Tag: pubmed

J Exp Orthop. 2023 Jul 1;10(1):67. doi: 10.1186/s40634-023-00629-5.

ABSTRACT

PURPOSE: The adjustable loop cortical suspension device (ALD) is a useful femoral fixation device in anterior cruciate ligament (ACL) reconstructions, but the possibility of loosening has been suggested. The purpose of this study was to evaluate the elongation of an adjustable loop and the position of the hamstring graft inside the femoral socket.

METHODS: The subjects were 33 patients who underwent ACL reconstruction with a hamstring tendon. The graft was fixed using ALD and completely filled the femoral socket. Magnetic resonance images were taken one week and one year after the operation. The loop length, femoral socket length, and graft length inside the socket were measured and statistically compared with the clinical outcomes.

RESULTS: The loop length one week after surgery was 18.9 ± 4.4 mm, and 1 year after surgery was 19.9 ± 4.5 mm (P < 0.001). The gap between the top of the graft and femoral socket was 0.9 ± 1.8 mm one week after surgery and 1.3 ± 1.7 mm one year after surgery (P = 0.259). At one week post-operation, a gap was found in nine patients (27.3%). The loop length and gap did not strongly correlate with clinical findings.

CONCLUSION: ACL reconstruction using ALD showed a gap between the graft and femoral socket at the one week post-operation mark in 27.3% of participants. One year after the surgery, there were cases where the gap increased and/or decreased, but the elongation of the loop was 1 mm on average. Our findings suggest that ALD is clinically safe to use; however, has the possibility of initial loop elongation and non-uniform changes.

LEVEL OF EVIDENCE: IV.

PMID:37393331 | DOI:10.1186/s40634-023-00629-5

Sci Rep. 2023 Jul 1;13(1):10675. doi: 10.1038/s41598-023-37380-x.

ABSTRACT

Social problems and suffering from the treatment process for infertile couples, especially for women, require the couples to cope with them to balance the infertility crisis. According to the close interactions of the couples with each other, the objective of the present study was to explore a theoretical framework for the relationships between women’s coping strategies, spouses’ coping strategies, and women’s psychological health in infertile couples who were candidates for assisted reproductive technology (ART). This cross-sectional study was carried out on 212 couples undergoing ART. The couples’ coping strategies were evaluated using a validated self-report questionnaire. The women’s psychological health was assessed using a 21-item stress, anxiety, and depression scale (DASS-21). Statistical analysis was performed using the plug-in application PROCESS macro for SPSS. The direct effect of the women’s self-blame and self-focused rumination strategies (p < .0001), and the indirect effect of the women’s self-blame on stress and depression by mediating spouses’ self-blame and self-focused rumination strategies, was significant. The indirect effect of the women’s self-focused rumination on the anxiety and depression levels by mediating spouses’ self-blame strategy was significant. The women’s self-blame and self-focused rumination strategies had a negative effect on the women’s psychological health who were undergoing ART. This negative effect was mediated by the spouse’s coping strategies.

PMID:37393323 | DOI:10.1038/s41598-023-37380-x

BMC Med Educ. 2023 Jul 1;23(1):490. doi: 10.1186/s12909-023-04458-z.

ABSTRACT

INTRODUCTION: Due to the technical progress point-of-care ultrasound (POCUS) is increasingly used in critical care medicine. However, optimal training strategies and support for novices have not been thoroughly researched so far. Eye-tracking, which offers insights into the gaze behavior of experts may be a useful tool for better understanding. The aim of this study was to investigate the technical feasibility and usability of eye-tracking during echocardiography as well as to analyze differences of gaze patterns between experts and non-experts.

METHODS: Nine experts in echocardiography and six non-experts were equipped with eye-tracking glasses (Tobii, Stockholm, Sweden), while performing six medical cases on a simulator. For each view case specific areas of interests (AOI) were defined by the first three experts depending on the underlying pathology. Technical feasibility, participants’ subjective experience on the usability of the eye-tracking glasses as well as the differences of relative dwell time (focus) inside the areas of interest (AOI) between six experts and six non-experts were evaluated.

RESULTS: Technical feasibility of eye-tracking during echocardiography was achieved with an accordance of 96% between the visual area orally described by participants and the area marked by the glasses. Experts had longer relative dwell time in the case specific AOI (50.6% versus 38.4%, p = 0.072) and performed ultrasound examinations faster (138 s versus 227 s, p = 0.068). Furthermore, experts fixated earlier in the AOI (5 s versus 10 s, p = 0.033).

CONCLUSION: This feasibility study demonstrates that eye-tracking can be used to analyze experts and non-experts gaze patterns during POCUS. Although, in this study the experts had a longer fixation time in the defined AOIs compared to non-experts, further studies are needed to investigate if eye-tracking could improve teaching of POCUS.

