Pericapsular Nerve Group Block Did Not Reduce Post-Operative Pain or Opioid Use After Total Hip Arthroplasty.

INTRODUCTION: The pericapsular nerve group (PENG) block is a newly developed regional anesthesia technique designed to manage post-operative hip pain following a fracture or surgery while also maintaining quadriceps strength and mobility. The goal of our study was to compare post-operative pain scores and opioid usage during the post-operative period prior to discharge following total hip arthroplasty (THA) using the posterior approach between patients who received a PENG block and those who did not. METHODS: We conducted a retrospective study on patients undergoing elective, posterior approach THA at a single tertiary care academic center. The two groups included a study group (THA with PENG block in 2021; n = 66) and a control group (THA prior to PENG block implementation in 2019; n = 70). RESULTS: There were no significant differences in pain scores during post-operative minutes 0 to 59 (study group 6.8; control group 6.6; P = 0.81) or during post-operative minutes 60 to 119 (study group 6.2; control group 5.6; P = 0.40). There were no significant differences in total post-operative in-hospital morphine milliequivalent (MME) opioid consumption (study group 55.8 MMEs; control group 75.0 MMEs; P = 0.14). The study group was found to have a shorter length of stay (LOS) (study group 17.0 hours; control group 32.6 hours; P < 0.0001) and faster mobilization (study group 3.0 hours; control group 4.9 hours; P < 0.0001) than the control group. CONCLUSION: Our results show that use of the PENG block did not result in lower post-operative pain scores or opioid consumption after THA using the posterior surgical approach. The study group had a shorter LOS and time to mobilization than the control group, though this was likely due to standard hospital procedure shifting to same day discharge for THA between 2019 and 2021 due to COVID-19.

Predictive model of the efficiency of hematopoietic stem cell collection in patients with multiple myeloma and lymphoma based on multiple peripheral blood markers.

INTRODUCTION: Autologous hematopoietic stem cell transplantation (ASCT) has gained extensive application in the treatment of lymphoma and multiple myeloma (MM). Plenty of studies demonstrate that peripheral blood indicators could be considered potential predictive biomarkers for hematopoietic stem cells (HSCs) collection efficiency, including white blood cell count (WBC), monocyte count (Mono), platelet count (PLT), hematocrit, and hemoglobin levels. Currently, clinically practical predictive models based on these peripheral detection indicators to quickly, conveniently, and accurately predict collection efficiency are lacking. METHODS: In total, 139 patients with MM and lymphoma undergoing mobilization and collection of ASCT were retrospectively studied. The study endpoint was successful collection of autologous HSCs. We analyzed the effects of clinical characteristics and peripheral blood markers on collection success, and screened variables to establish a prediction model. We determined the optimal cutoff value of peripheral blood markers for predicting successful stem cell collection and the clinical value of a multi-marker prediction approach. We also established a prediction model for collection efficacy. RESULTS: Univariate and multivariate logistic regression analyses showed that the mobilization regimen, Mono, PLT, mononuclear cell count (MNC), and peripheral blood CD34+ cell count (PB CD34+ counts) were significant predictors of successful collection of peripheral blood stem cells (PBSC). Two predictive models were constructed based on the results of multivariate logistic analyses. Model 1 included the mobilization regimen, Mono, PLT, and MNC, whereas Model 2 included the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts. Receiver operating characteristic (ROC) curve analysis showed that the PB CD34+ counts, Model 1, and Model 2 could predict successful HSCs collection, with cutoff values of 26.92 × 106/L, 0.548, and 0.355, respectively. Model 1 could predict successful HSCs collection with a sensitivity of 84.62%, specificity of 75.73%, and area under the curve (AUC) of 0.863. Model 2 could predict successful HSCs collection with a sensitivity of 83.52%, specificity of 94.17%, and AUC of 0.946; thus, it was superior to the PB CD34+ counts alone. CONCLUSION: Our findings suggest that the combination of the mobilization regimen, Mono, PLT, MNC, and PB CD34+ counts before collection has predictive value for the efficacy of autologous HSCs collection in patients with MM and lymphoma. Using models based on these predictive markers may help to avoid over-collection and improve patient outcomes.

