Potential Triggers Research Articles

BPSDiary study protocol: a multi-center randomized controlled trial to compare the efficacy of a BPSD diary vs. standard care in reducing caregiver's burden.

NCT05977855.

Potential triggers and development processes of submarine landslides in the Xisha Trough Basin, South China Sea

Both submarine landslides and submarine canyons can transfer large amounts of terrigenous quantities from the continental shelf to the deep sea. In some cases, they can have a close relationship to their spatial distribution, formation and evolution. Submarine landslides on the shelf–slope can provide early depressions for submarine canyons, representing the early stage of submarine canyons. The continuous downcutting process during the evolution of submarine canyons can steepen the gradient of the canyon sidewalls, which can lead to the occurrence of submarine landslides. However, the role of submarine canyons in the initiation of slope failure has been overlooked. In this study, high-resolution multibeam bathymetry data, submarine image data and 2-D seismic data were used to investigate two adjacent submarine landslides developed on the northern slope of the Xisha Trough and the spatiotemporal relationship of these landslides to the Central Canyon. We identified a steep downslope between the submarine landslides and the Central Canyon. The Central Canyon formation age was much earlier than those of the submarine landslides. The Central Canyon is filled with modern submarine landslide deposits. The characteristics of the multiple failure scarps indicate retrogressive failure of the submarine landslides. We suggest that the submarine landslides developed on the northern slope of the Xisha Trough Basin have finally been captured by the Central Canyon. We determined that the emptying of sediments at the end of the northern slope of the Xisha Trough Basin caused by the development of the Central Canyon caused the end of the northern slope of the Xisha Trough Basin to lose support, which may have affected the slope stability and could have even played a role in the initiation of submarine landslides. Consequently, the slope area along the Central Canyon may be susceptible to slope instability and slope failure processes.

A Mobile Health App for Facilitating Disease Management in Children With Atopic Dermatitis: Feasibility and Impact Study.

Inadequate control of atopic dermatitis (AD) increases the frequency of exacerbations and reduces the quality of life. Mobile health apps provide information and communication technology and may increase treatment adherence and facilitate disease management at home. The mobile health app, Atopic App, designed for patients and their caregivers, and the associated web-based patient education program, Atopic School, provide an opportunity for improving patients' and caregivers' engagement and adherence to the management of AD. This noninterventional, observational study aimed to explore the feasibility and potential impact on the management of AD in children by caregivers using the Atopic App mobile health app. The patient-oriented eczema measure (POEM) and numerical rating scale for the grading of pruritus were used as severity scores (scale range: 0-28). The artificial intelligence model of the app was used to assess the severity of AD based on the eczema area and severity index approach. The deidentified data enabled the analysis of the severity of AD, treatment plan history, potential triggers of flare-ups, usage of available features of the app, and the impact of patient education. During a 12-month period, of the 1223 users who installed the app, 910 (74.4%) registered users were caregivers of children with AD. The web-based Atopic School course was accessed by 266 (29.2%) caregivers of children with AD, 134 (50.4%) of whom completed the course. Usage of the app was significantly more frequent among those who completed the Atopic School program than among those who did not access or did not complete the course (P<.001). Users who completed a second POEM 21 to 27 days apart exhibited a significant improvement of AD severity based on the POEM score (P<.001), with an average improvement of 3.86 (SD 6.85) points. The artificial intelligence severity score and itching score were highly correlated with the POEM score (r=0.35 and r=0.52, respectively). The Atopic App provides valuable real-world data on the epidemiology, severity dynamics, treatment patterns, and exacerbation-trigger correlations in patients with AD. The significant reduction in the POEM score among users of the Atopic App indicates a potential impact of this tool on health care engagement by caregivers of children with AD.

Potential Poroelastic Triggering of the 2020 M 5.0 Mentone Earthquake in the Delaware Basin, Texas, by Shallow Injection Wells

