Assessment Of Adequacy Research Articles

New Instant Digital Pathology for EUS/EBUS Samples: The Last Advance in Bedside Diagnostics for Lung Carcinoma

Background Ex vivo fluorescence laser scanning microscopes (FCMs) allow digital tissue imaging directly from fresh, unfixed specimens without the need for conventional histological slide preparation. To date, no data have been reported on the use of FCMs in the endoscopy suite for immediate evaluation of endoscopic ultrasound (EUS)/endobronchial ultrasound (EBUS) fine needle aspiration/biopsy (FNA-B) specimens of lung lesions and/or mediastinal lymph nodes. Objectives The aim of this study was to evaluate the performance of the FCM Vivascope 2500 (Vivascope, Munich, Germany) in providing real-time adequacy assessment and diagnostic information on the digital images of fresh unprocessed EUS/EBUS FNA-B specimens and to compare it with the corresponding final histological sections of formalin-fixed and paraffin-embedded cell blocks. Methods and Results Thirty-two patients (50% male; 71 ± 8 years old) were enrolled between May 2023 and June 2024. In 28/32 (87.5%) patients, samples were defined as adequate at Vivascope evaluation, and in 20/28 (71.4%) patients, samples were classified as malignant. At final cytohistological evaluation, 87.5% of specimens were defined as adequate and 20/28 (71.4%) were diagnosed as malignant. There was perfect agreement between the Vivascope assessment of adequacy and the final cytohistological assessment on the same specimen (k Cohen 1). From a diagnostic point of view, perfect agreement was found between the two techniques in the identification of malignant neoplasms (k Cohen 1). Conclusion The use of FCM could provide rapid information on both the adequacy and malignancy of the sample obtained during EBUS tissue acquisition (EBUS-TA), with minimal or no preparation and without destroying or losing the tissue. This technique allows for obtaining representative material in EBUS/EUS for lung cancer staging and is expected to change the turnaround time from biopsy sampling to diagnostic characterization of the tumor, ultimately improving patient management both at diagnosis and at restaging in follow up.

Robustness of Divergence Time Estimation Despite Gene Tree Estimation Error: A Case Study of Fireflies (Coleoptera: Lampyridae).

Genomic data has become ubiquitous in phylogenomic studies, including divergence time estimation, but provide new challenges. These challenges include, amongst others, biological gene tree discordance, methodological gene tree estimation error, and computational limitations on performing full Bayesian inference under complex models. In this study, we use a recently published firefly (Coleoptera: Lampyridae) anchored hybrid enrichment dataset (AHE; 436 loci for 88 Lampyridae species and 10 outgroup species) as a case study to explore gene tree estimation error and the robustness of divergence time estimation. First, we explored the amount of model violation using posterior predictive simulations because model violations are likely to bias phylogenetic inferences and produce gene tree estimation error. We specifically focused on missing data (either uniformly distributed or systematically) and the distribution of highly variable and conserved sites (either uniformly distributed or clustered). Our assessment of model adequacy showed that standard phylogenetic substitution models are not adequate for any of the 436 AHE loci. We tested if the model violations and alignment errors resulted indeed in gene tree estimation error by comparing the observed gene tree discordance to simulated gene tree discordance under the multispecies coalescent model. Thus, we show that the inferred gene tree discordance is not only due to biological mechanism but primarily due to inference errors. Lastly, we explored if divergence time estimation is robust despite the observed gene tree estimation error. We selected four subsets of the full AHE dataset, concatenated each subset and performed a Bayesian relaxed clock divergence estimation in RevBayes. The estimated divergence times overlapped for all nodes that are shared between the topologies. Thus, divergence time estimation is robust using any well selected data subset as long as the topology inference is robust.

