Life Support Research Articles

Normothermic regional perfusion mobile teams in controlled donation after circulatory death pathway: Evidence and peculiarities

To facilitate the implementation of controlled donation after circulatory death (cDCD) programs even in hospitals not equipped with a local Extracorporeal Membrane Oxygenation (ECMO) team (Spokes), some countries and Italian Regions have launched a local cDCD network with a ECMO mobile team who move from Hub hospitals to Spokes for normothermic regional perfusion (NRP) implantation in the setting of a cDCD pathway. While ECMO teams have been clearly defined by the Extracorporeal Life Support Organization, regarding composition, responsibilities and training programs, no clear, widely accepted indications are to date available for NRP teams. Although existing NRP mobile networks were developed due to the urgent need to increase the number of cDCDs, there is now the necessity for transplantation medicine to identify the peculiarities and responsibility of a NRP team for all those centers launching a cDCD pathway. Thus, in the present manuscript we summarized the characteristics of an ECMO mobile team, highlighting similarities and differences with the NRP mobile team. We also assessed existing evidence on NRP teams with the goal of identifying the characteristic and essential features of an NRP mobile team for a cDCD program, especially for those centers who are starting the program. Differences were identified between the mobile ECMO team and NRP mobile team. The common essential feature for both mobile teams is high skills and experience to reduce complications and, in the case of cDCD, to reduce the total warm ischemic time. Dedicated training programs should be developed for the launch of de novo NRP teams.

Perceptions and Experiences of Exercise Snacks Among Middle-Aged and Older Adults: A Systematic Review and Meta-Synthesis.

Physical inactivity in middle-aged and older adults is a major health problem. Exercise snacks are an emerging form of physical activity characterized by shorter single bouts of high-intensity exercise spread out repeatedly throughout the day which can provide more exercise opportunities for middle-aged and older adults. To summarize perceptions and experiences of exercise snacks among middle-aged and older adults, and explore the barriers and facilitators of promoting exercise snacks. We followed the PRISMA and systematically searched five databases from the earliest to May 2024. The Critical Appraisal Skills Program tool is used to quality assess and the Capability, Opportunity, and Motivation Model of Behavior (COM-B model) is used to guide thematic synthesis. Fourteen categories from nine studies were summarized, and 277 findings were identified. Three synthesized findings were: capability of middle-aged and older adults (including health-related exercise disorders, learning and mastery skills, and health literacy), opportunities for exercise snacks (including flexible and free, easy and quick, integration into life, social and family support, and application of mobile health technology), and motivation of exercise snacks (including pleasurable experiences, gaining physical and mental benefits, effective reminders, incentives and feedback, personalized needs, and self-efficacy). Exercise snacks are a promising approach， however, they need to be continuously optimized. Our results can provide evidence for designing and optimizing exercise snack programs. Medical workers should assist middle-aged and older adults in developing appropriate exercise snack strategies. PROSPERO (CRD42024544089).

Intervention measures to improve the filter life of continuous renal replacement therapy in critically ill patients-A systematic review.

