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duces similar failure and re-operation rates. Limited evidence is available on the use of cannulated screws and arthroplasty, but available studies suggest that cannulated screws have an unacceptable revision rate (23%) while arthroplasty may be acceptable. Future studies examining the comparative efficacy of various fixation methods would benefit from strict definition of fracture type as well as consistent reporting of functional outcomes, re-operation rates, and mortality.
Acute Respiratory Distress Syndrome (ARDS) is a frequent cause of respiratory failure in intensive care unit (ICU) patients and results in significant morbidity and mortality. ARDS often develops as a result of a local or systemic inflammatory insult. Cancer can lead to systemic inflammation but whether cancer is an independent risk factor for developing ARDS is unknown. We hypothesized that critically ill cancer patients admitted to the ICU were at increased risk for the diagnosis of ARDS.

Retrospective cohort study of critically ill patients admitted between July 2017 and December 2018 at an academic medical center in Columbus, Ohio. The primary outcome was the association of patients with malignancy and the diagnosis of ARDS in a multivariable logistic regression model with covariables selected a priori informed through the construction of a directed acyclic graph.

412 ARDS cases were identified with 166 of those patients having active cancer. There was an association between cancer and ARDS, with antudy, cancer was found to be an independent risk factor for the diagnosis of ARDS in critically ill patients. To our knowledge, we are the first report an independent association between cancer and ARDS in critically ill patients.Objectives This study investigated the predictors of risk perception and its effect on older adults' preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Methods Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 (n = 4395). Structural equation models were used. Results Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Discussion Disseminating correct information to older adults could help them evaluate infection risk accurately. Educational programs on the precautions implemented at clinical settings to ensure patient safety may encourage older adults to seek timely medical care.Within the anamnesis, medical information is frequently withheld, incomplete, or incorrect, potentially causing negative consequences for the patient. The use of conversational agents (CAs), computer-based systems using natural language to interact with humans, may mitigate this problem. The present research examines whether CAs differ from physicians in their ability to elicit truthful disclosure and discourage concealment of medical information. We conducted an online questionnaire with German participants (N = 148) to assess their willingness to reveal medical information. The results indicate that patients would rather disclose medical information to a physician than to a CA; there was no difference in the tendency to conceal information. This research offers a frame of reference for future research on applying CAs during the anamnesis to support physicians. From a practical view, physicians might gain better understanding of how the use of CAs can facilitate the anamnesis.
Despite tetrahydrocannabinol (THC)'s reputation for creating dramatic effects at high doses, empirical work rarely addresses cannabis's impact on subjective responses common to the tryptamine psychedelics. We focused on these effects because they have preceded and covaried with the therapeutic impact of psilocybin in previous work.

The current study examined if self-reported responses to cannabis products might parallel those found in clinical trials of psilocybin administration. We also investigated if measures of demographics and cannabis use might correlate with these responses.

Participants reported the subjective effect of their highest THC experience using 27 items that assess oceanic boundlessness, a correlate of mystical experiences. They also answered infrequency items and questions on demographics and cannabis consumption.

In an effort to address concerns about replication, we divided respondents who passed infrequency items into two random samples. Self-reported "breakthrough" experiences wstress, treatment-resistant depression, alcohol problems, and cigarette dependence. Given the disparate mechanisms of action, comparing THC-induced to psilocybin-induced effects might improve our understanding of the mechanisms underlying subjective experiences. This work might also support the development of a cannabis-assisted psychotherapy comparable to psilocybin-assisted psychotherapy.
The objective was to review physical activity (PA) promotion interventions among individuals with intellectual disability and provide recommendations for increasing PA.

A systematic mapping review was conducted in which physical activity intervention studies for adults with a disability were identified, selected, and appraised. Data were extracted regarding the study design, results, and authors' recommendations. Data were analyzed using a social-ecological framework.

A comprehensive search of the peer reviewed literature yielded 5 studies (3 quantitative, 1 mixed methods, and 1 pre-post delayed). Studies used physical activity promotion strategies at the intrapersonal, interpersonal, organizational, community, and policy levels have been used to date.

