This paper is concerned with the regulation and the professionalization of occupations in public relations. It analyzes the role of professional, national associations in the professionalization ...process, providing an overview of these organizations in various countries around the world. The authors identify countries with no regulation (for instance, Italy), countries with some legal regulations (for instance, Brazil) and countries that have adopted self-regulation models (for instance, USA and South Africa). The authors point out the advantages and drawbacks of each regulation model and their impact on the development and professionalization of the occupation. Namely, in countries in which public relations are defined by law, public relations experts have guaranteed positions in society; however, they enjoy a negative public perception. In self-regulatory models, a significant number of experts are not covered by membership in organizations. Consequently, their behavior is not governed by any set of established professional obligations. Furthermore, countries with no clear professional regulation have enabled mass engagement in public relations; however, there are no criteria for professional advancement and affirmation. The issue of regulation in transition countries has shown itself to be a relatively unarticulated concept that can be expected to acquire greater definition with further professionalization of the occupation, a key role that must be played by professional associations.
This paper is concerned with the regulation and the professionalization of occupations in public relations. It analyzes the role of professional, national associations in the professionalization ...process, providing an overview of these organizations in various countries around the world. The authors identify countries with no regulation (for instance, Italy), countries with some legal regulations (for instance, Brazil) and countries that have adopted self-regulation models (for instance, USA and South Africa). The authors point out the advantages and drawbacks of each regulation model and their impact on the development and professionalization of the occupation. Namely, in countries in which public relations are defined by law, public relations experts have guaranteed positions in society; however, they enjoy a negative public perception. In self-regulatory models, a significant number of experts are not covered by membership in organizations. Consequently, their behavior is not governed by any set of established professional obligations. Furthermore, countries with no clear professional regulation have enabled mass engagement in public relations; however, there are no criteria for professional advancement and affirmation. The issue of regulation in transition countries has shown itself to be a relatively unarticulated concept that can be expected to acquire greater definition with further professionalization of the occupation, a key role that must be played by professional associations.
ABSTRACT
We derive constraints on the thermal and ionization states of the intergalactic medium (IGM) at redshift ≈ 9.1 using new upper limits on the 21-cm power spectrum measured by the LOFAR radio ...telescope and a prior on the ionized fraction at that redshift estimated from recent cosmic microwave background (CMB) observations. We have used results from the reionization simulation code grizzly and a Bayesian inference framework to constrain the parameters which describe the physical state of the IGM. We find that, if the gas heating remains negligible, an IGM with ionized fraction ≳0.13 and a distribution of the ionized regions with a characteristic size ≳ 8 h−1 comoving megaparsec (Mpc) and a full width at half-maximum (FWHM) ≳16 h−1 Mpc is ruled out. For an IGM with a uniform spin temperature TS ≳ 3 K, no constraints on the ionized component can be computed. If the large-scale fluctuations of the signal are driven by spin temperature fluctuations, an IGM with a volume fraction ≲0.34 of heated regions with a temperature larger than CMB, average gas temperature 7–160 K, and a distribution of the heated regions with characteristic size 3.5–70 h−1 Mpc and FWHM of ≲110 h−1 Mpc is ruled out. These constraints are within the 95 per cent credible intervals. With more stringent future upper limits from LOFAR at multiple redshifts, the constraints will become tighter and will exclude an increasingly large region of the parameter space.
ABSTRACT
A new upper limit on the 21 cm signal power spectrum at a redshift of z ≈ 9.1 is presented, based on 141 h of data obtained with the Low-Frequency Array (LOFAR). The analysis includes ...significant improvements in spectrally smooth gain-calibration, Gaussian Process Regression (GPR) foreground mitigation and optimally weighted power spectrum inference. Previously seen ‘excess power’ due to spectral structure in the gain solutions has markedly reduced but some excess power still remains with a spectral correlation distinct from thermal noise. This excess has a spectral coherence scale of 0.25–0.45 MHz and is partially correlated between nights, especially in the foreground wedge region. The correlation is stronger between nights covering similar local sidereal times. A best 2-σ upper limit of $\Delta ^2_{21} \lt (73)^2\, \mathrm{mK^2}$ at $k = 0.075\, \mathrm{h\, cMpc^{-1}}$ is found, an improvement by a factor ≈8 in power compared to the previously reported upper limit. The remaining excess power could be due to residual foreground emission from sources or diffuse emission far away from the phase centre, polarization leakage, chromatic calibration errors, ionosphere, or low-level radiofrequency interference. We discuss future improvements to the signal processing chain that can further reduce or even eliminate these causes of excess power.
