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Comparative Safety and Efficacy of Therapeutic Options in Resectable and Advanced/Metastatic Pancreatic Cancer: A Systematic Review and Indirect Comparison.

Oncol Res Treat 2021 Jul 27:1-9. Epub 2021 Jul 27.

Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA.

Objectives: FOLFIRINOX, gemcitabine/nab-paclitaxel (gem-nab/P), and gemcitabine-capecitabine (gem-cap) demonstrated superiority over gemcitabine monotherapy for pancreatic cancer (PC). It is still unclear which chemotherapy regimen is the most optimal. This study aimed to conduct a systematic review (SR) and indirect comparison to compare safety and efficacy of FOLFIRINOX versus gem-nab/P and gem-cap in PC. Read More

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Health behavior adherence and emotional adjustment during the COVID-19 pandemic in a US nationally representative sample: The roles of prosocial motivation and gratitude.

Soc Sci Med 2021 Jul 20;284:114243. Epub 2021 Jul 20.

Department of Psychology, Arizona State University, Tempe, AZ, 85287, USA.

Rationale: Substantial health behavior change (e.g., social distancing, mask-wearing) is needed to slow COVID-19. Read More

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Current state of knowledge on immunotherapy in ECOG PS 2 patients. A systematic review.

Adv Med Sci 2021 Jul 24;66(2):381-387. Epub 2021 Jul 24.

2nd Department of Lung Diseases and Tuberculosis, Medical University of Bialystok, Bialystok, Poland.

Background: Patients with Eastern Cooperative Oncology Group Performance Status 2 (ECOG PS 2) are not included in most randomized clinical trials and registry studies. Nevertheless, immune checkpoint inhibitors are registered in the USA and Europe regardless of the performance status. Evidence regarding the effectiveness and safety of such treatment in this cohort is sparse. Read More

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Evolution of physical activity and body weight changes in breast cancer survivors five years after diagnosis - VICAN 2 & 5 French national surveys.

Breast 2021 Jul 20;59:248-255. Epub 2021 Jul 20.

Aix Marseille Univ, INSERM, IRD, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, CANBIOS Team Labelled League Against Cancer, 232 Bd Sainte Marguerite, 13273, Marseille Cedex, 9, France; APHM, BIOSTIC, Hop Timone, 264 Rue Saint-Pierre, 13005, Marseille, France. Electronic address:

Background: Regular physical activity (PA) and healthy body weight have proven benefits on survival in breast cancer (BC) survivors. We aimed to define predictors of long-term PA and weight gain in a representative sample of BC survivors.

Methods: Data were analysed from 723 women with BC who participated in both the 2012 and 2015 French National VICAN surveys. Read More

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Recycling drainage effluents using reverse osmosis powered by photovoltaic solar energy in hydroponic tomato production: Environmental footprint analysis.

J Environ Manage 2021 Jul 24;297:113326. Epub 2021 Jul 24.

Agricultural Engineering Department, Technical University of Cartagena, Paseo Alfonso XIII 48, 30203, Cartagena, Spain.

Greenhouse cultivation in the Mediterranean region has undoubtedly enhanced the economic growth and has generated social benefits by making an efficient use of resources. However, these production systems caused undesirable environmental impacts. In order to move towards cleaner production in greenhouse areas, this study has assessed the potential environmental benefits and trade-offs of the integration of an on-farm reverse osmosis system powered by photovoltaic solar energy to recycle the drainage effluents from greenhouses. Read More

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Sports compression garments improve resting markers of venous return and muscle blood flow in male basketball players.

J Sport Health Sci 2021 Jul 24. Epub 2021 Jul 24.

Institute for Health and Sport (iHeS), Victoria University, Footscray, VIC 3011, Australia; Department of Physiology, Australian Institute of Sport, Bruce, ACT 2617, Australia.

Background: The benefits associated with sports compression garments are thought to be closely related to enhanced blood flow. However, findings are equivocal, possibly due to heterogeneity in techniques used for measuring blood flow, garment types used, and pressures applied. This study combined Doppler ultrasound and near-infrared spectroscopy technologies to provide the first comprehensive assessment of the effects of three sports compression garment types on markers of venous return and muscle blood flow at rest. Read More

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Protective effect of MSC-derived exosomes against cisplatin-induced apoptosis via heat shock protein 70 in auditory explant model.

