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BACKGROUND: Coronary heart disease(CHD) with stable angina pectoris is a common cardiovascular disease. It has been reported that 10%-81.4% of these patients suffer from psychological conditions,such as depression, which has been associated with more frequent angina, lower treatment satisfaction and lower perceived quality of life. Ginkgo biloba extract (GBE), the raw material of Ginkgo biloba dropping pills (GBDPs), is widely used to treat various conditions, including cardiovascular disease, ischaemic cerebrovascular disease, and depression. This clinical trial aimed to examine the efficacy and safety of GBDPs in improving the frequency of angina pectoris and the life quality of patients with stable angina pectoris and depression symptoms. METHODS: This randomised, double-blind, placebo-controlled, parallel-group and multicentre clinical trial will be conducted in four medical centres in China. We aim to recruit approximately 72 participants aged 18-75 years with depression and coronary heart disease with stable angina pectoris. Based on conventional drug treatment, participants will be randomly assignedto the treatment group (GBDPs group; n=36) or the control group (placebo group; n=36) at a 1:1 allocation ratio. After randomisation,follow-up will be done at 4 weeks, 8 weeks and 12 weeks (±3 days). Additionally, 30 healthy individuals will be enrolled to investigate the underlying pharmacological mechanisms of the effects of GBE. The primary outcomes will be the Seattle Angina Questionnaire score and the frequency of angina pectoris-related symptoms each week. The secondary outcomes will include the 36-item Short Form Health Survey quality-of-life scale, Hamilton Depression Scale and composite endpoint incidence of major adverse cardiovascular events. ETHICS AND DISSEMINATION: This trial has been approved by the Research Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, China (approval number: ZYYECK [2020]030). Written informed consent will be obtained from all participants. The results of this trial will be publicly shared through academic conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04529148 and ChiCTR2200066908.
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Angina Estável , Doença das Coronárias , Medicamentos de Ervas Chinesas , Humanos , Angina Estável/tratamento farmacológico , Ginkgo biloba , Medicamentos de Ervas Chinesas/farmacologia , Grupos Controle , Depressão/tratamento farmacológico , Qualidade de Vida , Resultado do Tratamento , Método Duplo-Cego , Doença das Coronárias/complicações , Doença das Coronárias/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como AssuntoRESUMO
BACKGROUND: Detection of suicidal ideation (SI) is key for trying to prevent suicide. The aim of this study was to analyze the frequency of SI and related factors in Spanish people with Parkinson's Disease (PwPD) and to compare them with a control group. METHODS: PD patients and controls recruited from the Spanish cohort COPPADIS from January 2016 to November 2017 were included. Two visits were conducted: V0 (baseline); V2 (2-year ± 1 month follow-up). SI was defined as a score ≥1 on item nine of the Beck Depression Inventory-II (BDI-II). Regression analyses were conducted to identify factors related to SI. RESULTS: At baseline, 693 PwPD (60.2% males; 62.59 ± 8.91 years old) and 207 controls (49.8% males; 60.99 ± 8.32 years old) were included. No differences between PwPD and controls were detected in SI frequency at either V0 (5.1% [35/693] vs. 4.3% [9/207]; p = 0.421) or at V2 (5.1% [26/508] vs. 4.8% [6/125]; p = 0.549). Major depression (MD) and a worse quality of life were associated with SI at both visits in PwPD: V0 (MD, OR = 5.63; p = 0.003; PDQ-39, OR = 1.06; p = 0.021); V2 (MD, OR = 4.75; p = 0.027; EUROHIS-QOL8, OR = 0.22; p = 0.006). A greater increase in the BDI-II total score from V0 to V2 was the only factor predicting SI at V2 (OR = 1.21; p = 0.002) along with an increase in the total number of non-antiparkinsonian drugs (OR = 1.39; p = 0.041). CONCLUSION: The frequency of SI (5%) in PwPD was similar to in controls. Depression, a worse quality of life, and a greater comorbidity were related to SI.
