Acute effects of static stretching and proprioceptive neuromuscular facilitation on non-local range of movement

Acute effects of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) on local and non-local range of motion (ROM) were assessed in 29 participants. Three evaluations were performed one week apart: week-1 Control session (CS); weeks 2-3 either SS or PNF interventions (randomized). Dominant and non-dominant limbs, local (hamstring extensibility) and non-local ROMs (Shoulder extension-ShE) were collected at baseline (T0), immediately after (T1), and fifteen minutes post-intervention (T2). No differences were found between time-points during the CS. Local-ROM significantly increased (p=0.0002, ES=0.74 and 0.0079, 0.56, for dominant and non-dominant lower limbs, respectively) after both SS and PNF. No interaction between time and treatment was detected for ShE in both limbs. However, post-hoc analysis revealed a significant increase in dominant upper limb ShE between T0 and T1 only after SS (p=0.002; +6.5%). Acute bouts of SS and PNF can increase local-ROM, however, no clear effects were observed for non-local ROM.

Corrigendum: Possible risk factors of opaque bubble layer and its effect on high-order aberrations after small incision Lenticule extraction

[This corrects the article DOI: 10.3389/fmed.2023.1156677.].

Possible risk factors of opaque bubble layer and its effect on high-order aberrations after small incision Lenticule extraction

Purpose

To evaluate the possible risk factors of opaque bubble layer (OBL) formation in small incision lenticule extraction (SMILE) surgery and its effects on visual quality.

Methods

Fifty-six eyes from 28 patients were included in this study. The preoperative parameters and intraoperative designs were recorded. Corneal high-order aberrations (HOAs), point spread function (PSF), and modulation transfer function (MTF) were measured using iTrace at pre-operation, 1 week, 1 month, and 3 months after SMILE. Generalized Estimating Equation and Linear Mixed Effects Model were employed for statistical analysis.

Results

The mean OBL area in SMILE surgery was 2.75% ± 1.25%. The patients were divided into groups based on whether the OBL was greater than the mean group or less than the mean group. Compared to the group with a smaller OBL area, the group with the larger OBL area had steeper corneal curvature and thinner cap thickness, the OBL area was positively correlated with the preoperative keratometry (r = 0.21, p = 0.04) and preoperative spherical value (r = 0.47, p = 0.01). The group with the larger OBL area induced more corneal SA and trefoil at 1 week postoperatively, but the difference was not significant at 1 month and 3 months postoperatively.

Conclusion

A steep corneal curvature, thin cap thickness, and high preoperative spherical value are possible risk factors for OBL formation in SMILE surgery. The OBL increased the ocular and corneal HOAs postoperatively for a short period (1 week), while it did not affect the long-term outcomes.

Static Baropodometry for Assessing Short-Term Functional Outcome after Unilateral Total Knee Arthroplasty: Exploring Correlation between Static Plantar Pressure Measurements and Self-Reported Outcomes

This study aimed to investigate the association between objective baropodometric and radiological measurements and patient self-reported functional outcomes, assessed through the Knee Injury and Osteoarthritis Outcome Score (KOOS). Additionally, it sought to evaluate the effectiveness of static baropodometry in predicting short-term KOOS results following unilateral total knee arthroplasty (TKA). We conducted a prospective single-center study involving 32 patients who underwent unilateral TKA for knee osteoarthritis (KOA). Patients were evaluated both preoperatively and six months postoperatively, utilizing objective measurements derived from static baropodometric analysis in a normal, relaxed, bipedal standing position using a multi-platform Plantar Pressure Analysis System (PPAS) and radiographic measurements of the femorotibial angle (FTA) and subjective assessments through the national validated version of the KOOS. The study found an insignificant average correction of -0.69° ± 4.12° in the preoperative FTA at the sixth month after TKA. Moreover, there were no significant differences in the KOOS based on different types of knee alignment (KA) both pre- and postoperatively (p > 0.05). No significant correlations were observed between the KOOS, and total average affected and unaffected plantar pressures (TAAPP and TAUPP) pre- and postoperatively, as well as KA pre- and postoperatively. However, significant changes were observed in TAAPP and TAUPP measurements after unilateral TKA. TAAPP demonstrated a significant increase postoperatively (mean change (SD) = 18.60 (47.71); p = 0.035). In conclusion, this study found no significant correlation between KA, static baropodometric measurements, including pre- and postoperative differences, and KOOS outcomes. Therefore, static plantar pressure measurements alone might not serve as a reliable predictor of short-term clinical outcomes after unilateral TKA, as reported by patients.

