Tag: pubmed

J Int Med Res. 2022 Nov;50(11):3000605221135147. doi: 10.1177/03000605221135147.

ABSTRACT

OBJECTIVE: To apply deep learning to a data set of dental panoramic radiographs to detect the mental foramen for automatic assessment of the mandibular cortical width.

METHODS: Data from the seventh survey of the Tromsø Study (Tromsø7) were used. The data set contained 5197 randomly chosen dental panoramic radiographs. Four pretrained object detectors were tested. We randomly chose 80% of the data for training and 20% for testing. Models were trained using GeForce RTX 2080 Ti with 11 GB GPU memory (NVIDIA Corporation, Santa Clara, CA, USA). Python programming language version 3.7 was used for analysis.

RESULTS: The EfficientDet-D0 model showed the highest average precision of 0.30. When the threshold to regard a prediction as correct (intersection over union) was set to 0.5, the average precision was 0.79. The RetinaNet model achieved the lowest average precision of 0.23, and the precision was 0.64 when the intersection over union was set to 0.5. The procedure to estimate mandibular cortical width showed acceptable results. Of 100 random images, the algorithm produced an output 93 times, 20 of which were not visually satisfactory.

CONCLUSIONS: EfficientDet-D0 effectively detected the mental foramen. Methods for estimating bone quality are important in radiology and require further development.

PMID:36412242 | DOI:10.1177/03000605221135147

Suicide Life Threat Behav. 2022 Nov 22. doi: 10.1111/sltb.12929. Online ahead of print.

ABSTRACT

INTRODUCTION: Suicide is a leading cause of death for men in the United States. Men traditionally have been hesitant to seek help, based on masculine norms of stoicism and self-reliance, among other factors. Man Therapy (MT) is an online suicide prevention and mental health initiative that provides promise for facilitating male help-seeking.

METHODS: This study draws on data from a randomized controlled trial which examined effects of MT on a sample of men residing in Michigan aged 25-64. The current study utilized logistic regression to test MT’s effect on nonprofessional and professional help-seeking, controlling for marital status, education, and sexual orientation.

RESULTS: A statistically significant positive association was found between MT and professional help-seeking (OR = 1.55, p = 0.049). A significant inverse association was also found with marital status, with partnered men less likely to seek professional help (OR = 0.53, p = 0.007). There was no significant association between MT and nonprofessional help-seeking.

CONCLUSION: Man Therapy demonstrates the promise of web-based suicide prevention efforts to reach men who typically do not engage in help-seeking, providing a gateway to vital professional support. As technology continues to emerge, further suicide research is needed on use of this modality with working-age men from diverse backgrounds.

PMID:36412229 | DOI:10.1111/sltb.12929

J Dermatol. 2022 Nov 22. doi: 10.1111/1346-8138.16644. Online ahead of print.

ABSTRACT

Psoriasis is a systemic, chronic, immunologically-mediated disease affecting approximately 2%-4% of the worldwide population. It is well known that psoriasis is associated with several comorbidities such as metabolic syndrome, cardiovascular disease, and malignancy. Although meta-analyses and large prospective cohort studies have shown an increased risk of malignancies in patients with psoriasis worldwide, an association between psoriasis and malignancy onset has not yet been established in Japan. We retrospectively analyzed 360 patients with psoriasis at our hospital to evaluate the incidence and types of malignancies in these patients. The incidence rate of malignancy was 14.4% (52/360). Colorectal cancer was the most commonly associated malignancy (20.9%), followed by skin cancer (16.4%), gastric cancer (10.4%), and lung cancer (10.4%). The calculated age- and sex-standardized incidence ratio of malignancies was 1.235 (95% CI 0.952-1.601) which indicated that the malignancy rate was higher in patients with psoriasis than in the general population, although the difference was not statistically significant. Furthermore, the multivariate analysis revealed increased risk of malignancy in males (HR = 3.15; 95% CI 1.381-7.187; p < 0.001), psoriasis onset at older age (HR = 1.08; 95% CI 1.058-1.111; p < 0.01), and psoriatic erythroderma (HR = 4.44; 95% CI 1.354-14.581; p < 0.05). We also observed that treatment with biological agents tends to reduce the risk of developing malignancy; however, no statistical significance was found. These results suggest that periodic screening for malignancy should be recommended in patients with psoriasis having these risk factors and in those with poorly controlled psoriatic inflammation.

PMID:36412216 | DOI:10.1111/1346-8138.16644

AIDS. 2022 Nov 23. doi: 10.1097/QAD.0000000000003436. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically assess the efficacy, safety, and tolerability of isoniazid preventive therapy (IPT) for tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV).

DESIGN: Systematic review and meta-analysis.

