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Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed.

Gerontology 2021 May 10:1-10. Epub 2021 May 10.

Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.

Background: Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF.

Methods: Of 121 older adults (age = 78. Read More

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Tissue sample analysis for post mortem determination of brain edema.

Forensic Sci Int 2021 Apr 29;323:110808. Epub 2021 Apr 29.

Institute of Forensic Medicine, Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Institute of Forensic Medicine, Health Department Basel-Stadt, Basel, Switzerland.

The post mortem evaluation of a brain edema is routinely performed by pathologists based on the macroscopic signs during autopsy. This method represents the current gold standard, but is subjective and observer dependent. Therefore, three post mortem evaluation methods of brain samples were analyzed in this work: histology, wet-dry weight and normalized cerebral weight, which was described in 2020 by Bauer et al. Read More

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Evaluating the Likelihood to be Helped or Harmed after Treatment with Viloxazine Extended-Release in Children and Adolescents with Attention Deficit/Hyperactivity Disorder.

Int J Clin Pract 2021 May 10:e14330. Epub 2021 May 10.

Children's Developmental Center, Winter Park, FL, USA.

Aims: When clinicians evaluate potential medications for their patients, they must weigh the probability of a treatment's benefits against the possible risks. To this end, the present analyses evaluate the novel nonstimulant viloxazine extended-release (viloxazine ER) using measures of effect size to describe the potential benefits of its treatment in children and adolescents with attention deficit/hyperactivity disorder (ADHD) as well as the risk of discontinuation due to intolerable adverse events.

Methods: These post-hoc analyses use pooled data from four pivotal Phase 3 trials in pediatric patients treated with viloxazine ER. Read More

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Treatments for unruptured intracranial aneurysms.

Cochrane Database Syst Rev 2021 May 10;5:CD013312. Epub 2021 May 10.

Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.

Background: Unruptured intracranial aneurysms are relatively common lesions in the general population, with a prevalence of 3.2%, and are being diagnosed with greater frequency as non-invasive techniques for imaging of intracranial vessels have become increasingly available and used. If not treated, an intracranial aneurysm can be catastrophic. Read More

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Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis.

PLoS Med 2021 May 10;18(5):e1003602. Epub 2021 May 10.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Background: Parents are the primary caregivers of young children. Responsive parent-child relationships and parental support for learning during the earliest years of life are crucial for promoting early child development (ECD). We conducted a global systematic review and meta-analysis to evaluate the effectiveness of parenting interventions on ECD and parenting outcomes. Read More

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The effects of chair intervention on low back pain, discomfort, and trunk muscle activation in office workers: A systematic review.

Int J Occup Saf Ergon 2021 May 10:1-35. Epub 2021 May 10.

Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.

The chair is one standard piece of workstation equipment in an office. Previous studies showed that a suitable chair may reduce musculoskeletal symptoms. This review investigated the effect of chair intervention on low back pain, discomfort, and trunk muscle activation among office workers. Read More

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Global Practice Patterns of Dorsal Preservation Rhinoplasty.

Facial Plast Surg Aesthet Med 2021 May 10. Epub 2021 May 10.

Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California, USA.

Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. An 11-item questionnaire was electronically distributed to regional academies/societies representing rhinoplasty surgeons worldwide. Read More

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Recent advances in the induced pluripotent stem cell-based skin regeneration.

Wound Repair Regen 2021 May 10. Epub 2021 May 10.

Department of Applied Biology, Council of Scientific & Industrial Research-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad, India.

Skin regeneration has been a challenging clinical problem especially in cases of chronic wounds such as diabetic foot ulcers, and epidermolysis bullosa-related skin blisters. Prolonged non-healing wounds often lead to bacterial infections increasing the severity of wounds. Current treatment strategies for chronic wounds include debridement of wounds along with antibiotics, growth factors, and stem cell transplantation therapies. Read More

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Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome.

Cochrane Database Syst Rev 2021 May 10;5:CD011672. Epub 2021 May 10.

Department of Paediatrics, Royal Hobart Hospital, Hobart, Australia.

Background: Non-invasive respiratory support is increasingly used for the management of respiratory dysfunction in preterm infants. This approach runs the risk of under-treating those with respiratory distress syndrome (RDS), for whom surfactant administration is of paramount importance. Several techniques of minimally invasive surfactant therapy have been described. Read More

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Sustaining Meaningful Patient Engagement Across the Lifecycle of Medicines: A Roadmap for Action.

