Efficacy Of Different Methods Research Articles

Evaluation of methods used to improve grasslands as ring‐necked pheasant brood habitat

AbstractRing‐necked pheasant (Phasianus colchicus) demographic response is sensitive to chick survival and nest success. The establishment and management of grasslands within agricultural landscapes, often through cropland conversion programs (e.g., Conservation Reserve Program [CRP]), have positive impacts on survival and nest success. Newly established CRP and early successional habitat can provide vegetative structure selected by pheasant chicks. Ideal brood habitat provides an abundance of arthropods, an open understory promoting efficient chick movement, and a protective canopy cover. However, the natural succession of grasslands changes desired vegetative structure and challenges managers with providing adequate habitat for pheasant chicks. We investigated the efficacy of different methods of CRP management, including haying, burning, herbicide application, interseeding, and grazing, to provide adequate brood rearing habitat in cool‐ and warm‐season grasslands. We assessed chick body mass change using human‐imprinted ring‐necked pheasant chicks and investigated changes in vegetation composition and structure in relation to various habitat treatments in north‐central and north‐eastern South Dakota during mid‐June and mid‐July of 2013, 2014, and 2015. Generally, treatments that incorporated interseeding, herbicide application, or their combination had the greatest chick mass gain, reduced litter cover and depth, and increased bare ground and forb cover. Effective management for brood habitat may require more aggressive techniques than simple haying or prescribed fire techniques.

Tympanostomy Tube Insertion Versus Myringotomy or Observation in Managing Otitis Media With Effusion Following Radiotherapy for Nasopharyngeal Carcinoma: An Updated Review.

Head and neck cancers, including nasopharyngeal carcinoma (NPC), are relatively common in Saudi Arabia. Radiotherapy is a standard treatment for NPC, but it can lead to side effects, including post-radiation otitis media with effusion (OME). Managing post-radiotherapy OME remains a topic of debate, with various interventions proposed. This study aims to review the efficacy of different methods to manage post-radiotherapy OME in NPC. This includes tympanostomy tube insertion, frequent myringotomies, and observation. A systematic review was carried out for articles published between 1975 and 2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Excluded from the analysis were articles that involved patients undergoing surgical treatment for nasopharyngeal cancer, studies that focused on patients with other head and neck cancers who developed OME after radiotherapy, research investigating the effectiveness of surgical procedures unrelated to tympanostomy tube insertion, studies written in non-English language, and case reports, reviews, or conference letters. A total of 450 studies were screened, of which six studies were included in the review, yielding 328 patients. The mean age ranged between 46 and 52 years. Follow-up varied from six months to 11 years. The intervention in all studies was tympanostomy tube insertion, and the controls were myringotomy, observation, or tympanic membrane fenestration with cauterization. The use of recurrent myringotomies for the treatment of OME in patients with NP post-radiotherapy is associated with improved chances for the resolution of effusion and decreased risk of complications when compared to tympanostomy tube insertion. Hence, we recommend following a step-wise approach when dealing with this group of patients, offering grommets for patients with persistent effusion or those who cannot tolerate frequent procedures.

A Comparative Study of the Diagnostic Value of Once and Twice Nasopharyngeal, Oropharyngeal, and Anal Swabs, and Saliva Specimens in COVID-19 Infection

Background: Since the emergence of COVID-19 and the pandemic declaration, this disease has become the top priority for global healthcare systems. The standard diagnostic tool for COVID-19 involves conducting imaging studies alongside real-time polymerase chain reaction (RT-PCR) tests on nasopharyngeal or oropharyngeal samples. Objectives: Given the potential extrapulmonary involvement of COVID-19, our objective was to evaluate the diagnostic effectiveness of double pharyngeal sampling, as well as the use of saliva and anal swabs. Methods: This cross-sectional study involved 102 pediatric patients suspected of having COVID-19. After the routine nasopharyngeal sampling, additional samples were collected from the nasopharynx, saliva, and anal canal. These samples were subjected to RT-PCR testing using Taq Man's probe-based technology. The statistical analysis included sensitivity, specificity, positive and negative predictive values, and Kappa agreement measurement. Results: In this study, with a COVID-19 prevalence of 92.2%, we compared the diagnostic efficacy of different methods. When having at least one positive sample was considered the gold standard, double nasopharyngeal sampling exhibited the highest sensitivity, followed by RT-PCR of saliva and anal swabs (94.9%, 92.9%, and 91.9%, respectively). When double sampling was considered the gold standard for diagnosis, saliva RT-PCR showed the highest sensitivity and negative predictive value (93.6% and 40.0%, respectively). However, there was no significant difference in the specificity and positive predictive value between anal swabs and saliva RT-PCR. However, when anal swabs and saliva were compared with only one nasopharyngeal sample, anal swabs performed slightly better than saliva. Conclusions: While the combination of double sampling from the nasopharynx and oropharynx, along with anal swabs and saliva, proved effective for diagnosing COVID-19, routine use of these methods may not be cost-effective. However, during periods of epidemic control, when comprehensive case identification is crucial, these methods may warrant consideration for more extensive investigations.

