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This article discusses the quasi-optimality of adaptive nonconforming finite element methods for distributed optimal control problems governed by 푚-harmonic operators for m = 1 , 2 . A variational discretization approach is employed and the state and adjoint variables are discretized using nonconforming finite elements. Error equivalence results at the continuous and discrete levels lead to a priori and a posteriori error estimates for the optimal control problem. The general axiomatic framework that includes stability, reduction, discrete reliability, and quasi-orthogonality establishes the quasi-optimality. Numerical results demonstrate the theoretically predicted orders of convergence and the efficiency of the adaptive estimator. [ABSTRACT FROM AUTHOR]

Background: Needle stick injury (NSI) is one of the significant and serious health hazards encountered by healthcare workers (HCWs), as it is a risk factor for transmission of blood-borne infections like HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). This study aims to describe the frequency and distribution of the NSIs reported in the institution over a period of four years, the factors associated with it and the immediate post-exposure prophylaxis administered., Methods: A record-based retrospective analysis of the NSIs suffered by HCWs working in the Pradyumna Bal Memorial Hospital (PBMH), Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar over a period of four years (2019 - 2022) was conducted. Data was extracted from the Exposure Prevention Information Network (EPINet) using a researcher-made proforma and analysed using Epi Info software 7.3.2., Results: There were a total of 115 reported cases of NSIs, the incidence being 2.52%, 1.55%, 0.85% and 1.64% in the years 2019,2020,2021 and 2022 respectively. The most commonly affected age group was 18-30 years with females constituting the majority. Nurses were more commonly affected in the first two years of the study (2019 and 2020) whereas in 2021 and 2022 housekeeping staff suffered more injuries. The highest incidence of NSIs (40%-59%) was noted to have occurred in the morning shift. Inpatient department (IPD) contributed the maximum number of cases of NSIs. Out of the 93 cases with known source patient, HIV serological status was negative for all, while HBV and HCV status was positive in nine and two cases respectively. The serology status for the three viral markers (HIV, HBV and HCV) was unknown in 22 cases. After evaluation for the necessity of post-exposure prophylaxis (PEP), initial PEP was given to 14 persons for prevention of HBV and to 20 persons for HIV prevention., Conclusion: Of the total NSIs reported over the four years, the incidence of NSIs per thousand HCWs showed a declining trend; with the younger age group and female gender reporting a higher incidence. Job category wise, housekeeping staff and nursing staff suffered more NSIs. Highest number of NSIs were reported from IPD. A greater proportion of NSIs were due to hollow bore needles. Most of the injuries occurred during daytime. Source patient could be identified in majority of the cases. HCWs who were identified to be at risk received immediate PEP as per the institutional policy. Stringent documentation of NSIs can assist in root cause analysis and to implement measures to prevent their occurrence., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee, Kalinga Institute of Medical Sciences issued approval KIIT/KIMS/IEC/1054/2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)