Careful Screening Research Articles

Strategies to improve research participation by older people with cognitive impairment: a systematic review.

Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation. Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092). Five databases were searched September 2020, March 2023 and April 2024. Screening, full text review and data extraction were independently performed. Risk of bias was assessed using Scottish Intercollegiate Guidelines Network Methodology Checklists. Outcomes were participant characteristics, recruitment and consent processes, retention, experience, involvement of others, adverse events, and other reported outcomes. Of 4564 identified sources, 12 studies were included. Nine compared recruitment strategies; three examined consent processes. Of 4,208 participants (mean age 78.3 years), 61% were female. Median (interquartile range) monthly recruitment rate was 10.3 (5.6-14.8). Participants had mild cognitive impairment, dementia and/or delirium and two-thirds of studies involved proxies or study partners. Community outreach or population screening had higher recruitment compared to primary care referral and/or screening. Formal capacity and consent methods achieved lower rates of consent compared to informal. A memory and organisational aid increased participants' ability to provide informed consent compared to standard assessment. Few studies reported participants' or recruiters' subjective experience, and no studies reported participant retention or adverse events. Targeted, tailored and multi-pronged recruitment and consent strategies to support inclusion of older people with cognitive impairment appear promising. Higher quality studies are needed to confirm this finding.

Relation of skinfold thickness with the serum lipids, glucose and blood pressure among Indian sedentary office workers

Background:Serum glucose, cholesterol, triglycerides and high-density lipoproteins (HDL) are established cardiovascular disease (CVD) markers, however accessibility to these markers is less in individuals from low-middle income countries. The non-invasive CVD risk marker especially skinfold measured fat percentages are less explored for its relevance with established serum biochemistry markers.Methods:A cross-sectional study was conducted in 70 sedentary office workers (aged 30–40 years) who were healthy. Peripheral fat percentages were estimated from four skinfold thickness measurements and biochemistry markers were measured and analysed using standard laboratory measurements. Blood pressure was also measured. Multivariate linear regression models were drawn to establish the association between the non-invasive and invasive CVD risk markers.Results:The skinfold measured fat percentage was negatively associated with the HDL (coefficient β = -0.15, standard error SE = 0.07, p < 0.05). No significant relation between the other biochemistry parameters with the skinfold thickness. Age and BMI were found to be mediating the above relationship.Conclusions:Skinfold thickness derived fat percentage is associated with the few of the CVD markers (especially HDL). Age and BMI are crucial mediating factors for the fat measurement. Skinfold measurements could be included as part of routine primary care screening for CVD risk, alongside invasive biochemistry parameters.

Proximal polyps are associated with higher incidence of colorectal cancer: Analysis of the Minnesota Colon Cancer Control Study: Polyp location and cancer incidence.

Despite reports indicating that polyps proximal to the splenic flexure have higher rates of metachronous colorectal adenocarcinoma (CRC), the role of adenoma location on surveillance recommendations remains unclear. This study aimed to analyze the association between index polyp location and post-colonoscopy CRC among participants of the Minnesota Colon Cancer Control Study (MCCCS). The MCCCS randomized 46,551 patients 50-80 years to usual care, annual, or biennial screening with fecal occult-blood testing (FOBT). Screening was performed between 1976-1992. Positive FOBT was followed by colonoscopy. We analyzed participants whose colonoscopy revealed at least one adenoma. Patients were divided into those with at least one lesion proximal to the splenic flexure and those without. Of 2,295 patients, 815 had proximal adenomas. The majority were men; mean age =62 years at randomization, and 69 years at index polyp. There was a high rate of advanced adenomas: 44% ≥1 polyp ≥1 cm, 35% with villous histology, and 5% high grade dysplasia. At 20 years, 87 patients had a CRC diagnosis, and the estimated cumulative incidence of CRC was 4.3%. Proximal adenomas had a higher risk of developing a post-colonoscopy CRC (SHR=1.63, 95% CI=1.05-2.53, P=0.03), which was attenuated after adjusting for polyp multiplicity in sensitivity analyses (SHR=1.56, 95% CI=0.96-2.53, P=0.07). Although patients with proximal adenomas were found to have higher hazards of post-colonoscopy CRC, adjusting for polyp multiplicity attenuated the strength of association. Further research is warranted to determine whether polyp location should be factored in the determination of appropriate surveillance intervals.

