Notes

Time-Driven Activity-Based Charging inside Emergency Treatments.
Describe driving patterns following moderate-to-severe traumatic brain injury (TBI). Participants Adults (N=438) with TBI that required inpatient acute rehabilitation who had resumed driving.

Cross-sectional, observational design.

Eight TBI Model System sites.

A driving survey was completed at phone follow-up.

Most respondents reported driving daily, although 41% reported driving less than before their injury. Driving patterns were primarily associated with employment, family income, sex, residence, and time since injury, but not injury severity. Confidence in driving was high for most participants and was associated with a perception that the TBI had not diminished driving ability. Lower confidence and perceived loss of ability were associated with altered driving patterns.

Most people with moderate-to-severe TBI resume driving but perhaps not at pre-injury or normal levels compared to healthy drivers. Some driving situations are restricted. The relationship between low confidence/perceived loss of ability and driving patterns/restrictions suggests people with TBI are exhibiting some degree of caution consistent with those perceptions. Careful assessment of driving skills and monitoring during early stages of RTD is warranted, particularly for younger, male, and/or single drivers who express higher levels of confidence.
Most people with moderate-to-severe TBI resume driving but perhaps not at pre-injury or normal levels compared to healthy drivers. Some driving situations are restricted. The relationship between low confidence/perceived loss of ability and driving patterns/restrictions suggests people with TBI are exhibiting some degree of caution consistent with those perceptions. Careful assessment of driving skills and monitoring during early stages of RTD is warranted, particularly for younger, male, and/or single drivers who express higher levels of confidence.Foetal ductus arteriosus (DA) constriction can be found in complex foetal heart malformations, but rarely as an isolated defect. Although many cases of DA constriction are usually related to Non-steroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake, other causes remain without an established aetiology and are referred to as idiopathic. Recently, a wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) showed a definitive effect upon the pathway of inflammation, causing DA constriction. We report a case of a premature DA constriction in a woman whose possible risk factor was identified in her maternal occupational exposure to solvents and a comprehensive literature review of 176 cases of NSAID-unrelated DA constriction. A 30-year-old Asian woman was referred to our institution at 33 gestational weeks and 0 days because of suspicion of premature DA constriction. The woman had no history of medication intake, including NSAIDs, alcohol, tobanimal models.KEY MESSAGESMany cases of DA constriction are usually related to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake.A wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) can cause foetal DA constriction.Further investigation are needed to confirm the role of maternal exposure to solvents in the pathogenesis of DA constriction.Background Cortisol is a crucial hormone for adaptation to challenging and stressful situations. Hair cortisol measurement is used to determine chronic stress; the growth rate of hair allows to determine averaged cortisol levels for a longer period. Objective Pre- and post-injury measures of hair cortisol were compared in patients with mild traumatic brain injury (mTBI), and related to their coping styles.Methods For 46 patients with mTBI, 3 cm scalp hair samples were collected 4-6 weeks post-injury, resulting in two 1 cm segments, pre- and post-injury. Hair samples were also collected for 11 healthy controls. Hair cortisol was quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Complaints, anxiety, depression and coping style were measured two weeks post-injury and long term (six-twelve months), added with measures for post-traumatic stress and functional outcome.Results There were no differences between patients' pre- and post-injury cortisol levels, nor between cortisol levels of patients and controls. However, pre- and post-injury cortisol levels of patients were negatively correlated with both passive and an avoidant coping style.Conclusions Our findings suggest that mTBI has no separate impact on chronic long-term cortisol levels, possibility indicating that variability in cortisol levels reflects individuals' premorbid characteristics determining coping with stress in general.Iron is a vital micronutrient required for growth and development at all stages of human life. Its deficiency is the primary cause of anemia that poses a significant global health problem and challenge for developing countries. Various risks are involved during iron deficiency anemia (IDA), such as premature delivery, low birth weight, etc. Further, it affects children's cognitive functioning, delays motor development, hampers physical performance and quality of life. It also speeds up the morbidity and mortality rate among women. The major reasons accountable are elevated iron demand in diet, socio-economic status, and disease condition. Various strategies have been adopted to reduce the IDA occurrence, such as iron supplementation, iron fortificants salts, agronomic practices, dietary diversification, biofortification, disease control measures, and nutritional education. Usually, the staple food groups for fortification are considered, but the selection of food fortificants and their combination must be safe for the consumers and not alter the finished product's stability and acceptability. Genetically modified breeding practices also increase the micronutrient levels of cereal crops. Therefore, multiple strategies could be relied on to combat IDA.Objectives The aim of this study is to explore and compare the relationships of both global longitudinal strain (GLS) and strain (SR) with E/e' ratio in a population of asymptomatic patients with systemic hypertension.Methods Retrospectively included 210 cases of essential hypertension patients. Dynamic images were analyzed for left ventricular myocardial systolic global longitudinal strain (GLS), left ventricular longitudinal peak systolic strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa). According to the 2012 baseline E/e' ratio, the population was divided into three groups, group A (E/e'14). In multivariable analysis, IVS-e' less then 7 cm/s showed almost 2.5-fold increased risk for decreased GLS (OR 2.48[95% CI 1.36-4.53]; p = 003).Conclusions Our current study demonstrated that hypertensive patients with preserved LVEF and elevated E/e' ratio have systolic and diastolic abnormalities in longitudinal directions as detected by speckle imaging. E/SRe correlates well with E/e' and predicted elevated left ventricular filling pressure.
We explored the influence of low-dose intravenous alteplase and intensive blood pressure lowering on outcomes of acute ischemic stroke according to status/location of vascular obstruction in participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).

