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AIM Acute oxygen inhalation and slow deep breathing improve measures of autonomic function transiently in individuals with short-duration type 1 diabetes. Our aims were to examine these interventions and changes in autonomic function in individuals with long-duration type 1 diabetes and to explore interactions with the presence of macroalbuminuria or existing cardiovascular autonomic neuropathy. METHODS Individuals with type 1 diabetes (n = 54) were exposed to acute oxygen inhalation, slow deep breathing and a combination of both (hereafter 'the combination'). Primary outcomes were change in baroreflex sensitivity and heart rate variability. Associations between changes in outcomes were evaluated using mixed effects models. RESULTS Mean age ± sd was 60 ± 10 years and diabetes duration was 38 ± 14 years. Changes are presented as per cent difference from baseline with 95% confidence intervals. Acute oxygen inhalation, slow deep breathing and the combination increased baroreflex sensitivity by 21 (10, 34)%, 32 (13, 53)% and 30 (10, 54)%, respectively. Acute oxygen inhalation trended towards increasing heart rate variability 8 (-1, 17)% (P = 0.056), and slow deep breathing and the combination increased heart rate variability by 33 (18, 49)% and 44 (27, 64)% respectively. Macroalbuminuria or cardiovascular autonomic neuropathy did not modify results. CONCLUSION Autonomic function is improved transiently in individuals with long-duration type 1 diabetes and normoalbuminuria or macroalbuminuria by acute oxygen inhalation and slow deep breathing. There is a risk of survival bias. Autonomic dysfunction might be a reversible condition, and hypoxia might represent a target of intervention. This article is protected by copyright. All rights reserved.BACKGROUND Motor coordination problems (MCP) in children can sometimes be diagnosed as developmental coordination disorder (DCD). Early intervention for DCD is necessary because it often continues into adolescence, causing mental and physical complications. Few studies have investigated the prevalence of childhood MCP in the Japanese population and examined the risk factors for MCP. Therefore, we investigated the prenatal factors associated with MCP in preschool-aged children. METHODS This study was based on a prospective cohort study, the Hokkaido Study on Environment and Children's Health. Mothers of 4,851 children who reached the age of 5 years within the study-period received questionnaires, including the Japanese version of the developmental coordination disorder questionnaire (DCDQ-J). We examined the risk factors associated with MCP using logistic regression analysis. RESULTS Of 3,402 returned DCDQ-J questionnaires, 3,369 were answered completely. From the 3,369 children, we categorized having MCP by using two cut-off scores that of the DCDQ'07 and the cut-off at the 5th percentile of a total DCDQ-J score. Comparing children with and without MCP, we found significant differences in the education level of the mothers, annual household income during pregnancy, maternal alcohol consumption and smoking during pregnancy, and sex and age of the children at the time of completing the DCDQ-J by both categorizations. Adjusted logistic regression analysis revealed that maternal smoking during the first trimester of pregnancy and male sex were significantly associated with MCP. CONCLUSIONS Our results suggest that maternal smoking during pregnancy is the main factor associated with MCP in preschool-aged children. This article is protected by copyright. All rights reserved.We present a case of type B aortic dissection with a rare aortic arch branching variation whereby two separate brachiocephalic trunks arise from the arch. This case also highlights the potential implications of this variant in the management of thoracic aortic dissections and aneurysms. https://www.selleckchem.com/products/PD-173074.html © 2020 Wiley Periodicals, Inc.OBJECTIVES We evaluated the prognostic impact of MK on post-remission outcomes of AML patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) in the first complete remission (CR1). METHODS We retrospectively analyzed 465 adult patients with AML who had received HSCT in the first CR between 2000 and 2016. RESULTS In MK+ AML, the median leukocyte count was significantly lower (P less then 0.001) and no NPM1 mutation was found (P=0.042). Multivariate analysis revealed that MK was the most powerful prognostic factors for OS (hazard ratio [HR], 2.6; P = 0.001), EFS (HR, 3.8; P less then 0.001), and cumulative incidence of relapse (HR, 6.1; P less then 0.001), compared to any other poor risk factors such as complex karyotype, FLT3-ITD mutations, old age, and higher leukocyte count. The adverse prognostic impact of MK tended to be more prominent in the younger age group ( less then 40 years) (HR, 6.3, P less then 0.001) than in the older age group (≥40 years) (HR, 3.4, P less then 0.001). CONCLUSION Novel treatment modalities for MK+ AML need to be investigated to reduce the risk of relapse after HSCT. This article is protected by copyright. All rights reserved.OBJECTIVE The aim of this work was to investigate an alternative hair dyeing method with vegetable colorants as the tannins, as well as the impact of pre-treatment as the bleaching process. METHODS Untreated, 1, 2 and 3 times bleached hair tresses which were dyed with tannins in combination with metal salts were characterized. The wash fastness and the color-strength of the vegetable dyed hair tresses were spectrophotometrically investigated. RESULTS To determine the color strength KS and the wash fastness of vegetable dyed and pre-bleached hair tresses a three dimensional color-coordinate system - CIELab - which describes the visual spectra is used. The distance between two colors in the CIE Lab color space is expressed by ΔE-values, which are used to identify the wash fastness of the vegetable dye. The hair tresses which had been 3 times pre-bleached showed the highest color-strength and the best wash fastness. The fixation of the tannin mordant complexes on the hair fibre proceeded