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Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Children and adolescents with cerebral palsy (CP) show a reduced physical activity (PA) level compared with their typically developed peers. This study aimed to identify potential predictors of objectively evaluated habitual PA using data from a national clinical registry—the Cerebral Palsy Follow-Up Program (CPFP)—and proxy-reported questionnaires. Data from the CPFP database showed that female sex was associated with a lower PA level. Additional questionnaire data revealed age, popliteal angle limitation, Pediatric Outcomes Data Collection Instrument–Sports and Physical Functioning Scale score, screen time, Functional Mobility Scale score at 50 m, and fatigue as predictors. The proposed models can be used for the prediction and early detection of the PA level and consequently for the potential improvement among ambulant/semiambulant individuals with CP. Further research should investigate the predictive impact of personal, social, and environmental factors on the PA level and the gap in PA levels between girls and boys. [ABSTRACT FROM AUTHOR]

Context: Aberrant movement patterns among individuals with concussion history have been reported during sport-related movement. However, the acute postconcussion kinematic and kinetic biomechanical movement patterns during a rapid acceleration–deceleration task have not been profiled and leaves their progressive trajectory unknown. Our study aimed to examine single-leg hop stabilization kinematics and kinetics between concussed and healthy-matched controls acutely (≤7 d) and when asymptomatic (≤72 h of symptom resolution). Design: Prospective, cohort laboratory study. Methods: Ten concussed (60% male; 19.2 [0.9] y; 178.7 [14.0] cm; 71.3 [18.0] kg) and 10 matched controls (60% male; 19.5 [1.2] y; 176.1 [12.6] cm; 71.0 [17.0] kg) completed the single-leg hop stabilization task under single and dual task (subtracting by 6's or 7's) at both time points. Participants stood on a 30-cm tall box set 50% of their height behind force plates while in an athletic stance. A synchronized light was illuminated randomly, queuing participants to initiate the movement as rapidly as possible. Participants then jumped forward, landed on their nondominant leg, and were instructed to reach and maintain stabilization as fast as possible upon ground contact. We used 2 (group) × 2 (time) mixed-model analyses of variance to compare single-leg hop stabilization outcomes separately during single and dual task. Results: We observed a significant main group effect for single-task ankle plantarflexion moment, with greater normalized torque (mean difference = 0.03 N·m/body weight; P =.048, g = 1.18) for concussed individuals across time points. A significant interaction effect for single-task reaction time indicated that concussed individuals had slower performance acutely relative to asymptomatic (mean difference = 0.09 s; P =.015, g = 0.64), while control group performance was stable. No other main or interaction effects for single-leg hop stabilization task metrics were present during single and dual task (P ≥.051). Conclusions: Greater ankle plantarflexion torque coupled with slower reaction time may indicate stiff, conservative single-leg hop stabilization performance acutely following concussion. Our findings shed preliminary light on the recovery trajectories of biomechanical alterations following concussion and provide specific kinematic and kinetic focal points for future research. [ABSTRACT FROM AUTHOR]

Introduction: Small‐cell lung cancer (SCLC) may be associated with neuronal autoantibodies and paraneoplastic neurological syndromes. It has been suggested that neuronal autoantibodies, especially antineuronal nuclear antibody type 1 (Hu) autoantibodies, are associated with longer survival of patients with SCLC. The objective of this study was to determine the frequency and distribution of neuronal autoantibodies at the time of diagnosis of SCLC patients and assess survival rates in relation to autoimmunity. Methods: In this retrospective study, serum from 40 patients with biopsy‐proven SCLC at the time of diagnosis was studied prior to treatment. The sera originated from a cancer registry at the Oncology Department, Vejle Hospital from 2007 to 2010. The sera were analyzed blindly to clinical status for the presence of neuronal autoantibodies. Medical records were reviewed for neurological symptoms. Results: Neuronal autoantibodies were detected in 22/40 (55%) of the SCLC patients. A broad range of neurological symptoms was recorded in 28/40 (70%) patients, of which 14/28 (50%) were positive for neuronal autoantibodies. The most frequently detected autoantibodies were Hu (7/40, 17.5%) followed by GAD65 (6/22, 15.0%). Striational and P/Q‐ or N‐type voltage‐gated calcium channel antibodies were less common, with each found in five patients (12.5%). Eight patients (20%) had coexisting autoantibodies. Autoantibody‐positivity was not associated with survival. Conclusion: Neuronal autoantibodies were at time of diagnosis found in approximately half of the treatment‐naïve SCLC patients. Neither autoantibody positivity at diagnosis nor neurological manifestations correlated with survival and their clinical importance requires further studies in larger, prospective cohorts. [ABSTRACT FROM AUTHOR]

To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE. An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed. Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests. PSCE can be useful to quantify the balance of post-TKA and KOA patients. Total knee arthroplasty is the definitive treatment for knee osteoarthrosis and it has several benefits, but its effect on balance is still unknown. Postural stability computerized evaluation is used to evaluate balance on vestibular diseases and it has been recently studied on musculoskeletal conditions. Postural stability computerized evaluation may be useful to evaluate patients' balance before and after total knee arthroplasty. [ABSTRACT FROM AUTHOR]

Patient activation is associated with treatment adherence, self-accountability for healthcare and a healthy lifestyle change. Mobile health (m-Health) apps can lead to greater patient treatment adherence and health behaviour change. This study aimed to evaluate the health behaviour change of elderly people through a healthcare programme focused on activation with the support of technology. Three phases were conducted: (1) pre-intervention – design of the intervention protocol and the app, (2) intervention – randomised clinical trial with 41 overweight/obese elderly people. m-Health app-supported group psychotherapy was compared with group psychotherapy only and individual psychotherapy (control) and (3) post-intervention – statistical analysis, intervention's assistant interviews and app heuristics evaluation. By crossing the results, the study has shown that there was no significant difference in the activation level before and after intervention between groups. However, there was a significant increase from the initial mean score to the final one when considering the three groups together. Group therapy, whether with or without the support of the app, was more effective for behaviour change measured by the achievement of the goals, than individual psychotherapy. The lack of impact on group therapy with app support calls into question which and how much technology support is useful. [ABSTRACT FROM AUTHOR]

Background: A proportion of head and neck carcinomas (HNSCCs) are induced by high-risk human papillomaviruses (HPVs) and are associated with better patient outcomes compared to patients with HNSCCs related to tobacco and alcohol abuse. In the microenvironment of solid tumors, including HNSCCs, oxygen levels are often reduced, and a hypoxic state is induced. This can lead to a poor treatment response and a worse patient prognosis. One of the hypoxia-responsive genes is aspartate-β-hydroxylase (ASPH), whose activity promotes the growth, invasiveness, and metastasis of many types of solid tumors. Methods: In our study, HNSCC samples were analyzed for the expression of ASPH and selected endogenous hypoxia markers by real-time PCR and/or multiplex fluorescence immunohistochemistry. Results: Except for the EPAS1 gene, which had higher mRNA expression in the HPV-negative group of HNSCC (p < 0.05), we found no other differences in the expression of the tested genes that were related to HPV status. On the contrary, a statistically significantly higher number of cells producing ASPH (p < 0.0001), HIF1A (p < 0.0001), GLUT1 (p < 0.0001), and MMP13 (p < 0.05) proteins were detected in the HPV-positive tumor group than in the HPV-negative sample group. All the evaluated markers, except for MMP9/13, were more abundant in the tumor parenchyma than in the tumor stroma. The Cox proportional hazard models showed that increased numbers of cells with GLUT1 and HIF1A protein expression were positive prognostic markers for overall and disease-specific survival in patients independent of HPV tumor status. Conclusion: The study examined HNSCC samples and found that elevated ASPH and hypoxia marker proteins, typically associated with poor prognosis, may actually indicate active HPV infection, the strongest prognostic factor in HNSCC patients. In cases where HPV status is uncertain, increased expression of HIF1A and GLUT1 can serve as positive prognostic factors. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the influence of green transformational leadership educational intervention on nurse managers' green behavior and creativity. Background: Organizational creativity is greatly influenced by leaders and their personality attributes. Additionally, innovative employee behavior is crucial for organizational performance and survival, which in turn promotes long-term organizational growth. Method: A quasi-experimental design was conducted by using pre-test, post-test, and follow-up for a group that included 116 nurse managers who completed the intervention. Data were collected through the green transformational leadership knowledge questionnaire, green transformational leadership scale, green behavior questionnaire, and green creativity scale. Results: Following the implementation of the Green Transformational Leadership educational intervention, there was an improvement in responses connected to the nurse manager's use of green behavior and creativity. Three months after the intervention ended, the improvement was still present. Conclusion: Nurse managers who had good knowledge about green transformational leadership showed increased green behavior and green creativity, which enhanced the organization's success. This study showed the significance of developing and improving the skills of managerial creativity for the nurse supervisor of a hospital through training in transformational leadership. Implications for nursing management: The concept of "green transformational leadership" refers to leadership behaviors and strategies aimed at promoting environmental sustainability and responsibility within an organization or a specific context. In the case we mentioned, it involves implementing educational interventions targeted at nurse managers to enhance their understanding and adoption of green practices, as well as fostering green behavior and creativity among them. [ABSTRACT FROM AUTHOR]

