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The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
The only randomized trial comparing the efficacy of disulfiram against placebo showed no differences in recovery time of alcohol consumption or total abstinence. Moreover, even if the potentially dangerous side effects are rare, their risks overcome the hypothetical benefits. Therefore, in December 2007 the division of addictology, department of psychiatry, decided to stop Disulfiram prescription. The healthcare team's perception of this decision was monitored.
An auto questionnaire (31 questions) was administered to the healthcare team in June 2009 for a 3 month period evaluating their perception of the utility of Disulfiram and of the pertinence of the decision.
Professions: 54.8% nurses, 30.6% MD, 9.7% social workers, 4.8% psychologists.
78.7% participants already worked in the team in December 2007.
54.6% didn’t agree to stop Disulfiram prescription. While 72.2% think that the decision is based on evidence based medicine, 69.1% think that Disulfiram works because of the context of administration and 69.1% think it works because of the fear generated by its effects, 75.5% still believe that Disulfiram is useful for some patients (76.8% at the time of the decision).
Despite the fact that aversive treatments in addictology have failed to demonstrate an efficacy through EBM, the perception of its utility is still strong in caregivers. While most of them admit that it works mainly trough psychological constraints, they don’t support the fact that EBM could generate a practice change such as stopping Disulfiram prescription.
To evaluate the long-term safety and efficacy of adjunctive aripiprazole (ARI) to lithium (LI) or valproate (VAL) in delaying time to relapse in bipolar I disorder.
Bipolar I disorder subjects with a current manic or mixed episode received LI or VAL for at least 2 weeks; inadequate responders (YMRS score ≥ 16 and ≤35% decrease from baseline at 2 weeks) received adjunctive ARI. Subjects maintaining mood stability (YMRS and MADRS ≤ 12 for 12 consecutive weeks) were randomised 1:1 to double-blind ARI (10 to 30 mg/day) or placebo (PBO) plus LI or VAL. Relapse was monitored up to 52 weeks.
337 subjects were randomised to continuation of mood stabiliser plus adjunctive ARI or PBO; 61.3% and 52.7%, respectively, completed the study. Adjunctive ARI significantly delayed the time to any relapse, hazard ratio = 0.544 (95% CI: 0.33, 0.89, log-rank p = 0.014). Overall relapse rates at 52 weeks were 14.9% and 25.4% in ARI vs PBO subjects. A superior reduction in CGI-BP Mania Severity of Illness from baseline at 52 weeks was also observed (0.3 vs. 0.0, respectively, p = 0.01). Adverse events generally were as expected per known drug and illness profiles with no significant difference in mean change in body weight between adjunctive PBO (0.60 kg) and adjunctive ARI (1.07 kg) (p = 0.49 Week 52, LOCF).
Continuation of aripiprazole treatment increased time to relapse to any mood episode compared with placebo plus LI/VAL over 1 year, indicating a long-term benefit in continuing adjunctive aripiprazole to a mood stabiliser after sustained remission is achieved.
Psychological distress and suicide are known to be associated with exposure to traumatic life events. No literature is available on prevalence of suicidal ideation in the aftermath of terrorist attacks in Pakistan.
To study suicidal ideation and desire for death in trauma exposed population in Pakistan.
To estimate the prevalence of suicidal ideation and desire for death one year after exposure to extreme trauma in a well-defined and accessible group in Pakistan.
Subjects were examined 1 year after exposure to a bomb blast in Islamabad, Pakistan. A semi-structured interview schedule and Beck Scale for Suicidal Ideation were used to assess a group of female University students. Assessment record of 50 consecutive study participants were evaluated to estimate point prevalence of suicidal ideation and desire for death in the study population.
All subjects were enroled in full time university education at the time of assessment. 17 subjects (34%) presented with weak desire for death whilst 5 subjects (10%) presented with moderate to severe desire for death. 15 Subjects (30%) presented with active suicidal ideation at the time of assessment. However, ony 3 subjects (6%) presented with moderate to severe suicidal ideation. The subjects presenting with suicidal ideation described family ties, religious beliefs, fear of irreversible injury as protective factors against their suicidal thoughts. Only 2 subjects (4%) had engaged in some degree of planning towards committing suicide.
