Tag: pubmed

Ophthalmol Ther. 2021 Jul 19. doi: 10.1007/s40123-021-00375-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to evaluate the correlation between several ocular parameters (intraocular pressure [IOP], corneal biomechanical properties) and the visual field (VF) mean deviation (VF MD) in eyes with open-angle glaucoma (OAG).

METHODS: We conducted a cross-sectional, observational study in which we measured the IOP with Goldmann applanation tonometry, the central corneal thickness (CCT), and the corneal parameters obtained from the Ocular Response Analyzer® (ORA®) and the Corvis® ST non-contact tonometer, in newly diagnosed and treatment-naïve eyes with OAG, to investigate whether there was any correlation between these ocular parameters and the VF MD.

RESULTS: A total of 51 eyes were analyzed. A statistically significant correlation was found only between the VF MD and corneal hysteresis (CH) (P = 0.003, r² = 0.16) and CCT (P = 0.03, r² = 0.08).

CONCLUSIONS: These results demonstrate that CH and CCT are associated with the amount of VF damage in treatment-naïve OAG eyes.

PMID:34279846 | DOI:10.1007/s40123-021-00375-w

Neuro Endocrinol Lett. 2021 Jul 19;42(3):185-199. Online ahead of print.

ABSTRACT

OBJECTIVES: The effect of short-term psychodynamic psychotherapy in patients with neurotic spectrum disorders may be related with predictive factors such as the severity of the disorder, diagnosis, self-stigma level, personality characteristics, comorbidity with depression and personality disorder, dissociation, and traumatic childhood experience. This study focuses on finding factors related to the effect of short-term psychodynamic psychotherapy in patients with neurotic spectrum disorders.

METHOD: The study was conducted at the Psychotherapeutic ward of the Psychiatric Department in Regional Hospital Liberec from October 2015 to March 2019. The assessment method used at the beginning was the objective and subjective Clinical global impression (objCGI, subjCGI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Dissociative Experience Scale (DES), Liebowitz Social Anxiety Scale (LSAS), Internalized Stigma of Mental Illness (ISMI), Temperament and Character Inventory (TCI), Parental Bonding Style (PBI), Childhood Trauma Questionnaire (CTQ). The 6-week therapeutic program combines group dynamic psychotherapy (4 times a week for 1.5 hours), pharmacotherapy and other therapeutic activities. The primary criterium of therapeutic outcome was the change in objCGI severity, and the secondary criteria were changes in subjCGI, BAI and BDI-II.

RESULTS: A total of 96 hospitalized patients with neurotic spectrum disorder diagnosed according to ICD-10, confirmed with the MINI (MINI-International Neuropsychiatric Interview) were included in the study and filled out the questionnaires’ battery. There was a statistically significant decrease in the anxiety and depression symptoms and an overall decrease in the disorder’s severity during the treatment. At the beginning of the treatment, a higher self-stigma rate was associated with a smaller decrease in anxiety symptoms (BAI) and depression (BDI-II). However, self-stigma is not a factor associated with the change in primary outcome criteria (objCGI change). Initial assessment of objective severity of the disorder (objCGI) and personality factor Novelty Seeking predict the change in objCGI severity.

CONCLUSIONS: Self-stigma predicted the change in anxiety and depressive symptom but not the change of the disorder’s global severity in short-term psychodynamic psychotherapy of patients with a neurotic spectrum disorder.

PMID:34279862

Adv Radiat Oncol. 2021 Jun 4;6(5):100735. doi: 10.1016/j.adro.2021.100735. eCollection 2021 Sep-Oct.

ABSTRACT

PURPOSE: We aimed to evaluate the growth of women within the general radiation oncology (RO) workforce in comparison to the growth among other medical specialties. We also sought to create a predictive model for gender diversity to guide future recruitment efforts.

