Relief Techniques Research Articles

A Deep Feature Driven Expert System to Estimate the Postmortem Interval From Corneal Opacity Development

ABSTRACTPostmortem interval (PMI) estimation remains an unresolved challenge in forensic science, necessitating practical, reliable and more accurate tools. This study aimed to develop a quantitative PMI estimation tool that effectively meets these needs. Focusing on the postmortem opacity development of the eye as a key marker for determining time since death, we propose an artificial intelligence‐based clinical PMI prediction system utilising computer vision, deep learning and machine learning methods. The AlexNet algorithm was utilised to extract deep features from the postmortem eye images. Extracted features were then processed by machine learning algorithms. For feature selection, Lasso and Relief techniques were employed, while SVM and KNN were applied for classifications. The results were validated using the leave‐one‐subject‐out method. The system was tested across different postmortem ranges, providing multi‐label predictions. The performance was evaluated using various metrics. The deep features exhibited effective performance in grading postmortem opacity development, achieving state‐of‐the‐art results. The accuracy scores were 0.96 and 0.97 for 3‐h intervals (i.e., 5‐class) and 5‐h intervals (i.e., 3‐class) experiments, respectively. The experimental results indicate that the proposed system represents a promising tool for PMI estimation.

Emergency practitioner-administered ultrasound nerve blocks in the emergency department: A retrospective analysis

Abstract OBJECTIVES: In the realm of acute pain management within emergency departments (EDs), the prevalent reliance on systemic analgesics, notably opioids, presents challenges due to associated risks and suboptimal efficacy. The emerging alternative of ultrasound-guided nerve blocks (USGNBs) has shown promise in prospective studies. However, the safety and efficacy of USGNBs when performed by emergency medicine practitioners remain largely unexplored, necessitating this study to address the research gap. The primary objectives of this study were to assess the efficacy of Emergency physician-performed USGNBs and changes in patient-reported pain (pre- and postnerve block) at 15 and 30 min. In addition, the time taken to perform nerve blocks, type of nerve block, frequency, indications, procedure time, and complications were all studied. METHODS: Conducted at a Tertiary Care Teaching Hospital in Pune, India, this single-center, retrospective observational study aimed to evaluate the effectiveness of USGNBs in the ED context. A retrospective analysis covered 274 emergency practitioner-performed USGNBs recorded from January 2022 to December 2023. Participants included consecutive ED patients consenting to nerve blocks, with practitioners utilizing bupivacaine (0.25%) and ropivacaine (0.25%) based on individual preferences. The study systematically recorded patient demographics, block types, indications, complications, and pre- and postpain scores on a Numerical Rating Scale. RESULTS: The study demonstrated a significant reduction in pain scores post-USGNB, with an average decrease of 2.9 ± 1.08 at 15 min and 5.8 ± 1.39 at 30 min. Commonly performed blocks included the femoral nerve, fascia iliaca, and serratus anterior, with notable pain relief in fracture management cases. Procedural durations varied, ranging from 2 to 12 min, while four complications were reported, including diaphragmatic paresis and arterial punctures during interscalene nerve block and fascia iliac compartment blocks, respectively. CONCLUSION: This extensive study in an academic ED setting supports the proficiency of emergency practitioners in performing USGNBs. The findings emphasize the transformative potential of USGNBs in academic ED pain management, showcasing notable pain reduction and minimal complications. These results advocate for the integration of advanced pain relief techniques into emergency medicine training programs, contributing to a comprehensive approach to acute pain management.

