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Mechanical and Biological Position Manual Techniques Can beat Freehand throughout Attaining Target Alignment of an Acetabular Element.
Immune-checkpoint inhibitors are effective in many advanced tumors. However, there is scarce information regarding the radiological response to these agents in hepatocellular carcinoma outside clinical trials. We aimed to describe the radiological response in a retrospective cohort of hepatocellular carcinoma patients treated with nivolumab and to analyze the radiological evolution according to tumor response at first post-treatment radiological assessment.

We reviewed pre-treatment and post-treatment images (CT or MRI) obtained at different time-points in patients with hepatocellular carcinoma treated with nivolumab outside clinical trials at seven Spanish centers, assessing the response according to RECIST 1.1 and iRECIST and registering atypical responses. We also analyzed the imaging findings on subsequent assessments according to tumor status on the first posttreatment imaging assessment.

From the 118 patients with hepatocellular carcinoma treated with nivolumab, we finally analyzed data from 31 pae management of hepatocellular carcinoma patients under immunotherapy challenging.An impedance biosensor using rotary magnetic separation and cascade reaction was developed for rapid and ultrasensitive detection of Salmonella typhimurium. First, magnetic nanoparticles (MNPs) modified with anti-Salmonella monoclonal antibodies were injected into a capillary at the presence of a rotary high gradient magnetic field, which was rotated by a stepper motor. Then, a bacterial sample was injected into the capillary and the target bacteria were continuous-flow captured onto the MNPs. After organic-inorganic hybrid nanoflowers were prepared using manganese dioxide (MnO2), glucose oxidase (GOx) and anti-Salmonella polyclonal antibodies (pAbs), they were injected to label the bacteria, resulting in the formation of MNP-bacteria-nanoflower sandwich complexes. Finally, glucose (low conductivity) was injected and oxidized by GOx on the complexes to produce H2O2 (low conductivity) and gluconic acid (high conductivity), leading to impedance decrease. Besides, the produced H2O2 triggered a cascade reduction of MnO2 into Mn2+, leading to further impedance decrease. The impedance changes were measured using an interdigitated microelectrode and used to determine the concentration of target bacteria. This biosensor was able to detect Salmonella ranging from 101 to 106 CFU/mL in 2 h with a low detection limit of 101 CFU/mL and a mean recovery of 100.1% for the spiked chicken samples.Humans use punishment to influence each other's behavior. Many current theories presume that this operates as a simple form of incentive. In contrast, we show that people infer the communicative intent behind punishment, which can sometimes diverge sharply from its immediate incentive value. In other words, people respond to punishment not as a reward to be maximized, but as a communicative signal to be interpreted. Specifically, we show that people expect harmless, yet communicative, punishments to be as effective as harmful punishments (Experiment 1). Under some situations, people display a systematic preference for harmless punishments over more canonical, harmful punishments (Experiment 2). People readily seek out and infer the communicative message inherent in a punishment (Experiment 3). And people expect that learning from punishment depends on the ease with which its communicative intent can be inferred (Experiment 4). Taken together, these findings demonstrate that people expect punishment to be constructed and interpreted as a communicative act.
Recent studies have demonstrated that first-line nurses involved in the coronavirus disease-2019 (COVID-19) crisis may experience sleep disturbances. As breathing relaxation techniques can improve sleep quality, anxiety, and depression, the current study aimed to evaluate the effectiveness of diaphragmatic breathing relaxation training (DBRT) for improving sleep quality among nurses in Wuhan, China during the COVID-19 outbreak.

This study used a quasi-experimental (before and after) intervention strategy, with 151 first-line nurses from four wards in Leishenshan hospital. The Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) to evaluate the effectiveness of DBRT before and after the intervention. Data were examined using the Shapiro-Wilk test, Levene's test, and paired t-test.

A total of 140 nurses completed the DBRT sessions. First-line nurses achieved significant reductions in global sleep quality (p<0.01), subjective sleep quality (p<0.001), sleep latency (p<0.01), sleep duration (p<0.001), sleep disturbances (p<0.001), habitual sleep efficiency (p=0.015), daytime dysfunction (p=0.001), and anxiety (p=0.001). There were no significant reductions in the use of sleeping medication (p=0.134) and depression (p=0.359).

DBRT is a useful non-pharmacological treatment for improving sleep quality and reducing anxiety among first-line nurses involved in the COVID-19 outbreak. The study protocol was clinically registered by the Chinese Clinical Trial Registry.

ChiCTR2000032743.
ChiCTR2000032743.
We aimed to determine whether bone-conducted acoustic stimulation could prematurely terminate sleep apnea events, thereby decreasing amplitude and duration of subsequent oxygen desaturation. Sirtuin activator As oxygen desaturation has been linked to cardiovascular consequences, we postulate this could be a viable therapy in some cases.

Eight patients with severe Obstructive Sleep Apnea (2 women, 45 [20-68] y.o. Apnea-Hypopnea Index 77.7±22.3/h) underwent polysomnography at the Lausanne University Sleep Center. Short acoustic stimulations were administered by bone conduction every second event of sleep apnea. Sounds were remotely administered using a Dreem® headband worn by patients while undergoing nocturnal polysomnography. Amplitude (%) and duration(s) of oxygen desaturations following terminated apneas were compared to that of non-stimulated previous and subsequent events.

