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Background: Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment. Aim: To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU). Study Design: This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay. Results: After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p <.001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p =.017) and higher GCS at discharge (12 vs. 11, p =.010). Conclusion: EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay. Relevance to Clinical Practice: Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip‐related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO. Methods: We screened 49 potential participants, 28 were enrolled, and 23 completed both study visits (pre‐PAO and 6 months post‐PAO). We evaluated dynamometer‐measured hip and thigh strength, loading patterns during a squat and countermovement jump (CMJ), pain intensity, and device‐measured physical activity (PA) levels (light, moderate‐to‐vigorous PA [MVPA], and daily steps). We used linear regression models to examine the influence of muscle strength (peak torque; limb symmetry index [LSI]) and loading patterns before PAO on pain intensity and PA levels in individuals 6 months following PAO. Additionally, we used Pearson correlation coefficient to examine cross‐sectional associations among all variables 6 months following PAO. Results: Lower extremity muscle strength and loading patterns during the squat and CMJ before PAO did not predict pain intensity or device‐measured PA levels in individuals 6 months following PAO (p > 0.05). Six months following PAO, higher knee extensor LSI was associated with higher time spent in MVPA (r = 0.56; p = 0.016), higher hip abductor LSI was associated with both lower pain (r = 0.50; p = 0.036) and higher involved limb loading during the squat task (r = 0.59; p = 0.010). Lastly, higher hip flexor LSI was associated with higher CMJ takeoff involved limb loading (r = 0.52; p = 0.021) and higher involved hip extensor strength was associated with higher CMJ landing involved limb loading (r = 0.56; p = 0.012). Conclusion: Six months after PAO, higher hip and thigh muscle strength and strength symmetry were associated with lower pain, higher PA levels, and greater normalized limb loading during dynamic movement tasks. [ABSTRACT FROM AUTHOR]

Background: Robotic‐assisted thoracoscopic surgery (RATS) can achieve traditional clinical outcomes comparable to those of video‐assisted thoracoscopic surgery (VATS). However, patient‐reported outcomes (PROs) during the early period after RATS and VATS remain unclear. This study aimed to utilize longitudinal electronic PRO (ePRO) assessments to evaluate symptom burden and functional status between these approaches from patients' perspective. Methods: This study comprised patients who underwent lobectomy via RATS or VATS for non‐small cell lung cancer. We collected multiple‐time‐point PROs data from the prospective longitudinal study via an ePRO system. Symptom severity and function status were assessed using the perioperative symptom assessment for patients undergoing lung surgery and were analyzed between groups using linear mixed‐effects models. Results: Of the 164 patients, 42 underwent RATS and 122 underwent VATS. After propensity score matching (PSM), 42 RATS and 84 VATS exhibited similar baseline characteristics. During the 7‐day postoperative period, participants underwent RATS reported milder pain (p = 0.014), coughing (p < 0.001), drowsiness (p = 0.001), and distress (p = 0.045) compared with those underwent VATS. Moreover, participants in RATS group showed less functional interference with walking (p < 0.001) and general activity (p < 0.001). RATS exhibited a shorter postoperative hospitalization (p = 0.021) but higher hospital cost (p < 0.001). Meanwhile, short‐term clinical outcomes of operative time, dissected lymph node stations, chest tube drainage, and postoperative complication rates were comparable. Conclusion: PROs are important metrics for assessing patients' recovery after lobectomy. Compared with VATS, RATS may induce less symptom burden and better functional status for patients in the early postoperative period. [ABSTRACT FROM AUTHOR]

Purpose: To investigate early structural and mechanical predictors of plantarflexor muscle strength and the magnitude of Achilles tendon (AT) nonuniform displacement at 6 and 12 months after AT rupture. Methods: Thirty‐five participants (28 males and 7 females; mean ± SD age 41.7 ± 11.1 years) were assessed for isometric plantarflexion maximal voluntary contraction (MVC) and AT nonuniformity at 6 and 12 months after rupture. Structural and mechanical AT and plantarflexor muscle properties were measured at 2 months. Limb asymmetry index (LSI) was calculated for all variables. Multiple linear regression was used with the 6 and 12 month MVC LSI and 12 month AT nonuniformity LSI as dependent variables and AT and plantarflexor muscle properties at 2 months as independent variables. The level of pre‐ and post‐injury sports participation was inquired using Tegner score at 2 and 12 months (scale 0–10, 10 = best possible score). Subjective perception of recovery was assessed with Achilles tendon total rupture score (ATRS) at 12 months (scale 0–100, 100=best possible score). Results: Achilles tendon resting angle (ATRA) symmetry at 2 months predicted MVC symmetry at 6 and 12 months after rupture (β = 2.530, 95% CI 1.041–4.018, adjusted R2 = 0.416, p = 0.002; β = 1.659, 95% CI 0.330–2.988, adjusted R2 = 0.418, p = 0.016, respectively). At 12 months, participants had recovered their pre‐injury level of sports participation (Tegner 6 ± 2 points). The median (IQR) ATRS score was 92 (7) points at 12 months. Conclusion: Greater asymmetry of ATRA in the early recovery phase may be a predictor of plantarflexor muscle strength deficits up to 1 year after rupture. Trial Registration: This research is a part of "nonoperative treatment of Achilles tendon rupture in Central Finland: a prospective cohort study" that has been registered in ClinicalTrials.gov (NCT03704532) [ABSTRACT FROM AUTHOR]

Background: New research in the field of psychological trauma has emphasized (a) the heterogeneity of psychological reactions after traumatic events and (b) the existence of distinct symptom trajectories. Aims: In this study, existing data on post-traumatic stress disorder (PTSD) symptoms in 66 parent-child dyads were re-examined in the light of this literature in order to establish whether a similar pattern of symptom trajectories also applies to this population. Study Design: A prospective observational cohort study. Participants' PTSD symptoms were assessed 3 and 12 months after discharge from a paediatric intensive care unit (PICU), using a short form of the Davidson Trauma Scale with parents and the Child Revised Impact of Events Scale with children aged 7-17 years. Results: Results confirmed that the majority of children (58%) and parents (46%) exhibited a 'Resilient' PTSD trajectory over the year, in the sense that their scores remained in the non-clinical range at both timepoints. Children displaying a 'Resilient' trajectory were more likely to have a parent who also displayed a 'Resilient' trajectory (p = .018). However, there was also evidence of a 'Recovery' trajectory in a significant minority in this sample and over 1 in 4 children and parents exhibited a 'Chronic' or 'Delayed' symptom trajectory. Conclusions: Although average PTSD scores reduced over time in this sample and 'Resilient' trajectories were common, a significant proportion of children and parents exhibited 'Chronic' and 'Delayed' symptom trajectories. Relevance to Clinical Practice: These results suggest that, although the majority do well, a significant number of children and family members may develop chronic or delayed symptoms of PTSD in the year following PICU discharge. The monitoring of individual family members' symptoms beyond 3 months post-discharge may help to determine those who might most benefit from further support. [ABSTRACT FROM AUTHOR]

Background: Treatment of anorexia nervosa (AN) sometimes requires hospitalisation, which is often lengthy, with little ability to predict individual trajectory. Depicting specific profiles of treatment response and their clinical predictors could be beneficial to tailor inpatient management. The aim of this research was to identify clusters of weight recovery during inpatient treatment, and their clinical predictors. Methods: A sample of 181 inpatients who completed a treatment programme for AN was included in a retrospective study. A latent class mixed model approach was used to identify distinct weight‐gain trajectories. Clinical variables were introduced in a multinomial logistic regression model as predictors of the different classes. Results: A four‐class quadratic model was retained, able to correctly classify 63.7% of the cohort. It encompassed a late‐rising, flattening, moderate trajectory of body mass index (BMI) increase (class 1), a late‐rising, steady, high trajectory (class 2), an early‐rising, flattening, high trajectory (class 3) and an early‐rising, steady, high trajectory (class 4). Significant predictors of belonging to a class were baseline BMI (all classes), illness duration (class 2), and benzodiazepine prescription (class 3). Conclusion: Predicting different kinetics of weight recovery based on routinely collected clinical indicators could improve clinician awareness and patient engagement by enabling shared expectations of treatment response. Highlights: Treatment of anorexia nervosa lacks tailored strategies to optimise individual patients' management.Latent class mixed model approach is a promising strategy to analyse treatment response as a dynamic entity.Baseline body mass index, duration of illness and benzodiazepine prescription are significant indicators of distinct weight recovery profiles. [ABSTRACT FROM AUTHOR]

