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Lycium barbarum have received an increasing popularity due to its powerful biological activity and medicinal use. However, the effect of Lycium barbarum on skin remains largely uncharacterized. The general purpose of this paper was to characterize the phenolic compounds in Lycium barbarum extract (LBE) using LC‐HRMS/QTOF method and to investigate whether topical administration of LBE can repair skin barrier dysfunction in mice. Our data demonstrated that LBE could not only decrease ROS level and matrix metalloproteinase expression, but also strengthen intrinsic antioxidant defense system including SOD, GSH‐Px and CAT, thereby resulting in increased skin collagen content and an improvement of UV‐induced skin erythema, thickness and wrinkles. Improved skin barrier functions were highly correlated with increased expression of filaggrin, involucrin and loricrin as well as antioxidant proteins such as Nrf2 and HO‐1 in UV‐irradiated mice, suggesting that LBE may be promising natural products at a lower cost for the topical application in the treatment of skin diseases with defective barrier function. [ABSTRACT FROM AUTHOR]

Early-infantile Krabbe disease (EIKD) is an autosomal recessive, progressive, neurodegenerative disorder that usually leads to death in infancy. A study published in 2005 indicated that hematopoietic stem-cell transplantation (HSCT) was effective in the treatment for EIKD when used before the onset of symptoms. This finding suggested that newborn screening for EIKD, which would allow earlier diagnosis, might lead to earlier treatment and better outcomes. In 2006, New York was the first state to implement newborn screening for Krabbe disease; however, the results were not as good as proponents had hoped. In this paper, we present the history of efforts to diagnose and treat EIKD. Based on our findings, we question the efficacy of newborn screening for Krabbe disease. We present two arguments. First, testing itself is too imprecise. Even with the most rigorous testing standards, such as those used in New York, many of the children who are identified as being 'at risk' for EIKD remain asymptomatic. It is unclear if they will remain asymptomatic forever and, thus, whether the tests should be considered 'false positives', or whether they will eventually develop the disease. Second, we question the efficacy of early HSCT. We recommend placing a moratorium on mandatory newborn screening for EIKD. WHAT THIS PAPER ADDS: Current tests to identify which children are likely to develop Krabbe diseased are inadequate. Many children identified as being 'at risk' for early infantile Krabbe disease remain asymptomatic. Psychosine appears to be more specific than low galactosylceramidase levels for diagnosing early infantile Krabbe disease. [ABSTRACT FROM AUTHOR]

The article discusses the research study on the treatment options for ovarian cancer patients with ascites and suggests the development of a consensus guidelines for treating ascites.

The article titled "Correction to 'Efficacy, safety and unmet needs of evolving medical treatments for carcinoid syndrome'" published in the Journal of Neuroendocrinology discusses an oversight in the original paper. The authors have identified an error in the definition of the abbreviated term 5-HT, which was mistakenly referred to as 5-hydroxytryptophane instead of 5-hydroxytryptamine, which is serotonin itself. The authors apologize for any confusion caused by this mistake. [Extracted from the article]

A recent article published in Haemophilia reports the results of a survey of treatment center practices in the United States, and specifically the use of prophylaxis as treatment regimen [ ] . This article discusses the issues that may contribute to utilization of prophylactic regimens and issues to consider when determining treatment programs for pediatric patients. [ABSTRACT FROM AUTHOR]

Presents several abstracts clinical investigation in the 2001 edition of the American Geriatrics Society. 'Tolterodine: A Safe and Effective Treatment for Older Patients with Overactive Bladder,' by J.G. Malone-Lee, J.B. Walsh, M-F. Maugourd, et al.

New coronavirus disease 2019 (COVID‐19), as a pandemic disaster, has drawn the attention of researchers in various fields to discover suitable therapeutic approaches for the management of COVID‐19 patients. Currently, there are many worries about the rapid spread of COVID‐19; there is no approved treatment for this infectious disease, despite many efforts to develop therapeutic procedures for COVID‐19. Emerging evidence shows that mesenchymal stromal/stem cell (MSC) therapy can be a suitable option for the management of COVID‐19. These cells have many biological features (including the potential of differentiation, high safety and effectiveness, secretion of trophic factors and immunoregulatory features) that make them suitable for the treatment of various diseases. However, some studies have questioned the positive role of MSC therapy in the treatment of COVID‐19. Accordingly, in this paper, we will focus on the therapeutic impacts of MSCs and their critical role in cytokine storm of COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Background: As the mainstream treatment of axillary osmidrosis, surgical treatment is still limited by various complications, such as paresthesia, scars, local infection, hematoma, flap necrosis, and long recovery time. In this study, we tried to adopt the improved mini‐incision surgery for osmidrosis treatment. Objectives: The paper aims to evaluate the clinical effectiveness and safety of the improved mini‐incision surgery for axillary osmidrosis treatment. Patients/Methods: Clinical series of patients underwent improved mini‐incision surgery were retrospectively reviewed. Dates of complications, including paresthesia, scars, infection, hematoma, skin necrosis, and recurrence were analyzed. Results: Among 61 cases, 58 cases had a preoperative osmidrosis score of 3 and 3 cases had a preoperative score of 2; while 13 cases had a postoperative osmidrosis score of 0, 43 cases had a postoperative score of 1 and 5 cases had a postoperative score of 2, significantly lower than that before (p < 0.001). A total of 12 axillae complications occurred, 2 axillae (1.6%) had paresthesia; 5 axillae (4.1%) had hematoma; 2 axillae (1.6%) had local flap necrosis due to hematoma; and 3 axillae (2.4%) had hypertrophic scars. Conclusions: The results showed that the improved mini‐incision surgery was safe and effective for osmidrosis treatment. [ABSTRACT FROM AUTHOR]