Effect of stress evolution in destressed borehole on gas desorption in deep coal seam

Hydraulic flushing is a crucial technology for enhancing deep coal seam gas extraction, while the gas desorption characteristic is a critical factor impacting efficient gas extraction. This paper first analyzed stress variation around borehole during flushing and subsequently conducted experimental research to explore the effect of stress evolution on gas desorption. The results indicated that stress variation had a relatively insignificant effect on gas desorption during the early stage. When stress variation peaked in coal samples, instability and damage occurred, leading to a surge in the gas desorption rate. The ultrasonic wave velocity and dynamic elastic modulus of coal under different stress paths exhibited significant changes. With an increase in desorption time, the coal dynamic elastic modulus decreased, and the damage coefficient gradually increased. When comparing gas desorption behavior during constant stress and stress relief, Pingdingshan Mine (PDS) and Jiaozishan Mine (JZS) coal samples exhibited desorption amounts 2.85 and 1.41 times higher after stress relief, respectively. Based on the influence of stress relief on gas desorption rate and structure, a theoretical matrix scale change model was deduced. The mechanism controlling the rate of gas desorption by stress relief was illustrated. These research results offer theoretical guidance for implementing stress relief techniques to optimize coal seam gas extraction in practical field applications.

Optimization of Support and Relief Parameters for Deep-Buried Metal Mine Roadways

The management of rock mass deformation in high-stress roadways is a pivotal aspect of deep geotechnical engineering. Given the fruitful outcomes of research in rock mechanics regarding traditional confining pressure control methods, scholars have increasingly turned their attention to exploring pressure-relieving techniques, including borehole pressure relief and blasting pressure relief. However, there is limited research on pressure relief methods for deep-buried hard rock tunnels. This article commences with an overview of pressure relief in the roadway and conducts a detailed study on the parameters and methods of pressure relief in the roadway. To address safety and mining efficiency challenges, such as severe deformation leading to support failures, this study conducted a parameter analysis using the Sanshandao Gold Mine as a case study. Based on existing support methods, a strategy for arranging pressure relief roadways at varying distances from the main roadway is proposed, significantly enhancing the stress environment there. Numerical simulation software was employed to model two scenarios: (1) excavating the pressure relief roadway, main roadway, and maintenance roadway simultaneously and (2) first excavating the pressure relief roadway, followed by the main roadway and the maintenance roadway simultaneously. Simulation results indicated that the first pressure relief approach outperforms the second. The optimal position for both pressure relief roadways is 15 m from the main roadway, resulting in maximum deformation of the main roadway within 100 mm. These findings align with on-site stress monitoring data and satisfy safety production criteria. The research offers a theoretical foundation for similar pressure relief techniques in deeply buried, high-stress roadways.

Mechanical Behavior of a Double-Layer Supported Large-Span Tunnel Excavated in Squeezing Rocks Employing Stress Release Technology

When excavating a large-span tunnel in squeezing rock, the tunnel support is subjected to significant loads. Therefore, the support structure must have enough stiffness and strength to withstand the pressure exerted by the ground. Various stress relief techniques can be used to reduce the ground pressure acting on the support and utilize the bearing capacity of the surrounding rock. One such technique is Deformation Reserved (DR). It involves reserving space outside the excavation boundary or between the two support layers. The proposed solution for the interaction between the double-layer tunnel support and the surrounding rock takes into account the excavation process and stress relief. The expressions for stress and deformation of the tunnel support and surrounding rock are provided in an elastoplastic solution. Parametric studies were conducted to investigate the effectiveness of a double-layer support structure with stress relief techniques. The monitoring data from the Lianchengshan Tunnel were compared with the proposed analytical solution. The results indicate that a larger reserved deformation behind the outer layer support is much more beneficial to tunnel stability when the total reserved deformation is constant. The ground pressure will be significantly reduced, thereby decreasing the force on the inner layer support.

