Tag: pubmed

Expert Rev Neurother. 2021 Nov 25. doi: 10.1080/14737175.2022.2011215. Online ahead of print.

ABSTRACT

INTRODUCTION: . Children with Autism Spectrum Disorder (ASD) experience difficulties in Executive Functions (EF) performances. However, efficacy of EF intervention needs to be further investigated.

OBJECTIVE: to evaluate the efficacy of different EF interventions in children and adolescents with ASD.

METHODS: A systematic review and meta-analysis were carried out according to PRISMA guidelines. Relevant databases including Pubmed, Psychinfo, Scopus and Web of Science were searched up to November 2019. Papers included in the study have the following characteristics: randomized controlled trial or quasi-experimental design and be published in English or Spanish.

RESULTS: After the elimination of duplicates, 949 were screened. Among these six were included in the systematic review. The main approaches for EF in ASD were computer-based interventions, cognitive-behavioral therapy and assisted-animal therapy. Statistically significant results (p=0.003) were found in using exergames.

CONCLUSION: Different approaches can be used for improving EF intervention, with positive effects on working memory, behavior, and flexibility.

PMID:34821185 | DOI:10.1080/14737175.2022.2011215

Clin Rehabil. 2021 Nov 25:2692155211057656. doi: 10.1177/02692155211057656. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke.

METHODS: We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database’s inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges’ g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I² value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility.

RESULTS: In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges’ g = 0.69, 95% CI = 0.36-1.01), gait speed (Hedges’ g = 0.57, 95% CI = 0.19-0.94), trunk control (Hedges’ g = 0.75, 95% CI = 0.33-1.17), and basic functional mobility (Hedges’ g = 0.63, 95% CI = 0.31-0.94) among people with stroke.

CONCLUSION: Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.

PMID:34821158 | DOI:10.1177/02692155211057656

Clin Rehabil. 2021 Nov 25:2692155211062110. doi: 10.1177/02692155211062110. Online ahead of print.

ABSTRACT

OBJECTIVE: To test with the Rasch analysis the psychometric properties of the Falls Efficacy Scale International, a questionnaire for measuring concern about falling.

DESIGN: Longitudinal observational study, before-after rehabilitation.

SETTING: Inpatient rehabilitation.

SUBJECTS: A total of 251 neurological patients with balance impairment.

INTERVENTIONS: Physiotherapy and occupational therapy aimed at reducing the risk of falling.

MAIN MEASURES: Participants (median age, first-third quartile: 74.0, 65.5-80.5 years; stroke and polyneuropathy: 43% and 21% of the sample, respectively) received a balance assessment (Falls Efficacy Scale International included) pre- and post-rehabilitation. Rasch analysis was used to evaluate the Falls Efficacy Scale International. Differential item functioning, which assesses the measures’ stability in different conditions (e.g. before vs. after treatment) and in different groups of individuals, was tested for several variables.

RESULTS: Patients suffered a moderate balance impairment (Mini-BESTest median score; first-third quartile: 15; 11-19), mild-moderate concern about falling (Falls Efficacy Scale International: 28; 21-37) and motor disability (Functional Independence Measure, motor domain: 70.0; 57.0-76.5). Falls Efficacy Scale International items fitted the Rasch model (range of infit and outfit mean square statistics: 0.8-1.32 and 0.71-1.45, respectively) and the questionnaire’s reliability was satisfactory (0.87). No differential item functioning was found for treatment, gender, age and balance impairment. Differential item functioning was found for diagnosis and disability severity, but it is shown that it is not such as to bias measures.

CONCLUSIONS: Falls Efficacy Scale International ordinal scores can be turned into interval measures, i.e. measures of the type of temperature. Being differential item functioning-free for treatment, these measures can be safely used to compare concern about falling before and after rehabilitation, such as when interested in assessing the rehabilitation effectiveness.

PMID:34821159 | DOI:10.1177/02692155211062110

Health Informatics J. 2021 Oct-Dec;27(4):14604582211052259. doi: 10.1177/14604582211052259.