Purpose: Persistent microvascular obstruction (MVO) after successful percutaneous coronary intervention (PCI) in acute ST segment elevation myocardial infarction (STEMI) has been well‐described. MVO predicts lack of recovery of left ventricular function and increased mortality. Sonothrombolysis utilizing diagnostic ultrasound induced cavitation of commercially available microbubble contrast has been effective at reducing infarct size and improving left ventricular ejection fraction (LVEF) when performed both pre‐ and post‐PCI. However, the effectiveness of post‐PCI sonothrombolysis alone after successful PCI has not been demonstrated. Methods: A prospective randomized controlled trial was performed in 50 consecutive consenting patients with anterior STEMI who underwent a continuous microbubble infusion immediately following successful PCI. Intermittent high mechanical index (MI) impulses were applied only in the sonthrombolysis group. Delayed enhancement magnetic resonance imaging (MRI) was performed at 48 h and again at 6–8 weeks to assess for differences in infarct size, LVEF, and MVO. Results: There were no differences between groups in age, gender, and cardiovascular risk factors. Significant (> 2 segments) MVO following successful PCI was observed in 66% of patients. Although sonothrombolysis reduced the extent of MVO acutely, there were no differences in infarct size, LVEF, or extent of MVO by MRI at 48 h. Twenty‐eight patients returned for a follow up MRI at 6–8 weeks. LVEF improved only in the sonothrombolysis group (∆LVEF 7.81 ± 4.57% with sonothrombolysis vs. 1.77 ± 7.02% for low MI only, p =.011). Conclusion: Post‐PCI sonothrombolysis had minimal effect on reducing myocardial infarct size but improved left ventricular systolic function in patients with acute anterior wall STEMI. [ABSTRACT FROM AUTHOR]

Background: Poor sleep quality is associated with multiple factors in cardiac surgery patients. Aim: To examine the trajectory of sleep quality and its associated factors over 3 months in Taiwanese patients undergoing cardiac surgery. Study Design: A longitudinal study. This study enrolled 95 patients undergoing cardiac surgery in northern Taiwan. Sleep quality was measured using the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale before surgery, at discharge, and at 1 month and 3 months postsurgery. Results: The majority of participants reported poor sleep quality before cardiac surgery (76.8%) and at discharge (81.6%), and they showed significant improvements in sleep quality at 1 month (B = −0.93, p =.023) and 3 months postsurgery (B = −1.50, p <.001). Significant daytime sleepiness was reported by 25.3% of patients before cardiac surgery, and this proportion significantly decreased at 3 months postsurgery (B = −2.59, p <.001). The significant predictors of sleep quality in cardiac surgery patients were symptom distress, sleep medications, occupation, left ventricular ejection fraction, ACE‐I drugs and potassium ions, which explained 53.7% of the total variance in sleep quality. Having a nap habit was an independent predictor of daytime sleepiness in cardiac surgery patients, which could explain 3.7% of the total variation. Conclusion: Poor sleep quality was common in patients undergoing cardiac surgery and was associated with multiple factors, including symptom distress, cardiac function, medications, and psychosocial and environmental factors. Relevance to Clinical Practice: Poor sleep quality was observed in cardiac surgical patients before surgery and at discharge postsurgery. Patient education on symptom management, medication adherence and sleep hygiene are suggested to improve sleep quality in patients undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis C virus (HCV)/HIV co‐infection has been identified as a risk for impaired CD4+ T‐cell recovery, possibly mediated by HCV‐induced liver fibrosis and/or immune activation. As HCV direct‐acting antivirals (DAAs) may partially reverse liver fibrosis and immune activation, sustained HCV virological response (SVR) may lead to improved CD4 recovery. We explored the effect of HCV DAA‐induced SVR on CD4 recovery among patients living with both HCV and HIV, including those with poor CD4 recovery on antiretroviral therapy (immunological non‐responders [INRs]). Methods: Subjects aged ≥18 years living with both HIV and HCV who achieved SVR with DAA were included. Pre‐DAA CD4 counts were included only after sustained HIV viral suppression and HIV viral suppression was maintained for the duration of the study. Segmented regression of interrupted time series analysis was used to evaluate changes in median CD4 count in the pre‐DAA period (−36 months) versus the post‐DAA period (+36 months). Results: In total, 156 patients were included. In the full cohort, median CD4 counts increased by 15% (p = 0.002) in the 6‐month period following DAA initiation, whereafter CD4 counts decreased by 2.7% per 6‐month period (p = 0.004). Among the 13 INRs, there was no immediate effect on median CD4 in the first 6 months after DAA initiation, whereafter there was a sustained CD4 increase (4.1% per 6‐month time interval [p = 0.02]). In total, 54% of INRs recorded a post‐DAA CD4 count of >350 cells/mm3. Conclusions: Successful DAA therapy induced a modest immediate CD4 immunological reconstitution among this cohort of patients living with both HIV and HCV, although this effect waned with time. By contrast, among INRs, achieving HCV SVR led to slower but sustained CD4 count recovery. [ABSTRACT FROM AUTHOR]

Preservation and restoration of hand function after burn injuries are challenging yet imperative. This study aimed to assess the curative effect of a composite skin graft over an acellular dermal matrix (ADM) and a thick split‐thickness skin graft (STSG) for treating deep burns on the hand. Patients who met the inclusion criteria at the First Affiliated Hospital of Wenzhou Medical University between September 2011 and January 2020 were retrospectively identified from the operative register. We investigated patient characteristics, time from operation to the start of active motion exercise, take rates of skin graft 7 days post‐surgery, donor site recovery, complications and days to complete healing. Patients were followed up for 12 months to evaluate scar quality using the Vancouver Scar Scale (VSS) and hand function through total active motion (TAM) and the Jebsen–Taylor Hand Function Test (JTHFT). A total of 38 patients (52 hands) who received thin STSG on top of the ADM or thick STSG were included. The location of the donor sites was significantly different between Group A (thick STSG) and Group B (thin STSG + ADM) (p = 0.03). There were no statistical differences in age, gender, underlying disease, cause of burn, burn area, dominant hand, patients with two hands operated on and time from burn to surgery between the two groups (p > 0.05). The time from operation to the start of active motion exercise, take rates of skin graft 7 days post‐surgery and days to complete healing were not significantly different between Group A and Group B (p > 0.05). The rate of donor sites requiring skin grafting was lower in Group B than in Group A (22.2% vs. 100%, p < 0.001). There were no statistically significant differences in complications between the groups (p = 0.12). Moreover, 12 months postoperatively, the pliability subscore in the VSS was significantly lower in Group A than in Group B (p = 0.01). However, there were no statistically significant differences in vascularity (p = 0.42), pigmentation (p = 0.31) and height subscores (p = 0.13). The TAM and JTHFT results revealed no statistically significant differences between the two groups (p = 0.22 and 0.06, respectively). The ADM combined with thin STSG is a valuable approach for treating deep and extensive hand burns with low donor site morbidity. It has a good appearance and function in patients with hand burns, especially in patients with limited donor sites. [ABSTRACT FROM AUTHOR]

While ample research has shown that sport injuries are associated with poor psychological status, scant attention has been given to changes in injured athletes' psychological status over the full course of recovery and return to sport. The aim of the present study was to prospectively investigate potential changes in injured athletes' psychological status across four phases of recovery and return to sport. A total of 38 severely injured adult competitive athletes (58% female; mean age 24.1 ± 7.18 years) participated in this prospective weekly investigation (n = 319 observations). Athletes' were asked to indicate their current phase of recovery or return to sport (acute care, rehabilitation, adapted training, or full return to sport) after which they responded to visual analog scales assessing post‐injury psychological status, including: perceived pain (frequency and intensity), emotions (positive and negative), anxiety (cognitive and physiological), motivation, self‐efficacy, and satisfaction. During the acute care phase, participants showed higher scores of perceived pain, and physiological anxiety compared to the other phases. During the adapted training phase, amotivation was higher than in the acute care phase, and self‐efficacy was lower than in other phases. At full return to sport, athletes showed less perceived pain, cognitive anxiety, and more satisfaction than during other phases. The present study provides a deeper prospective understanding of changes in athlete's psychological status over the course of injury recovery and return to sport and highlight the importance of monitoring psychological status. [ABSTRACT FROM AUTHOR]

The most prevalent form of cardiac arrhythmia is atrial fibrillation (AF), which is typically managed through catheter ablation or anti‐arrhythmic drug therapy. We compared the incidence and outcomes of wound complications in patients with atrial fibrillation who were treated with catheter ablation as opposed to anti‐arrhythmic drug therapy. From May to November 2023, 240 adult AF patients who were treated with catheter ablation or anti‐arrhythmic medications participated in a 6‐month retrospective cohort study at Sir Run Run Shaw Hospital in Hangzhou, China. An observation was made regarding 29 wound complications out of 240 patients. In comparison to drug therapy group, incidence of minor (8 vs. 11) and total complications (18 vs. 11) was greater in catheter ablation group. Significant adverse events occurred at higher rate in the catheter ablation group (6 versus 1) (p < 0.05). However, despite these patterns, there was no statistically significant difference in the rates of complications (total: p = 0.245; minor: p = 0.217; major: p = 0.128). Comparable treatment efficacy was observed across groups. In contrast to drug therapy, catheter ablation was associated with decreased probability of complications (odds ratio: 0.86), as determined by logistic regression; cardiac failure was a significant predictor of adverse outcomes. The study concluded that the risks of wound complications associated with catheter ablation and anti‐arrhythmic drug therapy in patients with atrial fibrillation are comparable. Notwithstanding an elevated propensity for complications in ablation group, the statistical analysis indicated comparable safety profiles. [ABSTRACT FROM AUTHOR]

