Search

BackgroundMobile technologies are increasingly being used in health care and public health practice for patient communication, monitoring, and education. Mobile health (mHealth) tools have also been used to facilitate adherence to chronic musculoskeletal pain (CMP) management, which is critical to achieving improved pain outcomes, quality of life, and cost-effective health care. ObjectiveThe aim of this systematic review was to evaluate the 25-year trend of the literature on the adherence, usability, feasibility, and acceptability of mHealth interventions in CMP management among patients and health care providers. MethodsWe searched the PubMed, Cochrane CENTRAL, MEDLINE, EMBASE, and Web of Science databases for studies assessing the role of mHealth in CMP management from January 1999 to December 2023. Outcomes of interest included the effect of mHealth interventions on patient adherence; pain-specific clinical outcomes after the intervention; and the usability, feasibility, and acceptability of mHealth tools and platforms in chronic pain management among target end users. ResultsA total of 89 articles (26,429 participants) were included in the systematic review. Mobile apps were the most commonly used mHealth tools (78/89, 88%) among the included studies, followed by mobile app plus monitor (5/89, 6%), mobile app plus wearable sensor (4/89, 4%), and web-based mobile app plus monitor (1/89, 1%). Usability, feasibility, and acceptability or patient preferences for mHealth interventions were assessed in 26% (23/89) of the studies and observed to be generally high. Overall, 30% (27/89) of the studies used a randomized controlled trial (RCT), cohort, or pilot design to assess the impact of the mHealth intervention on patients’ adherence, with significant improvements (all P

Premenstrual exacerbation of an existing psychiatric disorder refers to the worsening of symptoms inherent to the condition during the premenstrual phase. Research consistently indicates that hormonal fluctuations during the menstrual cycle present a unique period of vulnerability for the onset or exacerbation of psychiatric symptoms, impacting diagnosis, risk assessment, and treatment. This review sought to elucidate the phenomenon of premenstrual exacerbation and its impact across a spectrum of psychiatric illnesses, including mood, anxiety, psychotic, obsessive-compulsive, personality, and trauma-related disorders. Despite the expanded research in recent years on premenstrual dysphoric disorder and premenstrual syndrome, premenstrual exacerbation remains underexplored and poorly defined. This review offers significant contributions to the diagnosis and management of psychiatric conditions, advocating for heightened awareness and novel treatment approaches in the context of premenstrual exacerbation.

The research presented in this paper delves into the fascinating realm of how temperature, both physical and psychological, can influence human behavior, specifically in the context of charitable donations. It offers valuable insights into the intricate relationship between our sensory experiences and our motivations to engage in prosocial acts. Throughout the four comprehensive studies conducted, the authors shed light on the intricate dance between temperature and our innate need for social warmth and connection. They explore how feeling physically cold or being primed with cold imagery can trigger a desire for social affiliation and empathy, ultimately leading individuals to engage in charitable acts, such as donations. The studies provide robust evidence that when individuals experience the discomfort of cold, whether through physical touch or psychological priming, they are more inclined to seek remedies to rectify their feelings of loneliness and social isolation. This leads to a heightened desire for social connectedness, which, in turn, fosters increased levels of empathy and a greater likelihood of making charitable donations. In essence, the act of donation becomes a compensatory mechanism to counterbalance the perceived social deficit caused by feeling cold. Moreover, the research extends beyond the laboratory setting by conducting a field study in a coffee shop, demonstrating the generalizability of the findings. It reveals that the link between temperature, empathy, and charitable acts holds true in real-world scenarios. These findings offer valuable implications for social marketing and public service announcement campaigns, suggesting that the timing and context of these messages should be carefully considered. In conclusion, this research provides a deeper understanding of the complex interplay between temperature, social warmth, and charitable behavior. It highlights the significance of considering individuals' psychological states when designing campaigns or interventions aimed at promoting prosocial actions. Ultimately, it emphasizes the power of empathy and social connectedness in driving positive social change.