Artificial Intelligence in Software Testing for Emerging Fields: A Review of Technical Applications and Developments

The rapid evolution of the Internet industry has transformed software development in emerging fields, making it markedly different from traditional approaches. Consequently, software testing has become increasingly complex. Artificial Intelligence (AI) has introduced innovative technologies and methodologies to software testing, attracting growing research interest in recent years. This study employs a systematic literature review to gather and analyze relevant research on AI applications in software testing over the past four years. Through careful screening, synthesis, and organization of literature, the study provides a detailed analysis of research progress in this field. The review examines 30 carefully selected papers, primarily focusing on the technical advancements and applications of AI in software testing within emerging domains such as cloud technology, autonomous driving, and DevOps. It explores various AI applications in software testing, including test case generation, GUI testing, and defect prediction. As a comprehensive review, this paper summarizes recent progress in AI technology applications for software testing, with particular emphasis on emerging trends. Based on these findings, the study proposes potential research directions and topics, offering valuable insights and laying a foundation for future work in this rapidly evolving field.

COVID-19 and social care screening for older adults in social housing: a CP@clinic adaptation

BackgroundCOVID-19 has changed healthcare access and delivery, especially impacting older adults. The Community Paramedicine at Clinic (CP@clinic) program is a chronic disease prevention, management, and health promotion program for community-dwelling low-income older adults. We investigated a telephone-based CP@clinic program adaptation during the pandemic.MethodsCommunity paramedics delivered CP@clinic via telephone to residents of 36 social housing buildings. They conducted screening for COVID-19, emergency preparedness, and social health factors. Community paramedics provided education on staying safe, self-isolating, self-monitoring, and preparing for pandemics using governmental infographics. Descriptive analysis was conducted on assessments completed between March and June 2020. Paramedic documentation was thematically analyzed to identify common themes.ResultsAll 191 participants had ≥ 1 telephone visit and 34.6% had ≥ 2 telephone visits, 82.8% were aged 65 years and older, 30.9% had internet access, and 57.9% had cable TV (limiting exposure to COVID-19 information). The CP@clinic program infrastructure provided a platform for paramedics to swiftly contact many vulnerable older adults to screen for COVID-19, educate on safe practices, and facilitate healthcare access. One-quarter of participants screened positive for social isolation. Thematic analysis described participants’ experiences adapting to daily life in the pandemic, emotional experience during the pandemic, and paramedics supporting participants during the pandemic.ConclusionsPublic health interventions are needed for low-income or hard-to-reach older adults, especially during pandemics. Community paramedics were able to support vulnerable older adults living in social housing through the unique CP@clinic adaptation. This innovative program delivery increased vulnerable populations’ access to public health services and information at a time of great health need.

Current Review of Comorbidities in Chronic Rhinosinusitis.

Chronic rhinosinusitis (CRS) is a heterogenous disease with a significant impact on patient quality of life and a substantial economic burden. CRS is associated with several systemic inflammatory conditions. We provide an updated review of CRS comorbidities as a springboard for future comorbidity mapping and potential therapeutics. The link between environmental allergies and CRS is most evident for central compartment atopic disease (CCAD) and allergic fungal rhinosinusitis (AFRS) subtypes but remains inconclusive for CRS overall. The association between asthma and CRS, reinforced by the unified airway theory, is evidenced by their response to similar biologic therapies. Another lower respiratory tract disease, COPD, has up to a 50% co-occurrence with CRS and warrants careful screening and treatment. Eosinophilic esophagitis and CRS share eosinophilic inflammation in different sites, meriting further research. Obesity not only presents physiological challenges but also correlates with a more severe subset of CRS. Diabetes mellitus is associated with CRSwNP, possibly secondary to therapeutics with steroids. Autoimmunity may contribute to nasal polyp formation through cytokines such as B-cell activating factor (BAFF), offering potential for future therapeutics. This review illustrates the need to employ a macroscopic approach in clinical decision making and treatment of CRS. Comorbidities may contribute to an overall proinflammatory state, magnify severity of symptoms, be a source of treatment resistance, and even an opportunity for future therapeutics.