[Comparison of etoposide combined with G-CSF and cyclophosphamide combined with G-CSF in the mobilization of autologous peripheral blood stem cells in patients with multiple myeloma].

Objective: The effect and safety of etoposide combined with G-CSF were compared with those of cyclophosphamide combined with G-CSF in autologous peripheral blood mobilization in patients with multiple myeloma (MM) . Methods: Patients with MM who received autologous peripheral blood stem cell mobilization and collection in the Department of Hematology, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 1, 2020 to July 31, 2023 were included. A total of 134 patients were screened by propensity score matching technology according to a 1∶1 ratio. A total of 67 cases were each treated with ETO combined with G-CSF mobilization scheme (ETO group) and CTX combined with G-CSF mobilization scheme (CTX group). Their clinical data were retrospectively analyzed. Results: ①Collection results: the ETO and CTX groups [2 (1-3) d vs 2 (1-5) d; P<0.001] and CD34(+) cells [7.62×10(6) (2.26×10(6)-37.20×10(6)) /kg vs 2.73×10(6) (0.53×10(6)-9.85×10(6)) /kg; P<0.001] were collected. The success rate of collection was 100.0% (67/67) versus 76.1% (51/67) (P<0.001). Excellent rate of collection was 82.1% (55/67) versus 20.9% (14/67; P<0.001). Two patients in the ETO group switched protocols after 1 day of collection, and 11 patients in the CTX group switched protocols after 1-2 days of collection. ②Adverse reactions: granular deficiency with fever (21.5%[14/65] vs. 10.7%[6/56]; P=0.110), requiring platelet transfusion [10.7% (7/65) vs 1.8% (1/56) ; P=0.047]. ③Until the end of follow-up, 63 cases in the ETO group and 54 cases in the CTX group have undergone autologous transplantation. The median number of CD34(+) cells infused in the two groups was 4.62×10(6) (2.14×10(6)-19.89×10(6)) /kg versus 2.62×10(6) (1.12×10(6)-5.31×10(6)) /kg (P<0.001), neutrophil implantation time was 11 (9-14) d versus 11 (10-14) d (P=0.049), and platelet implantation time was 11 (0-19) d vs. 12 (0-34) d (P=0.035). One case in the CTX group experienced delayed platelet implantation. Conclusion: The mobilization scheme of etoposide combined with G-CSF requires relatively platelet transfusion, but the collection days are shortened. The collection success rate, excellent rate, and the number of CD34(+) cells obtained are high, and the neutrophil and platelet engraftment is accelerated after transplantation.

Overcoming drought: life traits driving tree strategies to confront drought stress.

This insight article comments on: Ziegler C, Cochard, H, Stahl C, Bastien Gérard LF, Goret J, Heuret P, Levionnois S, Maillard P, Bonal D, Coste S. 2024. Residual water losses mediate the trade-off between growth and drought survival across saplings of 12 tropical rainforest tree species with contrasting hydraulic strategies. Journal of Experimental Botany 75, 4128-4147.

Endomucin marks quiescent long-term multi-lineage repopulating hematopoietic stem cells and is essential for their transendothelial migration.

Endomucin (EMCN) currently represents the only hematopoietic stem cell (HSC) marker expressed by both murine and human HSCs. Here, we report that EMCN+ long-term repopulating HSCs (LT-HSCs; CD150+CD48-LSK) have a higher long-term multi-lineage repopulating capacity compared to EMCN- LT-HSCs. Cell cycle analyses and transcriptional profiling demonstrated that EMCN+ LT-HSCs were more quiescent compared to EMCN- LT-HSCs. Emcn-/- and Emcn+/+ mice displayed comparable steady-state hematopoiesis, as well as frequencies, transcriptional programs, and long-term multi-lineage repopulating capacity of their LT-HSCs. Complementary functional analyses further revealed increased cell cycle entry upon treatment with 5-fluorouracil and reduced granulocyte colony-stimulating factor (GCSF) mobilization of Emcn-/- LT-HSCs, demonstrating that EMCN expression by LT-HSCs associates with quiescence in response to hematopoietic stress and is indispensable for effective LT-HSC mobilization. Transplantation of wild-type bone marrow cells into Emcn-/- or Emcn+/+ recipients demonstrated that EMCN is essential for endothelial cell-dependent maintenance/self-renewal of the LT-HSC pool and sustained blood cell production post-transplant.