Background: There is limited research examining the views of general practice pharmacists (GPPs) on their role and their impact in general practice. The aim of this study was to explore GPPs' views regarding this role and its potential impact within general practice in Northern Ireland (NI). Methods: A paper-based self-administered questionnaire was mailed to 319 general practices in NI in 2022, directed to the GPP who spent most time at the practice. A variety of closed and open questions were included in six sections. Responses to closed questions were analysed descriptively whilst open question responses were analysed using content analysis. To ascertain associations between variables (e.g. GPP prescribing status, working arrangements and aspects of collaboration with GPPs), Fisher's exact test was employed with an a priori significance level of p < 0.05. Results: 155 responses were received equating to a response rate of 48.5%. Most participants (72.3%) were female, independent prescribers (71%), and 64.5% were currently using their independent prescriber qualification. Services that were provided by most GPPs were medication reconciliation (99.4%) and medication reviews (97.4%). The most common method of communication between GPPs and general practitioners (GPs) was face-to-face (89.0%). Telephone was the most common method of communication between GPPs, community pharmacists (97.4%) and patients (98.7%). Most GPPs (> 80%) showed positive attitudes towards collaboration with GPs and those who worked in multiple practices were more likely to agree with the Attitudes Towards Collaboration Instrument for pharmacists (ATCI-P) statements compared to those who worked in a single practice (p < 0.05). Less than 40% (36.8%) of GPPs agreed that patients were aware of the role they provided. The majority of GPPs (80.6%) expressed positive views on their impact on primary care. Analysis of the free-text comments revealed the need for more GPP patient-facing activities, GPP-specific training, and promotion of the GPP role. Conclusion: The findings indicated that GPPs had largely positive views about their role and their impact on primary care. The results may be helpful for practices and service commissioners. Further research is necessary to explore the perspectives of patients regarding the role of the GPP and to enhance patients' awareness of the GPP. [ABSTRACT FROM AUTHOR]

Background: Ankle fractures are frequent, and despite numerous publications on their treatment and outcome, there is a lack of precise data on the functional results in young, healthy and physically active patients. We hypothesized that patients who underwent open reduction and internal fixation (ORIF) for simple ankle fractures would have similar function compared to a healthy control group, whereas patients with complex fractures will have significant functional deficits. Furthermore, we postulate that there is a discrepancy between the radiological and the functional outcomes. Methods: A set of specific provocation tests was developed to evaluate the postoperative possibility of weight bearing, stop-and-go activities and range of motion. In combination with three questionnaires and a radiographic evaluation, the true functional outcome and the possibility of participating in sporting activities were investigated and compared with those of an age- and sex-matched control group. Results: A significant impairment was found in unilateral and simple ankle fractures. This impairment increased in tests including stop-and-go activities in combination with load bearing and with the complexity of the fractures. Concerning the subjective outcome, there was a significant adverse effect for daily activities without any difference in preoperative or postoperative sporting activity between the groups. No difference was found in the radiological assessment. Conclusions: Both simple and complex ankle fractures treated with ORIF have a significant and long-lasting impact on functional outcome in young and active patients. The radiological result is not associated with a good functional outcome. Trial registration: BASEC-Nr. 2018 − 01124. [ABSTRACT FROM AUTHOR]

Purpose Cefdinir and cephalexin are cephalosporin antibiotics commonly used in the treatment of urinary tract infections (UTIs). Their efficacy depends on achieving sufficient time with concentrations exceeding the minimum inhibitory concentration (MIC). Despite being frequently prescribed for UTIs, cefdinir has markedly lower urine penetration compared to cephalexin. It is possible that differences in pharmacokinetics could result in dissimilar efficacy between these agents; however, comparative studies of cephalosporins in UTIs are lacking. Methods This was a retrospective comparative study of patients discharged from emergency departments within a community health system with a diagnosis of acute cystitis who were prescribed cefdinir or cephalexin. Treatment failure rates at 7 and 14 days were compared between the 2 agents using a χ 2 or Fisher's exact test, as appropriate. Results There were no differences in overall treatment failure between the cefdinir and cephalexin groups. Treatment failure at 7 days occurred in 11.6% (n = 14) of patients in the cefdinir group and 8.3% (n = 10) of patients in the cephalexin group (P = 0.389). Treatment failure at 14 days was higher for cefdinir at 20.7% (n = 25) than for cephalexin at 11.8% (n = 14), but this difference was not statistically significant (P = 0.053). There were no differences in the rate of treatment failure in subgroup analyses of uncomplicated or complicated UTIs. Conclusion The results of this study suggest that cefdinir and cephalexin have comparable efficacy for the treatment of lower UTIs. While there was a numerically higher rate of treatment failure with cefdinir, there were no significant differences in treatment failure between the agents. [ABSTRACT FROM AUTHOR]

Objective: This study assessed firefighters' physiological stress response to a live fire training evolution (LFTE). Methods: Seventy-six (n = 76) firefighters completed an LFTE. Salivary samples were collected pre-, immediately post, and 30-min post-LFTE and analyzed for a-amylase (AA), cortisol (CORT), and secretory immunoglobulin-A (SIgA). Results: Concentrations of AA, CORT, and SIgA were elevated immediately post LFTE versus pre (P<0.001) and 30-min post (P<0.001). Cohen's d effect size comparing pre and immediately-post means were 0.83, 0.77, and 0.61 for AA, CORT, and SIgA and were 0.54, 0.44, and 0.69 for AA, CORT, and SIgA, comparing immediately-post and 30-min post, respectively. Conclusions: These data demonstrate the stress response and activation of the hypothalamic-pituitary-adrenal/sympathetic-adreno-medullar axis and immune system immediately after real-world firefighting operations. Future work is needed to understand the impact of elevated stress biomarkers on firefighter performance and disease risk. [ABSTRACT FROM AUTHOR]

Purpose: End-of-life (EOL) care is a vulnerable period in an individual’s life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient’s wishes. The aims of our study were to assess HPs’ knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcomes (PROs), such as the short CD activity index (sCDAI) and partial Mayo Score (PMS), are used to define clinical remission in IBD, but may not represent the true degree of inflammation and endoscopy is invasive. Non-invasive testing options include c-reactive protein (CRP) and fecal calprotectin (FCP). Aim: The aim of this study was to assess the degree of correlation of non-invasive biomarkers with PROs and the impact other clinical variables can have on their levels. Methods: We reviewed data collected from the prospective cohort, Study of a Prospective Adult Research Cohort with IBD (SPARC-IBD), comprised of over 3000 patients from 17 tertiary referral centers. Demographic and clinical variables were analyzed by disease type, disease severity was based on PROs, and baseline CRP and FCP were measured. For comparative analysis, we performed Fisher's exact test and Welch's t test, where p < 0.05 was significant. Results: 1547 patients were included; 63% had CD, 56% were female, with an average disease duration of 13.6 years. CRP and FCP were associated with symptom severity in inflammatory CD. CRP was useful to differentiate symptoms across different disease locations in CD, whereas FCP was associated with symptom severity in Crohn's colitis only. For UC, FCP was able to distinguish symptom severity better in distal UC, whereas in extensive or pancolitis, it was useful only to distinguish severe symptoms from other categories of symptom severity. Conclusion: PROs correlate with CRP and FCP; however, disease location and phenotype impact their ability to distinguish symptom severity. [ABSTRACT FROM AUTHOR]

