BACKGROUND Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between healthcare providers' knowledge of, and attitudes towards pain and pain management practices. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers regarding acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management; describe pain assessment and management behaviours and practices; and identify barriers to and enablers of pain care. METHODS A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey. RESULTS Responses of 100 participants were included in the analysis. The survey response rate results suggest that there is suboptimal knowledge and attitudes regarding pain among emergency care providers in the Western Cape, South Africa. Gaps in pain knowledge, attitudes and practices were identified. Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated.BACKGROUND Non-ischemic cardiomyopathy (NICM) has been associated with a better left ventricle reverse remodeling response and improved clinical outcomes after cardiac resynchronization therapy (CRT). The aims of our study were to identify the predictors of mortality and heart failure hospitalization in patients treated with CRT and design a risk score for prognosis. METHODS A cohort of 422 consecutive NICM patients with CRT was retrospectively enrolled between January 2010 and December 2017. The primary endpoint was all-cause mortality and heart transplantation. RESULTS In a multivariate analysis, the predictors of all-cause death were left atrial diameter [Hazard ratio (HR) 1.056, 95% confidence interval (CI) 1.020-1.093, P = 0.002]; non-left bundle branch block [HR 1.793, 95% CI 1.131-2.844, P = 0.013]; high sensitivity C-reactive protein [HR 1.081, 95% CI 1.029-1.134 P = 0.002]; and N-terminal pro-B-type natriuretic peptide [HR 1.018, 95% CI 1.007-1.030, P = 0.002]; and New York Heart Association class IV [HR 1.018, 95% CI 1.007-1.030, P = 0.002]. The Alpha-score (Atrial diameter, non-LBBB, Pro-BNP, Hs-CRP, NYHA class IV) was derived from each independent risk factor. The novel score had good calibration (Hosmer-Lemeshow test, P > 0.05) and discrimination for both primary endpoints [c-statistics 0.749 (95% CI 0.694-0.804), P  less then  0.001] or heart failure hospitalization [c-statistics 0.692 (95% CI 0.639-0.745), P  less then  0.001]. CONCLUSION The Alpha-score may enable improved discrimination and accurate prediction of long-term outcomes among NICM patients with CRT.BACKGROUND Despite the predictive role of body weight variation in treatment outcome in multidrug-resistant tuberculosis (MDR-TB), few corroborating data are available. We studied weight variation in patients with MDR-TB to identify groups of weight change and to determine factors that influence these changes. METHODS We analyzed patients with rifampicin resistance who were treated with an MDR-TB treatment regimen between June 07, 2016 and June 22, 2018 at three major drug-resistant TB centers in Guinea. Patients were seen monthly until the end of treatment. Clinical outcome was the body mass index (BMI). We used a linear mixed model to analyze trajectories of BMI and a latent class mixed model to identify groups of BMI trajectories. RESULTS Of 232 patients treated for MDR-TB during the study period, 165 were analyzed. These patients had a total of 1387 visits, with a median of 5 visits (interquartile range, 3-8 visits). Monthly BMI increase was 0.24 (SE 0.02) per kg/m2. Factors associated with faster BMI progression were success of MDR-TB treatment (0.24 [SE 0.09] per kg/m2; p = 0.0205) and absence of lung cavities on X-ray (0.18 [0.06] per kg/m2; p = 0.0068). Two groups of BMI change were identified rapid BMI increase (n = 121; 85%) and slow BMI increase (n = 22; 15%). Patients in the slow BMI increase group were mostly female (68%) had no history of TB treatment (41%), had a positive HIV infection (59%), and had a more severe clinical condition at baseline, characterized by a higher frequency of symptoms including depression (18%), dyspnea (68%), poor adherence to MDR-TB treatment (64%), lower platelet count, and higher SGOT. These patients also had a longer time to initial culture conversion (log-rank test p = 0.0218).  https://www.selleckchem.com/products/PD-98059.html  CONCLUSION Quantitative BMI data on patients with MDR-TB treated with a short regimen allowed the identification of subgroups of patients with different trajectories of BMI and emphasized the usefulness of BMI as a biomarker for the monitoring of MDR-TB treatment outcome.BACKGROUND Understanding root system morphology in bread wheat is critical for identifying root traits to breed cultivars with improved resource uptake and better adaptation to adverse environments. Variability in root morphological traits at early vegetative stages was examined among 184 bread wheat genotypes originating from 37 countries grown in a semi-hydroponic phenotyping system. RESULTS At the onset of tillering (Z2.1, 35 days after transplanting), plants had up to 42 cm in shoot height and 158 cm long in root depth. Phenotypic variation existed for both shoot and root traits, with a maximal 4.3-fold difference in total root length and 5-fold difference in root dry mass among the 184 genotypes. Of the 41 measured traits, 24 root traits and four shoot traits had larger coefficients of variation (CV ≥ 0.25). Strong positive correlations were identified for some key root traits (i.e., root mass, root length, and these parameters at different depths) and shoot traits (i.e., shoot mass and tiller number) (P ≤ 0.05). The selected 25 global traits (at whole-plant level) contributed to one of the five principal components (eigenvalues> 1) capturing 83.0% of the total variability across genotypes. Agglomerative hierarchical clustering analysis separated the 184 genotypes into four (at a rescaled distance of 15) or seven (at a rescaled distance of 10) major groups based on the same set of root traits. Strong relationships between performance traits (dry mass) with several functional traits such as specific root length, root length intensity and root tissue density suggest their linkage to plant growth and fitness strategies. CONCLUSIONS Large phenotypic variability in root system morphology in wheat genotypes was observed at the tillering stage using established semi-hydroponic phenotyping techniques. Phenotypic differences in and trait correlations among some interesting root traits may be considered for breeding wheat cultivars with efficient water acquisition and better adaptation to abiotic stress.