Background: The enhanced recovery after surgery (ERAS) method is designed for the patient to recover quickly, have less pain and have a more comfortable period after the surgery; that includes preoperative, intra and postoperative processes. ERAS has been started to be applied in cesarean section surgeries as the patients need to recover quickly. In the literature, there is no study about the results of ERAS in cesarean section about pain scores and complications. Objectives: It is aimed to compare the results of cesarean section patients using the ERAS method completely in patients who have had cesarean section without meeting some of the postoperative conditions of the ERAS criteria. Study Design: It is a prospective study designed as postoperative metoclopramide, enema and routine opioids in group 1, enema and metoclopramide in group 2, metoclopramide only in group 3 and nothing in group 4. Postoperative pain scoring was done by using visual analog scale (VAS). Analysis of variance tests and t tests were used for results. Results: There was no difference between groups according to age, parity, and birth weight. As a result, although there was no difference between the groups in terms of discharge time and complications, the VAS score used in pain scoring was found to be significantly lower in group 3 compared to the other groups (p: 0.000). Only metoclopramide group (group 3) had lowest VAS score. Conclusion: It has been revealed that the ERAS procedure does not need to be so detailed in the postoperative period, and the addition of metoclopramide may be sufficient. Since pain can be a subjective factor, other randomized studies are needed in terms of other criteria. [ABSTRACT FROM AUTHOR]

Aim: To analyse the ethical pathway as perceived by individuals with stroke (IwS) in the first three post‐stroke months. In the novel concept of ethical pathway, dignity, privacy, and autonomy are considered as dimensions of the ethical pathway while the pathway illustrates their potential change in the post‐stroke time. Furthermore, the focus of interest was on whether the perceived realisation of values is associated with the life situational factors of symptoms diminishing functioning, social environment, and self‐empowerment. Methodological Design and Justification: A follow‐up study with a descriptive correlational design was used to capture the changes in the perceived realisation of values. Ethical Issues and Approval: The study followed the ethical principles of research involving human participants. The study was approved by the ethics committee of the university and one of the university hospitals following national standards. Permission to conduct the study was obtained from the university hospitals. Research Methods and Instrument: Data were collected from IwS after the onset of stroke and 3 months post‐stroke with the Ethical Pathway of Individuals with Stroke instrument and background questions and were analysed statistically. Results: Thirty‐six participants completed the questionnaire at both measurement points. Wide variety in the ethical pathway was detected. IwS' perceived dignity decreased and autonomy increased. Privacy did not change significantly. Of the life situational factors, IwS perceived less symptoms diminishing functioning and stronger self‐empowerment while social environment was perceived as rather stable. Only one association was detected between the dimensions of the ethical pathway and life situational factors: autonomy had a low negative correlation with social environment of health care professionals. Conclusions and Study Limitations: The results provide preliminary evidence of the dynamic nature of the ethical pathway. The ethical pathway was incompletely realised for most participants and requires special attention and improvement in health care. The sample size is small and the results are therefore not generalisable. [ABSTRACT FROM AUTHOR]

Burn survivors experience profound physiological changes following injury, which may have lasting implications for cardiovascular health. This study aims to investigate the cardiovascular risk profile among burn survivors treated at a burn center in northern Iran. This observational study was conducted from 2022 to 2023 at the burn centre affiliated with Guilan University of Medical Sciences, Rasht, Iran. This study assessed a cohort study of 210 burn survivors, focusing on individuals with ≥20% TBSA burn injuries who had recovered and returned to their daily lives. This study assessed patients' lipid profiles, Framingham General Cardiovascular Risk Score (FGCRS) and risk factors, including demographics, clinical variables and physical activity. Statistical analysis employed descriptive and inferential statistics. The mean age was 49.23 years, and the mean TBSA burned was 37.06%. The risk of cardiovascular disease in 66% of the study population was less than 10%, and in 13%, it was more than 20%. Significant associations were identified between CVD risk and sex, diabetes, hypertension, BMI, TBSA burned, years after burn, physical activity level and LDL. Of the lipid profile measures, LDL, triglycerides and TC/HDL exceeded the desirable levels. This research highlights the heightened cardiovascular risk in burn survivors, emphasizing the necessity for targeted interventions and regular monitoring. Identifying modifiable risk factors enables healthcare practitioners to develop tailored strategies, enhancing cardiovascular health in this vulnerable population and improving overall outcomes and quality of life. [ABSTRACT FROM AUTHOR]

As medical technology continues to evolve, it becomes crucial to distinguish the outcomes of traditional versus modern surgical techniques. This was a retrospective cohort study, conducted to compare the wound infection rates and recovery outcomes between laparoscopic and open surgery (OS) in 180 patients. Participants were divided into laparoscopic (n = 105) and OS (n = 75) groups. Comprehensive data, including demographics, surgical details, and postoperative outcomes, were extracted. Wound infection rates, as measured by Wound Asepsis Score, were prioritized alongside recovery indicators such as duration of hospital stay and postoperative pain. The laparoscopic group had a mean operative time of 57.19 minutes, while the OS group required 85.10 ± 15.18 minutes (p < 0.05). Laparoscopic surgeries resulted in an average blood loss of 120.76 ± 13.3 mL compared to 170.01 ± 17.19 mL for OS (p < 0.05). The laparoscopic group had significantly reduced (p < 0.05) average hospital stays (2.1 ± 1.1 days) than the OS group (4.4 ± 2.1 days). Although the laparoscopic group had lower incidence of surgical site infection (4.76%) than the OS group (9.33%), this difference was not statistically significant (p > 0.05). On postoperative days 1, 3, and 7, the Visual Analog Scale assessment of pain in the laparoscopic group revealed significantly reduced pain (p < 0.05). Laparoscopic surgery appeared to offer distinct advantages over conventional open surgery, especially in terms of operative durations, recovery rates, and postoperative pain management. This study highlighted the potential of laparoscopic approaches for specific surgical interventions, as well as the importance of patient‐specific surgical strategy decision‐making. [ABSTRACT FROM AUTHOR]

Background: The 13C mixed triglyceride breath test (13C MTGT) is a diagnostic test for pancreatic exocrine insufficiency (PEI). It is poorly standardised with much heterogeneity of the test meal, the commonest being toast and butter. A standardised oral nutritional supplement that could be easily transported, stored and made up would be valuable for making this test accessible outside of specialist centres. Methods: A prospective, randomised, two‐arm crossover study of different test meals was carried out in 14 healthy controls. The 13C MTGT was performed in identical conditions on two separate days. Two test meals were given in random order, either standard (toast and butter) or novel (oral nutritional supplement), with 250 mg of 13C‐labelled mixed triglyceride incorporated. Breath samples were taken postprandially to calculate cumulative percentage dose recovery (cPDR) of 13C at 6 h. Results: All 14 participants completed both arms of the study with no protocol deviations. The mean cPDR was 39.39% (standard deviation [SD] 5.19) for the standard test meal and 39.93% (SD 5.20) for the novel test meal. A one‐way repeated measures analysis of variance (ANOVA) found no significant difference in cPDR between the two meals, F(1, 13) = 0.18, p = 0.68 (minimum detectable difference of 0.81 at 80% power). Conclusion: This study demonstrates that a standardised oral nutritional supplement can be used without compromising 13C recovery. Using this test meal provides a standardised dietary stimulus to the pancreas, avoiding possible variation in quantity of dietary components with other test meals. Further, the ease of use of this method would help establish the 13C MTGT test more widely. Highlights: The 13C mixed triglyceride breath test (13C MTGT) is a useful diagnostic test mainly used in specialist centres.Lack of a standardised protocol is a key limitation to more widespread use.The test meal in particular shows much heterogeneity across the literature.A standardised oral nutritional supplement could make the 13C MTGT more versatile and robust.This two‐way, randomised crossover trial showed no difference in cumulative percentage dose recovery (cPDR) with a standardised oral nutritional supplement in comparison to toast and butter.This novel test meal minimises potential for error, negates the need for any kitchen equipment and could make the 13C MTGT more accessible for routine clinical use.Further validation studies in specific patient cohorts are needed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the acceptability, feasibility, and preliminary effectiveness of "SupportED," a novel, online, self‐paced skills‐based program for carers/support people of those with lived and/or living experience of an eating disorder (ED). Method: Carers of a loved one with an ED were invited to undertake a five‐module skills‐based (one core module, four optional modules) online program at their own pace. Modules cover general information about EDs, communication, practical skills, treatment engagement, and recovery. Participants completed demographics and were assessed using EDSIS, CASK, and DASS‐21 for caregiver burden, skills, and distress, respectively, at program completion and 3‐month follow‐up. Feedback on the program and modules was also collected. Results: Most carers (65%; 82/126) completed the core module of the program, which is on par with other online learning programs. Nearly half of program completers responded to the 3‐month follow‐up (n = 39). On average, carers rated the program as relevant and useful and found the information validating and easy to understand, albeit a few carers found the program time‐consuming and technically challenging. Intent‐to‐treat (ITT) linear mixed models demonstrated the preliminary effectiveness of the program for improving carer burden and skills, although the change in carer distress was non‐significant. Conclusions: Results of this case series evaluation suggest SupportED is an acceptable and feasible program for carers and may improve burden and support skill development. Although the online, self‐paced format was highly rated, small improvements to improve acceptability were suggested. Reasons for a lack of impact on carer distress are discussed. Public significance: This article describes a case series evaluation of "SupportED," an online skills‐based support program for families, carers, and supporters of people with lived experience of an eating disorder. This is the first online carer support program that is designed to be inclusive of all carer types (e.g., partners, siblings) for all eating disorder presentations. Findings suggest the program's suitability and helpfulness for reducing carers' load and bolstering skills and knowledge. [ABSTRACT FROM AUTHOR]

