A comparison of in vivo viral targeting systems identifies adeno-associated virus serotype 9 (AAV9) as an effective vector for genetic manipulation of Leydig cells in adult mice.

Background: Despite the increasing popularity of deliverable transgenics, a robust and fully validated method for targeting Leydig cells, capable of delivering long-term transgene expression, is yet to be defined.

Objectives: We compared three viral vector systems in terms of their cell targeting specificity, longevity of gene expression and impact on targeted cell types when delivered to the interstitial compartment of the mouse testis.

Materials & Methods: We delivered lentiviral, adenoviral and adeno-associated (AAV) viral particles to the interstitial compartment of adult mouse testis.

Intra-thoracic gossypiboma (textiloma) in a 6-year-old cocker spaniel.

This report documents the first case of gossypiboma (textiloma) identified within the thorax of a dog. CT findings, surgical removal and histopathology are described. Intra-thoracic gossypiboma has not previously been reported in dogs and is rarely reported in the human medical literature, where it is most commonly associated with previous cardiac or pulmonary surgery.

Knowledge needs and use in long-term care homes for older people: A qualitative interview study of managers' views.

We explore the views of managers' knowledge needs and use to optimise care practices and enhance the life experience for older people living, and staff working, in long-term care homes (with and without nursing). This paper contributes to previous research by offering insights into the knowledge types drawn upon and used by managers to inform efforts to better support gaining and mobilising knowledge. Using a pragmatic qualitative approach, we undertook 19 semi-structured interviews with managers and leaders in 15 care homes in the South West of England, varying in geographical location, size and type of ownership.

Satisfaction With Quality of Health Care Among Medicare Beneficiaries With Functional Hearing Loss.

Background/objectives: Nearly 38 million Americans have hearing loss. Understanding how sensory deficits such as hearing loss, which limit communication, impact satisfaction has implications for Medicare value-based reimbursement mechanisms. The aim of this study was to characterize the association of functional hearing loss and dissatisfaction with quality of health care over the past year among Medicare beneficiaries.

Self-efficacy in non-concussed youth: a normative study.

Objective: In pediatric concussion, there has been a shift to consider how pre-injury profiles, such as self-efficacy, affect the recovery trajectory. The aim of this study was to investigate normal ranges of self-efficacy (overall, academic, social, emotional) in youth and to explore its relationship with the effects of daily stressors, operationalized as concussion-like symptoms, demographic factors, pre-injury/learning related factors, and concussion history.

Methods: A cross-sectional study of 1300 uninjured youth 13-18 years old (1111 males, 189 females) was conducted by secondary analysis of clinical pre-injury/baseline concussion data.

Investigation of pathological haemorrhage in Maine Coon cats.

Objective: Afibrinogenaemic haemorrhage was previously reported in a Maine Coon cat. Two littermates subsequently died from surgical non-haemostasis, suggesting a hereditable coagulopathy.

Methods: We prospectively recruited cats which were: a) Maine Coons with pathological haemorrhage (group 1, n=8), b) healthy familial relatives of group 1 (group 2, n=13) and c) healthy Maine Coons unrelated to groups 1 and 2 (group 3, n=12).

Effects of core titanium crystal dimension and crystal phase on ROS generation and tumour accumulation of transferrin coated titanium dioxide nanoaggregates.

Radionuclide-stimulated therapy (RaST), which is enhanced by Cherenkov radiation, has enabled deep tissue stimulation of UV photosensitizers, providing a new path for cancer treatment. Previous reports have shown UV-active titanium dioxide (TiO) nanoparticles (NPs) modified with transferrin inhibit tumour growth after orthogonal treatment with Cherenkov radiation-emitting radionuclides such as F-fluorodeoxyglucose (FDG). However, poor understanding of TiO NP parameters on reactive oxygen species (ROS) generation and particle distribution limits effective therapy.

Management of Seat Belt-type Blunt Abdominal Aortic Trauma and Associated Injuries in Pediatric Patients.

Background: "Seat belt-type" pediatric abdominal aortic trauma is uncommon but potentially lethal. During high speed motor vehicle collisions (MVCs), seat or lap belt restraints may concentrate forces in a band-like pattern across the abdomen, resulting in the triad of hollow viscus perforation, spine fracture, and aortoiliac injury. We report 4 cases of pediatric seat belt-type aortic trauma and review management strategies for the aortic disruption and the associated constellation of injuries.

Signal transducer and activator of transcription (STAT) 1 and STAT3 are expressed in the human ovary and have Janus kinase 1-independent functions in the COV434 human granulosa cell line.

Ovarian granulosa cells are fundamental for oocyte maintenance and maturation. Recent studies have demonstrated the importance of members of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) signalling pathway in the granulosa cell population of mouse and horse ovaries, with perturbation of JAK1 signalling in the mouse shown to impair oocyte maintenance and accelerate primordial follicle activation. The presence and role of the JAK/STAT pathway in human granulosa cells has yet to be elucidated.

