Τετάρτη 9 Μαΐου 2018

Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review

Journal of Oral Rehabilitation, EarlyView.


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Clarification of Obeticholic Acid Dosing: Response to “Occurrence of Jaundice Following Simultaneous Ursodeoxycholic Acid Cessation and Obeticholic Acid Initiation” by Quigley et al.



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A Systematic Review of the Effectiveness of Psychological Treatments for IBS in Gastroenterology Settings: Promising but in Need of Further Study

Abstract

Background

Psychological treatments are efficacious for irritable bowel syndrome (IBS) in clinical trials; however, their effectiveness when conducted in gastroenterology practice settings is unclear.

Aim

To perform a systematic review of the types and effects of psychological treatments for IBS conducted in gastroenterology clinics.

Methods

We searched PubMed, EMBASE, and Cochrane central register. Studies conducted in gastroenterology clinic settings with IBS patients who were clinically referred from gastroenterology were included.

Results

We identified 3078 citations, of which only eight studies were eligible. Seven studies compared psychological treatments (average n = 25.7; range 12–43) to controls (average n = 25.4 patients; range 12–47), whereas one study compared two active "bonafide" interventions. Psychological treatments varied (cognitive–behavioral therapy, guided affective imagery, mindfulness, hypnosis, biofeedback, emotional awareness training). However, across approaches, short-term benefits were seen. IBS symptoms improved significantly among patients in cognitive and behavioral therapies, mindfulness-based stress reduction, guided affective imagery, and emotional awareness training compared with controls; there was a similar trend for gut-directed hypnotherapy. Similarly, IBS symptoms improved in a study of two active biofeedback and hypnosis treatments.

Conclusions

Evidence for the effectiveness of psychological treatment in gastroenterology practice is promising but limited. Study designs that involve a blending of efficacy and effectiveness components are needed.



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EMT 12 HOUR SHIFT - Cabarrus County EMS

Essential Functions/Typical Tasks: Responding to calls for emergency medical services; providing emergency medical care; driving; maintaining records and files; preparing reports. (These are intended only as illustrations of the various types of work performed. The omission of specific duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position ...

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Clinical Compliance Coordinator - Galveston Area Ambulance Authority

Do you want to use your knowledge and help implement our EMS quality assurance program" Are you ready for the challenge" Galveston County Health District is seeking a new Clinical Compliance Coordinator! The right candidate will be responsible for developing and implementing a state approved quality assurance plan. We can offer you: • Excellent benefits; including an amazing retirement package, affordable ...

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Genomic Prediction Accounting for Genotype by Environment Interaction Offers an Effective Framework for Breeding Simultaneously for Adaptation to an Abiotic Stress and Performance Under Normal Cropping Conditions in Rice

Developing rice varieties adapted to alternate wetting and drying water management is crucial for the sustainability of irrigated rice cropping systems. Here we report the first study exploring the feasibility of breeding rice for adaptation to alternate wetting and drying using genomic prediction methods that account for genotype by environment interactions. Two breeding populations (a reference panel of 284 accessions and a progeny population of 97 advanced lines) were evaluated under alternate wetting and drying and continuous flooding management systems. The predictive ability of genomic prediction for response variables (index of relative performance and the slope of the joint regression) and for multi-environment genomic prediction models were compared. For the three traits considered (days to flowering, panicle weight and nitrogen-balance index), significant genotype by environment interactions were observed in both populations. In cross validation, predictive ability for the index was on average lower (0.31) than that of the slope of the joint regression (0.64) whatever the trait considered. Similar results were found for progeny validation. Both cross-validation and progeny validation experiments showed that the performance of multi-environment models predicting unobserved phenotypes of untested entrees was similar to the performance of single environment models with differences in predictive ability ranging from -6% to 4% depending on the trait and on the statistical model concerned. The predictive ability of multi-environment models predicting unobserved phenotypes of entrees evaluated under both water management systems outperformed single environment models by an average of 30%. Practical implications for breeding rice for adaptation to alternate wetting and drying system are discussed.