This study provides the first structured estimate of prevalence of suicidal ideation in trauma exposed population of Pakistan.
Severe stress or exposure to life threatening trauma is known to affect social functioning and quality of life.
To study well-being and anger arousal as markers of social functioning and quality of life in a group of University students exposed to a suicide bomb attack on a University in Pakistan.
To examine indicators of social functioning in order to higlight them as targets for therapeutic interventions.
Subjects were assessed after one year of exposure to a life threatening incident on University campus. Subjects completed an assessment schedule incorporating World Health Organization's Well-Being Index and Novarco Anger Inventory (25 items).
54 students completed the assessment. The mean age of the group was 24 years. All subjects had completed 14–16 years of education and were in full time education at the time of assessment. The Well Being Index Score range was 1–24 with 26 sujects scoring 13 or lower scores indicating poor quality of life. 29 subjects scored higer levels of anger arousal on 10 or more items of Novarco Anger Inventory indicating difficulties in social functioning. The overall group showed a statistically significant negative correlation between the Well-Being Index Scores and the number of Novarco Anger Inventory items scored in the two highest categories of anger arousal.
The results of the study highlight anger arousal and well-being as important markers of functioning in the aftermath of a stressful life event. The study confirms their usefulness as legitimate therapeutic targets for pharmacotherapy, psychotherapeutic, and social interventions.
Ego defense mechanisms, defined by Freud as unconscious resources used by the ego to reduce conflict between the id and superego, are a reflection of how an individual deals with conflict and stress. Vaillants’ proposed Hierarchy of Defenses states that mature defenses are associated with better adaptive functioning and health, as opposed to immature defense which are correlated negatively with measures of adaptive adult functioning.
This study assesses the prevalence of various ego defense mechanisms employed by medical students of Karachi, which is a group with higher stress levels than the general population.
A questionnaire based cross-sectional study was conducted on 682 students from five major medical colleges of Karachi in November 2006. Ego defense mechanisms were assessed using the Defense Style Questionnaire(DSQ-40) individually and as grouped under Mature, Immature, and Neurotic factors.
Neurotic defenses had a higher mean score(5.62) than Mature(5.60) and Immature(4.78) mechanisms. Immature mechanisms were more commonly employed by males whereas females employed more Neurotic mechanisms than males. Neurotic and Immature defenses were significantly more prevalent in first and second year students. Mature mechanisms were significantly higher in students enrolled in Government colleges than Private institutions (p< 0.05).
Neurotic mechanisms are more commonly encountered than Mature or Immature mechanisms among medical students of Karachi, and this could reflect greater stress levels than the general population. Employment of these mechanisms was associated with female gender, enrollment in a private medical college, and students enrolled in the first 2 years of medical school.
The northern area of Pakistan is hosting the terrorist actively involved in terrorism across the country and in neighboring country of Afghanistan. Government with support of international community initiated a war against terrorism which resulted in migration of huge number of population in the effected areas which was accommodated in refugee camps mainly established in Khyber Pukhtun Kha province.
To assess the extent of psychological impact on IDP's residing in the camps of Shahmansoor
The sample of the study was taken from the Shahmansoor camp, Swabi and was comprised of 200 individuals, including equal number of males and females. Random sampling was used in data collection. The age ranges from 18–80 years and literacy rate was estimated from illiterate people to master's level, Study tools included standardized psychological tests i.e. Pak anxiety and depression scale, and Bradford somatic inventory along with that clinical observation and interviews were also conducted. Findings of the study comprise of both qualitative and quantitative methods.
Majority of the IDP's were diagnosed as having the symptoms of Somatization, along with that depression, PTSD, ASD, anxiety and insomnia also predominates.