Background: A resuscitation plan is a medically authorised order to use or withhold resuscitation interventions. Absence of appropriate resuscitation orders exposes patients to the risk of invasive medical interventions that may be of questionable benefit depending on individual circumstances. Aims: To describe among junior doctors: (i) self‐reported confidence discussing and completing resuscitation plans; (ii) knowledge of resuscitation policy including whether resuscitation plans are legally enforceable and key triggers for completion; and (iii) the factors associated with higher knowledge of triggers for completing resuscitation plans. Methods: A cross‐sectional survey was conducted at five hospitals. Junior doctors on clinical rotation were approached at scheduled training sessions, before or after ward rounds or at change of rotation orientation days and provided with a pen‐and‐paper survey. Results: A total of 118 junior doctors participated. Most felt confident discussing (79%; n = 92) and documenting (87%; n = 102) resuscitation plans with patients. However, only 45% (n = 52) of doctors correctly identified that resuscitation plans are legally enforceable medical orders. On average, doctors correctly identified 6.8 (standard deviation = 1.8) out of 10 triggers for completing a resuscitation plan. Doctors aged >30 years were four times more likely to have high knowledge of triggers for completing resuscitation plans (odds ratio 4.28 (95% confidence interval 1.54–11.89); P = 0.0053). Conclusion: Most junior doctors feel confident discussing and documenting resuscitation plans. There is a need to improve knowledge about legal obligations to follow completed resuscitation plans, and about when resuscitation plans should be completed to ensure they are completed with patients who are most at risk. [ABSTRACT FROM AUTHOR]

If Parkinson's disease patients only present motorically when 50% of their dopamine cells are lost, then the condition must have been slowly evolving over 25 to 50 years. Thereafter, the pathology progresses at the rate of 1% to 2% of dopamine cells per year even though the pathological species was there from day zero- given the cells were placed into the brains of patients with moderately advanced PD. I would say this paper has fundamentally challenged the long-held view that the pathogenesis of PD is primarily a cell-autonomous process - although even at the time it was published this was being challenged both for PD and other proteinopathies of the brain. [Extracted from the article]

Chronic stress is a relevant disease to periodontal practice, encompassing 25%-28% of the US population (American Psychological Association 2015). While it is well established that chronic psychologic stress can have significant deleterious systemic effects, only in recent decades have we begun to explore the biochemical, microbial, and physiologic impacts of chronic stress diseases on oral tissues. Currently, chronic stress is classified as a "risk indicator" for periodontal disease. However, as the evidence in this field matures with additional clinically controlled trials, more homogeneous data collection methods, and a better grasp of the biologic underpinnings of stress-mediated dysbiosis, emerging evidence suggests that chronic stress and related diseases (depression, anxiety) may be significant contributing factors in periodontal/peri-implant disease progression and inconsistent wound healing following periodontal-related therapeutics. Ideal solutions for these patients include classification of the disease process and de-escalation of chronic stress conditions through coping strategies. This paper also summarizes periodontal/implant-related therapeutic approaches to ensure predictable results for this specific patient subpopulation. [ABSTRACT FROM AUTHOR]

This paper describes a 6‐month period of compassion‐focused therapy (CFT) for a client who has a 35‐year history of hearing voices that are threatening, derogatory, and abusive. In this intervention, the client is encouraged to develop compassionate motives toward herself and to her voices, recognizing that her voices may have been functional in the context of difficult early experiences. The client develops a compassionate self‐identity, which becomes the vehicle through which she approaches therapeutic tasks, such as listening and talking to voices, engaging with traumatic childhood pain, and resolving emotional conflicts. The client is an author on this study, so is able to provide valuable first‐hand insights into the experience of working compassionately with her voices, and of experiencing CFT techniques for the first time. [ABSTRACT FROM AUTHOR]

Background and aims: Several reports have documented risk factors for opioid use following treatment discharge, yet few have assessed sex differences, and no study has assessed risk using contemporary machine learning approaches. The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for each sex that are most strongly associated with opioid use following treatment. Design Secondary analysis of Global Appraisal of Individual Needs (GAIN) database with follow‐ups at 3, 6 and 12 months post‐OUD treatment discharge, exploring demographic, psychological and behavioral variables that predict post‐treatment opioid use. Setting One hundred and thity‐seven treatment sites across the United States. Participants: Adolescents (26.9%), young adults (40.8%) and adults (32.3%) in treatment for OUD. The sample (n = 1,126) was 54.9% male, 66.1% white, 20% Hispanic, 9.8% multi‐race/ethnicity, 2.8% African American and 1.3% other. Measurement Primary outcome was latency to opioid use over 1 year following treatment admission. Results: For women, regularized Cox regression indicated that greater withdrawal symptoms [hazard ratio (HR) = 1.31], younger age (HR = 0.88), prior substance use disorder (SUD) treatment (HR = 1.11) and treatment resistance (HR = 1.11) presented the largest hazard for post‐treatment opioid use, while a random survival forest identified and ranked substance use problems [variable importance (VI) = 0.007], criminal justice involvement (VI = 0.006), younger age (VI = 0.005) and greater withdrawal symptoms (VI = 0.004) as the greatest risk factors. For men, Cox regression indicated greater conduct disorder symptoms (HR = 1.34), younger age (HR = 0.76) and multiple SUDs (HR = 1.27) were most strongly associated with post‐treatment opioid use, while a random survival forests ranked younger age (VI = 0.023), greater conduct disorder symptoms (VI = 0.010), having multiple substance use disorders (VI = 0.010) and criminal justice involvement (VI = 0.006) as the greatest risk factors. Conclusion: Risk factors for relapse to opioid use following opioid use disorder treatment appear to be, for women, greater substance use problems and withdrawal symptoms and, for men, younger age and histories of conduct disorder and multiple substance use disorder. [ABSTRACT FROM AUTHOR]