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Comments on “Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria”

We read with great interest the article entitled "Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria" by Genevay et al. [1]. Although the results were very interesting, however, some methodological issues should be considered to avoid misinterpretation. The study [1] has suggested that the developed clinical classification criteria can be associated with neurogenic claudication (NC) caused by lumbar spinal stenosis (LSS). To us, the most important question is: Are the developed clinical classification criteria valid for the prediction of NC caused by LSS in independent dataset?

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Table of Contents



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Reply to “Comments on Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis. The N-CLASS criteria”

We thank Safiri et al. for their careful review of our paper and their interest in the process we used to develop and validate the Clinical classification criteria for neurogenic claudication caused by lumbar spinal stenosis (N-CLASS) criteria [1]. We agree with them that full validation of the N-CLASS criteria requires assessment in an independent sample. They highlight issues of model uncertainty in creating the N-CLASS criteria and how studies can better accomplish this. In our article, we used a multicenter, but modest-sized, sample of 209 patients to create a simple clinical score using five predictor variables.

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Editorial Board



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Table of Contents



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Re: Decompression alone versus fusion for pyogenic spondylodiscitis. Spine Journal 17: 1120–1126

It is difficult to define the optimal surgical treatment for spondylodiscitis because of the variety of clinical presentations and the diversity of anatomical regions involved. However, there are some accepted principles of surgical management. The principles include debridement of necrotic tissue, decompression of neural elements, and stabilization of the spine [1,2].

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Meetings Calendar



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Table of Contents



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CONTRA: Postoperative Epiduralanalgesie – der Goldstandard?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 246-251
DOI: 10.1055/s-0043-104667

Die Epiduralanalgesie (EDA) kann nicht für alle Eingriffe mit mittelstarkem bis starkem Schmerzniveau der Goldstandard der Therapie sein. Die EDA ist der PCA (patientenkontrollierte Analgesie) und den oralen Analgetika in Bezug auf Reduktion der postoperativen Schmerzintensität überlegen [1]. Mögliche schwerwiegende Komplikationen sowie die höheren Kosten der EDA erfordern aber eine sorgfältige, evidenzbasierte operationsspezifische Abwägung.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Spinalanästhesie bei Sectio: hyperbares oder isobares Bupivacain?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 230-231
DOI: 10.1055/a-0588-2078



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Die Bedeutung der Hämolyse in Anästhesie und Intensivmedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 296-305
DOI: 10.1055/s-0043-121622

Die intravasale Hämolyse mit erhöhten Plasmakonzentrationen von zellfreiem Hämoglobin tritt nicht nur bei hämolytischen Erkrankungen auf – sie ist auch bei der Transfusion von Blutkonserven sowie bei Patienten mit ARDS, Sepsis oder kardiopulmonalem Bypass für den Krankheitsverlauf von Bedeutung. Dieser Beitrag möchte den klinisch tätigen Anästhesisten für die Relevanz der Hämolyse sowie deren Prävention und Früherkennung sensibilisieren.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Intensivmedizin: Dysphagie nach Intensivbeatmung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 231-232
DOI: 10.1055/a-0589-4882



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Patientenkontrollierte Analgesie: Methoden, Handhabung und Ausbaufähigkeit

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 270-280
DOI: 10.1055/s-0043-104665

Eine nebenwirkungsarme und patientenadaptierte Schmerztherapie ist integraler Bestandteil aller multimodalen Behandlungskonzepte, die eine schnelle und komplikationsfreie Erholung nach operativen Eingriffen ermöglichen sollen. Die patientenkontrollierte Analgesie (PCA) bietet dabei eine etablierte und sichere Option für eine individuell angepasste Schmerztherapie, die – richtig genutzt – ein hohes Maß an Patientenzufriedenheit garantiert.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Opioid-Missbrauch bei chronischen Schmerzen: Messinstrumente zur Risikoeinschätzung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 232-234
DOI: 10.1055/a-0588-2062



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Neurologisches Defizit nach intraoperativem anaphylaktischen Schock

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 314-316
DOI: 10.1055/a-0592-8364

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle" stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Intraoperative Anaphylaxie: Nach Behandlung kann die OP meist weitergehen

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 234-234
DOI: 10.1055/a-0588-2034



Georg Thieme Verlag KG Stuttgart · New York

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Periphere Regionalanästhesie ohne Komplikationen – Ein Traum wird wahr?!

