Ann Intern Med. 2023 Jul;176(7):eL230074. doi: 10.7326/L23-0074.
NO ABSTRACT
PMID:37459624 | DOI:10.7326/L23-0074
Tag: pubmed
Issues Ment Health Nurs. 2023 Jul 17:1-9. doi: 10.1080/01612840.2023.2229438. Online ahead of print.
ABSTRACT
INTRODUCTION: The undergraduate mental health nursing course may be an optimal time to cultivate students’ positive attitudes toward people living with a mental illness.
AIM: To determine the impact of an undergraduate mental health nursing course on students’ attitudes toward people living with a mental illness, depression, and schizophrenia.
METHOD: A quasi-experimental single-group pretest posttest study was conducted using a sample of undergraduate nursing students in New York City (N = 44). Self-reported measures of prejudice toward those living with a mental illness were collected at the beginning of a mental health nursing course and again at its conclusion.
RESULTS: A statistically significant decrease in prejudice scores was found concerning mental illness (p = .03, d = 0.23), depression (p = .01, d = 0.31), and schizophrenia (p = .013, d = 0.34). Subscale analysis revealed significant decreases in the fear/avoidance and unpredictability subscales. Yet no significant change was found in the subscales of authoritarianism and malevolence for any of the three conditions.
DISCUSSION: A mental health course led to a modest decrease in prejudice. However, certain facets of prejudice remain unchanged.
IMPLICATIONS FOR PRACTICE: Major curricular reform is needed to optimize the impact of undergraduate nursing education.
PMID:37459622 | DOI:10.1080/01612840.2023.2229438
Photobiomodul Photomed Laser Surg. 2023 Jul;41(7):364-370. doi: 10.1089/photob.2023.0001.
ABSTRACT
Objective: Femtosecond laser (fs-laser) is a novel tooth preparation tool but its ablation efficiency is insufficient. The purpose is to establish a new fs-laser tooth ablation method based on a dual-wedges path ablation system, and explore the efficiency of tooth hard tissue and dental restorative materials ablation. Materials and methods: Extracted third molars, pure titanium, cobalt-chromium alloy, gold alloy, and 3Y-zirconia were prepared into samples. These samples were rotary ablated by an fs-laser with dual-wedges. The wavelength was 1030 nm and the pulse duration was 250 fsec. Laser parameters were set as a repetition frequency of 25 kHz, the power percentages as 50% for dental tissues, and 60% for restorative materials. The optical wedge angle was set as 0°, 20°, 40°, 60°, and 80° for restorative materials, 0°, 20°, 30°, 40°, and 60° for enamel, and 0°, 10°, 20°, 30°, and 40°for dentin. Three times of ablation was processed at each parameter to obtain total 90 ablation microcavities of 6 kinds of materials. The diameter, depth, and volume of microcavities were measured by confocal laser microscopy and plotted against optical-wedge-angle in curves of different materials. One-way analysis of variance (ANOVA) was used to test whether the ablation efficiency between different angles was statistically significant. Results: The ablation efficiency of each material at different optical-wedge-angle was statistically significant (p < 0.05) and tends to be correlated. For dental hard tissue, the enamel ablation efficiency was 208.1 times and dentin ablation efficiency were 65.2 times than before when the wedge angle was 40°. For pure titanium, zirconia, cobalt-chromium, and gold alloys, the ablation efficiencies were 3.1, 10.7, 81.5, and 128.8 times than before when the rotation angle was 80°. Conclusions: The ablation efficiency of dental hard tissues and restorative materials was significantly increased with the increase of laser oblique incidence angle. Clinical Trial Registration number: PKUSSIRB-201949124.
PMID:37459608 | DOI:10.1089/photob.2023.0001
J Clin Oncol. 2023 Jul 17:JCO2300428. doi: 10.1200/JCO.23.00428. Online ahead of print.
ABSTRACT
PURPOSE: Chemotherapeutic exposures are associated with subsequent malignant neoplasm (SMN) risk. The role of genetic susceptibility in chemotherapy-related SMNs should be defined as use of radiation therapy (RT) decreases.
