Notes

Probabilities of ethnomusicology used on the joy of community wellbeing.
Having diabetes mellitus is an independent risk to have neurological and cardio-respiratory symptoms and patients who were discharged with minimal support were to have an independent risk factor of renal symptoms on follow-up than other subjects.

The follow-up symptoms were associated with the patients' comorbidities, age, severity of illness, and environmental factors.
The follow-up symptoms were associated with the patients' comorbidities, age, severity of illness, and environmental factors.Background The adverse impact of maternal negative TPOAb of gestational subclinical hypothyroidism (SCH-TPOAb-) on the development of the offspring has not yet been clearly identified. A lingering controversy exists over the treatment of SCH-TPOAb- diagnosed during pregnancy. Therefore, this study was designed to evaluate the intellectual development of children of mothers who had SCH-TPOAb-. Methods A number of 139 children were recruited; 112 children were born to SCH TPOAb- and 27 children were born to euthyroid TPOAb- mothers. Based on the mothers' thyrotropin (TSH) levels during pregnancy and whether or not they received levothyroxine (LT4) treatment, the children were assigned to four groups Group A (2.5 mIU/L  0.05). Spearman's rank correlation analysis showed that DQ, FMQ, ABQ, LQ, and ISBQ were significantly negatively correlated with the TSH level (r = -0.417, -0.253, -0.273, -0.436, and -0.272; p  less then  0.05). In addition, multivariate logistic regression analysis revealed that mothers' education (short education), mothers' education (medium education), and TSH level (4.0 mIU/L less then TSH ≤10.0 mIU/L) were both risk factors affecting the intellectual development of the offspring (p  less then  0.05). Conclusion The effects of the intellectual development of the offspring with SCH-TPOAb- are related to the level of TSH. Standardized treatment for SCH-TPOAb- pregnant women before eight gestational weeks, whose TSH level was from 4.0 to 10.0 mIU/L, may significantly improve the intellectual development levels of the approximately two-year-old offspring. Although our study was a historical cohort study, the data analyzed provide the foundation for further investigation. Further prospective intervention trials with large numbers of participants are needed to confirm our conclusions. The Clinical Trial Registration number is 2021-K-84-02.
Saccharin test (ST) is a convenient method to assess the efficiency of mucociliary clearance, the primary defense mechanism of the upper airways' tract. The study objectives are to (1) substantiate its short- (3 days) and long-term (30 days) repeatability; (2) assess its tolerability; (3) conduct a systematic literature review and to compare our results with the existing evidence.

Twenty-nine healthy subjects were enrolled in an observational prospective study to perform an ST on three separate visits (at baseline; at follow-up visits at day 3 and at day 30). Transit times were recorded and self-reported nasal and general symptoms noted. A systematic review of the literature was conducted to compare our results with the existing literature.

The mean values (±SD) of ST transit time (STTT) were 7.085 (±2.19), 7.788 (±2.11), and 7.790 (±2.06) minutes at baseline, day 3, and day 30, respectively. Significant linear regression analysis was observed between day 3 and baseline (
= .193;
= .019) and day 30research.Significance The cutaneous repair process naturally results in different types of scarring that are classified as normal or pathological. Affected individuals are often affected from an esthetic, physical (functional), and psychosocial perspective. The distinct nature of scarring in humans, particularly the formation of pathological scars, makes the study of skin scarring a challenge for researchers in this area. Several established experimental models exist for studying scar formation. However, the increasing development and validation of newly emerging models have made it possible to carry out studies focused on different variables that influence this unique process. Recent Advances Experimental models such as in vitro, ex vivo, and in vivo models have obtained different degrees of success in the reproduction of the scar formation in its native milieu and true environment. These models also differ in their ability to elucidate the molecular, cellular, and structural mechanisms involved in scarring, as well as for testing new agents and approaches for therapies. The models reviewed here, including cells derived from human skin and in vivo animal models, have contributed to the advancement of skin scarring research. Critical Issues and Future Directions The absence of experimental models that faithfully reproduce the typical characteristics of the different types of human skin scars makes the improvement of validated models and the establishment of new ones a critical unmet need. The fields of wound healing research combined with tissue engineering have offered newer alternatives for experimental studies with the potential to provide clinically useful knowledge about scar formation.Background The field of surgical and interventional thyroidology is rapidly evolving. In the past few years, we have seen the introduction and establishment of many novel surgical adjuncts, techniques, and disruptive ablative technologies that have impacted the field. Methods We identified the most influential articles on technological developments in surgical and interventional thyroidology that were published from September 1, 2020, to August 1, 2021. We searched three electronic databases and consulted experts. Results Major findings are summarized. Continuous intraoperative nerve monitoring (cIONM) lowered the risk of early postoperative vocal cord palsy 1.8-fold and permanent palsy 29 · 4-fold compared with intermittent intraoperative nerve monitoring. Parathyroid autofluorescence yielded a diagnostic odds ratio (OR) of 228.9 for detection of parathyroid glands over visualization, with 96% sensitivity and 92% specificity. There was no significant difference in the incidence of major complications betweenhen compared with transcervical lobectomy. Conclusions cIONM, parathyroid autofluorescence, transoral vestibular approach thyroid surgery, and RFA for benign and malignant thyroid nodules are some of the latest additions to the surgeon's and interventionalist's armamentarium to manage thyroid disease. These technological advancements demonstrate promise to improve outcomes, decrease complications, and enhance a patient's quality of life, but further rigorous studies are needed to define their utility and value.
Childhood cancer survivors and bone marrow transplant recipients treated with radiation therapy (RT) are at increased risk for subsequent thyroid cancer. However, the genetic landscape of pediatric thyroid cancer, both primary and RT-induced, remains poorly defined, as pediatric papillary thyroid carcinoma (PTC) has been understudied compared to adults and data on pediatric follicular thyroid carcinoma (FTC) are virtually nonexistent. The objective of this study was to characterize and compare the molecular profiles of pediatric RT-induced PTC and FTC cases with primary pediatric thyroid cancers.

