Perssonbredahl9763

6±8.5 to 50.2±9.3), whereas the improvement was not significant in boys. The programme also had positive impact on well-being score for peers and social support (IG 50.2±10.2 to 50.8±10.1), but when analysed separately in the subgroups of boys and girls the changes were not significant. No between-group differences were found for psychological well-being or school environment. CONCLUSION The intervention programme had a positive between-group effect on physical well-being in girls, whereas the change was not significant in boys. The overall scores for peers and social support improved during the intervention period, but no subgroup differences were found. This article is protected by copyright. All rights reserved.AIMS AND OBJECTIVES This paper explores the conditions for the possibilities of recovery in a Danish mental healthcare practice, expressed from the perspective of nurses. The results and discussion of the study help to make visible and explore the muddle of conceptualisations of recovery in mental healthcare practice. BACKGROUND Few studies examine the possibilities of recovery for inpatients and outpatients in mental health centres from a nursing perspective. DESIGN A qualitative design using a critical social-constructionist frame of understanding, in which the real world is considered as a series of social constructions. METHOD A Fairclough-inspired critical discourse analysis was chosen as the analytical strategy. The analysis is comprised of ten interviews in mental healthcare and notes, written by nurses, in medical records of ten patients with a mental illness admitted to a mental healthcare centre in 2016-2017. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study (See Supplementary File 1). RESULTS From the findings of the textual analysis and the analysis of the discourse practice, it seems clear that the social relations and structures relating to recovery in Danish psychiatry are steered and controlled by discourses that reflect, in general terms, the essence of the core of neoliberal ideology. CONCLUSION Recovery is generally articulated from an overall discourse of neoliberalism with its embedded discourses of paternalism, biomedicine, self-care, and holism. All these discourses coexist in nursing practice, but the paternalistic discourse becomes the framework for the conditions for the possibility of how recovery is expressed in practice. RELEVANCE TO CLINICAL PRACTICE Nurses need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened. This article is protected by copyright. All rights reserved.BACKGROUND AND AIM Atrial septal defects with anomalous venous connections are commonly repaired via sternotomy, requiring careful baffle reconstruction to redirect pulmonary venous return and ensure a durable result. The cosmetically appealing periareolar incision may provide an esthetically superior alternative to the anterolateral minithoracotomy incision used in minimally invasive cardiac surgery. METHODS We describe a patient with a sinus venosus atrial septal defect and partial anomalous pulmonary venous connection who underwent successful minimally invasive, endoscopic repair with apical vein translocation and autologous pericardial baffle reconstruction through a periareolar approach. RESULTS Post-operative echocardiography demonstrated excellent results with no residual shunt and a widely patent baffle and preserved biventricular function. At 1-year post-op, our patient has had a greatly improved quality of life and an excellent cosmetic result with normal nipple-areolar sensation. CONCLUSIONS We believe that periareolar approaches should be considered for all adult patients with simple and complex atrial septal defects. © 2020 Wiley Periodicals, Inc.BACKGROUND AND AIM OF THE STUDY Transfusion of blood products after coronary artery bypass grafting (CABG) is associated with increased morbidity and mortality. We evaluated the perioperative use of blood products in patients undergoing CABG in our institution over the past two decades. METHODS The study included 18 992 patients who underwent isolated CABG at our hospital between 1998 and 2017. Baseline characteristics of patients and the number of perioperative transfusions during their hospital stay (including red blood cells [RBCs], platelets, and fresh frozen plasma [FFP]) were assessed. Logistic regression models were used to identify risk factors for perioperative transfusion. RESULTS The rates of perioperative RBC transfusion decreased for all patients undergoing isolated CABG (52.1% in 1998 vs 18.6% in 2017) in our institution. The mean number of transfused RBC units was significantly higher in women than in men (1.57 ± 2.2 vs 0.68 ± 1.84; P  less then  .005); this difference remained significant over the years. After adjusting the results for other risk factors, female sex was a significant independent risk factor for perioperative RBC transfusion. The platelet transfusion rate increased over the past two decades (1.4% in 1998 vs 9.7% in 2017). The number of FFP transfusions remained unchanged. CONCLUSIONS Over the past two decades, we observed a decrease in the incidence of perioperative RBC transfusions in patients undergoing isolated CABG, whereas platelet transfusions increased. Female sex was an independent predictor of perioperative RBC transfusion. © 2020 Wiley Periodicals, Inc.AIM OF THE STUDY To reveal the risk factors of intraoperative hypotension (IH) and investigate whether IH was corrected in time. METHODS USED TO CONDUCT THE STUDY This retrospective cohort study included patients undergoing surgeries in one medical center. We divided all patients into two groups, the IH group and non-IH group. The clinical features of these two groups were compared and the independent risk factors for IH were analyzed. RESULTS OF THE STUDY A total of 