Continuous renal replacement therapy (CRRT) is a method of blood purification, which is widely used in the treatment of critical diseases as a means of multiple organ function protection and life support therapy. However, because of the serious condition of ICU (intensive care unit) patients, CRRT needs to be carried out continuously, but the treatment is interrupted ahead of time as a result of various conditions, which not only affects the treatment effect but also increases the patient cost. To evaluate intervention measures to improve the filter life of CRRT in critically ill patients, and also to identify which interventions are considered 'promising interventions'. This is a systematic review. Seven databases were searched using terms related to the concepts of 'continuous renal replacement therapy' and 'filter life', from the establishment of the database to 31 December 2023. The quality of the methodology included in the study was assessed using standard evaluation tools developed by the Effective Public Health Practice Project (EPHPP), and pre-established criteria were used to identify 'promising interventions'. A total of 28 studies were included, of which 7 were rated 'strong' in terms of design and methodological quality, and the others were 'medium'. The most commonly identified interventions to extend the life of CRRT filters include the use of sodium citrate anticoagulation, the choice of CVVHD or CVVHDF or pre-diluted CVVH for CRRT and the use of personalized sodium citrate anticoagulant regimens to reduce the incidence of filter clotting. The intervention measures of 14 studies were statistically significant, while the other 14 studies were not statistically significant. Interventions in nine studies were identified as 'promising interventions' because they were published within 10 years, with a medium or strong methodological quality rating, significant positive results and a strong evidence base. In the promising interventions study, citrate anticoagulation and CVVHD or CVVHDF models were recommended to significantly prolong filter life. However, more high-quality studies are needed to identify interventions that can prolong the life of CRRT filters in critically ill patients, thereby supplementing the literature in this field. The existing studies lack blinding and have limited quality. Future studies should be carried out with the goal of 'best evidence', and the interventions should be more universal and clinically practical. This study uses the method of systematic review to scientifically and rigorously provide some suggestions for extending the life of CRRT filters in critically ill patients, such as 'By implementing personalized citrate anticoagulation protocols, the incidence of CRRT filter life shortening due to coagulation can be reduced', which can reduce the cost of patients and improve the quality of treatment to a certain extent in clinical practice.

Research on the Effect Mechanism of Career-Specific Parental Support Promoting Meaning in Life of Chinese Higher Vocational College Students

Adolescent students’ meaning in life is an important topic of research in positive psychology and educational psychology. Meaning in life is of outstanding value to the whole career development of Chinese higher vocational college students (CHVCS), and parental behaviors have a profound impact on CHVCS’ meaning in life. In order to explore the mechanism of the role of career-specific parental support in promoting CHVCS’ meaning in life from the perspective of career, this study was based on career construction theory (CCT) and investigated 2498 CHVCS. The results showed that (1) career-specific parental support could directly and positively influence meaning in life; (2) core self-evaluations, career exploration, and career adaptability individually played a partially mediating effect in the relationship between career-specific parental support and meaning in life; (3) “core self-evaluations + career exploration”, “core self-evaluations + career adaptability”, “career exploration + career adaptability”, and “core self-evaluations + career exploration + career adaptability” play a partial chain mediating effect in the relationship between career-specific parental support and meaning in life. This study contributes to meaning in life in CHVCS, enriches career-related research based on CCT, and has important implications for career counseling from a construct perspective.

Differences in the Usability of Fully Automated External Defibrillators between Medical and Nonmedical Professionals.

Objective Early defibrillation is crucial for improving the survival rates of patients with shockable cardiac arrest (OHCA). Automated external defibrillators (AEDs) are essential in basic life support (BLS), yet their usage in out-of-hospital cardiac arrests remains around 10%. There are two types of AEDs: semi-automatic (s-AED) and fully automatic (f-AED), with the latter automatically delivering a shock if indicated. Although f-AEDs were introduced in Japan in 2021, they have not yet been widely adopted. The present study investigated whether or not the ease of use and preferences for these AED types differ between healthcare professionals and laypersons. Methods BLS courses, including training on both AED types, were conducted between 2021 and 2022 at our institution. The participants were divided into medical and non-medical professional groups, and a survey was administered. Results A total of 443 participants were included, with 47 medical professionals and 396 non-medical professionals. Notably, 401 participants were new to f-AED lectures. The medical professional group had more prior experience with AED training courses than non-medical professionals and showed a preference for s-AEDs, whereas the non-medical professional group showed no significant preference. Although a subset of participants expressed hesitation in pressing the shock button on the s-AEDs, no statistically significant difference was observed between the groups. Conclusion This study suggests that preferences for AED types may vary between medical and non-medical professional groups, with some reluctance in using s-AEDs. Although no significant differences in hesitation were found between the groups, f-AEDs may reduce hesitation and potentially improve AED effectiveness during cardiopulmonary resuscitation.

Nurses' Knowledge and Skills After Use of an Augmented Reality App for Advanced Cardiac Life Support Training: Randomized Controlled Trial.

