Notes

Repair Robotic-Assisted Seminal Vesiculectomy for Merkel Mobile or portable Carcinoma Metastasis.
Of the 266 patients included in the primary analysis, the primary outcome occurred in 8 patients, for a cumulative incidence of 3.1% (95% CI, 1.6% to 6.1%) over the 90-day follow-up. The incidence of recurrent venous thromboembolism was 2.1% (CI, 0.8% to 5.5%) and 5.7% (CI, 2.2% to 14.4%) over the 90-day follow-up in patients with single and multiple isolated subsegmental pulmonary embolism, respectively. No patients had a fatal recurrent pulmonary embolism.

The study was restricted to patients with low-risk subsegmental pulmonary embolism.

Overall, patients with subsegmental pulmonary embolism who did not have proximal deep venous thrombosis had a higher-than-expected rate of recurrent venous thromboembolism.

Heart and Stroke Foundation of Canada and French Ministry of Health Programme Hospitalier de Recherche Clinique.
Heart and Stroke Foundation of Canada and French Ministry of Health Programme Hospitalier de Recherche Clinique.
The 2020 European Society of Cardiology (ESC) guidelines recommend using the 0/1-hour and 0/2-hour algorithms over the 0/3-hour algorithm as the first and second choices of high-sensitivity cardiac troponin (hs-cTn)-based strategies for triage of patients with suspected acute myocardial infarction (AMI).

To evaluate the diagnostic accuracies of the ESC 0/1-hour, 0/2-hour, and 0/3-hour algorithms.

PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from 1 January 2011 to 31 December 2020. (PROSPERO CRD42020216479).

Prospective studies that evaluated the ESC 0/1-hour, 0/2-hour, or 0/3-hour algorithms in adult patients presenting with suspected AMI.

The primary outcome was index AMI. Twenty unique cohorts were identified. Primary data were obtained from investigators of 16 cohorts and aggregate data were extracted from 4 cohorts. Two independent authors assessed each study for methodological quality.

A total of 32 studies (20 cohorts) with 30 066 patients were aampling time varied among studies.

The ESC 0/1-hour and 0/2-hour algorithms have higher sensitivities and NPVs than the 0/3-hour algorithm for index AMI.

National Taiwan University Hospital.
National Taiwan University Hospital.
The cost-effectiveness of screening mammography beyond age 75 years remains unclear.

To estimate benefits, harms, and cost-effectiveness of extending mammography to age 80, 85, or 90 years according to comorbidity burden.

Markov microsimulation model.

SEER (Surveillance, Epidemiology, and End Results) program and Breast Cancer Surveillance Consortium.

U.S. women aged 65 to 90 years in groups defined by Charlson comorbidity score (CCS).

Lifetime.

National health payer.

Screening mammography to age 75, 80, 85, or 90 years.

Breast cancer death, survival, and costs.

Extending biennial mammography from age 75 to 80 years averted 1.7, 1.4, and 1.0 breast cancer deaths and increased days of life gained by 5.8, 4.2, and 2.7 days per 1000 women for comorbidity scores of 0, 1, and 2, respectively. Annual mammography beyond age 75 years was not cost-effective, but extending biennial mammography to age 80 years was ($54000, $65000, and $85000 per quality-adjusted life-year [QALY] gained for women with CCSs of 0, 1, and ≥2, respectively). Overdiagnosis cases were double the number of deaths averted from breast cancer.

Costs per QALY gained were sensitive to changes in invasive cancer incidence and shift of breast cancer stage with screening mammography.

No randomized controlled trials of screening mammography beyond age 75 years are available to provide model parameter inputs.

Although annual mammography is not cost-effective, biennial screening mammography to age 80 years is; however, the absolute number of deaths averted is small, especially for women with comorbidities. Women considering screening beyond age 75 years should weigh the potential harms of overdiagnosis versus the potential benefit of averting death from breast cancer.

National Cancer Institute and National Institutes of Health.
National Cancer Institute and National Institutes of Health.
COVID-19 is more severe in transplant recipients. Variants of concern have supplanted wild-type virus. In transplant recipients, data are limited on 2-dose or 3-dose vaccine immunogenicity against variant viruses.

To assess neutralizing antibody responses against SARS-CoV-2 variants in transplant recipients after 2 and 3 vaccine doses.

Secondary analysis of a randomized, double-blind, controlled trial of a third dose of mRNA-1273 vaccine versus placebo. (ClinicalTrials.gov NCT04885907).

Single-center transplant program.

Organ transplant recipients.

Third dose of mRNA-1273 vaccine versus placebo.

Sera were analyzed for neutralization against wild-type virus and the Alpha, Beta, and Delta variants using a surrogate virus neutralization assay and a spike-pseudotyped lentivirus assay.

A total of 117 transplant recipients were analyzed (60 in the mRNA-1273 group and 57 in the placebo group). Sera were obtained before and 4 to 6 weeks after the third dose. After 2 doses, the proportion of patients wcebo.

