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BACKGROUND ANMD AIMS: Functional decline in older adults is related physiologically to both aging and lifestyle-related risk factors. The role of health promotion and lifestyle modifications in preventing functional performance decline in community-dwelling older adults has not been well established. We evaluated the effects of an education-based health promotion program on functional performance and body composition in midlife and older adults. METHODS: A prospective study of a 4-week health promotion program for community- dwelling older adults. Outcome measures of gait speed, chair rise time, grip strength, weight, body mass index (BMI) and bioelectric impedance analysis (BIA) for body fat were assessed at baseline, 6 and 12 months. RESULTS: Participants (n=117) with a mean age 62.9+/-8 years; 63.2% were women. Gait speed improved by 0.20 ms-1 (95% CI 0.14, 0.29; p<0.001) and chair rise time decreased by 0.36 s (95% CI -0.13, -0.56; p=0.001) at 12 months. There was no change in grip strength (p=0.433). There was a modest decrease in weight 0.55 kg (95% CI -0.08, -1.01; p=0.019), BMI 0.35 kgm-2 (95% CI -0.02, -0.64; p=0.033) and fat impedance 0.75% (95% CI -0.09, -1.26; p=0.021) at 12 months. Imputation to account for missing outcomes did not alter overall conclusions. CONCLUSION: A 4-week educationbased health promotion in later-life is feasible and may help to improve and maintain functional performance and body composition in midlife and older adults. [ABSTRACT FROM AUTHOR]

Background: Our objective was to determine the association between participation in habitual physical activity (including walking, shopping, and indoor and outdoor activities) and leisure-time or sports activities on physical performance and fitness in older persons.Methods: In an observational study, 123 predominantly ethnic Chinese participants aged 50 years and older were recruited from a health promotion program. Main outcome measures were bioelectric impedance for body fat composition, peak oxygen consumption (VO(2)max), gait speed, handgrip strength, and chair rise time.Results: The mean age of participants was years. Those with a higher self-reported walking level had a better VO(2)max; every 1 minute per day increase in habitual walking increases VO(2)max by 0.096 (ml/kg)/min (95% confidence interval [CI] 0.027-0.165, p=.007) and is possibly associated with a faster gait speed; (95% CI 0.000-0.005, p=.078). There is an age-related rise in body fat composition, decline in VO(2)max, and slower chair rise time. Men had a lower body fat composition, better VO(2)max, and stronger handgrip.Conclusions: Habitual walking may impart important health benefits in terms of improvement in physical performance, fitness, and its implications for the prevention of physical disability in older adults. This also reinforces the theory that low- to moderate-intensity activities may improve cardiorespiratory fitness. There is an inevitable physiological age-related decline in physical fitness. [ABSTRACT FROM AUTHOR]

