Unexpected Loss Research Articles

Enhancing survival in cardiac arrest: The urgent need for optimized extracorporeal cardiopulmonary resuscitation implementation and protocols: Editorial

Extracorporeal CPR (ECPR) involves venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients with sudden and unexpected pulse loss due to heart-stopping mechanical activity. ECPR in patients with cardiac arrest has been shown to significantly improve the prognosis. In emergency rooms, interdisciplinary coordination exists among emergency medicine, cardiology, critical care, and perfusion technology. However, some problems must be solved, such as excessive costs, resource allocation, and the need for specialized equipment. Resuscitation success and patient outcomes can be enhanced by combining ECPR and emergency care.

Time series forecasting of rain-induced attenuation using coupled ARIMA-SARIMA models for radio propagation applications over subtropical locations

This present research aimed to identify the optimum model for predicting the rain-induced attenuation along the terrestrial and satellite communication networks and employed the time series forecasting models of Autoregressive integrated moving average (ARIMA) and Seasonal Autoregressive integrated moving average (SARIMA) to examine and contrast several techniques for predicting rain-induced attenuation across a sub-tropical area of South Africa. In this research, the ARIMA was developed using the Box and Jenkins technique to predict long-term rain-induced attenuation in the following South African provinces: Kwazulu-Natal, Eastern Cape, Gauteng, and Northern Cape. The datasets used for the research were obtained from the South African Weather Station from 1994–2023 were used to build and check the model after generating rain-induced attenuation using synthetic storm techniques (SST). The forecasting performance of the seasonal autoregressive integrated moving average (SARIMA) model and that of autoregressive integrated moving average (ARIMA) were compared with four forecast performance measures: - Mean Squared Error (MSE), Mean Absolute Error (MAE), R- squared or the coefficient of determination (R2) and Root Mean Squared Error (RMSE). The results of the study showed that due to its lower forecast performance error indicators, SARIMA performed better than ARIMA in forecasting rain-induced attenuation in South Africa. There is no statistically significant difference between the two projected values, according to the results of a Ljung-box test for significant difference. The authors draw the inference that the two approaches can effectively be employed in their proper locations. Rain-attenuation prediction data indicates that this long-term projection can help decision makers to improve the performance of microwave networks in the face of random fluctuations and avoiding unexpected signal loss with efficient installation of communications infrastructure. It also has applications in prediction of floods, urban planning, and crop management.

Quantification Analysis of Sports Momentum Based on a Multi-Index Approach and TOPSIS

This study quantifies the concept of momentum in sports, inspired by Novak Djokovic's unexpected loss in 2023, and evaluates its impact on game outcomes. Utilizing a structured multi-index approach, we categorized performance into fourteen primary and three secondary indexes. The TOPSIS model enhanced by entropy weighting, along with the Delphi model, was applied for weight assessments of these indexes. Our analysis, incorporating the Mann-Kendall trend test and Spearman correlation coefficient, revealed a significant correlation of 0.51 between momentum and match results, underscoring its pivotal role. The results contribute to a deeper understanding of momentum, enabling coaches to refine strategies and optimize performance based on dynamic changes in momentum. This study provides a comprehensive framework for quantifying momentum, with potential applications extending beyond tennis to other sports where strategic momentum management could influence outcomes.

Health Insurance Provider Selection Through Novel Correlation Measure of Neutrosophic Sets Using TOPSIS

