FROM AUTHOR]

Few studies have examined the role of perceived neighborhood characteristics such as neighborhood safety, social cohesion, and contentedness on sedentary behavior (SB) and physical activity (PA) among adolescents. Furthermore, no studies have investigated how these associations are moderated by gender and race. This study aimed to examine the associations of the perceived neighborhood social environment with (SB) and moderate-to-vigorous physical activity (MVPA). Data from 6504 adolescents (aged 15.4 ± 0.03 years) who participated in the National Longitudinal Study of Adolescent Health was used. SB and PA were considered continuously and dichotomously. PNSE variables include safety, social cohesion, and contentedness, where higher values of PNSE indicate a more favorable neighborhood perception. Weighted linear and logistic regression models were used to examine the association of PNSE with continuous total SB (hours/week) and MVPA (bouts/week), and binary excessive SB (14 h/week) and meeting MVPA guidelines (≥ 5 bouts/week), respectively. Associations were stratified by gender and race to test moderation effects. Models were adjusted for demographic, health, parental, and neighborhood covariates. This study found that neighborhood safety and contentedness were negatively associated with SB, whereas neighborhood social cohesion and contentedness were positively associated with PA. Gender-specific and race-specific results remained somewhat consistent with overall findings; however, neighborhood safety was not associated with SB among female and non-White adolescents, respectively. Similarly, neighborhood safety and contentedness were not associated with MVPA for non-White adolescents. Findings suggest that an adolescent's neighborhood environment, gender, and race should be considered when implementing strategies to reduce SB and increase PA. [ABSTRACT FROM AUTHOR]

The aim of this review was to synthesise qualitative literature on physical activity experiences of community-dwelling older adults with physical disabilities. We conducted a scoping review of peer-reviewed, qualitative studies on physical activity with community-dwelling older adults with physical disabilities. We analysed eligible studies identified through electronic database searches (CINAHL Complete, MEDLINE, SPORTDiscus) and manual searches undertaken up to June 2023. Twenty-eight articles with 306 participants were included. As regard the experience of physical activity, although physical activity could elicit pleasure and enjoyment, many reported that physical activity sometimes produced pain. Various outcomes of physical activity were reported, with several physical, psychological, social, and lifestyle benefits prominent. Analyses of barriers and facilitators demonstrated how intrapersonal, interpersonal, environmental, and systems and programme factors influenced physical activity participation among older adults with physical disabilities. Our findings contribute to literature on physical activity in older adults with physical disabilities by synthesising qualitative research on physical activity experiences, outcomes, barriers, and facilitators in this population. Findings demonstrate the need for knowledgeable and supportive healthcare and exercise professionals, environments that support physical activity, and activities that promote pleasure and social connections. Physical activity is perceived to have wide-ranging benefits for community-dwelling older adults with physical disabilities. Various intrapersonal, interpersonal, environmental, and systems and programme barriers constrain physical activity in physically disabled people. Knowledgeable and supportive healthcare and exercise professionals, accessible environments, and activities that promote pleasure and social connections could enhance engagement in physical activity. [ABSTRACT FROM AUTHOR]

People with disability often require long-term support within the home. Advances in technology have made home automation more readily available to support people living with disability. However, few studies describe the perspectives of people using home automation. The aim of this study was to explore the experience of individuals living with long term serious disability using home automation. A phenomenological approach was adopted. In-depth, semi-structured interviews were conducted. Data were analysed using an inductive approach to identify themes. Two overarching categories of themes were identified: 'benefits' and 'challenges'. Benefits captured the outcomes experienced by people living with disability using home automation and the impact upon their lives. Participants described several challenges with using home automation such as self-advocating to receive home automation, long waiting periods in the assessment and installation process, frustrations when home automation did not work, and the challenges experienced from being without home automation. This research identified the benefits and challenges of home automation experienced by people with long term serious disability. The findings can be used to understand the importance of home automation and the impact it has upon the lives of people living with disability. It is recognised that home automation can have a positive impact upon the lives of people living with disability. Funding for home automation is a complicated process with long waiting times. This process needs to be readdressed in order for people to receive home automation in a timely manner to prevent negative experiences. Home automation within the community could support people living with disability to access the community more. It is important to develop facilities and communities that are accessible and inclusive for people with disabilities. [ABSTRACT FROM AUTHOR]