Understanding Medicare: Hearing Loss and Health Literacy.

Background/objectives: Medicare has become an increasingly complex program to navigate with numerous choices available to beneficiaries with important implications for their financial exposure and access to care. Although research has identified poor health literacy as a barrier to understanding Medicare, little information is available on the experience of individuals with hearing loss. This study examined how hearing loss impacts Medicare beneficiaries in understanding the program, their ability to compare and review plan options, and their satisfaction with available information.

Association of Hearing Loss With Psychological Distress and Utilization of Mental Health Services Among Adults in the United States.

Importance: Psychological distress affects health and health care utilization. Hearing loss (HL) is highly prevalent and undertreated, and it may be a potentially modifiable risk factor for psychological distress.

Objective: To investigate the association between HL, psychological distress, and mental health care utilization among adults in the United States.

British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: Recommendations for practice.

The purpose of this guideline is to collate evidence and propose evidence-based guidelines for the diagnosis and management of adult patients with vulva carcinoma treated in the UK. Malignant melanoma may present via similar routes and will be discussed. The reader is referred to the Ano-uro-genital Mucosal Melanoma Full Guideline [1] for more detailed recommendations.

A randomized double-blind phase II study evaluating the role of maintenance therapy with cabozantinib in high-grade uterine sarcoma after stabilization or response to doxorubicin ± ifosfamide following surgery or in metastatic first line treatment (EORTC62113).

Background: Uterine sarcomas are a group of rare tumors that include different subtypes. Patients with histopathological high-grade diseases are at high-risk of recurrence or progression, and have a poor prognosis. We aim to explore the most appropriate management in patients with uterine high-grade sarcomas.

Age-Related Hearing Loss and the Listening Environment: Communication Challenges in a Group Care Setting for Older Adults.

Ensuring that older adults in long-term care settings can effectively communicate is important. The goal of this study was to characterize key modifiable factors that could affect verbal communication in an adult day care setting, namely prevalence of audiometric hearing loss and the acoustic characteristics in the activity hall. The prevalence of age-related hearing loss among participants (n=51) was 71%, although only 15% of enrollees at the group care setting (n=21 of 140) used amplification.

Mood-related changes in children and adolescents with persistent concussion symptoms following a six-week active rehabilitation program.

Primary Objective: The purpose of this study is to explore changes in mood in youth with persistent post-concussion symptoms following participation in a six-week active rehabilitation program.

Research Design: A pre-post test design was used.

Methods And Procedures: Participants (N = 40 children and adolescents with concussion symptoms >2 weeks post-injury) were recruited from the concussion services at an urban children's rehabilitation hospital and the community.

Prevalence and Population Estimates of Obstructive Eustachian Tube Dysfunction in US Adolescents.

This cross-sectional cohort study uses census data to approximate population estimates of obstructive eustachian tube dysfunction among US adolescents.

Hearing loss and employment: a systematic review of the association between hearing loss and employment among adults.

Background: Hearing loss affects over 1.3 billion individuals worldwide, with the greatest burden among adults. Little is known regarding the association between adult-onset hearing loss and employment.

Implementation of a Patient and Family-Centered Intensive Care Unit Peer Support Program at a Veterans Affairs Hospital.

Peer support is a novel strategy to mitigate postintensive care syndrome and postintensive care syndrome-family. This project implemented a peer support program to address postintensive care syndrome for patients and family members. Using a free-flow, unstructured format, a chaplain, social worker, nurse, and intensive care unit survivor led veterans and loved ones in discussion of intensive care unit experiences, fears, and the challenges of recovery.

Social support during youth concussion recovery.

Purpose: We explored the lived experience of high-school aged girls receiving social support during concussion recovery to better understand (1) how they define meaningful social support and barriers/facilitators to receiving it; (2) who provides that support; and (3) the role of peers.

Methods: In person, semi-structured interviews were conducted with 10 girls (aged 14-19 years) with a personal history of concussion.

Results: Close friends, youth with personal history of concussion, and parents were identified as key providers of meaningful social support during concussion recovery.

Identifying contextually relevant improvement measures, illustrated by a case of executive walkrounds.

Purpose: A method to engage salient organisational stakeholders in identifying and ranking measures of healthcare improvement programs is described. The method is illustrated using Executive WalkRounds (EWRs) in a multi-site Australian Health District.

Design/methodology/approach: Subject matter experts (SMEs) conducted document analysis, identified potential EWRs measures, created driver diagrams and then eliminated weak measures.

The Hearing Intervention for the Aging and Cognitive Health Evaluation in Elders Randomized Control Trial: Manualization and Feasibility Study.

Objectives: This work describes the development of a manualized best-practice hearing intervention for older adults participating in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomized controlled clinical trial. Manualization of interventions for clinical trials is critical for assuring intervention fidelity and quality, especially in large multisite studies. The multisite ACHIEVE randomized controlled trial is designed to assess the efficacy of a hearing intervention on rates of cognitive decline in older adults.