Effectiveness Of Specific Interventions Research Articles

Treatment of acromegaly has substantial effects on body composition: a long-term follow-up study.

Acromegaly is associated with changes in body composition. Long-term changes following acromegaly treatment and the impact of different treatments have been less investigated. We performed a retrospective study in 201 patients with acromegaly. Body composition was assessed by dual-energy X-ray absorptiometry. To investigate the specific effects of treatment vs aging, changes in body composition were compared in one group of patients evaluated both at the time of active and controlled disease (active-to-controlled (A>C); n = 31) and in another group of patients evaluated two times while the disease was controlled (controlled-to-controlled (C>C); n = 32). In the whole cohort, insulin-like growth factor I (IGF-I) was correlated with fat (r = -0.369; P < 0.001) and lean mass (r = 0.383; P < 0.001). Patients from A>C and C>C groups were comparable for age, sex, BMI and follow-up duration (P = n.s.). Reduction in IGF-I levels was associated with an increase in fat mass and a decrease in lean mass in the A>C group, which was four and eight times more pronounced compared to the C>C group (fat mass: +39 ± 34% vs +10 ± 15%, P < 0.001; lean mass: -8 ± 8% vs -0.2 ± 6%, P < 0.001, respectively). Changes in fat mass were negatively associated with IGF-I (r = -0.450; P = 0.011) and independent of the individual therapy. The daily dose of pegvisomant correlated with fat mass (r = 0.421; P = 0.002) and insulin sensitivity index (r = -0.466; P < 0.001). Treatment of acromegaly strongly impacts body composition until biochemical disease remission, characterized by an increase in fat mass and a decrease in lean mass. These changes are closely associated with the normalization of IGF-I. Thereafter, body composition changes are similar to what is observed with aging.

EU health information progress: the harvest of policy supporting projects and networks

BackgroundThe European Commission supports the initiation of health information related projects and networks serving comparative population health monitoring and health system performance assessment. Many of these projects and networks have produced relevant data, standards, methods, indicators and knowledge that may be lost as these networks become inactive.The aim of this project retrieval and review was to identify health information projects and networks and their produced output; and subsequently facilitate systematic access to this information for policy makers, researchers and interested others via a web-based repository.MethodsThe scope of this article covers 1. population health oriented topics and 2. health system/health services oriented topics. Out of scope are specific infectious diseases; individual rare diseases; and the occurrence and effects of specific medical treatments, interventions and diagnostics; cohort studies; or studies focusing on research methods.We searched bibliographic databases and EU project databases for policy supporting projects and networks and selected those fulfilling our inclusion criteria after more in-depth inspection. We searched for their outputs. In addition, we reviewed country participation in these projects and networks.ResultsWe identified 36 projects and networks, 16 of which are population health oriented, 6 are health systems and services oriented and 14 cover both. Their total volume of output is not easily retrievable, as many project websites have been discontinued. Some networks and/or their outputs have found continuance within European agencies and/or national institutions. Others are struggling or have gone lost, despite their policy relevance. Participation in the projects was not evenly distributed across Europe. Project information was made available through the Health Information Portal.ConclusionsEU funded projects and networks have contributed greatly to the evidence-base for policy by providing comparative health information. However, more action is needed to evaluate and conserve their outputs and facilitate continued contribution to the field after project funding stops. The realization of a sustainable infrastructure for these projects and networks is urgent. The Health Information Portal can play an important role in conserving and reusing health information. Information inequalities may exist across Europe but need further investigating.

Functional Evaluation of KEL as an Oncogenic Gene in the Progression of Acute Erythroleukemia.

Acute erythroleukemia (AEL) is an infrequent subtype of acute myeloid leukemia (AML) with worse prognosis. Though the last decade has seen major advances in the novel features and genomic landscape in AEL, there is still a lack of specific therapeutic targets and effective treatment approaches for this disease. Here, we found a novel oncogene KEL that specifically and aberrantly expressed in patients with AEL. In this study, we demonstrated that KEL promoted cell proliferation and the downregulation of KEL reversed drug resistance in AEL cells to JQ1. Our findings suggested that KEL contributed to gain of H3K27 acetylation and promoted erythroid differentiation induced by GATA1. Additionally, GATA1 and TAL1 as cotranscription factors (TFs) modulated the expression of KEL. Maintaining cell viability and differentiation, KEL also played parts in the immune evasion of tumor cells. Our work expands the current knowledge regarding molecular mechanisms involved in cancer onset and progression, offering promising therapeutic target to broaden the treatment options.

