A computer model for the clearance of insoluble particles from the tracheobronchial tree of the human lung

A multi-compartment model for the clearance of insoluble particles from the tracheobronchial tree of the human lung was created. As a significant innovation, the model considers specific mass transfer paths that may play an important role for slow bronchial clearance. These include the accumulation of particulate mass in the periciliary sol layer, an uptake of stored particles by airway macrophages, and the endocytosis of deposited mass by epithelial cells. Besides the gel layer representing fast mucociliary clearance, all cellular and extracellular units involved into the slow clearance process are described by respective compartments which are connected by specific transfer paths. The gastrointestinal tract (GIT), lymph nodes (LN), and blood capillaries are included into the model as final accumulation compartments, to which mass is transferred via the airway route and the transepithelial path. Besides a basic version of the model describing the whole tracheobronchial region by one set of compartments, also an advanced approach is introduced which, in accordance with the International Commission on Radiation Protection (ICRP), subdivides the conducting airways into a bronchial (BB) and bronchiolar (bb) part. Preliminary results were generated with MS-Excel from deposition data of 1-mummass median aerodynamic diameter (MMAD) particles, calculating local slow clearance fractions according to mathematical procedures introduced in previous publications. While mucociliary clearance is completely finished within 24h after exposure, slow clearance takes place in distinct phases and needs several days to weeks. This multi-stage event is also reflected in the respective retention curves which correspond well to previously published graphs.     

Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): Importance of adopting a biopsychosocial model

Background

Reductions in quality of life (QOL) exist among individuals with multiple sclerosis (MS).

The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey

OBJECTIVES: The purpose of this investigation was to examine the relationship between psychosocial variables and working conditions, and nurses' coping methods and distress in response to the severe acute respiratory syndrome (SARS) crisis in Canada. PARTICIPANTS AND PROCEDURE: The sample consisted of 333 nurses (315 women, 18 men) who completed an Internet-mediated questionnaire that was posted on the Registered Nurses' Association of Ontario (RNAO) website between March and May 2004. The questionnaire was restricted to respondents who had to authenticate their RNAO membership with a valid username and password before accessing the questionnaire. This served a dual purpose: to ensure that only RNAO nurses completed the questionnaire and thereby safeguarding the generalizability of the findings; and second, to prevent any one nurse from contributing more than once to the overall sample. RESULTS: Correlational analysis yielded several significant relationships between psychosocial variables and working conditions, and the traditional correlates of burnout and stress. Three multiple regression analysis revealed that the model we evolved--including higher levels of vigor, organizational support, and trust in equipment/infection control initiative; and lower levels of contact with SARS patients, and time spent in quarantine--predicted to lower levels of avoidance behavior, emotional exhaustion, and state anger. CONCLUSIONS: By employing models of stress and burnout that combine psychosocial variables and working conditions, researchers can account for significant amounts of variance in outcomes related to burnout. These findings highlight the importance of vigor and perceived organizational support in predicting nurses' symptoms of burnout. For healthcare administrators, this means that a likely strategy for assuaging the negative outcomes of stress should address nurses' psychosocial concerns and the working conditions that they face during novel times of crisis.     

Emotional Control,Styles of Coping with Stress and Acceptance of Illness among Patients Suffering from Chronic Somatic Diseases

The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task‐oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness. Copyright © 2013 John Wiley & Sons, Ltd.     

Effectiveness of mobile applications in diabetic patients’ healthy lifestyles: A review of systematic reviews

Objective(1) Examine the mobile applications that address lifestyles to improve the metabolic control of adult patients with diabetes mellitus. (2) Describe the characteristics of the used mobile applications, identify the healthy lifestyles they target, and describe any of their adverse effects.MethodsReview systematic reviews. We included studies that used any mobile application to help patients improve diabetes mellitus self-management by focusing on healthy lifestyles. Studies needed to include a control group receiving regular care with no mobile devices. In May 2018, Medline, Embase, Cochrane, LILACS, PsychINFO, Cinahl and Science Direct were searched, updated in June 2021. The methodological quality of the studies was assessed by the Amstar-2 tool.ResultsFirst 804 articles were analyzed to select 17 systematic reviews, of which the methodological quality of seven was high or moderate. Interventions lasted 1−12 months. Twenty-three different mobile applications were identified that were all related to eating and physical activity. Significant changes were noted in HbA1c values. No clear improvement was observed for weight/BMI, lipid profile, quality of life or blood pressure. No adverse effects were found.ConclusionsManaging the lifestyle of patients with diabetes using mobile applications improves short-term glycemic control, but the long-term results are not conclusive. The identified mobile applications focus on food and physical activity. Most are free. No adverse effects caused by using them were identified.PROSPERO registerCRD42019133685     

The meaning of acceptance (Thum‐jai) in Thai people: Letting it go…so life goes on

