Recovery Stage Research Articles

Identifying the characteristics of patients with stroke who have difficulty benefiting from gait training with the hybrid assistive limb: a retrospective cohort study.

Robot-assisted gait training is effective for walking independence in stroke rehabilitation, the hybrid assistive limb (HAL) is an example. However, gait training with HAL may not be effective for everyone, and it is not clear who is not expected to benefit. Therefore, we aimed to identify the characteristics of stroke patients who have difficulty gaining benefits from gait training with HAL. We conducted a single-institutional retrospective cohort study. The participants were 82 stroke patients who had received gait training with HAL during hospitalization. The dependent variable was the functional ambulation category (FAC) that a measure of gait independence in stroke patients, and five independent [age, National Institutes of Health Stroke Scale, Brunnstrom recovery stage (BRS), days from stroke onset, and functional independence measure total score (cognitive items)] variables were selected from previous studies and analyzed by logistic regression analysis. We evaluated the validity of logistic regression analysis by using several indicators, such as the area under the curve (AUC), and a confusion matrix. Age, days from stroke onset to HAL initiation, and BRS were identified as factors that significantly influenced walking independence through gait training with HAL. The AUC was 0.86. Furthermore, after building a confusion matrix, the calculated binary accuracy, sensitivity (recall), and specificity were 0.80, 0.80, and 0.81, respectively, indicated high accuracy. Our findings confirmed that older age, greater degree of paralysis, and delayed initiation of HAL-assisted training after stroke onset were associated with increased likelihood of walking dependence upon hospital discharge.

A cluster analysis of European life in recovery data: what are the typical patterns of recovery experience?

Introduction There is little research around recovery pathways and how they cluster together by individual and situational factors according to time in recovery. Method This paper uses a cluster analysis with data from the European Life in Recovery (LiR) survey to produce typologies of recovery pathways around stages of recovery: early (<1 year), sustained (1-5 years), and stable (>5 years). A secondary aim was to explore evidence of national variations among clusters. Results Cluster analysis identified five typologies of persons in recovery, broadly reflecting the three stages. ‘Early Recovery’ participants had the highest barriers and lowest strengths in recovery and were most likely to reside in Spain, Portugal and Poland. ‘Sustained with residual barriers’ participants were characterized by high strengths in active addiction but most barriers in recovery and mainly resided in the Netherlands and Belgium. ‘Stable With Lower Recovery Support’ reported higher barriers and lowest strengths in active addiction and were mainly from the Balkan countries. ‘Stable With Higher Recovery Support’ participants experienced the most barriers in active addiction but also the most strengths in recovery and were largely from the UK. ‘Mixed With Fewer Barriers’ showed the least barriers in recovery and the highest strengths in active addiction and were also mainly from the UK. Implications Structural and cultural factors (possibly including location) are essential in recovery journeys and that, while all recovery journeys are unique, are several clusters of characteristics can be identified as broadly consistent with the Betty Ford Institute stages approach of early, sustained and stable recovery.

Plasma Metabonomics of Human Adenovirus-infected Patients with Pneumonia and Upper Respiratory Tract Infection.

Human adenovirus (HAdV) infection is common and can develop to serious conditions with high mortality, yet the mechanism of HAdV infection remains unclear. In the present study, the serum metabolite profiles of HAdV-7-infected patients with pneumonia or upper respiratory tract infection (URTI) were explored. In total, 35 patients were enrolled in the study following an outbreak of HAdV-7 in the army, of whom 14 had pneumonia and 21 had URTI. Blood samples were collected at the acute stage and at the recovery stage and were analyzed by untargeted metabolomics. Over 90% of the differential metabolites identified between the pneumonia patients and URTI patients were lipids and lipid-like molecules, including glycerophospholipids, fatty acyls, and sphingolipids. The metabolic pathways that were significantly enriched were primarily the lipid metabolism pathways, including sphingolipid metabolism, glycerophospholipid metabolism, and linoleic acid metabolism. The sphingolipid metabolism was identified as a significantly differential pathway between the pneumonia patients and URTI patients and between the acute and recovery stages for the pneumonia patients, but not between the acute and recovery stages for the URTI patients. Ceramide and lactosylceramide, involved in sphingolipid metabolism, were significantly higher in the pneumonia patients than in the URTI patients with good discrimination abilities [area under curve (AUC) 0.742 and 0.716, respectively; combination AUC 0.801]. Our results suggested that HAdV modulated lipid metabolism for both the patients with URTI and pneumonia, especially the sphingolipid metabolism involving ceramide and lactosylceramide, which might thus be a potential intervention target in the treatment of HAdV infection.

