Davidbyers2253

ose to exclude participant data from the therapists who did not adhere to CPT protocol resulting in a reduction of statistical power in these studies. The final study included in the review administered multiple treatment modalities concurrently.Purpose Digital storytelling (DST), broadly speaking, is a storytelling method that is interwoven with digital media. It is commonly used in educational settings or human services to support various sorts of social advocacy. While many of these DST practices have devised methods to engage marginalized groups to express their voices, they lack parallel initiatives to enable audiences to understand those voices. This study examined a story-retelling workshop model called StoryAd, which utilizes productions from DST activities to facilitate face-to-face contact. The workshop itself is also a lite version of DST activity. Method A pilot study was conducted in Hong Kong in 2019. Participants enrolled online, met offline, and their advertisement ideas might go online and contribute back to the stories. The workshop model was evaluated using a one-group pretest-posttest design. The participants were 45 Hong Kong Chinese, aged 18-60. Results Participants' critical thinking disposition, self-esteem, perspective-taking, and curiosity toward new information increased, while their need for cognitive-closure decreased. Ceftaroline Discussion and conclusion This study has proved the feasibility and acceptability of the workshop model. It also opens the discussion about extending DST pedagogy to engage and influence story-readers.Objective Evidence suggests that integrase strand transfer inhibitors (INSTIs) are associated with greater weight gain than other antiretrovirals. This real-world study compares weight/body mass index (BMI) change between insured US patients with human immunodeficiency virus (HIV-1) initiating a protease inhibitor (PI) or INSTI.Methods A retrospective longitudinal study was conducted using Decision Resources Group's Real World Data Repository (7/17/2017-6/1/2019). Adult patients with HIV-1 who initiated a new PI or INSTI on or after 7/17/2018 (index date) and had ≥12 months of continuous pre-index clinical activity were included. Baseline characteristics were balanced using inverse probability of treatment weighting. The proportion of patients with ≥5% weight/BMI increases and mean weight/BMI change from pre- to post-index were compared using odds ratios (ORs) and mean differences (MDs).Results 20,367 patients (9993 PI, 10,374 INSTI) were included (mean age = 50 years; ∼30% females). Pre- and post-index weight and BMI measurements were available in 429 and 430 PI patients, and 397 and 383 INSTI patients, respectively (mean time between index and post-index measurements ∼7 months). The PI cohort was 39%/49% less likely to experience ≥5% weight/BMI increase than the INSTI cohort, respectively (OR [≥5% weight gain] = 0.61; p = .014; OR [≥5% BMI gain] = 0.51; p less then .001). Mean weight/BMI gain was significantly lower in the PI cohort than the INSTI cohort (weight MD = -1.90 kg [-4.19 lbs], BMI MD = -0.61kg/m2; both p less then .001).Conclusions Relative to INSTI, patients initiating a new PI were less likely to experience ≥5% weight/BMI gain post-index. Additionally, mean weight/BMI gain was lower in the PI than in the INSTI cohort.Objective As a minimally invasive intervertebral fusion technique popularized in recent years, extreme lateral interbody fusion (XLIF) has various advantages. In this study, we describe the application and efficacy of XLIF for the treatment of thoracic tuberculosis (TB), as this may be an emerging treatment option for thoracic TB in the future. Methods We present the case of a 75-year-old man who had suffered from chest and back pain for 1 month. Imaging studies showed destruction of the T12 and L1 vertebral bodies and the T12-L1 intervertebral disc, accompanied by formation of a paravertebral abscess. After 2 weeks of standard anti-TB treatment, the patient underwent debridement of the lesions, XLIF, and percutaneous pedicle screw fixation. Results The patient's chest and back pain were significantly alleviated after the operation. The patient recovered well, and as of the most recent follow-up had no obvious limitation in thoracolumbar spine function. Conclusions XLIF combined with percutaneous pedicle screw fixation for the treatment of thoracic TB can allow for TB lesion debridement, discectomy, and interbody fusion under direct visualization, and can effectively improve patient prognosis.This section aims to review general principles of endoscopic management of urethral stricture disease and posterior urethral stenosis, with a special focus on the indications for treatment and technical aspects of urethral dilation and internal incision.The diagnosis of urethral stricture disease is often made when a man with obstructive voiding symptoms undergoes flexible cystoscopy (urethroscopy). However, a more complete and definitive diagnosis is then achieved when the urethra is subsequently evaluated with a retrograde urethrogram, and in many cases, a voiding cystourethrogram (VCUG). In situations where there is stricture disease involving the meatus or fossa navicularis that prevents the passage of adult flexible cystoscope, other testing appropriate in these cases include distal urethral calibration using bougie-a-boules and possibly the advancement of a pediatric cystoscope. It is only after the exact location and length and severity of the stricture is assessed that patients can be properly advised of all options before decision-making and the implementation of a treatment plan. This section will review the evaluation of the male urethra.Introduction Ureteral reimplantation is indicated for patients with congenital