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En esta investigación, mediante la exploración de la literatura, se realizó un mapeo sistemático sobre la aplicación de técnicas de programación neurolingüística (PNL) soportadas en la Web de las Cosas (WoT) para prevenir el síndrome de Burnout. Dicho síndrome es un tipo de estrés laboral que causa agotamiento físico, mental y emocional, generando una incapacidad para trabajar, dado que es un proceso paulatino en el cual el trabajador pierde interés por sus tareas, carece de sentido de responsabilidad y puede generar profundas depresiones. En los estudios encontrados se destaca el uso de la WoT para la detección de emociones y estrés laboral, para ello sobresale el uso de sensores capaces de medir Respuesta galvánica de la piel GSR, Frecuencia cardiaca HR, Fotopletismografía PPG, Electrocardiograma ECG, Cámaras, Micrófonos y Microprocesadores de bajo costo, así como la utilización de Inteligencia Artificial para procesar estos datos, entre las técnicas y los algoritmos más usados destacan Máquinas de Vectores de Soporte SVM, K-vecino más cercano y clasificador Naive Bayes. En los trabajos en los que se detectan emociones o estrés laboral son muy pocos los que intentan alterar el entorno mental o ambiental del usuario para llevarlo a una emoción positiva o disminuir el estrés. Se evidenció la posibilidad de la utilización de técnicas de PNL en la prevención del síndrome de Burnout. Sin embargo, no se encontró ningún trabajo que relacionara la WoT como soporte a las técnicas PNL para prevenir el síndrome de Burnout, lo cual se considera como una oportunidad de investigación en estos campos.

Background: Acute flaccid myelitis (AFM) is a childhood illness characterized by sudden-onset weakness impairing function. The primary goal was to compare the motor recovery patterns of patients with AFM who were discharged home or to inpatient rehabilitation. Secondary analyses focused on recovery of respiratory status, nutritional status, and neurogenic bowel and bladder in both cohorts., Methods: Eleven tertiary care centers in the United States performed a retrospective chart review of children with AFM between January 1, 2014, and October 1, 2019. Data included demographics, treatments, and outcomes on admission, discharge, and follow-up visits., Results: Medical records of 109 children met inclusion criteria; 67 children required inpatient rehabilitation, whereas 42 children were discharged directly home. The median age was 5 years (range 4 months to 17 years), and the median time observed was 417 days (interquartile range = 645 days). Distal upper extremities recovered better than the proximal upper extremities. At acute presentation, children who needed inpatient rehabilitation had significantly higher rates of respiratory support (P < 0.001), nutritional support (P < 0.001), and neurogenic bowel (P = 0.004) and bladder (P = 0.002). At follow-up, those who attended inpatient rehabilitation continued to have higher rates of respiratory support (28% vs 12%, P = 0.043); however, the nutritional status and bowel/bladder function were no longer statistically different., Conclusions: All children made improvements in strength. Proximal muscles remained weaker than distal muscles in the upper extremities. Children who qualified for inpatient rehabilitation had ongoing respiratory needs at follow-up; however, recovery of nutritional status and bowel/bladder were similar., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction/aims: Although electromyography remains the "gold standard" for assessing and diagnosing peripheral nerve disorders, ultrasound has emerged as a useful adjunct, providing valuable anatomic information. The objective of this study was to conduct a systematic review and meta-analysis evaluating the normative sonographic values for adult peripheral nerve cross-sectional area (CSA)., Methods: Medline and Cochrane Library databases were systematically searched for healthy adult peripheral nerve CSA, excluding the median and ulnar nerves. Data were meta-analyzed, using a random-effects model, to calculate the mean nerve CSA and its 95% confidence interval (CI) for each nerve at a specific anatomical location (= group)., Results: Thirty groups were identified and meta-analyzed, which comprised 16 from the upper extremity and 15 from the lower extremity. The tibial nerve (n = 2916 nerves) was reported most commonly, followed by the common fibular nerve (n = 2580 nerves) and the radial nerve (n = 2326 nerves). Means and 95% confidence interval (CIs) of nerve CSA for the largest number of combined nerves were: radial nerve assessed at the spiral groove (n = 1810; mean, 5.14 mm 2 ; 95% CI, 4.33 to 5.96); common fibular nerve assessed at the fibular head (n = 1460; mean, 10.18 mm 2 ; 95% CI, 8.91 to 11.45); and common fibular nerve assessed at the popliteal fossa (n = 1120; mean, 12.90 mm 2 ; 95% CI, 9.12 to 16.68). Publication bias was suspected, but its influence on the results was minimal., Discussion: Two hundred thirty mean CSAs from 15 857 adult nerves are included in the meta-analysis. These are further categorized into 30 groups, based on anatomical location, providing a comprehensive reference for the clinician and researcher investigating adult peripheral nerve anatomy., (© 2022 Wiley Periodicals LLC.)