Outcomes of 109 hospitalized COVID‐19 patients who received at least one vaccine dose 14 or more days prior the disease onset were retrospectively compared to control cohort of 109 age, sex, and ...Charlson comorbidity index‐matched patients chosen among 2990 total hospitalized patients in our tertiary‐level institution in a period from January to June 2021. Among 109 vaccinated patients, 84 patients were partially and 25 fully vaccinated. Vaccinated patients experienced significantly lower 30 days mortality (30% vs. 49%; hazard ratio HR: 0.56 0.37–0.85; p = 0.008), less frequently required high flow oxygen therapy (17% vs. 34%; HR: 0.45 0.26–0.76; p = 0.005), and mechanical ventilation (8% vs. 18%; HR: 0.41 0.20–0.88; p = 0.027) in comparison to the matched cohort of unvaccinated patients. More favorable survival was observed in patients receiving vector in comparison to messenger RNA (mRNA) vaccine types in unadjusted analysis (30 days mortality 18% vs. 40%; HR: 0.45 0.25–0.79; p = 0.034). In the multivariable Cox regression analysis model both mRNA (HR: 0.59 0.36–0.98; p = 0.041) and vector vaccine types (HR: 0.30 0.15–0.60; p < 0.001) were associated with improved survival in comparison to unvaccinated patients, independently of age (HR: 1.03 1.01–1.06; p = 0.011), male sex (HR: 1.78 1.14–2.76; p = 0.010), severity of illness (HR: 2.06 1.36–3.10; p < 0.001) and functional status on admission (HR: 1.42 1.07–1.85; p = 0.013).
Highlights
Vaccinated patients who required hospitalization were old and burdened with comorbidities.
Vaccinated in comparison to matched control patients experienced improved survival.
Favorable effects of vaccination were more pronounced in vector than mRNA vaccine recipients.
Background: As the natural healing capacity of damaged articular cartilage is poor, joint surface injuries are a prime target for regenerative
medicine. Characterized chondrocyte implantation uses an ...autologous cartilage cell therapy product that has been optimized
for its biological potency to form stable cartilage tissue in vivo.
Purpose: To determine whether, in symptomatic cartilage defects of the femoral condyle, structural regeneration with characterized
chondrocyte implantation is superior to repair with microfracture.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: Characterized chondrocyte implantation was compared with microfracture in patients with single grade III to IV symptomatic
cartilage defects of the femoral condyles in a multicenter trial. Patients aged 18 to 50 years were randomized to characterized
chondrocyte implantation (n = 57) or microfracture (n = 61). Structural repair was blindly assessed in biopsy specimens taken
at 1 year using (1) computerized histomorphometry and (2) evaluation of overall histological components of structural repair.
Clinical outcome was measured using the self administered Knee injury and Osteoarthritis Outcome Score. Adverse events were
recorded throughout the study.
Results: Characterized chondrocyte implantation resulted in better structural repair, as assessed by histomorphometry ( P = .003) and overall histologic evaluation ( P = .012). Aspects of structural repair relating to chondrocyte phenotype and tissue structure were superior with characterized
chondrocyte implantation. Clinical outcome as measured by the Knee injury and Osteoarthritis Outcome Score at 12 to 18 months
after characterized chondrocyte implantation was comparable with microfracture at this stage. Both treatment groups had a
similar mean baseline overall Knee injury and Osteoarthritis Outcome Score (56.30 ± 13.61 and 59.53 ± 14.95 for microfracture
and characterized chondrocyte implantation, respectively), which increased in both groups to 70.56 ± 12.39 and 72.63 ± 15.55
at 6 months, 73.26 ± 14.66 and 73.10 ± 16.01 at 12 months, and 74.73 ± 17.01 and 75.04 ± 14.50 at 18 months, respectively.
Both techniques were generally well tolerated; the incidence of adverse events after characterized chondrocyte implantation
was not markedly increased compared with that for microfracture.
Conclusion: One year after treatment, characterized chondrocyte implantation was associated with a tissue regenerate that was superior
to that after microfracture. Short-term clinical outcome was similar for both treatments. The superior structural outcome
may result in improved long-term clinical benefit with characterized chondrocyte implantation. Long-term follow-up is needed
to confirm these findings.
