Azimuth axis optical alignment system Final report

Azimuth axis optical alignment system to monitor and measure attitude or angular position of remote object about azimuth axis using phase information imposed on returning beam of ligh

Frequency of Aspirating Gastric Tubes for Patients Receiving Enteral Nutrition in the ICU: A Randomised Controlled Trial

Background: Enteral nutrition (EN) tolerance is often monitored by aspirating stomach contents by syringe at prescribed intervals. No studies have been conducted to assess the most appropriate time interval for aspirating gastric tubes. We compared gastric tube aspirations every 4 hours (usual care) with a variable regimen (up to every 8 hours aspirations).Methods: This randomized controlled trial (RCT) enrolled patients who stayed in the intensive care unit (ICU) for >48 hours, had a gastric tube, and were likely to receive EN for 3 or more days. Patients were randomized (computer-generated randomization) to either the control (every 4 hours) or intervention group (variable regimen). The primary outcome was number of gastric tube aspirations per day from randomization until EN was ceased or up to 2 weeks postrandomization.Results: Following Institutional Ethics Committee approval, 357 patients were recruited (control group, n = 179; intervention group, n = 178). No differences were found in age, sex, worst APACHE II score, or time to start of EN. In the intention-to-treat analysis, the intervention group had fewer tube aspirations per day (3.4 versus 5.4 in the control group, P < .001). Vomiting/regurgitation was increased in the intervention group (2.1% versus 3.6%, P = .02). There were no other differences in complications.Conclusion: This is the first RCT to examine the frequency of gastric tube aspirations. The frequency of gastric tube aspirations was reduced in the variable-regimen group with no increase in risk to the patient. Reducing the frequency of aspirations saves nursing time, decreases risk of contamination of feeding circuit, and minimizes risk of body fluid exposure

LGBTQIA+ inclusion in the global health policy agenda: A critical discourse analysis of the Lancet Commission report archive

Copyright: \ua9 2024 Rosa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. CONTEXT: LGBTQIA+ people worldwide experience discrimination, violence, and stigma that lead to poor health outcomes. Policy plays a crucial role in ensuring health equity and safety for LGBTQIA+ communities. Given Lancet Commissions\u27 substantial impact on health policy across domains, we aimed to determine how LGBTQIA+ communities and their care needs are incorporated throughout Lancet Commission reports and recommendations. METHODS: Using critical discourse analysis, we analyzed 102 Commissions for inclusion of and reference to LGBTQIA+ communities using 36 key terms. Three levels of analysis were conducted: 1) micro-level (overview of terminology use); 2) meso-level (visibility and placement of LGBTQIA+ references); and 3) macro-level (outlining characterizations and framing of references with consideration of broader social discourses). FINDINGS: 36 of 102 (35%) Commissions referenced LGBTQIA+ communities with 801 mentions in total. There were minimal (9/36) references made in the "Executive Summary," "Recommendations," and/or "Key Messages" sections of reports. LGBTQIA+ communities were most frequently discussed in reports related to HIV/AIDS and sexual and reproductive health. Few Commissions related to public health, or chronic conditions (9/60) referenced LGBTQIA+ communities. Some reports made non-specific or unexplained references; many discussed the LGBTQIA+ population without specific reference to sub-groups. LGBTQIA+ communities were often listed alongside other marginalized groups without rationale or a description of shared needs or experiences. We identified framings (legal, vulnerability, risk) and characterizations (as victims, as blameworthy, as a problem) of LGBTQIA+ communities that contribute to problematizing discourse. CONCLUSIONS: LGBTQIA+ people were rarely included in the Commissions, resulting in an inadvertent marginalization of their health needs. Policy initiatives must consider LGBTQIA+ groups from a strengths-based rather than problematizing perspective, integrating evidence-based approaches alongside community-based stakeholder engagement to mitigate inequities and promote inclusive care and policymaking

The incidence of ventilator-associated pneumonia using the PneuX System with or without elective endotracheal tube exchange: A pilot study

<p>Abstract</p> <p>Background</p> <p>The PneuX System is a novel endotracheal tube and tracheal seal monitor, which has been designed to minimise the aspiration of oropharyngeal secretions. We aimed to determine the incidence of ventilator-associated pneumonia (VAP) in patients who were intubated with the PneuX System and to establish whether intermittent subglottic secretion drainage could be performed reliably and safely using the PneuX System.</p> <p>Findings</p> <p>In this retrospective observational study, data was collected from 53 sequential patients. Nine (17%) patients were initially intubated with the PneuX System and 44 (83%) patients underwent elective exchange to the PneuX System. There were no episodes of VAP while the PneuX System was <it>in situ</it>. On an intention to treat basis, the incidence VAP was 1.8%. There were no complications from, or failure of, subglottic secretion drainage during the study.</p> <p>Conclusions</p> <p>Our study demonstrates that a low incidence of VAP is possible using the PneuX System. Our study also demonstrates that elective exchange and intermittent subglottic secretion drainage can be performed reliably and safely using the PneuX System.</p

