Notes

Correlation involving vestibular aqueduct dimensions using air-bone gap inside increased vestibular aqueduct symptoms.
ssociation between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.
Epicutaneo-caval catheters (ECCs) are extensively used in premature and ill neonates. This prospective, randomized, observational study aimed to compare the outcomes of ECC placement in the distal superficial femoral and axillary veins in neonates with difficult ECC access.

In a neonatal intensive care unit at a tertiary referral center, 60 neonates with difficult ECC access were randomized into two groups with catheters placed using the ultrasound-guided modified dynamic needle tip positioning (MDNTP) technique distal superficial femoral vein (DSFV) and axillary vein (AV) groups.

The first attempt success rate was significantly higher in the DSFV group than in the AV group [23/30 (76.7%) vs 11/30 (36.7%),
 = 0.001; odds ratio (OR), 0.176; 95% confidence interval (CI) 0.057-0.543]. The mean procedural duration was significantly shorter in the DSFV group than in the AV group [mean 308.5 (standard deviation 81.1) s vs 522.74 (134.8) s,
 = -7.17,
 < 0.001]. The incidence of complications was significantly lower in the DSFV group than in the AV group [4/30 (13.3%) vs 12/30 (40.0%),
 = 0.019; OR, 4.333; 95% CI 1.203-15.604]. The number of attempts was significantly fewer in the DSFV group than in the AV group (
 = 0.012).

The distal superficial femoral and axillary veins are two alternative and safe access points for ECC placement in premature neonates (weight < 2.5 kg) with difficult access. However, access through the distal superficial femoral vein was quicker, easier, and had fewer complications than through the axillary vein.
The distal superficial femoral and axillary veins are two alternative and safe access points for ECC placement in premature neonates (weight  less then  2.5 kg) with difficult access. However, access through the distal superficial femoral vein was quicker, easier, and had fewer complications than through the axillary vein.
Cognitive flexibility deficits are present in patients with schizophrenia and are strong predictors of functional outcome but, as yet, have no pharmacological treatments.

The purpose of this study was to investigate whether the phosphodiesterase type-4 inhibitor, roflumilast, can improve cognitive flexibility performance and functional brain activity in patients with schizophrenia.

This was a within-subject, randomised, double-blind, placebo-controlled, three-period crossover study using a version of the Intradimensional/Extradimensional (ID/ED) task, optimised for functional magnetic resonance imaging (fMRI), in 10 patients with schizophrenia who were scanned after receiving placebo, 100 µg or 250 µg roflumilast for 8 consecutive days. Data from an additional fMRI ID/ED study of 18 healthy participants on placebo was included to contextualise the schizophrenia-related performance and activations. The fMRI analyses included
driven region of interest (ROI) analysis of the dorsal frontoparietal attenti effects on the ID/ED task in patients with schizophrenia, and provides sufficient support for larger studies to test roflumilast's role in improving cognitive flexibility deficits in this clinical population.
Glucocorticoid (GC) administration prior to exposure-based cognitive-behavioural therapy (CBT) has emerged as a promising approach to facilitate treatment outcome in anxiety disorders. learn more Further components relevant for improved CBT efficacy include raised
GCs and reductions in information-processing biases to threat.

To investigate hydrocortisone as an adjunct to CBT for spider fear and the modulating role of threat bias change and endogenous short-term and long-term GCs for treatment response.

Spider-fearful individuals were randomized to receiving either 20 mg of hydrocortisone (
= 17) or placebo (
= 16) one hour prior to single-session predominantly computerised exposure-based CBT. Spider fear was assessed using self-report and behavioural approach measures at baseline, 1-day and 1-month follow-up. Threat processing was assessed at baseline and 1-day follow-up. Cortisol and cortisone were analysed from hair and saliva samples at baseline.

Self-report, behavioural and threat processing indices amples are needed.
Pilates-based core stability training (PBCST) is a controlled form of exercise that may improve the transmission of torque from the upper extremities and trunk to the lower extremities by enabling the core muscles to activate effectively.

The aim of this study was to investigate the effects of PBCST given as supervised or home-based on lower extremity strength and postural control in multiple sclerosis.

Fifty individuals were enrolled and randomly allocated into two groups. Primary outcome measures were knee muscle strength and postural sway in different conditions. The supervised group received PBCST 2 days per week for 8 weeks at the clinic, and the other group performed PBCST at home. Exercises were progressed every 2 weeks in both groups.

Between groups, the supervised group was mostly superior to the home group (
< 0.05). A significant improvement was noted in all parameters in both groups, except some sub-parameters of postural sway in home PBCST (
< 0.05).

Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.
Supervised PBCST was determined to be more effective than home PBCST in improving strength, postural control, core stability, physical capacity, and fatigue. Although supervised training is the primary choice, home training can be recommended to patients who have limitations attending supervised sessions.The extended producer responsibility (EPR) has been adopted in many countries throughout the world to give producers responsibility to manage their products until the post-consumer stage. On many occasions in developing countries, the system is mostly implemented for electronic waste. However, with the rising concern on the marine plastic issue, developing countries, including those in Asia, have started to apply EPR for package and container waste. In practice, developing countries show significant differences in their EPR implementation compared with developed ones due to contrasting conditions of several factors, including social, economic and technology. This article aims to explore the challenges of developing countries to apply EPR as well as determine possible measures to overcome the challenges. Results show that applying EPR system for plastic waste in developing countries faces many challenges, such as the existence of a market-based collection system of recyclables, high transportation cost, lack of waste collection services in rural areas, a limited number of facilities to manage certain types of plastic waste, insufficient pollution control and free riding and orphan products. The challenges, furthermore, can be minimised by differentiating the responsibility of producers, focusing on rural and remote areas, involving informal sectors, creating joint facilities in recycling parks, expanding waste management collection services, increasing the use of EPR and minimising free riding.
Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017.

National life table data were combined with cross-sectional data on functional ability for 70+ year-olds from the population-based Trøndelag Health Surveys 2-4 (1995-1997, 2006-2008 and 2017-2019) (
=24,733). Self-reported functional ability was assessed on a graded scale by a combination of Instrumental Activities of Daily Living (IADL) such as paying bills, going out or shopping (mild disability) and Personal Activities of Daily Living (PADL) such as washing, dressing or eating (severe disability). LE, DFLE, Mild-Disability LE and Severe-Disability LE at age 70 were estimated by the Sullivan method.

From 1995 to 2017 DFLE at age 70 increased from 8.4 to 13.0 years in women, and from 8.0 to 12.1 years in men. DFLE increased in the basic and high educational groups, but more so in the high educational group among men. Educational inequalities in years spent with disability however, remained low.


From the mid-1990s and over the past three decades both LE and DFLE at 70 years increased in the older Norwegian population, for both men and women, and across basic and high educational levels. Educational inequalities in DFLE increased, especially in men, but years spent with disability were similar across the three decades.This study evaluated an antibiotic stewardship program (ASP) intervention aimed at reducing inpatient fluoroquinolone (FQ) use and examined its impact on ciprofloxacin susceptibilities of gram-negative bacteria in a large 611-bed community hospital. A two-step ASP intervention was implemented an electronic medical record algorithm that prompted physicians to re-evaluate FQ use shortly after admission and changed institutional UTI/pneumonia guidelines that recommended options alternate to FQs for first-line empiric antibiotic therapy in 2010 and 2011 respectively. Between 2007 and 2017 FQ use and ciprofloxacin susceptibilities of all non-duplicate cultured isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa obtained ≥72 h after admission were reviewed. Ambulatory care isolates served as a comparison group. FQ utilization rates and relationships to ciprofloxacin susceptibility were evaluated using interrupted time series models. Over the 11-year period, FQ use decreased from 110.0 (2007) to 26.2 (2017) days of therapy/1000 days at risk (p  less then  0.001). Compared to pre-intervention, the estimated (post-intervention) reduction in FQ utilization was 28.4 (95% CI 10.9-46) days of therapy/1000 days at risk. Reduced FQ utilization was correlated with increase susceptibilities to ciprofloxacin of hospital onset isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis (p  less then  0.02), and Pseudomonas aeruginosa (p = 0.07). No significant susceptibility change was observed in the ambulatory care isolates. Persuasive interventions by an ASP successfully modified physicians' inpatient empiric antibiotic use, produced a sustained reduction in FQ utilization rates and increased ciprofloxacin susceptibility to four commonly encountered gram-negative bacteria in a community hospital.
This study uses a broad range of activities to examine how the type of activity, its social context, associated stress, importance, and the level of effort required are linked with activity enjoyment. Using aggregated data from all activities, it analyses the association between the experiential wellbeing of individuals and their satisfaction with life in general.

The data set included 1809 activities, reported by 200 non-institutionalised adults, aged 65 and above, living in Poland. Activity data were collected using the experience sampling method. Multilevel mixed effects models examined what makes an activity enjoyable for older adults. Linear regression models examined the relationship between aggregated subjective activity characteristics and satisfaction with life in general.

The most enjoyable activities were religious practice, childcare, and socialising. Enjoyment was positively associated with perceived activity importance, inversely associated with stress, and formed a U-shaped association with effort.
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