969 results match your criteria spans middle

Specialised training in paediatric anaesthesia: Need of the hour.

Indian J Anaesth 2021 Jan 20;65(1):17-22. Epub 2021 Jan 20.

Department of Anaesthesiology and Critical Care, Government Medical College, Thrissur, Kerala, India.

Paediatric anaesthesia is an upcoming speciality which is gaining wide interest and can be a career choice for the new trainees. The need to develop paediatric anaesthesia as a speciality was realised with the progress in the field of paediatric surgery. The profile of the 'patient' encountered by a paediatric anaesthesiologist spans from an extremely premature neonate on the fringes of survival, to a full-grown adolescent equivalent to an adult. Read More

View Article and Full-Text PDF
January 2021

Employing learning health system principles to advance research on severe neonatal and paediatric illness in Kenya.

BMJ Glob Health 2021 03;6(3)

Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya.

We have worked to develop a Clinical Information Network (CIN) in Kenya as an early form of learning health systems (LHS) focused on paediatric and neonatal care that now spans 22 hospitals. CIN's aim was to examine important outcomes of hospitalisation at scale, identify and ultimately solve practical problems of service delivery, drive improvements in quality and test interventions. By including multiple routine settings in research, we aimed to promote generalisability of findings and demonstrate potential efficiencies derived from LHS. Read More

View Article and Full-Text PDF

A microanatomical and histological study of the scales of the Devonian sarcopterygian Miguashaia bureaui and the evolution of the squamation in coelacanths.

J Anat 2021 Mar 21. Epub 2021 Mar 21.

Département Origines & Évolution, UMR 7207 (MNHN-Sorbonne Université-CNRS), CR2P, Centre de Recherche en Paléontologie-Paris, Muséum national d'Histoire naturelle, Paris, France.

Coelacanths have traditionally been described as morphologically conservative throughout their long evolutionary history, which spans more than 400 million years. After an initial burst during the Devonian, a morphological stasis was long thought to have prevailed since the Carboniferous, as shown by the extant Latimeria. New fossil discoveries have challenged this view, with punctual and sometimes unusual departures from the general coelacanth Bauplan. Read More

View Article and Full-Text PDF

Transmission of the human relapsing fever spirochete by the argasid tick involves blood meals from wildlife animal reservoirs and mainly transstadial transfer.

Appl Environ Microbiol 2021 Mar 19. Epub 2021 Mar 19.

Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel

transmitted by the argasid tick causes human tick-borne relapsing fever in the Middle East and Central Asia. Infection is acquired often when visiting tick-infested caves and reported to be transmitted mainly transovarially between ticks occasionally infecting humans. To study the epidemiology of this infection, ticks were trapped in 24 caves in 12 geographic zones covering all of Israel and identified morphologically. Read More

View Article and Full-Text PDF

The Middle to Later Stone Age transition at Panga ya Saidi, in the tropical coastal forest of eastern Africa.

J Hum Evol 2021 Apr 11;153:102954. Epub 2021 Mar 11.

Department of Archaeology, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, 07745, Jena, Germany; Department of Anthropology, National Museum of Natural History, Smithsonian Institution, 600 Maryland Ave SW, Washington, D.C., USA; School of Social Science, The University of Queensland, Brisbane, QLD, 4072, Australia.

The Middle to Later Stone Age transition is a critical period of human behavioral change that has been variously argued to pertain to the emergence of modern cognition, substantial population growth, and major dispersals of Homo sapiens within and beyond Africa. However, there is little consensus about when the transition occurred, the geographic patterning of its emergence, or even how it is manifested in the stone tool technology that is used to define it. Here, we examine a long sequence of lithic technological change at the cave site of Panga ya Saidi, Kenya, that spans the Middle and Later Stone Age and includes human occupations in each of the last five Marine Isotope Stages. Read More

View Article and Full-Text PDF

The characteristics of 527 discharged COVID-19 patients undergoing long-term follow-up in China.

Int J Infect Dis 2021 Mar 1;104:685-692. Epub 2021 Feb 1.