ENCHANTED was a multicenter, quasi-factorial, randomized trial to determine efficacy and safety of low- versus standard-dose intravenous alteplase and intensive- versus guideline-recommended blood pressure lowering in acute ischemic stroke patients. In those who had baseline computed tomography or magnetic resonance imaging angiography, the degree of vascular occlusion was grouped according to being no (NVO), medium (MVO), or large (LVO). Logistic regression models were used to determine 90-day outcomes (modified Rankin scale [mRS] shift [primary], other mRS cut-scores, intracranial hemorrhage, early neurologic deterioration, and recanalization) by vascular obstruction status/site. Heterogeneity in associations for outcomesion status/site according to analyses from ENCHANTED, although these results are compromised by low statistical power.
http//www.clinicaltrials.gov. Unique identifiers NCT01422616.
Functional outcome by dose of alteplase or intensity of blood pressure lowering is not modified by vascular obstruction status/site according to analyses from ENCHANTED, although these results are compromised by low statistical power.Clinical Trial Registration http//www.clinicaltrials.gov. Unique identifiers NCT01422616.The present study investigated the moderator role of multidimensional wisdom (i.e. see more individuals' positive personality traits) on the association between caregiver burden and depressive symptoms among family caregivers of disabled older adults in China.A quota sampling was used to recruit 789 pairs of disabled older adults and their primary family caregivers in Shanghai, China, in 2013. Multiple-group path analysis was used to test the proposed model.Cognitive, reflective, and affective wisdom were found to moderate the association between burden and depressive symptoms. The association was statistically significant among those with relatively low levels of cognitive, reflective, and affective wisdom. These associations, however, were found to be statistically nonsignificant among those with relatively high levels of cognitive, reflective, and affective wisdom.The findings highlight the important role of multidimensional wisdom in the underlying mechanisms of family caregiving from the perspective of the stress process model. Policy and intervention implications are discussed.Previous studies have presented a few evidences on the relationship between dietary carbohydrate intake, glycemic index (GI), glycemic load (GL), with the prostate cancer risk. We performed a case-control study to evaluate these associations in 50 men with histologically confirmed prostate cancer and 100 control men. Odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were derived using logistic regression. The fully adjusted ORs for the top vs. the bottom quartile were 15.02 (P trend = 0.004), 1.04 (P trend = 0.003), and 10.35 (P trend = 0.002) for carbohydrate intake, GI and GL, respectively. Significant associations with prostate cancer remained only among men with reduced fiber intake for carbohydrate intake, GI and GL and among those had increased fiber intake for GI. These findings support the hypothesis that diet with high carbohydrate, GI and GL enhance risk of prostate cancer.Formaldehyde (FA) is ubiquitous in the atmospheric environment. It is generally the dominant atmospheric carbonyl compound. Due to its well-known carcinogenicity, FA is a compound that arises the attention in the scientific community. In studies concerning the toxicological effects of FA on humans, animals, and the environment, testing and calibration of air sampling systems and analytical instruments are pivotal. Therefore, the preparation of controllable standard gaseous atmospheres containing FA at levels known with precision and accuracy is essential. This review summarizes the procedures for generating the FA atmosphere, given that operative solutions have been evolving recently. Furthermore, an overview on the available system to collect and store gaseous standard is reported. The progressively implemented FA generation techniques, together with commercially-available instruments, are herein described, classified, and compared.
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