Advanced cardiac life support (ACLS) skills are essential for nurses. During the COVID-19 pandemic, augmented reality (AR) technologies were incorporated into medical education to increase learning motivation and accessibility. This study aims to determine whether AR for educational applications can significantly improve crash cart learning, learning motivation, cognitive load, and system usability. It focused on a subgroup of nurses with less than 2 years of experience. This randomized controlled trial study was conducted in a medical center in southern Taiwan. An ACLS cart training course was developed using AR technologies in the first stage. Additionally, the efficacy of the developed ACLS training course was evaluated. The AR group used a crash cart learning system developed with AR technology, while the control group received traditional lecture-based instruction. Both groups were evaluated immediately after the course. Performance was assessed through learning outcomes related to overall ACLS and crash cart use. The Instructional Materials Motivation Survey, System Usability Scale, and Cognitive Load Theory Questionnaire were also used to assess secondary outcomes in the AR group. Subgroup analyses were performed for nurses with less than 2 years of experience. All 102 nurses completed the course, with 43 nurses in the AR group and 59 nurses in the control group. The AR group outperformed the control group regarding overall ACLS outcomes and crash cart learning outcomes (P=.002; P=.01). The improvement rate was the largest for new staff regardless of the overall learning effect and the crash cart effect. Subgroup analysis revealed that nurses with less than 2 years of experience in the AR group showed more significant improvements in both overall learning (P<.001) and crash cart outcomes (P<.001) compared to their counterparts in the control group. For nurses with more than 2 years of experience, no significant differences were found between the AR and control groups in posttraining learning outcomes for the crash cart (P=.32). The AR group demonstrated high scores for motivation (Instructional Materials Motivation Survey mean score 141.65, SD 19.25) and system usability (System Usability Scale mean score 90.47, SD 11.91), as well as a low score for cognitive load (Cognitive Load Theory Questionnaire mean score 15.42, SD 5.76). AR-based learning significantly improves ACLS knowledge and skills, especially for nurses with less experience, compared to traditional methods. The high usability and motivational benefits of AR suggest its potential for broader applications in nursing education. ClinicalTrials.gov NCT06057285; https://clinicaltrials.gov/ct2/show/NCT06057285.

An assessment of long-term complications following prehospital intraosseous access: A nationwide study

BackgroundThe guidelines for Advanced Life Support issued by the European Resuscitation Council recommend considering drug delivery through intraosseous access if intravenous access to the vascular bed is not feasible or unsuccessful. Emergency prehospital intraosseous cannulation may theoretically lead to an increased risk of long-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome. Such complications have previously been reported in case reports or small sample case series. We systematically investigated long-term complications potentially associated with intraosseous cannulation using validated Danish health registries. MethodsData sources were the nationwide electronic Prehospital Patient Record system, the Danish National Patient Registry, and the Danish Civil Personal Registry. We investigated all patients who were subjected to prehospital intraosseous cannulation in Denmark from January 2016 through December 2019. During a follow-up period of 180 days from the index date we extracted information concerning mortality status and potential long-term complications defined as osteomyelitis, osteonecrosis, or compartment syndrome from the day of prehospital intraosseous cannulation. ResultsOf the 5,387 patients receiving intraosseous access, 375 were unidentified and lost to follow-up. Of the 5012 remaining patients, 4,775 were adults, and 237 were children. No children and “less than five” adults had long-term complications. No osteonecrosis, osteomyelitis or compartment syndrome appeared later than 175 days after an intraosseous cannulation. ConclusionsLong-term complications such as osteomyelitis, osteonecrosis, or compartment syndrome following prehospital intraosseous cannulation and drug delivery occurred in less than 0.1% of the cases. Our findings indicate that prehospital intraosseous cannulation may be safe across age groups.

Return on Investment With Health Care Simulation.

