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Does the power of the laser devices matter for a successful HoLEP procedure? A prospective comparative study.

Int J Clin Pract 2021 Jun 15:e14531. Epub 2021 Jun 15.

Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.

Background: The objectives of this prospective study were to evaluate the efficiency, safety and applicability of medium power (MP) holmium laser devices in the endoscopic enucleation of the enlarged prostate (HoLEP) compared to high power (HP) laser devices.

Methods: From October 2019 to July 2020, a total of 120 consecutive patients planned for HoLEP were divided randomly into two groups formed in terms of the power of the device used. While patients in Group 1 were treated with a MP device (50W) at 39. Read More

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Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives.

Semin Liver Dis 2021 Jun 15. Epub 2021 Jun 15.

Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.

Advancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. Read More

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Early Goal-Directed Renal Replacement Therapy in Acute Decompensated Heart Failure Patients with Cardiorenal Syndrome.

Blood Purif 2021 Jun 15:1-9. Epub 2021 Jun 15.

Division of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.

Introduction: The aim of this study was to clarify the efficacy of early goal-directed renal replacement therapy (GDRRT) for treatment of cardiorenal syndrome (CRS) patients after acute decompensated heart failure (ADHF).

Methods: In the retrospective, observational study, we enrolled 54 patients in the early GDRRT group and 63 patients in the late GDRRT group. Baseline characteristics, clinical data at initiation renal replacement therapy time, and the clinical outcome were collected and several parameters were compared and analyzed between 2 groups. Read More

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Mat pilates method improve postural alignment women undergoing hormone therapy adjunct to breast cancer treatment. Clinical trial.

Complement Ther Clin Pract 2021 Jun 1;44:101424. Epub 2021 Jun 1.

Department of Physical Education at the Center for Health Sciences and Sports and Professor Postgraduate Program in Human Movement Sciences, Santa Catarina State University, Brazil.

The purpose of the study is to analyze the effects of a mat Pilates intervention on the postural alignment and balance of breast cancer women receiving hormone therapy. A two-arm randomized clinical trial included 34 breast cancer survivors divided randomly between a mat Pilates group (n = 18), that performed 16 weeks of mat Pilates exercises, and a control group (n = 16), who were invited to maintain their daily routine activities and received three educational sessions. Data collection occurred at baseline and at post-intervention time. Read More

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Exosome-based hybrid nanostructures for enhanced tumor targeting and hyperthermia therapy.

Colloids Surf B Biointerfaces 2021 Jun 8;205:111915. Epub 2021 Jun 8.

Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, 42988, Republic of Korea. Electronic address:

Recently, natural exosomes have attracted attention as an ideal drug carrier to overcome the limitations of existing drug delivery systems which are toxicity induction and low cancer-targeting performance. In this study, we propose an exosome-based hybrid nanostructure (EHN) with improved targeting ability and therapeutic efficacy against colorectal cancer by using exosomes isolated from the tumor cell line as a drug carrier. The proposed EHN can have high biocompatibility by using exosomes, a biologically derived material, and show improved targeting performance by adding a tumor-targeting ligand (folic acid). Read More

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Improved long-term functional outcome after a latissimus dorsi transfer with or without subscapularis muscle lengthening or release.

Acta Orthop Belg 2021 Mar;87(1):151-157

A brachial plexus birth injury (BPBI) can lead to a limited shoulder function, especially abduction and external rotation. One of the treatment options to restore those shoulder functions is a latissimus dorsi transfer (LDT). The aim of this study is to analyze long-term functional outcome after a single LDT and compare these results with LDT combined with subscapularis muscle lengthening (SSL) or subscapularis muscle release (SSR). Read More

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Attitudes, beliefs and behaviors of religiosity, spirituality, and cultural competence in the medical profession: A cross-sectional survey study.

PLoS One 2021 15;16(6):e0252750. Epub 2021 Jun 15.

University of South Carolina School of Medicine Greenville, Greenville, South Carolina, United States of America.

Introduction: Religion and spirituality play important roles in the lives of many, including healthcare providers and their patients. The purpose of this study was to examine the relationships between religion, spirituality, and cultural competence of healthcare providers.

Methods: Physicians, residents, and medical students were recruited through social platforms to complete an electronically delivered survey, gathering data regarding demographics, cultural competency, religiosity, and spirituality. Read More

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Improving Dialysis Adequacy And Quality Of Life In Patients Undergoing Hemodialyis with Twice a Week Range of Motion Exercise.

Ther Apher Dial 2021 Jun 15. Epub 2021 Jun 15.

Lecturers in School of Medicine, Universitas Muhammadiyah Yogyakarta.

