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Objectives Cognitive stimulation therapy (CST) is a brief, non-pharmacological intervention for people with dementia, with an established evidence base for improving cognition and quality of life. MK8353 It is widely implemented in National Health Service (NHS) settings, but little is known about its naturalistic use. The aim of this survey was to identify and explore inclusion criteria, dose and quality of CST across services in Great Britain (England, Scotland and Wales).Methods All NHS memory clinics and services for people with dementia were contacted and asked to complete a mixed methods online survey on CST delivery in their service. Questions were centred on who provided CST, who received CST, the dose of CST and any outcomes that were routinely measured.Results A total of 57/186 services responded, giving a response rate of 30.7%. While the majority reported offering CST (87.7%), there was variability in how this was delivered. Differing inclusion criteria included the use of varying cognitive and behavioural outcome measures, and CST was reported as being offered once and twice weekly. Services also differed in how they evaluated the quality of CST and how this evidence was incorporated for future sessions.Conclusion While there was a low response rate, this survey indicates that there is significant variability in how CST is used in clinical practice, with many trusts not adhering to the evidence base. To ensure that people with dementia are consistently offered evidence-based, high-quality CST across NHS settings, further standardisation of inclusion criteria, dose and outcomes is needed.Phenomenon Disparities in health and healthcare for gender minorities (GMs) such as transgender people are significant, and medical educators have a responsibility to ensure trainees master the clinical skills required to provide them with quality care. We implemented a standardized patient (SP) scenario designed to measure students' ability to provide gender-affirming care and sought to understand the experiences and perceptions of the GMs who served as SPs in this case. Our key research question was how do GM SPs describe the experience of serving as an SP on a gender-affirming care clinical case? Approach Semi-structured focus groups were conducted with GM SPs (n = 10) to understand their experiences and gauge their perceptions of portraying a patient seeking gender-affirming care. The patient they portrayed matched their own gender identity. Focus groups were transcribed verbatim and analyzed using inductive thematic analysis. Findings We developed three primary themes in our analysis personal connection,GM SPs' perspectives are valuable to provide a rationale and guidance to other schools implementing gender-affirming education. Efforts to create and implement gender-affirming care curriculum should include GMs in order to build partnerships and prioritize the voices and agency of GMs.

The use of mobile health (mHealth) interventions has the potential to enhance chronic obstructive pulmonary disease (COPD) treatment outcomes. Further research is needed to determine which mHealth features are required to potentially enhance COPD self-management.

The aim of this study was to explore the potential features of an mHealth intervention for COPD management with healthcare providers (HCPs) and patients with COPD. It could inform the development and successful implementation of mHealth interventions for COPD management.

This was a qualitative study. We conducted semi-structured individual interviews with HCPs, including nurses, pharmacists and physicians who work directly with patients with COPD. Interviews were also conducted with a diverse sample of patients with COPD. Interview topics included demographics, mHealth usage, the potential use of medical devices and recommendations for features that would enhance an mHealth intervention for COPD management.

A total of 40 people, including nurthe management of COPD.The reviews of this paper are available via the supplemental material section.

This study identifies important potential features so that the most effective, efficient and feasible mHealth intervention can be developed to improve the management of COPD.The reviews of this paper are available via the supplemental material section.Ebola virus (EBOV) causes an extremely contagious viral haemorrhagic fever associated with high mortality. While, historically, children have represented a small number of total cases of Ebolavirus disease (EVD), in recent outbreaks up to a quarter of cases have been in children. They pose unique challenges in clinical management and infection prevention and control. In this review of paediatric EVD, the epidemiology of past EVD outbreaks with specific focus on children is discussed, the clinical manifestations and laboratory findings are described and key developments in clinical management including specific topics such as viral persistence and breastfeeding while considering unique psychosocial and anthropological considerations for paediatric care including of survivors and orphans and the stigma they face are discussed. In addition to summarising the literature, perspectives based on the authors' experience of EVD outbreaks in the Democratic Republic of the Congo (DRC) are described.