Steady-State Versus Chemotherapy-Based Stem Cell Mobilization in Multiple Myeloma: A Single-Center Study to Analyze Efficacy and Safety.

Background: High-dose chemotherapy followed by autologous hematopoietic stem cell support is recommended in the treatment of eligible multiple myeloma (MM) patients. The aim of this study was to compare the efficacy and safety of steady-state versus chemotherapy-based stem cell mobilization in our Hungarian patient population. Methods: The subjects were 210 MM patients who underwent stem cell mobilization procedure between 2018 and 2022. Solo granulocyte colony-stimulating factor (G-CSF) was administered in 104 cases, while 106 patients received chemotherapy which was followed by G-CSF administration. We evaluated the ratio of successful mobilizations, the amount of collected stem cells, the incidence of infections and cost-effectivity in the two groups. Results: In the steady-state group, there was a significantly higher need for plerixafor (45% vs. 13%, P < 0.001), unsuccessful stem cell mobilization was more frequent (11% vs. 3%, P = 0.024) and the mean amount of collected stem cells was lower (6.9 vs. 9.8 × 106, P < 0.001) than in the chemotherapy group. However, infections were less frequent (4% vs. 27%, P < 0.001) and the number of days spent in hospital was significantly lower (6 vs. 14 days, P < 0.001). Plerixafor was more frequently administered in those who had received lenalidomide or daratumumab than in those who had been treated with other regimens (41% vs. 23%, P = 0.007 and 78% vs. 23%, P < 0.001, respectively). Conclusions: Steady-state mobilization is a safe method; however, the higher rate of plerixafor administration and unsuccessful attempts may question its superiority to chemomobilization.

Intensive care unit-acquired weakness - preventive, and therapeutic aspects; future directions and special focus on lung transplantation.

In this editorial, comments are made on an interesting article in the recent issue of the World Journal of Clinical Cases by Wang and Long. The authors describe the use of neural network model to identify risk factors for the development of intensive care unit (ICU)-acquired weakness. This condition has now become common with an increasing number of patients treated in ICUs and continues to be a source of morbidity and mortality. Despite identification of certain risk factors and corrective measures thereof, lacunae still exist in our understanding of this clinical entity. Numerous possible pathogenetic mechanisms at a molecular level have been described and these continue to be increasing. The amount of retrievable data for analysis from the ICU patients for study can be huge and enormous. Machine learning techniques to identify patterns in vast amounts of data are well known and may well provide pointers to bridge the knowledge gap in this condition. This editorial discusses the current knowledge of the condition including pathogenesis, diagnosis, risk factors, preventive measures, and therapy. Furthermore, it looks specifically at ICU acquired weakness in recipients of lung transplantation, because - unlike other solid organ transplants- muscular strength plays a vital role in the preservation and survival of the transplanted lung. Lungs differ from other solid organ transplants in that the proper function of the allograft is dependent on muscle function. Muscular weakness especially diaphragmatic weakness may lead to prolonged ventilation which has deleterious effects on the transplanted lung - ranging from ventilator associated pneumonia to bronchial anastomotic complications due to prolonged positive pressure on the anastomosis.

A Culture of Early Mobilization in Adult Intensive Care Units: Perspective and Competency of Physicians.