The Effectiveness of Laboratory Parameters in Predicting the in-Hospital Mortality of Iranian Patients with Coronavirus Disease 2019 (COVID-19).

The novel coronavirus 2019-nCoV (now SARS-CoV-2) has spread globally and affected healthcare systems worldwide. Due to lack of long-term immunization and effective specific treatments for the COVID-19 disease, there is a need of identifying the patients who are at the risk of a fatal outcome, according to the available epidemiological data and laboratory parameters. Thus, we aimed to evaluate the prognostic value of epidemiological data and laboratory para-meters for in-hospital case fatality in patients with COVID-19. A retrospective cohort of patients with COVID-19 admitted to the Shahid Mostafa Khomeini Hospital of Ilam University of Medical Sciences from February 29 until March 29, 2020 was performed. Epidemiologic data and laboratory results were collected. Univariate and multivariate logistic regression models were performed to evaluate the prognostic value of the laboratory parameters for in-hospital death. A total of 256 Iranian COVID-19 patients were included in the evaluation; 38 of them died, resulting in a in-hospital case-fatality rate of 14.8%. The univariate analysis showed that advanced age [OR=1.04, 95% CI: 1.02, 1.06, P=0.001], smoking [OR=4.041, 95% CI: 1.546-10.563, P=0.004], white blood cells [OR=0.941, 95% CI: 0.904-0.980, P =0.003] and hematocrit [OR=1.060, 95% CI: 1.009-1.113, P=0.020] were positively associated with the risk of a fatal outcome. Multivariate logistic regression analysis revealed that COVID-19 patients with an elevated white blood cell count and elevated hemoglobin level had 1% and 9% greater risk of an in-hospital death for each elevated unit [OR=1.07; 95 %CI: 1.024-1.088, P =0.002 and OR=1.379; 95% CI 0.064-1.788, P =0.015, respectively]. An increase in white blood cell count and an increase in hemoglobin level might be indepen-dent risk factors for in-hospital death in Iranian patients with COVID-19. Further studies are necessary in order to conferm the prognostic value of the variables discussed.

Association between case management and longitudinal decrease in negative symptoms in patients with first episode psychosis: A 2-year follow-up.

Negative symptoms (NS) severely affect daily functioning already at the psychosis onset. However, most studies investigating beneficial effects of specific treatments for NS mainly included individuals with prolonged psychotic disorders. Furthermore, evidence on psychosocial rehabilitation for NS in early psychosis is still relatively poor. The aims of this study therefore were (A) to longitudinally examine NS stability in people with first episode psychosis (FEP) along a 2-year follow-up period, and (B) to overtime explore any relevant association of NS levels with the specific intervention components of an 'early intervention in psychosis' (EIP) protocol during the follow-up. At baseline, 266 FEP subjects (aged 12-35 years) completed the positive and negative syndrome scale (PANSS). Multiple linear regression analyses were then performed. Along the follow-up, FEP participants had a relevant improvement in NS levels. This was specifically predicted by the total number of case management sessions offered within our 2-year EIP protocol, as well as by shorter duration of untreated psychosis at entry and by longitudinal reduction in PANSS depressive and positive symptom dimension levels. No association with antipsychotic medication was found. NS are clinically relevant in FEP, already at the recruitment time in specialized EIP services. However, their severity appears to improve over time together with the delivery of patient-tailored, integrated EIP case management.

The emerging importance and evolving understanding of clonal hematopoiesis in multiple myeloma

Multiple myeloma (MM) is the second most common hematologic malignancy diagnosed in the United States. With a growing arsenal of novel therapies, patients are living longer and hence are at increased risk of secondary cancers such as myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). While MDS-associated cytogenetic abnormalities have been described in patients with a diagnosis of for decades, clonal hematopoiesis (CH) has been described only recently. CH has been shown to correlate with inferior survival in MM due to increased risk of disease progression in patients who are treated with high-dose melphalan without lenalidomide maintenance. When involving specific high-risk genes, multiple genes, or when present at high variant allelic frequencies, CH could also potentially elevate the risk of secondary MDS and/or AML, cardiovascular events, and venous thromboembolic events. Despite growing knowledge about CH in patients with MM, many questions remain unanswered. Further studies are needed to better understand the prognostic and therapeutic significance of CH in MM and its precursor conditions, as well as the effect of specific treatments on long-term outcome.