PMID:37393288 | DOI:10.1186/s12909-023-04458-z

BMC Pulm Med. 2023 Jul 1;23(1):236. doi: 10.1186/s12890-023-02534-0.

ABSTRACT

BACKGROUND: Several markers have been identified to increase the risk for acute exacerbation of interstitial lung disease (AE-ILD) or mortality related to AE-ILD. However, less is known about the risk predictors of ILD patients who have survived AE. The aim of the study was to characterise AE-ILD survivors and investigate prognostic factors in this subpopulation.

METHODS: All AE-ILD patients (n = 95) who had been discharged alive from two hospitals located in Northern Finland were selected from a population of 128 AE-ILD patients. Clinical data related to the hospital treatment and six-month follow-up visit were collected retrospectively from medical records.

RESULTS: Fifty-three patients with idiopathic pulmonary fibrosis (IPF) and 42 patients with other ILD were identified. Two thirds of the patients had been treated without invasive or non-invasive ventilation support. The clinical features of six-month survivors (n = 65) and non-survivors (n = 30) did not differ in terms of medical treatment or oxygen requirements. Of the patients, 82.5% used corticosteroids at the six-month follow-up visit. Fifty-two patients experienced at least one non-elective respiratory re-hospitalisation before the six-month follow-up visit. In a univariate model, IPF diagnosis, high age and a non-elective respiratory re-hospitalisation increased the risk of death, although re-hospitalisation was the only independent risk factor in a multivariate model. In six-month survivors, there was no statistically significant decrease in pulmonary function test results (PFT) examined at the follow-up visit compared with earlier PFT examined near the time of AE-ILD.

CONCLUSIONS: The AE-ILD survivors were a heterogeneous group of patients both clinically and in terms of their outcome. A non-elective respiratory re-hospitalisation was identified as a marker of poor prognosis among AE-ILD survivors.

PMID:37393286 | DOI:10.1186/s12890-023-02534-0

BMC Oral Health. 2023 Jul 1;23(1):440. doi: 10.1186/s12903-023-03103-x.

ABSTRACT

BACKGROUND: Development of white spot lesions (WSLs) is common among orthodontic patients. Several measures have been introduced to prevent and remineralize the lesions. Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is used for both prevention and remineralization. The effect of its application before bonding is controversial. This systematic review was conducted to investigate the most up to date available literature regarding the effect of CPP-ACP enamel pre-treatment on shear bond strength (SBS) of metallic orthodontic brackets.

METHODS: A search was conducted in electronic databases (MEDLINE (via PubMed), Scopus, Cochrane Library, Web of Science and Google scholar (grey literature)) up to March 29^th, 2023. The inclusion criteria included in vitro studies comparing the SBS of metal orthodontic brackets following pre-treatment of enamel using CPP-ACP versus control. The exclusion criteria included study types other than in vitro studies, studies conducted on non-human enamel, or studies using CPP-ACP in combination with another intervention. The included studies were analysed by two reviewers, independently. The risk of bias assessment was done using a modified risk of bias tool. A Meta-analysis was performed. I² values and Q-test were used for assessment of heterogeneity. Results were displayed in forest plots with a random-effects model. Standardized mean difference, standard error (SE) and 95% confidence intervals were calculated for all studies.

RESULTS: The search resulted in 76 articles. After duplicate removal and assessment for eligibility, 15 studies were included in the review. High statistical heterogeneity was found among the included studies using I² values and Q-Test (I² = 95.147%; Q = 288.456; df = 14; P < 0.001). The overall effect of CPP-ACP pre-treatment on the SBS of metal orthodontic brackets was not significant (Mean difference = 1.163 MPa, SE = 0.757, 95% CI = -0.321, 2.648, p value = 0.125). The use of CPP-ACP for prevention of WSLs did not significantly affect the SBS of brackets (Standardized mean difference = 1.009, SE = 0.884, 95% CI = -0.723, 2.740, p value = 0.254). No significant change was found when CPP-ACP was used for remineralization of WSLs (Standardized mean difference = 1.501, SE = 1.087, 95% CI = -0.630, 3.632, p value = 0.167).

CONCLUSIONS: Within the limitations of the study, the evidence suggests that the use of CPP-ACP for either prevention or remineralization of WSLs before bonding does not affect the SBS of metal orthodontic brackets.

PMID:37393280 | DOI:10.1186/s12903-023-03103-x

Eye Vis (Lond). 2023 Jul 2;10(1):31. doi: 10.1186/s40662-023-00347-0.

