BackgroundThe recommended reinjection interval for botulinum neurotoxin (BoNT) formulations in the treatment of cervical dystonia (CD) is generally ≥12 weeks, though intervals ≥10 weeks are approved for incobotulinumtoxinA in Europe. However, recurring symptoms can occur before the end of this period. Using qualitative research, we sought a greater understanding of disease burden, unmet patient needs, and barriers to treatment.MethodsWe conducted online semistructured, focus-group discussions, and online forum follow-up discussions among patients with CD, focusing on disease burden, patient needs, injection cycle preferences, and relationships with health care professionals. A subset of patients was also questioned in telephone interviews about individual experiences of CD and BoNT treatment. All participants were UK residents who had received onabotulinumtoxinA or abobotulinumtoxinA for CD for ≥1 year.ResultsThirty-one patients (81% female; mean duration of CD 16.4 [range 4–31] years; mean BoNT injection cycle length 12.8 weeks) participated in the online focus-group and forum follow-up discussions. Of these, seven patients participated in telephone interviews. All had recurring symptoms between treatments, which substantially impacted on their work, family, and social life. Symptom severity fluctuated throughout an injection cycle and differed between patients and across injection cycles. Participants’ relationships with health care professionals and treatment satisfaction varied greatly. Many participants wanted longer-lasting and/or more stable symptom relief with shorter and/or more flexible injection intervals, according to individual needs. Lack of health care resources, long journeys to treatment centers, and immunogenicity/side-effect concerns were perceived as the main barriers to more flexible treatment.ConclusionThe high burden of recurring primary and secondary symptoms of CD considerably affects patients’ quality of life. Patient-led assessments of disease burden revealed that personalized, more flexible, and/or shorter BoNT injection intervals may reduce the day-to-day impact of CD. Collaboration between patients, clinicians, and health care systems may effect change and improve treatment for patients with CD.
Background Data on opinions and experiences of aesthetic medical procedures outside the United States and Western Europe are scarce. Aims This study aimed to survey users and non‐users of aesthetic procedures in countries where this information is less readily available, to understand attitudes and perceptions relating to beauty. Patients/Methods Two independent internet‐based observational surveys were conducted. Survey 1: individuals from Colombia, Lebanon, Malaysia, Russia and Turkey who were ‘users’ or ‘non‐users’ of aesthetic medical procedures. Survey 2: individuals from Colombia, Russia, Thailand, Turkey and the United Arab Emirates who were ‘users’ of non‐surgical aesthetic treatments. Results Surveys 1 and 2 were completed by 300 and 160 individuals, respectively, most of whom were female (94.0% and 99%). Overall, respondents rated the eyes and smile as the most pleasing male and female facial features. Most participants (mean 82.6%; range 75%‐100%) believed maintaining a healthy lifestyle was important for ageing gracefully, and over one‐third (36.0%; 28%‐47%) believed men age more gracefully than women. The emphasis respondents placed on the importance of physical attributes vs inner feelings, internal beauty and self‐confidence varied between countries. Users were often more positive about aesthetic medical procedure outcomes than non‐users. Adequate information, good physician communication (including managing treatment expectations), treatment recommendations based on patient need and good aftercare improved treatment satisfaction. Conclusions The eyes and smile were key features of attractiveness, but maintaining a healthy lifestyle was consistently considered an important factor for ageing gracefully. Ensuring patients are well informed was a major determinant of treatment satisfaction.
A large body of research has shown that suffi xes-both infl ectional and derivational-can be primed with adult native speakers, which informs our understanding of storage and access to morphology in mature systems. However, this line of research has not yet been conducted from an acquisition perspective: Little is known about whether or not representations of suffi xes are formed after very little exposure to new morphology and, if so, about the nature of those representations or about the infl uence of attentional orientation and meaning at this initial stage. The three experiments reported here begin to address this gap by investigating the nature of suffi xal representations following exposure to a small regular system of suffi xed words. The experiment used crossmodal priming of recognition memory judgments to probe morphological representation. Although the lack of priming suggestedThe experiments reported here were carried out with the support of a University of York et al. 620that abstract morphological representations were not yet established, recognition judgments showed a clear sensitivity to sublexical morphemic units. The pattern of results was unaffected by the orientation of attention or the assignation of meaning to the words or suffi xes during training. Offl ine tests of learning stem and suffi x meanings also showed that both were learned to some extent even when attention was not oriented to their meanings and that the resulting knowledge was partially implicit. Thus, there was evidence of sensitivity to both the forms and meanings of the suffi xes but not at the level required to support crossmodal priming. We argue that the reason for this may lie in the episodic nature of the knowledge gained after brief exposure.
Anaplasma phagocytophilum is an emerging pathogen known to cause human granulocytic anaplasmosis (HGA). Here we determined the prevalence and genetic characterization of A. phagocytophilum in Hebei Province, China. A total of 253 samples were taken from goats and sheep in Hebei Province, and 52 (20.6%) were positive for A. phagocytophilum. There was a higher positive rate in sheep (23.8%, 20/84) than in goats (18.9%, 32/169). Analysis of the partial 16S RNA gene sequences of A. phagocytophilum revealed that the isolates in this study were members of the same clade and were 100% homologous with each other. This study provides information on the epidemiologic features of A. phagocytophilum.
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