Tag: pubmed

J Appl Clin Med Phys. 2022 May 19:e13635. doi: 10.1002/acm2.13635. Online ahead of print.

ABSTRACT

BACKGROUND: The Halcyon is a linear accelerator-based treatment machine designed for a high-throughput simplified workflow. The machine features a compact jawless design, dual-layer multileaf collimators, and a single 6-MV flattening filter-free (FFF) beam. However, the machine’s 6-MV FFF beam may restrict its applicability to conventional techniques, such as field-in-field (FiF) radiotherapy, for breast cancer treatment. This study developed a practical and efficient hybrid method for imaging, planning, and irradiation procedures for whole-breast irradiation using Halcyon linear accelerators.

MATERIALS AND METHODS: The proposed method involves five major steps: (1) field arrangement, (2) planning target volume (PTV) generation and evaluation, (3) basal plan generation, (4) inverse planning intensity-modulated radiation therapy plan generation, and (5) plan evaluation and irradiation. The PTV is generated using isodose curves plotted on the basis of tangential fields, which are applied to create a basal plan. Subsequently, a basal-dose-compensation approach is applied to further optimize the treatment plan. This efficient workflow necessitates executing only one onboard cone-beam computed tomography procedure. This study included 10 patients with early-stage breast cancer who were treated at our center. The performance of the proposed method was evaluated by comparing its corresponding irradiation time and dose statistics with those derived for a dynamically flattened beam-based FiF (DFB-FiF) method.

RESULTS: All plans were normalized to ensure that 98% of the prescribed dose covered 95% of the PTV. On average, the global maximum doses in the proposed and DFB-FiF methods were lower than 106%. The homogeneity index for right-sided (left-sided) breast cancer was 0.053 (0.056) in the proposed method and 0.073 (0.076) in the DFB-FiF method. The dose statistics of normal tissues, including the contralateral breast, heart, and lungs, were comparable between the methods. However, the irradiation time per monitor unit in the proposed method was approximately five times faster than that in the DFB-FiF method, but the planning time and complexity were similar between the methods.

CONCLUSIONS: This study developed and evaluated an efficient and practical hybrid method for whole-breast irradiation using the Halcyon. This method can significantly reduce the irradiation time, while providing comparable dose statistics to the DFB-FiF method.

PMID:35587264 | DOI:10.1002/acm2.13635

S Afr Med J. 2022 Apr 29;112(5):335-340.

ABSTRACT

BACKGROUND: Human papillomavirus (HPV) is a sexually transmitted infection and a causative agent of cervical cancer. It is common in adolescent girls and young women, and the majority of infections are transient and asymptomatic. In Botswana, there are currently no data on the HPV prevalence against which the impact of prophylactic HPV vaccines can be measured.

OBJECTIVES: To establish a baseline HPV prevalence in an unvaccinated cohort of young women.

METHODS: Women aged ≥18 years were recruited from the University of Botswana between September 2016 and May 2020. Demographic and behavioural characteristics of participants were collected. Subsequently, cervicovaginal swabs were obtained and tested for HPV using polymerase chain reaction-restriction fragment length polymorphism. We determined the prevalent HPV types, and evaluated the risk factors associated with HPV positivity.

RESULTS: A total of 978 young women were recruited. Overall, there were 589 (60.2%) participants with HPV infection and 12 (1.2%) with HIV. The median (interquartile range) age of the study participants was 19 (18 – 20) years. Multivariate logistic regression analysis showed that significant factors associated with HPV positivity were sexual activity (adjusted odds ratio (aOR) 2.06; 95% confidence interval (CI) 1.49 – 2.63; p<0.001), number of sex partners ≥3 (aOR 2.10; 95% CI 1.39 – 3.18; p<0.001), and smoking (aOR 2.00; 95% CI 1.26 – 3.20; p=0.004).

CONCLUSION: Our results demonstrate for the first time the prevalence of HPV in unvaccinated young women in Botswana. We found a high prevalence of HPV infection, with statistical differences with different risk factors. This finding supports the need for HPV vaccination strategies for females prior to sexual debut to reduce the future burden of cervical cancer in Botswana.

PMID:35587246

Eur J Transl Myol. 2022 May 19. doi: 10.4081/ejtm.2022.10537. Online ahead of print.

