Could Neuro-Phenomenology Deepen an Interpretative Phenomenological Analysis of Seizure Consciousness Drawings

This article proposes a methodological stance, an Interpretative Phenomenological Analysis (IPA) of participants’ drawings as one that is useful for research into people’s experiences of seizure consciousness. Using empirical examples located in an original, larger study, this article offers a rationale for, and illustrates the analytic potential of, this combination. It also considers that elicitation interviewing techniques and methods from the field of neuro - phenomenology could take this work further in terms of deepening the analysis by reaching people’s pre - reflexive conscious experiences. This theoretical and practical combination has the potential to develop this work significantly

The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial.

ABSTRACT: BACKGROUND: Many Polio survivors have reduced mobility, pain and fatigue, which make access to conventional forms of aerobic exercise difficult. Inactivity leads to increased risk of health problems, many of which are prevalent among Polio survivors. Aerobic exercise programmes in Polio survivors should utilise stable muscle groups and should be designed to minimise exacerbation of pain and fatigue. A home-based arm ergometry aerobic exercise programme may represent an affordable and accessible exercise modality, incorporating exercise prescription principles in this group.Methods/design: This is a prospective, single blinded, randomised controlled trial. There are two arms; exercise intervention using arm ergometers and control. Polio survivors meeting eligibility criteria will be recruited and randomly allocated to intervention or control groups. Participants allocated to the intervention group will receive a small arm ergometer and a polar heart rate monitor. They will carry out a home-based moderate intensity (50-70% HRMax) aerobic exercise programme for eight weeks, following instruction by the treating physiotherapist. Assessments will occur at baseline and after eight weeks and will include tests of physical fitness, activity, energy cost of walking, fatigue and quality of life. Clinically feasible assessment tools including the Six Minute Arm Test, the Physical Activity Scale for People with Physical Disabilities questionnaire, the Physiological Cost Index, Fatigue Severity Scale and the SF-36v2 will be utilised. DISCUSSION: The efficacy of a home-based arm ergometry programme in Polio survivors will be examined. No previous trial has examined such a programme using a wide range of outcome measures pertinent to Polio survivors. This study will provide new information on the impact of arm ergometry on physical fitness, activity, body composition, fatigue, pain, muscle strength, and health related quality of life. Also, the study will provide information, which at present is lacking, on safety of aerobic exercise in Polio, as potential negative outcomes of activity including loss of muscle strength, increased pain and fatigue will be closely monitored.Trial registration: Clinicaltrials.gov identifier: NCT01271530

Atualização sobre a pandemia do COVID-19: uma revisão integrativa / Update on the COVID-19 pandemic: an integrative review

O coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2), causador da doença de coronavírus 2019 (COVID-19), é considerado uma emergência em saúde pública de interesse internacional, devido à sua rápida propagação, aumento exponencial no número de infectados e a ocorrência de milhares de mortes num curto período. Em razão da grande quantidade de publicações em diversos países abordando o conhecimento adquirido no que concerne ao vírus, o objetivo do presente estudo é atualizar o leitor ao apresentar uma síntese das evidências científicas sobre origem e disseminação, epidemiologia, transmissão, manifestações clínicas, fatores de risco, diagnóstico e prevenção do COVID-19. Trata-se de uma revisão integrativa da literatura realizada nas bases eletrônicas de dados PubMed, Scielo e Lilacs, no qual utilizou-se os descritores  “coronavirus infections” e “signs and symptoms” nas estratégias de busca, onde 23 trabalhos que respondiam ao objetivo proposto foram selecionados, somados ao relatório de situação diário da Organização Mundial da Saúde (OMS). Acredita-se que o mercado atacadista de frutos do mar de Huanan (China) foi o pontapé inicial na disseminação do SARS-CoV-2. Os Estados Unidos da América, Brasil e Índia representam o pódio dos países com maiores números de casos confirmados e de mortes por COVID-19 até o momento. Observou-se que, indivíduos assintomáticos, sintomáticos e objetos contaminados pela secreção respiratória podem ser fontes de infecção. Além disso, constatou-se um espectro sintomatológico heterogêneo, em que as comorbidades associadas agravam o estado de saúde do paciente. Para o diagnóstico, o padrão-ouro é o swab nasofaríngeo somado ao orofaríngeo, ou escarro ou aspirado traqueal para detecção de RNA viral através de RT-PCR. É válido enfatizar que o crescente número de pacientes infectados em um curto período sobrecarrega o sistema de saúde, o que pode resultar no seu colapso e no aumento da taxa de mortalidade. Nesse sentido, há muitos desafios a serem vencidos em meio à pandemia vigente, como controlar a disseminação da infecção viral através do cumprimento das estratégias de prevenção, além do desenvolvimento de uma vacina e medicamentos eficazes, que configuram avanços importantes para essa ameaça global ser contida