Risk monitoring aims to recognize and control potential threats to our assets or health activities. Insurance is vital, as it compensates for any unexpected loss of property or life. Clients selecting the best health insurance provider must consider various factors and their relative significance to their circumstances. Multi-criteria decision-making (MCDM) helps people analyze and compare policy alternatives to find the best option. This research aims to assist potential health policy purchasers by addressing the selection of health insurance providers as an MCDM problem. The correlation coefficient is useful for identifying the importance of several conflicting criteria. The idea of correlation coefficients is extended in a neutrosophic context to capture the indeterminacy and incomplete information in the relationship among the criteria. The technique for order preference by similarity to an ideal solution (TOPSIS) approach is a useful and straightforward approach to solving MCDM problems. However, it often became ambiguous to researchers due to its involvement in the distance measure technique. The proposed neutrosophic correlation measure may also replace the ambiguity of using a suitable distance measure in the TOPSIS approach. This study extends the TOPSIS method by using the proposed neutrosophic correlation coefficient on single-valued neutrosophic sets (SVNSs). The criteria preferences are computed using a method based on the removal effects of the criteria (MEREC) approach. Some valuable concepts, like the weighted closeness measure of type I and type II and the weighted index parameter, are introduced with their properties to establish the proposed neutrosophic TOPSIS approach. An MCDM approach for health insurance providers has been constructed to illustrate the proposed approach numerically. The proposed method suggest that the health insurance provider ϒ2 is the most beneficial alternative, whereas ϒ1 is the least suitable. The client considers the terms and conditions for non-coverage and the facilities provided for pediatric and maternity care while buying health insurance. The comparative analysis of the suggested technique demonstrates the merit of the research in terms of consistency. The sensitivity analysis demonstrates the flexibility and robustness of the obtained results.

Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study (update)

ObjectiveTo quantify the predictive value of unexpected weight loss for cancer according to patient’s age, sex, smoking status, and concurrent clinical features (symptoms, signs, and abnormal blood test results).DesignDiagnostic accuracy...

RETRACTION: Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study

RETRACTION: Prioritising primary care patients with unexpected weight loss for cancer investigation: diagnostic accuracy study

The Holiday Card.

Dr Vater shares about processing the unexpected loss of a patient and how a colleague unknowingly helped her cope.

Perry Disease: Current Outlook and Advances in Drug Discovery Approach to Symptomatic Treatment.

Perry disease (PeD) is a rare, neurodegenerative, genetic disorder inherited in an autosomal dominant manner. The disease manifests as parkinsonism, with psychiatric symptoms on top, such as depression or sleep disorders, accompanied by unexpected weight loss, central hypoventilation, and aggregation of DNA-binding protein (TDP-43) in the brain. Due to the genetic cause, no causal treatment for PeD is currently available. The only way to improve the quality of life of patients is through symptomatic therapy. This work aims to review the latest data on potential PeD treatment, specifically from the medicinal chemistry and computer-aided drug design (CADD) points of view. We select proteins that might represent therapeutic targets for symptomatic treatment of the disease: monoamine oxidase B (MAO-B), serotonin transporter (SERT), dopamine D2 (D2R), and serotonin 5-HT1A (5-HT1AR) receptors. We report on compounds that may be potential hits to develop symptomatic therapies for PeD and related neurodegenerative diseases and relieve its symptoms. We use Phase pharmacophore modeling software (version 2023.08) implemented in Schrödinger Maestro as a ligand selection tool. For each of the chosen targets, based on the resolved protein-ligand structures deposited in the Protein Data Bank (PDB) database, pharmacophore models are proposed. We review novel, active compounds that might serve as either hits for further optimization or candidates for further phases of studies, leading to potential use in the treatment of PeD.

Analysis of solar absorption, degradation mechanism and thermal stability in air environments for SS/TiB2/Al2O3 spectrally selective absorber coating

The quest for high solar-thermal conversion efficiency and thermal stability is a significant challenge in the development of high-efficiency spectrally selectivity absorber coatings. A key aspect of this challenge is the creation of air-stabilized coatings, particularly crucial for scenarios involving unexpected vacuum loss or applications of concentrating solar power systems in air environments. In our study, TiB2 films own excellent spectral selectivity and thermal stability at air environment. In pursuit of revealing the absorption mechanism of the coating, the optical constants, absoption and transmission of the single TiB2 layer were measured. The result of analysis display that the TiB2 layer contribute the bulk of the sunlight absorption. Reflectance spectra of the SS/TiB2/Al2O3 coating was succeeding simulated by CODE software with the optical constant to fit the experimental spectra, which confirms the results obtained by spectroscopic ellipsometry. The solar-thermal conversion efficiency of the as-deposited coating could reach 88.9 % of 100 suns at 500 °C. After annealing at 300–500 °C, the absorbance and emittance of the coating change slightly. But after annealing at 600 °C, the changing surface morphology, increasing surface roughness, and oxidation reaction of TiB2 resulted in a decrease in the optical performance of the coating.

