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Background: As the prevalence of chemotherapy‐related cognitive impairment rises, investigation into treatment options is critical. The objectives of this study were to test the effects of an aerobic exercise intervention initiated during chemotherapy compared to usual care (wait list control condition) on (1) objectively measured cognitive function and self‐reported cognitive function, as well as on (2) the impact of cognitive impairment on quality of life (QOL) postintervention (commensurate with chemotherapy completion). Methods: The Aerobic exercise and CogniTIVe functioning in women with breAsT cancEr (ACTIVATE) trial was a two‐arm, two‐center randomized controlled trial conducted in Ottawa and Vancouver (Canada). Fifty‐seven women (Mage, 48.8 ± 10 years) diagnosed with stage I–III breast cancer and awaiting chemotherapy were randomized to aerobic exercise initiated with chemotherapy (nEX = 28) or usual care during chemotherapy with aerobic exercise after chemotherapy completion (nUC = 29). The intervention lasted 12–24 weeks and consisted of supervised aerobic training and at‐home exercise. The primary outcome was objective cognitive function measured via 13 neuropsychological tests (standardized to M ± SD, 0 ± 1); secondary outcomes of self‐reported cognitive function and its impact on QOL were assessed via questionnaires. Data collected pre‐ and postintervention (the primary end point) were analyzed. Results: Although no significant differences between groups were found for objective cognitive function outcomes postintervention after accounting for multiple testing, four of six self‐reported cognitive function outcomes showed significant differences favoring the aerobic exercise group. Conclusions: Among women initiating chemotherapy for breast cancer, aerobic exercise did not result in significant differences in objective cognitive function postintervention after chemotherapy completion; however, the results do support the use of this intervention for improving self‐reported cognitive function and its impact on QOL. As the prevalence and consequences of chemotherapy‐related cognitive impairment rise, investigation into treatment options for patients is critical. Findings of this randomized controlled trial support the use of a 12‐ to 24‐week aerobic exercise intervention for women initiating chemotherapy for breast cancer to improve self‐reported cognitive function and its impact on QOL. [ABSTRACT FROM AUTHOR]

Background Accurate tools to distinguish Crohn's disease [CD] from cryptoglandular disease in patients with perianal fistulas without detectable luminal inflammation on ileocolonoscopy and abdominal enterography (isolated perianal fistulas [IPF]) are lacking. We assessed the ability of video capsule endoscopy [VCE] to detect luminal inflammation in patients with IPF. Methods We studied consecutive adults [>17 years] with IPF who were evaluated by VCE after a negative ileocolonoscopy and abdominal enterography between 2013 and 2022. We defined luminal CD by VCE as diffuse erythema, three or more aphthous ulcers, or a Lewis score greater than 135. We compared rates of intestinal inflammation in this cohort with age- and sex-matched controls without perianal fistulas, who underwent VCE for other indications. We excluded persons with pre-existing inflammatory bowel disease [IBD] and exposure to non-steroidal anti-inflammatory drugs or immunosuppressive treatments. Results A total of 45 patients with IPF underwent VCE without complications. Twelve patients [26%] met our definition of luminal CD. Luminal CD was more common in patients with IPF than in controls [26% vs 3%; p  <0.01]. Among patients with IPF, male sex (OR [odds ratio], 9.2; 95% confidence interval [CI] [1.1-79.4]), smoking (OR, 4.5; 95% CI [0.9-21.2]), abscess (OR, 6.3; 95% CI [1.5-26.8]), rectal enhancement on magnetic resonance imaging [MRI] (OR, 9.0; 95% CI [0.8-99.3]), and positive antimicrobial serology (OR, 7.1; 95% CI, [0.7-70.0]) were more common in those with a positive VCE study. Conclusions VCE detected small intestinal inflammation suggestive of luminal CD in approximately one-quarter of patients with IPF. Larger studies are required to validate these findings. [ABSTRACT FROM AUTHOR]

