Tag: pubmed

Turk Patoloji Derg. 2022 Jun 1. doi: 10.5146/tjpath.2022.01578. Online ahead of print.

ABSTRACT

OBJECTIVE: Mycosis fungoides (MF) is the most common type of cutaneous lymphoma. The early stage of MF is a difficult diagnostic case, as it is often confused with many benign inflammatory dermatoses (BID). The study aimed to evaluate the diagnostic utility of TOX, FOXP3, CDD4 and GATA3 in differentiating early stages of MF from histologically overlapping BID lesions.

MATERIAL AND METHOD: A retrospective cross-sectional study was performed, in which immunohistochemistry (IHC) was used to evaluate the expression of TOX, FOXP3, CD4 and GATA3 in formalin-fixed paraffin-embedded (FFPE) sections of skin lesions from 30 cases with BID and 30 patients with early-stage MF.

RESULTS: The association between TOX expression and early-stage MF was statistically significant (P < 0.001). TOX had the highest sensitivity of 96.77% and accuracy of 85.71% in diagnosis of MF; followed by CD4 with sensitivity of 85.71% and accuracy of 78.95%; and then, GATA3 with sensitivity of 76.7% and finally FOXP3 with sensitivity of 70.0%.

CONCLUSION: TOX is suggested to be of higher diagnostic value in the early stages of MF than the conventionally used CD4 and other markers examined.

PMID:35642346 | DOI:10.5146/tjpath.2022.01578

Turk Patoloji Derg. 2022 Jun 1. doi: 10.5146/tjpath.2022.01572. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate programmed cell death ligand-1 (PD-L1) expression and the relationship between driver mutations and survival analysis in advanced-stage non-small cell lung carcinoma (NSCLC).

MATERIAL AND METHOD: A total of 122 advanced-stage NSCLC patients were included in this retrospective study. The patients were diagnosed based on cytological examination and histopathological analysis of biopsy or resection material that had undergone at least 1 molecular analysis. The expression of PD-L1 in tumors and tumor-infiltrating lymphocytes (TIL) was scored and compared with age, sex, organ, biopsy method, tumor subtype, driver mutation status, and overall survival data.

RESULTS: There was no statistically significant difference between PD-L1-positivity and age, gender, location, pattern, or pathological diagnosis of the type of sample. When the threshold value for PD-L1 IHC evaluation was accepted as ≥1% and ≥50%, the rate of positivity was 19.7% and 7.4%, respectively.

CONCLUSION: Since there is a wide range of positivity rates reported in the literature, we could not reach a conclusion as to whether the PD-L1-positivity rate we observed was high or low. There is a need for comparative studies where the technique, clones, threshold values, and phases are homogenized. There is an inverse correlation between the EGFR-mutant population and PD-L1 positivity. In terms of overall survival, no relationship was found between PD-L1 positivity, the presence of TIL, and EGFR mutation status.

PMID:35642342 | DOI:10.5146/tjpath.2022.01572

Stat Methods Med Res. 2022 May 31:9622802221102621. doi: 10.1177/09622802221102621. Online ahead of print.

ABSTRACT

The restricted mean survival time measure has gained a lot of interests for designing and analyzing oncology trials with time-to-event endpoints due to its intuitive clinical interpretation and potentially high statistical power. In the non-inferiority trial literature, restricted mean survival time has been used as an alternative measure for reanalyzing a completed trial, which was originally designed and analyzed based on traditional proportional hazard model. However, the reanalysis procedure requires a conversion from the non-inferiority margin measured in hazard ratio to a non-inferiority margin measured by restricted mean survival time difference. An existing conversion method assumes a Weibull distribution for the population survival time of the historical active control group under the proportional hazard assumption using data from a single trial. In this article, we develop a methodology for non-inferiority margin conversion when data from multiple historical active control studies are available, and introduce a Kaplan-Meier estimator-based method for the non-inferiority margin conversion to relax the parametric assumption. We report extensive simulation studies to examine the performances of proposed methods under the Weibull data generative models and a piecewise-exponential data generative model that mimic the tumor recurrence and survival characteristics of advanced colon cancer. This work is motivated to achieve non-inferiority margin conversion, using historical patient-level data from a large colon cancer clinical database, to reanalyze an internationally collaborated non-inferiority study that evaluates 6-month versus 3-month duration of adjuvant chemotherapy in stage III colon cancer patients.

