ISLES 2022: A multi-center magnetic resonance imaging stroke lesion segmentation dataset.

Magnetic resonance imaging (MRI) is an important imaging modality in stroke. Computer based automated medical image processing is increasingly finding its way into clinical routine. The Ischemic Stroke Lesion Segmentation (ISLES) challenge is a continuous effort to develop and identify benchmark methods for acute and sub-acute ischemic stroke lesion segmentation. Here we introduce an expert-annotated, multicenter MRI dataset for segmentation of acute to subacute stroke lesions ( https://doi.org/10.5281/zenodo.7153326 ). This dataset comprises 400 multi-vendor MRI cases with high variability in stroke lesion size, quantity and location. It is split into a training dataset of n = 250 and a test dataset of n = 150. All training data is publicly available. The test dataset will be used for model validation only and will not be released to the public. This dataset serves as the foundation of the ISLES 2022 challenge ( https://www.isles-challenge.org/ ) with the goal of finding algorithmic methods to enable the development and benchmarking of automatic, robust and accurate segmentation methods for ischemic stroke.

Mindfulness-based and acceptance-based programmes in the treatment of obsessive-compulsive disorder: a study protocol for a systematic review and meta-analysis.

INTRODUCTION: Cognitive-behavioural therapy (CBT) with exposure and response prevention is the recommended standard for the treatment of obsessive-compulsive disorder (OCD). However, a high proportion of patients refuse this treatment, do not respond or relapse shortly after treatment. Growing evidence suggests that mindfulness-based and acceptance-based programmes (MABPs) are an effective option for the treatment of OCD. This systematic review and meta-analysis will examine the effectiveness of MABPs in treating OCD. We also aimed to explore potential moderators of the programmes' effectiveness. METHODS AND ANALYSIS: We will systematically search MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and Cochrane Register of Controlled Trials (no language restrictions) for studies that evaluate the effect of MABPs on patients with OCD. We will conduct backward and forward citation searches of included studies and relevant reviews and contact corresponding authors. The primary outcome will be pre-post intervention change in symptom severity. A secondary outcome will be change in depressive symptoms. Two reviewers will independently screen the records, extract the data and rate the methodological quality of the studies. We will include both controlled and uncontrolled trials. Randomised controlled trials will be meta-analysed, separately assessing between-group effects. A second meta-analysis will assess the within-group effect of all eligible studies. We will explore moderators and sources of heterogeneity such as the specific programme, study design, changes in depressive symptoms, hours of guided treatment, control condition and prior therapy (eg, CBT) using metaregression and subgroup analyses. We will perform sensitivity analyses using follow-up data. A narrative synthesis will also be pursued. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the quality of the evidence. ETHICS AND DISSEMINATION: Ethical approval is not required. Results will be published in peer-reviewed journals and presented at international conferences.

Mindfulness-Based Interventions to Reduce Burnout and Stress in Physicians: A Systematic Review and Meta-Analysis.

PURPOSE: To perform a systematic review and meta-analysis of studies evaluating the effectiveness of mindfulness-based interventions (MBIs) in reducing burnout and stress among physicians. METHOD: The authors searched records in MEDLINE, Embase, PsycINFO, PSYNDEX, Web of Science, CINAHL, and CENTRAL from database inception to August 8, 2019, using combinations of terms for mindfulness, interventions, and physicians. Eligible studies were randomized controlled trials (RCTs) and nonrandomized trials (NRTs), including controlled and noncontrolled before-after studies, all assessing burnout and stress among physicians preintervention and postintervention via validated instruments. Two reviewers independently screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. The authors used random-effects modeling to calculate pooled effect sizes and conducted prespecified subgroup and sensitivity analyses to explore potential moderators. RESULTS: Of 6,831 identified records, 25 studies (with 925 physicians) were ultimately included. MBIs were associated with significant small reductions in burnout in between-group analyses (5 comparisons: standardized mean difference [SMD] = -0.26; 95% confidence interval [CI] = -0.50, -0.03) and pre-post analyses (21 comparisons: SMD = -0.26; 95% CI = -0.37, -0.15), and with a significant medium reduction in stress in between-group analyses (4 comparisons: SMD = -0.55; 95% CI = -0.95, -0.14) and a significant small reduction in stress in pre-post analyses (17 comparisons: SMD = -0.41; 95% CI = -0.61, -0.20). Versions of established MBIs showed higher effectiveness in reducing stress than other forms of MBIs or a mindfulness app. Reductions were maintained over an average follow-up of 5.3 months. The risk of bias was moderate with RCTs and high with NRTs. The overall quality of evidence was low to very low. CONCLUSIONS: MBIs can be effective in reducing physicians' burnout and stress. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials providing long-term follow-up data.

Mindfulness-based interventions to reduce burnout and stress in physicians: a study protocol for a systematic review and meta-analysis.

INTRODUCTION: Physicians often suffer from burnout and stress, not only affecting themselves, but also their patients and the healthcare system in general. An increasing number of studies suggest that mindfulness-based interventions improve physicians' well-being as well as the quality of care they deliver. However, the evidence is scattered, and a systematic review and meta-analysis is lacking. To the best of our knowledge, this systematic review and meta-analysis will be the first to assess the effectiveness of mindfulness-based interventions in reducing burnout and stress among physicians. Further, it aims to uncover potential moderators of intervention effectiveness. METHODS AND ANALYSIS: MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and the Cochrane Central Register of Controlled Trials will be screened without language or publication date restrictions. In addition, backward and forward citation searches of included studies and relevant reviews will be conducted. Studies examining the effect of interventions for physicians explicitly based on mindfulness will be included. Primary outcomes will be pre-post changes in burnout and stress if assessed with validated measures. Two reviewers independently search, select and extract data, and rate the methodological quality of the studies. Both controlled and uncontrolled studies will be included. Randomised controlled trails will be meta-analysed separately using between-group effect. In addition, non-randomised trials including non-controlled before-after studies will be meta-analysed using within-group effect. Potential moderators and sources of between-study heterogeneity will be tested using meta-regression and subgroup analyses. Futhermore, a narrative synthesis will be pursued. The Grading of Recommendations Assessment, Development and Evaluation system (GRADE) will be used to assess the quality of the cumulated evidence. ETHICS AND DISSEMINATION: Ethical approval is not required. Results will be published in a peer-reviewed journal and presented at international conferences. PROSPERO REGISTRATION NUMBER: CRD42019133077.