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6%) were detected as outliers (mHKA > 0° ± 3°) at 3 months after surgery. Of the 64 cases, 25 cases (9.8%) were affiliated to group 1 and 39 cases (18.1%) were affiliated to group 2. Group 2 showed significantly higher occurrence of outliers than group 1 (p = 0.01). Multiple variables logistic regression analysis, which analyzed the difference in the occurrence rate of outliers (mHKA > 0° ± 3°), showed that the occurrence rate of group 2 was 2.04 times higher than group 1. After adjusting for patient's age, gender, and body mass index, the occurrence rate of outliers in group 2 was 2.01 times higher than group 1. Conclusion The benefit of computer-assisted navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative varus deformity is severely advanced.Hospitals and healthcare systems have nursing informaticists who contribute to quality patient care and safety by managing data and facilitating the use of technology. Schools typically do not employ nurses specifically in positions labeled as nursing informaticists, though the role is critical in the schools. This article highlights the subspecialty of nursing informatics within the school nurse role. Three school nurses will share their use of nursing informatics skills to optimize student health.Objective Adults with ADHD are often victims of psychological and physical violence by romantic partners, but less is known regarding whether ADHD is associated with sexual assault victimization. Method Adults with (n = 97) and without childhood histories of ADHD (n = 121) rated their experiences with sexual assault victimization and additional risk factors (i.e., alcohol abuse, illicit drug use, and experiencing child abuse). Results Adults with ADHD histories were more likely to report being victims of sexual assault, especially attempted rape or rape, than adults without ADHD histories. The rate of rape victimization was not greater for adults with ADHD histories and persistent symptoms or additional risk factors. Conclusion Research is needed to investigate potential mechanisms explaining the link between ADHD and sexual victimization. Clinicians seeking to prevent at-risk populations from becoming victims, or to provide services for victims, should consider screening adults for ADHD histories.Objective To translate the Hearing Handicap Inventory for Adults (HHIA) and Hearing Handicap Inventory for the Elderly (HHIE) into Arabic while ensuring that the reliability and validity are the same as those of the original English versions.Design Descriptive, cross-sectional study.Study sample In total, 115 individuals with hearing impairment and 114 controls with normal hearing completed the Arabic versions of HHIA/HHIE. Each subject underwent a complete audiological evaluation before answering the questionnaires. The construct and discriminant validities were determined in addition to the reliability, which was investigated by calculating the internal and test-retest consistencies.Results Internal consistency between the total and subscale scores were excellent for the Arabic versions of HHIA and HHIE (Cronbach's alpha ∼0.90). With regard to the test-retest reproducibility, the Spearman's correlation coefficient for consistency between total scores obtained at baseline and those obtained at 6 weeks was acceptable (r = 0.761, p less then 0.0001). The total scores were statistically proportional to the degree of hearing loss. Moreover, the questionnaire successfully differentiated between individuals with hearing impairment and those with normal hearing.Conclusions Our findings clarified that the Arabic versions of HHIA and HHIE are acceptable tools for evaluating the psychological influences of hearing loss in Arabic populations.Background Atrial fibrillation (AF) is a comorbidity associated with heart failure and catecholaminergic polymorphic ventricular tachycardia. Despite the Ca2+-dependent nature of both of these pathologies, AF often responds to Na+ channel blockers. We investigated how targeting interdependent Na+/Ca2+ dysregulation might prevent focal activity and control AF. Methods and Results We studied AF in 2 models of Ca2+-dependent disorders, a murine model of catecholaminergic polymorphic ventricular tachycardia and a canine model of chronic tachypacing-induced heart failure. Imaging studies revealed close association of neuronal-type Na+ channels (nNav) with ryanodine receptors and Na+/Ca2+ exchanger. Catecholamine stimulation induced cellular and in vivo atrial arrhythmias in wild-type mice only during pharmacological augmentation of nNav activity. In contrast, catecholamine stimulation alone was sufficient to elicit atrial arrhythmias in catecholaminergic polymorphic ventricular tachycardia mice and failing canine atria. Importantly, these were abolished by acute nNav inhibition (tetrodotoxin or riluzole) implicating Na+/Ca2+ dysregulation in AF. These findings were then tested in 2 nonrandomized retrospective cohorts an amyotrophic lateral sclerosis clinic and an academic medical center. Riluzole-treated patients adjusted for baseline characteristics evidenced significantly lower incidence of arrhythmias including new-onset AF, supporting the preclinical results. Conclusions These data suggest that nNaVs mediate Na+-Ca2+ crosstalk within nanodomains containing Ca2+ release machinery and, thereby, contribute to AF triggers. Disruption of this mechanism by nNav inhibition can effectively prevent AF arising from diverse causes.One of the top carnivores in the Andean mountains is the Andean bear (Tremarctos ornatus, Ursidae), the only bear in South America. This is a flagship and key umbrella species in Ecuador because its conservation has a positive impact on the conservation of many other species in the Andes. But to preserve, first one must know the genetic characteristics of a species, among other things. For this, we analyzed six mitochondrial genes and seven nuclear DNA microsatellites of 108 Andean bear