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The effectiveness of interventions and intervention components for increasing physical activity and reducing sedentary behaviour in people with persistent musculoskeletal pain: a systematic review and meta-analysis.

J Pain 2021 Nov 29. Epub 2021 Nov 29.

Population Health Research Institute, St. George's, University of London; Institute of Social Marketing and Health, University of Stirling.

This systematic review and meta-analysis investigated the effectiveness of physical activity (PA) and sedentary behaviour (SB) interventions on PA and SB levels in people with persistent musculoskeletal pain. We explored the effectiveness of behaviour change techniques (BCTs), the use of behaviour change theory and non-PA/SB outcomes. Randomised controlled trials of PA or SB interventions for people with persistent musculoskeletal pain were eligible. Read More

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November 2021

Systematic review and Meta-analysis: One-year outcomes of gastric peroral endoscopic myotomy for refractory gastroparesis.

Aliment Pharmacol Ther 2021 Dec 1. Epub 2021 Dec 1.

Division of Gastroenterology, University of California-San Francisco, San Francisco, California, USA.

Background: Several studies have examined the efficacy of gastric peroral endoscopic myotomy (G-POEM) for gastroparesis.

Aim: To evaluate the mid-term efficacy of G-POEM by meta-analysis of studies with a minimum 1 year of follow-up.

Methods: We reviewed several databases from inception to 10 June 2021 to identify studies that evaluated the efficacy of G-POEM in refractory gastroparesis, and had at least 1 year of follow-up. Read More

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December 2021

A pragmatic single centre retrospective comparative review of complication profile between PEEK cages and Zero-P cage screw constructs.

Br J Neurosurg 2021 Dec 1:1-7. Epub 2021 Dec 1.

Royal Orthopaedic Hospital, Birmingham, UK.

Background: Anterior Decompression and Fusion (ACDF) is a common surgery recommended for symptomatic cervical degenerative disc disease after failed conservative care. There is no consensus on the choice of implants, and it varies between surgeons. This study aims to analyse the early complications following ACDF performed using a standalone cage versus a Zero-P (Cage Screw - (CS)) construct for patients with cervical degenerative disc disease. Read More

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December 2021

Identifying and changing cognitive vulnerability in the classroom: preliminary evaluation of CUES-Ed, a school-based universal cognitive behavioural early intervention service for 7-10 year olds.

Child Adolesc Ment Health 2021 Nov 30. Epub 2021 Nov 30.

Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Background: School-based early intervention may alleviate current emotional and behavioural problems, and, by targeting underlying vulnerability, safeguard children's future mental health. Improving on mixed outcomes to date is an international public health priority. CUES-Ed is a classroom-based, clinician-led, universal cognitive behavioural programme for primary school children, designed to promote emotional literacy and regulation. Read More

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November 2021

Effect of maternal prenatal and postpartum vitamin D supplementation on offspring bone mass and muscle strength in early childhood: follow-up of a randomized controlled trial.

Am J Clin Nutr 2021 Nov 27. Epub 2021 Nov 27.

Centre for Global Child Health and SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.

Background: Maternal vitamin D status during pregnancy and lactation is a modifiable factor that may influence offspring musculoskeletal outcomes. However, few randomized trials have tested the effects of prenatal or postpartum vitamin D supplementation on offspring bone and muscle development.

Objective: To examine hypothesized effects of improvements in early-life vitamin D status on childhood musculoskeletal health in Dhaka, Bangladesh. Read More

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November 2021

Bio-Degradable Stents: Primary Experience in a Tertiary Hepatopancreaticobiliary Center in the United Kingdom.

Cureus 2021 Oct 27;13(10):e19075. Epub 2021 Oct 27.

Hepatobiliary and Pancreatic Surgery, East Lancashire Hospital Trust, Blackburn, GBR.