A total of 41 differentiated thyroid carcinomas (11 RT cases and 30 primary cases) from 37 patients seen at Phoenix Children's Hospital between January 1, 2010 and December 31, 2019 were evaluated by targeted next-generation sequencing and/or BRAF immunohistochemistry.

Eighty-six percent (6/7) of RT-PTC harbored a gene fusion compared to 56% (14/25) of primary PTC; 14% (1/7) of RT-PTC had a single nucleotide vaadic and syndromic) cases, with a high prevalence of gene fusions in RT-PTC (similar to PTC occurring after the Chernobyl nuclear reactor accident) and copy number alterations in RT-FTC. A better understanding of the molecular mechanisms underlying these cancers may lead to more accurate diagnosis, prognosis, and treatment, as some of the genomic alterations are potentially targetable.
The aim of this study was to evaluate two-dimensional and Doppler ultrasonographic changes of the ovary and uterus during estrus and the early post-estrus period in domestic cats.

Two-dimensional and Doppler ultrasonographic evaluations of the ovaries and uterus were performed in seven queens on days 1, 3 and 5 of estrus, and 5 days after estrus (AE5).

On day 1, 5.4 ± 0.5 follicles of 2.1 ± 0.1 mm were detected progressively increasing in number and size up to day 5 and then decreased on AE5 (
<0.05). A maximum follicular diameter of 4.1 ± 0.1 mm was achieved on day 5. Both during and after estrus, the uterus was generally hypoechoic compared with the surrounding tissues and delineated by a thin hyperechoic line corresponding to the serosa. In some animals, the uterine layers were distinguished during and after estrus. The blood flow waveforms of the intraovarian and uterine arteries were characterized by a systolic peak and diastolic flow extending throughout the remainder of the cardiac cycle to ccurs during and after follicular growth in domestic cats.Coronavirus disease 2019 (COVID-19) is associated with a high rate of thrombosis. Prolonged activated partial thromboplastin times (aPTT) and antiphospholipid antibodies (aPL) are reported in COVID-19 patients. The majority of publications have not reported whether patients develop clinically relevant persistent aPL, and the clinical significance of new aPL-positivity in COVID-19 is currently unknown. However, the reports of aPL-positivity in COVID-19 raised the question whether common mechanisms exist in the pathogenesis of COVID-19 and antiphospholipid syndrome (APS). In both conditions, thrombotic microangiopathy resulting in microvascular injury and thrombosis is hypothesized to occur through multiple pathways, including endothelial damage, complement activation, and release of neutrophil extracellular traps (NETosis). APS-ACTION, an international APS research network, created a COVID-19 working group that reviewed common mechanisms, positive aPL tests in COVID-19 patients, and implications of COVID-19 infection for patients with known aPL positivity or APS, with the goals of proposing guidance for clinical management and monitoring of aPL-positive COVID-19 patients. This guidance also serves as a call and focus for clinical and basic scientific research.Primary obstructive megaureter (POM) morphogenesis is not fully known. The aim of the study was to evaluate the appearance of different factors that might take part in the pathogenesis of POM. Megaureter tissues of 14 children were stained with hematoxylin and eosin as well as with immunohistochemistry for protein gene product 9.5, nerve growth factor receptor, transforming growth factor beta 1 (TGFβ1), fibroblast growth factor receptor 1 (FGFR1), matrix metalloproteinase 2 (MMP-2), angiotensin 2 receptor type 2, and sonic hedgehog (SHH) protein. Apoptosis was detected by terminal dUTP nick-end labeling reaction. POM tissues revealed transitional epithelium with scattered vacuolization, submucosa with inflammatory cells, and focally vacuolized and chaotically organized muscle layers. Apoptosis, appearance of MMP-2, FGFR1, and SHH prevailed, but TGFβ1 positive cell number was lower in patients. Correlation between MMP-2 in epithelium and endothelium, FGFR1 and MMP-2 in epithelium, and TGFβ1 in epithelium and connective tissue in patients was detected. POM morphopathogenesis involves an apoptotic cell death of epithelium and smooth muscle as well as tissue degradation in epithelium and connective tissue of the ureter wall. The decrease of tissue growth through diminished TGFβ1 expression and stimulation of FGFR1 and MMP-2 suggests a disbalance of tissue remodelation in the megaureter wall.
Microdoses of psychedelics (i.e. a sub-hallucinogenic dose taken every third day) can reduce symptoms of depression, anxiety and stress according to anecdotal reports and observational studies. Research with medium to high doses of psilocybin points towards potential underlying mechanisms, including the modulation of emotion and interoceptive processing.