Immediate and Long-Term Adverse Events of COVID-19 Vaccines: A One-Year Follow-Up Study From the Kurdistan Region of Iraq

Background The administration of COVID-19 vaccines has been critical in controlling the spread of the virus. However, understanding the potential adverse events (AEs) associated with these vaccines is crucial for public health. While most previous studies observed only short-term AEs, this study aimed to investigate the immediate and long-term AEs following the first and second doses of Pfizer, AstraZeneca, and Sinopharm vaccines, providing valuable long-term insights. Methodology A prospective, one-year, follow-up study was conducted by tracking 922 vaccinated individuals to assess short-term and long-term AEs. Demographics, clinical characteristics, vaccine types, and dose effects were taken into consideration. AEs were classified based on severity and duration. Statistical analyses were performed to compare differences among the vaccine groups, with p-values <0.05 considered significant. Bowker's and chi-square tests were performed using JMP Pro 14.3.0. Results Of the 922 participants, 55.53% (n = 512) were vaccinated with Pfizer, and 23.32% (n = 215) and 21.15% (n = 195) were vaccinated with Sinopharm and AstraZeneca, respectively. Overall, 72.34% of participants (n = 667) were suffering from AEs after the first dose, with a lower prevalence of AEs after the second dose (52.71%, n = 486). Pfizer exhibited the highest percentage and severity of AEs, followed by AstraZeneca and Sinopharm. Most AEs reported in this study were mild and resolved within 72 hours, with females experiencing more frequent AEs. The common short-term AEs observed were fever, injection-site pain, myalgia, fatigue, and headache. Notably, there were no chronic AEs, and only one case of myocarditis was associated with AstraZeneca. Conclusions Despite the variation in the prevalence of AEs among the three vaccines, the vaccination process proved to be safe with no serious short-term AEs. However, the long-term AEs associated with AstraZeneca and the decrease in the prevalence of AEs after the second dose of the COVID-19 vaccines warrant further investigations and priority for future research.

Understanding the 30-day mortality burden after revision total hip arthroplasty

BACKGROUND

Revision total hip arthroplasty (THA) is a challenging procedure that burdens the healthcare system. Despite being associated with worse outcomes relative to its primary counterpart, postoperative mortality after revision THA remains ill-defined. The present study aimed to (1) establish the overall 30-day mortality rate after revision THA and (2) explore the mortality rate stratified by age, comorbidity burden, and aseptic versus septic failure.

METHODS

The American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively reviewed for all patients who underwent revision THA from 2011 to 2019. A total of 23,501 patients were identified and grouped into mortality (n = 161) and mortality-free (n = 23,340) cohorts. Patient demographics, comorbidities, and aseptic/septic failure were evaluated.

RESULTS

The overall 30-day mortality was 0.69%. The mortality rate by age group (normalised per 1000 patients) was 0 (18-39 years [Y]), 0.67 (40-49 Y), 1.10 (50-59 Y), 2.58 (60-69 Y), 6.15 (70-79 Y) 19.32 (80-89 Y), and 58.22 (90+Y) (p < 0.001). The mortality rate by ASA classification (normalised per 1000 patients) was 0 (ASA I), 1.47 (ASA II), 6.94 (ASA III), 45.42 (ASA IV), and 200 (ASA V) (p < 0.001). The 30-day mortality rate for the septic and aseptic cohorts was 1.03% and 0.65%, respectively (p = 0.038). CCI scores (p < 0.001), diabetes (p < 0.001), systematic sepsis (p < 0.001), poor functional status (p < 0.001), BMI < 24.9 kg/m2 (p < 0.001), and dirty/infected wounds (p < 0.001) were all associated with increased mortality risk.

CONCLUSIONS

1 in 145 patients will suffer mortality during the 30 days after revision THA. PJI-related revision THA was associated with 1.5-fold increase in 30-day mortality rate compared to its aseptic counterpart. Certain patient determinants and baseline comorbidities, as measured by ASA and CCI scores, were associated with higher 30-day mortality rates. Therefore, it is imperative to identify such risk factors and implement perioperative patient optimisation pathways to mitigate the risk among vulnerable patients.

Combined Neurocognitive and Exercise Tolerance Testing Improves Objectivity of Buffalo Concussion Treadmill Test

CONTEXT

The Buffalo Concussion Treadmill Test (BCTT) is a standard assessment of exercise tolerance utilized for exercise prescription following concussion and to inform decisions regarding return to play. One limitation of the BCTT is that interpretation of test results is dependent on individuals' self-report of symptom exacerbation with exertion. Symptoms following concussion are significantly underreported or unreported. Combining objective neurocognitive assessment with exercise tolerance testing may enable clinicians to objectively identify those requiring further assessment or rehabilitation before return to play. The purpose of this study was to investigate how performance on a neurocognitive assessment battery is affected by provocative exercise testing.

DESIGN

Prospective cohort study, pretest/posttest.

METHODS

A total of 30 participants included 13 women (43.3%), age 23.4 (1.93) years, height 173.56 (10) cm, weight 77.35 (16.3) kg, and 11 (36.7%) with history of concussion. All participants completed a neurocognitive assessment battery, including the Stroop Test and standardized assessments of working memory, attention, and information processing speed/accuracy in single-task (seated position) and dual-task conditions (walking on a treadmill at 2.0 miles per hour). The neurocognitive assessment battery was performed at baseline and after the standard BCTT test protocol.

RESULTS

BCTT: Average percentage of heart rate maximum (%HRmax) = 93.97% (4.8%); average maximum rating of perceived exertion = 18.6 (1.5). Time-based performance in single-task and dual-task conditions significantly improved from baseline (P < .05) following maximal exercise testing on the BCTT for the following neurocognitive assessments: concentration-reverse digits, Stroop congruent, and Stroop incongruent.