Delivering simulation across a health system can engage the entire workforce by moving beyond traditional educational delivery and focusing on broader organizational needs specific to a particular organization. The commonly known use of simulation as a form of life support education has progressed to include fully immersive simulation experiences focusing on team-based communication, leadership, fellowship, and clinical care. It continues beyond this point with the inclusion of patient safety strategies, root cause analysis investigation, leadership, and management training, and recently, it has included environments that catalyze innovation in complex healthcare systems. The focus on pure fiscal elements of simulation-based approaches does not give a health system the accurate nontangible benefits simulation can provide, and importantly, acknowledging that each location has differing needs is essential when considering what investment should be made and where. A small community hospital will have vastly different needs from specialty hospitals that deliver specialist care. It must also be understood that every simulation center, to some extent, will always be unique, as it should. The commonly quoted statement "when you have seen one simulation center, you have seen one simulation center" really does reflect the reality of this established and rapidly growing specialty. In this article, we reflect on the traditional use of simulation and discuss some wider uses that may engage a wider audience and, importantly, provide a greater return on investment for your facility, making the case for investment more reasonable and impactful to each part of a busy health system.

Combating Manipulation and Encouraging Destructive Behavior as an Element of Political and Legal Culture

Negative spiritual and moral impact can be one of the manifestations of information confrontation within the framework of a hybrid war and can become a threat to the national security of modern Russia. This can be an impact on the political and legal culture of Russians through manipulation and encouragement of destructive behavior. The purpose of the study is to propose a system of measures to counter the threat of negative spiritual and moral impact. The axiological method was chosen as the main research method. Manipulation is considered as part of the strategy of opponents of modern Russia represented by the collective West, the encouragement of destructive behavior is a recognizable element of the policy of Westernization of culture, under the influence of which Russia has been for several decades. Counteraction to this threat should be comprehensive and based on both political and legal measures. Particular attention is paid to the consideration of measures to overcome the consequences of manipulation and encouragement of destructive behavior among Russians. Political measures and legal initiatives of the Federation Council of the Russian Federation, the State Duma of the Russian Federation and the Public Chamber of the Russian Federation are separately highlighted. The degradation of culture will inevitably lead to the degeneration of the nation, the loss of its national image, self-identity, sovereignty and support in life. Only joint efforts and responsibility of the state and society can lead to a positive result in the fight against manipulation and the encouragement of destructive behavior and form a developed and mature political and legal culture.

Toxic epidermal necrolysis: management strategies in burns units.

The most common severe exfoliative condition is toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, for which patients may sometimes require admission to hospital burns units. This study analyses the experience of the authors and results in this condition at the Cruces University Hospital in Bilbao, Spain. Over the last 22 years, the authors carried out a retrospective analytical observational study of TEN cases at the hospital and analysed risk factors including age, associated comorbidities, percentage of body surface area affected, positive bacterial culture, and treatment strategies used to assess their potential influence on prognosis. The results indicated an association between mortality and age (ρ (rho)=0.60, 95% CI [0.29, 0.79], p<0,001), ocular (ρ=0.58, 95% CI [0.28, 0.78], p<0.001), oropharyngeal (ρ=0.64, 95% CI [0.36, 0.81], p<0.001), genitourinary (ρ=0.58 CI [0.28, 0.78], p<0.001) respiratory mucosa involvement (ρ=0.53, 95 % CI [0.28, 0.78], p<0.001) and bacteraemia (ρ=0.44, 95% CI [0.17, 0.64], p=0.020). Bacteraemia also showed a higher incidence in elderly patients (ρ=0.4, 95% CI [0.03, 0.67], p=0.033) and in those with a higher Score for Toxic Epidermal Necrolysis at admission (ρ=0.51, CI [0.17, 0.74], p=0.006). A reduction in mortality was found in patients who received systemic treatment; cyclosporine, etanercept or a combination of both (ρ=-0.44, Cl [-0.70, -0.09], p=0.018). TEN is a rare but serious exfoliative condition. Traditionally, management of denuded skin was seen as the main prognostic factor; yet, systemic damage, especially to the respiratory mucosa, significantly increases mortality risk. While life support is crucial and recovery is possible, preventing long-term sequelae relies on effective care protocols. Current treatments may offer benefits, though their efficacy remains unclear. Clinicians in burns units should develop standardised protocols and collaborate on long-term studies to enhance patient care.