Leaving homes and migration to camps is actually a traumatic experience. Many people felt helpless in the current situation and they were hopeless about their future, lost their confidence in proper planning for their future and the flashback of the traumatic experience tortured them. Consequently, refugee residing in camps faced multiple problems which resulted in multiple psychological problems.
Similarly to other European countries, binge drinking among adolescents has become a major health issue in Switzerland. In order to better assess and orientate adolescents admitted to Pediactric Emergency Unit for alcohol intoxication, the Department of Pediatry and de Division of Substance Abuse of the University Hospitals of Geneva have implemented since 2006 an addiction-liaison team.
12 consecutively admitted patients (age 14-15, 6 girls) were assessed regarding to sociodemographic characteristics, familial context, alcohol consumption history and preferred drink.
For all 12 patients, the beverage leading to the intoxication (3 cases of coma) was vodka, in two cases mixed with nonalcoholic drinks. Four patients lived in an unstable familial context (divorce, separation), and one patient was adopted.
While selling Vodka (and other spirits) to persons under 18 is illegal in Switzerland, it was the preferred beverage of adolescents admitted for alcohol intoxication to a Pediatric Emergency Unit, confirming data from other countries. One of the reasons vodka is the preferred alcohol in these patients may be that it has the less telltale odor of the common spirits.
Comorbidity between ED and depression is high. Causal relation between two is bidirectional. Person with ED can have MDD because of psychological factors. MDD symptoms and associated hypogonadism affect on libido and erectile function. Diseases like ankolysing spondolysis, asthma, rheumatoid arthritis, coronary heart disease, psoriasis, diabetes, and multiple sclerosis have strong co morbid ED and MDD. Inflammation is common overlapping factor in these illnesses.
An internet search was made on pubmed, and psychiatrist.com, using key words, major depression, endothelial dysfunction, inflammation, erectile dysfunction, and cytokines. This was followed by study of relevant martial in different journal and books.
Men with ED had high levels of depressive, somatic, and anxious symptoms. Approximately one-third of people with MDD had higher levels of peripheral inflammatory marker. Incidences of ED are two fold higher in depressed people as compared with nondepressed.
Levels of pro inflammatory cytokine like IL-1,I patient L-6,TNF,CRP, interferon-gamma and homosystien are raised in MDD. Cytokines effect on the HPA axis, glucocorticoid resistance, neurotransmission and hippocampal neurogenesis. Patients treated with interferon have higher risk of developing MDD .Antidepressant therapy results in decreased inflammatory response.
Erectile function depends on integrity of endothelium which is target of inflammation. Endothelial dysfunction is linked to ED as they share a common pathway through the release of nitric oxide. Proinflammatory cytokines and homosystien play role, both in ED and MDD.
Inflammation and its markers need to be considered in cases of co morbid ED and MDD.
Many time people get addicted to a drug like opiods when prescribed for some medical purpose. Neurobiological models of addiction has proposed cellular adaptation as mechanism of drug addiction. Excessive release of dopamine in NA due to drug intake produces euphoric sensation leading to pathological learning. Repeated use of drug increase glutametergic drive from prefrontal to NA cause compulsive seeking of drug in drug addicts. Is it possible to prevent medically induced addiction.
Pub med search was made by using key words, addiction model, dopamine, glutamate, anticraving medicine, oxidative stress.
Different antiglutametergic medication like ketamine, mementine, accomprosate modulate glutamatic excitation to prevent addiction. Natural medicine like N acetyle cystine and oxytocin have protective role . Typical antipsychotic can block surge of dopamine in NA.
When addictive drug has to be used inevitably for medical purpose it should be combined with other drugs to prevent development of addiction. First euphoria related to dopamine release in NA can be blocked by use of low dose typical antipsychotic or dopamine partial antagonist . NMDA is molecular target of various addictive drugs. Memtentine, ketamine or accomprosate can minimize effects of glutametergic plasticity. N accetyle cystine can restore glutamatergic pathway by its system of cystine- glutamate antiporter. It is source of glutathione largest anti oxidant system of body. Intranasal oxytocin can prevent addiction through its action on stress, learning, memory and intimacy. Intranasal oxytocin can be delivered directly to the brain.
