4,587 research outputs found

    Differences in nurses’ perceptions of self-reported pain and the administered morphine dose according to the patient’s facial expression in Korea

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    Purpose This study aimed to compare nurses’ perceptions of self-reported pain, the recorded pain score, and pain treatment according to the patient’s facial expression. Methods In this descriptive cross-sectional survey, the participants were 472 nurses working at a tertiary hospital in Seoul, Korea. A self-report questionnaire presented nurses with a smiling patient complaining of acute post-surgical pain and a grimacing patient with cancer pain, both of whom reported a pain level of 8 out of 10, and asked nurses to indicate their perception of the pain intensity, the pain score that they would record, and the medication that they would provide for each patient. Results The pain intensity perceived by nurses for the grimacing patient was significantly higher than that for the smiling patient (P<0.001). The recorded pain score was likewise significantly higher for the grimacing patient than for the smiling patient (P<0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain interventions between the smiling and grimacing patients (P=0.040). Higher perceived pain intensity and score were associated with higher administered doses of morphine. Conclusion These findings suggest that nurses might be affected by patients’ facial expressions when treating pain. A pain management program should be developed that trains nurses to accurately recognize pain hidden in patients’ faces and provides them with the knowledge of how to appropriately assess and manage patients’ pain

    Star Formation History and Chemical Evolution of the Sextans Dwarf Spheroidal Galaxy

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    We present the star formation history and chemical evolution of the Sextans dSph dwarf galaxy as a function of galactocentric distance. We derive these from the VIVI photometry of stars in the 42×2842' \times 28' field using the SMART model developed by Yuk & Lee (2007, ApJ, 668, 876) and adopting a closed-box model for chemical evolution. For the adopted age of Sextans 15 Gyr, we find that >>84% of the stars formed prior to 11 Gyr ago, significant star formation extends from 15 to 11 Gyr ago (\sim 65% of the stars formed 13 to 15 Gyr ago while \sim 25% formed 11 to 13 Gyr ago), detectable star formation continued to at least 8 Gyr ago, the star formation history is more extended in the central regions than the outskirts, and the difference in star formation rates between the central and outer regions is most marked 11 to 13 Gyr ago. Whether blue straggler stars are interpreted as intermediate age main sequence stars affects conclusions regarding the star formation history for times 4 to 8 Gyr ago, but this is at most only a trace population. We find that the metallicity of the stars increased rapidly up to [Fe/H]=--1.6 in the central region and to [Fe/H]=--1.8 in the outer region within the first Gyr, and has varied slowly since then. The abundance ratios of several elements derived in this study are in good agreement with the observational data based on the high resolution spectroscopy in the literature. We conclude that the primary driver for the radial gradient of the stellar population in this galaxy is the star formation history, which self-consistently drives the chemical enrichment history.Comment: 36 pages, 14 figures, To appear in the ApJ, 200

    Protocol for studying cough frequency in people with pulmonary tuberculosis.

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    INTRODUCTION: Cough is a key symptom of tuberculosis (TB) as well as the main cause of transmission. However, a recent literature review found that cough frequency (number of coughs per hour) in patients with TB has only been studied once, in 1969. The main aim of this study is to describe cough frequency patterns before and after the start of TB treatment and to determine baseline factors that affect cough frequency in these patients. Secondarily, we will evaluate the correlation between cough frequency and TB microbiological resolution. METHODS: This study will select participants with culture confirmed TB from 2 tertiary hospitals in Lima, Peru. We estimated that a sample size of 107 patients was sufficient to detect clinically significant changes in cough frequency. Participants will initially be evaluated through questionnaires, radiology, microscopic observation drug susceptibility broth TB-culture, auramine smear microscopy and cough recordings. This cohort will be followed for the initial 60 days of anti-TB treatment, and throughout the study several microbiological samples as well as 24 h recordings will be collected. We will describe the variability of cough episodes and determine its association with baseline laboratory parameters of pulmonary TB. In addition, we will analyse the reduction of cough frequency in predicting TB cure, adjusted for potential confounders. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the ethics committees at each participating hospital in Lima, Peru, Asociación Benéfica PRISMA in Lima, Peru, the Universidad Peruana Cayetano Heredia in Lima, Peru and Johns Hopkins University in Baltimore, USA. We aim to publish and disseminate our findings in peer-reviewed journals. We also expect to create and maintain an online repository for TB cough sounds as well as the statistical analysis employed

    Mycobiota community and fungal species response to development stage and fire blight disease in apples

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    Fire blight disease, caused by the bacterial pathogen Erwinia amylovora, has been a significant concern for over 50 countries worldwide. The efficacy of chemical pesticides currently available for disease control is limited. To address this issue, research is being conducted to explore environmentally friendly control methods, particularly biological control using beneficial microorganisms. However, there is limited research on the apple microbiota community and minimal research has been conducted on fungal communities that may exhibit reliable performance in apple trees. Therefore, our objective was to analyze the fungal communities present in apples at different developmental stages and in different tissues, aiming to identify potential biological control agents for fire blight disease. Our findings indicate that the fungal communities present in apple buds, flowers and leaves play an important role in inhibiting the invasion of E. amylovora. Specifically, we propose GS11 and Lipomyces starkeyi as potential keystone taxa that respond to fire blight disease. These findings provide insights into the continuity and discontinuity of fungal community structure in different developmental stages of apples and offer predictions for potential biological control agents for fire blight disease