PATIENTS AND METHODS: SMNs among long-term childhood cancer survivors of European (EUR; N = 9,895) and African (AFR; N = 718) genetic ancestry from the Childhood Cancer Survivor Study and St Jude Lifetime Cohort Study were evaluated. An externally validated 179-variant polygenic risk score (PRS) associated with pleiotropic adult cancer risk from the UK Biobank Study (N > 400,000) was computed for each survivor. SMN cumulative incidence comparing top and bottom PRS quintiles was estimated, along with hazard ratios (HRs) from proportional hazards models.
RESULTS: A total of 1,594 survivors developed SMNs, with basal cell carcinomas (n = 822), breast cancers (n = 235), and thyroid cancers (n = 221) being the most frequent. Although SMN risk associations with the PRS were extremely modest in RT-exposed EUR survivors (HR, 1.22; P = .048; n = 4,630), the increase in 30-year SMN cumulative incidence and HRs comparing top and bottom PRS quintiles was statistically significant among nonirradiated EUR survivors (n = 4,322) treated with alkylating agents (17% v 6%; HR, 2.46; P < .01), anthracyclines (20% v 8%; HR, 2.86; P < .001), epipodophyllotoxins (23% v 1%; HR, 12.20; P < .001), or platinums (46% v 7%; HR, 8.58; P < .01). This PRS also significantly modified epipodophyllotoxin-related SMN risk among nonirradiated AFR survivors (n = 414; P < .01). Improvements in prediction attributable to the PRS were greatest for epipodophyllotoxin-exposed (AUC, 0.71 v 0.63) and platinum-exposed (AUC,0.68 v 0.58) survivors.
CONCLUSION: A pleiotropic cancer PRS has strong potential for improving SMN clinical risk stratification among nonirradiated survivors treated with specific chemotherapies. A polygenic risk screening approach may be a valuable complement to an early screening strategy on the basis of treatments and rare cancer-susceptibility mutations.
PMID:37459583 | DOI:10.1200/JCO.23.00428
Diabetes Care. 2023 Jul 17:dc222426. doi: 10.2337/dc22-2426. Online ahead of print.
ABSTRACT
OBJECTIVE: In participants with type 2 diabetes (T2D) and HbA1c >9.0-10.0%, guidelines recommend treatment with basal-bolus insulin.
RESEARCH DESIGN AND METHODS: This randomized trial compared the efficacy and safety of insulin degludec and liraglutide (IDegLira) and basal-bolus among participants with high HbA1c ≥9.0-15.0%, previously treated with 2 or 3 oral agents and/or basal insulin, allocated (1:1) to basal-bolus (n = 73) or IDegLira (n = 72). The primary end point was noninferiority (0.4%) in HbA1c reduction between groups.
RESULTS: Among 145 participants (HbA1c 10.8% ± 1.3), there was no statistically significant difference in HbA1c reduction (3.18% ± 2.29 vs. 3.00% ± 1.79, P = 0.65; estimated treatment difference (ETD) 0.18%, 95% CI -0.59, 0.94) between the IDegLira and basal-bolus groups. IDegLira resulted in significantly lower rates of hypoglycemia <70 mg/dL (26% vs. 48%, P = 0.008; odds ratio 0.39, 95% CI 0.19, 0.78), and less weight gain (1.24 ± 8.33 vs. 5.84 ± 6.18 kg, P = 0.001; ETD -4.60, 95% CI -7.33, -1.87).
CONCLUSIONS: In participants with T2D and HbA1c ≥9.0-15.0%, IDegLira resulted in similar HbA1c reduction, less hypoglycemia, and less weight gain compared with the basal-bolus regimen.
PMID:37459574 | DOI:10.2337/dc22-2426
J Clin Oncol. 2023 Jul 17:JCO2202705. doi: 10.1200/JCO.22.02705. Online ahead of print.
