Patients’ reports on their delusional memories from the intensive care unit: A systematic review of qualitative studies

Objective: To critically summarise the qualitative literature to understand patients’ experiences of delusional memories during their Intensive Care Unit stay. Research methodology: A systematic review of qualitative studies with meta-synthesis and meta-summary. We searched MEDLINE (via PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science to July 2022. All studies that provided qualitative insights into the subjective experience of adult patients with delusional memories in the Intensive Care Unit were selected. The Critical Assessment Skills Programme checklist was used for the quality assessment. Results: Fourteen studies were included. The 33 codes that emerged from the inductive thematic analysis were grouped into three themes: ‘The sense of danger and the terrifying aspect of death’ (feeling in danger, surrounded by death, persecuted by people around, and feeling unsafe), ‘The presence of someone or something nearby’ (perceiving the loved ones, feeling overwhelmed by scary creatures, and being neglected by those around me), and ‘The reality behind the world perceived by the senses’ (travelling the world, stimulating the senses, feeling peaceful, and living in a fantasy world). The most frequent code in the studies was ‘Be with a family member’, with an intensity of 35.7%. Conclusion: The patient's experience described as delusional is considered a real event by the person experiencing it. Further research is needed to investigate the extent to which these experiences lead to poorer early and late outcomes for patients, and to test strategies to prevent this. Implications for clinical practice: A deeper understanding of the phenomenon may help healthcare professionals to recognise precursors, symptoms and consequences of delusional memories and intervene with appropriate help. One strategy would be to further humanise care and focus on family involvement and communication with patients to overcome the factual events that can potentially alter patients’ quality of life

The experience of individuals placed in quarantine: A systematic review, meta-summary, and meta-synthesis

Objective: To summarize the experience of individuals placed in quarantine during an outbreak. Design: A meta-summary and a meta-synthesis based upon a systematic review of qualitative studies. Sample: The Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Scopus databases were all searched up to April 2020. Measurements: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed; then, the methodological quality of the studies included was assessed with the Critical Appraisal Screening Programme tool for qualitative studies. Results: Five studies have been included documenting the experience of 125 adult individuals. A total of 16 codes emerged: in the meta-summary, the most and least frequent codes were \u201cThinking about quarantine\u201d (80%) and \u201cEmotional roller coaster,\u201d \u201cBeing alert for any symptom,\u201d \u201cTrusting or not?,\u201d \u201cKnowing who brought the infection,\u201d and \u201cLiving in a surreal world\u201d (20%). The codes which emerged were categorized into three main themes which summarized the whole experience of being placed in quarantine: (a) \u201cBeing swamped with a thousand emotions\u201d; (b) \u201cBeing restrained\u201d; and (c) \u201cNeeding to be considered.\u201d. Conclusions: The experience of quarantine for people is a long journey which can feel chaotic due to uncertainty about the consequences on health, work, and the future. The findings of this study can help nurses in caring for quarantined individuals by enabling them to understand people's need for educational and emotional support. Ensuring the supply of consistent information is also important to increase people's compliance

Waste heat to power conversion by means of thermomagnetic hydrodynamic energy harvester

Energy harvesting from extremely low enthalpy sources can play an important role in increasing the sustainability of future energy applications: low temperature differences are common and offer an abundant source, available both in the natural environment and as the result of a many industrial process. This paper presents the first closed-loop thermomagnetic hydrodynamic energy harvester, based on thermomagnetic advection and exploiting a commercial ferrofluid. The lab-scale prototype has a toroidal geometry adopted from the well-known tokamak inertial machines. Peltier modules are used to control the thermal gradient that is harvested and converted directly to electric energy, while permanent magnets trigger the advection. Temperature sensors are installed along the toroidal walls (thermistors) and are placed in contact with the rotating fluid (thermocouples). To extract and ensure the electrical energy output, the structure is wrapped-up with induction coils. Two coil configurations (purely poloidal and mixed poloidal/toroidal windings) are tested, in a heterogeneous two-phase flow from the combination of water carrier and ferrofluid packets, reaching a maximum extracted electrical power per unit of temperature difference of 10.4 μW/K. This positions the device close to 20% of the ideal Carnot efficiency of a thermal machine working on the same temperature drop. Numerical analysis of the system has been performed developing a Fortran™ code in a Eulerian framework, using a mixed Fourier-Galerkin/finite difference spatial discretization. The harvester is suitable for producing electricity from running engines, appliances, warm gas exhausts, exothermic processes

Homeodomain Interacting Protein Kinase 2 Activation Compromises Endothelial Cell Response to Laminar Flow: Protective Role of p21waf1,cip1,sdi1