The International Association for the Study of Pain defines neuropathic pain as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". The associated changes can be observed in the peripheral as well as the central nervous system. The available literature discusses a wide variety of causes as predisposing for the development and amplification of neuropathic pain. Further, key interactions within sensory pathways have been discovered, but no common molecular mechanism leading to neuropathic pain has been identified until now. In the first part of this review, the pain mediating lateral spinothalamic tract is described. Different in vivo models are presented that allow studying trauma‐, chemotherapy‐, virus‐, and diabetes‐induced neuropathic pain in rodents. We furthermore discuss approaches to assess neuropathic pain in these models. Second, the current knowledge about cellular and molecular mechanisms suggested to underlie the development of neuropathic pain is presented and discussed. A summary of established therapies that are already applied in the clinic and novel, promising approaches closes the paper. In conclusion, the established animal models are able to emulate the diversity of neuropathic pain observed in the clinics. However, the assessment of neuropathic pain in the presented in vivo models should be improved. The determination of common molecular markers with suitable in vitro models would simplify the assessment of neuropathic pain in vivo. This would furthermore provide insights into common molecular mechanisms of the disease and establish a basis to search for satisfying therapeutic approaches. [ABSTRACT FROM AUTHOR]

New psychoactive substances (NPS) are a wide group of compounds that try to mimic the effects produced by the 'classical' illicit drugs, including cannabis (synthetic cannabinoids), cocaine and amphetamines (synthetic cathinones) or heroin (synthetic opioids), and which health effects are still unknown for most of them. Nowadays, more than 700 compounds are being monitored by official organisms, some of which have been recently identified in seizures and/or intoxication cases. Toxicological analysis plays a pivotal role in NPS research. A comprehensive investigation on NPS, from the first identification of a novel substance until its detection in drug users to help in diagnostics and medical treatment, requires the use of a wide variety of instruments and analytical strategies. This paper illustrates the key role of mass spectrometry (MS) along a comprehensive investigation on NPS. The synthetic cannabinoid XLR‐11 and the synthetic cathinone 5‐PPDi have been chosen as representative substances of the most consumed NPS families. Moreover, both compounds have been investigated at our laboratory in different stages of the three‐step strategy considered in this article. The initial identification and characterisation of the compound in consumption products, the first reported metabolic pathway and the development of analytical methodologies for its determination (and/or their metabolites) in different toxicological samples are described. The analytical strategies and MS instruments are briefly discussed to show the reader the possibilities that MS instrumentation offer to analytical scientists. This publication aims to be a starting point for those interested on the NPS research field from an analytical chemistry point of view. [ABSTRACT FROM AUTHOR]

Background: Aortic stenosis (AS) prevalence is estimated to reach 4.5 million cases worldwide by the year 2030. AS is a progressive disease without a pharmacological treatment. In the current review, we aimed to investigate novel therapeutic approaches for non‐surgical AS treatment, at least in patients with mild‐to‐moderate AS. Materials and Methods: The most recent and relevant papers concerned with novel molecular pathways that have potential as therapeutic targets in AS were selected from searches of PubMed and Web of Science up to February 2021. Results: Growing evidence indicates that therapies using proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, simvastatin/ezetimibe combination, cholesteryl ester transfer protein inhibitors or antisense oligonucleotides targeting apolipoprotein(a) reduce the risk of AS progression. It has been shown that enhanced valvular lipid oxidation may drive AS development by leading to the activation of valvular interstitial cells (VICs), the most abundant valvular cells having a major contribution to valve calcification. Since VICs are able to release pro‐inflammatory cytokines, clotting factors and proteins involved in calcification, strategies targeting these cell activations seem promising as therapeutic interventions. Recently, non‐vitamin K antagonist oral anticoagulants (NOACs) have been shown to inhibit activation of VICs. Conclusion: Several novel molecular pathways of AS development have been identified over the past few years. Therapies using PCSK9 inhibitors, simvastatin/ezetimibe combination, lipoprotein(a)‐lowering therapy are highly promising candidates as therapeutics in the prevention of mild AS progression, while preclinical studies show that NOACs may inhibit valvular inflammation and coagulation activation and slower the rate of AS progression. [ABSTRACT FROM AUTHOR]

Summary: Intra‐articular corticosteroids are an effective treatment for equine osteoarthritis, however, there is increasing evidence for the effectiveness of other treatments such as biologics. Whilst current evidence does support biologics and their use in patients diagnosed with osteoarthritis, there remains to be a lack of evidence regarding their long‐term outcomes and the efficacy of their use as a treatment, especially when compared to corticosteroids. This paper reviewed the evidence comparing intra‐articular corticosteroids and biologics in the treatment of equine osteoarthritis and found that whilst they are both effective treatments, more evidence directly comparing them is required. [ABSTRACT FROM AUTHOR]

In this paper, a near field focusing transmission metasurface (MS) based on polarization sensitivity is developed at microwave frequency. The MS unit cell has only three metal layers, which is less than the published dual‐polarized transmission structure. And the phase shifting range can cover 320° for x‐ and y‐polarized waves. The biggest bright spot of the focusing MS made of the proposed units is its changeable focus point by rotating the horn 0°–90° round its central axis: focusing switching between one and two focusing points. In addition, the developed MS has the following advantages: multifunctional, low sidelobe, high focusing efficiency, small size, wideband, and less layer number. The focusing relative bandwidth is 9.7%, and the maximum focusing efficiency is 30% at center frequency 15.5 GHz. The efficiency is higher than that of published results in transmission orthogonal polarization mode. The proposed MS has potential applications in medical treatment, noncontact sensing system. [ABSTRACT FROM AUTHOR]

Introduces a series of papers on wound healing presented at a symposium sponsored by the European Tissue Repair Society in May 2001. Therapies for scar management; Methods of achieving pressure therapy for scars.

