articulation

BACKGROUND: Active participation of cancer patients and their caregivers in decision-making, along with high-quality communication, is crucial in patient-centered cancer management. Although numerous factors affecting patients' communication and decision-making involvement have been identified, it is still unclear which ones are the most prevalent and critical. OBJECTIVE: To identify factors that contribute to high-quality patient-centered communication and decision-making participation from the perspectives of cancer patients, informal caregivers, and/or healthcare professionals...

As artificial intelligence (AI) continues to evolve rapidly, its integration into nursing education is inevitable. This article presents a narrative exploring the implementation of generative AI in nursing education and offers a guide for its strategic use. The exploration begins with an examination of the broader societal impact and uses of artificial intelligence, recognizing its pervasive presence and the potential it holds. Thematic analysis of strengths, weaknesses, opportunities, and threats collected from nurse educators across the southeastern United States in this case-based descriptive study used four codes: time, innovation, critical thinking, and routine tasks...

BACKGROUND: During articulation the velopharynx needs to be opened and closed rapidly and a tight closure is needed. Based on the hypothesis that patients with cleft lip and palate (CLP) produce lower pressures in the velopharynx than healthy individuals, this study compared pressure profiles of the velopharyngeal closure during articulation of different sounds between healthy participants and patients with surgically closed unilateral CLP (UCLP) using high resolution manometry (HRM)...

INTRODUCTION: Rhinophonia aperta may result from velopharyngeal insufficiency. Neuromuscular electrical stimulation (NMES) has been discussed in the context of muscle strengthening. The aim of this study was to evaluate in healthy subjects whether NMES can change the velopharyngeal closure pattern during phonation and increase muscle strength. METHOD: Eleven healthy adult volunteers (21-57 years) were included. Pressure profiles were measured by high resolution manometry (HRM): isolated sustained articulation of /a/ over 5 s (protocol 1), isolated NMES applied to soft palate above motor threshold (protocol 2) and combined articulation with NMES (protocol 3)...

Coping with complex landscape situations in the Anthropocene increasingly demands innovative governance practices that can be facilitated by investment in new epistemological and methodological approaches and capacities. This paper explores the use of a multimethodological research approach organized as a systemic co-inquiry to assist in the design of systemic governance for Agroextractivist Settlement Projects (PAEs) in the municipality of Abaetetuba, Pará, in the Brazilian Amazon. In the PAEs, the systemic co-inquiry was conducted alongside interested and influential stakeholders through the combined use of the Soft Systems Methodology and Strategic Options Development and Analysis problem structuring methods...

Endoscopic endonasal skull base surgery is increasingly prevalent, with its scope expanding from pathogens in the midline region to those in the paramedian region. Maximizing anterior sphenoidectomy is important for the median approach, and lateralizing the pterygopalatine fossa is crucial for the paramedian approach. Maximizing the surgical corridor in the nasal cavity and minimizing damage to neurovascular structures are vital for establishing a surgical field with minimal bleeding, ensuring safe, precise, and gentle procedures...

In a recent study based on the generalized mixed Yule coalescent method for delimiting species, a threshold of 2% genetic distance using cytochrome c oxidase subunit I sequences was used to delimit the species of Microglanis. That action resulted in assembling several populations of Microglanis from Atlantic coastal rivers between Rio Grande do Sul and São Paulo states as a single species, Microglanis cottoides, including Microglanis cibelae as a junior synonym. We reexamined these populations and found three species diagnosed by their morphology and that constitute separate mtDNA lineages, including a new species...

Diquat (DQ) is among the most widely used herbicides, and its intake can cause severe systemic toxicity that manifests rapidly. The resultant symptoms can cause the dysfunction of a range of tissues and organs,. As there is no specific antidote for diquat poisoning and the efficacy of extant treatments is suboptimal, physicians must acquire a more comprehensive understanding of the most effective approaches to managing affected patients. Relative few studies have been published to date focused on diquat poisoning in pediatric patients...

PURPOSE: To determine the superior spacer design, a growing number of studies are comparing treatment results between patients having been treated with articulating and static knee spacers in the setting of two-stage revision for periprosthetic joint infection (PJI). In contrast, the primary objective of this study was to compare preoperative characteristics between patients from both spacer groups and examine whether significant differences were present prior to spacer implantation. METHODS: This retrospective, single-centre, cohort study examined the preoperative situation of 80 consecutive knee PJIs between 2017 and 2020...

Unfair knowledge practices easily beset our efforts to achieve health equity within and between countries. Enacted by people from a distance and from a position of power ('the centre') on behalf of and alongside people with less power ('the periphery'), these unfair practices have generated a complex literature of complaints across various axes of inequity. We identified a sample of this literature from 12 journals, and systematised it using the realist approach to explanation. We framed the outcome to be explained as 'manifestations of unfair knowledge practices'; their generative mechanisms as 'the reasoning of individuals or rationale of institutions'; and context that enable them as 'conditions that give knowledge practices their structure'...