Vegetation recovery reshapes the composition and enhances the network connectivity of phoD-harboring microorganisms to promote P availability in a karst ecosystem

Soil phoD-harboring microorganisms can facilitate phosphorus (P) transformation and increase the available P (AP) in P-limited soils; however, the mechanism by which these microorganisms enhance AP throughout the vegetation recovery process of karst ecosystems is poorly understood. Accordingly, this study investigates the effect of vegetation recovery on soil AP and the community composition and network connectivity of phoD-harboring microorganisms to elucidate the mechanism by which phoD-harboring microorganisms enhance soil AP in the four vegetation recovery stages (i.e., grassland, shrubland, shrub-arbor forest, and arbor forest) in a karst ecosystem. Results show that soil total P, AP, and microbial biomass P concentrations, as well as alkaline phosphatase activities, litter and soil nutrients, and plant diversity indices (Shannon–Wiener and Pielou) increase with advancing vegetation recovery. Moreover, the diversity indices (Shannon–Wiener and Simpson) and network complexity of the phoD-harboring microorganisms also increase with advancing vegetation recovery, leading to distinct communities among the four recovery stages. Rhizobiales, Pseudomonadales, and Burkholderiales comprise the dominant phoD-harboring microorganism orders. The relative abundances of Pseudomonadales and Burkholderiales increase with advancing vegetation recovery; Rhizobiales is the highest in shrubland and the lowest in grassland. The structural equation model results show that advanced vegetation recovery is associated with increased plant diversity, litter nutrients, and soil nutrients. The network connectivity is enhanced with advancing vegetation recovery accompanied by increasing soil phosphatase activity and P availability. These results suggest that regulating the phoD-harboring microorganism composition and network connectivity is essential to alleviate plant P limitation in karst ecosystems.

Abstract 117: Bleeding Risks for Acute Ischemic Stroke Patients on Serotonergic Antidepressants and Anticoagulation/Dual Anti-Platelet Therapy

Background: Selective serotonin/serotonin-norepinephrine reuptake inhibitors (SSRI/SNRIs) are associated with improved stroke recovery. Some clinicians withhold SSRI/SNRIs over bleeding risk concerns. Our objectives were: 1) Quantify the association between early initiation of SSRI/SNRIs and adverse bleeding events among acute ischemic stroke (IS) patients, 2) Determine bleeding risks among patients receiving anticoagulation (AC) or dual antiplatelet therapy (DAPT), and 3) Evaluate bleeding risks between anti-depressant (AD) classes. Methods: Medication naïve first-time IS patients were identified from Electronic Medical Records of 70 healthcare organizations (2003-2023). Patients without ADs were considered “No AD”. Patients started on ADs within 3 months of the indexed stroke were classified as "SSRI/SNRI" or "Other AD" (i.e., Mirtazapine, bupropion, trazodone, or tricyclic ADs). The primary outcome was 1-year risk of major bleeding events (e.g., gastrointestinal/intracranial or shock). Secondary outcomes were hemorrhagic stroke (HS), fall and death. Baseline differences were adjusted for using 1:1 matched propensity scores. Results: A total of n=666,150 patients were included [No AD (n=607,278), SSRI/SNRI (n=35,631), Other AD (n=23,241)]. Early use of SSRI/SNRIs (vs. No ADs) was not associated with an increased risk of a major bleed for all patients (n=35,557 matched pairs) or among patients on AC (n=7,672 matched pairs). However, concurrent use of SSRI/SNRIs and DAPT was associated with a 29% increased risk of HS (RR:1.29, 95% CI: 1.11-1.50, n=8,381 matched pairs). Among patients on ADs, bleed risks were higher for use of “Other ADs” vs. "SSRI/SNRIs" (n=21,810 matched pairs). Discussion: SSRI/SNRIs treat post-stroke depression, promote functional recovery and are generally safe to start during the early stages of recovery for patients with IS. However, an increased risk of HS should be considered when starting ADs among patients on DAPT.

