Notes

Evaluation associated with immunohistochemical examination on nasal augmentation using demineralized enamel graft and bovine bone fragments.
Lateral lymph node dissection (LLND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity, thus the purpose of this study is to compare the postoperative morbidity and mortality between laparoscopic and conventional open LLND after mesorectal excision (ME) for advanced rectal cancer. A comprehensive search was conducted in August 2019 based on data from PubMed, Embase, Cochrane Library, CNKI and Wanfang Data to identify relevant studies, and studies comparing laparoscopic with conventional open LLND were included. Seven studies with 335 cases in the laparoscopic LLND group and 841 cases in the conventional open LLND group were finally included. Compared with the conventional open LLND group, the laparoscopic LLND group enjoys a lower postoperative morbidity (OR = 0.47,95% CI [0.23, 0.97], P = 0.04), same postoperative mortality (Postoperative mortality in both groups was zero), shorter length of postoperative hospitalization (WMD = -5.30, 95% CI [-8.42, -2.18], P = 0.0009), less wound infection (OR = 0.40,95% CI [0.21, 0.77], P = 0.006), less intestinal obstruction (OR = 0.50,95% CI [0.29, 0.84], P = 0.009), and less urinary retention (OR = 0.61,95% CI [0.38, 0.97], P = 0.04). There were no significant differences in the incidence of anastomotic leakage, abdominal pelvic abscess and urinary tract infection between the two groups (P > 0.05). But in the sensitivity analysis, there was a significant change of urinary tract infection (OR = 0.22, 95%CI [0.06, 0.89], P = 0.03), and the degree of between-study heterogeneity decreased greatly. In conclusion, laparoscopic LLND may be a better alternative to conventional open LLND for advanced rectal cancer with lower postoperative morbidity and shorter postoperative hospital stay.
Using indicators of campaign effort and relevant news stories, we sought to predict two patterns of patient behavior regarding information about aspirin and heart health patient use of a campaign web tool to determine whether they should talk with a physician about using aspirin and patient searches for information about aspirin and the heart.

We used ARIMA modeling to predict two time series as a function of independent variables.

We found significant prediction of time series in both models, but campaign expenditure only predicted use of a campaign web tool whereas weekly news stories predicted online searches regarding aspirin and the heart originating from Minnesota.

Patient information engagement is a function of information salience at least in part. Campaign advertising expenditure can prompt audience use of campaign tools but news coverage also operates as an important force on patient search behavior.

Health promotion professionals charged with reaching patients with heart health and stroke prevention messages should monitor news coverage as a potential complementary or rival force while at the same time promoting campaign-related information online.
Health promotion professionals charged with reaching patients with heart health and stroke prevention messages should monitor news coverage as a potential complementary or rival force while at the same time promoting campaign-related information online.
To review and synthesise definitions of the teach-back method in the literature. The second aim is to synthesise the barriers, facilitators and perceptions of teach-back use in healthcare consultations with patients.

A systematic review and thematic synthesis following Braun and Clarke's method.

The primary search found 1429 citations and the secondary search added 221 citations. Screening identified 66 citations eligible for data extraction. We contrasted and synthesised operational definitions of the teach-back method. The synthesis generated seven themes related to healthcare provider (HCP) and patient perceptions of teach-back (effectiveness, stigma and time-related perceptions), the universal application of teach-back, patient health outcomes and healthcare provider training.

Operational definitions of the teach-back method varied in the literature and contained implied steps. HCPs and patient perceptions of teach-back operated as both enablers and barriers to its use. HCPs training programs for the teach-back method were identified as beneficial for altering HCPs perceptions about the method and increased its use with patients.

Standardising operational definitions of the teach-back method can support replicability of research and enhance HCPs communication skills training programs. HCPs training on teach-back use can support the increased use of the technique with broader patient populations.
Standardising operational definitions of the teach-back method can support replicability of research and enhance HCPs communication skills training programs. HCPs training on teach-back use can support the increased use of the technique with broader patient populations.
To investigate the impact of a structured eight-week mindfulness-based cognitive therapy (MBCT) program on counseling self-efficacy among counseling trainees.

Undergraduate counseling trainees were randomized to an MBCT group (n = 25) or a waitlist control group (n = 25) with a crossover trial design. Psychological measurements regarding mindfulness, empathy, self-compassion, psychological distress, counseling self-efficacy as well as neuro-physiological measures including frontal midline theta activity, respiration rate, and skin conductance were taken at baseline (T1), after intervention (T2), and six-month follow-up (T3).

Mindfulness training could make significant positive changes in empathy, self-compassion, stress reduction, and counseling self-efficacy with this being backed up by both psychological and neuro-physiological evidence at T2. However, such differences between the two groups had greatly subsided after crossover in which carry-over effect and marked improvement were noted in the study and control group, respectively, at T3. SR-18292 clinical trial In addition, mindfulness was the most significant determinant that contributed to counseling self-efficacy, followed by psychological distress reduction and self-compassion according to the regression models.

