Notes

Expressive manufacturing understanding within mammals revisited.
Nurse managers can improve nurses' attitudes by advocating for tangible supports for staff such as appropriate staffing ratios, sufficient equipment, necessary training and work environments that allow safe patient interactions.
To obtain an in-depth understanding of the specific needs of patients for rehabilitation services delivered via mobile applications after total hip or knee arthroplasty.

Due to increased demand for arthroplasty, the provision of face-to-face rehabilitation services for patients is becoming challenging. New approaches using digital technologies are being developed, such as mobile applications to deliver rehabilitation services. However, the perspectives of patients on the delivery of these services via mobile applications after total hip or knee arthroplasty have not been explored extensively.

A qualitative descriptive study.

Twenty patients who had been discharged from the hospital after a total hip or knee arthroplasty were interviewed via telephone about their needs regarding the future use of mobile applications to conduct arthroplasty rehabilitation. Interview records were transcribed verbatim and analysed using inductive content analysis. Selleck 17-DMAG Reporting of the findings complies with the COREQ checklist their postoperative emotional well-being. The study findings will assist nurses with the preparation and delivery of telerehabilitation programmes after arthroplasty.
From the perspective of patients who have undergone arthroplasty, a mobile application rehabilitation programme should encourage patients in rehabilitation self-management, assist them to contact healthcare professionals and other patients and support their postoperative emotional well-being. The study findings will assist nurses with the preparation and delivery of telerehabilitation programmes after arthroplasty.Rare germline variations contribute to the missing heritability of human complex diseases including cancers. Given their very low frequency, discovering and testing disease-causing rare germline variations remains challenging. The tag-single nucleotide polymorphism rs17728461 in 22q12.2 is highly associated with lung cancer risk. Here, we identified a functional rare germline variation rs548071605 (A>G) in a p65-responsive enhancer located within 22q12.2. The enhancer significantly promoted lung cancer cell proliferation in vitro and in a xenograft mouse model by upregulating the leukemia inhibitory factor (LIF) gene via the formation of a chromatin loop. Differential expression of LIF and its significant correlation with first progression survival time of patients further supported the lung cancer-driving effects of the 22q-Enh enhancer. Importantly, the rare variation was harbored in the p65 binding sequence and dramatically increased the enhancer activity by increasing responsiveness of the enhancer to p65 and B-cell lymphoma 3 protein, an oncoprotein that assisted the p65 binding. Our study revealed a regulatory rare germline variation with a potential lung cancer-driving role in the 22q12.2 risk region, providing intriguing clues for investigating the "missing heritability" of cancers, and also offered a useful experimental model for identifying causal rare variations.
Communication of personalised disease risk can motivate smoking cessation. We assessed whether routine implementation of this intervention by general practitioners (GPs) in England is cost-effective or whether we need further research to better establish its effectiveness.

Cost-effectiveness analysis (CEA) with value of information (VoI) analysis from the UK National Health Service perspective, using GP communication of personalised disease risk on smoking cessation versus usual care.

GP practices in England.

Healthy smokers aged 35-60 years attending the GP practice.

Effectiveness of GP communication of personalised disease risk on smoking cessation was estimated through systematic review and meta-analysis. A Bayesian CEA was then performed using a lifetime Markov model on smokers aged 35-60 years that measured lifetime costs and quality-adjusted life-years (QALYs) assigned to the four diseases contributing the most to smoking-related morbidity, mortality and costs chronic obstructive pulmonary disth usual care.
Evidence to date shows that, in England, incorporating disease risk communication into general practitioners' practices to motivate smoking cessation is likely to be cost-effective compared with usual care.
Sobriety checkpoints are an effective strategy to reduce alcohol-impaired driving, motor vehicle crashes, injuries and fatalities. The aim of this study was to identify the geographic extent over which individual sobriety checkpoints affect alcohol-impaired driving.

Spatial ecological panel analysis using geolocated breath test data from the Queensland Police Service, Australia, for January 2012 to June 2018. Data were aggregated over 338 weeks within 528 Statistical Area level 2 (SA2) units (n = 178 464 SA2-weeks) and 84 Statistical Area level 3 (SA3) units (n = 28 392 SA3-weeks). SA2 units in Queensland contain a mean population of 8883.5 (SD = 55 018.3) and encompass 468.9 roadway kilometers (SD = 1490.0); SA3 units contain a mean population of 57 201.6 (SD = 29521.6) and encompass 2936.0 roadway kilometers (SD = 7025.0).

Independent measures were the density of sobriety checkpoints conducted per 500 roadway kilometers within local and spatially adjacent space-time units. The dependent measure was thiving. Relationships decay after approximately 1week and beyond local areas containing approximately 60 000 residents and 3000 kilometers of roadway.
Individual sobriety checkpoints appear to be associated with reductions in nearby alcohol-impaired driving. Relationships decay after approximately 1 week and beyond local areas containing approximately 60 000 residents and 3000 kilometers of roadway.
Management of alcohol use disorder (AUD) could be enhanced by effective remote treatments. This study tested whether supplementing intensive outpatient programs (IOPs) with continuing care delivered via (1) telephone, (2) smartphone or (3) their combination improves outcomes relative to (4) IOP only. Continuing care conditions were also compared.