Relationship between personal recovery, autobiographical memory, and clinical recovery in people with mental illness in the acute phase

AimNarratives are important in psychiatric rehabilitation. People with a psychiatric diagnosis find it difficult to recall specific autobiographical memories of events that lasted less than a day. Although personal narratives play a central role in personal recovery, the factors influencing personal and clinical recovery, such as psychiatric symptoms and cognitive function, have not been fully explored. Therefore, this study examined the associations between personal recovery and autobiographical memory, age, psychiatric symptoms, and neurocognitive function. MethodThe Self-Identified Stage of Recovery, Parts A and B (SISR-A, SISR-B), Autobiographical Memory Test (AMT), Japanese version of the Brief Assessment Scale of Schizophrenia Cognitive Function, and Brief Psychiatric Symptom Rating Scale were administered to 40 individuals with psychiatric disorders who were undergoing psychiatric rehabilitation. ResultsA significant positive correlation was found between the total number of specific memories in the AMT and total SISR-B scores. A binary logistic regression analysis revealed that the total number of specific memories, especially high responsiveness to negative cue words, significantly predicted greater personal recovery. Age, psychiatric symptoms, and neurocognitive function did not significantly predict higher personal recovery. ConclusionIn psychiatric rehabilitation, negative episodes should be treated with caution; however, they may also facilitate personal recovery.

Correlations between Sagittal Parameters and Functional Scores in 65-Year-Old Osteoporotic Females with Vertebral Body Fracture under Low-Energy Mechanism

Background: Vertebral compression fractures (VCFs) are the most common fragility fractures associated with low-energy injury mechanisms in postmenopausal women with osteoporosis. No clear consensus is currently available on the optimal timing for surgical intervention in specific cases. Methods: This study examined the correlations between sagittal parameters, functional scores, and the appropriate timing for surgical intervention during the recovery stage in patients with osteoporosis with thoracolumbar (TL) vertebral body fractures. A total of 161 women aged ≥ 65 years with osteoporosis were included in the study. Spinal sagittal parameters from standing plain films and functional outcomes as the Oswestry disability index (ODI) and the visual analogue scale (VAS) were collected. Results: We found that TL junction Cobb angle was significantly correlated with ODI &gt; 30 (p &lt; 0.001) and VAS &gt; 6 (p &lt; 0.001) and the discriminative values for predicting ODI &gt; 30 and VAS &gt; 6 were a TL kyphotic angle of 14.5° and 13.5°, respectively. Among women aged ≥ 65 years with osteoporosis, the back pain and functional impairment observed within 6 months following a compression fracture are associated with a greater TL kyphosis angle. Conclusions: This suggests that a more proactive approach may be necessary when addressing the conditions of these patients.

Misery loves company: evaluation of negative e-WOM effects at the post-service recovery stage

PurposeThe authors' research examines how negative electronic word-of-mouth (e-WOM) alters focal customers' post-recovery justice perceptions and attitudes to determine their future behavior with the service provider. Specifically, this paper develops and tests a conceptual model to investigate how negative e-WOM alters focal customers' perceptual and attitudinal outcomes after the service recovery experience. It also examines the post-recovery effect of negative e-WOM on focal customers’ willingness to patronize the service after their recovery experience.Design/methodology/approachTo test the hypotheses, two pretests and two experimental studies with created scenarios in the retail context were conducted.FindingsThe authors' findings reveal that services are judged during and well beyond failure and recovery occurrences. To maintain a loyal customer base, service managers should develop processes that address service complaints both within and beyond the service consumption stage. The authors also find that despite a favorable recovery, focal customers gravitate toward the failure experience and develop unfavorable attitudes toward the service provider, leading to likely defections.Originality/valueThe authors' research demonstrates the persuasive power of negative e-WOM at the post-service recovery stage, making a unique contribution to the service recovery literature. This research also contributes to the persuasive effect of negative e-WOM, demonstrating message context as a boundary condition of negative e-WOM effects. In general, the authors' work highlights the importance of understanding the psychological processes involved in eliciting the persuasive influence of negative e-WOM in the post-service recovery stage that may lead to the defection of “so-called” successfully recovered customers.