Introduction: High mobility group box 1 protein (HMGB1) is a member of the molecular family known as damage-associated molecular patterns, which is implicated to have a role in neuroinflammation processes. In recent years, a growing number of studies have focused on the role of inflammation in Bipolar Disorder (BD). This study aimed to investigate the serum levels of HMGB1 and other inflammatory markers in patients with bipolar manic episodes compared to those in healthy controls (HC). Methods: A single-center, observational, case-control study was conducted. Thirty-five patients with BD in manic episodes and 35 HC were assessed. Young Mania Rating Scale (YMRS) was used to assess the symptom severity of the patient group. While inflammatory markers (such as HMGB1, C-reactive protein (CRP) and white blood cell count) were assessed at the first three and the last day of hospitalization in the patient group, they were evaluated once in HC. Levels of inflammatory markers were compared between (patient-HC) and within groups (before-after treatment). Results: No difference was observed in serum HMGB1 levels of bipolar patients with manic episodes compared to the HC (p>0.05). C-reactive protein levels of manic patients were higher than HC (p<0.001), and the difference persisted even after treatment (p=0.007). In addition, there was a significant positive correlation between CRP levels and antipsychotic drug dosage (r=0.382, p=0.024). Conclusion: There were no differences in HMGB1 levels between bipolar patients with acute manic episode and HC. However, higher CRP levels in bipolar patients support the low-grade inflammation hypothesis in the etiology of BD. [ABSTRACT FROM AUTHOR]

Children with disabilities and their families should receive education appropriate for the needs of children with disabilities in order for them to lead a more independent life. The aim of this study is to evaluate the effectiveness of the sexual health education given to the parents of children with disabilities aged 10–19. This study, which used an experimental design with a pre-test and post-test control group, was conducted with the parents of children with disabilities enrolled at the Kozlu Disabled Association in Kozlu, district of Zonguldak province. The sample of the study consisted of 47 parents who met the inclusion criteria. Parents were assigned to the experimental (n = 23) and control (n = 24) groups with the randomization method. The data of the study were collected using "Introductory Information Form", "Parental Self-Efficacy Scale" and "Knowledge Assessment Questionnaire". Sexual health education including 8 modules and lasting for 8 weeks was given to the parents in the experimental group once a week for 30–45 min. While the mean score of the Parental Self-Efficacy Scale of the experimental group was 55.50 ± 23.16 before the education, it increased to 97.17 ± 7.88 after the education, and a statistically significant relationship was found between the two measurements (p < 0.05). When the scores of the Knowledge Assessment Questionnaire of the experimental group were evaluated after the education, the sub-dimension scores of the Self-care Knowledge, Sexual Behavior Control Knowledge, Sexual Abuse Knowledge and Communication Knowledge were determined to be statistically significant (p < 0.05). It was concluded in the study that the sexual health education given to parents of children with disabilities was effective in increasing the level of parental self-efficacy and sexual health knowledge. [ABSTRACT FROM AUTHOR]

Introduction: SB3 is a trastuzumab biosimilar approved in Australia, Brazil, Canada, the European Union, the Republic of Korea, Switzerland, and the USA. This real-world study evaluated safety and effectiveness of SB3 as part of the Korean post approval safety management system. Methods: This post-marketing surveillance in Korea included patients in line with approved indications, i.e., patients with early or metastatic breast cancer or metastatic gastric cancer. Safety outcomes were adverse events (AEs) and adverse drug reactions. Effectiveness outcomes were tumor response and event-free survival. Results: 424 patients were evaluated: 366 patients (86%) with early breast cancer, 53 patients (13%) with metastatic breast cancer, and 5 patients (1%) with metastatic gastric cancer. Among patients with breast cancer, AEs (mostly mild) and adverse drug reactions were reported by 158 (37.7%) and 57 (13.6%) patients, respectively. Most patients with an AE (141, 89.2%) had no change in treatment schedule. Treatment was temporarily suspended in 14 (8.9%) patients with an AE and completely discontinued in 7 (4.4%). Among patients with early and metastatic breast cancer who were evaluated for efficacy, objective response rates were 82.7% and 38.3%, respectively. Pathological complete response was 64.6% in patients with early breast cancer. Discussion/Conclusion: Safety and efficacy of SB3 demonstrated in this real-world study were comparable with previous studies of reference trastuzumab. [ABSTRACT FROM AUTHOR]

Introduction: Dolutegravir + rilpivirine (DTG + RPV) is an effective antiretroviral therapy regimen approved in clinical guidelines as a switch therapy for virologically suppressed people with HIV. Our study aimed to compare the effectiveness and tolerability of DTG + RPV in women and men in real‐world clinical practice. Methods: This was a retrospective analysis of treatment‐experienced people with HIV from a large HIV unit who switched to DTG + RPV. We analysed treatment effectiveness, rates of adverse events and discontinuation, and metabolic changes after 48 weeks of treatment. HIV‐RNA levels <50 copies/mL were analysed at 48 weeks using both intention‐to treat analysis (where missing data were interpreted as failures) and per‐protocol analysis (excluding those with missing data or changes due to reasons other than virological failure). Outcomes were compared between women and men based on sex at birth. Results: A total of 307 patients were selected (71 women and 236 men). No transgender people were included. At baseline, women had lived with HIV infection and received antiretroviral therapy for longer than men (23.2 vs 17.4 years and 18.9 vs 14.2 years, respectively). In the intention‐to‐treat analysis, 74.6% (95% confidence interval [CI] 63.4–83.3%) of women and 83.5% (95% CI 78.2–87.7) of men had HIV‐RNA <50 copies/mL. In the per‐protocol analysis, 96.4% (95% CI 87.7–99) of women and 99% (95% CI 98.9–99.7) of men had HIV‐RNA levels <50 copies/mL. Two women and two men had HIV‐RNA >50 copies/mL at 48 weeks. Discontinuation due to adverse events was more frequent in women than in men: 12.7% vs 7.2% (p < 0.02). Neuropsychiatric and gastrointestinal events were the most frequently reported. A median (interquartile range) weight gain of 1.9 kg (0–4.2) in women and 1.2 kg (−1–3.1) in men was reported (median of differences between baseline visit and week 48); the remaining changes in metabolic parameters were neutral. Conclusions: DTG + RPV exhibited good and similar virological effectiveness in women and men in real‐world settings. However, poorer tolerability and more treatment interruptions were observed in women. [ABSTRACT FROM AUTHOR]

The article discusses research which examined the prevalence of invasive bacterial infection (IBI) in febrile young infants in an urban tertiary pediatric emergency department to clarify the role of viral testing when procalcitonin is not available. Data shows the demographic characteristics of infants and prevalence of IBI and viral status among febrile infants classified as high or low risk for IBI based on C-reactive protein, absolute neutrophil count and maximum temperature measurements.

BACKGROUND AND OBJECTIVES: Despite advances in the prevention of rhesus (Rh)(D) alloimmunization, alloantibodies to Rh(D) and non-Rh(D) red blood cell antigens continue to be detected in _4% of US pregnancies and can result in hemolytic disease of the fetus and newborn (HDFN). Recent reports on HDFN lack granularity and are unable to provide antibody-specific outcomes. The objective of this study was to calculate the frequency of alloimmunization in our large hospital system and summarize the outcomes based on antibody specificity, titer, and other clinical factors. METHODS: We identified all births in a 6-year period after a positive red blood cell antibody screen result during pregnancy and summarized their characteristics and outcomes. RESULTS: A total of 707 neonates were born after a positive maternal antibody screen result (3.0/1000 live births). In 31 (4%), the positive screen result was due to rhesus immune globulin alone. Of the 676 neonates exposed to alloantibodies, the direct antibody test (DAT) result was positive, showing antigen-positivity and evidence of HDFN in 37% of those tested. Neonatal disease was most severe with DAT-positive anti-Rh antibodies (c, C, D, e, E). All neonatal red blood cell transfusions (15) and exchange transfusions (6) were due to anti-Rh alloimmunization. No neonates born to mothers with anti-M, anti-S, anti-Duffy, anti-Kidd A, or anti-Lewis required NICU admission for hyperbilirubinemia or transfusion. CONCLUSIONS: Alloimmunization to Rh-group antibodies continues to cause a majority of the severe HDFN cases in our hospital system. In neonates born to alloimmunized mothers, a positive DAT result revealing antigen-positivity is the best predictor of anemia and hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

Objectives Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3-associated autoinflammatory disease (NLRP3 -AID) is a rare autosomal dominant systemic autoinflammatory disease. We aimed to summarize the phenotypic and genotypic features of Chinese adult NLRP3 -AID patients with hearing loss. Methods A retrospective cohort study of twenty-one adult patients with NLRP3 -AID was conducted in Peking Union Medical College Hospital between July 2015 and March 2023. All patients underwent whole exome sequencing and otorhinolaryngologic assessments. Clinical features and therapeutic data were collected and analysed. Results We found that 13/21 (61.90%) of patients had hearing loss with high-frequency impairment in the majority, and most patients presented with vestibular dysfunction as a new finding. The NLRP3 -AID patients with early-onset, cold or stress triggered episodes, red eyes, fatigue, hypopsia and mutations located in the NACHT domain of the NLRP3 protein were more likely to suffer from hearing loss, especially sensorineural hearing loss, perhaps as a result of pathogenic variants of high penetrance. By a series of audiological evaluations, TNF-α inhibitors were confirmed to improve or reverse hearing loss. Conclusions We reported the first cohort of Chinese adult NLRP3 -AID patients with hearing loss and characterized vestibular dysfunction, highlighted the necessity for attention to high-frequency hearing and provided potential alternative treatment. [ABSTRACT FROM AUTHOR]