Respiratory Department, Shandong Provincial Qianfoshan Hospital, Shandong University, The First Affiliated Hospital of Shandong First Medical University, Shandong Institute of Respiratory Diseases, Jinan, China. Electronic address:

Background: Almost a year after the outbreak of coronavirus disease 2019 (COVID-19), many hospitalized COVID-19 patients have recovered. However, little is known about the long-term follow-up (> 2 months) of discharged patients.

Methods: This study enrolled 527 discharged COVID-19 patients from 05 February to 11 March 2020. Read More

View Article and Full-Text PDF

Perspectives of elder abuse in Lebanon.

J Elder Abuse Negl 2021 Jan-Feb;33(1):65-81. Epub 2021 Feb 2.

University of Southern California, Los Angeles, California, USA.

Elder abuse is a preventable problem. Presently, little is known about this phenomenon in Middle Eastern settings. The purpose of this study was to explore elder abuse in Beirut, Lebanon from different stakeholders' points of view with a focus on identifying behaviors that are considered to be abusive to older adults and predisposing factors. Read More

View Article and Full-Text PDF
February 2021

Case Management on the Front Lines of COVID-19: The Importance of the Individualized Care Plan Across Care Settings.

Prof Case Manag 2021 Mar-Apr 01;26(2):62-69

Michelle Baker, BS, RN, CRRN, CCM, is the 2020-2021 chair of the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers. She is also Associate Director, Network Services, for Paradigm Catastrophic Care Management. Her primary areas of focus include administrative management of workers' compensation catastrophic nurse case managers and program development/implementation and training of the clinical network.

Purpose: Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease known as COVID-19, case management has emerged as a critical intervention in the treatment of cases, particularly for patients with severe symptoms and medical complications. In addition, case managers have been on the front lines of the response across the health care spectrum to reduce risks of contagion, including among health care workers. The purpose of this article is to discuss the case management response, highlighting the importance of individual care plans to provide access to the right care and treatment at the right time to address both the consequences of the disease and patient comorbidities. Read More

View Article and Full-Text PDF
February 2021

Chromophoric dissolved organic matter in inland waters: Present knowledge and future challenges.

Sci Total Environ 2021 Mar 17;759:143550. Epub 2020 Nov 17.

Ocean College, Zhejiang University, Zhoushan, Zhejiang, China. Electronic address:

Chromophoric dissolved organic matter (CDOM) plays an important role in the biogeochemical cycle and energy flow of aquatic ecosystems. Thus, systematic and comprehensive understanding of CDOM dynamics is critically important for aquatic ecosystem management. CDOM spans multiple study fields, including analytical chemistry, biogeochemistry, water color remote sensing, and global environmental change. Read More

View Article and Full-Text PDF

Comparison of different anticoagulation strategies for renal replacement therapy in critically ill patients with COVID-19: a cohort study.

BMC Nephrol 2020 11 16;21(1):486. Epub 2020 Nov 16.

Department of Medicine IV: Nephrology and Primary Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Background: Critically ill coronavirus disease 2019 (COVID-19) patients have a high risk of acute kidney injury (AKI) that requires renal replacement therapy (RRT). A state of hypercoagulability reduces circuit life spans. To maintain circuit patency and therapeutic efficiency, an optimized anticoagulation strategy is needed. Read More

View Article and Full-Text PDF
November 2020

Preexisting morbidity profile of women newly diagnosed with breast cancer in sub-Saharan Africa: African Breast Cancer-Disparities in Outcomes study.

Int J Cancer 2021 May 25;148(9):2158-2170. Epub 2020 Nov 25.

Section of Environment and Radiation, International Agency for Research on Cancer, (IARC/WHO), Lyon, France.

The presence of preexisting morbidities poses a challenge to cancer patient care. There is little information on the profile and prevalence of multi-morbidities in breast cancer patients across middle income countries (MIC) to lower income countries (LIC) in sub-Saharan Africa (SSA). The African Breast Cancer-Disparities in Outcomes (ABC-DO) breast cancer cohort spans upper MICs South Africa and Namibia, lower MICs Zambia and Nigeria and LIC Uganda. Read More

View Article and Full-Text PDF

Anterior chamber angle imaging with swept-source optical coherence tomography: comparison between CASIAII and ANTERION.

Sci Rep 2020 10 30;10(1):18771. Epub 2020 Oct 30.

Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China.

This study compared the test-retest variabilities and measurement agreement of anterior chamber angle (ACA) dimensions measured by two anterior segment swept-source optical coherence tomography (SS-OCT)-the ANTERION (Heidelberg Engineering, Heidelberg, Germany) and CASIAII (Tomey, Nagoya, Japan). Thirty-eight subjects, 18 patients with primary angle closure and 20 healthy participants with open angles, were included. The mean age was 54. Read More

View Article and Full-Text PDF
October 2020

Environmental drivers of megafauna and hominin extinction in Southeast Asia.

Nature 2020 10 7;586(7829):402-406. Epub 2020 Oct 7.

Max Planck Institute for the Science of Human History, Jena, Germany.

Southeast Asia has emerged as an important region for understanding hominin and mammalian migrations and extinctions. High-profile discoveries have shown that Southeast Asia has been home to at least five members of the genus Homo. Considerable turnover in Pleistocene megafauna has previously been linked with these hominins or with climate change, although the region is often left out of discussions of megafauna extinctions. Read More

View Article and Full-Text PDF
October 2020

A Systematic Review of the Health and Healthcare Inequalities for People with Intersex Variance.

Int J Environ Res Public Health 2020 09 8;17(18). Epub 2020 Sep 8.

School of Health Sciences, University of Brighton, Brighton BN1 9PH, UK.

Extensive research documents the health inequalities LGBTI people experience, however far less is known for people with intersex variation. This paper presents a review of intersex health and healthcare inequalities by evaluating research published from 2012 to 2019. In total 9181 citations were identified with 74 records screened of which 16 were included. Read More

View Article and Full-Text PDF
September 2020

Frequency-Dependent Changes in Interhemispheric Functional Connectivity Measured by Resting-State fMRI in Children With Idiopathic Generalized Epilepsy.

Front Neurol 2020 29;11:645. Epub 2020 Jul 29.

Department of Radiology, Medical Imaging Center of Guizhou Province, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Epilepsy is associated with abnormal spatiotemporal changes in resting-state brain connectivity, but how these changes are characterized in interhemispheric coupling remains unclear. This study aimed to characterize frequency-dependent alterations in voxel-wise mirrored homotopic connectivity (VMHC) measured by resting-state functional magnetic resonance imaging (rs-fMRI) in children with idiopathic generalized epilepsy (IGE). Rs-fMRI data were collected in 21 children with IGE and 22 demographically matched children with typical development. Read More

View Article and Full-Text PDF

Hemichorea-hemiballismus as the initial manifestation of symptomatic middle cerebral artery dissection: A case report.

Medicine (Baltimore) 2020 Sep;99(36):e22116

Introduction: Hemichorea-hemiballismus, which spans a spectrum of involuntary, continuous, nonpatterned movement involving one side of the body, can emerge as the initial manifestation of acute ischemic stroke. However, because of its rarity in the community, the diagnosis and treatment are often delayed.

Patient Concerns: We report a unique case of a 47-year-old female who presented with acute onset hemichorea-hemiballismus. Read More

View Article and Full-Text PDF
September 2020

Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction.

Am J Cardiol 2020 09 3;131:1-6. Epub 2020 Jul 3.

Baylor University Medical Center, Dallas, Texas; Baylor Scott and White Heart and Vascular Hospital, Dallas, Texas; Baylor Heart and Vascular Institute, Dallas, Texas.

There is limited information regarding clinical characteristics and outcomes of patients with SARS-CoV-2 (COVID-19) disease presenting with ST-segment elevation myocardial infarction (STEMI). In this multicenter retrospective study, we reviewed charts of patients admitted with symptomatic COVID-19 infection and STEMI to a total of 4 hospitals spanning Italy, Lithuania, Spain and Iraq from February 1, 2020 to April 15, 2020. A total of 78 patients were included in this study, 49 (63%) of whom were men, with a median age of 65 [58, 71] years, and high comorbidity burden. Read More

View Article and Full-Text PDF
September 2020

Immune-Mediated Neuropathies.

Neurol Clin 2020 08 11;38(3):711-735. Epub 2020 Jun 11.