BACKGROUND: Polyaryl-ether-ether-ketone (PEEK) has gained popularity as a substrate for orthopaedic hardware due to its desirable properties such as heat and deformation resistance, low weight, and ease of manufacturing. However, we observed a relatively high failure rate of PEEK-based hinges in a distal femur reconstruction system. In this study, we aimed to evaluate the proportion of patients who experienced implant failure, analyse the mechanism of failure, and document the associated clinical findings...

STATEMENT OF PROBLEM: Different digital methods have been described for transferring the maxillary cast into a virtual articulator; however, its accuracy remains uncertain. PURPOSE: The purpose of this in vitro study was to compare the accuracy of the maxillary cast transfer into the virtual semi-adjustable articulator by using analog and digital methods. MATERIAL AND METHODS: A maxillary typodont with 5 markers was positioned into a mannequin, which was digitized by using an industrial scanner (ATOS Q) and an extraoral scan of the typodont obtained (T710)...

Water is an essential commodity for society, and alternate resources such as seawater and wastewater are vital for the future. There are various desalination technologies that can provide sufficient and sustainable water sources. Renewable energy-based desalination technologies like solar-based interfacial evaporation are very efficient and sustainable desalination methods. Solar-based interfacial evaporation has been a focus due to its efficient and easy-to-use methods. Still, research is needed for fouling resistance, scalable and low-cost materials, and devices for solar interfacial evaporation...

To access contemporary healthcare, patients must find and navigate a complex socio-technical network of human and digital actors linked in multi-modal pathways. Asynchronous, digitally-mediated triage decisions have largely replaced synchronous conversations between humans. In this paper, we draw on a large qualitative dataset from a multi-site study of remote and digital technologies in general practice to understand widening inequities of access. We theorise our data by bringing together traditional candidacy theory (in particular, concepts of self-assessment, help-seeking, adjudication and negotiation) and socio-technical and technology structuration theories (in particular, concepts of user configuration, articulation, distanciation, disembedding, and recursivity), thus producing a novel theory of digital candidacy...

BACKGROUND: Synovial chondromatosis is a non-malignant synovial disorder characterized by the presence of cartilage formation within the synovial membrane, leading to the emergence of multiple cartilaginous nodules that may be either attached or unattached. The presence of this anatomical feature is frequently observed in articulations such as the knee, hip, elbow, and ankle. CASE REPORT: In this study, we present a case of synovial chondromatosis in the knee joint of a healthy male in his early 60s...

BACKGROUND AND PURPOSE: Because the corpus callosum connects the left and right hemispheres and a variety of WM bundles across the brain in complex ways, damage to the neighboring WM microstructure may specifically disrupt interhemispheric communication through the corpus callosum following mild traumatic brain injury. Here we use a mediation framework to investigate how callosal interhemispheric communication is affected by WM microstructure in mild traumatic brain injury. MATERIALS AND METHODS: Multishell diffusion MR imaging was performed on 23 patients with mild traumatic brain injury within 1 month of injury and 17 healthy controls, deriving 11 diffusion metrics, including DTI, diffusional kurtosis imaging, and compartment-specific standard model parameters...

BACKGROUND: The large number of articulating joints within the spinal column provides an abundance of options to control its movement. However, the ability of individuals to consciously manipulate these movement options is poorly understood. OBJECTIVES: To determine if short-term training can improve the ability to consciously dissociate motion between the pelvis and thorax during repetitive pelvic tilting movements. DESIGN: Cross-over design with young healthy individuals...

Based on the behavioral theory of the firm, we research how performance feedback influences the formation of CEOs' passion. We articulate that previous performance directly increases CEOs' passion. Specifically, positive affective outcomes (performance above aspiration-level) advance CEOs' positive feelings and motivation toward the domains of success (obsessive passion). For instance, when a firm accomplishes performance objectives, such as reaching sales goals, CEOs' positive feelings toward developing current products would be boosted...

As the price of pharmaceuticals and biologicals rises so does the number of patients who cannot afford them. In this article, we argue that physicians have a moral duty to help patients access affordable medicines. We offer three grounds to support our argument: (i) the aim of prescribing is to improve health and well-being which can only be realized with secure access to treatment; (ii) there is no morally significant difference between medicines being unavailable and medicines being unaffordable, so the steps physicians are willing to take in the first case should extend to the second; and (iii) as the primary stakeholder with a duty to put the individual patient's interests first, the medical professional has a duty to address cost-barriers to patient care...

In this issue, we outline the central tenets of the culture-centered approach to health communication. What does the culture-centered approach address when suggesting the co-creation of voice infrastructures? What is the theory's methodological emphasis for mobilizing and transforming structures that shape health inequalities for communities at the margins? Drawing on examples of culture-centered interventions in over fifty communities spread across 17 countries and three continents, a large number of them housed under the umbrella of the Center for Culture-centered Approach to Research and Evaluation (CARE) at Massey University in Aotearoa, New Zealand, we articulate the communicative processes (referring to actionable sources and targets of communicative action) that shape the building of voice infrastructures mobilizing toward structural transformation...