ABSTRACT

BACKGROUND: To compare the safety and efficacy of femtosecond laser-assisted cataract surgery (FLACS) performed with the low-energy FEMTO LDV Z8 (Ziemer Ophthalmic Systems AG, Port, Switzerland) laser compared with conventional phacoemulsification (CP) in Chinese patients.

METHODS: This prospective, multicenter, interventional study included 126 patients who were randomized (1:1) to undergo either FLACS or CP followed by intraocular lens (IOL) implantation between January 2019 and April 2020. The primary endpoint included the comparison of the endothelial cell loss (ECL) between the two groups at 3 months. Secondary endpoints included the comparison of cumulative dissipated energy (CDE), change in central corneal thickness (CCT) from baseline, and postoperative uncorrected and corrected distance visual acuities (UDVA and CDVA) in the two groups.

RESULTS: At all postoperative time points, the FLACS group was found to be non-inferior to CP for the mean ECL (- 409.3 versus – 436.9 cells/mm² at 3 months) and mean CDE (4.1 versus 4.5 percent-seconds). The increase in CCT was significantly lower in the FLACS group compared with the CP group at Day 7 (4.9 versus 9.2 µm; P = 0.04); however, the difference was not statistically significant at 1 and 3 months. Postoperatively, mean UDVA and CDVA were comparable between the two groups. No intraoperative complications occurred.

CONCLUSIONS: Cataract surgery performed with a low-energy femtosecond laser was non-inferior to CP; however, the FLACS group had a statistically significantly lower increase in CCT at Day 7 compared with CP. Trial registration This trial is registered at ClinicalTrials.gov on May 15, 2019, with trial registration number: NCT03953053.

PMID:37393278 | DOI:10.1186/s40662-023-00347-0

Radiat Oncol. 2023 Jul 1;18(1):107. doi: 10.1186/s13014-023-02293-6.

ABSTRACT

BACKGROUND: Breast cancer brain metastases (BCBM) are highly heterogenous with widely differing survival. The prognosis of the oligometastatic breast cancer (BC) patients with brain metastases (BM) has not been well studied. We aimed to investigate the prognosis of BCBM patients with limited intracranial and extracranial metastatic lesions.

METHODS: Four hundred and forty-five BCBM patients treated between 1st January 2008 and 31st December 2018 at our institute were included. Clinical characteristics and treatment information were obtained from patient’s medical records. The updated breast Graded Prognostic Assessment (Breast GPA) was calculated.

RESULTS: The median OS after diagnosis of BM were 15.9 months. Median OS for patients with GPA 0-1.0, 1.5-2, 2.5-3 and 3.5-4 were 6.9, 14.2, 21.8, 42.6 months respectively. The total number of intracranial and extracranial metastatic lesions, in addition to the Breast GPA, salvage local therapy and systemic therapy (anti-HER2 therapy, chemotherapy and endocrine therapy) were demonstrated to be associated with prognosis. One hundred and thirteen patients (25.4%) had 1-5 total metastatic lesions at BM diagnosis. Patients with 1-5 total metastatic lesions had a significantly longer median OS of 24.3 months compared to those with greater than 5 total metastatic lesions with a median OS of 12.2 months (P < 0.001; multivariate HR 0.55, 95% CI, 0.43-0.72). Among the patients with 1-5 metastatic lesions, median OS for GPA 0-1.0 was 9.8 months, compared to 22.8, 28.8 and 71.0 for GPA 1.5-2.0, 2.5-3.0 and 3.5-4.0 respectively, which is much longer than the corresponding patients with greater than 5 total metastatic lesions, with medium OS of 6.8, 11.6, 18.6 and 42.6 months respectively for GPA 0-1.0, 1.5-2.0, 2.5-3.0 and 3.5-4.0.

CONCLUSIONS: The patients with 1-5 total metastatic lesions demonstrated better OS. The prognostic value of the Breast GPA and the survival benefit of salvage local therapy and continuation of systemic therapy after BM were confirmed.

PMID:37393259 | DOI:10.1186/s13014-023-02293-6

Malar J. 2023 Jul 1;22(1):201. doi: 10.1186/s12936-023-04635-x.

ABSTRACT

BACKGROUND: Plasmodium vivax malaria is now recognized as a cause of severe morbidity and mortality, resulting in a substantial negative effect on health especially in endemic countries. Accurate and prompt diagnosis and treatment of P. vivax malaria is vital for the control and elimination of the disease.

METHODS: A cross-sectional study was conducted from February 2021 to September 2022 at five malaria endemic sites in Ethiopia including Aribaminch, Shewarobit, Metehara, Gambella, and Dubti. A total of 365 samples that were diagnosed positive for P. vivax (mono and mixed infection) using RDT, site level microscopists and expert microscopists were selected for PCR. Statistical analyses were performed to calculate the proportions, agreement (k), frequencies, and ranges among different diagnostic methods. Fisher’s exact tests and correlation test were used to detect associations and relationship between different variables.