ABSTRACT The Delaware basin in Texas, one of the largest oil and gas production sites in the United States, has been impacted by widespread seismicity in recent years. The M 5.0 earthquake that occurred in March 2020 near the town of Mentone is one of the largest induced earthquakes recorded in this region. Characterizing the source parameters and triggering mechanism of this major event is imperative to assess and mitigate future hazard risk. A former study showed that this event may be attributed to the deep injection nearby. Interestingly, the earthquake is in proximity to shallow injection wells with much larger total injection volume. In this study, we investigate the role of these shallow injection wells in the triggering of the M 5.0 event despite their farther distance from the mainshock. We perform source-parameter inversion and earthquake relocation to determine the precise orientation of the south-facing normal-fault plane where the mainshock occurred, followed by fully coupled poroelastic stress modeling of the change of Coulomb failure stress (ΔCFS) on the fitted fault plane caused by shallow injection in the region. Results show that shallow wells caused up to 20 kPa of ΔCFS near the mainshock location, dominated by positive poroelastic stress change. Such perturbation surpasses the general triggering threshold of faults that are well aligned with the local stress field and suggests the nonnegligible role of these shallow wells in the triggering of the mainshock. We also discuss the complex effect of poroelastic stress perturbation in the subsurface and highlight the importance of detailed geomechanical evaluation of the reservoir when developing relevant operational and safety policies.

The age of extremism: a crime script analysis of violent and nonviolent extremists according to age of first extremist act

Purpose The purpose of this study is to compare violent and non-violent extremists in terms of their age when they first perpetrate an extremist act, and to understand how this relates to other factors underlying extremist behaviours. While the end goal of many extremists may be functionally similar, the pathways into extremism vary, and the literature has demonstrated that a “one-size-fits-all” explanation does not exist. Motivational drivers are complex and dynamic; therefore, attempting to identify a terrorist “profile” has limited applied efficacy. Design/methodology/approach This study applied a temporal approach (“crime script analysis” or CSA) to identify, map and compare the sequential stages (or “scenes”) in the life histories of violent and non-violent extremists who have committed acts of extremism across different age groups. Crime scripts comprising mainly qualitative data for 40 male extremists (20 violent, 20 non-violent “cases”) were developed, and CSA was conducted according to the age at which they committed their first extremist offence. Findings Results demonstrated key temporal, developmental differences between the pathways of extremists who commit their first offence at different ages. One key difference was that for both the violent and non-violent extremists, those under 30 used the internet as a main means of joining networks and spreading information, whereas the over 30s made more personal, community links. Originality/value This research can aid identification of potential environmental triggers and potential increased susceptibility to triggers across certain age groups.

Unraveling the MSG-Headache Controversy: an Updated Literature Review.

To review the evidence and role of monosodium glutamate (MSG) as a headache and migraine trigger. MSG is a common food additive, has widely been linked as a trigger of headache, as well as other symptoms. However, the evidence for MSG as a causative agent for headache is debated. Various clinical trials over the past several decades have reported conflicting results, with studies suggesting that MSG does and does not increase the incidence of headache. However, the dosages of MSG exposure are often inconsistent across studies, with many studies administering a dose significantly higher than the average consumption.. Additionally, there are misconceptions about which foods and cuisines have MSG in them. MSG could be a potential trigger for migraine and headaches. It is unclear exactly how MSG plays into the migraine pathophysiology. It's crucial to accurately determine if MSG is present in one's diet to evaluate its potential impact on headaches.

Neurotensin counteracts hair growth inhibition induced by chronic restraint stress.

Stress has been considered as a potential trigger for hair loss through the neuroendocrine-hair follicle (HF) axis. Neurotensin (NTS), a neuropeptide, is known to be dysregulated in the inflammatory-associated skin diseases. However, the precise role of NTS in stress-induced hair loss is unclear. To investigate the function and potential mechanisms of NTS in stress-induced hair growth inhibition, we initially detected the expression of neurotensin receptor (Ntsr) and NTS in the skin tissues of stressed mice by RNA-sequencing and ELISA. We found chronic restraint stress (CRS) significantly decreased the expression of both NTS and Ntsr in the skin tissues of mice. Intracutaneous injection of NTS effectively counteracted CRS-induced inhibition of hair growth in mice. Furthermore, NTS regulated a total of 1093 genes expression in human dermal papilla cells (HDPC), with 591 genes being up-regulated and 502 genes being down-regulated. GO analysis showed DNA replication, cell cycle, integral component of plasma membrane and angiogenesis-associated genes were significantly regulated by NTS. KEGG enrichment demonstrated that NTS also regulated genes related to the Hippo signalling pathway, axon guidance, cytokine-cytokine receptor interaction and Wnt signalling pathway in HDPC. Our results not only uncovered the potential effects of NTS on stress-induced hair growth inhibition but also provided an understanding of the mechanisms at the gene transcriptional level.