ABSTRACT
PURPOSE: The ALL10 protocol improved outcomes for children with ALL by stratifying and adapting therapy into three minimal residual disease-defined risk groups: standard risk, medium risk (MR), and high risk. IKZF1-deleted (IKZF1del) ALL in the largest MR group still showed poor outcome, in line with protocols worldwide, accounting for a high number of overall relapses. ALL10 showed high toxicity in Down syndrome (DS) and excellent outcome in ETV6::RUNX1 ALL. Poor prednisone responders (PPRs) were treated as high risk in ALL10. In ALL11, we prolonged therapy for IKZF1del from 2 to 3 years. We reduced therapy for DS by omitting anthracyclines completely, for ETV6::RUNX1 in intensification, and for PPR by treatment as MR.
METHODS: Eight hundred nineteen patients with ALL (age, 1-18 years) were enrolled on ALL11 and stratified as in ALL10. Results were compared with those in ALL10.
RESULTS: The five-year overall survival (OS), event-free survival (EFS), cumulative risk of relapse (CIR), and death in complete remission on ALL11 were 94.2% (SE, 0.9%), 89.0% (1.2), 8.2% (1.1), and 2.3% (0.6), respectively. Prolonged maintenance for IKZF1del MR improved 5-year CIR by 2.2-fold (10.8% v 23.4%; P = .035) and EFS (87.1% v 72.3%; P = .019). Landmark analysis at 2 years from diagnosis showed a 2.9-fold reduction of CIR (25.6%-8.8%; P = .008) and EFS improvement (74.4%-91.2%; P = .007). Reduced therapy did not abrogate 5-year outcome for ETV6::RUNX1 (EFS, 98.3%; OS, 99.4%), DS (EFS, 87.0%; OS, 87.0%), and PPR (EFS, 81.1%; OS, 94.9%).
CONCLUSION: Children with IKZF1del ALL seem to benefit from prolonged maintenance therapy. Chemotherapy was successfully reduced for patients with ETV6::RUNX1, DS, and PPR ALL. It has to be noted that these results were obtained in a nonrandomized study using a historical control group.
PMID:37459571 | DOI:10.1200/JCO.22.02705
Pediatr Blood Cancer. 2023 Jul 17:e30572. doi: 10.1002/pbc.30572. Online ahead of print.
ABSTRACT
Neuroblastoma is the most common extra-cranial solid tumor in children and is known for its clinical heterogeneity. A greater understanding of the biology of this disease has led to both improved risk stratification and new approaches to therapy. Outcomes for children with low and intermediate risk disease are excellent overall, and efforts to decrease therapy for such patients have been largely successful. Although survival has improved over time for patients with high-risk disease and treatments evaluated in the relapse setting are now being moved into earlier phases of treatment, much work remains to improve survival and decrease therapy-related toxicities. Studies of highly annotated biobanked samples continue to lead to important insights regarding neuroblastoma biology. Such studies, along with correlative biology studies incorporated into therapeutic trials, are expected to continue to provide insights that lead to new and more effective therapies. A focus on translational science is accompanied by an emphasis on new agent development, optimized risk stratification, and international collaboration to address questions relevant to molecularly defined subsets of patients. In addition, the COG Neuroblastoma Committee is committed to addressing the patient/family experience, mitigating late effects of therapy, and studying social determinants of health in patients with neuroblastoma.
PMID:37458162 | DOI:10.1002/pbc.30572
Pediatr Obes. 2023 Jul 17:e13066. doi: 10.1111/ijpo.13066. Online ahead of print.
ABSTRACT
BACKGROUND/OBJECTIVES: Electronic phenotyping is a method of using electronic-health-record (EHR) data to automate identifying a patient/population with a characteristic of interest. This study determines validity of using EHR data of children with overweight/obesity to electronically phenotype evidence of clinician ‘attention’ to high body mass index (BMI) and each of four distinct comorbidities.