Intro: Extracorporeal membrane oxygenation (ECMO) is a critical tool in the care of severe cardiorespiratory dysfunction. Simulation training for ECMO has become standard practice. Therefore, Keck Medicine of the University of California (USC) holds simulation-training sessions to reinforce and improve providers knowledge., Objective: This study aimed to understand the impact of simulation training approaches on interprofessional collaboration. We believed simulation-based ECMO training would improve interprofessional collaboration through increased communication and enhance teamwork., Methods: This was a single-center, mixed methods study of the Cardiac and Vascular Institute Intensive Care Unit at Keck Medicine of USC conducted from September 2021 to April 2023. Simulation training was offered for 1 hour monthly to the clinical team focused on the collaboration and decision-making needed to evaluate the initiation of ECMO therapy. Electronic surveys were distributed before, after, and 3 months post training. The survey evaluated teamwork and the effectiveness of training, and focus groups were held to understand social environment factors. Additionally, trainee and peer evaluation focus groups were held to understand socioenvironmental factors., Results: In total, 37 trainees attended the training simulation from August 2021 to August 2022. Using 27 records for exploratory factor analysis, the standardized Cronbach α was 0.717. The survey results descriptively demonstrated a positive shift in teamwork ability. Qualitative themes identified improved confidence and decision-making., Conclusions: The study design was flawed, indicating improvement opportunities for future research on simulation training in the clinical setting. The paper outlines what to avoid when designing and implementing studies that assess an educational intervention in a complex clinical setting. The hypothesis deserves further exploration and is supported by the results of this study., (© Joan Brown, Sophia De-Oliveira, Christopher Mitchell, Rachel Carmen Cesar, Li Ding, Melissa Fix, Daniel Stemen, Krisda Yacharn, Se Fum Wong, Anahat Dhillon. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Introduction: The phase 2 TROPiCS-03 study evaluated the efficacy/safety of sacituzumab govitecan (SG) as second-line treatment in patients with previously treated extensive-stage SCLC (ES-SCLC)., Methods: TROPiCS-03 (NCT03964727) is a multicohort, open-label, phase 2 basket study of solid tumors, including ES-SCLC. Adults with ES-SCLC that progressed after one previous line of platinum-based chemotherapy and anti-programmed death-(ligand) 1 (PD-[L]1) therapy received SG 10 mg/kg on days 1 and 8 of a 21-day cycle. The primary end point was the investigator-assessed objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumors version 1.1. Key secondary end points included investigator-assessed duration of response (DOR) and progression-free survival (PFS); blinded independent central review-assessed ORR, DOR, and PFS; overall survival (OS); and safety. Efficacy was evaluated in patients with platinum-resistant and platinum-sensitive disease., Results: Among 43 patients (median follow-up, 12.3 [range, 8.1-20.1] mo), investigator-assessed ORR was 41.9% (95% confidence interval [CI]: 27.0%-57.9%), with 18 confirmed partial responses; median (95% CI) DOR, PFS, and OS were 4.73 (3.52-6.70), 4.40 (3.81-6.11), and 13.60 (6.57-14.78) months, respectively. The efficacy results of the blinded independent central review assessments were similar. The investigator-assessed ORR (95% CI) was 35.0% (15.4%-59.2%) in patients with platinum-resistant disease (n = 20) and 47.8% (26.8%-69.4%) in patients with platinum-sensitive disease (n = 23). Furthermore, 32 patients (74.4%) had grade greater than or equal to 3 treatment-emergent adverse events (TEAEs). No TEAE led to SG discontinuation; one treatment-related TEAE (neutropenic sepsis) led to death., Conclusions: SG has promising efficacy as second-line treatment of ES-SCLC, irrespective of platinum sensitivity. Safety was manageable and consistent with that observed in other SG studies., Competing Interests: Disclosure Dr. Dowlati reports serving on the advisory board with AstraZeneca, Jazz, Seattle Genetics, Bristol Myers Squibb, Prelude Therapeutics, and Puma Biotechnology. Dr. Chiang reports serving on the advisory board with Amgen, AstraZeneca, Daiichi Sankyo, Fosun, Genentech, Janssen, and Zai Labs. Dr. Cervantes reports receiving institutional research funding from AbbVie, Bayer, Beigene, Bristol Myers Squibb, Genentech, HiFiBiO Therapeutics, invoX Pharma, Merck Serono, Merck Sharp & Dohme, Natera, Novartis, Roche, and Servier; serving on the advisory board or receiving speaker fees paid to his institution from AbbVie, Agenus, Arcus Biosciences, GlaxoSmithKline, and Roche. Dr. Babu reports having institutional grants or contracts from 1200 Pharma, AbbVie, Alexion Pharmaceuticals, Amgen, Aptose Biosciences, Argenx, AstraZeneca/MedImmune, Bristol Myers Squibb, Beigene, Genentech/Roche, Gilead Sciences, Janssen Oncology, Lilly, Merck, Nektar, Novartis, Scholar Rock, Sanofi, Syndax, Takeda, TG Therapeutics, and Torl Biotherapeutics; receiving personal consulting fees from Cornerstone Specialty Network, ER Squibb Sons, LLC, Kite (a Gilead Company), Novartis, and Taiho Oncology; receiving personal payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from Cornerstone Healthcare Group, Janssen Scientific Affairs, Novartis, and Pfizer; receiving personal support for attending meetings and/or travel from Beigene, Janssen, Karyopharm, Kite (a Gilead Company), and Pharmacyclics; receiving personal support for a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid from Exigent Research; having stock or stock options in Fort Wayne Medical Oncology and Hematology and Lutheran Hospital; and having personal employment at Fort Wayne Medical Oncology and Hematology. Dr. Hamilton reports receiving institutional support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges) from Gilead Sciences; receiving institutional grants or contracts from AbbVie, Acerta Pharma, Accutar Biotechnology, ADC Therapeutics, AKESOBIO Australia, Amgen, Aravive, ArQule, Artios, Arvinas, AstraZeneca, AtlasMedX, BeiGene, Black Diamond, Bliss BioPharmaceuticals, Boehringer Ingelheim, Bristol Myers Squibb, Cascadian Therapeutics, Clovis, Compugen, Context Therapeutics, Cullinan, Curis, CytomX, Daiichi Sankyo, Dana Farber Cancer Institute, Dantari, Deciphera, Duality Biologics, eFFECTOR Therapeutics, Eisai, Ellipses Pharma, Elucida Pharma, EMD Serono, Fochon Pharmaceuticals, FujiFilm, G1 Therapeutics, Gilead Sciences, H3 Biomedicine, Harpoon, Hutchinson MediPharma, Immunogen, Incyte, Infinity Pharmaceuticals, Inspirna, InvestisBio, Jacobio, Karyopharm, K-Group Beta, Kind Pharmaceuticals, Leap Therapeutics, Lilly, Loxo Oncology, Lycera, Mabspace Biosciences, Macrogenics, MedImmune, Mersana, Merus, Millennium, Molecular Templates, Myriad Genetic Laboratories, Novartis, Nucana, Olema, OncoMed, Oncothyreon, ORIC Pharmaceuticals, Orinove, Orum Therapeutics, Pfizer, PharmaMar, Pieris Pharmaceuticals, Pionyr Immunotherapeutics, Plexxikon, Prelude Therapeutics, Profound Bio, Radius Health, Regeneron, Relay Therapeutics, Repertoire Immune Medicine, Rgenix, Roche/Genentech, SeaGen, Sermonix Pharmaceuticals, Shattuck Labs, Silverback Therapeutics, StemCentRx, Stemline Therapeutics, Sutro, Syndax, Syros, Taiho, TapImmune, Tesaro, Tolmar, Torque Therapeutics, Treadwell Therapeutics, Verastem, Zenith Epigenetics, and Zymeworks; and receiving institutional consulting fees from Accutar Biotechnology, AstraZeneca, Daiichi Sankyo, Ellipses Pharma, Entos, Fosun Pharma, Gilead Sciences, Jazz Pharmaceuticals, Jefferies, Lilly, Medical Pharma Services, Mersana, Novartis, Olema Pharmaceuticals, Pfizer, Roche/Genentech, Stemline Therapeutics, Tempus Labs, Theratechnologies, Tubulis, Verascity Science, and Zentalis Pharmaceuticals. Dr. Sullivan reports receiving support for participation on a data safety monitoring board or advisory board from Roche and is an employee of and owns stock in Gilead Sciences, Inc. Dr. van Marcke reports (all institutional compensations) serving on the advisory board with AstraZeneca, Lilly, Merck, and Novartis; receiving research grants from DigiCore and Gilead Sciences, Inc. Dr. Italiano reports having grants or contracts from AstraZeneca, Bayer, Bristol Myers Squibb, Merck, Merck Sharp & Dohme, and Roche; receiving consulting fees from AstraZeneca, Bayer, Domain Therapeutics, Merck, Merck Sharp & Dohme, and Roche; receiving support for attending meetings and/or travel from AstraZeneca and Roche; and receiving support for participation on data safety monitoring boards or advisory boards from AbbVie, Boehringer, Daiichi Sankyo, Merck, Merck Sharp & Dohme, and Roche. Drs. Patel, Mekan, and Wu are employees of and own stock in Gilead Sciences, Inc. Dr. Waqar reports serving on the advisory board for AstraZeneca, Daiichi Sankyo, Gilead Sciences, Inc., Janssen Pharmaceuticals, Boehringer Ingelheim, and Pfizer. The remaining authors declare no conflict of interest., (Copyright © 2025 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

