A Novel Technique for Substrate Toughening in Wood Single Lap Joints Using a Zero-Thickness Bio-Adhesive.

In contemporary engineering practices, the utilization of sustainable materials and eco-friendly techniques has gained significant importance. Wooden joints, particularly those created with polyurethan-based bio-adhesives, have garnered significant attention owing to their intrinsic environmental advantages and desirable mechanical properties. In comparison to conventional joining methods, adhesive joints offer distinct benefits such as an enhanced load distribution, reduced stress concentration, and improved aesthetic appeal. In this study, reference and toughened single-lap joint samples were investigated experimentally and numerically under quasi-static loading conditions. The proposed research methodology involves the infusion of a bio-adhesive into the wooden substrate, reinforcing the matrix of its surfaces. This innovative approach was developed to explore a synergetic effect of both wood and bio-adhesive. The experimentally validated results showcase a significant enhancement in joint strength, demonstrating an 85% increase when compared to joints with regular pine substrates. Moreover, the increased delamination thickness observed in toughened joints was found to increase the energy absorption of the joint.

A terapia da dignidade: uma intervenção especializada no conforto da pessoa em situação paliativa / Dignity therapy: a specialised intervention to comfort people in a palliative situation

Ao longo dos últimos anos, temos assistido a um aumento da esperança média de vida e o consequente envelhecimento populacional, aliados ao aumento da prevalência de doenças crónicas. Isto leva-nos a refletir sobre o fim de vida, e sobre a necessidade de conforto e qualidade de vida até ao último momento. Portanto, emerge a necessidade de Cuidados Paliativos (CP), que têm o objetivo o alívio do sofrimento físico, psicológico, social e espiritual, com base na identificação precoce e no tratamento rigoroso da dor e outros sintomas físicos, mas também psicossociais e espirituais, das pessoas que são portadoras de uma doença incurável e/ou grave, progressiva e avançada assim como as suas famílias ou pessoas significativas. Neste sentido, dando continuidade ao processo de aprendizagem, optou-se por realizar o estágio num serviço de cuidados paliativos de um hospital central com o objetivo de desenvolver competências comuns e específicas de enfermeiro especialista na área da enfermagem à pessoa em situação paliativa. O presente relatório do Estágio de Natureza Profissional contempla a descrição e análise critico-reflexiva das atividades realizadas e as competências adquiridas ao longo do mesmo. Para dar resposta aos objetivos propostos, das atividades desenvolvidas destacam-se o estudo de investigação, que se debruçou sobre a dimensão espiritual, ­concretamente sobre a Terapia da Dignidade (TD) no doente em cuidados paliativos. Neste sentido realizou-se uma scoping review, com o objetivo de mapear os efeitos da terapia da dignidade em doentes em cuidados paliativos. Os principais resultados mostram que esta terapia produz efeitos benéficos a nível espiritual, psi-emocional, físico, social e da própria qualidade de vida. Com este estudo percebeu-se que a TD tem efeitos bastante positivos no alívio do sofrimento do doente em situação de fim de vida pelo que pode ser considerada uma estratégia útil no âmbito dos cuidados paliativos tornando-os em cuidados cada vez mais dignos, humanizados e com um olhar holístico sobre o doente e a família. A nível do desenvolvimento de competências comuns, nomeadamente nas competências de gestão e formação, destacam-se nas atividades realizadas a elaboração de uma "Proposta de Protocolo de Apoio no Luto", e ainda à realização de duas formações "Dignidade em Fim de Vida" e "Apoio no Luto" dando resposta as necessidades da equipa e do serviço onde foi realizado o estágio. A nível do desenvolvimento de competências específicas, as atividades assentaram nas dimensões essenciais dos CP, nomeadamente: gestão de sintomas; comunicação; trabalho em equipa, apoio à família e apoio no luto, respeitando os princípios éticos, deontológicos e legais. Concluindo, verifica-se a necessidade de continuar a concetualizar e desenvolver cuidados paliativos especializados, nomeadamente pelo enfermeiro especialista em enfermagem à pessoa em situação paliativa, através da inclusão de estratégias sustentadas na melhor evidência, tais como a terapia da dignidade, e assim, proporcionar cuidados mais dignos ao doente e família, com o propósito de os ajudar a um melhor entendimento das formas de alívio de sofrimento na sua fase final de vida.