Purpose: Up to 50% of patients do not achieve significant left ventricular ejection fraction (LVEF) recovery after primary percutaneous intervention (PPCI) for STEMI. We aimed to identify the echocardiographic predictors for LVEF recovery and assess the value of early follow‐up echocardiography (Echo) in risk assessment of post‐myocardial infarction (MI) patients. Methods: One hundred one STEMI patients undergoing PPCI were enrolled provided EF below 50%. Baseline echocardiography assessed LVEF, volumes, wall motion score index (WMSI), global longitudinal strain (GLS), global circumferential strain (GCS), and E/e'. Follow‐up echocardiography after 6 weeks reassessed left ventricular volumes, LVEF and GLS.GCS was not assessed at follow up. Patients were classified into recovery and non‐recovery groups. Predictors of LVEF recovery and major adverse cardiovascular events (MACE) at 6 months were analysed. Results: The mean change of EF was 8.04 ± 3.32% in group I versus ‐.39 ± 5.09 % in group II (p <.001). Recovered patients had better baseline GLS, baseline GCS, E/e', and follow‐up GLS. Multivariate regression analysis revealed E/e', GCS, and follow‐up GLS after 6 weeks to be strong independent predictors for LVEF recovery. Composite MACE was considerably higher in group II (32.7% vs. 4.1%, p <.001) mainly driven by higher heart failure hospitalisation Multivariate regression analysis revealed baseline GLS, E/e', and ejection fraction (EF) percentage recovery as strong independent predictors for MACE. Conclusions: Multiparametric echocardiographic approach incorporating LVEF, strain parameters, and diastolic function could allow early optimal risk stratification after STEMI treated with PPCI. Follow‐up GLS and LVEF percentage change are the strongest predictors for early LV recovery and long term clinical outcome, respectively. [ABSTRACT FROM AUTHOR]

Traumatic osteomyelitis with accompanying soft tissue defects presents a significant therapeutic challenge. This prospective, randomised controlled trial aims to evaluate the efficacy of antibiotic‐impregnated bone cement, flap coverage and negative pressure sealed irrigation in the management of traumatic osteomyelitis complicated by soft tissue defects. A total of 46 patients with clinically diagnosed traumatic osteomyelitis and soft tissue defects were randomised into a control group (n = 23) and an observation group (n = 23). The control group underwent standard flap coverage and negative‐pressure lavage, while the observation group received an additional treatment with antibiotic‐loaded bone cement. Efficacy was measured based on clinical criteria, surgical metrics and morphometric assessment of bone and soft tissue defects. Statistical analyses were performed using SPSS version 27.0. The observation group, treated with an integrated approach of flap coverage, negative pressure wound therapy (NPWT) and antibiotic‐impregnated bone cement, demonstrated significantly higher overall treatment efficacy (91.3%) compared to the control group, which received only flap coverage and NPWT (65.2%) (p < 0.01). This enhanced efficacy was evidenced through various outcomes: the observation group experienced reduced surgical times, shorter hospital stays, fewer dressing changes and accelerated wound healing, all statistically significant (p < 0.001). Additionally, a quantitative analysis at 6‐month post‐treatment revealed that the observation group showed more substantial reductions in both bone and soft tissue defect sizes compared to the control group (p < 0.001). The multi‐modal treatment strategy, combining skin flap coverage, antibiotic bone cement and negative‐pressure irrigation, showed marked efficacy in treating traumatic osteomyelitis and associated soft tissue defects. This approach accelerated postoperative recovery and lowered costs. [ABSTRACT FROM AUTHOR]

Background: Pilonidal sinus disease (PSD), a chronic inflammatory disease, affects the sacrococcygeal soft tissue, especially in young adults. The ideal treatment for PSD remains divergence. This study evaluated the application of a simplified modified Limberg flap combined with vacuum‐assisted closure for treating PSD. Methods: This prospective study was conducted from 1 June 2017 to 31 March 2022 in Changhai Hospital, Naval Military Medical University, Shanghai, China. The study included 88 male patients (91.7%) and 8 female patients (8.3%). The 96 patients ranged in age from 15 to 34 years (mean ± SD, 23 ± 4.4). Under general anaesthesia, all patients underwent simplified modified Limberg flap reconstruction with vacuum‐assisted closure. The patient's weight, surgical time, extubation time, hospital stay, time to return to normal life or work, wound infection, wound dehiscence and recurrence rate were recorded. The visual analogue scale (VAS) score and the Vancouver scar score were used to score patients' pain and scars in the surgical area. Results: The volume of resected diseased tissue was 13.5–120 (mean ± SD, 34.993 ± 24.406) cm2. The average surgical time during the treatment period was 97.68 ± 18.72 min, and the average extubation time was (6.36 ± 1.55) days, the mean hospital stay was 19.4 days; no patients were lost to follow‐up. None of the patients experienced post‐operative recurrence, wound infection, seroma or hematoma. Six patients (6.3%) experienced wound dehiscence at the flap tip around the natal cleft. The mean time to the resumption of daily activities was 26.3 days. The average VAS pain score was (6.00 ± 1.53) points, and the average Vancouver scar score was (5.96 ± 1.51) points, 12 patients (12.5%) were dissatisfied with their aesthetic results, and the average beauty satisfaction score is (6.64 ± 1.28) points. Conclusions: Simplified modified Limberg flap reconstruction with vacuum‐assisted closure surgery is an effective and innovative method for the treatment of PSD, with a low recurrence rate and rapid recovery. [ABSTRACT FROM AUTHOR]

Summary: We conducted a prospective observational service evaluation across the United Kingdom on the use of total intravenous anaesthesia (TIVA) for obstetric surgery between November 2022 and June 2023. The primary aim was to describe the incidence of TIVA for obstetric surgery within participating units, with secondary aims to describe maternal and neonatal postoperative recovery indicators. Of 184 maternity units in the United Kingdom, 30 (16%) contributed data to the service evaluation. There were 104 patients who underwent caesarean delivery under TIVA and 19 patients had TIVA for other reasons. Infusions of propofol and remifentanil were used in 100% and 84% of cases, respectively. Fifty‐nine out of 103 live neonates (57%) required some form of respiratory support. Of the neonates with recorded data, 73% and 17% had Apgar scores < 7 at 1 and 5 min respectively. No neonates were recorded to have Apgar scores < 7 at 10 min. Further prospective research is required to investigate the impact of obstetric TIVA on maternal and neonatal outcomes and inform best practice recommendations. [ABSTRACT FROM AUTHOR]

Background and Purpose: Studies that analyze gait without physical assistance recovery post‐stroke are scarce. There are few of the studies that analyze longitudinally the recovery of balance during the subacute post‐stroke inpatient rehabilitation. The aim of the study was to analyze the association between balance recovery during subacute stroke inpatient rehabilitation and gait without physical assistance achievement. Secondarily, to analyze the association between balance at admission of inpatient rehabilitation and gait without physical assistance achievement. Methods: An observational, longitudinal, and retrospective cohort study was conducted. Subacute stroke subjects with an admission Berg Balance Scale below or equal to 4 points were included (n = 164). Two logistic regression models were developed. Model 1 analyzes the association between balance recovery during inpatient rehabilitation and gait without physical assistance at discharge. Model 2 analyzes the association between balance at the admission and gait without physical assistance at discharge. Results: Of 164 severe post‐stroke patients, 60 (36.5%) achieved gait without physical assistance. Although the two models developed a statistically significant association (p < 0.001), Model 1 evinced better discrimination performance (Model 1: area below the curve was of 0.987 ‐CI 95%: 0.975–0.998‐ vs. Model 2: area below the curve 2 was of 0.705 ‐CI 95%: 0.789–0.601‐). Discussion: Balance recovery during rehabilitation was strongly associated with gait without physical assistance achievement at the time of discharge in severe subacute post‐stroke patients. Implications for Physiotherapy Practice: The longitudinal analysis of motor recovery in severe subacute post‐stroke patients may be helpful in the decision making process during inpatient rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Males constitute 25% of older adults who experience hip fractures in the United States; a concerning upward trend given poorer health and outcomes among male survivors. Male sex is associated with worse cognitive performance after hip fracture, impacting participation in rehabilitation and long‐term outcomes especially for those with Alzheimer's disease or related dementias (ADRD). However, little research has evaluated whether sex differences in post‐fracture recovery are greater among those living with ADRD. Methods: Data were drawn from 2010 to 2017 Medicare fee‐for‐service beneficiaries aged 65 years and older who survived hospitalization for hip fracture (n = 69,581). The primary outcome was days alive and at home (DAAH), a validated patient‐centered claims‐based outcome calculated as 365 days from fracture minus days in hospital, nursing home, rehabilitation facility, emergency department, or time after death. Multivariable Poisson regressions with an interaction term between sex and ADRD status were to model the association between DAAH and ADRD in the 12 months post hip fracture, adjusting for demographics, injury severity, chronic disease burden, and hospital‐level fixed effects. Results: Compared to females, males were younger and had more comorbidities at the time of fracture. Among survivors, males with ADRD spent a mean of 160.7 DAAH compared to 228.4 for males without ADRD, 177.8 for females with ADRD, and 248.0 for females without ADRD. In adjusted analyses, males without ADRD spent 8.2% fewer DAAH compared to females (rate ratio [RR] = 0.92, 95% CI 0.92–0.92). This relative sex difference increased significantly when comparing those living with ADRD, with males spending an additional 3.3% fewer DAAH (interaction RR = 0.96, 95% CI 0.96–0.97). Conclusions: Males spend fewer DAAH after hip fracture than females, and this difference increases modestly for males living with ADRD compared to females. This suggests that cognitive impairment may be a small but significant contributor to sex‐based differences observed during hip fracture recovery. [ABSTRACT FROM AUTHOR]

