Category: Nevin Manimala

Acta Oncol. 2023 Mar 11:1-7. doi: 10.1080/0284186X.2023.2186187. Online ahead of print.

ABSTRACT

BACKGROUND: Oligoprogression (OPD) is defined as a condition where limited progression (1-3 metastases) is observed in patients undergoing systemic cancer treatment. In this study we investigated the impact of stereotactic body radiotherapy (SBRT) in patients with OPD from metastatic lung cancer.

MATERIAL AND METHODS: Data from a cohort of consecutive patients with SBRT treated between June 2015 and August 2021 were collected. All extracranial metastatic sites of OPD from lung cancer were included. Dose regimens consisted of 24 in 2 fractions, 30-51 Gy in 3 fractions, 30-55 Gy in 5 fractions, 52.5 Gy in 7 fractions and 44-56 Gy in 8 fractions. Kaplan-Meier method was used to calculate Overall Survival (OS), Local Control (LC), and Disease-Free Survival (DFS) from the start date of SBRT to the event.

RESULTS: Sixty-three patients, 34 female and 29 males were included. Median age was 75 years (range 25-83). All patients received concurrent systemic treatment before the start of the SBRT: 19 chemotherapy (CT), 26 CT plus immunotherapy (IT) or Tyrosin kinase inhibitors (TKI) and 18 IT/TKI. SBRT was delivered to the lung (n = 29), mediastinal node (n = 9), bone (n = 7), adrenal gland (n = 19), other visceral metastases (1) and other node metastases (n = 4). After a median follow-up of 17 months, median OS was 23 months. LC was 93% at 1 year and 87% at 2 years. DFS was 7 months. According to our results, there was no statistically significant correlation between prognostic factors and OS after SBRT in OPD patients.

CONCLUSIONS: Median DFS was 7 months, translating into the continuation of effective systemic treatment as other metastases grow slowly. In patients with oligoprogression disease, SBRT is a valid and efficient treatment that may enable postponing the switch of systemic line.

PMID:36905644 | DOI:10.1080/0284186X.2023.2186187

Scand J Occup Ther. 2023 Mar 11:1-9. doi: 10.1080/11038128.2023.2184420. Online ahead of print.

ABSTRACT

BACKGROUND: Older drivers with mild cognitive impairment (MCI) often show declining driving performance. Evidence is lacking regarding whether their driving skills can be improved after practice.

AIMS/OBJECTIVES: To compare the practice effects of older drivers with MCI and drivers with normal cognition in an unfamiliar, standardized driving course with three practices.

MATERIALS AND METHODS: Single-blind two-group observational design. Twelve drivers with confirmed MCI as the experimental group and ten with normal cognition (NC) as the control, all ≥ 55 years old. The primary outcome was to assess the practice effects, measured with an in-car global-positioning-system mobile application to compare the speed and directional control of a complex manoeuvre after practices. Secondary outcomes were to assess the pass/fail rate and mistakes observed for the 3^rd/final on-road driving practice. No instructions were given during practice. Descriptive statistics and the Mann-Whitney U test were used for data analysis.

RESULTS: No significant inter-group difference in the pass/fail rate and number of mistakes. Some MCI drivers performed better in the speed and directional control of the S-Bend manoeuvre after practices.

CONCLUSIONS: The driving performance of drivers with MCI may improve with practice.

SIGNIFICANCE: Older drivers with MCI may potentially benefit from driver retraining.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT04648735).

PMID:36905632 | DOI:10.1080/11038128.2023.2184420

J Am Podiatr Med Assoc. 2023 Jan-Feb;113(1):21-229. doi: 10.7547/21-229.

ABSTRACT

BACKGROUND: Studies on the sensory perception of mass mostly focus on the hands rather than the feet. The aim of our study is to measure how accurately runners can perceive additional shoe mass in comparison to a control shoe (CS) while running, and moreover, whether there is a learning effect in the perception of mass. Indoor running shoes were categorized as a CS (283 g) and shoes with four additional masses: shoe 2 (+50 g), shoe 3 (+150 g), shoe 4 (+250 g), and shoe 5 (+315 g).

METHODS: There were 22 participants in the experiment, which was divided into two sessions. In session 1, participants ran on a treadmill for 2 min with the CS and then put on one set of weighted shoes and ran for another 2 min at a preferred velocity. A binary question was used after the pair test. This process was repeated for all the shoes to compare them with the CS.