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Transtorno Depressivo Maior , Doença de Parkinson , Masculino , Humanos , Idoso , Feminino , Ideação Suicida , Qualidade de Vida , Grupos ControleRESUMO
The use of 3D Hologram Technology (3DHT) in teaching and learning has many advantages, such as attracting students' attention, reducing cognitive load and self-effort, and improving spatial awareness. In addition, a number of studies have confirmed that the reciprocal teaching style is effective in teaching motor skills. Thus, the current study aimed to investigate the effectiveness of reciprocal style when combined with 3DHT in learning some fundamental boxing skills. A quasi-experimental design was used by creating two experimental and control groups. For the experimental group, the reciprocal style is combined with 3DHT to teach some fundamental boxing skills. In contrast, the control group is taught a program based on a teacher command style. Pretest-posttest designs were made for the two groups. The sample consisted of 40 boxing beginners aged 12 to 14 who were enrolled in the 2022/2023 training season at Port Fouad Sports Club in Port Said, Egypt. The participants were randomly divided into two experimental and control groups. There were homogenized based on age, height, weight, IQ, physical fitness, and skill level. The results showed the experimental group achieved a higher skill level due to the combination of 3DHT and a reciprocal style in compared to the control group, which relied solely on the teacher's command style,. Due to this, it is imperative to utilize hologram technology as a pedagogical resource to enhance the learning process and combine it with teaching strategies that support active learning.
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Boxe , Esportes , Humanos , Tecnologia , Grupos Controle , CogniçãoRESUMO
OBJECTIVES: Laughter as an expression of humor has been recognized as good medicine for centuries. The health benefits of humor-induced well-being remain unclear and thus we conducted a systematic review and meta-analysis of interventional studies to evaluate the impact of spontaneous laughter on stress response as measured by cortisol levels. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE/PubMed, EMBASE, PsycINFO, Scopus, and Clinicaltrials.gov. ELIGIBILITY CRITERIA: Interventional studies, which could be either randomized placebo-controlled trials (RCTs) or quasi-experimental studies, conducted in adults that compared any spontaneous laughter intervention to a controlled setting and reported changes in cortisol levels were selected. DATA EXTRACTION AND SYNTHESIS: We examined the impact of laughter on percentage change in cortisol levels by calculating pooled estimates of the absolute differences between arithmetic means before and after interventions as compared to control using random-effects model. RESULTS: Eight studies (315 participants; mean age 38.6) met our inclusion criteria; four were RCTs and four were quasi-experiment studies. Five studies evaluated the impact of watching a humor/comedy video, two studies evaluating laughter sessions administered by a trained laughter therapist, and one study evaluating a self-administered laughter program. Pooling these data showed a significant reduction in cortisol levels by 31.9% (95%CI -47.7% to -16.3%) induced by laughter intervention compared to control group with no evidence of publication bias (P = 0.66). Sensitivity analyses demonstrated that even a single laughter session induced a significant reduction of 36.7% in cortisol (95%CI -52.5% to -20.8%). In addition, analyses including the four RCTs reinforced these results by demonstrating a significant reduction in cortisol levels promoted by laughter as compared to the placebo arm [-37.2% (95%CI -56.3% to -18.1%)]. CONCLUSIONS: Current evidence demonstrates that spontaneous laughter is associated with greater reduction in cortisol levels as compared with usual activities, suggesting laughter as a potential adjunctive medical therapy to improve well-being. TRIAL REGISTRATION: Registration number: CRD42021267972.
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Riso , Medicina , Adulto , Humanos , Hidrocortisona , Pessoal Técnico de Saúde , Grupos ControleRESUMO
Metal-organic frameworks (MOFs) offer a unique platform to understand light-driven processes in solid-state materials, given their high structural tunability. However, the progression of MOF-based photochemistry has been hindered by the difficulty in spectrally characterizing these materials. Given that MOFs are typically larger than 100 nm in size, they are prone to excessive light scatter, thereby rendering data from valuable analytical tools like transient absorption and emission spectroscopy nearly uninterpretable. To gain meaningful insights of MOF-based photo-chemical and physical processes, special consideration must be taken toward properly preparing MOFs for spectroscopic measurements, as well as the experimental setups that garner higher quality data. With these considerations in mind, the present guide provides a general approach and set of guidelines for the spectroscopic investigation of MOFs. The guide addresses the following key topics: (1) sample preparation methods, (2) spectroscopic techniques/measurements with MOFs, (3) experimental setups, (3) control experiments, and (4) post-run stability characterization. With appropriate sample preparation and experimental approaches, pioneering advancements toward the fundamental understanding of light-MOF interactions are significantly more attainable.