Background: Participating in exercise following a stroke is essential for recovery. When community‐based rehabilitation services end, some people struggle to remain active. We codesigned Keeping Active with Texting After Stroke (KATS), a text message intervention to support home‐based, self‐directed plans to continue exercising. KATS delivers a series of automated text messages over a 12‐week period from the point of discharge from National Health Service‐funded therapy. The aim of this study was to explore the views and experiences of the first cohort of participants to complete the KATS intervention about the meaning, engagement, workability and worth of the intervention. Methods: We undertook a qualitative study, theoretically informed by Normalisation Process Theory. We conducted semi‐structured telephone interviews with people with stroke from two Health Boards in Scotland. Data collection took place over two phases, with each participant being interviewed twice: first, halfway through intervention delivery (Week 6) and then again at the end of the intervention (Week 12). All interviews were audio‐recorded, transcribed and analysed thematically. Results: A total of 24 interviews were conducted with 12 participants. Our findings were organised around four overarching analytical themes: (1) making sense of KATS: timing and complementarity in the rehabilitation journey; (2) engaging with KATS: connection and identification with others; (3) making KATS work: flexibility and tailorable guidance; (4) appraising the worth of KATS: encouragement and friendliness. Participants differentiated KATS from current rehabilitation practice, finding it relevant, fitting and worthwhile. Variations were reported in engagement with behaviour change techniques, but participants were able to tailor KATS use, making it work for them in different ways. Conclusions: Perceived benefits went beyond promoting physical activity, including feeling supported and connected. Future research will test the effectiveness of KATS in promoting physical activity and explore any associations with relevant social and emotional secondary outcomes. Patient or Public Contribution: A research funding proposal was developed in collaboration with five people with stroke and three spouses. After securing funding, six people with stroke were invited to join the project's Collaborative Working Group, alongside health professionals and stroke rehabilitation experts, to codevelop the intervention and support the feasibility study. [ABSTRACT FROM AUTHOR]

The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is associated with increasing exposure to multiple stressors and declining capacity to respond to health stressors. Resilience is defined broadly as the ability to resist or recover well from the adverse effects of a health stressor. In ageing‐related study designs of physical resilience after a health stressor, this dynamic resilience response can be observed as changes in repeated measures of function or health status in various domains important to older adults. Methodologic issues in selecting the study population, defining the stressor, covariates, outcomes, and analytic strategies are highlighted in the context of an ongoing prospective cohort study of physical resilience after total knee replacement surgery. The article concludes with approaches to intervention development to optimize resilience. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the optimal range of quantitative ablation index (AI) value during superior vena cava (SVC) electrical isolation by radiofrequency catheter ablation (RFCA). Methods: First, in a development cohort of patients with atrial fibrillation (AF), the RFCA with 40 W was performed to complete SVC isolation guided by the conduction breakthrough point from the right atrium to SVC. Then, the range of AI value was calculated by offline analysis on different segments of SVC. Lastly, for the validation of AF patients, the safety and effectiveness of SVC isolation with the optimized target range of AI value were evaluated with an additional adenosine test. Results: A total of 101 patients with AF were included in the study (44 patients in the development cohort/57 in the validation cohort). The segmental ablation strategy was applied in 70% of the patients. According to the offline analysis of the AI values in the development cohort, the target AI value range was set as 350–400. The success rate of SVC isolation in the validation cohort was significantly higher than that in the exploration cohort (100% vs. 90.9%, p =.02), and no complications occurred in the exploration cohort. During the adenosine test, the recovery rate of electrical conduction in SVC was significantly lower than that in the pulmonary vein (3.5% vs. 17.5%). Conclusion: The target AI value with a range from 350 to 400 is safe and effective for high‐power RFCA to complete SVC isolation. [ABSTRACT FROM AUTHOR]

Aim: The effects of statins on muscle health are not well established. Therefore, this study investigated the impact of statin use on muscle strength and mass recovery in patients with sarcopenia after stroke. Methods: This retrospective cohort study included stroke patients with sarcopenia hospitalized between 2015 and 2021 at a post‐acute rehabilitation hospital. Sarcopenia was diagnosed using handgrip strength and skeletal muscle mass index measured using bioelectrical impedance analysis according to the 2019 criteria of the Asian Working Group for Sarcopenia. The study outcomes included handgrip strength and skeletal muscle mass index at hospital discharge. We used multivariate analyses to examine whether statin use was independently associated with the outcomes. Statistical significance was set at P < 0.05. Results: Of the 586 patients enrolled, 241 (mean age 79.3 years, 44.4% men) presented with sarcopenia and were included in the analysis. Statin use was observed in 61 (25.3%) patients. Statin use was independently negatively associated with handgrip strength at discharge (β = −0.095, P = 0.032), but not with skeletal muscle mass index at discharge (β = 0.019, P = 0.692). Conclusions: Statin use was negatively associated with muscle strength recovery, but not with muscle mass in patients with sarcopenia who underwent rehabilitation after stroke. To maximize outcomes, sufficient consideration is needed for statin use in these patients. Geriatr Gerontol Int 2023; 23: 676–683. [ABSTRACT FROM AUTHOR]

Background: There is mixed evidence on whether living arrangements and social interactions are associated with poorer health outcomes after hip fracture repair. Distinct social profiles among male and female older adults may explain some of the differences. However, prior studies did not evaluate these differences by sex. This article aims to assess if the associations between living alone, social interaction, and physical performance differ by sex among hip fracture survivors. Methods: This prospective cohort study is part of the Baltimore Hip Studies seventh cohort, with 168 male and 171 female hip fracture patients assessed at baseline (≤22 days after hospitalization) and at 2, 6, and 12 months post admission. Living arrangements and interaction with children or siblings and others in the past 2 weeks were collected at all visits. Physical performance was measured in the follow‐up visits with the Short Physical Performance Battery (SPPB). Linear mixed models tested associations of living alone and social interaction with SPPB over time adjusted for age, education, comorbidities, physical functioning pre‐fracture, cognitive function, self‐rated health, and time. Results: For men only, living alone was associated with worse performance (0.7 points lower SPPB scores, p = 0.05). Higher social interaction was associated with 0.8 and 1.2 point higher SPPB scores for men and women, respectively (p < 0.05). Visiting with friends was significantly associated with better function among males, while visiting with children or siblings was associated with worse SPPB among females. Conclusions: Living arrangements and types of social interaction are differentially associated with physical function for older men and women. Screening for social isolation/integration and including interventions that promote social interaction and participation should be considered in healthcare programs for hip fracture survivors. [ABSTRACT FROM AUTHOR]

Background: Discourse analysis has recently received much attention in the aphasia literature. Even if post‐stroke language recovery occurs throughout the longitudinal continuum of recovery, very few studies have documented discourse changes from the hyperacute to the chronic phases of recovery. Aims: To document a multilevel analysis of discourse changes from the hyperacute phase to the chronic phase of post‐stroke recovery using a series of single cases study designs. Methods & Procedures: Four people with mild to moderate post‐stroke aphasia underwent four assessments (hyperacute: 0–24 h; acute: 24–72 h; subacute: 7–14 days; and chronic: 6–12 months post‐onset). Three discourse tasks were performed at each time point: a picture description, a personal narrative and a story retelling. Multilevel changes in terms of macro‐ and microstructural aspects were analysed. The results of each discourse task were combined for each time point. Individual effect sizes were computed to evaluate the relative strength of changes in an early and a late recovery time frame. Outcomes & Results: Macrostructural results revealed improvements throughout the recovery continuum in terms of coherence and thematic efficiency. Also, the microstructural results demonstrated linguistic output improvement for three out of four participants. Namely, lexical diversity and the number of correct information units/min showed a greater gain in the early compared with the late recovery phase. Conclusions & Implications: This study highlights the importance of investigating all discourse processing levels as the longitudinal changes in discourse operate differently at each phase of recovery. Overall results support future longitudinal discourse investigation in people with post‐stroke aphasia. What This Paper Adds: What is already known on the subject: Multi‐level discourse analysis allows for in‐depth analysis of underlying discourse processes. To date, very little is known on the longitudinal discourse changes from aphasia onset through to the chronic stage of recovery. This study documents multi‐level discourse features in four people with mild to moderate aphasia in the hyperacute, acute, subacute and chronic stage of post‐stroke aphasia recovery. What this paper adds to existing knowledge: The study found that most discourse variables demonstrated improvement throughout time. Macrostructural variables of coherence and thematic units improved throughout the continuum whereas microstructural variables demonstrated greater gains in the early compared to the late period of recovery. What are the potential or actual clinical implications of this work?: This study suggests that multilevel discourse analysis will allow a better understanding of post‐stroke aphasia recovery, although more research is needed to determine the clinical utility of these findings. Future research may wish to investigate longitudinal discourse recovery in a larger sample of people with aphasia with heterogenous aphasia profiles and severities. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular sequelae may occur in patients recovered from coronavirus disease 2019 (COVID‐19). Recent studies have detected a considerable incidence of subclinical myocardial dysfunction—assessed with speckle‐tracking echocardiography—and of long‐COVID symptoms in these patients. This study aimed to define the long‐term prognostic role of subclinical myocardial dysfunction and long‐COVID condition in patients recovered from COVID‐19 pneumonia. Methods: We prospectively followed up 110 patients hospitalized at our institution due to COVID‐19 pneumonia in April 2020 and then recovered from SARS‐CoV‐2 infection. A 7‐month clinical and echocardiographic evaluation was performed, followed by a 21‐month clinical follow‐up. The primary outcome was major adverse cardiovascular events (MACE), a composite of myocardial infarction, stroke, heart failure hospitalization, and all‐cause mortality. Results: A subclinical myocardial dysfunction—defined as an impairment of left ventricular global longitudinal strain (≥−18%)—was identified at a 7‐month follow‐up in 37 patients (34%), was associated with an increased risk of long‐term MACE with a good discriminative power (area under the curve:.73) and resulted in a strong independent predictor of extended MACE in multivariate regression analyses. Long‐COVID condition was not associated with a worse long‐term prognosis, instead. Conclusions: In patients recovered from COVID‐19 pneumonia, a subclinical myocardial dysfunction is present in one‐third of the whole population at 7‐month follow‐up and is associated with a higher risk of MACE at long‐term follow‐up. Speckle‐tracking echocardiography is a promising tool to optimize the risk‐stratification in patients recovered from COVID‐19 pneumonia, while the definition of a long‐COVID condition has no prognostic relevance. [ABSTRACT FROM AUTHOR]

