Multiple Analysis Of Variance Research Articles

Association between stress and catecholamines with painful TMD in children.

Studying biomarkers in children with temporomandibular disorders (TMD) such as epinephrine, norepinephrine, and dopamine may reveal factors like screen time or sleep loss that affect these biomarkers and predict TMD-related pain, offering new research opportunities. To determine the association between stress and catecholamines with myofascial pain and headache related to TMD in children. Sixty-six 9- to 11-year-old children assisting at the clinics of Pediatric Dentistry of Universidad CES participated in the study. Myofascial pain and headache attributed to TMD were determined according to the Diagnostic Criteria for TMD (DC/TMD) Axis I. Stress was evaluated with the Perceived Stress Scale-Children (PSS-C), and a 24-h urine sample was analyzed using liquid chromatography to assay catecholamines. Single and multiple regression analyses were performed. Children with a mean age of 10.3 years participated in the study. The mean score of stress was 29 ± 4. Perceived stress, dopamine, epinephrine, and norepinephrine were statistically significant predictors of myofascial pain and headache attributed to TMD in the single- and multiple variable logistic regression analyses. Stressful states and its biological biomarkers increase the probability of developing myofascial pain and headache attributed to TMD in children.

The impact of parenting practices and family economy on psychological wellbeing and learning patterns in higher education students

BackgroundThere is a large literature on the significant impact of rearing factors in the psychological development of different child’s learning patterns and wellbeing in elementary and secondary schools, but there is a scarcity of studies on to what extent those influences remain stable up to higher education.ObjectiveIn this study, parenting practices and family status were analyzed as predictors of the different learning styles, psychological difficulties, mental health factors, and academic performance, comprising the psychosocial diversity in learning (DinL) at the university classroom.MethodsUsing a cross-sectional design, a questionnaire was administered to a sample of 2522 students at the Complutense University of Madrid (Spain). It included a DinL scale measuring five psychological learning dimensions (coping with difficulties, effort, autonomy, Social/Physical Context, and understanding/career interest), plus several items on retrospective parenting practices, family, and sociodemographic variables. Multiple regressions and analyses of variance were conducted with the family factors as independent variables and the learning factors as dependent variables.ResultsResults showed parenting variables, parents’ education, and family economy as having a significant impact on psychological learning dimensions, academic performance, and especially on the students’ wellbeing and mental health status, being an important contributors to explain the DinL in the university classroom.ConclusionThe results bring interesting conclusions for developmental and health psychologists when working with parents aimed at fostering wellbeing and learning strategies related to academic inclusion and achievement.

Scheduling and Vendor Consistency Improves Turnover Time Efficiency in Total Joint Arthroplasty

BackgroundMaximizing operative room (OR) efficiency is important for hospital efficiency, patient care, and positive surgeon and staff morale. Reducing turnover time (TOT) has become a popular focus to improve OR efficiency. The present study evaluated if TOT is influenced by changing case type, implant vendor, and/or laterality. MethodsIn total, 444 turnovers from January to July 2023 were retrospectively analyzed. All turnovers were same-surgeon turnovers between primary arthroplasty cases in dedicated, overlapping rooms. Single linear regression models tested the predictability of TOT based on case type, vendor, and laterality. A multivariate multiple regression and 1-way Analyses of Variance analyzed variables against each other. Independent sample t-tests evaluated TOTs when all variables were the same or different. ResultsChanging versus keeping the same case type increased TOT by 2.4 minutes (95% confidence interval [CI] = 0.7, 4.0; P = .004). Changing vendors increased TOT by 2.9 minutes (95% CI = 1.1, 4.7; P = .002). Laterality did not affect TOT, with a change of 0.9 minutes (95% CI = −0.6, 2.5; P = .229). Vendor (P = .030) independently predicted TOT when analyzed as a covariate with case type (P = .410). The TOT with same case type and vendor (mean 38.2 minutes; range, 22 to 62) was less than that of different case types and vendors (mean 41.4 minutes; range, 26 to 73) (P = .017). Mean TOT differed by 5.5 minutes when keeping all variables the same versus all different (P = .018). ConclusionsMaintaining a consistent case type, vendor, and laterality had a synergistic effect in reducing TOT in arthroplasty ORs with the same primary surgeon running 2 overlapping rooms. Changing vendor representatives was found to independently predict TOT increases, which is likely attributed to a disruption in workflow and collaboration of the multidisciplinary OR team. Level of EvidenceLevel III.