Objective This study aimed to establish prediction models for respiratory-related mortality in microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using clinical characteristics. Methods We enrolled patients with MPA with ILD between May 2005 and June 2021 in a multicentre cohort of Japanese patients with MPA (REVEAL cohort). We evaluated the demographic, clinical, laboratory, radiological findings, treatments and the presence of honeycombing 1 cm above the diaphragm using chest high-resolution CT (HRCT) on admission. We explored the risk factors predictive of respiratory-related mortality. Results Of 115 patients, 26 cases died of respiratory-related diseases during a median follow-up of 3.8 years. Eighteen patients (69%) died due to respiratory infection, three (12%) had diffuse alveolar haemorrhage, and five (19%) had exacerbation of ILD. In univariate analysis, older age, lower percent forced vital capacity (%FVC), lower percent diffusing capacity of carbon monoxide (%DLCO), and the presence of honeycombing in the right lower lobe were identified as risk factors. Additionally, in multivariate analysis adjusted for age and treatment, %FVC, %DLCO and the presence of honeycombing in the right lower lobe were independently associated with respiratory-related mortality. We created prediction models based on the values of %FVC, %DLCO and presence of honeycombing on chest HRCT (termed "MPF model"). The 5-year respiratory-related death-free rate was significantly different between patients with MPA with ILD stratified by the number of risk factors based on the MPF model. Conclusions Our study indicates that the MPF model may help predict respiratory-related death in patients with MPA with ILD. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sexually transmitted diseases (STDs) remains high worldwide in today's society, especially among young people. Youth education on STDs could help to reduce the prevalence of the condition in society and prevent new cases. Aim: The aim of this study is to assess the effectiveness of peer‐based short‐form educational videos on youths' knowledge of STDs. Methods: This quasi‐experimental study was conducted in Turkey. The sample consisted of 121 students divided into experimental and control groups. Pre‐ and post‐test control group quasi‐experimental research design was employed in this study during the spring semester of the academic year 2021–2022. Peer‐based short‐form educational videos created by nursing students were used as an intervention. The survey form and Sexually Transmitted Disease Knowledge Questionnaire were used to collect data. Results: Participants with parental responsibilities and had previous STD experience had higher knowledge score than the other subgroups. There was a significant main effect of peer‐based short‐form educational video on participants overall knowledge score of STDs. Additionally, the effect of intervention continued at 12‐week follow‐up measurement. Conclusion: Peer‐based short‐form educational videos increase young people's knowledge of STD, and the impact of the intervention continued at 12‐week follow up. Summary statement: What is already known about this topic? Sexually transmitted diseases continue to be prevalent in society, particularly among young people.Sexually transmitted diseases can lead to serious health conditions and have a significant impact on sexual and reproductive health.The effectiveness of internet‐based education and lectures on sexually transmitted diseases has already been investigated.Little research has been addressed to determine the impact of educational materials, which are short videos on knowledge of sexually transmitted diseases created by utilizing nursing students' peer assessment. What this paper adds? Peer‐based short‐form educational videos increase young people's sexually transmitted disease knowledge.People with parental responsibilities and a previous sexually transmitted infections responded to interventions more favourably.The effects of peer‐based short‐form educational videos persisted 3 months afterwards. The implications for this paper: This cost‐free method has a potential to be widely used as a public health intervention to educate young people on sexually transmitted diseases.The peer‐based short‐form educational videos can be combined with other interventions to increase young people's knowledge of sexually transmitted diseases. [ABSTRACT FROM AUTHOR]

Aim: This study compared the effects of web‐based and face‐to‐face education given to office workers on health beliefs and physical activity levels towards obesity. Methods: The research was conducted as a randomized controlled experimental study. The study population consisted of 768 office workers between February 2020 and April 2021, and the sample of the research consisted of 90 individuals selected from the population using the nonprobability sampling method. Clinical trial number of the study is NCT05591846. Results: A total of 90 people, including 30 people in each group, were included in the study. According to the obesity health belief model, a positive change was achieved in the beliefs of individuals about obesity; it was determined that there was a significant increase in the subdimensions of the importance of health, sensitivity, seriousness and perception of benefit and a decrease in the perception of obstacles (p < 0.05). After both education methods were given according to the health belief model, a positive change was achieved in the physical activity level of the individuals; it was determined that the physical activity level score increased significantly (p < 0.05). Conclusion: It was determined that web‐based and face‐to‐face education given to individuals had a positive effect on the obesity health belief model components and the levels of physical activity level. Summary statement: What is already known about this topic? Beliefs about obesity and physical activity are changed by face‐to‐face education methods.Along with the changing and developing technology, web‐based education has gained importance as well as face‐to‐face education.Studies on the effect of web‐based education compared with face‐to‐face education are limited. What this paper adds? This study determined that face‐to‐face education and web‐based education had an effect on beliefs about effecting change in obesity and the duration of physical activity.Web‐based education can be as effective as face‐to‐face education for this. The implications of this paper: Individuals' beliefs about reducing obesity can change with face‐to‐face education and also with web‐based education, which can be accessed more easily in desired time periods.Web‐based education can be used to improve obesity in cases where face‐to‐face education cannot be applied. [ABSTRACT FROM AUTHOR]

Background: Various cutoffs have been used to diagnose computed tomography (CT)‐defined low skeletal muscle mass; however, the impact of this variability on predicting physical functional limitations (PFL) remains unclear. In the present study we aimed to evaluate the diagnostic test metrics for predicting PFLs using a fixed cutoff value from previous reports and sought to create a prediction score that incorporated the skeletal muscle index (SMI) and other clinical factors. Methods: In this cross‐sectional study including 237 patients with lung cancer, the SMI was assessed using CT‐determined skeletal muscle area at the third lumbar vertebra. Physical function was assessed using the short physical performance battery (SPPB) test, with PFL defined as an SPPB score ≤9. We analyzed the diagnostic metrics of the five previous cutoffs for CT‐defined low skeletal muscle mass in predicting PFL. Results: The mean age of participants was 66.0 ± 10.4 years. Out of 237 patients, 158 (66.7%) had PFLs. A significant difference was observed in SMI between individuals with and without PFLs (35.7 cm2/m2 ± 7.8 vs. 39.5 cm2/m2 ± 8.4, p < 0.001). Diagnostic metrics of previous cutoffs in predicting PFL showed suboptimal sensitivity (63.29%–91.77%), specificity (11.39%–50.63%), and area under the receiver operating characteristic curve (AUC) values (0.516–0.592). Age and the SMI were significant predictors of PFL; therefore, a score for predicting PFL (age – SMI + 21) was constructed, which achieved an AUC value of 0.748. Conclusion: Fixed cutoffs for CT‐defined low skeletal muscle mass may inadequately predict PFLs, potentially overlooking declining physical functions in patients with lung cancer. [ABSTRACT FROM AUTHOR]

Objective: In the treatment of lumbar degenerative spondylolisthesis (LDS) with Posterior lumbar interbody fusion (PLIF) surgery, interbody fusion implants play a key role in supporting the vertebral body and facilitating fusion. The objective of this study was to assess the impact of implantation depth on sagittal parameters and functional outcomes in patients undergoing PLIF surgery. Methods: This study reviewed 128 patients with L4‐L5 LDS between January 2016 and August 2019. All patients underwent an open PLIF surgery that included intravertebral decompression, implantation of pedicle screws and cage. We grouped according to the position of the center of the cage relative to the L5 vertebral endplate. Patients with the center of the cage located at the anterior 1/2 of the upper end plate of the L5 vertebral body were divided into Anterior group, and located at the posterior 1/2 of the upper end plate of the L5 vertebral body were divided into Posterior group. The lumbar lordosis (LL), segmental lordosis (SL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT) and slope degree (SD) was measured for radiographic outcomes. We used the visual analog scale (VAS) and the oswestry disability index (ODI) score to assess functional outcomes. Paired t‐test was used to compare imaging and bedside data before and after surgery between the two groups, and independent sample t‐test, χ2 test and Fisher exact test were used to compare the data between the two groups. Result: The mean follow‐up of Anterior group was 44.13 ± 9.23 months, and Posterior group was 45.62 ± 10.29 months (P > 0.05). The LL, SL, PT, SS, SD and PI‐LL after operation showed great improvements, relative to the corresponding preoperative values in both groups (P < 0.05). Compared to Posterior group, Anterior group exhibited far enhanced SL (15.49 ± 3.28 vs. 13.67 ± 2.53, P < 0.05), LL (53.47 ± 3.21 vs. 52.08 ± 3.15, P < 0.05) outcomes and showed depressed PI‐LL (8.87 ± 5.05 vs. 10.73 ± 5.39, P < 0.05) outcomes at the final follow‐up. Meanwhile, the SL in Anterior group (16.18 ± 3.99) 1 months after operation were also higher than in Posterior group (14.12 ± 3.57) (P < 0.05). We found that VAS and ODI at the final follow‐up in Anterior group (3.62 ± 0.96, 25.19 ± 5.25) were significantly lower than those in Posterior group (4.12 ± 0.98, 27.68 ± 5.13) (P < 0.05). Conclusions: For patients with LDS, the anteriorly placed cage may provide better improvement of SL after PLIF surgery. Meanwhile, the anteriorly placed cage may achieve better sagittal parameters of LL and PI‐LL and functional outcomes at the final follow‐up. [ABSTRACT FROM AUTHOR]