Magneto-Acoustic Waves in antiferromagnetic CuMnAs excited by Surface Acoustic Waves

Magnetoelastic effects in antiferromagnetic CuMnAs are investigated by applying dynamic strain in the 0.01% range through surface acoustic waves in the GaAs substrate. The magnetic state of the CuMnAs/GaAs is characterized by a multitude of submicron-sized domains which we image by x-ray magnetic linear dichroism combined with photoemission electron microscopy. Within the explored strain range, CuMnAs shows magnetoelastic effects in the form of N\'eel vector waves with micrometer wavelength, which corresponds to an averaged overall spin-axis rotation up to 2.4 deg driven by the time-dependent strain from the surface acoustic wave. Measurements at different temperatures indicate a reduction of the wave amplitude when lowering the temperature. However, no domain wall motion has been detected on the nanosecond timescal

Gaia GraL: Gaia DR2 Gravitational Lens Systems. VII. XMM-Newton Observations of Lensed Quasars

© 2022. The Author(s). Published by the American Astronomical Society. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.3847/1538-4357/ac4476We present XMM-Newton X-ray observations of nine confirmed lensed quasars at 1 ≲ z ≲ 3 identified by the Gaia Gravitational Lens program. Eight systems are strongly detected, with 0.3-8.0 keV fluxes F 0.3-8.0 ≳ 5 ×10-14 erg cm-2 s-1. Modeling the X-ray spectra with an absorbed power law, we derive power-law photon indices and 2-10 keV luminosities for the eight detected quasars. In addition to presenting sample properties for larger quasar population studies and for use in planning for future caustic-crossing events, we also identify three quasars of interest: a quasar that shows evidence of flux variability from previous ROSAT observations, the most closely separated individual lensed sources resolved by XMM-Newton, and one of the X-ray brightest quasars known at z > 3. These sources represent the tip of the discoveries that will be enabled by SRG/eROSITA.Peer reviewe

Prevalence, concordance and determinants of human papillomavirus infection among heterosexual partners in a rural region in central Mexico

Background: Although human papillomavirus (HPV) infection in heterosexual couples has been sparsely studied, it is relevant to understand disease burden and transmission mechanisms. The present study determined the prevalence and concordance of type-specific HPV infection as well as the determinants of infection in heterosexual couples in a rural area of Mexico. Methods: A cross-sectional study was conducted in 504 clinically healthy heterosexual couples from four municipalities in the State of Mexico, Mexico. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot in cervical samples from women and in genital samples from men. Thirty-seven HPV types were detected, including high-risk oncogenic types and low-risk types. Multivariate logistic regression models were utilized to evaluate factors associated with HPV. Results: The prevalence of HPV infection was 20.5% in external male genitals and 13.7% in cervical samples. In 504 sexual couples participating in the study, concordance of HPV status was 79%; 34 partners (6.7%) were concurrently infected, and 21 out of 34 partners where both were HPV positive (61.8%) showed concordance for one or more HPV types. The principal risk factor associated with HPV DNA detection in men as well as women was the presence of HPV DNA in the respective regular sexual partner (OR = 5.15, 95% CI 3.01-8.82). In men, having a history of 10 or more sexual partners over their lifetime (OR 2.5, 95% CI 1.3 - 4.8) and having had sexual relations with prostitutes (OR 1.7, 95% CI 1.01 - 2.8) increased the likelihood of detecting HPV DNA. Conclusions: In heterosexual couples in rural regions in Mexico, the prevalence of HPV infection and type-specific concordance is high. High-risk sexual behaviors are strong determinants of HPV infection in men

Gaia GraL: Gaia DR2 Gravitational Lens Systems. VII. XMM-Newton Observations of Lensed Quasars