METHODS AND MATERIALS: We identified 16 medical specialties, including RO, for analyses. We used data from the Association of American Colleges and assessed female representation at 4 time points (2006, 2011, 2016, and 2020). Additionally, we determined characteristics of medical specialties that were predictive of increased gender diversity. We performed univariate statistical analysis with linear regression to evaluate factors predictive of greater gender diversity among the medical specialties in our cohort.

RESULTS: The proportion of women within the represented specialties increased over time. Obstetrics/gynecology (14,750 [2006], 23,921 [2020]; 18.7% absolute growth) and dermatology (3568 [2006], 6329 [2020]; 15.1% absolute growth) experienced the highest absolute growth in female representation between 2006 and 2020. When assessing changes between various time points in RO, the absolute change in female physicians increased by 1.5% between 2006 and 2011, by 2.2% between 2011 and 2016, and by only 0.4% between 2016 and 2020, which was the lowest growth pattern relative to the other 15 specialties. Factors predictive of gender diversity among specialties were lower average step 1 scores (P = .0056), fewer years of training (P = .0078), fewer work hours (P = .046), the availability of a standard third year clerkship for a given specialty (P = .0061), and a high baseline number of female physicians within a specialty (P = .0078). Research activities (P = .099) and interest among matriculating medical students (P = .28) were not statistically significant.

CONCLUSIONS: The percentage of women in RO lags behind other medical specialties and has been notably low in the last few years. Interventions that incorporate novel initiatives proposed within this study may accelerate current recruitment milestones.

PMID:34278054 | PMC:PMC8267431 | DOI:10.1016/j.adro.2021.100735

Heliyon. 2021 Jul 1;7(7):e07424. doi: 10.1016/j.heliyon.2021.e07424. eCollection 2021 Jul.

ABSTRACT

BACKGROUND: At the heart in the development of any organization or nation is human resource. Over the years the world over, a sharp increase in too many numbers of qualified persons is being experienced yearly. This has impacted on recruitment and promotion costs to increase immensely, thereby affecting negatively manpower system costs. Dynamic Programming (DP) approach to optimal manpower recruitment and promotion policies for the two grade system has been proposed.

METHODS: Considering the fact that contemporary manpower systems are not limited to just two grades – a kind of “switch-approach” to manpower systems, we first establish the link between a manpower planning problem and a dynamic decision-making process. This linkage resulted to a multistage real-life decision-making problem whose solution demands that decisions be made sequentially at different levels and at different points in time and space. Dynamic Programming is a mathematical technique well appropriate for the optimization of multistage decision problems. This allows us to give a generalization to manpower systems by modifying the model to finite grades which came out to be more robust and actionable, a constrained deterministic Dynamic Programming (CDDP) found to function computationally as the very well-known Wagner-Whitin Model in inventory/production management. Five cost variables associated with manpower planning were identified and used as inputs to the modified deterministic DP model.

RESULTS/RELEVANCE: The data shows yearly recruitments and promotions totaling 507 and 266 staff respectively for a ten-period (year) planning horizon. Total manpower system cost (in ooo’s of Nigerian Naira) occasioned by yearly recruitments and promotions exercises for the period is 11334 (7092 for recruiting, 4100 for promoting, and 142 for overstaffing). Our DP model minimizes the manpower system cost to 9462 making a significant reduction of 1872. The optimal policy for the planning period calls for recruiting and promoting respectively 79 and 41 in period 1 only, 86 and 24 in period 2 for periods 2 and 3, 86 and 46 in period 4 for periods 4 and 5, 89 and 29 in period 6 only, 85 and 70 in period 7 for periods 7 and 8, and 82 and 56 in period 9 for periods 9 and 10.The study will contribute to the growing literature on applications of OR models to problems in manpower planning. The model outcomes would provide the basis for evaluating decision policies aimed at conducting recruitment promptly and to eliminate over-stagnated promotions.