PMID:35642291 | DOI:10.1177/09622802221102621

Biometrics. 2022 May 31. doi: 10.1111/biom.13683. Online ahead of print.

ABSTRACT

Shortreed and Ertefaie introduced a clever propensity score variable selection approach for estimating average causal effects, namely, the outcome adaptive lasso (OAL). OAL aims to select desirable covariates, confounders, and predictors of outcome, to build an unbiased and statistically efficient propensity score estimator. Due to its design, a potential limitation of OAL is how it handles the collinearity problem, which is often encountered in high-dimensional data. As seen in Shortreed and Ertefaie, OAL’s performance degraded with increased correlation between covariates. In this note, we propose the generalized OAL (GOAL) that combines the strengths of the adaptively weighted L₁ penalty and the elastic net to better handle the selection of correlated covariates. Two different versions of GOAL, which differ in their procedure (algorithm), are proposed. We compared OAL and GOAL in simulation scenarios that mimic those examined by Shortreed and Ertefaie. Although all approaches performed equivalently with independent covariates, we found that both GOAL versions were more performant than OAL in low and high dimensions with correlated covariates.

PMID:35642320 | DOI:10.1111/biom.13683

Cleft Palate Craniofac J. 2022 May 31:10556656221104036. doi: 10.1177/10556656221104036. Online ahead of print.

ABSTRACT

The purpose of this study is to determine areas of agreement and disagreement among American Cleft Palate-Craniofacial Association (ACPA)members in the clinical practice of alveolar bone grafting (ABG), to guide further research to optimize ABG practices.

A cross-sectional survey was conducted.

The respondents were in an academic, combination, or private practice.

The respondents were either plastic or oral and maxillofacial surgeons (OMFS) from various countries.

A de-identified 24-question online survey was distributed to ACPA surgeon members utilizing the Research Electronic Data Capture (REDCap) tool.

Data collected included surgeon specialty, use of various alveolar bone graft surgical techniques, as well as protocols.

There was more variability than consensus between specialties with regards to the preoperative workup, timing of surgery, materials used for bone graft, surgical techniques, perioperative management, and postoperative evaluation. There was consensus on grafting during mixed dentition, not staging soft and hard tissue closure, and using iliac crest for primary and secondary grafting. Disagreements involved factors used to time the procedure and type of imaging used to assess viability. Technical differences involved incision type, part of bone grafted, use of minimally invasive technique, and material used for revisions.

Aside from areas of consensus among surgeons on ABG, several areas, including use of bone substitutes in revision grafting, incision and type of iliac crest graft used during initial grafting, and postoperative protocols, had no consensus. These areas should be targets of further research to determine if there truly is an optimal method to perform ABG.

The study was approved by the University of Illinois at Chicago Institutional Review Board. A de-identified 24-question online survey was distributed to surgeon members of the ACPA utilizing the REDCap tool on August 7, 2020. The survey questions consisted of multiple choice and multiple selection questions including an option to select “other” and specify the information in a blank space. Data collected included surgeon specialty, use of various alveolar bone graft surgical techniques, as well as pre and postoperative protocols. The full survey is included in online Supplemental material. Data analysis was performed in SPSS Statistics 27 (IBM Corp.). Descriptive statistics were performed, and chi-square was used to test for significant differences in survey responses between groups.

PMID:35642289 | DOI:10.1177/10556656221104036

J Intellect Disabil Res. 2022 May 31. doi: 10.1111/jir.12951. Online ahead of print.

ABSTRACT

BACKGROUND: The body index [body mass, body mass index (BMI), waist circumference and waist-height ratio] and functional fitness (aerobic capacity, muscular strength, balance, flexibility and functional ability) of people with Down syndrome (DS) are substantially lower than those in the general population, as DS has an overall negative impact on health.

AIMS: This study explored the effect of a 24-week basketball training programme on the body composition and functional fitness of adults with DS.

