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Comparison of endoscopic therapies pertaining to anus neuroendocrine malignancies: endoscopic submucosal dissection using myectomy compared to endoscopic submucosal dissection.
45 ± 7.04 (range, 3.4-25.1) in malignant lesions and 2.88 ± 2.5 (range, 0.5-19.81) in benign lesions. The mean strain index for malignant lesions was significantly higher than that for benign lesions (P  less then  .05). The highest sensitivity was found for B-mode US, and the highest specificity was found for the strain index. The diagnostic performance of the strain index was higher than that of the 5-point scoring method. CONCLUSIONS The addition of a sonoelastographic examination to B-mode US prevents unnecessary biopsies. The strain index was found to be superior to the 5-point scoring method to a limited extent. © 2020 by the American Institute of Ultrasound in Medicine.Our article depicts and interrogates the claims for seeing coaching and mentoring as being distinct from each other, and rather suggests that context is agentic in determining which aspects of these two helping orientations are likely to be used by practitioners. To start with, our article traces the development of coaching and mentoring as two separate discourses. Traditionally, coaching has been associated with a shorter term performance focus, with the coach portrayed as a process- rather than a content knowledge-based expert. By contrast, mentoring has a longer-term holistic focus, where the mentor has direct experience and knowledge in the setting that the mentee is operating in. Then, we discuss some limitations of seeking conceptual distinctiveness in purely theoretical terms, including accentuating differences of practices that cannot easily be disentangled from each other in practice. Therefore, on the basis of a case study, where coaching and mentoring behaviors are used by leaders and managers, we argue that context plays an agentic role and influences which of the helping orientations is used by practitioners. https://www.selleckchem.com/products/plerixafor.html We conclude that, context being multifaceted, it leads to a kaleidoscope of coaching/mentoring behaviors, which supports a practice-based approach to the debate. © 2020 New York Academy of Sciences.BACKGROUND Developing countries bear the burden of childhood stunting but lack resources for cohort studies to develop preventive strategies. To enable future prospective studies, we designed and tested the Child Electronic Growth Monitoring System (CEGROMS) using a readily available electronic data capture platform, the Research Electronic Data Capture (REDCap). OBJECTIVES To demonstrate the feasibility of using CEGROMS for data collection for a pilot study for the Kaduna Infant Development (KID) Birth Cohort Study in Nigeria. METHODS CEGROMS consists of the data capture form for growth monitoring, a central cloud server, electronic tablets, and desktop computer. We implemented the pilot study in 2017-2019 at the Barau Dikko Teaching Hospital, Kaduna, Nigeria. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for completeness of baseline data (relative to individuals with incomplete data) and completion of follow-up at different time points (relative to individuals with no follow-up visit) by the participant characteristics. Complete data were defined as date of birth, sex, and birthweight recorded at recruitment. RESULTS Among 3152 infant records in CEGROMS, 2789 (88.5%) had complete data. Of these, 1905 (68.3%) had at least one follow-up visit. The main determinants of data completeness were health facility delivery (OR 19.17, 95% CI 13.65,26.92) and tertiary education (OR 3.54, 95% CI 2.69,4.67). Follow-up was greater for women with tertiary education (OR 1.33, 95% CI 1.06, 1.51 for at least one visit). Maternal education is associated with completeness and follow-up (following adjustments for parity and employment). CONCLUSIONS The CEGROMS electronic data collection system enables complete and consistent data collection. The data will enable design of strategies to improve follow-up in the future implementation of the birth cohort study. © 2020 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.BACKGROUND The objective of this retrospective cohort study was to assess the frequency, duration, and causes of hospitalizations in patients receiving home parenteral support (HPS) due to short-bowel syndrome (SBS) of nonmalignant causes. Furthermore, we aimed to investigate potential risk factors and hypothesized that patients with the shortest remnant, functional, small bowel-hence, the highest need for HPS-would have the highest incidence of hospitalizations. METHODS Patients with nonmalignant SBS who initiated HPS in the period from 1970 to 2016 from the Department of Gastroenterology, Rigshospitalet, Copenhagen, Denmark, were included. Information about demography, hospitalizations at the department, and duration of HPS was obtained from the Copenhagen intestinal failure database. RESULTS Patients (n = 331) received HPS for a total of 1409.9 years in the period. Hospitalizations accounted for 6.6% of the time registered as HPS-dependent. The average patient was hospitalized for 5.7% (range 0%-82%) of the registered HPS days. The incidence of admissions was 2.5 per HPS year. The median length of stay was 7 days (range; 0-387). Catheter-related complications were the most frequently registered causes of admissions (35.2%), subsequently accounting for 31.3% of the total admission time. A Cox regression of admissions showed no significant influence of the remnant-bowel anatomy but identified the ability to administer HPS unaided as associated with a significantly reduced hazard. CONCLUSIONS This retrospective study illustrated that 6.6% of the provided HPS days were, in fact, spent hospitalized. Since admissions elsewhere were not accounted for, this may be an underestimation. © 2020 American Society for Parenteral and Enteral Nutrition.This review aimed to summarize existing nursing literature to provide an overview of the extent, range, and nature of nurses' involvement