Assessment of Adequacy of Product Appearance Attributes to the Design Objective

A new method for assessment of product aesthetics („Assessment of adequacy of product appearance attributes to the design objective and to values of market segment”, Adequacy Method, in short) was developed by the author. The method is based on the need to assess product aesthetics against the design objective and the human values / goals of the target market segment. In a pre-test, eight products (from four classes) with the most different design were chosen for testing the method. Then, in an experimental study, the products were assessed using the proposed method by students from a technical university. After statistically analysing the assessment results, it was found that the method criteria and the method itself proved to be reliable, efficient, and clear. The proposed method was also tested by comparison with a complex method (FTESE – Functional, Technical, Ergonomic, Significance and Esthetic Analysis). The same products used in the paper presenting the FTESE method were assessed using the proposed method and lead to the same ordering of products according to their aesthetics. But the comparison also indicated that the proposed method allows for a superior refinement.

Anesthesia for Posterior Tracheopexy in Pediatric Patients.

Tracheobronchomalacia refers to an abnormally excessive collapse of the trachea and/or bronchi during exhalation. In the pediatric population, tracheobronchomalacia is increasingly recognized as a cause of morbidity and mortality. Historically, options for medical management and surgical intervention were limited, and patient outcomes were poor. Over the last decade, select US pediatric institutions have devoted significant resources to the establishment of dedicated surgery and anesthesia teams and the development of novel techniques for the successful identification, assessment, and surgical correction of tracheobronchomalacia in a highly complex subset of the pediatric population. The close communication, collaboration, and evolution of anesthesia techniques to meet the unique requirements of new surgical procedures have greatly improved patient safety and optimized outcomes. More than 800 cases have been performed across 2 US pediatric institutions using these techniques. This article reviews the posterior tracheopexy procedure, a newer but increasingly common surgery designed to address tracheobronchomalacia, and provides an overview of related anesthesia considerations and unique challenges. In addition, this article describes novel anesthesia techniques developed specifically to facilitate optimal diagnosis of tracheobronchomalacia and intraoperative management of posterior tracheopexy and similar airway surgeries. These include methods to safely enable 3-phase rigid dynamic bronchoscopy for accurate tracheobronchomalacia diagnosis, recurrent laryngeal nerve monitoring during cervical and thoracic surgical dissection, continuous intraoperative bronchoscopy to enable real-time images during airway reconstruction, and intraoperative assessment of airway repair adequacy to ensure successful correction of tracheobronchomalacia.

Nonstandardized High-Intensity Dialysis Dose Improves Survival in Patients With End-Stage Renal Disease.

Introduction One of the most important critical determinants of quality of life and adequacy of hemodialysis (HD) performed in patients is the recorded survival and mortality rates. Nowadays, as an adequately performed HD dialysis, we accept the one with reaching values for the index single pool Kt/V (spKt/V) higher than 1.2. In recent years, more intensive HD regimens with spKt/V≥1.5 have been increasingly discussed, which can significantly improve patient survival. However, their benefit has yet to be proven, as extremely high spKt/V values can be misleading as they may result from malnutrition leading to reduced survival and increased relative risk of death. The aim of this study is to present to the community the impact of nonstandardized high dialysis doses (spKt/V>1.5) on annual survival and mortality rates in the dialysis population and to explore new strategies for enhancing quality of life and survival, as well as to promote their regular implementation in clinical practice and personalized patient care. Material and methods The present retrospective study was conducted at the Clinic of Nephrology and Dialysis at University Hospital St. Marina in Varna, Bulgaria for a period of five years. It involved a survival analysis of 100 dialysis patients who met the inclusion and exclusion criteria. The dialysis dose delivered was the criterion for their allocation into three studied groups: Group 1 with adequate dose (standardized) - spKt/V = 1.2-1.49, Group 2 with high dose (nonstandardized) - spKt/V≥1.5, and Group 3 with inadequate dose (low) - spKt/V≤1.19. We recorded total annual mortality and survival rates, analyzing their relationship with the delivered dialysis dose and assessing the relative risk of death and expected survival. Results The analysis results indicated that high-intensity regimens with an spKt/V≥1.5 were linked to a better patient prognosis, with a significantly lower risk of death compared to standard regimens and increased survival expectancy. Data from the survival analysis suggested that the long-term impact of increasing the dialysis dose (spKt/V≥1.5) on survival becomes evident after the third year. Additionally, nutritional status parameters emerged as key risk factors for deterioration, along with the indicators of dialysis adequacy. Discussion Improved survival rates have been observed in patients undergoing nocturnal HD. In the latter, significantly higher spKt/V values have been achieved due to extended dialysis sessions, as well as in those performing dialysis at home. Despite concerns about possible misinterpretation of extremely high spKt/V values (>1.5) as a sign of malnutrition when urea volume of distribution is reduced, it is found that when only urea clearance (Kt) is used, without volume counts, the risk of death decreases by 2% for each liter increase in clearance. This demonstrates that the assessment of dialysis adequacy is a much broader concept than the values of generally accepted indicators and should be focused on individualized care and risk assessment tailored to each patient. Conclusions We believe that the modern nephrological community should strive to achieve a high dialysis dose (spKt/V≥1.5) to improve clinical outcomes and patient prognosis. Assessing dialysis adequacy is complex and goes beyond a simple numerical value such as spKt/V. It requires careful monitoring of nutritional status and the management of all HD-related complications.