Assessment of the health status in pharmaceutical workers

Introduction. Pharmaceutical workers (PW) being exposed to adverse physical, chemical, and biological factors are responsible for the performance results and experience psycho-emotional stress. This contributes to the emergence of diseases associated with professional activity, and, therefore, it is necessary to find ways to prevent them. The purpose of the study: assessment of the state of health in the pharmaceutical workers; determination of factors affecting morbidity, search for ways to preserve and strengthen the health in specialists. Materials and methods. To study the health status in PW, data were collected by using the questionnaire method, which made it possible to identify symptoms of diseases of the nervous, respiratory, cardiovascular, digestive, musculoskeletal, immune, genitourinary, and reproductive systems. The level of anxiety in PW was determined by the method of CD Spielberger. Results. In PW there were found symptoms of diseases of all body systems, but the greatest number of complaints were about disorders of the nervous (25.3%), digestive (18.1%), and respiratory (16.0%) systems. The majority of respondents revealed medium and high levels of situational anxiety as much as 46.7% and 36.5%, respectively. Almost half of the respondents have a high level of personal anxiety. The influence of age and work experience on the health status in PW was noted. The highest level of personal anxiety is observed in women. Situational anxiety is expressed among workers who have bad habits. Employees with high situational anxiety have more symptoms of nervous system diseases. Research limitations. A total of 107 questionnaires were evaluated, when studying the health status of PW in pharmacy organizations. Conclusion. Most PW maintain a healthy lifestyle: they do not have bad habits, follow a healthy diet, have sufficient sleep, and an active lifestyle. However, 80% noted non-compliance with the work-rest balance when performing occupational activities (working). In this regard, it is important to pay attention to the labour optimization, ensuring a favourable socio-psychological climate at work, and the use of relief techniques.

Exploring Factors Impacting Engagement in Speech Pathology Intervention for Inducible Laryngeal Obstruction

Speech pathology is the first-line treatment for inducible laryngeal obstruction (ILO) and involves behavioral techniques to address symptoms and modify maladaptive laryngeal postures. Benefit from speech pathology is reliant on patients engaging in treatment sessions, regular home practice, and generalizing techniques to everyday activities. There is limited research exploring engagement in speech pathology treatment for ILO, particularly from the patient perspective. This study aimed to explore the experiences of living with ILO and how this experience may impact the way patients engage in speech pathology treatment. Qualitative study. Semistructured interviews were completed with seven participants exploring their experiences living with ILO, their diagnostic process and their experiences with speech pathology treatment. Data were analyzed using reflexive thematic analysis to determine shared meanings across participants and themes were developed. Three major themes were identified - Life with ILO, Challenges of Speech Pathology Treatment, and What Matters to Me. Patients' reports of living with ILO and interacting with speech pathology suggested that these experiences impacted their readiness to start treatment and persist through the challenges of the treatment. Engagement appeared to be positively associated with significant ILO symptom burden and life impact, confidence in the diagnostic process, recommendation for speech pathology treatment, a tailored intervention by a patient-perceived expert in the field and working in a partnership with the speech pathologist to develop a sense of agency. Patients indicated their engagement was negatively influenced by competing time demands, social embarrassment when using symptom relief techniques and laryngeal exercises, and a low ILO symptom burden and life impact. The reasons behind engagement in speech pathology treatment for ILO appear to be a complex interaction between previous experiences of living with ILO including the diagnostic process and the experience of speech pathology treatment. A patient-centered approach to therapy may help to maximize engagement by exploring readiness and expectations for treatment. The greater understanding of the patient experience provided through this study may allow speech pathologists to devise meaningful ways to maximize engagement in treatment for people with ILO.

Veterinary High-Stakes Immersive Simulation Training With Repeat Practice Following Structured Debriefing Improves Students' Ability to Cope With High-Pressure Situations.

Immersive simulation is used increasingly in medical education, and there is increasing awareness of the impact of simulation scenarios on emotional state and cognitive load and how these impact learning. 1 There is growing awareness of the requirement to equip veterinarians with skills for managing high-pressure environments and provide training on human factors. Veterinary students participated in a high-fidelity immersive simulation of a road traffic collision involving multiple casualties. The students took part in the same simulation twice, the second time after a debrief. Each participant's emotional state and cognitive load were assessed after participating in each simulation. Each participant was asked to score the effect of pressure on their performance. One hundred twenty-five students participated and demonstrated a higher cognitive load with more positive emotional states during the second scenario after the completion of a structured debrief and discussion focusing on pressure relief techniques (cognitive load - ¯ μ Scenario run 1 = 4.44 ± 1.85 [SD], ¯ μ Scenario2 = 5.69 ± 1.74 [SD]). Most (63%) participants described being in a low-performance state of frazzle during the first scenario compared with most (61%) who described being in a high-performance state of flow during the second. Immersive simulation scenarios, with structured debriefing, may allow the measurement of emotional state and cognitive load in participants. Furthermore, this study suggests that curriculum training in human factors and pressure relief techniques, coupled with immersive simulation and debrief, may improve future performance in high-stakes and high-pressure scenarios.