Background: Management of benign biliary strictures (BBS) post bilioenteric anastomoses requires a multidisciplinary approach including surgical, radiological, and/or endoscopic input. Patients often need multiple hospital visits for treatment with the long-term possibility of restenosis. Conventionally BBS have been treated with serial percutaneous transhepatic biliary dilatations necessitating repeat procedures for drain exchange or removal. Read More

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October 2021

Optimising exposure for adolescents with public speaking anxiety: Affect labelling or positive coping statements?

Behav Res Ther 2021 Nov 19;148:103997. Epub 2021 Nov 19.

Department of Experimental Psychology & Department of Psychiatry, University of Oxford, UK.

Cognitive Behavioural Therapy (CBT) is the first line treatment for anxiety disorders in youth however many adolescents do not benefit. Behavioural exposure is believed to be the critical ingredient of CBT and research with adults has shown that labelling affect, but not positive coping statements, enhances exposure outcomes. However, many CBT protocols for young people involve using positive coping statements alongside exposure. Read More

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November 2021

Rates of Reversal of Volume Overload in Hospitalized Acute Heart Failure: Association With Long-term Kidney Function.

Am J Kidney Dis 2021 Nov 26. Epub 2021 Nov 26.

Division of Nephrology, Tufts Medical Center, Boston, Massachusetts. Electronic address:

Rationale And Objective: Achievement of decongestion in acute heart failure (AHF) is associated with improved survival and cardiovascular outcomes, but can be associated with acute declines in estimated glomerular filtration rate (eGFR). We sought to examine whether rate of in-hospital decongestion is associated with longer term kidney function decline.

Study Design: Post hoc analysis of trial data. Read More

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November 2021

Effects of Live Music Therapy on Autonomic Stability in Preterm Infants: A Cluster-Randomized Controlled Trial.

Children (Basel) 2021 Nov 22;8(11). Epub 2021 Nov 22.

Neonatal Department, Meir Medical Center, Kfar Saba 44281, Israel.

Unbuffered stress levels may negatively influence preterm-infants' autonomic nervous system (ANS) maturation, thus affecting neurobehavior and psycho-emotional development. Music therapy (MT) is an evidence-based treatment modality in neonatal care. When coupled with skin-to-skin care (SSC), it may reduce stress responses in both preterm infants and their parents and enhance family-centered care. Read More

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November 2021

Reverse Shoulder Arthroplasty Humeral Lateralisation: A Systematic Review.

Cureus 2021 Nov 23;13(11):e19845. Epub 2021 Nov 23.

Trauma and Orthopaedics, Lister Hospital, Stevenage, GBR.

Different studies on reverse shoulder arthroplasty (RSA) have proposed changes to the humeral design to lateralise the humeral centre of rotation (COR), with humeral inclination to 135 or 145 from 155 degrees or to switch to onlay humeral trays from inlay design; with both having also been used in combination. There have been many studies and systematic reviews to show the difference in outcomes and complications to the variations in glenoid design but to date, there have been no systematic studies to compare different humeral inclinations for RSA implants. Searches using keywords were used in common medical search engines in a systematic fashion. Read More

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November 2021

Reoperation rate and implant survivorship compared between cementless and cemented bipolar hemiarthroplasty in femoral neck fracture patients with chronic kidney disease.

Injury 2021 Nov 14. Epub 2021 Nov 14.

Division of Adult Reconstructive Surgery, Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand. Electronic address:

Background: Chronic kidney disease (CKD) is commonly associated with aging and disorders of mineral and bone metabolism. Femoral neck fracture (FNF) is one of the most common fractures among older adults with coexisting CKD, and bipolar hemiarthroplasty (BHA) is a preferred treatment. However, the optimal method of stem fixation has not been conclusively determined. Read More

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November 2021

The 7-Year Effectiveness of School-Based Alcohol Use Prevention From Adolescence to Early Adulthood: A Randomized Controlled Trial of Universal, Selective, and Combined Interventions.

J Am Acad Child Adolesc Psychiatry 2021 Nov 19. Epub 2021 Nov 19.

The Matilda Centre for Research in Mental Health & Substance Use, The University of Sydney, Australia.

