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Hostility is associated with greater risk for cardiac disease, cardiac events and dysrhythmias. Investigators have reported equivocal findings regarding the association of hostility with acute coronary syndrome (ACS) recurrence and mortality. Given mixed results on the relationship between hostility and cardiovascular outcomes, further research is critical.

The aim of our study was to determine whether hostility was a predictor of ACS recurrence and mortality.

We performed a secondary analysis of data (

= 2321) from a large randomized clinical trial of an intervention designed to reduce pre-hospital delay among patients who were experiencing ACS. Hostility was measured at baseline with the Multiple Adjective Affect Checklist (MAACL) and patients were followed for 24 months for evaluation of ACS recurrence and all-cause mortality. We used Cox proportional hazards modeling to determine whether hostility was predictive of time to ACS recurrence or all-cause mortality.

The majority of patients were married (73%), Caucasian (97%), men (68%), and had a mean age of 67 ± 11 years. Fifty-seven percent of participants scored as hostile based on the established MAACL cut point (mean score = 7.56 ± 3.8). Hostility was an independent predictor of all-cause mortality (

= < 0.039), but was not a predictor of ACS recurrence (

= 0.792).

Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality.

Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality.

Acetabular components utilising novel ultraporous metal matrices have been recently introduced into clinical practice with improved interference fit, decreased stress shielding, and hope for more reliable osseointegration. 1 such example is the Dynasty Biofoam cup, which has been in clinical use for over a decade but has few reports documenting its clinical and radiographic performance.

A single-centre retrospective study was performed evaluating 96 Dynasty Biofoam acetabular components implanted between March 2010 and August 2014 with minimum 2-year radiographic follow-up. Patients that received components for revision surgery or that had early complications postoperatively (femur fracture, prosthetic infection) were excluded. Biofoam patients were compared to 96 patients that received the Trident PSL acetabular component and were matched for age, gender, and BMI. Reparixin reported outcomes, component position and radiographic features of cup loosening, including radiolucent lines and sclerosis were compared among groups.

Patient-reported outcomes at 2 years were similar among groups. Cup anteversion was similar but inclination was significantly greater in the Biofoam group (

 = 0.006). A significantly greater number of Biofoam components exhibited 2-zone (27.2%) and 3-zone (12.0%) radiolucencies compared to 0% of the Trident shells (

 < 0.05). 2 Biofoam cups were revised for aseptic loosening compared to no Trident cups (

 = 0.49).

Despite adequate implant survivorship, over a quarter of Biofoam cups had 2 or more radiolucent zones in early follow-up. Longer follow-up is needed to determine if the aseptic revision rate for this cup will increase.

Despite adequate implant survivorship, over a quarter of Biofoam cups had 2 or more radiolucent zones in early follow-up. Longer follow-up is needed to determine if the aseptic revision rate for this cup will increase.People enjoy well-being benefits if their personal characteristics match those of their culture. This person-culture match effect is integral to many psychological theories and-as a driver of migration-carries much societal relevance. But do people differ in the degree to which person-culture match confers well-being benefits? In the first-ever empirical test of that question, we examined whether the person-culture match effect is moderated by basic personality traits-the Big Two and Big Five. We relied on self-reports from 2,672,820 people across 102 countries and informant reports from 850,877 people across 61 countries. Communion, agreeableness, and neuroticism exacerbated the person-culture match effect, whereas agency, openness, extraversion, and conscientiousness diminished it. People who possessed low levels of communion coupled with high levels of agency evidenced no well-being benefits from person-culture match, and people who possessed low levels of agreeableness and neuroticism coupled with high levels of openness, extraversion, and conscientiousness even evidenced well-being costs. Those results have implications for theories building on the person-culture match effect, illuminate the mechanisms driving that effect, and help explain failures to replicate it.

Current pharmacologic therapies for patients with osteoarthritis are suboptimal.

To determine the efficacy of

extract (CL) for reducing knee symptoms and effusion-synovitis in patients with symptomatic knee osteoarthritis and knee effusion-synovitis.

Randomized, double-blind, placebo-controlled trial. #link# (Australian New Zealand Clinical Trials Registry ACTRN12618000080224).

Single-center study with patients from southern Tasmania, Australia.

70 participants with symptomatic knee osteoarthritis and ultrasonography-defined effusion-synovitis.

2 capsules of CL (

= 36) or matched placebo (

= 34) per day for 12 weeks.

The 2 primary outcomes were changes in knee pain on a visual analogue scale (VAS) and effusion-synovitis volume on magnetic resonance imaging (MRI). The key secondary outcomes were change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and cartilage composition values. Outcomes were assessed over 12 weeks.

