Notes

Organizing kids pertaining to climate-related catastrophes.
he adolescent patient.
Previous research unambiguously establishes the importance of knowledge and education about opioids and pain management in medical care. This article aimed at describing the perception of the general public on the uses and the risks of morphine in palliative care in an Ecuadorian sample, where training and access to those services is limited.

We used an online recruited sample of 257 participants for this cross-sectional descriptive study. Participants responded to an online self-report survey regarding morphine's effects and its relationship with addiction and death in a palliative care context.

Analyses indicate that there is a lack of understanding about the effectiveness of morphine and that, overall, participants did not associate morphine with death and dying. Results also show that people in health-related occupations did not differ from the general public in beliefs about the addiction and the effectiveness of morphine. However, occupation and education effects were noted for several other items, as well as whether the participants had direct experiences with palliative care as either a patient or a caregiver.

There is still misinformation about opioids such as morphine in the general public and health professionals in Ecuador. Although personal experiences with pain control and palliative care are linked to better knowledge about opioids, education is still necessary to overcome the myths around them. Future research could address the found misconceptions to increase health literacy through education policies and interventions.
There is still misinformation about opioids such as morphine in the general public and health professionals in Ecuador. Although personal experiences with pain control and palliative care are linked to better knowledge about opioids, education is still necessary to overcome the myths around them. Future research could address the found misconceptions to increase health literacy through education policies and interventions.Optimization studies on blood pumps that require complex designs are gradually increasing in number. The essential design criteria of centrifugal blood pump are minimum shear stress with maximal efficiency. The geometry design of impeller sidewall gaps (blade tip clearance, axial gap, radial gap) is highly effective with regard to these two criteria. Therefore, unlike methods such as trial and error, the optimal dimensions of these gaps should be adjusted via a heuristic method, giving more effective results. In this study, the optimal gaps that can ensure these two design criteria with The Bees Algorithm (BA), which is a population-based heuristic method, are investigated. Firstly, a Computational Fluid Dynamics (CFD) analysis of sample pump models, which are selected according to the orthogonal array and pre-designed with different gaps, are performed. The dimensions of the gaps are optimized through this mathematical model. The simulation results for the improved pump model are nearly identical to those predicted by the BA. The improved pump model, as designed with the optimal gap dimensions so obtained, is able to meet the design criteria better than all existing sample pumps. Thanks to the optimal gap dimensions, it has been observed that compared to average values, it has provided a 42% reduction in aWSS and a 20% increase in efficiency. Moreover, original an approach to the design of impeller sidewall gaps was developed. The results show that computational costs have been significantly reduced by using the BA in blood pump geometry design.
Literature review.

An increasing number of obese patients requires operative care for degenerative spinal disorders. The aim of this review is to analyze the available evidence regarding the role of obesity on outcomes after spine surgery. Peri-operative complications and clinical results are evaluated for both cervical and lumbar surgery. Furthermore, the contribution of MIS techniques for lumbar surgery to play a role in reducing risks has been analyzed.

Only articles published in English in the last 10 years were reviewed. Inclusion criteria of the references were based on the scope of this review, according to PRISMA guidelines. Moreover, only paper analyzing obesity-related complications in spine surgery have been selected and thoroughly reviewed. Each article was classified according to its rating of evidence using the Sacket Grading System.

A total number of 1636 articles were found, but only 130 of them were considered to be relevant after thorough evaluation and according to PRISMA checklist.onists and bariatric surgeons, in order to plan proper weight loss before elective spine surgery.Studies have shown that losing a spouse can cause both physical and mental suffering for the bereaved. This qualitative study aimed to gather knowledge about how men and women in the Faroe Islands, a small-scale society in the North Atlantic Ocean, managed the transition to widowhood. Five women and three men were interviewed, their age varying from 67 to 74 years. A hermeneutic analytic method was applied. Our findings showed that managing the transition to widowhood followed two tracks, namely the process of loss and the process of restoration. For participants locked in either process, the transition caused severe disruption in daily living, while participants who managed to oscillate between the two processes appeared to manage the transition to widowhood and get on with their lives. Our findings, and those from other studies, point to the need to offer structured individual support for people who have lost their life partner.
Research over how suicide survivors approach services is limited.
This cross-sectional study explores the psychological state and perceived social support of Italian survivors, including those who have not sought for help, and investigates differences for gender or kinship with the departed.
Rule-based system (RBS) analyses identified relationships between social support and reported formal/informal help-seeking behavior. One-hundred thirty-two (103F; 27M) suicide survivors (53 having never sought for support) answered an anonymous online survey. Life satisfaction, wellbeing, perceived social support, suicidal ideation and formal/informal help-seeking were investigated.
RBS analysis identified different help-seeking behaviors survivors lacking social support may avoid reaching a psychologist and prefer GPs, look for advice in online forums and rely on people out of their narrower network such as co-workers.
These unique study's results offer insight to identify which specific areas would be fruision These unique study's results offer insight to identify which specific areas would be fruitful to investigate while assessing social support in bereaved individuals.
Hyperinflammation and cytokine release has been associated with severe Covid-19. Hemadsorption cartridges may have a potential role in treatment of cytokine storm associated with the development of severe Covid-19.