Biologgers reveal unanticipated issues with descending angled walleye with barotrauma symptoms

Without sufficient time to diffuse air from their swim bladders, physoclistous fish caught in deep water can exhibit symptoms of barotrauma. In this study, we tested the effectiveness of four barotrauma relief techniques on 76 walleye ( Sander vitreus) and compared their 10 min post-release behaviour and depth selection with an untreated control group using a biologger containing a tri-axial accelerometer and depth sensor. Vented fish showed the best success rate of returning to depth, while no untreated controls were able to swim down. For fish that remained at depth, half were found to have lost orientation and were upside down during the entire monitoring period, with this orientation being strongly associated with the relief method. Vented fish had higher chances (80%) of remaining in the correct orientation at depth compared with the other methods (average of 38%). Our research shows that the best way to prevent negative outcomes of barotrauma is to avoid fishing at depths that yield barotrauma; however, if unavoidable, affected fish should be carefully vented by trained anglers to best reduce post-release impairments.

Mental Health Challenges: Anxiety Among Medical Students - A Cross-Sectional Analytical Study

BACKGROUND: Generalized Anxiety Disorder (GAD) is characterized by consistent and excessive worry, significantly impacting daily functioning and academic performance. Medical students encounter various challenges during their academic years and clinical rotations that put them at a higher risk of developing anxiety. In addition, Sudan is currently experiencing a complex social and political environment characterized by political unrest and economic crises. These factors may further increase medical students' risk of developing GAD. Unfortunately, limited research has been conducted on GAD among medical students in Sudan. This study aimed to determine GAD prevalence, assess risk factors, and examine its impact on academic achievement and daily activities among Sudanese medical students. METHODS: A cross-sectional analytical study was done among undergraduate medical students at Omdurman Islamic University in Sudan from January to February 2023. A systematic random sampling technique was used to select 374 participants. Data were collected via an electronic self-administered questionnaire comprising two parts: sociodemographic information and the Generalized Anxiety Disorder Questionnaire (GAD-7), a validated tool for screening and assessing GAD severity. Descriptive statistics, t-tests, one-way ANOVA, and multivariate regression analysis were used to analyze the data. Effect sizes were measured using Cohen's d and eta-squared. The cut-off p-value for statistical significance was set at < 0.05. RESULTS: The prevalence of generalized anxiety disorder (GAD) was 33.7%, with severity levels of 41.2% for mild anxiety, 21.4% for moderate anxiety, and 12.3% for severe anxiety. The mean GAD score was significantly higher among female medical students (p < 0.001) and those with chronic diseases (p = 0.034). GAD significantly impacted daily activities among those who reported higher GAD scores (p < 0.001). In multivariate regression analysis, medical students in the final year had almost 4.246 higher odds of having GAD [95% CI for AOR = 1.267, 14.221] (p = 0.019). Females had 2.4 times higher odds of having GAD [95% CI for AOR = 1.458, 3.946] (p < 0.001). CONCLUSION: The prevalence of generalized anxiety disorder (GAD) among Sudanese medical students is relatively high and has a detrimental impact on daily activities. Medical students in the final year have a higher risk of GAD, and significant associations were found between GAD and female sex, as well as chronic diseases. The high prevalence of GAD among medical students is concerning and highlights the urgent need for increased awareness, normalizing discussions about mental health issues, and providing resources and support to students struggling with anxiety. Universities should identify and offer medical students effective anxiety relief techniques and promote a wellness culture that encourages healthy routines such as regular exercise, sufficient rest, and effective stress management. Future research should evaluate the effectiveness of different interventions in preventing and treating GAD among medical students and identify and address the barriers to accessing mental health care for medical students in Sudan.