METHODS AND PROCEDURE OUTCOMES: Twenty-two adults with DS (24 ± 6 years; 25 ± 4 kg/m² ) were randomly allocated to the experimental (n = 11, 67.04 kg) and control groups (n = 11, 69.36 kg). The experimental group performed 24 weeks of basketball programme training (3 times per week, 60 min per session), while the control group maintained their daily activities without any special physical training. Body composition and functional fitness parameters were measured before and after the intervention. To evaluate the differences between groups, an analysis of covariance (ANCOVA) was used while controlling for differences at baseline.

RESULTS: Hip circumference and waist-height ratio were statistically different at baseline between the intervention and control groups. After the 24-week basketball training programme, the results showed significant differences between the exercise and control groups for hip circumference, body mass, BMI, waist circumference, hip circumference, waist-height ratio, flexibility, aerobic capacity, static and dynamic balance, balance and basketball functional ability (P < 0.05). The exercise group showed significant improvements in all variables of body composition and functional fitness (P < 0.05) except for the waist-hip ratio. There was no statistical significance between all physical composition and functional health variables in the control group except for the standing long jump (P > 0.05), with effect sizes ranging from small to large.

CONCLUSIONS AND IMPLICATIONS: The basketball training programme improved body composition and functional fitness of adults with DS.

PMID:35642288 | DOI:10.1111/jir.12951

Clin Teach. 2022 May 31. doi: 10.1111/tct.13507. Online ahead of print.

ABSTRACT

BACKGROUND: Having previously shown that an interprofessional immersive course, AELPS (Academy for Emerging Leaders in Patient Safety) can change the way young clinicians think about patient safety, we surveyed them between 1 and 5 years later to determine its longer-term influence on careers, relationships with colleagues and with patients.

METHODS: All alumni from 2016 to 2019 (n = 116) were invited to complete a survey on the usefulness of their AELPS experience in: obtaining their current position; doing patient safety projects; understanding and working with patients; improving communication skills; breaking down hierarchies; networking; mentoring and using new skills in the workplace. Data were analysed using descriptive statistics and thematic analysis.

RESULTS: Response rate was 56%. Over 85% reported ongoing improvement in medication safety knowledge, communication with patients, use of graded assertiveness, communicating more effectively with colleagues, seeking views of their patients about treatment options and seeing things from the patient perspective. Sixty seven per cent agreed that AELPS helped them in their career choice and 57% agreed it had helped them obtain their current position. Skills transferred to the workplace included ability to make improvements, establish education initiatives and model patient-centred care. Stumbling blocks included a hierarchal culture and lack of accountability for patient safety practices in some hospitals.

DISCUSSION: An intensive, interdisciplinary program on patient safety can provide future health leaders with ongoing tools to improve communication, understand the patient view and speak up on behalf of the patient, all factors that contribute to improving safety of patients.

PMID:35642287 | DOI:10.1111/tct.13507

J Oncol Pharm Pract. 2022 May 31:10781552221105584. doi: 10.1177/10781552221105584. Online ahead of print.

ABSTRACT

BACKGROUND: Chemotherapy drug handling and occupational exposure are topics of concern for a variety of oncology health care professionals. Inappropriate handling can pose health risks to practitioners particularly, those who handle them on a daily basis. Therefore, this study aimed to assess chemotherapy handling practices among oncology pharmacists and pharmacy technicians in Saudi Arabia.

METHODS: A cross-sectional study was conducted using an online survey with a structured pre-validated questionnaire. Data was collected from pharmacists and pharmacy technicians who handle chemotherapeutic agents in Saudi Arabia, and analyzed using descriptive and inferential statistics.