Diverse Methods for Diverse Systems: A Large-Scale Comparison of Reptile Sampling Methods

Abstract Reptiles play a crucial role in maintaining biodiversity and ecosystem health, yet many species face increasing threats due to various anthropogenic factors. Enhancing our understanding of reptile diversity and habitat use worldwide necessitates evaluating the effectiveness of diverse survey techniques. The relative efficacy of different methods may vary significantly across regions or communities, highlighting the need for a comprehensive approach using multiple survey methods over extensive spatial and temporal scales. In this study, we compared the effectiveness of seven survey methods – pitfall traps, funnel traps, spotlighting, arboreal cover boards, incidental encounters, camera traps, and passive acoustic monitoring (PAM) – for assessing reptile biodiversity over several years across an extensive spatial range in open eucalypt woodlands throughout eastern Australia. Pitfall and funnel traps were the most effective methods for detecting reptiles across all sites and latitudes. A combination of pitfall and funnel traps accumulated species the quickest, had high detection probabilities, and accounted for nearly 90% of all different reptile species detected in this study. However, with a decrease in latitude reptile diversity increased and other survey methods became necessary to document the full extent of the reptile communities. Reptile assemblages captured by different survey methods varied significantly, except for the communities captured by pitfall and funnel traps. No single method captured all species, and no species was detected by every method. Passive acoustic monitoring failed to detect any reptiles and may not be viable for assessing reptile biodiversity in Australia. Pitfall and funnel traps proved highly effective for detecting terrestrial reptiles within open eucalypt woodlands in Australia, however, the selection of methods for evaluating reptile biodiversity depends on the objectives and target fauna, and when possible, to maximize species richness, survey designs should incorporate an array of concurrently deployed methods, particularly in regions with higher overall species richness. Nevertheless, if resources and time are limited, pitfall and funnel traps, combined with incidental encounters, should capture the majority of species.

Comparative Analysis of Various Materials Used for Mastoid Cavity Obliteration in Canal Wall Down Mastoid Surgery.

To study the surgical result and efficacy of different methods of mastoid obliteration with cavity care. This prospective study included 60 patients who had cholesteatoma, conducted in the Department of Ear Nose and Throat (ENT), Institute of Medical Sciences, Banaras Hindu University, Varanasi from July 2015 to July 2017. The mastoid cavity was obliterated with either muscle flap/bone dust/hydroxyapatite. detailed history otoscopic examination was done pre-operatively and follow up were recorded at 1month and 3months in postoperative period. 60 patients were included, who underwent canal wall down mastoid surgery. each group muscle flap (group 1), bone dust (group 2) and hydroxyapatite (group 3) included 20 patients, age group 31-40year with its maximum incidence of 43.3%, Preop PTA value were almost equal in all group but on comparison at 1month in postoperative period significant improvement was present in group 1 versus 2(0.021) and group 2 versus 3(0.003) but not in group 1 versus 3. Although at 3month there were significant improvement was present in all groups. The incidence of pain, discharge, giddiness and wax formation were markedly reduced and healing of cavities was early and better in obliterated cavities done by muscle flap and bone dust material as compared to hydroxyapatite cavities, at the end of 3months. outcome and quality of life was better and almost equal in muscle flap and bone dust material group as compared to hydroxyapatite group.