LINKED CONTENT: This article is linked to Sharma et al papers. To view these articles, visit https://doi.org/10.1111/apt.16369 and https://doi.org/10.1111/apt.16910 [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a typical chronic inflammatory skin disease that affects all age groups and requires basic skin care for treatment. Anti‐inflammatory and antiallergy steroids are the most frequently used treatments but they are limited due to their side effects caused by a weakening of the immune system. Many consumers focus on performance as a criterion for selecting cosmetics. However, steroids have been illegally used to improve the performance of cosmetics, and consumers have been adversely affected by the corresponding side effects. In this paper, we propose a simple and rapid method using liquid chromatography–tandem mass spectrometry to simultaneously analyze ten non‐permitted atopic therapeutic compounds in cosmetic products: chlorpheniramine maleate, ketotifen fumarate, doxepin hydrochloride, azelastine hydrochloride, bufexamac, clotrimazole, tranilast, fusidic acid, tacrolimus, and pimecrolimus. Additionally, the major characteristic fragment ions for tacrolimus, pimecrolimus, and clotrimazole were identified by time‐of‐flight mass spectrometry. The specificity, linearity, limit of detection, limit of quantification, recovery, precision, accuracy, and stability of the proposed method were validated. The limit of detection and quantification were in the ranges of 5.05–203.30 pg/mL and 15.15–609.90 pg/mL, respectively. The proposed analysis method could help improve the safety management of cosmetics. [ABSTRACT FROM AUTHOR]

Medical image fusion focuses to fuse complementary diagnostic details for better visualization of comprehensive information and interpretation of various diseases and its treatment planning. In this paper, a multistage multimodal fusion model is presented based on nonsubsampled shearlet transform (NSST), stationary wavelet transform (SWT), and feature‐adaptive pulse coupled neural network. Firstly, NSST is employed to decompose the source images into optimally sparse multi‐resolution components followed by SWT. Secondly, structural features are extracted by a weighted sum‐modified Laplacian and applied to an adaptive model to map feature weights for low‐band SWT component fusion, and texture feature‐based fusion rule is applied to fuse high‐band SWT components. High‐frequency NSST components are fused using the absolute maximum and sum of absolute difference based rule to retain complex directional details. Experimental results show that the proposed method obtains significantly better fused medical images compared to others with excellent visual quality and improved computational measures. [ABSTRACT FROM AUTHOR]

Background: Subjective well‐being (SWB) and quality of life (QOL) are intricately related constructs. Recent research shows both constructs share some facets, but are distinct entities. It is unclear, both internationally and in the Netherlands, if and how SLTs address SWB in clinical practice. The current study was set up to explore Dutch SLTs' perceptions of SWB in relation to the management of people with aphasia. Aims: To describe how Dutch SLTs, working with people with aphasia in a private practice or a healthcare setting, address patient's SWB during diagnosis and treatment, and to identify barriers and facilitators they experience when addressing SWB. Methods & Procedures: A qualitative research design with a phenomenological approach was used. SLTs from private practices and healthcare settings were invited to participate in individual interviews and a focus group. The data were analysed thematically using a combination of inductive and deductive methods. Outcomes & Results: Eight SLTs participated in the study. The SLTs' experiences were captured in four themes that emerged from the data: (1) SWB is a multifaceted concept and depends on patient‐specific factors: premorbid factors, life priorities and time post‐stroke; (2) SLTs experience more responsibility for patients' SWB than their profession allows; (3) collaboration between SLTs and patients, patients' network and other healthcare professionals is required to address SWB during diagnosis and treatment; and (4) misinterpretations are inevitable when SLTs or the patients' network address patients' SWB. Conclusions & Implications: The results showed that SLTs feel responsible for addressing SWB in the management of people with aphasia. Their perception of the concept of SWB is similar to the definition used in the literature and is multifaceted. They feel responsible for the part of SWB that is related to communicative functioning, but less so for the more heuristic aspects of SWB. This is related to their experienced limitation of influence on SWB, which for some leaves them feeling out of depth and uncertain about boundaries between professionals. Addressing SWB in a multidisciplinary team is therefore considered important in order to adequately and fully capture someone's SWB and reduce to clinicians' experienced burden and responsibility. What this paper addsWhat is already known on this subjectRecent studies suggest that quality of life measures may lack facets related to subjective well‐being (SWB). Aphasia is likely to impact on SWB of a stroke survivor, but it is unclear if and how SWB is addressed by speech and language therapists in diagnosis, and treatment of Dutch PWA.What this study addsThis study provides insight into the operationalization of SWB in Dutch clinical practice, including barriers SLTs experience when addressing SWB.Clinical implications of this studyMonitoring and influencing SWB of people with aphasia is a complex process, that SLTs consider only possible in multi‐disciplinary teams. Clear guidelines on roles and responsibilities between various disciplines involved are necessary to improve care for people with aphasia. [ABSTRACT FROM AUTHOR]

In this paper, I discuss the question of partiality and impartiality in the application of triage. Triage is a process in medical research which recommends that patients should be sorted for treatment according to the degree or severity of their injury. In employing the triage protocol, however, the question of partiality arises because socially vulnerable groups will be neglected since there is the likelihood that the social determinants of a patient's health may diminish her chance of survival. As a process that is based on the severity of a patient's injury, triage will be unfair, and hence negatively partial, to socially vulnerable people. Thus, I aim in this paper to show that the triage protocol fails as an impartial evaluative process because its only aim is to maximize survivability. I contend that: (i) triage would lead to the neglect of the social condition of patients or victims, and (ii) it will only serve the utilitarian purpose of maximization of outcomes which may not be justified in some cases. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a benign vascular proliferation of the skin and mucous membranes, whose pathogenesis is not fully understood. Despite its benign nature, it can have a significant negative impact on patients' quality of life, and therefore appropriate therapy is needed. Over the years, a lot of therapeutic modalities have been used in order to successfully treat this condition. This paper is an updated systematic overview of all the reported successful treatments described in the literature and was conducted according to the PRISMA guidelines for systematic reviews. Articles derived from the databases PubMed, EMBASE, and SCOPUS, published between 1981 and 2018, were analyzed for this study. In the literature, there are several studies, case series, and case reports that demonstrate encouraging results with the use of various methods, such as surgical intervention or laser treatment, but also with more conservative approaches, including the application of topical and systemic agents. The selection of the appropriate treatment should be made individually, depending on severity of the disease and patient characteristics. Both research efforts as well as clinical reporting are necessary in order to provide more insight on the management of these vascular tumors. This paper aims to provide a summarized update on the reported therapies and to raise awareness for the need to conduct larger systematic studies in order to adequately evaluate and compare the effectiveness of the presented therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background: Many people with aphasia have word‐finding difficulties, with some showing particular difficulties with verbs. Picture‐naming therapy is often used to improve naming, but gains are usually limited to therapy items and do not transfer to conversation. Therapy where words are produced in sentences and in real‐life activities may be more effective. Aims: The current pilot study investigated whether an activity‐oriented therapy approach would be accepted and viable if implemented in a community setting, and whether communicating whilst cooking was more beneficial than using paper‐based activities. If successful, it would be expected that verb production would improve in structured and unstructured tasks in both naming and narrative tasks. Methods & Procedures: The study employed a case‐series repeated‐measures design, with testing of treated and control items. Seven adults with anomia participated, although only five completed the full programme. Participants were divided into two groups and each group completed both treatments, but in different orders. Each treatment was employed for six 2‐h sessions over a 3‐week period. Outcomes & Results: Naming of both treated and untreated verbs showed a statistically significant improvement following both treatments and this continued into the maintenance phase. There was a numerical but not statistically significant gain in the variety of verbs used in spoken narratives. Participants predominantly chose positive terms to describe their experience of the programme, but did not prefer one therapy over the other. Conclusions & Implications: Preliminary findings suggest that an activity‐oriented therapy approach, whether it involves carrying out tasks or paper‐based activities, can result in clinically meaningful improvements for people with chronic aphasia. Further research using a randomized control trial is required to determine whether cooking therapy alone is effective. [ABSTRACT FROM AUTHOR]