Increased glucose metabolism and impaired glutamate transport in human astrocytes are potential early triggers of abnormal extracellular glutamate accumulation in hiPSC-derived models of Alzheimer's disease.

Glutamate recycling between neurons and astrocytes is essential to maintain neurotransmitter homeostasis. Disturbances in glutamate homeostasis, resulting in excitotoxicity and neuronal death, have been described as a potential mechanism in Alzheimer's disease (AD) pathophysiology. However, glutamate neurotransmitter metabolism in different human brain cells, particularly astrocytes, has been poorly investigated at the early stages of AD. We sought to investigate glucose and glutamate metabolism in AD by employing human induced pluripotent stem cell (hiPSC)-derived astrocytes and neurons carrying mutations in the amyloid precursor protein (APP) or presenilin-1 (PSEN-1) gene as found in familial types of AD (fAD). Methods such as live-cell bioenergetics and metabolic mapping using [13C]-enriched substrates were used to examine metabolism in the early stages of AD. Our results revealed greater glycolysis and glucose oxidative metabolism in astrocytes and neurons with APP or PSEN-1 mutations, accompanied by an elevated glutamate synthesis compared to control WT cells. Astrocytes with APP or PSEN-1 mutations exhibited reduced expression of the excitatory amino acid transporter 2 (EAAT2), and glutamine uptake increased in mutated neurons, with enhanced glutamate release specifically in neurons with a PSEN-1 mutation. These results demonstrate a hypermetabolic phenotype in astrocytes with fAD mutations possibly linked to toxic glutamate accumulation. Our findings further identify metabolic imbalances that may occur in the early phases of AD pathophysiology.

Reactions to environmental allergens in cats with feline lower airway disease.

Aeroallergens have been discussed as potential triggers for feline asthma (FA), which can be induced experimentally by allergen sensitization. To date, only few studies have investigated reactions to environmental allergens in cats with naturally occurring feline lower airway disease (FLAD). The aim of the study was to compare results of intradermal testing (IDT) and serum allergen-specific immunoglobulin E-(IgE) testing (SAT) in cats with FLAD, and to investigate possible associations with allergen exposure. Eight cats with eosinophilic airway inflammation (EI), ten cats with mixed inflammation (MI), six with neutrophilic inflammation (NI), and 24 healthy cats (HC) were included. Cats diagnosed with FLAD were assigned to the different inflammatory groups based on bronchoalveolar lavage fluid (BLAF) cytology. SAT was performed in all cats; IDT was only carried out in cats with FLAD. Information about the cats' environment and potential allergen exposure was obtained using an owner questionnaire. In comparison to 83% of HC with positive reactions on SAT only 52% of cats with FLAD had positive responses (p = 0.051). Significantly more positive reactions per cat were detected on IDT than on SAT (p = 0.001). No significant difference was found for positive reactions per cat on SAT when compared between HC, NI, EI, and MI (p = 0.377). Only "slight" agreement was found for most allergens when reactions obtained in both tests in cats with FLAD were compared, except for "moderate" agreement for English plantain (k = 0.504) and Alternaria alternata (k = 0.488). Overall, no clear association between the cats' environment and allergen reactions were detected. Interpretation of allergy test results in cats with FLAD should be done in the context of clinical signs and individual factors.

Inflammatory Pathways in Overweight and Obese Persons as a Potential Mechanism for Cognitive Impairment and Earlier Onset Alzeihmer's Dementia in the General Population: A Narrative Review.

The overweight status or obesity can be confirmed through classical methods such as the body mass index (BMI) and the waist-to-hip ratio (WHR). Apart from metabolic issues such as atherosclerosis, liver steatosis, or diabetes mellitus, long-term obesity or overweight status can pose a risk for cardiovascular and neurovascular complications. While some acute adverse events like coronary syndromes of strokes are well-documented to be linked to an increased body mass, there are also chronic processes that, due to their silent onset and evolution, are underdiagnosed and not as thoroughly studied. Through this review, we aimed to collect all relevant data with regard to the long-term impact of obesity on cognitive function in all ages and its correlation with an earlier onset of dementia such as Alzheimer's disease (AD). The exact mechanisms through which a decline in cognitive functions occurs in overweight or obese persons are still being discussed. A combination of factors has been acknowledged as potential triggers, such as a sedentary lifestyle and stress, as well as a genetic predisposition, for example, the apolipoprotein E (ApoE) alleles in AD. Most research highlights the impact of vascular dysfunction and systemic inflammation on the nervous system in patients with obesity and the subsequent neurological changes. Obesity during the early to mid-ages leads to an earlier onset of cognitive dysfunction in various forms. Also, lifestyle intervention can reverse cognitive dysfunction, especially dieting, to encourage weight loss.