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 252-268
DOI: 10.1055/s-0043-104664

Periphere Regionalanästhesieverfahren sind relativ sichere Verfahren der klinischen Anästhesie – dennoch können typische, meist transiente und selten sogar persistierende Komplikationen auftreten. Neben allgemeinen Komplikationen und Strategien zur Risikoreduktion widmet sich dieser Artikel akzidentellen Mitblockaden anderer nervaler Strukturen am Beispiel des Plexus brachialis. Ein Ausblick in die Zukunft informiert über selektivere Blockaden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Postoperative Schmerztherapie: Wie gehtʼs uns denn heute?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 235-236
DOI: 10.1055/a-0588-5760



Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Organisation der perioperativen Schmerztherapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 282-294
DOI: 10.1055/s-0043-104671

Organisatorische Aspekte der postoperativen Schmerztherapie werden oft vernachlässigt – dabei sind sie ebenso wichtig wie Details zu pharmakologischen oder regionalanalgetischen Verfahren. Anhand virtueller Fragen und Erfahrungen eines Assistenzarztes beleuchten wir in diesem Artikel die „Organisation der perioperativen Schmerztherapie": Schmerzerfassung und Dokumentation, Patienteninformation und -edukation, Aufgaben eines Akutschmerzdienstes.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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PRO: Epiduralanalgesie – Goldstandard bei abdominalen und thorakalen Eingriffen

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 237-244
DOI: 10.1055/s-0043-104668

Die Kombination aus thorakaler Epiduralanalgesie (TEA) und Allgemeinanästhesie hat sich bei großen abdominellen und thorakalen Operationen aufgrund der ausgezeichneten Analgesiequalität bewährt 1. Komplikationen sind selten, aber potenziell schwerwiegend – sie müssen rasch erkannt und therapiert werden. Daher sollte die TEA in ein den gesamten perioperativen Verlauf umfassendes Konzept integriert sein, wie es in diesem Beitrag vorgestellt wird.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Transfusion in der Herzchirurgie: liberal oder restriktiv?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 229-230
DOI: 10.1055/a-0589-4915



Georg Thieme Verlag KG Stuttgart · New York

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Kasuistik: Opioidtherapie bei chronischem Rückenschmerz

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 306-313
DOI: 10.1055/s-0043-115205

Ein 76-jähriger stellt sich mit chronischen lumbalen Rückenschmerzen vor, die trotz hochdosierter Opioidtherapie nicht suffizient behandelt sind. Nach Ausschluss spezifischer Ursachen konnte im Rahmen eines multimodalen tagesklinischen Behandlungsprogramms für Senioren die Opioidtagesdosis von 480 mg auf 28 mg Morphinäquivalent und die initiale hohe Schmerzintensität von 7 auf 4 Punkte auf einer numerischen Rangskala erfolgreich reduziert werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Patients with chronic spinal pain benefit from pain neuroscience education regardless the self-reported signs of central sensitization: secondary analysis of a randomized controlled multicentre trial

Pain neuroscience education is effective in chronic pain management. Central sensitization (i.e. generalized hypersensitivity) is often explained as underlying mechanism for chronic pain, because of its clinical relevance and influence on pain severity, prognosis, and treatment outcome.

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Cardiovascular Responses During Resistance Exercise in Patients with Parkinson Disease

Patients with Parkinson disease (PD) present cardiovascular autonomic dysfunction which impairs blood pressure control. However, cardiovascular responses during resistance exercise are unknown in these patients.