Background: Cerebral gas embolism is a complication of several medical procedures and occurs when gas enters the cerebral circulation. Knowledge about etiology and outcome in affected patients is limited, and prospective trials on management and treatment are hardly feasible. Case reports are therefore an important source of information.Methods: A systematic literature search was conducted in June 2016 and May 2018, supplemented by a manual search. Titles and abstracts were systematically assessed for eligibility, followed by full-text screening for included papers. Screening and data extraction were performed independently by two researchers. Cases of cerebral gas embolism due to any iatrogenic cause were included. Criteria for exclusion were: animal studies, non-cerebral localization, extravascular gas only, and non-iatrogenic causes. 264 cases reported in 189 papers were included.Results: A broad range of procedures leading to iatrogenic cerebral gas embolism (ICGE) were identified and a comprehensive list is presented in this article. Procedures were mostly reported as conducted correctly, but procedure related error, patient activity, or defective equipment were also reported as causes. Neurological, neuropsychological, and cardiopulmonary symptoms were common. The diagnosis was frequently based on or confirmed by radiology, usually CT. Hyperbaric oxygen therapy was applied in a large number of cases.Conclusion: The reported causes, symptoms and signs, and outcomes of ICGE vary significantly, and awareness of the condition in the medical community is essential. A standardized method of reporting could facilitate higher quality research in the field. [ABSTRACT FROM AUTHOR]

Aims: Understanding how much healthcare professionals (HCPs) know about medication can help in devising strategies to improve rational medication use. This study aimed to synthesize information on the level of medication knowledge of HCPs in Africa. Method: We performed a systematic literature study in Embase and PubMed. We included original studies quantifying HCPs' medication knowledge, published between 2012 and 2016. We extracted disease focus, country, number and type of HCPs included and all medication‐related knowledge questions and scored the quality of papers. The outcome measure was the percentage of HCPs who correctly answered medication knowledge questions. Results: We identified 64 studies from 12 African countries, comprising 13 911 HCPs, mostly nurses/midwifes and physicians. We extracted 306 medication‐related knowledge questions, and only 52% (SD 28) of HCPs correctly answered them. Knowledge questions were mainly about medication prescribed for communicable diseases (70%), followed by non‐communicable diseases (11%), and family planning/gynaecology (10%). Most papers concluded that there was a considerable medication knowledge gap among HCPs. Conclusion: We found a low level of medication knowledge across different disease areas, countries and HCPs. This underlines the continuous need to strengthen the undergraduate and postgraduate education in (clinical) pharmacology and therapeutics in Africa. [ABSTRACT FROM AUTHOR]

Aim: To describe existing evidence on non-pharmacological interventions to manage sleep disturbance in children with neurodisabilities.Method: We systematically reviewed non-pharmacological interventions aimed at improving non-respiratory sleep disturbance in children with neurodisability. Sixteen databases, grey literature, and reference lists of included papers were searched up to February 2017. Two researchers (B.B., C.M., G.S., A.S., A.P.) undertook screening, data extraction, and quality appraisal.Results: Twenty-five studies were included: 11 randomized controlled trials and 14 before-and-after studies. All studies were at high or unclear risk of bias. Parent-directed interventions were categorized as comprehensive tailored interventions (n=9), comprehensive non-tailored interventions (n=8), and non-comprehensive interventions (n=2). Six 'other' non-pharmacological interventions were included. Seventy-one child and parent sleep-related outcomes were measured across the included studies. We report the two most commonly measured outcomes: the Child Sleep Habits Questionnaire and sleep onset latency. Five studies reported significant improvements on at least one of these outcomes.Interpretation: Various types of non-pharmacological intervention for managing sleep disturbance have been evaluated. Clinical heterogeneity and poor study quality meant we could not draw definitive conclusions on the effectiveness of these interventions. Current clinical guidance recommends parent-directed interventions as the first approach to managing sleep disturbance; prioritizing research in this area is recommended.What This Paper Adds: Existing evidence on non-pharmacological interventions to manage sleep disturbance in children with neurodisabilities is predominately of poor quality. Most included studies evaluated parent-directed interventions of varying content and intensity. There was very little consistency between studies in the outcome measures used. There is some evidence that parent-directed interventions may improve child outcomes. [ABSTRACT FROM AUTHOR]