ABSTRACT

Renal transplant therapy is essential in patients with End-Stage Renal Disease (ESRD). It is used in patients awaiting a kidney transplant or those who cannot be a transplant candidate. Central venous catheter is one of the most used access routes worldwide but has been recorded as the one with highest mortality and morbidity rate. Thromboembolic events have played a major part for that. This is a descriptive-analytical study, which conducted in a university treatment center in Tehran, Iran. A total of 225 patients were selected for this study that 108 were excluded because of our criteria. Statistical analysis was performed by SPSS v19 and a total of 117 patients were included in this study. The average age of the patients was 51.62±11.26. 79 (67.5%) and 38 (32.5%) patients had medial and lateral tip direction, respectively. The catheter of 85(72.6%) and 32(27.4%) patients was patent and occluded, respectively. The average catheter tip occlusion time in both groups was 22.5 and 7.5 months. Three-month, six-month, twelve-month, and twenty-four-month patency rate were 99%, 94%, 88%, and 30%, respectively. our findings suggest that medial direction of the tip of the catheter reduces complications caused in CVS. Because our study has been conducted in a small scale and there is lack of similar studies, our team suggests extension to a larger scale to confirm or not our results.

PMID:35587263 | DOI:10.4081/ejtm.2022.10537

Adv Clin Exp Med. 2022 May 19. doi: 10.17219/acem/148112. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system (CNS). Most exercise studies concentrate on the impact of exercise on cardiovascular system; this study aims to present the effects of exercise of varying intensity on the nervous system. Most recently in MS, positive outcomes were obtained with resistance and high-intensity exercises. This study also analyzes the effects of a prior conditioning program before the induction of demyelination and subsequent neuroprotective effects of such program.

OBJECTIVES: To study and determine the neuroprotective and remyelinating effects of different intensity of aquatic exercise and a preconditioning exercise program on demyelination induced by oral administration of cuprizone (Cup).

MATERIAL AND METHODS: Six groups of animals, each containing 6 rats, were used in the study. The groups were as follows: group I – control group; group II – Cup group; group III – treated with methylprednisolone (MP); group IV – treated with low-intensity exercise (LIE), free swimming for 40 min and high-intensity exercise (HIE); group V – treated with a resistance of 9% body weight and free swimming for 40 min; group VI – treated with preconditioning exercise (free swimming for 40 min for 3 weeks) before Cup administration followed by the same exercise protocol as for group V. All data were analyzed using one-way analysis of variance (ANOVA) with Tukey’s test, by means of SigmaPlot v. 14.5 software.

RESULTS: Similarly to the MP group, group VI showed a positive outcome. A value of p < 0.001 was considered statistically significant. Also, group VI showed improved areas of remyelination in histopathology, an increased expression of myelin basic protein (MBP), reduced expression of glial fibrillary acidic protein (GFAP) in corpus callosum, and improved gene expression of brain-derived neurotrophic factor (BDNF) in the hippocampus region.

CONCLUSIONS: General fitness achieved through a preconditioning program combined with HIE showed neuroprotective effects, as evidenced by increased areas of remyelination and improved neuronal plasticity, observed mostly in group VI (conditioning+HIE).

PMID:35587221 | DOI:10.17219/acem/148112

J Am Geriatr Soc. 2022 May 19. doi: 10.1111/jgs.17884. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of this study was to determine associations between use of oral anticoagulation (OAC) and stroke and bleeding-related outcomes for older people ≥80 years with atrial fibrillation (AF), and to determine trends over time in prescribing of OAC for this population.

METHODS: A retrospective cohort study was conducted. People aged ≥80 years with AF receiving (1) no OAC; (2) warfarin; or (3) a non-vitamin-K antagonist oral anticoagulant (NOAC) between 2011 and 2019 were included. Propensity score matching was used to balance cohorts (no OAC, warfarin or a NOAC) on characteristics including age, sex, ethnicity, and co-morbidities. Cox proportional hazard models were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS: The proportion of people aged ≥80 years receiving any OAC increased from 32.4% (n = 27,647) in 2011 to 43.6% (n = 110,412) in 2019. After propensity score matching, n = 169,067 individuals were included in the cohorts receiving no OAC or a NOAC. Compared to no OAC, participants receiving a NOAC had a lower risk of incident dementia (hazHR 0.68, 95% CI 0.65-0.71), all-cause mortality (HR 0.49, 95% CI 0.48-0.50), first-time ischaemic stroke (HR 0.87, 95% CI 0.83-0.91), and a higher risk of major bleeding (HR 1.08, 95% CI 1.05-1.11). Compared to participants receiving warfarin, participants receiving a NOAC had a lower risk of dementia (HR 0.90, 95% CI: 0.86-0.93), all-cause mortality (HR 0.74, 95% CI: 0.72-0.76), ischaemic stroke (HR 0.86, 95% CI: 0.82-0.90) and major bleeding (HR 0.88, 95% CI: 0.85-0.90). Similar results were observed when only including people with additional bleeding risk factors.