Modelling of Claim and Pricing of Motor Insurance Based on Bonus-Malus System Considering the Frequency and Severity of Claims

This article proposes new distributions for claim frequency and severity, specifically tailored for a bonus-malus system in automobile insurance. The mixed Poisson with weighted quasi Lindley distribution is recommended for modeling claim frequency, while the mixed exponential with weighted quasi Lindley distribution is suggested for modeling claim severity. To estimate insurance premiums, the Bayesian method is employed, incorporating both frequency and severity distributions. The study validates the proposed models using real data from an Australian insurance company, which includes 67,856 policies. The assessment of model adequacy indicates that the Poisson-weighted quasi Lindley distribution is a suitable fit for modeling claim frequency, while the exponential-weighted quasi Lindley distribution is appropriate for modeling claim severity. Overall, the results suggest that the proposed models offer optimal premium estimations, considering both claim frequency and severity, which can lead to fairer pricing and increased customer appeal during claim occurrences compared to conventional models.

Assessment of nutritional status & dietary adequacy of women of reproductive age group residing in slum areas of Sitapur City, INDIA.

Assessment of nutritional status & dietary adequacy of women of reproductive age group residing in slum areas of Sitapur City, INDIA.

A clinical assessment of preperitoneal packing adequacy for pelvic fracture bleeding control

BackgroundThis study aimed to objectively assess the laparotomy pads to potential hemorrhage sites proximity in pelvic fracture patients who underwent post-pre peritoneal packing (PPP) CT scans with packs in situ. MethodsThe CT scans of 19 patients were assessed to measure the distance between laparotomy pads and predetermined pelvic anatomical landmarks. ResultsA total of 38 measurements showed that the median pack-to-point distance for the sacroiliac joint was 2.7 cm (IQR, 2.1–4.0), for the common iliac artery 4.1 cm (IQR, 3.2–5.0), for the external iliac artery 0 cm (IQR, 0.0–0.2), for the internal iliac artery 0.1 cm (IQR, 0–0.7), and for the iliac bifurcation 2.0 cm (IQR, 1.7–3.9). There were 60 % direct contact measurements for the iliac arteries. ConclusionThis study shows that with adequately executed PPP a reasonable proximity of laparotomy packs to the potential bleeding sites to provide tamponade for arresting hemorrhage may be achieved.