Resilience dynamics and their determinants: the transition to coronavirus pandemic recovery

Purpose This study aims to introduce a dynamic perspective of tourism resilience by analyzing tourism demand in Spain during the 2020 and 2021 summers in the context of the COVID-19 pandemic. Design/methodology/approach This study uses regression and Lasso-type methods to demonstrate a great explanatory capacity of past determinants to explain the tourism demand of the Spanish provinces. Findings Results show how the previous specialization of the domestic market, the density and the geographic location related to the type of product are behind the bulk of the territorial differences in demand resilience, although in 2021 there has been a process of adaptation to the new context. Research limitations/implications This study contributes to the theoretical understanding of tourist behavior and tourism destination management by introducing the concept of resilience dynamics of destinations. Practical implications The results are useful, on the one hand, for tourist destinations to understand the different stages of recovery from a shock, and on the other hand, to go in deep in consumer behavior after a shock. Originality/value These findings represent a paradigm shift in the static conception of resilience in tourism.

Dysautonomia and activity in the early stroke recovery period.

Maintaining cerebral perfusion in the early stages of recovery after stroke is paramount. Autoregulatory function may be impaired during this period leaving cerebral perfusion directly reliant on intravascular volume and blood pressure (BP) with increased risk for expanding cerebral infarction during periods of low BP and hemorrhagic transformation during BP elevations. We suspected that dysautonomia is common during the acute period related to both pre-existing vascular risk factors and potentially independent of such conditions. Thus, we sought to understand the state of the science specific to dysautonomia and acute stroke. The scoping review search included multiple databases and key terms related to acute stroke and dysautonomia. The team employed a rigorous review process to identify, evaluate, and summarize relevant literature. We additionally summarized common clinical approaches used to detect dysautonomia at the bedside. The purpose of this scoping review is to understand the state of the science for the identification, treatment, and impact of dysautonomia on acute stroke patient outcomes. There is a high prevalence of dysautonomia among persons with stroke, though there is significant variability in the type of measures and definitions used to diagnose dysautonomia. While dysautonomia appears to be associated with poor functional outcome and post-stroke complications, there is a paucity of high-quality evidence, and generalizability is limited by heterogenous approaches to these studies. There is a need to establish common definitions, standard measurement tools, and a roadmap for incorporating these measures into clinical practice so that larger studies can be conducted.

How incumbents respond to the threat of disruptive innovation: an organisational resilience perspective

ABSTRACT Organisational resilience is a crucial ability to help enterprises overcome crises. However, little attention has been paid to how incumbents form organisational resilience to achieve sustainable development under the impact of disruptive innovation. This paper takes Fujifilm's anti-disruption management practice as a case sample. It adopts an inductive single-case methodology to explore the formation process of organisational resilience in incumbents. The results show that: (1) the development of the incumbent firm is reborn through the stages of recovery, rebound, and surpass. (2) at each stage of the growth of the incumbent firm, it adopts proactive strategic changes and agile resource allocation actions. Under this configuration, its organisational resilience evolves from technology-focused organisational resilience, business-focused organisational resilience, and dual-focused organisational resilience. In turn, the incumbent firm captures recovery, rebound, and surpassing capability. (3)the co-evolution between external crises, organisational resilience, and incumbent growth is the critical path to resist the impact of disruptive innovation for the incumbent. This study enriches the theoretical system of disruptive innovation and organisational resilience. It also proposes valuable managerial insights for incumbents to cope with disruptive innovation crises in future innovation markets.

