Is Massage Therapy Effective in Reducing Labor Pain in Intrapartum Women?

OBJECTIVE: The objective of this selective EBM review is to determine whether massage therapy is an effective intervention in reducing pain in intrapartum women. STUDY DESIGN: A systematic review of two randomized controlled trails (RCTs) and one case study published between 2009-2019. All studies were published in English. DATA SOURCES: The two double-blind RCTs and case study were found via PubMed. All sources were published in peer reviewed journals and chosen based on their relevance to the clinical question. OUTCOMES: Pain reduction was the outcome measured in all three studies using visual analog scale. In this systematic review, pain level was evaluated as change from baseline. RESULTS: In the double-blind RCT conducted by Gallo et.al, there was a statistically significant reduction in pain at -17mm with massage therapy. In the quasi-experimental study viewed as a case study conducted by Hajiamini et.al, ice massage was found to reduce pain from baseline by 1.74cm and 1.57cm at zero and thirty minutes, respectively, with a p-value \u3c0.05. However, pain reduction was not found to be statistically significant at sixty minutes after intervention. Lastly, in a double-blind RCT by Taghinejad et.al, the massage therapy group reported 36.3% less pain than the music therapy group with a p-value \u3c0.001. CONCLUSIONS: Both a clinical and statistically significant reduction in pain were demonstrated by all three studies. Thus, the results of this review are conclusive in that massage therapy is an effective method in reducing pain in intrapartum women. Furthermore, massage therapy is an inexpensive, informal, and widely available therapeutic method with the added benefit of having no side effects

Supplying Improved Seed to Farmers in Rural Kenya: The Case of Freshco Kenya Ltd.

Freshco, a small producer and distributor of hybrid maize seed and macadamia seedlings, was one of the first private companies to enter the Kenya seed market after its liberalization. Currently, the company produces and markets six high yielding maize varieties that are suited for diverse agro-ecological conditions. Despite the company’s encouraging growth in the local maize seed market, Freshco’s executives recognize the need to scale up operations to stay competitive. The company’s challenge is to recognize business opportunities and customer needs in an environment susceptible to ecological, political, and socioeconomic change.Kenya, seed industry, smallholder farmers, scenario planning, Crop Production/Industries, Farm Management, Research Methods/ Statistical Methods, Q10, Q12,

Neutrophil elastase facilitates tumor cell intravasation and early metastatic events

Functional roles of neutrophil elastase (NE) have not been examined in distinct steps of the metastatic cascade. NE, delivered to primary tumors as a purified enzyme or within intact neutrophils or neutrophil granule content, enhanced human tumor cell intravasation and subsequent dissemination via NE-mediated formation of dilated intratumoral vasculature. These effects depended on picomole range of NE activity, sensitive to its natural inhibitor, α1PI. I

EXPANSION OF ACCESS TO HEALTHY FOODS THROUGH THE CREATION OF AN ACCOUNTABLE CARE COMMUNITY IN ROBESON COUNTY, NORTH CAROLINA

Many individuals, especially those living in low-income communities and communities of color, face the challenge of access to healthy foods that support eating patterns. This has been a persistent issue for Robeson County, North Carolina. Research suggests that healthy food choices such as eating fruits and vegetables have nutritional, physical, and mental health benefits. However, there are barriers and disparities in the accessibility and availability of foods that support healthy eating patterns. In recognition of this, an Accountable Care Community plan was established to implement public health policy and program to limit barriers and improve access to healthy foods. The proposed policy involves expanding the Supplemental Nutrition Assistance Program and Electronic Benefit Transfer benefits at the Robeson County Farmers Market. The proposed program consists of expanding the same benefits to be accessible to purchase Robeson County Farmers Market Community Supported Agriculture’s produce box. For this summary, the phrase “access to foods that support healthy eating patterns” is interchangeable with “access to healthy foods.”Master of Public Healt

Literature review - Energy saving potential of user-centered integrated lighting solutions

Measures for the reduction of electric energy loads for lighting have predominantly focussed on increasing the efficiency of lighting systems. This efficiency has now reached levels unthinkable a few decades ago. However, a focus on mere efficiency is physically limiting, and does not necessarily ensure that the anticipated energy savings actually materialize. There are technical and non-technical reasons because of which effective integration of lighting solutions and their controls, and thus a reduction in energy use, does not happen. This literature review aims to assess the energy saving potential of integrated daylight and electric lighting design and controls, especially with respect to user preferences and behaviour. It does so by collecting available scientific knowledge and experience on daylighting, electric lighting, and related control systems, as well as on effective strategies for their integration. Based on this knowledge, the review suggests design processes, innovative design strategies and design solutions which – if implemented appropriately – could improve user comfort, health, well-being and productivity, while saving energy as well as the operation and maintenance of lighting systems. The review highlights also regulatory, technical, and design challenges hindering energy savings. Potential energy savings are reported from the retrieved studies. However, these savings derived from separate studies are dependent on their specific contexts, which lowers the ecological validity of the findings. Studies on strategies based on behavioural interventions, like information, feedback, and social norms, did not report energy saving performance. This is an interesting conclusion, since the papers indicate high potentials that deserve further exploration. Quantifying potential savings is fundamental to fostering large scale adoption of user-driven strategies, since this would allow at least a rough estimation of returns for the investors. However, such quantification requires that studies are designed with an inter-disciplinary approach. The literature also shows that strategies, where there is more communication between façade and lighting designers, are more successful in integrated design, which calls for more communication between stakeholders in future building processes

Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries

IMPORTANCE: Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS). OBJECTIVES: To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation management, and use of adjuncts-for example prone positioning-in routine clinical practice for patients fulfilling the ARDS Berlin Definition. DESIGN, SETTING, AND PARTICIPANTS:The Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients undergoing invasive or noninvasive ventilation, conducted during 4 consecutive weeks in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across 5 continents. EXPOSURES:Acute respiratory distress syndrome. MAIN OUTCOMES AND MEASURES: The primary outcome was ICU incidence of ARDS. Secondary outcomes included assessment of clinician recognition of ARDS, the application of ventilatory management, the use of adjunctive interventions in routine clinical practice, and clinical outcomes from ARDS. RESULTS: Of 29,144 patients admitted to participating ICUs, 3022 (10.4%) fulfilled ARDS criteria. Of these, 2377 patients developed ARDS in the first 48 hours and whose respiratory failure was managed with invasive mechanical ventilation. The period prevalence of mild ARDS was 30.0% (95% CI, 28.2%-31.9%); of moderate ARDS, 46.6% (95% CI, 44.5%-48.6%); and of severe ARDS, 23.4% (95% CI, 21.7%-25.2%). ARDS represented 0.42 cases per ICU bed over 4 weeks and represented 10.4% (95% CI, 10.0%-10.7%) of ICU admissions and 23.4% of patients requiring mechanical ventilation. Clinical recognition of ARDS ranged from 51.3% (95% CI, 47.5%-55.0%) in mild to 78.5% (95% CI, 74.8%-81.8%) in severe ARDS. Less than two-thirds of patients with ARDS received a tidal volume 8 of mL/kg or less of predicted body weight. Plateau pressure was measured in 40.1% (95% CI, 38.2-42.1), whereas 82.6% (95% CI, 81.0%-84.1%) received a positive end-expository pressure (PEEP) of less than 12 cm H2O. Prone positioning was used in 16.3% (95% CI, 13.7%-19.2%) of patients with severe ARDS. Clinician recognition of ARDS was associated with higher PEEP, greater use of neuromuscular blockade, and prone positioning. Hospital mortality was 34.9% (95% CI, 31.4%-38.5%) for those with mild, 40.3% (95% CI, 37.4%-43.3%) for those with moderate, and 46.1% (95% CI, 41.9%-50.4%) for those with severe ARDS. CONCLUSIONS AND RELEVANCE: Among ICUs in 50 countries, the period prevalence of ARDS was 10.4% of ICU admissions. This syndrome appeared to be underrecognized and undertreated and associated with a high mortality rate. These findings indicate the potential for improvement in the management of patients with ARDS

Integrating daylighting and lighting in practice: Lessons learned from international case studies

This report presents lessons learned from twenty-five worldwide real-life case studies implementing the integration of daylighting and electric lighting. The case studies were monitored with respect to energy use for lighting, visual performance, non-visual performance, and users’ satisfaction. The monitoring is largely based on field measurements, but it is also complemented with simulations and calculations where needed. The report is divided in two parts. The first part provides an overview of the case studies and the overall lessons learned. The second part provides factsheets for each of the case studies; the factsheets include details on the monitoring, results, and specific lessons learned. Based on the lessons learned from the case studies, this report concludes that: • The energy demand for lighting is drastically reduced thanks to the combined effect of more efficient light sources, advances in controls, and raised awareness in the integration of daylighting and electric lighting. • Integrative lighting is currently driving the innovation in lighting technology and wider implementation is expected as knowledge in the field of non-visual requirements for lighting expands. • However, the current integration of the integrative lighting concept with daylighting in practice is limited, which may result in significant energy rebound (increases). • Daylighting integration is of utmost importance for achieving quality beyond energy savings. • Integrated daylighting and electric lighting design is facing new challenges: questions connected with comfort and health are yet to be answered

3D genomics across the tree of life reveals condensin II as a determinant of architecture type