Objective: Alcohol use is a leading cause of burden of disease among young people. Prevention strategies can be effective in the short-term, however little is known about their longer-term effectiveness. The aim of this study was to examine the sustainability of universal, selective and combined alcohol use prevention across the critical transition period from adolescence into early adulthood. Read More

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November 2021

Effects of different remineralization agents on MIH defects: a randomized clinical study.

Clin Oral Investig 2021 Nov 25. Epub 2021 Nov 25.

Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey.

Objectives: The aim of this study was to present a comparative evaluation of the long-term efficacy of fluoride varnish and pastes containing CPP-ACP and CPP-ACP with fluoride (CPP-ACFP) in the remineralization of creamy-white and yellow-brown defects in permanent first molars with MIH.

Materials And Methods: The study included 120 teeth with yellow-brown or creamy-white defects in 67 children (37 girls, 30 boys) aged 6-9 years (mean, 7.2) who were newly diagnosed with MIH with no substance loss or caries or prior restorative treatment. Read More

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November 2021

Economic Outcomes of Rehabilitation Therapy in Older Patients With Acute Heart Failure in the REHAB-HF Trial: A Secondary Analysis of a Randomized Clinical Trial.

JAMA Cardiol 2021 Nov 24. Epub 2021 Nov 24.

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Importance: In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a novel 12-week rehabilitation intervention demonstrated significant improvements in validated measures of physical function, quality of life, and depression, but no significant reductions in rehospitalizations or mortality compared with a control condition during the 6-month follow up. The economic implications of these results are important given the increasing pressures for cost containment in health care.

Objective: To report the economic outcomes of the REHAB-HF trial and estimate the potential cost-effectiveness of the intervention. Read More

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November 2021

Critical event debriefing: a checklist for the aftermath.

Curr Opin Anaesthesiol 2021 Dec;34(6):744-751

Department of Emergency Medicine, Brigham and Women's Hospital.

Purpose Of Review: Millions of perioperative crises (e.g. anaphylaxis, cardiac arrest) may occur annually. Read More

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December 2021

An Asian Perspective on Gender Differences in In-Hospital and Long-Term Outcome of Cardiac Mortality and Ischemic Stroke after Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.

J Stroke Cerebrovasc Dis 2021 Nov 20;31(1):106215. Epub 2021 Nov 20.

Department of Cardiology, National University Heart Centre, National University Health System, Singapore.

Objectives: Gender differences historically exist in cardiovascular disease, with women experiencing higher rates of major adverse cardiovascular events. We investigated these trends in a contemporary Asian cohort, examining the impact of gender differences on cardiac mortality and ischemic stroke after primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI).

Materials And Methods: We analysed 3971 consecutive patients who underwent primary PCI for STEMI retrospectively. Read More

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November 2021

Time to Benefit of Bisphosphonate Therapy for the Prevention of Fractures Among Postmenopausal Women With Osteoporosis: A Meta-analysis of Randomized Clinical Trials.

JAMA Intern Med 2021 Nov 22. Epub 2021 Nov 22.

Division of Geriatrics, Department of Medicine, University of California, San Francisco.

Importance: The clinical decision to initiate bisphosphonate therapy for the treatment of osteoporosis requires balancing shorter-term harms and burdens (eg, gastroesophageal irritation or severe musculoskeletal pain) with longer-term benefits in reducing potential fractures.

Objective: To assess the time to benefit (TTB) of bisphosphonate therapy for the prevention of nonvertebral and other fractures among postmenopausal women with osteoporosis.

Data Sources: Randomized clinical trials (RCTs) were identified from systematic reviews commissioned by the US Preventive Services Task Force (1 review), the Agency for Healthcare Research and Quality (1 review), the Cochrane Library (2 reviews), and the Endocrine Society (1 review). Read More

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November 2021

Long-term safety of the tafenoquine antimalarial chemoprophylaxis regimen: A 12-month, randomized, double-blind, placebo-controlled trial.

Travel Med Infect Dis 2021 Nov 18;45:102211. Epub 2021 Nov 18.