BACKGROUND: Providing effective health education is essential for patients with cancer-related pain. One solution is leveraging instant messaging tools for teach-back health education. OBJECTIVES: This study investigated the effects of WeChat-based teach-back health education on patients with advanced cancer who underwent patient-controlled intrathecal analgesia implantation and used hydromorphone. METHODS: This retrospective study evaluated 150 hospitalized patients with advanced cancer pain. Patients were classified into a conventional health education group (N = 50) and a teach-back group (N = 100) based on whether they received WeChatbased teach-back health education. Pain was rated using a numeric rating scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index at one, two, and three months postdischarge. FINDINGS: Patients who received remote teachback health education better managed their pain. Data also demonstrated improvements in patients' sleep quality and caregiver satisfaction, and reductions in the occurrence of adverse reactions. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to validate the Delirium Observation Screening Scale (DOSS) in a population of long‐term care facility (LTCF) residents in Flanders. Currently there is no validated screening tool for delirium available for the population in this setting in Flanders. Methods: A multisite, cross‐sectional study was conducted in six LTCFs. A total of 338 residents aged 65 years and older were included. Sociodemographic and clinical data, including data from the Montreal Cognitive Assessment (MoCA), Confusion Assessment Method (CAM) and DOSS, were obtained by three trained nurse researchers. For the DOSS, internal consistency was determined, and inter‐rater reliability was calculated. To validate the DOSS, the sensitivity, specificity, and positive and negative predictive value of the DOSS relative to the CAM were determined through receiver operating characteristic analysis. This article adheres to the Strengthening the Reporting of Observational Studies (STROBE) checklist for observational research. Results: For 338 residents, delirium assessments were completed during an early or late shift. The prevalence of delirium was 14.2% as measured with the DOSS. The reliability (α) for the CAM and DOSS was assessed, as was the inter‐rater reliability (κ) and the area under the curve. The sensitivity and specificity for a cut‐off value of 3 on the DOSS by Youden's index were very high, as was the negative predictive value. The positive predictive value was good. Conclusions: This study showed that the DOSS is a reliable and valid instrument to screen for delirium in LTCF residents in Flanders. Geriatr Gerontol Int 2024; 24: 619–625. [ABSTRACT FROM AUTHOR]

Background: Spinopelvic parameters, including pelvic tilt (PT), sacral slope (SS), and pelvic incidence, have been developed to characterize the relationship between lumbar spine and hip motion, but a paucity of literature is available characterizing differences in spinopelvic parameters among patients with femoroacetabular impingement syndrome (FAIS) versus patients without FAIS, as well as the effect of these parameters on outcomes of arthroscopic treatment of FAIS. Purpose: To (1) identify differences in spinopelvic parameters between patients with FAIS versus controls without FAIS; (2) identify associations between spinopelvic parameters and preoperative patient-reported outcomes (PROs); and (3) identify differences in PROs between patients with stiff spines (standing-sitting ΔSS ≤10°) versus those without. Study Design: Cohort study; Level of evidence, 2. Methods: The study enrolled patients ≥18 years of age who underwent primary hip arthroscopy for treatment of FAIS with cam, pincer, or mixed (cam and pincer) morphology. Participants underwent preoperative standing-sitting imaging with a low-dose 3-dimensional radiography system and were matched on age and body mass index (BMI) to controls without FAIS who also underwent EOS imaging. Spinopelvic parameters measured on EOS films were compared between the FAIS and control groups. Patients with FAIS completed the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) before surgery and at 1-year follow-up. Outcome scores were compared between patients with stiff spines versus those without. Associations between spinopelvic parameters and baseline outcome scores were assessed with Pearson correlations. Continuous variables were compared with Student t test and/or Mann-Whitney U test, and categorical variables were compared with Fisher exact test. Results: A total of 50 patients with FAIS (26 men; 24 women; mean age, 36.1 ± 10.7 years; mean BMI, 25.6 ± 4.2) were matched to 30 controls without FAIS (13 men; 17 women; mean age, 36.6 ± 9.5 years; mean BMI, 26.7 ± 3.6). Age, sex, and BMI were not significantly different between the FAIS and control groups (P >.05). Standing PT was not significantly different between stiff and non-stiff cohorts (P =.73), but sitting PT in the FAIS group was more than double that of the control group (36.5° vs 15.0°; P <.001). Incidence of stiff spine was significantly higher in the FAIS group (62.0% vs 3.3%; P <.001). Among FAIS patients, those with stiff spines had a significantly higher prevalence of cam impingement, whereas those with non–stiff spines had a higher prevalence of mixed impingement (P =.04). No significant differences were seen in preoperative mHHS or NAHS scores or pre- to postoperative improvement in scores between FAIS patients with stiff spines versus those without (P >.05), but a greater sitting SS was found to be positively correlated with a higher baseline mHHS (r = 0.36; P =.02). Conclusion: Patients with FAIS were more likely to have a stiff spine (standing-sitting ΔSS ≤10°) compared with control participants without FAIS. FAIS patients with stiff spines were more likely to have isolated cam morphology than patient without stiff spines. Although sitting SS was positively correlated with baseline mHHS, no significant differences were seen in 1-year postoperative outcomes between FAIS patients with versus without stiff spine. [ABSTRACT FROM AUTHOR]

Background: Patients with borderline hip dysplasia (BHD) and concomitant femoroacetabular impingement syndrome (FAIS) have demonstrated similar outcomes at short- and midterm follow-up compared with equivalent patients without dysplasia. However, comparisons between these groups at long-term follow-up have yet to be investigated. Purpose: To compare long-term clinical outcomes between patients with BHD undergoing primary hip arthroscopy for FAIS versus matched control patients without BHD. Study Design: Cohort study; Level of evidence, 2. Methods: A retrospective cohort study was conducted on patients with BHD (lateral center-edge angle, 18°-25°) who underwent hip arthroscopy for FAIS between January 2012 and February 2013. Patients were propensity matched in a 1:3 ratio by age, sex, and body mass index to control patients without BHD who underwent primary hip arthroscopy. Groups were compared in terms of patient-reported outcomes (PROs) preoperatively and at 10 years postoperatively, including the Hip Outcome Score Activities of Daily Living subscale (HOS-ADL) and Sports subscale (HOS-SS), modified Harris Hip Score, 12-item International Hip Outcome Tool, visual analog scale (VAS) for pain and satisfaction. Achievement rates for minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were compared between groups. Kaplan-Meier survivorship curves were assessed between groups. Results: At a mean follow-up of 10.3 ± 0.3 years, 28 patients with BHD (20 women; age, 30.8 ± 10.8 years) were matched to 84 controls who underwent primary hip arthroscopy. Both groups significantly improved from preoperative assessment in all PRO measures at 10 years (P <.001 for all). PRO scores were similar between groups, aside from HOS-SS (BHD, 62.9 ± 31.9 vs controls, 80.1 ± 26.0; P =.030). Rates of MCID achievement were similar between groups for all PROs (HOS-ADL: BHD, 76.2% vs controls, 67.9%, P =.580; HOS-SS: BHD, 63.2% vs controls, 69.4%, P =.773; modified Harris Hip Score: BHD, 76.5% vs controls, 67.9%, P =.561; VAS pain: BHD, 75.0% vs controls, 91.7%, P =.110). Rates of PASS achievement were significantly lower in the BHD group for HOS-ADL (BHD, 39.1% vs controls, 77.4%; P =.002), HOS-SS (BHD, 45.5% vs controls, 84.7%; P =.001), and VAS pain (BHD, 50.0% vs controls, 78.5%; P =.015). No significant difference was found in the rate of subsequent reoperation on the index hip between groups. Kaplan-Meier survival analysis demonstrated comparable survivorship at long-term follow-up (P =.645). Conclusion: After primary hip arthroscopy, patients with BHD in the setting of FAIS had significantly improved PRO scores at 10-year follow-up, comparable with propensity-matched controls without BHD. Rates of MCID achievement were similar between groups, although patients with BHD had lower rates of PASS achievement. Patients with BHD had similar long-term hip arthroscopy survivorship compared with controls, with no significant difference in rates of revision hip arthroscopy or conversion to total hip arthroplasty. [ABSTRACT FROM AUTHOR]