House Dust Mites (HDMs) like Dermatophagoides farinae (D. farinae), Dermatophagoides pteronyssinus (D. pteronyssinus) and Blomia tropicalis (B. tropicalis) were found all over the world. Their relationship with allergy diseases was one of the focal points of epidemiological investigations spanning various geographical regions globally but specifically in regions with warm temperatures. Their omnipresence underscores their pivotal role in the etiology and exacerbation of some respiratory disorders, emphasizing their significance as environmental allergens. Despite the availability of numerous eradication treatments ranging from sun exposure to ozone-based approaches, the quest for efficacious HDM eradication encounters obstacles due to the diversity in study methodologies employed to evaluate these different intervention strategies. This methodological heterogeneity complicates the quantification of treatment efficacy, impeding the establishment of definitive criteria distinguishing "effective" from "ineffective" approaches. Despite the urgency of developing solutions, current efforts are hindered by this lack of consensus. This review aims to bridge this gap by synthesizing existing knowledge on HDM eradication strategies and discussing their efficacy, safety, and practicality. By addressing these discrepancies, this article endeavors to provide insights and clues for the future development of evidence-based interventions aimed at mitigating HDM infestations and ultimately reducing its sensitization rate worldwide.

Objectives: The feared possible self refers to an imagined version of self that one is afraid of being or becoming. Previous evidence has shown that dysfunctional reasoning (i.e., inferential confusion) is associated with obsessive-compulsive disorder (OCD) symptoms, which is partially mediated by a feared self. However, the evidence is reliant on non-clinical samples and a general measure of the feared self., Methods: Using a cross-sectional design, the current study attempted to replicate and extend this literature in a sample clinically diagnosed with OCD (n = 350) to assess the pathway from inferential confusion to OCD symptoms when feared self is accounted for as a mediator, particularly the individual dimensions of feared self (i.e., corrupted, culpable, and malformed feared selves). Participants completed a structured clinical interview for DSM-5, as well as measures of inferential confusion (Dysfunctional Reasoning Processes Task), obsessive beliefs, feared self, OCD symptoms, and psychological distress., Results: Inferential confusion directly, and indirectly through the feared corrupted self, affected OCD symptoms, even after adjusting for obsessive beliefs, psychological distress, and comorbidity. However, the feared culpable and malformed selves did not play a role in this pathway., Conclusions: The study underscores that the feared corrupted self links inferential confusion to OCD symptoms, translating to the need to consider both dysfunctional reasoning processes and this specific feared self in clinical settings when treating OCD. Furthermore, the study provides more support for the inference-based approach (IBA) to OCD., (© 2024 British Psychological Society.)

