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2). The detection rate of polyps (72 of 172 [41.9%] vs 46 of 172 [26.7%]; P = .003) and the detection rate of adenomas (56 of 172 [32.6%] vs 38 of 172 [22.1%]; P = .03) were also higher in the VR video group. Patients who received VR education had better compliance (119 [68.8%] vs 87 [50.3%]; P < .001) and higher mean (SD) overall satisfaction (8.68 [1.70] vs 8.16 [2.15]; P = .01) with bowel preparation.

Patients who received VR video education before colonoscopy had better bowel preparation, higher polyp and adenoma detection rates, and improved compliance and satisfaction.

ClinicalTrials.gov Identifier NCT03667911.

ClinicalTrials.gov Identifier NCT03667911.

To perform segmentation of specular microscopy (SM) images of the corneal endothelium for comparing average perimeter length (APL) between Fuchs endothelial corneal dystrophy (FECD) patients and healthy subjects.

A retrospective review of clinical records of FECD patients and those with healthy endothelium was carried out to collect images of the endothelium. The images were segmented by modified U-Net, a deep learning architecture, followed by the Watershed algorithm to resolve merged cell borders (<5%). The segmented images were analyzed for endothelial cell density (ECDUW) and APL.

The combination of the U-Net and Watershed algorithm, referred to as the UW approach, enabled a complete segmentation of the endothelium. In healthy, ECDUW was close to estimates by SM and manual segmentation (31 subjects; P > 0.1). However, in FECD, ECDUW was closer to estimates by manual segmentation but not by SM (27 patients; P < 0.001). ECDUW in FECD (2547 ± 499 cells/mm2; 60 patients) was smaller compared to that in the healthy (2713 ± 401 cells/mm2; 70 subjects) (P < 0.001). APL in the healthy was 66.87 ± 7.68 µm/cell (70 subjects), but it increased with %Guttae in FECD (56.60-195.30 µm/cell; 60 patients) (P < 0.0001).

The UW approach is precise for the segmentation of SM images from the healthy and FECD. Our analysis has revealed that APL increases with %Guttae.

The average perimeter length of the corneal endothelium, which represents the length of the paracellular pathway for fluid flux into the stroma, is increased in Fuchs dystrophy.

The average perimeter length of the corneal endothelium, which represents the length of the paracellular pathway for fluid flux into the stroma, is increased in Fuchs dystrophy.Despite extensively examining the effects of family policies on marriage and fertility rates, previous research has paid little attention to the process of policy implementation and has implicitly assumed that individuals are fully aware of the policy information when making marital and fertility decisions. Challenging this assumption, we theorize policy awareness as an important mechanism for understanding the potential influence of family policies on individuals' marital intentions, an understudied yet crucial determinant of family formation behavior. In an experiment using a national survey of young unmarried individuals in Japan, respondents were randomly assigned to treatment and control groups. The treatment group was informed about 17 Japanese family policy benefits, but most of the respondents knew none or only a few of these benefits. After exposure to the policy information, the treatment group had significantly higher marital intentions than the control group, which had similar baseline characteristics but no information exposure. Crucially, such positive effects were particularly pronounced among high-educated women and high- and low-educated men, reflecting the differentiated effects of policy awareness under Japan's traditional gender role norms. Overall, these findings highlight the pivotal role of policy awareness during the family formation process and contribute to the debate over whether and how family policies may influence different subpopulations.

The number of adolescents who are diagnosed with a genetic disorder is increasing as genome sequencing becomes the standard of clinical diagnostic testing. However, the experience of receiving a diagnosis of a genetic condition has not been extensively studied in adolescents.

To identify how adolescents with a genetic condition engage with genetic or genomic counseling services as well as interpret, adapt to, and experience their diagnosis.

A literature search of MEDLINE, Embase, CINAHL, and PsycINFO was undertaken. Articles (primary literature, knowledge syntheses, and gray literature) in English that investigated the experiences of adolescents between 10 and 19 years of age who received genetic or genomic counseling were included. Data were extracted from 45 eligible articles and analyzed descriptively.

A total of 45 studies were included, most of which were quantitative in nature (21 of 45 [47%]) and conducted in the US (n = 13), followed by the UK (n = 8), Australia (n = 8), and Canada (n = 6). A at is tailored to the needs of this adolescent population.

This scoping review found that most of the included studies focused on adolescents' knowledge about their genetic condition and communication about genetic risks, whereas fewer studies explored their adaptation to the condition and the genetic counseling process. A systematic reconsideration of the genetic counseling process may be undertaken to provide an evidence-informed health care service that is tailored to the needs of this adolescent population.Innovative drug treatments for malaria, optimally with novel targets, are needed to combat the threat of parasite drug resistance. As drug development efforts continue, there may be a role for a host-targeting, repurposed cancer drug administered together with an artemisinin combination therapy that was shown to improve the speed of recovery from a malaria infection.