Background: The incremental biological changes in the synovial microenvironment of the shoulder in acute and chronic instability that may contribute to joint degeneration are poorly understood. Proteomic analysis of synovial fluid in patients with shoulder instability may improve our understanding of proteins that are shed into shoulder synovial fluid after an injury. Hypothesis: Injury-specific factors such as the direction of instability and the severity of glenoid and humeral bone loss are associated with the proteome of synovial fluid in patients with shoulder instability. Study Design: Descriptive laboratory study. Methods: Synovial fluid lavage samples were compared between patients with anterior (n = 12) and posterior (n = 8) instability and those without instability (n = 5). Synovial proteins were identified with liquid chromatography–tandem mass spectrometry. Orthogonal validation of protein targets found to be significant on tandem mass spectrometry was performed in a separate set of prospective patients with Western blotting. Data were processed and analyzed, and P values were adjusted with the Benjamini-Hochberg method for multiple comparisons. Results: A total of 25 patients were included. Tandem mass spectrometry identified 720 protein groups in synovial fluid of patients with shoulder instability. There were 4 synovial proteins that were significantly expressed in patients with anterior instability relative to posterior instability: periostin (POSTN) (adjusted P value =.03; log fold change [logFc] = 4.7), transforming growth factor beta–induced protein ig-h3 (adjusted P value =.05; logFc = 1.7), collagen type VI alpha-3 chain (adjusted P value =.04; logFc = 2.6), and coagulation factor V (adjusted P value =.04; logFc = −3.3). Among these targets, POSTN showed a moderate correlation with the Hill-Sachs lesion size (r = 0.7). Prospective validation with Western blotting confirmed a significantly higher level of POSTN in synovial fluid of patients with anterior instability (P =.00025; logFc = 5.1). Conclusion: Proteomic analysis enriched our understanding of proteins that were secreted into shoulder synovial fluid of patients with shoulder instability. The identification of POSTN, a proinflammatory catabolic protein involved with tissue remodeling and repair, as a significant target in anterior shoulder instability is a novel finding. Therefore, further study is warranted to determine the role that POSTN may play in the progression of bone loss and posttraumatic osteoarthritis. Clinical Relevance: Proteomic analysis of synovial fluid in patients with shoulder instability improved our understanding of this abnormality after an injury. [ABSTRACT FROM AUTHOR]

Cardiopulmonary and infectious complications are more common in preterm newborns after preterm premature rupture of membranes (pPROM). Fetal echocardiography may be helpful in predicting neonatal condition. Our aim was to assess the cardiovascular changes in fetuses from pregnancies complicated by pPROM and possible utility in predicting the intrauterine or neonatal infection, and neonatal heart failure (HF). It was a prospective study enrolling 46 women with singleton pregnancies complicated by pPROM between 18+0 and 33+6 weeks of gestation and followed until delivery. 46 women with uncomplicated pregnancies served as a control group. Fetal echocardiographic examinations with the assessment of cardiac structure and function (including pulmonary circulation) were performed in all patients. Mean gestational age of pPROM patients was 26 weeks. Parameters suggesting impaired cardiac function in fetuses from pPROM were: higher right ventricle Tei index (0.48 vs. 0.42 p<0.001), lower blood flow velocity in Ao z-score (0.14 vs. 0.84 p=0.005), lower cardiovascular profile score (CVPS), higher rate of tricuspid regurgitation (18.2 % vs. 4.4 % p=0.04) and pericardial effusion (32.6 vs. 0 %). Intrauterine infection was diagnosed in 18 patients (39 %). 4 (8.7 %) newborns met the criteria of early onset sepsis (EOS). HF was diagnosed in 9 newborns. In fetal echocardiographic examination HF group had shorter mitral valve inflow time and higher left ventricle Tei index (0.58 vs. 0.49 p=0.007). Worse cardiac function was observed in fetuses from pPROM compared to fetuses from uncomplicated pregnancies. [ABSTRACT FROM AUTHOR]

Purpose: Evidence is growing that high salt intake is an independent risk factor for obesity, but the mechanisms are unknown. Our novel working hypothesis is that high salt intake drives cortisol production, which in turn, drives obesity. The current study aimed to demonstrate an acute cortisol response following a single high salt meal. Methods: Eight participants (age 30.5 ± 9.8 years [mean ± SD], 50% female), consumed high salt (3.82 g; 1529 mg sodium) and low salt (0.02 g; 9 mg sodium) meals in a randomized cross-over design. Results: Urinary and salivary cortisol and plasma adrenocorticotropic hormone (ACTH) demonstrated order effects. When high salt was given second, there was a peak above baseline for urinary cortisol (26.3%), salivary cortisol (9.4%) and plasma ACTH (4.1%) followed by a significant decline in each hormone (treatment*time, F[9, 18] = 2.641, p = 0.038, partial η2 = 0.569; treatment*time, F[12, 24] = 2.668, p = 0.020, partial η2 = 0.572; treatment*time, F[12, 24] = 2.580, p = 0.023, partial η2 = 0.563, respectively), but not when high salt was given first (p > 0.05 for all). Conclusion : These intriguing findings provide partial support for our hypothesis and support a need for further research to elucidate the role of high salt intake in cortisol production and, in turn, in the aetiology of obesity. Trial registration number: ACTRN12623000490673; date of registration 12/05/2023; retrospectively registered. [ABSTRACT FROM AUTHOR]

Design. Retrospective review. Objective. Characterize negative reviews of spine surgeons in the United States. Summary. Physician rating websites significantly influence the selection of doctors by other patients. Negative experiences are impacted by various factors, both clinical and nonclinical, geography, and practice structure. The purpose of this study was to evaluate and categorize negative reviews of spine surgeons in the United States, with a focus on surgical versus nonsurgical reviewers. Methods. Spine surgeons were selected from available online professional society membership directories. A search for reviews was performed on Healthgrades.com, Vitals.com, and RateMDs. com for the past 10 years. Free response reviews were coded by complaint, and qualitative analysis was performed. χ2 and Fisher exact tests were used to compare categorical variables, and multiple comparisons were adjusted with Benjamini-Hochberg correction. A binary logistic regression model was performed for the top three most mentioned nonclinical and clinical complaint labels. A P-value <0.05 was considered statistically significant. Results. A total of 16,695 online reviews were evaluated, including 1690 one-star reviews (10.1%). Among one-star reviews, 64.7% were written by nonsurgical patients and 35.3% by surgical patients. Nonclinical and clinical comments constituted 54.9% and 45.1% of reviews, respectively. Surgeons in the South had more "bedside manner" comments (43.3%, P <0.0001), while Northeast surgeons had more "poor surgical outcome" remarks compared with all other geographic regions (14.4%, P< 0.001). Practicing in the South and Northeast were independent predictors of having complaints about "bedside manner" and "poor surgical outcome," respectively. Conclusion. Most one-star reviews of spine surgeons were attributed to nonsurgical patients, who tended to be unsatisfied with nonclinical factors, especially "bedside manner." However, there was substantial geographic variation. These results suggest that spine surgeons could benefit from focusing on nonclinical factors (bedside manner), especially among nonoperative patients, and that regional nuances should be considered in delivering spine care. [ABSTRACT FROM AUTHOR]