In this preregistered study, we investigated whether psilocybin microdoses alter self-reported interoceptive awareness and whether repeated microdosing over 3 weeks modulates emotion processing and reduces symptoms of anxiety and depression.

We used a double-blind, placebo-controlled, within-subject crossover design. Participants completed the Multidimensional Assessment of Interoceptive Awareness Questionnaire 1½ h after self-administering their second dose (or placebo), and the emotional go/no-go task and the shortened Depression Anxiety Stress Scale 1½ h after self-administering their seventh dose.

Our confirmatory analyses revealed that psilocybin second block and that there was no effect of expectations. Further research in a substance-naïve population with clinical range anxiety and depressive symptoms is needed to substantiate the potential beneficial effects of microdosing.Localization of cannabinoid receptor type 1 (CB1) immunoreactivity on mitochondrial membranes, at least their outer membranes distinctly, was detected in progesterone-producing cells characterized by mitochondria having tubular cristae and aggregations of lipid droplets in ovarian interstitial glands in situ of adult mice. Both immunoreactive and immunonegative mitochondria were contained in one and the same cell. Considering that the synthesis of progesterone is processed in mitochondria, the mitochondrial localization of CB1 in the interstitial gland cells suggests the possibility that endocannabinoids modulate the synthetic process of progesterone in the cells through CB1.The anesthesia process in the epidural space is quite difficult as it requires a high level of skill. Therefore, a medical accident occurs, and intensive training is required. In order to reduce these medical accidents, medical technology is being developed, which provides safe and accurate treatment services. This paper proposes a smart syringe design for safe and accurate anesthesia in the epidural space. The smart syringe is designed to measure the electrical sensing waveform by using a sensor instead of the sense of the hand during anesthesia and show the position of the needle through external monitoring. To design a smart syringe, a force sensor, actuator, and CPU were used, and a 3D printer was used to produce the outer shape. An animal test was conducted to evaluate the performance test of the smart syringe, and satisfactory results were obtained by measuring the needle insertion process of the smart syringe and the position of the needle through the animal experiment.
Primary healthcare teams (general practice and community nursing services) within the United Kingdom provided the majority of community end-of-life care during COVID-19, alongside specialist palliative care services. As international healthcare systems move to a period of restoration following the first phases of the pandemic, the impact of rapidly-implemented service changes and innovations across primary and specialist palliative care services must be understood.

To provide detailed insights and understanding into service changes and innovation that occurred in UK primary care to deliver end-of-life care during the first phase of the COVID-19 pandemic.

Cross-sectional online survey. Responses were analysed using descriptive statistics and thematic analysis.

United Kingdom survey of general practitioners and community nurses, circulated via regional and national professional networks.

A total of 559 valid responses were received from 387 community nurses, 156 general practitioners and 16 'other'. Os, who for and how, within the context of increased patient need and complexity.The large number of animal models used in Spinal Cord Injury (SCI) research complicates the objective selection of the most appropriate model to investigate the efficacy of biomaterial-based therapies. This systematic review aims to identify a list of relevant animal models of SCI by evaluating the confirmation of SCI and animal survival in all published SCI models used in biomaterials research up until April 2021. A search in PubMed and EMBASE based on 'spinal cord injury', 'animal models' and 'biomaterials' yielded 4606 papers, 393 of which were further evaluated. A total of 404 individual animal experiments were identified based on type of SCI, level of SCI, and the sex, species and strain of the animals used. Finally, a total of 149 unique animal models were comparatively evaluated, which led to the generation of an evidence-based list of well-documented mid-thoracic rat models of SCI. These models were used most often, clearly confirmed SCI and had relatively high survival rates, and therefore could serve as a future starting point for studying novel biomaterial-based therapies for SCI. Furthermore, the review discusses (i) the possible risk of bias in SCI animal models, (ii) the difficulty in replication of such experiments due to frequent poor reporting of the methods and results, and (iii) the clinical relevance of the currently utilized models. Systematic review registration The study was prospectively registered in PROSPERO, registration number CRD42019141162.Acute and chronic cutaneous wounds pose a significant health and economic burden. Cutaneous would healing is a complex process that occurs in four distinct, yet overlapping, highly coordinated stages hemostasis, inflammation, proliferation, and remodeling. Postnatal wound healing is reparative, which can lead to the formation of scar tissue. Regenerative wound healing occurs during fetal development and in restricted postnatal tissues. This process can restore the wound to an uninjured state by producing new skin cells from stem cell reservoirs, resulting in healing with minimal or no scarring. Focusing on the pathophysiology of acute burn wounds, this review highlights reparative and regenerative healing mechanisms (including the role of cells, signaling molecules, and the extracellular matrix) and discusses how components of regenerative healing are being used to drive the development of novel approaches and therapeutics aimed at improving clinical outcomes. Important components of regenerative healing, such as stem cells, growth factors, and decellularized dermal matrices, are all being evaluated to recapitulate more closely the natural regenerative healing process.
Dental caries is the most prevalent disease globally, and
(
) is a common associated oral bacteria. Additionally,
possess esterase activity capable of degrading resin composites (RC). However, the effect of degradation on the physical-mechanical properties of the RC has not been extensively studied. We evaluated the flexure strength (FS), the diametral tensile strength (DTS), the modulus of elasticity (ME), and the microhardness of three contemporary RC to establish if
could affect them.