Background: Despite recent advances in arthroscopic rotator cuff repair, the retear rate remains high. New methods to optimize healing rates must be sought. Bone channeling may create a quicker and more vigorous healing response by attracting autologous mesenchymal stem cells, cytokines, and growth factors to the repair site. Hypothesis: Arthroscopic rotator cuff repair with bone channeling would result in a higher healing rate compared with arthroscopic rotator cuff repair without adjuvant channeling. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Our primary objective was to compare healing rates in patients undergoing arthroscopic rotator cuff repair for degenerative tears, with and without bone channeling. Secondary objectives included comparisons of the Western Ontario Rotator Cuff Index (WORC) score, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Constant strength subscore, and visual analog scale (VAS) for pain score between groups. Patients undergoing arthroscopic rotator cuff repair were recruited at 3 sites and were randomized to receive either bone channeling augmentation or standard repair. Healing was determined via ultrasound at 24 months postoperatively. WORC, ASES, and Constant scores were compared between groups at baseline and at 3, 6, 12, and 24 months postoperatively. Results: A total of 168 patients were enrolled between 2013 and 2018. Intention-to-treat analysis revealed no statistical differences in healing rates between the 2 interventions at 24 months postoperatively. Statistically significant improvements occurred in both groups from preoperatively to all time points for the WORC, the ASES score, the Constant score or Constant strength subscore, and the VAS for pain (P <.0001). No differences were observed between the bone channeling and control groups in WORC, ASES, Constant, and VAS pain scores at any time point. Conclusion: This trial did not demonstrate the superiority of intraoperative bone channeling in rotator cuff repair over standard rotator cuff repair at 24 months postoperatively. Healing rates, patient-reported function, and quality-of-life outcomes were similar between groups. Registration: NCT01877772 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

Burnout is a growing concern, with significant negative consequences for physicians and patient care. Burnout is negatively associated with physician empathy, while resilience may be a protective factor against the development of burnout but few studies have examined all three constructs in the same cohort. Understanding the associations between these constructs could aid in the development of interventions for physicians experiencing burnout and improve the delivery of compassionate care. We conducted a cross-sectional survey to determine levels of burnout, empathy and resilience in a sample of academic physicians and investigate the relationships between these variables. Validated scales were administered online to measure burnout (Maslach Burnout Inventory – Human Services Survey, MBI-HSS), empathy (Jefferson Scale of Empathy – Physicians/Health Professions Version, JSE) and resilience (Connor-Davidson Resilience Scale, CD-RISC). Descriptive statistics, correlation coefficients, and group comparisons were examined. Eighty-three physicians completed the JSE and CD-RISC, while a subset of 49 physicians also completed the MBI-HSS. Response rates were 31.9% and 18.8%, respectively. High burnout was reported by 49% of the sample. Physicians with high burnout reported lower levels of resilience than those who were not burnt-out. No differences in levels of empathy were observed between these two groups. Older physicians (>45 years) reported higher resilience scores than younger physicians. Resilience and empathy were significantly positively correlated. The reported rate of physician burnout in this sample of academic physicians is concerning, with burnout associated with lower levels of resilience. Further research is required to explore the relationship between physician age and resilience, the impact of resilience-building interventions on burnout and empathy in physicians, and how modifying these variables influences the delivery of compassionate care for patients. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsDiscussionClinical evidence suggests that nutrition interventions can significantly improve symptoms of major depressive disorder; however, the effect on clinical anxiety symptoms in individuals with anxiety disorders has not been studied. The primary objective of the present study was to assess the feasibility and acceptability of a nutrition intervention. The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers.This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with generalized anxiety disorder. Questionnaires and blood work were completed at baseline, after the waiting period, and after the intervention.443 individuals expressed interest within eight months; 50 met the criteria for enrollment. The mean number of sessions attended was 6.4. Final questionnaires were completed by 46 participants. Eighty-four percent of participants strongly agreed with the statement ‘My experience during this study was positive’. The mean anxiety symptom severity score in the intervention group was 26.2 (95% CI 22.94–29.48) at baseline and 11.0 (95% CI 8.05–13.87) at week 12. The mean diet quality score was 7.2 (95% CI 6.32–8.10) and 10.5 (95% CI 9.55–11.49) at baseline and week 12, respectively. Among the waitlist participants, the mean baseline anxiety score was 29.3 (95% CI 24.73–33.91) and 26.8 (95% CI 22.09–31.56) at week 12.This study was feasible and acceptable. Participation in the intervention was associated with a decrease in anxiety symptoms. These findings lay the foundation for large-scale studies. Trial registration: ClinicalTrials.gov NCT05573672. [ABSTRACT FROM AUTHOR]

