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Husted Skriver posted an update 6 months ago
les inherent in pregnancy and the early stages of child rearing.Objective High-value medical care is described as care that leads to excellent patient outcomes, high patient satisfaction, and efficient costs. Neurosurgical care in particular can be expensive for the hospital, as substantial costs are accrued during the operation and throughout the postoperative stay. The authors developed a “Safe Transitions Pathway” (STP) model in which select patients went to the postanesthesia care unit (PACU) and then the neuro-transitional care unit (NTCU) rather than being directly admitted to the neurosciences intensive care unit (ICU) following a craniotomy. They sought to evaluate the clinical and financial outcomes as well as the impact on the patient experience for patients who participated in the STP and bypassed the ICU level of care. Methods Patients were enrolled during the 2018 fiscal year (FY18; July 1, 2017, through June 30, 2018). The electronic medical record was reviewed for clinical information and the hospital cost accounting record was reviewed for financial informmplications or adverse patient outcomes in the STP group.Objective Robotic spine surgery systems are increasingly used in the US market. As this technology gains traction, however, it is necessary to identify mechanisms that assess its effectiveness and allow for its continued improvement. One such mechanism is the development of a new 3D grading system that can serve as the foundation for error-based learning in robot systems. Herein the authors attempted 1) to define a system of providing accuracy data along all three pedicle screw placement axes, that is, cephalocaudal, mediolateral, and screw long axes; and 2) to use the grading system to evaluate the mean accuracy of thoracolumbar pedicle screws placed using a single commercially available robotic system. Methods The authors retrospectively reviewed a prospectively maintained, IRB-approved database of patients at a single tertiary care center who had undergone instrumented fusion of the thoracic or lumbosacral spine using robotic assistance. https://www.selleckchem.com/GSK-3.html Patients with preoperatively planned screw trajectories and postoperathod of grading screw placement accuracy that measures deviation in all three relevant axes. This grading system could provide the error signal necessary for unsupervised machine learning by robotic systems, which would in turn support continued improvement in instrumentation placement accuracy.New Zealand blackcurrant (NZBC) contains anthocyanins, known to moderate blood flow and display anti-inflammatory properties that may improve recovery from exercise-induced muscle damage. The authors examined whether NZBC extract supplementation enhances recovery from exercise-induced muscle damage after a half-marathon race. Following a randomized, double-blind, independent groups design, 20 (eight women) recreational runners (age 30 ± 6 years, height 1.73 ± 0.74 m, body mass 68.5 ± 7.8 kg, half-marathon finishing time 15633 ± 01808 hrmins) ingested either two 300-mg/day capsules of NZBC extract (CurraNZ™) or a visually matched placebo, for 7 days prior to and 2 days following a half-marathon. Countermovement jump performance variables, urine interleukin-6, and perceived muscle soreness and fatigue were measured pre, post, and at 24 and 48 hr after the half-marathon and analyzed using a mixed linear model with statistical significance set a priori at p .05). Supplementation with NZBC extract had no effect on the recovery of countermovement jump variables and perceptions of muscle soreness or fatigue following a half-marathon in recreational runners.The authors examine the effect of an acute dose of beetroot juice on endurance running performance in “real-world” competitive settings. In total, 70 recreational runners (mean ± SD age = 33.3 ± 12.3 years, training history = 11.9 ± 8.1 years, and hours per week training = 5.9 ± 3.5) completed a quasi-randomized, double-blind, placebo-controlled study of 5-km competitive time trials. Participants performed four trials separated by 1 week in the order of prebaseline, two experimental, and one postbaseline. Experimental trials consisted of the administration of 70-ml nitrate-rich beetroot juice (containing ∼4.1 mmol of nitrate, Beet It Sport®) or nitrate-depleted placebo (containing ∼0.04 mmol of nitrate, Beet It Sport®) 2.5 hr prior to time trials. Time to complete 5 km was recorded for each trial. No differences were shown between pre- and postbaseline (p = .128, coefficient variation = 2.66%). The average of these two trials is therefore used as baseline. Compared with baseline, participants ran faster with beetroot juice (mean differences = 22.2 ± 5.0 s, p less then .001, d = 0.08) and placebo (22.9 ± 4.5 s, p less then .001, d = 0.09). No differences in times were shown between beetroot juice and placebo (0.8 ± 5.7 s, p less then .875, d = 0.00). These results indicate that an acute dose of beetroot juice does not improve competitive 5-km time-trial performance in recreational runners compared with placebo.This study examined the feasibility and effects of a 1-hr physical activity (PA) behavior change (PABC) discussion session on PA, 12 weeks after completing an exercise trial. Adults at high risk of Type II diabetes were randomized to the PABC or a control group. PA was self-reported using the International Physical Activity Questionnaire. Chi-square tests compared the proportion of participants classified as moderately active or greater at the 12-week follow-up. Participants (N = 50) were M = 61.8 ± 5.5 years old and mostly female (80%). All participants completed the PABC discussion session, and compliance with the International Physical Activity Questionnaire at 12-week follow-up was 78%. Barrier self-efficacy increased immediately following the PABC (MΔ0.5 ± 0.9; t(22) = -2.45, p = .023). At 12-week follow-up, 88% in the PABC were moderately active or greater, compared with 50% in the control (p = .015). Incorporating a PABC discussion session as part of an exercise efficacy trial was feasible and may help improve PA maintenance.Context Although skin-temperature assessment has received much attention in recent years as a possible internal-load measurement, scientific evidence is scarce. Purpose To analyze baseline skin temperature and its rewarming through means of a cold-stress test before and after performing a marathon and to study the association between skin temperature and internal/external-load measurements. Methods A total of 16 runners were measured 48 and 24 h before and 24 and 48 h after completing a marathon. The measurements on each day of testing included urine biomarkers of oxidative stress, pain and fatigue perception, skin temperature (at baseline and after a cold-stress test), and jump performance. Results Reduced jump performance (P 0.8). Although no differences in baseline skin temperature were observed between the 4 measuring days, posterior legs presented lower constant (P less then .01 and ES = 1.4) and higher slope (P = .04 and ES = 1.1) parameters in the algorithmic equations fitted for skin-temperature recovery after the cold-stress test 24 h after the marathon than on the day before the marathon.
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