The purpose of this qualitative study was to explore the meaning of acceptance (Thum‐jai) as a culturally embedded coping strategy in the lives of Thai people who have experienced adversity that caused suffering. Thematic analysis was used to examine the responses of 47 participants to written, open‐ended questions or face‐to‐face interviews. The EQUATOR's COREQ checklist for qualitative research was followed. Participants came from diverse religious’ traditions and geographic regions throughout Thailand. Findings revealed seven themes: circumstance and emotion; thought and action; time, experience, and effort; social and moral support; religious and spiritual ethos; acceptance and hope; and survive and thrive. The adverse circumstance is central to the concept of acceptance. Before acceptance, there is often hope; yet Thai people reach an existential point whether to accept the reality of the situation or continue in distress. Purposeful approaches to deal with the event flow from the cultural contexts of spirituality and social support. Drawing upon psychological strength, Thai people undertake purposive thought and action to facilitate redirecting their lives for better mental health. Thum‐jai brings release and peace of mind. Clinicians may find that people experiencing adverse life events are best served by nondirective approaches. Acceptance and change in thoughts and behaviours may come from meditation and therapeutic mindfulness practices that allow those in Western and non‐Western cultures to use their own values, expressions, and societal expectations to cope with suffering and formulate effective decisions.     

Pancreatic fate of 6-deoxy-6-[125I]iodo-D-glucose: in vitro experiments

The apparent distribution space of 6-[¹²⁵I]iodi-d-glucose, recently proposed as a tracer of d-glucose transport, was measured in rat isolated islets, acinar tissue, and pieces of pancreas. While such a space reached a steady-state value corresponding to the ³HOH volume in pancreatic islets within 5 min, it slowly increased in pieces of pancreas and, even after 60-min incubation, remained lower than the ³HOH volume. Moreover, the net uptake of 6-deoxy-6-[¹²⁵I]iodo-d-glucose by pancreatic pieces was inhibited by unlabeled 6-deoxy-6-iodo-d-glucose, d-glucose, and cytochalasin B, while being less or not affected by these agents in isolated islets. A preferential labeling of the endocrine, relative to exocrine, moiety of the pancreas was documented both by comparing, after 2 min incubation, the uptake of 6-deoxy-6-[¹²⁵I]iodo-d-glucose by pieces of pancreas from normal vs streptozotocin-injected rats and by comparing the radioactive content of pancreatic islets and acinar tissue obtained from normal rats injected intravenously 3 min before sacrifice with 6-deoxy-6-[¹²⁵I]iodo-d-glucose. It is proposed, therefore, that advantage could conceivably be taken from the vastly different time course for the uptake of selected monosaccharides by pancreatic islets vs acinar cells in the perspective of imaging of the endocrine pancreas by a non invasive method.     

Elevated levels of soluble fibrin in patients with venous thromboembolism

The fibrin-related markers (FRMs), including soluble fibrin (SF), d-dimer and fibrin and fibrinogen degradation products (FDP) are considered to be useful for the diagnosis of thrombosis; however, evidence for the diagnosis of thrombosis by SF is still not well established. The present study was designed to evaluate the usefulness of SF in the diagnosis of venous thromboembolism (VTE). The plasma concentrations of FRMs were measured in 551 in-patients suspected to have a VTE. The plasma levels of SF, d-dimer and FDP were significantly higher in patients with VTE than patients without VTE and those were significantly higher in patients without VTE than in healthy volunteers. In a receiver operating characteristic analysis for the diagnosis of VTE, the area under the curve was 0.950 for SF, 0.933 for FDP and 0.805 for d-dimer. The appropriate cut-off values for the diagnosis were as follows SF 5.9 μg/ml, FDP 2.1 μg/ml and d-dimer 4.8 μg/ml. To obtain a 100% negative predictive value for the diagnosis of VTE, the SF was less than 5.2 μg/ml, FDP was less than 1.3 μg/ml, and d-dimer was less than 0.5 μg/ml. Our findings suggest that the SF assay is useful for the diagnosis and exclusion of VTE.     

心理弹性在武警新兵应付方式与适应不良间的中介效应

目的探讨心理弹性对应付方式与适应不良间关系的影响。方法在新兵入伍第3周采用应付方式问卷(CSQ)、军人适应不良自评量表(MMQ)、心理弹性量表(CD-RISC)对广东省某部337名武警新兵进行调查。结果解决问题、求助与MMQ总分显著负相关(r=-0.628,-0.432;P0.01),与CD-RISC总分显著正相关(r=0.594,0.346;P0.01);自责、幻想、退避、合理化与MMQ总分显著正相关(r=0.581,0.461,0.477,0.331,P0.01),与CD-RISC总分显著负相关(r=-0.380,-0.278,-0.341,-0.183;P0.01),CD-RISC总分与MMQ总分显著负相关(r=-0.612,P0.01)。CD-RISC总分在应付方式各因子与MMQ总分之间起部分中介作用(P0.01)。结论应付方式可以通过心理弹性对武警新兵的适应不良起作用,也能直接影响适应不良。