Monday, April 25, 2022

Epicardial adipose tissue in coronary microvascular dysfunction

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International Journal of Obesity, Published online: 25 April 2022; doi:10.1038/s41366-022-01125-z

Epicardial adipose tissue in coronary microvascular dysfunction
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ONC201 and ONC206: metabolically ClipPing the wings of diffuse midline glioma

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Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis

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European Journal of Clinical Nutrition, Published online: 25 April 2022; doi:10.1038/s41430-022-01148-9

Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis
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Identification of BRAF V600E mutation in odontogenic tumors by high-performance MALDI-TOF analysis

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International Journal of Oral Science, Published online: 25 April 2022; doi:10.1038/s41368-022-00170-8

Identification of BRAF V600E mutation in odontogenic tumors by high-performance MALDI-TOF analysis
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Salbutamol for analgesia in renal colic: study protocol for a prospective, randomised, placebo-controlled phase II trial (SARC)

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Renal colic is the pain experienced by a patient when a renal calculus (kidney stone) causes partial or complete obstruction of part of the renal outflow tract. The standard analgesic regimes for renal colic a...
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Management der Ohrmuschelteilamputationen

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Laryngorhinootologie
DOI: 10.1055/a-1792-2194

Ohrmuschelverletzungen zählen zu den selteneren Traumata im Kopf-Hals-Bereich. Aufgrund der komplexen Anatomie des Knorpels und der begrenzten Blutversorgung bedürfen sie einer raschen und strukturierten Behandlung. Für die Behandlung sowohl von leichten Verletzungen als auch von (sub-)totalen Abrissen der Ohrmuschel stehen unterschiedliche Therapieoptionen zur Verfügung. Eine direkte Readaptation einer (sub-)total abgerissenen Ohrmuschel ohne mikrovaskulare Anastomose ist aufgrund des hohen Risikos von Haut- und Knorpelnekrosen nur selten erfolgreich. Mehrzeitige Rekonstruktionen mit Pocket-Methoden sind dagegen gut etabliert. Die vorliegende Arbeit beschreibt einige dieser Ansä tze und demonstriert eine 2-stufige OP-Technik eines Ohrmuschelteilabrisses aus dem eigenen Patientengut.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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The Impact of the COVID-19 Global Pandemic on Undergraduate Nursing Students' Study of Anatomy and Physiology

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imageThe COVID-19 global pandemic caused major disruptions to the delivery of human Anatomy and Physiology courses to nursing students worldwide. The aim of the current study is to evaluate nursing students' experiences and perceptions of transitioning from a blended to a purely online study mode for first year Anatomy and Physiology courses during the global pandemic. Qualitative and quantitative methodologies were used with a sample of undergraduate nursing students enrolled at a regional Australian university across its three campuses. Descriptive statistical analysis was used to describe the study population. Content a nalysis was used to evaluate the participants' use of resources, experiences, and preferences in studying anatomy and physiology. There were 101 participants recruited in the study. Results indicated that face-to-face study mode (41.86%) was the preferred method of delivery during the global pandemic and participants were having a renewed appreciation for the blended study mode (38.37%). Online study mode was the least preferred (19.77%), with the participants' opinions of this mode of study not altered by the global pandemic. Although the COVID-19 global pandemic shifted the traditional teaching of anatomy and physiology in nursing programs to an online environment, the long-term impacts of this disruption have yet to be ascertained.
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Barriers to Adoption of Electronic Health Record Systems from the Perspective of Nurses: A Cross-sectional Study

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imageThis study report aimed to investigate the barriers to implementation of electronic health record systems from the perspective of nurses. The research data comprised responses from nurses working in a university hospital. Our data collection instruments were the Participant Information Form and EHR Nurse Opinion Questionnaire, which were developed by the researchers. Data analysis was presented as summary statistics, including mean values of variables, standard deviation, frequency, and percentages. A total of 160 nurses participated in the study. The mean age of participants was 30.94 ± 0.59 years, and 77.5% were university graduates. Barriers to adoption of the electronic health record system included high number of patients (82.8%), limited time (79%), lack of knowledge and skills for effective use of the system (22.9%), lack of user-friendly interface and inability to create a common language within the team (17.8%), and attachment to the traditional method (17.2%). Although most nurses thought that the electronic health record system offered some advantages, they reported that factors such as large numbers of patients, limited time, and lack of user-friendly interface hindered its adoption. Innovative strategies should be explored to develop user-friendly designs for electronic health records and to produce solutions for nursing shortages to increase the time allocated for patient care.
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Prediction of Bedridden Duration of Hospitalized Patients by Machine Learning Based on EMRs at Admission