Meaning-making in psychotherapy after traumatic loss: therapists’ perspectives

ABSTRACT Sudden, unexpected loss can be particularly devastating for the bereaved as they struggle to make sense of their loss. We interviewed 11 therapists who specialized in loss/trauma about how each of them helped one client make meaning after a traumatic loss. Data, analyzed using Consensual Qualitative Research (CQR), revealed that the traumatic loss had negatively impacted clients’ relationships, mental health, and beliefs/religion/spirituality; therapists utilized a range of interventions to facilitate meaning-making, including supporting clients through the grief process, as well as helping them experience/regulate emotion and change their narratives around the loss; clients made meaning in diverse ways that could be broadly categorized under meaning-as-comprehensibility and meaning-as-significance; and clients experienced positive adjustment (in mental health, relationships, etc.) through the meaning-making work. Implications for counseling psychology research and practice are discussed.

Social, economic and food insecurity among people living with HIV in Kenya during coinciding public health and environmental emergencies: a mixed-methods study

IntroductionDuring the COVID-19 response, Kenya experienced widespread regional floods, resulting in the displacement of communities and agricultural loss. This study aimed to characterise food insecurity and other social and economic...

Family Coping With COVID-19: Unexpected Parental Loss and Surviving Parent Coping, Grief and Posttraumatic Growth Outcomes Based on Child Age.

Guided by the conceptual framework of widowed parenting, the current study takes a relational approach to understand more about how the characteristics of parents of young and adult children relate to coping following the unexpected death of a partner due to COVID-19, and how these variables predict complicated grief and posttraumatic growth. A sample of 81 widowed parents completed self-report measures examining parenting self-efficacy, relationship uncertainty, coping, complicated grief, and posttraumatic growth. Results of hierarchical regression analyses suggest that, when controlling for time since death (1) relationship uncertainty and avoidant coping significantly predict complicated grief for parents in the sample with adult children, and (2) widowed parenting self-efficacy and both problem-focused and emotion-focused coping significantly predict posttraumatic growth for parents in the sample with young children. Results of the current study may inform future practices (e.g., use of Emotionally Focused Family Therapy) to aid families grieving an unexpected loss.

Risk Factors of Prolonged Grief Disorder.

Prolonged Grief Disorder (PGD) is characterized by extensive yearning, which includes a strong desire, for the deceased that occurs for at least 12 months. The aim of this study was to identify risk factors that contribute to PGD including the type of loss, relationship to the deceased, and coping. The sample included 190 bereaved adults (71 unexpected or violent loss and 119 natural loss) that experienced the loss of a loved one at least 12 months prior to completing the survey used in this study. There were non-significant results for type of loss, the presence of PGD, and coping. Findings showed that dysfunctional coping including self-blame explained the presence of PGD. Closeness to the deceased prior to the loss contributed to the presence of PGD. The findings highlight the risk factors for adults that experience a presence of PGD.

Enhanced Carbon Flux Response to Atmospheric Aridity and Water Storage Deficit During the 2015–2016 El Niño Compromised Carbon Balance Recovery in Tropical South America