BACKGROUND: Early mobility (EM) is vital in the intensive care unit (ICU) to counteract immobility-related effects. A multidisciplinary approach is key, as it requires precise initiation knowledge. However, physicians' understanding of EM in adult ICU settings remains unexplored. This study was conducted to investigate the knowledge and clinical competency of physicians working in adult ICUs toward EM. METHODS: This cross-sectional study enrolled 236 physicians to assess their knowledge of EM. A rigorously designed survey comprising 30 questions across the demographic, theoretical, and clinical domains was employed. The criteria for knowledge and competency were aligned with the minimum passing score (70%) stipulated for physician licensure by the medical regulatory authority in Saudi Arabia. RESULTS: Nearly 40% of the respondents had more than 5 years of experience. One-third of the respondents received theoretical knowledge about EM as part of their residency training, and only 4% of the respondents attended formal courses to enhance their knowledge. Almost all the respondents (95%) stated their awareness of EM benefits and its indications and contraindications and considered it safe to mobilize patients on mechanical ventilators. However, 62.3% of the respondents did not support EM for critically ill patients on mechanical ventilators until weaning. In contrast, 51.7% of respondents advised EM for agitated patients with RASS > 2. Only 113 (47.9%) physicians were competent in determining the suitability of ICU patients for EM. For critically ill patients who should be mobilized, nearly 60% of physicians refused to initiate EM. CONCLUSIONS: This study underscores insufficient practical knowledge of ICU physicians about EM criteria, which leads to suboptimal decisions, particularly in complex ICU cases. These findings emphasize the need for enhanced training and education of physicians working in adult ICU settings to optimize patient care and outcomes in critical care settings.

Comparison of Treatment Outcomes of Different Immobilized Finger Positions After Repair of Flexor Tendon Rupture in Zones I and II: A Nonrandomized Controlled Trial With Historical Control Group.

Introduction The position of finger immobilization after flexor tendon rupture repair is changed to the extended position to prevent flexion contracture of the interphalangeal (IP) joint. However, in Strickland's assessment, We believe that a reduction in TAF (total active flexion) affects the outcome and that extension fixation is not necessarily the primary focus. For example, there are management methods that swap the fixed position between day and night. It is assumed that some effect is sought by placing the fingers in the flexed position. That is, the method of fixation is currently selected at individual facilities through twists and turns; however, the indications and criteria for selecting finger fixation positions are ambiguous, and they are apparently subject to the experience of therapists. This study aimed to characterize follow-up outcomes of flexion and extension fixation after zones I and II flexor tendon rupture repair. Methods This nonrandomized controlled trial with historical controls included 25 patients with flexor tendon ruptures of 30 fingers. The flexion fixation group consisted of 12 patients (n=16 fingers) and the extension fixation group consisted of 13 patients (n=14 fingers). The group with flexion fixation comprised patients who slept with their injured fingers in the flexed position (intervention group). The group with extension was retrospectively selected between April 2017 and March 2019, who slept with their injured finger in the extended position (historical control group). Strickland assessments of the range of motion (ROM) of each joint at the conclusion of hand therapy, the ratio of total active motion of the repaired, to the healthy finger (%TAF), and IP joint extension limitation angles were compared using Mann-Whitney U tests. Ratios of excellent and good ratings based on the Strickland assessment were compared using Fisher exact tests. Result The results of the Strickland assessment showed excellent or good outcomes for 22 (73%) of 30 fingers, which was in line with our previous findings. Strickland ratings of excellent were achieved in seven (44%) of 16 fingers and four (28%) of 14 fingers in the groups with flexion and extension fixation, respectively. The outcomes for two (22%) of 16 fingers and seven (78%) of 14 fingers in the groups with flexion and extension fixation were, respectively, rated as good. The proportion of patients rated as excellent was significantly higher in the group with flexion than extension fixation (p=0.040). The %TAF and the active flexion angle of the distal interphalangeal (DIP) joint were higher in the group with flexion than extension fixation (p=0008 and p=0.025, respectively). Furthermore, the total angle of the IP joint limit of extension did not significantly differ between the groups. Conclusion Flexion fixation after flexor tendon rupture achieved an excellent Strickland rating and was more effective than extension fixation, especially in terms of the active flexion ROM of the DIP joint. Flexion fixation might be an alternative to extension fixation because the range of flexion should be greater and might provide a range of finger extension motion equivalent to that of extension fixation.

Spring buds of European woody plants have old 14C age.

