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The recent approval of human papillomavirus (HPV) vaccine means that decision makers need information beyond that available from randomized clinical trials to recommend funding for this vaccination programme. Modelling and economic studies have addressed some of those information needs. We conducted a qualitative systematic review to summarize the existing data. Review articles were obtained from an extensive literature search on studies using mathematical modelling (either a Markov or transmission dynamic model) to determine the effectiveness or cost effectiveness of an HPV vaccine compared with the current cytology-based Pap smear screening programme. A total of 21 studies (but 22 models) were included in the review after being assessed for methodological quality. All of the included studies had used a mathematical model to determine the effectiveness of an HPV vaccine, whilst 13 had also conducted a cost-effectiveness analysis. Although the studies used different model structures, baseline parameters and assumptions, all studies showed that vaccination would decrease rates of HPV infection, precancerous lesions and cervical cancer. Studies had a consistent message with respect to cost effectiveness: a female-only vaccination programme is cost effective compared with the current cytology-based Pap smear screening programme, while the cost effectiveness of a male and female vaccination programme is generally not cost effective compared with female-only vaccination. [ABSTRACT FROM AUTHOR]

Objective: The choice of optimal analgesia following an adenotonsillectomy is a clinical issue because of the risk of respiratory depression and bleeding. The objective of this study was to assess the effect of celecoxib on opioid use and pain scores in children hospitalized after adenotonsillectomy and to document its adverse effects., Methods: This retrospective study was conducted in a tertiary care pediatric hospital. We compared a group of subjects aged 1 to 17 years who were prescribed celecoxib and opioids between January 2017 and June 2020 following an adenotonsillectomy during a 3-day or less hospitalization to a group of matched controls for sex, age, and length of stay who were prescribed opioids., Results: A total of 228 patients were identified (76 in the celecoxib + opioids group, 152 in the control group). Opioid use, in oral morphine equivalent daily dose, was lower in the celecoxib + opioids group at 0 to 24 hours of hospitalization (0.15 vs 0.20 mg/kg/day, p = 0.05). Initiating celecoxib within 24 hours of surgery (n = 60) significantly reduced opioid requirement for up to 48 hours compared with controls (0-24 hours: 0.12 vs 0.20 mg/kg/day, p = 0.002; 25-48 hours: 0.02 vs 0.09 mg/kg/day, p = 0.001). A shorter length of stay was observed for patients receiving celecoxib + opioids during the first 24-hour post--operative period (27 vs 32 hours, p = 0.01). With celecoxib use, no significant change in pain scores and occurrence of adverse effects including bleeding was found., Conclusions: Using celecoxib early after an adenotonsillectomy has reduced both opioid use and duration of hospital stay without increasing adverse effects or bleeding., Competing Interests: Disclosure. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts and honoraria. The authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., (Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: membership@pediatricpharmacy.org.)

Our study examined the role of instructions, response type, and definition on the judgement of enjoyment and nonenjoyment smiles. Participants viewed symmetric Duchenne, non-Duchenne, and asymmetric smiles. They were instructed to judge the happiness, authenticity, and sincerity of the smiles using either Likert scales or a dichotomous response type. Participants were also either given a definition of the instruction words "happy," "authentic," and "sincere" or not. Results showed that the probability of saying "really (happy/sincere/authentic)" was higher for the symmetric Duchenne than the asymmetric smiles and higher for the asymmetric than non-Duchenne smiles. Changing the instructions given to participants did not override the effect of smile type with the use of Likert scale or dichotomous response. However, with the use of Likert scale, we observed subtilities that were not observed with the use of dichotomous response. When given a definition, in the case of symmetric non-Duchenne smiles, Likert ratings were significantly lower, and participants were more accurate in their judgement on the dichotomous scale. However, no differences were observed for the asymmetric Duchenne and symmetric Duchenne smiles whether a definition was given or not. Symmetric non-Duchenne and asymmetric Duchenne smiles were also viewed longer when a definition was given than when one was not. Nevertheless, considering methodological variations of our study failed to explain the variations in the pattern of results of previous studies, other avenues should be explored, such as the use of dynamic stimuli and a greater variety of encoders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The objective of the Psyche Magnetometry Investigation is to test the hypothesis that asteroid (16) Psyche formed from the core of a differentiated planetesimal. To address this, the Psyche Magnetometer will measure the magnetic field around the asteroid to search for evidence of remanent magnetization. Paleomagnetic measurements of meteorites and dynamo theory indicate that a diversity of planetesimals once generated dynamo magnetic fields in their metallic cores. Likewise, the detection of a strong magnetic moment ( > 2 × 10 14 Am 2 ) at Psyche would likely indicate that the body once generated a core dynamo, implying that it formed by igneous differentiation. The Psyche Magnetometer consists of two three-axis fluxgate Sensor Units (SUs) mounted 0.7 m apart along a 2.15-m long boom and connected to two Electronics Units (EUs) located within the spacecraft bus. The Magnetometer samples at up to 50 Hz, has a range of ± 80 , 000 nT , and an instrument noise of 39 pT axis - 1 3 σ integrated over 0.1 to 1 Hz. The two pairs of SUs and EUs provide redundancy and enable gradiometry measurements to suppress noise from flight system magnetic fields. The Magnetometer will be powered on soon after launch and acquire data for the full duration of the mission. The ground data system processes the Magnetometer measurements to obtain an estimate of Psyche's dipole moment., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s) 2023.)

A 7-week-old female developed thrombosis of a mechanical mitral valve and was successfully treated with recombinant tissue plasminogen activator (rt-PA). The management of infants with thrombosed mechanical prosthesis is reviewed., (© 2017 Wiley Periodicals, Inc.)

The aim of this study was to examine the overall changes in healthcare services utilization after providing an empirically supported cognitive-behavioral treatment for panic disorder with agoraphobia. Data on healthcare utilization were collected for a total of 84 adults meeting DSM-IV criteria. Participants were completers of a cognitive-behavioral treatment for panic disorder with agoraphobia. Data on utilization of healthcare services and medication were obtained from semi-structured interviews from baseline to 1-year after treatment. Results of the Friedman non-parametric analysis reveal a significant decrease in overall and mental health-related costs following treatment. This study shows a significant reduction in healthcare costs following cognitive behavior therapy for panic disorder with agoraphobia. More studies are needed to examine the potential long-term cost-offset effect of empirically supported treatments for panic disorder.