Randomized controlled trial of four groups with 3-, 6-, 9-, 12- and 18-month follow-ups.

University research center in Philadelphia, PA, USA.

Participants (n= 262) met DSM-V criteria for AUD, were largely male (71%) and African American (82%).

Telephone monitoring and counseling (TMC; n= 59), addiction comprehensive health enhancement support system (ACHESS; n= 68) and TMC + ACHESS (n= 70) provided for 12 months. The control condition received IOP only (TAU; n= 65).

The primary outcome was percentage of days heavy drinking (PDHD) in months 1-12. Secondary outcomes were any drinking, any drug use, drinking consequences and quality of life.

Mean PDHD in mohol use disorder. The combination of both interventions was not superior to either alone and effects did not persist post-treatment.
A telephone-delivered intervention and a smartphone-delivered intervention, alone and in combination, provided effective remote continuing care for alcohol use disorder. The combination of both interventions was not superior to either alone and effects did not persist post-treatment.
Youth with craniopharyngioma experience weight gain, fragmented sleep, excessive daytime sleepiness (EDS), fatigue, and psychosocial problems that negatively impact their overall health-related quality of life (HRQoL). Greater hypothalamic tumor involvement (HI) may be associated with higher rates or severity of these impairments; however, the direct and indirect impact of HI on the physical and psychosocial consequences associated with pediatric craniopharyngioma remain unclear. The purpose of the current study was to examine relations between HI, body mass index (BMI), fragmented sleep, EDS, fatigue, psychosocial problems, and HRQoL among youth with craniopharyngioma.

Eighty-four youth with craniopharyngioma (M
=10.27±4.3years, 53.6% female, 64.3% White) were assessed with actigraphy, nocturnal polysomnography, and multiple sleep latency tests prior to proton therapy, when indicated. Caregivers completed measures of fatigue, psychosocial functioning, and HRQoL.

Hypothalamic tumor involvement was assrventions targeting fatigue and psychosocial health to improve HRQoL.
Observational studies have yielded conflicting results on the association of prescription opioid use (POU) with the risk of cardiovascular diseases (CVD). Residual confounding and potential reverse causality are inevitable in such conventional observational studies. This study used Mendelian randomization (MR) design to estimate the causal effect of POU on the risk of CVD, including coronary heart disease (CHD), myocardial infarction (MI) and ischemic stroke (IS), as well as their common risk factors.

We estimated the causal effect of genetic liability for POU on CVD in a two-sample MR framework. Complementary sensitivity analyses were conducted to test the robustness of our results.

Genome-wide association studies (GWAS) that were based on predominantly European ancestry.

The sample sizes of the GWAS used in this study ranged from 69 033 to 757 601 participants.

Genetic variants predictive of the POU and their corresponding summary-level information in the outcomes were retrieved and extracted from the respective GWAS.

Using univariable MR, we found evidence for a causal effect of genetic liability for POU on an increased risk of CHD [odds ratio (OR) = 1.09; 95% confidence interval (CI) = 1.02-1.16; P = 0.008] and MI (OR = 1.13; 95% CI = 1.04-1.22; P = 0.002). In multivariable MR, the association remained after accounting for comorbid pain conditions, but was attenuated with adjustment for potential mediators, including body mass index (BMI), waist circumference (WC) and type 2 diabetes (T2D).

Mendelian randomization estimates provide robust evidence for the causal effects of genetic liability for prescription opioid use on an increased risk of coronary heart disease and myocardial infarction, which might be mediated by obesity-related traits.
Mendelian randomization estimates provide robust evidence for the causal effects of genetic liability for prescription opioid use on an increased risk of coronary heart disease and myocardial infarction, which might be mediated by obesity-related traits.
Intensity-modulated proton therapy (IMPT) demonstrates superior dose distribution over volumetric-modulated arc therapy (VMAT) for sparing organs-at-risk (OARs) in ipsilateral radiotherapy. To determine a clinical benefit, assessment of patient-reported outcomes (PRO) and physician-reported toxicities alongside a dosimetric analysis is needed.

Plans were analyzed for dosimetric differences. PROs were compared for patients undergoing ipsilateral curative-intent radiotherapy for tonsil and salivary gland cancers with VMAT or IMPT from 2015 to 2020. Physician-reported toxicities were compared.

In 40 patients, IMPT was associated with decreased dose to multiple OARs and less deterioration in the following PROs pain, swallowing function, dry mouth, sticky saliva, sensory change, cough, speech, feeling ill, and social eating. Physician-reported toxicities demonstrated less oral pain.

IMPT is associated with decreased dose to OARs and less patient-reported acute deterioration in multiple head and neck domains.
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