Centre for Ophthalmology and Visual Sciences (incorporating Lions Eye Institute), The University of Western Australia, Nedlands, WA, 6009, Australia; Linear Clinical Research, Nedlands, WA, 6009, Australia.

Background: Tafenoquine is a long-acting 8-aminoquinoline approved for antimalarial prophylaxis for ≤6 months. Additional data is needed to establish the drug's longer-term safety profile, including potential ophthalmic or neuropsychiatric effects.

Method: This was a randomized, double-blind, placebo-controlled trial in 600 healthy adults. Read More

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November 2021

Pulmonary vein stenosis: Anatomic considerations, surgical management, and outcomes.

J Thorac Cardiovasc Surg 2021 Oct 23. Epub 2021 Oct 23.

Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.

Objective: The study objective was to evaluate outcomes of pulmonary vein stenosis repair in a large single-center cohort.

Methods: Clinical data from a pulmonary vein stenosis registry were retrospectively reviewed identifying patients who underwent pulmonary vein stenosis repair. The primary/index operation was defined as the patient's first pulmonary vein stenosis operation during the study period. Read More

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October 2021

Survivorship Rate and Clinical Outcomes 10 Years After Arthroscopic Correction of Symptomatic Femoroacetabular Impingement.

Am J Sports Med 2021 Nov 19:3635465211055485. Epub 2021 Nov 19.

UPMC Sports Medicine Clinic, WIT Arena, Waterford, Ireland.

Background: Femoroacetabular impingement (FAI) is a common mechanical hip condition, prevalent in both the athletic and the general population. Surgical intervention is an effective treatment option that improves both symptoms and function in short- to medium-term follow-up. Few studies within the literature have reported the longer-term success of arthroscopic surgery. Read More

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November 2021

Outcomes of Unconstrained Proximal Interphalangeal Joint Arthroplasty: A Systematic Review.

J Hand Surg Asian Pac Vol 2021 Dec;26(4):684-696

AToMS-Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester.

: Unconstrained pyrocarbon and metal-on-polyethylene (MoP) proximal interphalangeal (PIP) joint arthroplasty is an increasingly popular alternative to silicone implants and arthrodesis. This systematic review appraises their outcomes. : 30 studies comprising 1,324 joints (813 pyrocarbon, 511 MoP) were included. Read More

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December 2021

Leadless vs. transvenous single-chamber ventricular pacing in the Micra CED study: 2-year follow-up.

Eur Heart J 2021 Nov 11. Epub 2021 Nov 11.

Duke University Medical Center & Duke Clinical Research Institute, 40 Duke Medicine Circle Clinic 2F/2 G, Durham, NC 27710, USA.

Aims : Clinical trials have demonstrated the safety and efficacy of the Micra leadless VVI pacemaker; however, longer-term outcomes in a large, real-world population with a contemporaneous comparison to transvenous VVI pacemakers have not been examined. We compared reinterventions, chronic complications, and all-cause mortality at 2 years between leadless VVI and transvenous VVI implanted patients.

Methods And Results : The Micra Coverage with Evidence Development study is a continuously enrolling, observational, cohort study of leadless VVI pacemakers in the US Medicare fee-for-service population. Read More

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November 2021

Outcomes Over Follow-up ≥10 Years After Surgical Myectomy for Symptomatic Obstructive Hypertrophic Cardiomyopathy.

Am J Cardiol 2021 Nov 13. Epub 2021 Nov 13.

Hypertrophic Cardiomyopathy Institute, Division of Cardiology, Tufts Medical Center, Boston, Massachusetts.

For over 50 years, surgical septal myectomy has been the preferred treatment for drug-refractory heart failure symptoms in obstructive hypertrophic cardiomyopathy (HCM). However, given the relatively youthful adult ages at which HCM surgery is usually performed, it is informative to evaluate longer-term results of myectomy after ≥10 years. We identified 139 consecutive obstructive HCM patients (50 ± 15 years of age; 55% men) who underwent surgical myectomy, 2003 to 2010 at Tufts HCM Center and followed 11. Read More

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November 2021

Prenatal and Early Childhood Exposure to Lead and Repeated Measures of Metabolic Syndrome Risk Indicators From Childhood to Preadolescence.