Seat tilting wheelchair features can increase the comfort and safety of the user. Although many power wheelchairs have tilting mechanisms, they are often designed with a specific wheelchair model in mind. In this study, a design process for seat tilting mechanisms that can be applied to most rear-wheel drive wheelchair models is developed. Equations were developed to describe the geometrical and load constraints that were used to size the electric actuator that powers the system and define its position. Finally, the equations were used to create the seat tilting mechanism of a prototype wheelchair, which was then tested. The equations yielded coherent results which showed that advantageous actuator positions from a load minimization perspective usually require dimensions that cannot be found in commercial actuators. Also, there are positions in which the load increases exponentially, which should be avoided. The tests showed that the system was able to function properly on the prototype wheelchair and that the actuator position affected the time taken for the actuator to execute different parts of the tilting movement. The design process presented here was successful and modelled by general equations that can be applied to most front-wheel drive wheelchairs. It presents a low-cost option for the design of seat tilting systems, which can increase their accessibility. Developing new systems to provide improvements in assistive technologies is fundamental for social reintegration and quality of life improvement. Wheelchairs with a seat stabilization system for moving through inclined terrain can provide greater comfort and safety to the user. Adding low-cost functionalities to wheelchairs is essential to make them more accessible to people, therefore, this paper provides a design method of a new seat stabilization system applied to low-cost wheelchairs. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is essential to relieve bronchospasm or specific asthma symptoms by administering immediate inhaler treatment during an asthma exacerbation. The present study compared the effect of Fowler position and forward-leaning positions during nebulization on heart rate, SpO2, breathing frequency, pain, and anxiety levels in children experiencing asthma exacerbations. METHODS: The data originated from a randomized trial that compared 86 participants (study group n = 43, control group n = 43) who presented to the pediatric emergency department with asthma exacerbations between October 2019-February 2020. The subjects were administered nebulization 3 times, during which the study group was placed in the forward-leaning position and the control group in the routine Fowler position. The subjects provided information on chest pain and anxiety levels before and after nebulization, and heart rate, SpO2, and breathing frequency were measured before and after each nebulization. RESULTS: The difference in the mean SpO2 measured at admission and after the third nebulization was significantly higher (3.2 ± 1.5% vs 2.3 ± 1.9%, P = .01); the difference in the mean breathing frequency was considerably higher (-6.0 ± 1.7 breaths/min vs -3.2 ± 1.8 breaths/min, P < .001), and the difference in the mean pain scores was significantly higher (-3.3 ± 2.5 vs -2.0 ± 2.3, P = .02) in the study group than in the control group. In addition, after the third nebulization, the breathing frequency (22.8 ± 2.8 breaths/min vs 24.2 ± 2.7 breaths/min, P = .02) and pain score of the study group were lower (0.8 ± 1.3 vs 1.5 ± 1.5, P = .01). There was no difference in the mean heart rate (20.6 ± 16.2 beats/min vs 20.0 ± 15.4 beats/min, P = .85) and anxiety levels (-2.0 ± 2.2 vs -1.9 ± 2.2, P = .90) between the groups. CONCLUSIONS: Placing children in a forward-leaning position during nebulization was effective in improving SpO2 and reducing breathing frequency and chest pain. The forward-leaning position implemented during nebulization is a non-pharmacologic method that supports recovery in children with asthma exacerbations. [ABSTRACT FROM AUTHOR]

Background: In 2013, a new predictor of successful mechanical ventilation liberation named timed inspiratory effort (TIE) index was devised with the normalization of the maximum inspiratory pressure (obtained within 60 s of unidirectional airway occlusion) with the time at which the value was reached. The aim of this study was to verify whether the presence of a sequence of a certain number of inspiratory effort values between 30-60 s > 1.0 cm H2O/s could predict weaning success in a performance comparable to the TIE index. Methods: This was a retrospective observational study using 4 databases of previous studies on the TIE index. All patients receiving mechanical ventilation for ≤ 24 h were eligible. Liberation from mechanical ventilation-extubation decisions was made based on performance with spontaneous breathing trials. P < .05 was considered significant. The performance of the TIE index was evaluated by calculating the area under the receiver operating characteristics (AUROC) curve. Results: From 349 eligible patients, 165 subjects were selected for analysis. The AUROC for the TIE index in the studied sample was 0.92 (95% CI 0.87-0.97, P < .001). A sequence of ≤ 4 inspiratory efforts > 1.0 cm H2O/s was found in 51.5% of the subjects, with successful ventilatory liberation occurring in 95.3%. The highest specificity values belonged to the sequence of ≤ 4 and ≤ 5 inspiratory efforts > 1.0 cm H2O/s; the highest positive predictive value and positive likelihood ratio belonged to the sequence of ≤ 4 inspiratory efforts > 1.0 cm H2O/s. The mean time that could have been spared if the procedure were interrupted after the first sequence of 4 inspiratory efforts > 1.0 cm H2O/s was 23 ± 3 s. Conclusions: The presence of a sequence of ≤ 4 inspiratory efforts > 1.0 cm H2O/s during the TIE index measurement was a reliable predictor of weaning success, which could allow timely interruption of the procedure and entail a substantial reduction in airway occlusion time. [ABSTRACT FROM AUTHOR]