BACKGROUND: In the cardiovascular system, laminar shear stress (SS) is one of the most important source of endothelial protecting signals. Physical and chemical agents, however, including ionising radiations and anticancer drugs, may injure endothelial cells determining an increase in oxidative stress and genotoxic damage. Whether the SS protective function remains intact in the presence of strong oxidants or DNA damage is currently unclear. METHODS AND RESULTS: To investigate this aspect a series of experiments were performed in which HUVEC were exposed to sub-lethal doses of the radio-mimetic compound Bleomycin (Bleo; 10 microg/ml) which generated free radicals (ROS) without significantly compromising cell survival. Remarkably, the application of a SS of 12 dyne/cm(2) did not protect endothelial cells but markedly accelerated apoptosis compared to controls kept in static culture and in the presence of Bleo. Experiments with the inducible nitric oxide synthase (iNOS) inhibitor GW274150 significantly reduced the SS-dependent apoptosis indicating that the production of NO was relevant for this effect. At molecular level, the ataxia-telangectasia-mutated (ATM) kinase, the homeodomain-interacting protein kinase-2 (HIPK2) and p53 were found activated along a pro-apoptotic signalling pathway while p21(waf1,cip1,sdi1) was prevented from its protective action. RNA interference experiments revealed that HIPK2 and p53 were both important for this process, however, only the forced expression p21(waf1,cip1,sdi1) fully restored the SS-dependent pro-survival function. CONCLUSIONS: This study provides the first evidence that, in the presence of genotoxic damage, laminar flow contributes to endothelial toxicity and death and identifies molecular targets potentially relevant in endothelial dysfunction and cardiovascular disease pathogenesis

On the equivalence between hierarchical segmentations and ultrametric watersheds

We study hierarchical segmentation in the framework of edge-weighted graphs. We define ultrametric watersheds as topological watersheds null on the minima. We prove that there exists a bijection between the set of ultrametric watersheds and the set of hierarchical segmentations. We end this paper by showing how to use the proposed framework in practice in the example of constrained connectivity; in particular it allows to compute such a hierarchy following a classical watershed-based morphological scheme, which provides an efficient algorithm to compute the whole hierarchy.Comment: 19 pages, double-colum

Epidemiological Characteristics of Foot and Ankle Injuries in 2 Professional Ballet Companies: A 3-Season Cohort Study of 588 Medical Attention Injuries and 255 Time-Loss Injuries.

The foot and ankle are often reported as the most common sites of injury in professional ballet dancers; however, epidemiological research focusing on foot and ankle injuries in isolation and investigating specific diagnoses is limited. To investigate the incidence rate, severity, burden, and mechanisms of foot and ankle injuries that (1) required visiting a medical team (medical attention foot and ankle injuries; MA-FAIs) and (2) prevented a dancer from fully participating in all dance-related activities for at least 24 hours after the injury (time-loss foot and ankle injuries; TL-FAIs) in 2 professional ballet companies. Descriptive epidemiological study. Foot and ankle injury data across 3 seasons (2016-2017 to 2018-2019) were extracted from the medical databases of 2 professional ballet companies. Injury-incidence rate (per dancer-season), severity, and burden were calculated and reported with reference to the mechanism of injury. A total of 588 MA-FAIs and 255 TL-FAIs were observed across 455 dancer-seasons. The incidence rates of MA-FAIs and TL-FAIs were significantly higher in women (1.20 MA-FAIs and 0.55 TL-FAIs per dancer-season) than in men (0.83 MA-FAIs and 0.35 TL-FAIs per dancer-season) (MA-FAIs, = .002; TL-FAIs, = .008). The highest incidence rates for any specific injury pathology were ankle impingement syndrome and synovitis for MA-FAIs (women 0.27 and men 0.25 MA-FAIs per dancer-season) and ankle sprain for TL-FAIs (women 0.15 and men 0.08 TL-FAIs per dancer-season). work and jumping actions in women and jumping actions in men were the most common mechanisms of injury. The primary mechanism of injury of ankle sprains was jumping activities, but the primary mechanisms of ankle synovitis and impingement in women were related to dancing . The results of this study highlight the importance of further investigation of injury prevention strategies targeting work and jumping actions in ballet dancers. Further research for injury prevention and rehabilitation strategies targeting posterior ankle impingement syndromes and ankle sprains are warranted. [Abstract copyright: © The Author(s) 2023.

On morphological hierarchical representations for image processing and spatial data clustering

Hierarchical data representations in the context of classi cation and data clustering were put forward during the fties. Recently, hierarchical image representations have gained renewed interest for segmentation purposes. In this paper, we briefly survey fundamental results on hierarchical clustering and then detail recent paradigms developed for the hierarchical representation of images in the framework of mathematical morphology: constrained connectivity and ultrametric watersheds. Constrained connectivity can be viewed as a way to constrain an initial hierarchy in such a way that a set of desired constraints are satis ed. The framework of ultrametric watersheds provides a generic scheme for computing any hierarchical connected clustering, in particular when such a hierarchy is constrained. The suitability of this framework for solving practical problems is illustrated with applications in remote sensing