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Reduced Smoothened level rescued Aβ-induced memory deficits and neuronal inflammation in animal models of Alzheimer's disease

Publication date: Available online 9 May 2018
Source:Journal of Genetics and Genomics
Author(s): Weiwei Ma, Mengnan Wu, Siyan Zhou, Ye Tao, Zuolei Xie, Yi Zhong
Emerging evidence suggests that neuro-inflammation begins early and drives the pathogenesis of Alzheimer's disease (AD), and anti-inflammatory therapies are under clinical development. However, several anti-inflammatory compounds failed to improve memory in clinical trials, indicating reducing inflammation alone might not be enough. On the other hand, neuro-inflammation is implicated in a number of mental disorders which share the same therapeutic targets. Based on these observations, we screened a batch of genes related with mental disorder and neuro-inflammation in a classical olfactory conditioning in an amyloid beta (Aβ) overexpression fly model. A Smoothened (SMO) mutant was identified as a genetic modifier of Aβ toxicity in 3-min memory and downregulation of SMO rescued Aβ-induced 3-min and 1-h memory deficiency. Also, Aβ activated innate inflammatory response in fly by increasing the expression of antimicrobial peptides, which were alleviated by downregulating SMO. Furthermore, pharmaceutical administration of a SMO antagonist LDE rescued Aβ induced upregulation of SMO in astrocytes of mice hippocampus, improved memory in Morris water maze, and reduced expression of astrocyte secreting pro-inflammatory factors IL-1β, TNFα and the microglia marker IBA-1 in an APP/PS1 transgenic mice model. Our study suggests that SMO was an important conserved modulator of Aβ toxicity in both fly and mice models of AD.



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Germline silencing of UASt depends on the piRNA pathway

Publication date: Available online 9 May 2018
Source:Journal of Genetics and Genomics
Author(s): Yi-Chun Huang, Henry Moreno, Sarayu Row, Dongyu Jia, Wu-Min Deng
One of the most extensively used techniques in Drosophila is the Gal4/UAS binary system, which allows tissue-specific misexpression or knockdown of specific genes of interest. The original UAS vector, UASt, can only be activated for transgene expression in somatic tissues but not in the germline cells (Brand and Perrimon, 1993). Here, we find that the piwi-interacting RNA (piRNA) pathway is involved in suppressing UASt expression in ovarian germline cells. Individually knocking down or mutating components of the piRNA biogenesis pathway (e.g., Piwi, AGO3, Aub, Spn-E, Su(var)2–10, Hsp83, and Vasa) resulted in the expression of the UASt-reporter (GFP or RFP) in the germline. An RNA-seq analysis of small RNAs revealed that the hsp70 promoter of UASt is targeted by piRNAs, and in the aub mutant ovary, the amount of piRNAs targeting the hsp70 promoter is reduced by around 40 folds. In contrast, the SV40 3′UTR of the UASt, which happens to be targeted by the nonsense-mediated RNA decay (NMD) pathway, is not responsible for germline UASt suppression, as UASt-reporters with NMD-insensitive 3′UTR fail to show germline expression. Taken together, our studies reveal a crucial role of the piRNA pathway, potentially via the suppression of the hsp70 promoter, in germline UASt silencing in Drosophila ovaries.



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The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

Abstract

Background

The FIB4 index is clinically useful, but because its formula includes age, the appropriate cutoff point may differ by age group. Here, new FIB4 index cutoff points were validated using cohort data from 14 hepatology centers in Japan.

Methods

The FIB4 index was determined in biopsy-confirmed NAFLD patients (n = 1050) who were divided into four groups: ≤ 49, 50–59, 60–69, and ≥ 70 years. ROC analysis predicted advanced fibrosis in each age group; low and high cutoff points were defined by a sensitivity and specificity of 90%. The new and conventional cutoffs were compared for detecting advanced fibrosis.

Results

The modified low and high cutoff points were 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50–59 years, 1.88 and 3.24 in 60–69 years, and 1.95 and 4.56 in ≥ 70 years. In ≥ 60 years, the false-negative rate was increased using the modified high cutoff point, and the high cutoff point was better with the conventional cutoff point. The new proposed low and high cutoff points are 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50–59 years, 1.88 and 2.67 in 60–69 years, and 1.95 and 2.67 in ≥ 70 years; these cutoff points improved the accuracy of advanced fibrosis diagnosis.