Аксиологический конфликт как потенциальный триггер дискурсивной практики культуры отмены (на материале обновленных словарных статей “woman” / “man” в Кембриджском словаре (2022))

The study aims to identify a potential trigger for the discourse practice of cancel culture in the context of supplementing/redefining/correcting the meaning of linguistic units, changing their evaluative qualification. The paper considers the change in the value components of the notional content as a result of updating the dictionary entries of the words “woman” / “man”. Based on the discourse analysis of the article “Biden admin agencies refuse to answer, What is a woman?”, the researcher examines a set of communicative means used by the author of the article to achieve communicative intention, as well as the communicative behaviour, tactics and strategies of government agencies of American linguistic culture in the zone of communicative risk. The study is novel in that it is the first to consider the discourse practice of cancel culture within the framework of axiological linguistics. As a result of the study, the implicit possibility of activating public censure in the media sphere due to an axiological conflict has been established and the communicative strategies and tactics of avoiding the communicative situation of cancel culture have been identified.

Anti-MDA5 antibody-positive dermatomyositis: pathogenesis and clinical progress.

Anti-melanoma differentiation-associated protein 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) is a subtype of dermatomyositis. Although the aetiology and pathology remain unclear, increasing evidence suggests that viral infection is a potential trigger of MDA5-DM. Multiple factors, including T cells, B cells, neutrophils and macrophages, are implicated in the pathophysiology of MDA5-DM. Distinctive skin rashes, rapidly progressive interstitial lung disease, peripheral lymphopenia and elevated serum ferritin levels are the most prominent clinical and laboratory features of MDA5-DM. Concomitant infection is a common complication of MDA5-DM. The proper evaluation of patients with MDA5-DM requires knowledge of the disease heterogeneity and clinical course variability. Several biomarkers, including serum levels of anti-MDA5 antibodies and biomarkers related to macrophage activation, have been identified as useful tools for monitoring disease activity and prognosis. MDA5-DM shows a poor response to conventional glucocorticoid and immunosuppressant therapy and has a poor overall prognosis. Therefore, there is an urgent need to explore the key pathogenic mechanisms of MDA5-DM and develop novel therapeutic options for patients. This Review discusses recent clinical progress and pathogenic findings of MDA5-DM.

Investigating ground-related design deficiencies as potential triggers to cost overruns in highway projects

Purpose This study aims to investigate ground-related design deficiencies as potential avenues of avoidable cost overruns, discernible from the geotechnical practices of highway agencies in the Niger Delta region of Nigeria. Design/methodology/approach The study deploys an interpretivist qualitative methodology to provide a detailed descriptive analysis of the design-related geotechnical practices of highway agencies during the pre-contract phase of highway projects. Semi-structured interviews were conducted with in-house professionals, consultants and contractors affiliated with the three highway agencies in the Niger Delta and thematically analysed to identify significant deviations from geotechnical best practices. Findings The study outcome shows that during the pre-contract phase, a chain of design-related geotechnical shortcomings has plagued highway projects executed in the Niger Delta. This view of practice uncovered in this study demonstrates a culture of significant deviation from best practice recommendations, which could plausibly contribute to the history of significant project cost overruns recorded in the region. Originality/value The study qualitatively spotlights gaps in the practice of highway agencies and reinforces the need for a re-orientation of the attitude to risk management, to give geotechnical concerns a priority in the financial management of highway projects executed in the Niger Delta region of Nigeria.

Molecular Mimicry between SARS-CoV-2 Proteins and Human Self-Antigens Related with Autoimmune Central Nervous System (CNS) Disorders.