We investigated genome folding across the eukaryotic tree of life. We find two types of three-dimensional(3D) genome architectures at the chromosome scale. Each type appears and disappears repeatedlyduring eukaryotic evolution. The type of genome architecture that an organism exhibits correlates with theabsence of condensin II subunits. Moreover, condensin II depletion converts the architecture of thehuman genome to a state resembling that seen in organisms such as fungi or mosquitoes. In this state,centromeres cluster together at nucleoli, and heterochromatin domains merge. We propose a physicalmodel in which lengthwise compaction of chromosomes by condensin II during mitosis determineschromosome-scale genome architecture, with effects that are retained during the subsequent interphase.This mechanism likely has been conserved since the last common ancestor of all eukaryotes.C.H. is supported by the Boehringer Ingelheim Fonds; C.H., Á.S.C., and B.D.R. are supported by an ERC CoG (772471, “CohesinLooping”); A.M.O.E. and B.D.R. are supported by the Dutch Research Council (NWO-Echo); and J.A.R. and R.H.M. are supported by the Dutch Cancer Society (KWF). T.v.S. and B.v.S. are supported by NIH Common Fund “4D Nucleome” Program grant U54DK107965. H.T. and E.d.W. are supported by an ERC StG (637597, “HAP-PHEN”). J.A.R., T.v.S., H.T., R.H.M., B.v.S., and E.d.W. are part of the Oncode Institute, which is partly financed by the Dutch Cancer Society. Work at the Center for Theoretical Biological Physics is sponsored by the NSF (grants PHY-2019745 and CHE-1614101) and by the Welch Foundation (grant C-1792). V.G.C. is funded by FAPESP (São Paulo State Research Foundation and Higher Education Personnel) grants 2016/13998-8 and 2017/09662-7. J.N.O. is a CPRIT Scholar in Cancer Research. E.L.A. was supported by an NSF Physics Frontiers Center Award (PHY-2019745), the Welch Foundation (Q-1866), a USDA Agriculture and Food Research Initiative grant (2017-05741), the Behavioral Plasticity Research Institute (NSF DBI-2021795), and an NIH Encyclopedia of DNA Elements Mapping Center Award (UM1HG009375). Hi-C data for the 24 species were created by the DNA Zoo Consortium (www.dnazoo.org). DNA Zoo is supported by Illumina, Inc.; IBM; and the Pawsey Supercomputing Center. P.K. is supported by the University of Western Australia. L.L.M. was supported by NIH (1R01NS114491) and NSF awards (1557923, 1548121, and 1645219) and the Human Frontiers Science Program (RGP0060/2017). The draft A. californica project was supported by NHGRI. J.L.G.-S. received funding from the ERC (grant agreement no. 740041), the Spanish Ministerio de Economía y Competitividad (grant no. BFU2016-74961-P), and the institutional grant Unidad de Excelencia María de Maeztu (MDM-2016-0687). R.D.K. is supported by NIH grant RO1DK121366. V.H. is supported by NIH grant NIH1P41HD071837. K.M. is supported by a MEXT grant (20H05936). M.C.W. is supported by the NIH grants R01AG045183, R01AT009050, R01AG062257, and DP1DK113644 and by the Welch Foundation. E.F. was supported by NHGR

COVID19 Disease Map, a computational knowledge repository of virus-host interaction mechanisms.

Funder: Bundesministerium für Bildung und ForschungFunder: Bundesministerium für Bildung und Forschung (BMBF)We need to effectively combine the knowledge from surging literature with complex datasets to propose mechanistic models of SARS-CoV-2 infection, improving data interpretation and predicting key targets of intervention. Here, we describe a large-scale community effort to build an open access, interoperable and computable repository of COVID-19 molecular mechanisms. The COVID-19 Disease Map (C19DMap) is a graphical, interactive representation of disease-relevant molecular mechanisms linking many knowledge sources. Notably, it is a computational resource for graph-based analyses and disease modelling. To this end, we established a framework of tools, platforms and guidelines necessary for a multifaceted community of biocurators, domain experts, bioinformaticians and computational biologists. The diagrams of the C19DMap, curated from the literature, are integrated with relevant interaction and text mining databases. We demonstrate the application of network analysis and modelling approaches by concrete examples to highlight new testable hypotheses. This framework helps to find signatures of SARS-CoV-2 predisposition, treatment response or prioritisation of drug candidates. Such an approach may help deal with new waves of COVID-19 or similar pandemics in the long-term perspective

Characterising the biophysical properties of normal and hyperkeratotic foot skin

BACKGROUND: Plantar foot skin exhibits unique biophysical properties that are distinct from skin on other areas of the body. This paper characterises, using non-invasive methods, the biophysical properties of foot skin in healthy and pathological states including xerosis, heel fissures, calluses and corns. METHODS: Ninety three people participated. Skin hydration, elasticity, collagen and elastin fibre organisation and surface texture was measured from plantar calluses, corns, fissured heel skin and xerotic heel skin. Previously published criteria were applied to classify the severity of each skin lesion and differences in the biophysical properties compared between each classification. RESULTS: Calluses, corns, xerotic heel skin and heel fissures had significantly lower levels of hydration; less elasticity and greater surface texture than unaffected skin sites (p < 0.01). Some evidence was found for a positive correlation between hydration and elasticity data (r ≤ 0.65) at hyperkeratotic sites. Significant differences in skin properties (with the exception of texture) were noted between different classifications of skin lesion. CONCLUSIONS: This study provides benchmark data for healthy and different severities of pathological foot skin. These data have applications ranging from monitoring the quality of foot skin, to measuring the efficacy of therapeutic interventions. KEYWORDS: Biophysical parameters; Callus; Corns; Dry skin; Heel fissures; Plantar foot skin hyperkeratosis; Quantification; Skin classification (SELs); Xerosi