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gners remains to be further elucidated to achieve more predictable treatment results.

Depression and anxiety are now considered as common adverse reactions to cancer. Prior research has shown that social support and functional coping strategies alleviate depressive and anxious symptoms of cancer patients but the exact relationship between social support and coping strategies in amelioration of the symptoms is yet to be elaborated.

The current study examined the relationship between social support, coping strategies and depressive-anxious symptomatology and explored the possible role of coping strategies in mediating the relationship between social support, depression and anxiety in Iranian breast cancer patients (N=221). Anxiety and depressive symptoms were measured using the Depression-Anxiety-Stress (DASS-21) scale, social support was measured using the Medical Outcome Survey, Social Support Scale (MOSS-SSS), and coping strategies were measured using the brief COPE.

All of the social support subscales were negatively correlated with depression and anxiety. Most of the coping strategies were negatively correlated with depressive-anxious symptoms. When controlling for covariates, mediation analysis revealed that active coping, positive reframing and acceptance partially mediated the association of social support of different types with depression. Positive reframing also partially mediated the relationship of the total social support and positive social interactions with anxiety.

High levels of social support may relieve depressive and anxious symptoms of breast cancer patients through functional coping. The management of breast cancer patients should also focus on providing patients with social support and educating them on the practice of functional coping strategies.

High levels of social support may relieve depressive and anxious symptoms of breast cancer patients through functional coping. The management of breast cancer patients should also focus on providing patients with social support and educating them on the practice of functional coping strategies.

Simulation is an effective adjunct to surgical training. There is increasing interest in the use of mental rehearsal as a form of cognitive simulation. The mental visualisation of a motor skill is recognised to enhance performance; a concept not novel to surgeons. Despite this, mental rehearsal has yet to be formally incorporated into surgical training. This study aims to assess the use of mental rehearsal amongst general surgical trainees and consultants.

A six-item questionnaire was designed and electronically circulated to general surgical core trainees, registrars, fellows and consultants. Qualitative and quantitative analysis was independently performed.

153 responses (consultants=51.6%, trainees=48.4%) were received over 3 weeks. 91.5% of surgeons mentally rehearse prior to operating. Its use predominates for complex cases only. There is no difference in case complexity and the surgeon's grade in regard to when mental rehearsal is performed (χ

=1.027, p=0.31). Individual mental rehearsal is preferred. Consultants are more likely to mentally rehearse with others, although there was no statistical difference compared to trainees (χ

=0.239, p=0.63). Clarification, confidence and anticipation of potential difficulties were the perceived benefits of mental rehearsal reported in 58.6% of responses.

Mental rehearsal prior to operating appears instinctive for general surgeons irrespective of seniority and case complexity. Whether the efficacy of mental rehearsal on training is sustained and continues as surgeons progress along the training curve are unknown. Alternative methods of surgical training are very much needed. We propose mental rehearsal.

Mental rehearsal prior to operating appears instinctive for general surgeons irrespective of seniority and case complexity. Whether the efficacy of mental rehearsal on training is sustained and continues as surgeons progress along the training curve are unknown. Alternative methods of surgical training are very much needed. We propose mental rehearsal.

Presence of intraluminal viable cancer cells implanting into the anastomosis has been proposed as a potential cause for developing local recurrence in patients undergoing anterior resection for rectal cancer. Rectal washout has been proposed as a method to prevent this from happening. There have been conflicting reports in literature regarding the effect of rectal washout on local recurrence. We aim to look at the role of rectal washout in preventing local recurrence of rectal cancer in patients undergoing total or tumor-specific mesorectal excision (TME).

A literature review of studies evaluating the role of rectal washout on rectal cancer local recurrence was performed using PubMed, Scopus, EMBASE and non-English language literature search using CiNii (Japanese) and CNKI (Chinese). Inclusion criteria were use of TME, comparison of rectal washout with no washout, and evaluation of local recurrence as outcome.

Four studies were identified according to inclusion criteria. The meta-analysis showed a protective effect of rectal washout on local recurrence (OR 0.45 95% CI 0.45-0.75). However, one of the studies included had more than 90% weightage. Excluding this study from analysis showed no difference on local recurrence with rectal washout(OR 0.94, 95% CI 0.37-2.36).

The effect of rectal washout on rectal cancer local recurrence in patients who undergo TME is questionable and needs to be evaluated further by prospective studies.

The effect of rectal washout on rectal cancer local recurrence in patients who undergo TME is questionable and needs to be evaluated further by prospective studies.

Patients with new-onset diabetes are known to be at a higher risk of developing pancreatic cancer. The Enriching New-Onset Diabetes for Pancreatic Cancer (ENDPAC) model was recently developed to identify new-onset diabetics with this higher risk. Fenebrutinib order Further validation is needed before the ENDPAC model is implemented as part of a screening program to identify pancreatic cancer.