Purpose: To evaluate rates of familial disclosure of hereditary cancer syndrome information. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines (PROSPERO no.: CRD42020134276). Key electronic databases were searched to identify studies evaluating hereditary cancer syndrome cascade relative disclosure. Eligible studies were subjected to meta-analysis. Results: Thirty-four studies met inclusion criteria. Among 11,711 included relatives, 70% (95% CI 60 - 78%) were informed of their risk of carrying a cancer-associated pathogenic variant; of 2,875 relatives informed of their risk who were evaluated for uptake of cascade testing, 43% (95% CI 27 - 61%) completed testing. Rates of disclosure were higher among female vs male relatives (79% [95% CI 73% - 84%] vs 67% [95% CI 57% - 75%]) and first-degree vs second-degree relatives (83% [95% CI 77% - 88%] vs 58% [95% CI 45 – 69%]). Conclusion: Nearly one-third of at-risk relatives remain uninformed of their risk of carrying a cancer-associated pathogenic variant. Even among those informed, fewer than half subsequently complete genetic testing, representing a critical missed opportunity for precision cancer prevention. Innovation: Five studies evaluating interventions to improve disclosure rates were generally ineffective. Urgent work is needed to elucidate barriers to relative disclosure by probands to develop targeted interventions that can optimize proband-mediated cascade genetic testing rates.

Purpose: To highlight a case series of three pediatric patients who presented with acute ischemic stroke (AIS) in the setting of influenza illness. Methods: Retrospective chart review was performed. Results: Three patients of ages 23 months (patient 1), 2 years (patient 2), and 4 years (patient 3) presented with acute hemiparesis or focal status epilepticus. Two patients had trisomy 21 and trivial cardiac septal defects, and one was previously healthy. All patients tested positive for influenza within a week of symptoms. Neuroimaging showed AIS involving right deep grey matter and bilateral posterior cortex in patient 1, left parietal lobe in patient 2, and right parietotemporal and deep grey matter in patient 3. Vascular abnormalities were found and included moyamoya syndrome in two patients and focal arteriopathy in one patient. For secondary stroke prevention, patients 2 and 3 were started on clopidogrel initially and later transitioned to aspirin after the resolution of the acute influenza infection. Patient 1 was started on aspirin at diagnosis since he was not acutely ill. Conclusions: This case series highlights three pediatric patients with AIS with underlying arteriopathy in the setting of influenza infection. Pediatric AIS is a separate entity from adult stroke. There is limited understanding of its underlying pathophysiology. The most common risk factors described in literature for pediatric AIS are arteriopathy and cardiac disorders. Minor infection may be a significant risk factor in a child that is predisposed to vascular insult. There is some evidence in literature to suggest that vaccination against such illnesses may be protective for AIS.

This article explores how diasporic Chinese video artists present familial histories and tales of cross-cultural exchange in the context of an exhibition I am curating, Another Beautiful Country: Moving Images by Chinese American Artists, at the University of Southern California (USC) Pacific Asia Museum. I discuss projects by featured artists Richard Fung and Patty Chang. These artists’ experimental documentaries and performative videos foster deep personal discoveries that defy the late-capitalist obsession with the new as defined by youth, novelty, and the next trend, providing revelatory insights through recuperative engagements with what has come before. In analyzing artworks by Fung and Chang, I also reference related texts by/about artists and historical figures including Walter Benjamin, Anna May Wong, and Zhang Ailing, who emigrated from the People’s Republic of China to the United States in the 1950s and whose special collections in the USC Libraries helped inform the exhibition’s programming. I also interweave my own related familial histories and share some (not-so-new) curatorial ideas for immersing audiences in intercultural art and reflection.

Abstract Background Postmenopausal breast cancer survivors (PBCS) are at increased risk of bone loss and fractures due to age-related decline of estrogen, and this risk is compounded by aromatase inhibitor cancer therapy. Several patient-level targetable risk factors can mitigate osteoporosis risk; however, adequate health behavior and risk perception in this population are underreported. The goal of this study was to evaluate osteoporosis knowledge and beliefs and assess their association with engagement in osteoporosis preventive behaviors among PBCS. Methods In this cross-sectional descriptive study, early stage I–IIIA PBCS (ages 55–86 years) completed the Facts on Osteoporosis Quiz, Osteoporosis Health Beliefs Scale, and Osteoporosis Preventive Behaviors questionnaires. Participants who were non-English speaking or declined to participate were excluded. Clinical and sociodemographic information were obtained from chart review and baseline questionnaire, respectively. Fisher’s exact test, Student t-test, and Wilcoxon Mann–Whitney tests were used where appropriate to assess the association between knowledge and beliefs with engagement in osteoporosis preventive behaviors. Results The mean participant age was 66.1 years with 20% self-reporting as non-Hispanic White, 40% non-Hispanic Black, 27% Hispanic, and 13% other. Approximately 83% of the cohort had estrogen receptor positive breast cancer and received a bone density scan within the last six years. Osteoporosis knowledge (10.5 ± 3.4), seriousness (14.9 ± 3.8), and susceptibility (14.0 ± 3.5) mean scores were low among PBCS. Most PBCS (75%) were adherent to calcium and vitamin D supplements, but only 47% reported engagement in strength-training exercises. Married/partnered, higher osteoporosis knowledge and health motivation scores were associated with strength-training exercise. After adjustment for marital status and osteoporosis knowledge, only health motivation score remained significantly associated with strength-training exercise (OR 5.56, 95% CI 1.35–22.93). Conclusions PBCS are highly motivated to keep a healthy lifestyle despite limited osteoporosis knowledge, perceived risk, and susceptibility. However,