    A Case of Crohn's Disease with Improvement after Azathioprine-Induced Pancytopenia

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    The immunosuppressant azathioprine (AZA) is widely used in the treatment of inflammatory bowel disease (IBD) for both inducing and maintaining remission. However, the adverse effects of AZA can often necessitate a dose reduction or discontinuation. Bone marrow suppression is one of the most serious complications with AZA treatment. On the other hand, some reports have suggested that neutropenia during AZA therapy reduced the relapse rates of IBD patients, and there have been some cases where eradication of the sensitized leukocytes by leukapheresis or bone marrow transplantation improved the IBD, which may explain the relevant role of neutropenia in controlling disease activity. This report describes the case of a 22-year-old male patient who had Crohn's colitis and complicated perianal fistulas that required immunosuppression; he achieved endoscopically determined remission and showed accelerated mucosal healing as well as clinical remission following the AZA-induced pancytopenia

    Protective Effect of Hypoxic Preconditioning on Hypoxic-Ischemic Injured Newborn Rats

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    Brief episodes of cerebral hypoxia-ischemia cause transient ischemic tolerance to subsequent ischemic events that are otherwise lethal. This study was conducted to evaluate the protective effect of hypoxic preconditioning on hypoxic-ischemic injury in the neonatal rat and the persistence of a protective window after hypoxic preconditioning. The rats were preconditioned with hypoxia (8% oxygen, 92% nitrogen) for three hours, subjected to ischemia using ligation of the right common carotid artery, and then exposed to another three hours of hypoxia. Using proton magnetic resonance spectroscopy, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) staining, and morphologic scores, this study shows that hypoxic preconditioning 6-hr to 1-day before hypoxic-ischemic injury increases survival rates and has neuroprotective effects against subsequent hypoxic-ischemic injury. The mechanism of the protective effects of hypoxic preconditioning in the newborn rat brain may involve downregulation of apoptotic cell death

    The Hamiltonian Dynamics of Bounded Spacetime and Black Hole Entropy: The Canonical Method

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    From first principles, I present a concrete realization of Carlip's idea on the black hole entropy from the conformal field theory on the horizon in any dimension. New formulation is free of inconsistencies encountered in Carlip's. By considering a correct gravity action, whose variational principle is well defined at the horizon, I derivederive a correct classicalclassical Virasoro generator for the surface deformations at the horizon through the canonical method. The existence of the classical Virasoro algebra is crucial in obtaining an operator Virasoro algebra, through canonical quantization, which produce the right central charge and conformal weight A+/G\sim A_+/\hbar G for the semiclassical black hole entropy. The coefficient of proportionality depends on the choice of ground state, which has to be put in by hand to obtain the correct numerical factor 1/4 of the Bekenstein-Hawking (BH) entropy. The appropriate ground state is different for the rotating and the non-rotating black holes but otherwise it has a universalityuniversality for a wide variety of black holes. As a byproduct of my results, I am led to conjecture that {\it non-commutativity of taking the limit to go to the horizon and computing variation is proportional to the Hamiltonian and momentum constraints}. It is shown that almost all the known uncharged black hole solutions satisfy the conditions for the universal entropy formula.Comment: Much details omitted, references added, accepted in Nucl. Phys.

    Distances and ages of globular clusters using Hipparcos parallaxes of local subdwarfs

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    We discuss the impact of Population II and Globular Cluster (GCs) stars on the derivation of the age of the Universe, and on the study of the formation and early evolution of galaxies, our own in particular. The long-standing problem of the actual distance scale to Population II stars and GCs is addressed, and a variety of different methods commonly used to derive distances to Population II stars are briefly reviewed. Emphasis is given to the discussion of distances and ages for GCs derived using Hipparcos parallaxes of local subdwarfs. Results obtained by different authors are slightly different, depending on different assumptions about metallicity scale, reddenings, and corrections for undetected binaries. These and other uncertainties present in the method are discussed. Finally, we outline progress expected in the near future.Comment: Invited review article to appear in: `Post-Hipparcos Cosmic Candles', A. Heck & F. Caputo (Eds), Kluwer Academic Publ., Dordrecht, in press. 22 pages including 3 tables and 2 postscript figures, uses Kluwer's crckapb.sty LaTeX style file, enclose

    Multiple shifts and fractional integration in the us and uk unemployment rates

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    This paper analyses the long-run behaviour of the US and UK unemployment rates by testing for possibly fractional orders of integration and multiple shifts using a sample of over 100 annual observations. The results show that the orders of integration are higher than 0 in both series, which implies long memory. If we assume that the underlying disturbances are white noise, the values are higher than 0.5, i.e., nonstationary. However, if the disturbances are autocorrelated, the orders of integration are in the interval (0, 0.5), implying stationarity and mean-reverting behaviour. Moreover, when multiple shifts are taken into account, unemployment is more persistent in the US than in the UK, implying the need for stronger policy action in the former to bring unemployment back to its original level
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