Physical Deterioration Research Articles

Burden of acute malnutrition in the conflict-affected urban communities of Tigray, Northern Ethiopia: a cross-sectional study

BackgroundMalnutrition impedes the growth, development, and survival of children. Conflict has severely affected the livelihoods of families and caused an alarming increase in food insecurity, population displacements, and extreme poverty in Tigray. Therefore, this study aimed to assess the prevalence and factors associated with acute malnutrition among 6- to 23-month-old children in the armed conflict-affected urban areas of Tigray.MethodsThe study population were randomly selected children aged 6 to 23 months. A cross-sectional study design was used. Data was collected from July 13 to 28, 2022 in Tigray region, Northern Ethiopia. A systematic random sampling technique was used to select the participants. Sociodemographic, lifestyle, anthropometric, and clinical variables were collected using a structured questionnaire. The data were analyzed using SPSS version 24 and presented using descriptive and analytical statistics. Binary logistic regression was used to identify independent predictors of acute malnutrition. All variables were declared statistically significant at a p-value of < 0.05.ResultsA total of 368 participants aged 6–23 months were included in the study. Half (50.5%) and around three-fourths (72.6%) of the participants were females and 12 to 23 months old children, respectively, with a mean (SD) age of 15.2 (5.1) months. The overall proxy global acute malnutrition rate was 44.3%, with 34.5% and 9.8% being moderate acute malnutrition and severe acute malnutrition, respectively. In the multivariable logistic regression model, three variables (consumption of legumes, maternal nutritional status, and household access to clean water) were identified as significant predictors of proxy global acute malnutrition. Children who didn’t eat legumes (AOR (95%CI): 2.39 (1.44, 3.97)), children of acutely malnourished mothers (AOR (95%CI): 1.60 (1.02, 2.51)), and children from households with insufficient water supply (AOR (95%CI): 1.99 (1.20, 3.31)) were significantly associated with an increased likelihood of acute malnutrition as compared with their counterparts.ConclusionsChildren from the armed conflict areas of Tigray are disproportionally impacted by acute malnutrition. Nearly half of the children were acutely malnourished, with one in ten suffering from the more serious severe acute malnutrition. Hence, urgent action is needed to prevent their permanent mental and physical deterioration and death by improving consumption of high protein foods, nutritional status of mothers, and access to clean water.

Metabolic biomarkers of appetite control in Parkinson's disease patients with and without cognitive impairment

BackgroundAppetite dysregulation in Parkinson’s Disease (PD) appears to be linked to physical and cognitive deterioration. PD patients with and without cognitive impairment (CI) were compared to an age-matched control group to explore predictors of appetite control in fasting and post-prandial conditions. MethodsFifty-five patients were recruited and divided into three groups: twenty controls (age: 74y, BMI: 25.8kg/m2), nineteen PD patients without CI (72.5y, 25.1kg/m2) and sixteen PD patients with CI (74.3y, 24.0kg/m2). Self-reported appetite perception and circulating blood metabolic biomarkers were measured in fasting and over a three-hour post-prandial period. Biomarkers included glucose, insulin, tumour necrosis factor alpha (TNF-α), leptin, acyl-ghrelin, total ghrelin, peptide YY (PYY), glucagon like peptide 1 (GLP-1), insulin growth factor 1 (IGF-1), growth factor (GF) and triglycerides. Patients were then provided with a mixed meal to eat ad libitum with the aim to evaluate links between metabolic biomarkers and control of energy intake. ResultsPD patients with CI had a significant lower protein intake (7.4±2.5g, p=0.01) compared to controls (21.9±3.1g) and PD patients without CI (14.3±3.0g). Post-prandial plasma GLP-1 concentrations were associated with decreased hunger perception (B±SE, -5.3±2.4mm·hour-1, p=0.04). PYY concentrations were significantly associated with GLP-1 in fasting (r=0.40, p=0.005) and post-prandial (r=0.46, p<0.001) conditions. In a multivariate model, post-prandial PYY concentrations were a significant predictor of ad libitum energy intake in all subjects (B±SE, -87.5±34.9kcal, p=0.01) and in patients with PD (B±SE, -106.8±44.9kcal, p=0.04). ConclusionsPYY and GLP-1 appeared to influence appetite control in PD patients and their roles merit further investigation.

