Tag: pubmed

Adv Exp Med Biol. 2023;1424:135-144. doi: 10.1007/978-3-031-31982-2_14.

ABSTRACT

OBJECTIVE: Epilepsy patients could possibly benefit from the remuneration observed in the use of virtual reality (VR) and virtual environments (VEs), especially in cognitive difficulties associated with visuospatial navigation (memory, attention, and processing speed).

AIM: Research questions under consideration in the present systematic review are associated to VEs’ efficiency as a cognitive rehabilitation practice in epilepsy and the particular VR methods indicated for epilepsy patients. To meet criteria, studies included participants suffering from any form of epilepsy and a methodological design with a structured rehabilitation program/model. Data were collected online, using academic databases.

RESULTS: Fourteen studies were included in the literature review and 6 in the statistical analysis. ROBINS-I protocol was implemented to assess the risk of bias. An inverse variance analysis (random effects) of pooled estimates of differences was implemented, in the form of continuous data. Despite the heterogeneity of the studies, all of them agree on the beneficial aspects of VR and VEs in cognitive rehabilitation in relation to visuospatial memory, attention, and information processing speed.

CONCLUSION: We suggest that patients suffering from epilepsy may benefit from the use of VR cognitive rehabilitation interventions, concerning visuospatial memory, attention, and information processing speed. However, further investigation is needed in order to gain a better understanding of the mechanisms involved in cognitive rehabilitation via VEs and establish efficient and dynamic rehabilitation protocols.

PMID:37486487 | DOI:10.1007/978-3-031-31982-2_14

Breast Cancer. 2023 Jul 24. doi: 10.1007/s12282-023-01485-y. Online ahead of print.

ABSTRACT

BACKGROUND: Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) improve the prognosis of hormone receptor-positive HER2-negative advanced/metastatic breast cancer (HR+/HER2- mBC). However, some cancers show resistance to CDK4/6i and have a poor prognosis. The non-luminal disease score (NOLUS) was developed to predict non-luminal disease using immunohistochemical analysis.

METHODS: The association between the efficacy of CDK4/6i and NOLUS was investigated by evaluating pathological and clinical data, including real-world progression-free survival (rw-PFS) and overall survival (OS). Real-world data of patients with HR+/HER2- mBC who received CDK4/6i therapy [palbociclib or abemaciclib] as first- or second-line endocrine treatments was obtained. NOLUS was calculated using the formula: NOLUS (0-100) = – 0.45 × estrogen receptor (ER) (%) – 0.28 × progesterone receptor (PR) (%) + 0.27 × Ki67(%) + 73, and the patients were divided into two groups: NOLUS-positive (≥ 51.38) and NOLUS-negative (< 51.38).

RESULTS: Of the 300 patients, 28 (9.3%) were NOLUS-positive, and 272 (90.7%) were NOLUS-negative. The expression rates (%) of ER and PgR in NOLUS-positive patients were lower than those in NOLUS-negative patients (p < 0.001). Ki67 expression was higher in NOLUS-positive patients. There were statistically significant differences in prognosis (rw-PFS and OS) between the two groups. Moreover, NOLUS-negative patients showed statistically better rw-PFS with first-line therapy than second-line therapy. However, NOLUS-positive patients showed poor prognoses with both the first and second therapeutic lines, suggesting CDK4/6i inefficacy for NOLUS-positive patients.

CONCLUSIONS: The efficacy and prognosis of CDK4/6i significantly differed between the NOLUS-positive and NOLUS-negative patients. This feasible method can predict patients with HR+/HER2- mBC resistant to CDK4/6i and help select a better therapeutic approach to overcome resistance.

PMID:37486454 | DOI:10.1007/s12282-023-01485-y

Med Biol Eng Comput. 2023 Jul 24. doi: 10.1007/s11517-023-02859-2. Online ahead of print.