One hundred thirty-eight bar-shaped and 276 disc-shaped specimens were fabricated with Enamel Plus HRi, IPS Empress Direct, and Clearfil AP-X, and physical-mechanical testing was done after been incubated during 30 and 60 days in culture media with or without
. Also, a scanning electron microscope was used to identify surface changes.

None of the tested RC were affected in their mechanical properties (FS, ME, and DTS). However, Clearfil AP-X and Enamel Plus HRI showed eroded surfaces and a decreased microhardness after 30 and 60 days
incubation. IPS Empress Direct presented the lowest values in all the tests, but its physical-mechanical features and surface were not affected by bacteria's exposure.

Exposure to
could affect some contemporary RC; however, the effect seems superficial since its mechanical features were not affected.
Exposure to S. mutans could affect some contemporary RC; however, the effect seems superficial since its mechanical features were not affected.
Cisplatin, an effective drug against cancer, commonly induces nephrotoxicity; limiting its therapeutic efficacy and application. In this study, Cisplatin NanoComposite (Cis NC) was formulated successfully from irradiated chitosan coated Cisplatin and MgO nanoparticles (CHIT/Cis/MgO NPs) to promote cisplatin release in a more sustained manner to improve therapeutic efficacy via the reduction of its nephrotoxicity. To compare the relative induced renal toxicity of cisplatin with Cisplatin NanoComposite, histological and biochemical mechanisms underlying nephrotoxicity were investigated.

Thirty rats were equally separated to three groups, first group received saline injections and adjusted as the control group, the second group was injected intra-peritoneal with cisplatin 0.64mg/kg b. wt./day for 6weeks, the third group was injected intra-peritoneal with Cis NC 5.75mg/kg b. wt. daily for 6weeks.

Cisplatin-induced renal functional impairment and histopathological damages in the kidney; also, cisplatin disrupted the balance of the redox system in renal tissue, stimulated the inflammatory reactions in the kidney via triggering signal transducer and activator of transcription-1 (STAT1) dependent pathways. Moreover, Cisplatin-induced activation of mammalian target of rapamycin mTOR and inactivation of AMPK/PI3K/Akt signal pathway, and was coupled with induction of p53 activity and the executioner caspase3 to induce apoptotic renal cell death. On the other hand, Cis NC exerted a minimal stimulatory effect on apoptotic and inflammatory signal cascade with negligible renal functional and morphological alterations.

We postulated that Cis NC may be a valued possible drug to decrease the cytotoxicity of cisplatin thus reserves the renal function and structure.
We postulated that Cis NC may be a valued possible drug to decrease the cytotoxicity of cisplatin thus reserves the renal function and structure.Background Image-guided radiofrequency ablation (RFA) for benign nonfunctional thyroid nodules in adults has been shown to be effective and safe, but few trials address the use of RFA in children. Therefore, this study was designed to assess the efficacy and safety of RFA application to benign nonfunctional thyroid nodules in children. Methods A retrospective study of RFA for 70 benign nonfunctional thyroid nodules in 62 children with four-year follow-up was conducted. Volume reduction ratio (VRR), technique efficacy, regrowth rate, symptom score, and cosmetic score were calculated to evaluate the efficacy. Complications and side effects were recorded. Logistic regression analysis was performed to identify risk factors, and subgroup analyses were performed. Results Patients were followed up for at least four years (59.1 ± 10.5 months, range 48-85 months). After RFA treatment, the VRR and technique efficacy rates were highest at two years (77.5% and 91.4%, respectively) but decreased by four years (55.1% and 8 good minimally invasive treatment modality for selected pediatric patients, and it may not be appropriate for the treatment of bilateral thyroid nodules in children.
Molecular testing (MT) enhances the diagnostic accuracy of thyroid fine needle aspiration (FNA) biopsy, reducing the need for diagnostic lobectomy in adult patients with indeterminate nodules (Bethesda class III/IV). However, little is known about genetic alterations in pediatric thyroid carcinoma (TC). Our aim was to analyze MT results in pediatric differentiated TC (DTC) to determine associations with histologic and clinical features.

A retrospective review identified all patients (age <19 years) diagnosed with DTC from 2001-2017 at the University of Pittsburgh Medical Center. Histology was re-reviewed to confirm diagnosis and identify tissue for MT using next-generation sequencing (ThyroSeq version 3, TSv3). Correlation with histologic and clinical features was analyzed using regression analysis.