Recommendations are presented for researchers and practitioners seeking to increase the level of PA of adults with intellectual disability.
Recommendations are presented for researchers and practitioners seeking to increase the level of PA of adults with intellectual disability.
The systemic lupus erythematosus (SLE) symptom checklist (SSC) is a patient-reported outcome measure consisting of 38 queries. We translated SSC into Japanese and attempted to validate its usefulness for evaluating the quality of life (QOL) of SLE patients and identify factors that affect QOL.

Data from the Medical Outcomes Study Short-form 36 questionnaire (SF-36), Japanese LupusPRO, the Japanese version of the SSC (SSC-J) questionnaire, SLEDAI-2k, and the physician global assessment (PGA) were obtained on the same day from 226 SLE outpatients of the Kyoto Lupus cohort at Kyoto University Hospital. Relationships between the total scores or each item of SSC-J and SF-36, Japanese LupusPRO, SLEDAI-2k, or PGA were analyzed by Spearman's rank test.

The total scores of SSC-J correlated with the scores of SF-36 and Japanese LupusPRO. In each item of SSC-J, all 38 items correlated with the physical component summary and mental component summary of SF-36 as well as the Health-Related QOL (HRQOL) scores of Japanese LupusPRO, but not with the non-HRQOL of LupusPRO. SSC-J scores correlated with age, PGA, and corticosteroid doses, but not with SLEDAI-2k.

SSC-J is suitable as a disease-specific QOL assessment tool for SLE.
SSC-J is suitable as a disease-specific QOL assessment tool for SLE.Immunoglobulins play a fundamental role in the protection of the human body against internal and external threats. They also contribute to the immune system homeostasis and maintenance of self-tolerance. Hypogammaglobulinemia is occasionally encountered in routine clinical practice by rheumatologists. Low levels of immunoglobulins can occur as primary or secondary issues and may predispose patients to various forms of infection. However, the impact of the low immunoglobulin level abnormality varies with the underlying condition. In this narrative review, we shed light on the overall types and functions of immunoglobulins for clinicians. We discuss important principles of immunoglobulin measurements. We then consider the primary and secondary causes of low immunoglobulins with a special focus on hypogammaglobulinemia in patients with systemic lupus erythematosus (SLE).
Drug-induced prolongation of cardiac repolarization limits the treatment with many psychotropic drugs. Recently, the contribution of polygenic variation to the individual duration of the QT interval was identified.

To explore the interaction between antipsychotic drugs and the individual polygenic influence on the QT interval.

Retrospective analysis of clinical and genotype data of 804 psychiatric inpatients diagnosed with a psychotic disorder. The individual polygenic influence on the QT interval was calculated according to the method of Arking et al.

Linear regression modelling showed a significant association of the individual polygenic QT interval score (ß
= 0.176,
< 0.001) and age (ß
= 0.139,
< 0.001) with the QTc interval corrected according to Fridericia's formula. Pterostilbene cell line Sex showed a nominal trend towards significance (ß
= 0.064,
= 0.064). No association was observed for the number of QT prolonging drugs according to AZCERT taken. Subsample analysis (
= 588) showed a significant association of potassium serum concentrations with the QTc interval (ß
= -0.104,
= 0.010). Haloperidol serum concentrations were associated with the QTc interval only in single medication analysis (
= 26, ß
= 0.101,
= 0.004), but not in multivariate regression analysis. No association was observed for aripiprazole, clozapine, quetiapine and perazine, while olanzapine and the sum of risperidone and its metabolite showed a negative association.

Individual genetic factors and age are main determinants of the QT interval. Antipsychotic drug serum concentrations within the therapeutic range contribute to QTc prolongation on an individual level.
Individual genetic factors and age are main determinants of the QT interval. Antipsychotic drug serum concentrations within the therapeutic range contribute to QTc prolongation on an individual level.
The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization.

This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed.

The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.
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