CONCLUSIONS

Healthy participants demonstrated improvements across multiple domains of neurocognitive performance following the exercise tolerance testing on the BCTT. Understanding normal responses in neurocognitive performance for healthy individuals following exercise tolerance testing may allow clinicians to more objectively monitor the trajectory of recovery following sports-related concussion.

Prophylactic management of patients with von Willebrand disease

Von Willebrand disease, the most common inherited bleeding disorder that affects both males and females, is due to quantitative or qualitative defects of the multimeric glycoprotein von Willebrand factor, which cause mucous membrane bleeding but also soft tissue bleeding owing to the secondary deficiency of factor VIII. The aim of treatment is to correct this dual defect of hemostasis. In addition to the episodic management of bleeding episodes, therapy includes their short- or long-term prevention. Short-term prophylaxis is mainly warranted in order to provide effective hemostatic coverage to patients undergoing surgery or invasive procedures and to affected women at the time of delivery or during menstruations associated with excessive bleeding. The aim of long-term prophylaxis is to prevent bleeding in particular categories of patients at increased risk of frequent and spontaneous bleeding in the joints, nose, and gastrointestinal tract.

Impact of a structured training program to enhance skills in phacoemulsification surgery

Purpose

The aim of this study was to determine whether the introduction of a structured short-term phacoemulsification training program improved the ICO-OSCAR (International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric) score and the learning curve of the trainees and decreased the complication rates of the cases.

Methods

This study was a retrospective, observational study conducted in a tertiary eye care hospital in India. The study was conducted from March 2018 to October 2019 based on a structured phacoemulsification training program introduced in January 2019. The trainees enrolled in the phacoemulsification training program were divided into two groups: Group 1 (n = 33), who underwent training before the introduction of the structured program, and Group 2 (n = 29), who underwent the training after the introduction of the structured training program. Each trainee performed 20 cases. Group 1 training consisted of wet-lab and phacoemulsification surgeries. Group 2 training program comprised three modules over 5 weeks and a preassessment examination. Premodule 1 imparted cognitive skills; Module 1 was on structured wet-lab, Module 2 was about phacoemulsification step surgery, and Module 3 had independent complete surgeries. Group 2 also underwent compulsory Observation of cases being performed in the operation theater, surgical video recording review, and formative feedback. Mean OSCAR score comparison was done for both the groups. The OSCAR score was also calculated case-wise to obtain the learning curve with respect to the entry and exit levels, by classifying the trainees in each group as Novice, Beginner, Advanced Beginner, or Competent. A comparison of the posterior capsular rupture (PCR) rates and vision at discharge of all the cases was done.

Results

Group 2 had a significantly better mean OSCAR score than Group 1 (4.03 and 3.43, respectively; P < 0.001). The PCR rate of the cases was significantly lower in Group 2 than in Group 1 (9.14% and 20.30%, respectively; P < 0.001). Group 2 had a significantly better visual acuity outcome of the cases than Group 1. Group 1 started as Novice (OSCAR score: 2), whereas Group 2 started as Beginner (OSCAR score: 3). Group 2 reached the Advanced Beginner level eight to 10 cases prior to Group 1.

Conclusion

A structured training curriculum can make a significant difference in the training experience of the trainees and enable better surgical outcomes and a decrease in the complication rates.

Assessment of the number of admissions for road traffic collisions and severity of injury in daylight saving time and permanent daylight saving time periods

BACKGROUND/AIM

Permanent daylight saving time has been implemented in Turkey since 2016. The present study determines the characteristics of road traffic collisions in the short-term, trauma severity, and whether permanent daylight saving time has an impact on these parameters.

MATERIALS AND METHODS

Drivers admitted because of road traffic collisions to a tertiary care university hospital emergency service two weeks before and after the transition to wintertime in 2014 and 2015 and summertime in 2015 and 2016 as well as those admitted two weeks before and after the same period with permanent daylight saving time in 2016 and 2017 wintertime and 2017 and 2018 summertime were included in the study. Trauma severity was measured using the Injury Severity Score.

RESULTS

The study analysed the data of 710 patients. There was no statistically significant difference was found between admissions in the summertime and permanent daylight saving time periods in terms of gender, time of admission, week of admission, Injury Severity Score and outcome (P > .05 for all values).

CONCLUSIONS

In this study, we examined the short-term effects of daylight saving time on road traffic collisions, and demonstrated that it had no impact on the number or time of admission, trauma severity and patient outcomes. More comprehensive studies covering longer periods can be performed across the country.

Physiological and Clinical Responses in Pigs in Relation to Plasma Concentrations during Anesthesia with Dexmedetomidine, Tiletamine, Zolazepam, and Butorphanol

Simple Summary

Reliable protocols are needed for short-term anesthesia in pigs. The study’s aim is to identify an anesthetic procedure that, without the use of sophisticated equipment, ensures an acceptable depth and length of anesthesia, a regular spontaneous breathing pattern, and a stable hemodynamic condition for the animal. A total of 12 pigs were given a single intramuscular injection of dexmedetomidine, tiletamine, zolazepam, and butorphanol. To investigate the possibility of prolonging the anesthesia, six of the pigs also received an intravenous dose of the drug combination after one hour. Physiological and clinical responses and drug plasma concentrations were examined. The main results suggest that intramuscular administration of the drug combination provides up to two hours of anesthesia with stable physiological parameters and an acceptable level of analgesia. An intravenous administration of one-third of the original dosage prolonged the anesthesia for another 30 min. Since the pigs were able to breathe spontaneously, none of them were intubated. The study also provides new information about each drug’s plasma concentrations and the impact of the drug combination in pigs. This technique can be used to perform nonsurgical operations or transports when short-term anesthesia is required.