Objective: Investigate the economic consequences of injuries to female Australian footballers from a health sector and societal perspective. Methods: This prospective observational study invited 242 females to complete an online questionnaire 3–6 months following an Australian football injury which involved presentation to an ED in Victoria, Australia. The questionnaire inquired regarding healthcare use, time off work, return to playing football and extent of recovery following injury. Relevant information was also extracted from respondents' medical records regarding injury‐type, body part injured, investigations and treatments. Healthcare costs were determined for each respondent's ED presentation, hospital admission/s (when relevant), and subsequent healthcare use. Societal costs were determined as lost income to the respondent and/or carer. Results: A total of 108 people responded to the questionnaire. Sprains/strains and fractures accounted for 84.2% of respondents' injuries. Sixteen respondents (14.8%) required admission to hospital at the time of injury and 81 (75.0%) required subsequent healthcare appointments following discharge from the ED or hospital. Time off work or school following the injury was common (64.8% of respondents) and 27.8% of respondents had a carer take time off work. More than 80% of respondents missed training and matches following the injury. The median healthcare cost per respondent was AUD$753 and the median cost due to work absence was AUD$1393. One‐quarter of respondents reported a full recovery. Conclusions: Injuries to female Australian footballers can produce substantial healthcare and societal costs, which has important implications for healthcare provision and prioritising and implementing injury prevention programmes and post‐injury rehabilitation. [ABSTRACT FROM AUTHOR]

Background and Aims: Limited information exists regarding individual subgroups of recovery from opioid use disorder (OUD) following treatment and how these subgroups may relate to recovery trajectories. We used multi‐dimensional criteria to identify OUD recovery subgroups and longitudinal transitions across subgroups. Design, Setting and Participants: In a national longitudinal observational study in the United States, individuals who previously participated in a clinical trial for subcutaneous buprenorphine injections for treatment of OUD were enrolled and followed for an average of 4.2 years after participation in the clinical trial. Measurements: We identified recovery subgroups based on psychosocial outcomes including depression, opioid withdrawal and pain. We compared opioid use, treatment utilization and quality of life among these subgroups. Findings Three dimensions of the recovery process were identified: depression, opioid withdrawal and pain. Using these three dimensions, participants were classified into four recovery subgroups: high‐functioning (minimal depression, mild withdrawal and no/mild pain), pain/physical health (minimal depression, mild withdrawal and moderate pain), depression (moderate depression, mild withdrawal and mild/moderate pain) and low‐functioning (moderate/severe withdrawal, moderate depression and moderate/severe pain). Significant differences among subgroups were observed for DSM‐5 criteria (P < 0.001) and remission status (P < 0.001), as well as with opioid use (P < 0.001), treatment utilization (P < 0.001) and quality of life domains (physical health, psychological, environment and social relationships; Ps < 0.001, Cohen's fs ≥ 0.62). Recovery subgroup assignments were dynamic, with individuals transitioning across subgroups during the observational period. Moreover, the initial recovery subgroup assignment was minimally predictive of long‐term outcomes. Conclusions: There appear to be four distinct subgroups among individuals in recovery from OUD. Recovery subgroup assignments are dynamic and predictive of contemporaneous, but not long‐term, substance use, substance use treatment utilization or quality of life outcomes. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, a reduction in the life expectancy gap between people living with HIV (PLWH) and the general population has been observed, irrespective of CD4 lymphocyte count, due to widespread access to antiretroviral treatment. The increase in the life expectancy of PLWH has increased awareness of both the ageing process and gender discrepancies in immune restoration and survival. Materials and Methods: Longitudinal data were collected for 2240 patients followed up at the Hospital for Infectious Diseases in Warsaw, Poland (n = 1482), and the Department of Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, Poland (n = 758). Immune restoration was measured from the time of starting combination antiretroviral therapy until achieving 500 CD4 lymphocytes/μL, 800 CD4 lymphocytes/μL, and CD4/CD8 lymphocyte ratios of > 0.8 and > 1.0. Full recovery was achieved when the patient was restored to both 800 CD4 lymphocytes/μL and a CD4/CD8 lymphocyte ratio > 1.0. Results: For all endpoints, immune restoration had a protective effect by reducing mortality. Patients who achieved immune restoration had a greater chance of reduced mortality than those who did not achieve immune restoration: for CD4 count > 500 cells/μL, HR = 5.4 (interquartile range: 3.09–9.41), p < 0.001; for CD4 > 800 cells/μL, HR = 5.37 (2.52–11.43), p < 0.001; for CD4/CD8 ratio > 0.8, HR = 3.16 (1.81–5.51), p < 0.001; for CD4/CD8 ratio > 1.0, HR = 2.67 (1.49–5.24), p = 0.001, and for full immune recovery, HR = 3.62 (1.63–8.04), p = 0.002. Conclusions: Immune restoration remains a powerful factor in improving the survival of PLWH, regardless of the speed of recovery. [ABSTRACT FROM AUTHOR]

Introduction: Occupation‐based groups are used in inpatient rehabilitation to enhance delivery and intensity of intervention; however, little research is available to understand their effectiveness. The aim of this study was to examine the process of an occupation‐based group to understand mechanisms and success factors. Methods: A mixed methods process evaluation using an evidence‐based framework guided implementation and analysis. Participants were those involved in the 'LifeSkills' group run daily in an adult inpatient general rehabilitation ward. Quantitative administrative data, goal achievement outcome measures, group observations and qualitative semistructured interviews were conducted. Results: Thirty participants were recruited. Factors for success included consistency in group structure and support, using meaningful practise opportunities and facilitating a real‐world experience. There was no significant relationship between patient outcomes and dose of training or patient demographics. Conclusion: This evaluation contributes to a growing body of evidence for incorporating occupation‐based approaches into rehabilitation and offers insights into practice implementation. [ABSTRACT FROM AUTHOR]

Background: In Canterbury, near complete identification of coronavirus disease 2019 (COVID‐19) cases during a limited outbreak provides unique insights into sequelae. Aims: The current study aimed to measure symptom persistence, time to return to normal activity, generalised anxiety and health‐related quality of life (HrQoL) among COVID‐19 survivors compared with uninfected participants. Methods: The authors conducted a prospective cohort study of people tested for COVID‐19 by reverse transcriptase polymerase chain reaction of nasopharyngeal swabs from 1 March to 30 June 2020. They enrolled participants who tested positive and negative at a 1:2 ratio, and administered community‐acquired pneumonia, 7‐item generalised anxiety disorder (GAD‐7) and HrQoL (RAND‐36) questionnaires. Results: The authors recruited 145 participants, 48 with COVID‐19 and 97 without COVID‐19. The mean time from COVID‐19 testing to completing the health questionnaire was 306 days. The mean age of patients was 46.7 years, and 70% were women. Four (8%) COVID‐19–positive and eight (8%) COVID‐19–negative participants required hospitalisation. Fatigue (30/48 [63%] vs 13/97 [13%]; P < 0.001), dyspnoea (13/48 [27%] vs 6/97 [6%]; P < 0.001) and chest pain (10/48 [21%] vs 1/97 [1%]; P < 0.001) were persistent in those with COVID‐19. Fewer COVID‐19–positive participants returned to normal activity levels (35/48 [73%] vs 94/97 97%; P < 0.001), with longer times taken (median 21 vs 14 days; P = 0.007). The GAD‐7 and RAND‐36 scores of both groups were similar across all anxiety and HrQoL subscales. Conclusions: Persistent symptoms and longer recovery times were found in COVID‐19 survivors, but not impaired generalised anxiety levels or HrQoL compared with COVID‐19–uninfected participants. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the processes involved in a guided self‐help (GSH) pre‐treatment intervention (RecoveryMANTRA) for patients with anorexia nervosa (AN), by measuring the levels of patient/mentor Language Style Matching (LSM). RecoveryMANTRA was supported by student mentors or peer mentors (recovered individuals) over six weekly chat‐based sessions. We examined whether LSM during RecoveryMANTRA predicted patients'working alliance with the clinic therapist, motivation, eating disorder (ED) and general psychopathology. A further aim was to examine differences in LSM between student mentors and peer mentors. Method: 87 AN adults received RecoveryMANTRA plus treatment as usual. The LSM algorithm was used to calculate verbal attunement between patient and mentor. Participants were assessed at baseline and at the end of the intervention. Results: Both early (1st session) and late (6th session) LSM predicted higher working alliance with the clinic therapist. Moreover, late LSM predicted lower EDs symptoms at the end of the RecoveryMANTRA intervention. Patient/peer mentor dyads showed higher late verbal attunement than patient/student mentor dyads. Conclusions: These findings suggests that in the early phase of treatment relational aspects can impact on engagement with treatment. Verbal attunement in a GSH for AN is associated with working alliance and better clinical outcome. Highlights: Language Style Matching (LSM) between patients and mentors in both the early and late phase of the RecoveryMANTRA intervention predicted higher working alliance with the clinic therapist.LSM in the last phase (6th session) was associated with lower eating disorders (EDs) symptoms at the end of the RecoveryMANTRA intervention.Patients/peer mentors dyads showed higher late LSM than patients/student mentors dyads. [ABSTRACT FROM AUTHOR]