ABSTRACT

Accurate diagnosis of autism spectrum disorder (ASD) is crucial for effective treatment and prognosis. Functional brain networks (FBNs) constructed from functional magnetic resonance imaging (fMRI) have become a popular tool for ASD diagnosis. However, existing model-driven approaches used to construct FBNs lack the ability to capture potential non-linear relationships between data and labels. Moreover, most existing studies treat the FBNs construction and disease classification as separate steps, leading to large inter-subject variability in the estimated FBNs and reducing the statistical power of subsequent group comparison. To address these limitations, we propose a new approach to FBNs construction called the deep unrolling-based spatial constraint representation (DUSCR) model and integrate it with a convolutional classifier to create an end-to-end framework for ASD recognition. Specifically, the model spatial constraint representation (SCR) is solved using a proximal gradient descent algorithm, and we unroll it into deep networks using the deep unrolling algorithm. Classification is then performed using a convolutional prototype learning model. We evaluated the effectiveness of the proposed method on the ABIDE I dataset and observed a significant improvement in model performance and classification accuracy. The resting state fMRI images are preprocessed into time series data and 3D coordinates of each region of interest. The data are fed into the DUSCR model, a model for building functional brain networks using deep learning instead of traditional models, that we propose, and then the outputs are fed into the convolutional classifier with prototype learning to determine whether the patient has ASD disease.

PMID:37486440 | DOI:10.1007/s11517-023-02859-2

Neuroradiology. 2023 Jul 24. doi: 10.1007/s00234-023-03201-1. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the ability of neurite orientation dispersion and density imaging (NODDI) for detecting white matter (WM) microstructural abnormalities in minimal hepatic encephalopathy (MHE).

METHODS: Diffusion-weighted images, enabling the estimation of NODDI and diffusion tensor imaging (DTI) parameters, were acquired from 20 healthy controls (HC), 22 cirrhotic patients without MHE (NHE), and 15 cirrhotic patients with MHE. Tract-based spatial statistics were used to determine differences in DTI (including fractional anisotropy [FA] and mean/axial/radial diffusivity [MD/AD/RD]) and NODDI parameters (including neurite density index [NDI], orientation dispersion index [ODI], and isotropic volume fraction [ISO]). Voxel-wise analyses of correlations between diffusion parameters and neurocognitive performance determined by Psychometric Hepatic Encephalopathy Score (PHES) were completed.

RESULTS: MHE patients had extensive NDI reduction and rare ODI reduction, primarily involving the genu and body of corpus callosum and the bilateral frontal lobe, corona radiata, external capsule, anterior limb of internal capsule, temporal lobe, posterior thalamic radiation, and brainstem. The extent of NDI and ODI reduction expanded from NHE to MHE. In both MHE and NHE groups, the extent of NDI change was quite larger than that of FA change. No significant intergroup difference in ISO/MD/AD/RD was observed. Tissue specificity afforded by NODDI revealed the underpinning of FA reduction in MHE. The NDI in left frontal lobe was significantly correlated with PHES.

CONCLUSION: MHE is characterized by diffuse WM microstructural impairment (especially neurite density reduction). NODDI can improve the detection of WM microstructural impairments in MHE and provides more precise information about MHE-related pathology than DTI.

PMID:37486421 | DOI:10.1007/s00234-023-03201-1

Hum Vaccin Immunother. 2023 Jul 24:2234792. doi: 10.1080/21645515.2023.2234792. Online ahead of print.

ABSTRACT

Immunoprofiling has become a crucial tool for understanding the complex interactions between the immune system and diseases or interventions, such as therapies and vaccinations. Immune response biomarkers are critical for understanding those relationships and potentially developing personalized intervention strategies. Single-cell data have emerged as a promising source for identifying immune response biomarkers. In this review, we discuss the current state-of-the-art methods for immunoprofiling, including those for reducing the dimensionality of high-dimensional single-cell data and methods for clustering, classification, and prediction. We also draw attention to recent developments in data integration.