Transcriptional patterns and histone modification signatures reveal dehydration memory behaviour in seedlings of Gossypium hirsutum

In nature, plants often experience recurring stress conditions. Some plants have evolved a memory response, which shows an enhanced reaction upon subsequent stress. However, whether cotton (Gossypium hirsutum L.) exhibits dehydration stress memory and the underlying mechanisms have remained unclear. Here, we characterized the responses to recurring dehydration stress in cotton seedlings from physiological changes, gene expression patterns and histone modification levels. Our results showed that short-term dehydration stress memory could develop in cotton seedlings. Transcriptome analysis identified 602 transcriptional dehydration memory genes (DMGs), and these genes could be divided into four distinct response patterns. A homology analysis indicated that conservation and species-specific memory responses existed between cotton and other plants. Chromatin immunoprecipitation - qPCR results revealed that the transcriptional behaviour of [+ /+ ] memory genes was related to the retention of increased H3K4me3 levels during the recovery stage and that H3K4me3 could act as a memory mark at the [+ /+ ] dehydration memory genes in cotton. A virus-induced gene silencing assay indicated that the histone demethylase gene GhJMJ17-A/D may participate in the transcriptional behaviour of [+ /+ ] memory genes in cotton. These results will improve the understanding of the mechanisms of formation and maintenance of dehydration stress memory in plants and will be useful for the improvement of cotton and other crops.

Genetic Analysis and Epidemiological Impact of SARS-CoV-2: A Multinational Study of 1000 Samples Using RT-PCR

The ongoing global public health challenge posed by the COVID-19 pandemic necessitates continuous research and surveillance efforts. In this study, we comprehensively analyzed over 1000 COVID-19 RT-PCR tests conducted on a cohort of 1200 patients in Saudi Arabia. Our primary goal was to investigate mutations in specific genes RdRp, N, and E different infection and recovery stages in Saudi patients with SARS-CoV-2. We also extended our analysis to include patients of various nationalities residing in Saudi Arabia, with the overarching objective of assessing these genes as markers for COVID-19 presence and progression. To diagnose and investigate potential genetic variations in COVID-19, we engaged RT-PCR. Our study primarily focused on detecting mutations in the RdRp, N, and E genes in Saudi patients with SARS-CoV-2, as well as individuals from various national residing in Saudi Arabia. This molecular technique provided valuable insights into the virus’s genetic makeup during infection and recovery. In our analysis of 671 positive COVID-19 cases, diverse gene involvement patterns were observed. Specifically, 55.91% had mutations in all three genes (RdRp, N, and E), 62.33% in both N and E genes, and 67.16% in RdRp and N genes. Additionally, 30.75% exhibited mutations exclusively in the RdRp gene, and 51.58% had mutations in the N gene. The N gene, in particular, showed high sensitivity as a marker for identifying active viral circulation. Regarding the temporal dynamics of the disease, the median duration between a positive and a subsequent negative COVID-19 RT-PCR test result was approximately 33.86 days for 44% of cases, 14.31 days for 30%, and 22.67 days for 4%. The insights from this study hold significant implications for managing COVID-19 patients during the ongoing pandemic. The N gene shows promise as a marker for detecting active viral circulation, potentially improving patient care and containment strategies. Establishing a defined positive threshold for diagnostic methods and correlating it with a low risk of infection remains a challenge. Further research is needed to address these complexities and enhance our understanding of COVID-19 epidemiology and diagnostics.

Dynamic change of vestibular function and the long-term prognosis of vestibular neuritis.

To comprehensively evaluate the dynamic change of vestibular function during long-term follow-up of vestibular neuritis, as well as the co-relationship with the outcomes of vestibular neuritis (VN), which provides the recommendations for vestibular function tests during the course of VN. A prospective cohort study was conducted on 16 patients with acute VN. Caloric test, vHIT, rotatory chair tests, VEMP, dizziness handicap inventory (DHI) score, and dynamic dizzy scales (VAS-DD) was first performed within 7 days of neuritis onset, which were further re-evaluated during the 6-12 months of follow-up. The dynamic changes on multiple objective vestibular examinations were analyzed during the acute and recovery stage of VN. We further evaluated the co-relationship between the vestibular dysfunction scales and the prognosis of VN. In more than 6 months of follow-up, 44% of the ultralow frequency, 94% of the low-to-mid frequency, and 44% of the high-frequency function of the horizontal semicircular canal returned to normal (p < 0.05). The change degree in symmetry of the rotatory chair test was correlated with the gain of the horizontal semicircular canal on the vHIT and the unilateral weakness (UW) value on the caloric test (p < 0.05). The change in DHI score was correlated with the phase; change in VAS-DD level correlated with the symmetry and TC of the rotatory chair test at VN recovery stage (p < 0.05). There was no significant correlation between the change in DHI score or change in VAS-DD and the degree of vestibular function recovery (p > 0.05). In general, vestibular function improved during the course of VN. The rotatory chair test can be used to evaluate the overall function of the vestibular system and the compensatory state in patients with VN.

