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Patients with cancer are at higher risk of more severe COVID-19 infection and have more associated complications. The position paper describes the management of cancer patients, especially those receiving anticancer treatment, during the COVID-19 pandemic. Polyinosinic acid-polycytidylic acid datasheet Dyspnea is a common emergency presentation in patients with cancer with a wide range of differential diagnoses, including pulmonary embolism, pleural disease, lymphangitis, and infection, of which SARS-CoV-2 is now a pathogen to be considered. Screening interviews to determine whether patients may be infected with COVID-19 are imperative to prevent the spread of infection, especially within healthcare facilities. Cancer patients testing positive with no or minimal symptoms may be monitored from home. Telemedicine is an option to aid in following patients without potential exposure. Management of complications of systemic anticancer treatment, such as febrile neutropenia (FN), is of particular importance during the COVID-19 pandemic where clinicians aim to minimize patients' risk of infection and need for hospital visits. Outpatient management of patients with low-risk FN is a safe and effective strategy. Although the MASCC score has not been validated in patients with suspected or confirmed SARS-CoV-2, it has nevertheless performed well in patients with a range of infective illnesses and, accordingly, it is reasonable to expect efficacy in the clinical setting of COVID-19. Risk stratification of patients presenting with FN is a vital tenet of the evolving sepsis and pandemic strategy, necessitating access to locally formulated services based on MASCC and other national and international guidelines. Innovative oncology services will need to utilize telemedicine, hospital at home, and ambulatory care services approaches not only to limit the number of hospital visits but also to anticipate the complications of the anticancer treatments.Few evidences are available about the impact of temperature variation on childhood asthma in different seasons. This study aimed to assess the influence of temperature changes between neighboring days (TCN) on the exacerbation of asthma among children. Daily outpatient visits for childhood asthma (DOVCA) were collected from 17 main hospitals in Shanghai, China, from 2016 to 2018. A quasi-Poisson regression combined with distributed lagged nonlinear models was employed to estimate the association between TCN and asthma visits in cool or warm seasons, after controlling for short- and long-term trends, day of week, holidays, daily mean temperature, daily mean relative humidity, and air pollutants. The TCN varied from - 9.6 to 6.7 °C. The relationship between TCN and DOVCA greatly varied by season. In warm seasons, positive TCN (temperature rise) was associated with higher risks of asthma outpatient visits and negative TCN (temperature drop) was associated with lower risks; the associations were present on lag 1 day and lasted for 2 weeks; the cumulative relative risk of childhood asthma over 0 to 14 days was 1.98 (95% confidence interval 1.42, 2.76) and 0.31 (95% confidence intervals 0.21, 0.44) comparing a TCN of 2.5 °C (5th percentile) and - 3.2 °C (95th percentile) with 0 °C, respectively. In cool seasons, neither negative nor positive TCN showed significant risks. In conclusion, temperature rise might increase the risk of childhood asthma exacerbation and temperature drop might decrease the risks in warm seasons. There were no statistically significant influences in cool seasons.There can be few indoor workplaces that are more subject to the meteorological and atmospheric conditions of their locations than permanent stations on the high, inland polar plateau of Antarctica. The US Amundsen-Scott South Pole Station is such a workplace, totally isolated during the 8-9 months of the austral winter, more than 800 miles (1287 km) from the nearest other human habitation. The wintering party at the South Pole must deal with all the demands and stressors of an isolated, confined, and extreme environment without the prospect of relief from the outside world. In 1975, the seventeen men chosen to winter at the South Pole had an additional challenge. In February, as the austral winter was about to begin, a new geodesic-domed research station had just been completed. The station was the first of its kind, and the vagaries of its design and construction would be significant factors in the health and well-being of station residents as winter progressed. Potential physical and psychological problems from isolation literature are commented upon, and some significant events from this noteworthy winter are described. In addition, supporting quantitative data from current research at South Pole are used to better understand these events.
Food selection is an important factor in the prevalence of obesity, and regularly choosing nutrient-poor high-energy foods can have negative health consequences. The present study tested whether the use of mindful construal diaries (MCD) combined with self-kindness could promote healthier eating choices.
Ninety participants were randomly assigned to either a self-kindness to the mind condition or self-kindness to the mind and body condition, and were served M&Ms and grapes as an unhealthy and healthy option, respectively.
The results suggested that a difference in consumption was found between the two conditions, with participants in the self-kindness to the mind condition consuming significantly more grapes than those in the self-kindness to the mind and body condition. However, this difference was restricted to those who are usually low consumers of fruit and vegetable.
The effect of self-kindness towards promoting heathier eating whilst considering the body thus appears to require further investigation. Limitations and recommendations for future research are discussed.
The effect of self-kindness towards promoting heathier eating whilst considering the body thus appears to require further investigation. Limitations and recommendations for future research are discussed.
The directionality of associations between self-regulatory variables, behavior, and automaticity is seldomly tested. In this study, we aimed to examine a volitional, self-regulatory sequence of variables proposed in the Health Action Process Approach framework (intention → action plans → action control → behavior) and its relationship with the construct of automaticity of the physical activity habit.