RESULTS: A total of 79 oncology pharmacy practitioners responded to the survey. The majority (92.4%) had written chemotherapy guidelines at their workplaces. Almost all participants (98.7%) reported the availability of protective gloves and gowns, however, the availability of eye protection was only 57%. Most used chemotherapy-designated gloves (83.6%), and gowns (86.1%). However, 54.4% have reused disposable gowns. The extent of utilization of most protective equipment ranged from 70% (always using closed system transfer device) to 98% (always using shoe cover); while the practice of always using eye protection and face shield was only 30.4% and 38%, respectively. With regard to cleaning practice, the work area was cleaned at least once a day by 35%; monthly decontamination (77%); certification by the biomedical department every 6 months (67%) and at least yearly (95%). Accidental exposure was reported by 28%, and the most common adverse effect was skin irritation (82%). There was no workplace medical surveillance available for 50%. The majority (88.6%) received relevant training, but not periodic updates on their training (38%). The main barriers against the use of personal protective equipment were: that some personal protective equipments were not always available (38%), and personal protective equipments were too uncomfortable to use (30.4%). The demographic variables did not have a statistically significant effect (p > 0.05) on the responses except for type of institution (workplace) on some of the cleaning practices that showed significant differences namely, the monthly decontamination and certification by the biomedical department.

CONCLUSIONS: Most protective equipment and chemotherapy guidelines were available, and the majority of pharmacy practitioners adhered to many aspects of chemotherapy safe-handling practices. Nevertheless, some areas such as medical surveillance programs, use of eye protection and face shields, the practice of re-using disposable gowns, some of the barriers against personal protective equipment use, and the provision of periodic training need improvement for better protection of the health care professionals.

PMID:35642271 | DOI:10.1177/10781552221105584

Food Sci Technol Int. 2022 May 31:10820132221105476. doi: 10.1177/10820132221105476. Online ahead of print.

ABSTRACT

In predictive microbiology, primary and secondary models can be used to predict microbial growth, usually in a two-step modelling approach. The inverse dynamic modelling approach is an alternative method to direct modelling methods, in which the primary and secondary models are fitted simultaneously from non-isothermal data, minimising experimental effort and costs. Thus, the main aim of the present study was to compare the prediction capabilities of the mathematical modelling approaches used for calculating growth kinetics of microorganisms in predictive food microbiology field. For this purpose, the bacterial growth data of Pseudomonas spp. in oyster mushroom (Pleurotus ostreatus) subjected to isothermal and non-isothermal storage temperatures were collected from previously published growth curves. Temperature-dependent kinetic growth parameters (maximum specific growth rate ‘µ_max‘ and lag phase duration ‘λ‘) were described as a function of storage temperature using the direct two-step, direct one-step and inverse dynamic modelling approach based on Baranyi and Huang models. The fitting capability of the modelling approaches was separately compared, and the one-step modelling approach for the direct methods provided better goodness of fit results regardless of used primary models, which leads the Huang model with being RMSE = 0.226 and R²_adj = 0.949 became best for direct methods. Like seen in direct methods, the Huang model gave better goodness of fit results than Baranyi model for inverse method. Results revealed there was no significant difference (p > 0.05) between the growth kinetic parameters obtained from direct one-step modelling approach and inverse modelling approaches based on the Huang model. Satisfactorily statistical indexes show that the inverse dynamic modelling approach can be reliably used as an alternative way of describing the growth behaviour of Pseudomonas spp. in oyster mushroom in a fast and minimum labour effort.

PMID:35642261 | DOI:10.1177/10820132221105476

AIDS Care. 2022 May 31:1-12. doi: 10.1080/09540121.2022.2080802. Online ahead of print.

ABSTRACT

Although people living with HIV/AIDS (PLWHA) are known to be vulnerable to psychological distress (PD), little is known about the prevalence of PD among PLWHA. A systematic literature search of several databases was conducted from inception to August 2021 focusing on studies reporting on PD symptoms among PLWHA. The overall prevalence estimates were pooled using a random-effects meta-analysis. Differences according to study-level characteristics were examined using stratified meta-analysis. We pooled and analyzed data from 15 studies comprising 5593 PLWHA. The prevalence rate of PD among PLWHA was 43.7% (95% Confidence Interval: 29.9-57.5%). Subgroup analyses by gender, country, CD4 count, employment status and ever attended school found no statistically significant differences in the prevalence of PD. Heterogeneity in the prevalence of PD among PLWHA was partially explained by the assessment tool. Further large-scale studies of high quality are warranted to identify risk factors of PD in PLWHA in their respective socio-cultural contexts.

PMID:35642250 | DOI:10.1080/09540121.2022.2080802