Do physical or imaging changes explain the effectiveness of progressive tendon loading exercises? A causal mediation analysis of athletes with patellar tendinopathy.

Objectives: To investigate whether the effectiveness of progressive tendon loading exercises (PTLE) on patellar tendinopathy is mediated through changes in physical or imaging properties.

Design: Mediation analyses based on a randomized clinical trial (n = 76) in patellar tendinopathy comparing PTLE with eccentric exercise therapy (EET).

Methods: Pain-related disability on Victorian Institute of Sports Assessment-Patella (VISA-P, 0 to 100) and pain (Visual Analogue Score) after single-leg decline squat (VAS-SLDS, 0 to 10) at 24 weeks were outcome measures.

COVID-19 Pandemic and its Impact on Vaccine Hesitancy: A Review.

Vaccination is one of the most successful public health initiatives in human history, significantly reducing the incidence and severity of infectious diseases. The success of any vaccination program depends on several factors, including effective leadership, funding, distribution management, and addressing vaccine hesitancy. Vaccine hesitancy, the delay or refusal to be vaccinated despite the availability of immunization services, has always been prevalent in societies but has become more pronounced during the COVID-19 pandemic.

Physiological versus time based cord clamping in very preterm infants (ABC3): a parallel-group, multicentre, randomised, controlled superiority trial.

Background: Physiological-based cord clamping (PBCC) in preterm infants is beneficial for cardiovascular transition at birth and may optimize placental transfusion. Whether PBCC can improve clinical outcomes is unknown. The aim of the Aeration, Breathing, Clamping (ABC3) trial was to test whether PBCC results in improved intact survival in very preterm infants.

WDR49-Positive Astrocytes Mark Severity of Neurodegeneration in Frontotemporal Lobar Degeneration and Alzheimer's Disease.

A subpopulation of astrocytes expressing WD Repeat Domain 49 (WDR49) was recently identified in frontotemporal lobar degeneration (FTLD) with GRN pathogenic variants. This is the first study to investigate their expression and relation to pathology in other FTLD subtypes and Alzheimer's disease (AD). In a postmortem cohort of TDP-43 proteinopathies (12 GRN, 11 C9orf72, 9 sporadic TDP-43), tauopathies (13 MAPT, 8 sporadic tau), 10 AD, and four controls, immunohistochemistry and immunofluorescence were performed for WDR49 and pathological inclusions on frontal, temporal, and occipital cortical sections.

Cost-Effective and Sustainable Drug Use in Hospitals: A Systematic and Practice-Based Approach.

Background And Objective: Rising healthcare costs challenge the financial sustainability of healthcare systems. Interventional pharmacoeconomics has emerged as a vital discipline to improve the cost-effective and sustainable use of drugs in clinical practice. However, current efforts are often fragmented, highlighting the need for an integrated hospital-wide approach.

From applause to disappointment - appreciation among healthcare providers that provided end-of-life care during the COVID-19 pandemic and its impact on well-being - a longitudinal mixed methods study (the CO-LIVE study).

Background: The healthcare sector is facing increasing work pressure, making a healthy workforce essential. Appreciation is a factor influencing well-being, and the COVID-19 pandemic offers valuable insights into this. This study aims to: 1) describe to what extent end-of-life care providers felt appreciated and understood during the first 18 months of the pandemic, 2) examine the impact of appreciation on their well-being, and 3) explore their perceptions of what appreciation should look like.

Colposcopy referrals and CIN3 detection after triage by host cell DNA methylation and/or HPV genotyping in HPV positive women with low-grade cytology from a population-based Dutch primary HPV screening trial.

High-risk HPV (hrHPV)-based screening has led to many unnecessary colposcopy referrals, mainly because of direct referral after low-grade cytology (ASC-US/LSIL). DNA methylation and genotyping tests on ASC-US/LSIL samples have the potential to significantly improve the efficiency of screening. In this study, 12 triage strategies were constructed from FAM19A4/miR124-2 or ASCL1/LHX8 methylation, HPV16/18 or HPV16/18/31/33/45 genotyping and 1-year repeat cytology.

A Systematic Review and Meta-Analysis of the Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitor in Patients Using Left Ventricular Assist Devices.

Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have been shown to reduce risks of clinical events in patients with heart failure (HF). However, data on the use of SGLT2-i in patients with left ventricular assist devices (LVADs) are scarce. We thought to assess the efficacy and safety of SGLT2-i in patients with LVADs.

Endothelial Protection and Improved Micro- and Macrocirculation with Hemoadsorption in Critically Ill Patients.

A dysregulated immune response is associated with an excessive release of cytokines that can lead to systemic vasoplegia and vasoplegic shock with the development of multiorgan failure that is associated with an increased risk of dying. Under physiological circumstances, the endothelium and the glycocalyx are responsible for maintaining vascular tone, capillary permeability, and hemostasis, and controlling inflammation. In hyperinflammation, the endothelium and glycocalyx become damaged due to the excessive production of certain toxic proteins, along with an overwhelming release of cytokines.

Quality Improvement Intervention for Reducing Acute Treatment Times in Ischemic Stroke: A Cluster Randomized Clinical Trial.

Importance: Efficient care processes are crucial to minimize treatment delays and improve outcome after endovascular thrombectomy (EVT) in patients with ischemic stroke. A potential means to improve care processes is performance feedback.

Objective: To evaluate the effect of performance feedback to hospitals on treatment times for EVT.

The efficacy of wound catheter infusion with local anesthetics for the treatment of postoperative pain in children: A systematic review.

