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Lianne Jeffs,1–3 Trevor Jamieson,4,5 Marianne Saragosa,5 Geetha Mukerji,3,5,6 Arsh K Jain,7 Rachel Man,7 Laura Desveaux,3,5 James Shaw,3,5 Payal Agarwal,5,8 Jennifer M Hensel,5,9 Maria Maione,10 Megan Nguyen,5 Nike Onabajo,5 R Sacha Bhatia3,5,11 1Sinai Health System, Toronto, ON M5G 1X5, Canada; 2Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON M5G 1WB, Canada; 3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1B2, Canada; 4Department of Medicine, University of Toronto, Division of General Internal Medicine, St Michael’s Hospital, Women’s College Hospital, Toronto, ON M5G 1WB, Canada; 5Institute for Health System Solutions and Virtual Care (WIHV), Women’s College Hospital, Toronto, ON M5S 1B2, Canada; 6Women’s College Hospital, Toronto, ON M5S 1B2, Canada; 7London Health Sciences Centre, London, ON N6A 5W9, Canada; 8Department of Family and Community Medicine, Women’s College Hospital, University of Toronto, Toronto, ON M5S 1B2, Canada; 9Department of Psychiatry, University of Toronto, Women’s College Hospital, Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada; 10St Michael’s Hospital, Toronto, ON M5G 1WB, Canada; 11University Health Network, Toronto, ON M5S 1B2, Canada Background: Although there is a growing body of literature on the outcomes and impacts of remote home management with peritoneal dialysis (PD) patients, less is understood how this virtual care solution impacts the quality and efficiency of the healthcare system care. In this context, a study was undertaken to understand the perceptions of patients and their caregivers, healthcare providers, health system decision makers, and vendors associated with a remote monitoring and tracking solution aimed at enhancing the outcomes and experiences of chronic kidney disease (CKD) patients receiving PD at home. Methods: A qualitative design using semi-structured interviews with 25 stakeholders was used in this study. Narrative data were analyzed by a thematic analysis approach. Results: The following two themes emerged from the data: (1) leveraging data to monitor and intervene to keep patients safe and (2) increasing efficiencies and having control over supplies. Discussion: Our study findings elucidated the ability of patients (and in some cases, caregivers) to monitor and trend their data and order and track directly on-line their dialysis supplies were key to their active participation in managing their CKD and keeping them safe at home. Their active participation and functionality of the virtual care solution also led to enhanced efficiencies (eg, process faster, easier, convenient, time savings) for both patients and healthcare providers. Conclusion: The virtual care solution showed promising signs of a patient-centric approach and may serve as a blueprint for other virtual care solutions for chronic disease management. Keywords: peritoneal dialysis, chronic kidney disease, virtual care, qualitative research, patient centric care

Acute calcific tendonitis is a common cause of musculoskeletal pain. However, it seldom affects the hand and wrist. For that reason, it is frequently mistaken for more common etiologies. This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris, which was initially misdiagnosed as cellulitis, in a 65-year-old woman, who was unnecessarily prescribed with antibiotics. However, further evaluation confirmed the correct diagnosis of acute calcific tendinitis and her symptoms were subsequently resolved within 2 weeks with rest, wrist immobilization, and an intake of anti-inflammatories. This case underscores the need for the physicians to be aware of this less common but important cause of acute wrist pain in order to prevent misdiagnosis and avoid unnecessary medical treatments.

The impact of common variants in the apolipoprotein gene cluster (APOC3-A4-A5) on prospective CHD risk was examined in healthy UK men. Of the 2808 men followed over nine years, 187 had a clinically defined CHD event. Examination of 9 single nucleotide polymorphisms (SNPs) in this group revealed that homozygotes for APOA4 S347 had significantly increased risk of CHD [Hazard ratio (HR) of 2.07 (95%CI 1.04-4.12)] while men homozygous for APOC3 1100T were protected (HR 0.28 (95%CI 0.09-0.87)). In stepwise multiple regression analysis, after entering all the variants and adjusting for established risk factors APOA4 T347S alone remained in the model. Using nine-SNP haplotype analysis, highest risk-estimate haplotypes carried APOA4 S347 and rare alleles of the two flanking intergenic markers. The protective effect of APOC31100T could be explained by negative linkage disequilibrium with these alleles. To determine the association of APOA4 T347S with apoAIVlevels, the relationship was examined in over 1600 healthy young European men and women. S347 homozygotes had significantly lower apoAIV plasma levels (13.48 + 0.6mg/dl) compared to carriers of the T347 allele (14.85 + 0.12 mg/dl) (p=0.025). These results demonstrate that genetic variation in and around APOA4, independent of effects of TG, is associated with risk of CHD and apoAIV levels, supporting an anti-atherogenic role for apoAIV.