Over the last few years, we have witnessed an increase in life expectancy and the subsequent aging of the population, along with the rise in the prevalence of chronic diseases. This leads us to reflect on the end of life and the need for comfort and quality of life until the last moment. Thus, the need for palliative care arises. Palliative care's goal is the relief of physical pain, psychological, social and spiritual suffering for people diagnosed with an incurable and/or severe, progressive and advanced disease and their families or close friends. To achieve this, it uses early identification and rigorous treatment of pain and other physical, psychosocial and spiritual symptoms. In this sense, continuing the learning process, it was chosen to carry out the internship in a palliative care service at a central hospital aiming to develop common and specific specialist nurse skills in the field of nursing for individuals in palliative situations. This Professional Nature Internship report includes the description and critical-reflexive analysis of the activities carried out and the competencies acquired throughout the internship. To address the proposed objectives, among the activities carried out, the research study is highlighted, which focused on the spiritual dimension - specifically on Dignity Therapy (DT) in palliative care patients. In this regard, a scoping review was conducted aiming to map the effects of Dignity Therapy (DT) on patients in palliative care. The main findings show that this therapy has beneficial effects on the spiritual, psychosocial, physical, social, and overall quality of life aspects. Through this study, it was understood that DT has highly positive effects in relieving the suffering of patients in end-of-life situations, making it a valuable strategy within palliative care, which contributes to providing increasingly dignified, humanized care, with a holistic approach to the patient and their family. Regarding the development of common competencies, namely in management and training skills, the activities undertaken included the creation of a "Proposal for a Bereavement Support Protocol." Additionally, two training sessions were conducted on "Dignity at the End of Life" and "Bereavement Support," addressing the needs of the team and the service where the internship took place. Regarding the development of specific competencies, the activities focused on the essential dimensions of palliative care, including symptom management, communication, teamwork, family support, and bereavement support, adhering to ethical, deontological, and legal principles. In conclusion, there is a need to continue conceptualizing and developing specialized palliative care, particularly by the nurses specialized in nursing for individuals in palliative situations, through the incorporation of evidence-based strategies, such as dignity therapy, to provide more dignified care for patients and their families, aiming to help them better understand ways to alleviate suffering in their end-of-life phase.

Comparing randomized controlled trials of outpatient family-based or inpatient multimodal treatment followed by outpatient care in youth with anorexia nervosa: Differences in populations, metrics, and outcomes.

OBJECTIVE: Various approaches exist to treat youth with anorexia nervosa (AN). Family-based treatment (FBT) has never been compared to long inpatient, multimodal treatment (IMT) in a randomized controlled trial (RCT). The aim of this study was to compare data on body weight trajectories, change in eating disorder psychopathology, hospital days and treatment costs in RCTs delivering FBT or IMT. METHOD: Review of RCTs published between 2010 and 2020 in youth with AN, delivering FBT or IMT. RESULTS: Four RCTs delivering FBT (United States, n = 2; Australia, n = 2), one RCT delivering Family Therapy for AN (United Kingdom) and two RCTs delivering IMT (France, n = 1; Germany, n = 1) were identified from previous meta-analyses. The comparison of studies was limited by (1) significant differences in patient baseline characteristics including pretreated versus non-pretreated patients, (2) use of different psychometric and weight measures and (3) different initial velocity of weight recovery. Minimal baseline and outcome reporting standards for body weight metrics and nature/dose of interventions allowing international comparison are needed and suggestions to developing these standards are presented. DISCUSSION: An RCT should investigate, whether FBT is a viable alternative to IMT, leading to comparable weight and psychopathology improvement with less inpatient time and costs.

"How Come You Don't Call Me?" Smartphone Communication App Usage as an Indicator of Loneliness and Social Well-Being across the Adult Lifespan during the COVID-19 Pandemic.