Head and Neck Soft Tissue Sarcoma Patient: Age and Tumor Region Are Predictive in Disease-Free Survival and Overall Survival

Head and neck soft tissue sarcoma (HNSTS), rare and heterogeneous malignancies, are treated primarily treated with surgery. However, prognostic indicators that might guide HNSTS management are poorly defined. Main purpose of this study is to find variables linked to HNSTS patients' prognosis. Assessment of the Tumor, Node, Metastatis (TNM) system is the secondary purpose. This study is a retrospective cohort performed on HNSTS patients who received surgery at the Department of Oral and Maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital School of Medicine, Shanghai Jiao Tong University from January 1, 2006, to December 31, 2014. Strict inclusion criteria were applied. The predictor variable was a set of heterogenous risk factors and were grouped into the following categories: demographic (age and gender), clinical (primary tumor, tumor region, tumor size, and TNM stage), and treatment (surgical margin, treatment therapy). The primary outcome variables were time to 5-year disease-free survival (DFS) and 5-year overall survival (OS). The secondary outcome variables were time to 5-year tumor local recurrence and metastasis. Not applicable. Descriptive statistical analysis was carried out. Pearson χ2 test was employed in univariate analysis. Cox regression was modified for multiple variable analysis with components that had significant P values in univariate analysis or variables with potential prognostic value. Log-rank test was applied to compare survival situations under various variables. P value less than .05 was statistically significant. The sample was composed of 100 subjects with a mean age of 43.47 (standard deviation: 16.15) years old and 56 (56%) were male. The 5-year DSF and OS were 59 and 60%, respectively. Variables associated with poor DFS and OS were age > 60years (P=.003, hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.71,14.1; P=.005, HR: 4.48, 95% CI: 1.57,12.8) and non-primary tumors (P＜.001, HR: 8.41, 95% CI: 2.85,24.8; P=.002, HR: 6.90, 95% CI: 2.46,19.4), respectively. Maxilla and skull base cancers had local recurrence (12/18, 66.7%) more common. T2 (TNM) tumor displayed higher tendency in DFS(P=.009, HR: 4.20, 95% CI: 1.42,12.4) and metastasis(P=.09, HR: 3.51, 95% CI: 0.82,15.0) than T1 (TNM) tumors. Poor prognosis is associated with maxilla and skull base tumors as well as patients over 60years. TNM stage appeared to have limited prognostic significance.

TRUST AND SATISFACTION WITH HELP RECEIVED FROM SIGNIFICANT LOVED ONES

Background. Numerous studies have noted the role of trust in building a variety of relationships. In our study, we focused on studying the connection between trust (personalized and generalized) and a person’s perception of the help provided to him in difficult life situations from their loved ones. Research methods. Method of “Critical life situations” by I.V. Kuznetsova, A.L. Sventsitsky; Method of “Trust” L.G. Pochebut, M.I. Kiloshenko, A.L. Sventsitsky, T.V. Kazantseva; Method of “Psychological Well-Being Scale” by K. Rieff, adapted by T.D. Shevelenkova; socio-demographic questionnaire. Processing of the obtained data was carried out in IBM SPSS Statistics Subscription. The following methods of mathematical statistics were used in the study: analysis of primary statistics, Student's t test, multiple analysis of variance (Scheffé test and intergroup effects), correlation and regression analyses. Results. Our study confirms the important positive relationship between trust (both personal and generalized) and the level of satisfaction with assistance. The most requested help (regardless of gender) is the need for moral support. The most significant person is mostly either the mother or the father. An overabundance of help is often associated with the excessive involvement of loved ones in solving situations of interpersonal interactions and providing help without a request. Men with a high level of psychological well-being admit that more often. Conclusion. This study also touched upon such issues as the roles and functions of modern friends, partners (spouses/wives/fiancés and grooms) in the life of a modern young man, in which he can only receive basic help from relying on himself or his parents. This issue will be further discussed in the future.