Coronary artery vasospasm is an under-recognized yet fatal condition that can manifest as sudden cardiac arrest. A 51-year-old man presented with out-of-hospital cardiac arrest due to ventricular fibrillation during exercise. Coronary angiogram showed severe disease at ostial left main coronary artery and left anterior descending artery (LAD), that was not present anymore on repeated angiography and intravascular ultrasound assessment. Cardiac magnetic resonance demonstrated evidence of prior myocardial infarction in the LAD territory. Acetylcholine challenge test was performed that induced severe left main coronary artery and LAD spasm. Coronary artery vasospasm has contributed to a significant proportion of patients presenting with coronary artery disease. Establishing the correct diagnosis is detrimental to future management of patients. This case highlighted a multimodality approach in the diagnosis of coronary vasospasm., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)

Collecting duct carcinoma (CDC) is an aggressive rare subtype of kidney cancer with unmet clinical needs. Little is known about its underlying molecular alterations and etiology, primarily due to its rarity, and lack of preclinical models. This study aims to comprehensively characterize molecular alterations in CDC and identify its therapeutic vulnerabilities. Through whole-exome and transcriptome sequencing, we identified KRAS hotspot mutations (G12A/D/V) in 3/13 (23%) of the patients, in addition to known TP53, NF2 mutations. 3/13 (23%) patients carried a mutational signature (SBS22) caused by aristolochic acid (AA) exposures, known to be more prevalent in Asia, highlighting a geologically specific disease etiology. We further discovered that cell cycle-related pathways were the most predominantly dysregulated pathways. Our drug screening with our newly established CDC preclinical models identified a CDK9 inhibitor LDC000067 that specifically inhibited CDC tumor growth and prolonged survival. Our study not only improved our understanding of oncogenic molecular alterations of Asian CDC, but also identified cell-cycle machinery as a therapeutic vulnerability, laying the foundation for clinical trials to treat patients with such aggressive cancer., (© 2024. The Author(s).)

A feared possible self refers to the unwanted characteristics that a person may possess or develop. We tested an experimental paradigm to target fear of possible self using imagery rescripting. A student sample ( n = 91), with moderate obsessive-compulsive disorder symptoms, engaged in written and audio-guided exercises to evoke episodic future mental imagery that represented their feared possible self. Participants were then randomized between imagery rescripting or neutral imagery control tasks. The results revealed no difference between conditions in fear of self or general obsessional beliefs following the manipulation. State anxiety and the urge to neutralize the imagery reduced more in the control condition than in the rescripting condition. These findings suggest that the current paradigm is emotionally engaging but not effective at addressing fear of self as measured. Methodological improvements such as removing a written component of the rescripting task and idiosyncratic measuring of fear of self are proposed., (© Copyright 2024 Springer Publishing Company, LLC.)

Background: During a prolonged quarantine, there is a need to monitor aerobic fitness levels of trained individuals who are isolated with a simple fitness test that can be performed in confined space of their own homes. This study examined the reliability, validity, usefulness and sensitivity of a novel 3-min submaximal heart rate burpees test (or SubHR3-MBT) to assess and monitor changes in aerobic fitness, of trained athletes. In the SubHR3-MBT, male and female athletes performed 48 and 39 burpees respectively, within 3 min by following a constant beeping pace. The performance criterion of the SubHR3-MBT is the highest heart rate attained (or exercise HRpeak) at the end of 3-min (wherein a lower exercise HRpeak indicates a higher level of aerobic fitness)., Methods: A total of 40 male and female national athletes from various sports volunteered for the study., Results: For reliability (Part 1), the SubHR3-MBT showed good relative and excellent reliability, with intraclass correlation coefficient 0.90 and coefficient of variation 2.6%, respectively. For validity (Part II), there was significant negative correlation between relative exercise HRpeak with respiratory gas-measured VO2max (r=-0.51, large; P<0.001). The test's technical error of measurement of 2.3 is slightly greater than its smallest worthwhile change of 1.5. For sensitivity (Part III), the athletes were tested twice for their SubHR3-MBT and VO2max, once at baseline and another at a followed-up test after >10 weeks. There was a significant correlation between the % change in relative exercise HRpeak with the % change in VO2max (r=-0.66, large; P<0.001)., Conclusions: The SubHR3-MBT is a reliable, valid, marginally useful test and may be able to track changes in aerobic fitness in trained athletes with moderate levels of sensitivity, in case of future isolation due to pandemic occurrence.