Investigating the effects of the ARG258HIS mutation on RAD51C in inherited Fanconi Anemia and cancer disease

Fanconi anemia is a rare chromosomal instability disorder associated with developmental abnormalities, bone marrow failure, and a heightened susceptibility to leukemia and other cancers. It is an autosomal recessive genetic disorder, necessitating both parents to carry the faulty gene. Diagnostic methods include blood tests, chromosome breakage assessments, and genetic testing. While there is no cure, treatments encompass blood transfusions, bone marrow transplants, and gene therapy, with patients requiring regular check-ups, supportive care, and cancer screening to enhance their quality of life. In this study, we identify a specific substitution (R258H) targeting the crucial binding site of the alpha-helix region in RAD51C. This substitution induces structural disorder in distinct regions, as indicated by the near absence of electron density for multiple amino acids. Intriguingly, these disordered regions do not follow a continuous sequence from the mutation site and extend across domain boundaries. We utilized computational prediction algorithms and Molecular Dynamics (MD) simulations to model RAD51C and its mutation (R258H) structurally. These simulations highlighted alterations in conformational dynamics, the Free Energy Landscape (FEL), and intrinsic molecular motions induced by the mutation, suggesting structural destabilization that could disrupt its function. This observed destabilization in RAD51C due to mutations offers valuable insights that may serve as diagnostic markers for individuals carrying these mutations, particularly in Fanconi anemia.

Abstract PR006: The potential of multi-cancer early detection screening for reducing cancer mortality

Abstract Background: Currently, routine screening is recommended for only four cancer types (i.e., breast, cervical, colorectal, and lung) by the United States Preventive Services Task Force (USPSTF), and two-thirds of incident cancers have no screening guidelines. Emerging liquid biopsy multi-cancer early detection (MCED) tests have the potential to revolutionize early cancer detection. Their impact on cancer mortality remains uncertain. Computer models are needed to forecast long-term outcomes. Methods: We developed Simulation Model for MCED (SiMCED), a continuous-time, discrete-event microsimulation model of 14 solid tumor cancers: breast, cervical, colorectal, endometrial, esophageal, gastric, head and neck, kidney, liver, lung, ovarian, pancreatic, prostate, and urinary bladder. Cancer type- and stage-specific dwell times informed the transitions between cancer stages I-IV. Cancer type- and stage-specific MCED test sensitivities were derived from a large, multi-center, prospective, case-control study: Ascertaining Serial Cancer patients to Enable New Diagnostic 2 (ASCEND-2). The model was calibrated to reproduce annual incidence rates of cancer diagnosis as captured in the Surveillance, Epidemiology, and End Results (SEER) database, while accounting for the unobserved cancer burden. Using a 10-year time horizon, we simulated the life course of 5 million US adults aged 50-84 years, representative of the US population age distribution. Cancer diagnosis could arise from usual care or annual MCED screening. The MCED test was administered at the beginning of each year to individuals aged 50-84 years. After a cancer diagnosis, individuals followed SEER survival curves to determine the time and cause of death (cancer- or non-cancer-related). Results: Over the 10-year time horizon, the supplemental use of MCED screening reduced stage IV incidence by 876 (42%) per 100,000, relative to usual care. The 10-year reduction in cancer mortality was 439 (17%) per 100,000, which translates to 505,600 cancer-related deaths averted among US adults aged 50-84 years. Lung cancer had the highest absolute 10-year cancer mortality reduction at 126 (13%) per 100,000. Among the cancer types for which there is no routine screening, the 10-year cancer mortality reduction was 175 (15%) per 100,000, equating to 201,500 cancer-related deaths averted among US adults aged 50-84 years. Within the 10-year time window, earlier diagnosis by MCED led to an aggregated life-year gain of 1,165 per 100,000, which translates to a gain of 1,340,000 life-years among US adults aged 50-84 years. Conclusion: Our study suggests that MCED screening could be effective for reducing both stage IV incidence and cancer mortality. The real-world impact of MCED tests and their cost-effectiveness require further investigation. Citation Format: Jagpreet Chhatwal, Jade Xiao, Andrew ElHabr, Christopher Tyson, Xiting Cao, Sana Raoof, A. Mark Fendrick, A. Burak Ozbay, Paul Limburg, Tomasz M. Beer, Ashish Deshmukh, Andrew Briggs. The potential of multi-cancer early detection screening for reducing cancer mortality [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr PR006.