Of 71 patients with MT results, 62 (87%) of patients had papillary TC. All patients were alive at a median follow-up of 6 years (range 18 days-18 years). Genetic alterations were identified in 65 (92%) pa90% had an identifiable genetic alteration. Aggressive features were primarily associated with BRAF-like gene fusions. Preoperative MT results may be useful in guiding the extent of initial operation in pediatric patients (age less then 19 years) with TC.Background Although previous meta-analyses have suggested a dose-response relationship between body mass index (BMI) and thyroid cancer risk, limited evidence has been presented about Asian populations. To assess this association among Asian populations, where underweight is more prevalent than in other regions, a pooled analysis from the Asia Cohort Consortium was conducted. Methods Baseline height and weight were measured in five cohorts and self-reported in eight cohorts. Thyroid cancer incidence was ascertained by linkage to local cancer registries. Cohorts were treated as a stratum in the Cox proportional hazard model to estimate the pooled hazard ratios (HRs) and corresponding confidence intervals (CIs) from the estimates for each cohort. All analyses were stratified by sex. Results A total of 538,857 men and women from 13 cohorts from mainland China, Korea, Japan, and Singapore were included in the analysis. During a mean of 15.1 years of follow-up, 1132 thyroid cancer cases were ascertained. Using a BMI of 18.5-22.9 kg/m2 as a reference, an elevated risk of thyroid cancer was observed for groups with a BMI between 25 and 29.9 kg/m2 (HR 1.31, [CI 0.95-1.80]) and a BMI of 30 kg/m2 and greater (HR 1.84, [CI 0.89-3.81]) in men. Thyroid cancer risk was elevated in women with a BMI of 23-24.9 kg/m2 (HR 1.26, [CI 1.07-1.48]). The HRs for 5-U increment of BMI showed a linear association among men (HR 1.25, [CI 1.10-1.55]) but not among women (HR 1.07, [CI 0.97-1.18]). Although the overall thyroid cancer risk was lower among underweight men and women, the papillary cancer risk may be elevated among underweight men (HR 2.24, [CI 0.75-6.66]). Conclusion While higher BMI is associated with an elevated risk of thyroid cancer in both men and women, the association of underweight BMI may differ by sex and histological subtype.
Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in "perfect health." There is considerable scope to improve current care/outcomes and patient experience.
Despite a substantial number of consultations, individuals experiencing the care pathways in this study continued to have far from perfect health over their life course. The modeling suggests they would only experience 18 y in "perfect health." There is considerable scope to improve current care/outcomes and patient experience.
Multinodular goiter (MNG) is the most common disorder of the thyroid gland. Aging and genetic mutations that impair thyroid hormone production have been implicated in the development of MNG. XB130 is an adaptor/scaffold protein predominantly expressed in the thyroid gland. XB130 deficiency leads to transient post-natal growth retardation in mice due to congenital hypothyroidism. We studied the formation of MNG and possible mechanisms in elderly mice.

Thyroid glands of male and female xb130-knockout (Xb130-/-), heterozygous (Xb130+/-), and wild-type (Xb130+/+) mice at the ages of 12-20 months were harvested for visual examination, histopathological and immunohistological analyses. Blood and thyroid samples were collected after feeding elderly mice with a low iodine diet for 125I uptake and perchlorate discharge assay. The activity of thyroperoxidase (Tpo) was examined by spectrophotometric evaluation of iodide-oxidation.

While moderate MNG was seen in Xb130+/+ and Xb130+/- mice, severe MNG, characterizede should be further investigated.
The pathophysiological features in the thyroid glands of aged Xb130-/- mice closely resemble the features of MNG in humans. Moderate MNG in elderly mice was dramatically aggravated by XB130 deficiency. Reduced affinity of Tpo for H2O2 may contribute to MNG development via oxidative stress. This could be specific to XB130 deficiency, but also could be a common mechanism in MNG. Its clinical relevance should be further investigated.Domestic violence is a complex social issue worldwide that includes a wide range of physical, sexual, psychological, economic, or emotional trauma to a child or adult. A large proportion of domestic violence cases remain unreported or undocumented. Dentists can play an important role in identifying and reporting these cases, but no such local study is available assessing the dental practitioners' attitudes and knowledge of evaluating physical abuse in Pakistan. The objective of this study was to assess the knowledge and practices of dental practitioners of Pakistan about domestic violence. This cross-sectional study was carried out over 2 months, among 330 dentists across Pakistan, selected by convenience sampling technique. Data was collected via a pre-validated online questionnaire, filled anonymously after taking informed consent. The survey questionnaire collected data about dentists' demographics, awareness, and experiences about domestic violence cases via close-ended questions. Only 10.6% of participatse management.
People who survive after primary cancer are at an increased risk for subsequent primary cancers. We aimed to investigate the possible determinants of second primary cancer (SPC) in HIV-positive cancer survivors.

This was a multicenter retrospective study using longitudinal data from the French Dat'AIDS cohort. Subjects who developed at least 2 primary cancers were selected. Cancer cases were identified using ICD10 codes and distributed in 3 cancer categories AIDS-defining cancer (ADC), virus-related non-ADC (VR-NADC), and virus-unrelated-NADC (VU-NADC). The possible determinants considered were the first primary cancer category, sex, age, HIV transmission route, duration of HIV infection follow-up, duration of ART exposure, nadir CD4
T cell count, and hepatitis C and hepatitis B serostatus.

Among the 44642 patients in the Dat'AIDS cohort, 4855 were diagnosed with cancer between 1 December 1983 and 31 December 2015, of whom 444 (9.1%) developed at least 2 primary cancers 130 ADCs, 85 VR-NADCs, and 229 VU-NADCs. A longer delay between the first primary cancer and the SPC was associated with an increased risk of occurrence of a VR-NADC rather than a secondary ADC. Having had a first primary VU-NADC, an older age, and a longer delay between the HIV diagnosis and the first primary cancer as well as between the first primary cancer and the SPC were associated with an increased risk of VU-NADC rather than ADC.

SPCs are now a major concern in HIV-positive cancer survivors justifying the development of monitoring strategies after a first cancer.
SPCs are now a major concern in HIV-positive cancer survivors justifying the development of monitoring strategies after a first cancer.
Mental health is essential to students' academic success as well as their ability to participate fully and meaningfully throughout all aspects of their lives and throughout their lifespan.