Background: Coronary guidewire entrapment is not an uncommon complication of percutaneous coronary intervention, especially in the setting of complex coronary anatomy. Core wire fracture with uncoiling of spring wire represents a catastrophic complication, posing great technical difficulty in percutaneous retrieval., Case Summary: The patient was a 50-year-old Asian male with ischaemic cardiomyopathy and severe left ventricular impairment. Coronary angiography showed severe left main and triple-vessel disease. Coronary artery bypass graft was declined due to high surgical risk. Percutaneous coronary intervention was performed under mechanical circulatory support. However, it was complicated with guidewire entrapment and unravelling with deformity of the newly implanted stent in the left anterior descending artery. The complication was successfully bailed out by rotational atherectomy and the novel intravascular ultrasound (IVUS) and enhanced stent visualization (ESV) system guided 'Twist-wire' technique. Complete wire fragments retrieval was achieved with excellent final angiographic and IVUS results immediately after procedure and at 4-month follow-up angiography., Discussion: This case represents a rare phenomenon of branch point protrusion of stent causing guidewire-stent edge entanglement. A novel 'Twist-wire' technique with IVUS and ESV guidance was highlighted to allow successful retrieval of fluoroscopically invisible uncoiled wire filaments., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

A 75-year-old man was admitted for non-ST-segment elevation myocardial infarction (NSTEMI).

A 71-year-old man who had undergone percutaneous transluminal coronary angioplasty (PTCA) in 2013 was admitted for unstable angina.

Pteropine orthoreovirus (PRV) causes respiratory tract infections in humans. Despite its emergence as a zoonotic and respiratory virus, little is known about its cell tropism, which hampers progress in fully understanding its pathogenesis in humans. Hek293 cells are most susceptible to PRV infection, while HeLa cells are the least. Human cytokeratin 1 (CK1) was identified as the protein that interacts with PRV. The immunofluorescence assay and qPCR results revealed prior treatment with anti-CK1 may provide Hek293 cells protection against PRV. The KRT1-knockout Hek293 cells were less susceptible to PRV infection. Further study into the pathogenesis of PRV in humans is needed., Competing Interests: Declaration of competing interest The authors declare no competing interests exist., (Copyright © 2023 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

A 65-year-old man was admitted with non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography showed a left dominant system with severe and diffuse left anterior descending artery (LAD) disease, necessitating percutaneous coronary intervention (PCI).

Objectives: There is a significant relationship between a general feared self and contact contamination concerns in obsessive-compulsive disorder (OCD), especially when the influence of mental contamination is considered a part of this relationship. However, these associations have not been explored in a clinical OCD sample when using each dimension of the multidimensional conceptualization of the feared self as the predictor (i.e., the corrupted, culpable, and malformed feared selves)., Methods: We tested these associations using a cross-sectional design. Specifically, a sample of patients diagnosed with OCD (N = 417) completed a series of self-report measures of OCD symptoms and its related constructs. We also explored these associations with unacceptable thoughts as the outcome, rather than contamination concerns, due to unacceptable thoughts having evidenced strong associations with the feared self and mental contamination., Results: After controlling for relevant cognitive (i.e., obsessive beliefs) and affective (i.e., depressive symptoms) constructs and comorbidity, the corrupted feared self was found to have a direct link, along with an indirect link through mental contamination, with symptoms of contact contamination and unacceptable thoughts., Conclusions: The fear of being corrupted may be associated with feelings of contamination in the absence of direct contact with a contaminant, which may then predict OCD symptoms of repugnant obsessional thoughts and contact contamination concerns. The corrupted feared self and mental contamination should therefore be targeted in treatments for repugnant obsessions and contamination-related OCD., (© 2023 British Psychological Society.)