Background: Cervical medial branch radiofrequency ablation (CMBRFA) is effective when patients are selected by dual medial branch blocks (MBBs). SIS guidelines recommend 100% pain improvement after dual comparative MBBs before CMBRFA; however, our prior investigation showed similar outcomes in those selected by a lesser strict paradigm., Objective: Compare pain and patient impression of improvement after CMBRFA in individuals stratified by a less stringent (80-99%) dual MBB response than those selected by the 100% criteria., Design: Cross-sectional study., Methods: Follow-up was conducted via standardized telephone survey at ≥6 months post-CMBRFA to obtain Numerical Rating Scale (NRS) pain and Patient Global Impression of Change (PGIC) scores. Primary and secondary outcomes were within-group and between-group differences in the proportions of patients reporting ≥50% NRS score reduction and PGIC scores., Results: Medical records of 195 consecutive patients were reviewed; 100 individuals were analyzed. 48% (95% CI 35-61%) and 52% (95% CI 37-67%) of the 80-99% and 100% MBB groups, reported ≥50% pain reduction at ≥6 months post-CMBRFA. 74% (95% CI 63-85%) and 67% (95% CI 52-81%) of the 80-99% and 100% MBB groups reported a PGIC score consistent with "improved" or "very much improved." There were no significant between-group differences in any outcome at any time point., Conclusions: We observed similar rates of pain relief and global improvement after CMBRFA in patients selected by dual MBBs with ≥80% symptom relief versus 100% relief. This provides evidence that a more practical criteria, compared to a more strict selection paradigm, may result in similar clinical outcomes., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zachary L. McCormick, MD reports a relationship with Spine Intervention Society that includes: board membership. Zachary L. McCormick, MD reports a relationship with Avanos Medical US that includes: funding grants., (Crown Copyright © 2022 Published by Elsevier Inc. on behalf of Spine Intervention Society.)

Background: The Balance Error Scoring System (BESS) is a tool to measure balance, however, no studies have shown its reliability between novice and expert raters., Research Question: What is the inter-rater reliability of BESS measurements when performed by novice raters compared to experts, and does completion of a focused, online training module increase the inter-rater reliability among novice raters?, Methods: In this reliability study, 5 novice volunteers were asked to independently rate BESS tests from 50 random prerecorded BESS videos of normal healthy subjects aged 5-14. Novice raters regraded the same 50 videos after receiving a formal training. The novices' scores before and after the formal training were compared to one another and then the scores were compared to 4 expert scores. Intraclass correlation (ICC) with 95 % confidence intervals or percent agreements were calculated and compared across groups., Results: For the total BESS score, novice raters showed good reliability (ICC 0.845) which did not change with a formal training (ICC 0.846). Expert raters showed excellent reliability (ICC 0.929). Poor to moderate reliability was noted in the foam stance-single leg in the untrained novice and trained novice group (ICCs 0.452 and 0.64 L respectively)., Significance: BESS testing by novice raters with only written instruction and no formal training yields good inter-rater reliability. In contrast, BESS testing by expert raters yields excellent reliability. A focused training for novice raters conferred a small improvement in the reliability of the scoring of the single leg stance on foam condition but not a significant difference to the overall BESS score. While novices demonstrated promising reliability for overall BESS scores, optimizing clinical research using the BESS with expert raters show the highest reliability., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: This study compared the end-of-life care (EOLC) content in pharmacy-related textbooks to textbooks evaluated in a comparable 2003 study., Methods: Six common pharmacy-related textbooks were reviewed for content relating to EOLC. Five of the textbooks were the newest editions of the same texts reviewed in a similar 2003 study, and one focused primarily on clinical ethics, a topic that was underrepresented in the previous study. The six texts were searched for a list of 33 keywords or phrases pertaining to EOLC. Entries containing any of these 33 keywords were assigned a domain and scored using a simple scoring system of one if minimally helpful content was present or two if helpful content was present. The total number of entries and their average scores were compared to the results of the previous study., Results: The average number of entries per textbook was 154, which represents an increase from the 110.1 average number of entries in the 2003 study. However, one of the textbooks had a total of 470 entries alone. Of a total number of 78 possible domains, 40 had either zero or one entries. The average ratings for each book ranged from 0.5 to 1.6, whereas they ranged from 0.9 to 1.6 in 2003. Four of six books in this study had average rating of less than 0.9., Conclusion: Although certain texts have made strides to include more EOLC content, overall, EOLC content in pharmacy textbooks may still be improved., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Twelve female division I collegiate volleyball players were recruited to examine the reliability of several methods for calculating the rate of force development (RFD) during the isometric midthigh clean pull. All subjects were familiarized with the isometric midthigh clean pull and participated in regular strength training. Two isometric midthigh clean pulls were performed with 2 minutes rest between each trail. All measures were performed in a custom isometric testing device that included a step-wise adjustable bar and a force plate for measuring ground reaction forces. The RFD during predetermined time zone bands (0-30, 0-50, 0-90, 0-100, 0-150, 0-200, and 0-250 milliseconds) was then calculated by dividing the force at the end of the band by the band's time interval. The peak RFD was then calculated with the use of 2, 5, 10, 20, 30, and 50 milliseconds sampling windows. The average RFD (avgRFD) was calculated by dividing the peak force (PF) by the time to achieve PF. All data were analyzed with the use of intraclass correlation alpha (ICCα) and the coefficient of variation (CV) and 90% confidence intervals. All predetermined RFD time bands were deemed reliable based on an ICCα >0.95 and a CV <4%. Conversely, the avgRFD failed to meet the reliability standards set for this study. Overall, the method used to assess the RFD during an isometric midthigh clean pull impacts the reliability of the measure and predetermined RFD time bands should be used to quantify the RFD.