Value-based optimization model for cultural route design: Ancient Water Supply Heritage of Istanbul (Türkiye)

Cultural tourism has become an increasingly growing human activity in today's world. Therefore, various cultural/natural heritage areas or buildings face large tourist crowds, causing physical, social, or cultural deterioration. Cultural routes, which provide a systematic approach and planned tourists move, can reduce the negative effects of overtourism. This study aims to develop an optimization model as a supportive tool for the cultural route design process. The proposed optimization model aims to maximize cultural experience while satisfying constraints on heritage values, building types, historical eras, and general routing rules. Moreover, this model, creating optimized cultural routes, is expected to contribute to regulating economic income and tourist density. As a case study, the ancient water supply systems of Istanbul, inherited from the Roman and the Ottoman empires and currently overlooked, are investigated. Heritage values, mentioned in the extensive literature, are reviewed and the values/attributes for this study are appointed according to the characteristics of the case heritage assets, and their environment. The values of the case structures are evaluated with value analysis after field study. An optimum cultural route for Istanbul's historical water supply heritage, according to the objective and the constraints of the model, is obtained by solving the model with the case data. The resulting route can make this overlooked heritage of Istanbul recognized and spread the tourist density in the city center. The model is flexible, allowing for easy modification of the objective function, constraints, and values when designing routes across various heritage sites. This model can be used not only in the design of new cultural routes but also in optimizing existing routes.

Socio-demographic and clinical predictors of post-acute, mid-and long-term psychological sequelae of COVID-19: a two-year cross-sectional investigation on 1317 patients at the University Hospital of Verona

BackgroundThe present paper focuses on socio-demographics, clinical variables, and the distance from the infection in predicting the long-term psycho-social consequences of COVID-19.MethodsPatients were screened with a cross-sectional design at the Psychological Service of the University Hospital of Verona (Italy) at 3, 6, 12, and 18 months after their SARS-CoV-2 infection. The assessment was part of the Horizon 2020-funded ORCHESTRA Project and included the Hospital Anxiety and Depression Scale (HADS), the Short Form Health Survey 36 (SF-36), the Impact of Event Scale-Revised (IES-R), and ad-hoc questions measuring pre-post COVID-19 changes on psycho-social dimensions (sleep quality, nutrition, level of autonomy, work, social relationships, emotional wellbeing).ResultsBetween June 2021 and June 2023, we evaluated 1317 patients (mean age 56.6 ± 14.8 years; 48% male): 35% at three months, 40% at 6, 20% at 12, and 5% at 18 months after the infection. Thirty-five percent were hospitalized due to COVID-19. Overall, 16% reported some form of clinically significant mental distress following the infection (HADS-TOT), with 13% and 6%, respectively, experiencing anxiety (HADS-Anxiety) and depressive symptoms (HADS-Depression). Four percent testified post-traumatic symptoms. The SF-36 scale revealed that 16% and 17% of subjects had physical or psychological deterioration in quality of life, respectively. The regression analyses showed that females experienced higher levels of anxiety and depression compared to males, along with worse mental and physical quality of life and pre-post infection changes in nearly all the investigated psycho-social dimensions. Younger people felt more anxiety and had a reduced mental quality of life than their older counterparts, who, in turn, had poorer scores in terms of autonomy and physical functioning. Hospitalized patients had lower levels of self-sufficiency, social relationships, and work than non-hospitalized people. The latter were more anxious and reported a lower physical quality of life. Finally, patients evaluated for the first time at 12- and 18 months showed a more significant impairment in mental and physical quality of life than those assessed at three months.ConclusionsOur data show that COVID-19 psychological sequelae tend to persist over time, still needing clinical attention and intervention planning, especially for females.

Fermentation Performance of Carob Flour, Proso Millet Flour and Bran for Gluten-Free Flat-Bread.