The study aimed to determine the effects of giving range of motion (ROM) twice a week as a form intradialytic exercise on patients' dialysis adequacy and quality of life. A total of 48 eligible participants were recruited and completed this study. The intervention group (n=24) received twice a week range of motion exercise over a 4 weeks period. Read More

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Timing of pyloric stenosis and effectiveness of endoscopic balloon dilation after pyloric endoscopic submucosal dissection.

J Gastroenterol Hepatol 2021 Jun 15. Epub 2021 Jun 15.

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Background And Aim: There have been studies on risk factors for stenosis after pyloric endoscopic submucosal dissection (ESD). However, the most appropriate strategies for the management of cases with these risk factors have not been established. This study aimed to investigate post-ESD management by evaluating the timing of stenosis and the effectiveness of endoscopic balloon dilation (EBD) after pyloric ESD. Read More

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Dapagliflozin reduces hepatic and visceral fat in type-2 diabetes patients with non-alcoholic fatty liver disease.

J Gastroenterol Hepatol 2021 Jun 15. Epub 2021 Jun 15.

Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Background/purpose Of The Study: Sodium-glucose cotransporter 2 inhibitors have shown excellent results in glucose control in type 2 diabetes mellitus (T2DM) patients, while also promoting weight loss. These mechanisms may be beneficial in the treatment of non-alcoholic fatty liver disease (NAFLD). Our study aims to investigate the effect of dapagliflozin on hepatic and visceral fat contents, and related biochemical markers in T2DM with NAFLD patients. Read More

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Palliative Care Nursing Development in the Middle East and Northeast Africa: Lessons From Oman.

J Cancer Educ 2021 Jun 15. Epub 2021 Jun 15.

School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Nurses are on the frontline of palliative care, and in some countries, are the only contact for patients and families facing life-threatening illness. The Oman Cancer Association in the Sultanate of Oman, in collaboration with the Middle Eastern Cancer Consortium and the Oncology Nursing Society, led a palliative care initiative over the past decade to better integrate palliative care into the health care system. Components of this initiative include integrating palliative care into the health care curricula and providing palliative care education to over 400 nurses and other health care professionals within Oman. Read More

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Between-group minimally important change versus individual treatment responders.

Qual Life Res 2021 Jun 15. Epub 2021 Jun 15.

Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.

Purpose: Estimates of the minimally important change (MIC) can be used to evaluate whether group-level differences are large enough to be important. But responders to treatment have been based upon group-level MIC thresholds, resulting in inaccurate classification of change over time. This article reviews options and provides suggestions about individual-level statistics to assess whether individuals have improved, stayed the same, or declined. Read More

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Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus.

Eur Arch Otorhinolaryngol 2021 Jun 15. Epub 2021 Jun 15.

Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, 230022, Anhui, China.

Purpose: This study was conducted to evaluate outcomes in patients presenting with fungus ball of the maxillary sinus (MSFB) and frontal sinusitis who were treated via middle meatal antrostomy alone.

Methods: This was a randomized, controlled study with a parallel group design. Patients with MSFB and frontal sinusitis were randomly assigned to the maxillary middle meatal antrostomy (MMMA) or control (MMMA + frontal sinusotomy) groups. Read More

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Detection of relevant extracardiac findings on coronary computed tomography angiography vs. invasive coronary angiography.

Eur Radiol 2021 Jun 15. Epub 2021 Jun 15.

Department of Radiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.

Objectives: To compare the detection of relevant extracardiac findings (ECFs) on coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA) and evaluate the potential clinical benefit of their detection.

Methods: This is the prespecified subanalysis of ECFs in patients presenting with a clinical indication for ICA based on atypical angina and suspected coronary artery disease (CAD) included in the prospective single-center randomized controlled Coronary Artery Disease Management (CAD-Man) study. ECFs requiring immediate therapy and/or further workup including additional imaging were defined as clinically relevant. Read More

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Pythagorean Self-Awareness Intervention for Multiple Sclerosis Patients: A Quasi-Experimental Pragmatic Trial.

Arch Clin Neuropsychol 2021 Jun 15. Epub 2021 Jun 15.

1st Department of Neurology, Aeginition Hospital, Medical School, National Kapodistrian University of Athens, Athens, Greece.

Objective: Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system affecting patients' well-being and quality of life. Pythagorean Self-Awareness Intervention (PSAI) is a novel non-pharmaceutical intervention with significant benefits both in MS and other chronic diseases. In this study, the longstanding effectiveness of PSAI was investigated. Read More

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Comparison of the improvement of flow-mediated dilatation in patients with acute coronary syndrome versus stable angina after six-month cardiac rehabilitation.

Cardiovasc J Afr 2021 Jun 8;32:1-6. Epub 2021 Jun 8.