Sodium functionalised carbon nanofibers draw solution for a solar-thermal forward osmosis water desalination system

Desalination offers the potential to bridge the demand-supply gap in the increasing global freshwater scarcity, with the forward osmosis (FO) technique appearing as an attractive solution amongst the various desalination technologies. However, the significant energy demand encountered during the draw-solute recovery process in FO desalination is considered the major anathema amongst other contending factors for which the allure of FO as a desalination technology becomes questioned. Consequently, a potentially innovative draw solution (DS) regeneration strategy, enabling the circumvention of the energy requirements associated with the recovery stage in FO desalination, is evaluated. The direct solar thermal FO (DSTFO) desalination concept is predicated on engineering and applying solar absorptive DS to directly leverage solar energy for solute recovery without recourse to electric power. In advancing the DSTFO concept, this study fabricated and evaluated a novel and highly osmotic sodium functionalised carbon nanofibres (Na/CNF) DS having a high osmotic pressure (93.9 bar), a low reverse solute flux (RSF) of 0.24 gMH, and a photothermal conversion efficiency of 63.49%, resulting in an evaporation rate of 1.85 kg/m2/hr under 2 suns of solar radiation. The DSTFO strategy offers a low-cost solution for enhancing water recovery and decreasing energy use in FO desalination systems.

In situ and bio-green synthesis of silver nanoparticles immobilized on zeolite as a recyclable catalyst for the degradation of OPDs

In this study, silver nanoparticles (Ag-NPs) were synthesized using a green and biologically inspired approach by utilizing reducing compounds from Thyme plant leaves. Zeolite was used to immobilize the synthesized Ag-NPs (Ag@Z). The modified Zeolite served as a catalyst for the reduction reaction of various organic pollutant dyes (OPDs) including 4-nitrophenol (4-NP), 4-nitroaniline (4-NA), methylene blue (MB), and methyl orange (MO) with sodium borohydride. The degradation of OPDs was monitored by measuring changes in their maximum absorption wavelength intensity. A thorough examination of multiple parameters (catalyst, silver and sodium borohydride dosage, yield degradation, and reaction time) was carried out to identify the optimized conditions for the degradation of OPDs. The results showed that the Ag@Z catalyst achieved an efficiency of over 93% in less than 10 min for the degradation of OPDs. The recoverability and reusability of the catalyst were examined, revealing a partial loss in efficiency after four recovery stages. Structural analysis using XRD, SEM, and TEM techniques confirmed the characteristics and morphology of the synthesized catalyst.

Research on the variation law of floor stress information entropy in upper protective layer mining based on Brillouin optical fiber sensing

The characteristics of floor failure and stress changes during the mining process of protective layers are crucial for determining the effectiveness of pressure relief. Three boreholes were designed in the 21104 fully mechanized mining face of Hulusu Coal Mine to implant optical fibers into the floor of the working face. A fiber optic monitoring system was established to monitor the dynamic evolution of stress in the floor rock mass at different mining distances. Based on the information entropy in information theory, the monitoring results in the fiber optic monitoring system are calculated to obtain the stress information entropy at different mining distances. A quantitative dynamic analysis is conducted on the stress change process of the mining floor rock layer, and the stress change law of the protective layer after mining is verified through numerical calculation and similar simulation experiments. The results indicate that the evolution of stress information entropy can be divided into four stages, namely the original rock stress stage, stress concentration stage, stress release stage, and stress recovery stage. The stress information entropy shows a fluctuating upward trend, indicating that coal seam mining leads to a decrease in the orderliness of the overlying rock system and an increase in disorder. In different spatial evolution processes, there are also significant differences in stress information entropy. In the vertical direction, the entropy value of shallow rock layers changes greatly, while the entropy value of deep rock layers changes slightly. Mining leads to a decrease in the orderliness of the entire overlying rock system, an increase in stress information entropy, and a fluctuating upward trend in stress information entropy. The information entropy of overlying rock deformation and re compaction increases, but the degree of change of the former is greater than that of the latter. The Brillouin fiber optic sensing technology provides a new method for monitoring the stress changes in the protective layer mining floor, achieving quantitative analysis of floor rock failure.