Objective: Cardiac involvement in recovered COVID‐19 patients assessed by cardiac magnetic resonance imaging (MRI). Methods: Subjects recently recovered from COVID‐19 and with an abnormal left ventricular global longitudinal strain were enrolled. Cardiac MRI in all the enrolled subjects was done at baseline (within 30–90 days following recovery from COVID‐19) with a follow‐up scan at 6 months in individuals with an abnormal baseline scan. Additionally, 20 age‐and sex‐matched individuals were enrolled as healthy controls (HCs). Results: All the 30 enrolled subjects were symptomatic during active COVID‐19 disease and were categorized as mild: 11 (36.7%), moderate: 6 (20%), and severe: 13 (43.3%). Of the 30 patients, 16 (53.3%) had abnormal CMR findings. Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) had late gadolinium enhancement (LGE). No difference was observed in terms of conventional left ventricular (LV) parameters; however, COVID‐19‐recovered patients had significantly lower right ventricular (RV) ejection fraction, RV stroke volume, and RV cardiac index compared to HCs. Follow‐up scan was abnormal in 4/16 (25%) with LGE persisting in three patients (who had severe COVID‐19 [3/4;75%]). Subjects with severe COVID‐19 had a greater frequency of LGE (53.8%) and myocardial edema (61.5%) as compared to mild and moderate cases. Myocardial T1 (1284 ± 43.8 ms vs. 1147.6 ± 68.4 ms; p <.0001) and T2 values (50.8 ± 16.7 ms vs. 42.6 ± 3.6 ms; p =.04) were significantly higher in post COVID‐19 subjects compared to HCs. Similarly, T1 and T2 values of severe COVID‐19 patients were significantly higher compared to mild and moderate cases. Conclusions: An abnormal CMR was seen in half of the recovered patients with persistent abnormality in one‐fourth at 6 months. Our study suggests a need for closer follow‐up among recovered subjects in order to evaluate for long‐term cardiovascular sequelae. COVID‐19 causes structural changes in the myocardium in a small segment of patients with partial spontaneous resolution. [ABSTRACT FROM AUTHOR]

Aim: In sarcopenic dysphagia, confirmation of recovery of the swallowing function and activity of daily living is insufficient. The aim of this study was to examine differences in the recovery of the swallowing function and activities of daily living between sarcopenic dysphagia patients and non‐sarcopenic dysphagia patients. Methods: The registry data of the Japanese Sarcopenic Dysphagia Database were used for the analysis; 440 patients met the eligibility criteria of the study. Dysphagia was evaluated according to the Food Intake Level Scale and a five‐step diagnostic algorithm for the disorder. Patients were divided into two groups according to the presence or absence of sarcopenic dysphagia. Results: Sarcopenic dysphagia was found in 268 cases (60.9%). The rate of improvement in the Food Intake Level Scale was 47.4% in sarcopenic dysphagia patients and 62.2% in non‐sarcopenic dysphagia patients. The rate of improvement in the Food Intake Level Scale was lower in the sarcopenic dysphagia patients (P = 0.008). A multiple regression analysis showed that the presence of sarcopenic dysphagia had a significant influence on changes in the Food Intake Level Scale and Barthel Index (β = −0.191, 95% confidence interval, −1.484 to −0.530, P < 0.001, β = 0.112, 95% confidence interval, 0.587 to 10.450, P = 0.028). Conclusion: Improvement in the swallowing function was poor in patients with sarcopenic dysphagia. Sarcopenic dysphagia should be examined to improve swallowing function. Geriatr Gerontol Int 2022; 22: 839–845. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of oral carbohydrate at 2 h before elective cesarean section on postoperative recovery indicators such as the time to colostrum and vaginal bleeding. Methods: Women undergoing elective cesarean section under spinal‐epidural anesthesia, aged 20–40 years, with a body mass index (BMI) of 19–30 kg/m2 and an American Society of Anesthesiology (ASA) score of II were randomized to the oral carbohydrate group (the OC group), the oral placebo group (the OP group), or the control group (the C group). The OC group underwent oral carbohydrate preloading (300 mL/bottle), the OP group orally consumed 300 mL of distilled water, and the C group was forbidden from drinking or eating on the day of the operation. The time to colostrum, vaginal bleeding, time to exhaust, and complications were recorded. Results: A total of 38 participants in the OC group, 37 in the OP group, and 37 in the C group completed the study. Compared with the OP group and the C group, the OC group produced colostrum significantly earlier, had a lower amount of 24‐h vaginal bleeding, and had a higher 24‐h consumption of analgesics. Compared with OP and OC groups, the C group took longer to exhaust. No significant intergroup difference was observed for any other indicator. Conclusion: Oral carbohydrates loading 2 h before elective cesarean section significantly reduces the time to produce colostrum and the amount of vaginal bleeding, which contributes to postoperative recovery. [ABSTRACT FROM AUTHOR]

Aim: Prolonged diaper dermatitis may increase the risk of atopic dermatitis or infections. This prospective observational study aimed to investigate the prevalence, symptoms, areas, and recovery time of diaper dermatitis in infants aged 1 month and identify the factors related to recovery time. Methods: Diaper dermatitis was defined as the presence of erythema, papules, dryness, erosion, or ulceration in the diapered area. Recovery time was days between infant's 1‐month medical check‐up and disappearance of symptoms. Survival analysis was performed using the Kaplan–Meier method, and the log‐rank test was used to identify the factors related to recovery time. Results: Among 113 infants, 66 (58.4%) had diaper dermatitis, with erythema at the perianal area being the most common symptom. The median recovery time was 10 days. Four infants (6.1%) had diaper dermatitis for >5 weeks. Severity was not related to recovery time. Conclusions: A frequency of diaper changing of ≤10 times per day was a risk factor for recovery time. Our data showed recovery in approximately 10 days, regardless of severity at study enrollment. Health care professionals could inform parents of recovery time and recommended diaper changing frequency. [ABSTRACT FROM AUTHOR]

In this trial, we evaluated the role of alginate dressings in the secondary intention wound healing and quality of life (QoL) after pilonidal sinus resection. The study was designed as a prospective randomised controlled trial (RCT). In the experimental group, alginate dressings with silver and high‐G cellulose were introduced after elective pilonidal cyst excision, whereas in the control group, simple gauges were used. The primary end point was the difference in terms of the wound healing period. Blinding existed at the level of the investigator. Overall, 65 patients were included during the study period. Wound healing duration was comparable between the two groups (P =.381). No difference in postoperative pain scores or recovery outcomes was found. The experimental group was associated with reduced wound secretions at specific time end points. Similarly, no effect was identified, on overall Wound‐QoL or SF‐36 scores. Alginate dressings do not accelerate wound healing or improve QoL. Due to suboptimal sample size and several study limitations, further RCTs are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Aim: The Kihon Checklist (KCL) is used to assess frailty in daily life. We aimed to identify KCL items associated with the development of frailty and recovery to robust status during the COVID‐19 pandemic. Methods: We conducted a 1‐year prospective cohort study of community‐dwelling adults aged 70 and 75 years in Otawara City, Tochigi Prefecture, Japan. Information regarding age, sex, presence of disease and KCL items was collected in May 2020 (baseline) and June 2021 (follow‐up) using a mailed questionnaire. Changes in frailty status as determined by the KCL at baseline and follow‐up were evaluated. To clarify factors related to changes in the frailty status, we conducted two sets of binomial logistic regression analyses with the presence/absence of development of frailty and presence/absence of recovery to robust status at follow‐up as the dependent variables and the KCL items as the independent variables. Results: The analysis included 716 participants who provided complete responses to both questionnaires. The KCL Items 6, 10, 20, 23 and 24 were related to the development of frailty, and the KCL Items 6, 15, 21 and 23 were associated with the recovery to robust status. Conclusions: The baseline KCL items regarding physical function and associated mental aspects were related to both development of frailty and recovery to robust status during the COVID‐19 pandemic. Cognitive and depressive declines were associated with the development of frailty, while good oral environment and sense of fulfillment in life were associated with the recovery to robust status. Geriatr Gerontol Int 2022; 22: 745–752. [ABSTRACT FROM AUTHOR]