The Influence of Work-Life Balance on Job Satisfaction of Employees in Merchandising Enterprises in the City of Mati

The study seeks to determine the influence of work-life balance on job satisfaction of employees in merchandising enterprises in the City of Mati, Davao Oriental, Philippines. To achieve the objectives of the study, a correlational research design was employed to analyze data collected through a structured survey questionnaire. The 389 respondents were selected using a purposive sampling method. The collected data from the survey were analyzed through multiple linear regression and analysis of variance (ANOVA). The study discovered that most of the indicators of work-life balance have a significant influence on job satisfaction. It was also discovered that there is no significant difference in work-life balance when grouped according to age and gender. There is also no significant difference in job satisfaction in terms of age, however, results showed a significant difference in job satisfaction in terms of gender. This study will contribute to the existing literature as it can give benefit to employees and employers in merchandising enterprises. The findings could give employees the opportunity for better working conditions and could also help employers and managers in designing policies that can attract and retain qualified employees.

Experimental Investigations on the Thermal Characteristics of Domestic Convectors

Better understanding of local thermal characteristics of domestic convectors could play a crucial role in reducing energy consumption for space heating and decarbonizing the economy. The current study evaluates the impact of varying water inlet temperature and flowrate on the local surface temperature of domestic convectors through extensive empirical investigations. Experiments are performed using a custom-made test-rig featuring a 400 mm × 600 mm Type 11 convector within a large and well-ventilated environment, minimizing the thermal influence of the surrounding space on the thermal behavior of the convector. Infrared thermography (IR) is used to acquire local surface temperature data for further analysis. Based on the results obtained, it has been observed that the inlet water temperature has a negligible effect on thermal characteristics of the convector while increasing the flowrate substantially decreases the time required for the convector to reach maximum surface temperature. Based on the numerical data, an analytical model for average surface temperature has been developed using multiple variable regression analysis, demonstrating a prediction accuracy of >90% compared with the experimental data. A detailed understanding of the heating behavior exhibited by domestic convectors has led to a better understanding of the local thermal characteristics, while the prediction model can be used to develop machine learning algorithms to install better flow control techniques for efficient space heating.

Does Negative Pressure Wound Therapy Impact the Outcome for Patients With Necrotizing Soft Tissue Infection Infected With Anaerobic Bacteria?

Background: A notable improvement in the treatment of necrotizing soft tissue infections (NSTIs) is the development of negative pressure wound therapy (NPWT). Clinicians are still debating whether NPWT is as successful as conventional wet-to-dry dressings at removing bacteria. Recent research has revealed potential oxygen deprivation effects of NPWT in underlying wound tissues, although clinical trials regarding the effects of reduced oxygen on anaerobic bacterial soft tissue infections remain noticeably lacking. Hypothesis: We hypothesized that NPWT-treated patients with NSTIs who were solely infected by anaerobic bacteria would have worse outcomes than those who were infected with other bacterial species. Patients and Methods: Our study included a retrospective examination of the 2008-2022 period of our Acute and Critical Care Surgery database. Patients who had been identified as having necrotizing fasciitis, Fournier gangrene, or gas gangrene and who had their conditions verified by positive wound cultures acquired during the initial debridement and subsequently received NPWT made up the study cohort. Comorbidities, surgical techniques, and clinical results were all covered by the data. Based on their wound infections, patients were divided into two groups: those with exclusively anaerobic NSTIs and those with different bacterial groups (such as polymicrobial and aerobic). Multiple regression, χ2 analysis, and analysis of variance (ANOVA) were among the analytical methods used. Results: One hundred twelve patients with NSTI who had received NPWT comprised the study cohort. Sixteen of these patients (14.3%) had NSTIs that were exclusively anaerobic, whereas the remaining 96 (85.7%) had NSTIs that were mixed aerobic, facultative, or polymicrobial. Between the two groups, there was no difference in the initial wound size. Patients with anaerobic NSTI who underwent NPWT showed a statistically significant increase in the number of debridements (3 [interquartile range {IQR},1-9] vs. 2 [IQR, 1-4]; p = 0.012) and an increased 100-day re-admission rate (37.5% vs. 12.5%; p = 0.012) when compared with patients with non-anaerobic NSTI. The 100-day re-admission rate increased three-fold in NPWT-treated anaerobic NSTIs, according to a logistic regression analysis (odds ratio [OR], 3.63; 95% confidence interval [CI], 1.06-12.44; p = 0.04). Conclusions: In contrast to patients with other bacterial strains, our data show that patients with NSTI treated with NPWT who only have anaerobic bacterial infections have a larger number of debridements and are much more likely to require re-admission within 100 days. We call for additional prospective studies to be conducted to identify additional risk factors and consider alternate treatment options for individuals with exclusively anaerobic NSTIs in light of these findings.