Ther Innov Regul Sci 2021 May 10. Epub 2021 May 10.

EURORDIS-Rare Diseases Europe, Paris, France.

Background: There is increased recognition that incorporating patients' perspectives and insights into the medicines development process results in better health outcomes and benefits for all involved stakeholders. Despite the increased interest and the existence of frameworks and practical recommendations, patient engagement (PE) is not yet considered standard practice. The objective of this work was to provide a roadmap to support systematic change in all stakeholder organisations involved in medicines development across Europe, patients and patient organisations, medicines developers, academia, regulatory authorities, Health Technology Assessment bodies, payers, policy-makers and public research funders, to sustain PE practices. Read More

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Cocoa-flavanols enhance moderate-intensity pulmonary [Formula: see text] kinetics but not exercise tolerance in sedentary middle-aged adults.

Eur J Appl Physiol 2021 May 10. Epub 2021 May 10.

School of Sport and Exercise Science, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.

Introduction: Cocoa flavanols (CF) may exert health benefits through their potent vasodilatory effects, which are perpetuated by elevations in nitric oxide (NO) bioavailability. These vasodilatory effects may contribute to improved delivery of blood and oxygen (O) to exercising muscle.

Purpose: Therefore, the objective of this study was to examine how CF supplementation impacts pulmonary O uptake ([Formula: see text]) kinetics and exercise tolerance in sedentary middle-aged adults. Read More

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Cost-effectiveness calculators for health, well-being and safety promotion: a systematic review.

Eur J Public Health 2021 May 10. Epub 2021 May 10.

Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland.

Background: The health, well-being and safety of the general population are important goals for society, but forecasting outcomes and weighing up the costs and benefits of effective promotional programmes is challenging. This study aimed to identify and describe the cost-effectiveness calculators that analyze interventions that promote health, well-being and safety.

Methods: Our systematic review used the CINAHL, PsycINFO, SocINDEX, EconLit, PubMed and Scopus databases to identify peer-reviewed studies published in English between January 2010 and April 2020. Read More

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A Breast Cancer Smartphone App to Navigate the Breast Cancer Journey: Mixed Methods Study.

JMIR Form Res 2021 May 10;5(5):e28668. Epub 2021 May 10.

Department of Obstetrics and Gynecology, Centro di Senologia della Svizzera Italiana, Ente Ospedaliero Cantonale, Viganello, Switzerland.

Background: Several mobile apps have been designed for patients with a diagnosis of cancer. Unfortunately, despite the promising potential and impressive spread, their effectiveness often remains unclear. Most mobile apps are developed without any medical professional involvement and quality evidence-based assessment. Read More

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Patient Portal Use, Perceptions of Electronic Health Record Value, and Self-Rated Primary Care Quality Among Older Adults: Cross-sectional Survey.

J Med Internet Res 2021 May 10;23(5):e22549. Epub 2021 May 10.

Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, United States.

Background: Older adults are increasingly accessing information and communicating using patient-facing portals available through their providers' electronic health record (EHR). Most theories of technology acceptance and use suggest that patients' overall satisfaction with care should be independent of their chosen level of portal engagement. However, achieving expected benefits of portal use depends on demonstrated support from providers to meet these expectations. Read More

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Adverse Events of Sodium-Glucose Cotransporter-2 Inhibitors in Chronic Kidney Disease: A Retrospective Chart Review.

Perm J 2021 May;25

Department of Nephrology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, CA.

Background: The renal benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2) are now well established, and these agents are recommended by the American Diabetes Association and Kidney Disease: Improving Global Outcomes guidelines for patients with type 2 diabetes and chronic kidney disease. However, the safety profile of SGLT2 inhibitors in chronic kidney disease is not as clear. We describe the adverse event rates of SGLT2 inhibitors, primarily empagliflozin, in Kaiser Permanente Southern California members with diabetic kidney disease. Read More

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Colorectal Cancer and Return to Work: A Pilot Study of Recruiting Cancer Survivors and Their Employers.

Perm J 2021 May;25

Kaiser Permanente Center for Health Research, Portland, OR.

Introduction: In this study we assessed the feasibility of recruiting colorectal cancer survivors and their employers to participate in research on returning to work after a cancer diagnosis.