Abstract

Reliable protocols for short-term anesthetics are essential to safeguard animal welfare during medical investigations. The aim of the study was to assess the adequacy and reliability of an anesthetic protocol and to evaluate physiological and clinical responses, in relation to the drug plasma concentrations, for pigs undergoing short-term anesthesia. A second aim was to see whether an intravenous dosage could prolong the anesthesia. The anesthesia was induced by an intramuscular injection of dexmedetomidine, tiletamine-zolazepam, and butorphanol in 12 pigs. In six of the pigs, a repeated injection intravenously of one-third of the initial dose was given after one hour. The physiological and clinical effects from induction to recovery were examined. Plasma concentrations of the drugs were analyzed and pharmacokinetic parameters were calculated. Each drug’s absorption and time to maximal concentration were rapid. All pigs were able to maintain spontaneous respiration. The route of administration did not alter the half-life of the drug. The results suggest that intramuscular administration of the four-drug combination provides up to two hours of anesthesia with stable physiological parameters and an acceptable level of analgesia while maintaining spontaneous respiration. A repeated intravenous injection may be used to extend the time of anesthesia by 30 min.

Nursing empowerment by simulation in percutaneous endoscopic gastrostomy short-time complication control: Protocol study

BACKGROUND

Percutaneous endoscopic gastrostomy (PEG) is one of the most suitable methods for long-term nutritional support. In this study, the empowerment of intensive care nurses is examined by a simulation technique to control the short-term complications of PEG.

METHODS

A two-group clinical trial study will be conducted on eighty intensive care nurses in a teaching hospital in Tehran. The study participants will be randomly assigned to one of the two control and intervention groups based on the inclusion criteria. A pretest will be given to both groups using a researcher-made tool. Then, the empowerment package developed by the researcher will be provided to the intervention group in two stages. Next, a posttest will be administered. After this stage, patients' complications with PEG will be observed using a researcher-made checklist. Nurses' performances in both control and intervention groups will be evaluated in terms of preventing and controlling short-term complications up to 1 week after PEG insertion. All of the data collected in this research will be analyzed with statistic tests such as independent t-test, standard deviation, T pair, ANOVA, and mean based on the SPSS 16 software.

RESULTS

At present, the research team is designing an empowerment package for nurses and tools needed to evaluate the nurses' empowerment.

CONCLUSION

This study will attempt to design and evaluate the empowerment package of graduate nurses with a cognitive empowerment approach and using a simulation technique to care for patients with PEG and to control their short-term complications.

Non-Energy-Restricted Low-Carbohydrate Diet Combined with Exercise Intervention Improved Cardiometabolic Health in Overweight Chinese Females

This study aimed to examine the effects of four weeks of a low-carbohydrate diet (LC) and incorporated exercise training on body composition and cardiometabolic health. Fifty-eight overweight/obese Chinese females (age: 21.2 ± 3.3 years, body mass index (BMI): 25.1 ± 2.8 kg/m²) were randomly assigned to the control group (CON, n = 15), the LC control group (LC-CON, n = 15), the LC and high-intensity interval training group (LC-HIIT, n = 15), or the LC and moderate-intensity continuous training group (LC-MICT, n = 13). Subjects consumed a four week LC, whereas LC-HIIT and LC-MICT received extra training 5 d/week (LC-HIIT: 10 × 6 s cycling interspersed with 9 s rest, MICT: 30 min continuous cycling at 50–60% VO_2peak). After intervention, the three LC groups demonstrated significant reductions in body weight (−2.85 kg in LC-CON, −2.85 kg in LC-HIIT, −2.56 kg in LC-MICT, p < 0.001, η² = 0.510), BMI (p < 0.001, η² = 0.504) and waist-to-hip ratio (p < 0.001, η² = 0.523). Groups with extra training (i.e., LC-HIIT and LC-MICT) improved VO_2peak by 14.8 and 17.3%, respectively. However, fasting glucose and blood lipid levels remained unchanged in all groups. Short-term LC is a useful approach to improve body composition in overweight/obese Chinese females. Incorporated exercise training has no additional effects on weight loss, but has additional benefits on cardiorespiratory fitness, and HIIT is more time efficient than the traditional MICT (2.5 min vs. 30 min).