Ajmera Transplant Centre.
Ajmera Transplant Centre.
Patients with heart failure (HF) and preserved left ventricular ejection fraction comprise a heterogeneous group including some with mildly reduced EF. We hypothesized that mode of death differs by EF in ambulatory patients with HF and preserved left ventricular ejection fraction.

PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blocker Global Outcomes in Heart Failure With Preserved Ejection Fraction) compared clinical outcomes in 4796 patients with chronic HF and EF ≥45% randomly assigned to sacubitril/valsartan or valsartan. We examined the mode of death in relation to baseline EF in logistic regression models and the effect of randomized treatment on cause-specific death in Cox regression models. Nonlinear relationships with continuous EF were modelled using quadratic and cubic terms.

Of 691 deaths during the trial, 416 (60%) were ascribed to cardiovascular, 220 (32%) to noncardiovascular, and 55 (8%) to unknown causes. click here Of cardiovascularh HF and preserved left ventricular ejection fraction enrolled in PARAGON-HF, the proportion of cardiovascular and sudden death were higher in those with lower left ventricular EF, and the proportion of noncardiovascular death rose with EF. Regardless of EF, sacubitril/valsartan did not reduce death from any cause compared with valsartan. Registration URL https//www.clinicaltrials.gov; Unique identifier NCT01920711.Implicit motor learning paradigms aim to minimize verbal-analytical engagement in motor performance. Some paradigms do this by decreasing working memory activity during practice, which reduces explicit processes associated with the search for motor solutions (e.g., hypothesis testing). Here we designed a mentally demanding motor task to fatigue working memory prior to motor practice and then tested whether it reduced hypothesis testing. Fifty-nine participants were randomly assigned to complete the mentally demanding motor task (cognitive fatigue group) or to complete an undemanding motor task (nonfatigued control group). Feelings of fatigue, working memory functions, electroencephalography (EEG) Fz power, and vagal control were assessed pre- and posttask to quantify the effect of the mentally demanding motor task on cognitive fatigue. Thereafter, an adapted shuffleboard task was completed to determine the impact on hypothesis testing. Hypothesis testing was assessed by self-report, technique changes, and equipment-use solutions. Additionally, verbal-analytical engagement in motor performance was (indirectly) gauged with EEG T7-Fz connectivity and T7 power measures. Participants in the cognitive fatigue group reported more fatigue and displayed moderated working memory functions and Fz theta power. During practice of the shuffleboard task, participants also displayed more technique changes and higher verbal-analytical engagement in motor planning (EEG T7-Fz connectivity), compared with participants in the control group. The mentally demanding motor task suppressed working memory functions, but resulted in more, rather than less, hypothesis testing during shuffleboard practice. The implications are discussed in the context of implicit motor learning theory. (PsycInfo Database Record (c) 2021 APA, all rights reserved).Automatic imitation refers to the act of unintentionally mimicking observed actions. Inspired by a theoretical framework that allows for controlled yet unintentional processes, we tested whether automatic imitation depends on the task relevance of the to-be-imitated movements. Replicating previous results, we find that movements that are part of the participant's task set unintentionally influence response. Our key finding is that participants generally do not imitate similar and highly familiar movements that are not part of the task set and hence are task-irrelevant. Furthermore, the results of computational data modeling are consistent with the notion that task-relevance modulates the mental activation of information, as posited by the above theoretical framework. Our findings are not predicted and cannot be explained using current accounts of automatic imitation, such as Associative Sequence Learning or Theory of Event Coding. At a broader level, the key contribution of this study is in challenging the empirical basis for automatic imitation by showing that the effects interpreted as imitation occur only for task relevant responses. This pattern lends itself to a different interpretation which is not related to imitation, automatic or otherwise, but rather to the general phenomenon of response compatibility effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).When deciding whom to choose for a cooperative interaction, two features of prospective partners are especially relevant ability to provide benefits, and willingness to provide those benefits. Often, these traits are correlated. But, when ability and willingness are in conflict, people often indicate that they value willingness over ability, even when doing so results in immediate losses. Why would such behavior be favored by natural selection acting at the level of the individual? Across nine experimental studies (seven preregistered) and a mathematical model we explore one way of explaining this costly choice, demonstrating that choosing a willing over an able partner affords one a moral reputation and makes one more likely to be chosen as a cooperation partner. In fact, even people who choose an able over a willing partner for themselves prefer others who choose a willing over an able partner. Crucial to our model, we find that valuing willingness over ability is an honest signal of both higher levels of generosity in an economic game and lower levels of trait Machiavellianism. These findings provide the first extensive exploration of the signaling benefits of partner choice decisions. Furthermore, this work provides one explanation for why we choose those who are willing over those who are able, even at a cost to ourselves By doing so, we in turn look like good potential partners. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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