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Estruturas Metalorgânicas , Análise Espectral , Grupos Controle , Confiabilidade dos Dados , FotoquímicaRESUMO
BACKGROUND: Although fibromyalgia is associated with poor outcomes following orthopedic surgeries, several studies show some benefit from surgical intervention and nevertheless recommend operative treatment when indicated. There is sparse evidence of the effect of fibromyalgia on the outcomes of shoulder surgery. The purpose of this study was to investigate the effect of fibromyalgia on patient-reported outcomes of arthroscopic rotator cuff repair (ARCR). METHODS: All patients with a confirmed diagnosis of fibromyalgia who underwent ARCR in one institution between 2010 and 2021 were included. Data retrieved from medical records included demographics, characteristics of the cuff tear and the surgical procedure, and preoperative and last follow-up (minimum 1 year) postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score, Subjective Shoulder score (SSV), and Numeric Pain Rating Scale (NPRS). A matched controlled group of patients without fibromyalgia who had undergone ARCR was selected according to age, sex, and preoperative DASH, SSV, and NPRS scores. RESULTS: There were no significant differences in demographics, cuff tear and surgical procedure characteristics, and preoperative scores between the fibromyalgia and control groups. The fibromyalgia patients' postoperative scores for all 3 measurements showed significant improvement: SSV by 32.1 (P = 0.004), DASH by 20.3 (P = 0.016), and NPRS by 2.33 (P = 0.017). There were no significant differences in the postoperative DASH, SSV, and NPRS between the fibromyalgia and control groups. CONCLUSION: Fibromyalgia patients with rotator cuff tears who undergo ARCR do not have inferior patient-reported outcomes compared with non-fibromyalgia controls. Fibromyalgia should not be a considered a contraindication for ARCR. LEVEL OF EVIDENCE: III.
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Lesões do Manguito Rotador , Manguito Rotador , Humanos , Manguito Rotador/cirurgia , Grupos Controle , Resultado do Tratamento , Lesões do Manguito Rotador/complicações , Lesões do Manguito Rotador/cirurgia , Artroscopia/métodos , Ruptura/cirurgia , Estudos Retrospectivos , Amplitude de Movimento ArticularRESUMO
BACKGROUND: Long waiting time in hospital leads to patient's low satisfaction. In addition to reducing the actual waiting time (AWT), we can also improve satisfaction by adjusting the expected waiting time (EWT). Then how much can the EWT be adjusted to attribute a higher satisfaction? METHODS: This study was conducted though experimental with hypothetical scenarios. A total of 303 patients who were treated by the same doctor from August 2021 to April 2022 voluntarily participated in this study. The patients were randomly divided into six groups: a control group (n = 52) and five experimental groups (n = 245). In the control group, the patients were asked their satisfaction degree regarding a communicated EWT (T0) and AWT (Ta) under a hypothetical situation. In the experimental groups, in addition to the same T0 and Ta as the control group, the patients were also asked about their satisfaction degree with the extended communicated EWT (T1). Patients in five experimental groups were given T1 values with 70, 80, 90, 100, and 110 min respectively. Patients in both control and experiment groups were asked to indicate their initial EWT, after given unfavorable information (UI) in a hypothetical situation, the experiment groups were asked to indicate their extended EWT. Each participant only participated in filling out one hypothetical scenario. 297 valid hypothetical scenarios were obtained from the 303 hypothetical scenarios given. RESULTS: The experimental groups had significant differences between the initial indicated EWT and extended indicated EWT under the effect of UI (20 [10, 30] vs. 30 [10, 50], Z = -4.086, P < 0.001). There was no significant difference in gender, age, education level and hospital visit history (χ2 = 3.198, P = 0.270; χ2 = 2.177, P = 0.903; χ2 = 3.988, P = 0.678; χ2 = 3.979, P = 0.264) in extended indicated EWT. As for patient's satisfaction, compared with the control group, significant differences were found when T1 = 80 min (χ2 = 13.511, P = 0.004), T1 = 90 min (χ2 = 12.207, P = 0.007) and T1 = 100 min (χ2 = 12.941, P = 0.005). When T1 = 90 min, which is equal to the Ta, 69.4% (34/49) of the patients felt "very satisfied", this proportion is not only significantly higher than that of the control group (34/ 49 vs. 19/52, χ2 = 10.916, P = 