Loneliness and lack of social well-being are associated with adverse health outcomes and have increased during the COVID-19 pandemic. Smartphone communication data have been suggested to help monitor loneliness, but this requires further evidence. We investigated the informative value of smartphone communication app data for predicting subjective loneliness and social well-being in a sample of 364 participants ranging from 18 to 78 years of age (52.2% female; mean age = 42.54, SD = 13.22) derived from the CORONA HEALTH APP study from July to December 2020 in Germany. The participants experienced relatively high levels of loneliness and low social well-being during the time period characterized by the COVID-19 pandemic. Apart from positive associations with phone call use times, smartphone communication app use was associated with social well-being and loneliness only when considering the age of participants. Younger participants with higher use times tended to report less social well-being and higher loneliness, while the opposite association was found for older adults. Thus, the informative value of smartphone communication use time was rather small and became evident only in consideration of age. The results highlight the need for further investigations and the need to address several limitations in order to draw conclusions at the population level.

The fatty acid site is coupled to functional motifs in the SARS-CoV-2 spike protein and modulates spike allosteric behaviour

The SARS-CoV-2 spike protein is the first contact point between the SARS-CoV-2 virus and host cells and mediates membrane fusion. Recently, a fatty acid binding site was identified in the spike (Toelzer et al. Science 2020). The presence of linoleic acid at this site modulates binding of the spike to the human ACE2 receptor, stabilizing a locked conformation of the protein. Here, dynamical-nonequilibrium molecular dynamics simulations reveal that this fatty acid site is coupled to functionally relevant regions of the spike, some of them far from the fatty acid binding pocket. Removal of a ligand from the fatty acid binding site significantly affects the dynamics of distant, functionally important regions of the spike, including the receptor-binding motif, furin cleavage site and fusion-peptide-adjacent regions. The results also show significant differences in behaviour between clinical variants of the spike: e.g. the D614G mutation shows a significantly different conformational response for some structural motifs relevant for binding and fusion. The simulations identify structural networks through which changes at the fatty acid binding site are transmitted within the protein. These communication networks significantly involve positions that are prone to mutation, indicating that observed genetic variation in the spike may alter its response to linoleate binding and associated allosteric communication.

Simulations support the interaction of the SARS-CoV-2 spike protein with nicotinic acetylcholine receptors and suggest subtype specificity

Changeux et al. recently suggested that the SARS-CoV-2 spike (S) protein may interact with nicotinic acetylcholine receptors (nAChRs). Such interactions may be involved in pathology and infectivity. Here, we use molecular simulations of validated atomically detailed structures of nAChRs, and of the S protein, to investigate this nicotinic hypothesis. We examine the binding of the Y674-R685 loop of the S protein to three nAChRs, namely the human 4{beta}2 and 7 subtypes and the muscle-like {beta}{gamma}d receptor from Tetronarce californica. Our results indicate that Y674-R685 has affinity for nAChRs and the region responsible for binding contains the PRRA motif, a four-residue insertion not found in other SARS-like coronaviruses. In particular, R682 has a key role in the stabilisation of the complexes as it forms interactions with loops A, B and C in the receptors binding pocket. The conformational behaviour of the bound Y674-R685 region is highly dependent on the receptor subtype, adopting extended conformations in the 4{beta}2 and 7 complexes and more compact ones when bound to the muscle-like receptor. In the 4{beta}2 and {beta}{gamma}d complexes, the interaction of Y674-R685 with the receptors forces the loop C region to adopt an open conformation similar to other known nAChR antagonists. In contrast, in the 7 complex, Y674-R685 penetrates deeply into the binding pocket where it forms interactions with the residues lining the aromatic box, namely with TrpB, TyrC1 and TyrC2. Estimates of binding energy suggest that Y674-R685 forms stable complexes with all three nAChR subtypes. Analyses of the simulations of the full-length S protein show that the Y674-R685 region is accessible for binding, and suggest a potential binding orientation of the S protein with nAChRs.