METHODS: We built five electronic phenotypes classifying 2-18-year-old children with overweight/obesity (n = 17,397) by electronic/health-record evidence of distinct attention to high body mass index, hypertension, lipid disorders, fatty liver, and prediabetes/diabetes. We reviewed, selected and cross-checked random charts to define items clinicians select in EHRs to build problem lists, and to order medications, laboratory tests and referrals to electronically classify attention to overweight/obesity and each comorbidity. Operating characteristics of each clinician-attention phenotype were determined by comparing comprehensive chart review by reviewers masked to electronic classification who adjudicated evidence of clinician attention to high BMI and each comorbidity.
RESULTS: In a random sample of 817 visit-records reviewed/coded, specificity of each electronic phenotype is 99%-100% (with PPVs ranging from 96.8% for prediabetes/diabetes to 100% for dyslipidemia and hypertension). Sensitivities of the attention classifications range from 69% for hypertension (NPV, 98.9%) to 84.7% for high-BMI attention (NPV, 92.3%).
CONCLUSIONS: Electronic phenotypes for clinician attention to overweight/obesity and distinct comorbidities are highly specific, with moderate (BMI) to modest (each comorbidity) sensitivity. The high specificity supports using phenotypes to identify children with prior high-BMI/comorbidity attention.
PMID:37458161 | DOI:10.1111/ijpo.13066
Vet Pathol. 2023 Jul 17:3009858231186189. doi: 10.1177/03009858231186189. Online ahead of print.
ABSTRACT
Phocine distemper virus (PDV) is a significant cause of mortality for phocid seals; however, the susceptibility of otariids to this virus is poorly understood. The authors used a lymph-node explant culture system from California sea lions (Zalophus californianus, CSL) to investigate: (1) the role of signaling lymphocyte activation molecule (SLAM) and nectin-4 in PDV infection and their cellular expression patterns, (2) if PDV induces transcriptional regulation of cell-entry receptors, and (3) the involvement of apoptosis in PDV infection. PDV replicated in the lymph-node explants with peak replication 3 days post-infection (dpi), but the replication was not sustained 4 to 5 dpi. The PDV+ cells co-localized SLAM and nectin-4. These cells expressed IBA1, indicating a histiocytic lineage. Comparison of receptor expression between infected and mock-infected lymph nodes suggested transcriptional downregulation of both receptors during the initial stage of infection and upregulation during the late stage of infection, but the values lack of statistical significance. Cleaved caspase-3+ cells were slightly increased in the infected lymph nodes compared with the mock-infected lymph node from 1 to 4 dpi, but without statistical significance, and a few apoptotic cells co-expressed PDV. The results suggest that lymph-node explants might be an important model to study PDV pathogenesis. CSLs have the potential to be infected with PDV, as they express both cell-entry receptors in histiocytes. The lack of statistical significance in the PDV replication, transcriptional regulation of viral receptors, and changes in apoptosis suggest that although CSL might be infected by PDV, they might be less susceptible than phocid species.
PMID:37458158 | DOI:10.1177/03009858231186189
Health Psychol Rev. 2023 Jul 17:1-107. doi: 10.1080/17437199.2023.2236180. Online ahead of print.
ABSTRACT
AbstractConsiderable research has examined how involvement in gay-affiliated communities is associated with sexual health behaviors in sexual minority men (i.e., gay, bisexual, and other men who have sex with men), yet findings in this domain are often contradictory and inconclusive. This systematic review aimed to (a) synthesize the related empirical literature, and (b) identify potential factors driving inconsistent findings. Peer-reviewed publications were included if they contained quantitative data and at least one measure of the statistical association between gay community involvement and sexual health behavior. The search strategy was implemented in six databases and returned 6,409 articles, of which 86 met the inclusion criteria. There was considerable heterogeneity in how gay community involvement was assessed across studies. Although gay community involvement was consistently associated with greater engagement in protective behaviors across studies, the association between gay community involvement and risk behaviors appeared to depend on how gay community involvement was conceptualized and measured (e.g., nightlife involvement vs. political activism). Findings emphasize a need for studies that employ validated measures that reflect the multidimensional nature of gay community involvement, as well as research designs better suited to address the causal effects of community involvement on HIV/STI transmission and prevention.
PMID:37458157 | DOI:10.1080/17437199.2023.2236180