RESULTS: Based on our statistical analysis (mixed effect logistic regression), the independent variable (ie, mass) did have a significant effect on perceived mass (F4,193 = 10.66, P < .0001), whereas repeating the task did not show a significant learning effect (F1,193 = 1.06, P = .30).

CONCLUSIONS: An increase of 150 g is the just-noticeable difference among other weighted shoes and the Weber fraction is equal to 0.53 (150:283 g). Learning effect did not improve by repeating the task in two sessions in the same day. This study facilitates our understanding about sense of force and enhances multibody simulation in running.

PMID:36905625 | DOI:10.7547/21-229

J Am Podiatr Med Assoc. 2023 Jan-Feb;113(1):21-008. doi: 10.7547/21-008.

ABSTRACT

BACKGROUND: Clinical studies have shown that posterior malleolar fractures treated with a posterior buttress plate have improved outcomes compared to anterior-to-posterior screw fixation. The aim of this study was to evaluate the impact of posterior malleolus fixation on clinical and functional results.

METHODS: The patients with posterior malleolar fractures who were treated between January of 2014 and April of 2018 at our hospital were investigated retrospectively. Fifty-five patients included in the study were divided into three groups according to the fixation preferences of fractures (group I, posterior buttress plate; group II, anterior-to-posterior screw; and group III, nonfixated). The groups consisted of 20, nine, and 26 patients, respectively. These patients were analyzed according to demographic data, fixation preferences of fractures, mechanism of injury, hospitalization length of stay, surgical time, syndesmosis screw use, follow-up time, complications, Haraguchi fracture classification, van Dijk classification, American Orthopaedic Foot and Ankle Society score, and plantar pressure analysis.

RESULTS: There were no statistically significant differences between the groups in terms of gender, operation side, injury mechanism, length of stay, anesthesia types, and syndesmotic screw usage. However, when the age, follow-up time, operation time, complications, Haraguchi classification, van Dijk classification, and American Orthopaedic Foot and Ankle Society scores were evaluated, statistically significant differences were observed between the groups. Plantar pressure analysis data showed that group I yielded balanced pressure distribution between both feet compared to the other study groups.

CONCLUSIONS: The posterior buttress plating of posterior malleolar fractures yielded better clinical and functional outcomes compared to the anterior-to-posterior screw fixation and nonfixated groups.

PMID:36905619 | DOI:10.7547/21-008

Int J Epidemiol. 2023 Mar 11:dyad023. doi: 10.1093/ije/dyad023. Online ahead of print.

ABSTRACT

Common tasks encountered in epidemiology, including disease incidence estimation and causal inference, rely on predictive modelling. Constructing a predictive model can be thought of as learning a prediction function (a function that takes as input covariate data and outputs a predicted value). Many strategies for learning prediction functions from data (learners) are available, from parametric regressions to machine learning algorithms. It can be challenging to choose a learner, as it is impossible to know in advance which one is the most suitable for a particular dataset and prediction task. The super learner (SL) is an algorithm that alleviates concerns over selecting the one ‘right’ learner by providing the freedom to consider many, such as those recommended by collaborators, used in related research or specified by subject-matter experts. Also known as stacking, SL is an entirely prespecified and flexible approach for predictive modelling. To ensure the SL is well specified for learning the desired prediction function, the analyst does need to make a few important choices. In this educational article, we provide step-by-step guidelines for making these decisions, walking the reader through each of them and providing intuition along the way. In doing so, we aim to empower the analyst to tailor the SL specification to their prediction task, thereby ensuring their SL performs as well as possible. A flowchart provides a concise, easy-to-follow summary of key suggestions and heuristics, based on our accumulated experience and guided by SL optimality theory.

PMID:36905602 | DOI:10.1093/ije/dyad023

Headache. 2023 Mar 10. doi: 10.1111/head.14480. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore whether the association between change in headache management self-efficacy and posttraumatic headache-related disability is partially mediated by a change in anxiety symptom severity.

BACKGROUND: Many cognitive-behavioral therapy treatments for headache emphasize stress management, which includes anxiety management strategies; however, little is currently known about mechanisms of change in posttraumatic headache-related disability. Increasing our understanding of mechanisms could lead to improvements in treatments for these debilitating headaches.

METHODS: This study is a secondary analysis of veterans (N = 193) recruited to participate in a randomized clinical trial of cognitive-behavioral therapy, cognitive processing therapy, or treatment as usual for persistent posttraumatic headache. The direct relationship between headache management self-efficacy and headache-related disability, along with partial mediation through change in anxiety symptoms was tested.