Symptoms of depression, but not PTSD, influence cognitive performance in healthy Army National Guard Soldiers

IntroductionResearch suggests that comorbid depression and PTSD may contribute to cognitive impairment. However, few studies have explored this dynamic in military personnel who report only subclinical symptoms of PTSD and depression. MethodsArmy National Guard Soldiers (ARNG; N = 1415) completed the Automated Neuropsychological Assessment Metrics (ANAM), the PTSD Checklist (PCL), and the Center for Epidemiological Studies Depression Scale (CES-D). The effects of PTSD and depression symptoms on ANAM performance were examined using multiple linear regression analyses. Exploratory factor analysis and regression models examined the relationship between symptom clusters and ANAM performance. ResultsSix factors were identified: avoidance/flashbacks, cognitive/social difficulty, depressed mood, positive mood, sleep difficulty, and hypervigilance. Elevated symptoms of depression (measured using factor scores) were associated with poorer attention (β range −0.19–0.18, p range < 0.01–0.04, f2 effect size range 0.02–0.94). ConclusionDepression symptoms were associated with diminished attentional performance in a large sample of ARNG Soldiers who reported no clinical diagnosis. This study was limited in that unmeasured factors other than depression, PTSD, or demographics may explain much of the variance in cognitive performance. These findings highlight the importance of careful mental health screening and strategies to heighten awareness of the potential detrimental effects of depression and PTSD on health and performance.

Interplay of paternal caregiving and screen use habits on early childhood development and children’s tantrums

BackgroundThis study aims to examine the association for paternal care and father-child screen use with early childhood development and children’s temper tantrums.MethodStudy file included questions about paternal characteristics, child care, father-child screen habits, and utilized the UNICEF Early Childhood Development Index (ECDI). Factors influencing ECDI-on-track status and children’s responses when screen use was restricted were investigated with Chi-square test and multiple logistic regression.ResultsThe study included 464 fathers having children aged 3–4 years. The findings showed that 89.7% of the children were on track in three out of the four ECDI subgroups. When screen use was restricted, 55.6% of the children engaged in another activity, while 44.4% reacted by crying. Multiple logistic regression analysis revealed that the father’s education level, the child’s age and gender, the starting age for screen usage, the child’s reaction to screen restriction, and having three or more books were associated with ECDI. Furthermore, the child’s reaction to screen restriction was related to the child’s and father’s screen time, the presence of three or more books, the adequacy of care, and being on track in the literacy-numeracy ECDI subgroup.ConclusionScreen usage habits significantly impact early childhood development and children’s reactions to screen restrictions. These findings underscore the importance of educating fathers about the effects of their own and their child’s media habits, the quality of fatherly caregiving, and the presence of books in fostering positive child development.

Determination of Genotype and Phenotypes in Pediatric Patients With Biventricular Noncompaction.