Proper end-of-life (EOL) management of mixed plastic waste remains a global challenge in both developed and developing countries as disposed plastic circulating within the ecosystem continues to increase at unprecedented rates. Presently, plastic EOL pathways are largely designed based on prevailing geographical conditions and environmental regulations across different regions. Till date, no work has been reported on the environmental and socioeconomic assessment on EOL pathway focusing on mechanical recycling of mixed plastic waste into raw ingredients for construction materials. This paper presents a life cycle assessment to characterize the environmental and socioeconomic impacts of four different plastic EOL pathways using Singapore as a case study. The present study describes how Singapore can redesign its current waste-to-resource taxonomy and reiterates the need to maximize mechanical recycling throughput of mixed plastic waste so to alleviate the reliance on thermal energies for waste valorisation and improve the overall performance of current plastic EOL pathway., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background and Objectives: Individuals with hoarding disorder, especially those with problems around acquiring, typically demonstrate a lack of motivation and awareness of their problematic behaviours. Since acquiring behaviours are important targets in interventions for hoarding, effective strategies for increasing motivation in this population are required to enhance the acceptability and efficacy of these interventions., Methods: The aim of the current study was to evaluate the ability of a brief online motivational intervention to reduce acquiring in a community sample of high acquirers (N = 159). Participants were randomly assigned to either a motivational interviewing protocol (n = 73) or progressive muscle relaxation control condition (n = 86). Readiness to change and motivation to acquire was measured via self-report, and acquiring behaviour was measured using a modified version of the Preston Acquisition Decision Making Task (to increase ecological validity)., Results: In both conditions, participants' readiness and motivation to change increased over time. Contrary to hypotheses, the magnitude of this improvement did not significantly differ between conditions. Furthermore, conditions did not perform differently on the behavioural measure of acquiring., Limitations: Insufficient dose of the intervention may have precluded any differences being observed between conditions., Conclusions: Results underscore the need to better address the problem of lowered motivation in this population., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Previous research has shown that vulnerable self-themes and feared self-perceptions may play an important role in the development and maintenance of obsessive-compulsive disorder (OCD). In particular, the recently validated Multidimensional Version of the Fear-of-Self Questionnaire (FSQ-MV) has shown strong relationships with OCD symptoms independent of cognitive constructs and negative mood in non-clinical samples. The current study aimed to further evaluate the validity and reliability of a Persian version of the FSQ-MV in OCD patients (N = 300), as well as non-clinical individuals (N = 300). Participants completed a set of scales evaluating feared self-perceptions and OCD-related symptoms/conditions. The results showed that the Persian version of the FSQ-MV replicated the three-factor structure of the original scale in non-clinical and OCD patients. The FSQ-MV and its subscales had excellent reliability. Additionally, the FSQ-MV was significantly associated with related cognitive constructs, as well as OCD symptoms and their severity, in both samples. The feared self, especially the corrupted feared self, was a significant unique predictor of OC symptomology, especially for repugnant obsessions, and OCD severity. The study confirmed the validity and reliability of the Persian version of the FSQ-MV. Moreover, cognitive conceptualizations may benefit from a consideration of the feared self in OCD, which may play an important role in its development, maintenance and severity., (© 2023 John Wiley & Sons Ltd.)

Introduction: Falls are an important public health issue with consequences that include injuries, quality of life reduction and high healthcare costs. Studies show that falls prevention strategies are effective in reducing falls rate among community-dwelling older adults. However, the evaluation for effectiveness was usually done in a controlled setting with homogeneous population, and thus may not be generalisable to a wider population. This study aims to evaluate the impact of community falls prevention programmes with group-based strength and balance exercises, on falls risk and health outcomes for older adults with falls risk in Singapore., Methods and Analysis: This is a pragmatic closed cohort stepped-wedge cluster randomised trial design study, which involves sequential crossover of clusters from the waitlist control condition to the intervention condition, with the sequence of crossover randomly determined. The intervention will be sequentially rolled out to 12 clusters (a minimum of 5 participants/cluster), over 6 time periods with 8-week intervals in Central and North regions of Singapore. The primary analysis will be conducted under the intention-to-treat principle. A general linear mixed model or generalised estimating equation analysis appropriate for a multilevel longitudinal study incorporating an appropriate error distribution and link function will be used. Markov model will be developed to estimate the incremental cost per quality-adjusted life years and incremental cost per fall prevented from the implementation of falls prevention strategies from a societal perspective. Conditional on there being clinically relevant differences in short-term outcomes, we will implement simulation modelling to project the long-term divergence in trajectories for outcomes and costs using the Markov model., Ethics and Dissemination: Ethics approval has been obtained. Results will be disseminated in publications and other relevant platforms., Trial Registration Number: NCT04788251., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The relationship between muscle activation during motor tasks and cerebral cortical activity remains poorly understood. The aim of this study was to investigate the correlation between brain network connectivity and the non-linear characteristics of muscle activation changes during different levels of isometric contractions. Methods: Twenty-one healthy subjects were recruited and were asked to perform isometric elbow contractions in both dominant and non-dominant sides. Blood oxygen concentrations in brain from functional Near-infrared Spectroscopy (fNIRS) and surface electromyography (sEMG) signals in the biceps brachii (BIC) and triceps brachii (TRI) muscles were recorded simultaneously and compared during 80% and 20% of maximum voluntary contraction (MVC). Functional connectivity, effective connectivity, and graph theory indicators were used to measure information interaction in brain activity during motor tasks. The non-linear characteristics of sEMG signals, fuzzy approximate entropy (fApEn), were used to evaluate the signal complexity changes in motor tasks. Pearson correlation analysis was used to examine the correlation between brain network characteristic values and sEMG parameters under different task conditions. Results: The effective connectivity between brain regions in motor tasks in dominant side was significantly higher than that in non-dominant side under different contractions ( p < 0.05). The results of graph theory analysis showed that the clustering coefficient and node-local efficiency of the contralateral motor cortex were significantly varied under different contractions ( p < 0.01). fApEn and co-contraction index (CCI) of sEMG under 80% MVC condition were significantly higher than that under 20% MVC condition ( p < 0.05). There was a significant positive correlation between the fApEn and the blood oxygen value in the contralateral brain regions in both dominant or non-dominant sides ( p < 0.001). The node-local efficiency of the contralateral motor cortex in the dominant side was positively correlated with the fApEn of the EMG signals ( p < 0.05). Conclusion: In this study, the mapping relationship between brain network related indicators and non-linear characteristic of sEMG in different motor tasks was verified. These findings provide evidence for further exploration of the interaction between the brain activity and the execution of motor tasks, and the parameters might be useful in evaluation of rehabilitation intervention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Luo, Zhang, Zhao, Xie, Wong, Hu and Li.)