Assessment of energy and nutrient intake adequacy and dietary diversity of pregnant women in Abidjan

Background: Dietary diversity is a potential indicator of adequate nutrient intake. Aims: The study assessed dietary diversity and adequacy of nutrient intake among pregnant women in Abidjan (Côte d’Ivoire). Subjects and Methods: A cross-sectional study was conducted on 389 healthy pregnant adult women aged 20 to 43. Participants completed a three-day, 24-hour dietary recall questionnaire and dietary data were converted into nutrient amounts using Nutrisurvey software. Dietary Diversity Score (DDS) was based on nine food groups aggregated from a 15-item questionnaire. Nutrient intake was assessed using the Nutrient Adequacy Ratio (NAR) with the mean adequacy ratio (MAR) serving as an overall indicator of diet quality. Data were analyzed using SPSS version 25. Results: The mean DDS among pregnant women was low at 4.30 ± 1.04, with diet primarily consisting of cereals, white tubers, roots, vegetables and fish. The average energy intake of pregnant women was 2429 kcal/day for over 60 % of participants. While the majority met the Recommended Daily Allowance (RDA) for carbohydrates, fats, proteins, and vitamin B12. However, intakes of calcium, iron, magnesium, zinc, folates and vitamin C were below the RDAs for most pregnant women. The average MAR for pregnant women was 70.86% and exhibited a positive correlation with DDS (r = 0.37; p < 0.001). NAR for energy and other nutrients was positively correlated with DDS, except for vitamins B12 and C. Conclusions: Pregnant women with adequate nutrient intakes consumed a diverse range of foods. Dietary diversity can therefore provide be a reliable indicator of nutrient adequacy in the diets of pregnant women in Abidjan’s hospital. Keywords: Dietary diversity, nutrient intake, nutrient adequacy ratio, pregnant women, Côte d'Ivoire.

Automated estimation of thoracic rotation in chest X-ray radiographs: a deep learning approach for enhanced technical assessment.

This study aims to develop an automated approach for estimating the vertical rotation of the thorax, which can be used to assess the technical adequacy of chest X-ray radiographs (CXRs). Total 800 chest radiographs were used to train and establish segmentation networks for outlining the lungs and spine regions in chest X-ray images. By measuring the widths of the left and right lungs between the central line of segmented spine and the lateral sides of the segmented lungs, the quantification of thoracic vertical rotation was achieved. Additionally, a life-size, full body anthropomorphic phantom was employed to collect chest radiographic images under various specified rotation angles for assessing the accuracy of the proposed approach. The deep learning networks effectively segmented the anatomical structures of the lungs and spine. The proposed approach demonstrated a mean estimation error of less than 2° for thoracic rotation, surpassing existing techniques and indicating its superiority. The proposed approach offers a robust assessment of thoracic rotation and presents new possibilities for automated image quality control in chest X-ray examinations. This study presents a novel deep-learning-based approach for the automated estimation of vertical thoracic rotation in chest X-ray radiographs. The proposed method enables a quantitative assessment of the technical adequacy of CXR examinations and opens up new possibilities for automated screening and quality control of radiographs.

ANALYSIS OF WORKING CAPITAL EFFICIENCY FOR ARABLE CROP FARMS IN HUNGARY

Our study is a thematic analysis of the literature on working capital, aiming to present the latest research and interpretations on working capital management. In the second part of the paper, we present an assessment of capital adequacy and working capital efficiency and their results, based on our own data collection and compared with the findings of the literature. There is a substantial international literature on the impact of working capital, which examines the returns and the impact on profitability of the stock of inventories, the turnover of various current assets and the cycle days associated with working capital management. In our study, we used these aspects to select asset endowment and turnover-income profitability indicators from the EMIS database for Hungarian arable crop farms, searching for correlations by regression analysis for three years 2018, 2020 and 2022. Our results show that working capital endowment specifically showed significant correlations with operating revenue in all three years, while the other explanatory variables mostly gave significant correlations only for the year 2022. The size of the Hungarian agricultural economy is specifically characterised by micro and small enterprises, therefore we categorised the enterprises into micro, small, medium and large enterprises based on the value of their assets and their revenue. The number of enterprises specifically engaged in cereal and oilseed production by size category thus differed significantly, and multivariate regression was no longer possible for the two larger categories. In these cases, correlation analysis preceded regression analysis. Examining working capital efficiency by firm size, small farms showed significant correlations with profitability, but they also tended to do so only for the year 2022.

Spatial adequacy of afforestation in Poland: do afforestation needs and environmental preferences matter?