This research highlights that street layouts, including the vegetation ratio, street orientation, and aspect ratio, are key in diminishing urban heat islands (UHIs), building energy use, and carbon emissions. The optimal street layout for minimal building energy consumption, carbon emissions, and maximal outdoor thermal comfort in Tianjin was established via field measurements, ENVI-met 5.6.1, Energy Plus simulations, and correlation analysis. The findings indicate the following: (1) The carbon emissions of winter residential heating energy consumption are 2.9–3.2 times higher than those for summer cooling. Urban design should thus prioritize winter energy efficiency and summer thermal comfort outdoors. (2) The summer street PET (physiological equivalent temperature) inversely correlates with the vegetation ratio and aspect ratio. Winter heating energy use inversely correlates with the street orientation and directly correlates with the aspect ratio. Adequate vegetation and proper orientation can decrease energy and carbon output while enhancing summer outdoor comfort. (3) Streets with an NW–SE orientation, H/W = 0.9, and 50% trees in summer yield the best thermal comfort, while those with an NE–SW orientation, H/W = 0.3, and 50% vegetative trees in winter produce the lowest carbon emissions. These insights are instrumental in refining urban streets and building designs in cold zones. [ABSTRACT FROM AUTHOR]

As we navigate the fast-paced era of urban expansion, the integration of machine learning (ML) and remote sensing (RS) has become a cornerstone in environmental management. This research, focusing on Silchar City, a non-attainment city under the National Clean Air Program (NCAP), leverages these advanced technologies to understand the urban microclimate and its implications on the health, resilience, and sustainability of the built environment. The rise in land surface temperature (LST) and changes in land use and land cover (LULC) have been identified as key contributors to thermal dynamics, particularly focusing on the development of urban heat islands (UHIs). The Urban Thermal Field Variance Index (UTFVI) can assess the influence of UHIs, which is considered a parameter for ecological quality assessment. This research examines the interlinkages among urban expansion, LST, and thermal dynamics in Silchar City due to a substantial rise in air temperature, poor air quality, and particulate matter PM2.5. Using Landsat satellite imagery, LULC maps were derived for 2000, 2010, and 2020 by applying a supervised classification approach. LST was calculated by converting thermal band spectral radiance into brightness temperature. We utilized Cellular Automata (CA) and Artificial Neural Networks (ANNs) to project potential scenarios up to the year 2040. Over the two-decade period from 2000 to 2020, we observed a 21% expansion in built-up areas, primarily at the expense of vegetation and agricultural lands. This land transformation contributed to increased LST, with over 10% of the area exceeding 25 °C in 2020 compared with just 1% in 2000. The CA model predicts built-up areas will grow by an additional 26% by 2040, causing LST to rise by 4 °C. The UTFVI analysis reveals declining thermal comfort, with the worst affected zone projected to expand by 7 km2. The increase in PM2.5 and aerosol optical depth over the past two decades further indicates deteriorating air quality. This study underscores the potential of ML and RS in environmental management, providing valuable insights into urban expansion, thermal dynamics, and air quality that can guide policy formulation for sustainable urban planning. [ABSTRACT FROM AUTHOR]

Urban areas with parks tend to have the best outdoor thermal comfort in regions with high urban heat island effects during summer. This study analyzed the synergistic cooling effects of 94 urban parks and the adjacent built-up areas in six districts of Xi'an City using four cooling indicators: park cooling intensity (PCI), park cooling area (PCA), park cooling effect (PCE), and park cooling gradient (PCG). The results showed that 84 out of 94 parks exhibited significant cooling effects, with an average PCI of 1.98 °C, PCA of 51.7 ha, PCE of 6.6, and PCG of 8.2 °C/km. Correlation analyses indicated that the intrinsic park attributes, external buffer zone building height, and building density were the main factors affecting the cooling effect. The park landscape configuration, building height, and density significantly influenced the PCI and PCG, while the park shape and size were crucial for the PCA (positive) and PCE (negative). The optimal park areas for improving the thermal environment were identified as 26 ha (cooling area focus, building density <13%) and 15 ha (cooling intensity focus, building height <21 m, density >32%). This study provides theoretical guidance for planning urban parks and the surrounding areas based on cooling effects, offering insights for future climate resilience planning. [ABSTRACT FROM AUTHOR]