Background: Uterine compression suture is an important conservative surgical technique in managing atonic postpartum hemorrhage. In this study, we aim to evaluate the subsequent menstrual, fertility and psychological outcomes after uterine compression sutures., Methods: This was a prospective cohort study between 2009 and 2022 conducted in a tertiary obstetric unit (6000 deliveries per year) in Hong Kong SAR. Women with primary postpartum hemorrhage successfully treated with uterine compression sutures were followed-up in postnatal clinic for two years after delivery. Data on menstrual pattern were collected during each visit. Psychological impact after uterine compression suture was assessed using a standardized questionnaire. Subsequent pregnancies were identified by territory-wide computer registry and telephone interviews. Women with postpartum hemorrhage treated with uterotonic agents only were chosen as controls., Results: In our cohort (n = 80), 87.9% of women had return of menses within six months after delivery. Regular monthly cycle was observed in 95.6% of women. Majority of women reported similar menstrual flow (75%), menstrual days (85.3%) and no change in dysmenorrhea status (88.2%) as compared before. Among eight (11.8%) women who reported hypomenorrhea after uterine compression sutures, two cases of Asherman's syndrome were diagnosed. Among 23 subsequent pregnancies (16 livebirths), no significant differences in outcome were observed except more omental or bowel adhesions (37.5% vs. 8.8%, p = 0.007), recurrence of hemorrhage (68.8% vs. 7.5%, p < 0.001) and repeated compression sutures (12.5% vs. 0%, p = 0.024) were seen in women with previous compression sutures. Over half of the couple declined future fertility after uterine compression sutures with 38.2% of women recalled unpleasant memories and 22.1% reported life-long adverse impact especially tokophobia., Conclusion: Majority of women with history of uterine compression sutures had similar menstruation and pregnancy outcomes as compared to those who did not have sutures. However, they had higher intrapartum risk of visceral adhesions, recurrence of hemorrhage and repeated compression sutures next pregnancy. Furthermore, couple could be more susceptible to negative emotional impact., (© 2023. The Author(s).)

Introduction: We examined information and communications technology (ICT) use in family services and its perceived benefits and barriers amid the COVID-19 pandemic in Hong Kong., Methods: We invited all family service social workers of 12 NGOs to complete an anonymous online questionnaire in May 2020 (Part A) and a management representative from each NGO to provide written feedback on ICT use in January 2021 (Part B)., Results: In Part A, of 255 respondents (response rate: 67.3%), perceived ICT use in conducting programmes, groups, casework and preventive family programmes showed net increases of 33.9-54.5%; perceived ICT use in different work processes showed net increases of 18.8-48.6%. The three most common perceived benefits were "providing another option to service users" (74.2%), "more convenient service" (60.2%) and "maintaining normal service" (59.7%). In Part B, 12 management representatives consistently reported positive impacts of ICT use on family services. They shared actionable strategies (e.g., ICT skill-related training) and concerns about data privacy and management., Conclusions: ICT use in family services markedly increased amid the COVID-19 pandemic in Hong Kong. It helped make the services more accessible especially when the pandemic restricted face-to-face services.

The influence of pharmacotherapy regimens on surgical patient outcomes is increasingly appreciated in the era of enhanced recovery protocols and institutional focus on reducing postoperative complications. Specifics related to medication selection, dosing, frequency of administration, and duration of therapy are evolving to optimize pharmacotherapeutic regimens for many enhanced recovery protocolized elements. This review provides a summary of recent pharmacotherapeutic strategies, including those configured within electronic health record (EHR) applications and functionalities, that are associated with the minimization of the frequency and severity of postoperative complications (POCs), shortened hospital length of stay (LOS), reduced readmission rates, and cost or revenue impacts. Further, it will highlight preventive pharmacotherapy regimens that are correlated with improved patient preparation, especially those related to surgical site infection (SSI), venous thromboembolism (VTE), nausea and vomiting (PONV), postoperative ileus (POI), and emergence delirium (PoD) as well as less commonly encountered POCs such as acute kidney injury (AKI) and atrial fibrillation (AF). The importance of interprofessional collaboration in all periprocedural phases, focusing on medication management through shared responsibilities for drug therapy outcomes, will be emphasized. Finally, examples of collaborative care through shared mental models of drug stewardship and non-medical practice agreements to improve operative throughput, reduce operative stress, and increase patient satisfaction are illustrated.