Methods: Semistructured qualitative interviews were conducted with 6 survivors and 4 employers to collect feedback on 2 recruitment approaches: 1) an employee/cancer survivor-focused approach whereby researchers obtained employer contact information directly from survivors and 2) an employer-focused approach whereby researchers interviewed employers to identify pathways to recruiting survivor-supervisor dyads. Recordings of all interviews were transcribed and analyzed. Read More

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Better Together: Long-term Behaviors and Perspectives after a Practitioner-Family Writing Intervention in Clinical Practice.

Perm J 2021 May;25

Advocate Children's Hospital, Park Ridge, IL.

Background: An expressive writing intervention, the Three-minute Mental Makeover (3MMM), was previously associated with reduced stress for practitioners, patients, and families. The goal of this follow-up study was to evaluate long-term use of writing and perspectives after participation in the 3MMM.

Methods: The original study involved patients and families in the neonatal and pediatric Intensive Care Units, inpatient units, and outpatient clinics of a children's hospital. Read More

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The perception and knowledge about episiotomy: A cross-sectional survey involving healthcare workers in a low- and middle-income country.

Afr J Prim Health Care Fam Med 2021 Apr 28;13(1):e1-e6. Epub 2021 Apr 28.

Department Obstetrics and Gynaecology, Greys Hospital, Pietermaritzburg, South Africa; and, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Pietermaritzburg.

Background: Episiotomy was introduced into clinical practice without clear evidence of its benefits.The knowledge and understanding of episiotomy guidelines and practice by healthcare workers is substandard in our setting; hence, the injudicious use of this procedure have led to high rates.

Aim: To assess the knowledge, perception and practice of episiotomy by healthcare workers. Read More

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Lidocaine before esophageal manometry and ambulatory pH monitoring: A randomized controlled trial.

Neurogastroenterol Motil 2021 May 10:e14167. Epub 2021 May 10.

Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.

Background: Lidocaine is commonly applied to improve the tolerance of esophageal manometry (EM) and ambulatory pH monitoring (PM). We recently published data suggesting a benefit to this practice and we aimed to confirm these findings in a randomized trial.

Methods: We conducted a double-blind, randomized trial of lidocaine nasal spray versus placebo (saline) before EM and PM. Read More

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Comparison of Two Major Staging Systems in Predicting Survival and Recommendation of Postoperative Radiotherapy Based on the 11th Japanese Classification for Esophageal Carcinoma After Curative Resection: A Propensity Score-Matched Analysis.

Ann Surg Oncol 2021 May 9. Epub 2021 May 9.

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Objective: The aim of this study was to compare the prognostic predictive power of the 11th Japan Esophageal Society (JES) staging system with the 8th edition of the American Joint Committee on Cancer (AJCC) staging system in patients with thoracic esophageal squamous cell carcinoma (TESCC), and to estimate the survival benefits of postoperative radiotherapy (PORT) based on a substage of the JES staging system.

Methods: Area under the curve (AUC) values of the receiver operating characteristic curve were calculated to evaluate prognostic efficacy. Propensity score matching (PSM) analysis was conducted to balance the two groups (surgery only [S group] or surgery plus PORT [S+RT group]) across substages of the 11th JES staging system according to independent prognostic factors for overall survival (OS) identified using Cox proportional hazards regression. Read More

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A review on the motivations, decision-making factors, attitudes and experiences of couples using pre-implantation genetic testing for inherited conditions.

Hum Reprod Update 2021 May 10. Epub 2021 May 10.

Division of Surgery and Cancer, Institute of Developmental Reproductive & Developmental Biology, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK.

Background: In pre-implantation genetic testing (PGT), fertile couples undergo IVF with genetic testing of embryos to avoid conceptions with a genetic condition. There is an exponentially increasing uptake with over 600 applications listed by the Human Fertilisation and Embryology Authority in the UK. The psychological aspects of the decision-making process and the experience of PGT, however, are relatively underevaluated, with the potential to leave patients unsupported in their journeys. Read More

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Randomized controlled trials of remdesivir in hospitalized coronavirus disease 2019 patients: A meta-analysis.

Turk J Emerg Med 2021 Apr-Jun;21(2):43-50. Epub 2021 Feb 12.

Division of Research and Academic Affairs, Larkin Health System, South Miami, Florida, USA.

Background: The first cases of the coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. No antiviral treatment options are currently available with proven clinical efficacy. However, preliminary findings from phase III trials suggest that remdesivir is an effective and safe treatment option for COVID-19 patients with both moderate and severe disease. Read More

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February 2021

Hesitation and Refusal Factors in Individuals' Decision-Making Processes Regarding a Coronavirus Disease 2019 Vaccination.