CONCLUSION/FURTHER RESEARCH: We formulate decisions making in a finitely-graded manpower system as a multistage decision-making optimization problem which are best handled by dynamic programming. Five cost variables associated with manpower planning were identified and used as inputs to the modified deterministic DP model. Our model is resolute for minimizing manpower system costs occasioned by recruitments and promotions exercises in a wide range of multi-graded manpower systems instead of just two grades. The study’s limitations and scope for future research work are presented in the end.

PMID:34278026 | PMC:PMC8264120 | DOI:10.1016/j.heliyon.2021.e07424

Contemp Clin Trials Commun. 2021 Jun 29;23:100805. doi: 10.1016/j.conctc.2021.100805. eCollection 2021 Sep.

ABSTRACT

Herniated nucleus pulposus (NP), one of the most common diseases of the spine, is surgically treated by removing the sequestered NP. However, intervertebral disc (IVD) defects may remain after discectomy, leading to inadequate tissue healing and predisposing patients to IVD degeneration. An acellular, bioresorbable, ultra-purified alginate (UPAL) gel (dMD-001) implantation system can be used to fill any IVD defects in order to prevent IVD degeneration after discectomy. This first-in-human pilot study aims to determine the feasibility, safety, and perceived patient response to a combined treatment involving discectomy and UPAL gel implantation for herniated NP. We designed a one-arm, double-centre, open-label, pilot trial. The study started in November 2018 and will run until a sample of 40 suitable participants is established. Patients aged 20-49 years, diagnosed with isolated lumbar IVD herniation and scheduled for discectomy represent suitable candidates. All eligible participants who provide informed consent undergo standard discectomy followed by UPAL gel implantation. The primary outcomes of the trial will be the feasibility and safety of the procedure. Secondary outcomes will include self-assessed clinical scores and magnetic resonance imaging-based measures of morphological and compositional quality of the IVD tissue. Initial outcomes will be published at 24 weeks. Analysis of feasibility and safety will be performed using descriptive statistics. Both intention-to-treat and per-protocol analyses of treatment trends of effectiveness will be conducted.

PMID:34278043 | PMC:PMC8261539 | DOI:10.1016/j.conctc.2021.100805

Heliyon. 2021 Jun 26;7(7):e07393. doi: 10.1016/j.heliyon.2021.e07393. eCollection 2021 Jul.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, the health professionals who are at the frontline of this crisis have been facing extreme psychological disorders. This research aims to provide an overall scenario of the prevalence of depression, anxiety, stress, as well as insomnia and to inspect the changes in these prevalence over time by analyzing the existing evidence during this COVID-19 pandemic.

METHODS: A systematic search was performed on March 30, 2021, in PubMed, MEDLINE, Google Scholar databases, and Web of Science. To assess the heterogeneity, Q-test, I2 statistics, and Meta regression and to search for the publication bias, Eggers’s test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity.

RESULTS: Among eighty-three eligible studies in the final synthesis, 69 studies (n = 144649) assessed the depression prevalence of 37.12% (95% CI: 31.80-42.43), 75 studies (n = 147435) reported the anxiety prevalence of 41.42% (95% CI: 36.17-46.54), 41 studies (n = 82783) assessed the stress prevalence of 44.86% (95% CI: 36.98-52.74), 21 studies (n = 33370) enunciated the insomnia prevalence of 43.76% (95% CI: 35.83-51.68). The severity of the mental health problems among health professionals increased over the time during January 2020 to September 2020.

LIMITATIONS: A significant level of heterogeneity was found among psychological measurement tools and across studies.

CONCLUSIONS: Therefore, it is an emergency to develop psychological interventions that can protect the mental health of vulnerable groups like health professionals.

PMID:34278018 | PMC:PMC8261554 | DOI:10.1016/j.heliyon.2021.e07393

Clin Transl Radiat Oncol. 2021 Jun 29;30:7-14. doi: 10.1016/j.ctro.2021.06.005. eCollection 2021 Sep.