The EMERGE and ENGAGE phase 3 randomized clinical trials of aducanumab provide a robust data set to characterize amyloid-related imaging abnormalities (ARIA) that occur with treatment with aducanumab, an amyloid-β (Aβ)-targeting monoclonal antibody, in patients with mild cognitive impairment due to Alzheimer disease or mild Alzheimer disease dementia.

To describe the radiographic and clinical characteristics of ARIA that occurred in EMERGE and ENGAGE.

Secondary analysis of data from the EMERGE and ENGAGE trials, which were 2 double-blind, placebo-controlled, parallel-group, phase 3 randomized clinical trials that compared low-dose and high-dose aducanumab treatment with placebo among participants at 348 sites across 20 countries. Enrollment occurred from August 2015 to July 2018, and the trials were terminated early (March 21, 2019) based on a futility analysis. The combined studies consisted of a total of 3285 participants with Alzheimer disease who received 1 or more doses of placebo (n = 1087) or adu.1%) and 151 participants (14.7%), respectively.

In this integrated safety data set from EMERGE and ENGAGE, the most common adverse event in the 10-mg/kg group was ARIA-E, which occurred in 362 of the 1029 patients (35.2%) in the 10-mg/kg group with at least 1 postbaseline MRI scan, with 94 patients (26.0%) experiencing associated symptoms. The most common associated symptom was headache.

ClinicalTrials.gov Identifiers NCT02484547, NCT02477800.

ClinicalTrials.gov Identifiers NCT02484547, NCT02477800.

Systemic corticosteroids are commonly used in treating severe COVID-19. However, the role of inhaled corticosteroids in the treatment of patients with mild to moderate disease is less clear.

To determine the efficacy of the inhaled steroid ciclesonide in reducing the time to alleviation of all COVID-19-related symptoms among nonhospitalized participants with symptomatic COVID-19 infection.

This phase 3, multicenter, double-blind, randomized clinical trial was conducted at 10 centers throughout the US and assessed the safety and efficacy of a ciclesonide metered-dose inhaler (MDI) for treating nonhospitalized participants with symptomatic COVID-19 infection who were screened from June 11, 2020, to November 3, 2020.

Participants were randomly assigned to receive ciclesonide MDI, 160 μg per actuation, for a total of 2 actuations twice a day (total daily dose, 640 μg) or placebo for 30 days.

The primary end point was time to alleviation of all COVID-19-related symptoms (cough, dyspnea, chills, feeling fcy department visits or hospital admissions for reasons related to COVID-19 (odds ratio, 0.18; 95% CI, 0.04-0.85). No participants died during the study.

The results of this randomized clinical trial demonstrated that ciclesonide did not achieve the primary efficacy end point of reduced time to alleviation of all COVID-19-related symptoms.

ClinicalTrials.gov Identifier NCT04377711.

ClinicalTrials.gov Identifier NCT04377711.

Youth firearm-related deaths are a public health crisis in the US. The association between county-level poverty and the risk of firearm-related deaths among youth is unknown, however.

To examine the association between county-level poverty concentration and firearm-related mortality rates in US youth.

This cross-sectional study analyzed US firearm fatalities in children and young adults aged 5 to 24 years that occurred between January 1, 2007, and December 31, 2016. Data were obtained from the Centers for Disease Control and Prevention's Compressed Mortality File, and annual intercensal county population data were obtained from the US Census Bureau. Data analyses were conducted between November 1, 2019, and June 30, 2020.

County-level poverty was categorized into 5 groups 0% to 4.9%, 5% to 9.9%, 10% to 14.9%, 15% to 19.9%, and ≥20% of the population living below the federal poverty level.

The main outcomes were firearm-related deaths in total and by specific intent (homicide, suicide, and unintentiorearm-related deaths is urgently needed.

This study found an association between firearm-related mortality rates among youth and county-level poverty concentration. With more than half of firearm-related deaths and two-thirds of firearm-related homicides potentially associated with living in an area with a high concentration of poverty, a multidimensional strategy to reduce poverty and firearm-related deaths is urgently needed.

Cytoplasmic dynein-1 (henceforth dynein) moves cargo in conjunction with dynactin toward the minus end of microtubules. The dynein heavy chain, DYNC1H1, comprises the backbone of dynein, a retrograde motor. Deletion of Dync1h1 abrogates dynein function. The purpose of this communication is to demonstrate effects of photoreceptor dynein inactivation during late postnatal development and in adult retina.

We matedDync1h1F/F mice with iCre75 and Prom1-CreERT2 mice to generate conditional rod and tamoxifen-induced knockout in rods and cones, respectively. We documented retina degeneration with confocal microscopy at postnatal day (P) 10 to P30 for the iCre75 line and 1 to 4 weeks post tamoxifen induction (wPTI) for the Prom1-CreERT2 line. buy EG-011 We performed scotopic and photopic electroretinography (ERG) at P16 to P30 in the iCre75 line and at 1-week increments in the Prom1-CreERT2 line. Results were evaluated statistically using Student's t-test, two-factor ANOVA, and Welch's ANOVA.

Cre-induced homologous recombination of Dync1h1F/F mice truncated DYNC1H1 after exon 23.