Mental Health Services for Autistic People with Intellectual Disability: An Exploratory Study on Patient and Treatment Characteristics, and Intervention - Outcome Associations

ABSTRACT Introduction Autistic people with co-occurring intellectual disability have a high risk of mental disorders. This study aimed to investigate specialized mental health services for this group, emphasizing inpatient/outpatient treatment, patient characteristics, interventions, and outcomes. Methods The current study used data from a Norwegian multicenter study (the AUP study), 151 participants were included. Statistical analyses included comparisons of the two treatment groups and multiple analyses of variance on outcome measures of behavioral and mental health symptoms for all patients. Results Seventy-four patients received outpatient treatment and 77 received inpatient treatment. The inpatients had significantly more “severe” mental disorders and received a higher number of interventions. Both groups improved significantly during treatment, inpatients slightly more. Psychotherapy was associated with positive outcomes. Psychopharmacological treatment or duration were not associated with outcomes. Conclusion Treatment of mental disorders is effective in autistic people with co-occurring intellectual disability. Psychotherapy may be beneficial for these patients.

Relationship Between Occupational Burnout and Negative Affective Responses of Nurses During the Public Health Crisis

Background: Long-term exposure of nurses to coronavirus disease 2019 (COVID-19) and the lack of necessary and sufficient facilities to deal with the disease have had significant negative effects on their occupational and mental health. Objectives: The present study aimed to investigate the association between occupational burnout and negative affective responses, including depression, anxiety, and stress, in nurses during the recent pandemic. Methods: A total of 270 nurses who worked at Razi hospital, one of the principal referral hospitals for COVID-19 patients in the northern province of Guilan, Iran, throughout 2021 - 2022, were included in this study. These nurses were selected using convenience sampling and were assigned to one of three wards: COVID-19 (n = 43), emergency (n = 55), or other wards (n = 172). In addition to providing their sociodemographic information, the participants completed two assessments: the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Depression, Anxiety, and Stress Scales-42 (DASS-42). Results: The correlation matrix showed that all MBI-HSS and DASS-42 scores, except in one case, had a positive correlation with each other (P < 0.0001). In the multiple analysis of variance, gender (P = 0.17), education (P = 0.005), hospital ward (P = 0.048), social support (P = 0.001), family support (P < 0.0001), financial support (P = 0.01), occupational satisfaction (P = 0.044), social respect (P < 0.0001), history of death in the family (P = 0.006) and relatives (P = 0.043), and having a child in primary school age (P = 0.04) created a significant difference in MBI-HSS and DASS-42 scores. Conclusions: In general, nurses tend to be considerably affected by the negative effects of the recent public health crisis, especially occupational burnout, and it is necessary to make arrangements to improve their mental health and reduce the level of occupational burnout in them.

