Tag: pubmed

Anat Histol Embryol. 2023 Jul 5. doi: 10.1111/ahe.12947. Online ahead of print.

ABSTRACT

Fossa masseterica, to which the musculus masseter is attached, is the pit on the lateral surface of the ramus mandibulae. Processus coronoideus is a protrusion on the upper part of fossa masseterica. Carnivores have a more developed fossa masseterica and a wider processus coronoideus than other species, due to their well-developed jaw muscles. However, there is limited information about the differences of these two structures among carnivorous species. In this study, it was investigated whether fossa masseterica and processus coronoideus differ in shape in domestic cats and domestic dogs. For this purpose, 22 dogs and 20 cats were examined by 3D geometric morphometry. Eighty-one landmarks were used on the fossa masseterica and processus coronoideus. The difference in centroid sizes and shape for cats and dogs was statistically significant (p < 0.0001). PC1 explained 26.47% of the total variance. It was seen that cats and dogs were completely separated according to PC1 results. In cats with a high PC1 value, the processus coronoideus was narrower than in dogs. Also, feline processus coronoideus was more curved than domestic canine processus coronoideus. In addition, the caudal inclination of processus coronoideus was deeper in dogs than in cats. Dogs had a negative PC1 value except for one sample (German Shepherd). The sample with the lowest PC1 value was the French Bulldog (female, 7 years, and 13 kg). Discriminant analysis results showed that the domestic cats and domestic dogs used in the study were completely separated from each other, and this difference was statistically significant. The results of this study showed that dogs with stronger jaw muscles had a deeper fossa masseterica and a wider processus coronoideus than cats.

PMID:37403741 | DOI:10.1111/ahe.12947

Cancer Med. 2023 Jul 5. doi: 10.1002/cam4.6234. Online ahead of print.

ABSTRACT

BACKGROUND: Melanoma frequently harbors BRAF, NRAS, or KIT mutations which influence both tumor development and treatment strategies. For example, it is still controversial whether adjuvant anti-PD-1 monotherapy or BRAF/MEK inhibitors may better improve the survival for resected BRAF-mutant melanoma. Furthermore, outcomes for melanoma with NRAS and KIT mutation receiving adjuvant immunotherapy remain unclear.

METHODS: One hundred seventy-four stage III melanoma patients who underwent radical surgery in Fudan University Shanghai Cancer Center (FUSCC) during January 2017 to December 2021 were included in this real-world study. Patients were followed up until death or May 30th, 2022. Pearson’s chi-squared test or Fisher’s exact test was performed for univariable analysis of the different category groups. Log-rank analysis was used to identify the prognostic factors for disease-free survival (DFS).

RESULTS: There were 41 (23.6%) patients with BRAF mutation, 31 (17.8%) with NRAS mutation, 17 (9.8%) with KIT mutation, and 85 (48.9%) wild-type patients without either genomic alteration of those three genes. Most ( n = 118, 67.8%) of them were acral melanoma, while 45 (25.9%) were cutaneous subtype, and 11 were (6.3%) primary unknown. Among them, 115 (66.1%) patients received pembrolizumab or toripalimab monotherapy as adjuvant therapy; 22 (12.6%) patients received high-dose interferon (IFN), and 37 (21.3%) patients were just for observation. There was no statistical difference in clinicopathologic factors between anti-PD-1 group and IFN/OBS group. Of all the enrolled patients, anti-PD-1 group had a better DFS than IFN/OBS group ( p = 0.039). In anti-PD-1 group, patients with BRAF or NRAS mutations had poorer DFS than wild-type group. No survival difference was found among patients harboring different gene mutations in IFN/OBS group. In wild-type patients, anti-PD-1 group had a better DFS than IFN/OBS group ( p = 0.003), while no survival benefits were found for patients with BRAF, NRAS, or KIT mutations.

CONCLUSION: Although anti-PD-1 adjuvant therapy provides a better DFS in the general population and in wild-type patients, patients with BRAF, KIT or, especially, NRAS mutation may not benefit further from immunotherapy than conventional IFN treatment or observation.