At its inception, "brain death" was proposed not as a coherent concept but as a useful one. The 1968 Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death gave no reason that "irreversible coma" should be death itself, but simply asserted that the time had come for it to be declared so. Subsequent writings by chairman Henry Beecher made clear that, to him at least, death was essentially a social construct, and society could define it however it pleased. The first widely endorsed attempt at a philosophical justification appeared thirteen years later, with a report from the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and a seminal paper by James Bernat, Charles Culver, and Bernard Gert, which introduced the insightful tripartite scheme of concept, criterion, and tests for death. Their paper proposed that the correct concept of death is the "permanent cessation of functioning of the organism as a whole," which tenuously remains the mainstream concept to this day. In this essay, I focus on this mainstream concept, arguing that equating brain death with death involves several levels of incoherence: between concept and criterion, between criterion and tests, between tests and concept, and between all of these and actual brain death praxis. [ABSTRACT FROM AUTHOR]

Abstract: According to results of a recent literature search performed by the European Academy of Dermatology and Venereology (EADV) Task Forces (TF) on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS), most of the publications where health‐related (HR) QoL of acne patients was studied were clinical trials. Members of the EADV TF on QoL and PO decided to detect which acne treatment has the best influence on HRQoL of acne patients. A new literature search was organized to find publications on acne treatment where the HRQoL of patients was assessed as an outcome measure. From 186 papers with HRQoL assessment, 37 papers were included for further analysis. Our results revealed that oral isotretinoin had the best influence on HRQoL of acne patients. Several other treatment methods also showed good effects on the HRQoL of acne patients. Oral isotretinoin and norethindrone acetate/ethinyl estradiol, topical clindamycin phosphate/benzoyl peroxide and adapalene/benzoyl peroxide showed significantly better effect on HRQoL than placebo. There is limited number of the high‐quality studies on acne treatment where HRQoL was assessed. Dermatology‐specific and acne‐specific instruments showed much better sensitivity to successful therapeutic intervention than generic HRQoL instruments. The most frequently used HRQoL instrument was the Dermatology Life Quality Index questionnaire. [ABSTRACT FROM AUTHOR]

With the heightened popularity of childhood sporting activity, the number of paediatric anterior cruciate ligament (ACL) ruptures has increased. Management of these injuries presents a particular challenge due to the open femoral and tibial growth plates. Physeal damage has the potential to cause angular deformity or length discrepancy. This review was conducted to determine the best way to treat this injury. A primary search of Ovid MEDLINE (1 October 2017) used the terms: (ACL or anterior cruciate ligament) and (young or child or children or pediatric or immature or pre-pubescent). Titles/Abstracts of 369 articles were screened for relevance. A total of 217 were excluded, leaving 152 articles for full-paper retrieval. Of these, 9 articles remained with one further article identified during cross-referencing; 10 papers (1 level 2 and 9 level 3) were included for analysis. Comparative studies investigating surgical (140 knees) versus conservative (110 knees) treatment provide evidence in favour of the former, in reducing instability and meniscal tears and improving return to previous activity. Of the papers analysed (163 reconstructions), there was only one case of growth arrest (0.6%) and no cases of length discrepancy. In those studies investigating early (218 patients) versus delayed (140 patients) reconstruction, medial meniscal tears and chondral injuries occurred more frequently in the delayed group. To conclude, for children, there is level 2/3 evidence that early operative ACL reconstruction offers the best chance of a return to pre-injury sporting activity and minimises the risks of further structural damage. Iatrogenic growth disturbance remains a rare but worrying complication. [ABSTRACT FROM AUTHOR]

Abstract: This study discusses the current status of evidence‐based psychological therapies for generalised anxiety disorder (GAD). It points to the dominance of cognitive‐behavioural therapies (CBTs) and compares this dominance with the position of humanistic‐experiential therapies (HEPs) in this area. The paper hypothesises several reasons for this situation, including historical developments as well as HEPs’ ambivalence around embracing mainstream mental health classification systems, and corresponding types of research. The paper then highlights some recent developments in HEPs for anxiety disorders (particularly emotion‐focused therapy; EFT); developments that are breaking new conceptual grounds while also generating new outcome research. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Dr Leslie E. Keeley was perhaps the world's most famous addiction cure doctor at the turn of the 20th century, but mainstream medicine dismissed him as a quack because he dispensed a secret cure. This paper aims to describe Keeley's now largely forgotten story and to draw attention to the role of contextual issues in the acceptance or rejection of any theory of addiction, particularly the neuroscientific theories of the early 21st century. Methods: This study is a qualitative assessment and contextualization of historical documents. Its main sources are archival and are, for the most part, unknown to historians. The paper also offers intellectual and historical context that is drawn from leading historical and sociological analyses. Results: Keeley's addiction cure was dismissed as quackery because it failed to meet the changing standards of late 19th‐century professional medicine. This begs us to consider contextual issues in any assertion of the viability of addiction therapeutics, in the present as well the past. Conclusions: Keeley's near erasure from the historical record was a consequence of a broader, late 19th‐century medical power struggle that took precedence over the testimony of tens of thousands of satisfied patients who claimed that Keeley's cure worked. Context matters in the assessment of the viability of theories of addiction from the past, but also from the present. Historians and social scientists are well placed to make those assessments. [ABSTRACT FROM AUTHOR]

Aim: Early intervention in psychosis (EIP) is a well‐established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementation and presents ideas and strategies to overcome some of these obstacles. Methods: This paper is a narrative review about the evidence supporting EIP, with examples of successful implementation of EIP and of cases where major obstacles still need to be overcome. Results: Experience from successfully implemented EIP services into the mental healthcare system have generated evidence, concepts and specific strategies that might serve as guidance or inspiration in other countries or systems where EIP is less well developed or not developed at all. Previous experience has made clear that evidence of clinical benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation. Conclusions: Users’ narratives, close collaboration with community organizations and support from policy‐makers and known people within the community championing early intervention (EI) services are just a few of the approaches that should be considered in campaigns for implementation of EI services. Fast progress in implementation is possible. [ABSTRACT FROM AUTHOR]