Exploring the Benefits of Vocational Activity for People with Schizophrenia Spectrum Disorder in Norway

AbstractVocational activity holds many benefits for people with severe mental illness. The purpose of the present study is to explore potential benefits of vocational activity on self-esteem and benefits as described by employment specialists. Data from 148 adults with schizophrenia spectrum disorders participating in a comprehensive vocational rehabilitation program was collected as part of the Job Management Program (JUMP) study. Assessments were conducted at inclusion, post intervention (10 months) and 2 years after inclusion. Multiple regressions and mixed between-within subjects analysis of variance were applied to assess potential effects of vocational activity on self-esteem as measured by the Rosenberg Self-Esteem Scale. One hundred and twenty-one reports submitted by the employment specialists post intervention were assessed through a qualitative approach based on thematic analysis. Statistical analyses indicate that vocational activity might be beneficial for self-esteem. Qualitative analysis indicate that vocational activity may provide opportunities for experiencing capability, achievement, and positive social interaction, and be beneficial for well-being, self-confidence, and self-esteem. Vocational activity may be beneficial for well-being and self-esteem among people with schizophrenia spectrum disorders. Statistical analysis indicate that vocational activity may have a positive effect on self-esteem, and there was a non-significant trend indicating that competitive employment may be particularly favourable. However, more research is needed regarding potential differences in effect between types of vocational activity.

Analysis of Households’ Water Access and Consumption in Differential Urban Neighbourhoods of Osogbo, Nigeria

The study focused on scrutinizing the sources and consumption patterns of domestic water supply in Osogbo, with an emphasis on households' socio-economic characteristics. Data were collected from three deliberately chosen residential neighborhoods representing low, medium, and high-density areas, with a cumulative population of 134,159 and an estimated 26,829 households. Employing a multistage sampling technique, 25% of streets in each neighborhood were randomly selected, and systematic sampling was utilized to distribute 268 structured questionnaires (1% of households) to gather information. Descriptive analyses, such as means and percentages, were employed to scrutinize socio-economic characteristics and water consumption patterns. The study also utilized inferential statistics, specifically Multiple Analysis of Variance (MANOVA), to assess the impact of residential densities and water sources on water consumption volume. Results highlighted hand-dug wells (46%), public taps (22.4%), and boreholes (15.7%) as thepredominant water sources. MANOVA revealed a statistically significant influence of residential densities and water sources on water consumption volume (p=0.049). In low-density areas, households consumed an average of 960 liters per day, compared to 735 and 517.5 liters in medium- and high-density areas, respectively. Across Osogbo, the average household consumed 664.7 liters daily. Correlation analysis indicated a positive and statistically significant relationship between resident population and water consumption (p<0.05). The study concluded by emphasizing the pivotal roles of government, communities, NGOs, and individuals in addressing water provision challenges in the area.

Impact of COVID-19-related lifestyle changes on diabetic macular edema.

To assess diabetic macular edema (DME) progression during the early phases of the COVID-19 pandemic, when severe societal restrictions raised the concern of possible deterioration of health in patients with systemic conditions, particularly those requiring frequent office visits. This is a multicenter retrospective chart review of 370 patients (724 eyes) with an established diagnosis of DME seen on 3 separate visits between January 2019 and July 2021. Period 1 was January 2019 to February 2020 (considered pre-COVID-19), period 2 was March 2020 to December 2020 (considered the height of the pandemic; highest level of pandemic-related clinical and societal regulations) and period 3 was January 2021 to July 2021 (re-adjustment to the new "pandemic norms"). Main outcome measures included visual acuity, body mass index (BMI), blood pressure (BP), hemoglobin A1c (HbA1c), macular thickness, patient adherence to scheduled ophthalmology visits, and DME treatment(s) received at each visit. To facilitate measurement of macular thickness, each macula was divided into 9 Early Treatment Diabetic Retinopathy Study (ETDRS)-defined macular sectors as measured by OCT imaging. There was no change of BMI, systolic BP, and diastolic BP between any of the time periods. HbA1c showed a very small increase from period 1 (7.6%) to period 2 (7.8%, P=0.015) and decreased back to 7.6% at period 3 (P=0.12). Macular thickness decreased for 100% of macular regions. The central macular thickness decreased across all 3 periods from 329.5 to 316.6 µm (P=0.0045). After analysis of multiple variables including HbA1c, BMI, adherence to scheduled appointments, different clinic centers, and treatment interventions, there was no easily identifiable subgroup of patients that experienced the increase in DME. DME doesn't worsen during the COVID-19 pandemic, instead sustaining a very small but statistically significant improvement. While identifying a mechanism behind our findings is beyond the scope of this study, potential explanations may include a delay in retinal changes beyond our study period, an unexpected increase in treatment frequency despite pandemic restrictions, and an unanticipated pandemic-related improvement in some lifestyle factors that may have had a positive impact on DME.