549 stimulations (68.6±38 sounds per patient) in N1 (16.2%), N2 (69.9%), N3 (4.2%), and REM(9.6%) were conducted. Compared to the previous and subted oxygen desaturations. Stimulations were well tolerated and rarely perceived by patients. This therapeutic approach deserves further investigation, with monitoring of effects on sleep quality, daytime function/sleepiness and cardiovascular parameters.
Sleep disturbances (insufficient or poor sleep quality) have been linked to abnormal glucose metabolism. This systematic review and meta-analysis aimed to explore the effects of behavioral and pharmacological sleep interventions on glucose metabolism.

Medline and Embase were used for systematic search. Studies reporting behavioral or pharmacological interventions in population with sleep disturbances, with measured outcomes of glucose metabolism and sleep parameters were selected.

Twenty two studies were eligible for review (eight were conducted in people with type 2 diabetes). Studies were grouped into three types of intervention sleep extension (n=6), sleep education or cognitive behavioral therapy for insomnia (CBT-I, n=6) and pharmacological interventions (n=10). CBT-I and sleep education resulted in significantly improved self-reported sleep quality (Pittsburgh Sleep Quality Index, mean difference, MD,-1.31, 95% confidence interval (CI)-1.83,-0.80), non-significant reduction in hemoglobin A1c levelal causal relationship.Little is known about the follow-up healthcare needs of patients hospitalized with coronavirus disease 2019 (COVID-19) after hospital discharge. Due to the unique circumstances of providing transitional care in a pandemic, post-discharge providers must adapt to specific needs and limitations identified for the care of COVID-19 patients. In this study, we conducted a retrospective chart review of all hospitalized COVID-19 patients discharged from an Emory Healthcare Hospital in Atlanta, GA from March 26 to April 21, 2020 to characterize their post-discharge care plans. A total of 310 patients were included in the study (median age 58, range 23-99; 51.0% female; 69.0% African American). The most common presenting comorbidities were hypertension (200, 64.5%), obesity (BMI≥30) (138, 44.5%), and diabetes mellitus (112, 36.1%). The median length of hospitalization was 5 days (range 0-33). Sixty-seven patients (21.6%) were admitted to the intensive care unit and 42 patients (13.5%) received invasive mechanical ventilation. The most common complications recorded at discharge were electrolyte abnormalities (124, 40.0%), acute kidney injury (86, 27.7%) and sepsis (55, 17.7%). The majority of patients were discharged directly home (281, 90.6%). Seventy-five patients (24.2%) required any home service including home health and home oxygen therapy. The most common follow-up need was an appointment with a primary care provider (258, 83.2%). Twenty-four patients (7.7%) had one or more visit to an ED after discharge and 16 patients (5.2%) were readmitted. To our knowledge, this is the first large study to report on post-discharge medical care for COVID-19 patients.Analysis of a twenty-year (1998-2018) data series on 7Be concentrations in weekly collected aerosol samples in northern Poland showed a clear pattern of seasonal changes in 7Be with a maximum in the summer period associated with the most intensive thermal convection and vertical mixing. Activity concentrations of 7Be ranged from 480 μBq m-3 to 9370 μBq m-3. A strong relationship has been shown between 7Be concentrations observed in years and the activity of the Sun related to the sunspot number. Activity concentrations of 210Pb in aerosol ranged from 17 μBq m-3 to 1490 μBq m-3 with maximum occurring in the winter. The difference in the seasonal pattern in 7Be and 210Pb concentrations were directly related to the different sources of both isotopes, as an additional source of 210Pb was the products of combustion during the heating season. Similar pattern with maximum concentrations in winter was observed for PM10, as the main source is the same as in the case 210Pb. A content of PM10 was in the range from 6.5 to 81.7 μg m-3. A statistically significant correlation between both isotopes occurs. At the same time, 7Be, 210Pb and PM10 are visibly related to the dust concentrations ranged from 7.3 μg m-3 in winter to 134.8 μg m-3 in spring. Statistical analysis carried out with simple regression model, stepwise multiple regression, and Random Forest models showed that the sunspots number, air temperature and sunshine duration have the most substantial impact on transport, and hence the concentration of 7Be in the surface layer of the atmosphere. The increase in relative humidity and precipitation and higher wind speed have a statistically significant effect on the reduction of 7Be concentrations in surface air.
We examined correlates, psychiatric comorbidities, and social adjustment difficulties in children with disruptive mood dysregulation disorder (DMDD) from a national epidemiological study in Taiwan.

The sample consisted of 4816 children, who were 3
, 5
, and 7
graders from schools randomly chosen based on the urbanization level in a recent national survey of childhood mental disorders. Among the 4816 children (2520 boys, 52.3%) interviewed using the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia (K-SADS-E) for the DSM-5, 30 children were diagnosed as DMDD (23 boys, 76.7%). They and their parents also reported on the Social Adjustment Inventory for Children and Adolescents (SAICA). We conducted regressions for survey data that controlled for stratification and clustering.

The weighted prevalence of DMDD was 0.3~0.76% in Taiwanese children. Lower parental educational levels, male predominance, higher psychiatric comorbidities, and worse self-report school functions (e.
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