Nanomedicine 2021 Jul 24:102447. Epub 2021 Jul 24.

Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, South Korea; Research Institute of Hearing Enhancement, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, South Korea. Electronic address:

Therapeutics based on stem cell technology, including stem cell-derived exosomes, have emerged in recent years for the treatment of what were otherwise considered incurable diseases. In this study, we evaluated the efficacy of human MSC-derived exosomes for protection against cisplatin induced ototoxic hearing loss. Incubation of cochlear explants with MSC-derived exosomes prior to addition of cisplatin induced a reduction in cisplatin-induced drug toxicity in auditory hair cells but not when the exosomes were introduced simultaneously with or after cisplatin. Read More

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Risk management recommendations for environmental releases of gene drive modified insects.

Biotechnol Adv 2021 Jul 24:107807. Epub 2021 Jul 24.

Department of Biological Sciences, Western Michigan University, Kalamazoo, MI, United States.

The ability to engineer gene drives (genetic elements that bias their own inheritance) has sparked enthusiasm and concerns. Engineered gene drives could potentially be used to address long-standing challenges in the control of insect disease vectors, agricultural pests and invasive species, or help to rescue endangered species. However, risk concerns and uncertainty associated with potential environmental release of gene drive modified insects (GDMIs) have led some stakeholders to call for a global moratorium on such releases or the application of other strict precautionary measures to mitigate perceived risk assessment and risk management challenges. Read More

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ECONOMIC VALUE OF PODIATRY SERVICE IN LIMB SALVAGE ALLIANCE.

J Vasc Surg 2021 Jul 24. Epub 2021 Jul 24.

Department of Surgery, Division of Vascular Surgery, University of Arizona.

Introduction: Over the last decade, multidisciplinary "toe and flow" programs have gained great popularity with proven benefits in limb salvage. Many vascular surgeons have incorporated podiatrists into their practices. The viability of this practice model requires close partnership, hospital support, and financial sustainability. Read More

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Greater efficacy of a combination of conservative therapies for thumb base OA in individuals with lower radial subluxation - a pre-planned subgroup analysis of the COMBO trial.

Osteoarthritis Cartilage 2021 Jul 24. Epub 2021 Jul 24.

Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia.

Objective: To investigate heterogeneous effects of a combination of conservative therapies compared with an education comparator for thumb base (TB) osteoarthritis (OA) according to clinically relevant characteristics.

Methods: Pre-planned subgroup analysis of the COMBO trial (n=204) which compared a combination of education on self-management and ergonomic principles, a prefabricated neoprene splint, hand exercises, and diclofenac sodium gel, with education alone for radiographic and symptomatic TB OA. Primary outcomes were change in pain (visual analogue scale [VAS], 0-100 mm) and hand function (Functional Index for Hand Osteoarthritis questionnaire, 0-30) from baseline to week-6. Read More

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The potential and outgoing trends in traditional, phytochemical, economical, and ethnopharmacological importance of family Onagraceae: A comprehensive review.

J Ethnopharmacol 2021 Jul 24:114450. Epub 2021 Jul 24.

Department of Pharmacognosy, Faculty of Pharmacy, Egyptian Russian University. Badr City, 11829, Cairo, Egypt. Electronic address:

Ethnopharmacological Relevance: The Onagraceae is a widely distributed family of flowering plants comprises about 17 genera and more than 650 species of herbs, shrubs, and trees. Onagraceae also common as willowherb family or evening primrose family is divided into two subfamilies; Ludwigioideae (mainly genus; Ludwigia) and Onagroideae. Family Onagraceae is characterized by its numerous traditional uses as treatment of hormonal imbalances, urinary system ailments, prostate health maintenance, and antimicrobial effects. Read More

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MICAL1 regulates actin cytoskeleton organization, directional cell migration and the growth of human breast cancer cells as orthotopic xenograft tumours.

Cancer Lett 2021 Jul 24. Epub 2021 Jul 24.