The health and quality of life of dental workers in jordan during COVID-19: A cross-sectional study.

Dental team members are susceptible to high mental and physical stress levels, which could have increased during the Coronavirus disease 2019 (COVID-19). This study aimed to evaluate Jordanian dental workers' health-related quality of life (HRQoL) and determine its predictors during the COVID-19 Pandemic. This was a cross-sectional survey study conducted on dental team members, namely; Dentists, dental Assistants, and Dental Technicians. The survey questionnaire was composed of questions related to stress during COVID-19, a short-form survey of 12 items (SF-12), a Depression, Anxiety, and Stress scale (DASS-21), and a Nordic musculoskeletal disorder questionnaire (NMQ). Descriptive analyses were used to describe the main outcome measures, and multiple variable regression analysis was conducted to identify the quality of life predictors. Participants' HRQoL measured by SF-12 showed a mean±SD score of 67.1±17.19 for the physical component and 54.51±20.27 for the mental component. The Nordic scale showed symptoms of lower back pain as 63.9% over 12 months, 32% over 12 months' functional limitation symptoms, and 45% in 7 days The regression model was found strong for our study with 53.8% variations (r2 = 0.538, F = 43.739, P < 0.001) in health-related quality of life. Our study concluded that the level of HRQoL among Jordanian dental specialists during COVID-19 was observed to impact levels of physical and mental well-being which negatively influence the quality of life. Predictive factors like depression, stress, anxiety, musculoskeletal health, and individual everyday quality of life significantly affect the HRQoL of dental specialists.

The Influence of Direct Instruction (Di), Teaching Games for Understanding (TGFU) and Motivation on Learning Outcomes of Volleyball Underpass

This research aims to determine the interaction between the Direct Instruction (DI) and Teaching Games for Understanding (TGfU) learning models with learning motivation (high and low) on the learning outcomes of volleyball underpass. Experimental method with a quantitative approach in class VII. The data collection technique uses a measurement test on the learning outcomes of volleyball underpassing and uses a questionnaire to measure student motivation. Two-way ANOVA (multiple variance analysis) Tukey test analysis technique if there is an interaction. The results of data analysis show that there is a significant difference, namely the TGfU model has a higher value, namely 15.85, compared to the DI model with a value of 10.55 in learning outcomes for volleyball bottom passing. The research conclusion is that there is an interaction and difference in influence between the DI and TGfU models with learning motivation on the learning outcomes of volleyball underpassing, and there is a difference in influence between students who have high and low learning motivation on learning outcomes for volleyball underpassing.

Effects of combined nutrient and pesticide exposure on algal biomass, and Daphnia magna abundance

Fertilisers and pesticides are increasingly used in agriculture to improve productivity and protect crops from fungi and insects. However, these farm inputs may lead to adverse effects on aquatic biodiversity through eutrophication and pesticide toxicity. This study aimed to establish the effects of nutrient-only, pesticide-only, combined nutrients and pesticides, and control on the abundance of Daphnia magna, and algal biomass. In each of the treatments, different concentrations of nutrients and pesticides residues were added separately or in combination. Responses were measured every 24 h, and the experiments ended after 168 h of exposure. The experiment was set in four concentration treatments comprising high, moderately high, moderately low, and low concentrations. Data analysis was done using Multiple Analysis of Variance (MANOVA) and ANOVA to determine the effect of time, concentrations and the interaction of time and concentrations for each of the treatments on D. magna abundance, and algal biomass. Higher concentrations of pesticide additives were associated with lower abundance of D. magna, and higher algal biomass over the exposure periods. There was a significant reduction in the abundance of D. magna in the combined treatment indicating the toxic effect of pesticide addition. Determination of effect concentrations based on combined nutrients-pesticides experiments becomes important in setting water quality standards, and monitoring the quality status, to avoid underestimating the ecological implications of combined contamination.