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imageBeing bedridden is a frequent comorbid condition that leads to a series of complications in clinical practice. The present study aimed to predict bedridden duration of hospitalized patients based on EMR at admission by machine learning. The medical data of 4345 hospitalized patients who were bedridden for at least 24 hours after admission were retrospectively collected. After preprocessing of the data, features for modeling were selected by support vector machine recursive feature elimination. Thereafter, logistic regression, support vector machine, and extreme gradient boosting algorithms were adopted to predict th e bedridden duration. The feasibility and efficacy of above models were evaluated by performance indicators. Our results demonstrated that the most important features related to bedridden duration were Charlson Comorbidity Index, age, bedridden duration before admission, mobility capability, and perceptual ability. The extreme gradient boosting algorithm showed the best performance (accuracy, 0.797; area under the curve, 0.841) when compared with support vector machine (accuracy, 0.771; area under the curve, 0.803) and logistic regression (accuracy, 0.765; area under the curve, 0.809) algorithms. Meanwhile, the extreme gradient boosting algorithm had a higher sensitivity (0.856), specificity (0.650), and F1 score (0.858) than that of support vector machine algorithm (0.843, 0.589, and 0.841) and logistic regression (0.852, 0.545, and 0.839), respectively. These findings indicate that machine learning based on EMRs at admission is a feasible avenue to predict the bedridden duration. The extreme gradient boosting algorithm shows great potential for further clinical application.
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Prospective Study of PET/MRI Tumor Response During Chemoradiotherapy for Patients With Low-risk and Intermediate-risk p16-positive Oropharynx Cancer

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imageObjective: The objective of this study was to examine tumor response with positron emission tomography (PET)/magnetic resonance imaging (MRI) during chemoradiotherapy as a predictor of outcome in patients with p16-positive oropharynx cancer. Materials and Methods: Patients with p16-positive oropharynx cancer were treated with chemoradiotherapy. Low-risk (LR) disease was defined as T1-T3 and N0-2b and ≤10 pack-years and intermediate-risk (IR) disease as T4 or N2c-3 or >10 pack-years. Patients underwent a PET/MRI scan pretreatment and at fraction 10. Change in value of imaging means were analyzed by analysis of variance. K-means clustering with Euclidean distance functions were used for patient clustering. Silhouette width was used to determine the optimal number of clusters. Linear regression was performed on all radiographic metrics using patient and disease characteristics. Results: Twenty-four patients were enrolled with 7 LR and 11 IR patients available for analysis. Pretreatment imaging characteristics between LR and IR patients were similar. Patients with LR disease exhibited a larger reduction in maximum standardized uptake value (SUV) compared with IR patients (P
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A Proposal to Modify the 8th IASLC System: Is it Suitable for T4N2M0 Lung Adenocarcinoma to Be Placed in Stage IIIB?

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imagePurpose: The International Association for the Study of Lung Cancer (IASLC) of TNM staging system has been well accepted as a precise model. However, the latest American Joint Committee on Cancer (AJCC) staging system to solve the different survival and prognosis of lung adenocarcinoma in the same period is still controversial. Therefore, it is necessary to thoroughly explore the applicability between the new system and survival prediction in terms of lung adenocarcinoma. Methods: We recruited 52,517 patients with lung adenocarcinoma from the Surveillence, Epidemiology, and End Results database. Cox regression analysis was performed to determine survival related factors. The mortality rate per 1000 persons per year of the T4N2M0 lung adenocarcinoma stage and other stages were compared. Survival curves were obtained using the Kaplan-Meier analysis and log-rank test. Results: The results of Cox proportional hazards regression analysis showed that age at diagnosis, race, T stage, distant metastasis, extrathoracic extension, radiotherapy, chemotherapy, and surgery are independent factors related to cancer-specific survival (CSS) and all-cause survival. Furthermore, patients with stage IIIA disease (P0.05). Conclusion: The survival rate of patients with T4N2M0 stage was significantly lower than that of patients with IIIA and IIIB stages excluding T4N2M0, there was no significant difference between T4N2M0 and IIIC. It was suggested that this group of patients with stage T4N2M0 were upgraded in the 8th IASLC system.
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Short-term ADT and Dose-escalated IMRT in Patients With Intermediate-risk Prostate Cancer: Benefit or Caution?

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imageObjectives: In the era of dose-escalated prostate radiation therapy (RT), the use of androgen deprivation therapy (ADT) is undefined for intermediate-risk (IR) prostate cancer. There is growing concern of the risk of ADT to be detrimental to quality of life. This single-institution retrospective analysis aimed to evaluate outcomes of IR patients treated with dose-escalated intensity modulated radiation therapy (IMRT) with or without concurrent/adjuvant short-term ADT. Materials and Methods: Data was collected from 260 consecutive patients treated with dose-escalated IMRT with daily image-guided RT for newly diagnosed IR prostate cancer. Biochemical recurrence-free survival (BCRFS), distant metastasis-free survival, prostate cancer-specific survival, and overall survival (OS) were calculated using Kaplan-Meier methodology. Results: Median follow-up was 93 months. A total of 181 patients had unfavorable IR disease, and 36.2% (N=94) received ADT, with median ADT duration of 6 months. Seven-year BCRFS was 94.1% vs. 86.2% (P=0.067), for ADT and no ADT, respectively, and no difference in distant metastasis-free survival or prostate cancer-specific survival was observed. ADT was associated with significantly worse 7-year OS (80.0% vs. 91.3%, P=0.010). Analysis of the unfavorable IR cohort alone, showed similar results; 7-year BCRFS and 7-year OS in patients who received ADT versus no ADT were 93.7% vs. 85.9% (P=0.093), and 79.0% vs. 90.6% (P=0.019), respectively. Conclusions: In our 15-year experience treating IR prostate cancer with dose-escalated IMRT with daily image-guided RT, short-term concurrent ADT was associated with a statistically significant worse OS. Additional studies are needed to determine if ADT is beneficial or detrimental for patients with IR prostate cancer treated with dose-escalated radiation.
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