Sourdough fermentation is rarely used for gluten-free flatbread (GFFB), a product that is challenging to produce, especially when using high-fiber ingredients that bring nutritional benefits but lead to physical deterioration. The aim of this study was therefore to evaluate the fermentation performance of carob flour (CSPF), proso millet flour (PMF), and proso millet bran (PMB) individually and in combination with Limosilactobacillus fermentum and Kluyveromyces marxianus (LF + KM) and to compare the performance of LF + KM with a commercial starter (LIVENDO® LV1). A mixture design (n = 13) was used to evaluate the fermentation performance of LF + KM (total titratable acidity (TTA); lactobacilli and yeast growth; acetic and lactic acid, fructose, glucose, and saccharose content) at 35 °C for 16 h. The comparison of LF + KM with LV1 fermentation was based on the acidity rate, fermentation quotient, TTA, and finally by determining the physical properties (texture, shape, color) of a rice-corn GFFB in which 10% of flour was supplemented with the sourdoughs. PMB promoted the growth of lactobacilli and the production of organic acids, especially in combination of CSPF and PMF. The optimum flour ratio was 2.4:1:1.2 (PMB:PMF:CSPF). LF + KM shortened the sourdough fermentation time by 2.5 times compared to LV1. The use of LF + KM sourdough reduced the hardness (32%) and chewiness (28%) of the GFFB, while the volume (35%) was increased compared to LV1 sourdough. This study shows the potential of using local alternative flours in sourdough fermentation for the production of GFFB.

Exploring the Lived Experiences of Family Caregivers Who Provided End-of-Life Care to Hemodialysis Patients: A Phenomenological Study in Iran

Background: Providing end-of-life care involves offering care and support to patients with advanced incurable diseases who are in their final stages of life. Family caregivers of these patients often dedicate substantial time to their care, which can significantly impact their physical and psychological well-being. Objectives: This study aimed to explore the lived experiences of family caregivers providing care for hemodialysis patients at the end of life. Methods: This qualitative study employed a descriptive phenomenological design. To ensure information-rich samples, nine family caregivers of hemodialysis patients at the end of life were selected from two dialysis centers using a purposive sampling method. Data collection involved conducting in-depth, semi-structured, face-to-face interviews, which were digitally recorded for accuracy. Analysis was conducted using van Kaam's seven-step method. Results: Nine family caregivers, including 3 men and 6 women, participated in this study. They had a mean age of 59.44 years, and on average, they had been caring for their patients for 6.33 years. Four main themes and twelve sub-themes emerged from the analysis of the interviews. These themes, as well as their sub-themes, were: (1) complex care (individual-social struggles and healthcare hurdles); (2) care as an opportunity for skill development (experience of spirituality and development of mental capacity); (3) care as a chain of caregivers (ignorance of the caregiver, lifestyle adjustments, persistent concerns, questioning circumstances, and mental strain due to prolonged care); and (4) moments of misfortune (emotional exhaustion from witnessing the patient's physical deterioration, a sense of helplessness regarding the patient's mental and cognitive state, and a sense of helplessness regarding the patient's mental and cognitive state). Conclusions: Caregivers expressed a spectrum of both positive and negative experiences. While some viewed their role as fostering intellectual growth and development, others described feelings of confinement, entrapment, and sacrifice. Further comprehensive research is required to determine the factors contributing to this diversity of perspectives.

Macro-meso physical and mechanical deterioration properties and damage prediction model of rock under Freeze–thaw cycles

Macro-meso physical and mechanical deterioration properties and damage prediction model of rock under Freeze–thaw cycles

Метод оцінювання фізичного та функціонального зносу при визначенні якісного стану автородорожніх мостів

Introduction. Assessment of the qualitative condition of road bridges is a complex process that involves the analysis of physical and functional deterioration of structures. Physical deterioration is associated with deterioration of materials and loss of strength of elements, while functional deterioration is manifested in a decrease in the bearing capacity and deformability of the bridge. Problems. To determine the level of wear, a comprehensive method is used, including visual inspection, calculation estimates and experimental studies. In addition, a differentiated method is used, which allows comparing actual values with design values and drawing conclusions about the quality of individual elements and the structure as a whole. Objective. The expert method is an important addition to other methods of assessing the technical condition of bridges.