Examining the relationship between autism spectrum disorder in children whose mother had labour epidural analgesia for their birth: A retrospective cohort study.

Controversy exists regarding the association between autism spectrum disorder (ASD) in children whose mother had labour epidural analgesia for their birth, as the few existing investigations have reported mixed findings. This study aims to evaluate the possibility of an association in our heterogeneous population. A retrospective population-based cohort study. Vaginal deliveries that took place between the years 2005 and 2017 at Soroka University Medical Center, a tertiary referral hospital in Israel, and a follow-up on the incidence of ASD in the children. A hundred and thirty-nine thousand, nine hundred and eighty-one labouring patients and their offspring. The incidence of children diagnosed with ASD (both hospital and community-based diagnoses) was compared based on whether their mothers had received labour epidural analgesia during their labour. A Kaplan-Meier survival curve compared cumulative incidence of ASD. A Cox proportional hazards model was used to control for relevant confounders. Labour epidural analgesia was administered to 33 315 women. Epidural analgesia was more common among high-risk pregnancy groups (including pregnancies complicated with diabetes mellitus, hypertensive disorders, intrauterine growth restriction, and oligohydramnios; P < 0.001). In a Cox proportional hazards model, the association between epidural analgesia during labour and ASD in the children lost statistical significance following adjustment for confounders such as maternal age, gestational age, hypertensive disorders, diabetes mellitus, and ethnicity [adjusted hazard ratio = 1.13, 95% confidence interval (CI), 0.96 to 1.34, P = 0.152]. In our population, after adjusting for confounders, epidural analgesia is not independently associated with autism spectrum disorder in the children. These findings enhance our knowledge regarding the safety of epidural analgesia and enable patients to make informed decisions about their pain relief techniques during labour.

Knowledge, Perceptions and Desire to Pain Relief in Labor among Iranian Pregnant Women

Background: One way to promote vaginal delivery and reduce unnecessary caesarean section, is paying attention to labor pain relief techniques. The aim was to investigate factors affecting the desire of pregnant women for painless delivery. Methods: This descriptive study was conducted on 325 pregnant women who referred to prenatal clinics in 2020 and met the inclusion criteria. Data were collected using researcher-made questionnaire on painless delivery. Data analysis was performed using SPSS v.21. Results: Most of respondents (74%) were between 20-29 years old. 19.69% of participants were nulliparous and 62.76% had diploma. 72% were housewives. 56.61% of the participants had not enough information about pain relief in labor. Only 14 people of whom had information, (9.92%) desired to experience pain relief in labor. Many of the respondents 90.76% were worry about the effects of pain relief on their unborn. 44.68% of participants, who had information about pain relief in labor; got their information regarding the pain relief in labor internet sources. Conclusions: Due to the low level of awareness of pregnant women to use painless delivery and labor pain relief techniques, it is recommended that the necessary measures be taken in order to increase women’s knowledge of the benefits and limitations of painless delivery. Plain language summary: Labor pain is the most painful experience in many women’s lives. It causes a large number of unnecessary cesareans. There are different kinds of pain relief methods. However, it is used a little. This study investigated the information, attitude and tendency to pain relief in labor among pregnant women. It was declared that participants have a few information. They were unwilling to use pain relief methods duo to their probable side effects. So it is felt educational sessions about painless delivery during prenatal care.

