Philipsenankersen3804

The goal was to measure the effects of trauma types, cumulative trauma, posttraumatic stress disorder (PTSD), existential annihilation anxiety (EAA), and posttraumatic growth (PTG) on executive functions. The study sample consists of 1155 from Egypt and Kuwait. Measures included adults working memory deficits (WMD) and inhibition deficits (ID), and cumulative stressors and traumas (CST) and trauma types, PTSD, EAA, and PTG. We used Stepwise regression and PROCESS macro to analyze the data. Results indicated that survival and cumulative traumas have direct effects on a lower WMD and ID, attachment traumas and gender discrimination by parents have direct impacts on higher WMD and ID, while personal identity, status identity, secondary trauma, gender discrimination by society, community violence do not have any direct effects on WMD or ID. All traumas have indirect effects on higher WMD or/and ID via PTSD. Gender discrimination by society, community violence, and CST has an additional indirect higher impact on WMD and ID via EAA. There were indirect trajectories from survival trauma, personal identity, status identity trauma, secondary trauma, gender discrimination by society, and CST on lower WMD or/and ID via PTG. Attachment trauma, gender discrimination by parents, perpetration traumas, and community violence were not associated with PTG and its trajectories of lower WMD or/and ID. We discussed the research and clinical implication for these results.

Octogenarians comprise an increasing proportion of patients presenting with non-small-cell lung cancer (NSCLC). This study examines postoperative morbidity and mortality, and long-term survival in octogenarians undergoing thoracoscopic anatomic lung resection for NSCLC, compared with younger cohorts.

We conducted a retrospective review of our institutional Society of Thoracic Surgeons General Thoracic Surgery Database of all patients ≥60 years old undergoing elective lobectomy or segmentectomy for pathologic stage I, II, and IIIA NSCLC between 2009 and 2018. Results were compared between octogenarians (

= 71) to 2 younger cohorts of 60- to 69-year-olds (

= 359) and 70- to 79-year-olds (

= 308). Long-term survival among octogenarians was graphically summarized using the Kaplan-Meier method. Cox regression analysis was used to identify preoperative risk factors for mortality.

A greater proportion of octogenarians required intensive care unit admission and discharge to extended-care facilities; howevion can be performed with favorable early postoperative outcomes among octogenarians. Long-term survival, although comparable to their healthy peers, is worse than those of younger cohorts. Further study into preoperative risk stratification and alternative therapies among octogenarians is needed.

To evaluate the safety and efficacy of modified facet joint fusion (MFF) for the treatment of multilevel (three-level or more) lumbar spinal stenosis (LSS).

In this retrospective study, 135 consecutive patients who underwent initial MFF for multilevel LSS were included. Clinical outcomes included fusion rate, change of visual analogue scale pain scores for low back pain (VAS-LBP) and leg pain (VAS-LP), Japanese Orthopedic Association scores (JOA), Oswestry Disability Index (ODI) and MacNab classification before and after MFF. The complications were also analyzed.

The fusion rates were 46.7% (63/135) at 6-month and 89.6% (121/135) at 1-year. The mean VAS-LBP, VAS-LP, and ODI significantly decreased from 5.2 ± 0.6, 5.7 ± 0.8 and 65 ± 7.9 to 1.58 ± 0.4, 0.58 ± 0.3 and 20.8 ± 5.8, respectively (all

 < 0.001). The mean JOA markedly improved from 10.0 ± 1.3 to 26.1 ± 1.5 (

 < 0.001). Excellent/good results of MacNab classification were achieved in 88.9% (120/135) of the patients. The overall rate of complications after MFF was 5.9%, including poor wound healing (2.2%), calf muscular venous thrombosis (0.74%), deep venous thrombosis (0.74%), superficial wound infection (1.48%), transient foot drop (0.74%). All the complications were transient and improved without prolonged hospital stay and sequelae.

MFF may be safe and efficient for multilevel LSS with high fusion rate and significant symptom relief, which is worthy of further study.

MFF may be safe and efficient for multilevel LSS with high fusion rate and significant symptom relief, which is worthy of further study.

SuPAR (soluble urokinase-type plasminogen activator receptor) is a biomarker reflecting the inflammatory state of the human body. Earlier studies suggest that urinary suPAR/creatinine ratio levels are elevated in chronic pancreatitis (CP), and that plasma suPAR (P-suPAR) level is elevated in pancreatic cancer (PC). Our aim was to study the levels of P-suPAR in CP in a long-term prospective follow-up setting to explore the possibility of distinguishing between PC and CP.

Two patient groups were compared. The first group included 83 patients who were prospectively followed up after their first acute alcohol-induced pancreatitis (AAP) for median 7.0 (range 0.3-9.8) years. P110δ-IN-1 mouse Twelve patients in this group developed CP during follow-up, and two patients were further excluded from the CP cohort. The second group consisted of 25 patients operated on for suspicion of pancreatic malignancy and final pathological diagnosis of PC. P-suPAR levels were measured and compared within and between these groups.

P-suPAR levels remained low during follow-up despite the development of CP. P-suPAR was significantly higher in PC patients [median 3.7 (IQR 3.1-4.4) ng/mL] than in CP patients [2.6 (1.8-3.6) ng/mL];

 = .014. A cutoff value of 2.8 ng/mL resulted from a ROC curve with area under curve (AUC) of 0.79 (95% CI 0.61-0.97),

 = .009 in differentiation between PC and CP with a sensitivity and a specificity of 88% and 70% respectively.