Different strategies can be used to prevent medically induced addiction.
Multimorbidity may impose an overwhelming burden on patients with psychosis and is affected by gender and age. Our aim is to study the independent role of familial liability to psychosis as a risk factor for multimorbidity.
We performed the study within the framework of the Genetic Risk and Outcome of Psychosis (GROUP) project. Overall, we compared 1024 psychotic patients, 994 unaffected siblings and 566 controls on the prevalence of 125 lifetime diseases, and 19 self-reported somatic complaints. Multimorbidity was defined as the presence of two or more complaints/diseases in the same individual. Generalized linear mixed model (GLMM) were used to investigate the effects of gender, age (adolescent, young, older) and familial liability (patients, siblings, controls) and their interactions on multimorbidity.
Familial liability had a significant effect on multimorbidity of either complaints or diseases. Patients had a higher prevalence of multimorbidity of complaints compared to siblings (OR 2.20, 95% CI 1.79–2.69, P < 0.001) and to controls (3.05, 2.35–3.96, P < 0.001). In physical health multimorbidity, patients (OR 1.36, 95% CI 1.05–1.75, P = 0.018), but not siblings, had significantly higher prevalence than controls. Similar finding were observed for multimorbidity of lifetime diseases, including psychiatric diseases. Significant results were observed for complaints and disease multimorbidity across gender and age groups.
Multimorbidity is a common burden, significantly more prevalent in patients and their unaffected siblings. Familial liability to psychosis showed an independent effect on multimorbidity; gender and age are also important factors determining multimorbidity.
Oxleas NHS Foundation Trust has run a Court Diversion Service in South East London since 1991. It provides services for people within the earlier stages of the Criminal Justice System.
This evaluation aims to combine data from across the 25-year period since the introduction of the diversion scheme. It seeks to provide a longitudinal picture to elucidate the impact of service changes during this time.
The evaluation uses data obtained from a variety of sources for four points in time: 2015/2016, 2011, 1999 and 1991. Data across domains was collated to allow longitudinal analysis.
After the initial introduction of the scheme in 1991, the total mean time on remand was noted to drop from 67.1 days to 49.5 days (P < 0.001). There were 280 referrals over 18 months in 1991, 210 per year in 1999, 190 in 2011 and 174 between April 2015 and March 2016. Violent crimes increased from 29% in 1991 to 47% in 2011. The proportion with schizophrenia decreased from 31% in 1991 to 18% in 1999, before increasing again to 25% in 2011. The use of Section 37 hospital order disposal decreased from 15% in 1991 to just 4% in 2011.
The court diversion scheme has produced significant benefits since it was introduced in 1991, despite a rise in the proportion of violent alleged offences. Changes to the service have seen decreased use of hospital orders.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries.
People with type 2 diabetes treated in out-patient settings aged 18–65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of ‘upset’) between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.
In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.
This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.
A developing application of laser-driven currents is the generation of magnetic fields of picosecond–nanosecond duration with magnitudes exceeding
. Single-loop and helical coil targets can direct laser-driven discharge currents along wires to generate spatially uniform, quasi-static magnetic fields on the millimetre scale. Here, we present proton deflectometry across two axes of a single-loop coil ranging from 1 to 2 mm in diameter. Comparison with proton tracking simulations shows that measured magnetic fields are the result of kiloampere currents in the coil and electric charges distributed around the coil target. Using this dual-axis platform for proton deflectometry, robust measurements can be made of the evolution of magnetic fields in a capacitor coil target.