Objectives: To compare 5-year survival rate and morbidity in children with spina bifida, transposition of great arteries (TGA), congenital diaphragmatic hernia (CDH) or gastroschisis diagnosed prenatally with those diagnosed postnatally. Methods: Population-based registers' data were linked to hospital and mortality databases. Results: Children whose anomaly was diagnosed prenatally (n = 1088) had a lower mean gestational age than those diagnosed postnatally (n = 1698) ranging from 8 days for CDH to 4 days for TGA. Children with CDH had the highest infant mortality rate with a significant difference (p < 0.001) between those prenatally (359/1,000 births) and postnatally (116/1,000) diagnosed. For all four anomalies, the median length of hospital stay was significantly greater in children with a prenatal diagnosis than those postnatally diagnosed. Children with prenatally diagnosed spina bifida (79% vs 60%; p = 0.002) were more likely to have surgery in the first week of life, with an indication that this also occurred in children with CDH (79% vs 69%; p = 0.06). Conclusions: Our findings do not show improved outcomes for prenatally diagnosed infants. For conditions where prenatal diagnoses were associated with greater mortality and morbidity, the findings might be attributed to increased detection of more severe anomalies. The increased mortality and morbidity in those diagnosed prenatally may be related to the lower mean gestational age (GA) at birth, leading to insufficient surfactant for respiratory effort. This is especially important for these four groups of children as they have to undergo anaesthesia and surgery shortly after birth. Appropriate prenatal counselling about the time and mode of delivery is needed. Significance: What is already known on this subject?: Prenatal detection of congenital anomalies has become more common with improvements in technology and increased accuracy of detection. Previous findings on the effect of timing of diagnoses on newborn outcomes are limited and conflicting. What this study adds?: Our findings do not show better outcomes for prenatally diagnosed infants with spina bifida, transposition of great arteries, congenital diaphragmatic hernia or gastroschisis. More severe anomalies may be more likely to be prenatally detected. Appropriate prenatal counselling about the time and mode of delivery is needed. [ABSTRACT FROM AUTHOR]

Introduction: Exclusive breastfeeding is recognized as the optimal source of nutrition for infants. Although exclusive breastfeeding rates have increased overall in the United States, substantial inequities exist in breastfeeding among individuals of different socioeconomic statuses, races, and ethnicities. The purpose of this study was to examine characteristics associated with exclusive breastfeeding intentions among pregnant women in Arkansas enrolled in a Healthy Start program. Methods: The current study included a cross-sectional design, with a sample of 242 pregnant women in Arkansas enrolled in a Healthy Start program. Results: The majority of the participants (56.6%) indicated their infant feeding intentions included a combination of breastfeeding and formula feeding. There were substantial differences in breastfeeding intentions among women of different races/ethnicities, with 18.5% of Marshallese women indicating they planned to exclusively breastfeed, compared to 42.1% of White women, 47.6% of Black women, and 31.8% of Hispanic women (p < 0.001). Women over the age of 18 and with higher educational attainment were more likely to intend on exclusively breastfeeding. Discussion: This is the first study to examine characteristics associated with exclusive breastfeeding intentions among pregnant women in Arkansas enrolled in a Healthy Start program. The study found that race/ethnicity and age were most strongly associated with breastfeeding intentions. These findings are critical to identifying populations for resource allocation and to developing culturally-tailored interventions to help women in Arkansas achieve their desired infant feeding methods. Significance: What is already known on this subject?: Exclusive breastfeeding is recognized as the optimal source of nutrition for infants, and it has been associated with decreased risk of obesity and cardiometabolic disease for both mother and infant. Although exclusive breastfeeding rates have increased overall in the United States, substantial inequities exist in breastfeeding among individuals of different socioeconomic statuses, races, and ethnicities. What this study adds?: This is the first study to examine characteristics associated with exclusive breastfeeding intentions among pregnant women in Arkansas enrolled in a Healthy Start program. The study found that race/ethnicity and age were most strongly associated with breastfeeding intentions. [ABSTRACT FROM AUTHOR]

Innovation is an organizational learning process that demands a reflexive perspective to take on uncertainties and question deeply held assumptions, propelling leadership and organizational structures forward. Discussions on the relationships between innovation and reflexivity predominantly focus on individuals rather than considering it a shared capability within an organization. This study elucidates the impact of reflexive-learning-based leadership development on promoting collective reflexivity, navigating its implications for organizational leadership and structures in innovation. A reflexive-learning-based leadership development program is a set of collective actions comprising four fundamental steps: acknowledging problems, reassessing assumptions, thinking of alternatives, and developing new perspectives. This study demonstrates its effectiveness in developing collective reflexivity within an engineering organization by repurposing the After-Action Review (AAR) as reflexive learning training. The findings underscore reflexive learning, making leaders exhibit the traits of ambiguity tolerance and interdisciplinary knowledge that favor innovation. This research contributes to an academic framework, opening avenues for future investigations into organizational development from a reflexive perspective and providing a proven managerial practice to improvise an effective solution to overcome those uncertainties in real-world innovations. [ABSTRACT FROM AUTHOR]

This article describes data on the gender distribution of mental health disorders among adolescents of Togo, West Africa. The sample size of this study included 242 patients. Gender and mental health disorders according to the definition of International Classification of Disease, tenth revision (ICD-10) were considered. Females were significantly more likely to develop a mental health disorder than males (61.16% vs 38.84% of the sample), and females were significantly 3 times more likely to develop Somatoform Disorders- Other Neurotic Disorders compared to males. Males were significantly 2 times more likely to develop Acute and Transient Psychotic Disorders. [ABSTRACT FROM AUTHOR]

Summary: Anti‐Müllerian hormone (AMH) is commonly used as a marker of ovarian reserve. Although obesity is associated with decreased fertility, the relationship between body mass index (BMI) and AMH remains uncertain, hindering the accurate interpretation of AMH. We sought to assess the relationship between serum AMH and BMI in patients with and without polycystic ovarian syndrome (PCOS). This study analysed 500 patients at a single centre between 2020 and 2021. Patients were divided into cohorts: those with BMI <40 kg/m2 and those with BMI >40 kg/m2. Patients with and without PCOS were included. Chi‐square tests, Fisher's exact tests, multiple linear regression analysis and independent t‐tests were performed as appropriate. In the general study population, serum AMH was not significantly different in the BMI >40 kg/m2 group compared to the BMI <40 kg/m2 group (4.3 ± 5.6 vs. 4.3 ± 5.6, p =.35). Patient ages between these two groups differed, with an average age of 35.4 ± 5.4 years in the BMI <40 kg/m2 group and 33.7 ± 5.4 years in the BMI <40 kg/m2 group (p =.031). Our multivariate regression analysis, which adjusted for age, demonstrated a significant interaction effect between BMI and PCOS diagnosis, indicating that the relationship between BMI and AMH is dependent on PCOS status (β = −.03, 95% confidence interval [CI]: −0.05, 0.00, p =.044). In patients without PCOS, we found a non‐significant relationship between AMH and BMI (β =.00, 95% CI −0.01, 0.01, p =.7); however, in patients with PCOS, AMH significantly decreased as BMI increased (β = −.03, 95% CI −0.06, 0.00, p =.034). BMI has an inverse association with AMH levels in patients with PCOS, indicating a need for future research to determine if that interaction represents a clinically significant negative effect on reproductive function. [ABSTRACT FROM AUTHOR]

To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2019 and received standard level of physiotherapy. The intervention group were recruited between May and December 2019 and received extended physiotherapy, corresponding to 50% additional physiotherapist, working 4 hours per weekday. The intervention participants received an individual rehabilitation plan developed in collaboration with a ward-based physiotherapist, and an extended number of sessions provided by the extra resource included practicing individualized exercises, for example walking and stair climbing. Physical function was measured with the Chelsea Critical Care Physical Assessment tool (CPAx) at ICU discharge, during hospital stay and discharge. Group differences were analyzed using the Mann–Whitney U-test and Chi2 test. Out of 46 eligible patients, 39 (85%) fulfilled the study (comparison n = 12, intervention n = 27) and were included in the final analyses. No adverse events occurred, and the attendance rate was high (98.5%). There were no statistically significant differences between the groups regarding physical function, hospital stay, and readmissions, but there were tendencies to better outcomes in all these parameters in favor of the intervention group. Additionally, patients in the intervention group had statistically significantly higher scores in the CPAx items "transferring from bed to chair" (median 5 vs 4, p =.039) and "stepping" (median 5 vs 4, p =.005) at hospital discharge. This pilot study indicates that extended physiotherapy after ICU discharge is feasible and does not entail patient safety risks. However, determining the potential beneficial effects for the patients remains to be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