0.001), but also the highest among all groups. When T1 = 100 min (10 min longer than Ta), 62.5% (30/48) of the patients felt "very satisfied", it is significantly higher than that of the control group (30/ 48 vs. 19/52, χ2 = 6.732, P = 0.009). When T1 = 80 min (10 min shorter than Ta), 64.8% (35/54) of the patients felt "satisfied", it is significantly higher than that of the control group (35/ 54 vs. 17/52, χ2 = 10.938, P = 0.001). However, no significant difference was found when T1 = 70 min (χ2 = 7.747, P = 0.052) and T1 = 110 min (χ2 = 4.382, P = 0.223). CONCLUSIONS: Providing UI prompts can extend the EWT. When the extended EWT is closer to the AWT, the patient's satisfaction level can be improved higher. Therefore, medical institutions can adjust the EWT of patient's through UI release according to the AWT of hospitals to improve patient's satisfaction.
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Satisfação do Paciente , Listas de Espera , Humanos , Grupos Controle , Escolaridade , Satisfação PessoalRESUMO
Machine learning (ML) models are used in clinical metabolomics studies most notably for biomarker discoveries, to identify metabolites that discriminate between a case and control group. To improve understanding of the underlying biomedical problem and to bolster confidence in these discoveries, model interpretability is germane. In metabolomics, partial least square discriminant analysis (PLS-DA) and its variants are widely used, partly due to the model's interpretability with the Variable Influence in Projection (VIP) scores, a global interpretable method. Herein, Tree-based Shapley Additive explanations (SHAP), an interpretable ML method grounded in game theory, was used to explain ML models with local explanation properties. In this study, ML experiments (binary classification) were conducted for three published metabolomics datasets using PLS-DA, random forests, gradient boosting, and extreme gradient boosting (XGBoost). Using one of the datasets, PLS-DA model was explained using VIP scores, while one of the best-performing models, a random forest model, was interpreted using Tree SHAP. The results show that SHAP has a more explanation depth than PLS-DA's VIP, making it a powerful method for rationalizing machine learning predictions from metabolomics studies.
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Pesquisa Biomédica , Grupos Controle , Análise Discriminante , Aprendizado de Máquina , MetabolômicaRESUMO
Background: There is limited data on the prevalence and risk factors for long COVID and few prospective studies with appropriate control groups and adequate sample sizes. We performed a prospective study to determine the prevalence and risk factors for long COVID. Methods: We recruited individuals aged ≥15 years who were clinically suspected of having an acute SARS-CoV-2 infection from September 2020 to April 2021. We collected nasopharyngeal swabs three to five days following symptom onset for analysing using reverse transcriptase polymerase chain reaction (RT-PCR). We also collected clinical and sociodemographic characteristics from both SARS-CoV-2 positive and negative participants using structured questionnaires. We followed-up the participants via telephone interview to assess early outcomes and persistent symptoms. For COVID-19 cases, 5D-3L EuroQol questionnaire was used to assess the impact of symptoms on quality of life. Results: We followed 814 participants (412 COVID-19 positive and 402 COVID-19 negative persons). Most (n = 741/814) had mild symptoms. Both groups had similar sociodemographic and clinical characteristics, except for the hospitalization rate (15.8% in the COVID-19 positive vs 1.5% in the COVID-19 negative group). One month after disease onset, 122/412 (29.6%) individuals in the COVID-19 positive (long COVID) and 24 (6%) in the COVID-19 negative group reported residual symptoms. In the long COVID group, fatigue, olfactory disorder, and myalgia were the most frequent symptoms in the acute phase. Compared to recovered individuals, older age and having more than five symptoms during the acute phase were risk factors for long COVID. Quality of life was evaluated in 102 out of 122 cases of long COVID, with 57 (55.9%) reporting an impact in at least one dimension of the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) questionnaire. Conclusions: In this prospective study consisting predominantly of individuals with mild disease, the persistence of symptoms after an acute respiratory illness was associated with a diagnosis of COVID-19. Polysymptomatic acute disease and older age were risk factors for long COVID.