METHODS: A thorough literature search was performed using PubMed, Cochrane CENTRAL, and Google Scholar from their inception to June 30, 2021. All randomized controlled trials (RCTs) investigating the efficacy, safety, or tolerability of IPT on PLHIV compared to placebo or active comparators were included in the study. The heterogeneity among the studies was identified by using the I2 statistic and Cochran’s Q test.

RESULTS: Out of the 924 non-duplicate RCTs identified through database searching and other sources, 26 studies comprising 38005 patients were included. The overall effect estimate identified the reduction of active TB incidence (OR 0.69; 95% CI 0.57, 0.84; P < 0.001), but not all-cause mortality (OR 0.91; 95% CI 0.82, 1.02; P = 0.10) with IPT compared to the control. Additionally, no significant association was identified between the use of IPT and the risk of peripheral neuropathy (OR 1.50; 95% CI 0.96, 2.36; P = 0.08) and hepatotoxicity (OR 1.21; 95% CI 0.97, 1.52; P = 0.09).

CONCLUSIONS: This systematic review and meta-analysis identified a significant reduction in the incidence of active TB, but not all-cause mortality, among PLHIV who received IPT compared to the control. Lesser number of outcomes may be the reason for non-significant results in terms of safety outcomes of IPT. Therefore, there is a need for extensive and long-term studies to address these issues further, especially in TB/HIV endemic areas.

PMID:36412204 | DOI:10.1097/QAD.0000000000003436

Chronobiol Int. 2022 Nov 22:1-9. doi: 10.1080/07420528.2022.2148182. Online ahead of print.

ABSTRACT

The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

PMID:36412198 | DOI:10.1080/07420528.2022.2148182

Sci Med Footb. 2022 Nov;6(4):405-414. doi: 10.1080/24733938.2021.1943756. Epub 2021 Aug 17.

ABSTRACT

BACKGROUND: The aim was to investigate the association of injuries with male football player continuity, progression and chances of reaching the First team in an elite academy.

METHODS: Injuries and exposure time were prospectively recorded, following the FIFA guidelines, over 6 seasons (2011-2017) in Under (U)12, U14, U16, U19, 2nd/3rd team and First team players from the same professional football club.

RESULTS: U19 and 2nd/3rd team players progressing to the next level had a lower injury burden and higher match availability compared to players that did not progress. Injury burden was lower in players progressing from U12 to U14. All players progressing from the 2nd/3rd teams to the First team had a match availability higher than 84% and did not suffer an anterior cruciate ligament (ACL) rupture or an injury requiring over 200 (+200) days to return to play. In U19 and 2nd/3rd team players, injuries requiring +100 and +200 days to return to play, ACL ruptures and groin pain, but not hamstring and ankle ligament injuries, were associated with lower odds of continuing in the academy each season.

CONCLUSION: Injuries were negatively associated with player progression, and injury prevention and return-to-play strategies should be a priority for football academies.

PMID:36412177 | DOI:10.1080/24733938.2021.1943756

J Geriatr Psychiatry Neurol. 2022 Nov 22:8919887221135552. doi: 10.1177/08919887221135552. Online ahead of print.

ABSTRACT

INTRODUCTION: People with suspected Alzheimer’s disease and related dementias (ADRD) and their families experience a burdensome process while seeking a diagnosis. These challenges are problematic in the most common dementia syndromes, but they can be even more distressing in rarer, atypical syndromes such as rapidly progressive dementias (RPDs), which can be fatal within months from onset. This study is an examination of the diagnostic journey experience from the perspective of caregivers of people who died from the prototypic RPD, sporadic Creutzfeldt-Jakob Disease (sCJD).

METHODS: eIn this mixed-methods study, qualitative data were drawn from interviews with former caregivers of 12 people who died from sCJD. Chart review data were drawn from research and clinical chart data about the person with sCJD. Data were analyzed by a multidisciplinary research team using qualitative and descriptive statistical analysis.

RESULTS: We identified 4 overarching themes that characterized the experience of the diagnostic journey in sCJD: clinician knowledge, clinician communication, experiences of uncertainty, and the caregiver as advocate. We also identified 4 phases along the diagnostic journey: recognition, the diagnostic workup, diagnosis, and post-diagnosis. Sub-themes within each phase include struggles to recognize what is wrong, complex processes of testing and referrals, delay and disclosure of diagnosis, and access to resources post-diagnosis.

CONCLUSIONS: Findings suggest that more work is needed to improve clinician diagnostic knowledge and communication practices. Furthermore, caregivers need better support during the diagnostic journey. What we learn from studying sCJD and other RPDs is likely applicable to other more common dementias.

PMID:36412170 | DOI:10.1177/08919887221135552

Med Phys. 2022 Nov 22. doi: 10.1002/mp.16104. Online ahead of print.