Coronavirus Disease 2019 (COVID-19) became a significant challenge for the work and personal experience of physiotherapists (PTs) To investigate how the work activities of PTs in a region in Italy have changed, describe the reasons for change, perceived competence, and effectiveness of professional education, and explore their personal experience We adopted a monocentric convergent mixed-methods light–questionnaire variant study. The questionnaire contains both closed-ended and open-ended questions. Quantitative and qualitative data were combined to interpret the results Among 78 respondents (response rate 24.4%), 87.2% worked during the pandemic, 52.9% treated patients with COVID-19, and 45.6% changed their working activities. Professional competence was perceived as low in intensive and sub-intensive care settings. The major critical aspect of professional education was respiratory rehabilitation. Life-learning education was judged as effective, even if mainly focused on safety. Nine themes emerged from the analysis of the PTs' experiences: 1) Physiotherapy during COVID-19; 2) Fear and negative feelings; 3) Positive aspects; 4) Organization and management; 5) Prevention measures; 6) Patients; 7) Change; 8) Information; and 9) Professional education PTs who have direct experience with patients with COVID-19 showed great resilience. They overcame the first phase of disorientation and fear, despite a specific lack of competence in the respiratory field. [ABSTRACT FROM AUTHOR]

The risk of injury in archery is supposedly low. However, relations between pain, shooting phases and types of bow have not been studied. Understanding the biomechanical mechanisms of archery-related injuries. Online survey for archers from all types of bow. Variables were analyzed using contingency tables and chi-squared tests. 396 surveys were completed. 36.9% of the archers had practiced archery for more than 10 years, 23.3% between 5 and 10 years. Olympic recurve bow was the most commonly used (38.2%), followed by traditional (23.3%) and compound (22.0%). 57.3% of the archers suffered some kind of injury during archery practice. Drawing shoulder (28.2%) and neck/back injuries (19.9%) were the most prevalent, preventing 50.3% of those who suffered them from continuing archery practice. There was a moderate association between drawing arm injuries and symptomatology in the drawing phase, especially in the shoulder region (0.55), elbow (0.20), and hand (0.13), and to a lesser extent in the neck/back (0.28). Our results show that injury chronicity is frequent on archery. Correlations between types of bow, phases of the shoot and areas of pain could be a starting point for future studies on the repercussions of different types of injuries in archery practice. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Despite a negative magnetic resonance imaging (MRI), some patients may still harbor clinically significant prostate cancer (csPCa, Gleason grade group =2). Highresolution micro-ultrasound (microUS) is a novel imaging technology that could visualize csPCa that is missed by MRI. METHODS: This retrospective review included 1011 consecutive patients biopsied between September 2021 and July 2023 in Alberta, Canada. Among them were 103 biopsy-naive patients with negative MRI (Prostate Imaging Reporting & Data System [PI-RADS] =2) undergoing microUS-informed prostate biopsy (n=56) scored using Prostate Risk Identification Using Micro-ultrasound (PRI-MUS) or standard transrectal ultrasound prostate biopsy (n=47). The primary outcome was detection rate of csPCa stratified by biopsy technique and PRIMUS score. RESULTS: MicroUS biopsy identified csPCa in 14/56 (25%) compared to standard biopsy in 8/47 (17%) (p=0.33). Patients with lesions PRI-MUS =3 had csPCa detected at a higher rate compared to patients with PRI-MUS =2 (42% vs. 16%, p=0.03). The csPCa detection rate was significantly different comparing patients with prostate-specific antigen (PSA) density <0.15 and PRI-MUS =2 compared to patients with PSA density =0.15 and PRI-MUS =3 (14% vs. 60%, p=0.02). CONCLUSIONS: MicroUS may aid in the detection of csPCa for patients with negative MRI. [ABSTRACT FROM AUTHOR]

Objective: To evaluate requests for legal abortion due to pregnancies resulting from sexual violence (SV) in a reference service, and characterise and compare the outcome groups. Retrospective cohort study with review of medical records of women assisted between 2015 and 2020. The variables were socio-demographic and SV characteristics, gestational age, reactions towards pregnancy and outcome. We compared outcome groups using the chi-square test, Fisher's exact test and the Kruskal–Wallis test. The significance level was 5%. We evaluated the medical records of 235 women, of which 153(65%) had undergone to abortion; 17(7.2%) had a spontaneous abortion; 19(8%) remained pregnant; 25(10.6%) had an abortion denied; and 21(8.9%) had been lost to follow-up. Out of the total number of women, 44(18.7%) were adolescents, 152(65.2%) were white and 201(88.5%) had an education ≥9 years. Women who remained pregnant had a known aggressor, disclosed the pregnancy (p < 0.001) and were more ambivalent (p < 0.001) than the other groups. Gestational age was higher in the denied abortion group than in the performed abortion group (p < 0.001). Feelings related to decision-making about abortion affected all groups, with differences. It is important to give women space to be heard, so they can make their own decisions. Abortion care is possible in places with restrictive laws; however, women with more vulnerable characteristics did not seek the service. Legal restrictions interfere with women's decision-making about abortion and can promote inequality in gaining access to health services. [ABSTRACT FROM AUTHOR]

Background: We aimed to develop a tool for predicting HNF1B mutations in children with congenital abnormalities of the kidneys and urinary tract (CAKUT). Methods: The clinical and laboratory data from 234 children and young adults with known HNF1B mutation status were collected and analyzed retrospectively. All subjects were randomly divided into a training (70%) and a validation set (30%). A random forest model was constructed to predict HNF1B mutations. The recursive feature elimination algorithm was used for feature selection for the model, and receiver operating characteristic curve statistics was used to verify its predictive effect. Results: A total of 213 patients were analyzed, including HNF1B-positive (mut + , n = 109) and HNF1B-negative (mut − , n = 104) subjects. The majority of patients had mild chronic kidney disease. Kidney phenotype was similar between groups, but bilateral kidney anomalies were more frequent in the mut + group. Hypomagnesemia and hypermagnesuria were the most common abnormalities in mut + patients and were highly selective of HNF1B. Hypomagnesemia based on age-appropriate norms had a better discriminatory value than the age-independent cutoff of 0.7 mmol/l. Pancreatic anomalies were almost exclusively found in mut + patients. No subjects had hypokalemia; the mean serum potassium level was lower in the HNF1B cohort. The abovementioned, discriminative parameters were selected for the model, which showed a good performance (area under the curve: 0.85; sensitivity of 93.67%, specificity of 73.57%). A corresponding calculator was developed for use and validation. Conclusions: This study developed a simple tool for predicting HNF1B mutations in children and young adults with CAKUT. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke. This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl–Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36). In the MHG, FM-Lower extremity score (−6.4, p = 0.024), FM-Upper extremity score (−12.87, p = 0.013), TIS (−5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG. Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life. NCT03528993 NCT03528993 It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients. [ABSTRACT FROM AUTHOR]

Background: Given students' lack of self‐directed learning skills and the growing concern about implementing massive online open courses (MOOCs) in K12 education, learning strategies are needed to facilitate MOOC learning. Many studies have provided different strategies for effective learning in MOOCs. However, there is still limited research to confirm whether these strategies effectively support MOOC learning when deployed by secondary schools, which are not MOOC developers. Objectives: This mixed‐method study examines the provision of different learning strategies, including a learning guide, an academic mentoring programme, a training workshop, and a reimbursement scheme, and investigates the impact of these strategies on student learning in MOOCs. Methods: The study uses two data sources: (1) surveys with 40 participants and (2) semi‐structured interviews with 12 participants. The quantitative data were analysed with descriptive statistics and Fisher's exact test, and the qualitative data were analysed with thematic analysis. Results and Conclusion: The findings indicate that MOOC learners had positive attitudes towards the overall school support, with mentoring enjoying great popularity amongst the students. In terms of the effectiveness of the school support, the mentoring programme and reimbursement scheme were more effective than the university training and learning guide. The paper discusses the implications for researchers and educators. Lay Description: What is already known about this topic: There are a large number of K12 MOOC implementations, which are (i) STEM‐related and computer science courses, and (ii) from Europe and the USA.Limited studies provided different learning strategies for MOOC learning from the perspective of K12 schools, which are not MOOC developers.There is a need to explore MOOC initiatives encompassing a wide variety of subjects, including computer science MOOCs and non‐computer science MOOCs, in regions beyond Europe and the USA.There is also a need for further scrutiny of the effectiveness of learning strategies provided by the K12 school. What this paper adds: Our study launched the first MOOC implementation in K12, encompassing several subject areas beyond computer science in the region of Asia.Our study provided different learning strategies adopted by the K12 school, and the analysis revealed that MOOC learners took positive attitudes towards overall school support with mentoring enjoying great popularity with these students.Our study examined the effectiveness of school support and identified that mentoring and reimbursement are more effective than university training and the learning guide. Implications for practitioners: The insights gained from the study enable other K12 schools and educators to implement MOOC into existing school infrastructures successfully.These strategies provided in the MOOC implementation program can be helpful in many different online learning contexts. [ABSTRACT FROM AUTHOR]