Department of Chemistry and Biology, Ryerson University, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada. Electronic address:

The Molecule Interacting with CasL 1 (MICAL1) monooxygenase has emerged as an important regulator of cytoskeleton organization via actin oxidation. Although filamentous actin (F-actin) increases MICAL1 monooxygenase activity, hydrogen peroxide (HO) is also generated in the absence of F-actin, suggesting that diffusible HO might have additional functions. MICAL1 gene disruption by CRISPR/Cas9 in MDA MB 231 human breast cancer cells knocked out (KO) protein expression, which affected F-actin organization, cell size and motility. Read More

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One therapeutic approach for triple-negative breast cancer: Checkpoint kinase 1 inhibitor AZD7762 combination with neoadjuvant carboplatin.

Eur J Pharmacol 2021 Jul 24:174366. Epub 2021 Jul 24.

Institute of Pharmacology and Toxicology, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China; The Innovation Institute for Artificial Intelligence in Medicine, Zhejiang University, Hangzhou, China; Cancer Center of Zhejiang University, Hangzhou, China. Electronic address:

Carboplatin treatment is associated with potential benefits in practice in the neoadjuvant chemotherapy for Triple-negative breast cancer (TNBC) patients. In order to enhance its anti-tumor effects, new concepts for successful combination therapy are needed. Here, we interestingly found that the combination treatment of carboplatin with the Chk1 inhibitor AZD7762 synergistically inhibits TNBC cell growth in multiple TNBC cell lines in vitro. Read More

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Carbon myopia: the urgent need for integrated social, economic and environmental action in the livestock sector.

Glob Chang Biol 2021 Jul 27. Epub 2021 Jul 27.

Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia.

Livestock have long been integral to food production systems, often not by choice but by need. While our knowledge of livestock greenhouse gas emissions (GHG) mitigation has evolved, the prevailing focus has been - somewhat myopically - on technology applications associated with mitigation. Here, we (1) examine the global distribution of livestock GHG emissions, (2) explore social, economic and environmental co-benefits and trade-offs associated with mitigation interventions, and (3) critique approaches for quantifying GHG emissions. Read More

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Phase 2 Study of Danicopan in Paroxysmal Nocturnal Hemoglobinuria Patients with an Inadequate Response to Eculizumab.

Blood 2021 Jul 27. Epub 2021 Jul 27.

Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.

Paroxysmal nocturnal hemoglobinuria (PNH) is characterised by uncontrolled terminal complement activation and subsequent intravascular hemolysis (IVH). C5 inhibitors prevent membrane attack complex formation, but patients may experience extravascular hemolysis (EVH) and continue to require blood transfusions. Danicopan, an oral, proximal complement inhibitor of alternative pathway factor D (FD), is designed to control IVH and EVH. Read More

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Transdisciplinary research and clinical priorities for better health.

PLoS Med 2021 Jul 27;18(7):e1003699. Epub 2021 Jul 27.

Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Modern medicine makes it possible for many people to live with multiple chronic diseases for decades, but this has enormous social, financial, and environmental consequences. Preclinical, epidemiological, and clinical trial data have shown that many of the most common chronic diseases are largely preventable with nutritional and lifestyle interventions that are targeting well-characterized signaling pathways and the symbiotic relationship with our microbiome. Most of the research priorities and spending for health are focused on finding new molecular targets for the development of biotech and pharmaceutical products. Read More

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Placement Overlap with Other Students; Effects on Medical Student Learning Experience.

Teach Learn Med 2021 Jul 27:1-11. Epub 2021 Jul 27.

Norfolk and Norwich University Hospital Foundation Trust, Norwich, UK.

Phenomenon: In the United Kingdom (UK) the government has increased the number of places at university to study medicine in England to meet workforce demands. In parallel, there have been growing student numbers in other healthcare professions and new professions whose roles overlap with doctors, such as advanced nurse practitioners and physician associates, have been introduced. These increasing numbers of medical students and other healthcare professions training in the same clinical setting have led to questions about the effect on the student experience. Read More

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How does perceived fall risk influence decisions about whether to undertake activities in people with Parkinson's disease and their care partners? A qualitative study.