specimens sampled throughout Ecuador. We adopted three strategies for analyzing the data by Province, by Region (north vs south), and by Cordillera. Four main results were obtained. First, the mitochondrial genetic diversity levels were elevated, but there were no differences in genetic diversity by Province or by Cordillera. By Regions, southern Ecuador had higher genetic diversity levels than to northern Ecuador. The genetic diversity for the microsatellites was only medium for the Andean bear at this country. Second, there s. Therefore, all of the Andean bear specimens in Ecuador should be treated as a unique Management Unit (MU) for conservation purposes, differently to that determined for other countries as Colombia.Objectives An increasing bulk of data underlined that mood disorders show alterations that are not confined to the brain, but involve several other systems. The aim of this retrospective study was to explore metabolic/inflammatory profiles, blood pressure, and BMI in patients affected by bipolar disorders (BDs) to better understand the role of peripheral biomarkers in mood disorders.Methods Different metabolic/inflammatory parameters and clinical characteristics were evaluated in 97 BD inpatients from Sicily, a southern Italian region, and compared with normative values from the same area.Results No difference was detected between the assessed parameters and the normative values, or between treated and untreated patients. Interestingly, the mean acid uric levels were at the lowest extreme of the normative values, with men showing higher concentrations than women.Conclusions No metabolic nor inflammatory alterations emerged in BD patients, even if when obese. A possible explanation might be due to their geographical origin, with culinary traditions based on the Mediterranean diet. Therefore, it would be interesting to ascertain whether such a diet might improve the metabolic impairment often associated with mood disorders. Again, the routine assessment of different clinical/chemistry parameters might be helpful to improve the diagnostic stratification and the personalised treatment.Objectives The aims of this cross-sectional study were to assess the pneumococcal antibody coverage in patients with autoimmune inflammatory rheumatic disease (AIRD) and to identify predictors associated with inadequate protective antibody levels. Method Antibodies to 12 serotypes occurring in the commonly applied pneumococcal vaccines in Denmark were measured in AIRD patients with a diagnosis of rheumatoid arthritis, spondyloarthritis, or psoriatic arthritis attending the Department of Rheumatology at the North Denmark Regional Hospital. Immunization against pneumococcal infection was defined as a geometric mean level ≥ 1 μg antibodies/mL. Clinical information about vaccination status and disease/treatment history was retrieved from the medical file system. Results Results of antibody measurement and vaccination status were available from 346 AIRD patients, of whom 200 (58%) were registered as receiving pneumococcal vaccination, whereas the remaining 146 patients (42%) were not. Of all 346 patients, only 61 (18%) were measured with an adequate level of protective antibodies (30% vs 1%, respectively). Methotrexate treatment at the time of vaccination and increasing age were identified as predictors of poor vaccination outcome in multiple logistic regression analysis. Conclusions This post-vaccination study showed that less than one-fifth of the AIRD patients are adequately protected against pneumococcal infection, although the immunization programme had been implemented in more than half of the study population. Development of improved vaccination strategies is required to achieve a higher immunization coverage rate and more efficient lasting antibody response.Methamphetamine-associated cardiomyopathy (MACM) is an increasingly recognized disease entity in the context of a rapidly spreading methamphetamine epidemic. MACM may afflict individuals with a wide range of ages and socioeconomic backgrounds. Presentations can vary greatly and may involve several complications unique to the disease. Given the public health significance of this disease, there is a relative dearth of consensus material to guide clinicians in understanding, diagnosing, and managing MACM. This review therefore aims to (1) describe pathologic mechanisms of methamphetamine as they pertain to the development, progression, and prognosis of MACM, and the potential to recover cardiac function; (2) summarize existing data from epidemiologic studies and case series in an effort to improve recognition and diagnosis of the disease; (3) guide short- and long-term management of MACM with special attention to expected or potential sequelae of the disease; and (4) highlight pivotal unanswered questions in need of urgent investigation from a public health perspective.Objectives To examine the associations and the mechanisms between caregiver burden and compassion fatigue among family caregivers. Method A cross-sectional study comprising 300 family caregivers of older relatives in Arab communities in Israel was conducted. Data were collected via face-to-face interviews in Arabic using structured questionnaires to identify factors associated with compassion fatigue (using a secondary traumatization stress scale). Bootstrapping with resampling strategies tested the multiple mediator model. Main findings The results show a significant total effect of caregiver burden on compassion fatigue (b = 3.79, t(300) = 3.47, p less then .001; R2 =.50). This association was found to be partially mediated by family support (B = .81, 95% confidence interval [CI] = 0.23, 1.85) and disengagement coping (B = .97, 95% CI = 0.19, 2.14), but was not mediated by engagement coping strategies. kira6 molecular weight Conclusion Compassion fatigue is prevalent among family caregivers and requires more attention from professionals and policymakers.
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