Wound catheter infusion (WCI) with local anesthetics (LA) is a regional anesthesia technique, which has shown to produce effective postoperative analgesia in adults, without any adverse effects on wound healing. To investigate the efficacy and safety of WCI with LA for the treatment of postoperative pain in children, we conducted a systematic review of literature published until 2020. The literature search included articles concerning subcutaneous WCI with LA, in the surgical wound, as treatment of postoperative pain, in children <18 years of age.

QCT-based spatio-temporal aging atlas of the proximal femur BMD and cortical geometry.

Aging is associated with an increased risk of fragility fractures at the hip, resulting from a loss of bone mass. While this loss is typically reported as a decreased mean areal bone mineral density (aBMD) in the proximal femur or the femoral neck, its evolution is spatially inhomogeneous, which might also contribute to the increased risk of fractures. Yet, little is known about the evolution of BMD distribution and cortical thickness with age in the proximal femur.

Daily rhythm in DNA methylation and the effect of total sleep deprivation.

Numerous hormones and genes exhibit diurnal 24-hr rhythms that can also be affected by sleep deprivation. Here we studied diurnal rhythms in DNA methylation under a 24-hr sleep/wake cycle and a subsequent 29 hr of continual wakefulness (1 night of sleep deprivation). Fifteen healthy men (19-35 years) spent 3 days/nights in a sleep laboratory: (1) adaptation; (2) baseline; (3) total sleep deprivation day/night.

Baroreflex Sensitivity and Long-Term Dementia Risk in Older Adults.

Background: Increased blood pressure (BP) variability is linked to dementia risk, but the relationship between baroreflex sensitivity (BRS), a fundamental mechanism for maintaining stable BP, and dementia risk is undetermined.

Methods: We tested the hypothesis that impaired BRS is associated with increased dementia risk in 1819 older adults (63% women; age, 71.0±6.

In varietate concordia - cluster analysis of EQ-5D-5L value sets in European Union countries.

Background: The transferability of health policies in the European Union (EU) faces challenges due to economic, political, and healthcare system factors, including cross-country differences in health preferences. In order to aid policymaking, previous research has grouped EU countries based on geographical proximity or literature-based criteria, but not on health preference data. The EQ-5D-5L instrument, which measures health-related quality of life and reflects unique national health preferences shaped by cultural and social factors, is used to evaluate policies, technologies and interventions, but has not been used to group countries.

Associations between plasma osteopontin, sex, and 2-year global and cardiorenal outcomes in older outpatients screened for CKD: a secondary analysis of the SCOPE study.

Background: Plasma osteopontin (pOPN) is a promising aging-related biomarker among individuals with and without kidney disease. The interaction between sex, pOPN levels, and global and cardiorenal outcomes among older individuals was not previously evaluated.

Methods: In this study we investigated the association of pOPN with 24-month global mortality, major cardiovascular events (MACEs), MACEs + cardiovascular (CV) mortality, and renal decline among older individuals; we also evaluated whether sex modified observed associations.

Two Cases of Intraocular Undifferentiated Pleomorphic Sarcoma.

Introduction: Undifferentiated pleomorphic sarcoma (UPS), formerly known as malignant fibrous histiocytoma, is a high-grade soft tissue sarcoma arising from mesenchymal stem cells. UPSs are rare and account for about 5% of all soft tissue sarcoma. UPSs arising in the head and neck are especially rare, comprising 1-3% of all UPSs.

Expert Opinions on Uveal Melanoma: Insights from the 58th Ophthalmic Oncology Group Meeting.

Introduction: Clear evidence for the best clinical management of uveal melanoma is lacking in some areas. Therefore, reports on expert opinions in the field can be valuable.

Methods: A questionnaire comprising 10 questions was distributed to potential participants of the 58th Ophthalmic Oncology Group Meeting in Stockholm, Sweden, in June 2024.

Yield of Targeted Polymerase Chain Reaction in Probable Early-Onset Sepsis: A Prospective Cohort Study in Term and Near-Term Neonates With Negative Blood Culture Results.

Background: Discriminating noninfected from infected neonatal cases remains challenging, and subsequently many neonates are treated with antibiotics in the first week of life. We aimed to study the additional value of a targeted polymerase chain reaction (PCR) for group B streptococcus (GBS) and on leftover blood culture media from term and near-term neonates with probable early-onset sepsis (EOS).

Methods: Leftover blood culture material from neonates participating in the RAIN study was stored after 5 days of incubation.

Impaired maternal central hemodynamics precede the onset of vascular disorders of pregnancy at high altitude.

Hypertensive disorders of pregnancy represent an escalating global health concern with increasing incidence in low- to middle-income countries and high-income countries alike. The current lack of methods to detect the subclinical stages of preeclampsia (PE) and fetal growth restriction (FGR), two common vascular disorders of pregnancy, limits treatment options to minimize acute- and long-term adverse outcomes for both mother and child. To determine whether impaired maternal cardiovascular or uteroplacental vascular function precedes the onset of PE and/or FGR (PE-FGR), we used non-invasive techniques to obtain serial measurements of maternal cardiac output (CO), stroke volume (SV), systemic vascular resistance (SVR), as well as uterine and fetal arterial resistance at gestational weeks 10-16, 20-24 and 30-34 for 79 maternal-infant pairs in La Paz-El Alto, Bolivia (3850 m), where the chronic hypoxia of high altitude increases the incidence of PE and FGR.

Cholangiocarcinoma in Latin America: a multicentre observational study alerts on ethnic disparities in tumour presentation and outcomes.

Background: Cholangiocarcinoma (CCA) represents a global health challenge, with rising incidence and mortality rates. This study aimed to elucidate the clinical course and practices of CCA in Latin America.

Methods: This observational cohort study investigated individuals diagnosed with CCA between 2010 and 2023 at five referral centres across Latin America.