Enhancing Emergency Management Skills Through Manikin-Based Basic Life Support Simulations: An Evidence-Based Approach for Nursing Students

Introduction: Effective Basic Life Support (BLS) is crucial in improving survival rates during emergencies. Current nursing education often relies on traditional methods, which may not fully prepare students for the pressure and decision-making required in real-life situations. Objective: This study explores the effectiveness of manikin-based BLS simulation with scenarios in enhancing nursing students' skills in emergency management. Method: This study employed a one-group pre-test post-test design. Thirty nursing students were randomly assigned to participate in a Manikin-Based BLS Simulation training program. Their BLS skills were assessed using a validated and reliable questionnaire based on the American Heart Association (AHA) 2020 guidelines, administered both before and after the training. Data collection occurred in May 2024. The subsequent analysis will compare pre-test and post-test scores to evaluate the effectiveness of the Manikin-Based BLS Simulation in improving students' BLS skills. Result: Post-training, knowledge improved significantly (p &lt; 0.001), with 93.3% of students achieving 'Good' knowledge and 96.7% passing skill assessments. Conclusion: Manikin-based simulations effectively enhance knowledge and skills, supporting their integration into nursing curricula.

Analysis of social determinants with quality of life in people with HIV/AIDS at the voluntary counseling test clinic

Introduction: HIV and AIDS are known to have become an emergency problem around the world, where infection transmission, morbidity rates, and mortality rates are still high. The existence of the HIV/AIDS epidemic is one of the scary scourges among the community because of its unexpected transmission by HIV due to human behaviour. Objective: This study aims to analyze social determinants with quality of life in people with HIV/AIDS in the Voluntary Counseling and Testing Clinic. Methods: This study is an analytical study using a cross-sectional study research design. The population in this study is all HIV/AIDS patients domiciled in Kendari City. The number of samples was 177 respondents which was determined by simple random sampling. Data analysis uses the chi-square test and the multiple logistics test. Result: The results of the study showed that there was a stigma relationship with Odhiv's quality of life at the VCT Clinic of Kendari City Hospital (p = 0.000) and there was a relationship between social support and Odhiv's quality of life at the VCT Clinic of Kendari City Hospital (p = 0.000). The variable that has the greatest influence on the quality of life of ODHIV is the social support variable with an OR of 0.353. Conclusion: The variable that has the greatest influence on the quality of life of People with HIV/AIDS (ODHIV) is social support. Social support has proven to be a very significant factor in improving the quality of life of people living with HIV. Individuals with strong social support, whether from family, friends, or the community, tend to have a better quality of life than those who receive less social support. Social support plays a role in helping people with HIV cope with stigma, reduce psychological pressure, and provide a sense of security and comfort that can have a positive impact on their physical and mental well-being.

Extracorporeal Life Support: Making Ethically Sound Allocation Decisions for a Limited Resource.

Extracorporeal Life Support: Making Ethically Sound Allocation Decisions for a Limited Resource.

"Awake" Cannulation of Patients for Venovenous Extracorporeal Membrane Oxygen: An Analysis of the Extracorporeal Life Support Organization Registry.

"Awake" cannulation for venovenous extracorporeal membrane oxygenation (ECMO), where patients remain spontaneously breathing without invasive mechanical ventilation during the cannulation procedure, may reduce lung injury from positive pressure ventilation and promote patient mobility. To examine the association between "awake" cannulation for venovenous ECMO and patient outcomes. Analysis of the prospectively collected by the multicenter Extracorporeal Life Support Organization registry. Patients 18 years old or older who were cannulated for venovenous ECMO between 2016 and 2022 were included. Propensity score matching techniques were used to examine the association between the primary exposure of "awake" cannulation and the primary outcome of hospital mortality. This study analyzed data from 28,627 patients who received venovenous ECMO, including 797 (2.8%) who underwent awake cannulation. Patients undergoing awake cannulation were older (52.2 vs. 47.8 yr), had greater prevalence of chronic lung diseases (50.6% vs. 48.9%), and ischemic heart disease (4.3% vs. 2.7%) compared with those cannulated while receiving mechanical ventilation. Hospital survival to discharge was did not differ significantly between awake and nonawake cannulation groups after propensity score matching (2.4% increased rate of survival for patients cannulated awake; 95% CI, -1.7% to 6.4%; p = 0.26). In this large, multicenter study, awake cannulation for venovenous ECMO was uncommon but increasingly used over time. Survival to hospital discharge was similar to patients cannulated while on mechanical ventilation. Future research should focus on identification of patient cohorts most likely to benefit from ""awake" cannulation.