Department of Neurology, Virginia Commonwealth University, 1101 East Marshall Street, PO Box 980599, Richmond, VA 23298-0599, USA.

The immune-mediated neuropathies are a broad category of diseases differentiated by time course, affected nerve fibers, and disease associations. This article spans the common, well-defined inflammatory demyelinating polyradiculoneuropathies (Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy) to the rarer, acquired demyelinating neuropathy variants (Miller-Fisher syndrome and multifocal motor neuropathy), vasculitic neuropathies, and sensory neuronopathies (dorsal root ganglionopathies). These case studies illustrate the characteristic clinical patterns of the immune-mediated neuropathies encountered in neurologic practice. Read More

View Article and Full-Text PDF

Fourteen Years of Archaeological and Heritage Research in the Iringa Region, Tanzania.

Afr Archaeol Rev 2020 20;37(2):271-292. Epub 2020 May 20.

Department of Anthropology, University of Alberta, Edmonton, AB Canada.

The Iringa Region is famous among archaeologists for the Acheulean site of Isimila, and among historians as the stronghold where Chief Mkwawa led the Hehe resistance against German colonial forces. However, our research reveals that Iringa has a rich archaeological record that spans the period from the Stone Age into the recent past. This article summarizes the results of 14 years of research by our team, the Iringa Region Archaeological Project (IRAP). Read More

View Article and Full-Text PDF

Autoantibody and Cytokine Profiles during Treatment with Belimumab in Patients with Systemic Lupus Erythematosus.

Int J Mol Sci 2020 May 14;21(10). Epub 2020 May 14.

Division of Rheumatology, Department of Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden.

We investigated whether belimumab treatment impacts on levels of autoantibodies and cytokines of interest in systemic lupus erythematosus (SLE). Longitudinally collected serum samples from 78 belimumab-treated Swedish SLE patients were analysed. Serum cytokine levels were determined using Luminex xMAP technology, and nuclear antigen autoantibody specificities using addressable laser bead immunoassay. Read More

View Article and Full-Text PDF

No evidence for differences among language regions in their temporal receptive windows.

Neuroimage 2020 10 11;219:116925. Epub 2020 May 11.

Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.

The "core language network" consists of left frontal and temporal regions that are selectively engaged in linguistic processing. Whereas functional differences among these regions have long been debated, many accounts propose distinctions in terms of representational grain-size-e.g. Read More

View Article and Full-Text PDF
October 2020

A C chronology for the Middle to Upper Palaeolithic transition at Bacho Kiro Cave, Bulgaria.

Nat Ecol Evol 2020 06 11;4(6):794-801. Epub 2020 May 11.

Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany.

The stratigraphy at Bacho Kiro Cave, Bulgaria, spans the Middle to Upper Palaeolithic transition, including an Initial Upper Palaeolithic (IUP) assemblage argued to represent the earliest arrival of Upper Palaeolithic Homo sapiens in Europe. We applied the latest techniques in C dating to an extensive dataset of newly excavated animal and human bones to produce a robust, high-precision radiocarbon chronology for the site. At the base of the stratigraphy, the Middle Palaeolithic (MP) occupation dates to >51,000 yr BP. Read More

View Article and Full-Text PDF

Clinical aspects of otosclerotic ossicular chain fixations.

Orv Hetil 2020 05;161(19):780-788

Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika,Szegedi Tudományegyetem Szeged.

Otosclerosis is a human-specific ear disease characterised by complex bone-remodelling with multifactorial aetiology. It affects the bony labyrinth capsule and consequently fixates the stapes to the oval window rim. The fixation of the ossicular chain leads to a decrease in the middle ear's acoustic impedance-fitting and amplifier function that leads to conductive hearing loss. Read More

View Article and Full-Text PDF

Impact of Body Mass Index on Outcomes of Autogenous Fistulas for Hemodialysis Access.

Ann Vasc Surg 2020 Oct 25;68:192-200. Epub 2020 Apr 25.