Quantitative differences in volumetric calculations for radiation dosimetry in segmental Y90 treatment planning using hybrid angiography-CT compared with anatomic segmentation.

To compare treatment volumes reconstructed from hybrid Angio-CT catheter-directed infusion imaging and Couinaud anatomic model as well as the implied differences in Y-90 radiation dosimetry. Patients who underwent transarterial radioembolization (TARE) using Y-90 glass microspheres with pretreatment CT or MRI imaging as well as intraprocedural angiography-CT (Angio-CT) were analysed. Treatment volumes were delineated using both tumoural angiosomes (derived from Angio-CT) and Couinaud anatomic landmarks. Segmental and lobar treatment volumes were calculated via semi-automated contouring software. Volume and dose differences were compared by the two-tailed Student t test or Wilcoxon signed-rank test. Factors affecting volume and dose differences were assessed via simple and/or multiple variable linear regression analysis. From September 2018 to March 2021, 44 patients underwent 45 lobar treatments and 38 patients received 56 segmental treatments. All target liver lobes and all tumours were completely included within the field-of-view by Angio-CT. Tumour sizes ranged between 1.1 and 19.5 cm in diameter. Segmental volumes and treatment doses were significantly different between the Couinaud and Angio-CT volumetry methods (316 vs 404 mL, P < .0001 and 253 vs 212 Gy, P < .01, respectively). Watershed tumours were significantly correlated with underestimated volumes by the Couinaud anatomic model (P < .001). There was a significant linear relationship between tumour diameter and percent volume difference (R2 = 0.44, P < .0001). The Couinaud model overestimated volumes for large tumours that exhibited central hypovascularity/necrosis and for superselected peripheral tumours. Angio-CT may confer advantages over the Couinaud anatomic model and enable more accurate, personalized dosimetry for TARE. Angio-CT may confer advantages over traditional cross-sectional and cone-beam CT imaging for selective internal radiation therapy planning.

Efficacy, safety, and predictive model of Palbociclib in the treatment of HR-positive and HER2-negative metastatic breast cancer

PurposeThis research designeded to: 1. Analyze the efficacy and safety of Palbociclib treatment in HR-positive and HER2-negative (HR + /HER2-) metastatic breast cancer(MBC) patients. 2. Establish and validate a nomogram model for predicting the progression-free survival (PFS) rates of 6 months, 12 months, and 18 months in HR + /HER2- MBC patients after receiving Palbociclib plus endocrine therapy (ET).Patients and methods1. This research retrospectively analyzed the efficacy and safety of Palbociclib combined with ET in 214 patients with HR + /HER2- MBC. 2. A nomogram was designed and constructed with the retrospective clinical data of 214 patients with HR + /HER2- MBC who received Palbociclib plus ET at Zhejiang Cancer Hospital in China from August 2018 to August 2022. Among these patients, 161 were randomly assigned to the training cohort, while 53 to the validation cohort. The predictive accuracy of the nomogram was assessed through the analysis the area under the receiver operating characteristic(ROC) curve, calibration curve, and decision curve analysis(DCA).Results1. Median PFS was 7.17 months (95% CI: 7.61—10.05 months), with an objective response rate (ORR) of 2.80% and a disease control rate (DCR) of 34.58%. The most prevalent grade 3–4 adverse event was neutropenia (38.79%). 2. Multiple variable analysis of the training set revealed that age < 60 years old, PR < 20%, Ki-67 ≥ 20%, luminal B molecular subtype, primary resistance to ET, receipt of late-stage chemotherapy, and presence of liver metastasis or ≥ 2 visceral metastases were independent prognostic factors associated with poor PFS (P < 0.05). Then, the predictive model underwent development and validation utilizing the aforementioned parameters. On the one hand, the area under the ROC curve (AUC) values of the training set at 6 months, 12 months, and 18 months were 0.771, 0.783, and 0.790, respectively, indicating a strong predictive ability of the developed model. On the other hand, the AUC of the validation set at 6 months, 12 months, and 18 months were 0.720, 0.766, and 0.754, respectively, suggesting the favorable discriminatory ability of the model. The calibration curves also exhibited a good fit with the ideal curves, and the DCA demonstrated the clinical applicability of the model. The nomogram's different scores could distinguish PFS.ConclusionThis retrospective study demonstrates the efficacy of Palbociclib in Chinese breast cancer patients. Moreover, the clinical parameters showed a significant association with the prognosis of HR + /HER2- MBC, and the prognostic models constructed based on these variables also displayed robust predictive power, which could offer more intuitive and convenient references for clinical doctors to formulate follow-up treatment plans.