Trees and shrubs maintain carbon reserves to support their functions during periods when metabolic demand exceeds carbon supply, such as during the dormant season. To gain a better understanding of carbon storage and utilisation dynamics of eight woody plant species in temperate Central Europe, bud scale and leaf samples were collected to determine the radiocarbon age of fresh sprouts in trees and shrubs, at three background sites avoiding local emissions that may influence affect the observed 14C/12C ratio. The accelerator mass spectrometry-based bomb-radiocarbon approach, to determine the age of the mobilized carbon in the plant bud samples from storage, was complemented by stable carbon isotope measurements. The bomb-radiocarbon dating technique was used to determine the age of the samples, while a northern hemispheric atmosphere 14CO2 dataset was used to calibrate the radiocarbon ages of the plant samples. The youngest observed calibrated radiocarbon age of the buds was over 4 years, and the oldest was even 9 years old. There was no significant difference between the ages of bud scales and embryonal leaf laminas. Our results show that there is a considerable amount of stored older carbon in the woody stems that can be used to produce buds in spring, which is a complex mixture of stored carbon of different ages, but there is no relationship between the radiocarbon age and the stable carbon isotope composition. The observed results show that not only the tree species, but shrubs also can store and use significantly older carbon pools, the carbon storage intensity is similar for trees with trunks and short-stemmed shrubs branching directly above the ground, i.e. carbon storage starts in young twigs and continues in ageing branches.

Treatment of wrist stiffness through posture orthosis and active exercise: A case report.

Introduction: Wrist fractures, particularly the distal radius, can result in significant stiffness and hand dysfunction if not mobilized early. The variable immobilization period post-fracture depends on fracture type, location, stability, and surgical intervention. Inadequate early mobilization typically leads to structured stiffness, influenced by patient health, injury mechanism, joint surface involvement, associated tissue injuries, and patient motivation. Case presentation: A 64-year-old female in good health suffered a distal radius fracture, treated with open reduction and internal fixation. A modified treatment plan, including custom orthosis and active wrist exercises, was initiated after the standard immobilization phase to enhance the range of motion while accommodating the patient's daily activities. Clinical discussion: The patient underwent 15 evaluations of active range of motion (AROM) using a goniometer, guided by the American Society of Hand Therapists. A Tissue Composition Analysis (TCA) was performed to guide the orthosis-treatment choice. Despite consistent improvement shown in AROM, it was inconclusive whether the modified treatment contributed significantly beyond the standard approach. Conclusions: While the patient's AROM improved, the treatment's effect on this single case cannot definitively confirm the efficacy of the modified approach. A more extensive study is necessary to evaluate the conservative treatment strategy's validity for such fractures in high-demand patients, considering the biomechanical complexity of the injury and the patient's professional needs.

Early physical rehabilitation dosage in the intensive care unit associates with hospital outcomes after critical COVID-19.

OBJECTIVE: To examine the relationship between physical rehabilitation parameters including an approach to quantifying dosage with hospital outcomes for patients with critical COVID-19. DESIGN: Retrospective practice analysis from March 5, 2020, to April 15, 2021. SETTING: Intensive care units (ICU) at four medical institutions. PATIENTS: n = 3780 adults with ICU admission and diagnosis of COVID-19. INTERVENTIONS: We measured the physical rehabilitation treatment delivered in ICU and patient outcomes: (1) mortality; (2) discharge disposition; and (3) physical function at hospital discharge measured by the Activity Measure-Post Acute Care (AM-PAC) "6-Clicks" (6-24, 24 = greater functional independence). Physical rehabilitation dosage was defined as the average mobility level scores in the first three sessions (a surrogate measure of intensity) multiplied by the rehabilitation frequency (PT + OT frequency in hospital). MEASUREMENTS AND MAIN RESULTS: The cohort was a mean 64 ± 16 years old, 41% female, mean BMI of 32 ± 9 kg/m2 and 46% (n = 1739) required mechanical ventilation. For 2191 patients who received rehabilitation, the dosage and AM-PAC at discharge were moderately, positively associated (Spearman's rho [r] = 0.484, p < 0.001). Multivariate linear regression (model adjusted R2 = 0.68, p < 0.001) demonstrates mechanical ventilation (ß = - 0.86, p = 0.001), average mobility score in first three sessions (ß = 2.6, p < 0.001) and physical rehabilitation dosage (ß = 0.22, p = 0.001) were predictive of AM-PAC scores at discharge when controlling for age, sex, BMI, and ICU LOS. CONCLUSIONS: Greater physical rehabilitation exposure early in the ICU is associated with better physical function at hospital discharge.