AbstractDuring the 2015–2016 El Niño, the Amazon basin released almost one gigaton of carbon (GtC) into the atmosphere due to extreme temperatures and drought. The link between the drought impact and recovery of the total carbon pools and its biogeochemical drivers is still unknown. With satellite‐constrained net carbon exchange and its component fluxes including gross primary production and fire emissions, we show that the total carbon loss caused by the 2015–2016 El Niño had not recovered by the end of 2018. Forest ecosystems over the Northeastern (NE) Amazon suffered a cumulative total carbon loss of ∼0.6 GtC through December 2018, driven primarily by a suppression of photosynthesis whereas southeastern savannah carbon loss was driven in part by fire. We attribute the slow recovery to the unexpected large carbon loss caused by the severe atmospheric aridity coupled with a water storage deficit during drought. We show the attenuation of carbon uptake is three times higher than expected from the pre‐drought sensitivity to atmospheric aridity and ground water supply. Our study fills an important knowledge gap in our understanding of the unexpectedly enhanced response of carbon fluxes to atmospheric aridity and water storage deficit and its impact on regional post‐drought recovery as a function of the vegetation types and climate perturbations. Our results suggest that the disproportionate impact of water supply and demand could compromise resiliency of the Amazonian carbon balance to future increases in extreme events.

A scoping review of unexpected weight loss and cancer: risk, guidelines, and recommendations for follow-up in primary care.

Cancer diagnoses often begin with consultations with general practitioners (GPs), but the nonspecific nature of symptoms can lead to delayed diagnosis. Unexpected weight loss (UWL) is a common nonspecific symptom linked to undiagnosed cancer, yet guidelines for its diagnostic assessment in general practice lack consistency. To synthesise evidence on the association between UWL and cancer diagnosis, and to review clinical guidelines and recommendations for assessing patients with UWL. Systematic search and analysis of studies conducted in primary care. Four databases searched for peer-reviewed literature from 2012 to 2023. Two reviewers conducted all the steps. A narrative review was conducted detailing the evidence for UWL as a risk factor for undiagnosed cancer, existing clinical guidance, and recommended diagnostic approach. We included 25 studies involving 916,092 patients; 92% provided strong evidence of an association between UWL and undiagnosed cancer. The National Institute for Health Care and Excellence Cancer Guideline in the UK was frequently cited. General suggestions encompassed regular weight monitoring, family history, risk factor evaluation, additional signs and symptoms, and a comprehensive physical examination. Commonly recommended pathology tests included C-reactive protein, complete blood count, alkaline phosphatase, and thyroid-stimulating hormone. Immunochemical faecal occult blood test, abdominal ultrasound, and chest X-ray were also prevalent. One large cohort study provided age, sex, and differential diagnosis-specific recommendations. This evidence review informs recommendations for investigating patients with UWL and will contribute to a computer decision support tool implementation in primary care, enhancing UWL assessment and potentially facilitating earlier cancer diagnosis.

Full-operating-temperature tensile mechanisms of [111] oriented single-crystal superalloy: New intermediate temperature toughening behavior against ductility losing

Single crystal (SX) superalloys are required for full-operating-temperature mechanical properties. However, the quest for intermediate temperature (IT) resistance often encounters a perplexing phenomenon: anomalous yielding behavior coupled with an unexpected loss of ductility. This study delved into the tensile behavior of a [111]-oriented SX superalloy from room temperature (RT) to 1150 °C, uncovering temperature-dependent tensile mechanisms where the interplay among phases and deferent defects governs plastic deformation. Desirable high strength-ductility properties were observed at IT, showcasing comparable strength with increased ductility. Microstructural evidences show that the primary strengthening effects stem from coupled interface boundary strengthening and anti-phase boundary (APB) strengthening, while the plasticity arises from planer defects transitioning from the stacking fault (SF) within γ phase at small strains, to superlattice SFs, ultimately to the erasure of superlattice SFs, leaving cutting dislocation pairs in γʹ phase. Energy analysis of APB and SF, along with adherence to Schmid laws, reinforce the plausibility of such intricate defect interactions. The strength-ductility balance can be ascribed to the collective effect of preferentially generated dislocations and prompt formation of SF. This strategy of sequential defects’ competition provides a new route for solving the strength-ductility trade-off of alloys.