Evaluation of a new out-of-hospital newborn life support (OH-NLS) course in the UK South West region: a mixed-methods survey study

Introduction: Unplanned out-of-hospital births (UOHBs) are associated with poorer outcomes for babies, especially those born prematurely. The current Newborn Life Support (NLS) course offered by Resuscitation Council UK (RCUK) is not designed to address the challenges associated with birth out of hospital. A new course was developed to address these challenges. This study aimed to evaluate the impact of this course on attendees’ knowledge and confidence in supporting transition, resuscitation, stabilisation and onward transfer of newborns in an out-of-hospital setting.Methods: A convergent mixed-methods approach was used consisting of pre-, post- and follow-up surveys and a post-course multiple-choice questionnaire (MCQ). The surveys asked participants to rate their confidence, on a five-point Likert scale (from ‘Underconfident/fearful’ to ‘Very confident’) across seven domains of NLS, as well as making an individual assessment of provider confidence before and after the course. Free-text comments were collected and analysed using thematic analysis.Results: Attendees comprised multidisciplinary staff from the South West of England. The pre-course survey was completed by 32 of the 33 participants, the post-course survey by 31 and the MCQ by all 33. A total of 18 participants completed the follow-up survey. Analysis showed a significant, positive change in confidence across NLS domains between the pre- and post-course surveys (p &lt;0.0001).The follow-up survey data showed self-reported increases in knowledge and largely sustained confidence. The qualitative analysis revealed themes relating to the participants’ feelings about managing babies born out of hospital.Conclusion: The proof-of-concept OH-NLS course appears to address the learning needs of the target professional group, and the results suggest improved knowledge and confidence in the immediate management of babies born out of hospital. Further evaluation is required to determine whether such training has a long-term impact and translates into improved outcomes across a larger group of participants.

Gas bubble disease in captive Golden Trevally: Pathological insights and needs for life support system and water quality management.

This study aims to elucidate the cause of mass mortality in Golden Trevally Gnathanodon speciosus at an aquarium and reports the first instance of gas bubble disease (GBD) in the species. Identifying the factors leading to this mortality event is intended to propose preventive measures for avoiding similar occurrences in the future. This case study involved the examination of Golden Trevally displaying symptoms of GBD, including abnormal swimming behavior, lethargy, and visible gas bubble formation in the cornea, aqueous humor, and oral mucosa. Necropsy and histopathology were conducted to assess the internal accumulation of gas bubbles in tissues. The etiology was investigated by analyzing the total dissolved gas (TDG) levels and inspecting the integrity of the water circulation system for structural defects. The affected Golden Trevally exhibited significant symptoms of GBD. Necropsy and histopathology confirmed the presence of gas bubbles in various tissues throughout the body. The analysis suggested that TDG supersaturation was caused by excessive microbubble formation due to structural defects in the water circulation system. This case highlights the importance of practical TDG monitoring and maintaining system integrity to prevent GBD in aquaculture. Effective management of TDG levels is crucial to safeguarding the health of captive aquatic species.

Virgin unmarried scientist Elnaz Ghaffari is a volunteer to give birth in space on her space mission design: Ensuring safety during space missions

The title "Virgin, Unmarried Scientist Elnaz Ghaffari is a Volunteer to Give Birth in Space on Her Space Mission Design: Ensuring Safety During Space Missions" compellingly captures the groundbreaking nature of this mission and highlights Elnaz Ghaffari's unique commitment to advancing space science. It not only underscores the scientific and exploratory aspects but also brings a personal touch by mentioning her volunteerism and detailed design for safety. This title is clear, informative, and intriguing—sure to grab attention and spark curiosity about the mission, making it a great choice for communicating the innovative and inspirational goals of the project. The resuscitation and care of a mother-astronaut during space missions present unique challenges that necessitate meticulous planning and precise execution. This article outlines a comprehensive plan for managing maternal cardiopulmonary arrest, addressing critical steps such as high-quality CPR, advanced cardiac life support (ACLS), airway management, and preparation for potential cesarean sections. Additionally, it discusses the importance of fitness, nutrition, and fetal weight control for the mother-astronaut. The presence of a Crew Medical Officer (CMO), who is a trained astronaut with medical expertise, significantly enhances the safety and success of the mission. The article concludes with a detailed overview of the space mission program, emphasizing pre-flight, in-flight, and post-flight activities to ensure the safe return of both mother and neonate to Earth.