ABSTRACT

BACKGROUND: Boron Neutron Capture Therapy (BNCT) has recently been used in clinical oncology thanks to recent developments of accelerator-based BNCT systems. Although there are some specific processes for BNCT, they have not yet been discussed in detail.

PURPOSE: The aim of this study is to provide comprehensive data on the risk of accelerator-based BNCT system to institutions planning to implement an accelerator-based BNCT system.

METHODS: In this study, failure mode and effects analysis (FMEA) was performed based on a treatment process map prepared for the accelerator-based BNCT system. A multidisciplinary team consisting of a medical doctor (MD), a registered nurse (RN), two medical physicists (MP), and three radiologic technologists (RT) identified the failure modes (FMs). Occurrence (O), severity (S), and detectability (D) were scored on a scale of 10, respectively. For each FM, risk priority number (RPN) was calculated by multiplying the values of O, S, and D, and it was then categorized as high risk, very high risk, and other. Additionally, FMs were statistically compared in terms of countermeasures, associated occupations, and whether or not they were the patient-derived.

RESULTS: The identified FMs for BNCT were 165 in which 30 and 17 FMs were classified as high risk and very high risk, respectively. Additionally, 71 FMs were accelerator-based BNCT-specific FMs in which 18 and 5 FMs were classified as high risk and very high risk, respectively. The FMs for which countermeasures were “Education” or “Confirmation” were statistically significantly higher for S than the others (p = 0.019). As the number of BNCT facilities is expected to increase, staff education is even more important. Comparing patient-derived and other FMs, O tended to be higher in patient-derived FMs. This could be because the non-patient-derived FMs included events that could be controlled by software, whereas the patient-derived FMs were impossible to prevent and might also depend on the patient’s condition. Alternatively, there were non-patient-derived FMs with higher D, which were difficult to detect mechanically and were classified as more than high risk. In O, significantly higher values (p = 0.096) were found for FMs from MD and RN associated with much patient intervention compared to FMs from MP and RT less patient intervention. Comparing conventional radiotherapy and accelerator-based BNCT, although there were events with comparable risk in same FMs, there were also events with different risk in same FMs. They could be related to differences in the physical characteristics of the two modalities.

CONCLUSIONS: This study is the first report for conducting a risk analysis for BNCT using FMEA. Thus, this study provides comprehensive data needed for quality assurance/quality control (QA/QC) in the treatment process for facilities considering the implementation of accelerator-based BNCT in the future. Because many BNCT-specific risks were discussed, it is important to understand the characteristics of BNCT and to take adequate measures in advance. If the effects of all FMs and countermeasures are discussed by multidisciplinary team, it will be possible to take countermeasures against individual FMs from many perspectives and provide BNCT more safely and effectively. This article is protected by copyright. All rights reserved.

PMID:36412161 | DOI:10.1002/mp.16104

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(11. Vyp. 2):24-29. doi: 10.17116/jnevro202212211224.

ABSTRACT

OBJECTIVE: A clinical approbation of a proprietary method for evaluation of the diagnostic value of computer video analysis of hypomimia in patients with Parkinson’s disease (PD).

MATERIAL AND METHODS: The study included 31 patients diagnosed with PD and 31 healthy people. The method consists in contactless recognition of 68 reference points on the face that are used to determine the movement of eyebrows, eyelids and the mouth during diagnostic tests: smiling, drawing of the letter “O”, winking, eyebrow raising, frowning, and text reading.

RESULTS: Comparison of the results obtained with characteristics of healthy subjects has revealed statistically significant difference in the amplitude and speed of eyebrow, eyelid and mouth movement in PD patients.

CONCLUSION: The method offers prospects for screening of patients with suspected PD and evaluation of therapy efficacy.

PMID:36412152 | DOI:10.17116/jnevro202212211224

Stat Methods Med Res. 2022 Nov 22:9622802221136067. doi: 10.1177/09622802221136067. Online ahead of print.

ABSTRACT

Simulation studies play an important role in evaluating the performance of statistical models developed for analyzing complex survival data such as those with competing risks and clustering. This article aims to provide researchers with a basic understanding of competing risks data generation, techniques for inducing cluster-level correlation, and ways to combine them together in simulation studies, in the context of randomized clinical trials with a binary exposure or treatment. We review data generation with competing and semi-competing risks and three approaches of inducing cluster-level correlation for time-to-event data: the frailty model framework, the probability transform, and Moran’s algorithm. Using exponentially distributed event times as an example, we discuss how to introduce cluster-level correlation into generating complex survival outcomes, and illustrate multiple ways of combining these methods to simulate clustered, competing and semi-competing risks data with pre-specified correlation values or degree of clustering.

PMID:36412111 | DOI:10.1177/09622802221136067