Search Results (10,729)

Nurses make decision for patients and the quality of nurses’ decision making can affect patient outcomes. For some reason, nurses are experiencing impaired decision making and it can negatively impact patient care. A valid and reliable instrument to assess decision fatigue may let people know about the concept and guide the development of new policies or interventions for Korean nurses’ decision fatigue. This study aimed to evaluate the psychometric properties of the Korean version of the decision fatigue scale. The design was a cross-sectional descriptive study and convenience sampling was used to recruit participants. A total of 247 nurses from across South Korea participated in an online survey. The survey consisted of demographic questionnaires, decision fatigue scale, nursing practice environment scale, and compassion fatigue scale. It was validated through confirmatory factor analysis that the Korean version of the decision fatigue scale was a single factor with the same structure as the original scale. The Korean version of the decision fatigue scale showed significant correlations with compassion fatigue, and the scale showed appropriate internal consistency. This study established well enough the psychometric characteristics of the Korean version of decision fatigue. Full article

In this study, the wear characteristics of the die were tested and analyzed through compaction tests, and the distribution of wear depth along the direction toward the extrusion outlet was obtained. A discrete element method (DEM) model of the die’s wear process was established. The results show that the severe wear area is located near the stop position of the compression rod, forming a plow-shaped wear area along the extrusion direction, accompanied by fatigue peeling. The wear depth gradually decreases towards the extrusion outlet. The DEM model partially reveals the occurrence of the wear phenomenon, but the particle motion speed deviates from the actual situation. The maximum compression force value range during the DEM compression stage is within the actual maximum compression force value range, and the relative error range of the average maximum compression force is less than 2%. By verifying the formula to calibrate the model, the calibrated model is compared with the actual mold wear, and the predicted value is close to the actual test result. The DEM can be used to explore the wear mechanism and predict the die’s wear failure process, laying the foundation for optimizing die wear resistance design. Full article

Background: Colorectal cancer is a leading cause of morbidity and mortality worldwide, with chemotherapy being a crucial treatment despite its significant side effects, such as chemotherapy-induced peripheral neuropathy (CIPN). Physical exercise has shown potential benefits in mitigating these side effects and improving patients’ overall well-being. Objective: This study aims to evaluate the efficacy of a strength exercise program in reducing CIPN in patients with colorectal cancer undergoing chemotherapy, along with secondary objectives including impacts on quality of life, body mass index, oxygen consumption, anxiety and depression, fatigue, sleep quality, and various analytical parameters. Methods: A double-blind randomized controlled trial was conducted with 44 participants, divided into an intervention group (supervised resistance training twice a week and home exercises) and a control group (home exercises only). The primary outcome measure was CIPN, assessed using the EORTC QLQ-CIPN20 questionnaire. Secondary outcomes included assessments using the EORTC QLQ-C30, the 6-minute walk test, HADS, FACT-F, and MISS, along with various blood parameters. Results and Conclusions: The study will provide insights into the effectiveness of physical exercise in managing CIPN and improving various health parameters in colorectal cancer patients. By developing tailored exercise protocols, this research aims to enhance patient quality of life, optimize treatment outcomes, and reduce the incidence of debilitating side effects, thereby supporting the integration of physical exercise into standard oncological care. Full article

The adhesive properties of tack coats between asphalt pavement layers are crucial for the pavement’s structural behavior. This study first involved numerical analyses to compare stress patterns, deformations, and displacements in the pavement structure under various geometric and mechanical conditions. A rational calculation method based on the theory of elastic multilayer systems was used to quantify the impact of layer properties such as thickness, stiffness modulus, and Poisson’s ratio on interlayer bonding. Three bonding conditions—Full Friction, Partial Bonding, and Full Debonding—were analyzed to understand the tack coat’s effect between the top two layers. The second phase involved characterizing the mechanical behavior of the interface through shear strength tests (Leutner shear test) on both laboratory-prepared specimens and samples from a 10-year-old highway. Specimens were prepared using a Roller Compactor and tested under different interface conditions: hot-on-hot (H/H), residual bitumen 200 g/m² (RB 200), and residual bitumen 400 g/m² (RB 400). The tests examined the bonding effects in terms of tangential force and shear displacement at failure, as well as the impact of vehicular traffic on rutting and fatigue failure. Finally, this study investigated the long-term aging effects of the binder on interlayer bonding and sought to correlate the results of numerical calculations with those of the laboratory tests. Full article