Flexural Strength Prediction Models for Soil⁻Cement from Unconfined Compressive Strength at Seven Days

Soil⁻cement is an environmentally friendly road construction technique for base and subbase materials, which allows employing soils placed in the right-of-way of the road or in the surroundings, by improving its engineering properties. With this technique, it is possible to reduce the over-exploitation of quarries, the necessity of landfills and the pollutant gas emission due to the reduction of aggregate fabrication and transport. The manufacturing of soil⁻cement is generally controlled by means of the Uniaxial Compressive Strength (UCS) test at seven days, according to the regulations of each country. Nonetheless, one of the properties that best defines the performance of soil⁻cement is the Flexural Strength (FS) at long term, usually at 90 days. The aim of this paper is to develop new equations to correlate the UCS and the FS at long term and the UCS at seven days and at 90 days. Obtained results validate the proposed models and, hence, the flexural strength can be predicted from the Uniaxial Compressive Strength at seven days, allowing, if necessary, correcting measures (recalculation or rejection) in early stages of the curing time to be taken.

Prefrontal high gamma during a magnetoencephalographic working memory task

In human electrophysiology research, the high gamma part of the power spectrum (~>60 Hz) is a relatively new area of investigation. Despite a low signal-to-noise ratio, evidence exists that it contains significant information about activity in local cortical networks. Here, using magnetoencephalography (MEG), we found high gamma activity when comparing data from an n-back working memory task to resting data in a large sample of normal volunteers. Initial analysis of power spectra from 0-back, 2-back, and rest trials showed three frequency bands exhibiting task-related differences: alpha, beta, and high gamma. Unlike alpha and beta, the high gamma spectrum was broad, without a peak at a single frequency. In addition, power in high gamma was highest for the 2-back and lowest during rest, while the opposite pattern occurred in the other bands. Beamformer source localization of each of the three frequency bands revealed a distinct set of sources for high gamma. These included several regions of prefrontal cortex that exhibited greater power when both n-back conditions were compared to rest. A subset of these regions had more power when the 2-back was compared to 0-back, which indicates a role in working memory performance. Our results show that high gamma will be important for understanding cortical processing during cognitive and other tasks. Furthermore, data from human intracortical recordings suggest that high gamma is the aggregate of spiking in local cortical networks, which implies that MEG could serve to bridge experimental modalities by noninvasively observing task-related modulation of spiking rates.

Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts

BACKGROUND AND AIM

Exercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts.

METHODS

This systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (<8 wk) HIIT versus either no exercise control (CON) or moderate continuous training (MCT) within diseased cohorts. Literature searches of the following databases were performed: MEDLINE, EMBASE, CINAHL, AMED, and PubMed (all from inception to December 1, 2017), with further searches of Clinicaltrials.gov and citations via Google Scholar. Primary outcomes were effect on CRF variables: V˙O2peak and anaerobic threshold.

RESULTS

Thirty-nine studies met the inclusion criteria. HIIT resulted in a clinically significant increase in V˙O2peak compared with CON (mean difference [MD] = 3.32 mL·kg·min, 95% confidence interval [CI] = 2.56-2.08). Overall HIIT provided added benefit to V˙O2peak over MCT (MD = 0.79 mL·kg·min, 95% CI = 0.20-1.39). The benefit of HIIT was most marked in patients with cardiovascular disease when compared with MCT (V˙O2peak: MD = 1.66 mL·kg·min, 95% CI = 0.60-2.73; anaerobic threshold: MD = 1.61 mL·kg·min, 95% CI = 0.33-2.90).

CONCLUSIONS

HIIT elicits improvements in objective measures of CRF within 8 wk in diseased cohorts compared with no intervention. When compared with MCT, HIIT imparts statistically significant additional improvements in measures of CRF, with clinically important additional improvements in V˙O2peak in cardiovascular patients. Comparative efficacy of HIIT versus MCT combined with an often reduced time commitment may warrant HIIT's promotion as a viable clinical exercise intervention.

Systematic Review and Meta-analysis of the Efficacy of Short-Course Antibiotic Treatments for Community-Acquired Pneumonia in Adults

The duration of therapy for community-acquired pneumonia (CAP) remains undefined. We sought to investigate whether short-course antibiotic treatment for CAP is associated with favorable clinical outcomes in adult patients. We systematically searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for studies comparing the effectiveness and safety between treatment regimens administered for ≤6 days and ≥7 days. We defined treatment for ≤6 days as short-course treatment and treatment for ≥7 days as long-course treatment. Twenty-one clinical trials (4,861 clinically evaluable patients) were included, and 19 out of 21 trials were randomized. Clinical cure was similar between the compared groups (4,069 patients, risk ratio [RR] = 0.99 [95% confidence interval {CI}, 0.97 to 1.01]), irrespective of patient setting (RR = 0.98 [95% CI, 0.96 to 1.00] for the outpatient setting and RR = 1.00 [95% CI, 0.92 to 1.09] for the inpatient setting) or severity of pneumonia (RR = 1.05 [95% CI, 0.96 to 1.14]). Also, relapses were similar between the short- and long-course treatment groups (1,923 patients, RR = 0.67 [95% CI, 0.30 to 1.46]). Short-course treatment was associated with fewer serious adverse events (1,923 patients, RR = 0.73 [95% CI, 0.55 to 0.97]) and, importantly, resulted in lower mortality than long-course treatment (2,802 patients, RR = 0.52 [95% CI, 0.33 to 0.82]). In CAP, short-course antibiotic treatment (≤6 days) is as effective as and potentially superior to, in terms of mortality and serious adverse events, longer-course treatment.

