Dehnroche8001

germline settings might be used to help identify disease-related genes by guiding the development of background-mutation models that are informed by both somatic and germline patterns of variation.Background We present a case with a close temporal association of the first diagnosis of multiple sclerosis and stress cardiomyopathy. Case presentation A 19-year-old man experienced severe dyspnoea. The cardiac biomarkers troponin T and NT-proBNP were elevated, and transthoracic echocardiography showed basal hypokinesia. The man was diagnosed with stress cardiomyopathy after main differential diagnoses such as acute coronary syndrome, myocarditis, and pheochromocytoma were excluded. Furthermore, the patient reported vertigo and paraesthesia. Brain and spinal MRI revealed T2-hyperintense lesions with a prominent acute lesion in the pontomedullary area. Cerebrospinal fluid findings revealed a lymphocytic pleocytosis and intrathecal IgG synthesis. Serum neurofilaments were elevated. The patient was diagnosed with MS, and treatment with intravenous Methylprednisolone was initiated. The brainstem lesion due to multiple sclerosis was assumed to be the cause of stress cardiomyopathy. The patient fully recovered. Conclusion Stress cardiomyopathy may be linked with the first manifestation of multiple sclerosis in the presented case since pontomedullary lesions could affect the sympathetic nervous system. This case highlights the importance of neurological history and examination in young patients with unexplained acute cardiac complaints.Background More older people are living in the community with multiple diagnoses and medications. Managing multiple medications produces issues of unrivalled complexity for those involved. Despite increasing literature on the subject, gaps remain in understanding how, why and for whom complex medication management works, and therefore how best to improve practice and outcomes. MEMORABLE, MEdication Management in Older people Realist Approaches Based on Literature and Evaluation, aimed to address these gaps. Methods MEMORABLE used realism to understand causal paths within medication management. Informed by RAMESES (Realist And Meta-narrative Evidence Synthesis and Evolving Standards) guidelines, MEMORABLE involved three overlapping work packages 1) Realist Review of the literature (24 articles on medication management exploring causality); 2) Realist Evaluation (50 realist-informed interviews with older people, family carers and health and care practitioners, explaining their experiences); and 3) data synthesiMORABLE identified five burdens amenable to mitigation ambiguity, concealment, unfamiliarity, fragmentation and exclusion. Two initial improvement propositions were identified for further research a risk screening tool and individualised information. Conclusions Older people and family carers often find medication management challenging and burdensome particularly for complex regimens. Practitioners need to be aware of this potential challenge, and work with older people and their carers to minimise the burden associated with medication management. Trial registration PROSPERO 2016CRD42016043506.The scope of AGHE's responsibility to gerontology and geriatrics extends worldwide, as reflected in its tag line, "Global Leaders in Education on Aging." Optimal responses to worldwide demographic transitions can only come from persons well versed in the dimensions of aging and trained and globally situated to translate that knowledge into effective and culturally appropriate solutions. This article reviews the evolution of AGHE's role in initiating and fostering global networks of educators in gerontology and geriatrics, including collaborative efforts with major international organizations (e.g., WHO, UN, IAGG) to increase the visibility and appreciation of aging-related issues among world leaders; sponsoring national and international meetings and publications to promote the exchange of ideas and refinement of teaching methodologies; initiating and adapting new models of gerontological training enhanced by advances in information and communication technology; and supporting world-wide cohorts of emerging scholars to assume leadership roles within the organization. Recommendations for next steps are considered.This study aimed to improve verb retrieval ability in Mandarin-English bilinguals with aphasia by adapting the Verb Network Strengthening Treatment (VNeST) into Mandarin Chinese. Two Mandarin-English bilingual patients with chronic post-stroke aphasia participated in this study via online conferencing system following a multiple-baseline design. Both of them completed a 10-week of Mandarin VNeST treatment, and were probed on verb retrieval ability in a sentence context in both languages. Response accuracy was analysed to investigate the treatment acquisition, within-language generalization, and cross-language generalization effects. Standardized language assessments in both languages were administered pre- and post-treatment to further examine generalization to other linguistic tasks. Error analysis was conducted to investigate the evolution of within- and cross-language errors. Both patients improved after training in Mandarin VNeST, and showed different patterns of within-language and cross-language generalizations. T3 activator mw They also improved in a variety of standardized language tasks. Error analysis showed a decline in semantic errors over the course of treatment in both patients, with cross-linguistic errors showing a decrease during Mandarin probes and an increase during English probes in one of the patients. This study contributes to our current understanding of theories of bilingual verb processing, and provides treatment guidance in Mandarin-English bilinguals with aphasia.Purpose The growing range and complexity of community care services require robust approaches to ensuring quality. Method This review collated studies on the use of standards in regulating community health and social care using Social Care Online, MEDLINE and CINAHL databases. Studies were appraised by two reviewers and synthesized by study themes. Results Sixteen studies were synthesized under three themes standards in quality assurance and quality improvement; effectiveness of standards; and design of regulatory standards. Standards facilitate providers in self-regulation and enable regulators to support and monitor improvement. Effectiveness of standards depends on their language and interpretation, and on organizational factors. There was little evidence of scales within quality standards. Discussion There is continuing debate about self-regulation versus external regulation. Social care service regulation requires more research. Conclusion Regulatory organizations should take note of wider initiatives toward evidence-based practice in the design of quality standards.