PMID:37485833 | DOI:10.1080/21645515.2023.2234792

Disaster Med Public Health Prep. 2023 Jul 24;17:e436. doi: 10.1017/dmp.2023.100.

ABSTRACT

OBJECTIVE: In Turkey, which is a land of disasters, it is vital for nurses to be prepared before a disaster, and to exhibit an effective attitude and behavior during it. Having a large number of casualties during a disaster may cause inadequacies in receiving basic health care in the hospital.

METHODS: This study was conducted in a descriptive and cross-sectional style to determine the disaster preparedness and preparedness perceptions of nurses. Data were collected with the Personal Information Form and Nurses’ Perception of Disaster Preparedness Scale (NPDPS).

RESULTS: Nurses’ disaster experience, drill experience, and perusal of the disaster plan positively affected the perception of disaster. The disaster preparedness of the institution positively affected the perception of disaster preparation. A significant difference was determined between the requests for information regarding disaster education and NPDPS. A statistically significant relationship was found between terrorist attacks, earthquake exposure, and the total scale score of NPDPS.

CONCLUSIONS: Consequently, nurses and health institutions, whose responsibilities become graver in disasters, have duties such as providing treatment and medical support. Therefore, it was suggested that disaster nursing and disaster management should have been included in the in-service training of nurses.

PMID:37485823 | DOI:10.1017/dmp.2023.100

CNS Neurosci Ther. 2023 Jul 23. doi: 10.1111/cns.14378. Online ahead of print.

ABSTRACT

AIMS: To compare the children’s sleep electroencephalogram according to their intellectual profile.

METHODS: Children were grouped according to their Wechsler Intelligence Scale for Children (WISC) scores (17 with normal intelligence quotient [IQ, NIQ] and 24 with high IQ [HIQ]). Comparisons of spectral power between groups and its relationship with WISC scores were assessed using analyses of variance and linear regression models, adjusted for age and sex.

RESULTS: Children with HIQ had more rapid eye movement (REM) sleep, especially late at night, and more power in slow-frequency bands during REM sleep than those with NIQ. There were also positive associations between the processing speed index and the spectral power in β bands in NREM sleep, and with the spectral power in α, σ, β, and γ bands in REM sleep, with different associations between groups.

CONCLUSION: The enhanced power in slow bands during REM sleep in children with HIQ overlaps with that of typical REM sleep oscillations thought to be involved in emotional memory consolidation. The dissimilar relationships between spectral power and WISC scores in NIQ and HIQ groups may underlie functional differences in brain activity related to cognitive efficiency, questioning the direction of the relationship between sleep and cognitive functioning.

PMID:37485816 | DOI:10.1111/cns.14378

Vet Surg. 2023 Jul 24. doi: 10.1111/vsu.13995. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the impact of variables on use and preference of common laparoscopic instruments.

STUDY DESIGN: Online survey.

SAMPLE POPULATION: Surgeons (n = 140) with 3 years or more laparoscopic experience.

METHODS: Electronic survey distributed via specialty group LISTSERVEs and Facebook groups. Responses collected included surgeon attributes, preferences, and surgical practice data. Statistical analysis was performed using Fishers exact, ANOVA, Tukey Kramer honestly significant difference (HSD) test, linear regression, and logistic regression.

RESULTS: Ninety-eight of 140 respondents answered instrument-related questions and the completion rate of these questions was 76%: 48% of females and 49% of males responded to the survey. The median glove size of respondents was size 7 (range, 5.5 to 8.5). Closing laparoscopic Babcock forceps (p = .018), rotating cup biopsy forceps (p = .003), and manipulating endoscopic staplers (p < .001) were more difficult for surgeons with smaller glove sizes. The median difficulty score for the endoscopic stapler was 4/10 and the median percentage of time this was found difficult was 25%. Reusable instruments were preferred over disposable single-use instruments. The pistol grip was preferred for grasping and retracting (54/98, 55%) and fine dissection (46/96, 48%), while the axial grip was preferred for suturing and knot tying (61/98, 62%).

