Nurse-led Telehealth Visits for Patients with Multiple Sclerosis During the COVID-19 Pandemic and Beyond

Background: Nearly one million individuals are affected with Multiple Sclerosis (MS) in the United States, and it was estimated the annual economic burden of multiple sclerosis in the U.S. at over $85.4 billion in 2022. Problem: During the outbreak of COVID-19, the number of nurse-led patient education sessions has decreased due to the conversion of in-person clinic visits to telehealth visits. Despite the widespread use of telehealth for MS patients post-COVID-19 pandemic, limited data is available about the use of nurse-led telehealth visits with a standardized workflow. Method: A quality improvement project was implemented at the MS clinic in Northern California, by developing, implementing, and evaluating the nurse-led telehealth visit with a standardized workflow. An educational presentation on the use of the nurse-led telehealth visit with a standardized workflow was provided to clinical staff in this MS clinic to improve their effectiveness and confidence level in utilizing and promoting nurse-led telehealth visits and to increase the number of referrals to nurse-led telehealth visit. Intervention: The educational presentation session was held on January 13, 2023, during the MS clinic staff meeting. The Standardized Workflow for Nurse-Led Telehealth Visits Experience Survey that this author developed was used to collect the baseline data pre- and post-training to measure the project outcome. Result: In total, eleven clinic staff in the MS clinic, including seven MS physicians, one NP, one RN, and two MAs, participated in the educational presentation about nurse-led telehealth visits with the standardized workflow. After the educational presentation, the knowledge base and confidence level of MS clinical staff in utilizing and promoting nurse-led telehealth was increased by 41.7%. Comparing the three months pre- and post- intervention, the number of nurse-led telehealth visits was increased by 220%. Conclusion: The standardized workflow for nurse-led telehealth visits has been shown to improve the effectiveness and confidence of MS clinical staff in utilizing and promoting nurse-led telehealth visits, as well as increase the number of nurse-led telehealth visits in the MS clinic

S/W Fault-tolerant OFP System for UAVs based on Partition Computing

AbstractPartition computing of the new Integrated Modular Avionics architecture reduces the heavy cabling of traditional federated architecture. On the other hand, fault-tolerant Operational Flight Programs (OFP) for unmanned aerial vehicles have usually been implemented as primary-backup systems based on dual nodes. However, in the case of a small UAV, it is preferred to implement a S/W fault-tolerant system that runs primary and recovery systems together in a single flight control computer to reduce the payload. In this case, because the primary and backup must not interfere with each other in using CPU and memory, it is common to use virtualization-based partitions. In this paper, a new S/W fault-tolerant OFP based on the real-time-object partition, TMO.p, is presented to overcome the large overheads of virtualization approaches

OPTIMAL REGRESSION MODEL FOR PREDICTING THE WINNING GAME AND CONTRIBUTING FACTORS IN ICE HOCKEY WORLD CHAMPIONSHIP

The purpose of this study was to present the statistical model to predict the winning of ice hockey game and determine the contributing factors for win in the world ice hockey championship. In order to find the optimal regression model for ice hockey, we compared two regression model (logistic and linear model) with the database of all games and the separate databases of top/bottom teams. The logistic regression model using the separate database was most accurately predicted the actual outcome of games. This model and database further revealed that goalkeeping and scoring efficiencies and the number of shots on goal were significantly contributing factors to win. In addition, the results for prediction analysis of winning rate for each team indicated that offensive skills were more important factors than defense power to increase winning rate for teams

Designing Fashion with Qi Energy

This practice-led research explores the significance of Qi energy for fashion by materialising the East Asian culturally-specific concept of Qi. Qi features prominently in the traditional philosophy of everyday life in East Asia and my research aims to show how this philosophy can also provide an understanding of the relationship between body, garment and making, which is new to more Western concepts of fashion culture. This reflective journey unravels fashion practice in this context, focusing on the making process and the methods that were developed during that process. I engaged in significant handwork in the field of contemporary womenswear, integrating concepts of the body and garment as a circulatory system for Qi energy. It is the objective of this research to realise garments which help the understanding of Qi as a communication tool in relationships that arise in fashion, namely those that exist between the material and the maker during the making process, the body and the garment, and the wearer and the viewer. My research question originates from a desire to find a way to materialise Qi in garments through the making process. To pursue this, I explore a range of fields including anthropology, material culture, psychoanalysis, literature, cultural theory, and language. Apart from contextual studies, I adopted conversations and filming as methods to develop my research further. In practice, I investigate the meridians (as seaming which constructs garments), the finishing and the openings of the garment, all of which amount to a transitional interface. I view this as a concrete way of injecting Qi energy into the garment on a material level. I have reflected deeply on my making experience; this reflection has led the entire process and also given me a much better understanding of body and garment. Through my making process, aimed at materialising Qi in the garment, I essentially tried to establish a better connection between body and garment. This thesis oscillates between practice and theory. My research suggests Qi energy as a new perspective on fashion making; it offers a new understanding of the body in fashion and tries to fill the gap between practice and theory through embodied knowledge

Intention to Use Long-Term Care Facilities: Differences between Korean Pre-elderly and Korean Baby-boomers