ARDS acute respiratInternational Children's Emergency Fund; USA United States of America; WHO World Health Organization.

project CONDIFA ("Consenso Digestivo-Farmacia Hospitalaria") aims to establish lines of agreement between both specialties in order to improve patient care and resource optimization. In this initial work our goal was to collect the views held by both fields on issues pertaining to their mutual cooperation in our country.

an online survey was administered to members of the Sociedad Española de Patología Digestiva (SEPD) and Sociedad Española de Farmacia Hospitalaria (SEFH). It comprised 31 questions, and was developed by a task force established by both Societies.

the survey was filled out by 241 gastroenterologists and 126 pharmacists. Of these, 55 % were women. A total of 76.8 % of gastroenterologists and 88.1 % of pharmacists answered that relations between both specialties are good/very good, without reaching statistically significant differences. For both groups pharmaceutical expenditure is a priority/annual objective in their department, albeit they do not agree on prescription freedom and industry influence. Biologics committees are considered to be useful by most respondents, and both groups think it appropriate that meetings/sessions be scheduled between both specialties, and that a reference pharmacist be appointed for gastroenterology.

this institutional research, driven by SEPD and SEFH, demonstrates that, while cooperation between the gastroenterology and hospital pharmacy departments is close and adequate, some areas remain open to improvement, which will result in better, more effective patient care.

this institutional research, driven by SEPD and SEFH, demonstrates that, while cooperation between the gastroenterology and hospital pharmacy departments is close and adequate, some areas remain open to improvement, which will result in better, more effective patient care.

controversy exists on the diagnostic performance of sentinel lymph node (SLN) mapping in colorectal cancer. This study aimed to provide a more precise estimation of its clinical significance.

a systematic search of electronic databases was conducted to retrieve all relevant studies up to August 31st, 2019. Detection rate, sensitivity, and upstaging rate were pooled together, and a subgroup analysis was performed to identify factors that affect diagnostic performance. The prognostic value of upstaging was also explored.

sixty-eight studies were eligible and included. The pooled SLN detection rate was 0.93 (95 % CI, 0.91-0.94), with a significant higher rate in colon cancer or in studies including more than 100 patients. The overall sensitivity of the SLN procedure in colorectal cancer was 0.72 (95 % CI, 0.67-0.77). The tracers used were found to influence sensitivity. A mean weighted upstaging of 0.22 (95 % CI, 0.18-0.25) was identified. True upstaging, defined as micro-metastases, was 14 %. Upstaged patients were associated with worse overall survival (OS) when compared with node-negative patients (HR = 2.60, 95 % CI, 0.16-4.63). In addition, upstaged patients had a lower 5-year disease-free survival (DFS) rate than node-negative patients.

based on the results of the present meta-analysis, the SLN mapping procedure should focus on early stage patients to refine staging, since upstaging appeared to be a prognostic factor for DFS and OS. The SLN procedure can be recommended for colorectal cancer patients in addition to conventional resection.

based on the results of the present meta-analysis, the SLN mapping procedure should focus on early stage patients to refine staging, since upstaging appeared to be a prognostic factor for DFS and OS. The SLN procedure can be recommended for colorectal cancer patients in addition to conventional resection.While catalysis is highly dependent on the electronic structure of the catalyst, the understanding of catalytic performance affected by electron spin regulation remains challenging and rare. Herein, we have developed a facile strategy to the manipulation of the cobalt spin state over covalent organic frameworks (COFs), COF-367-Co, by simply changing the oxidation state of Co centered in the porphyrin. Density functional theory (DFT) calculations together with experimental results confirm that CoII and CoIII are embedded in COF-367 with S = 1/2 and 0 spin ground states, respectively. Remarkably, photocatalytic CO2 reduction results indicate that COF-367-CoIII exhibits favorable activity and significantly enhanced selectivity to HCOOH, accordingly much reduced activity and selectivity to CO and CH4, in sharp contrast to COF-367-CoII. The results highlight that the spin-state transition of cobalt greatly regulates photocatalytic performance. Theoretical calculations further disclose that the presence of CoIII in COF-367-Co is preferable to the formation of HCOOH but detrimental to its further conversion, which clearly accounts for its distinctly different photocatalysis over COF-367-CoII. To the best of our knowledge, this is the first report on regulating photocatalysis by spin state manipulation in COFs.V-domain Ig suppressor of T-cell activation (VISTA) is an immune checkpoint that affects the ability of T-cells to attack tumors. A FRET-based high throughput screening identified NSC622608 as the first small-molecule ligand for VISTA. Investigation of the interaction of NSC622608 with VISTA using STD NMR and molecular modeling enabled the identification of a potential binding site in VISTA for NSC622608. Screening NSC622608 against a library of single-point VISTA mutants revealed the key residues in VISTA interacting with NSC622608. Further structural optimization resulted in a lead with submicromolar VISTA binding affinity. The lead compound blocked VISTA signaling in vitro, enhanced T-cell proliferation, and restored T-cell activation in the presence of VISTA-expressing cancer cell lines. This work would enable future development of small molecules targeting VISTA as immunomodulators and imaging probes.