The article concerns the afforestation of agricultural land, especially soils of low quality classes with little suitability for agriculture. The assumption was made that in order to effectively implement afforestation and optimize spatial structures, these lands should be analyzed from the point of view of environmental and spatial conditions (including the quality of the land and its suitability for field crops, cohesion of the forest ecosystem, the presence of naturally valuable areas), according to the potential of a given area. Land that is ineffective in cultivation and does not improve the cohesion of the ecosystem should be treated as preferred for afforestation. The assessment of the spatial adequacy (optimization) of afforestation in the context of afforestation needs and predispositions was carried out for Poland in terms of municipalities using the spatial autocorrelation model and methods. The research results indicate the need to strengthen the effectiveness of solutions that take into account the endogenous potential of municipalities.

Artificial intelligence and design of experiments for resource adequacy assessment in power systems

Assessing the effects of the energy transition and liberalization of energy markets on resource adequacy is an increasingly important and demanding task. The rising complexity of energy systems requires adequate methods for energy system modeling leading to increased computational requirements. Furthermore, with complexity, uncertainty increases likewise calling for probabilistic assessments and scenario analyses. To adequately and efficiently address these various requirements, new methods from the field of data science are needed to accelerate current modeling approaches. With our systematic literature review, we want to close the gap between the three disciplines (1) resource adequacy assessments, (2) artificial intelligence (AI), and (3) design of experiments. For this, we conduct a large-scale systematic review of selected fields of application and methods and make a synthesis that relates the different disciplines to each other. Among other findings, we identify metamodeling of complex probabilistic resource adequacy assessment models using AI methods and applications of AI-based methods for forecasts of storage dispatch and (non-)availabilities as promising fields of application that have not yet been sufficiently covered. Eventually, we define a new methodological pipeline for adequately and efficiently addressing the present and upcoming challenges in the assessment of resource adequacy accounting for modeling the complexity and uncertainties of future developments.

Assessment of prenatal care adequacy using different normative criteria in a municipality in Santa Catarina, Brazil

The current study aimed to evaluate the quality of prenatal care and identify associated factors among women admitted for delivery at a public maternity hospital in greater Florianópolis, Santa Catarina. This cross-sectional study included women who had received prenatal care through the Government Unified Health System in the city of São José and had been subsequently admitted to the hospital for delivery from November 2021 to April 2022. Data were obtained from the pregnant women’s booklet, their health records, and a specific questionnaire. The evaluation criteria included the Takeda-modified Kessner index, adapted adequacy of prenatal care utilization index, and Anversa classification. Adequacy was assessed based on pregnancy parameters and the patients’ characteristics. Among the 237 pregnant women in the sample, prenatal care adequacy ranged from 48.5 to 83.1% and was associated with older age, education, referral to high-risk prenatal care (HRPN) (20 – 30% higher prevalence of adequacy), and pregnancy planning. Notably, there was a tendency toward a reduction in the number of examinations (laboratory and physical) during pregnancy. The adequacy rate decreased with the application of stricter normative criteria and in advanced pregnancy stages. In conclusion, prenatal care quality was predominantly adequate, although it varied across indices and was associated with age, education, HRPN, and pregnancy planning.

