Do Upper Limb Loss and Prosthesis Use Affect Lower Limb Gait Dynamics?

Introduction: Intentional interruption of upper and lower limb coordination of able-bodied subjects alters their gait biomechanics. However, the effect of upper-limb loss (ULL) on lower-limb gait biomechanics is not fully understood. The aim of this secondary study was to perform a follow-up analysis of a previous dataset to characterize the spatiotemporal parameters and lower-limb kinematics and kinetics of gait for persons with ULL when wearing and not wearing an upper limb prosthesis (ULP).

Evaluating Screening Participation, Follow-up, and Outcomes for Breast, Cervical, and Colorectal Cancer in the PROSPR Consortium.

Background: Cancer screening is a complex process encompassing risk assessment, the initial screening examination, diagnostic evaluation, and treatment of cancer precursors or early cancers. Metrics that enable comparisons across different screening targets are needed. We present population-based screening metrics for breast, cervical, and colorectal cancers for nine sites participating in the Population-based Research Optimizing Screening through Personalized Regimens consortium.

Stress-Associated Neurobiological Pathway Linking Socioeconomic Disparities to Cardiovascular Disease.

Background: Lower socioeconomic status (SES) associates with a higher risk of major adverse cardiac events (MACE) via mechanisms that are not well understood.

Objectives: Because psychosocial stress is more prevalent among those with low SES, this study tested the hypothesis that stress-associated neurobiological pathways involving up-regulated inflammation in part mediate the link between lower SES and MACE.

Methods: A total of 509 individuals, median age 55 years (interquartile range: 45 to 66 years), underwent clinically indicated whole-body F-fluorodeoxyglucose positron emission tomography/computed tomography imaging and met pre-defined inclusion criteria, including absence of known cardiovascular disease or active cancer.

Improving patient flow in a regional anaesthesia block room.

University Hospital is a tertiary academic centre in London, Ontario, Canada. A designated space known as the block room (BR) supports a model of care to perform regional anaesthesia prior to entering the resource intense operating room (OR). Stress due to time pressure was reported by BR staff.

Communicating Uncertainty: a Narrative Review and Framework for Future Research.

Discussing the uncertainty associated with a clinical decision is thought to be a critical element of shared decision-making. Yet, empirical evidence suggests that clinicians rarely communicate clinical uncertainty to patients, and indeed the culture within healthcare environments is often to equate uncertainty with ignorance or failure. Understanding the rationale for discussion of uncertainty along with the current evidence about approaches to communicating and managing uncertainty can advance shared decision-making as well as highlight gaps in evidence.

Linac-Based Radiosurgery for Patients With Brain Oligometastases From a Breast Primary, in the Trastuzumab Era-Impact of Tumor Phenotype and Prescribed SRS Dose.

The role of stereotactic radiosurgery (SRS) in the treatment of limited numbers of brain metastases in selected breast cancer patients is well-established. To analyse outcome from a single institutional experience with SRS, to identify any significant prognostic factors and to assess the influence of Her-2, estrogen receptor status, and prescribed dose on outcome. The medical records of 56 patients treated at in a single institution between 2009 and 2014 were reviewed.

Effect of Redox Active Ligands on the Electrochemical Properties of Manganese Tricarbonyl Complexes.

The synthesis, structural characterization, and electrochemical behavior of the neutral Mn(azpy)(CO)(Br) 4 (azpy = 2-phenylazopyridine) complex is reported and compared with its structural analogue Mn(bipy)(CO)(Br) 1 (bipy = 2,2'-bipyridine). 4 exhibits reversible two-electron reduction at a mild potential (-0.93 V vs Fc in acetonitrile) in contrast to 1, which exhibits two sequential one-electron reductions at -1.

Neuropsychological functioning in early and chronic stages of schizophrenia and psychotic bipolar disorder.

Background: Neuropsychological impairment is common in schizophrenia and psychotic bipolar disorder. It has been hypothesized that the pathways leading to impairment differ between disorders. Cognitive impairment in schizophrenia is believed to result largely from atypical neurodevelopment, whereas bipolar disorder is increasingly conceptualized as a neuroprogressive disorder.

Illicit Use of Prescription Stimulants: Gender Differences in Perceptions of Risk.

: Little research exists on gender differences regarding the relationship between illicit use of prescription stimulants (IUPS) and perceptions of risk of illicit use. Risk perception is a common target for both prevention and intervention programs. : To measure gender differences in prevalence rates of illicit use and perceptions of legal, health, and social risks of illicit use.

Assessment of Job Satisfaction and Feeling Valued in Academic Medicine.

This cross-sectional survey study examines the factors associated with satisfaction at work in academic health care centers.

Clinical Development of Therapeutic Agents for Hospitalized Patients With Influenza: Challenges and Innovations.

Background: Since 1999, the US Food and Drug Administration approved neuraminidase and endonuclease inhibitors to treat uncomplicated outpatient influenza but not severe hospitalized influenza. After the 2009 pandemic, several influenza hospital-based clinical therapeutic trials were unsuccessful, possibly due to certain study factors. Therefore, in 2014, the US Health and Human Services agencies formed a Working Group (WG) to address related clinical challenges.

Acizzia errabunda sp. nov. and Ctenarytaina insularis sp. nov.: Descriptions of two new species of psyllids (Hemiptera: Psylloidea) discovered on exotic host plants in New Zealand.

