Synthesis of fluorene‐based conjugated polyelectrolytes was achieved via Suzuki polycondensation in water and completely open to air. The polyelectrolytes were conveniently purified by dialysis and ...analysis of the materials showed properties expected for fluorene‐based conjugated polyelectrolytes. The materials were then employed in solar cell devices as an interlayer in conjunction with ZnO. The double interlayer led to enhanced power conversion efficiency of 10.75 % and 15.1 % for polymer and perovskite solar cells, respectively.
Fluorene‐based conjugated polyelectrolytes were prepared by using a green synthetic route with polymerization in water and in air. High‐performance polymer and perovskite solar cells were fabricated using the polyelectrolytes in the cathode interlayer giving power conversion efficiency of 10.75 % and 15.1 %.
Introduction: Cervical total disc replacement (CTDR) is an alternative to anterior cervical discectomy and fusion for select patients that may preserve range of motion and reduce adjacent segment ...disease. Various CTDR prostheses are available; however, comparative data are limited. This study aimed to compare the short-term kinematic and radiological parameters of the M6-C, Mobi-C, and the CP-ESP prostheses.
Methods: This retrospective cohort study included patients treated with CTDR between March 2005 and October 2020 at a single institution. Patients were included if their follow-up assessment included lateral erect and flexion/extension radiographs. The primary outcome assessed at 3-months postoperatively was range of motion, measured by the difference in functional spinal unit angle between flexion and extension.
Results: A total of 131 CTDR levels (120 patients, 46.2 ± 10.1 years, 57% male) were included. Prostheses implanted included the M6-C (n = 52), Mobi-C (n = 54), and CP-ESP (n = 25). Range of motion varied significantly (8.2° ± 4.4° vs. 10.9° ± 4.7° vs. 6.1° ± 2.7°, P < 0.001). On post hoc analysis, the Mobi-C prosthesis demonstrated a significantly greater range of motion than either the M6-C prosthesis (P = 0.003) or CP-ESP (P < 0.001).
Conclusion: Although the optimal range of motion for CTDR has not been established, short-term differences in the range of motion may guide the selection of CTDR prosthesis. Further studies with longer follow-up and consideration of clinical outcome measures are necessary.
Anterior cervical discectomy and fusion (ACDF) immobilizes surgical segments and can lead to the development of adjacent segment degeneration and adjacent segment disease. Thus, cervical total disc ...replacement (CTDR) has been developed with the aim to preserve the biomechanics of spine. However, heterotopic ossification (HO), a complication following CTDR, can reduce the segmental range of motion (ROM) and defects the motion-preservation benefit of CTDR. The pathological process of HO in CTDR remains unknown. HO has been suggested to be a self-defense mechanism in response to the non-physiological biomechanics of the cervical spine following CTDR. The current literature review is concerned with the association between the biomechanical factors and HO formation and the clinical significance of HO in CTDR. Endplate coverage, disc height, segmental angle, and center of rotation may be associated with the development of HO. The longer the follow-up, the higher the rate of ROM-limiting HO. Regardless of the loss of motion-preservation benefit of CTDR in patients with HO, CTDR confers patients with a motion-preservation period before the development of ROM-limiting HO. This may delay the development of adjacent segment degeneration compared with ACDF. Future clinical studies should explore the association between HO and changes in biomechanical factors of the cervical spine.
Resilience training is gaining attention as a strategy to build students' resistance to adversity and promote their mental well-being. However, owing to inconsistencies and variations in the content ...and delivery of resilience training, more work is needed to examine students' experiences and preferences to address issues relating to intervention fidelity. This study adopted a qualitative approach in exploring students' experience of synchronous and asynchronous versions of a digital resilience training program. Seventeen students were interviewed using a semi-structured virtual face-to-face interview via Zoom. The thematic analyses unveiled four themes: embarking on a journey toward resilience, discovering strategies to develop resilience, finding a balance to benefit from resilience skill enhancement, and instilling resilience in the everyday. Future resilience training should consider students' workload and interactivity to enhance their engagement. As being resilient is associated with better mental well-being, the findings of this study may support the development of future wellness programs.