Division of Vascular Surgery, Johns Hopkins Medical Institutions, Baltimore, MD; Division of Vascular Surgery, University of California San Diego, La Jolla, CA. Electronic address:

Background: The prevalence of obesity is increasing in the United States. The treatment of end-stage renal disease (ESRD) via hemodialysis spans the spectrum of body mass index (BMI). This study examines the impact of BMI on outcomes of autogenous fistulas for hemodialysis access in a large population-based cohort of patients. Read More

View Article and Full-Text PDF
October 2020

Dual-room twin-CT scanner in multiple trauma care: first results after implementation in a level one trauma centre.

Eur J Trauma Emerg Surg 2020 Apr 25. Epub 2020 Apr 25.

Department of Anesthesia and Critical Care, Subsection Emergency- and Disaster Relief Medicine, University Hospital of Wuerzburg, Oberduerrbacherstrasse 6, 97080, Würzburg, Germany.

Purpose: The trauma centre of the Wuerzburg University Hospital has integrated a pioneering dual-room twin-CT scanner in a multiple trauma pathway. For concurrent treatment of two trauma patients, two carbon CT examination and intervention tables are positioned head to head with one sliding CT-Gantry in the middle. The focus of this study is the process of trauma care with the time to CT (tCT) and the time to operation (tOR) as quality indicator. Read More

View Article and Full-Text PDF

'I had to tell my GP I had lung cancer': patient perspectives of hospital- and community-based lung cancer care.

Aust J Prim Health 2020 Apr;26(2):147-152

Cancer and Palliative Care Research and Evaluation Unit, Medical School, University of Western Australia, Nedlands, WA 6009, Australia.

Lung cancer care spans both hospital- and community-based healthcare settings, and suboptimal communication between healthcare providers impacts on continuity and quality of care. Patients' experiences regarding: (1) communication between healthcare providers; and (2) the role of their GP during cancer treatment was explored in interviews with 47 Western Australian lung cancer patients. Thematic analysis using a phenomenological approach was undertaken to derive key themes regarding participant experiences. Read More

View Article and Full-Text PDF

Automated Pulse Oximeter Waveform Analysis to Track Changes in Blood Pressure During Anesthesia Induction: A Proof-of-Concept Study.

Anesth Analg 2020 05;130(5):1222-1233

From the Department of Anesthesiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Background: Intraoperative hypotension is associated with postoperative complications and death. Oscillometric brachial cuffs are used to measure arterial pressure (AP) in most surgical patients but may miss acute changes in AP. We hypothesized that pulse oximeter waveform analysis may help to detect changes in systolic AP (SAP) and mean AP (MAP) during anesthesia induction. Read More

View Article and Full-Text PDF

End of Life Care's Ongoing Evolution.

Prof Case Manag 2020 May/Jun;25(3):111-131

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP, is an award winning, industry subject matter expert who empowers health care's transdisciplinary workforce through professional speaking, writing, mentoring, and consultation. Ellen is an esteemed author with more than 100 publications to her credit. She has authored content for the industry's knowledge projects for case managers, including books, chapters, and articles on the Ethical Use of Case Management Technology, Workplace Bullying, Collaborative Care, and the Social Determinants of Health.

Purpose/objectives: PRIMARY PRACTICE SETTINGS:: Applicable to all settings across the transitions of care where case management practice occurs.

Findings/conclusions: Continuing shifts in society's cultural landscape, ongoing emphasis on value versus volume, and other industry fiscal imperatives continue to evoke an evolution in end-of-life care. The attainment of successful outcomes by professional case managers with those populations will be dependent on awareness and comprehension of regulations, legislation, and reimbursement; the influences of ongoing industry trends; availability of emerging resources; and ongoing technological advances. Read More

View Article and Full-Text PDF
December 2020

High-risk multimorbidity patterns on the road to cardiovascular mortality.

BMC Med 2020 03 10;18(1):44. Epub 2020 Mar 10.

Section for Science of Complex Systems, CeMSIIS, Medical University of Vienna, Spitalgasse 23, Vienna, A-1090, Austria.

Background: Multimorbidity, the co-occurrence of two or more diseases in one patient, is a frequent phenomenon. Understanding how different diseases condition each other over the lifetime of a patient could significantly contribute to personalised prevention efforts. However, most of our current knowledge on the long-term development of the health of patients (their disease trajectories) is either confined to narrow time spans or specific (sets of) diseases. Read More

View Article and Full-Text PDF