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This study demonstrates consistent cross-site positive regard in the skill and competency of the APP in paediatric orthopaedics, to enhance orthopaedic services for children.

This paper highlights many of the factors that should be considered when introducing an APP service in an outpatient setting. This study demonstrates consistent cross-site positive regard in the skill and competency of the APP in paediatric orthopaedics, to enhance orthopaedic services for children.Kontinuierliche medizinische Fortbildung (Continuing Medical Education, CME) ist die wesentliche Grundlage der studentischen Lehre sowie der Aus- und Weiterbildung von Ärzten. Eine moderne und adäquate Patientenversorgung ist ohne sie nicht denkbar. Vor kurzem zwang die durch das schwere akute respiratorische Syndrom-Coronavirus 2 (SARS-CoV-2) verursachte Pandemie die gesamte medizinische Gemeinschaft, ihre Gewohnheiten bezüglich der medizinischen Fortbildung und Lehre sowie des Lernens in der Medizin zu ändern. Infolgedessen rückten über soziale Medien (Social Media) verbreitete digitale Aus-, Fortbildungs- und Lehrformate, medizinische Online-Enzyklopädien, webbasierte medizinische Lernportale und medizinische Podcasts in den Vordergrund. In diesem Beitrag geben wir einen Überblick zu aktuelle Konzepten in der medizinischen Online-Fortbildung, unter besonderer Berücksichtigung der Dermatologie.Bcl-2 and Mcl-1, the two arms of the anti-apoptotic Bcl-2 family proteins, have been identified as key regulators of apoptosis and effective therapeutic targets of cancer. However, no small-molecular probe is capable of profiling and visualizing both Bcl-2 and Mcl-1 simultaneously in situ. Herein, we report a multifunctional molecular probe (BnN3 -OPD-Alk) by a "three-in-one" molecular designing strategy, which integrated the Bcl-2/Mcl-1 binding ligand, fluorescent reporter group and photoreactive group azido into the same scaffold. #link# BnN3 -OPD-Alk exhibited sub-micromolar affinities to Bcl-2/Mcl-1 and bright green self-fluorescence. It was then successfully applied for Bcl-2/Mcl-1 labeling, capturing, enriching, and bioimaging both in vitro and in cells. This strategy could facilitate the precise early diagnosis and effective therapy of dual Bcl-2/Mcl-1-related diseases.By examining the global public good nature of pandemic preparedness we can identify key social justice issues that need to be confronted to increase citizens' voluntary compliance with prevention and mitigation measures. As people tend to cooperate on a voluntary basis only with systems they consider fair, it becomes difficult to ensure compliance with public health measures in a context of extreme inequality. Among the major inequalities that need to be addressed we can find major differences in the extensiveness and intensiveness of quarantine experiences, lack of opportunities to participate in common efforts, hardship in complying with disease control recommendations, and an unfair distribution of the cooperative surplus.We systematically reviewed outcome assessment methods, outcome classification, and severity grading of reported outcomes in studies investigating the burden of physical long-term morbidity in childhood cancer survivors (CCS). A MEDLINE and EMBASE search identified 56 studies reporting on three or more types of health conditions in 5-year CCS, for which information was extracted on outcome types and classification, methods of outcome ascertainment, and severity grading. There was substantial variability in classification and types of health conditions reported and in methods of outcome ascertainment. Only 59% of the included studies applied severity grading, mainly the common terminology criteria of adverse events. This large variation in assessment and definition of the burden of physical long-term morbidity in CCS challenges interpretation, comparison, and pooling data across studies. Global collaboration is needed to standardize assessments and harmonize definitions of long-term physical morbidity and associated outcomes in childhood cancer survivorship research.

Influenza has been well studied in developed countries with temperate climates, in contrast to low- and middle-income (LMIC) countries, thus hampering the effort to attain representative global data. Furthermore, data on non-influenza respiratory infections are also limited. Insight in viral respiratory infections in Suriname, a tropical LMIC in South America, would contribute to improved local preventive measures and a better global understanding of respiratory viruses.

From May 2016 through April 2018, all patients (n=1096) enrolled in the national severe acute respiratory infection and influenza-like illness surveillance were screened for the presence of 10 respiratory viruses with singleplex RT-PCR.

The overall viral-positive detection rate was 45.3%, specified as RSV (19.4%), influenza (15.5%), hMPV (4.9%), AdV (4.6%), and parainfluenza (3.8%). Co-infections were detected in 6.2% of the positive cases. link2 Lower overall positivity was observed in the SARI vs ILI surveillance and influenza prevalence waes to continue ongoing surveillance and accumulate local data.

It is long established that von Willebrand factor (VWF) is central to hemostasis and thrombosis. Endothelial VWF is stored in cell-specific secretory granules, Weibel-Palade bodies (WPBs), organelles generated in a wide range of lengths (0.5-5.0 µm). WPB size responds to physiological cues and pharmacological treatment, and VWF secretion from shortened WPBs dramatically reduces platelet and plasma VWF adhesion to an endothelial surface.

We hypothesized that WPB-shortening represented a novel target for antithrombotic therapy. Our objective was to determine whether compounds exhibiting this activity do exist.

