subscapularis.People with diabetes frequently have elevated diabetes distress. Although mindfulness-based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This study was aimed to pilot evaluate the feasibility of a nurse-led MBSR therapy and explore its potential efficacy amongst people with type 2 diabetes mellitus. A total of 100 participants were randomly allocated either to the intervention group (nurse-led MBSR therapy + regular diabetes education) or the control group (regular diabetes education). Data on diabetes distress, diabetes self-efficacy, and diabetes self-management were collected at baseline, 8 and 12 weeks. Hemoglobin A1c (HbA1c) was collected at baseline and 12 weeks. A generalized estimating equation analysis for repeated measures was used to determine intervention and time effects. As predicted, the nurse-led MBSR therapy had a significant time-by-group interaction effect on diabetes distress total score (95% confidence interval [CI] 0.58-0.77, p  less then  0.001), diabetes self-efficacy (95% CI -0.93 to -0.74, p  less then  0.001), diabetes self-management (95% CI -10.80 to -7.83, p  less then  0.001), and HbA1c levels (95% CI 0.04-1.14, p = 0.03) in the intervention group compared with the control group over 12 weeks. read more This is the first nurse-led MBSR therapy in a hospital setting that is feasible and has the potential to improve health outcomes. This approach may offer an innovative model to deliver MBSR therapy. A randomized controlled trial comparing the nurse-led MBSR plus usual diabetes education with usual diabetes education along with a mechanism to equalize intervention attention between the groups is indicated.Isolated sulfite oxidase deficiency (ISOD) is a rare recessive and infantile lethal metabolic disorder, which is caused by functional loss of sulfite oxidase (SO) due to mutations of the SUOX gene. SO is a mitochondrially localized molybdenum cofactor (Moco)- and heme-dependent enzyme, which catalyzes the vital oxidation of toxic sulfite to sulfate. Accumulation of sulfite and sulfite-related metabolites such as S-sulfocysteine (SSC) are drivers of severe neurodegeneration leading to early childhood death in the majority of ISOD patients. Full functionality of SO is dependent on correct insertion of the heme cofactor and Moco, which is controlled by a highly orchestrated maturation process. link2 This maturation involves the translation in the cytosol, import into the intermembrane space (IMS) of mitochondria, cleavage of the mitochondrial targeting sequence, and insertion of the cofactors. Moco insertion has proven as the crucial step in this maturation process, which enables the correct folding of the homodimer and traps SO in the IMS. Here, we report on a novel ISOD patient presented at 17 month of age carrying the homozygous mutation NM_001032386.2 (SUOX)c.1097G>A, which results in the expression of SO variant R366H. Our studies show that histidine substitution of R366, which is involved in coordination of the Moco-phosphate, causes a severe reduction in Moco insertion efficacy in vitro and in vivo. Expression of R366H in HEK SUOX-/- cells mimics the phenotype of patient’s fibroblasts, representing a severe reduction of SO expression and specific activity. Our studies disclose a general paradigm for a kinetic defect in Moco insertion into SO caused by residues involved in Moco coordination causing in the case of R366H an attenuated form of ISOD. This article is protected by copyright. All rights reserved.Intestinal metaplasia (IM) of the sinonasal mucosa is a putative precursor lesion of sinonasal intestinal type adenocarcinoma (sITAC), a carcinoma associated with wood-dust exposure(1-5). In this article, we compare genomic alterations in matched IM and sITAC to substantiate this connection. Case presentation A 68-year-old man with a history of wood-dust exposure and one-month bloody nasal secretion was seen at his local hospital. A biopsy demonstrated poorly differentiated carcinoma with neuroendocrine features. Fine needle aspiration (FNA) from a slightly enlarged cervical lymph node was without metastatic tumor cells. On MRI, the tumor measured 38x33x37mm; no signs of lymph-node pathology were seen (T2N0M0). A tertiary center performed endoscopic surgery; perioperative frozen sections showed sITAC (margins were macroscopically free).Rate-adaptive single chamber pacemakers with accelerometer, closed loop stimulation (CLS), and remote monitoring functionality (Eluna 8 SR-T, Biotronik, SE & Co, Germany) were implanted in 3 miniature donkeys with third-degree atrioventricular block and syncope. After recovery, different pacemaker programming modes were tested at rest, during stress without physical exercise and during physical exercise. Pacing rates were compared to actual atrial rates and showed that CLS functionality allowed physiological heart rate adaptation. A transmitter installed in the stable provided wireless connection of the pacemaker to the internet. Home monitoring was activated which performed daily wireless transmission of pacemaker functional measurements to an online server allowing diagnosis of pathological arrhythmias and pacemaker malfunction from a distance. Closed loop stimulation and remote monitoring functionality resulted in nearly physiological rate adaptation and allowed remote „from-the-stable“ patient follow-up.The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.