Left ventricular noncompaction (LVNC) is a hereditary type of cardiomyopathy characterized by prominent trabeculations. Detailed characteristics of biventricular noncompaction (BiVNC) remain unknown. This study aimed to elucidate the clinical characteristics and genetic landscape of BiVNC. We recruited children with left ventricular noncompaction from Japanese multi-institutional centers from 2013 to 2021. Left ventricular noncompaction was classified as BiVNC, congenital heart disease, arrhythmia, dilated cardiomyopathy, or normal function. In these patients, cardiomyopathy-associated genes were screened. A total of 234 patients (127 male; mean age, 4 months [range, 0-6.6 years]) were enrolled in this study, of whom 25 had BiVNC; 55, normal function; 84, dilated cardiomyopathy; 38, congenital heart disease; and 32, arrhythmia. BiVNC was diagnosed during the perinatal period in 10 patients, in whom the prevalence was higher than that in other patients. A total of 14 patients in the group with BiVNC had congenital heart disease, but not necessarily right heart lesions. Left ventricular dyskinesis was frequently observed in the lateral wall (24%) and apex (28%). Eleven pathogenic variants were found in 11 patients with BiVNC (44.0%). The group with BiVNC had a higher ratio of mitochondrial and developmental gene variants than the other groups. Among all groups, the group with BiVNC had the worst survival rate (P=0.0009). Pediatric patients with BiVNC had a high rate of ventricular dyskinesis and poor outcome. A comprehensive and careful screening for disease-causing genes and phenotype may help identify specific patients with left ventricular noncompaction and mortality-related cardiac phenotypes.

Transapical Transcatheter Aortic Valve Implantation with the J-Valve System in Aortic Regurgitation

BackgroundAortic regurgitation (AR) is a condition associated with significant morbidity and mortality, particularly in severe cases. The J-valve system, next-generation transcatheter heart valve (THV), may overcome the procedural challenges associated with treating pure AR. This study reported the outcome of J-valve for treatment of AR. MethodsThis study observed 47 patients undergoing transcatheter aortic valve implantation (TAVI) with the J-Valve system. Diagnostic evaluation included transthoracic echocardiography and multislice computed tomography to assess AR severity and anatomical characteristics essential for TAVI. Follow-ups were conducted at various intervals post-operation to evaluate outcomes. ResultsThe patients had a mean age of 73.0±9.0 years and a median ejection fraction (EF) of 58.0% (IQR, 45.0%-64.0%). The median EuroSCORE II was 3.0% (IQR, 2.0%-6.7%).The procedural success rate was 100%, with no need for a second valve implantation or conversion to sternotomy. Short-term outcomes showed significant improvements in the New York Heart Association (NYHA) functional classification (P<0.001), left ventricular ejection fraction (LVEF) (P=0.009) and left ventricular end-diastolic diameter (LVEDD) (P<0.001). A singular case of valve migration and severe perivalvular leakage (PVL) due to Behçet's disease prompted a revised approach incorporating immunomodulation therapy. ConclusionsTAVI with the J-Valve system presents a viable alternative for managing severe AR, demonstrating high procedural success and substantial clinical improvement. However, the case of valve migration due to Behçet's disease highlights the need for careful preoperative screening and consideration of autoimmune disorders in differential diagnoses.

A systematic review on the prevalence of a silent female disorder in Arabic-speaking countries and the Middle East: sexual dysfunctions and the role of culture.

Female sexual dysfunction (FSD) remains a silent problem, especially in Arabic-speaking countries and the Middle East and most of the data are from Western countries. Sociocultural determinants haven't been getting the same attention as biological and psychological factors when studying sexual health. To assess the prevalence of FSD in the Arab and Middle Eastern world and understand the sociocultural determinants related. On January 13, 2024, we searched electronic databases including Pubmed, Scielo, PsycArticles, Scopus, Cochrane Library and Google Scholar, Middle East Current Psychiatry, and Journal of Middle East Women's Studies, following PRISMA guidelines. Female participants, aged at least 16years old from Middle East or Arabic-speaking countries, including North Africa, and cross-sectional studies in Arabic, English, and/or French were included. After careful screening of titles, abstracts, and full texts, ineligible articles were excluded. A total of 19 papers were included in the present review. The most common FSD in each country were as follows: in Egypt, Turkey, Morocco, and Jordan, desire problems. In Iran, orgasm problems, and pain. In Palestine, pain. In Saudi Arabia, arousal. Sociocultural determinants such as language, poor sexual education, poor sexual self-awareness-and of partners-, lack of training, and help-seeking were related to FSD. FSD is prevalent in Arabic-speaking countries and the Middle East, yet little to no attention is given to this matter. Causes for FSD are mainly cultural, and Arab and Middle Eastern healthcare professionals lack training. Culturally sensitive, evidence-based studies regarding sexual health need to be conducted.