The external building walls are significant in mitigating adverse weather conditions. Current research on the thermal insulation of exterior walls often overlooks crucial factors such as human comfort, seasonal changes and environmental dynamics. This study introduced a performance evaluation approach for external walls that considered the human thermal zone, annual air temperature and solar radiation. Taking Nanjing City as a case study, the thermal insulation performance of five distinct types of building exterior walls was investigated. The findings highlight the impact of various insulated wall systems on thermal insulation. While different insulated walls exhibited significant variations in effectiveness during extreme weather episodes, these variations were minor over the course of the year. Analysis revealed a spectrum of performance for insulated exterior walls, ranging from excellent to poor: Outer Insulated Wall > Inside Insulated Wall = Sandwich Insulated Wall = Self-Insulated Wall > Mortar-Insulated Wall. The disparity in thermal insulation performance amongst four wall types was minimal, with the mortar-insulated wall demonstrating the lowest performance. The highest temperature recorded for the mortar-insulated wall surpassed 32.2°C over 68 days. This research contributes insights into the nuanced performance of various insulated walls, paving the way for decision-making in climate resilience strategies. [ABSTRACT FROM AUTHOR]

The radiant systems come to the fore due to energy saving potential and good integration. The effect of different forms of cold surfaces on human thermal comfort is focused on its application. A novel natural convection-radiant evaporator for heat pumps was developed and its influence on thermal comfort was investigated. A numerical model of the chamber with the evaporator was established and verified with experimental results. Thermal comfort experiments were conducted in a climate chamber and the influence of its asymmetric and uneven cold radiation on the thermal comfort was investigated. Due to the limitation of PMV in uneven radiation situations, the revised predicted mean vote (RPMV) was proposed to assess the thermal comfort in asymmetric and uneven radiation environments based on experimental results. Based on RPMV, the influence of the surface area and temperature of the evaporator on thermal comfort was numerically analyzed. The results indicate that indoor air temperature and relative humidity, RPMV increase with the increase of plate temperature, but decrease with an increase in plate area. The most favourable indoor thermal comfort environment was obtained at an indoor air temperature of 28°C and relative humidity of 50%, which is 2°C higher than traditional air conditioning system. [ABSTRACT FROM AUTHOR]

Purpose/Method: The videofluoroscopic swallowing study (VFSS) is an instrumental exam for patients with dysphagia. Analysis of images generated during the study leads to diagnosis of swallowing events/physiology and the generation of treatment plans. As critical as the reading of images are to the VFSS, there exist multiple additional considerations for successfully conducting the study with pediatric patients. Due to difficulties inherent in testing infants and children, the pediatric VFSS poses implementation challenges. Speech-language pathologists may facilitate pediatric patients in issues of feeding engagement, crying, volume consumed, bolus size, and method. Results/Conclusion: Facilitative techniques during pediatric VFSS benefit the obtaining of accurate diagnostic results to guide pediatric feeding disorder management and recommendations. [ABSTRACT FROM AUTHOR]

Schools and school teachers often focus on content aimed at delaying sexual debut and preventing teenage pregnancy, and address the impacts of risky behaviours on infant health. Infant simulators are increasingly used in health education courses. However, it is unclear how effective this education is. In this review, we examined the evidence for the effectiveness and use of pregnancy/parenting education programmes for school-aged students using infant simulators. Infant simulators are lifelike replicas of human newborn babies that have electronic capacity to mimic a range of infant behaviours. These may include feeding, comfort needs and nappy changing. Responses to these replicated behaviours may be recorded to provide feedback of the adequacy of the response for educational purposes and provide feedback to prospective parents and caregivers. This review followed the guidelines for conducting a scoping review developed by Joanna Briggs Institute (JBI). After following the process as recommended by the JBI, 32 eligible articles were selected for inclusion. Eight themes emerged from the analysis and it was found that the use of infant simulators in terms of effectiveness was not conclusive. This may be due to lack of longitudinal studies examining the impact of the education provided. Furthermore, the literature did not address innovations of infant simulators that replicate infants with particular characteristics, those with fetal alcohol spectrum disorder, shaken baby syndrome or challenges from parental substance use. Further research is required to determine the long-term impact of using infant simulators on reducing risky behaviours. Given these challenges, it is important to support initiatives for sex, pregnancy and parenting education among all students. [ABSTRACT FROM AUTHOR]