The efficacy of short-term clobetasol lotion in the treatment of scalp psoriasis

BACKGROUND

Scalp psoriasis can have a considerable impact on patients' quality of life and is considered difficult to treat. Treatment failure may, however, be due to poor adherence, as application of topical treatments to hair bearing areas is difficult and time consuming and also poor communication between physician and patient.

OBJECTIVE

To assess the efficacy of short-term treatment of scalp psoriasis with topical clobetasol lotion.

MATERIALS AND METHODS

Twelve patients with mild to severe scalp psoriasis were recruited for this study. Patients applied clobetasol 0.05% lotion twice daily for seven days. They were followed up with phone calls three days after starting the treatment. Skin hydration, transepidermal water loss (TEWL) and skin erythema were assessed noninvasively at baseline and end of study.

RESULTS

One week after treatment, median PSI score decreased significantly (p = .002). There was also a significant decrease in median TEWL (p = .012) and increase in skin hydration one week after treatment (p = .010). Eighty three percent of patients were satisfied with treatment result and felt convenient with applying clobetasol lotion.

LIMITATIONS

Lack of a long-term follow-up.

CONCLUSIONS

Psoriasis is a long-term disease, and improving adherence in the short time could improve patient's adherence to treatment in long time.

Short- and long-term effects of habitat fragmentation differ but are predicted by response to the matrix

Habitat loss and fragmentation are major threats to biodiversity and ecosystem processes. Our current understanding of the impacts of habitat loss and fragmentation is based largely on studies that focus on either short-term or long-term responses. Short-term responses are often used to predict long-term responses and make management decisions. The lack of studies comparing short- and long-term responses to fragmentation means we do not adequately understand when and how well short-term responses can be extrapolated to predict long-term responses, and when or why they cannot. To address this gap, we used data from one of the world's longest-running fragmentation experiments, The Wog Wog Habitat Fragmentation Experiment. Using data for carabid beetles, we found that responses in the long term (more than 22 yr post-fragmentation ≈22 generations) often contrasted markedly with those in the short term (5 yr post-fragmentation). The total abundance of all carabids, species richness and the occurrence of six species declined in the short term in the fragments but increased over the long term. The occurrence of three species declined initially and continued to decline, whilst another species was positively affected initially but decreased in the long term. Species' responses to the matrix that surrounds the fragments strongly predicted both the direction (increase/decline in occurrence) and magnitude of their responses to fragmentation. Additionally, species' responses to the matrix were somewhat predicted by their preferences for different types of native habitat (open vs. shaded). Our study highlights the degree of the matrix's influence in fragmented landscapes, and how this influence can change over time. We urge caution in using short-term responses to forecast long-term responses in cases where the matrix (1) impacts species' responses to fragmentation (by isolating them, creating new habitat or altering fragment habitat) and (2) is likely to change through time.

The Short- to Medium-Term Predictive Validity of Static and Dynamic Risk-of-Violence Measures in Medium- to Low-Secure Forensic and Civil Inpatients

The prediction and subsequent management of aggression by psychiatric inpatients is a crucial role of the mental health professional. This retrospective cohort study examines the predictive validity of 10 static and dynamic risk-of-violence measures and subscales in 37 forensic and 37 civil inpatients residing in a medium- to-low security psychiatric facility for a period of up to 6 months. Retrospective file records were sourced to conduct an AUC analysis of the ROC curve for short- and medium-term follow-up periods. The hypothesis that dynamic measures would be better predictors than static measures over the short term was supported. Albeit to a lesser extent, dynamic measures were still better predictors than static measures over the medium term. This result was seen in both civil and forensic groups. Three previously untested measures were found to predict aggression within the sample. It is recommended that mental health services employ the use of dynamic measures when making short-term risk-of-violence predictions for civil and/or forensic inpatients.

The Safety and Efficacy of Irreversible Electroporation for Large Hepatocellular Carcinoma

This study aimed to investigate the safety and effectiveness of irreversible electroporation ablation for unresectable large liver cancer. Fourteen patients were enrolled: 8 with large hepatocellular carcinoma (tumor diameter: 5.1-11.5 cm) and 6 with medium hepatocellular carcinoma (tumor diameter: 3.0-4.1 cm). All patients received percutaneous irreversible electroporation ablation. Ablation time and the incidence of complications were assessed by a t test. Post-irreversible electroporation and regular contrast-enhanced computerized tomography scans were performed to investigate the effect of tumor size (large vs medium) on irreversible electroporation treatment efficacy; 4-table data were assessed using a Fisher exact test. The 14 patients completed irreversible electroporation ablation successfully. In the large hepatocellular carcinoma group, no major complications occurred in the perioperative period. Minor complications comprised bloating, hypokalemia, edema, low white blood cells, and blood clotting abnormalities. All complications were mild and improved after symptomatic treatment. The frequency of minor complications was not significantly different (P > .05) compared with the medium hepatocellular carcinoma group. The average follow-up time was 2.8 ± 2.1 months and complete ablation was achieved in 25% (2/8; residual = 75%). For the patients with medium hepatocellular carcinoma, the mean follow-up time was 4.3 ± 3.2 months; the rate of complete ablation was 66.6% (4/6; residual rate = 33.3%). The complete ablation rate was not statistically different between the 2 groups (P > .05). Irreversible electroporation ablation for unresectable large hepatocellular carcinoma is safe, with no major complications. Short-term efficacy is relatively good; however, long-term efficacy remains to be explored.