Disabil Rehabil 2021 Jul 27:1-9. Epub 2021 Jul 27.

Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

Purpose: To explore how perceptions of fall risk influence decisions to undertake activities in people with Parkinson's disease who have fallen, along with their care-partners.

Materials And Methods: This qualitative study used semi-structured interviews to collect data from eight people with moderate to severe Parkinson's Disease and freezing of gait (including those with cognitive impairments) and their care-partners. An inductive approach to thematic analysis was used to analyse the data. Read More

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Early versus Late Surgical Decompression for Traumatic Spinal Cord Injury on Neurological Recovery: A Systematic Review and Meta-analysis.

J Neurotrauma 2021 Jul 27. Epub 2021 Jul 27.

National Taiwan University Hospital, 38006, Department of Emergency Medicine, Taipei, Taiwan.

This study aimed to investigate whether early surgical decompression was associated with favourable neurological recovery in patients with traumatic spinal cord injury (tSCI). We searched PubMed and Embase from the database inception through December 2020 and selected studies comparing the impact of early versus late surgical decompression on neurological recovery as assessed by American Spinal Injury Association Impairment Scale (AIS) for adult patients sustaining tSCI. We pooled the effect estimates in random-effects models and quantified the heterogeneity by the I2 statistics. Read More

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Embedding Aphasia-Modified Cognitive Behavioral Therapy in Script Training for Primary Progressive Aphasia: A Single-Case Pilot Study.

Am J Speech Lang Pathol 2021 Jul 27:1-16. Epub 2021 Jul 27.

Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin.

Purpose This study sought to determine the initial feasibility and benefit of a novel intervention that combines speech-language treatment with counseling treatment for an individual with the nonfluent/agrammatic variant of primary progressive aphasia (PPA). Method Using a single-case experimental design, we evaluated the utility of modified script training paired with aphasia-modified cognitive behavioral therapy. The study employed a multiple baseline design across scripts for the primary linguistic outcome measure and a mixed methods approach for analyzing counseling outcomes. Read More

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Affinity-Directed Dynamics of Host-Guest Motifs for Pharmacokinetic Modulation Supramolecular PEGylation.

Biomacromolecules 2021 Jul 27. Epub 2021 Jul 27.

Department of Bioengineering, Stanford University, Stanford, California 94305, United States.

Proteins are an impactful class of therapeutics but can exhibit suboptimal therapeutic performance, arising from poor control over the timescale of clearance. Covalent PEGylation is one established strategy to extend circulation time but often at the cost of reduced activity and increased immunogenicity. Supramolecular PEGylation may afford similar benefits without necessitating that the protein be permanently modified with a polymer. Read More

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Reduced medical spending associated with integrated pharmacy benefits.

Am J Manag Care 2021 Jul 1;27(7):e242-e247. Epub 2021 Jul 1.

Blue Cross and Blue Shield of Louisiana, 5525 Reitz Ave, Baton Rouge, LA 70809. Email:

Objectives: Although pharmacy benefit carve-outs are promoted as a cost-containment tool, their impact on medical spending is not well understood. We compare the health care spending of Blue Cross and Blue Shield of Louisiana (BCBSLA) members covered by an integrated ("carved-in") pharmacy benefit with that of members covered under a pharmacy benefit carve-out.

Study Design: Matched, longitudinal cohort study. Read More

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Reply to "industry-informed perspectives on the benefits of rideshare-based medical transportation".

Am J Manag Care 2021 Jul;27(7):272-273

Department of Disability and Human Development, University of Illinois at Chicago, 1640 W Roosevelt Rd, MC 626, Chicago, IL 60608. Email:

The authors of "Rideshare Transportation to Health Care: Evidence From a Medicaid Implementation" respond to a letter to the editor. Read More

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Industry-informed perspectives on the benefits of rideshare-based medical transportation.

Am J Manag Care 2021 Jul;27(7):271-272

Lyft, Inc, 185 Berry St #5000, San Francisco, CA 94107. Email:

Previous research on rideshare-based nonemergency medical transportation has limited generalizability due to the specific model studied, and the lack of trip-level data raises concerns of ecological fallacy. Read More

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Beneficial Use of Dredged Sediment as a Sustainable Practice for Restoring Coastal Marsh Habitat.

