How young adults with sickle cell disease define "being a good patient" in the adult healthcare system.

Background: Young adulthood brings new challenges for managing sickle cell disease. There are fewer adult specialists, sickle cell disease morbidities accumulate, and mortality increases. Developmental changes in roles and responsibilities also affect management.

Computational Biology Dynamics of Mps1 Kinase Molecular Interactions with Isoflavones Reveals a Chemical Scaffold with Potential to Develop New Therapeutics for the Treatment of Cancer.

The protein kinase Mps1 (monopolar spindle 1) is an important regulator of the Spindle Assembly Checkpoint (SAC), the evolutionary conserved checkpoint system of higher organisms that monitors the proper bipolar attachment of all chromosomes to the mitotic spindle during cell division. Defects in the catalytic activity and the transcription regulation of Mps1 are associated with genome instability, aneuploidy, and cancer. Moreover, multiple Mps1 missense and frameshift mutations have been reported in a wide range of types of cancer of different tissue origin.

Systematic review of interventions aimed at improving HIV adherence to care in low- and middle-income countries in Sub-Saharan Africa.

Long-term adherence to antiretroviral medication continues to present as a challenge along the continuum of the HIV care cascade. HIV interventions and support programs are significantly threatened in resource-limited settings by challenges in maintaining long-term follow-up for ART adherence. We sought to complete a systematic review to comprehensively examine ART adherence and retention in care interventions in Sub-Saharan Africa and to report on the implementation of interventions in real-world settings to inform future health investments in HIV care.

APETALA2 functions as a temporal factor together with BLADE-ON-PETIOLE2 and MADS29 to control flower and grain development in barley.

Cereal grain develops from fertilised florets. Alterations in floret and grain development greatly influence grain yield and quality. Despite this, little is known about the underlying genetic control of these processes, especially in key temperate cereals such as barley and wheat.

Health Care in the Age of Mass Incarceration: A Selective Course for Medical Students in Their Preclinical Years.

Introduction: While medical school curricula increasingly address health disparities, content regarding health care for persons impacted by incarceration is a persistent and notable gap. There is a high burden of disease among incarcerated populations, and health care challenges continue postincarceration. We developed a course to introduce medical students to the current landscape of mass incarceration in the US and implications for health and health care delivery to people impacted by this system.

Lung health in older adults.

One in five people in the UK live with lung disease. The National Taskforce for Lung Health, supported by 29 organisations, published its report in December 2018 with 43 recommendations for the UK, most of which are highly relevant to older adults. Prevention is key, especially relating to the introduction of clean air zones and air pollution alerts.

Choosing Wisely in Georgia: A Quality Improvement Initiative in 25 Adult Ambulatory Medicine Offices.

Background: Scant evidence exists of effective Choosing Wisely® initiatives, which are intended to reduce the use of unnecessary care. In 2013 substantial variations existed at Kaiser Permanente Georgia in the frequency of nonbeneficial services in ambulatory care. A Choosing Wisely campaign was implemented across 25 medical offices serving approximately 300,000 members.

Examining the Factor Structure and Psychometric Properties of a Guilt Management Scale (GMS).

Background: Guilt is commonly associated with distress and psychopathology. However, there is a lack of validated measures that assess how people cope with this aversive emotional and cognitive experience.

Aims: We therefore developed and validated a self-report measure that assesses how people manage their guilt: the Guilt Management Scale (GMS).

Endobronchial metastasis of mixed Mullerian tumour of the uterus.

Endobronchial metastasis occurs in only 2%-5% of non-pulmonary cancers. Here we report on an 84-year-old woman who presented with breathlessness and light-headedness while on holiday in Australia, 2 years post-treatment for endometrial cancer. Initial CT pulmonary angiogram identified a soft tissue mass in the left hemithorax.

Axillary tumour burden in women with a fine-needle aspiration/core biopsy-proven positive node on ultrasonography compared to women with a positive sentinel node.

Background: The sensitivity of axillary ultrasonography (AUS) has increased in recent years, enabling detection of even low-volume axillary nodal metastases. The aim here was to evaluate the axillary tumour burden in women with a fine-needle aspiration/core biopsy-proven positive node on AUS and in those with a positive sentinel node biopsy (SNB).

Methods: This retrospective cohort study included all patients with early breast cancer who had AUS and axillary lymph node dissection (ALND) between 2011 and 2014.

Correction of Tibial Torsion in Children With Cerebral Palsy by Isolated Distal Tibia Rotation Osteotomy: A Short-term, In Vivo Anatomic Study.

Background: Excessive internal or external tibial torsion is frequently present in children with cerebral palsy. Several surgical techniques have been described to correct excessive tibial torsion, including isolated distal tibial rotation osteotomy (TRO). The anatomic changes surrounding this technique are poorly understood.

The role of guilt in the development of post-traumatic stress disorder: A systematic review.

Background: Post-traumatic stress disorder (PTSD) can be a debilitating condition associated with a myriad of emotions. Guilt is an important associated feature of PTSD that has received far less recognition than other symptoms often associated with fear and intense threat. The nature of the relationship between guilt and PTSD remains elusive and requires further clarification.

Results of the Oxford Phase 3 mobile bearing medial unicompartmental knee arthroplasty from an independent center: 467 knees at a mean 6-year follow-up: analysis of predictors of failure.