RESULTS: Of the 365 samples, 324 (88.8%), 37(10.1%), 2 (0.5%), and 2 (0.5%) were P. vivax (mono), P. vivax/Plasmodium falciparum (mixed), P. falciparum (mono) and negative by PCR, respectively. The overall agreement of rapid diagnostic test (RDT), site level microscopy and expert microscopists result with PCR was 90.41% (k: 0.49), 90.96% (k: 0.53), and 80.27% (k: 0.24). The overall prevalence of sexual (gametocyte) stage P. vivax in the study population was 215/361 (59.6%). The majority of these 215 samples (180; 83.7%) had below 1000 parasites/µl, with only four samples (1.9%) had ≥ 5000 parasites/µl. The gametocyte density was found to be weakly positive but statically significant with asexual parasitaemia (r = 0.31; p < 0.001).

CONCLUSION: Both microscopy and RDT showed moderate agreement with PCR in the detection and identification of P. vivax (mono) and P. vivax/P. falciparum (mixed) infections. Therefore, to achieve malaria elimination goals, strengthening routine malaria diagnostic methods by implementing diagnostic tools with a good performance in detecting and accurately identifying malaria species in clinical settings is recommended.

PMID:37393257 | DOI:10.1186/s12936-023-04635-x

BMC Bioinformatics. 2023 Jul 1;24(1):273. doi: 10.1186/s12859-023-05398-7.

ABSTRACT

Pathogenic bacteria present a major threat to human health, causing various infections and illnesses, and in some cases, even death. The accurate identification of these bacteria is crucial, but it can be challenging due to the similarities between different species and genera. This is where automated classification using convolutional neural network (CNN) models can help, as it can provide more accurate, authentic, and standardized results.In this study, we aimed to create a larger and balanced dataset by image patching and applied different variations of CNN models, including training from scratch, fine-tuning, and weight adjustment, and data augmentation through random rotation, reflection, and translation. The results showed that the best results were achieved through augmentation and fine-tuning of deep models. We also modified existing architectures, such as InceptionV3 and MobileNetV2, to better capture complex features. The robustness of the proposed ensemble model was evaluated using two data splits (7:2:1 and 6:2:2) to see how performance changed as the training data was increased from 10 to 20%. In both cases, the model exhibited exceptional performance. For the 7:2:1 split, the model achieved an accuracy of 99.91%, F-Score of 98.95%, precision of 98.98%, recall of 98.96%, and MCC of 98.92%. For the 6:2:2 split, the model yielded an accuracy of 99.94%, F-Score of 99.28%, precision of 99.31%, recall of 98.96%, and MCC of 99.26%. This demonstrates that automatic classification using the ensemble model can be a valuable tool for diagnostic staff and microbiologists in accurately identifying pathogenic bacteria, which in turn can help control epidemics and minimize their social and economic impact.

PMID:37393255 | DOI:10.1186/s12859-023-05398-7

BMC Cancer. 2023 Jul 1;23(1):609. doi: 10.1186/s12885-023-11070-3.

ABSTRACT

BACKGROUND: Even though chemotherapy-induced nausea and vomiting (CINV) can be well controlled in the acute phase, the incidence of delayed CINV remains high. In this study, we intend to investigate whether prolonged use of NK-1 receptor antagonist (RA) in addition to 5-HT3 RA and dexamethasone (DEX) was more effective in preventing delayed CINV.

METHODS: This randomised, open-label, controlled study was designed to compare the efficacy and safety of fosaprepitant 150 mg given on days 1,3 (prolonged group) versus on day 1 (regular group) in patients receiving highly emetogenic chemotherapy (HEC). All patients also treated with palonosetron on day 1 and DEX on days 1-3. The primary endpoint was the incidence of delayed nausea and vomiting. The second endpoint was AEs. All the above endpoints were defined according to CTCAE 5.0.

RESULTS: Seventy-seven patients were randomly assigned to prolonged group and seventy-nine to regular group. Prolonged group demonstrated superiority in controlling delayed CINV to regular group, with statistically significant lower incidence of nausea (6.17% vs 12.66%, P = 0.0056), and slightly lower incidence of grade 1 vomiting (1.62% vs 3.80%, P = 0.0953) in the delayed phase. In addition, prolonged use of fosaprepitant was safe. No significant difference was found between the two groups regarding constipation, diarrhea, hiccough, fatigue, palpitation and headache in delayed phase.

CONCLUSIONS: Prolonged use of fosaprepitant can effectively and safely prevent delayed CINV in patients receiving HEC.

PMID:37393241 | DOI:10.1186/s12885-023-11070-3