CONCLUSIONS: The proportion of people aged ≥80 years receiving OAC has increased since the introduction of NOACs, but remains low. Use of a NOAC was associated with improved outcomes compared to warfarin, and compared to no OAC, except for a small but statistically significant higher risk of major bleeding.

PMID:35587227 | DOI:10.1111/jgs.17884

Health Rep. 2022 May 18;33(5):13-21. doi: 10.25318/82-003-x202200500002-eng.

ABSTRACT

INTRODUCTION: Data from the first round of the nationally representative Survey on COVID-19 and Mental Health (SCMH) revealed that the prevalence of recent suicidal ideation in the fall of 2020 in Canada did not differ significantly from that in the pre-pandemic period in 2019. The objective of the present study was to reassess the prevalence of recent suicidal ideation in the spring of 2021.

METHODS: The prevalence of suicidal ideation among adults in Canada was examined using the 2021 SCMH (conducted between February 1 and May 7, 2021), and it was compared with the prevalence in the 2019 Canadian Community Health Survey. Unadjusted logistic regression analysis was used to assess the differential likelihood of reporting suicidal ideation in population subgroups.

RESULTS: Among adults in Canada, the prevalence of suicidal ideation since the pandemic began was 4.2%, which was significantly higher than the pre-pandemic prevalence of 2.7% in 2019. A statistically significant increase in prevalence was observed among females and males, age groups younger than 65, and several other sociodemographic groups, as well as in British Columbia, the Prairie provinces and Ontario. People who were younger than 65 years, were born in Canada, had lower educational attainment, or were never married were significantly more likely to report suicidal ideation than others during the pandemic.

CONCLUSION: As the second year of the pandemic began, the prevalence of recent suicidal ideation in Canada was higher than it had been before the pandemic in 2019. Continuous monitoring of suicide-related outcomes and risks is necessary so that population-level changes can be detected and inform public health action.

PMID:35587219 | DOI:10.25318/82-003-x202200500002-eng

Health Rep. 2022 May 18;33(5):22-33. doi: 10.25318/82-003-x202200500003-eng.

ABSTRACT

BACKGROUND: Canadian and international research has shown that the COVID-19 pandemic has led to changes in health behaviours, including physical activity.

METHODS: The Canadian Community Health Survey asked Canadian youth (12 to 17 years) and adults (18 years and older) to report the amount of time they spent in the past seven days engaged in physical activity across the following domains: recreation, transportation, household or occupation, and school (youth only). The present analysis compares the physical activity from two cross-sectional samples collected during the fall of 2018 (n=13,482) and the fall of 2020 (n=27,234).

RESULTS: Youth reported accumulating, on average, two hours less physical activity per week in the fall of 2020 compared with the fall of 2018 (-129 minutes per week). The percentage of youth meeting the Canadian physical activity recommendation for children and youth dropped from 50.8% in the fall of 2018 to 37.2% in the fall of 2020. Physical activity decreased more among youth living in urban (-135 minutes per week) compared with rural (-86 minutes per week) areas. Physical activity decreased more among youth from Ontario (-168 minutes per week), Quebec (-121 minutes per week) and the Prairies (-106 minutes per week) compared with youth from the Atlantic provinces (-38 minutes per week) and British Columbia (-75 minutes per week). There was no change in the percentage of adults aged 18 and older meeting the Canadian physical activity recommendation between the fall of 2018 (52.7%) and the fall of 2020 (53.3%). Weekly physical activity was stable between fall 2018 and fall 2020 among 18 to 49 year olds, while significant increases were observed among adults aged 50 to 64 years (+41 minutes per week), 65 to 79 years (+55 minutes per week) and 80+ years (+20 minutes per week). Increases in physical activity among adults were statistically significant only among non-immigrant, non-Indigenous, those not designated as a visible minority, those living in urban areas and those with a postsecondary degree.

INTERPRETATION: The COVID-19 pandemic had a detrimental impact on the physical activity of youth but not adults. The findings of this study add to a growing body of evidence that shows the considerable impact the pandemic has had on many aspects of Canadian life, including physical activity.

PMID:35587220 | DOI:10.25318/82-003-x202200500003-eng

Health Rep. 2022 May 18;33(5):3-12. doi: 10.25318/82-003-x202200500001-eng.