The aim of the study was to investigate whether high endogenous levels of insulin-like growth factor-1 (IGF-1) and its binding protein-3 (IGFBP-3) were related to a faster reconstitution of different blood cell populations in the early phase after allogeneic myeloablative haematopoietic stem cell transplantation (HSCT).

We measured IGF-1 and IGFBP-3 by chemiluminescence during the first three weeks after transplantation in 35 adult patients undergoing myeloablative HSCT and calculated area under the curve divided by time (AUC/t) for each patient.

Circulating levels of IGF-1 and IGFBP-3 correlated with counts of reticulocytes (r

=0.44, p=.011 and r=0.41, p=.017, respectively) and thrombocytes (r

=0.38, p=.030 and r

=0.56, p=.0008) three weeks post-transplant. link3 Furthermore, high IGFBP-3levels correlated with absolute lymphocyte counts 3weeks post-HSCT (r

=0.54, p=.012) and were associated with shorter time to neutrophil engraftment (r

=-0.35, p=.043). Both IGF-1 and IGFBP-3levels were associated with the number of circulating natural killer cells one month after HSCT (r

=0.42, p=.032 and r

=0.57, p=.0026).

These data indicate that high levels of IGF-1 and IGFBP-3 relate to a faster haematopoietic reconstitution after HSCT and suggest a biological influence of these mediators in haematopoietic homeostasis in these patients.

These data indicate that high levels of IGF-1 and IGFBP-3 relate to a faster haematopoietic reconstitution after HSCT and suggest a biological influence of these mediators in haematopoietic homeostasis in these patients.

Household emergency preparedness, at the individual and family micro-level, is often identified as below national disaster preparedness standards.

Conceptual clarity of household emergency preparedness is foundational for disaster preparedness research, theory construction, and instrument use.

Adhering to Walker and Avant’s (2019) concept analysis method, the purpose of this paper is to outline the concept of household emergency preparedness by identifying the uses of the concept, the defining attributes, antecedents, consequences, and empirical referents. Literature sources were identified using the Cumulative Index for Nursing and Allied Health (CINAHL), ProQuest Central, PsycInfo, PubMed, and government websites.

Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.

Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.

Coronary heart disease (CHD) is the most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people living with CHDmay need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve the health and outcomes of people with CHD. This is an update of a Cochrane Review previously published in 2016.

To assess the clinical effectiveness and cost-effectiveness of exercise-based CR (exercise training alone or in combination with psychosocial or educational interventions) compared with ’no exercise‘ control, on mortality, morbidity and health-related quality of life (HRQoL) in people with CHD.

We updated searches from the previous Cochrane Review, by searching CENTRAL,MEDLINE, Embase, and two other databases in September 2020. We also searched two clinical trials registers in June 2021.

We included randomised controlled trials (RCTs) of exercise-based interventions with at least six months‘ follow-up, compared with’ncitly report clinical outcomes, including mortality and hospital admissions, and include validated HRQoL outcome measures, especially over longer-term follow-up, and assess costs and cost-effectiveness.Parameter estimation for scale-up of downstream operations from microtiter plates (MTPs) is mostly done empirically because engineering correlations between microplates and stirred tank reactors (STRs) are not yet available. It is challenging to change the operation mode from shaken MTPs to large-scale STRs. For the scale-up of STRs, volumetric power input is well-established although it is unclear whether this parameter can be used to transfer the operations from MTPs. We determine the volumetric power input in MTPs via the temperature increase caused by the motion of the liquid. The hydrodynamics in MTPs are studied with computational fluid dynamics (CFD). Mixing is investigated in 96-, 24-, and 6-well MTPs to cover different geometries, filling volumes, shaking diameters, and shaking frequencies. All CFD simulations are validated by experimental results, which now allows prediction of the volumetric power input and hydrodynamics at various conditions in MTPs without the need for further experiments. We provide a map of the power input achievable in MTPs.