effectively just when the hair tresses were bleached before the dying process. It is suggested that the sulfonic acid groups, which increase after bleaching hair, interact with the tannin mordant hair dye and lead to stronger crosslinks between keratinous fibres and tannin mordant complexes. It was observed that the color strength of the vegetable dyed tresses correlates with the bleaching process. CONCLUSION The presented results demonstrate that the fixation of the vegetable tannin mordant dying solution on the hair fibres succeed effectively on pre-bleached hair tresses. This article is protected by copyright. All rights reserved.BACKGROUND The saphenous vein remains the most frequently used conduit for coronary artery bypass grafting, despite reported unsatisfactory long-term patency rates. Understanding the pathophysiology of vein graft failure and attempting to improve its longevity has been a significant area of research for more than three decades. This article aims to review the current understanding of the pathophysiology and potential new intervention strategies. METHODS A search of three databases MEDLINE, Web of Science, and Cochrane Library, was undertaken for the terms "pathophysiology," "prevention," and "treatment" plus the term "vein graft failure." RESULTS Saphenous graft failure is commonly the consequence of four different pathophysiological mechanisms, early acute thrombosis, vascular inflammation, intimal hyperplasia, and late accelerated atherosclerosis. Different methods have been proposed to inhibit or attenuate these pathological processes including modified surgical technique, topical pretreatment, external graft support, and postoperative pharmacological interventions. Once graft failure occurs, the available treatments are either surgical reintervention, angioplasty, or conservative medical management reserved for patients not eligible for either procedure. CONCLUSION Despite the extensive amount of research performed, the pathophysiology of saphenous vein graft is still not completely understood. Surgical and pharmacological interventions have improved early patency and different strategies for prevention seem to offer some hope in improving long-term patency. © 2020 The Authors. Journal of Cardiac Surgery published by Wiley Periodicals, Inc.AIMS & OBJECTIVES This study aimed to explore the experiences of liver transplant recipients during their journey through the treatment and their need for psychotherapeutic support related to this process. BACKGROUND Over time, measures of survival and quality of life in liver transplant recipients have continued to improve but their emotional needs remain under explored. In the longer-term recovery from transplantation, the focus shifts from physical health to psychological health. In the UK, there are no known embedded adult psychological services in liver transplant centres to react to this need. DESIGN A qualitative descriptive design was used. METHODS Grounded theory analysis was used to study the narratives of six adult liver transplant recipients. Through a process of coding, conceptual categories were established to describe the participant experiences. The study adhered to the EQUATOR checklist, SRQR. RESULTS Four categories emerged that were related to the experience of liver transplantation for the recipients. These were a process of adjustment, the phenomenon of waiting, liver transplant as a transformative experience and on the value of support. The participants identified a lack of psychotherapeutic support provided by the liver transplant service and felt that an embedded psychotherapeutic service would promote accessing such support during challenging times. CONCLUSION Through the process of liver transplantation, recipients experience challenges with adjustment, waiting, feeling transformed and they value support with these feelings. In correlation with other studies, the findings of this study highlight the need for providing psychotherapeutic support within liver transplant services. RELEVANCE TO CLINICAL PRACTICE The study provides evidence to support recommendations for a conjoined psychotherapy service within liver transplant services to support patients with their holistic needs. This article is protected by copyright. All rights reserved.With the ongoing coronavirus, journals and the media have extensively covered the impacts on doctors, nurses, physician assistants, and other healthcare workers. However, one group that has rarely been mentioned despite being significantly impacted is medical students and medical education overall. This piece, prepared by both a medical student and a cardiothoracic surgeon with a long career in academic medicine, discusses the recent history of medical education and how it has led to issues now with distance-based learning due to COVID-19. It concludes with a call to action for the medical education system to adapt so it can meet the needs of healthcare learners during COVID-19 and even beyond. © 2020 Wiley Periodicals, Inc.BACKGROUND The present study investigates the wellbeing effects for 10-12-year-old children of the school-based intervention "11 for Health in Denmark", which comprises physical activity (PA) and health education. Subgroup analyses were carried out for boys and girls. METHOD 3061 children were randomly assigned to an intervention group (IG) or a control group (CG) by 51 cluster randomisation by school. 2533 children (mean age 11.5±0.4; 49.7% boys) were assigned to IG and 528 children (mean age 11.4±0.5; 50.8% boys) were assigned to CG. IG participated in the "11 for Health in Denmark" 11-week programme, consisting of 2x45 min per week of football drills, small-sided games and health education. CG did not participate in any intervention and continued with their regular education. Before and after the intervention period, both groups answered a shortened version of the multidimensional well-being questionnaire KIDSCREEN-27. RESULTS The "11 for Health in Denmark" intervention programme had a positive effect on physical well-being in girls (IG 48.

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