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COVID-19 , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Síndrome Pós-COVID-19 Aguda , Estudos Prospectivos , Estudos de Coortes , Qualidade de Vida , Prevalência , Grupos Controle , Fatores de RiscoRESUMO
OBJECTIVE: Evidence about the negative caffeine effect on enuresis in children remains understudied or poorly understood. The study aimed to investigate the effect of caffeine restriction on the improvement and severity of primary monosymptomatic nocturnal enuresis (PMNE). DESIGN: Randomised clinical trial. SETTING: Two referral hospitals in Tehran, Iran, from 2021 to 2023. PATIENTS: Five hundred and thirty-four PMNE children aged 6-15 years (each group 267). INTERVENTIONS: Amount of caffeine consumption was recorded by the feed frequency questionnaire and was estimated by Nutrition 4 software. Caffeine consumption per day in the intervention group was <30 mg, and in the control group, 80-110 mg. All children were asked to return 1 month later to check the recorded data. The ordinal logistic regression analysis was used to assay the effects of caffeine restriction on PMNE by relative risk (RR) at a 95% CI. MAIN OUTCOME MEASURES: The effect of limited caffeine consumption on the improvement and severity of PMNE. RESULTS: The mean age of the intervention and control groups was 10.9±2.3 and 10.5±2.5 years, respectively. The mean number of bed-wetting before caffeine restriction in the intervention and control group was 3.5 (SD 1.7) times/week and 3.4 (SD 1.9) times/week (p=0.91) and 1 month after intervention were 2.3 (SD 1.8) times/week and 3.2 (SD 1.9) times/week, respectively (p=0.001). Caffeine restriction significantly reduced the severity of enuresis in the intervention group. Fifty-four children (20.2%) improved (dry at night) in caffeine restriction and 18 children (6.7%) in the control group with RR 0.615 at 95% CI 0.521 to 0.726, p=0.001. The caffeine restriction significantly reduced the enuresis in children with a number-needed-to-treat benefit 7.417. It means you must treat 7.417 PMNE children with caffeine limitation to improve one child with enuresis (become dry). CONCLUSION: Caffeine restriction can be helpful in reducing PMNE or its severity. Constructive limitation of caffeine is suggested as one of the first-line treatments in the management of PMNE. TRIAL REGISTRATION NUMBER: IRCT20180401039167N3.