New Score Models for Predicting Bleeding and Ischemic of Ticagrelor Therapy in Patients with Diabetes Mellitus.

Ticagrelor is an antiplatelet drug, and its use increases the risk of bleeding. Coronary artery disease is significantly influenced by the widespread occurrence of diabetes mellitus. In order to decrease the incidence of clinical adverse events, a novel bleeding and thrombosis score is developed in this research. We conducted a retrospective analysis of patient data from two medical centers who were diagnosed with diabetes mellitus and treated with ticagrelor. We gathered information on every patient from the electronic database of the hospital and follow-up. The collected data were statistically analyzed to obtain risk factors for bleeding and ischemic events. A total of 851 patients with diabetes mellitus who have been administered ticagrelor are included in our investigation. A total of 76 patients have bleeding events and 80 patients have ischemic events. The analysis of multiple variables indicates that characteristics like the age of >65, having a previous occurrence of bleeding, experiencing anemia, using aspirin, and taking atorvastatin are linked to a higher likelihood of bleeding. Additionally, the age of >65, smoking, having a history of blood clots, and having a BMI ≥ 30 are found to increase the risk of ischemia. The A4B score established in this study was better than the HAS-BLED score，and the same is true for the ABST score to the CHA2DS-VASc score. This new risk assessment model can potentially detect patients who are at high risk for bleeding and ischemic events. For high-risk patients, the dose of ticagrelor can be adjusted appropriately or the medication can be adjusted.(2023-09-11, ChiCTR2300075627).

Patient Motivation to Reduce or Discontinue Opioids for Chronic Pain: Self-efficacy, Barriers, and Readiness to Change.

This study aimed to assess levels and predictors of self-efficacy and motivation to change opioid use among a community sample of patients using opioids for chronic pain, as well as patient-reported barriers to pursuing opioid discontinuation. Participants with a variety of chronic pain conditions, recruited from ResearchMatch.org , completed a battery of electronic, self-report questionnaires assessing demographic and medical characteristics, pain treatment history, and levels of readiness, self-efficacy, and other attitudes toward reducing or discontinuing opioid use. Multiple regression analyses and analyses of variance were conducted to examine predictors of readiness and self-efficacy to change opioid use. A modified version of rapid qualitative analysis was utilized to analyze themes in participant responses to an open-ended item about "what it would take" to consider opioid discontinuation. The final sample included N=119 participants, the majority of whom were female (78.2%), Caucasian (77.3%), and well-educated. Readiness and self-efficacy to decrease or stop opioid use were fairly low on a 0 to 10 Visual Analog Scale (2.6 to 3.8) and significantly higher to decrease than stop ( P <0.01). Higher readiness to change was predicted by lower pain severity and higher concern about opioids, whereas higher self-efficacy was predicted by shorter pain duration. Results from the qualitative analyses revealed that the availability of an alternative treatment option was the most commonly cited requirement to consider opioid discontinuation. Patients with lower pain severity, shorter duration of pain, and higher concerns about opioids may be a prime target from a motivation standpoint for interventions addressing opioid tapering and discontinuation.