Inpatient Management of Pulmonary Embolism: Clinical Characteristics and Mortality in a High-Volume Tertiary Care Center.

The optimal management strategy for submassive or intermediate risk pulmonary embolism (IRPE)—anticoagulation alone versus anticoagulation plus advanced therapies—remains in equipoise leading many institutions to create multidisciplinary PE response teams (PERTs) to guide therapy. Cause-specific mortality of IRPE has not been thoroughly examined, which is a meaningful outcome when examining the effect of specific interventions for PE. In this retrospective study, we reviewed all adult inpatient admissions between 8/1/2018 and 8/1/2019 with an encounter diagnosis of PE to study all cause and PE cause specific mortality as the primary outcomes and bleeding complications from therapies as a secondary outcome. There were 429 total inpatient admissions, of which 59.7% were IRPE. The IRPE 30-day all-cause mortality was 8.7% and PE cause-specific mortality was 0.79%. Treatment consisted of anticoagulation alone in 93.4% of cases. Advanced therapies—systemic thrombolysis, catheter directed thrombolysis, or mechanical thrombectomy, were performed in only six IRPE cases (2.3%). Decompensation of IRPE cases requiring higher level of care and/or rescue advanced therapy occurred in only five cases (2%). In-hospital major bleeding and clinically relevant non-major bleeding were more common in those receiving systemic thrombolysis (61.5%) compared to anticoagulation combined with other advanced therapies (11.7%). Despite the high overall acuity of PE cases at our institution, in-hospital all-cause mortality was low and cause-specific mortality for IRPE was rare. These data suggest the need to target other clinically meaningful outcomes when examining advanced therapies for IRPE.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11239-021-02619-9.

The Effect of Sanitizing Treatments on Respirator Filtration Performance.

The potential for alcoholic vapors emitted by common sanitizing treatments to deteriorate the (electrostatic) filtration performance of disposable respirator masks has been investigated. Reports in the literature and some standard test methods provide a confusing and ambiguous picture concerning the relevance of this effect. Four different types of exposure were investigated in this study to clarify the effect of alcoholic vapor emissions on respirator masks. These included exposure to saturated vapors, use of hand sanitizers, cleaning of table surfaces and sanitization of masks by spraying them with alcohol-containing solutions. Methods employed were designed to be as real-world oriented as possible while remaining reproducible. Filtration performance and deterioration effects on exposure to the different treatments were determined on three different types of certified commercial respirator masks—a P2 and two KN95 masks. This study provides substantial evidence that disposable respirator masks with an accepted performance rating are seriously compromised from an exposure to saturated alcoholic vapors, can tolerate a one-off spray treatment with an alcoholic solution and retain their attested protection under the influence of alcoholic vapors from the use of hand sanitizer or spray sanitizer. Considering the range of vastly different outcomes obtained from the four treatments investigated, it seems prudent to assess in each case the specific effects of alcoholic solution treatments and vapors on respirator masks before use.

Systematic Review and Meta-Analysis of Perioperative Administration of Acetazolamide for Management of Postoperative Pain after Laparoscopy.

Background and Objective:To perform a systematic review and meta-analysis to evaluate the efficacy of perioperative acetazolamide (ACTZ) administration with laparoscopy for reducing postoperative referred pain.Methods:The following databases were searched from inception to March 1, 2020: Cochrane, PubMed, PubMed Central, Ovid, and Embase. Electronic search used: Acetazolamide AND (laparoscopy OR laparoscopic OR Celioscopy OR Celioscopies OR Peritoneoscopy OR Peritoneoscopies). No limits or filters were used. We included only studies of patients who underwent abdominal laparoscopy (LSC), had a pain assessment at approximately 24 hours postoperatively, and included a treatment with ACTZ group and a no-treatment or minimal-treatment comparison group.Results:Five studies met inclusion criteria, with a combined total of 253 participants, 116 in the ACTZ group and 137 in the control group. A Bayesian hierarchical model was assumed for the study specific treatment effects. Posterior sampling was conducted via Markov Chain Monte Carlo methods, and posterior inference carried out on the hierarchical treatment effect. ACTZ significantly decreased average pain scores compared to control group by −0.726 points (95% confidence interval −1.175–0.264). The posterior probability that ACTZ decreases mean pain scores by ≥ 0.5 was 0.846.Conclusion:Current available evidence demonstrates that perioperative ACTZ may provide a modest improvement in postoperative referred pain following LSC.