Is pancreatic adenosquamous carcinoma (PASC) a surgical disease? A large healthcare system review

IntroductionPancreatic cancer represents an increasing cause of cancer-related deaths. Pancreatic adenosquamous carcinoma (PASC) is a rare subtype of pancreas cancer. Optimal treatment is not well-defined. This review aims to provide a detailed analysis of the natural history, management, and outcomes of the patients with PASC within a single large healthcare system. Materials and methodsA large healthcare database was used to retrospectively identify all patients with histological diagnosis of PASC from 2010 to 2020. The cohort was evaluated as a whole and according to the following management modalities: operative, non-metastatic non-operative, and patients with metastatic disease. Abstracted data included patient characteristics, oncologic characteristics at presentation, and details of surgical and non-surgical treatment. ResultsIn total, 60 patients with PASC were identified. All patients had confirmed histopathological diagnosis of PASC. Mean age at the time of diagnosis was 70.9 years, and 28 patients were male (46.7 %). Most patients presented with pancreas head tumors (60 %). Thirty-four patients presented with non-metastatic disease (56.6 %). The operative group consisted of 17 patients (28.3 %). Most patients received adjuvant systemic therapy (70.6 %). Majority of patients experienced recurrence (76.5 %), with median time to recurrence at 6.5 months. Median overall survival in the operative group was 19.1 months. Seventeen patients with non-metastatic disease (28.3 %) did not undergo resection. Median overall survival of this cohort was 3.3 months. Systemic chemotherapy was used in 8 patients. Approximately half of patients with non-metastatic disease (9/17) did not receive any treatment due to rapid physical deterioration or poor functional status at baseline. Median survival for the non-treatment group was 1.7 months. At presentation, 26 patients (43.3 %) had metastatic disease. Most common site of metastasis was the liver. Median survival for patients with metastatic disease was 3.1 months. DiscussionPASC is a distinct entity from glandular PDAC, and it appears to be a more aggressive disease process. Complete resection confers survival benefit but is not curative. Furthermore, few patients undergo surgery, even with seemingly resectable disease. Systemic therapy administration is limited in many patients due to physiologic decline. Dismal clinical course and poor survival is universal among all patients who do not undergo any treatment modality, regardless of metastatic status. Globally grim prognosis appears to be due early systemic effects, disease progression and lack of effective systemic therapy. ConclusionsPASC remains a poorly understood cancer and portends particularly poor prognosis. It is associated with a rapid clinical decline, poor response to systemic therapy, early recurrence, and poor overall survival. However, ability to treat with surgery and chemotherapy may best prolong survival. SynopsisPancreatic adenosquamous carcinoma (PASC) is a rare subtype of pancreatic cancer. In this study, we evaluated 60 patients with PASC. PASC is a systemic disease characterized by rapid clinical decline, poor response to systemic therapy, early recurrence, and poor survival. Despite resection or systemic therapy, patients succumb rapidly.

IMPACT OF HABITUAL SMOKING ON THE ORGANISM OF ADOLESCENTS LIVING IN THE NORTH OF RUSSIA

The aim of the work is to analyze the impact of habitual smoking on the physiological systems of adolescents living in the north of Russia (65º N). Materials and Methods. Using generally accepted methods, morphofunctional, physiometric, physiological and psychological parameters were determined in 34 boys aged 14–15 years (11 smokers for at least 2–3 years and 23 non-smokers). The level of physical health was assessed according to Apanasenko method. Results. Compared with non-smokers, smoking adolescents have statistically significantly higher body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean blood pressure (MBP) during exercise, heart rate (HR) during exercise and its increase while working, HR recovery after exercise (Martine-Kushelevsky test), rate pressure product (RPP), and scores of activity (WAM questionnaire). At the same time, they demonstrated lower strength index (SI), maximum expiratory pressure (MEP), vital capacity (VC), vital index (VI), Skibinskaya index (SI), level of physical health (LPH), and WAM parameters. Smokers, compared to 11 non-smokers of the same weight, have statistically significantly lower height, strength and SI, Genchi test time, MEP, VC, VI, SI, LPH, and scores of well-being and mood (WAM parameters). However, they have higher HR during exercise, its increase while working, and HR recovery. Excess body weight in smokers leads to hypertension, while long-term smoking in teenagers living in the north of Russia causes physiological decline and physical health deterioration. In some cases, our results (decrease in strength, Genchi test time, VC, VI, increased HR, hypertensive reactions, and health deterioration in smokers) correlate with the data obtained both in our country and abroad.