Macauba (Acrocomia aculeata) pulp oil reduces fat accumulation and enhances the lifespan of Caenorhabditis elegans at low temperatures via fat-1- and fat-7-dependent pathway.

Macauba (Acrocomia aculeata) is a Brazilian palm tree whose oil in the pulp is rich in oleic acid and carotenoids. However, its physiological function remains unknown. This study aimed to investigate the effects of macauba pulp oil (MPO) on the metabolic link between lipid metabolism and lifespan using Caenorhabditis elegans (C. elegans). C. elegans were treated with 5.0 mg/mL of MPO for analyzing triglyceride and glycerol accumulation, fatty acid profile, gene expression of lipid and oxidative metabolism proteins under cold (4°C) stress conditions, and lifespan analysis under stress conditions such as cold (4°C), heat (37°C), and oxidative (paraquat) stress. MPO significantly suppressed fat accumulation and increased glycerol (a lipolysis index) and the lifespan of C. elegans at low temperature (4°C). This was accompanied by decreased mRNA levels of the genes involved in lipogenesis (spb-1 and pod-2) and increased levels of the genes involved in fatty acid ß-oxidation (acs-2 and nhr-49) and fat mobilization genes (hosl-1 and aak-2). Additionally, MPO treatment modulated fatty acid pools in C. elegans at low temperatures in that MPO treatment decreased saturated fatty acid levels and shifted the fatty acid profile to long-chain fatty acids. Moreover, the effect of MPO on fat accumulation at low temperatures was abolished in fat-7 mutants, whereas both fat-1 and fat-7 contribute, at least in part, to MPO-elevated survival of C. elegans under cold conditions. PRACTICAL APPLICATION: The results obtained in the present study may contribute to the understanding of the health benefits of consuming macauba pulp oil and consequently stimulate economic growth and the industrial application of this new type of oil, which may result in the creation of new jobs and increased value of small producers.

Loss of microbial diversity increases methane emissions and arsenic release in paddy soils.

Microorganisms are vital to the emission of greenhouse gases and transforming pollutants in paddy soils. However, the impact of microbial diversity loss on anaerobic methane (CH4) oxidation and arsenic (As) reduction under flooded conditions remains unclear. In this study, we inoculated microbial suspensions into natural As-contaminated paddy soils using a dilution approach (untreated, 10-2, 10-4, 10-6, 10-8 dilutions) to manipulate microbial diversity levels. The results revealed that the 10-4 and 10-6 dilutions resulted in the highest CH4 emissions (97.0 µmol and 102.3 µmol) compared to untreated groups (27.6 µmol). However, anaerobic CH4 oxidation was not observed in 10-4 dilution groups and higher dilutions, suggesting the loss of diversity inhibited the natural reduction of CH4. Moreover, the porewater As concentration in the dilution groups was 1.8-8.2 times greater than in the untreated groups. The loss of microbial diversity promoted the reductive dissolution of iron (Fe) minerals bearing As, leading to increased concentrations of Fe(II) and dissolved organic carbon (DOC), which further enhanced As release (Fe(II), R = 0.9, p < 0.001) (DOC, R = 0.8, p < 0.001) from soil to porewater. However, CH4-dependent As(V) reduction was almost entirely inhibited under diversity loss. The decline in microbial diversity increased the relative abundances of methanogens (e.g., Methanobacterium and Methanomassiliicoccus), Fe(III)/As(V)-reducing bacteria (e.g., Bacillus, Clostridium_sensu_stricto_10, and Geobacter), and the related functional genes (i.e., mcrA and Geo). These findings suggest that microbial diversity is critical for specialized soil processes, highlighting the detrimental effects of biodiversity loss on CH4 emissions and As release in As-contaminated paddies.

Arthro-distension with early and intensive mobilization for shoulder adhesive capsulitis: A randomized controlled trial.