ABSTRACT

BACKGROUND AND PURPOSE: Magnetic resonance-guided focal salvage high-dose-rate brachytherapy (FS-HDR-BT) for radiorecurrent prostate cancer (PCa) shows low toxicity rates. However, biochemical failure (BF) after treatment occurs frequently. We developed two prediction models for BF (Phoenix definition) with the aim of enhancing patient counselling before FS-HDR-BT and during follow-up.

MATERIALS AND METHODS: A prospective cohort of 150 radiorecurrent PCa patients treated with FS-HDR-BT between 2013 and 2020 was used for model development and internal validation. Multivariable Cox Proportional Hazards regression was applied. For model 1, only pre-salvage variables were included as candidate predictors. For model 2, additional (post-)salvage characteristics were tested. After calibration, nomograms and webtools were constructed. Finally, three risk groups were identified.

RESULTS: Sixty-one patients (41%) experienced BF. At baseline (model 1), age, gross tumour volume, pre-salvage PSA, and pre-salvage PSA doubling time (PSADT) were predictive of BF. During follow-up (model 2), age, pre-salvage PSA and PSADT, seminal vesicle involvement, post-salvage time to PSA nadir, and percentage PSA reduction were predictive of BF. The adjusted C-statistics were 0.73 (95% CI: 0.66-0.81) and 0.84 (95% CI: 0.78-0.90), respectively, with acceptable calibration. Estimated 2-year biochemical disease-free survival for the low-, intermediate-, and high-risk groups were 84%, 70%, and 31% (model 1), and 100%, 71%, and 5% (model 2).

CONCLUSION: Two models are provided for prediction of BF in patients with radiorecurrent PCa treated with FS-HDR-BT. Based on pre- and post-salvage characteristics, we are able to identify patients with a high risk of BF. These findings can aid patient counselling for FS-HDR-BT.

PMID:34278009 | PMC:PMC8261471 | DOI:10.1016/j.ctro.2021.06.005

Clin Transl Radiat Oncol. 2021 Jul 1;30:15-18. doi: 10.1016/j.ctro.2021.06.006. eCollection 2021 Sep.

ABSTRACT

PURPOSE: To examine the impact of epidermal growth factor receptor (EGFR) mutations on objective response to palliative lung radiotherapy in patients with metastatic non-small cell lung cancer (NSCLC).

MATERIALS AND METHODS: A multicentre retrospective study was conducted of patients with metastatic NSCLC diagnosed between March 2010 and June 2012 who received palliative radiotherapy to the chest. Patients included for study had baseline imaging and follow-up imaging 1-3 months after radiotherapy. The primary endpoint was 1-3 month local objective imaging response by the Response Evaluation Criteria in Solid Tumours (RECIST). Patients were divided into EGFR mutation positive (EGFR+) and EGFR wild type (WT) cohorts for analysis.

RESULTS: There were 121 patients for study inclusion: 89 (74%) were EGFR WT and 32 (26%) were EGFR+. The response rate between EGFR WT and EGFR+ cohorts was not significantly different (49 vs. 63%, p = 0.21). On multivariate analysis, initiation of a tyrosine kinase inhibitor (TKI) after radiotherapy was associated with a higher rate of response (OR: 5.07, 95%CI: 1.08-23.69, p = 0.039) but EGFR mutation status was not. For the EGFR+ cohort, patients with disease progression after initial management on a TKI had a worse response rate compared to patients who were TKI-naïve before starting radiotherapy (30 vs. 77%, p = 0.018). Local control was not statistically different between the EGFR cohorts.

CONCLUSION: The EGFR mutation status alone was not an independent predictor of objective radiographic response to palliative thoracic radiotherapy. Acquired resistance to TKI therapy may be associated with disease cross-resistance to palliative radiotherapy.