Front Pediatr 2021 29;9:750316. Epub 2021 Oct 29.

Occupational Health Research Unit, Mexican Institute of Social Security (IMSS), Mexico City, Mexico.

Exposure to lead (Pb) during the early life stages has been associated with the development of metabolic syndrome (MetS). Longitudinal studies of Pb exposure in critical developmental windows in children are limited. Our study included 601 mother-child dyads from the PROGRESS (Programming Research in Obesity, Growth, Environment and Social Stressors) birth cohort. Read More

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October 2021

The Choice Point Model of Acceptance and Commitment Therapy With Inpatient Substance Use and Co-occurring Populations: A Pilot Study.

Front Psychol 2021 28;12:758356. Epub 2021 Oct 28.

Retreat Behavioral Health, Clinical Department, Ephrata, PA, United States.

Acceptance and Commitment Therapy (ACT) is an empirically supported treatment which aims to enhance self-acceptance and a commitment to core values. The present study examined the effectiveness of the Choice Point model of ACT in a residential substance use disorder (SUD) setting. Choice Point is a contemporary approach to ACT and targets transdiagnostic processes. Read More

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October 2021

Life satisfaction among individuals with opioid use disorder receiving extended-release naltrexone: A 12-week randomized controlled trial and a 36-week follow-up.

J Subst Abuse Treat 2021 Nov 9:108656. Epub 2021 Nov 9.

Department of Research and Development in Mental Health, Akershus University Hospital, Lørenskog, Sykehusveien 25, 1478 Nordbyhagen, Norway; Department of Health Science, Oslo Metropolitan University, Pilestredet 46, 0167 Oslo, Norway. Electronic address:

Introduction: Life satisfaction (LS) in opioid-dependent individuals is lower than in the general population. This study aimed to explore changes in LS during short- and long-term treatment with extended-release naltrexone (XR-NTX).

Methods: This open-label 12-week clinical trial randomized 159 participants to either monthly XR-NTX or daily buprenorphine-naloxone (BP-NLX). Read More

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November 2021

Long-term effects of opioid overdose prevention and response training on medical student knowledge and attitudes toward opioid overdose: A pilot study.

Addict Behav 2021 Nov 3:107172. Epub 2021 Nov 3.

Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA. Electronic address:

Background: Medical settings provide ideal opportunities to identify patients with substance use disorders and provide harm reduction and treatment resources. Medical students often volunteer in the community and can spend substantial time with patients, serving as touchpoints. Accordingly, medical schools have begun training in harm reduction. Read More

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November 2021

The economic impact of two diagnostic strategies in the management of restorations in primary teeth: a health economic analysis plan for a trial-based economic evaluation.

Trials 2021 Nov 12;22(1):794. Epub 2021 Nov 12.

Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Lineu Prestes Avenue, 2227, São Paulo, SP, 05508000, Brazil.

Background: Different approaches have been used by dentists to base their decision. Among them, there are the aesthetical issues that may lead to more interventionist approaches. Indeed, using a more interventionist strategy (the World Dental Federation - FDI), more replacements tend to be indicated than using a minimally invasive one (based on the Caries Around Restorations and Sealants-CARS). Read More

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November 2021

Challenges and practical solutions for managing secondary genomic findings in primary care.

Eur J Med Genet 2021 Nov 9;65(1):104384. Epub 2021 Nov 9.

University of Toronto, Toronto, Ontario, Canada; The Genomics Health Services Research Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. Electronic address:

Primary care providers will increasingly be tasked with managing most secondary findings from genomic sequencing, but literature exploring their capacity to manage findings beyond conventional genetic testing is limited. This study aimed to explore primary care providers' challenges and potential solutions for managing secondary findings. Providers were recruited in two groups. Read More

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November 2021