The Relationship between Family Support And Quality of Life in Elderly with Dementia

BACKGROUND : The growing number of elderly individuals can result in a decline in physical and mental functioning, which in turn affects the quality of life of the elderly. The family serves as the primary support system for the elderly in maintaining their health. Effective family support can enhance the quality of life of the elderly, enabling them to enjoy a fulfilling life in their later years. OBJECTIVE: to determine the relationship between family support and quality of life in elderly people with dementia. METHOD : This is a quantitative-correlative study design with a cross-sectional design. The analysis test used is chi-square. A total of 73 respondents were sampled for the purposes of data collection. This was achieved by administering two questionnaires: one pertaining to family support and the other to quality of life (Short Form 12). RESULT : The results of this study indicate that the majority of elderly individuals aged 60–74 (69.9%), females (53.4%), reside in the same household as their children (53.4%), work as farm laborers (69.9%), have basic education (72.6%), and have moderate levels of dementia. (50.7%). Having family support shows the moderate category (91.8%), while the quality of life is mostly good (58.9%), with a significance p-value of 0.033. CONCLUSION : There is a significant relationship between family support and quality of life in elderly people with dementia.

Laboratory-based assessment of geotechnical characteristics of organic waste-amended soil for landfill biocover.

A landfill biocover is essential for addressing environmental concerns, especially in waste management, as it plays a crucial role in mitigating the release of methane gas. This study investigates the geotechnical characteristics of soil amended with organic wastes for landfill biocover applications. Various organic waste amendments, viz., rice husk, crushed coconut coir, and compost, were examined at different percentages (0%, 25%, 50%, and 75%) compared with conventional landfill cover material, i.e. natural clay, as biocovers. Laboratory experiments analysed geotechnical characteristics, including organic content, Atterberg limit, compaction, consolidation, and desiccation cracking. The study revealed that organic waste amendment significantly impacted the geotechnical characteristics of landfill biocover, enhancing organic content and porosity and reducing permeability and desiccation susceptibility. Soils amended with organic content support methanotrophic bacteria growth and reduce methane emissions in landfills. The most promising biocovers were identified as 75CR (crushed coconut coir/wastewater sludge/clay in percentage ratio of 70:5:25), followed by 75CT (compost/wastewater sludge/clay in percentage ratio of 70:5:25), and 25RH (rice husk/wastewater sludge/clay in percentage ratio of 20:5:75). Biocovers offer sustainable landfill alternatives, underscoring the need to understand their geotechnical characteristics for successful installation in landfills.

Can a Bayesian approach clarify if corticosteroids are beneficial for severe community-acquired pneumonia?

Despite advances in the antimicrobial treatment of sepsis and organ support in the intensive care unit (ICU), community-acquired pneumonia (CAP) remains a leading cause of mortality and disability-adjusted life years lost globally.1 Severe CAP, where CAP becomes complicated by acute hypoxaemic respiratory failure or shock, is also the most common cause of sepsis, where complex and heterogeneous biological mechanisms underlie a dysregulated inflammatory host response that ultimately leads to major organ dysfunction and death. Along with the emerging threats of respiratory pandemics, antimicrobial resistance, ageing populations and the rise of chronic diseases, much research has been conducted to improve the treatment outcomes of CAP via host immunomodulation. These efforts have focused almost exclusively on anti-inflammatory effects of corticosteroids, which have a proven track record of improving outcomes in other forms of sepsis, such as bacterial meningitis, Pneumocystis jirovecii pneumonia and severe COVID-19.