EPM2AIP1 immunohistochemistry is inadequate as a surrogate marker for MLH1 promoter hypermethylation testing in colorectal cancer

MLH1 promoter hypermethylation (MPH) analysis is an essential step in the universal tumor testing algorithm for Lynch syndrome, the most common inherited predisposition to colorectal cancer (CRC). MPH usually indicates sporadic CRC. EPM2AIP1 gene shares the same promoter as MLH1, therefore MPH should also silence EPM2AIP1 transcription leading to loss of protein expression on immunohistochemistry (IHC). It has been previously reported that EPM2AIP1 IHC can be used as a surrogate for MPH in endometrial cancer. Our goal was to evaluate the feasibility of EPM2AIP1 IHC as a surrogate for MPH in CRC. 101 microsatellite instable CRC cases were selected, including 19 cases from whole tumor sections and 82 cases from tissue microarrays. 74 cases were with MPH and 27 without MPH. All 74 cases with MPH showed absent MLH1 by IHC, but only 47 (64%) exhibited loss of expression of EPM2AIP1. Of the 27 cases without MPH, 9 (33%) cases had unexpected loss of EPM2AIP1 expression. Of note, 10 cases were MLH1-mutated Lynch syndrome without MPH, and 2 of these cases showed unexpected loss of EPM2AIP1 staining. Of the 6 cases with double somatic mutations of MLH1 gene (without MPH), only 4 cases demonstrated intact expression of EPM2AIP1 as expected. Taken together, EPM2AIP1 loss was 64% sensitive and 67% specific for MPH, with an accuracy of 64%. We conclude that, unless stain quality improves with different clones or platforms, EPM2AIP1 IHC will likely not be useful as a surrogate test for MPH in CRC.

Vision loss associated with silicone oil endotamponade in vitreoretinal surgery - a review.

To clarify the definition, prevalence and classification of different types of unexplained vision loss associated with silicone oil (SO) endotamponades (SO in situ (SOIS) or after removal of SO (ROSO)) in vitreoretinal surgery and identifying the most specific clinical findings and suggesting possible causes. Review of the literature regarding randomized clinical trials (RCTs), retrospective case-control, cohort studies and case series evaluating the risk of using SO, published in English between 1994 and 2023, conducting a computer-based search of the following databases: PubMed, Web of Science, Scopus and Embase. The search was supplemented using the Medline option 'Related Articles' and consulting review articles on the topic. Findings from reported clinical examinations in SOIS and ROSO are analyzed and finally different theories regarding the underlying pathophysiology are described. From the clinical point of view, findings have been found in OCT, OCTA, microperimetry and electrophysiological studies. Other clearly identifiable causes of vision loss related to the use of SO are listed and commented as differential diagnosis. Finally, the different physiopathological theories of the two types of causes of unexplained vision have been analyzed. Unexpected vision loss under or after SO tamponade (SOIS and ROSO) is a significant concern which is probably underestimated because it is not a clearly defined and known entity. The most frequently described changes were in the ganglion cell complex but this unexpected vision loss remains a serious and unexplained concern for vitreoretinal surgeons and should be identified by clinicians, addressed by manufacturers and reported to Health Authorities as a serious incident according to the new regulation.

An accelerated emergence of the self during the coronavirus (COVID-19) pandemic: a hermeneutic phenomenological analysis

ABSTRACT While research within positive psychology has demonstrated the potential for growth and flourishing when facing adversity, experiences of psychological growth during the coronavirus (COVID-19) pandemic have not yet been investigated. A hermeneutic phenomenological approach was used to explore the meaning and experience of personal growth and transformation during the COVID-19 first lockdown phase. Semi-structured interviews, with 49 adults between the ages of 20 and 58 occurred. Five themes emerged across participants: (1) pre-pandemic life as functionally complacent (2) the unexpected loss of coping strategies and familiar rhythms due to lockdown, (3) choice to engage with emotion and discomfort as a means to experience growth, (4) discovering and embracing an authentic sense of self, and (5) integration of the growth through sharing with others. Participants reported that participating in the interview itself was growth-enhancing. The findings of the study are discussed in light of existing AEDP (Accelerated Experiential Dynamic Psychotherapy) theory.

The Short-Run Effects of Unexpected Job Loss on Health

The Short-Run Effects of Unexpected Job Loss on Health