PMID:34278010 | PMC:PMC8267427 | DOI:10.1016/j.ctro.2021.06.006

Endocrinol Diabetes Metab. 2021 Jun 7;4(3):e00266. doi: 10.1002/edm2.266. eCollection 2021 Jul.

ABSTRACT

INTRODUCTION: Thyroid cancer is the most common endocrine malignancy, and it has the fastest increase rate in incidence in both sexes, with a yearly increase of 3% over the last decade. Thyroid-stimulating hormone (TSH) is the main driver for the thyroid gland to produce thyroid hormone. The main purpose of this study was to assess the relationship between serum TSH level and the stage of malignancy in patients with differentiated thyroid cancer.

METHODS: This cross-sectional study was performed on 77 patients with thyroid cancer. The demographic characteristics, TSH level and stage of malignancy were recorded for all patients in the data collection form. The data analysis was conducted by descriptive statistics using SPSS 20.0 software.

RESULTS: The results show a significant relationship (p-value = .025) between the malignancy stage and serum TSH level. The mean TSH level in patients of stage 3 (5.70 ± 2.03) was significantly higher than patients in stage 2 (2.58 ± 0.52) and stage 1 (2.33 ± 0.28). No significant relationship was observed between the age of patients and serum TSH level. Although the mean serum TSH level in men (3.61 ± 0.98) was higher than in women (2.52 ± 0.25), the difference was not statistically significant.

CONCLUSIONS: According to the results of this study, serum TSH level can be considered as a predictor of the stage of differentiated thyroid cancer. Therefore, it can be used to predict the likelihood of cancer and improve the outcome and extent of thyroidectomy in patients with thyroid cancer.

PMID:34277989 | PMC:PMC8279600 | DOI:10.1002/edm2.266

J Clin Tuberc Other Mycobact Dis. 2021 Jun 22;24:100253. doi: 10.1016/j.jctube.2021.100253. eCollection 2021 Aug.

ABSTRACT

Tuberculosis (TB), which is caused by Mycobacterium tuberculosis (MTB), is a serious infectious disease with high infection and mortality rates and is a public health problem around the world. According to the World Health Organization (WHO) report, one-third of the world’s population is latently infected with MTB, and 5 to 10% of those with latent TB infection (LTBI) have the potential to develop active TB once in their lifetime. Therefore, TB management for promptly distinguishing LTBI from active TB and for proper treatment is important. LTBI is currently diagnosed using the tuberculin skin test (TST) and interferon gamma (IFN-γ) release assay (IGRA). However, this test is substantially limited by its inability to distinguish active TB from LTBI. It is necessary to discover indicators that can be used for effective TB management and to develop diagnostic methods. In the present study, we used IGRA and complete blood count (CBC) analysis for discrimination of active TB, LTBI, and healthy control groups. The results showed that the number of WBC was significantly increased in the group with active TB (p < 0.0100) and level of hemoglobin (Hb) was significantly decreased (p < 0.0010) in the CBC than those of the healthy control and LTBI groups. In the WBC differential count, the number of neutrophils and monocytes were increased (p < 0.0010) in active TB group, where as those of lymphocytes were significantly decreased (p < 0.0100) in active TB group compared healthy control group. Results verified that the levels of total WBC, Hb, neutrophils, lymphocytes and monocytes were statistically significant (p < 0.0500) and the AUC was approximately 0.8613. In addition, receiver operating characteristic (ROC) curve analysis was performed to confirm the clinical usefulness between active TB and healthy control groups. In conclusion, based on these data demonstrated that the usefulness of these potential indicators for differential diagnosis, according to the result can be provided for effective diagnosis and treatment by comparing the expression patterns of the markers in the whole blood of the active TB, LTBI, and healthy control groups. Furthermore, this study needs to investigate a larger number of clinical specimens later to develop biomarkers according to the state of infection with MTB such as LTBI and active TB, as well as after treatment.

PMID:34278005 | PMC:PMC8262775 | DOI:10.1016/j.jctube.2021.100253