Enhancing antenatal education in Pakistan: an audit and recommendations

BackgroundAntenatal Education equips parents with knowledge for safe maternal health and infant care. It also reduces fear and anxiety during childbirth. ANE curriculum can vary according to country and institute. It can include classes focusing on childbirth, pain relief techniques, mode of birth, parenting, breastfeeding, breathing techniques, etc. Although ANE is widely practiced in developed countries, there is no standard program in developing countries like Pakistan. This study aims to improve antenatal education at a tertiary care hospital in Karachi, Pakistan potentially proposing an upgraded curriculum as a national standard.MethodsThis multiphase study used mix-method design was conducted in the Obstetrics and Gynaecology Department of a tertiary care hospital of Karachi, Pakistan from 2019 to 2021. Phase 1 of the study included reviewing and comparing the hospital’s antenatal curriculum with existing literature, followed by Phase 2, which was a desk review of attendance and patient feedback. The 3rd phase involved IDIs (in depth interviews) from health care workers (Obstetrics experts) to understand their perspectives regarding the ANE and the conducted classes. For phase one, gaps were identified and reported theoretically. For phase two, the annual attendance was recorded and participants’ satisfaction with the classes assessed. Qualitative data from phase 2 and 3 was converted into themes and sub-themes.ResultsThe audit showed a decline in the attendance of antenatal classes due to the pandemic and consequent shift to online sessions. The low attendance in online courses could be attributed to various factors. Patient feedback was generally positive, with a majority expressing high satisfaction levels. Expert feedback highlighted the need for additional topics such as mental health and COVID in pregnancy, as well as fathers' involvement. The curriculum was updated to include these topics and made more interactive with printed handouts for parents.ConclusionA standardized antenatal education covering various topics surrounding pregnancy, childbirth, and postnatal care must be available to parents nationwide.

Factors Affecting Women's Attitudes Toward the Use of Epidural Anesthesia During Labor in Riyadh in 2023.

Background Epidural analgesia (EA) is a type of central nerve block achieved by injecting a local anesthetic near the pain-transmitting nerves. It is commonly used to relieve pain during labor. The intensity of pain experienced and the effectiveness of pain relief can affect a woman's labor and delivery experience. Labor pain is a long-lasting and debilitating pain that women experience; therefore, pain relief techniques have become widely available. However, not all women are willing to use EA for pain relief. The factors that influence women's choices regarding EA should be explored. This study aimed to comprehend women's perspectives on EA in Riyadh and clarify the variables influencing their decision-making. Methodology A total of 336 women in their reproductive years participated in this study. An online questionnaire with five sections was used to collect data. The socio-demographic information in the first section covered age, level of education, occupation, income, marital status, pregnancy, maternity, and prenatal care. The second section focused on how painful labor was for women who had already given birth. The third and fourth sections discussed labor pain relief techniques, including epidural anesthesia. The final section assessed the participant's interest in receiving EA during the next delivery. Socio-demographic data were considered to be a predictor, whereas awareness levels and a desire to receive EA were seen as results. The information was cleaned, coded, and entered into SPSS version 29 (IBM Corp., Armonk, NY, USA). The results are presented as frequencies and percentages. A Likert scale was used for data analysis. Statistical significance was established at p-values <0.05. Results In total, 336 Saudi women were included in this study, 86% of whom were between the ages of 30 and 35 years, and 69% of whom had a university education. One-third of the women (32%) had a monthly income of 10,000 to 20,000 SAR, and 55% of them had experienced three or more pregnancies. Fear of pain was the main reason for using epidural anesthesia in more than half of the participants given the choice. The most reinforcing factor was obtaining proper and sufficient information about EA, while the most restrictive factor was the fear of harming the infant. In particular, women aged 30-35 years (i.e., most of the included women) were commonly influenced by negative factors. Marital status and educational level played no significant role in women's use of EA. Conclusions Saudi women showed a good attitude toward EA. However, the awareness of EA was quite low. Fear of labor pain appeared to be the main reason for using EA. Health education programs on EA can increase the knowledge of and intent to use EA among women.

Chronic pain management and a comprehensive approach for integration of Ayurveda with modern medicine

This paper aims to provide a comparative analysis of pain relief techniques for chronic pain management in Ayurveda and modern medicine. The analysis is based on available literature and evidence of efficacy. The paper also explores the commonalities between these disciplines and suggests methods for integrating both disciplines for effective pain management.