Purpose: Physician burnout is a global issue associated with low job satisfaction, decreased quality of patient care, reduced productivity, and early retirement from clinical practice. We sought to evaluate the impact of the leadership qualities of direct physician supervisors on the burnout and professional satisfaction of the physicians they supervise., Methods: An online survey was distributed by Email to all staff physicians practicing at a large Canadian academic tertiary care hospital. The primary outcome was the prevalence of burnout and professional satisfaction, assessed using the 2-item Maslach Burnout Inventory and a single item 5-point Likert scale rating, respectively. The secondary outcome was the relationship between composite leadership score and burnout/satisfaction, with leadership assessed by the 12-item Mayo Clinic Participatory Management Leadership Index., Results: Out of the 1176 physicians surveyed, 383 (32.6%) responded (51.2% male; 41.5% female). Overall, 41.7% of physicians reported at least one symptom of burnout (40.0% reported high emotional exhaustion; 15.3% reported high depersonalization). 40.1% of physicians reported being satisfied with the organization, 26.3% were neutral, and 33.6% were dissatisfied. On multivariate analysis adjusting for age, sex, duration of employment at the institution, and specialty, each one-point increase in composite leadership score was associated with a 3.1% decrease in the likelihood of burnout ( p = 0.0017), and a 6.6% increase in the likelihood of satisfaction ( p < 0.0001)., Conclusion: Physician burnout is prevalent and positive leadership qualities of direct supervisors decreases the likelihood of burnout in physicians and increases the likelihood of their satisfaction with the organization., Trial Registration: ClinicalTrials.gov; Identifier: NCT04896307., Competing Interests: The authors report no conflicts of interest in this work., (© 2025 Spilg et al.)

Background: Biomechanical studies have shown that the transosseous equivalent suture bridge (TOE-SB) rotator cuff repair technique improves contact areas and pressure between the tendon and footprint, which may facilitate healing. However, few studies have directly compared its outcomes with traditional double-row (DR) repair., Purpose/hypothesis: The primary objectives of this study were to (1) compare the functional outcomes of DR with TOE-SB fixation in patients undergoing arthroscopic rotator cuff repairs and (2) compare healing rates between the 2 groups and investigate whether any factors were associated with healing. It was hypothesized that arthroscopic rotator cuff repair using DR repair would demonstrate no difference in disease-specific quality of life, patient-reported outcomes, or healing rates compared with TOE-SB repair., Study Design: Cohort study; Level of evidence, 3., Methods: This was a cohort study conducted as a subanalysis of 2 larger randomized controlled trials. Patients ≥18 years old with degenerative rotator cuff tears confirmed by magnetic resonance imaging who had persistent symptoms of pain and functional impairment after 6 months of nonoperative management were enrolled in prospective randomized controlled trials and underwent either a traditional DR repair or a TOE-SB rotator cuff repair. Functional outcomes were assessed using the Western Ontario Rotator Cuff index, the American Shoulder and Elbow Surgeons score, and the Constant score at baseline and 3, 6, 12, and 24 months postoperatively. Healing rates were determined using ultrasound at 24 months postoperatively., Results: A total of 184 patients were included in this study; 34 patients underwent conventional DR repair and 150 underwent TOE-SB repair. Postoperative changes in the outcome measures from baseline were statistically significant for all outcomes in both groups ( P < .0001). No statistically significant differences were found between outcomes at any of the follow-up times, except a significant difference in the Constant score at 24 months in favor of the DR group (mean ± SE, 80.5 ± 1.1 [95% CI, 78.4-82.7]) and TOE-SB and DR, respectively (mean ± SE, 85.7 ± 2.2 [95% CI, 81.2-90.1]) ( P = .041). Healing rates were 77.8% for DR and 83% for TOE-SB (odds ratio, 1.34 [95% CI, 0.53-3.38]; P = .53). Multivariable regression analysis showed a positive correlation between nonhealing rates and the rotator cuff tear size in the sagittal plane (odds ratio, 1.97 (95% CI, 1.02-3.78); P = .042)., Conclusion: No difference was found between DR and TOE-SB rotator cuff repair in the Western Ontario Rotator Cuff index, the American Shoulder and Elbow Surgeons score, Constant strength subscore, or the healing rate. The Constant score at the 24-month follow-up favored DR repair but did not reach the minimal clinically important difference. An association was found between higher healing rates and smaller sagittal plane tear sizes., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: P.L. is a paid consultant and performs educational talks with Stryker (previously Wright Medical), related to shoulder arthroplasty work. J.W.P. is a paid consultant and performs educational talks with Stryker and CONMED. P.M. is a paid consultant and performs educational talks with Stryker and CONMED. M.B. performs paid educational talks with Stryker and Smith+Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from The Ottawa Hospital (7966)., (© The Author(s) 2025.)