The COVID-19 pandemic has necessitated the use of video-teleconferencing (VTC) for psychological treatments but VTC effectiveness studies are sparse. We examined treatment outcomes for a modified Buried in Treasures (BIT) group program for hoarding disorder (HD) delivered via VTC. Participants were 10 individuals with HD. Hoarding severity was evaluated at pre, mid, post, and six-month follow-up. Results showed significant decrease in hoarding symptoms over time (with an average decrease of 32%). The dropout rate was low (9%) and 30% of participants were fully recovered at follow-up. These results support the adaptation of in-person BIT for HD into a VTC format., (Copyright © 2022. Published by Elsevier B.V.)

Dengue is a vector-borne disease affected by meteorological factors and is commonly recorded from ground stations. Data from ground station have limited spatial representation and accuracy, which can be overcome using satellite-based Earth Observation (EO) recordings instead. EO-based meteorological recordings can help to provide a better understanding of the correlations between meteorological variables and dengue cases. This paper aimed to first validate the satellite-based (EO) data of temperature, wind speed, and rainfall using ground station data. Subsequently, we aimed to determine if the spatially matched EO data correlated with dengue fever cases from 2011 to 2019 in Malaysia. EO data were spatially matched with the data from four ground stations located at states and districts in the central (Selangor, Petaling) and east coast (Kelantan, Kota Baharu) geographical regions of Peninsular Malaysia. Spearman's rank-order correlation coefficient (ρ) was performed to examine the correlation between EO and ground station data. A cross-correlation analysis with an eight-week lag period was performed to examine the magnitude of correlation between EO data and dengue case across the three time periods (2011-2019, 2015-2019, 2011-2014). The highest correlation between the ground-based stations and corresponding EO data were reported for temperature (mean ρ = 0.779), followed by rainfall (mean ρ = 0.687) and wind speed (mean ρ = 0.639). Overall, positive correlations were observed between weekly dengue cases and rainfall for Selangor and Petaling across all time periods with significant correlations being observed for the period from 2011 to 2019 and 2015 to 2019. In addition, positive significant correlations were also observed between weekly dengue cases and temperature for Kelantan and Kota Baharu across all time periods, while negative significant correlations between weekly dengue cases and temperature were observed in Selangor and Petaling across all time periods. Overall negative correlations were observed between weekly dengue cases and wind speed in all areas from 2011 to 2019 and 2015 to 2019, with significant correlations being observed for the period from 2015 to 2019. EO-derived meteorological variables explained 48.2% of the variation in dengue cases in Selangor. Moderate to strong correlations were observed between meteorological variables recorded from EO data derived from satellites and ground stations, thereby justifying the use of EO data as a viable alternative to ground stations for recording meteorological variables. Both rainfall and temperature were found to be positively correlated with weekly dengue cases; however, wind speed was negatively correlated with dengue cases.

Due to a prolonged period of quarantine during the COVID-19 pandemic, it is essential to monitor the physical condition of athletes isolated at home with a fitness tool that measures various aspects of physical fitness, which does not require any special equipment, and can be performed within a small space. This study assessed the reliability and validity of the test of performing the maximal number of burpees in 3 min (or 3-MBT) to monitor strength, power, and aerobic endurance in trained athletes. For Part I (reliability of the 3-MBT), 20 (10 male, 10 female) national athletes from various sports performed the 3-MBT on two separate test sessions. Athletes performed as many burpees as possible within 3 min and the primary performance criteria was the number of burpees completed (where a higher number reflected a better performance). The 3-MBT displayed excellent relative reliability in the athletes, with an intraclass correlation coefficient (ICC) and coefficient of variation (CV %) of >0.92, and <3.0%, respectively. For Part II (validity of the 3-MBT), 40 (20 M, 20 F) athletes performed the 3-MBT, and the countermovement jump (CMJ), isometric mid-thigh pull (IMTP), seated medicine ball throw (SMBT), isometric bench (IBP) and maximal aerobic power (VO2max) tests on separate sessions. When data of male and female athletes were pooled, there were significant correlations between relative 3-MBT and relative CMJ height (r = 0.65, large; p < 0.001), relative IMPT peak force (r = 0.50, large; p < 0.001), relative IBP peak force (r = 0.36, moderate, p = 0.02), and relative VO2max (r = 0.50, large; p < 0.001). In conclusion, the 3-MBT is a reliable and reasonably useful test and is a valid assessment of lower body power and strength, upper body strength and aerobic fitness in trained male and female athletes.

There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the 'Unhealthy' cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the 'Healthy' cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the 'Unhealthy' cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49-3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the 'Unhealthy' cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68-6·06), respectively), relative to Chinese ethnicity. In conclusion, this study identified two dietary patterns in children, labelled as the 'Unhealthy' and 'Healthy' clusters. Mothers' educational attainment and ethnicity were two correlates that were associated with the children's assignments to the clusters. These findings can assist in informing health promotion programmes targeted at Asian children.