Keywords:
chondrocyte
chondral
regenerative medicine
autologous chondrocyte implantation (ACI)
characterized chondrocyte implantation (CCI)
cell therapy product
microfracture
cartilage repair
Mild cognitive impairment (MCI) is associated with an increased risk of further cognitive decline, partly depending on demographics and biomarker status. The aim of the present study was to survey ...the clinical practices of physicians in terms of biomarker counseling, management, and follow-up in European expert centers diagnosing patients with MCI.
An online email survey was distributed to physicians affiliated with European Alzheimer's disease Consortium centers (Northern Europe: 10 centers; Eastern and Central Europe: 9 centers; and Southern Europe: 15 centers) with questions on attitudes toward biomarkers and biomarker counseling in MCI and dementia. This included postbiomarker counseling and the process of diagnostic disclosure of MCI, as well as treatment and follow-up in MCI.
The response rate for the survey was 80.9% (34 of 42 centers) across 20 countries. A large majority of physicians had access to biomarkers and found them useful. Pre- and postbiomarker counseling varied across centers, as did practices for referral to support groups and advice on preventive strategies. Less than half reported discussing driving and advance care planning with patients with MCI.
The variability in clinical practices across centers calls for better biomarker counseling and better training to improve communication skills. Future initiatives should address the importance of communicating preventive strategies and advance planning.
Background: Characterized chondrocyte implantation (CCI) results in significantly better early structural tissue regeneration than microfracture (MF), and CCI has a midterm clinical benefit over ...microfracture.
Purpose: This study was undertaken to evaluate the 5-year clinical outcome of CCI in a randomized comparison with MF for the treatment of symptomatic cartilage defects of the femoral condyles of the knee.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: Participants aged 18 to 50 years with a symptomatic isolated International Cartilage Repair Society (ICRS) grade III or IV cartilage lesion of the femoral condyles between 1 and 5 cm2 were randomized to either CCI or MF. Clinical outcomes were measured up to 60 months after surgery using the Knee Injury and Osteoarthritis Outcome Score (KOOS). The main outcome parameter was change from baseline in overall KOOS (oKOOS). Adverse events were monitored.
Results: Fifty-one participants were treated with CCI and 61 with MF. On average, clinical benefit was maintained through the 60-month follow-up period. The average change from baseline in oKOOS was not different between both groups (least squares LS mean ± standard error SE 18.84 ± 3.58 for CCI vs 13.21 ± 5.63 for MF; P = .116). Treatment failures were comparable (n = 7 in CCI vs n = 10 in MF), although MF failures tended to occur earlier. Subgroup analysis revealed that CCI resulted in better outcome in participants with time since symptom onset of less than 3 years, which was statistically significant and clinically relevant (change in oKOOS <3 years mean ± SE 25.96 ± 3.45 for CCI vs 15.28 ± 3.17 for MF; P = .026 vs oKOOS >3 years mean ± SE 13.09 ± 4.78 for CCI vs 17.02 ± 4.50 for MF, P = .554). Other subgroup analyses such as age (cutoff 35 years) did not show a difference. Female patients showed more failures irrespective of treatment.
Conclusion: At 5 years after treatment, clinical outcomes for CCI and MF were comparable. In the early treatment group, CCI obtained statistically significant and clinically relevant better results than MF. Delayed treatment resulted in less predictable outcomes for CCI. These results provide strong evidence that time since onset of symptoms is an essential variable that should be taken into account in future treatment algorithms for cartilage repair of the knee.
Plastic bronchitis is a rare disorder characterized by formation and sometimes dramatic expectoration of bronchial casts. It may occur at any age, but most published cases refer to pediatric ...population. We report a case of an 81-year-old man hospitalized at intensive care unit, who presented with the appearance of plastic bronchitis type I. He had profuse expectoration of several pieces, a few cm long and up to 1 cm wide, of wormlike reddish-brownish "tissue". Histologically, it was a slimy purulent secretion with abundant fibrin and blood and with cytopathic effect of herpes virus. The pathogenesis of plastic bronchitis is not clear.
Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAID) are considered to be the two major risk factors implicated in the development of gastric ulcer. Helicobacter ...pylori infection related chronic gastritis is known to be the underlying condition which may lead to gastric ulcer. Development of gastric ulcer as the consequence of underlying chronic gastritis is caused by many factors. Treating Helicobacter pylori infection entails the healing of gastric ulcer, it concomitantly prevents recurrences and complications of gastric ulcer, primarily bleeding, and changes the natural course of gastric ulcer disease. Continuation of antisecretory maintenance treatment beyond ulcus healing and eradication of Helicobacter pylori infection is only indicated in risk groups. Patients with gastric ulcer caused by NSAID use are managed with antisecretory therapy.
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