Notes

RENANO: any REference-based converter for NANOpore FASTQ information.
To this context, validated analytical methods for routine quality control are essential for quantification of LND as an API alone and together with pharmaceutical formulations. This review suggests therapeutic, pharmacological, and analytical aspects regarding the novel drug LND and particularly focuses on discussing various reported analytical methods present for analytical or bioanalytical estimation of the drug and suggest to develop a simple and validated method which also complies to green chemistry.Levels of self-harm for young people in care are high, and even higher for those in residential care. Recent research highlights the importance of understanding self-harm relationally. Epigenetic inhibitor order Such an approach may be of particular value for understanding the self-harm of young people in care. The aim of this research was to understand the experiences of young people who self-harm whilst living in residential care, with a particular focus on the effect of the care setting on their self-harm. Five young people participated in semi-structured interviews which were analysed using Interpretive Phenomenological Analysis. Four themes emerged 'The black hole of self-harm', 'Seeking genuine care and containment', 'The cry to be understood' and 'Loss of control to the system.' Young people recognised their need for support with their self-harm, but organisationally driven approaches to managing risk contributed to a perception that the care offered was not genuine, which led to an unwillingness to accept care. The findings highlight the need for a more compassionate, relational response to young people who self-harm in residential care.A psychosomatic model of dissociation is proposed that addresses the ever adjusting mind-body relation-the constant titration of the quality and degree of the psyche's embeddedness in the sensorial and temporal life of the body. The model highlights the function of hypnoid mechanisms (autohypnosis, distraction, somatic autostimulation) and of altered states of consciousness in facilitating and masking the work of mind-body dissociation. Transient altered states, which enable new and creative forms of mind-body experience in everyday life and in the therapy situation, are contrasted with pathological forms of retreat into alter worlds-rigidly organized, timeless, often inescapable trancelike states of mind-body dislocation. These pathological dissociative structures reshape the life of the mind and of the body, requiring new clinical approaches to these phenomena.The analyst's embodied attunement and participation arises within an embodied analytic relationship. Understanding this "deep structure" of the interaction and attention to this level of interaction opens up new modes of engagement and therapeutic action. The importance of embodied attunement is supported by recent research and theories that the developing mind is shared and dialogical through bodily communication, by rhythms of cadence, tone, intensity, and movement. The analyst's embodied awareness of two bodies together and their interpersonal rhythm is the "tool" used to gauge the pulse, vitality of connection, and particular rhythmic qualities of a uniquely shared world. This provides a read on the most elemental way the dyad shares emotional experience (or fails to). The analyst's embodied participation is interpretation in another mode. Clinical examples illustrate how embodied attunement and intentional participation work in the session, and their therapeutic effect. Failures of attunement are also discussed in terms of how the analyst recognizes these failures and his internal process of reattunement.Psychoanalytic treatment is often indicated when trauma and its psyche/soma companion, dissociation, severely disrupt symbolic functioning and associative linking. After Freud's initial thinking on these matters, repression replaced rather than supplemented dissociation (which occasions segregating units of experience) as the primary defensive response to severe trauma. Because psychoanalysis had "repressed" the salience of dissociation as actively motivated (though passively experienced), an unnecessary schism has occurred between trauma theories and mainstream North American psychoanalysis, and within psychoanalysis itself. To fully restore dissociation's role in primitive mental states and provide a more integrated approach to technique, it is necessary to comprehend the triadic nature of trauma, which entails economic/drive, structural conflict and deficit, and object-relational factors. For a treatment model that addresses defensive dissociation in the here and now, primary and secondary dissociation must be distinguished, with each differentiated from splitting and repression. Technique requires addressing unconscious, repressed fantasies associated with the "trauma," object-relational patterns that interfere with linking, and psycho-economic issues that have disrupted ego functioning. A clinical example illustrates both the analyst's persistence in suffering the dead, eerie space of dissociated trauma and efforts to find language that helps structure the patient's somatic and enacted expressions (and accompanying dissociative and repressive processes) by which traumatic experiences are registered and conveyed.Although the importance of caregiver engagement in a child's psychological treatment is well established within outpatient treatment settings, the question remains whether these findings can be generalized to more intensive treatment settings where caregiver engagement may be more challenging to facilitate. A correlational, multi-informant design was used to collect data by caregiver self-report and therapist-report from a sample of 64 caregivers of youth referred for partial hospitalization. Results show that caregivers' attitudinal self-assessment of engagement was not significantly related to their self-report of behavioral engagement (e.g. number of family sessions attended) or therapists' report of caregiver engagement. After controlling for caregiver expectations and therapist ratings of caregiver engagement, only caregiver ratings of attendance at family sessions marginally predicted treatment outcomes, but in the negative direction. Implications for adapting measures of caregiver engagement to intensive treatment settings and its impact on treatment outcomes are discussed.
Bronchoscopic lung volume reduction (BLVR) by either the endobronchial valve (EBV) or coil (EBC) procedure is recommended for severe emphysematous patients. BLVR applications generally help healthy lung areas ventilate more comfortably by reducing the hyperinflation and improving the contraction capacity of diaphragm.