Association between dynapenic obesity phenotypes and physical performance in middle-age and older women living in community.

Dynapenic obesity (DO) is the coexistence of excess adipose tissue/body weight and low muscle strength. This condition is associated with an increased risk of suffering from various chronic diseases and physical deterioration in older people. To analyze the association between DO phenotypes and physical performance in middle-aged women living in the community. This cross-sectional study was conducted on middle-aged and older women (≥50 years) residing in Guayaquil, Ecuador. Dynapenia was diagnosticated by a handgrip strength (HGS) < 16 kg; obesity was determined based on body mass index (BMI) ≥ 30 kg/m2. Participants were categorized into four groups based on their dynapenia and obesity status: non-dynapenic/non-obesity (ND/NO), obesity/non-dynapenic (O/ND), dynapenic/non-obesity (D/NO) and dynapenic/obesity (D/O). Physical performance was assessed by the Short Physical Performance Battery (SPPB). A total of 171 women were assessed. The median (IQR) age of the sample was 72.0 (17.0) years. Obesity and dynapenia were 35% (n = 60) and 57.8% (n = 99) of the participants, respectively. The prevalence of ND/NO was 25.1% (n = 43), O/ND 17% (n = 29), D/NO 39.8% (n = 68) and DO 18.1% (n = 31). The mean SPPB total score was 6.5 ± 3.2. Participants of D/NO and DO groups presented significantly lower mean SPPB scores (p < 0.001) compared to those of NO/ND and O/ND groups. Women with DO and D/NO exhibited significantly lower SPPB scores, indicating poorer physical performance. These findings emphasize the importance of incorporating a comprehensive assessment of muscle strength and obesity in middle-aged and older women.

Unraveling of Molecular Mechanisms of Cognitive Frailty in Chronic Kidney Disease: How Exercise Makes a Difference.

As our population ages, the medical challenges it faces become increasingly acute, with chronic kidney disease (CKD) becoming more prevalent among older adults. Frailty is alarmingly more common in CKD patients than in the general populace, putting the elderly at high risk of both physical and cognitive decline. CKD not only accelerates physical deterioration, but also heightens vascular dysfunction, calcification, arterial rigidity, systemic inflammation, oxidative stress, and cognitive impairment. Cognitive frailty, a distinct syndrome marked by cognitive deficits caused by physiological causes (excluding Alzheimer's and other dementias), is a critical concern. Although cognitive impairment has been well-studied, the molecular mechanisms driving cognitive frailty remain largely uncharted. Comprehensive interventions, including cutting-edge pharmaceuticals and lifestyle changes, are pivotal and effective, especially in the early stages of CKD. Recent research suggests that systematic exercise could counteract cognitive decline by improving brain blood flow, boosting neuroplasticity through the brain-derived neurotrophic factor (BDNF), and by triggering the release of neurotrophic factors such as insulin-like growth factor (IGF-1). This review delves into the molecular pathways of cognitive frailty in CKD, identifies key risk factors, and highlights therapeutic approaches, particularly the potent role of exercise in enhancing cognitive health.

Social mix in Zagreb’s large housing estates

In Western and Northern Europe, post-war large housing estates (LHEs) stand out as areas of segregated and minority-populated housing, and have faced numerous attempts of reconstruction with the idea of social mixing. LHEs in Central and Eastern Europe had different developmental pathways. The heterogeneous structure of these estates has persisted until today, but due to the systematic neglect and aging, the estates are threatened by physical and social deterioration. The analysis is based on a survey conducted in Croatia in 2022 on two types of housing estates (socialist and post-socialist; N (Zagreb = 657). The results confirm that the social composition in both types of estates is mixed, with a predominance of middle-class residents and without pronounced social differences. The residential satisfaction is high, so the majority of residents are stayers. Nevertheless, certain regeneration policies should be adopted because the population of the socialist LHEs is aging, which could jeopardize the present heterogeneity and make maintenance of multifamily buildings more challenging, thus contributing to further deterioration of the estates.