Moisture (i.e., sweat) management is essential for maintaining human physiological comfort. But conventional fabrics and moisture‐absorbent and quick‐drying fabrics cannot simultaneously possess directional water transport (DWT) functionality and environmental protection characteristics, while also causing a sticky sensation on the skin when worn. Herein, the polylactic acid (PLA) electrospun membranes were deposited on the PLA side of a double‐yarn weft‐knitted fabric (hydrophobic PLA filament and hydrophilic cotton yarn) with asymmetric wettability, and green composite fabrics with papillary structures and unidirectional moisture transport capability were obtained using hot‐press. The properties of these composite fabrics were evaluated by scanning electron microscopy, moisture management testing, dynamic scanning calorimetry, water contact angle (WCA), and water permeability. The results showed that the wettability gradient difference between the two sides of the fabric increased, enhancing the unidirectional moisture transport capability. The optimal performance composite fabric achieved an accumulative one‐way transport capacity of 1285% and an overall moisture management capacity of 0.693. Additionally, the WCA on the hydrophobic side measured 150°, remaining at 146.8° after two washes. Overall, this composite fabric strikes a balance between biodegradability and exceptional DWT performance, rendering it an environmentally friendly and recyclable choice for moisture‐wicking and quick‐drying apparel applications. Highlights: Created PLA/cotton‐knitted fabric with asymmetric wettability.Hydrophobic PLA membrane deposited on fabric surface using electrospinning.Green composite fabrics with excellent DWT functionality were made by hot‐press.Best composite fabric: R‐value 1285.6%, OMMC 0.696, WCA 150°.Best composite fabric retains WCA of 146.8° after two washes. [ABSTRACT FROM AUTHOR]

While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction. [ABSTRACT FROM AUTHOR]

Demodex blepharitis, a chronic lid margin disease, is caused by an infestation of Demodex mites, the most common ectoparasites in human skin and eyelids. Lotilaner ophthalmic solution, 0.25% (Xdemvy, Tarsus Pharmaceuticals), is the first therapy approved to treat Demodex blepharitis. This narrative review characterizes lotilaner ophthalmic solution, 0.25%, and describes its efficacy, safety, and tolerability. The safety and efficacy of lotilaner ophthalmic solution, 0.25%, for treating Demodex blepharitis was evaluated in four phase 2 and two phase 3 trials. The data of 980 patients included in these phase 2 and 3 clinical trials revealed that the proportion of eyes with a clinically meaningful reduction to 10 or fewer collarettes (the cylindrical, waxy debris found at the base of the eyelashes) ranged from 81 to 93%. The mite eradication rate confirmed by a microscopy of epilated lashes ranged from 52 to 78%. No serious treatment-related adverse events were reported in any of these clinical studies. As high as 92% of the patients receiving lotilaner eyedrops in the phase 3 trials found it to be neutral to very comfortable. Given the positive safety and efficacy outcomes, the drug is likely to become the standard of care in the treatment of Demodex blepharitis. [ABSTRACT FROM AUTHOR]

A well-designed learning environment is crucial for enhancing both the physical and mental health of students, which in turn improves their learning outcomes. However, many classrooms in China, particularly in rural areas, were constructed and designed several decades ago, so it is essential to redesign these learning spaces to align with the requirements of 21st Century education. This study aims to develop the stimulation, individuality, and naturalness (SIN) theoretical framework for identifying the learning environment of current classroom by examining the full range of sensory effects experienced by individuals. This study conducted qualitative interviews with 72 students and 18 class teachers to explore major issues with their existing learning spaces in four primary schools in Shandong Province of China. The results show that high temperatures and poor air quality are frequently raised by respondents, which directly impact students' learning experience. This finding confirms naturalness likely underpins human comfort. Teachers and students felt that the classroom should be improved from the aspects of crowded space, imperceptible decoration, congestion and monotonous layouts. The study emphasised the important factors that designers and policymakers should consider to promote a comfortable, efficient, and healthy learning environment. [ABSTRACT FROM AUTHOR]