This study aims to determine the psychological health status of Moroccan nursing and technique health students. In doing so, it also seeks to compare differences based on sociodemographic factors.

A multicenter cross-sectional study with a convenience sample was conducted with 2,054 participants in the academic year of 2018/2019. A set of socio-demographic information were collected, and The General Health Questionnaire-12 (GHQ-12) was used.

The mean GHQ-12 score was 4.33 ± 2.61, and 58.7% respondents scored 4 and above in the GHQ-12 scores and thus were considered to be in psychological distress. Students' psychological distress was associated with female gender (60.4% for female compared to 52.4% for men,
= .003); living in parental residence (61.6% compared to 54.7% living away parental residence;
= .02 ), the second and the third training level year respectively (64.6%; 59.2%) compared to first-year (55.2%,
= .001), and midwifery and nursing students (61.6%; 60.3%) as compared to technique health students (43.6%,
= .001).

It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students' educational attainment and wider wellbeing.
It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students' educational attainment and wider wellbeing.Osteoclasts are cells whose main function is the resorption of bone matrix. However, several factors, including medications, can interfere with the resorption process. Alendronate (ALN), a nitrogen-containing type of bisphosphonate, and dexamethasone (DEX), a glucocorticoid, are drugs that may affect the resorption activity. The aim of this study is to investigate the effects of ALN, and/or DEX on osteoclast gene expression and resorption activity in primary mouse marrow cultures stimulated with 1,25-dihydroxyvitamin D3, a model for the bone microenvironment. Cultures were treated only with ALN (10-5 M), DEX (10-6 M), and with a combination of both agents. Viability assays performed at days 5, 7, and 9 showed the highest number of viable cells at day 7. All the following assays were then performed at day 7 of cell culture tartrate resistant acid phosphatase (TRAP) histochemistry, receptor activator of nuclear factor kappa B ligand (RANKL) immunofluorescence, osteoprotegerin (OPG), and RANKL gene expression by qPCR and resorption analysis by scanning electron microscopy. Treatment with ALN, DEX, and the combination of both did not promote significant changes in the number of TRAP+ cells, although larger giant cells were detected in groups treated with DEX. DEX treatment increased the gene expression of RANKL and reduced OPG. The treatment with ALN reduced the depth of the resorption pits, but their inhibitory effect was less effective when administered with DEX.Introduction Perceived control is an individual's subjective beliefs about the amount of control he or she has over the environment or outcome. Objective To examine the relationship between perceived control, preventive health behaviors, and mental health effects of undergraduate nursing students during the COVID-19 pandemic. Methods This cross-sectional correlational study used online self-administered questionnaires. Participants were nursing students attending 3 universities in Tokyo, Japan. Relationships among variables were quantitatively analyzed using linear regressions and a structural equation modeling after adjusting for demographic factors. Results A total of 557 students participated in the survey. The analysis indicated that higher levels of perceived control were significantly related to higher levels of preventive health behaviors. Although higher preventive health behaviors were related to negative mental health effects, higher levels of perceived health competence translated to improved mental health effects. Perceived control was not directly related to mental health effects but positively related to perceived health competence. Long work hours per week and short hours of sleep per day were associated with lower preventive health behaviors. There were significant differences in the levels of perceived control and preventive health behaviors among students at the 3 universities. Discussion To improve health behaviors and health competence and subsequently alleviate the mental health effects caused by strictly adhering to recommended health behaviors, students may be supported by the strategies that increase their perceived control. In addition to institutional support, students also require adequate sleep and financial stability to help prevent infections while protecting their mental health.Background The noninvasive subtype of encapsulated follicular variant of papillary thyroid carcinoma (eFVPTC) has been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in 2016 to reflect the indolent behavior and favorable prognosis of this type of tumor. This terminology change has also de-escalated its management approach from cancer treatment to a more conservative treatment strategy befitting a benign thyroid neoplasm. Objective To characterize the reduced health care costs and improved quality of life (QOL) from management of NIFTP as a nonmalignant tumor compared with the previous management as eFVPTC. Methods A cost-effectiveness analysis was performed by creating Markov models to simulate two management strategies for NIFTP (i) de-escalated management of the tumor as NIFTP involving lobectomy with reduced follow-up, (ii) management of the tumor as eFVPTC involving completion thyroidectomy/radioactive iodine ablation for some patients, and follow-up rost savings and improved patient utility of de-escalated NIFTP management compared with traditional management was estimated to be $3883.05 and 0.03 QALYs per patient. We demonstrate that these findings persisted in sensitivity analysis to account for variability in recurrence rate, surveillance approaches, and other model inputs. These findings allow for greater understanding of the economic and QOL impact of the NIFTP reclassification.
Our goal was to evaluate long-term safety and durability of response to UGN-101, a mitomycin-containing reverse thermal gel, as primary chemoablative treatment for low-grade upper tract urothelial carcinoma.