Longitudinal data was collected from high school students (N=203, M
=15.39 (SD=1.43), 52% women) at three measurement points. First, a confirmatory factor analysis measurement model was used to examine the study variables across measurement points. Next, a cross-lagged panel model was used to test directionality between variables.
After adequate fit of the measurement model was confirmed, a mechanism integrating self-regulation with behavior and automaticity was examined. The hypothesized directionality between variables was verified overall by cross-lagged analysis. However, for the intention-action plan association, the inverse relationship was found plans were associated with subsequent intentions, but intentions did not predict plans. Moreover, automaticity was not associated with subsequent physical activity behavior.
In general, our findings supported the hypothesized longitudinal direction of the associations, confirming that self-regulation may lead to behavior performance and automaticity. Unexpected findings and implications for intervention and future research are discussed.
In general, our findings supported the hypothesized longitudinal direction of the associations, confirming that self-regulation may lead to behavior performance and automaticity. Unexpected findings and implications for intervention and future research are discussed.
The timing of surgery for congenital adrenal hyperplasia (CAH) is contentious. We aimed to survey expert families and patients for their recommendations regarding timing of surgery for a family with a newly diagnosed CAH child.
A Survey Monkey questionnaire was performed at the 2017 meeting of the CAH support group, "Living with CAH", and also sent to the members of the CAH support group. The surgical-timing responses were a Likert score from 1 (strongly disagree) to 5 (strongly agree). Data were analysed by Kruskal-Wallis test. p < 0.05 taken as significant.
Of the 61 respondents, 12 were CAH patients, 43 were CAH parents, 3 were physicians, 1 surgeon and 2 others. For all respondents, the Likert score was 3 for infant, toddler and adult timing of surgery (neutral), not statistically significant (ns). For parents and/or children who had surgery (n = 26), the score was 4 (3-5) for infant vs. 4 (3-4) for toddler-years vs. 2 (1-3) for adulthood. This was statistically significant (p = 0.0002). When only patients who had CAH surgery were included, there were only 8 respondents and their scores were infancy 3 (2-4) vs. toddler-years 4 (2-4) vs. adulthood 1 (1-4), ns.
Expert families and patients in the United Kingdom who have had CAH surgery, recommend surgery in the first few years of life vs. adulthood. There is a selection bias, however this may support MDTs in continuing to discuss surgery as an option in childhood.
Expert families and patients in the United Kingdom who have had CAH surgery, recommend surgery in the first few years of life vs. adulthood. There is a selection bias, however this may support MDTs in continuing to discuss surgery as an option in childhood.The objectives were to compare the effectiveness of poultry by-product meal (PBM) with xylose-treated soybean meal (x-SBM) as a conventional protein source and rumen-undegraded protein (RUP)rumen-degraded protein (RDP) ratio on nutrient digestibility, nitrogen metabolism, and production of early- to mid-lactation Holsteins. Twelve multiparous cows averaging (mean ± SD) 50 ± 9 days in milk were randomly assigned to a replicated 4 × 4 Latin square design within a 2 × 2 factorial arrangement of treatments. Each period was 28 days in length. Treatments were RUP sources (PBM or x-SBM) with either a high or a low RUPRDP ratio (high ratio = 4060 or low ratio = 3664; based on % of crude protein (CP)). Experimental diets were balanced to be similar in protein and energy contents (CP = 16.7% of DM; NEL = 1.67 Mcal/kg DM). Prior to diet formulation, an in situ pilot experiment was conducted to estimate the RUP fractions of x-SBM and PBM as 63.9% and 54.1% of CP, respectively. Treatments had no effect on ruminal pH and t excretion (fecal and urinary N). Feeding a diet with PBM supported milk production comparable with x-SBM and had positive effects on feed intake, milk protein yield, and milk N efficiency.Prudent intraoperative fluid replacement therapy, inotropes, and vasoactive drugs should be guided by adequate hemodynamic monitoring. The study aimed to evaluate the single-centre practice on intraoperative fluid therapy in abdominal surgery (AS). The evaluation, based on a review of medical files, included 235 patients (103 men), aged 60 ± 15 years who underwent AS between September and November 2017. Fluid therapy was analyzed in terms of quality and quantity. There were 124 high-risk patients according to the American Society of Anaesthesiologists Classification (ASA Class 3+) and 89 high-risk procedures performed. The median duration of procedures was 175 (IQR 106-284) min. Eleven patients died post-operatively. The median fluids volume was 10.4 mL/kg/h of anaesthesia, including 9.1 mL/kg/h of crystalloids and 2.7 mL/kg/h of synthetic colloids. Patients undergoing longer than the median procedures received significantly fewer fluids than those who underwent shorter procedures. The volume of fluids in the longer procedures depended on the procedural risk classification and was significantly greater in high-risk patients undergoing high-risk surgery.