PMID:37403699 | DOI:10.1002/cam4.6234

Eur J Heart Fail. 2023 Jul 5. doi: 10.1002/ejhf.2970. Online ahead of print.

ABSTRACT

AIMS: Multivariable prediction models can be used to estimate risk of incident heart failure (HF) in the general population. A systematic review and meta-analysis was performed to determine the performance of models.

METHODS AND RESULTS: From inception to 3rd November 2022 MEDLINE and EMBASE databases were searched for studies of multivariable models derived, validated and/or augmented for HF prediction in community-based cohorts. Discrimination measures for models with cstatistic data from ≥3 cohorts were pooled by Bayesian meta-analysis, with Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using PROBAST. We included 36 studies with 59 prediction models. In meta-analysis, the Atherosclerosis Risk in Communities (ARIC) Risk Score (summary c-statistic 0.802, 95% CI 0.707-0.883), graph-based attention model (GRAM; 0.791, 95% CI 0.677-0.885), Pooled Cohort equations to Prevent Heart Failure (PCP-HF) white men model (0.820, 95% CI 0.792-0.843), PCP-HF white women model (0.852, 95% CI 0.804-0.895), and REverse Time AttentIoN Model (RETAIN; 0.839, 95% CI 0.748-0.916) had a statistically significant 95% PI and excellent discrimination performance. The ARIC Risk Score and PCP-HF models had significant summary discrimination among cohorts with a uniform prediction window. 77% of model results were at high risk of bias, certainty of evidence was low, and no model had a clinical impact study.

CONCLUSIONS: Prediction models for estimating risk of incident HF in the community demonstrate excellent discrimination performance. Their usefulness remains uncertain due to high risk of bias, low certainty of evidence, and absence of clinical effectiveness research. This article is protected by copyright. All rights reserved.

PMID:37403669 | DOI:10.1002/ejhf.2970

Curationis. 2023 Jun 29;46(1):e1-e8. doi: 10.4102/curationis.v46i1.2350.

ABSTRACT

BACKGROUND: Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with.

OBJECTIVES: This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa.

METHOD: A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse.

RESULTS: Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007).

CONCLUSION: Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

PMID:37403668 | DOI:10.4102/curationis.v46i1.2350

Curationis. 2023 Jun 23;46(1):e1-e6. doi: 10.4102/curationis.v46i1.2364.

ABSTRACT

BACKGROUND: The attribute of empathy leads to more desired patient outcomes. A patient who experiences empathy from student nurses will feel important and cared for. It is vital to know how student nurses perceive themselves in terms of empathy in caring. Thus, self-reflection is a requirement on the part of student nurses in a caring relationship.

OBJECTIVES: This study aimed to determine student nurses’ self-perceptions of empathy in caring and compare the third- and fourth-year student nurses’ self-perceptions of empathy in caring.

METHOD: A quantitative, descriptive and comparative approach was employed in the study. The population was undergraduate student nurses in their third- and fourth-year level of study (n = 77), while 56 respondents participated in the study. Ethical approval was obtained prior to commencing with the study. Data were collected by way of the Consultation and Relational Empathy measure questionnaire that consisted of 10 items responded to by using the 5-point Likert scale. Data were analysed by means of descriptive statistics, inferential statistics and t-tests.

RESULTS: All the student nurses perceived themselves to have empathy in caring. There was no significant difference in perceptions of empathy in caring by the nurses in their third- and fourth-year level of study.

CONCLUSION: The results of the study provide insights for nursing education and training to shape and mould the empathy perceived by the student nurses. Future research could focus on the patients’ perspective coupled with the student nurses’ perspective to prevent bias.Contribution: This paper contributes by adding self perceptions of empathy by student nurses to support best practice in nursing.

PMID:37403667 | DOI:10.4102/curationis.v46i1.2364

Curationis. 2023 Jun 15;46(1):e1-e11. doi: 10.4102/curationis.v46i1.2353.

ABSTRACT

BACKGROUND: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase.

OBJECTIVES: To explore and describe midwives’ perceptions and attitudes towards PMTCT of HIV services.