The Role of Health Education Campaigns in Promoting Preventive Care and Early Screening in Rural China

Objectives: Chronic diseases often result in deadly outcomes if not prevented or diagnosed early. This emphasizes the integration of effective health education campaigns in order to improve the knowledge among rural people regarding the chronic diseases in order to promote preventive care and early screening. This study also aims to determine the role of health education campaigns in promoting preventive care and early screening within rural China. Methods: For this purpose, a multi-staged mixed method approach was used. A health education campaign of 30 days was carried out in rural areas of China for the prevention of chronic diseases. In this regard, the subjects were categorized into two distinct groups which included: control group (including 105 participants) and intervention group (including 100 participants). A questionnaire proposed by the researcher was used for gathering the required data and SPSS was used for analysis purpose. Results: The results obtained show that the mean scores of attitudes, practice and knowledge were insignificant between the groups before the intervention (p &gt; 0.005). However, the total mean scores were found to be higher within the intervention group in context of attitude and knowledge (p &lt; 0.001) after the intervention. Conclusion: However, the preventive behaviors were still found to attain insignificant mean scores. Intra-group comparison also showed that the mean scores of attitudes, knowledge, and practice increased in intervention group after the intervention as compared to control group. The current research has also been effective in presenting different practical as well as theoretical implications which can be crucial for improving preventive behaviors and early screening of chronic diseases in rural areas of China.

Cancer prevention in people experiencing homelessness: feasibility of the Health Navigator Model

Abstract Background The Health Navigator Model (HNM) is a newly developed skill-mixed model that may improve access to cancer prevention services for over 895,000 People who are currently Experiencing Homelessness (PEH) in Europe. The aim of this study was to assess the feasibility and implementation of the model in European settings. Methods A co-designed pilot implementation study was undertaken in Austria, Spain, Greece and the United Kingdom. A total of 20 trained health navigators were appointed at support centres for PEH and facilitated PEH’s access to cancer prevention activities based on a comprehensive and tailored needs assessment. The study duration was 19 months, with two follow-ups. Feasibility data (recruitment/retention/participation rates, barriers, facilitators) were monitored throughout the study. Results More than 1,981 PEH were informed about the study and 652 of them participated. Most participants were male (64%), with low or no income (42%) and had previously experienced homelessness (51.7%). The mean age of participants was 47.4 years old. Overall, 69% of participants completed the first, and 42.5% completed the second follow-up. Main dropout reasons were loss of contact, loss of interest or having other priorities. Participants undertook a range of cancer prevention activities, including education (n = 494), workshops (n = 280), health consultations (n = 251), referrals for specialist care (n = 212) and cancer screening tests (n = 169). Difficulties in accessing the healthcare system, de-prioritising cancer and PEH’s complex needs were identified as the main barriers. Building trusting relationships with PEH, increasing cancer awareness and coordinating social and health services were identified as the main facilitators. Conclusions Implementing the Health Navigator Model was a feasible and dynamic process leading to improved equity and inclusion of people experiencing homelessness in cancer preventive services. Key messages • The Health Navigator Model is a feasible model to enhance cancer prevention among people experiencing homelessness following a person-centred, destigmatising approach. • Effective liaison between health and social services under the Health Navigator Model plays a critical role in facilitating access to cancer preventive care among people experiencing homelessness.