We retrospectively examined the case records of patients with severe Covid-19 receiving adjunctive hemadsorption (HA) in our ICU. We analyzed inflammatory biomarkers pre- and post- HA.

Fifteen patients received HA during the study period. All were intubated, ventilated and required renal replacement therapy. 11/15 were supported on ECMO. Mean ferritin 2652 (±3286) ng/ml, mean CRP 154 (±92) mg/ml, median D-dimer 3071 (±2689) ng/ml, mean troponin 236 (±461) ng/L. We found significant difference in pre-and post- treatment ferritin 3622 ng/ml versus 1682 ng/ml (
= 0.022), CRP 222 mg/ml versus 103 mg/ml (
= 0.008, 95% CI 22.4-126.5), lactate 2 mmol/L versus 1.3 mmol/L (
= 0.017), and procalcitonin 15.3 ng/ml versus 4.2 ng/ml (
= 0.023). No significant difference in pre- and post- treatment IL-6 14 pg/ml versus 43 pg/ml (
= 0.32), IL-10 3.4 pg/ml versus 2.6 pg/ml (
= 0.31), IL1 β 0.37 pg/ml versus 0.77 pg/ml (
= 0.75), TNF α 12.77 pg/ml versus 12.49 pg/ml (
= 0.75), VIS 10.04 versus 6.01 (
= 0.31, 95% CI 5.98-17.16) was seen.

The use of HA as adjunctive treatment in a critically unwell group of COVID-19 patients lead to a reduction in ferritin, CRP, procalcitonin and lactate with no significant change in other parameters. The use of HA in the treatment of severe COVID-19 requires further larger randomized studies.
The use of HA as adjunctive treatment in a critically unwell group of COVID-19 patients lead to a reduction in ferritin, CRP, procalcitonin and lactate with no significant change in other parameters. The use of HA in the treatment of severe COVID-19 requires further larger randomized studies.
Focal cartilage injuries, and posttraumatic osteoarthritis (OA) in the wrist are likely common and a cause of wrist pain. To estimate the incidence of cartilage lesions and to understand the pathomechanisms leading to wrist cartilage injuries and OA, a literature review on the subject was performed combined with a presentation of one of the authors' own experience.

This study includes a literature review of the topic. As a comparison to the review findings, the observations of one of the authors' consecutive 48 wrist arthroscopies, were assessed. PubMed, Scholar, and Cochrane databases were searched using the keywords "cartilage injury AND wrist AND treatment" and "wrist AND cartilage AND chondral AND osteochondral AND degenerative OA."

A total of 11 articles, including 9 concerning chondral and osteochondral repair and treatment and 2 regarding posttraumatic OA, were retrieved. The cartilage repair treatments used in these articles were drilling, osteochondral autograft, juvenile articular cartilage ald.COVID-19 has grossly impacted lives of people across the globe. In particular, children have also been affected due to closure of schools, therapy, and day care centers. Families have been challenged with new circumstances, and mental health professionals are coming up with novel ways to help these families who have children with mental health issues. This article describes experiences of families who have children with a diagnosed neurodevelopmental disorder with comorbid mental health difficulties and their ways of coping with the pandemic challenges. The series will throw light on ground level experiences of families during the pandemic, give insights into their ways of adapting, and brings out problem areas which healthcare professionals must work on, to design novel ways of care. The case series is novel and a similar report has probably not been presented from India or other low and middle income countries.
Extensive research relying on Injury Severity Scores (ISS) reports a mortality benefit from routine non-selective thoracic CTs (an integral part of pan-computed tomography (pan-CT)s). Recent research suggests this mortality benefit may be artifact. We hypothesized that the use of pan-CTs inflates ISS categorization in patients, artificially affecting admission rates and apparent mortality benefit.

Eight hundred and eleven patients were identified with an ISS >15 with significant findings in the chest area. Patient charts were reviewed and scores were adjusted to exclude only occult injuries that did not affect treatment plan. Pearson chi-square tests and multivariable logistic regression were used to compare adjusted cases vs non-adjusted cases.

After adjusting for inflation, 388 (47.8%) patients remained in the same ISS category, 378 (46.6%) were reclassified into 1 lower ISS category, and 45 (5.6%) patients were reclassified into 2 lower ISS categories. Patients reclassified by 1 category had a lower rate of mortality (
< 0.
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