Conclusions

FIB4 index cutoff points for predicting advanced fibrosis in NAFLD increased with age. Cutoff points modified by age improved the diagnostic accuracy of estimations of advanced liver fibrosis using the FIB4 index.



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The Design and Implementation of the 2016 National Survey of Children’s Health

Abstract

Introduction Since 2001, the Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA MCHB) has funded and directed the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN), unique sources of national and state-level data on child health and health care. Between 2012 and 2015, HRSA MCHB redesigned the surveys, combining content into a single survey, and shifting from a periodic interviewer-assisted telephone survey to an annual self-administered web/paper-based survey utilizing an address-based sampling frame. Methods The U.S. Census Bureau fielded the redesigned NSCH using a random sample of addresses drawn from the Census Master Address File, supplemented with a unique administrative flag to identify households most likely to include children. Data were collected June 2016–February 2017 using a multi-mode design, encouraging web-based responses while allowing for paper mail-in responses. A parent/caregiver knowledgeable about the child's health completed an age-appropriate questionnaire. Experiments on incentives, branding, and contact strategies were conducted. Results Data were released in September 2017. The final sample size was 50,212 children; the overall weighted response rate was 40.7%. Comparison of 2016 estimates to those from previous survey iterations are not appropriate due to sampling and mode changes. Discussion The NSCH remains an invaluable data source for key measures of child health and attendant health care system, family, and community factors. The redesigned survey extended the utility of this resource while seeking a balance between previous strengths and innovations now possible.



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Association of activity status and patterns with salivary cortisol: the population-based CoLaus study

Abstract

Purpose

Physical activity (PA) has been shown to influence salivary cortisol concentrations in small studies conducted among athletes. We assessed the association of activity status and patterns with salivary cortisol in the general population.

Methods

Cross-sectional study including 1948 adults (54.9% women, 45–86 years). PA and sedentary behaviour (SB) were measured for 14 days by accelerometry. Low PA and high SB status were defined, respectively, as the lowest and highest tertile of each behaviour. 'Inactive', 'Weekend warrior', and 'Regularly active' patterns were also defined. Four salivary cortisol samples were collected over a single day and the following parameters were calculated: area under the curve to ground (AUCg), awakening response (CAR) and diurnal slope.

Results

After multivariable adjustment, low SB remained associated to steeper slopes relative to high SB (− 1.54 ± 0.03 vs. − 1.44 ± 0.04 nmol/l per hour). Non-significant trends were found for high PA relative to low PA with steeper slopes (− 1.54 ± 0.03 vs. − 1.45 ± 0.04) and lower AUCg (208.7 ± 2.0 vs. 215.9 ± 2.9 nmol.h/l). Relative to 'Inactives', 'Regularly actives' had lower AUCg (205.4 ± 2.4 vs. 215.5 ± 2.9) and 'Weekend warriors' had steeper slopes (− 1.61 ± 0.05 vs. − 1.44 ± 0.04). No associations were found for CAR.

Conclusion

Low SB and high PA are related to lower cortisol secretion as measured by different parameters of salivary cortisol, but the effects were only modest.



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The prognostic value of discontinuous EEG patterns in postanoxic coma

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Publication date: Available online 8 May 2018
Source:Clinical Neurophysiology
Author(s): Barry J. Ruijter, Jeannette Hofmeijer, Marleen C. Tjepkema-Cloostermans, Michel J.A.M. van Putten
ObjectiveTo assess the value of background continuity and amplitude fluctuations of the EEG for the prediction of outcome of comatose patients after cardiac arrest.MethodsIn a prospective cohort study, we analyzed EEGs recorded in the first 72 hours after cardiac arrest. We defined the background continuity index (BCI) as the fraction of EEG not spent in suppressions (amplitudes <10 µV for ≥0.5 s), and the burst-suppression amplitude ratio (BSAR) as the mean amplitude ratio between non-suppressed and suppressed segments. Outcome was assessed at 6 months and categorized as "good" (Cerebral Performance Category 1-2) or "poor" (CPC 3-5).ResultsOf the 559 patients included, 46% had a good outcome. Combinations of BCI and BSAR resulted in the highest prognostic accuracies. Good outcome could be predicted at 24 hours with 57% sensitivity (95% confidence interval (CI): 48-67) at 90% specificity (95%-CI: 86-95). Poor outcome could be predicted at 12 hours with 50% sensitivity (95%-CI: 42-56) at 100% specificity (95%-CI: 99-100).ConclusionsEEG background continuity and the amplitude ratio between bursts and suppressions reliably predict the outcome of postanoxic coma.SignificanceThe presented features provide an objective, rapid, and reliable tool to assist in EEG interpretation in the Intensive Care Unit.