Meta-analysis of 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT, and 68Ga-PSMA PET/CT in diagnostic efficacy of prostate Cancer

ObjectiveTo compare 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT and 68Ga-PSMA PET/CT in the diagnostic value of prostate cancer.MethodThe Chinese and foreign databases, such as Pubmed, Cochrane Library, Embase, CNKI, VIP, Wanfang, etc., were systematically searched within the period from the establishment of the database to June 1, 2022. Clinical studies related to the diagnosis of prostate cancer by methods such as 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CTCT, 68Ga-PSMA PET/CT, were researched. Two (2) investigators independently screened literatures, extracted data, and assessed the risk of bias when these data were included in the studies with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Review Manager5.4, Stata 14.0, and Meta-disc 1.4 software were used for meta-analysis to compare the efficacy of different methods in the diagnose of prostate cancer. ResultsTwenty-seven (27) studies, including 2891 subjects were included in our study. Meta-analysis results showed that the pooled sensitivities of 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT, and 68Ga-PSMA PET/CT were 0.912 (95%CI: 0.883–0.936), 0.748 (95%CI: 0.698–0.795), and 0.916 (95%CI: 0.896–0.934), respectively; the pooled specification were 0.878 (0.844–0.907), 0.639 (95%CI: 0.589–0.687), and 0.734 (95%CI: 0.685–0.779), respectively; the positive likelihood ratios were 6.335 (95%CI: 4.288–9.357), 2.282 (95%CI: 1.497–3.477), and 3.593 (95%CI: 2.986–4.323), respectively; the negative likelihood ratios were 0.878 (95%CI: 0.844–0.907), 0.374 (95%CI: 0.280–0.499), and 0.110 (95%CI: 0.083–0.144), respectively; the diagnostic odds ratios were 65.125 (95%CI: 34.059–124.53), 7.094 (95%CI: 4.091–12.301), and 29.722 (95%CI: 20.141–43.863), respectively; the positive posterior probability was 64%, 38%, and 62%, respectively; the area under the SPOC curve was 0.95 (95%CI: 0.93–0.97), 0.81 (95%CI: 0.78–0.84), and 0.96 (95%CI: 0.92–0.98), respectively. The funnel plots indicated that there was no significant publication bias in the included literatures. ConclusionThe current evidences showed that 18 F-PSMA-1007 PET/CT and 68Ga-PSMA PET/CT had higher diagnostic efficacy of prostate cancer compared with 18 F-FDG PET/CT, among which 68Ga-PSMA PET/CT was slightly higher in the sensitivity of the diagnosis of prostate cancer, while 18 F-PSMA-1007 PET/CT may have higher efficacy in specificity and confirmed positive rate. Due to the limitations of the quality of the included samples and literatures, the above conclusions should be further validated by expanding the sample size and improving the quality.

Comparative assessment of clinical efficacy of different methods of medical rehabilitation in patients with rhinosinusitis polyposa

The article presents the results of a comparative assessment of the effectiveness of the course application of therapeutic physical factors (alternating magnetic field and low-intensity laser radiation) in complex medical rehabilitation of patients with moderate and severe rhinosinusitis polyposa with uncontrolled course. It was shown that the use of genetically engineered biological therapy (GEBT) with dupilumab contributed to the positive dynamics of the clinical parameters of sinonasal polyposis. Complementing GEBT with the course application of an alternating magnetic field was accompanied by an increase in the regression of the main clinical manifestations of rhinosinusitis polyposa. The maximum corrective activity was noted in the group with the complex use of therapeutic physical factors — an alternating magnetic field and low-intensity laser radiation against the background of GEBT. The growth is based on the ability of the complex use of physiotherapeutic factors to cause the development of synergistic phenomena through the use of corrective effects of different modality, having different mechanisms of action. The physical factors under consideration are able to improve hemo- and microcirculation in the area of chronic inflammation, exhibit anti-inflammatory, analgesic, and trophic-stimulating effects, which, together with the inactivation of the main pro-inflammatory interleukins of type 2 inflammation, enhances the sanogenetic potential that determines the duration of remission. Taking into account the chronic relapsing nature of the rhinosinusitis polyposa course, it is planned to conduct prolonged studies covering a follow-up period of 1.5–2 years.