distal ureteral strictures, for iatrogenic intraoperative distal ureteral injuries, and for those who require distal ureterectomy for transitional cell carcinoma. Methods Using the da Vinci system from Intuitive, we demonstrate distal ureterectomy with reimplantation. Both a refluxing extravesical reimplant and nonrefluxing extravesical reimplant are shown. We also demonstrate modifications, including psoas hitch and Boari flap. Results Robotic ureteral reimplantation with psoas hitch and Boari flap are demonstrated in a reproducible manner. Additional topics covered include the delineation of diseased ureter vs healthy ureter, the applications of indocyanine green, and the use of interoperative ureteral stents. Conclusions Robotic ureteral reimplantation is safe and feasible when performed with proper technique. Ureteroscopy and near-infrared fluorescence technology facilitate improved detection of diseased ureteral segments. Key points include the maintenance of principles of open surgery such as a tension-free, watertight, and stented anastomosis.This article aims to demonstrate a step-by-step technique of semirigid ureteroscopy (URS) for the treatment of ureteral stones, urothelial tumors, and ureteral stenosis. Operating room setup, camera settings, access to the bladder, and negotiation of the ureteral orifice, lasertripsy, basketing of the stone fragments, endoscopic treatment of ureteral tumors and ureteral stenosis, flexible URS at the end of semirigid URS, and Double-J stent placement are described step by step.Renal cell carcinoma has historically been managed by radical nephrectomy, but as knowledge of the disease has advanced, nephron sparing surgery has become the norm in appropriately selected tumors. Laparoscopic partial nephrectomy (LPN) has been shown to have comparable oncologic outcomes and a shorter convalescence period compared to the traditional open partial nephrectomy. Dissemination of techniques has led to significantly increased use of minimally invasive nephron sparing surgery, and LPN remains a cost-effective and efficacious method for approaching small renal masses.The turnover rate of producer biomass in aquatic ecosystems is generally faster than in terrestrial. That is, aquatic producer biomass grows, is consumed, and is replaced considerably faster than terrestrial. The WKL model describes the flow of phosphorus and carbon through a grazer-producer system, hence varying the model parameters allows for analysis of different ecosystems of this type. Here we explore the impacts of the intrinsic growth rate of the producer and the maximal ingestion rate of the grazer on these dynamics because these parameters determine turnover rate. Simulations show that for low intrinsic growth rate and maximal ingestion rate, the grazer goes extinct; for higher values of these parameters, coexistence occurs in oscillations. Sensitivity analysis reveals the relative importance of all parameters on asymptotic dynamics. Lastly, the impacts of changing these two parameters in the LKE model appears to be quantitatively similar to the impacts in the WKL model.Cronkhite-Canada syndrome is rarely encountered in clinical practice. Notably, most patients with Cronkhite-Canada syndrome exhibit hypoalbuminemia. Because the cause of Cronkhite-Canada syndrome is unknown, no specific treatment method has been established. Here, we describe a 59-year-old woman with Cronkhite-Canada syndrome in whom clinical manifestations were considerably relieved after treatment with prednisone.The outbreak of viral pneumonia caused by the novel coronavirus SARS-CoV-2 that began in December 2019 caused high mortality. It has been suggested that the main protease (Mpro) of SARS-CoV-2 may be an important target to discover pharmaceutical compounds for the therapy of this life-threatening disease. Remdesivir, ritonavir and chloroquine have all been reported to play a role in suppressing SARS-CoV-2. Here, we applied a molecular docking method to study the binding stability of these drugs with SARS-CoV-2 Mpro. It appeared that the ligand-protein binding stability of the alliin and SARS-CoV-2 Mpro complex was better than others. The results suggested that alliin may serve as a good candidate as an inhibitor of SARS-CoV-2 Mpro. Therefore, the present research may provide some meaningful guidance for the prevention and treatment of SARS-CoV-2.Major histocompatibility complex class I (MHC-I) is a key molecule in anti-tumor adaptive immunity. MHC-I is essential for endogenous antigen presentation by cancer cells and subsequent recognition and clearance by CD8+ T cells. Defects in MHC-I expression occur frequently in several cancers, leading to impaired antigen presentation, immune evasion and/or resistance to immune checkpoint blockade (ICB) therapy. Pancreatic ductal adenocarcinoma (PDAC), a deadly malignancy with dismal patient prognosis, is resistant to ICB and shows frequent downregulation of MHC-I independent of genetic mutations abrogating MHC-I expression. Previously, we showed that PDAC cells exhibit elevated levels of autophagy and lysosomal biogenesis, which together support the survival and growth of PDAC tumors via both cell-autonomous and non-cell-autonomous mechanisms. In our recent study, we have identified NBR1-mediated selective macroautophagy/autophagy of MHC-I as a novel mechanism that facilitates immune evasion by PDAC cells. Importantly, autophagy or lysosome inhibition restores MHC-I expression, leading to enhanced anti-tumor T cell immunity and improved response to ICB in transplanted tumor models in syngeneic host mice. Our results highlight a previously unknown function of autophagy and the lysosome in regulation of immunogenicity in PDAC, and provide a novel therapeutic strategy for targeting this deadly disease.