Manual Dexterity Predictors of Artificial Urinary Sphincter Success

ObjectiveTo determine better in-office measures for artificial urethral sphincter outcomes, we investigated the ability of preoperative timed peg-transfer, pinch strength, grip strength, and Disabilities of the Arm Shoulder and Hand Outcome questionnaire in predicting postoperative satisfaction, confidence, and ease of use of artificial urethral sphincter placement for stress urinary incontinence. Materials and MethodsA timed 9-hole peg test, pinch and grip strength assessment, and upper extremity questionnaire were administered during the preoperative visit before sphincter placement. In addition to standard preoperative workup, short form International Consultation of Incontinence Questionnaire and physician handshake were recorded. Activation occurred 6 weeks after surgery along with assessment of adequacy of pump placement. Three months from surgery a repeat incontinence questionnaire and a survey measuring satisfaction, difficulty of use, and confidence were given. Correlation between preoperative assessment variables and the postoperative questionnaire was assessed. ResultsThirty-nine patients were included. Average age and body mass index were 68.8 years and 28.8 kg/m2 respectively. Prior prostatectomy accounted for 92.3% of patients, and 46.2% had prior pelvic radiation. Postoperatively 59.0% of patients were very satisfied; 64.1% of patients reported no difficulty of use; 53.8% felt confidence within one day; and 66.7% had much better bladder control. Average pad improvement count was 5.3. Pinch test was associated with satisfaction (p= 0.011) while peg test was associated with confidence (p = 0.049). Handshake and upper extremity questionnaire were not significant. ConclusionsThe pinch and 9-hole peg transfer tests are cost-effective and easily performed adjuncts that could be used during artificial urethral sphincter evaluation for patients with unclear manual functional status.

Assessing Libya’s First Ṣukūk: Sharīʿah Compliance and Financial Viability

ABSTRACT Purpose — This study aims to assess the first ṣukūk issuance in Libya from two main perspectives: the compliance of the ṣukūk with the Sharīʿah and its compliance with the Libyan legal system. Further, the study evaluates the adequacy of the provided financial disclosures to assess the feasibility of the ṣukūk issuance. Design/Methodology/Approach — A qualitative case study methodology was used to assess the ṣukūk issuance in question. For the assessment of disclosure adequacy, a tailored model was devised featuring main and subsidiary points of interest. Findings — The Sharīʿah assessment findings suggest potential non-compliance issues within the ṣukūk issuance. Additionally, there are significant gaps in the disclosure of key financial aspects related to both the ṣukūk originator and the project, potentially hindering stakeholders from gaining a comprehensive understanding of the issuance’s feasibility. Originality/Value — One unique advantage of this paper is that it is the first to gain access to the actual documentation of ṣukūk issuances in Libya. Research Limitations/Implications — The study’s scope was constrained by a scarcity of data and documents from Libyan parties. Practical Implications — After analysing the ṣukūk issuance, a framework of Sharīʿah and financial disclosures was developed. The application of the proposed framework can be extended to effectively assess other comparable ṣukūk offerings within the Libyan legal system. Social Implications — Libyan policymakers are recommended to strengthen the regulations governing forthcoming ṣukūk issuances. The proposed improvements should include mandating comprehensive disclosures regarding the financial viability of the ṣukūk issuance and ensuring ample disclosures to guarantee full adherence to Sharīʿah principles.

Assessment of adequacy of single number quantities for wall insulation performance based on the Zwicker’s loudness of transmitted indoor noise

Previous work suggested a method that makes use of the Zwicker’s loudness value of transmitted sound to validate single number quantities (SNQs) determining the airborne sound insulation of walls in dwellings. The correlation between the ranking of walls based on a SNQ, and the one based on transmitted sound loudness was used to qualify the adequacy of that SNQ. The underlying idea is that Zwicker’s loudness adequately represents people’s perception of loudness and that evaluations based on calculated loudness can substitute listening tests. The current work compares 16 SNQs: eight standardized or proposed in past studies, and eight new ones. The results are more robust, since more (56) walls were included, among which also highly isolating ones. SNQs are assessed for the indoor noise stimulus recently suggested by CSTB, France, and also for four filtered variants, and for two levels, the ‘usual’ or ‘normal’ level (as reported by CSTB), and that level increased by 10 dB, expressing the less common but psychologically and socially relevant situation of excessive neighbour noise. The adequacy of SNQs is analysed per wall category, (1) lightweight, (2) heavyweight, (3) CLT-based and (4) combined walls and per stimulus type. Three approaches are used to quantify the correlation between SNQ-based wall insulation performance rankings and Loudness based ones: (i) Spearman’s correlation coefficient, (ii) correlation and (iii) inverse RMS residual of fitting with a parametrized function that has been empirically conceived so as to describe as good as possible the correlation SNQ-Loudness correlation behaviour for the considered population of walls.