BACKGROUND: There are several therapeutic options for the management of shoulder adhesive capsulitis (AC). The superiority of arthro-distension over intra-articular steroid injection (ISI) for AC remains controversial. OBJECTIVES: To evaluate the efficacy of a single arthro-distension procedure combined with early and intensive mobilization (ADM) and physiotherapy, versus ISI and physiotherapy, in people with AC lasting ≥3 months. METHODS: This was a prospective, 2 parallel-group, 2-center, observer-blind randomized controlled trial conducted in tertiary care settings. Adults with AC were randomly assigned to the treatment or control group. Efficacy was assessed using the self-administered Shoulder Pain and Disability Index (SPADI). Total, pain and disability SPADI scores 15 days, 6 weeks, and 3, 6 and 12 months after the procedure (total SPADI at 15 days: primary outcome; other outcomes were secondary) were compared between groups using analysis of covariance (ANCOVA). A post hoc analysis stratified on the initial range of passive glenohumeral abduction, which had not been pre-specified, was conducted. RESULTS: There were 33 participants in each group. Both groups improved over time. Mean (SD) total SPADI score at 15 days was 33.8 (19.6) in the treatment group and 32.8 (17.5) in the control group, p = 0.393. There were no significant differences for any variables in the overall sample. The post hoc analysis found ADM to be associated with a significant decrease in total SPADI score at 15 days compared with ISI (p = 0.049) in individuals with initial passive glenohumeral abduction >45°. CONCLUSIONS: The effects of ADM on pain and function were not statistically different from those of ISI. However, ADM may be useful in individuals with initial passive glenohumeral abduction >45°. DATABASE REGISTRATION: NCT00724113.

Knowledge mobilization between the food industry and public health nutrition scientists: findings from a case study.

BACKGROUND: Improving the nutritional quality of the food supply increases access to nutritious foods, which improves dietary habits and population health. Yet, knowledge mobilization initiatives between public health nutrition researchers and food industries are often not adequately considered and understood. This study explored what elements related to this specific context need to be recognized so that researchers can better mobilize nutrition science knowledge with the food industry to promote the nutritional improvement of food products. METHOD: A case study qualitative approach was selected to answer the research question, using semi-structured interviews as the data collection technique. Québec baking industry actors were shown a mock-up of an online mobilization platform sharing the results of the Food Quality Observatory that describes the nutritional quality of breads offered in Québec, Canada. They were asked to think aloud as they explored the web platform and were interviewed. Two coders analyzed the data using an inductive approach and thematic content analysis, starting with individual open coding, and then put forward their analyses and drafted the final themes. RESULTS: The final data consisted of 10 semi-structured interviews conducted between October 2019 and August 2020. Four main themes were identified: the industry's context, the knowledge mobilization initiative, the product-related matters stemming from the information shared and the motivation within the industry. Within each theme, sub-themes were highlighted and related to the industries' motivation to improve their products' nutritional quality. This study also specified key considerations for changes to the sodium and fiber content in bread. CONCLUSION: Other steps beyond using simple language and a website format could be taken to better mobilize scientific knowledge with food industries, such as providing more consumer information, using an integrated knowledge mobilization approach that includes a consideration of ethics, working with communication professionals, collaborating with food science experts, and providing resources to act on shared information. Legislation such as the front-of-pack regulations could accelerate the pace of collaboration between researchers and industry. Overall, establishing a prior relationship with industries could help gain a better understanding of the themes highlighted in this study. Future research could build on this case study to provide more insights and solidify these findings. CLASSIFICATION CODES: Public Health, Public Private, Policy Making, Research Institutions, Use of Knowledge.

Healthcare professionals' perspectives on optimizing pain care-related education at a Canadian children's hospital: A qualitative study.