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Approaches to Sleep in Severely Brain Damaged Patients: Opposite or Complementary? Reply to “Sleep and Circadian Rhythms in Severely Brain-Injured Patients - A Comment”

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Publication date: Available online 8 May 2018
Source:Clinical Neurophysiology
Author(s): Boris Kotchoubey, Yuri G. Pavlov




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Feasibility of an EEG-based brain-computer interface in the intensive care unit

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Publication date: Available online 9 May 2018
Source:Clinical Neurophysiology
Author(s): Camille Chatelle, Camille A. Spencer, Sydney S. Cash, Leigh R. Hochberg, Brian L. Edlow
ObjectiveWe tested the feasibility of deploying a commercially available EEG-based brain-computer interface (BCI) in the intensive care unit (ICU) to detect consciousness in patients with acute disorders of consciousness (DoC) or locked-in syndrome (LIS).MethodsTen patients (9 DoC, 1 LIS) and 10 healthy subjects (HS) were enrolled. The BCI utilized oddball auditory evoked potentials, vibrotactile evoked potentials (VTP) and motor imagery (MoI) to assess consciousness. We recorded the assessment completion rate and the time required for assessment, and we calculated the sensitivity and specificity of each paradigm for detecting behavioral signs of consciousness.ResultsAll 10 patients completed the assessment, 9 of whom required less than 1 hour. The LIS patient reported fatigue before the end of the session. The HS and LIS patient showed more consistent BCI responses than DoC patients, but overall there was no association between BCI responses and behavioral signs of consciousness.ConclusionsThe system is feasible to deploy in the ICU and may confirm consciousness in acute LIS, but it was unreliable in acute DoC.SignificanceThe accuracy of the paradigms for detecting consciousness must be improved and the duration of the protocol should be shortened before this commercially available BCI is ready for clinical implementation in the ICU in patients with acute DoC.



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Sleep and Circadian Rhythms in Severely Brain-Injured Patients – A Comment

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Publication date: Available online 8 May 2018
Source:Clinical Neurophysiology
Author(s): Manuel Schabus, Malgorzata Wislowska, Monika Angerer, Christine Blume




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10 rules for EMS at the emergency department

Behave, play nice and show some respect to strive for fellowship with doctors and nurses on hospital grounds

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The arresting LVAD patient: A review of the updated recommendations

By Stephanie Louka, MD Case scenario: Paramedics are called to the home of a 59-year-old male patient with an LVAD who was found unconscious and unresponsive by family members. He was last seen two hours earlier acting normally. There is no evidence of trauma. Family members are unaware of any recent illness or mechanical issues with his LVAD. Your assessment is notable for warm but pale skin, lack ...

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The transition to modernity and chronic disease: mismatch and natural selection

The transition to modernity and chronic disease: mismatch and natural selection

The transition to modernity and chronic disease: mismatch and natural selection, Published online: 09 May 2018; doi:10.1038/s41576-018-0012-3

The authors review the changes in life history traits brought forth by the Industrial Revolution and the evidence for antagonistic pleiotropic effects, whereby genetic variants associated with higher fitness in the past now predispose to diseases such as cancer and coronary artery disease.