Background:. Breast pocket irrigation with antiseptic solutions is performed to reduce contamination with breast implants. The optimal antiseptic irrigation solution and the efficacy of individual practices are unclear. Oxychlorosene sodium is frequently used at our institution. Oxychlorosene is bactericidal with a mechanism of action of oxidation and hypochlorination. The purpose of our study was to compare the outcomes of oxychlorosene sodium irrigation with triple antibiotic solution (TAS) in implant-based breast reconstruction. Methods:. All patients who underwent implant-based reconstruction after mastectomy were reviewed. The primary predictive variable was type of solution used for pocket irrigation (TAS or oxychlorosene). Outcome variables included surgical site infection, device removal, and wound complications. Results:. Between 2013 and 2018, 331 implant-based breast reconstructions were performed. Of these, 62% (n = 206) received oxychlorosene for surgical pocket irrigation (group I), and 38% (n = 125) received TAS (group II). Group I had an 11.7% (n = 24) 90-day surgical site infection rate, with 4.9% (n = 10) requiring oral antibiotics, 2.4% (n = 5) requiring intravenous antibiotics without device removal, and 4.4% (n = 9) requiring prosthetic removal. Group II had an 11.2% (n = 14) 90-day infection rate, with 5.6% (n = 7) requiring oral antibiotics, 2.4% (n = 3) requiring intravenous antibiotics without device removal, and 3.2% (n = 4) requiring removal (P = 0.90). When comparing the cost of oxychlorosene irrigation with TAS irrigation, oxychlorosene was less expensive. Conclusions:. Oxychlorosene and TAS have similar surgical site infection rates in prosthetic breast reconstruction. Ease of preparation and cost make oxychlorosene a more favorable option for antibiotic irrigation in reconstructive breast surgery with prosthetic devices.

The literature demonstrates that the quality of cancer family history (CFH) as currently collected in the outpatient setting is inadequate to assess disease risk. Prior to implementation of a web-based application for cancer family history collection, we aimed to review the quality of collected CFH in a gynecologic oncology outpatient clinic and determine contributing patient factors. Medical records were reviewed for 200 new patients presenting between 4/2019–7/2019. CFH was collected during the patient interview and evaluated for inclusion of eight elements based on standards set by the genetics community. Univariate and multivariable linear regression analyses were utilized to evaluate the effect of patient characteristics on the number of relatives included in the CFH. Among our cohort of 200 patients, CFH was documented for 185 patients (92.5%). On univariate analysis, patients with a family history of cancer and prior genetic testing had significantly greater median number of relatives included in the CFH. On multivariable analysis, patients with family members with cancer had significantly more relatives included. Our data are consistent with the literature, suggesting that the current collection methods may not adequately capture all measures of a high quality CFH. Patients reporting no family history of cancer and those without prior genetic testing were least likely to have CFH that included key quality elements and these patients might benefit from health information technology CFH collection tools.

A typical clinical symptom of human norovirus infection is projectile vomiting. Although norovirus RNA and viral particles have been detected in vomitus, infectivity has not yet been reported. We detected replication-competent norovirus in 25% of vomit samples with a 13-fold to 714-fold increase in genomic equivalents, confirming infectious norovirus.

Circadian clocks must maintain their fidelity despite stochasticity arising from finite protein copy numbers. Here, the authors show that a small cyanobacterium relies on an environmentally driven timer likely because its low protein copy numbers cannot support an accurate free-running clock.