Using a microscopy approach coupled to automated image analysis, we measured the size of WPB bodies in primary human endothelial cells treated with licensed compounds for 24 hours.

A novel approach to identification of antithrombotic compounds generated a significant number of candidates with the ability to shorten WPBs. In vitro assays of two selected compounds confirm that they inhibit the pro-hucing drugs might also provide welcome therapeutic leads for frontline clinicians and researchers.

To elucidate the factors that influence occupational physicians' decision to issue an employer warning.

The interview was conducted with 10 Japan Society for Occupational Health certified occupational physicians (COPs) and certified senior occupational physicians (CSOPs) to create nine fictive scenarios in which an occupational physician may need to consider issuing a warning. Sixteen CSOPs assessed the seriousness of the problem in each of nine scenarios where they may need to consider issuing an employer warning. Next, using a survey questionnaire, 597 COPs and CSOPs were asked to rate how likely they were to issue a warning in each of the nine scenarios, and answer items on their characteristics and number of previously issued warnings. A multilevel logistic regression analysis nested for various scenarios was used to assess the odds ratio (OR) of being likely to issue a warning.

Valid questionnaires were obtained from 117 participants (19.6%). The ORs and 95% confidence intervals (CIs) were as follows mean score of seriousness of the problem, 5.90 (4.50-7.75); years of experience as occupational physician, 1.04 (1.02-1.06); women, 1.75 (1.20-2.54); being a part-time occupational physician without in-house experience, 2.08 (1.31-3.29); and having previously issued two or more times warnings, 1.99 (1.29-3.06), compared with those who had never issued a warning.

Occupational physicians' likelihood to issue a warning was associated with the seriousness of the problem as assessed in various scenarios, years of experience as occupational physician, gender, employment type, experience as in-house occupational physician, and number of past warnings.

Occupational physicians' likelihood to issue a warning was associated with the seriousness of the problem as assessed in various scenarios, years of experience as occupational physician, gender, employment type, experience as in-house occupational physician, and number of past warnings.

Infraorbital dark circles are a common esthetic concern which can be challenging to treat given their multifactorial nature. Under-eye darkcircles are seen in all skin types, with a strong familial component in darker skin types. link3 Other major contributing factors include soft tissue and bony changes, skin changes, lifestyle contributions, and allergies. Involutional periorbital volumetric changes cause volume loss in the tear trough, naso-jugal and palpebro-malar grove, skin and subcutaneous tissues with tethering of the eyelid skin to the tear trough ligament, giving a sunken and hollow appearance to the lower lid. Associated prolapse of the orbital fat and thin skin can worsen the appearance of a dark circle. Hyaluronic acid fillers placed in the pre-periosteal plane in the tear trough, palpebro-malar and naso-jugal grooves, give good results in patients with thick eyelid skin and negligible fat prolapse. However, in patients with thin skin and moderate fat prolapse, authors have reported worsening outcomes with risk of Tyndall (blue-gray discoloration) and contour irregularities from visible lumps.

To describe a novel technique to improve dark circles caused by a diffuse valley-type pre-septal tear trough deformity in patients with thin eyelid skin.

Retrospective case note review of 330 eyelids treated with microdroplet subdermal placement of filler in the preseptal tear trough area by a single surgeon.

This novel technique shows good esthetic outcomes in patients with dark circles, with good longevity and a low risk of complications.

This novel technique shows good esthetic outcomes in patients with dark circles, with good longevity and a low risk of complications.

To investigate associations between changes in vegetable and fruit (V&F) intakes and anthropometric indices (weight, BMI, % body fat, waist circumference), including differences by sex, during a dietary weight-loss intervention.

Adults (18-45 years) with overweight/obesity (BMI 25-35 kg/m

) entered a 10-week pre-post study, receiving individualised consults with an Accredited Practising Dietitian targeting increased V&F intakes. Dietary intake was assessed using 24-hour recalls and food frequency questionnaires. Linear mixed models were used to examine how much of the changes in anthropometric indices were explained by changes in V&F intakes. GSK923295 in vivo were assessed by Wilcoxon rank sum tests.

Of the 43 participants enrolled, 34 completed the study (53% female). Significant differences in energy intake and anthropometric indices were observed between males and females at baseline. After 10 weeks, females significantly reduced their weight (-2.9%, P < .01), BMI (-0.82 kg/m

, P < .01), waist circumference (-1.70 cm, P < .01), energy intake (-824 kJ/day, P = .01) and improved diet quality (-14.0% energy-dense, nutrient-poor foods, P < .01). Males significantly reduced weight (-2.5%, P = .04), BMI (-0.76 kg/m

, P = .03), waist circumference (-2.40 cm, P = .02), energy intake (-2875 kJ/day, P < .01), increased fruit intake (+0.89 serves/day, P = .02) and improved diet quality (-6% energy-dense, nutrient-poor foods, P < .01). Compared to the other sex, greater reductions were observed in energy intake in males and energy-dense, nutrient-poor foods in females. Linear mixed models identified that changes in V&F intakes did not explain the variation in anthropometric measures.

Future interventions may benefit from trialling sex tailored messages to enhance effects on anthropometric changes.

Future interventions may benefit from trialling sex tailored messages to enhance effects on anthropometric changes.

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