SARS-CoV-2 can trigger autoimmune central nervous system (CNS) diseases in genetically susceptible individuals, a mechanism poorly understood. Molecular mimicry (MM) has been identified in other viral diseases as potential triggers of autoimmune CNS events. This study investigated if MM is the process through which SARS-CoV-2 induces the breakdown of immune tolerance. The frequency of autoimmune CNS disorders was evaluated in a prospective cohort with patients admitted to the COVID-19 Intense Care Unity (ICU) in Rio de Janeiro. Then, an in silico analysis was performed to identify the conserved regions that share a high identity between SARS-CoV-2 antigens and human proteins. The sequences with significant identity and antigenic properties were then assessed for their binding capacity to HLA subtypes. Of the 112 patients included, 3 were classified as having an autoimmune disorder. A total of eleven combinations had significant linear and three-dimensional overlap. NMDAR1, MOG, and MPO were the self-antigens with more significant combinations, followed by GAD65. All sequences presented at least one epitope with strong or intermediate binding capacity to the HLA subtypes selected. This study underscores the possibility that CNS autoimmune attacks observed in COVID-19 patients, including those in our population, could be driven by MM in genetically predisposed individuals.

Acute generalized exanthematous pustulosis: Analysis of cases managed in a Tunisian tertiary hospital

Acute generalized exanthematous pustulosis (AGEP) is a severe and life-threatening cutaneous adverse reaction. Drug-induced AGEP is mainly related to antibiotics. More recently, AGEP following spider bites has been increasingly described. Treatment includes withdrawal of the offending drug and supportive care. In Tunisia, data concerning severe cutaneous adverse reactions (SCARs) in general and especially AGEP is lacking. Herein, we conducted a retrospective study to investigate the epidemiological, clinical characteristics and etiologies of AGEP referred to the Dermatology department. Our study included 32 cases of AGEP. AGEP cases occurred in overall 8.9% of all SCARs referred to the department during the same period study. The majority were females (24 women and 7 men). The median age of the patients was 33 years. A history of psoriasis was reported in 16.1% of patients. All patients presented with an extensive erythematous rash with pinhead pustules. Neutrophil hyperleukocytosis (greater than 7000/mm3) was noted in 17 patients (63% of cases). It was associated with hypereosinophilia exceeding 500 elements/mm3 in 8 cases (29.6%). Drug-induced AGEP was reported in 53% of cases. Antibiotics were implicated in the majority of cases. Delay in onset ranged from 15hours to 7 days, with an average of 2.8 days. A non-drug-induced etiology was considered if the pharmacological investigation was negative, or if a clear non-drug trigger was found. It was retained in ten cases (48.4% of all observations). Spider bites were revealed in 8 cases. AGEP represents a severe, usually drug-related skin reaction. It is classified as a type IVd reaction mediating T cell-related sterile neutrophilic inflammatory response. It typically occurs within 24-48h of ingestion of the offending drug. Antibiotics are the most common drug family to cause AGEP. Spider bites were involved in 25.8% of cases in our study, as important as antibiotic-induced AGEP. Analysis of the particularities of AGEP according to etiology, whether drug-induced or not, revealed the presence of an initial escarotic lesion (P=0.01) and the finding of blood hypereosinophilia (P=0.014) in the non-drug AGEP group were the distinguishing features. Blood hyperesoniophilia, more frequent in the non-drug AGEP group, suggests a pathophysiology probably different from that of the drug AGEP group. Clinicians should be aware of both etiologies. Our study focuses on the importance of AGEP associated with spider bite as a potential triggering factor in Tunisia.

COVID-19 as a potential trigger for ulcerative colitis

Introduction: SARS-CoV-2 infection is a global pathology. Recent international studies have reported involvement of various organs, including the gastrointestinal system. It was shown that incidence rates of inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis (UC) were 14.6% and 10% higher during the pandemic respectively than rates during the pre-COVID-19 period. Also, COVID-19 has been found to increase the risk of developing new autoimmune diseases. Materials and methods: The study included scientific publications, selected by keywords in the database PubMed, Google Scholar, and Hinari. Results: The angiotensin-converting enzyme receptor (ACE2) is highly expressed in the terminal ileum and colon. The surface receptor ACE2 interacts directly with the spike glycoprotein (protein S), which allows the virus to enter cells and reproduce new virions, followed by its replication and the initiation of an advanced inflammatory process. SARS-CoV-2 can result in alteration of gut microbiota and increased risk of intestinal inflammation. COVID-19 moderately severe form is characterized by a cytokine storm in which there are extensive neutrophils, lymphocytes, macrophages and immune mediators, including tumor necrosis factor (TNF), the major inflammatory mediator in IBD and in almost all acute inflammatory reactions. Conclusions: The latest research has provided evidence about the ability of infections to precipitate autoimmune diseases. In this case, the causative organism is not necessarily isolated from gastrointestinal cells, and the enhanced inflammatory response after infection can eliminate the infectious agent. However, in people genetically sensitive to IBD, the initial immune reaction can turn into a chronic response, leading to disease.