Loneliness is commonly reported by young people and has been shown to contribute to the rapid onset and escalation of depression and suicidal ideation during adolescence. Lonely people may also be ...particularly susceptible to disengaging from treatment early given the likelihood of their more complex clinical profiles leading to cognitive fatigue. While a smartphone intervention (LifeBuoy) has been shown to effectively reduce suicidal ideation in young adults, poor engagement is a well-documented issue for this therapeutic modality and has been shown to result in poorer treatment outcomes.
This study aims to determine whether loneliness affects how young people experiencing suicidal ideation engage with and benefit from a therapeutic smartphone intervention (LifeBuoy).
A total of 455 community-based Australian young adults (aged 18-25 years) experiencing recent suicidal ideation were randomized to use a dialectical behavioral therapy-based smartphone intervention (LifeBuoy) or an attention-matched control app (LifeBuoy-C) for 6 weeks. Participants completed measures of suicidal ideation, depression, anxiety, and loneliness at baseline (T0), post intervention (T1), and 3 months post intervention (T2). Piecewise linear mixed models were used to examine whether loneliness levels moderated the effect of LifeBuoy and LifeBuoy-C on suicidal ideation and depression across time (T0 to T1; T1 to T2). This statistical method was then used to examine whether app engagement (number of modules completed) influenced the relationship between baseline loneliness and suicidal ideation and depression across time.
Loneliness was positively associated with higher levels of overall suicidal ideation (B=0.75, 95% CI 0.08-1.42; P=.03) and depression (B=0.88, 95% CI 0.45-1.32; P<.001), regardless of time point or allocated condition. However, loneliness did not affect suicidal ideation scores across time (time 1: B=1.10, 95% CI -0.25 to 2.46; P=.11; time 2: B=0.43, 95% CI -1.25 to 2.12; P=.61) and depression scores across time (time 1: B=0.00, 95% CI -0.67 to 0.66; P=.99; time 2: B=0.41, 95% CI -0.37 to 1.18; P=.30) in either condition. Similarly, engagement with the LifeBuoy app was not found to moderate the impact of loneliness on suicidal ideation (B=0.00, 95% CI -0.17 to 0.18; P=.98) or depression (B=-0.08, 95% CI -0.19 to 0.03; P=.14).
Loneliness was not found to affect young adults' engagement with a smartphone intervention (LifeBuoy) nor any clinical benefits derived from the intervention. LifeBuoy, in its current form, can effectively engage and treat individuals regardless of how lonely they may be.
Australian New Zealand Clinical Trials Registry ACTRN12619001671156; https://tinyurl.com/yvpvn5n8.
RR2-10.2196/23655.
Background: The association between Lynch syndrome (LS) and a higher risk of upper tract urothelial carcinoma is well established, but its effect on the risk of bladder and kidney cancers remains ...controversial. This review aimed to compare the relative risk (RR) of bladder and kidney cancer in confirmed LS germline mutation carriers compared to the general population. Methods: Medline, Embase, Cochrane Central, and Google Scholar were searched on 14 July 2022 for studies published in English that reported on the rates of urological cancer in adults with confirmed LS germline mutation. The quality of included studies was assessed using Cochrane’s tool to evaluate risk of bias in cohort studies. Random effects meta-analysis estimated the pooled relative risk of bladder and kidney cancer in LS carriers compared to the general population. The quality of the overall evidence was evaluated using GRADE. Results: Of the 1839 records identified, 5 studies involving 7120 participants from 3 continents were included. Overall, LS carriers had a statistically significantly higher RR of developing bladder cancer (RR: 7.48, 95% CI: 3.70, 15.13) and kidney cancer (RR: 3.97, 95% CI: 1.23, 12.81) compared to unaffected participants (p < 0.01). The quality of the evidence was assessed as “low” due to the inclusion of cohort studies, the substantial heterogeneity, and moderate-to-high risk of bias. Conclusion: Lynch syndrome is associated with a significant increase in the relative risk of kidney and bladder cancer. Clinicians should adopt a lower threshold for germline mutation genetic testing in individuals who present with bladder cancer. Further studies evaluating the role and cost-effectiveness of novel urine-based laboratory tests are needed. High-quality studies in histologically proven renal cell carcinoma and their underlying germline mutations are necessary to strengthen the association with LS.