Identity in the context of physical activity and smoking: A scoping review among adults aged 45+

Abstract Background Identity (i.e., self-perceptions of oneself) plays an important role in health behaviors such as physical activity (PA) and smoking. This review offers a comprehensive synthesis and comparison of how PA- and smoking-related identity is associated with PA and smoking behavior in adults aged 45+. It further synthesizes and compares identity terminology and measurement tools used to capture identity concerning smoking cessation and PA among adults aged 45+. Where applicable, the role of personal, PA-, and smoking-related characteristics were considered. Methods A thorough search across 11 databases, updated in May 2023, yielded 5801 unique publications. Ensuing careful screening procedures, 45 peer-reviewed empirical studies were systematically reviewed. Experts in the field contributed to validate and structure the narrative. Results The review reveals a complex, enduring connection between identity and behavior in both PA and smoking domains, encompassing processes like identity formation, maintenance, change, and loss. In essence, identities linked to PA and abstaining from smoking emerged as pivotal for promoting active lifestyles and successful smoking cessation. Many parallels but also distinctions emerged within this association, alongside variations in the terminology and measurement tools pertaining to identity. Factors such as gender, age, and behavioral history emerged as influential in shaping identities related to smoking and PA. Conclusions Despite variances, findings suggest that the relationship between identity and behavior, including associated processes, may not fundamentally differ between health-promoting and health-compromising behaviors. There is however need for more unified identity definitions and measurement tools. We propose avenues for future research, including exploring causality between identity and behavior to facilitate the development of identity-related smoking cessation and PA-promotion interventions. Key messages • Identities associated with physical activity and refraining from smoking are associated with a physically active lifestyle and successful smoking cessation. • Despite differences, the relationship between identity and behavior may not fundamentally vary between health-promoting and health-compromising behaviors.

Exploring the Discriminant Validity of the Modified Arm Care Screen (MACS), Designed for Overhead Athletes, in Detecting Musculoskeletal Risk Factors in the General Population

Background: Shoulder pain is the third most common musculoskeletal issue in primary care, affecting up to 50% of patients six months post-consultation, leading to significant functional impairments and societal costs, especially due to sick leave. Shoulder injuries are particularly prevalent among ‘overhead athletes’ in sports like swimming, volleyball, and handball, with high injury rates reported annually. Screening tools like the Arm Care Screen (ACS) have been used to effectively identify athletes at risk of shoulder injuries. However, their applicability to the general population is less understood. This study aimed to assess the discriminant validity of a modified ACS (MACS) in detecting musculoskeletal risk factors among non-athletes. Methods: A prospective cross-sectional study was conducted with 30 asymptomatic subjects over 18, excluding those with a history of shoulder injuries or surgeries. The MACS, comprising four tests, was administered, and its diagnostic performance was evaluated through sensitivity, specificity, predictive values, and likelihood ratios. Results: The results indicated low sensitivity (0–47.62%) and variable specificity (55.56–100%), suggesting that the MACS may not effectively identify risk factors in the general population. Positive and negative predictive values were inconsistent (ranging from 0 to 100), as well as positive and negative likelihood ratios (ranging from 0 to 3.47), highlighting the need for non-athlete-specific screening tools. Conclusion: While the MACS shows promise in athletes, its application in the general population requires further refinement. This study underscores the necessity for tailored screening methods to enhance the early detection and prevention of musculoskeletal issues in diverse populations.

Best Evidence Summary for the Prevention of Pressure Injuries in Orthopaedic Patients.