There is growing interest in psychological factors maintaining healthy functioning following adverse events. One such variable is a sense of coherence (SOC), an orientation to life comprising manageability, comprehensibility, and meaningfulness. Little research has examined the role of SOC in adjustment to bereavement. The present longitudinal study examined the role of SOC in recovery from loss, in a Danish sample (N = 221) of elderly spousally bereaved people. The aim was twofold. First, we aimed to establish the optimal measurement model of SOC, evaluating the fit of different factor solutions for the 29‐item SOC‐29 scale and 13‐item SOC‐13 scale, using confirmatory factor analysis. Second, we sought to examine associations of emerging SOC factors with symptoms levels of prolonged grief disorder (PGD) and depression, and with satisfaction with life, assessed concurrently (at 6 months post‐loss) and at two consecutive time points, 13 and 18 months post‐loss. Results showed that the three‐factor model of the SOC‐13 (with distinct manageability, comprehensibility, and meaningfulness factors) provided a good fit to our data. With respect to our second aim, analyses showed that the three SOC factors were associated with concurrently assessed PGD, depression, and satisfaction with life. In the analyses predicting outcomes at Wave 2 and Wave 3, meaningfulness (but not manageability and comprehensibility) predicted some of the outcomes, above and beyond baseline scores of the outcomes. Findings suggest that meaningfulness may increase healthy and attenuate unhealthy responses to loss. Helping bereaved people to experience life's demands as worthy of investment and engagement is likely an important target for bereavement care. [ABSTRACT FROM AUTHOR]

Aim: The presence of periodontal disease (PD) at a single time point has been suggested as a predictor of diabetes risk, but whether changes in PD status are associated with altered risk of diabetes is yet to be reported on a population scale. This study investigated whether recovery from or development of PD in a population is associated with an altered risk of diabetes occurrence. Materials and Methods: Data of subjects who received health screening from 2002 to 2007 were obtained from the National Health Insurance Service–National Health Screening cohort database of Korea. Patients with a history of diabetes were excluded. Changes in PD status were determined from the first two health screenings. Study subjects were divided into four groups according to the changes in PD status: PD‐free, PD‐recovered, PD‐developed, and PD‐chronic. The outcome was the occurrence of diabetes. Results: Overall, 111,611 subjects were included for analysis. During a median follow‐up of 9.10 years, diabetes developed in 6102 subjects. The adjusted hazard ratios (HRs) for incident diabetes across various PD change groups (in reference to the PD‐free group) were as follows: PD‐chronic group = 1.096 (95% confidence interval [CI] 1.026–1.170, p =.006); PD‐developed group = 1.073 (95% CI 0.993–1.159, p =.075); and PD‐recovered group = 1.019 (95% CI 0.945–1.100, p =.622). The subjects who recovered from PD had a lower diabetes risk than those who had consistent PD (adjusted HR 0.930, 95% CI 0.865–1.000, p =.050), whereas those who developed PD had a higher risk of diabetes than those who remained PD‐free. Conclusion: The longitudinal change in PD status is associated with incident diabetes risk. Future intervention studies are necessary to determine whether PD treatment can prevent incident diabetes. [ABSTRACT FROM AUTHOR]

Objective: Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive‐compulsive disorder/symptoms (OCD/OCS). During the COVID‐19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS. Method: In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS‐CoV‐2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/−) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS‐CoV‐2 at the start of the pandemic and re‐assessed OCS 3 months later. Results: In Study 1, UP was higher in the OCS+ compared to the OCS− group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS‐CoV‐2, but not for infection itself. Conclusions: Exaggeration of one's personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample. Practitioner points: Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well‐being in the face of danger or uncertainty.The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive‐compulsive disorder and may also be involved in the development of the disorder.This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the educational expectations and experiences of surgical patients. Design: Prospective, longitudinal, descriptive and two‐centre study. Data were collected with questionnaires at the hospital and 6 weeks and 6 months postsurgery. Methods: Patients undergoing elective surgery and hospitalized overnight from January to July 2016 answered questions about the content of received pre‐operative and pre‐discharge education, topics they wanted more information on, sources of information, satisfaction with and usefulness of the information and if their recovery was as expected. Results: Patients (N = 697, 49% male, mean age 64.1 [SD 12.6] years) perceived the provided education as useful and satisfactory but less so after discharge. Most common topics which they expected more education about were postoperative complications, pain management, fatigue, lack of stamina and expected recovery time. Most patients received information through face‐to‐face teaching (79.7%) and in writing (78.4%). Expectations on recovery were related to patients' satisfaction with the education and how useful they evaluated it. [ABSTRACT FROM AUTHOR]

Early in the pandemic when hospitals reached capacity, Home Health Care (HHC) became a critical source of care for COVID‐19 patients and continues to be an important source of care for recovering COVID‐19 patients. Little is known about the COVID‐19 patient population treated in HHC. This retrospective observational cohort follows 1614 HHC patients with a COVID‐19 diagnosis and compares an "Early Cohort" between March 31 and May 31, 2020 to a "Late Cohort" between June 1 and December 31, 2020 for differences in: (1) sociodemographic and clinical characteristics (2) health care utilization, and (3) outcomes. Early patients were younger, more likely to be a minority, referred from hospitals or directly from emergency departments, started their care with greater independence in functional abilities, and had fewer comorbidities. Early patients were more likely to have COVID‐19 as their primary diagnosis (88.5% vs. 79.4%, p < 0.001), and were assessed as having more severe COVID‐19 symptoms. Early and Late Cohorts were assessed similarly for dyspnea at the start of care. COVID‐19 patients in the Early Cohort were more likely to have their vital signs monitored remotely (7.3% vs. 1.4%; p < 0.001), have received oxygen in their home (27.8% vs. 15.3%; p < 0.001), and received more virtual care than patients in the Late Cohort (2.04 visits vs. 0.86 visits; p < 0.001), although they had approximately two fewer total visits (12.48 vs. 14.45; p < 0.001). Patients in both cohorts had substantial improvement in dyspnea and functional ability during the course of HHC. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the recovery of physical function, health related quality of life (HRQoL), and pain for people following hip fracture for the initial 12 months, and to examine whether postoperative outcome measures of physical function, HRQoL, and pain can predict physical function at 3 and 12 months. Design: A prospective single‐center observational study, as part of the HIPFRAC trial. Settings: One hospital with two associated municipalities in Norway. Subjects: 207 participants with hip fracture included in the study (140 participants transferred to a short‐term nursing home placement and 67 transferred directly home at discharge from hospital). Method: Outcome measures were Short Physical Performance Battery (SPPB), Timed Up & Go (TUG), Stair climbing test (SC), Numeric Rating Scale (NRS) for pain at rest and in activity, and EQ‐5D‐5L index and health score. Data were analysed by repeated measures of variance and multivariate regression analyses. Results: There were statistically significant improvements in physical function (SPPB total score and TUG), NRS‐pain in activity, and HRQoL (EQ‐5D‐5L) from hospital discharge to 3‐month follow‐up for the whole cohort and the two groups (p < 0.001). However, the largest improvements occurred within the first 3 months. Further statistically significant improvements occurred between 3 and 12 months (p < 0.05). The strongest predictors of physical function at 3 and 12 months post‐fracture were physical function (SPPB) at hospital discharge and pre‐fracture requirement of a walking aid. Conclusion: The recovery of physical function, HRQoL, and pain in participants after hip fracture indicates gradual improvements during the initial 12‐month follow‐up, with the largest improvements within the first 3 months. [ABSTRACT FROM AUTHOR]

Introduction: Left bundle branch area pacing (LBBAP) maintains electrical and mechanical synchronization of the ventricles. It is a relatively physiological pacing mode, with low and stable pacing threshold and wider indications. LBBAP in children has been rarely reported. Methods: This study observed 12 children attempted LBBAP from January 2019 to January 2021 in the department of pediatric cardiology of Anzhen Hospital prospectively. Clinical data, pacing parameters, electrocardiograms, intracardiac electrograms, echocardiographic measurements and complications were recorded at implant and during follow‐up. Results: The 12 patients aged between 3 and 14 years old and weighted from 13 to 48 kg. Eleven patients were diagnosed with third‐degree atrioventricular block and 1 patient (case 4) suffered from cardiac dysfunction due to right ventricular apical pacing (RVAP). Left bundle branch area pacing was successfully achieved in all patients with narrow QRS complexes and V1 lead showed changes like right bundle branch block in the pacing electrocardiogram. Left ventricular ejection fraction in case 4 recovered on the 3rd day after LBBAP. The median of left ventricular end diastolic diameter Z score of the 12 patients decreased from 1.75 to 1.05 3 months after implantation (p < 0.05). The median of paced QRS duration was 103 ms. The median of pacing threshold, R‐wave amplitude and impedance were 0.85 V, 15 mV and 717 Ω respectively and remained stable during follow‐up. No complications such as loss of capture, lead dislodgement or septal perforation occurred. Conclusions: Left bundle branch area pacing can be performed safely in children with narrow QRS duration and stable pacing parameters. Cardiac dysfunction caused by long‐term RVAP can be corrected by LBBAP quickly. [ABSTRACT FROM AUTHOR]