Exploring Factors Linked to Home-Reported Acute Pain Events and Pain Crises in Sickle Cell Disease (SCD) through Flare Tracking in the Ascend Study

Introduction: Pain is a prominent symptom in sickle cell disease (SCD) and often broadly categorized as persistent chronic pain or more intense acute pain episodes compared to regular chronic pain experiences. Many research studies focus solely on pain events requiring healthcare utilization, neglecting those experienced at home, which may cloud the understanding of an individual's daily experience in managing their symptoms. Capturing home-reported evidence is crucial for comprehending SCD's impact on patients and potential effects of medical interventions. Objective: The objective of the Ascend Study was to collect individuals' experiences with pain events in SCD, employing a flexible, home-reported outcomes data collection methodology in Folia Health's mobile and web-based platform. Methods: The Advarra IRB-approved study recruited individuals with any genotype of SCD in the U.S., aged 13 and above, and caregivers of children aged 4 to 12. E-consent and data collection occurred through the Folia platform, where participants selected and tracked relevant symptoms (including, but not limited, to pain-specific symptoms) and treatments, along with health-related quality of life, over the course of 3 months per participant. Baseline severity scores were collected on a 1 to 10 Likert scale for symptoms that were pre-selected by participants at the start of the study. Participants also directly reported potential acute pain events and pain crises experienced in monthly surveys. Detailed flare tracking was set up for four symptom types (chronic pain, acute pain, pain crises, pain and discomfort), enabling structured follow-up questions on select pain flare events. Flare tracking was activated if participants reported a 2-point increase in severity compared to self-identified baselines or opted to track a pain symptom outside of their pre-selected routine. Overall pain burden was collected by participants who routinely tracked all of these various pain experiences, comprising the Ascend Study's home-reported pain hierarchy (Figure A). Results: 89% (n=59) of tracking participants reported experiencing a potential pain crisis for at least 1 month through monthly surveys. Analysis using the flare threshold applied to all pain symptoms tracked (sensitivity 77.5%; specificity 44.9%) identified 2,660 potential pain flare events. Among participants, 86% (n=57) experienced at least one flare event based on the flare threshold. On average, each participant had 24.9 flare days. Flare events identified by the threshold included 9 pain types tracked on a 1-10 Likert scale and 26 pain types tracked as binary “yes/no.” A total of 812 potential pain flare events reported by 46 participants prompted flare tracking follow-up questions (Table 1). Increases in chronic pain were more common than new types. 74% of these participants (n=34) opted to provide additional information through flare tracking in 282 pain flare events. Real-time flare tracking was reported in 85% of flare tracking events. From follow-up responses, most common classifications of pain were stabbing(188, 30.3%), pulsing or throbbing(144, 23.2%), and dull or aching(143, 23.0%). The back (155, 15.7%) and leg (268, 27.2%) were the most prevalent pain locations, with weather (177) and seasonal change (92) identified as potential triggers. Top flare descriptors included ‘can't do normal activities’ (84, 24.4%) and ‘not getting better with home pain meds’ (78, 22.7%). Conclusion: The Ascend Study provides detailed insights into SCD acute pain experiences, showing a high percentage of real-time flare tracking. Chronic pain flares were frequently reported, back and leg pain being the most prevalent locations, and seasonal changes identified as potential triggers. While the flare threshold analysis identified many potential pain flare events, the method's sensitivity might lead to lower specificity for pain flare events and the inclusion of potentially non-flare events. Findings provide valuable insights into the acute pain experiences of individuals with SCD, emphasizing the significance of capturing home-reported evidence to improve patient care and SCD therapies.