This article is a systematic review and meta-analysis that examines the placental architectural characteristics in monochorionic twins with Twin-twin transfusion syndrome (TTTS) following laser ablation. The study analyzed 26 studies with a total of 4013 MC twins and found that approximately 24% of TTTS placentas had residual anastomoses after laser ablation. The presence of residual anastomoses was associated with an increased risk of adverse fetal outcomes, including intrauterine fetal demise, neonatal death, recurrent TTTS, and post-laser twin anemia-polycythemia sequence. Additionally, abnormal cord insertions were detected in almost half of the MC twins with TTTS that underwent laser ablation. The authors suggest that further research is needed to explore the relationship between abnormal cord insertion and residual anastomoses. [Extracted from the article]

Dian-Jeng Li,1– 3 Agata Chudzicka-Czupa&lstrok;a,4 Mateusz Paliga,5 Nadiya Hapon,6 Liudmyla Karamushka,7 Marta &Zdot;ywio&lstrok;ek-Szeja,4 Roger S McIntyre,8– 10 Soon-Kiat Chiang,11 Yi-Lung Chen,12,13 Cheng-Fang Yen,1,14,15 Roger Ho Chun Man16,17 1Graduate Institute of Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; 2Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, 80276, Taiwan; 3Department of Nursing, Meiho University, Pingtung, 91200, Taiwan; 4Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland; 5Faculty of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland; 6Department of Psychology, Faculty of Philosophy, Ivan Franko National University in Lviv, Lviv, Ukraine; 7G. S. Kostiuk Institute of Psychology, National Academy of Educational Sciences of Ukraine, Kyiv, Ukraine; 8Department of Psychiatry University of Toronto, Toronto, Canada; 9Department of Pharmacology, University of Toronto, Toronto, Canada; 10Brain and Cognition Discovery Foundation, Toronto, Canada; 11Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; 12Department of Psychology, Asia University, Taichung, Taiwan; 13Department of Healthcare Administration, Asia University, Taichung, Taiwan; 14Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 15College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan; 16Department of Psychological Medicine, National University of Singapore, Singapore, Singapore; 17Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, SingaporeCorrespondence: Cheng-Fang Yen, Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 80708, Taiwan, Tel +886-7-3121101 ext. 6822, Fax +886-7-3134761, Email chfaye@cc.kmu.edu.tw Yi-Lung Chen, Department of Healthcare Administration, Asia University, No. 500, Lioufeng Road, Wufeng, Taichung, 41354, Taiwan, Tel +886-4-23323456&num;20106, Fax +886-4-23321206, Email elong@asia.edu.twBackground: The Russo-Ukrainian War has resulted in massive social, economic, and psychological burdens worldwide. This study aimed to investigate the associations between time spent on the war-related news and psychological distress, including depression, anxiety, and post-traumatic stress disorder (PTSD) and the mediating effects of rumination on the associations in people residing in Poland and Ukraine.Methods: This cross-sectional study recruited 1438 internet users in Poland and Ukraine, and collected data on levels of rumination, psychological distress, and the amount of time spent on and sources of the news of the Russo-Ukrainian War. Structural equation modeling with bootstrapping methods was used to evaluate the mediation effect. Multivariate linear regression was used to identify predictive effect of the source of the war-related news on psychological distress and rumination.Results: The results showed a mediating effect of rumination on the association between the amount of time spent on the war-related news and psychological distress among participants in Poland (β = 0.16, p < 0.001) and Ukraine (β = 0.15, p < 0.001). Approaching the news from television was associated with rumination (β = 0.607, p < 0.001) and PTSD symptoms in Poland (β = 2.475, p = 0.009), while approaching news from the internet was associated with rumination in Poland (β = 0.616, p = 0.001).Conclusion: The study identified the mediating effect of rumination and the associations of approaching the war-related news from television and the internet with mental health.Keywords: Russo-Ukrainian war, rumination, psychological distress, mediation, time spent on the news of war

Objective: We aimed to examine the effectiveness and safety of a novel torque-controlled catheter for cerebral angiography. Methods: A total of 417 patients who underwent routine transfemoral cerebral angiography were enrolled in a randomized controlled study to compare the new torque-controlled and control group catheters. Device success was assessed on parameters such as the assessment of the common carotid artery, device rotation force, and success rate with the crossover group after the failed procedure. Four neurointerventionalists investigated the degree of satisfaction of using the new device. Superiority and non-inferiority tests of satisfaction scores were estimated for the new torque-controlled and the control group catheters. Results: The new torque-controlled catheter showed improved performance in terms of technical device success (92.79 vs. 98.09 %, P = 0.010), crossover after technical device failure (0 vs. 86.67 %, P = 0.004), and common carotid artery access (92.79 vs. 98.56 %, P = 0.004). The flexibility and rotational force of the new torque-controlled catheter were higher than those of the control group catheters (75.48 vs. 100 %, P

Background: Serum hepatitis B surface antigen (HBsAg) levels correlate with the duration of chronic hepatitis B virus (HBV) infection and may predict the extent of hepatic fibrosis.Methods: We analyzed data from the SONIC-B database, which contains data from 8 global randomized trials and 2 large hepatology centers. Relationship between HBsAg levels and presence of significant fibrosis (Ishak 3-4) or cirrhosis (Ishak 5-6) were explored, and clinically relevant cutoffs were identified to rule out cirrhosis.Results: The dataset included 2779 patients: 1866 hepatitis B e antigen (HBeAg)-positive; 322 with cirrhosis. Among HBeAg-positive patients, lower HBsAg levels were associated with higher rates of significant fibrosis (odds ratio [OR], 0.419; P < .001) and cirrhosis (OR, 0.435; P < .001). No relationship was observed among HBeAg-negative patients. Among HBeAg-positive patients, genotype-specific HBsAg cutoffs had excellent negative predictive values (>97%) and low misclassification rates (≤7.1%) and may therefore have utility in ruling out cirrhosis. Diagnostic performance of the HBsAg cutoffs was comparable among patients in whom cirrhosis could not be ruled out with fibrosis 4 (FIB-4).Conclusions: Hepatitis B virus genotype-specific HBsAg cutoffs may have utility in ruling out presence of cirrhosis in HBeAg-positive patients with genotypes B, C, and D and can be an adjunct to FIB-4 to reduce the need for further testing. [ABSTRACT FROM AUTHOR]