Telecytology - remote rapid on-site evaluation for ultrasound-guided head and neck fine needle aspiration utilising a clinical imaging assistant with an extended practice role.

Rapid On-Site Evaluation (ROSE) of fine needle aspirations (FNA) is widely accepted as best practice, resulting in better outcomes and delivery of care for patients. However, it is not always practical for cytology laboratories to release staff. To increase the availability of ROSE, this study aimed to robustly test the effectiveness of Telecytology ROSE (TCROSE) utilising a clinical imaging assistant (CIA) to prepare the samples and operate the microscope. The study was divided into 3 phases. Phase 1, equipment testing, validation and in-house training for the CIA and the Consultant Biomedical Scientist (CBMS) performing TCROSE. Phase 2, Verifying TCROSE on the same site as the cytology laboratory and phase 3, TCROSE utilising a clinic at a peripheral site away from the cytology laboratory. 78/80 (97% sensitivity, 95% accuracy) of TCROSE cases matched the final report for assessment of adequacy and sufficient sampling, demonstrating 94% reliability with a 95% confidence value. An appropriately trained CIA effectively prepared the samples and operated the microscope for remote interpretation. The samples were triaged effectively, and biopsy requests were appropriate to reduce the need for repeat procedures and delays in treatment. This approach received positive feedback from patients. TCROSE utilising a CIA provides a highly effective alternative to conventional ROSE, minimising the resources required from cytopathology services and improving patient care and access to best practice. This study supports the validity of trained CIAs for a more involved role in the ultrasound-guided FNA service.

СОВЕРШЕНСТВОВАНИЕ СРЕДСТВ МЕДИЦИНСКОГО ОБЕСПЕЧЕНИЯ ВНЕКОРАБЕЛЬНОЙ ДЕЯТЕЛЬНОСТИ

Special medical procedures are conducted to prevent and mitigate the medical risks for cosmonauts working outside the pressurized space vehicles, both during preparations for and implementing the extravehicular activities (EVA). These include assessment of health adequacy for EVA, control of preventing instructions, EVA medical monitoring, and advice as appropriate. The paper presents the integrated EVA medical monitoring data from the cosmonauts of orbital station Mir and International space station (ISS RS). Experience shows the criticality of medical prevention for successful EVAs, and necessity to have an EVA medical kit in ISS RS.

Programa de exercícios multicomponentes domiciliar (VIVIFRAIL®) para longevos durante a pandemia da covid-19

Abstract Objective To investigate the acceptability and adequacy of a multicomponent exercise program via videoconferencing for the oldest-old in Porto Alegre, a city in southern Brazil. Method This is a quasi-experimental study. Fourteen participants were enrolled in the multicomponent exercise program Vivifrail® for 12 weeks, 5 days a week, with weekly video calls for assessment of acceptability and adequacy. The acceptability and adequacy questionnaire was based on 6 barriers that older adults face when engaging in physical exercise. Responses were measured using a 5-point Likert scale ranging from 0 to 4 points, with a maximum score of 24 points (maximum acceptability). Results Fourteen participants (89.07±6.30 years) concluded the protocol, with an acceptability rate of 70%. Internal consistency was moderate, with a Cronbach’s coefficient alpha of 0.7. Participants showed an overall increase in acceptability and adequacy (from 17.8±3.51 points in the first week to 22.0±2.94 in the 12th week). Four participants (28.6%) required some modification to the exercise protocol. Conclusion The Vivifrail® protocol, together with weekly follow-up via videoconferencing, was well accepted and adequate. It could be an important tool for promoting quality of life, especially in the oldest-old with difficulty leaving home. The acceptability questionnaire was able to detect exercise barriers and suggest possible modifications to the training program and could be presented as a suggestion for the evaluation of intervention protocols in the oldest-old population. Therefore, the Vivifrail® protocol, with weekly follow-up via videoconferencing, could be a new field of intervention for health professionals.