Department of Rehabilitation Medicine, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Background: We investigated whether the improvement in endothelial function, measured using flow-mediated dilatation (FMD), an important predictor of cardiovascular outcomes, was comparable in acute coronary syndrome (ACS) versus stable angina patients after percutaneous coronary intervention (PCI) and a six-month cardiac rehabilitation (CR) programme.

Methods: We analysed the results from 119 patients who completed a six-month CR programme after successful PCI for stable angina ( = 50) and ACS ( = 69).

Results: After six months of CR, the results of FMD were significantly improved in both groups. Read More

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Improving work-life balance among administrative officers in Catholic primary schools: Assessing the effect of a Christian religious rational emotive behavior therapy.

Medicine (Baltimore) 2021 Jun;100(24):e26361

Department of Educational Foundations, University of Nigeria, Enugu, Nigeria.

Objective: Work-life balance (WLB) is an essential precursor of workers' mental health. The theory of rational emotive behaviour therapy proposes that an imbalance in work and family life may result from people's dysfunctional perceptions of their work and other aspects of their personal life. Also, the constructive philosophies of rational emotive behavior therapy are said to be congruent with most religious belief systems of Christian clients. Read More

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Effect of Mobile Phone Text Message Reminders on the Completion and Timely Receipt of Routine Childhood Vaccinations: Superiority Randomized Controlled Trial in Northwest Ethiopia.

JMIR Mhealth Uhealth 2021 Jun 15;9(6):e27603. Epub 2021 Jun 15.

Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.

Background: Nonattendance at vaccination appointments is a big challenge for health workers as it is difficult to track routine vaccination schedules. In Ethiopia, 3 out of 10 children have incomplete vaccination and the timely receipt of the recommended vaccines is low. Thus, innovative strategies are required to reach the last mile where mobile technology can be effectively utilized to achieve better compliance. Read More

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Clinical characteristics of anti-isoleucyl-tRNA synthetase antibody associated syndrome and comparison with different patient cohorts.

Clin Exp Rheumatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.

Objectives: This study aimed to analyse the clinical features of anti-isoleucyl-tRNA synthetase (OJ) antibodies in Chinese patients and to compare with previously published cohorts. We reviewed the clinical data of anti-OJ antibody positive patients, including their long-term follow-up.

Results: Anti-OJ antibodies were present in 10 of 1269 (0. Read More

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Irritable Bowel Syndrome: Questions and Answers for Effective Care.

Am Fam Physician 2021 Jun;103(12):727-736

Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Irritable bowel syndrome (IBS) is a heterogeneous group of conditions related to specific biologic and cellular abnormalities that are not fully understood. Psychological factors do not cause IBS, but many people with IBS also have anxiety or depressed mood, a history of adverse life events, or psychosocial stressors. Physicians must understand the fears and expectations of patients and how they think about their symptoms and should also respond empathetically to psychosocial cues. Read More

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Is multidisciplinary rehabilitation for low back pain effective in patients above 65 years? An observational cohort study with 12-month follow-up.

Eur J Phys Rehabil Med 2021 Jun 15. Epub 2021 Jun 15.

Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Germany -

Background: In contrast to the broad evidence for the effectiveness of multidisciplinary biopsychosocial rehabilitation (MBR) in chronic low back pain (CLBP) patients of working age, little is known about the benefit in patients aged ≥ 65 years.

Aim: To quantify the short-term and 12-month effects of a 3-week CLBP specific MBR program in patients ≥ 65 years of age; to compare the effects in patients ≥ 65 years of age to the effects in younger patients.

Design: Observational prospective cohort study. Read More

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Botulinum toxin A (Botox) injection into muscles of pelvic floor as a treatment for persistent pelvic pain secondary to pelvic floor muscular spasm: A pilot study.

Aust N Z J Obstet Gynaecol 2021 Jun 15. Epub 2021 Jun 15.

Endosurgery Department, Mercy Hospital for Women, Melbourne, Victoria, Australia.

Background: Persistent pelvic pain (PPP) remains an important cause of morbidity. Pelvic floor muscle spasm is an important contributor to PPP.

Aims: The study's primary aim was to assess if botulinum toxin (BoNT) injection to pelvic floor muscles altered pain scores or quality of life (QoL) at six, 12 and 26 weeks. Read More

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A Gastrointestinal Endoscopy Quality Control System Incorporated With Deep Learning Improved Endoscopist Performance in a Pretest and Post-Test Trial.

Clin Transl Gastroenterol 2021 Jun 15;12(6):e00366. Epub 2021 Jun 15.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.

Introduction: Gastrointestinal endoscopic quality is operator-dependent. To ensure the endoscopy quality, we constructed an endoscopic audit and feedback system named Endo.Adm and evaluated its effect in a form of pretest and posttest trial. Read More

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Experimental-based validation of corneal lenticule banking in a health authority-licensed facility.