Sportswear manufactured from hygroscopic fibres can absorb moisture during activity or intermittent exercise and may change the thermal management of clothing. This change in the thermal behaviour of the fabric can lead to buffer the post-exercise chill. During activity in a moderately cold environment clothing made of 100% wool fibre helps wearers to slow down evaporative and conductive cooling, which can provide more thermal and comfort sensation compared to 100% cotton, 100% viscose, and 100% polyester. Twelve males performed cycling in a controlled climate chamber of temperature: 15 ± 0.5 °C, and relative humidity (RH):50 ± 5% followed by a drying phase in a windy environment by wearing full-sleeve t-shirts. Wool shirt was observed to hold a greater torso skin temperature (p < 0.05) than the other fibre types. Participants were asked a range of comfort-related questions at varying intervals. The temperature sensation was found (p < 0.05) significant for wool clothing. Moreover, participants rated wool shirt significantly (p < 0.05) as more comfortable during the post-exercise phase. Both clothing and physiological responses were investigated during exercise and post-exercise periods for male participants while wearing full-sleeve sportswear made of wool, cotton, viscose, and polyester. Wool clothing maintained a higher skin microclimate temperature and a warmer sensation, helping buffer the post-exercise chill. [ABSTRACT FROM AUTHOR]

As the manipulation object of a patient transfer robot is a human, which can be considered a complex and time-varying system, motion adjustment of a patient transfer robot is inevitable and essential for ensuring patient safety and comfort. This paper proposes a motion adjustment method based on a two-level deep neural network (DNN) and a greedy algorithm. First, a dataset including information about human posture and contact forces is collected by experiment. Then, the DNN, which is used to estimate contact force, is established and trained with the collected datasets. Furthermore, the adjustment is conducted by comparing the estimated contact force of the next state and the real contact force of the current state by a greedy algorithm. To assess the validity, first, we employed the DNN to estimate contact force and obtained the accuracy and speed of 84% and 30 ms, respectively (implemented with an affordable processing unit). Then, we applied the greedy algorithm to a dual-arm transfer robot and found that the motion adjustment could reduce the contact force and improve human comfort efficiently; these validated the effectiveness of our proposal and provided a new approach to adjust the posture of the care receiver for improving their comfort through reducing the contact force between human and robot. [ABSTRACT FROM AUTHOR]

Objective: To develop a novel mandibular advancement device (MAD) with high comfort, good compliance, and bidirectional fine-tuning capability for patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and to evaluate the therapeutic efficacy of the new MAD. Methods: The MAD, featuring upper and lower dental splints with a fine-tuning mechanism for mandibular adjustment, incorporates improved design elements such as partial dental coverage, shortened baffles, and memory resin lining. The novel MAD was used to treat 30 OSAHS patients in the study, comparing pre- and post-treatment scores on the Epworth Sleepiness Scale (ESS), the Apnea-Hypopnea Index (AHI), and the lowest oxygen saturation (LSO2). Results: The novel MAD reduced size and side effects, enhancing comfort. All patients complied well, using it for an average of 95% over 30 days and ≥ 5 h nightly. After treatment, significant improvements were observed in ESS, AHI, and LSO2 (P < 0.05). Conclusions: This novel bidirectional adjustable MAD provides high comfort and compliance, improving treatment precision. It is an effective choice for mild to moderate OSAHS patients and an alternative for those intolerant to CPAP or averse to surgery. [ABSTRACT FROM AUTHOR]

Background: The combination of virtual reality (VR) and palliative care potentially represents a new opportunity for palliative care. Many previous studies have evaluated the application of VR therapy to patients with advanced disease receiving palliative care. However, patient-perspective reviews to comprehensively understand the actual experiences and feelings of patients and provide practical guidance for designing future studies are currently lacking. This review of qualitative evidence aimed to explore the experiences and perceptions of patients receiving VR therapy in palliative care. Methods: This study was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement guidelines. Ten databases, namely, PubMed, Web of Science, EBSCO, OVID MEDLINE, Scopus, John Wiley, ProQuest, CNKI, WANFANG DATA, and SinoMed, were searched, and qualitative and mixed studies from the establishment of each database to June 30, 2023 were included. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the quality of the included studies. The data included in the literature were analyzed and integrated by "thematic synthesis" to formalize the identification and development of themes. Results: The nine selected studies altogether included 156 participants from seven hospice care facilities of different types and two oncology centers. Three key themes were identified: experiences of palliative care patients in VR therapy, the perceived value that palliative care patients gain in VR therapy, and perspectives of palliative care patients toward using VR therapy. Conclusions: The patients' feedback covered discomfort caused by VR devices, good sense of experiences, and situations that affected the interactive experience. Some patients were unable to tolerate VR therapy or reported newer forms of discomfort. The findings indicated that VR therapy may be an effective approach to relieve patients' physical and psychological pain and help them gain self-awareness. Moreover, patients showed a preference for personalized VR therapy. [ABSTRACT FROM AUTHOR]