METHOD: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services.

RESULTS: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services.

CONCLUSION: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved.Contribution: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

PMID:37403663 | DOI:10.4102/curationis.v46i1.2353

Eur J Heart Fail. 2023 Jul 5. doi: 10.1002/ejhf.2968. Online ahead of print.

ABSTRACT

Both acetazolamide and sodium-glucose cotransporter 2 (SGLT2) inhibitors block sodium reabsorption in the proximal renal tubule primarily through inhibition of sodium hydrogen exchanger isoform 3 (NHE3), but neither SGLT2 inhibitors nor acetazolamide produce a sustained natriuresis due to compensatory upregulation of sodium reabsorption at distal nephron sites. Nevertheless, acetazolamide and SGLT2 inhibitors have been used as adjunctive therapy to loop diuretics in states where NHE3 is upregulated, e.g., acute heart failure. Two randomized controlled trials have been carried out with acetazolamide in acute heart failure (DIURESIS-CHF and ADVOR). In ADVOR, acetazolamide improved physical signs of fluid retention, but this finding could not be explained by the modest observed diuretic effect. Acetazolamide did not produce a natriuresis in the DIURESIS-CHF trial, and in ADVOR, immediate effects on symptoms and body weight were not reported, and the drug had no effect on morbidity or mortality after 90 days. Three randomized controlled trials have been carried out with empagliflozin (EMPAG-HF, EMPA-RESPONSE-AHF and EMPULSE in acute heart failure. The EMPULSE trial did not report effects on diuresis or in changes in physical signs of congestion during the first week of treatment, but in EMPAG-HF and EMPA-RESPONSE-AHF, empagliflozin had no effect of dyspnea, urinary sodium excretion or body weight during the first 4 days. In the EMPULSE trial, empagliflozin improved health status at 15 days and reduced the risk of worsening heart failure events at 90 days, but these effects are similar in magnitude and time course to the early statistical significance on the risk of heart failure hospitalizations achieved within 14-30 days in the major trials of SGLT2 inhibitors in patients with chronic heart failure. Neurohormonal inhibitors produce this early effect in the absence of a diuresis. Additionally, in numerous randomized controlled trials, in-hospital diuretic intensification has not reduced the risk of major heart failure events, even when treatment is sustained. These findings, taken collectively, suggest that any immediate diuretic effects of acetazolamide and SGLT2 inhibitors in acute heart failure are not likely to influence the short- or long-term clinical course of patients This article is protected by copyright. All rights reserved.

PMID:37403655 | DOI:10.1002/ejhf.2968

Orthop Surg. 2023 Jul 5. doi: 10.1111/os.13804. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite rapid advances in minimally invasive surgery, en bloc laminectomy remains the most common surgical approach for treating thoracic ossification of the ligamentum flavum (TOLF). However, the learning curve of this risky operation is rarely reported. Therefore, we aimed to describe and analyze the learning curve of ultrasonic osteotome-based en bloc laminectomy for TOLF.

METHODS: Among 151 consecutive patients with TOLF who underwent en bloc laminectomy performed by one surgeon between January 2012 and December 2017, we retrospectively analyzed their demographic data, surgical parameters, and neurological function. Neurological outcome was evaluated with the modified Japanese Orthopaedic Association (mJOA) scale, and the Hirabayashi method was used to calculate the neurological recovery rate. The learning curve was assessed with logarithmic curve-fitting regression analysis. Univariate analysis methods were used for statistical analysis, including t-test, rank sum test, and chi-square test.

RESULTS: A total of 50% of learning milestones could be reached in approximately 14 cases, and the asymptote in 76 cases. Therefore, 76 of the 151 enrolled patients were defined as the “early group,” and the remaining 75 were delimitated as the “late group” for comparison. There was a significant intergroup difference in the corrected operative time (94.80 ± 27.77 vs 65.93 ± 15.67 min, P < 0.001) and the estimated blood loss (median 240 vs 400 mL, P < 0.001). The overall follow-up was 83.1 ± 18.5 months. The mJOA significantly increased from a median of 5 (IQR: 4-5) before the surgery to 10 (IQR: 9-10) at the last follow-up (P < 0.001). The overall complication rate was 37.1%, and no significant intergroup difference was found, except for the incidence of dural tears (31.6% vs 17.3%, p = 0.042).