Perception, attitude, and practice of labor analgesia among obstetric care providers in Eastern Uttar Pradesh

Background: Labor pain is among the foremost severe pain that ladies experience in their lifespan, if inadequately treated can lead to certain complications in labor. Relieving this pain with medical interventions is also full of misconceptions and disagreement among people. Different traditional and pharmacological methods for labor pain relief are utilized by obstetric care providers. Aims and Objectives: The aim of the study was to obtain perception, attitude, and practice of labor analgesia among obstetric care providers in Eastern Uttar Pradesh. Materials and Methods: A cross-sectional online survey was conducted among obstetric care providers practicing in eastern Uttar Pradesh to access the perception, attitude, and practice of labor analgesia. Results: A total of 152 valid responses were obtained from the 250 participants contacted (response rate of 60.8%). The majority (98%) of them were in favor of utilizing some or the other technique of labor pain relief, and 80.3% of the participants were utilizing some of the available methods solely or in combination. Non-pharmacological methods were the most frequently used technique (77.9%). Epidural analgesia was used by only 9.8% of participants. Less awareness among pregnant women, fear of harm to the baby, lack of dedicated supporting staff, and non-availability of anesthesiologists were among the most commonly pointed out as barriers to utilizing labor epidural analgesia. Conclusion: The majority of obstetric care providers were in favor of using some or the other technique of labor analgesia, but there was a large gap between the practice and attitude among health-care service providers regarding labor analgesia. Epidural analgesia was practiced very less due to some myths and scarcity of workforce.

The PHYSIOLOGY OF MENSTRUAL PAIN AND THE EFFECTIVENESS OF TECHNOLOGY-BASED PAIN MANAGEMENT TECHNIQUES

Dysmenorrhea or menstrual pain significantly affects the quality of life for many women, necessitating effective and non-invasive pain management strategies. This study systematically reviewed existing literature on the physiological causes of menstrual pain and the effectiveness of technology-based pain relief techniques. The review shows that menstrual pain is mainly regulated by the hypothalamus-pituitary-ovary axis, with prostaglandins and inflammatory cytokines playing key roles. Also, stress and anxiety can amplify menstrual discomfort. It also uncovers several technology-based interventions for effective pain management, including Transcutaneous Electrical Nerve Stimulation (TENS), heat therapy, mobile apps, virtual reality (VR), and wearable tech. However, potential risks and limitations of these interventions, such as overreliance, data security, limited accessibility, varying effectiveness, cost, user acceptance, and lack of human contact, were also identified. Despite these limitations, technology-based pain management techniques represent promising non-invasive alternatives for managing menstrual discomfort. Additional high-quality research is needed to further validate the efficacy of these approaches and address potential risks.

Accuracy of tooth-implant impressions: Comparison of five different techniques.

To compare the accuracy of five different tooth-implant impression techniques. In this in vitro, experimental study, an acrylic model containing one bone-level Straumann dental implant at the site of maxillary first molar and an adjacent second premolar prepared for a porcelain fused to metal restoration was used. Impressions were made from the model using five different one-step tooth-implant impression techniques including scanning with an intraoral scanner, occlusal matrix, wax relief, closed-tray, and open-tray techniques. Each technique was repeated 15 times. The impressions were poured with dental stone, and the obtained casts were scanned by a laboratory scanner. The scan file of each technique was compared with the scan file of the original acrylic model by Geomagic Design X software. Data were analyzed by one-way analysis of variance, and Tamhane's post-hoc test (α = 0.05). For dental implant, intraoral scanning had the highest accuracy (0.1004 mm2 ) followed by open-tray (0.1914 mm2 ), occlusal matrix (0.2101 mm2 ), closed-tray (0.2422 mm2 ), and wax relief (0.2585 mm2 ) techniques (p < 0.05). For the prepared tooth, wax relief (0.0988 mm2 ) had the highest accuracy followed by occlusal matrix (0.1211 mm2 ), open-tray (0.1663 mm2 ), closed-tray (0.1737 mm2 ), and intraoral scanning (0.4903 mm2 ) technique (p < 0.05). For both dental implant and prepared tooth, occlusal matrix (0.2431 mm2 ) had the highest accuracy followed by open-tray (0.2574 mm2 ), wax relief (0.2693 mm2 ), closed-tray (0.2862 mm2 ), and intraoral scanning (0.3192 mm2 ) technique (p > 0.05). The compared simultaneous tooth-implant impression techniques had comparable accuracy with no significant difference.