Tissue Eng Part A 2021 Jun 15. Epub 2021 Jun 15.

Singapore National Eye Centre, Cornea External Disease and Refractive, 11 Third Hospital Avenue, Level 8, Singapore, Singapore, 168751.

With the expected rise in patients undergoing refractive lenticule extraction worldwide, the amount of discarded corneal stromal lenticules will increase. Therefore, establishing a lenticule bank to collect, catalog, process, cryopreserve and distribute the lenticules (for future therapeutic needs) could be advantageous. Here, we validated the safety of lenticule banking, which involved the collection of human lenticules from our eye clinic, transportation of the lenticules to a Singapore Ministry of Health-licensed lenticule bank, processing and cryopreservation of the lenticules, which after 3 months or, a longer-term, 12 months, were retrieved and transported to our laboratory for implantation in rabbit corneas. Read More

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Efficacy of hydrated phospholipid polymer interfaces between all-polymer bearings for total hip arthroplasty.

J Biomed Mater Res B Appl Biomater 2021 Jun 15. Epub 2021 Jun 15.

Department of Materials Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan.

Measurements of wear resistance and metal ion release are important for designing bearing couples or interfaces in total hip arthroplasty (THA). In this study, we investigated wear resistance and metal ion release of surface-modified metal-free all-polymer hip bearings, such as poly(ether-ether-ketone), (PEEK) on cross-linked polyethylene (PEEK-on-CLPE), with a hydrated gel-like surface layer, to propose an improved alternative to the conventional materials used to design THA bearings. The PEEK surface resulted in less metal ion release than the cobalt-chromium-molybdenum (Co-Cr-Mo) alloy surface owing to the lack of metal. Read More

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The early course and treatment of posttraumatic stress disorder in very young children: diagnostic prevalence and predictors in hospital-attending children and a randomized controlled proof-of-concept trial of trauma-focused cognitive therapy, for 3- to 8-year-olds.

J Child Psychol Psychiatry 2021 Jun 14. Epub 2021 Jun 14.

Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.

Background: The introduction of developmentally adapted criteria for posttraumatic stress disorder (PTSD) has improved the identification of ≤6-year-old children with clinical needs. Across two studies, we assess predictors of the development of PTSD in young children (PTSD-YC), including the adult-led acute stress disorder (ASD) diagnosis, and provide proof of principle for cognitive-focused therapy for this age range, with the aim of increasing treatment options for children diagnosed with PTSD-YC.

Method: Study 1 (N = 105) assessed ASD and PTSD-YC diagnosis in 3- to 8-year-old children within one month and at around three months following attendance at an emergency room. Read More

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Incremental value of Alberta Stroke Program Early CT Score to collateral score for predicting target mismatch in stroke patients with extended time window or unknown onset time.

Neurol Sci 2021 Jun 14. Epub 2021 Jun 14.

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, China.

Purpose: To evaluate whether Alberta Stroke Program Early CT Score (ASPECTS) could provide incremental value to collateral score, and their integration could be an effective surrogate of CTP in predicting target mismatch.

Material And Methods: One hundred and fifty-nine stroke patients (onset time 6-16 h or with unknown onset time) with MCA and/or ICA occlusion underwent non-contrast computed tomography (NCCT) and CT perfusion (CTP) scan for initial assessment. Simulated single-phase CT angiography (sCTA, peak arterial phase) and multiphase CTA (mCTA) were reconstructed from CTP. Read More

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Status of Intestinal Helminth Infection in Schools Implementing the Home-Grown School Feeding Program and the Impact of the Program on Pupils in Anambra State, Nigeria.

Acta Parasitol 2021 Jun 14. Epub 2021 Jun 14.

Virology Department, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.

Purpose: Intestinal helminthiasis among pupils is a major impediment to their well-being and development. This 2-year study determined how home-grown school feeding programme (HGSFP) impacted on pupils' school attendance and created opportunity for more children to assess interventions geared towards the prevention and possible elimination of intestinal helminthiasis.

Methods: Faecal samples were collected from 1677 consented pupils and examined for helminths using Kato-Katz technique. Read More

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Heat Reacclimation Using Exercise or Hot Water Immersion.

Med Sci Sports Exerc 2021 Jul;53(7):1517-1528

Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, THE NETHERLANDS.

Introduction: The aim of this study was to compare the effectiveness of exercise versus hot water immersion heat reacclimation (HRA) protocols.

Methods: Twenty-four participants completed a heat stress test (HST; 33°C, 65% RH), which involved cycling at a power output equivalent to 1.5 W·kg-1 for 35 min whereby thermophysiological variables were measured. Read More

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