In this open-label, single-arm, multicenter, phase 3 trial (NCT02793128), patients ≥18 years of age with primary or recurrent biopsy-proven low-grade upper tract urothelial carcinoma received 6 once-weekly instillations of UGN-101 via retrograde catheter to the renal pelvis and calyces. Those with complete response (defined as negative ureteroscopic evaluation, negative cytology and negative for-cause biopsy) 4-6 weeks after the last instillation were eligible for up to 11 monthly maintenance instillations and were followed for ≥12 months with quarterly evaluation of response durability. Durability of complete response was determined by ureteroscopic evaluation; duration of response was estimated by the Kaplan-Meier method. Treatment-emergent adverse events (TEAEs) were monitored.

Of 71 patients who initiated treatment, 41 (58%) had complete response to induction therapy and consented to long-term followup; 23/41 patients (56%) remained in complete response after 12 months (95% CI 40, 72), comprising 6/12 (50%) who did not receive any maintenance instillations and 17/29 (59%) who received ≥1 maintenance instillation. Kaplan-Meier analysis of durability was estimated as 82% (95% CI 66, 91) at 12 months. Ureteric stenosis was the most frequently reported TEAE (31/71, 44%); an increasing number of instillations appeared to be associated with increased incidence of urinary TEAEs.

Durability of response to UGN-101 with or without maintenance treatment is clinically meaningful, offering a kidney-sparing therapeutic alternative for patients with low-grade disease.
Durability of response to UGN-101 with or without maintenance treatment is clinically meaningful, offering a kidney-sparing therapeutic alternative for patients with low-grade disease.
Recent trials showed thrombectomy alone was comparable to bridging therapy in patients with anterior circulation large vessel occlusion eligible for both intravenous alteplase and endovascular thrombectomy. We performed this study to examine whether occlusion site modifies the effect of intravenous alteplase before thrombectomy.