Integrating mindfulness into counseling training is beneficial for helping profession trainees.

Incorporating mindfulness into counseling training can enhance the necessary "being mode" qualities in counseling and address self-care issues during training.
Incorporating mindfulness into counseling training can enhance the necessary "being mode" qualities in counseling and address self-care issues during training.The assessment and prevention of cardiovascular risk (CVR) that persists in patients with dyslipidaemia despite treatment and achievement of goals specific to the plasma concentration of cholesterol linked to low density (c-LDL) is a clinical challenge today, and suggests that conventional lipid biomarkers are insufficient for an accurate assessment of CVR. Apart from their lipid content, there are other lipid particle characteristics. The results of this study show that there are a number of lipoprotein compounds that determine atherogenic potential and its influence on the CVR. However, such additional characteristics cannot be analysed by the techniques commonly used in clinical laboratories. Nuclear Magnetic Resonance (NMR) is a technique that allows a detailed analysis to be made of the amount, composition, and size of lipoproteins, as well as providing more information about the detailed status of lipid metabolism and CVR in dyslipidaemia patients. In this article a group of lipidologists from the Spanish Society of Arteriosclerosis review the existing evidence on the atherogenic mechanisms of particles and describe the technical basis and interpretation of the profiles lipoproteins obtained by MRI, with special reference to the test available in Spain (Liposcale®). Likewise, the main patient profiles are defined as such that an analysis would provide information of greater clinical interest. These include a) Suspected mismatch between lipid concentrations and particles, a common situation in diabetes, obesity, metabolic syndrome; b) Early atherothrombotic cardiovascular disease (ECVA) or recurrent without CVR factors to justify it; c) Lipid disorders, rare or complex, such as extreme concentrations of c-HDL, and d) Clinical situations where classical analytical techniques cannot be applied, such as very low c-LDL values.
Very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is a mitochondrial fatty acid oxidation disorder that causes episodic attacks, such as general fatigue, hypotonia, myalgia, and rhabdomyolysis accompanied by lack of energy. link2 As yet, there are no preventative drugs for these VLCADD-associated metabolic attacks.

We conducted an open-label, non-randomized, multi-center study into the effects of bezafibrate on five patients with VLCADD. Bezafibrate was administered for 4years, and we analyzed the number of myopathic attacks requiring hospitalization and treatment infusions.

The number of myopathic attacks requiring infusions of 24h or longer significantly decreased during the study period. The patients' ability to conduct everyday activities was also improved by the treatment.

Our findings show the potential long-term efficacy of bezafibrate in preventing myopathic attacks for patients with VLCADD.
Our findings show the potential long-term efficacy of bezafibrate in preventing myopathic attacks for patients with VLCADD.
The ALDH18A1 gene is located at 10q24.1 and encodes delta-1-pyrroline-5-carboxylate synthetase (P5CS), a mitochondrial bifunctional enzyme that catalyzes the first two steps in de novo biosynthesis of proline, ornithine, citrulline, and arginine. link3 ALDH18A1-related disorders have been classified into four groups, such as autosomal dominant and recessive hereditary spastic paraplegia (SPG9A and SPG9B, respectively), as well as autosomal dominant and recessive cutis laxa (ADCL3 and ARCL3A, respectively). Neurodegeneration is a characteristic feature of all groups.

Here, we report a girl with compound heterozygous disease-causing variants (c.-28-2A>G and c.383G>A, p.Arg128His) in the ALDH18A1 gene, revealed by whole exome sequencing. The c.-28-2A>G variant in intron 1, inherited from the mother, is a novel mutation, while the c.383G>A variant in exon 4, inherited from the father, has already been reported. The patient presented with vigorous infantile tremor preceding progressive spastic paraplegia. Dysmorphic features included elongated face, deep-set ears, upturned nose, long philtrum and pointed chin. Intrauterine and postnatal growth retardation, microcephaly, global developmental delay and profound intellectual disability were also noticed. Blood fasting ammonia level, plasma proline, ornithine and arginine levels were normal, while citrulline level was slightly decreased. Brain MRI revealed moderate hypoplasia of the corpus callosum and reduction of white matter volume.

The patient represents SPG9B, a rare form of autosomal recessive hereditary spastic paraplegias. The early onset tremor, preceding lower limb spasticity appears to be a unique early manifestation of neurodegeneration in this case.
The patient represents SPG9B, a rare form of autosomal recessive hereditary spastic paraplegias. The early onset tremor, preceding lower limb spasticity appears to be a unique early manifestation of neurodegeneration in this case.
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