A retrospective case-control study was performed; a cohort of patients with new-onset diabetes was identified using hemoglobin A1c. Patients were scored by the ENDPAC model and then divided based on whether pancreatic cancer was diagnosed after the diagnosis of diabetes. The performance of the model was assessed globally and at different cutoffs.

There were 6254 controls and 48 cases of pancreatic cancer. Bivariate analysis showed that patients with pancreatic cancer lost weight before diagnosis while controls gained weight (-0.93kg/m2 vs. 0.45kg/m2, p<0.00∗). Cases had a more significant increase in their HbA1C from one year before (1.3% vs. 0.82%, p=0.02). Smoking and pancreatitis rates were higher in cases compared to controls (p<0.00∗). The area under the curve (AUC) of the ENDPAC model was 0.72. A score >1 was the optimal cutoff. At this cutoff, the sensitivity was 56%, specificity was 75%, and pancreatic cancer prevalence increased from 0.78% at baseline to 1.7%.

The ENDPAC model was validated in an independent cohort of patients with new-onset diabetes.

The ENDPAC model was validated in an independent cohort of patients with new-onset diabetes.

Medical science is increasingly recognizing the role of gut health in achieving optimal wellbeing. A healthy gut improves digestion. Additionally, it has a positive impact on multiple physiological networks such as immune system, central nervous system and hepato-endocrine system, thus contributing to the overall quality of life. Functional gastrointestinal disorders also known as disorders of gut-brain interaction, such as irritable bowel syndrome are increasing worldwide. Conditions like stress, anxiety and mental disorders are correlated with these disorders. Mind-body interventions have been shown to ameliorate stress, anxiety and related conditions that may aggravate functional gastrointestinal disorders.

The present study aims to investigate the benefits of a novel meditation technique called the Vaishvanara Agni meditation (VAM) on the gastrointestinal quality of life.

54 subjects participated in the study and practiced VAM for 50 days. During the Vaishvanara Agni meditation (VAM), attention is directed to the navel region and the digestive system. The effect of the meditation was evaluated using the gastrointestinal quality of life (GI-QoL) questionnaire, which was administered to subjects at three different time points i.e. day 0, day 24 and day 50.

GI-QoL was significantly improved with the practice of VAM. Additionally, significant improvements were noticed in all sub domains especially core symptoms, physical strength and the psychological domain.

Meditation practices that focus on improving digestion can be an effective tool for improving gut health.

Meditation practices that focus on improving digestion can be an effective tool for improving gut health.

This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms among adolescents in mainland China under COVID-19. The direct effects of the perceived threat of COVID-19 and positive youth development (PYD) qualities, as well as the moderating effect of PYD qualities on PTSD symptoms, were studied.

Five schools in Chengdu, Sichuan, China, participated in this study. Two waves of data were collected before school lockdown (Wave 1, between December 2019 and January 2020) and after school resumption (Wave 2, between June 2020 and July 2020), respectively. A total of 4,981 adolescents aged above 11years (Mean age= 13.15, SD= 1.32 at Wave 1, 51.5% girls) completed questionnaires at both waves. Students responded to measures of PYD qualities at both waves and perceived threat and PTSD symptoms at Wave2.

A total of 517 adolescents (10.4%) could be regarded as having PTSD. Results indicated significant unique main effects of perceived threat (β= .13, p < .001) and Wave 1 PYD qualities (β=-.16, p < .001) on PTSD symptoms. Besides, results showed a significant moderating effect of PYD qualities in mitigating the negative impact of perceived threat on PTSD symptoms.

This study revealed the protective effect of PYD attributes in reducing the negative influence of traumatic situations such as COVID-19 on adolescent mental health. Results underscore the importance of promoting PYD qualities in adolescents in mainland China via effective PYD programs.

This study revealed the protective effect of PYD attributes in reducing the negative influence of traumatic situations such as COVID-19 on adolescent mental health. Results underscore the importance of promoting PYD qualities in adolescents in mainland China via effective PYD programs.

To evaluate the effectiveness of a school-based comprehensive sexual health curriculum (FLASH) on high-school students' sexual behavior and related outcomes.

A cohort of 1,597 9th and 10th grade students representing 20 schools from two regions in the U.S. (Midwest and South) were enrolled and completed the baseline survey. Following baseline, the 20 schools were randomly assigned to receive FLASH (n= 10 schools, five per region) or a knowledge-based sexual health curriculum (n= 10 schools, five per region). Follow-up surveys were administered at 3 months and 12 months after the instruction period.

There were no statistically significant differences between conditions for the overall sample on rates of vaginal sex in the past 3months or the rates of vaginal sex without a condom or other birth control. In supplementary subgroup analyses of students who were not sexually experienced at baseline, FLASH showed a statistically significant protective impact at the 3-month follow-up on vaginal sex without a condom or birth control (p= .