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The transition to modernity and chronic disease: mismatch and natural selection



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Complete Abstract Supplement



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1.10-P1Systematic Review on international qualification programmes for the labour market integration of refugees and immigrant health professionals

Background:

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6.10-P7Using multivariable analysis to explore the coping and adaptation of Sub Saharan migrant women in South Africa. Human and social livelihood capital

South Africa is a country perceived by many as a progressive democratic country with one of the highest Human Development Indexes (HDI) according to the United Nations Development Program (UNDP). In reality, the country has its fair share of challenges such as unemployment, lack of adequate basic services for its citizens, developmental challenges and many international migrants mainly from the African continent and the Sub-Saharan region. The influx of migrants has negatively affected South Africa politically, socially and economically and the movement of migrants into the country continues unabated. This paper discusses how Sub Saharan African migrant women utilised their human and social livelihood capital to cope and adapt in South Africa. This is despite the numerous challenges that the country is facing. A case study of 332 randomly sampled migrant women from 23 Sub Saharan African countries resident in balloted six metropolitan cities (Johannesburg, Pretoria, Ekurhuleni, Bloemfontein, Durban and Cape Town) in 4 purposively selected provinces of South Africa was used for the study. A multi variant analysis of the human and social livelihood capital factors identified to be inherent and acquired by the migrant women was analysed and rated after the respondents ranked them. The results indicate that the migrant women used human (knowledge and skills; capacity to work; health and education), and social (relations of trust and mutual support; networks and connections; collective representation and formal and informal groups) capital factors for coping and adaptation in South Africa. The human and social capital factors were acquired in their home countries, developed in the host country and manipulated so that they could cope and adapt. One recommendation that came out of the study was for policy makers in South Africa to focus on human capital development.

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7.10-P6Attitude of Roma toward smoking: qualitative study in Switzerland

Background:

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5.5-O4Place mediated negotiation of vulnerability to the risk of HIV by migrant women of sub-Saharan African descent in New Zealand

Background:

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6.4-O6Astonishing new insight into the relationship between health literacy and health practices of adolescents with Turkish migration background in Germany

Quantitative studies show the link between the health status, health literacy level, and socioeconomic status. Thus, it is reported that people with a high socioeconomic status have a high health literacy level, show health-promoting practices, and consequently a good health condition. In this way the health status of adolescents is derived from the health status of their parents. However, Germany has a high share of migrants. People with a Turkish migration background are the largest group. The studies reported that people with a Turkish migration background in Germany are more likely to have lower educational attainment and lower economic status than the ingenious population. In this way, the studies described the people with Turkish migration background as a vulnerable group. But do we know what people with Turkish migration background associate with health and health-related practices? Are those two the same with the various available definitions?

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7.4-O5Immigrants healthcare utilization before and after being granted disability pension due to common mental disorders: a comparison with Swedish native population

Background:

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6.10-P18Psychiatric care utilisation among migrants and Swedish born

Background:

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6.2-O6Navigating the points based system and racialisation: African healthcare professionals in the United Kingdom

This paper examines labour migration of East African healthcare professionals to the United Kingdom (UK) under the points based system. As a qualitative study methodologically, the paper relies on a literature study, interviews, field observations and policy analysis. The analysis takes an interdisciplinary socio-legal and International Relations/Political Economy Perspective.

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7.10-P10Incidence and associated risk factors for cancer in immigrants to Northern Europe; a review

Background:

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6.10-P26“There is no time for these patients”: ethics, obstacles and palliative care in humanitarian settings

There is a lack of evidence clarifying ethical and practical possibilities and consequences of humanitarian organisations addressing or failing to address patients' palliative needs. This qualitative study seeks to inform realistic, context-sensitive guidance, education, and practice for the provision of palliative care in humanitarian contexts.

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7.2-O5What has happened during the last two decades? A follow up study of unaccompanied Somali girls in Sweden

Unaccompanied asylum-seeking children (UASC) from Somalia are one of the largest groups of UASC in Europe and Sweden. The current study is a follow-up of a Swedish study in 1999, where unaccompanied asylum seeking girls (UASG) from Somalia were interviewed. There are limited follow-up studies how UASG have experienced their life after the initial years in the new country. In 2013, UASG from the 1999 study were interviewed again, as adults who have settled and found a new life in Sweden.