Abstract We present XMM-Newton X-ray observations of nine confirmed lensed quasars at 1 ≲ z ≲ 3 identified by the Gaia Gravitational Lens program. Eight systems are strongly detected, with 0.3–8.0 keV fluxes F 0.3−8.0 ≳ 5 ×10−14 erg cm−2 s−1. Modeling the X-ray spectra with an absorbed power law, we derive power-law photon indices and 2–10 keV luminosities for the eight detected quasars. In addition to presenting sample properties for larger quasar population studies and for use in planning for future caustic-crossing events, we also identify three quasars of interest: a quasar that shows evidence of flux variability from previous ROSAT observations, the most closely separated individual lensed sources resolved by XMM-Newton, and one of the X-ray brightest quasars known at z &gt; 3. These sources represent the tip of the discoveries that will be enabled by SRG/eROSITA.</jats:p

PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

Background & Aims: Acute decompensation (AD) of cirrhosis may present without acute-on-chronic liver failure (ACLF) (ADNo ACLF), or with ACLF (AD-ACLF), defined by organ failure(s). Herein, we aimed to analyze and characterize the precipitants leading to both of these AD phenotypes. Methods: The multicenter, prospective, observational PREDICT study (NCT03056612) included 1,273 non-electively hospitalized patients with AD (No ACLF = 1,071; ACLF = 202). Medical history, clinical data and laboratory data were collected at enrolment and during 90-day follow-up, with particular attention given to the following characteristics of precipitants: induction of organ dysfunction or failure, systemic inflammation, chronology, intensity, and relationship to outcome. Results: Among various clinical events, 4 distinct events were precipitants consistently related to AD: proven bacterial infections, severe alcoholic hepatitis, gastrointestinal bleeding with shock and toxic encephalopathy. Among patients with precipitants in the AD-No ACLF cohort and the AD-ACLF cohort (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Survival was similar in patients with proven bacterial infections or severe alcoholic hepatitis in both AD phenotypes. The number of precipitants was associated with significantly increased 90day mortality and was paralleled by increasing levels of surrogates for systemic inflammation. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with a lower ACLF development rate and lower 90-day mortality. Conclusions: This study identified precipitants that are significantly associated with a distinct clinical course and prognosis in patients with AD. Specific preventive and therapeutic strategies targeting these events may improve outcomes in patients with decompensated cirrhosis. Lay summary: Acute decompensation (AD) of cirrhosis is characterized by a rapid deterioration in patient health. Herein, we aimed to analyze the precipitating events that cause AD in patients with cirrhosis. Proven bacterial infections and severe alcoholic hepatitis, either alone or in combination, accounted for almost all (96-97%) cases of AD and acute-on-chronic liver failure. Whilst the type of precipitant was not associated with mortality, the number of precipitant(s) was. This study identified precipitants that are significantly associated with a distinct clinical course and prognosis of patients with AD. Specific preventive and therapeutic strategies targeting these events may improve patient outcomes. (c) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

Acute decompensation (AD) of cirrhosis is defined as the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, infection or any combination thereof, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF). The PREDICT study is a European, prospective, observational study, designed to characterize the clinical course of AD and to identify predictors of ACLF. A total of 1,071 patients with AD were enrolled. We collected detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed up for 3 months. Outcomes (liver transplantation and death) at 1 year were also recorded. Three groups of patients were identified. Pre-ACLF patients (n = 218) developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ≥1 readmission but did not develop ACLF and had mortality rates of 21.0% and 35.6%, respectively. Stable decompensated cirrhosis (SDC) patients (n = 620) were not readmitted, did not develop ACLF and had a 1-year mortality rate of only 9.5%. The 3 groups differed significantly regarding the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in SDC) and the prevalence of surrogates of severe portal hypertension throughout the study (high in UDC vs. low in pre-ACLF and SDC). Acute decompensation without ACLF is a heterogeneous condition with 3 different clinical courses and 2 major pathophysiological mechanisms: systemic inflammation and portal hypertension. Predicting the development of ACLF remains a major future challenge. ClinicalTrials.gov number: NCT03056612. Lay summary: Herein, we describe, for the first time, 3 different clinical courses of acute decompensation (AD) of cirrhosis after hospital admission. The first clinical course includes patients who develop acute-on-chronic liver failure (ACLF) and have a high short-term risk of death - termed pre-ACLF. The second clinical course (unstable decompensated cirrhosis) includes patients requiring frequent hospitalizations unrelated to ACLF and is associated with a lower mortality risk than pre-ACLF. Finally, the third clinical course (stable decompensated cirrhosis), includes two-thirds of all patients admitted to hospital with AD - patients in this group rarely require hospital admission and have a much lower 1-year mortality risk