Background: Associated with adverse pregnancy outcomes, intrahepatic cholestasis of pregnancy is the most prevalent liver disease that women typically experience during pregnancy. This study aimed to evaluate prenatal comfort, sleep, and quality of life in pregnant women with cholestasis. Methods: This cross-sectional study was implemented between November 2022 and June 2023 at Mardin Training and Research Hospital with 150 pregnant women who received a diagnosis of pregnancy-induced intrahepatic cholestasis and agreed to participate. The following tools were utilized to collect data: A personal information form exploring socio-demographic and obstetric characteristics of participants, the Prenatal Comfort Scale (PCS), the Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief Form (WHOQOL-BREF). Results: The mean age of participants was 27.79 ± 6.33 years. The mean PCS and PSQI scores were 61.20 ± 5.84 and 9.52 ± 3.02, respectively. The mean scores of "physical health, psychological health, social relationships, and environmental health" sub-dimensions in WHOQOL-BREF were 10.63 ± 2.18, 10.48 ± 2.10, 11.31 ± 3.28, and 11.27 ± 2.10, respectively. A significant difference was found for PSQI regarding hospitalization status and change in sleep quality variables (p = 0.025 and p = 0.035, respectively). Conclusions: Cholestasis of pregnancy creates problems such as pruritus, body image changes, hospitalization, and poor sleep quality in women. This study showed that pregnant women with cholestasis had low levels of sleep quality and quality of life, implying that cholestasis affects their sleep quality, prenatal comfort levels, and quality of life in general. In addition, it is seen that women with this problem do not want to fall pregnant again. [ABSTRACT FROM AUTHOR]

To provide food supply chains, reduce losses from various crops after the harvesting process, and also to preserve vegetable and fruit crops purchased for consumption from rotting and not being wasted. The drying process is one of the most appropriate ways to solve such problems. In this research, several simple thermal modeling methods were proposed to perform the drying process through open sun drying (OSD) under forced pressure (FGD) and natural convection (NGD). This study was conducted at the King Faisal University Training and Research Station (25.4° latitude). North, longitude 49.6° east, height 142 meters above sea level). The thermal performance analysis of the models was evaluated by calculating the amount of solar radiation, air temperature, product temperature, moisture evaporation rate, and wind speed. The results obtained showed that drying inside the greenhouse is the best alternative to drying under direct sunlight, so that the maximum temperatures were obtained, ranging between 55 to 52 in FGD and 40-45 inside NGD. Also, the heat transfer coefficient was highest in the amount of moisture removed from the product, reaching its maximum. The weight of the product was reduced to 83%, 80 and 73%, in GFD, NGD and OSD, respectively Accordingly, it was found that drying gave the highest expected results, and the temperature of the product ranged between 9.25 to 14.36 and 4.93 to 10.32, and the correlation coefficient ranged between 0.95-0.52 and 0.95. -0.89 at OSD and NGD respectively. Moisture evaporation from the product is 28.92-2.77 at NGD and moisture evaporation exerted for FGD is 31.35 and the correlation coefficient for the product at FGD ranges from 0.93-0.84. The product and greenhouse temperature range are between 0.99-0.96. The moisture evaporation rate indicating that the values obtained were well matched. Finally, the economic analysis of the different methods of drying was done through a mathematical model. [ABSTRACT FROM AUTHOR]