The meaning of the recovery process and its stages for people attending a mental health day hospital: A qualitative study.

This study sought to explore the meaning of the recovery process and its stages from the perspective of people attending a mental health day hospital. A descriptive exploratory qualitative study was carried out. Semi-structured interviews were conducted with people attending a mental health day hospital. The data were analysed deductively by means of content analysis. The participants described the recovery process as a process based on three pillars; the attitude towards recovery, hardship, and the effort required throughout the process. Regarding the stages of recovery, for the participants in the first stage of the process (Moratorium), the search for hope was the most important element. In the second stage (Awareness), the reestablishment of their identity, through the acceptance of the consequences derived from the mental health problem, together with being able to feel full and fulfilled, were the most outstanding elements. In the third stage (Preparation), participants highlighted the search for meaning in life, facing their fears and the process with an open mind. Finally, the last two stages (Rebuilding and Growth) were related to taking responsibility and empowerment for recovery. The results of this study provide insight into the perception of the recovery process and its stages in people attending a mental health day hospital. These findings may contribute to aligning the nurse-patient perspective, helping nurses to understand the key elements of patients according to their stage of recovery, and thus be able to subsequently individualise interventions. This study was based on interviews with 15 patients receiving treatment at an adult mental health day hospital. This study would not have been possible without their participation.

Post-COVID-19 enterocolitis - a cause of rebellious diarrhea, acute abdomen and liver failure.

Currently, worldwide, the coronavirus disease 2019 (COVID-19) pandemic, which first appeared in Wuhan, China, in December 2019, is capsizing the medical system and turning the attention of the entire healthcare system through the many aspects it presents, both from a pathophysiological and from a semiological view, insufficiently studied aspects. With a high rate of morbidity and mortality, the COVID-19 pandemic was initially observed as a pathology leading to a severe acute respiratory syndrome, but over time gastrointestinal and hepatic manifestations have been reported. The study includes an analysis of 21 patients in the stage of the clinical disease of COVID-19 or in the stage of recovery, hospitalized in the Departments of General Surgery II or Gastroenterology, Emergency Clinical County Hospital of Craiova, Romania, with predominantly digestive symptoms, with the clinical expression of infectious enterocolitis, although stool culture was negative for pathogenic bacteria. The evolution of patients was influenced by the appearance of peritonitis through colonic necrosis or remission of clinical symptoms under empirical therapy.

Probability causal inference of interest rate fluctuations: Evidence from private credit in emerging markets

Preventing risks in the private credit market is an important component of maintaining financial stability, especially in emerging markets. As loan amounts serve as both the cause and the effect of credit interest rates, through the weighted path convergence design of conditional probability and joint probability, this study establishes a probabilistic causal inference framework of loan amounts and interest rates to explore the mechanism of interest rate fluctuations in China's private credit market, market behaviour of the allocation of private loan amount, and the design of policies. The analysis provides several results. (1) The fluctuation of private credit interest rate occurred during the outbreak of the epidemic (2019Q1-2020Q1), the credit interest rate was mainly controlled by the loan amount, and the interest rate fluctuation mainly originated from private credit market behaviour. In the early stage of the post COVID-19 economic recovery (2020Q3-2021Q3), the credit interest rate is mainly controlled by non-loan amount factors, and the interest rate fluctuations occurred mainly because of the non-market behaviour of private credit, which is related to government policy support and the increase in low-interest loans from financial institutions. (2) As a result of market behaviour, for the 19.54 %–22.50 % of high interest rates on borrowing, the probability of high interest rates due to the loan amount increased by 40.48 %. (3) By policy design, reallocating the risky loan amount, the interest rate can be reduced by up to 7.36 % on a highlight-interest rate day. The reallocation of loan amounts for different security methods has varying effects on interest rates reductions, and there may even be ineffective allocations. The findings provide decision support for financial regulators in emerging markets to stabilise interest rate volatility in private credit markets.