ABSTRACT

BACKGROUND: Compared to the general Canadian population, military members exhibit a higher prevalence of depressive disorders, anxiety disorders, and post-traumatic stress disorder. However, there is a paucity of research investigating the extent to which military members experience positive mental health. Validation of positive mental health measures, including the Mental Health Continuum – Short Form (MHC-SF), is necessary to determine whether well-being can be assessed in a valid and reliable manner among Canadian Armed Forces (CAF) military members. The purpose of this research was to assess the internal consistency reliability, convergent validity, factor structure, and measurement invariance of the MHC-SF among CAF Regular Force and Reserve Force military members.

DATA AND METHODS: Data were drawn from the nationally representative 2013 Canadian Forces Mental Health Survey (CFMHS) conducted by Statistics Canada. A random sample of 8,200 CAF military personnel completed the CFMHS, representing 64,400 Regular Force and 4,460 Reserve Force CAF personnel.

RESULTS: As expected, all three MHC-SF subscales (psychological, social, and emotional well-being) correlated positively with life satisfaction, self-rated mental health, sense of belonging, and social support, and correlated negatively with psychological distress and disability due to health conditions. Internal consistency was high. Confirmatory factor analysis supported the three-factor structure of the MHC-SF, and measurement invariance was satisfied.

INTERPRETATION: Findings provided support for the reliability, convergent validity, factorial validity, and measurement invariance of the MHC-SF among both Regular Force and Reserve Force military samples. Therefore, researchers and clinicians can reliably implement the MHC-SF as a tool to assess, interpret, and predict military members’ psychological, social, and emotional well-being.

PMID:35587218 | DOI:10.25318/82-003-x202200500001-eng

Comput Methods Biomech Biomed Engin. 2022 May 19:1-12. doi: 10.1080/10255842.2022.2047952. Online ahead of print.

ABSTRACT

This paper discussed the size of 3 D-printed personalized titanium plates that can gain maximum stability of mandibular fracture and minimize stress shielding through finite element analysis. A 3 D virtual model of mandible with mandibular angle fracture was created from the CT data of patient. 3 D-printed personalized titanium plates varying in length and thickness were designed, and finite element analysis was performed under different loading conditions and fracture healing periods. After that, the stress distribution and deformation of the mandible with gonial fracture could be observed, and the stress shielding rate could be obtained. Finally, SPSS21.0 was used for statistical analysis. The results of finite element analysis indicated that as the thickness of titanium plates and the healing time decreased, the maximum displacement increased, under a certain condition in which the pore size, the width, the hole distance and the bridge spacing were 2.0 mm, 4.0 mm, 6.0 mm, 12.0 mm, respectively. What’s more, in this condition, the thicker the titanium plate and the shorter the healing time were, the higher the stress shielding was at central occlusion. When the thickness of the personalized 3 D-printed titanium plate was 1.0 mm, the maximum displacement tended to be stable and the stress shielding was minimized. It can not only improve the bone stability after tension band fixation, but also minimize the stress shielding, which is expected to expand the indications of tension band fixation.

PMID:35587215 | DOI:10.1080/10255842.2022.2047952

Pediatr Allergy Immunol Pulmonol. 2022 May 18. doi: 10.1089/ped.2021.0229. Online ahead of print.

ABSTRACT

Background and Objective: Although high-flow nasal cannula (HFNC) is widely used in children, there is no consensus on the methods for starting, maintenance, and weaning. The aim of this study was to compare weaning methods in children. Methods: The study included all patients in pediatric intensive care unit (PICU) who were started on HFNC treatment. The respiratory assessment score was used in the decisions for starting, continuing, and weaning from HFNC. The patients who responded and for whom weaning was planned were randomized by month into 2 groups as directly weaned from HFNC and weaned by reducing the flow. Success rates, treatment, and length of stay (LOS) in weaning methods were compared. Results: Of the 145 patients initially included in the study, 32 (22%) were excluded, and analysis was made of 113 patients. Successful weaning from HFNC was obtained in 76.9% of the patients, in 82.1% of flow weaning, and 73.6% of direct weaning, with no statistically significant difference determined between the groups (P = 0.286). The median duration of HFNC and the median LOS in PICU were determined to be statistically significantly shorter in direct weaning than in flow weaning [36 h interquartile range (IQR) 24-48 h] versus 60 h (IQR 60-72 h), P < 0.001 and 6 days (4-14 days) versus 9.5 days (5.25-20.75 days, P = 0.043, respectively). Conclusion: In patients who responded to HFNC in PICU, the responses to direct weaning and flow reduction were seen to be similar. In patients directly weaned off, both the HFNC duration and LOS in PICU were significantly shorter.

PMID:35587212 | DOI:10.1089/ped.2021.0229