RESULTS: The mediated latent change direct, mediated, and total pathways were statistically significant. The path analysis supported a significant direct pathway between headache management self-efficacy and headache-related disability (b = -0.45, p < 0.001; 95% confidence interval [CI: -0.58, -0.33]). The total effect of change of headache management self-efficacy scores on change in Headache Impact Test-6 scores was significant with a moderate-to-strong effect (b = -0.57, p = 0.001; 95% CI [-0.73, -0.41]). There was also an indirect effect through anxiety symptom severity change (b = -0.12, p = 0.003; 95% CI [-0.20, -0.04]).

CONCLUSIONS: In this study, most of the improvements in headache-related disability were related to increased headache management self-efficacy with mediation occurring through change in anxiety. This indicates that headache management self-efficacy is a likely mechanism of change of posttraumatic headache-related disability with decreases in anxiety explaining part of the improvement in headache-related disability.

PMID:36905163 | DOI:10.1111/head.14480

Int J Audiol. 2023 Mar 10:1-7. doi: 10.1080/14992027.2023.2183353. Online ahead of print.

ABSTRACT

OBJECTIVE: To ascertain the prevalence, causes, and risk factors of hearing healthcare delays in older people with self-reported hearing loss in the United States.

DESIGN: This cross-sectional study used data from the National Health and Ageing Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries. A supplemental COVID-19 survey was mailed to the participants from June to October 2020.

STUDY SAMPLE: By January 2021, 3257 participants had returned completed COVID-19 questionnaires, with the majority having been self-administered between July and August 2020.

RESULTS: The participants in the study represented 32.7 million older adults in the US, with 29.1% reporting hearing loss. Among over 12.4 million older adults who put off needed or planned medical care, 19.6% of those with self-reported hearing loss and 24.5% of hearing aid or device users stated they delayed hearing appointments. Approximately 629,911 older adults with hearing devices were impacted by the COVID-19 outbreak for audiological services. The top three reasons were deciding to wait, service cancellation, and fear of going. Education and race/ethnicity were associated with delaying hearing healthcare.

CONCLUSIONS: The COVID-19 pandemic impacted hearing healthcare utilisation among older adults with self-reported hearing loss in 2020, with both patient- and provider- initiated delays.

PMID:36905138 | DOI:10.1080/14992027.2023.2183353

J Appl Biomater Funct Mater. 2023 Jan-Dec;21:22808000231159238. doi: 10.1177/22808000231159238.

ABSTRACT

OBJECTIVE: This study was aimed at including 2.5 wt.% of carbon nanoparticles (CNPs) and graphene oxide NPs (GNPs) in a control adhesive (CA) and then investigate the effect of this inclusion on their mechanical properties and its adhesion to root dentin.

MATERIALS AND METHODS: Scanning electron microscopy and energy dispersive X-ray (SEM-EDX) mapping were conducted to investigate the structural features and elemental distribution of CNPs and GNPs, respectively. These NPs were further characterized by Raman spectroscopy. The adhesives were characterized by evaluating their push-out bond strength (PBS), rheological properties, degree of conversion (DC) investigation, and failure type analysis.

RESULTS: The SEM micrographs revealed that the CNPs were irregular and hexagonal, whereas the GNPs were flake-shaped. EDX analysis showed that carbon (C), oxygen (O), and zirconia (Zr) were found in the CNPs, while the GNPs were composed of C and O. The Raman spectra for CNPs and GNPs revealed their characteristic bands (CNPs-D band: 1334 cm^-1, GNPs-D band: 1341 cm^-1, CNPs-G band: 1650 cm^-1, and GNPs-G band: 1607 cm^-1). The testing verified that the highest bond strength to root dentin were detected for GNP-reinforced adhesive (33.20 ± 3.55 MPa), trailed closely by CNP-reinforced adhesive (30.48 ± 3.10 MPa), while, the CA displayed lowest values (25.11 ± 3.60 MPa). The inter-group comparisons of the NP-reinforced adhesives with the CA revealed statistically significant results (p < 0.01). Failures of adhesive nature were most common in within the adhesives and root dentin. The rheological assessment results demonstrated a reduced viscosity for all the adhesives observed at advanced angular frequencies. All the adhesives verified suitable dentin interaction shown by hybrid layer and appropriate resin tag development. A reduced DC was perceived for both NP-reinforced adhesives, compared to the CA.