When Love Meets Money: Priming the Possession of Money Influences Mating Strategies

Money is an important factor that influences the development of romantic relationships. The current paper examines how the feeling of having relatively more or less money influences human mating strategies in long-term and short-term mating contexts under the framework of evolutionary psychology. We recruited mainland Chinese college students involved in steady, heterosexual romantic relationships to participate in two experiments. In each study, we experimentally triggered participants' feelings of having relatively more or less money and then examined their thoughts and behaviors related to mating. Results of Study 1 showed that men who were primed to feel that they had relatively more money were less satisfied with their partners' physical attractiveness than those primed to feel that they had less money, suggesting that the subjective feeling of having more or less money may affect men's preferences regarding the physical appearance of a mate in a long-term relationship. Interestingly, this difference was not significant for women. Results of Study 2 indicated that both men and women who were primed to feel that they had relatively more money exhibited a greater “behavioral approach tendency” toward an attractive member of the opposite sex than those primed to feel that they had less money. This finding suggests that people who feel they have relatively more money may have more interest in an attractive alternative than those who feel they have relatively less money. The differences in mating strategies between and within the genders brought about by money support the evolutionary hypothesis that individuals adopt conditional mating strategies in response to environmental conditions. Additionally, the results of experimental studies provide evidence for the causal effects of money on mating strategies. These findings have both conceptual and practical implications for the psychology of evolution and romantic relationships.

Accuracy of short-term sea ice drift forecasts using a coupled ice-ocean model

Arctic sea ice drift forecasts of 6 h-9 days for the summer of 2014 are generated using the Marginal Ice Zone Modeling and Assimilation System (MIZMAS); the model is driven by 6 h atmospheric forecasts from the Climate Forecast System (CFSv2). Forecast ice drift speed is compared to drifting buoys and other observational platforms. Forecast positions are compared with actual positions 24 h-8 days since forecast. Forecast results are further compared to those from the forecasts generated using an ice velocity climatology driven by multiyear integrations of the same model. The results are presented in the context of scheduling the acquisition of high-resolution images that need to follow buoys or scientific research platforms. RMS errors for ice speed are on the order of 5 km/d for 24-48 h since forecast using the sea ice model compared with 9 km/d using climatology. Predicted buoy position RMS errors are 6.3 km for 24 h and 14 km for 72 h since forecast. Model biases in ice speed and direction can be reduced by adjusting the air drag coefficient and water turning angle, but the adjustments do not affect verification statistics. This suggests that improved atmospheric forecast forcing may further reduce the forecast errors. The model remains skillful for 8 days. Using the forecast model increases the probability of tracking a target drifting in sea ice with a 10 km × 10 km image from 60 to 95% for a 24 h forecast and from 27 to 73% for a 48 h forecast.

Clinical features, epidemiology, and short-term outcomes of proliferative lupus nephritis in Eastern India

Race and ethnicity are important predictors of prognosis in lupus nephritis. This study was conducted to determine the clinical features, epidemiological profile, and short-term outcomes in patients of lupus nephritis from a single center in Eastern India. A total of 86 patients of class III/IV lupus nephritis were studied. Seventy-eight of them received cyclophosphamide for induction and eight of them received mycophenolate. The patients were evaluated for response, estimated glomerular filtration rate (eGFR), and proteinuria at 6 months. About 44% patients had a partial or complete response at 6 months and 64% at 1 year. The factors correlating with response at 6 months were older age at diagnosis, hypertension, activity, and chronicity indices and duration of symptoms prior to therapy. Chronicity index and hypertension were the predictors of response by logistic regression at 6 months. Compared to the Caucasian and African American patients, patients with proliferative lupus in Eastern India presented with a lower eGFR, lower proteinuria, and higher chronicity scores. Older age at diagnosis, hypertension, activity, chronicity indices, and duration of symptoms correlated with response. Short-term outcomes were similar to those described in Caucasian patients.

The influence of colour on memory performance: a review

Human cognition involves many mental processes that are highly interrelated, such as perception, attention, memory, and thinking. An important and core cognitive process is memory, which is commonly associated with the storing and remembering of environmental information. An interesting issue in memory research is on ways to enhance memory performance, and thus, remembering of information. Can colour result in improved memory abilities? The present paper highlights the relationship between colours, attention, and memory performance. The significance of colour in different settings is presented first, followed by a description on the nature of human memory. The role of attention and emotional arousal on memory performance is discussed next. The review of several studies on colours and memory are meant to explain some empirical works done in the area and related issues that arise from such studies.

How do short-term rates of femorotibial cartilage change compare to long-term changes? Four year follow-up data from the osteoarthritis initiative

OBJECTIVE

To compare unbiased estimates of short- vs long-term cartilage loss in osteoarthritic knees.