ABSTRACT

Online symptom checkers (SCs) are eHealth solutions that offer healthcare organizations the possibility to empower their patients to independently assess their symptoms. The successful implementation of eHealth solutions, such as SCs, requires a supportive organizational culture and leadership. However, there is limited knowledge about the factors associated with leaders’ support for the use of SCs. The aim of the study was to identify the factors associated to primary care leaders’ support for SCs in triage and their experiences of the benefits and challenges related to the use of SCs. An online survey was used to collect data from 84 Finnish primary care leaders. The data were analyzed using statistical analysis methods and content analysis. Vision clarity, perceiving efficiency improvements, and considering the service to be beneficial for patients were associated with leaders’ support for the service (β ranging from 0.41 to 0.44, p < 0.001). Leaders’ support for the service was also associated with how well the leaders provided information about the service to their subordinates (β =0.22, p < 0.048). SCs present slightly more challenges than benefits regarding health professionals’ work. The developers of SCs should focus more on features that decrease health professionals’ workload as well as how the solution can benefit patients.

PMID:34821152 | DOI:10.1177/14604582211052259

Radiol Oncol. 2021 Nov 19;55(4):426-432. doi: 10.2478/raon-2021-0043.

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the diagnostic accuracy of p16/Ki-67 dual immunostaining (p16/ Ki-67 DS) in cervical cytology and the number of positive p16/Ki-67 cells to diagnose high grade cervical intraepithelial neoplasia (CIN2+) in colposcopy population.

SUBJECTS AND METHODS: We performed an analysis on a subset cohort of 174 women enrolled within a large-scale randomised controlled human papillomavirus (HPV) self-sampling project organised as part of the population-based Cervical Cancer Screening Programme ZORA in Slovenia. This subset cohort of patients was invited to the colposcopy clinic, underwent p16/Ki-67 DS cervical cytology and had the number of p16/Ki-67 positive cells determined.

RESULTS: Among analysed women, 42/174 (24.1%) had histologically confirmed CIN2+. The risk for CIN2+ was increasing with the number of positive cells (p < 0.001). The sensitivity of p16/Ki-67 DS for detection of CIN2+ was 88.1%, specificity was 65.2%, positive predictive value was 44.6% and negative predictive value was 94.5%.

CONCLUSIONS: Dual p16/Ki-67 immunostaining for the detection of CIN2+ has shown high sensitivity and high negative predictive value in our study, which is comparable to available published data. The number of p16/Ki-67 positive cells was significantly associated with the probability of CIN2+ detection. We observed a statistically significant and clinically relevant increase in specificity if the cut-off for a positive test was shifted from one cell to three cells.

PMID:34821133 | DOI:10.2478/raon-2021-0043

J Clin Periodontol. 2021 Nov 24. doi: 10.1111/jcpe.13576. Online ahead of print.

ABSTRACT

AIM: This study aimed to investigate effects of a six-week Mediterranean diet (MD) intervention on gingival inflammatory and anthropometric parameters of patients with gingivitis.

MATERIALS AND METHODS: Forty-two participants were allocated to MD group (MDG) or control group (CG). After a two weeks equilibration period regarding dental care procedures, only MDG changed their diet to MD for six weeks, supported by a diet counseling. Gingival and anthropometric parameters were assessed at baseline (T0), Week 2 (T1, beginning of MD intervention), and Week 8 (T2). Adherence to MD was assessed by the Mediterranean Diet Adherence Screener (MEDAS), dietary behavior was evaluated by the German Health Interview and Examination Survey for Adults Food Frequency Questionnaire (DEGS-FFQ).

RESULTS: Plaque values remained constant in both groups. Inflammatory periodontal and anthropometric parameters decreased in the MDG only (gingival index: T1 1.51±0.21, T2 1.49±0.24; bleeding on probing: T1 51.00±14.65, T2 39.93±13.74; body weight: T1 79.01±15.62, T2 77.29±17.00; waist circumference: T1 84.41±10.1, T2 83.17±10.47 (p < 0.05). MEDAS revealed a sufficient diet adherence for MDG.

CONCLUSION: Within this study, gingival inflammatory parameters were significantly reduced by MD, whereas plaque parameters remained constant. The diet counseling achieved sufficient adherence with beneficial changes in weight loss and waist circumference.

PMID:34818686 | DOI:10.1111/jcpe.13576

Gynecol Obstet Invest. 2021 Nov 24. doi: 10.1159/000520979. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019.

METHODS: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis.

RESULTS: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia.

LIMITATION: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data.

CONCLUSION: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

PMID:34818651 | DOI:10.1159/000520979

Eur Surg Res. 2021 Nov 24:1-13. doi: 10.1159/000519718. Online ahead of print.