Effect of Spontaneous and Water-Based Passivation on Components and Parameters of Ti6Al4V (ELI Grade) Surface Tension and Its Wettability by an Aqueous Solution of Sucrose Ester Surfactants

Solid wettability is especially important for biomaterials and implants in the context of microbial adhesion to their surfaces. This adhesion can be inhibited by changes in biomaterial surface roughness and/or its hydrophilic–hydrophobic balance. The surface hydrophilic–hydrophobic balance can be changed by the specifics of the surface treatment (proper conditions of surface preparation) or adsorption of different substances. From the practical point of view, in systems that include biomaterials and implants, the adsorption of compounds characterized by bacteriostatic or bactericidal properties is especially desirable. Substances that are able to change the surface properties of a given solid as a result of their adsorption and possess at least bacteriostatic properties include sucrose ester surfactants. Thus, in our studies the analysis of a specific surface treatment effect (proper passivation conditions) on a biomaterial alloy’s (Ti6Al4V ELI, Grade 23) properties was performed based on measurements of the contact angles of water, formamide and diiodomethane. In addition, the changes in the studied solid surface’s properties resulting from the sucrose monodecanoate (SMD) and sucrose monolaurate (SML) molecules’ adsorption at the solid–water interface were also analyzed. For the analysis, the values of the contact angles of aqueous solutions of SMD and SML were measured at 293 K, and the surface tensions of the aqueous solutions of studied surfactants measured earlier were tested. From the above-mentioned tests, it was found that water environment significantly influences the components and parameters of Ti6Al4V ELI’s surface tension. It also occurred that the addition of both SMD and SML to water (separately) caused a drop in the water contact angle on Ti6Al4V ELI’s surface. However, the sucrose monolaurate surfactant is characterized by a slightly better tendency towards adsorption at the solid–water interface in the studied system compared to sucrose monodecanoate. Additionally, based on the components and parameters of Ti6Al4V ELI’s surface tension calculated from the proper values of components and parameters of model liquids, it was possible to predict the wettability of Ti6Al4V ELI using the aqueous solutions of SMD and SML at various concentrations in the solution.

The Effectiveness of Direct Method and Counseling Method Blended Learning to Upgrade College Students' Speaking Skill/ لترقية مهارة الكلام لدي طلاب الجامعة Counseling Learning Method فعالية تمازج بين طريقة المباشرة وطريقة

This research is to determine the Implementation of a combination between the Direct Method and the Counseling Learning Method to improve speaking skills for students of Islamic University Sultan Syarif Kasim Riau and to determine the factors that influence this combination Method. This study is experimental research is about research method that is used to search for a specific treatment effect against the other in uncontrolled conditions. By using experimental design Pretest – Posttest None Control Group Design. The data collection method is (1) observation and (2) an oral test. The writer used Tests T Analyze to Analyze the data an oral test. The results of the analysis of the data obtained on the Application Direct Method and Counseling Learning Method in Learning Arabic to improve speaking skills for students of Islamic University Sultan Syarif Kasim Riau based on observations obtained 93.75 % means "Very Good" on the level of 80-100%. And based on the results of the oral test of the analysis of the data obtained, it can be concluded that the adoption of a combination between Direct Method and Counseling Learning Method in Learning Arabic to improve speaking skills for students of Islamic University Sultan Syarif Kasim Riau is effective.

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in Pediatric Anesthesia-Part 2: Anesthesia-related risk and treatment options.

Perioperative respiratory adverse events are the most common cause of critical events in children undergoing anesthesia and surgery. While many risk factors remain unmodifiable, there are numerous anesthetic management decisions which can impact the incidence and impact of these events, especially in at-risk children. Ongoing research continues to improve our understanding of both the influence of risk factors and the effect of specific interventions. This review discusses anesthesia risk factors and outlines strategies to reduce the rate and impact of perioperative respiratory adverse events with a chronologic based inquiry into anesthetic management decisions through the perioperative period from premedication to postoperative disposition.

Effect of regulatory interventions on agomelatine use in Spain: A multiple intervention time-series analysis in a nationwide electronic healthcare record database.