CL improved VAS pain compared with placebo by -9.1 mm (95% CI, -17.8 to -0.4 mm [

= 0.039]) but did not change effusion-synovitis volume (3.2 mL [CI, -0.3 to 6.8 mL]). CL also improved WOMAC knee pain (-47.2 mm [CI, -81.2 to -13.2 mm];

= 0.006) but not lateral femoral cartilage T2 relaxation time (-0.4 ms [CI, -1.1 to 0.3 ms]). The incidence of adverse events was similar in the CL (

= 14 [39%]) and placebo (

= 18 [53%]) groups (

= 0.16); 2 events in the CL group and 5 in the placebo group may have been treatment related.

Modest sample size and short duration.

CL was more effective than placebo for knee pain but did not affect knee effusion-synovitis or cartilage composition. Multicenter trials with larger sample sizes are needed to assess the clinical significance of these findings.

University of Tasmania and Natural Remedies Private Limited.

University of Tasmania and Natural Remedies Private Limited.The prescription drug market in the United States relies on competition to keep prices reasonable. Although many policies have been implemented to spur competition and decrease costs for patients, these policies may be outdated and should be redesigned and updated to achieve success in the current prescription drug market. In this paper, the American College of Physicians (ACP) proposes that new policies should be implemented to prevent market manipulation, help lower-cost alternatives make it to the market faster, and ensure a robust and competitive market for generic and biosimilar drugs. link2 The ACP believes these changes will have a meaningful effect on patients without shifting costs to other areas of the health care system.Promoting health-related campaigns on Twitter has increasingly become a world-wide choice to raise awareness and disseminate health information. Data retrieved from Twitter are now being used to explore how users express their views, attitudes and personal experiences of health-related issues. We focused on Twitter discourse reproduced during Mental Health Awareness Week 2017 by examining 1,200 tweets containing the keywords 'mental health', 'mental illness', 'mental disorders' and '#MHAW'. link3 The analysis revealed 'awareness and advocacy', 'stigmatization', and 'personal experience of mental health/illness' as the central discourses within the sample. The article concludes with some recommendations for future research on digitally-mediated health communication.

The coronavirus disease 2019 (COVID-19) pandemic dramatically altered the delivery of surgical care.

Members of the Southeastern Surgical Congress were surveyed regarding system adjustments, personal impact, and productivity losses. Subgroups were analyzed for disproportionate impact across practice models (academic/employed/private), practice communities (urban, suburban, rural), and practice case-mix categories (broad general surgery, narrow general surgery, specialty practice, hospital-based practice).

135 respondents reported that 98.5% of surgeons and 97% of hospitals canceled elective cases. Practices and hospitals reduced staffing dramatically. Telemedicine was utilized by most respondents. Hospitals variably implemented system changes, developed tests, and set up diagnostic centers. Most surgeons anticipated resumption of practice and hospital activity by July 1, 2020. More than one-quarter reported worsened financial status and personal well-being. Interestingly, family/personal relationships w affected surgeons throughout the southeastern United States. Variations between different practice models, communities, and case-mix categories may help inform surgeons in the future.Opioid use disorder is a growing public health concern in South Texas. To assist in mitigating the effects of this epidemic, staff produced a program that focused on replicating, modifying, and evaluating the impact of the "Opioid Addiction Treatment ECHO™ (Extension of Community Health Outcomes) for CHWs (community health workers) program" on 26 CHWs practicing in rural and other medically underserved areas through teleconferencing technology. CHWs trained on the topic of substance use disorder concentrated on behavioral health integration with a focus on opioid prescription misuse. The analysis found that knowledge attainment was increased above the pretest means. The ECHO™ model proved to be effective at linking subject matter experts and specialists at an academic "hub" with CHWs in local communities.Tuberculosis claims more human lives than any other bacterial infectious disease and represents a clear and present danger to global health as new tools for vaccination, treatment, and interruption of transmission have been slow to emerge. Additionally, tuberculosis presents with notable clinical heterogeneity, which complicates diagnosis, treatment, and the establishment of nonrelapsing cure. How this heterogeneity is driven by the diversity ofclinical isolates of the causative agent, Mycobacterium tuberculosis, has recently garnered attention. Herein, we review advances in the understanding of how naturally occurring variation in clinical isolates affects transmissibility, pathogenesis, immune modulation, and drug resistance. We also summarize how specific changes in transcriptional responses can modulate infection or disease outcome, together with strain-specific effects on gene essentiality. Further understanding of how this diversity of M. tuberculosis isolates affects disease and treatment outcomes will enable the development of more effective therapeutic options and vaccines for this dreaded disease.