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Cafeína , Enurese Noturna , Humanos , Criança , Adolescente , Cafeína/uso terapêutico , Irã (Geográfico)/epidemiologia , Enurese Noturna/tratamento farmacológico , Inquéritos e Questionários , Grupos ControleRESUMO
BACKGROUND: Plenty of studies have focused on the bile acids profile in gallstones. The objective of our systematic review is to provide a comprehensive summary about bile acids profiles in gallstones and analyzes the difference between gallstones and control group in diverse samples, determining the characteristic bile acids as the metabolite biomarkers for predicting gallstone. METHODS: EMBASE, the Cochrane Library, PubMed, Web of Science, Wanfang databases, China National Knowledge Infrastructure (CNKI), VIP Information Resource Integration Service Platform (CQVIP), and China Biology Medicine Disc (SinoMed) will be searched with the keywords of gallstones and metabolomics. The screening process will be performed strictly according to inclusion and exclusion criteria. The CONSORT checklist and the Newcastle-Ottawa Scale (NOS) will assess the risk of bias for randomized controlled trials and observational studies, respectively. The qualitative review will be conducted to summarize the bile acids profile in gallstones. The concentrations of bile acids in both case group and control group will be the primary outcomes to perform the meta-analyses. EXPECTED RESULTS: Our systematic review will find the characteristic bile acids as the candidate metabolite biomarkers which equipped potential value to predict gallstones. CONCLUSION: Expanding the current knowledge on the physiopathology of gallstones and identifying novel predictive biomarkers can help to facilitate the detection and management of gallstones. Consequently, we expect this protocol to be a reasonable method to filtrate candidate differential bile acids which have potential value to predict gallstones. PROSPERO REGISTRATION NUMBER: CRD42022339649.
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Cálculos Biliares , Humanos , Cálculos Biliares/diagnóstico , Ácidos e Sais Biliares , Projetos de Pesquisa , Grupos Controle , Biomarcadores , Metanálise como Assunto , Revisões Sistemáticas como AssuntoRESUMO
Although cyberbullying and cybervictimization prevention programs have proved effective in the short term, their effectiveness remains unclear in the long run. Thus, the present study evaluated the long-term effects of the Tabby Improved Prevention and Intervention Program (TIPIP). Participants were 475 middle and high school students (Mage = 12.38; SD = 1.45; F = 241, 51%), of whom, 167 were in the Experimental Group (EG; Mage = 13.15; SD = 1.52; M = 51.5%), and 308 were in the Control Group (CG; Mage = 13.47; SD = 1.35; M = 47.7%). Students completed measures assessing cyberbullying and cybervictimization at three time points: baseline (T1), immediately after the intervention (6 months, T2), and at 1 year (T3). The results showed no significant effects of the TIPIP in reducing both cyberbullying and cybervictimization over time. Overall, our results confirm the lack of effectiveness of long-term preventive programs and emphasize that different curricula should be implemented in future programs to prevent and manage cyberbullying and cybervictimization, also taking into account psychological mechanisms and processes involved in such behaviors.
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Bullying , Vítimas de Crime , Cyberbullying , Humanos , Cyberbullying/psicologia , Vítimas de Crime/psicologia , Estudantes/psicologia , Grupos Controle , Bullying/prevenção & controle , Bullying/psicologiaRESUMO
CONTEXT: Transtibial Amputation (TA) predisposes to a sedentary lifestyle. OBJECTIVES: To evaluate the efficiency of a short-term (8-week) Concurrent Training (CT) program in Unilateral Transtibial Amputees (UTA) and to compare it with the physical condition of a group of Paralympic athletes in preparation for the Rio de Janeiro Paralympics. DESIGN: This was a longitudinal, prospective and controlled trial study. METHODS: Thirty-four male subjects with UTA and using prostheses for six months or more were selected for this study. They were divided into two groups: Group 1 (G1) â 17 non-athlete and untrained UTA and Group 2 (G2) â 17 paralympic athletes with active UTA in the training phase. G1 was evaluated before and after eight weeks of CT and G2 made a single evaluation for control. All were submitted to anamnesis, clinical evaluation (blood pressure, electrocardiogram, and heart rate) and cardiopulmonary exercise testing on a lower limb cycle ergometer, and isokinetic knee dynamometry. The CT of G1 included resistance exercise and aerobic interval training on a stationary bicycle and G2 followed the training of the Paralympic teams. RESULTS: Patients were retested by the same methods after CT. The two most important central dependent variables (maximal oxygen uptake and muscular strength) increased by 22% and knee extensor and flexor strength by 106% and 97%, respectively. CONCLUSION: After eight weeks of CT, there was an improvement in general functional condition, muscle strength, and cardiorespiratory performance improving protection against chronic diseases and quality of life.