With the rapidly increasing number of older adults, dealing with long-term care (LTC) needs becomes an emerging issue in South Korea. This study aims to examine factors affecting the intention to use longtermcare facilities with two groups of young-old adults: (1) Korean pre-elderly (KPE) and (2) Korean babyboomers (KBB). Guided by Andersen's behavioral model of health service use and prior research, predisposing characters, enabling resources, need factors, availabilities of informal care and self-care activities were used as predictors. In the final analyses, 803 KPE and 966 KBB were included. The results of logistic regression analyses showed different findings in two groups. Age, education, spouse's physicalhealth, and self-care activities for relationship with family and friends are significantly associated with intention to use LTC facilities among KPE. However, income, physical health of respondents, and relationship satisfaction with children are significantly related to intention of use LTC facilities in the group of KBB. This study suggests different LTC needs between KPE and KBB. Health care professionals and policy makers need to consider such differences to provide quality LTC care for them

Sonographic Detection of Intrathyroidal Branchial Cleft Cyst: A Case Report

We report here on an extremely rare case of an intrathyroidal branchial cleft cyst. Intrathyroidal branchial cleft cyst is rare disease entity and it has nonspecific findings on sonography, so the diagnosis of the lesion is very difficult. However, during aspiration, if pus-like materials are aspirated from a thyroid cyst, we should consider the possibility of intrathyroidal branchial cleft cyst in the differential diagnosis

Knowledge, Awareness and Risk of Occurrence of Venous Thromboembolism of Perinatal Women

PURPOSE: The purpose of this study is to identify knowledge, awareness, and risk of occurrence of venous thromboembolism among pregnant women. METHODS: Subjects were 106 pregnant women treated as inpatients and outpatients at a women's health hospital in a metropolitan city February 19–March 22, 2018. Instruments consisted of questionnaires that included knowledge, awareness, and risk of occurrence of venous thromboembolism queries. Collected data were analyzed by t-test, one-way analysis of variance, Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Mean score of subjects' knowledge of venous thromboembolism was 4.47 (0–15), mean score of subjects' awareness of venous thromboembolism was 66.98 (25–100), and mean score of subjects' risk factor of venous thromboembolism was 0.98 (0–44). CONCLUSIONS: Pregnant women's level of knowledge and awareness of prevention and risk factors on venous thromboembolism, is significantly low. To raise their awareness of risk symptoms and prevent occurrence of the disease, it is essential for nurses as well as medical staffs to: 1) provide an educational program on venous thromboembolism for patients; 2) assess and monitor pregnant women with a risk factor of venous thromboembolism; and 3) implement proper prophylaxis for patients

Two-point discrimination values vary depending on test site, sex and test modality in the orofacial region: a preliminary study

The two-point discrimination (TPD) test is one of the most commonly used neurosensory tests to assess mechanoperception in the clinical settings. While there have been numerous studies of functional sensibility of the hand using TPD test, there have been relatively not enough reports on TPD in the orofacial region. Objective The aims of the present study were to determine the normal values of TPD in the six trigeminal sites (the forehead, cheek, mentum, upper lip, lower lip, and the tongue tip) and to investigate the effect of the site, sex, and test modality on the TPD perception. Material and Methods Forty healthy volunteers consisting of age-matched men (20) and women (20) with a mean age of 27.1 years were recruited. One examiner performed the TPD test using a simple hand-operated device, i.e., by drawing compass with a blunt or sharp-pointed tip. The static TPD with a blunt-pointed tip (STPDB), moving TPD with a blunt-pointed tip (MTPDB), and static TPD with a sharp-pointed tip (STPDS) were measured. The predictors were the site, sex, and test modality, and the outcome variable was the TPD value. Three-way ANOVA was used for statistics. Results The analysis showed a significant effect of the site, sex and test modality on the TPD values. Significant differences between the test sites were observed with the descending order from the forehead and cheek>;mentum>;upper lip and lower lip>;tongue tip and index finger. Women showed lower TPD values than those of men. The STPDS measurements were consistently lower than those of the STPDB and MTPDB. Conclusions The normal values of TPD in this study suggest that the cheek and forehead were less sensitive than other regions evaluated and women were more sensitive than men. The STPDS was the most sensitive test modality

The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

BACKGROUND: Little information is available on the use of chest computed tomography (CT) to predict breast tumor size in breast cancer, despite the fact that chest CT examinations are being increasingly used. The purpose of this study was to evaluate the value of chest CT for predicting breast tumor size using pathology measurements as reference standards. METHODS: Tumor sizes (defined as greatest diameter) were retrospectively measured on the preoperative chest CT images of 285 patients with surgically proven unifocal, invasive breast carcinoma. Greatest tumor diameters as determined by chest CT and pathologic examinations were compared by linear regression and Spearman’s rho correlation analysis. Concordance between CT and pathology results was defined as a diameter difference of <5 mm. Subgroup analyses were also performed with respect to tumor size (<20 mm or ≥20 mm) and histological subtype (invasive ductal carcinoma(IDC) or non-IDC). RESULTS: CT and pathology measured diameters were found to be linearly related (size at pathology = 1.086 × CT determined tumor size - 1.141; Spearman’s rho correlation coefficient = 0.84, P<0.001). Most tumors (n = 228, 80.0%) were concordant by chest CT and pathology, but 36 tumors (12.7%) were underestimated by CT (average underestimation, 11 mm; range, 6–36 mm) and 21 tumors (7.4%) were overestimated (average overestimation by CT, 10 mm; range, 6–19 mm). The concordance rate between the two sets of measurements was greater for tumor of <20 mm and for IDC (P<0.001 and P = 0.011, respectively). CONCLUSIONS: Tumor size by chest CT is well correlated with pathology determined tumor size in breast cancer patients, and the diameters of the majority of tumors by chest CT and pathology differed by <5 mm. In addition, the concordance rate was higher for breast tumors of <20 mm and for tumors of the IDC histologic subtype