Sabatolimab in combination with spartalizumab in patients with non-small cell lung cancer or melanoma who received prior treatment with anti-PD-1/PD-L1 therapy: a phase 2 multicentre study

ObjectiveThis study evaluates the safety/efficacy of sabatolimab plus spartalizumab in patients with melanoma or non-small cell lung cancer (NSCLC).Design, setting and participantsThis is a phase 1–1b/2, open-label, multinational, multicentre study...

Multilocular subcutaneous bacillary angiomatosis as a primary manifestation of AIDS

AbstractA 34‐year‐old male patient presented with a clinical picture of multilocular subcutaneous skin nodules in addition to marked lymphadenopathy and general physical deterioration. A comprehensive diagnostic workup including serology, skin biopsy and imaging studies led to the initial diagnosis of human immunodeficiency virus (HIV) infection in AIDS stage with rare multilocular subcutaneous bacillary angiomatosis (BA) caused by Bartonella henselae. BA describes a process of neovascularisation of the skin or of internal organs (particularly the liver and spleen) and was first described in HIV‐positive patients by Stoler et al. in 1983. Both cutaneous and systemic symptoms are variable. There is no standardized treatment. The patient was started on antibiotic therapy with doxycycline, which was subsequently augmented with rifampicin. As the patient's general condition deteriorated and lymphocytopenia aggravated, he was transferred to an internal medicine ward for further treatment and subsequently commenced on antiretroviral therapy. This case corroborates numerous aspects of the cases described in the literature yet differs from them in that subcutaneous lesions are uncommon, particularly when infected with Bartonella henselae, illustrating the clinical spectrum of BA. Furthermore, it emphasises the significance of prompt and thorough diagnosis encompassing HIV serology in instances of skin lesions, accompanied by systemic signs and evidence of immunosuppression.

Family Members' Explanatory Models of Cancer Anorexia-Cachexia.

The experience of bearing witness to the lack of appetite and involuntary weight loss that characterizes cancer anorexia-cachexia syndrome (CACS) is reported to be stressful for family members. Research identifies that family members engage in a wide range of behaviors in response to a relative who shows minimal interest in eating and is literally 'wasting away' before their eyes. Some families, though concerned about the symptoms of CACS, do not dwell excessively on the patient's nutritional intake while others continually harass the patient to eat and petition health care providers for aggressive nutritional interventions to eat in an attempt to stave off further physical deterioration. While studies have detailed how family members respond to a terminally ill relative with CACS, empirical work explicating the explanatory models of CACS that they hold is lacking. Explanatory models (EMs) reflect the beliefs and ideas that families have about why illness and symptoms occur, the extent to which they can be controlled, how they should be treated, and how interventions should be evaluated. To address this gap in the literature, a grounded theory study guided by Kleinman's Explanatory Model questions was conducted with 25 family members of advanced cancer patients. The core category of 'Wayfaring' integrates the key categories of the model and maps onto Kleinman's questions about CACS onset, etiology, natural course, physiological processes/anatomical structures involved, treatment, and the impacts of disease on patient and family. Findings suggest that a divergence between some biomedical constructions of CACS and explanatory models held by family members may fuel the family-health care provider conflict, thereby providing direction for communication with families about care of the patient with anorexia-cachexia.

Physical Deconditioning in Lung Cancer Patients Who Underwent Lung Resection Surgery in Spain: A Prospective Observational Study.