Predictors of one year pressure injury outcomes in hospitalized spinal cord injured veterans with one stage 3 or 4 pressure injury

Objective The purpose of this study is to investigate predictors of pressure injury (PrI) outcomes at one year after discharge for Veterans with spinal cord injury (SCI) hospitalized with a Stage 3 or 4 PrI. Design/Setting/Participants This is a retrospective medical record review from one VA Health Care System SCI unit. Participants were Veterans with traumatic or non-traumatic SCI admitted with one Stage 3 or 4 pelvic PrI treated medically (e.g. without flap surgery). Logistic models were used to select the significant predictors of PrI healing outcomes. Outcome Measure One year after discharge wound outcomes (healed vs non-healed) for Veterans with SCI hospitalized with a Stage 3 or 4 PrI. Results A total of 62 hospitalizations were included for analyses resulting in 33 healed and 29 non-healed PrIs. Three significant predictors of non-healed PrI outcomes included use of pressure mapping during hospitalization, greater PrI depth, and usage of alginate dressings. Two significant predictors of healed PrI outcomes included the use of animal-based tissue and hydrocolloid dressings. Area under curve of this logistic regression model was 79.98%. Conclusion The clinical decision of having a patient pressure mapped predicts that the PrI may not heal at one year of discharge. Pressure mapping protocol correlated with another variable that could not serve as a predictor by itself, including using powered pressure relief techniques. The three PrI treatment predictors may represent characteristics of the PrI itself, rather than the efficacy of the product. Further investigation on these clinical decision-making factors is warranted to ensure efficient and cost-effective treatment strategies for individuals with SCI hospitalized with PrIs.

Инкорпорирование театральных идей В.Э. Мейерхольда в сценическую практику США: режиссерская деятельность Герберта Бибермана

The study focuses on the incorporation of Vsevolod Meyerhold’s theatrical methodology to American stage practices specifically through the directing activities of Meyerhold’s follower in the US Herbert Biberman. The characteristic of the main ways for exporting Meyerhold’s ideas overseas are provided. Among them — the arrival of American theatrical figures in Moscow, studying with the master at the Meyerhold’s Moscow State Theatre, as well as the translation and publication of Soviet theatrical literature about the director and his method. The reception of Meyerhold’s stage work is given by theatrical figures of the USA (among them — Brooks Atkinson, Henry Dana, Norris Houghton). On the basis of Biberman’s first two productions, the material for which was Soviet dramaturgy — “Konstantin Terekhin (Rust)” by Vladimir Kirshon and Andrey Uspensky and “Roar, China!” by Sergey Tretyakov — the continuity of the stage practice of the American director to the Meyerhold’s theatrical principles is revealed. The Broadway production of “Rust” was distinguished by poster expressiveness and conciseness of style, generalized and relief techniques of the acting. In the performance based on Tretyakov’s play, Biberman built expressive, almost graphic mise en scene and acting angles. The author presents an analysis of “Meyerholdovsky” theatrical ideas overseas on the basis of materials from the collections of the New York Public Library for the Performing Arts (newspaper and magazine reviews) and the Russian State Archive of Literature and Arts (RGALI, Moscow), as well as documents from the Houghton Library at Harvard University and the Beinecke Rare Book and Manuscript Library at Yale University. The work is aimed at expanding both the understanding of Vsevolod Meyerhold’s theatrical ideas in the United States and the stage fate of Soviet plays in America.