METHOD

441 knees [216 Kellgren Lawrence (KL) grade 2, 225 KL grade 3] from participants of the Osteoarthritis Initiative were studied over a 4-year period. Femorotibial cartilage thickness was determined using 3 T double echo steady state magnetic resonance imaging, the readers being blinded to time points. Because common measurement time points bias correlations, short-term change (year-1 to year-2: Y1 → Y2) was compared with long-term change (baseline to year-4: BL → Y4), and initial (BL → Y1) with subsequent (Y2 → Y4) observation periods.

RESULTS

The mean femorotibial cartilage thickness change (standardized response mean) was -1.2%/-0.8% (-0.42/-0.28) over 1 (BL → Y1/Y1 → Y2), -2.1%/-2.5% (-0.56/-0.55) over 2 (BL → Y2/Y2 → Y4), -3.3% (-0.63) over 3 (Y1 → Y4), and -4.5% (-0.78) over 4 years. Spearman correlations were 0.33 for Y1 → Y2 vs BL → Y4, and 0.17 for BL → Y1 vs Y2 → Y4 change. Percent agreement between knees showing progression during Y1 → Y2 vs BL → Y4 was 59%, and 64% for BL → Y1 vs Y2 → Y4. The area under the receiver operating characteristic curve was 0.66 for using Y1 → Y2 to predict BL → Y4, and 0.59 for using BL → Y1 to predict Y2 → Y4 change.

CONCLUSION

Weak to moderate correlations and agreement were observed between individual short- vs long-term cartilage loss, and between initial and subsequent observation periods. Hence, longer observation periods are recommended to achieve robust results on cartilage loss in individual knees. At cohort and subcohort level (e.g., KLG3 vs KLG2 knees), the mean cartilage loss increased almost linearly with the length of the observation period and was constant throughout the study.

A comparison of short-term and long-term air pollution exposure associations with mortality in two cohorts in Scotland

BACKGROUND

Air pollution-mortality risk estimates are generally larger at longer-term, compared with short-term, exposure time scales.

OBJECTIVE

We compared associations between short-term exposure to black smoke (BS) and mortality with long-term exposure-mortality associations in cohort participants and with short-term exposure-mortality associations in the general population from which the cohorts were selected.

METHODS

We assessed short-to-medium-term exposure-mortality associations in the Renfrew-Paisley and Collaborative cohorts (using nested case-control data sets), and compared them with long-term exposure-mortality associations (using a multilevel spatiotemporal exposure model and survival analyses) and short-to-medium-term exposure-mortality associations in the general population (using time-series analyses).

RESULTS

For the Renfrew-Paisley cohort (15,331 participants), BS exposure-mortality associations were observed in nested case-control analyses that accounted for spatial variations in pollution exposure and individual-level risk factors. These cohort-based associations were consistently greater than associations estimated in time-series analyses using a single monitoring site to represent general population exposure {e.g., 1.8% [95% confidence interval (CI): 0.1, 3.4%] vs. 0.2% (95% CI: 0.0, 0.4%) increases in mortality associated with 10-μg/m³ increases in 3-day lag BS, respectively}. Exposure-mortality associations were of larger magnitude for longer exposure periods [e.g., 3.4% (95% CI: -0.7, 7.7%) and 0.9% (95% CI: 0.3, 1.5%) increases in all-cause mortality associated with 10-μg/m³ increases in 31-day BS in case-control and time-series analyses, respectively; and 10% (95% CI: 4, 17%) increase in all-cause mortality associated with a 10-μg/m³ increase in geometic mean BS for 1970-1979, in survival analysis].

CONCLUSIONS

After adjusting for individual-level exposure and potential confounders, short-term exposure-mortality associations in cohort participants were of greater magnitude than in comparable general population time-series study analyses. However, short-term exposure-mortality associations were substantially lower than equivalent long-term associations, which is consistent with the possibility of larger, more persistent cumulative effects from long-term exposures.

Coach mid-season replacement and team performance in professional soccer

The coaching carousel or turnover is an extreme but frequently occurring phenomenon in soccer. Among the reasons for firing a coach, the most common is the existence of a shock-effect: a new coach would be able to motivate the players better and therefore to improve results. Using data from the Spanish Soccer League during the seasons from 1997–1998 to 2006–2007, this paper investigates the relationship between team performance and coach change over time. The empirical analysis shows that the shock effect of a turnover has a positive impact on team performance in the short term. Results reveal no impact of coach turnover in the long term. The favourable short-term impact on team performance of a coach turnover is followed by continued gradual worsening of results. The turnover effect is nonexistent when the comparison between the new coach and the old coach is done over 10, 15 or 20 matches before and after termination.

Acetoxycycloheximide and transient amnesia in the rat

Rats were trained during the severe inhibition of protein synthesis that follows intracerebral injection of acetoxycycloheximide. Amnesia was consistently observed 24 hours after training, but memory spontaneously returned within 6 days. There was, consequently, no evidence of interference by acetoxycycloheximide with the consolidation phase of memory, but rather a transient deficit in the retrieval phase. It is suggested that this deficit may be due to a deficiency in neurotransmitters.