Maximising offset well information in unravelling onshore geohazards indicators: Case study of the Gale field

An attempt is made in this study towards maximising offset wells information in unravelling onshore geohazards indicators in the Gale field. The Gale field is located about 100km north-west of Port Harcourt, Nigeria. The field consists of a highly faulted and elongated rollover anticline, bounded to the north by a regional growth fault. The data used for this study integrates the quadrature and reflectivity amplitude attributes from seismic data, with offset well data. The conventional reflectivity seismic data was 90° phase rotated to derive the quadrature volume. The quadrature seismic was considered a more appropriate reflectivity seismic attribute for use in shallow geohazard analysis as it is known for its characteristic preservation of high frequency spectrum inherent in the data. Offset wells (GALE-01, GALE-03, GALE-04, GALE-05, GALE-06, and GALE-08) analysis revealed mud losses, stuck pipe, overpull and gas cut as gathered from the daily drilling reports. These could translate to potential triggers of some geohazards where poorly managed. Review of field geotechnical report did not reveal any geohazards issues. Based on the geohazards assessment carried out for these wells; chances of encountering shallow gas for all the units as shown in the well summary is rated low. Results from a geohazards analysis indicate the presence of possible shallow gas within the area of interest and particularly along the shallow section of planned well trajectory. This is further supported by the presence of faults within the vicinity of gas bearing reservoirs at deeper level and a potential for these faults extending to the shallower interval. These faults are likely to serve as migration pathways for gas to seep to the shallower section, hence forming a potential geohazard. In addition, some of the offset wells targeting deeper gas reservoirs penetrated pockets of gas at the shallower interval that stratigraphically correlates with the shallow section that would be penetrated by the planned wells. The results of this work were used to move the proposed drilling location of the Gale planned wells to a nearby area free of shallow gas signatures.

Nursing Care in Risk of Violent Behavior

&#x0D; &#x0D; &#x0D; &#x0D; The aim of this research is to analyze and design nursing care for two patients, who are at risk of violent behavior. Observations, interviews, and medical record documentation studies are data collection methods. Based on the research results, it is known that both patients have a high risk of violent behavior, especially related to a history of previous violence and underlying mental disorders. Initial assessment includes identification of potential triggers for violence, evaluation of level of coping, and assessment of social support. Risk of violent behavior is the patient's second nursing diagnosis. Treatment plans are implemented with a focus on violence prevention, involving collaboration with a multidisciplinary team, including medical personnel, and psychiatrists. Nursing interventions involve therapeutic approaches to improve coping, interpersonal skills training, and close monitoring for signs of violence. Periodic evaluations are conducted to assess the effectiveness of the treatment plan and identify changes in patient behavior. Discharge planning involves coordination with family and mental health services in the community to ensure continuity of care after discharge. The conclusion of this research is that nursing care for patients at risk of violent behavior requires a careful, proactive and collaborative approach. Implementing integrated violence prevention strategies and close monitoring can help reduce the risk of violent incidents.&#x0D; &#x0D; &#x0D; &#x0D;

Comparative Epidemiological Assessment of Monkeypox Infections on a Global and Continental Scale Using Logistic and Gompertz Mathematical Models.

The monkeypox virus (MPXV) has caused an unusual epidemiological scenario-an epidemic within a pandemic (COVID-19). Despite the inherent evolutionary and adaptive capacity of poxviruses, one of the potential triggers for the emergence of this epidemic was the change in the status of orthopoxvirus vaccination and eradication programs. This epidemic outbreak of HMPX spread worldwide, with a notable frequency in Europe, North America, and South America. Due to these particularities, the objective of the present study was to assess and compare cases of HMPX in these geographical regions through logistic and Gompertz mathematical modeling over one year since its inception. We estimated the highest contagion rates (people per day) of 690, 230, 278, and 206 for the world, Europe, North America, and South America, respectively, in the logistic model. The equivalent values for the Gompertz model were 696, 268, 308, and 202 for the highest contagion rates. The Kruskal-Wallis Test indicated different means among the geographical regions affected by HMPX regarding case velocity, and the Wilcoxon pairwise test indicated the absence of significant differences between the case velocity means between Europe and South America. The coefficient of determination (R2) values in the logistic model varied from 0.8720 to 0.9023, and in the Gompertz model, they ranged from 0.9881 to 0.9988, indicating a better fit to the actual data when using the Gompertz model. The estimated basic reproduction numbers (R0) were more consistent in the logistic model, varying from 1.71 to 1.94 in the graphical method and from 1.75 to 1.95 in the analytical method. The comparative assessment of these mathematical modeling approaches permitted the establishment of the Gompertz model as the better-fitting model for the data and the logistic model for the R0. However, both models successfully represented the actual HMPX case data. The present study estimated relevant epidemiological data to understand better the geographic similarities and differences in the dynamics of HMPX.