In the present study, an effective secondary selection of transgressive variants from a homozygous population of Pusa Sugandh 3 (PS3) has led to the development of basmati variant SKUA 494. SKUA 494 exhibited a grain yield (7.9 t/ha) with superiority of 21.5% over its progenitor (6.5 t/ha). Besides, the genotype revealed an earliness of about 13 and 15 days for flowering and maturity, respectively. Hulling, milling and head rice recovery traits of SKUA 494 were comparatively better over the controls PS3 and Pusa Basmati 1509. No significant differences in the cooking quality were observed in SKUA 494 over its parental line. Quality traits of SKUA 494 revealed an intermediate score for alkali spreading value, besides similar values for gel consistency and amylose content in comparison to PS3. On the basis of stability variables, stability index and overall mean for most of the traits, SKUA 494 depicted stable performance across the locations and over the years. Molecular analysis based on simple sequence repeat markers revealed polymorphism at locus flanking the quantitative trait loci for days to heading (Hd6) between SKUA 494 and its parent (PS3). Based on overall superiority in the performance and adaptability of SKUA 494, the variety has been recommended to farmers for general cultivation under temperate ecology.
The paper presents the design and experimental testing of the control system used in a new morphing wing application with a full-scaled portion of a real wing. The morphing actuation system uses four similar miniature brushless DC (BLDC) motors placed inside the wing, which execute a direct actuation of the flexible upper surface of the wing made from composite materials. The control system of each actuator uses three control loops (current, speed and position) characterised by five control gains. To tune the control gains, the Particle Swarm Optimisation (PSO) method is used. The application of the PSO method supposed the development of a MATLAB/Simulink® software model for the controlled actuator, which worked together with a software sub-routine implementing the PSO algorithm to find the best values for the five control gains that minimise the cost function. Once the best values of the control gains are established, the software model of the controlled actuator is numerically simulated in order to evaluate the quality of the obtained control system. Finally, the designed control system is experimentally validated in bench tests and wind-tunnel tests for all four miniature actuators integrated in the morphing wing experimental model. The wind-tunnel testing treats the system as a whole and includes, besides the evaluation of the controlled actuation system, the testing of the integrated morphing wing experimental model and the evaluation of the aerodynamic benefits brought by the morphing technology on this project. From this last perspective, the airflow on the morphing upper surface of the experimental model is monitored by using various techniques based on pressure data collection with Kulite pressure sensors or on infrared thermography camera visualisations.
As image analysis expands into clinical and basic applications it is important that users be aware of opportunities and limitations. A common image analysis workflow involves the digitization of stained tissue sections into a red-green-blue (RGB) colour model for quantitative interpretation. Upstream of the digital image, quality and variability can be degraded at each step (tissue handling, fixation, sectioning, staining, image acquisition). Digital image analysis presents additional steps where variables can affect data quality. Image analysis platforms are not uniform. Aside from interface preferences, some introduce unintended variability due to their processing architecture that may not be obvious to the end-user. One important component of this is colour space representation: hue-saturation-intensity (HSI) vs. colour deconvolution (CD). A potential weakness of analyses within the HSI colour space is the mis-identification of darkly stained pixels, particularly when more than one stain is present. We were interested to discover whether HSI or CD provided greater fidelity in a typical immunoperoxidase/hematoxylin dataset.
Fifty-nine samples were processed using HSI- and CD-based analyses. Processed image pairs were compared with the original sample to determine which processed image provided a more accurate representation. CD proved superior to HSI in 94.9% of the analyzed image pairs. Where the option exists, CD-based image analysis is strongly recommended.