CONCLUSION: Initially, mastering the en bloc laminectomy technique using ultrasonic osteotome for TOLF treatment can be challenging, but the surgeon’s experience improves as the operative time and blood loss decrease. Improved surgical experience reduced the risk of dural tears but was not associated with the overall complication rate or long-term neurological function. Despite the relatively long learning curve, en bloc laminectomy is a secure and valid technique for TOLF treatment.

PMID:37403615 | DOI:10.1111/os.13804

Schweiz Arch Tierheilkd. 2023 Jul;165(7):524-528. doi: 10.17236/sat00400.

ABSTRACT

Determination of somatic cell counts (SCC) becomes more and more important also for ewe’s milk. SCC can be a useful indicator of milk quality for milk processors while it can be a mastitis indicator for sheep keepers and an important selection criterion for breeders. The objective of our study was to acquire basic information about factors influencing SCC variability in lambing ewes of the Tsigai (T) and Improved Valachian (IV) breeds. Somatic cell counts (SCC) were determined in 866 milk samples in 2017 and 2018, during lamb sucking and during milking period. An instrument Fossomatic 90 (Foss Electric, Hillerød, Denmark) was used for analysis. Average SCC varied from 270 to 1897 × 103 cells/ml during lamb sucking and from 268 to 2139 × 103 cells/ml during milking period. Differences between the sampling periods were statistically significant in 2017. An increase in SCC was observed at the end of both sucking and milking periods. An overall evaluation of lactation brought about the average SCC at 364 × 103 cells/ml in 2017 (log(10) SCC – 2,25) and at 1,091 × 103 cells/ml in 2018 (log(10) SCC – 2,68). The indicator log(10) was significantly influenced by breed in 2017 (T – 2,61; IV – 2,75). The effect of lactation number and number of sucking lambs did not have any significant influence on SCC.

PMID:37403592 | DOI:10.17236/sat00400

Med Phys. 2023 Jul 5. doi: 10.1002/mp.16584. Online ahead of print.

ABSTRACT

BACKGROUND: Colonic polyps are the most prevalent neoplastic lesions detected during colorectal cancer screening, and timely detection and excision of these precursor lesions is crucial for preventing multiple malignancies and reducing mortality rates.

PURPOSE: The pressing need for intelligent polyp detection has led to the development of a high-precision intelligent polyp segmentation network designed to improve polyp screening rates during colonoscopies.

METHODS: In this study, we employed ResNet50 as the backbone network and embedded a multi-channel grouping fusion encoding module in the third to fifth stages to extract high-level semantic features of polyps. Receptive field modules were utilized to capture multi-scale features, and grouping fusion modules were employed to capture salient features in different group channels, guiding the decoder to generate an initial global mapping with improved accuracy. To refine the segmentation of the initial global mapping, we introduced an enhanced boundary weight attention module that adaptively thresholds the initial global mapping using learnable parameters. A self-attention mechanism was then utilized to calculate the long-distance dependency relationship of the polyp boundary area, resulting in an output feature map with enhanced boundaries that effectively refines the boundary of the target area.

RESULTS: We carried out contrast experiments of MGF-Net with mainstream polyp segmentation networks on five public datasets of ColonDB, CVC-ColonDB, CVC-612, Kvasir, and ETIS. The results demonstrate that the segmentation accuracy of MGF-Net is significantly improved on the datasets. Furthermore, a hypothesis test was conducted to assess the statistical significance of the computed results.

CONCLUSIONS: Our proposed MGF-Net outperforms existing mainstream baseline networks and presents a promising solution to the pressing need for intelligent polyp detection. The proposed model is available at https://github.com/xiefanghhh/MGF-NET.

PMID:37403578 | DOI:10.1002/mp.16584