Compare our experience with valve and coil BLVR devices.

Retrospective.

Single tertiary care centre.

Demographic data, vital signs, pulmonary function tests (PFTs), the six-minute walking test (6MWT), vital signs, arterial blood gases and complications were recorded.

Change in PFTs and completion of the 6MWT.

60 Turkish men with a diagnosis of chronic pulmonary lung disease.

Clinical and demographic characteristics were similar in patients who underwent EBV and EBC. Thirty (96.8%) EBV patients and 27 (93.1%) of the EBC patients were able to properly complete the PFT before the procedures, but all complied after the procedures. Significant improvement in PFTs were achieved after the procedure and there were no statistically significant differences in post-procedure performance. For the 6MWT, the completion rate improved from 15 (48.4%) to 19 (61.3%) patients in the EBV patients (
=.125) and from 19 (65.5%) to 21 (72.4%) patients in the EBC patients (
=.500). There was no significant difference in completion rates for the walking test for either group (median 32 meters in EBV patients and 37 meters in EBC patients;
=.652). Vital signs and arterial blood gases were similar in the two groups. The rates of complications were similar in both groups.

Endobronchial valves and coils are safe and effective methods for BLVR for patients with severe emphysema.

Relatively small sample, retrospective design, single-centre retrospective study.

None.
None.
Diabetes mellitus increases stroke risk 1.5 to 3 fold, particularly ischemic stroke. There is limited literature on the impact of diabetes on stroke patients in Saudi Arabia.

Determine the association of diabetes on the presentation, subtypes, in-hospital complications and outcomes of ischemic stroke and transient ischemic attacks (TIA).

IRB approved, retrospective chart review.

Tertiary care center.

All adult patients with ischemic stroke or TIA aged 18 years or older admitted from January 2016 to December 2017 were included.

Stroke severity at presentation, stroke-related complications, discharge disposition and discharge modified Rankin Scale (mRS) in relation to diabetes.

802 patients.

Among 802 cases, 584 (72.8%) had diabetes; the majority (63.1%) were males. The mean age was younger in the non-diabetic stroke group (54.6 [15.5] years vs. 63.3 [9.9],
<.001). Hypertension (83.6% vs 49.1%,
<.001), dyslipidemia (38.9% vs. 28.9%,
=.009), prior stroke (27.7% vs. 19.3%
=.014), andatients.

Missing data about time of presentation in few patients, missing modified Rankin Scale score at discharge.

None.
None.
Consanguinity is a commonly recognized practice among marriages in the Middle East and may lead to an increase in the prevalence of inherited disorders. Autosomal recessive deafness is the most common form of inherited congenital hearing loss (CHL).

Determine the association of consanguineous marriages with congenital sensorineural hearing loss (SNHL) and auditory neuropathy.

Descriptive and analytical cross-sectional study.

Ear specialist hospital.

Children with severe-to-profound congenital SNHL, who had been referred to the specialist hospital for cochlear implant were analyzed. Patients were divided into subgroups based on degree of consanguinity.

The relative risk of having more than one child with SNHL in offspring of a consanguineous marriage.

189 parents and children with CHL.

The parents of 157 children (83.1%) were blood-related. Of those, 48 had more than one child with CHL (31.4%), while only two parents who were not blood-related had more than one child with CHL (6.25%;
=.005). Among the 189 children, 131 (69.3%) parents were direct cousins. Only 39 (20.6%) and 43 (22.8%) children had family histories of CHL on the paternal and maternal sides, respectively. There was no statistically significant difference in the prevalence of auditory neuropathy between the offspring of consanguineous and non-consanguineous marriages (
=.648).

The risk of having more than one child with SNHL in the offspring from a consanguineous marriage is 3.5 times higher than that of a non-consanguineous mating.

The association of hearing loss degree with consanguinity was not studied.

None.
None.
Cochlear implant (CI) recipients with a cochleovestibular malformation (CVM) are at a higher risk of experiencing an intra-operative cerebrospinal fluid (CSF) gusher and, therefore are at greater risk of developing postoperative meningitis than are CI recipients with normal cochlear anatomy. To control CSF gushers, the FORM electrode array was developed.

To assess the ability of the FORM24 electrode array in managing intraoperative CSF gushers and preventing postoperative CSF leakage in a population of CI recipients.

Retrospective.

Tertiary health care center.

All CIs in which a FORM24 was used between January 2014 and March 2018 were reviewed for demographic and safety results.

Safety results were assessed as the intraoperative or postoperative presence of an episode of CSF leakage or meningitis.

177 CI recipients.

Thirty-six (20.3%) had a CVM and 141 had normal anatomy (79.7%). Of the 36 participants with a CVM, 20 (55.6%) experienced an intraoperative CSF gusher, all of which were resolved.
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