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K-2Superdiversity, population health and health care: opportunities and challenges in a changing world

The last three decades have witnessed the emergence of superdiversity as more people arrive from more places and greater heterogeneity is observable within country of origin or ethnic groups, as well as across categories. Such changes are in evidence throughout much of the developed and developing world and bring a range of challenges and opportunities for health researchers and providers. Superdiversity also brings additional complexity to already multicultural populations challenging methodological nationalism and associated essentialisation and sometimes rarefication (Wimmer & Glick-Schiller 2002). Categorisation of populations has been important, enabling inequalities in access and outcomes to be identified and the development of interventions targeted at groups assessed as having specific, generally considered cultural, needs. At the same time categories are frequently political having little foundation in lived reality and failing to reflect the diversification of diversity and population fluidity. This plenary session focuses upon the opportunities and challenges of categorisation highlighting some of the problems associated with a groupist approach. Examples from genomics and migrant maternity studies are used to illustrate some of the risks associated with categorisations and argue the case for a need to explore a more nuanced approach to categorising populations. The plenary ends with a discussion of the progress made in qualitative methods through approaches such as maximum variation sampling and community research and ongoing challenges in adapting quantitative methods to take account of the superdiversification of populations.

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5.4-O4The potential of disaggregation of data about racial and ethnic subgroups to improve the health of immigrants and communities of color in the US

Issue:

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6.10-P1Distress or resilience? Examining socio-spatial relations impacting the wellbeing and emotional health of seasonal agricultural migrant workers in rural Canada

In Canada, nearly 50 000 migrant agricultural worker positions were available on temporary work permits in 2016. While the wellbeing of future Canadian citizens is considered an issue of national importance, health inequalities among the agricultural migrant workers seem to be increasing which pose challenges for public health management. This is particularly true for the health of Mexican migrant workers participating in the Canadian Seasonal Agricultural Workers Program (SAWP) who have been recognised as a precarious labour force and one of the longest standing group of circular migrants. These workers face higher risks of work-related illnesses and injuries within the agricultural industry. In rural areas, where greater obstacles to migration may exist, they are often exposed to abuse, discrimination, and exploitation in addition to the emotional and mental health distress of working away from their home community.

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6.1-O6Improving access to appropriate health care for asylum seekers, migrants and refugees in Greece

Introduction:

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6.3-O6Beyond silences: young people as minorities and migrant workers in the Scottish Highlands

The discussion of racism and xenophobia takes place under silences, verging on absence, in current rural migration forums: silences reflected in the scarcity of effective anti-racist policies in contemporary rural communities. This paper discusses race and ethnicity and the impact they have on the life experiences and aspirations of young minorities and migrant workers in rural Scotland. Through research for my doctoral thesis, the presence of racism, xenophobia and a wide range of exclusionary practices faced by these young people emerges as the norm in the Scottish Highlands.

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6.5-O6A qualitative study of acceptability of rapid screening for HIV, Hepatitis B, and Hepatitis C among migrants in France (STRADA study)

Background:

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7.10-P19Health situation among Finnish immigrants living in Sweden, better or worse than among native Swedish people?

Issue/problem:

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7.1-O5Views on risk, prevention and management of type 2 diabetes among UK Black Caribbean

Background:

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Polymyalgia rheumatica and diverticular disease: Just two distinct age-related disorders or more? Results from a case-control study

Clinical Rheumatology

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Preoperative chemoradiation therapy induces primary-tumor complete response more frequently than chemotherapy alone in gastric cancer: Analyses of the National Cancer Database 2006-2014 using propensity score matching

Gastric Cancer

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Stricturing and fistulizing Crohn's disease is associated with anti-tumor necrosis factor-induced psoriasis in patients with inflammatory bowel disease

Digestive Diseases and Sciences

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Preoperative neutrophil-to-lymphocyte ratio as a prognosticator in early stage pancreatic ductal adenocarcinoma

European Journal of Surgical Oncology

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Highly elevated soluble Tim-3 levels correlate with increased hepatocellular carcinoma risk and poor survival of hepatocellular carcinoma patients in chronic hepatitis B virus infection

Cancer Management and Research

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