Liver injury is an important identified risk for agomelatine and several measures were put in place to prevent and minimize such risk. The study aims to assess the impact of four interventions on the incidence of agomelatine use, particularly among patients aged ≥75 in Spain between 2011 and 2018. Quasi-experimental interrupted time-series analysis to examine data from a nationwide electronic healthcare record database (BIFAP). Quarterly cumulative incidence of agomelatine use per 100 000 patients was calculated and the impact of four regulatory interventions was quantified. The incidence of agomelatine use decreased by 85% and 87% from first quarter 2011 to last quarter 2018 in patients below and above 75 years old, respectively. Regulatory actions taken were not associated with an immediate and significant falling level of use or slope. The incidence was less than expected 6months after the first and third intervention for patients below and above 75 years old, and more than expected after the second and fourth intervention for both populations, though these analyses were underpowered to observe significant results. The downward trend became less pronounced, reaching a residual level of use, which remained stable in the last segment of the study period. New users of agomelatine decreased throughout the study period, starting before interventions took place. The effect of specific interventions might be masked by the progressive decrease tendency, constant over the study period. The effects of external factors that might overlap, unintended consequences, and issues concerning statistical modeling in situations where rates are already falling, should be considered when interpreting the results.

Detrimental orofacial manifestations of dengue and dengue hemorrhagic fever clinical case series, review of the causes, complications, and vaccine strategies

It is estimated that there are about 10% of cases that involve oral mucosa in patients with dengue hemorrhagic fever (HF), and even less number of cases in dengue fever (DF) has been reported. This leads to a lack of future investigation. Aims and objectivesThis review intends to enhance the understanding of the epidemiology, clinical features involving the oral manifestations, and treatment of dengue disease. Design and Methods Several search engines, including PubMed, World Health Organization (WHO), and Pan American Health Organization (PAHO) websites were utilized for the literature search using the terms dengue and dengue shock syndrome.Results Dengue is a major arthropod-borne viral disease of humans. Its presentation is protean and varies from an undifferentiated viral syndrome to viral HF and severe shock. The early diagnosis of the oral manifestations, hemorrhagic, or mucocutaneous, may lead to timely clinical evaluation of the patient with signs and symptoms suggestive of dengue viral infection.Conclusion The specific therapy for dengue infections is still undiscovered. Proper care, including vector control and prevention of mosquito bites, may be beneficial. However, the role of dental professionals and general practitioners is important in identifying the oral manifestations of dengue viral infection and providing specific diagnosis and effective treatment to the patients.

Quo Vadis, COVID-19?

Quo Vadis, COVID-19?

Biological Bases of Empathy and Social Cognition in Patients with Attention-Deficit/Hyperactivity Disorder: A Focus on Treatment with Psychostimulants.

In recent years, there has been growing interest in investigating the effect of specific pharmacological treatments for ADHD not only on its core symptoms, but also on social skills in youths. This stands especially true for ADHD patients displaying impulsive aggressiveness and antisocial behaviors, being the comorbidity with Disruptive Behavior Disorders, one of the most frequently observed in clinical settings. This systematic review aimed to synthesize research findings on this topic following PRISMA guidelines and to identify gaps in current knowledge, future directions, and treatment implications. Search strategies included the following terms: ADHD; methylphenidate and other ADHD drugs; empathy, theory of mind and emotion recognition. Full-text articles were retrieved and data from individual studies were collected. Thirteen studies were finally included in our systematic review. Ten studies assessing changes in empathy and/or theory of mind in patients with ADHD treated after pharmacological interventions were identified. Similarly, seven partially overlapping studies assessing changes in emotion recognition were retrieved. Despite a great heterogeneity in the methodological characteristics of the included studies, most of them reported an improvement in emphatic and theory of mind abilities in youths with ADHD treated with psychostimulants and nonstimulant drugs, as well as positive but less consistent results about emotion recognition performances.

A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders

This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear. Protocol registry: Registered at Prospero on November 3rd, 2017 (CRD42017076810).

Meta-Analysis of COVID-19 treatments on patients with a previous diagnosis of cardiovascular disease