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Amputados , Paratletas , Humanos , Masculino , Brasil , Grupos Controle , Estudos Prospectivos , Qualidade de Vida , Estudos LongitudinaisRESUMO
BACKGROUND AND OBJECTIVE: The diagnosis of rare diseases (RDs) is often challenging due to their rarity, variability and the high number of individual RDs, resulting in a delay in diagnosis with adverse effects for patients and healthcare systems. The development of computer assisted diagnostic decision support systems could help to improve these problems by supporting differential diagnosis and by prompting physicians to initiate the right diagnostic tests. Towards this end, we developed, trained and tested a machine learning model implemented as part of the software called Pain2D to classify four rare diseases (EDS, GBS, FSHD and PROMM), as well as a control group of unspecific chronic pain, from pen-and-paper pain drawings filled in by patients. METHODS: Pain drawings (PDs) were collected from patients suffering from one of the four RDs, or from unspecific chronic pain. The latter PDs were used as an outgroup in order to test how Pain2D handles more common pain causes. A total of 262 (59 EDS, 29 GBS, 35 FSHD, 89 PROMM, 50 unspecific chronic pain) PDs were collected and used to generate disease specific pain profiles. PDs were then classified by Pain2D in a leave-one-out-cross-validation approach. RESULTS: Pain2D was able to classify the four rare diseases with an accuracy of 61-77% with its binary classifier. EDS, GBS and FSHD were classified correctly by the Pain2D k-disease classifier with sensitivities between 63 and 86% and specificities between 81 and 89%. For PROMM, the k-disease classifier achieved a sensitivity of 51% and specificity of 90%. CONCLUSIONS: Pain2D is a scalable, open-source tool that could potentially be trained for all diseases presenting with pain.
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Dor Crônica , Distrofia Muscular Facioescapuloumeral , Humanos , Dor Crônica/diagnóstico , Doenças Raras , Grupos Controle , Distrofia Muscular Facioescapuloumeral/diagnóstico , SoftwareRESUMO
Rheumatoid arthritis (RA) is a systemic autoimmune disease that impairs mobility. How does sensory information influence postural responses in people with RA? The aim of this study was to evaluate the postural control of people with RA during a sensory organization test, comparing how sensory information influences postural responses in people with rheumatoid arthritis compared with healthy people. Participants were 28 women with rheumatoid arthritis (RA group) and 16 women without any rheumatoid disease (Control group CG). The Sensory Organization Test (SOT) was performed on a Smart Balance Master® (NeuroCom International, Inc., Clackamas, OR, USA) and center of pressure (COP) was measured. SOT conditions: SOT1 (eyes open, fixed support surface and surround; SOT2) eyes closed, fixed support surface and surround; and SOT5) eyes closed, sway-referenced support surface, and fixed surround. To compare the demographic and clinical aspects between groups, independent t-test or Mann-Whitney's U-test were used. Differences were found between groups. Between SOT conditions, for CG and RA, COP was faster for SOT-5 than SOT-1, while SOT-1 and SOT-2 presented similar COP velocity. For SOT-2 and SOT-5, COP was larger for the RA group. For both groups, SOT-1 presented the smallest COP, and SOT-5 showed the largest COP.
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Manipulações Musculoesqueléticas , Equilíbrio Postural , Humanos , Feminino , Equilíbrio Postural/fisiologia , Modalidades de Fisioterapia , Grupos ControleRESUMO
INTRODUCTION: Mentorship is an important aspect of medical education in providing students guidance and connections to new opportunities, ultimately leading to increased productivity and career satisfaction. The purpose of this study was to design and implement a formal mentoring program between medical students participating in their orthopedic surgery rotation and orthopedic residents to determine if this relationship improved students' experiences during their rotation compared to students who were not mentored. DESIGN: Third- and fourth-year medical students rotating in orthopedic surgery and PGY2-PGY5 orthopedic residents at one institution were eligible to participate in a voluntary mentoring program between the months of July and February during 2016 to 2019. Students were either randomly paired with a resident mentor (experimental group) or not (unmentored control group). Anonymous surveys were distributed to participants at weeks 1 and 4 of their rotation. There were no minimum number of meetings required between mentors and mentees. RESULTS: Twenty-seven students (18 mentored, 9 unmentored) and 12 residents completed surveys during week 1. Fifteen students (11 mentored, 4 unmentored) and 8 residents completed surveys during week 4. While both mentored and unmentored students experienced an increase in enjoyment, satisfaction, and level of comfort at week 4 compared to week 1, the unmentored group demonstrated a greater overall increase. However, from the perspective of the residents, excitement for the mentoring program and the perceived value of mentoring decreased and 1 (12.5%) resident felt that it detracted from their clinical responsibilities. CONCLUSION: While formal mentoring enhanced the experience of medical students on orthopedic surgery rotations, it did not substantially improve medical student perceptions when compared to students who did not receive formal mentoring. The greater satisfaction and enjoyment observed in the unmentored group may be explained by informal mentoring that naturally occurs among students and residents with similar interests and goals.