Objectives: Pain affects all children and youth, yet acute and procedural pain remains undertreated in Canadian hospitals. To improve pain management practices in paediatric hospitals, it is necessary to understand how healthcare professionals (HCPs) wish for educational interventions to be designed to improve their pain management practice. Methods: Semi-structured interviews were conducted with 18 HCPs between October and December 2020. Snowball sampling was used to first recruit interested members from the hospital's Pediatric Pain Management Committee. Interviews were conducted per participant preference and included Zoom, telephone, and in-person interviews. Recruitment ceased when data were determined sufficiently rich. A thematic analysis of verbatim transcripts and reflexive field notes were used to create a data set focused on knowledge mobilization and clinical education. Results: Three core themes were identified: (a) the necessity for just-in-time education for HCPs; (b) the availability of clinical pain champions to educate staff; and (c) the provision of resources to educate children and their families about available pain management interventions. Just-in-time education included suggestions for in-service training, hands-on training, and regular updates on the latest research. Pain champions, including clinical nurse educators, were stressed as being important in motivating staff to improve their pain management practices. Participants noted the lack of resources for patient and family education on pain management and suggested providing more multimodal resources and educational opportunities. Conclusion: Having local champions introduce pain management initiatives and just-in-time education positively impacts the implementation climate, which also helps HCPs provide evidence-based education and resources to patients and families.

Comparison of biosimilar filgrastim and originator filgrastim for peripheral blood stem cell mobilization for allogeneic hematopoietic stem cell transplantation.

BACKGROUND: Nivestym, a biosimilar granulocyte colony-stimulating factor (G-CSF) to the originator filgrastim (Neupogen), is now being used for the mobilization of peripheral blood stem cells (PBSC) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aim to compare the efficacy of Nivestym and Neupogen for PBSC mobilization in healthy allogeneic donors. METHODS: We conducted a retrospective single-center study including 541 adult allo-HSCT donors receiving Nivestym (January 2013-July 2020), or Neupogen (July 2020-June 2023) for donor PBSC mobilization. Bivariate analysis was conducted using SPSS version 28. Statistical significance was determined at a p-value <.05. RESULTS: Our study included 541 allo-HSCT donors who received Neupogen (n = 345, 64%) or Nivestym (n = 196, 36%) for PBSC mobilization. The median age was 47 years (range 17-76). The median donor weight was 86 kg (95% confidence interval [CI]: 87-91). Donors receiving Neupogen had similar pre-G-CSF white blood cell count, CD34+ percentages, and circulating CD34+ count compared with donors receiving Nivestym. The Neupogen group had similar median PBSC product total neutrophil count, CD34+ percentage, absolute CD34+ count, and infused CD34+ dose compared with the Nivestym group. For donors aged 35 years or younger, the median CD34+ dose was higher in donors who received Neupogen compared with Nivestym (6.9 vs. 6.3 million cells/kg, p = .044). CONCLUSIONS: Nivestym demonstrated similar efficacy for PBSC mobilization compared with Neupogen among allo-HSCT donors. In donors aged 35 years or younger, a slightly lower PBSC product CD34+ count was noted with Nivestym compared with Neupogen.

Early Postoperative Weight-Bearing Ability after Total Hip Arthroplasty versus Bipolar Hemiarthroplasty in Elderly Patients with Femoral Neck Fracture.

Background: Femoral neck fractures are among the most common types of fractures and particularly affect elderly patients. Two of the most common treatment strategies are total hip arthroplasty (THA) and bipolar hemiarthroplasty (BA). However, the role of the different treatment strategies in the postoperative weight-bearing ability in the early postoperative phase is still not entirely clear. Methods: Patients who underwent either THA or BA were consecutively included in our prospective cohort study. Gait analysis was performed during the early postoperative period. The gait analysis consisted of a walking distance of 40 m coupled with the turning movement in between. During the gait analysis, the duration of the measurement, the maximum peak force and the average peak force were recorded. Results: A total of 39 patients were included, 25 of whom underwent BA and 14 of whom underwent THA. The maximum peak force during the gait analysis was, on average, 80.6% ± 19.5 of the body weight in the BA group and 78.9% ± 21.6 in the THA group. The additionally determined average peak force during the entire gait analysis was 66.8% ± 15.8 of the body weight in the BA group and 60.5% ± 15.6 in the THA group. Conclusions: Patients with femoral neck fractures undergoing THA and BA can achieve sufficient weight bearing on the operated leg in the early postoperative period. In our study, BA did not allow for a significantly higher average and maximum loading capacity compared with THA.