BackgroundThe COVID-19 pandemic has spread globally, infecting and killing millions. Those subjects with cardiovascular disease (CVD) are at higher risk of severe COVID-19 morbidity and mortality following SARS-CoV-2 infection.PurposeTo investigate the response to different treatments against COVID-19 in patients with a pre-existing CVD.MethodsWe conducted a systematic review and meta-analysis following Cochrane, PRISMA and MOOSE guidelines (PROSPERO ref:CRD42020183057). Eligible articles reported in-hospital mortality rate in COVID-19 patients with CVD after testing specific treatments. Statistical concordance was performed by Cohen's kappa coefficient. The primary outcome was in-hospital mortality rate, secondary outcome was the length of hospital stay (LOS). The analysis utilised a random-effects model. Categorical variables were expressed as risk ratio (RR) and continuous variable with weighted mean difference (WMD) and standard deviation with 95% confidence interval (CI). I2 and Chi-tests were used to assess studies' heterogeneity. Publication bias was visualised by L'Abbe' plot and funnel plot with Egger's test. Subgroup analysis (pooling analysis) was also performed to compare the three groups' mortality differences: 'CVD treated' vs.'CVD untreated' vs.'no-CVD (treated and untreated)'. Meta-regression models were used to determine the effects of specific treatments and risk factors on the primary outcomes. R-studio used for analysis.ResultsOf 1,673 articles retrieved, 46 studies included CVD patients from which 11 included control group, finally five were comparative studies and were included in the quantitative analysis. From those studies, the sample size was 130 (mean age 63.9±2.7 years; 55.3% male). There was 100% concordance between reviewers equating to a Cohen's kappa coefficient of κ=1. The most frequent CV risk factor (CVRF) was hypertension (60%) followed by diabetes (28.5%). The most frequent CVD seen in patients was coronary artery disease at 9.09% and peripheral arterial disease at 5.4%. Mortality rate was significant higher in the CVD treated group (RR:1.52; 95% CI [1.05,2.21], CVD treated vs overall population p=0.03). Meta-regression showed that no treatment was significant associated to mortality and systemic hypertension, but an independent risk factor for mortality. Pooled single analysis showed no difference between treated vs untreated CVD patients. There was certain degree of heterogeneity (I2 50%) across the studies. L'Abbe and funnel plot visualized not significant dispersion (Egger test, p=0.71). There was no difference in terms of LOS [0,79, 95% CI (−0.48, 2,05); p-value 0.22].ConclusionsThis quantitative analysis showed that CVD patients despite specific treatments were exposed to significant higher mortality when compared to the overall population. These results remark the clinical relevance to reduce CVD risk factors and ameliorate specific COVID-19 treatments to lower the risk of mortality in this groupFunding AcknowledgementType of funding sources: None.

Cutoff criteria for the placebo response: a cluster and machine learning analysis of placebo analgesia

Computations of placebo effects are essential in randomized controlled trials (RCTs) for separating the specific effects of treatments from unspecific effects associated with the therapeutic intervention. Thus, the identification of placebo responders is important for testing the efficacy of treatments and drugs. The present study uses data from an experimental study on placebo analgesia to suggest a statistical procedure to separate placebo responders from nonresponders and suggests cutoff values for when responses to placebo treatment are large enough to be separated from reported symptom changes in a no-treatment condition. Unsupervised cluster analysis was used to classify responders and nonresponders, and logistic regression implemented in machine learning was used to obtain cutoff values for placebo analgesic responses. The results showed that placebo responders can be statistically separated from nonresponders by cluster analysis and machine learning classification, and this procedure is potentially useful in other fields for the identification of responders to a treatment.

Empty nose syndrome pathogenesis and cell-based biotechnology products as a new option for treatment.

Empty nose syndrome (ENS) is a rare complication that develops after partial or complete turbinectomy. The main feature of ENS is paradoxical nasal obstruction feeling despite objectively wide nasal airway. ENS pathogenesis is multifactorial and includes changes in laminar physiological airflow, disruption of mucosa functions and deficient neural sensation. This leads to the development of ENS symptomatology such as dyspnea, nasal dryness, nasal burning, nasal obstruction, feeling of suffocation and even comorbid psychiatric disorders that significantly impairs life quality. Specific effective treatment of ENS does not exist up to date. In this review we outline existing biomaterial for surgical reconstitution of nasal anatomy and discuss the perspective of stem cell-based technologies in ENS management. The main focus is directed to justification of rationality application of adult mesenchymal stem cells (MSCs) from different tissues origin and neural crest-derived stem cells (NCSCs) based on their intrinsic biological properties. MSCs transplantation may stimulate mucosa tissue regeneration via trophic factors secretion, direct transdifferentiation into epithelial cells and pronounced immunosuppressive effect. From the other hand, NCSCs based on their high neuroprotective properties may reconstitute nerve structure and functioning leading to normal sensation in ENS patients. We postulate that application of cell-based and tissue-engineered products can help to significantly improve ENS symptomatology only as complex approach aimed at reconstitution of nasal anatomy, recovery the nasal mucosa functionality and neural tissue sensation.