5864 non-cardiac surgery patients were included, of which 931 patients had IH diagnose. The independent risk factors of IH include older age, high grade ASA physical status, intrathecal anesthesia, emergency surgery and medical history of hypertension (P less then 0.01). Among the patients with IH, 44.5% had hypotension lasting between 30 minutes and 120 minutes, and 25.2% had hypotension lasting more than 120 minutes. Patients with IH are more likely to develop major postoperative complications after surgery (p less then 0.01). CONCLUSIONS The independent risk factors of IH include older age, high grade ASA physical status, intrathecal anesthesia, emergency surgery and history of hypertension. Hypotension during surgery is not always effectively treated. This article is protected by copyright. All rights reserved.In all eukaryotic organisms, gene expression correlates with the condensation state of the chromatin. Highly packed genome regions, known as heterochromatin, are associated with repressed loci, while euchromatic regions represent a relaxed state of the chromatin actively transcribed. However, even in these active regions, associations between chromatin domains dynamically modify genome topology and alter gene expression. Long-range interaction within and between chromosomes determines chromatin domains that help to coordinate transcriptional events. On the other hand, short-range chromatin interactions emerged as dynamic mechanisms regulating the expression of specific loci. Our current capacity to decipher genome topology at high resolution allowed us to identify numerous cases of short range regulatory chromatin interactions that are reviewed in this insight article. This article is protected by copyright. All rights reserved.BACKGROUND A method for modeling the acute pain trajectory using the simple linear fit of an individual's pain intensity scores after surgery was developed and affords more precise measurement than conventional pain assessment. However, the method has disadvantage of using only the slope without considering the intercept. The purpose of this study is to verify our modification of the pain trajectory model including slope and intercept and to identified clusters. METHODS The pain intensity was measured in 60 patients after surgery, and we calculated their pain trajectories. The pain trajectory normally resolves in intensity over a period of days, and the linear fit of an individual patient's pain intensity score defines the trajectory. In this simple linear model (X days; Y pain intensity), each patient's trajectory has the slope and the intercept. A multiple regression analysis model known as structural equation modeling was used to predict postoperative pain at 30 days after surgery. Finally, we performed hierarchical cluster analysis using the pain trajectory. RESULTS The "slope and intercept model" was the best fit in the among models. Based on cluster analysis results, we created four pain trajectory groups (slope and intercept). CONCLUSION Our results suggest that the pain trajectory using the slope and intercept is quite useful for predicting postoperative pain at 30 days after surgery. Additionally, patients were classified into four groups using the slope and intercept. By considering both the slope and intercept, clinicians may be able to detect the risk of prolonged pain earlier than other methods. This article is protected by copyright. All rights reserved.The clinical features of COVID-19 range from a mild illness to patients with a very severe illness with acute hypoxemic respiratory failure requiring ventilation and Intensive Care Unit admission. Risk factors for a fatal disease include older age, respiratory disease, diabetes mellitus, obesity and hypertension. Little is known about the mechanisms behind observed episodes of sudden deterioration or the infrequent idiosyncratic clinical demise in otherwise healthy and young subjects. As in other diseases, the answer to some of these questions may in time be provided by genotyping as well careful clinical, serological, radiological and histopathological phenotyping, which enable mechanistic insights into the differences in pathogenesis and underlying immunological and tissue regenerative response patterns. We will aim to provide a brief overview of the existing evidence for such differences in host response and outcome, and generate hypotheses for divergent patterns and avenues for future research, by highlighting similarities and differences in histopathological appearance between COVID19 and influenza as well as previous coronavirus outbreaks, and by discussing predisposition through genetics and underlying disease. https://www.selleckchem.com/products/amg-900.html This article is protected by copyright. All rights reserved.Immune checkpoint inhibitors improved the survival rate of patients with unresectable melanoma. However, some patients do not respond, and variable immune-related adverse events have been reported. Therefore, more effective and antigen-specific immune therapies are urgently needed. We previously reported the efficacy of an immune cell therapy with immortalized myeloid cells derived from induced pluripotent stem cells (iPS-ML). In this study, we generated OX40L-overexpressing iPS-ML (iPS-ML-Zsgreen-OX40L) and investigated their characteristics and in vivo efficacy against mouse melanoma. We found that iPS-ML-Zsgreen-OX40L suppressed the progression of B16-BL6 melanoma, and prolonged survival of mice with ovalbumin (OVA)-expressing B16 melanoma (MO4). The number of antigen-specific CD8+ T cells was higher in spleen cells treated with OVA-peptide-pulsed iPS-ML-Zsgreen-OX40L than in those without OX40L. The OVA-peptide-pulsed iPS-ML-Zsgreen-OX40L significantly increased the number of tumor-infiltrating T lymphocytes (TILs) in MO4 tumor.