ABSTRACT

Backgroud/Objectives: Transoral laser laryngeal microsurgery (LTLM) has been widely used in the treatment of early-stage glottic laryngeal squamous cell carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, anterior commissure involvement, type of cordectomy, positive surgical margin, and postoperative additional therapies were accused as the prognostic factors for recurrence, there is still controversy about these data in the literature. The purpose of this study was to evaluate the oncological results of our patients with early glottic LSCC treated with LTLM as a single-modality therapy in a single-center study.

METHODS: Patients with early-stage (Tis-1-2/N0) glottic LSCC who underwent LTLM as a primary treatment from 2011 to 2019 were retrospectively reviewed. The clinicopathological factors and oncologic outcomes were analyzed.

RESULTS: One hundred and sixty-one patients were enrolled in this study. The 5-year overall (OS), disease-specific (DSS), disease-free (DFS), and laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, respectively. The most common stage, histopathological type, and type of endoscopic cordectomy were T1 stage, well-differentiated cancer, and type 2 cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) patients. There was a significant relationship between histopathological grade and positive surgical margins (p = 0.038). OS and DSS rates of “wait and see” modality were lower, while DFS of radiotherapy was lower than that of other treatment modalities in patients with positive surgical margins, but the differences were not statistically significant. Nineteen (11.8%) patients had a recurrence. DSS was statistically significantly lower in patients with recurrence (p < 0.001).

CONCLUSION: The results of our study showed that anterior commissure involvement, surgical margin positivity, and higher T stage statistically did not reduce survival rates in early-stage LSCC patients treated with LTLM. As the histopathological grade of the tumor worsens, the risk of surgical margin positivity increases. RT may have a negative effect on recurrence and organ preservation in the additional treatment of patient with positive surgical margins.

PMID:34818662 | DOI:10.1159/000519718

J Phys Condens Matter. 2021 Nov 24. doi: 10.1088/1361-648X/ac3cef. Online ahead of print.

ABSTRACT

We report a experimental study of the motion of 1μm single particles interacting with functionalized walls at low and moderate ionic strengths conditions. The 3D particle’s trajectories were obtained by analyzing the diffracted particle images (point spread function). The studied particle/wall systems include negatively charged particles interacting with bare glass, glass covered with polyelectrolytes and glass covered with a lipid monolayer. In the low salt regime (pure water) we observed a retardation effect of the short-time diffusion coefficients when the particle interacts with a negatively charged wall; this effect is more severe in the perpendicular than in the lateral component. The decrease of the diffusion as a function of the particle-wall distance h was similar regardless the origin of the negative charge at the wall. When surface charge was screened or salt was added to the medium (10mM), the diffusivity curves recover the classical hydrodynamic behavior. Electroviscous theory based on the thin electrical double layer (EDL) approximation reproduces the experimental data except for small h. On the other hand, 2D numerical solutions of the electrokinetic equations showed good qualitative agreement with experiments. The numerical model also showed that the hydrodynamic and Maxwellian part of the electroviscous total drag tend to zero as h → 0 and how this is linked with the merging of both EDL’s at close proximity.

PMID:34818642 | DOI:10.1088/1361-648X/ac3cef

Phys Med Biol. 2021 Nov 24. doi: 10.1088/1361-6560/ac3d15. Online ahead of print.

ABSTRACT

Recent medical image segmentation methods heavily rely on large-scale training data and high-quality annotations. However, these resources are hard to obtain due to the limitation of medical images and professional annotators. How to utilize limited annotations and maintain the performance is an essential yet challenging problem. In this paper, we try to tackle this problem in a self-learning manner by proposing a Generative Adversarial Semi-supervised Network (GASNet). We use limited annotated images as main supervision signals, and the unlabeled images are manipulated as extra auxiliary information to improve the performance. More specifically, we modulate a segmentation network as a generator to produce pseudo labels for unlabeled images. To make the generator robust, we train an uncertainty discriminator with generative adversarial learning to determine the reliability of the pseudo labels. To further ensure dependability, we apply feature mapping loss to obtain statistic distribution consistency between the generated labels and the real labels. Then the verified pseudo labels are used to optimize the generator in a self-learning manner. We validate the effectiveness of the proposed method on right ventricle dataset, Sunnybrook dataset, STACOM, ISIC dataset, and Kaggle lung dataset. We obtain 0.8402 to 0.9121, 0.8103 to 0.9094, 0.9435 to 0.9724, 0.8635 to 0.886, and 0.9697 to 0.9885 dice coefficient with 1/8 to 1/2 proportion of densely annotated labels, respectively. The improvements are up to 28.6 points higher than the corresponding fully supervised baseline.

PMID:34818627 | DOI:10.1088/1361-6560/ac3d15