To systematically search, evaluate and synthesise the most robust evidence regarding pressure injury prevention in orthopaedic patients admitted to general wards. The present study provides an evidence-based summary of the most robust findings, adhering to the evidence guidelines established by the Center for Evidence-Based Nursing of Fudan University. According to the "6S" model, a systematic search was conducted for literature on pressure injury prevention among orthopaedic patients in general wards. The types of literature included guidelines, clinical decisions, expert Consensus, evidence summaries, etc. The search period covered the time from the beginning of the database up to December 2023. The following databases and resources were systematically searched: Up To Date, JBI, NICE, WOCN, NZWCS, etc. RESULTS: Fifteen literature sources were included, comprising one clinical decision, eight guidelines, one systematic review, and one expert Consensus. In these sources, a comprehensive collection of 34 pieces of best evidence was formed across six key topics: risk assessment, position management, skin care, device used for device-related pressure injury, nutritional assessment, and support, as well as health education and training. Among the evidence gathered, a strong recommendation was made for 18 pieces, while the remaining 16 received a weak recommendation. This study provides a comprehensive synthesis of the most robust evidence on pressure injury prevention in orthopaedic patients, encompassing 34 pieces of evidence that can serve as valuable references for clinical practice. Before implementing this evidence, it is crucial to evaluate the specific contextual factors within different countries and medical institutions, as well as the facilitators and barriers influencing its application by healthcare professionals and patient's preferences. Furthermore, targeted evidence selection should be conducted through careful screening and subsequent adjustments in implementation, thereby offering a more scientifically grounded basis for clinical nursing practice. Future research endeavours should prioritise investigating strategies for effective evidence utilisation. The prevention of pressure injuries poses a significant challenge for orthopaedic patients. This study presents a synthesis of 34 pieces of best evidence to provide guidance on preventive measures for pressure injuries in orthopaedic patients. Adhering to and implementing these 34 pieces of evidence can effectively aid in preventing pressure injuries in clinical practice. This evidence encompasses risk assessment, position management, skin care, device usage for device-related pressure injuries, nutritional support and evaluation, and health education and training, establishing a comprehensive and systematic implementation process. Assessing the risk of pressure injuries during interventions serves as an essential prerequisite for developing effective strategies to prevent such injuries among orthopaedic patients. Ultimately, this study will offer valuable guidance to healthcare professionals worldwide regarding preventing pressure injuries in orthopaedic patients. Upon admission to the hospital, it is essential to conduct a risk assessment and implement evidence-based, individualised prevention measures for pressure ulcers in patients to prevent their occurrence. This study will provide valuable insights into preventing pressure injuries in orthopaedic patients admitted to orthopaedic wards for healthcare workers worldwide. The PRIMA manifest is utilised during the text preparation process. ES20245365.

Utilizing laser therapy to manage oral potentially malignant disorders in older adults at the primary care level.

Oral lesions are a significant concern among older adults because they can progress to oral cancer if not diagnosed and treated promptly and effectively. Transportation to the hospital is a major barrier to oral healthcare for many older adults. The purpose of this editorial is to address the challenges of managing oral potentially malignant disorders in the older population, highlighting the barriers they face in accessing healthcare services, the potential use of laser therapy for management, and the direction of research in this area. Due to the limited access of the older to healthcare services, primary healthcare facilities within communities serve as their primary providers. Laser therapy is recommended for the management of oral potentially malignant disorders due to its favorable outcomes. This approach has been tested in several primary healthcare centers in Thailand. In our project, laser therapy was used to treat oral potentially malignant disorders in primary and secondary healthcare services. This includes photodynamic therapy for older patients with extensive lesions, as well as individuals with oral leukoplakia and erythroplakia who have declined curative surgery. It has also been used in cases of recalcitrant lichen planus to steroid or photobiomodulation therapy. This approach has been well accepted by both oral healthcare providers and patients. To expand access to these treatment options in such settings, it is critical to empower healthcare professionals, particularly dentists and dental nurses, to integrate laser techniques into geriatric care and oral cancer screening. Establishing a network foundation for orofacial laserology would also enhance the potential of such settings.

Palladium-Catalyzed α-Arylation of Cycloalkanones with Sterically Hindered Bromoazines under Neat Conditions

AbstractThe palladium-catalyzed cross-coupling of cycloalkanones with a range of heteroaryl bromides is described herein. The transformation proceeds best with third-generation tris-tBu-phosphine Pd pre-catalyst in neat cycloalkanones. Careful screening of the reaction conditions revealed K3PO4 as an effective weak and mild base thereby tolerating base-sensitive functional groups such as acetals or nitrogen protecting groups. Moderate to good yields were achieved for a series of 29 examples with various degrees of structural complexity. Importantly, these optimized conditions allow the α-(hetero)aryl cross-coupling of ortho-substituted (hetero)aryl bromide substrates with different cyclo­alkanones that typically failed to react efficiently under previously reported conditions.