P-suPAR is higher in patients with PC than in patients with CP, and it could thus be used in differentiating between PC and CP.

P-suPAR is higher in patients with PC than in patients with CP, and it could thus be used in differentiating between PC and CP.Background Sleep disturbances are common during pregnancy and are associated with the development of adverse pregnancy outcomes. Personal health monitors (PHM) can facilitate change in health behaviors, though few studies have examined their use in improving sleep during pregnancy. This pilot study aimed to characterize sleep changes during pregnancy in women participating in a self-management intervention using a PHM. Participants/Methods Participants with low risk, singleton pregnancies from Western Massachusetts were randomized at 24 weeks gestation to receive sleep education only (n = 12) or sleep education, and PHM intervention (n = 12). The single-session sleep education was given at baseline by a registered nurse. Sleep quality, duration, efficiency, disturbances, daytime sleepiness, and fatigue were assessed at baseline and 12 weeks follow-up using questionnaires. We described mean ± standard deviation within and between-group changes in each sleep outcome from baseline to 12 weeks follow-up. Results The PHM arm experienced larger sleep quality improvements and daytime sleepiness than the sleep-education only arm, but the differences were not statistically significant. In the PHM arm, the Pittsburgh Sleep Quality Index (PSQI) score decreased (i.e., sleep quality increased) 1.22 ± 2.39 (p = .16), and the Epworth Sleepiness Scale (ESS) score decreased (i.e., daytime sleepiness decreased) 1.11 ± 2.08 (p = .15). In the sleep-education arm PSQI decreased 0.57 ± 2.37 (p = .55) and ESS decreased 1.29 ± 2.93 (p = .29). Neither group experienced statistically significant changes in sleep duration, efficiency, disturbances, or fatigue. Conclusion Sleep education with PHM may improve or prevent decreases in sleep outcomes during pregnancy. Further investigation in larger trials is warranted.Aims To test the hypothesis that in non-diabetic patients with early-stage chronic kidney disease (CKD), the renal excretion of urate and glucose transportation are coupled and interconnected. Methods A cross-sectional study of 255 non-diabetic participants with stage 1-2 CKD recruited from our department was conducted. Spearman's correlation and multiple linear regression analyses were used to study the correlation between urinary glucose and renal uric acid excretion. ANOVA was used to compare urinary uric acid excretion among three tertiles of urinary glucose (UG; UG1 UG3.99 μmol/L). Results According to the multiple linear regression analysis, FEG and EgGF were positively correlated with the excretion of uric acid per volume of glomerular filtration (EurGF) after adjusting for confounding factors. The EurGF levels in the highest tertiles of UG, FEG and EgGF were higher than those in the lowest tertiles of UG, FEG and EgGF. Conclusion Urinary glucose excretion is closely related to renal excretion of uric acid in non-diabetic patients with stage 1-2 CKD.

To measure and compare progression in children's power mobility skill among process and task-based measures following a loan of one of four early power mobility devices. Additionally, to explore different power mobility learner groups and skill development trajectories.

In this pre-post study, children were purposefully sampled and power mobility skill was measured from video taken pre-post several months' experience (mean 192.40; SD 42.79 days) using the Assessment of Learning Powered mobility use (ALP) and two task-based measures. Associations among power mobility skill measures were examined. Child and environmental factors influencing ALP phase at loan-end were explored.

Forty-six children aged 13 - 68 months (mean 40.40; SD 15.60) participated, with cerebral palsy being the most common condition (

 = 33; 71.74%). ALP change scores ranged from -2 to +4 ALP phases (median 1.0). Wilcoxon signed rank test was significant for pre-post differences with a large effect size (

 = 5.50,

 < 0.001;

 =se can demonstrate positive change in power mobility skill using different devices and switch as well as joystick access methods The Assessment of Learning Powered mobility use (ALP) is useful for assessing tool-use and learning process skills for young children across the power mobility skill continuum. Task-based measures may also be helpful for guiding training and recording progress; The Power Mobility Training Tool (PMTT) is most useful for children exploring cause-effect and direction (ALP Phases 1-5), while the Power Mobility Program (PMP) is most useful for functional learners and those progressing from exploring direction to functional use (ALP Phases 5-8). Access method may influence power mobility learning trajectory and training.Dexamethasone was shown to decrease the mortality in coronavirus disease-2019 (COVID-19) recently. Use of corticosteroids was harmful in other coronavirus infections previously. WHO recommended against routine use of corticosteroids in COVID-19. In view of these, we reviewed the evidence about the use of corticosteroids in virus-induced acute respiratory distress syndrome (ARDS). Corticosteroids are beneficial in ARDS regardless of etiology. However, they increased the mortality rate in influenza-associated ARDS. In SARS and the Middle East respiratory syndrome, corticosteroids increased the mortality, delayed the viral clearance and increased the length of hospital stay. In the case of COVID-19, the available evidence from retrospective and observational studies is inconclusive about the corticosteroid use. Low-dose therapies appear to be effective. Evidence from a randomized control study found dexamethasone is effective in decreasing mortality in severe COVID-19 cases. More studies are needed to validate the benefit of corticosteroids in COVID-19.