Notes

[Obstetric Medical procedures with higher Chance of Postpartum Lose blood within a Jehovah's Witness].
The embodied meaning approach posits that understanding action-related language recruits motor processes in the brain. However, the functional impact of these motor processes on cognition has been questioned. The present study aims to provide new electrophysiological (EEG) evidence concerning the role of motor processes in the comprehension and memory of action language. Participants read lists of sentences including manual-action or attentional verbs, while keeping their hands either in front of them or crossing them behind their back. Results showed that posture impacted selectively the processing of manual action sentence, and not of attentional sentences, in three different ways 1) EEG fronto-central beta rhythms, a signature of motor processes, were desynchronized while reading action sentences in the hands-in-front posture compared to the hands-behind posture. The estimated source was the posterior cingulate cortex, involved in proprioceptive regulation. 2) Recall of nouns associated with manual sentences decreased when learning occurred in the hands-behind posture. 3) ERPs analysis revealed that the initial posture at learning modulates neural processes during subsequent recall of manual sentences in the left superior frontal gyrus, which is related to motor processes. These results provide decisive evidence for the functional involvement of embodied simulations in the encoding and retrieval of action-related language.The dual-hub account posits that the neural organization of semantic knowledge is segregated by the type of semantic relation with anterior temporal lobe (ATL) specializing for taxonomic relations and inferior parietal lobule (IPL) for thematic relations. This study critically examined this account by recording intracranial EEG from an array of depth electrodes within ATL, IPL, and two regions within the semantic control network, inferior frontal gyrus (IFG) and posterior middle temporal gyrus (pMTG), while 17 participants with refractory epilepsy completed a semantic relatedness judgment task. We observed a significant difference between relation types in ATL and IPL approximately 600-800 ms after trial presentation, and no significant differences in IFG or pMTG. Within this time window, alpha and theta suppression indexing cognitive effort and memory retrieval was observed in ATL for taxonomic trials and in IPL for thematic trials. These results suggest taxonomic specialization in ATL and thematic specialization in IPL, consistent with the dual-hub account of semantic cognition.An association has been found between cannabis use disorder (CUD) and violence in several clinical populations, including veterans with posttraumatic stress disorder (PTSD), and there is evidence that CUD has been increasing among veterans since September 11, 2001. There is also evidence that some veterans may be attempting to self-medicate psychological problems including PTSD and aggression with cannabis, despite the lack of safety and efficacy data supporting this use. To date, however, the association between CUD and aggression has yet to be examined in a large, non-clinic sample of veterans. The present study examined the association between cannabis use disorder, anger, aggressive urges, and difficulty controlling violence in a large sample of Iraq/Afghanistan-era veterans (N = 3028). Results of multivariate logistic regressions indicated that current CUD was significantly positively associated with difficulty managing anger (OR = 2.93, p less then .05), aggressive impulses/urges (OR = 2.74, p less then .05), and problems controlling violence in past 30 days (OR = 2.71, p less then .05) even accounting for demographic variables, comorbid symptoms of depression and PTSD, and co-morbid alcohol and substance use disorders. Lifetime CUD was also uniquely associated with problems controlling violence in the past 30 days (OR = 1.64, p less then .05), but was not significantly associated with difficulty managing anger or aggressive impulses/urges. Findings indicated that the association between CUD and aggression needs to be considered in treatment planning for both CUD and problems managing anger and aggressive urges, and point to a critical need to disentangle the mechanism of the association between CUD and violence in veterans.In recent years, fluorescent sensors have emerged as attractive imaging probes due to their distinct responses toward bio-relevant metal ions. However, the bioimaging application main barrier is the 'turn-off' response toward paramagnetic metal ions such as Cu2+ under physiological conditions. Herein, we report a new sensor (2-methyl(4-bromo-N-ethylpiperazinyl-1,8-naphthalimido)-4-(1H-phenanthro[9,10-d]imidazole-2-yl) phenol)NPP with multifunctional (Naphthalimide, Piperazine, Phenanthroimidazole) units for fluorescent and colourimetric detection of Cu2+ in an aqueous medium. Both absorption and fluorescence spectral titration strategies were used to monitor the Cu2+-sensing property of NPP. The NPP displays a weak emission at ca. 455 nm, which remarkably enhances (⁓3.2-fold) upon selective binding of Cu2+ over a range of metal ions, including other paramagnetic metal ions (Mn2+, Fe3+, Co2+). The stoichiometry, binding constant (Ka) and the LOD (limit of detection) of NPP toward Cu2+ ions were found to be 11, 5.0 (± 0.2) × 104 M-1 and 6.5 (± 0.4) × 10-7 M, respectively. We have also used NPP as a fluorescent probe to detect Cu2+ in live (human cervical HeLa) cancer cells. The emission intensity of NPP was almost recovered in HeLa cells by incubating 'in situ' the derived Cu2+ complex (NPP-Cu2+) in the presence of a benchmark chelating agent such as EDTA (ethylenediaminetetraacetate). The fluorescent emission of NPP was reverted significantly in each cycle upon sequencial addition of Cu2+ and EDTA to the NPP solution. Overall, NPP is a novel, simple, economic and portable sensor that can detect Cu2+ in biological and environmental scenarios.
There is an underuse of genetic testing in breast cancer patients with a lower level of education, limited health literacy or a migrant background. We aimed to study the effect of a health literacy training program for surgical oncologists and specialized nurses on disparities in referral to genetic testing.

