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Results from trials and nonexperimental studies are often directly compared, with little attention paid to differences between study populations. When target and trial population data are available, accounting for these differences through transporting trial results to target populations of interest provides useful perspective. We aimed to compare two-year risk differences (RDs) for ischemic stroke, mortality, and gastrointestinal bleeding in older adults with atrial fibrillation initiating dabigatran and warfarin when using trial transport methods versus nonexperimental methods.

We identified Medicare beneficiaries who initiated warfarin or dabigatran from a 20% nationwide sample. To transport treatment effects observed in the randomized evaluation of long-term anticoagulation trial, we applied inverse odds weights to standardize estimates to two Medicare target populations of interest, initiators of (1) dabigatran and (2) warfarin. Separately, we conducted a nonexperimental study in the Medicare populatopulations of interest, particularly when comparing trial with nonexperimental findings. See video abstract http//links.lww.com/EDE/B703.
To investigate the expression levels of nerve growth factor (NGF) and its receptors TrkA and p75NTR in the anterior vaginal wall of postmenopausal patients with pelvic organ prolapse (POP).

The tissues of anterior vaginal wall of the patients (n = 31) with POP and patients (n = 16) with nonpelvic floor dysfunction were collected during the operation. The expressions of NGF, TrkA, and p75NTR were detected by real-time quantitative polymerase chain reaction, immunohistochemistry and Western blot.

The expression levels of mRNA and protein of NGF and its receptors in vaginal anterior wall tissues of postmenopausal POP patients were significantly decrease compared with those of the control group. selleck compound The ratio of p75NTR/TrkA expression in POP patients was significantly increase compared with that in the control group and was proportional to the degree of prolapse.

The decreased expression of NGF and its receptors p75NTR and TrkA in vaginal anterior wall tissue of postmenopausal POP patients and the change of the ratio of 2 receptors may be related to the occurrence and development of POP.
The decreased expression of NGF and its receptors p75NTR and TrkA in vaginal anterior wall tissue of postmenopausal POP patients and the change of the ratio of 2 receptors may be related to the occurrence and development of POP.
The objective of this study was to determine the prevalence of burnout among active practicing members of the American Urogynecologic Society (AUGS).

This was an anonymous electronic survey of AUGS nontrainee physician members. Basic demographic, personal, and professional characteristics were collected. Levels of emotional exhaustion, depersonalization and personal accomplishment, as defined by the Maslach Burnout Inventory-Human Services Survey, were utilized to categorize participants into burnout profiles and to determine 2 alternative burnout definitions. Descriptive statistics and models were used to summarize provider characteristics and to explore differences among the burnout profiles.

Of the 1039 active members of AUGS, 280 (26.9%) responded to the survey. Burnout profiles were delineated using the Maslach Burnout Inventory-Human Services Survey. Forty-three percent fit the Engaged profile, whereas 13% fit the Burnout profile. Significant differences were seen in the distribution of the burnout profiles for physicians who take call (P=0.015), have a current mentor (P=0.016), screen positive for major depression (P < 0.001), experience suicidal ideation (P=0.018), have a feeling of control regarding their schedule (P < 0.001) and those who would become a physician again (P < 0.001). The overall rate of burnout in female pelvic medicine and reconstructive surgery providers was significantly different depending on the definition utilized (P < 0.01) and ranged from as low as 6.5% to as high as 51.9%.

There were some differences in respondent characteristics seen among the burnout profiles. The chosen definition of burnout significantly affected the purported rate of burnout, complicating comparisons among provider populations.
There were some differences in respondent characteristics seen among the burnout profiles. The chosen definition of burnout significantly affected the purported rate of burnout, complicating comparisons among provider populations.Knee dislocations leading to multiligament knee injuries are associated with a wide variety of bony, ligamentous, soft tissue, and neurovascular injury patterns. Numerous management strategies have been proposed including nonoperative treatment and surgical repair or reconstruction. In recent years, an emphasis has been placed on anatomic repair and reconstruction principles, which have shown superior outcomes compared with older techniques. However, despite these advances, clinical outcomes continue to vary widely, with many patients experiencing chronic pain, stiffness, loss of range of motion, instability, and failure to return to work or sports. The purpose of this chapter is to review clinical outcomes following combined anterior and posterior cruciate ligament, medial collateral ligament, and posterolateral corner injuries sustained during a knee dislocation. Understanding the available treatment options and reported outcomes will allow surgeons to individualize management to address each patient's specific injury pattern and functional goals.Ultra-low-velocity knee dislocations are historically rare but increasingly common events. They occur most frequently in obese, morbidly obese, and super obese patients during everyday activities, but they can be as severe or more severe than high-velocity knee dislocations. Ultra-low-velocity knee dislocations frequently are associated with neurovascular injury and other complications. Diagnosis, early reduction, and identification and treatment of vascular injuries are critical to reducing the risk of limb ischemia and possibly amputation. Given the size of the limb, maintenance of reduction in these patients almost always requires external fixation. Although surgery on morbidly obese patients may be technically challenging, surgical reconstruction leads to improved subjective and objective results and is recommended.
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