in artificial nutrition and hydration (ANH) at the end of life and to map the key concepts underpinning nurses' involvement in ANH. A scoping review was designed following the methodological framework guidelines of Arksey and O'Malley and the recommendations for advancing the methodology by Levac et al. An inductive qualitative content analysis was conducted according to the guidelines by Elo and Kyngäs. Thirty-nine articles were identified. Content analysis revealed 1 main category "nurses' role in the decision-making process," with the 2 subcategories of "mediator" and "activator." The category and subcategories are influenced by the following generic categories "being," "feeling," and "knowing," each of them constituted by 2 subcategories in their turn. Nurses perform the roles of activator and mediator. Their ability to establish good relationships and their attitudes enable the creation of teamwork and closeness to patients and family relationships and attitudes are the subcategories of the "being" category. The category "feeling" represents the ways nurses experience the decision-making process, which can raise ethical and moral dilemmas and cause emotional responses. For these reasons, nurses have to create the right balance between personal-self and professional-self. The category "knowing" includes nurses' clinical and ethical knowledge about ANH. It emerges that deep clinical and ethical knowledge of ANH is necessary to provide consistent, adequate care at end of life. © 2020 American Society for Parenteral and Enteral Nutrition.We recently showed that TLR8 is critical for the detection of Gram-positive bacteria by human monocytes. Here, we hypothesized that TLR8 and complement together regulate antibacterial responses in human blood. Anticoagulated blood was treated with selective inhibitors of TLR8 and/or complement C5, and then challenged with live Streptococcus agalactiae (Group B streptococcus, GBS), Staphylococcus aureus, or Escherichia coli. Cytokine production, plasma membrane permeability, bacterial survival, phagocytosis, and activation of coagulation was examined. GBS and S. aureus, but not E. coli, triggered TLR8-dependent production of IL-12p70, IL-1β, TNF, and IL-6 in fresh human whole blood. In purified polymorphonuclear neutrophils (PMN), GBS and S. aureus induced IL-8 release in part via TLR8, whereas PMN plasma membrane leakage and extracellular DNA levels increased independently of TLR8. TLR8 was more important than C5 for bacteria-induced production of IL-12p70, IL-1β, and TNF in blood, whereas IL-8 release was more C5 dependent. Both TLR8 and C5 induced IL-6 release and activation of prothrombin cleavage, and here their combined effects were additive. Blocking of C5 or C5aR1 attenuated phagocytosis and increased the extracellular growth of GBS in blood, whereas TLR8 inhibition neither reduced phagocytosis nor intracellular killing of GBS and S. aureus. In conclusion, TLR8 is more important than C5 for production of IL-12p70, IL-1β, and TNF upon GBS and S. aureus infection in blood, whereas C5 is central for IL-8 release and phagocytosis. Both TLR8 and C5 mediate IL-6 release and activation of coagulation during challenge with Gram-positive bacteria in blood. © 2020 The Authors. Journal of Leukocyte Biology published by Wiley Periodicals, Inc. on behalf of Society for Leukocyte Biology.The diagnosis of temporomandibular disorders (TMD) is complex, and it is not yet clear in the literature whether the clinical changes associated with these disorders are also reflected in the electromyographic (EMG) activity of the muscles of mastication. To determine whether there is a difference in the electromyographic activity of the masticatory muscles between individuals with TMD and healthy controls. ScienceDirect, EMBASE, MEDLINE, PEDro, SciELO, CINAHL and LILACS databases from January 2000 to February 2019. Cross-sectional studies, crossover studies and randomised controlled trials evaluating EMG activity of right and left masseter and anterior temporal muscles in patients with TMD and healthy controls. Two independent assessors extracted data from the selected articles. The risk of bias was determined using a checklist for assessing methodological quality created based on the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology and International Society of Electrophysiology and Kinesiology. Mean differences and 95% confidence intervals were calculated and combined in meta-analyses. A total of 51 267 studies were retrieved, and 12 were included in this review. Only two studies enabled the comparative analysis of the results. The different EMG signal capturing, processing and analysis methods used constitute an important limitation to the comparative analyses of the results reported in the studies selected for the present review. This systematic review did not demonstrate evidence of significant differences in the EMG activity of the masticatory muscles between individuals with TMD and healthy controls. © 2020 John Wiley & Sons Ltd.Growth and nutrition in preterm infants have long-term implications for neurodevelopmental and cardiometabolic outcomes. Many infants are discharged from the neonatal intensive care unit (NICU) with growth restriction, but often without a specialized team to monitor postdischarge growth. At our institution, we addressed our ongoing concerns for the health and growth of these infants post-discharge by creating a Nutrition NICU Graduate Clinic. This clinic serves infants discharged from our NICU who were born with very low birth weight, had difficulty growing or feeding while inpatient, had a gastrostomy tube placed during hospitalization, or were deemed high risk for other reasons by our neonatal team, with the first clinic visit within 5 weeks of discharge. Data from our first 227 patients at time of discharge, first clinic visit, and any available second clinic visits are described. Anthropometrics show a high rate of extrauterine growth restriction at time of discharge with continued growth restriction at follow-up.
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