CONCLUSION: The present study’s findings have demonstrated that 2.5% GNP adhesive revealed the highest, suitable root dentin interaction, and acceptable rheological properties. Nevertheless, a reduced DC was observed (matched with the CA). Prospective studies probing the influence of diverse concentrations of filler NPs on the adhesive’s mechanical properties to root dentin are recommended.

PMID:36905128 | DOI:10.1177/22808000231159238

J Med Virol. 2023 Mar 10. doi: 10.1002/jmv.28668. Online ahead of print.

ABSTRACT

Polio cases can be missed by acute flaccid paralysis AFP case surveillance alone, emphasizing the importance of environmental surveillance. In this study, to investigate the serotype distribution and epidemiological trends of poliovirus (PV), we characterized PV isolated from domestic sewage in Guangzhou city, Guangdong province, China from 2009 to 2021. A total of 624 sewage samples were collected from the Liede Sewage Treatment Plant, and the positive rates of PV and non-polio enteroviruses were 66.67% (416/624) and 78.37% (489/624), respectively. After sewage sample treatment, each sewage sample was inoculated in six replicate tubes of three cell lines, and 3,370 viruses were isolated during the 13-year surveillance period. Among these, 1086 isolates were identified as PV, including type 1 PV (21.36%), type 2 PV (29.19%), and type 3 PV (49.48%). Based on VP1 sequences, 1057 strains were identified as Sabin-like, 21 strains were high-mutant vaccine, and eight strains were vaccine-derived poliovirus (VDPV). The numbers and serotypes of PV isolates in sewage were influenced by the vaccine switch strategy. After type 2 OPV was removed from the trivalent oral poliovirus vaccine and a bivalent OPV was adopted in May 2016, the last type 2 PV strain was isolated from sewage, with no detection thereafter. Type 3 PV isolates increased significantly and became the dominant serotype. Before and after the second vaccine switch in January 2020, that is, from the first dose of IPV and second-fourth doses of bOPV to the first two doses of IPV and third-fourth doses of bOPV, there was also a statistical difference in PV positivity rates in sewage samples. Seven type 2 VDPVs and one type 3 VDPV were identified in sewage samples in 2009-2021, and a phylogenetic analysis indicated that all VDPVs isolated from ES in Guangdong are newly discovered VDPVs, different from VDPV previously discovered in China, and were classified as ambiguous VDPV. It is noteworthy that no VDPV cases were reported in AFP case surveillance in the same period. In conclusion, continued PV environmental surveillance in Guangzhou since April 2008 has been a useful supplement to AFP case surveillance, providing an important basis for evaluating the effectiveness of vaccine immunization strategies. Environmental surveillance improves early detection, prevention, and control; accordingly, this strategy can curb the circulation of VDPVs and provide a strong laboratory basis for maintaining a polio-free status. This article is protected by copyright. All rights reserved.

PMID:36905116 | DOI:10.1002/jmv.28668

Fundam Clin Pharmacol. 2023 Mar 10. doi: 10.1111/fcp.12891. Online ahead of print.

ABSTRACT

The treatment options are limited in A.baumannii infections. In this study, the effectiveness of colistin monotherapy and combinations of colistin with different antibiotics were investigated in an experimental pneumonia model induced by carbapenem-resistant A. baumannii strain. Mice in the study were divided into five groups as control (no treatment), colistin monotherapy, colistin+sulbactam, colistin+imipenem and colistin+tigecycline combinations. Modified experimental surgical pneumonia model of Esposito and Pennington was applied to all groups. The presence of bacteria in blood and lung samples was investigated. Results were compared. In blood cultures while there was no difference between the control and colistin group, there was a statistical difference between the control and the combination groups (p=0,029). When the groups were compared in terms of lung tissue culture positivity, there was a statistical difference between the control group and all treatment groups (colistin, colistin + sulbactam, colistin + imipenem, and colistin + tigecycline) (p=0.026, p=<0.001, p=<0.001, p=0.002 respectively). The amount of microorganisms that grew in the lung tissue was found to be statistically significantly lower in all treatment groups in comparison with the control group (p= 0.001). Both monotherapy and combination therapies of colistin were found to be effective in the treatment of carbapenem-resistant A.baumannii pneumonia, but the superiority of combination therapies over colistin monotherapy has not been demonstrated.

PMID:36905104 | DOI:10.1111/fcp.12891