We conducted a multicenter study in a quasi-experimental pre-post (intervention) design. The intervention consisted of an online module and a group training for surgical oncologists and specialized nurses in three regions in the Netherlands. Six months pre- and 12 months post intervention, clinical geneticists completed a checklist with socio-demographic characteristics including the level of health literacy of each referred patient. We conducted univariate and logistic regression analysis to evaluate the effect of the training program on disparities in referral to genetic testing.

In total, 3179 checklists were completed, of which 1695 were from hospital referrals. No significant differences were fr factors might contribute.
The phase 3 NCT00793962 trial demonstrated that postmastectomy hypofractionated radiation therapy (HFRT) was noninferior to conventional fractionated radiation therapy (CFRT) in patients with high-risk breast cancer. This study assessed the cost-effectiveness of postmastectomy HFRT vs CFRT based on the NCT00793962 trial.

A Markov model was adopted to synthesize the medical costs and health benefits of patients with high-risk breast cancer based on data from the NCT00793962 trial. Main outcomes were discounted lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). We employed a time-dependent horizon from Chinese, French and USA payer perspectives. Model robustness was evaluated with one-way and probabilistic sensitivity analyses.

Patients receiving CFRT versus HFRT gained an incremental 0.0163 QALYs, 0.0118 QALYs and 0.0028 QALYs; meanwhile an incremental cost of $2351.92, $4978.34 and $8812.70 from Chinese, French and USA payer perspectives, respectively. Thus CFRT versus HFRT yielded an ICER of $144,281.47, $420,636.10 and $3,187,955.76 per QALY from Chinese, French and USA payer perspectives, respectively. HFRT could maintain a trend of >50% probabilities of cost-effectiveness below a willingness-to-pay (WTP) of $178,882.00 in China, while HFRT was dominant relative to CFRT, regardless of the WTP values in France and the USA. Sensitivity analyses indicated that the ICERs were most sensitive to the parameters of overall survival after radiotherapy.

Postmastectomy HFRT could be used as a cost-effective substitute for CFRT in patients with high-risk breast cancer and should be considered in appropriately selected patients.
Postmastectomy HFRT could be used as a cost-effective substitute for CFRT in patients with high-risk breast cancer and should be considered in appropriately selected patients.
Over the past decade, chemotherapy has been used more selectively in early breast cancer (EBC) due to better risk stratification. Neoadjuvant chemotherapy (NACT) has evolved to the primary treatment option. The type and size of hospitals is known to have a substantial influence on the kinds of treatment they provide, and therefore on patient outcomes (e.g. rates for pathological complete response, pCR), but it is not yet known how this has affected delivery of chemotherapy for EBC in Germany.

This study analyzed chemotherapy use and pCR rates after NACT for EBC patients treated at 104 German institutions 2008-2017. Institutions were separated into associated hospital type (university hospital; teaching hospital; community hospital) and annual caseload (≤100; 101-250; >250 cases/year).

Overall, 124,084 patients were included, of whom 11.6% were treated at university hospitals, 63.1% at teaching hospitals, and 25.3% at community hospitals. In total, 46,274 (37.3%) received chemotherapy, of whom 44,765 had information available about systemic treatment and surgery. From 2008 to 2017, chemotherapy use declined from 48.3% to 36.4% for university hospitals, from 40.7% to 30.3% for teaching hospitals, and from 42.4% to 33.7% for community hospitals. Furthermore, the proportion of NACT increased the most in university hospitals (from 32.0% to 68.1%); whereas, the rate of pCR (defined as ypT0 ypN0) increased irrespective of institutional type. Analyses regarding annual caseload did not show any differences.

The results from this large, nationwide cohort reflect a more selective use of chemotherapy in Germany, irrespective of institutional type or case load.
The results from this large, nationwide cohort reflect a more selective use of chemotherapy in Germany, irrespective of institutional type or case load.
New Hampshire (NH) ranked first for fentanyl- and all opioid-related overdose deaths per capita from 2014 to 2016 and third in 2017 with no rate reduction from the previous year relative to all other states in the US. In response to the opioid crisis in NH, Manchester Fire Department (MFD), the state's largest city fire department, launched the Safe Station program in 2016 in partnership with other community organizations. This community-based response to the crisis-described as a connection to recovery-focuses on reducing barriers to accessing resources for people with substance use and related problems. AZD9291 The study aim is to characterize the multi-organizational partnerships and workflow of the Safe Station model and identify key components that are engaging, effective, replicable, and sustainable.

A mixed-methods design included semi-structured qualitative interviews conducted with 110 stakeholders from six groups of community partners (Safe Station clients, MFD staff and leadership, and local emergency department, ambulance, and treatment partner staff); implementation and sustainability surveys (completed by MFD stakeholders); and ethnographic observations conducted at MFD.
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