Abstract: Background: Although high rates of depression symptoms are reported in adults with intellectual disabilities (IDs), there is a lack of knowledge about non‐pharmacological treatment options for depression in this population. The first research question of this paper is: Which non‐pharmacological interventions have been studied in adults with ID and depression? The second research question is: What were the results of these non‐pharmacological interventions? Method: Systematic review of the literature with an electronic search in six databases has been completed with hand searches. Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines have been followed. Selected studies met predefined inclusion criteria. Results: Literature search resulted in 4267 papers of which 15 met the inclusion criteria. Five different types of non‐pharmacological interventions have been studied: cognitive behavioural therapy, behavioural therapy, exercise intervention, social problem‐solving skills programme and bright light therapy. Conclusion: There are only a few studies of good quality evaluating non‐pharmacological interventions for adults with ID and depression. Some of these studies, especially studies on cognitive behavioural therapy, show good results in decreasing depressive symptoms. High‐quality randomised controlled trials evaluating non‐pharmacological interventions with follow‐up are needed. [ABSTRACT FROM AUTHOR]

The article discusses various issues published within the issue, including one by Ian Jones and colleagues on the factors that may contribute to bacterial contamination of intravenous catherers in hospitalized dogs and cats, one by Jackson Thomas and colleagues on the efficacy of an ointment containing kunzea oil in treating pastern dermatitis, and one by Bertrand Losson and Claude Saegernan on the outbreaks of parafilariosis in cattle in Belgium.

An introduction to the journal is presented in which the editor discusses the review of the canine osteoarthritis management by Richard Sanderson and colleagues, the review of the 180 cases of Vitis intoxication in dogs from the reports in Veterinary Poisons Information Service in London, England in August 1994 and September 2007 by Nick Sutton and colleagues, and the description of the selamectin spot-on formulation in the treatment of sarcoptic mange in a group of rabbits by Rania Farmaki and colleagues.

The study refers to the social aspect of Autism Spectrum Disorder (ASD) and focuses on pro‐social behaviour that has a positive effect on social adaptability. The first goal of the study was to determine whether there is a gap in prosocial‐behaviour between children with High‐Functioning ASD (HFASD) and children with typical‐development; and secondly, to foster prosocial‐behaviour with a computer‐mediated intervention versus a non‐computer‐mediated intervention. The study comprises 58 preschool children, divided into three groups: HFASD experiencing a computer‐mediated intervention, HFASD experiencing a non‐computer‐mediated intervention, and typically‐developing children with no intervention. The 2‐month intervention was based on the Cognitive Behavioural Therapy model, and pairs of children learned how to solve social‐problems. Following preliminary screening tests (PPVT; SCQ), observations designed to evaluate prosocial‐ability and Vineland questionnaires measuring prosocial‐behaviour were conducted pre‐ and post‐intervention. Pre‐intervention findings indicated that children with typical‐development exhibited higher prosocial‐behaviour than children with HFASD. This changed however, post‐intervention, as the gap between the two groups decreased. Additionally, the study found that the computer‐mediated intervention group improved in some prosocial measures compared to the non‐computer‐mediated intervention. Lay Description: What is currently known about the subject matter?: Prosocial behaviour is the ability to channel positive feelings/behaviours towards others for their benefit.It contributes to social acceptance, psychosocial adjustment, and academic achievement.Studies point to difficulties in prosocial ability among children with Autism.There is a positive impact of assistive‐technologies on children with Autism, especially in early childhood. What the paper adds to this?: We compared computer‐mediated prosocial intervention to non‐computer‐mediated intervention.Post intervention, the prosocial ability gap between typically developed children and children with Autism decrease.Comparing the two interventions yield that the computer‐mediated intervention led to a more significant improvement. Implications of study findings for practitioners: The study highlights the effectiveness of using computers in working with young children with Autism.An effective computer‐moderated therapy could help these children progress in prosocial ability.Developing prosocial ability may contribute to the children' social status, self‐image, and other areas. [ABSTRACT FROM AUTHOR]

Inflammation can be created by several different causes, including a blood clot, an immune system disorder, a cancer, an infection, a chemical exposure, a physical injury, or a neurological condition, such as Alzheimer's or depression. In particular, many infections by viral, bacterial, fungal and protozoan pathogens can cause inflammation. Inflammations can have far‐reaching medical consequences, because chronic or frequent inflammation can assist cancers and initiate autoimmune diseases. Determining the cause of an inflammation can be essential for the medical treatment of an individual, and a classification system can be a useful tool to help a diagnosis, confirm a diagnosis and to determine the most appropriate treatment. However, at present there is no classification system for the different causes of inflammation. This paper describes a classification system that uses seven distinct cytokine parameters to enable the determination of the cause of an inflammation. This classification system is expandable, and it can help determine whether an inflammation is caused by an ischaemia, an immune system disorder, a cancer, an infection, a chemical, a physical injury, or a neurological condition. In some cases, this classification system can help enable a quick primary or secondary determination of an urgent medical emergency when other medical diagnostic resources are unavailable. [ABSTRACT FROM AUTHOR]

There is increasing national and international interest in overprescribing and polypharmacy, and the burden that the inappropriate use of multiple medicines can place on individual patients and on society as a whole. This paper explores the challenges faced by prescribers and pharmacists wishing to reduce polypharmacy, including the uncertainties about the risks and benefits of continuing or stopping individual drugs. We discuss the factors influencing us to prescribe—which may lead to overprescribing—including the increasing number of guidelines, perceived patient pressure and advertising. We offer a critical appraisal of the tools currently available to clinicians and pharmacists aiming to rationalise medicines, and finally a systems‐wide approach to improving overprescribing and problematic polypharmacy. [ABSTRACT FROM AUTHOR]

Occupational therapists routinely use a variety of learning strategies as part of their engagement with clients. This paper is the second of a two-part presentation of the Four-Quadrant Model of Facilitated Learning (4QM), a client-centred means of employing teaching–learning approaches to intervention. The first paper examined the way teaching–learning approaches can be used in occupational therapy. The current paper discusses the ways that various learning strategies can be used as therapeutic tools. Useful learning strategies are grouped according to purpose and presented in the 4QM as a coordinated way of organising therapeutic intervention. In this way, the 4QM is posited to enhance the repertoire of strategies from which therapists can draw, and to help coordinate the learning process over time. The 4QM is advanced as a way of informing clinical reasoning in teaching–learning approaches to occupational therapy by providing a means of understanding how and when various strategies are most appropriately used. Although grounded in theories of child learning, applications to adult learning may also be possible. [ABSTRACT FROM AUTHOR]

