Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: A cluster analysis

Background: Self-care is important in heart failure (HF) treatment, but patients may have difficulties and be inconsistent in its performance. Inconsistencies in self-care behaviors may mirror patterns of self-care in HF patients that are worth identifying to provide interventions tailored to patients. Objectives: The aims of this study are to identify clusters of HF patients in relation to self-care behaviors and to examine and compare the profile of each HF patient cluster considering the patient's sociodemographics, clinical variables, quality of life, and hospitalizations. Methods: This was a secondary analysis of data from a cross-sectional study in which we enrolled 1192 HF patients across Italy. A cluster analysis was used to identify clusters of patients based on the European Heart Failure Self-care Behaviour Scale factor scores. Analysis of variance and [chi]2 test were used to examine the characteristics of each cluster. Results: Patients were 72.4 years old on average, and 58% were men. Four clusters of patients were identified: (1) high consistent adherence with high consulting behaviors, characterized by younger patients, with higher formal education and higher income, less clinically compromised, with the best physical and mental quality of life (QOL) and lowest hospitalization rates; (2) low consistent adherence with low consulting behaviors, characterized mainly by male patients, with lower formal education and lowest income, more clinically compromised, and worse mental QOL; (3) inconsistent adherence with low consulting behaviors, characterized by patients who were less likely to have a caregiver, with the longest illness duration, the highest number of prescribed medications, and the best mental QOL; (4) and inconsistent adherence with high consulting behaviors, characterized by patients who were mostly female, with lower formal education, worst cognitive impairment, worst physical and mental QOL, and higher hospitalization rates. Conclusion: The 4 clusters identified in this study and their associated characteristics could be used to tailor interventions aimed at improving self-care behaviors in HF patients

MORPH: A Reference Architecture for Configuration and Behaviour Self-Adaptation

An architectural approach to self-adaptive systems involves runtime change of system configuration (i.e., the system's components, their bindings and operational parameters) and behaviour update (i.e., component orchestration). Thus, dynamic reconfiguration and discrete event control theory are at the heart of architectural adaptation. Although controlling configuration and behaviour at runtime has been discussed and applied to architectural adaptation, architectures for self-adaptive systems often compound these two aspects reducing the potential for adaptability. In this paper we propose a reference architecture that allows for coordinated yet transparent and independent adaptation of system configuration and behaviour

Low- and high-energy phenomenology of a doubly charged scalar

We explore the phenomenology of an $SU(2)$-singlet doubly charged scalar at the high and low energy frontier. Such a particle is predicted in different new physics models, like left-right symmetric models or the Zee-Babu model. Nonetheless, since its interactions with Standard Model (SM) leptons are gauge invariant, it can be consistently studied as a UV complete SM extension. Its signatures range from same-sign di-lepton pairs to flavour changing decays of charged leptons to muonium-antimuonium oscillations. In this article, we use a systematic effective-field-theory approach for studying the low-energy observables and comparing them consistently to collider bounds. For this purpose, experimental searches for doubly charged scalars at the Large Hadron Collider are reinterpreted, including large width effects, and projections for exclusion and discovery reaches in the high-luminosity phase are provided. The sensitivities of the future International Linear Collider and Compact Linear Collider for the doubly charged scalar are presented with focus on di-lepton final states and resonant production. Theoretically and phenomenologically motivated benchmark scenarios are considered showing the different impact of low- and high-energy observables. We find that future low- and high-energy experiments display strong complementarity in studying the parameter space of the model.Comment: 22 pages, 18 figures. v2: minor revisions, it matches the version published in Physical Review

Spontaneous fertility and in vitro fertilization outcome: New evidence of human papillomavirus sperm infection

Objective To evaluate the reproductive outcome of infertile couples undergoing assisted reproduction techniques (ART) with or without human papillomavirus (HPV) semen infection. Design Cross-sectional clinical study. Setting Units of andrology, reproductive medicine, and gynecology. Patient(s) A total of 226 infertile couples. Intervention(s) Male partners were evaluated by means of fluorescence in situ hybridization (FISH) for HPV on semen. After a diagnostic period, female partners underwent intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI). Main Outcome Measure(s) Seminal parameters and FISH analysis for HPV in sperm head. Spontaneous or assisted pregnancies, live births, and miscarriages were recorded. Statistical analysis included unpaired Student t test and chi-square test. Result(s) Fifty-four male partners (23.9%) had HPV semen infection confined to sperm, confined to exfoliated cells, or in both cells. During the diagnostic period, noninfected couples showed spontaneous pregnancies. IUI and ICSI treatments were performed in, respectively, 60 and 98 noninfected and in 21 and 33 infected couples, with 38.4% and 14.2% cumulative pregnancy rates, respectively. The follow-up of pregnancies showed a higher miscarriage rate in infected couples (62.5% vs. 16.7%). Ongoing pregnancies of the latter group were characterized by HPV infection confined to exfoliated cells. Conclusion(s) A reduction in natural and assisted cumulative pregnancy rate and an increase in miscarriage rate are related to the presence of HPV at sperm level. Although the exact mechanism by which sperm infection is able to impair fertility remains unclear, this aspect is worthy of further investigations. If confirmed, these results could change the clinical and diagnostic approach to infertile couples

Geochemical characterization of recent Nile Delta inner shelf sediments: Tracing natural and human-induced alterations into a deltaic system

Abstract The present study deals with the geochemical changes observed along Nile Delta inner shelf sediments over a period of 20 years (1995–2015). Major, minor, and trace constituents as well as rare earth elements (REE) were investigated in the surface sediments collected from seven transects along the inner shelf on five years intervals. Geochemical composition of sediments in Nile Delta inner shelf exhibits continuous changes over time due to the depositional and sediment transport processes. The sediments are generally enriched with Fe and Ti oxides, as well as Ta, Nb, Y in comparison to the Upper Continental Crust (UCC). These alterations signify the impact of processes such as erosion and sediment transport, as well as the impact of anthropogenic interferences such as damming the Nile River Flow. The reduction of the sediment input from the Nile River has somehow altered the geochemical signature of the inner shelf sediments. The REE patterns indicate weathering in areas subjected to erosion, while trace elements and major oxides spatial and temporal distributions concentrate eastwards under the influence of the easterly sediment transport pattern. Nile Delta inner shelf presented a typical case for understanding the link between geochemistry and sedimentary processes in nearshore and deltaic systems