CONCLUSION: Surgeons with smaller glove sizes (<6.5) experience more difficulty when using common laparoscopic instruments. The endoscopic stapler was the most difficult to use.

CLINICAL SIGNIFICANCE: When purchasing laparoscopic instrumentation, surgeons should review all available options in handle size and design to improve ergonomics during minimally invasive procedures.

PMID:37485785 | DOI:10.1111/vsu.13995

Rev Med Virol. 2023 Jul 23:e2473. doi: 10.1002/rmv.2473. Online ahead of print.

ABSTRACT

Our study is aimed to access the efficacy and safety outcomes for coronavirus disease 2019 (COVID-19) patients treated with Paxlovid. According to inclusion and exclusion criteria, databases were used to retrieve articles from 1 January 2020 to 1 January 2023. Article screening, quality evaluation and data extraction were completed and cross-checked. The meta-analysis and trial sequential analysis (TSA) were conducted using RevMan, StataMP, and TSA software. A total of 42 original articles were included. Overall meta-analysis results showed that for death, hospitalisation, death or hospitalisation, emergency department (ED) visit, intensive care unit (ICU) admission, and extra oxygen requirement outcomes, every odds ratio (OR) was <1 and p < 0.05. For rebound outcome, the OR was >1 and p > 0.05. For adverse events (AEs) outcome, the OR was >1 and p < 0.05. In conclusion, Paxlovid effectively reduced the risks of death, hospitalisation, death or hospitalisation, ED visit, ICU admission, and extra oxygen requirement. There was no significant statistical difference considering rebound, but people should pay attention to possible AEs. However, for rebound and AEs outcomes, observations in certain subgroups suggested conclusions contrary to the overall meta-analysis. Trial sequential analysis indicated these two outcomes have a risk of false negative or false positive conclusions, so additional original studies are needed for further validation.

PMID:37485774 | DOI:10.1002/rmv.2473

J Neuroendocrinol. 2023 Jul 4. doi: 10.1111/jne.13319. Online ahead of print.

ABSTRACT

The mTOR-inhibitor everolimus has been approved for the treatment of advanced neuroendocrine tumors (NETs) but is associated with relevant toxicities in clinical practice. Hence, optimal treatment sequencing and the impact of dose reductions have yet to be clarified. This retrospective analysis assessed patients with advanced, well-differentiated NET treated with everolimus at the Medical University of Vienna. The primary objective was to evaluate the efficacy of everolimus in a real-world cohort. A total of 52 patients treated with everolimus for advanced NET grade 1 (G1) or G2 (or typical or atypical carcinoid) 2010-2021 were included in this analysis. The most common sites of origin were pancreas (44%) and lung (29%). The initial dose was decided by the treating physician based on clinical assessment and 25 patients (48%) each were started at 10 mg/day and 5 mg/day. Median progression-free survival (PFS) following everolimus in the overall cohort was 9.8 months (95% CI: 4.3-15.3), with a statistically significant PFS difference (p = .03) between NET G1/typical carcinoids (42.9 months) and NET G2/atypical carcinoids (8.9 months). PFS was numerically but not significantly shorter in patients treated with a reduced dose (7.5 months vs. 12.4 months, p = .359). Even in this mixed full/half dose cohort, 93% developed treatment-related side effects (mostly grade I, no grade IV), 63% had dose reductions or interruptions, and five stopped due to toxicity. Median survival following treatment was 40.9 months (95% CI: 21.5-60.3) and no difference with regard to dosing was observed (p = .517). These data from an unselected patient cohort show long-term outcomes similar to those reported in the pivotal studies. Comparing everolimus starting dose, median PFS did not significantly differ for patients treated at a lower dose. While this finding is limited by the sample size and warrants prospective verification, initiating therapy at a reduced dose might be practicable and safe in a distinct subset of patients.

PMID:37485760 | DOI:10.1111/jne.13319