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Tutoria , Procedimentos Ortopédicos , Estudantes de Medicina , Humanos , Grupos Controle , Mentores/educação , Avaliação de Programas e Projetos de SaúdeRESUMO
INTRODUCTION: Bile leakage (BL) after hepatectomy cannot always be detected with conventional methods; moreover, BL cannot be completely prevented. Recently, navigation procedures with indocyanine green (ICG) have been reported. Furthermore, we previously reported the possibility of detecting BLs with high sensitivity during hepatectomy by administering ICG into the bloodstream, which is quickly excreted in the bile. This study aims to verify whether detecting and addressing ICG leakage from the hepatic dissection plane using an ICG camera can reduce the bilirubin concentration in the drainage fluid, and consequently, the incidence of BL. METHODS AND ANALYSIS: This prospective single-centre non-randomised single-arm trial will be conducted with historical controls. Overall, 85 patients will be enrolled, including 40 and 45 in the ICG and historical control groups, respectively. In the ICG group, 10 mg/2 mL of ICG will be transvenously or transportally administered during liver surgery. After its uptake by liver cells and excretion into bile, it will be visualised using a camera following the completion of hepatectomy, and the site of ICG leakage will be sutured. Moreover, we will record the number of bile leak spots detected by the naked eye and ICG camera. The primary endpoint of the study will be the total bilirubin concentration in the drain fluid on postoperative day 3, and we will determine whether the concentration differs significantly between the ICG and historical control groups. The results of our study will be used to suggest whether intraoperative ICG administration and evaluation at the hepatic dissection plane can be widely used in liver surgery for more reliable detection of BL and consequent reduction of biliary fistula. ETHICS AND DISSEMINATION: The protocol was approved by the Certified Review Board of Tottori University Hospital (approval number: 21C002). Findings from this trial will be published in peer-reviewed journals and presented at academic conferences. TRIAL REGISTRATION NUMBER: jRCTs061210043.
Assuntos
Hepatectomia , Verde de Indocianina , Humanos , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Bile , Grupos Controle , Estudos Prospectivos , BilirrubinaRESUMO
Background: Gene expression (GE) data have shown promise as a novel tool to aid in the diagnosis of childhood growth hormone deficiency (GHD) when comparing GHD children to normal children. The aim of this study was to assess the utility of GE data in the diagnosis of GHD in childhood and adolescence using non-GHD short stature children as a control group. Methods: GE data was obtained from patients undergoing growth hormone stimulation testing. Data were taken for the 271 genes whose expression was utilized in our previous study. The synthetic minority oversampling technique was used to balance the dataset and a random forest algorithm applied to predict GHD status. Results: 24 patients were recruited to the study and eight subsequently diagnosed with GHD. There were no significant differences in gender, age, auxology (height SDS, weight SDS, BMI SDS) or biochemistry (IGF-I SDS, IGFBP-3 SDS) between the GHD and non-GHD subjects. A random forest algorithm gave an AUC of 0.97 (95% CI 0.93 - 1.0) for the diagnosis of GHD. Conclusion: This study demonstrates highly accurate diagnosis of childhood GHD using a combination of GE data and random forest analysis.