A retrospective review of 467 Oxford UKAs was performed in 387 patients. Thirty-eight knees (8.1%) were revised to TKA at a mean of 49 months, most commonly for lateral compartment OA (47%).

Evidence-based screening for low bone mineral density in HIV-infected men.

Low bone mineral density, which leads to osteoporosis and fracture risk, is an emerging clinical problem in HIV-infected patients. Our evidence-based practice project screened a convenience sample of 225 HIV-infected men for low bone mineral density using the Osteoporosis Self-Assessment Tool, and of those men, 173 were also screened by quantitative ultrasound of the calcaneus. One hundred twelve men had low bone mineral density by either or both screening methods.

Tumor endoprosthesis revision rates increase with peri-operative chemotherapy but are reduced with the use of cemented implant fixation.

Chemotherapy may reduce osseointegration of tumor endoprosthesis, while delaying chemotherapy may reduce survival. We studied the effects of chemotherapy and cemented fixation on tumor endoprosthesis survivorship with a retrospective analysis of 50 consecutive patients receiving lower limb salvage surgery. We compared rates of radiographic loosening/revision and effect of cement fixation between chemotherapy/no chemotherapy cohorts.

Reduction in bone volume resection with a newer posterior stabilized total knee arthroplasty design.

Background: Posterior stabilized total knee arthroplasty requires an intercondylar notch to accommodate the cam housing that articulates with the tibial post to create femoral rollback required for deep flexion. The volume of bone resected for the intercondylar notch varies with implant design, and newer designs may accommodate high flexion with less bone resection.

Questions/purposes: This study aims to analyze the bone volume and density resected from the intercondylar notch for three posterior stabilized implants from a single company: a Posterior Stabilized (PS) system, a Hi-Flex system (HF), and a rounded new box-reamer (RB) system and to further assess whether the newer RB with a cylindrical cutting tool would preserve more native bone.

Zellweger syndrome: an older child with progressive foot deformity.

Zellweger spectrum disorders result from defects in the assembly of the peroxisome and are sometimes referred to as peroxisome biogenesis disorders. Orthopedic manifestations of this condition are variable. This case report illustrates an ambulatory child with Zellweger syndrome and progressive foot deformity.

Central polydactyly of the foot: surgical management with plantar and dorsal advancement flaps.

Background: Central polydactyly is the least common form of foot polydactyly, and the intercalary location of the duplicated ray makes the surgical exposure, excision, and closure more complex. For these reasons there is little consensus concerning the optimal technique for surgical management.

Methods: A retrospective case series of 22 patients with 27 feet with central polydactyly, treated surgically by the dorsal and plantar advancement flap technique, was performed.

The Boyd amputation in children: indications and outcomes.

Background: The level of amputation in the pediatric population requires appropriate planning to provide an optimal residual limb for prosthetic fitting and must include long-term strategies to accommodate future growth of the extremity.

Methods: A retrospective review over a 15-year period was performed of all Boyd procedures (calcaneotibial fusion) in the pediatric limb deficiency population at a single institution. A chart review and radiographic analysis was performed to identify the indications, surgical outcomes, complications, need for additional surgical intervention, and nature of the postoperative prosthetic management.

The operative correction of symptomatic flat foot deformities in children: the relationship between static alignment and dynamic loading.

At our institution surgical correction of symptomatic flat foot deformities in children has been guided by a paradigm in which radiographs and pedobarography are used in the assessment of outcome following treatment. Retrospective review of children with symptomatic flat feet who had undergone surgical correction was performed to assess the outcome and establish the relationship between the static alignment and the dynamic loading of the foot. A total of 17 children (21 feet) were assessed before and after correction of soft-tissue contractures and lateral column lengthening, using standardised radiological and pedobarographic techniques for which normative data were available.

Proximal femoral geometry before and after varus rotational osteotomy in children with cerebral palsy and neuromuscular hip dysplasia.

Background: Surgical management of hip dysplasia in children with cerebral palsy (CP) usually includes varus rotational osteotomy (VRO) of the proximal femur. Several techniques of VRO (end-to-end, EE; end-to-side, ES) have been designed to maximize correction and minimize associated deformities. The goals of the current study were to establish the prevalence and contribution of caput valgum to coxa valga deformity in children with CP, compare the geometry of the proximal femur after EE and ES techniques of VRO, and document the response of the proximal femur to subsequent growth after VRO.

Alternate light sources in sexual assault examinations: an evidence-based practice project.

The ability of sexual assault nurse examiners to correctly identify and collect DNA evidence improves patient outcomes and prosecution rates. The purpose of this paper is to present findings from a collaborative evidence-based practice (EBP) project between forensic nurses and baccalaureate nursing students. The goal of the project was to determine best practice using an alternate light source (ALS) to identify trace DNA evidence in sexual assault forensic examinations.

Hemolysis of coagulation specimens: a comparative study of intravenous draw methods.

Introduction: Hemolysis of blood samples creates significant delays in the treatment and disposition of patients in the emergency department. The purpose of this study was to compare the hemolysis rates of coagulation blood samples obtained during insertion of an intravenous (IV) catheter without (group 1) or with (group 2) extension tubing connected to the IV catheter hub. A secondary purpose of this study was to determine whether the investigators could predict whether a coagulation sample was hemolyzed based on visual observation during the specimen withdrawal process.