Front Public Health 2021;9:626852. Epub 2021 Apr 21.

Faculty of Economics and Business, University of Talca, Talca, Chile.

Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures-and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, information will be needed to support a potential campaign to promote vaccination. The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects. Read More

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NEOGAMES: A Serious Computer Game That Improves Long-Term Knowledge Retention of Neonatal Resuscitation in Undergraduate Medical Students.

Front Pediatr 2021 21;9:645776. Epub 2021 Apr 21.

Department of Education and Training, Children's Hospital of Fudan University, Shanghai, China.

Serious games are potential alternatives for supplementing traditional simulation-based education for neonatal resuscitation training. However, evidence regarding the benefits of using serious games to improve long-term knowledge retention of neonatal resuscitation in undergraduate medical students is lacking. We designed a serious computer game "NEOGAMES" to train undergraduate medical students in neonatal resuscitation in a cost-friendly and accessible way and to examine whether serious game-based training improves long-term knowledge retention in medical students. Read More

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Nivolumab and Hypofractionated Radiotherapy in Patients With Advanced Lung Cancer: ABSCOPAL-1 Clinical Trial.

Front Oncol 2021 22;11:657024. Epub 2021 Apr 22.

Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Background: More clinical practice need to be performed to verify the toxicity of the hypofractionated radiotherapy (HFRT) combined with PD-1 blockade in lung cancer. This phase I study aimed to investigate the safety and efficacy of nivolumab combined with HFRT in patients with progressive advanced lung cancer following multiline treatment.

Methods: We enrolled 31 patients with advanced lung cancer pathologically confirmed to have progressive disease and treated with first-line or a higher therapy. Read More

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Laparoscopic vs. Open Repeat Hepatectomy for Recurrent Liver Tumors: A Propensity Score-Matched Study and Meta-Analysis.

Front Oncol 2021 22;11:646737. Epub 2021 Apr 22.

Department of Liver Surgery & Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.

It remains unclear whether the short-term benefits of laparoscopic repeat hepatectomy (LRH) accrue to patients with recurrent liver tumors. The present study aimed to report our own center's experience and perform a meta-analysis to evaluate the safety and feasibility of LRH in comparison with open repeat hepatectomy (ORH) for treating recurrent liver tumors. A propensity score-matched study was performed including 426 patients receiving LRH or ORH for recurrent hepatocellular carcinoma between January 2017 and December 2018. Read More

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Effect of Pelvic Bone Marrow Sparing Intensity Modulated Radiation Therapy on Acute Hematologic Toxicity in Rectal Cancer Patients Undergoing Chemo-Radiotherapy.

Front Oncol 2021 22;11:646211. Epub 2021 Apr 22.

Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: While chemo-radiotherapy improves local control in patients with locally advanced rectal cancer, it can also increase acute hematological toxicity (HT), which leads to poor outcomes. Patients receiving bone marrow radiation have been shown to develop acute HT. However, the safety and efficacy of bone marrow sparing is undetermined. Read More

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Circulating Biomarkers for Early Stage Non-Small Cell Lung Carcinoma Detection: Supplementation to Low-Dose Computed Tomography.

Front Oncol 2021 21;11:555331. Epub 2021 Apr 21.

The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, QLD, Australia.

Lung cancer is currently the leading cause of cancer death in both developing and developed countries. Given that lung cancer has poor prognosis in later stages, it is essential to achieve an early diagnosis to maximize patients' overall survival. Non-small cell lung cancer (NSCLC) is the most common form of primary lung cancer in both smokers and non-smokers. Read More

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Nomogram to differentiate between aortic dissection and non-ST segment elevation acute coronary syndrome: a retrospective cohort study.

Cardiovasc Diagn Ther 2021 Apr;11(2):457-466

Center of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Background: Aortic dissection (AD) and non-ST segment elevation acute coronary syndrome (ACS) are two of the most life-threatening diseases encountered in the emergency department (ED), but there are no rapid and reliable tools for differentiation. The purpose of this study is to develop and validate a nomogram that incorporates both the clinical characteristics and bedside laboratory tests available to differentiate between AD and non-ST segment elevation ACS (NSTE-ACS).

Methods: Between January 2016 and July 2018, patients with AD and NSTE-ACS were enrolled and divided into training and validation groups. Read More

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