Integr Environ Assess Manag 2021 Jul 27. Epub 2021 Jul 27.

US Army Corps of Engineers, New Orleans District, 7400 Leake Ave., New Orleans, LA, 70118, USA.

Coastal Louisiana (USA) continues to sustain immense land and habitat losses due to subsidence, sea-level rise, and storm events. Approximately 65 million cubic meters (85 million cubic yards) of sediment is dredged annually from Gulf coast Federal navigation channels to maintain safe waterway passage. The beneficial use of these sediments continues to increase and now this sediment is recognized as a critical resource in large-scale (estimated multi-billion dollar) ecosystem restoration efforts to mitigate land and habitat losses along the U. Read More

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Estimating the Public Health and Economic Impact of Introducing the 13-Valent Pneumococcal Conjugate Vaccine or 10-Valent Pneumococcal Conjugate Vaccines into State Immunization Programs in India.

Infect Dis Ther 2021 Jul 27. Epub 2021 Jul 27.

Pfizer Inc., Health Economics and Outcomes Research, New York, USA.

Introduction: Although the pneumococcal conjugate vaccine (PCV) has been introduced into select state immunization programs (SIPs) in India, many children remain unvaccinated. Recently, India's Advisory Committee on Vaccines & Immunization Practices recommended PCV on the pediatric immunization schedule nationally. This study estimates the public health and economic impact of introducing either Pfizer's 13-valent PCV (PCV13-PFE), GlaxoSmithKline's 10-valent PCV (PCV10-GSK), or Serum Institute of India's 10-valent PCV (PCV10-SII) into every pediatric SIP. Read More

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Intracorporeal versus extracorporeal anastomosis for robotic ileocolic resection in Crohn's disease.

J Robot Surg 2021 Jul 27. Epub 2021 Jul 27.

Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.

To date, there is no cohort in the literature focusing on the impact of the type of anastomosis in robotic ileocolonic resections for Crohn's Disease (CD). We aimed to compare short-term postoperative outcomes of robotic ileocolic resection for CD between patients who had intracorporeal (ICA) or extracorporeal anastomosis (ECA). We retrospectively included all consecutive robotic ileocolonic resections for CD at our institution between 2014 and 2020. Read More

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Positive Effects of Religion and Social Ties on the Health of Former NFL Athletes.

J Relig Health 2021 Jul 27. Epub 2021 Jul 27.

Population Studies Center of the Institute for Social Research, University of Michigan, P. O. Box 1248, Ann Arbor, MI, 48106, USA.

This study explores the relationship between religious service attendance, social ties, and health among former NFL players, a population with relatively high levels of religious attendance who endure physically demanding occupations. Research shows that frequent religious service attenders tend to have better health, partly because of social connections formed through religious involvement. We analyzed a sample of 1029 former NFL players. Read More

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Cutting Instruments to Cut Costs: A Simple Initiative with Breast Surgical Operating Room Trays that Resulted in Substantial Savings.

Ann Surg Oncol 2021 Jul 27. Epub 2021 Jul 27.

Section of Breast Surgery, Division of Surgical Oncology, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA, USA.

Background: A substantial expense in surgical care is incurred in the operating room (OR). We evaluated the financial impact of a systematic reduction in instrument tray contents on charges for breast surgery procedures.

Methods: A catalog of OR trays historically used for breast procedures (excisional biopsy, segmental and total mastectomy with or without axillary staging) was reviewed by four dedicated breast surgeons and downsized to a single tray accommodating all surgeon preferences. Read More

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Neurosurgical management of petrous bone lesions: classification system and selection of surgical approaches.

Acta Neurochir (Wien) 2021 Jul 27. Epub 2021 Jul 27.

Division of Neurosurgery, Duke University Medical Center, Durham, NC, USA.

Background: Surgery of petrous bone lesions (PBLs) is challenging for neurosurgeons. Selection of the surgical approach is an important key for success. In this study, the authors present an anatomical classification for PBLs that has been used by our group for over the past 26 years. Read More

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