The health effects associated with physical, sexual and psychological gender-based violence against men and women:a Burden of Proof study

The health impacts of exposure to physical, sexual or psychological gender-based violence (GBV) against men and women are substantial yet not well delineated. We systematically reviewed and meta-analysed 40 studies to evaluate the associations between GBV (including but not limited to intimate partner violence) and eight health outcomes: sexually transmitted infections excluding HIV, maternal abortion and miscarriage, HIV/AIDS, major depressive disorder, anxiety disorders, drug use disorders, alcohol use disorders and self-harm. Using the Burden of Proof methods, we generated conservative metrics of association-including star ratings from one to five-reflecting both effect size and evidence strength. Sexual violence was associated with six outcomes, with moderate, three-star evidence of association for sexually transmitted infections, maternal abortion and miscarriage, and major depressive disorder-increasing the risk by at least 104%, 101% and 50%, respectively. Seven outcomes were associated with physical GBV with two- or one-star associations, reflecting weak associations and/or inconsistent evidence. Of the four health outcomes analysed in relation to psychological GBV, one, major depressive disorder, had a significant association with a one-star rating. These findings emphasize the serious health consequences of GBV for survivors and the necessity of additional data to further our understanding of this complex public health issue.</p

Health effects associated with exposure of children to physical violence, psychological violence and neglect:a Burden of Proof study

The health toll of child maltreatment or violence against children (VAC) has not yet been comprehensively evaluated. Here, in our systematic review and meta-analyses, we focused on the health impacts of physical violence, psychological violence and neglect during childhood. Utilizing the Burden of Proof methodology, which generates conservative measures of association while accounting for heterogeneity between input studies, we evaluated 35 associations between VAC and adverse health outcomes, identifying 27 statistically significant links. The associations between physical violence and major depressive disorder, ischaemic heart disease, alcohol use disorder, eating disorders and drug use disorders were rated as moderately weak, reflecting a small effect size and/or inconsistent evidence. The minimum increased risk ranged from 16% for depression to 2% for drug use disorders. Psychological violence showed similar moderately weak associations with drug use disorders (8% minimum risk increase), migraine (7%) and gynaecological diseases (2%). Neglect was linked to at least a 15% increased risk for anxiety disorders. The other 18 associations were weaker due to smaller effect sizes and/or less consistent evidence. Despite the limitations of the existing evidence, our analysis highlights substantial health impacts for VAC survivors, underscoring the need for health system prioritization and continued efforts to eliminate all forms of VAC.</p

Relationship between human tumour angiogenic profile and combretastatin-induced vascular shutdown: an exploratory study

Combretastatin-A4-phosphate (CA4P) acts most effectively against immature tumour vasculature. We investigated whether histological angiogenic profile can explain the differential sensitivity of human tumours to CA4P, by correlating the kinetic changes demonstrated by dynamic MRI (DCE-MRI) in response to CA4P, with tumour immunohistochemical angiogenic markers. Tissue was received from 24 patients (mean age 59, range 32–73, 18 women, 6 men). An angiogenic profile was performed using standard immunohistochemical techniques. Dynamic MRI data were obtained for the same patients before and 4 h after CA4P. Three patients showed a statistically significant fall in Ktrans following CA4P, and one a statistically significant fall in IAUGC60. No statistically significant correlations were seen between the continuous or categorical variables and the DCE-MRI kinetic parameters other than between ang-2 and Ktrans (P=0.044). In conclusion, we found no strong relationships between changes in DCE-MRI kinetic variables following CA4P and the immunohistochemical angiogenic profile

Health effects associated with exposure to intimate partner violence and childhood sexual abuse:A Burden of Proof study

The health impacts of intimate partner violence against women and childhood sexual abuse are not fully understood. Here we conducted a systematic review by comprehensively searching seven electronic databases for literature on intimate partner violence-associated and childhood sexual abuse-associated health effects. Following the burden of proof methodology, we evaluated the evidence strength linking intimate partner violence and/or childhood sexual abuse to health outcomes supported by at least three studies. Results indicated a moderate association of intimate partner violence with major depressive disorder and with maternal abortion and miscarriage (63% and 35% increased risk, respectively). HIV/AIDS, anxiety disorders and self-harm exhibited weak associations with intimate partner violence. Fifteen outcomes were evaluated for their relationship to childhood sexual abuse, which was shown to be moderately associated with alcohol use disorders and with self-harm (45% and 35% increased risk, respectively). Associations between childhood sexual abuse and 11 additional health outcomes, such as asthma and type 2 diabetes mellitus, were found to be weak. Although our understanding remains limited by data scarcity, these health impacts are larger in magnitude and more extensive than previously reported. Renewed efforts on violence prevention and evidence-based approaches that promote healing and ensure access to care are necessary