This presentation will enable the learner to:
1.To describe differences between HSI and CD colour spaces
2.To explain limitations in the use of HSI-based analyses
3.To be aware of recent developments in CD-based platforms
Background: SMA1, a rapidly progressing disease, results in muscle weakness, respiratory failure, hospitalization, and early death. This study highlights the value of onasemnogene abeparvovec (AVXS-101) gene-replacement therapy for SMA1. Methods: Twelve SMA1 patients received a one-time intravenous proposed therapeutic dose of AVXS-101 (CL-101; NCT02122952). Event-free survival (no death/permanent ventilation), pulmonary/nutritional interventions, swallow function, hospitalization rates, CHOP-INTEND, motor milestones, and safety were assessed (2-year follow-up). Results: By study end, all 12 patients survived event-free; 7 did not require non-invasive ventilation; 11 had stable/improved swallowing function (6 exclusively fed by mouth); 11 spoke. On average, patients experienced 1.4 (SD=0.41, range=0–4.8) respiratory hospitalizations/year. The mean proportion of time hospitalized was 4.4% (range=0–18.3%); mean unadjusted rate of hospitalization/year was 2.1 (range=0–7.6), with a mean hospital stay of 6.7 (range=3–12.1) days. CHOP-INTEND increased by 9.8 (SD=3.9) and 15.4 (SD=6.4) points at 1- and 3-months post-treatment. At long-term follow-up, 11 patients sat unassisted, 4 stood with assistance, and 2 walked. Adverse events included elevated serum aminotransferase levels, which were attenuated by prednisolone. Conclusions: AVXS-101 in CL-101 resulted in dramatic survival and motor function improvements. The reduced healthcare utilization in treated infants could decrease cost and alleviate patient, caregiver, and societal burden.
Introduction: Renal colic is one of the most common presentations to the emergency department (ED), and often requires complex interdisciplinary collaboration between emergency physicians and urology surgeons. Previous literature has shown that adoption of interdisciplinary rapid referral clinics can improve both timeliness of care and patient outcomes. However, these Acute Care Surgery models have not yet been commonly adopted for urology care in the ED. Methods: In July 2016, we adopted the intervention of an Acute Care Urology (ACU) model through the creation of a rapid referral clinic dedicated to ED patient referrals, the addition of an ACU surgeon, and enhanced use of daytime OR blocks. We conducted a manual chart review of 579 patients presenting to the ED with a complaint of renal colic. Patient data was collected in two separate time periods to analyze trends before implementation of the ACU model (pre-intervention, September - November 2015), to examine the model's impact (post-intervention, September - November 2016). Secondary methods of evaluation included a survey of 20 ED physicians to capture subjective feedback through Likert scale data. Results: Of the evaluated 579 patients with a complaint of renal colic,194 patients were discharged from ED with an diagnosis of obstructing kidney stone and were referred to urology for outpatient care. The ED-to-clinic time was significantly lower for those in the ACU model (p <0.001). The mean time to clinic was 15.76 days (SD = 15.47, range 1-93) pre-intervention versus 4.17 days (SD = 2.33, range = 1-12) post-intervention. Furthermore, the ACU clinic allowed significantly more patients to be referred for outpatient care (p = 0.0004). There was also higher likelihood that patients would successfully obtain an appointment following referral (p = 0.0055). Decreasing trends were shown in mean ED wait time, in addition to time from assessment to procedure. Results of the qualitative survey were overwhelmingly positive. All 20 surveyed ED physicians were more confident that outpatients would be seen in a timely manner (85% strongly agree, 15% agree). Qualitative feedback included the belief that follow-up is more accessible, that ED physicians are less likely to page the on-call urologist, and that they are able to discharge patients sooner. Conclusion: The ACU model for patients with renal colic may be beneficial in reducing ED-to-clinic time, ensuring proper follow-up after ED diagnosis, and improving patient care within the ED.
Advances in material science and semiconductor technology have enabled a variety of inventions to be implemented in electronic systems and devices used in the medical, telecommunications, and consumer electronics sectors. In this paper, a wireless charging system is described as a wearable body heater that uses a chair as a transmitter (Tx). This system incorporates the widely accepted Qi wireless charging standard. Alignment conditions of a linear three-element coil arrangement and a 3 × 3 coil matrix array are investigated using voltage induced in a coil as a performance indicator. The efficiency obtained is demonstrated to be up to 80% for a voltage of over 6.5 Volts and a power transfer of over 5 Watts. Our results and proposed approach can be useful for many applications. This is because the wireless charging system described herein can help design seating areas for the elderly and disabled, commercial systems, consumer electronics, medical devices, electronic textiles (e-textiles), and other electronic systems and devices.