Introduction: The transition from medical student to houseman is well recognised as a stressful period for newly qualified doctors. This stress is likely to be heightened when the transition occurs ...during a pandemic. We aimed to evaluate the perceived stress levels of housemen as they begin housemanship and explore their sentiments and preparedness in starting work amidst the coronavirus disease 2019 (COVID-19) pandemic.
Methods: Housemen starting work at a tertiary institution in Singapore in May 2020 completed the following: (1) Perceived Stress Scale, (2) open-ended questions on perceived challenges and concerns and (3) questionnaire on preparedness and confidence in starting work. Descriptive statistics were used to analyse quantitative data and modified thematic analysis performed for qualitative data.
Results: Sixty-one housemen participated. Thirty-five (57.4%) reported high perceived stress. The themes for perceived challenges in this transition included coping with constant change, lack of reliable information from authorities, dealing with disappointment, physical fatigue, and loss of autonomy. The themes for concerns in beginning housemanship elicited relate to clinical competence, transitioning into new responsibilities, risk of infection with COVID-19, senior expectations, physical fatigue and training-related concerns. Despite these challenges and concerns, housemen were prepared to begin work during this pandemic.
Conclusion: Housemen transitioning during this pandemic experienced additional stressors and unique challenges pertaining to working in a pandemic. Encouragingly, they remain prepared to start work. Institutions and departments should be mindful of the specific concerns and challenges so that appropriate support can be put in place to support these junior doctors.
Oedema over an inoculation site Ng, Nicholas Beng Hui; Ramachandran, Rajeev
BMJ (Online),
01/2020, Letnik:
368
Journal Article
Recenzirano
New onset erythema and oedema over the previously healed BCG vaccine scar site on the child’s left upper arm during the course of the febrile illness, also termed BCG-itis Results of initial ...investigations are shown in table 1.Table 1 Results of initial investigations Result Normal range White cell count 15×109/L 5.00-15.00×109/L Absolute neutrophil count 8×109/L 1.50-8.00×109/L Platelets 402×109/L 150-450×109/L C reactive protein 76 mg/L 0-10 mg/L Erythrocyte sedimentation rate 97 mm/h 3-9 mm/h Urinalysis was normal. BCG-itis, raised inflammatory markers, leucocytosis, thrombocytosis, hypoalbuminaemia, anaemia for age, elevated transferase level, and/or pyuria.123 T cell mediated inflammation around a healed BCG inoculation site causes BCG-itis; it is different to BCG vaccination related local reactions, which usually heal after 4-6 weeks.4 As BCG-itis occurs early in the course of Kawasaki disease, it is a useful sign for the early diagnosis of patients with IKD.56 Results from a retrospective case study and a data analysis suggest that BCG-itis is present in 50-70% of classic Kawasaki disease cases and up to 85% of IKD cases,56 and another retrospective case study in 2019 found that, as a sign of Kawasaki disease in infants, BCG-itis had a positive predictive value of 90.8%.7 Prompt treatment with intravenous immunoglobulin (IVIG) reduces the risk of coronary complications.1 Learning point Consider Kawasaki disease in children with high fever and BCG-itis when there is no obvious source of infection, especially if they are from countries where BCG vaccination is part of the immunisation schedule, Patient outcome With IVIG the patient’s fever lysed and her inflammatory markers markedly improved. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association.
Synthesis of fluorene‐based conjugated polyelectrolytes was achieved via Suzuki polycondensation in water and completely open to air. The polyelectrolytes were conveniently purified by dialysis and ...analysis of the materials showed properties expected for fluorene‐based conjugated polyelectrolytes. The materials were then employed in solar cell devices as an interlayer in conjunction with ZnO. The double interlayer led to enhanced power conversion efficiency of 10.75 % and 15.1 % for polymer and perovskite solar cells, respectively.
In Wasser und an der Luft können Fluoren‐basierte konjugierte Polyelektrolyte mithilfe einer umweltschonenden Syntheseroute hergestellt werden. Polymer‐ und Perowskitsolarzellen, die mit diesen Polyelektrolyten in der Kathodenzwischenschicht gefertigt wurden, zeigen Wirkungsgrade von 10.75 % und 15.1 %.
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