A recent molecular-based assessment of the psyllid fauna of New Zealand reported two genetically distinct, undescribed psyllid taxa on host plants not native to that country. Here, a morphological examination confirmed species-level variation that resulted in the description of two new psyllid species: Acizzia errabunda sp. nov.

Childhood temperament is associated with distress, anxiety and reduced quality of life in schizophrenia spectrum disorders.

Schizophrenia is conceptualized as a neurodevelopmental disorder and pre-morbid differences in social function and cognition have been well-established. Less is known about pre-morbid temperament and personality. Inhibited temperament-the predisposition to respond to novelty with wariness, fear, or caution-is a premorbid risk factor for anxiety, depression, and substance use but is understudied in schizophrenia.

Genome-wide association study in frontal fibrosing alopecia identifies four susceptibility loci including HLA-B*07:02.

Frontal fibrosing alopecia (FFA) is a recently described inflammatory and scarring type of hair loss affecting almost exclusively women. Despite a dramatic recent increase in incidence the aetiopathogenesis of FFA remains unknown. We undertake genome-wide association studies in females from a UK cohort, comprising 844 cases and 3,760 controls, a Spanish cohort of 172 cases and 385 controls, and perform statistical meta-analysis.

A randomized experimental study to assess the effect of language on medical students' anxiety due to uncertainty.

Background Communication and handoff failures are common causes of diagnostic errors in hospital. Human quest for certainty can increase the likelihood of premature closure in decision-making, the most common phenomenon in misdiagnosis. Little research exists on whether language choice in handoffs affects physicians' sense of uncertainty.

Measuring individual physician clinical productivity in an era of consolidated group practices.

Background: As physician groups consolidate and value-based payment replaces traditional fee-for-service systems, physician practices have greater need to accurately measure individual physician clinical productivity within team-based systems. We compared methodologies to measure individual physician outpatient clinical productivity after adjustment for shared practice resources.

Methods: For cardiologists at our hospital between January 2015 and June 2016, we assessed productivity by examining completed patient visits per clinical session per week.

The Impact of a Risk-Based Breast Cancer Screening Decision Aid on Initiation of Mammography Among Younger Women: Report of a Randomized Trial.

Guidelines recommend that initiation of breast cancer screening (BCS) among women aged 40 to 49 years include a shared decision-making process. The objective of this study is to evaluate the effect of a breast cancer screening patient decision-aid (BCS-PtDA) on the strength of the relationship between individual risk and the decision to initiate BCS, knowledge, and decisional conflict. We conducted a randomized clinical trial of a BCS-PtDA that included individual risk estimates compared with usual care.

Are we documenting performance validity testing in pediatric neuropsychological assessments? A brief report.

A 2016 survey of pediatric neuropsychologists found that 92% of clinicians reported use of "at least one" performance validity test (PVT) in each assessment. The present investigation sought to verify documented PVT use among clinicians by review of actual reports. A convenience sample of pediatric neuropsychological reports of children ages 6-17 were reviewed over an 24-month period (January 2015-January 2017); reports were those seen as part of our routine practice, including reports on children we were reevaluating, cases that we consulted on, or cases evaluated elsewhere presenting to our centers that required record review for clinical decision making (e.

Physiological Responses to Exercise in Pediatric Heart Transplant Recipients.

Introduction: Pediatric heart transplant (HTx) recipients have reduced exercise capacity typically two-thirds of predicted values, the mechanisms of which are not fully understood. We sought to assess the cardiorespiratory responses to progressive exercise in HTx relative to controls matched for age, sex, body size, and work rate.

Methods: Fourteen HTx recipients and matched controls underwent exercise stress echocardiography on a semisupine cycle ergometer.

The Evidence Project risk of bias tool: assessing study rigor for both randomized and non-randomized intervention studies.

Background: Different tools exist for assessing risk of bias of intervention studies for systematic reviews. We present a tool for assessing risk of bias across both randomized and non-randomized study designs. The tool was developed by the Evidence Project, which conducts systematic reviews and meta-analyses of behavioral interventions for HIV in low- and middle-income countries.

Breaking the Cycle: Understanding the Needs of Women Involved in the Criminal Justice System and the Role of Mentoring in Promoting Desistance.

An increasingly popular gender-specific intervention to assist women involved in the criminal justice system (e.g., ex-prisoners) is mentoring.

The fear of Alzheimer's disease: mediating effects of anxiety on subjective memory complaints.

To determine if the fear of developing Alzheimer's disease (FDAD) construct, in combination with similar psychoemotional factors, could help elucidate the nature of older adults' subjective memory complaints (SMCs) and subsequent objective memory performance. One hundred ninety-three healthy older adults (aged 65-93) were administered clinician and self-report measures of depression, worry, anxiety, illness attitudes, and memory, and each rated their concern with developing AD. Self-reported FDAD was not associated with objective memory performance ( > .

Regionally specific volume deficits along the hippocampal long axis in early and chronic psychosis.

Previous studies in psychosis patients have shown hippocampal volume deficits across anterior and posterior regions or across subfields, but subfield specific changes in volume along the hippocampal long axis have not been examined. Here, we tested the hypothesis that volume changes exist across the hippocampus in chronic psychosis but only the anterior CA region is affected in early psychosis patients. We analyzed structural MRI data from 179 patients with a non-affective psychotic disorder (94 chronic psychosis; 85 early psychosis) and 167 heathy individuals demographically matched to the chronic and early psychosis samples respectively (82 matched to chronic patients; 85 matched to early patients).