Patients with interstitial lung disease (ILD) represent a vulnerable population against an acute SARS-CoV-2 infection. It has been observed that up to 80% of patients with ILD can develop post-COVID-19 symptomatology one year after. This secondary analysis aimed to, 1, compare serological biomarkers before and after surpassing a SARS-CoV-2 infection in individuals with interstitial lung disease (ILD) and, 2, to compare serological biomarkers between ILD patients who develop and those who do not develop post-COVID-19 symptoms. Seventy-six patients with ILD (40.4% women, age: 69, SD: 10.5 years) who survived a SARS-CoV-2 infection participated. High-resolution computerized tomography (CT) of the lungs, two pulmonary function tests (forced vital capacity (FVC) and diffusion value of carbon monoxide (DLCO)) and fourteen serological biomarkers were collected before and after SARS-CoV-2 infection. Participants were asked for the presence of post-COVID-19 symptomatology a mean of twelve (SD: eight) months after infection. Sixty patients (79%) showed post-COVID-19 symptoms (mean: 3.5, SD 1.1), with fatigue (68.4%), dyspnea (31.5%), and concentration loss (27.6%) being the most prevalent. Creatine phosphokinase (CPK) was the only biomarker showing differences in our study. In fact, CPK levels were higher after the acute SARS-CoV-2 infection (mean difference: 41.0, 95%CI 10.1 to 71.8, p = 0.03) when compared to before the infection. Thus, CPK levels were also higher in ILD patients with post-COVID-19 fatigue (mean difference: 69.7, 95%CI 12.7 to 126.7, p = 0.015) or with post-COVID-19 dyspnea (mean difference: 34.8, 95%CI 5.2 to 64.4, p = 0.025) than those patients without these post-COVID-19 symptoms. No significant changes in CT or functional pulmonary tests were observed after COVID-19 in patients with ILD. In conclusion, patients with ILD exhibited an increase in CPK levels after SARS-CoV-2 infection, albeit no changes in other serological biomarkers were identified. Similarly, the presence of post-COVID-19 fatigue or dyspnea was also associated with higher CPK levels in ILD patients. Studies investigating long COVID mechanisms in vulnerable populations such as ILD are needed. Full article

Competitive ice climbing involves ascending ice and natural rock/manmade features using specialized equipment. Despite its growing popularity, there is limited knowledge regarding the relationship between ice climbers’ biomechanics and performance. The purpose of this study was to analyze spatiotemporal variables and upper-extremity joint kinematics during an elite lead ice-climbing competition. A total of 24 (16 male, 8 female) competitors participated. Video data was recorded during the ice climbing competition, and biomechanical analysis software was used to measure kinematic variables (shoulder and elbow angles) and spatiotemporal (time climbing/resting and number of moves/rests) throughout a section of the competition route. Independent t-tests examined differences between the top and bottom 50% of competitors, and correlations assessed the strength of the relationship between the measured variables and competition rank. We found a strong correlation between elbow and shoulder angles at weight bearing on the ice tool, indicating that ice climbers rely on more extended arm positions, which may decrease muscle fatigue, maintain optimal muscle fiber lengths, and keep the trunk close to the wall with lower contact forces. Additionally, we found that higher-performing ice climbers moved faster with fewer moves, which is likely due to their ability to identify specific holds as affordances to guide their movement. Full article

This study investigates the tribological properties of resin composites reinforced with the fillers of glass powder and micro-bubbles. Resin composites were prepared with varying concentrations from 1% to 5% wt of fillers. Tribological tests were conducted using a block-on-ring scheme under dry friction conditions. The measurements of friction coefficient and wear values were performed under variable rotation speeds and loading conditions. The study showed that resin composites with 2–3% glass powder fillers and resin composites with 3–4% micro-bubbles exhibited optimal tribological properties. The resin glass powder modifications reduce the wear by 63% and resin micro-bubbles reduce wear by 32%. SEM analysis of the surfaces revealed surface imperfections and structural damage mechanisms, including abrasive and fatigue wear. The study concludes that specific filler concentrations improve the friction and wear resistance of resin composites, highlighting the importance of material preparation and surface quality in tribological performance. The increased wear resistance on both composites would hopefully expand the usage of additive manufactured composite, namely industrial moving components such as polymer gear, wheel, pulley, etc. Full article

This study analyzes temperature trends and thermal comfort during the key hours (i.e., from noon to 3:00 p.m.) of human tower (castells) performances in four significant festivities involving this outdoor exhibition (diada castellera) in Catalonia. Human towers were recognized by UNESCO in 2010 as an Intangible Cultural Heritage. The selected exhibitions were Sant Joan in Valls on 24 June; Festa Major de La Bisbal del Penedès on 15 August; Sant Magí in Tarragona on 19 August; and Sant Fèlix in Vilafranca del Penedès on 30 August. Temperature and relative humidity data were downloaded from the Copernicus Climate Change Service’s ERA5-Land and ERA5 pressure level datasets, respectively, with reanalysis from 1951 to 2023. The results revealed a clear upward trend in temperatures over the last several decades in these four places and for the respective dates, from +0.3 °C per decade in La Bisbal del Penedès to +0.42 °C per decade in Valls. Most of the positive temperature anomalies were concentrated in the last 25 years. The calculation of the Heat Index revealed a higher occurrence of years with possible fatigue due to prolonged exposure and/or physical activity in the three inland locations (i.e., Valls, La Bisbal del Penedès, and Vilafranca del Penedès) and a greater frequency of years with possible heat stroke, heat cramps, and/or heat exhaustion in Tarragona, which is near the Mediterranean Sea. This warming trend and increased discomfort pose potential health risks for participants and suggests a need for adaptive measures. These findings emphasize the importance of incorporating climate considerations into human tower planning. Full article