This is a prespecified subgroup analysis of a randomized trial evaluating risk and benefit of intravenous alteplase before thrombectomy (DIRECT-MT [Direct Intra-Arterial Thrombectomy in Order to Revascularize AIS Patients With Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals]). Among 658 randomized patients, 640 with baseline occlusion site information were included. The primary outcome was the score on the modified Rankin Scale at 90 days. Multivariable ordinal logistic regression analysis with an interaction term was used to estimate treatment effect modification by occlusion location (internal carotid artery versus M1 versus M2). We report the adjusted common od.clinicaltrials.gov; Unique identifier NCT03469206.Introduction About 1-in-11 Americans will experience a kidney stone, but underlying causes remain obscure. The objective of the present study was to separate idiopathic calcium oxalate stone formers by whether or not they showed positive evidence of forming a stone on Randall's plaque (RP). Materials and Methods In patients undergoing either percutaneous or ureteroscopic procedures for kidney stone removal, all stone material was extracted, and analyzed using micro computed tomographic imaging (micro CT), in order to identify those attached to RP. 24-hour urines were collected weeks after the stone removal procedure and off of medications that would affect urine composition. Endoscopic video was analyzed for papillary pathology (RP, pitting, plugging, dilated ducts, loss of papillary shape) by an observer blinded to the data on stone type. Percent papillary area occupied by RP and ductal plugging was quantified using image analytic software. Results Patients having even 1 stone on RP (N=36) did not differ from Non-RP patients (N=37) in age, sex, BMI, or other clinical characteristics. Compared to the Non-RP group, RP stone formers had more numerous but smaller stones, more abundant papillary RP, and fewer ductal plugs, both by quantitative measurement of surface area (on average, 3 times more plaque area, but only 41% as much plug area as Non-RP) and by semi-quantitative visual grading. Serum and blood values did not differ between RP and Non-RP stone formers by any measure. Conclusions Growth of many small stones on plaque seems the pathogenetic scheme for the RP stone forming phenotype, whereas the Non-RP phenotype stone pathogenesis pathway is less obvious. Higher papillary plugging in Non-RP suggests that plugs play a role in stone formation, and that these patients have a greater degree of papillary damage. Underlying mechanisms that create these distinctive phenotypes are presently unknown.Background The main aim of this study was to assess the efficacy of advanced respiratory support (ARS) for acute respiratory failure in do-not-attempt cardiopulmonary resuscitation order (DNACPR) COVID-19 patients. Methods In this single-center study, the impact of different types of ARS modality, PaO2/FiO2 (PF) ratio, clinical frailty score (CFS) and 4C score on mortality was evaluated. Results There was no significant difference in age, type of ARS modality, PF ratio and 4C scores between those who died and those who survived. Overall survival rates/hospital discharge of patients still requiring ARS at 5 and 7 days post admission were 20 and 17%, respectively. Conclusion Our study showed that ARS can be a useful tool in frail, elderly and high-risk COVID-19 patients irrespective of high 4C mortality score.Background A growing body of empirical research shows that suicidal behaviors are prevalent in childhood. Yet, few studies have examined risk factors related to suicidal ideation (SI) among children aged 12 and younger. Aims The current study addresses this gap. Method A questionnaire was filled out by 1,350 Flemish primary caregivers (94.7% mothers) of 9-year-old children (50.4% boys, Mage = 9.45). Their responses were analyzed using logistic regression and independent samples t tests. Results The presence of passive SI was reported in 10.5% of the children. A psychiatric, developmental, or behavioral condition (or multiple conditions), a learning disorder, impulsivity, aggression, and experiencing multiple stressful family life events were discovered as potential risk factors of passive SI in childhood. Limitations The cross-sectional nature of this study meant that causality could not be inferred. In addition, it was based on reports of primary caregivers, rather than on reports from the children themselves. Conclusion These new empirical findings can be used for the development of prevention programs and be taken into account in risk assessments of SI in clinical practice. Confirmation of our findings in a longitudinal child-reported study is needed.Background Family members often provide informal care following a suicide attempt. Carers may be vulnerable to caregiver burden. Yet, little is known about what contributes to this. Aims To determine the predictors of caregiver burden in those carers who support people who have attempted suicide. Method An online survey of 435 participants assessed exposure to suicide, caring behaviors, and psychological variables and caregiver burden. Results A multivariate model explained 52% of variance in caregiver burden. Being female, closeness to the person, impact of suicide attempt, frequency of contact pre-attempt, and psychological distress were positively associated with caregiver burden. Confidence in supporting the person after suicide attempt, perceived adequacy of healthcare the person received and the support the carer received, and suicidal ideation of the carer were negatively associated with caregiver burden. Moderation analysis suggested that carers with high levels of distress reported negative association between suicidal ideation and caregiver burden. Limitations The cross-sectional online survey design of self-identified carers is a limitation of the study. Conclusion Carers are highly distressed, and if unsupported report increased suicide ideation. In their caring roles they may have contact with support services, thus attending to their needs may ameliorate caregiver burden and associated negative outcomes.Background Despite the widespread use of the Suicidal Behaviors Questionnaire-Revised (SBQ-R) and advances in item response theory (IRT) modeling, item-level analysis with the SBQ-R has been minimal. Aims This study extended IRT modeling strategies to examine the response parameters and potential differential item functioning (DIF) of the individual SBQ-R items in samples of US (N = 320) and Chinese (N = 298) undergraduate students. Method Responses to the items were calibrated using the unidimensional graded response IRT model. Goodness-of-fit, item parameters, and DIF were evaluated. Results The unidimensional graded response IRT model provided a good fit to the sample data. Results showed that the SBQ-R items had various item discrimination parameters and item severity parameters. Also, each SBQ-R item functioned similarly between the US and Chinese respondents. In particular, Item 1 (history of attempts) demonstrated high discrimination and severity of suicide-related thoughts and behaviors (STBs). Limitations The use of cross-sectional data from convenience samples of undergraduate students could be considered a major limitation. Conclusion The findings from the IRT analysis provided empirical support that each SBQ-R item taps into STBs and that scores for Item 1 can be used for screening purposes.Background Reporting on suicide can elicit an increase in suicides, a phenomenon termed the "Werther effect." The name can be traced back to an alleged spike in suicides after the publication of Goethe's novel The Sorrows of Young Werther in 1774, in which the protagonist Werther dies by suicide. Aims Acknowledging the importance and primacy of systematic ecological and individual-level studies, we provide a historical single-case report of the suicide of a "late arrival of the Werther epidemic," as the death was headlined in a news report in 1927. Method Archival research on tenor Paul Vidal's suicide was conducted. Results Vidal reconstructed the scene of the final act of the opera Werther in his apartment and died by a gunshot, as did Werther. Limitations Causal interpretations must be made with caution. Conclusion Striking similarities between Werther's and Vidal's deaths support the idea of strong identification with the fictional narrative and suggest causal effects. Considering the repeated high level of immersiveness and the intense emotions of opera performances, it is likely that performing the role of Werther increases identification processes, contributing to detrimental effects. The lack of knowledge regarding the role of fictional suicide stories on artists' suicides is discussed.Background Some authors claimed that the US Food and Drug Administration (FDA) black box warning on treatment-emergent suicidality with antidepressants in adolescents (issued 2004) and young adults (issued 2006) led to an increase of suicides, based on the analyses of ecological data with debatable assumptions about putative changes in suicide rates. Aims To explore if putative changes in suicide rates in adolescents and young adults at the time of the FDA warnings is a detectable signal in the data or compatible with random fluctuations. Method We applied different changepoint analyses for adolescent and young adult suicide rates from 1981 to 2019 in the USA. Results Changepoint analysis did not support a detrimental effect of the FDA black box warnings. The downward trend of suicides reversed several years after the warning in adolescents (2007-2009) and many years before in young adults (1999-2001). Limitations Our analyses cannot rule out detrimental effects of the FDA warnings. However, even if there was such an effect, it was likely small and indistinguishable from random fluctuations in the available suicide data. Conclusion There is no detectable change of trend in adolescent or young adult suicide rates in line with a detrimental effect of the FDA black box warnings on treatment-emergent suicidality.
Computed tomography-based evaluation of aortic stenosis (AS) by calcium scoring does not consider interleaflet differences in leaflet characteristics. Here, we sought to examine the functional implications of these differences.

We retrospectively reviewed the computed tomography angiograms of 200 male patients with degenerative calcific AS undergoing transcatheter aortic valve replacement and 20 male patients with normal aortic valves. We compared the computed tomography angiography (CTA)-derived aortic valve leaflet calcification load (AVLC
), appearance, and systolic leaflet excursion (LE
) of individual leaflets. We performed computer simulations of normal valves to investigate how interleaflet differences in LE
affect aortic valve area. We used linear regression to identify predictors of leaflet-specific calcification in patients with AS.

In patients with AS, the noncoronary cusp (NCC) carried the greatest AVLC
(365.9 [237.3-595.4] Agatston unit), compared to the left coronary cusp (LCC, 278.5 [169.
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