Lung resection represents the main curative treatment modality for lung cancer. These patients present with physical deterioration that has been studied previously using objective variables; however, no previous studies have evaluated the self-perceived physical fitness of these patients. For these reasons, to increase the current knowledge on lung cancer patients' impairment, the aim of this study was to characterize the self-perceived physical deconditioning of lung cancer patients undergoing lung resection in the short and medium term after surgery. A longitudinal, observational, prospective cohort study was performed in the Thoracic Surgery Service of the Hospital Virgen de las Nieves (Granada). Symptoms (pain, fatigue, cough and dyspnea) and physical fitness (upper and lower limbs) were assessed before surgery, at discharge and at one month after discharge. Among the total of 88 patients that we included in our study, significant differences were found at discharge in symptoms (p < 0.05) and physical fitness (p < 0.05). One month after surgery, higher levels of pain (p = 0,002) and dyspnea (p = 0.007) were observed, as well as poorer results in the upper (p = 0.023) and lower limbs' physical fitness, with regard to the initial values. Patients undergoing lung resection present an increase in symptoms and physical fitness deterioration at discharge, which is maintained one month after surgery.

Microorganisms in Red Ceramic Building Materials—A Review

Ceramic materials have a very long tradition of use in construction. Their durability is related to the surface of the material and the action of the corrosive environment. One of the corrosive factors acting on ceramic materials is microorganisms. They can contribute to the deterioration of the technical and performance properties of building materials. Aesthetic, physical, and chemical deterioration are considered to be the main destructive processes in ceramic materials. This work shows how the different types of the most commonly used ceramic materials, i.e., brick and tiles, are damaged. Each of these types is susceptible to microbial growth. Most microorganisms that occur on ceramic materials produce staining substances and thus form coloured biofilms. The direct action of metabolic products secreted by organisms on inorganic substrates is the main cause of chemical biodeterioration. Therefore, this work presents the impact of microorganisms on ceramic building materials.

Development and Validation of the Dementia Caregiver Burden Scale: A Tool for Community-Dwelling Dementia Caregiver.

The number of patients with dementia increases rapidly in aging populations. Dementia is an irreversible disease that causes a patient to be dependent on others' care and also causes family caregivers to experience difficulties in multiple domains. In this study, a dementia caregiver's burden scale that addresses family caregivers' characteristics and caring environments was developed and validated. In-depth interviews with nine caregivers were conducted to identify the attributes of perceived burden and establish preliminary questions. Content validity was confirmed by seven experts using the item content validity index and scale content validity index/average. Construct validity, criterion-related validity, and reliability were verified using data from 205 primary caregivers of patients with dementia. Exploratory factor analysis revealed that five factors, including physical health deterioration, responsibility and role of caregiver, emotional distress, medical expense concerns, and family conflict, and 24 items explained 68.6% of the total variance. The calculated Cronbach's α for the overall scale was .96. The scale developed in this study may be used to measure the burden perceived by family caregivers of patients with dementia in the physical, emotional, social, financial, and situational domains. Also, the scale may be used to guide the development of tailored interventions that take into consideration different family caregiver and caring situation-related characteristics.

Tunable Dual Self-Healing Composite Coatings with Self-Assembled Structures Regulated by Janus Nanoparticles.

The durability of concrete structures can be enhanced in a convenient and permanent manner through the surface protection of cementitious materials with composite polymer coatings. However, polymer coatings are susceptible to various mechanical and physical deterioration in complex and variable environments. In this paper, the theory of polymer microstructure regulation was employed to improve the sustainability of the protective performance of composite coatings. The self-assembled core-shell structure regulated by amphiphilic Janus nanoparticles is employed to modify the tunable polystyrene acrylate-polysiloxane self-healing coatings. The results demonstrate that the adhesion strength of the prepared self-assembled coating reached 3.7 MPa, which is sufficient to resist the damage to the microstructure of cementitious materials caused by physical erosion, seepage, and ionic corrosion. The self-healing coating, regulated by Janus particles, exhibited a residual creep of only 57.03% and a maximum loss angle tangent of 0.381. Furthermore, the material exhibited a superior shape memory function due to the presence of strong hydrogen bonding. The regulated self-healing coating repaired the polymer structural damage under mechanical and thermal deformation by bridging and filling effects. The coating demonstrated a tensile strength recovery of up to 71.23% in a wetted state, accompanied by a rapid restoration of its electrochemical properties and corrosion resistance. Furthermore, the self-healing emulsion penetrates the substrate defects and forms numerous polymer crystalline particles that effectively fill the microcracks.