External motivational stimuli have been shown to improve athletic performance. However, the neurophysiological mechanisms underlying this improvement remain poorly understood. This randomized crossover study investigated the effects of music and verbal encouragement on measures of muscle excitation and myoelectric manifestations of fatigue in the biceps brachii and brachioradialis muscles during an endurance task. Fifteen untrained (mean age 29.57 ± 2.77 years) and 13 trained individuals (mean age 32.92 ± 2.90 years) were included. The endurance task, performed to exhaustion, consisted of keeping the dominant arm flexed to 90 degrees while holding a dumbbell loaded to 80% of 1RM with a supine grip in three randomized conditions: standard, with self-selected music, and with verbal encouragement. The untrained subjects showed an increase in task duration of 15.26% (p < 0.003) with music and 15.85% (p < 0.002) with verbal encouragement compared to the condition without external stimuli. There were no significant differences in the myoelectric manifestations of fatigue between the different conditions. Regarding the muscle excitation metrics, although the mean amplitude, peak value, and area under the curve remained unchanged across conditions, a significant reduction in the trend coefficient, indicating motor unit recruitment over time, was observed with both music (biceps brachii: −10.39%, p < 0.001; brachioradialis: −9.40%, p < 0.001) and verbal encouragement (biceps brachii: −7.61%, p < 0.001; brachioradialis: −6.51%, p < 0.001) compared to the standard condition. For the trained participants, no significant differences were observed between conditions in terms of task duration and outcome measures related to muscle excitation and myoelectric manifestations of fatigue, suggesting the possible presence of a ceiling effect on motivation. These results highlight the important role of external motivational stimuli, such as music and verbal encouragement, in improving task performance in untrained subjects, probably through more effective and efficient recruitment of motor units. Full article

Patients who survive critical COVID-19 frequently report post-acute sequelae of COVID-19 (PASC) such as psychosomatic and neurocognitive health problems. The goal of this study was to identify clinical risk factors and other predictors for such long-term consequences in severely ill COVID-19 patients. Adult COVID-19 intensive care unit (ICU) survivors from August 2020 to May 2021 were enrolled. A broad range of clinical, laboratory and chest computed tomography (CT) data was collected during their ICU stays. The association between ICU predictors and psychosomatic, respiratory, and neurocognitive assessments 12 months after ICU discharge was analyzed using univariate regression analysis. In 17 patients (mean age 58.9 ± 11.4 years), laboratory markers (CRP, lymphocytes, hemoglobin), ICU severity (SOFA, SAPS II, need for mechanical ventilation), complications (ARDS), and lung CT data (ground-glass opacity) were promising predictors of depressive and anxiety symptoms, fatigue, and sleep problems. Recovery of psychosomatic health such as fatigue, depression, and anxiety correlated with lower levels of inflammation and high hemoglobin levels. ARDS, mechanical ventilation, and worse SOFA and SAPS II scores were further risk factors for depressive and anxiety symptoms. Our study identified novel associations such as pulmonary ground-glass opacity being positively associated with depression, anxiety, fatigue, and insomnia levels. Full article

A knotter is a core component for the automatic bundling of agricultural materials, and a knotter with double-fluted discs is one type. Currently, the research on knotters with double-fluted discs has gradually transitioned from structural design to reliability optimization. To address rope-clamping failures in the rope-clamping drive mechanisms in knotters, the specific failure position of the rope-clamping mechanism and the failure causes were analyzed first. The redesign of the rope-clamping drive mechanism in knotters with double synclastic fluted discs was proposed, including structure optimization and 3D modeling using the GearTrax/KISSsoft and SolidWorks software. A virtual prototype model of a knotter with a flexible rope was established by combining ANSYS with the ADAMS software. A rigid–flexible coupling dynamic simulation of the knotter was carried out using ADAMS, and the simulation results were used as the data input for the ANSYS nCode DesignLife module for the fatigue life simulation of the weak parts (the worm shaft) of the knotter. The operation test results for the rope-clamping drive mechanism indicate that the redesigned rope-clamping drive mechanism is reliable in transmission, with a rope-clamping success rate of 100%. The actual operation times for the worm shaft exceed the minimum fatigue life obtained through joint simulation. The applied joint simulation method has high simulation accuracy. Full article