Occupational therapists routinely use teaching–learning approaches to support clients in their acquisition of skills supporting occupational performance goals. This paper is the first of a two-part presentation that positions teaching–learning in occupational therapy through a discussion of the Four-Quadrant Model of Facilitated Learning (4QM). The 4QM provides a means of informing clinical reasoning when using teaching–learning approaches in occupational therapy. Although developed to actualise teaching–learning approaches with children, it has the potential to be applied more broadly. This first paper explores the relationship between occupational therapy principles and the use of teaching–learning approaches. It draws on current literature to understand the use of learning strategies as therapeutic tools. In this context, the 4QM is presented as a way of organising occupational therapy intervention when a teaching–learning approach is used. [ABSTRACT FROM AUTHOR]

Diagnostic medical imaging plays an imperative role in clinical assessment and treatment of medical abnormalities. The fusion of multimodal medical images merges complementary information present in the multi-source images and provides a better interpretation with improved diagnostic accuracy. This paper presents a CT–MR neurological image fusion method using an optimised biologically inspired neural network in nonsubsampled shearlet (NSST) domain. NSST decomposed coefficients are utilised to activate the optimised neural model using particle swarm optimisation method and to generate the firing maps. Low and high-frequency NSST subbands get fused using max-rule based on firing maps. In the optimisation process, a fitness function is evaluated based on spatial frequency and edge index of the resultant fused image. To analyse the fusion performance, extensive experiments are conducted on the different CT–MR neurological image dataset. Objective performance is evaluated based on different metrics to highlight the clarity, contrast, correlation, visual quality, complementary information, salient information, and edge information present in the fused images. Experimental results show that the proposed method is able to provide better-fused images and outperforms other existing methods in both visual and quantitative assessments. [ABSTRACT FROM AUTHOR]

Exercise training is playing an increasing role in lung cancer care. Lung cancer is associated with significant burden to the individual and healthcare system. There is now substantial evidence that exercise training is safe, feasible and effective at improving several outcomes in people with lung cancer, especially in those with NSCLC. Exercise is beneficial across the lung cancer disease and treatment pathway, including in patients with early stage disease before and after surgery, and in patients with advanced disease. This review describes the impact of lung cancer and lung cancer treatment on patient health outcomes and summarizes the aims, safety, feasibility and effects of exercise training in the context of both early stage and advanced stage lung cancer. The paper also includes a discussion of current topical discussion areas including the use of exercise in people with bone metastases and the potential effect of exercise on suppression of tumour growth. Finally, seven clinical questions are included, which are a priority to be addressed by future research over the next decade as we strive to progress the field of lung cancer and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Building on Lieberman's Transgenerational theory (1979), which posited that many inexplicable family problems could be traced to unresolved conflicts arising from clashes between cultural differences across generations, forty multi‐generation families that have been treated with either a child, an adult, or a member from the older generation as symptom bearers were reviewed in this project. This paper is a discussion of the findings obtained from exploring these presenting symptoms from the perspective of transgenerational dynamics, and a presentation of a treatment approach in working transgenerationally. In addition to family histories, we also focused in this work on the importance of working with problematic interpersonal patterns across generations in order to negotiate a more satisfactory and developmentally appropriate boundary between subsystems. Practitioner points: Analysis of clinical data with Chinese families shows that many individual mental health problems can reflect unresolved conflict in transgenerational relationshipsTransgenerational theory is useful in helping us understand the link between generationsAlong with structural family therapy theory this enables members of multi‐generations to negotiate a developmentally appropriate pattern between subsystemsUsing biofeedback in a family assessment protocol to elicit children's responses to parental conflict helps link repeated patterns transmitted transgenerationally [ABSTRACT FROM AUTHOR]

Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self-sustained feed-forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host-modulation therapies for the treatment of periodontitis. Such host-modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application. [ABSTRACT FROM AUTHOR]

Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it. [ABSTRACT FROM AUTHOR]

Background: Based on subjective experience, patients can identify research priorities important for health services research. A systematic method for priority setting has been developed by the James Lind Alliance. Objective: This article reviews the literature on the research priorities of patients, caregivers and health‐care professionals and presents the prioritized research themes and prioritization methods used. Search strategy: Three electronic databases were searched on 22 May 2018. The search was not limited to any time period or language. Inclusion criteria: The included studies reported the identification and prioritization of research priorities involving patients, relatives and caregivers. Each included paper addressed a specific ICD‐coded health problem, and at least one‐third of the sample involved in the prioritization process was affected by the health problem. Data extraction and synthesis: The 10 top‐ranked research priorities were included in the thematic analysis. With an inductive approach, a system of identified themes and subthemes was developed from the research priorities. Each research priority was assigned to one research theme. Main results: The priority lists of 34 publications involving 331 research priorities were included. Nine main themes represent the content of the research priorities. The most frequently represented main themes are 'Treatment', 'Patients' and 'Health condition'. The distribution of the research priorities varied depending on the health conditions and prioritization methods. Discussion and conclusions: This review provides a comprehensive overview of the overarching research themes in research priorities of affected individuals. The results can guide future patient‐oriented research. [ABSTRACT FROM AUTHOR]

The boundary treatment for modeling complex geometries in smoothed particle hydrodynamics (SPH) methods is always challenging, especially for objects with sharp corners. In this paper, we propose an improved boundary treatment technique to handle boundary conditions in the SPH method where objects are represented as implicit surfaces. The improved boundary treatment technique provides a full treatment for complicated geometries and can handle sharp edges without any special treatment. The boundary particles are uniformly distributed in compliance with the curvature of the objects, therefore taking into consideration the effect of the boundary. Several simulations are presented to validate and demonstrate the applicability and versatility of the proposed technique. [ABSTRACT FROM AUTHOR]