Background: Many cancer patients prefer to receive palliative treatment at home, as it allows them to be in a familiar and comfortable environment. Integrating Advance Care Planning (ACP) into routine practice in primary healthcare helps patients and their relatives prepare for end-of-life (EoL) care in accordance with patients' preferences. This includes the option to spend their final days at home if desired. The aim of this study was to gain insights from experiences of advanced seriously ill cancer patients at home while receiving palliative treatment and being engaged in ACP within primary healthcare settings. Method: This study employed a qualitative design, utilizing individual, semi-structured interviews that were analysed through reflexive thematic analysis, employing an abductive approach with a latent-level focus. The study included interviews with 12 participants with cancer who were receiving palliative care, had an estimated lifetime under 3 months, and had undergone an organized ACP approach in primary healthcare, documented with a palliative plan. Results: Participants emphasized the importance of (1) Preserving normality at home, maintaining a sense of routine, comfort, and familiarity in the face of present and future challenges. The top obstacles for success identified by participants included (1a) The challenge of deterioration and the dual aspects of (1b) The value and burden of family caregivers. Cancer treatment placed a significant demand on patients due to side effects. Family caregivers played a crucial role for participants, providing support in daily life and serving as a key factor in the overall decision to which extend they are able to involve in support and care at home in the future. (2) Compassionate health care personnel (HCP) made a difference by fostering a culture of understanding participants' concerns, fears, and preferences, which was a key element that built and maintained trust for the participants. (3) Preparing for the future, especially EoL discussions initiated by healthcare personnel, was deemed important but, at times, uncomfortable for participants as it confronted them with reality. Guidance from ACP provided them with a sense of certainty and control. Conclusion: Preserving normality at home, along with the desire to stay at home for as long as possible, is a crucial goal for advanced cancer patients. Consistent professional communication and care in primary healthcare play a key role in building and maintaining trust, as well as fostering a sense of certainty and control for the participants. [ABSTRACT FROM AUTHOR]

This study compared the effectiveness of N95 FFRs in providing respiratory protection for healthcare staff in a residential aged care facility (RACF) and tertiary teaching hospital (TTH) who had previously passed their occupational respiratory protection program fit test. A total of 126 healthcare workers who were regularly using N95 FFRs and who had previously passed a fit test participated in this comparative study. In this study, participants were again fit tested with the PortaCount machine, and their self-assessed tolerability of wearing an N95 FFR was assessed using a standardized questionnaire. The main outcome measures included the pass rate of the fit test and the assessment of tolerability and comfort of the N95 FFR. Across all participants, the fit test pass rate was low (27%), indicating persistent gaps in respiratory protection programs for healthcare workers during the ongoing COVID-19 pandemic. Hospital workers were 3.7 times more likely to pass the test compared to their counterparts in RACFs (p < 0.001). It was also found that workers in RACFs reported higher levels of discomfort and overall dissatisfaction with N95 FFRs compared to hospital staff. These findings highlight the need for targeted interventions and improvements in respiratory protection practices beyond annual fit testing, particularly in RACFs, to ensure the safety of healthcare workers and the vulnerable population they serve. [ABSTRACT FROM AUTHOR]

The article focuses on the future of human exploration beyond Earth, addressing the critical need for advanced technologies and strategies to enable interstellar travel. Topics include the challenges of space travel and the limitations of current technology, potential solutions like faster spacecraft or extended human lifespans, and the need for multigenerational missions to reach distant stars.

The onset of the coronavirus disease 2019 (COVID-19) necessitated a rapid transition to virtual care for chronic pain treatment. This study examined experiences of patients and caregivers who received virtual multidisciplinary pain treatment (MDT) for pediatric chronic pain between March 2020 and August 2021. A mixed methods design was implemented using qualitative interviews and quantitative satisfaction surveys. Satisfaction surveys were administered to a convenience sample of patients (aged 8 to 18; N = 20) and their caregivers (N = 20) who received MDT through an outpatient hospital pediatric chronic pain program. Interviews were conducted with a subset of these patients and their caregivers (n = 6). Analysis of interviews revealed four themes: 1) benefits of virtual care; 2) challenges of virtual care; 3) recommendations and evaluation of virtual care; and 4) patient preferences. Analysis of the satisfaction survey data revealed that while patients and caregivers were satisfied with many aspects of virtual care, 65% (n = 13) of patients reported a preference for in-person appointments, with caregivers showing equal preference for in-person and virtual appointments, though this was a non-significant difference (p =.37). Overall, both patients and caregivers stated a stronger preference for in-person physiotherapy sessions but were willing to have psychology sessions provided virtually. Finally, the most reported preference was for a hybrid model of care incorporating at least some in-person contact with providers. This study provides a rich exploration of virtual care for multidisciplinary pediatric chronic pain treatment. The current results may inform the future development of guidelines for virtual care delivery with pediatric chronic pain populations. [ABSTRACT FROM AUTHOR]