Patients consistently rate cancer-related fatigue (CrF) as the most prevalent and debilitating symptom. CrF is an important but often neglected patient concern, partly due to barriers to implementing evidence-based interventions. This study explored what an ideal intervention for CrF would look like from the perspectives of different stakeholders and the barriers to its implementation. Three participant populations were recruited: healthcare providers (HCPs; n = 32), community support providers (CSPs; n = 14), and cancer patients (n = 16). Data were collected via nine focus groups and four semi-structured interviews. Data were coded into themes using content analysis. Two main themes emerged around addressing CrF: “It takes a village” and “This will not be easy”. Participants discussed an intervention for CrF could be anywhere, offered by anyone and everyone, and provided early and frequently throughout the cancer experience and could include peer support, psychoeducation, physical activity, mind–body interventions, and interdisciplinary care. Patients, HCPs, and CSPs described several potential barriers to implementation, including patient barriers (i.e., patient variability, accessibility, online literacy, and overload of information) and systems barriers (i.e., costs, lack of HCP knowledge, system insufficiency, and time). As CrF is a common post-treatment symptom, it is imperative to offer patients adequate support to manage CrF. This study lays the groundwork for the implementation of a patient-centered intervention for CrF in Canada and possibly elsewhere. Full article

Malignant pleural mesothelioma (MPM) represents a significant clinical challenge due to limited therapeutic options and poor prognosis. Beyond mere survivorship, setting up an effective framework to improve functioning and quality of life is an urgent need in the comprehensive management of MPM patients. Therefore, this study aims to review the current understanding of MPM sequelae and the effectiveness of rehabilitative interventions in the holistic approach to MPM. A narrative review was conducted to summarize MPM sequelae and their impact on functioning, disability, and quality of life, focusing on rehabilitation interventions in MPM management and highlighting gaps in knowledge and areas for further investigation. Our findings showed that MPM patients experience debilitating symptoms, including fatigue, dyspnea, pain, and reduced exercise tolerance, decreasing quality of life. Supportive and rehabilitative interventions, including pulmonary rehabilitation, physical exercise improvement, psychological support, pain management, and nutritional supplementation, seem promising approaches in relieving symptoms and improving quality of life but require further research. These programs emphasize the pivotal synergy among patient-tailored plans, multidisciplinary team involvement, and disease-specific focus. Despite advancements in therapeutic management, MPM remains a challenging disease with limited effective interventions that should be adapted to disease progressions. Rehabilitative strategies are essential to mitigate symptoms and improve the quality of life in MPM patients. Further research is needed to establish evidence-based guidelines for rehabilitative interventions tailored to the unique needs of MPM patients. Full article

Bearing life calculation is a well-researched and standardized topic for rotating operation conditions. However, there is still no validated and standardized calculation for oscillating operation, only different calculation approaches. Due to the increasing number of oscillating rolling bearings, for example, in wind turbines, industrial robots, or 3D printers, it is becoming more and more important to validate one of these approaches or to formulate a new one. In order to achieve this goal, the damage mechanisms for oscillating operating conditions must first be analyzed in more detail by means of experimental investigations. The open question is whether fatigue is the relevant damage mechanism or whether wear damage, such as fretting corrosion or false brinelling, dominates. The present work therefore shows under which oscillation angle and frequency fatigue occur in oil-lubricated cylindrical roller bearings. Full article

Fatigue load modeling is crucial for optimizing and assessing the lifespan of floating wind turbines. This study addresses the complex characteristics of fatigue loads on floating wind turbines under the combined effects of wind and waves. We propose a fatigue load modeling approach based on Vine copula theory and machine learning. Firstly, we establish an optimal joint probability distribution model using Vine copula theory for the four-dimensional random variables (wind speed, wave height, wave period, and wind direction), with model fit assessed using the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), and Root Mean Square Error (RMSE). Secondly, representative wind and wave load conditions are determined using Monte Carlo sampling based on the established joint probability distribution model. Thirdly, fatigue load simulations are performed using the high-fidelity simulator OpenFAST to compute Damage Equivalent Load (DEL) values for critical components (blade root and tower base). Finally, utilizing measured wind and wave data from the Lianyungang Ocean Observatory in the East China Sea, simulation tests are conducted. We apply five commonly used machine learning models (Kriging, MLP, SVR, BNN, and RF) to develop DEL models for blade root and tower base. The results indicate that the RF model exhibits the smallest prediction error, not exceeding 3.9%, and demonstrates high accuracy, particularly in predicting flapwise fatigue loads at the blade root, achieving prediction accuracies of up to 99.97%. These findings underscore the effectiveness of our approach in accurately predicting fatigue loads under real-world conditions, which is essential for enhancing the reliability and efficiency of floating wind turbines. Full article