Comparison of the efficacy of different methods to apply acaricides for control of Rhipicephalus (Boophilus) microplus

The present study compared the efficacy of different methods to apply an acaricide formulation to control Rhipicephalus (Boophilus) microplus. To compare the methods, an acaricide blend containing three active ingredients (a pyrethroid and two organophosphates) was used. In experiment 1 (farm 1: Goiânia, GO, Brazil), three methods were tested: a backpack sprayer (BS), power sprayer (PS) and spray race (SR). In experiment 2 (farm 2: São José do Rio Pardo, SP, Brazil), two methods were tested: BS and PS. In both experiments, 10 cattle with similar tick burdens were used. On day 0 in both experiments, the animals were treated with the acaricide. On day +1 (only in experiment 1), +3, +7, +14, +21, +28 and +35 (only in experiment 2), tick counts were performed to determine the control efficacy. The time application, pressure (KPa), volume applied (L) and ergonomic aspects of each spraying system were also evaluated. The adult immersion test (AIT) using three different acaricide blends (combinations of pyrethroid + organophosphate) was performed to compare the susceptibility of strains of each farm. In experiment 1, all treatments significantly reduced (p < 0.05) the number of ticks on the animals, and PS resulted in the greatest acaricide efficacy since day +1. In experiment 2, both treatments (PS and BS) reduced (p < 0.05) the tick burden, and as observed in experiment 1, PS resulted in the best reduction. The application times were 4.5, 150 and 330 s, while pressures were 306.8, 4,826.3 and 220.6 KPa for SR, PS and BS, respectively. In the AIT, the efficacy values were between 99.8 and 100% for the tick strain form farm 1 (Goiânia), while for tick strain from farm 2 (São José do Rio Pardo), the efficacy was between 67.2 and 80.9%. We conclude that the sprayer methods chosen influences the efficacy of the acaricide. All sprayer methods were efficient for acaricide application; the best efficacy was obtained using the PS, while the SR resulted in good efficacy and lower application time. The strain from farm 2 was less susceptible to all acaricides tested.

Induction of Labor in Twins—Double Trouble?

To determine and compare the safety and efficacy of different methods of induction of labor in twin gestations and their effect on maternal and neonatal outcomes. A retrospective observational cohort study was conducted at a single university-affiliated medical center. Patients with a twin gestation undergoing induction of labor at >32 + 0 weeks comprised the study group. Outcomes were compared to patients with a twin gestation at >32 + 0 weeks who went into labor spontaneously. The primary outcome was cesarean delivery. Secondary outcomes included operative vaginal delivery, postpartum hemorrhage, uterine rupture, 5 min APGAR < 7, and umbilical artery pH < 7.1. A subgroup analysis comparing outcomes for the induction of labor with oral prostaglandin E1 (PGE1), IV Oxytocin ± artificial rupture of membranes (AROM), and extra-amniotic balloon (EAB)+ IV Oxytocin was performed. Data were analyzed using Fisher's exact test, ANOVA, and chi-square tests. 268 patients who underwent induction of labor with a twin gestation comprised the study group. 450 patients with a twin gestation who went into labor spontaneously comprised the control group. There were no clinically significant differences between the groups for maternal age, gestational age, neonatal birthweight, birthweight discordancy, and non-vertex second twin. There were significantly more nulliparas in the study group compared to the control group (23.9% vs. 13.8% p < 0.001). The study group was significantly more likely to undergo a cesarean delivery of at least one twin (12.3% vs. 7.5% OR, 1.7 95% CI 1.04-2.85 p = 0.03). However, there was no significant difference in the rate of operative vaginal delivery (15.3% vs. 19.6% OR, 0.74, 95% CI 0.5-1.1 p = 0.16), PPH (5.2% vs. 6.9% OR, 0.75 95% CI 0.39-1.42 p = 0.37), 5-min APGAR scores < 7 (0% vs. 0.2% OR, 0.99 95%CI 0.99-1.00 p = 0.27), umbilical artery pH < 7.1 (1.5% vs. 1.3% OR, 1.12 95% CI 0.3-4.0), or combined adverse outcome (7.8% vs. 8.7% OR, 0.93 95% CI 0.6-1.4 p = 0.85). Furthermore, there were no significant differences in the rates of cesarean delivery or combined adverse outcomes in patients undergoing induction with oral PGE1 compared to IV Oxytocin ± AROM (13.3% vs. 12.5% OR, 1.1 95% CI 0.4-2.0 p = 1.0) (7% vs. 9.3% OR, 0.77 95% CI 0.5-3.5 p = 0.63 ) or EAB+ IV Oxytocin (13.3% vs. 6.9% OR, 2.1 95% CI 0.1-2.1 p = 0.53) (7% vs. 6.9% OR, 1.4 95% CI 0.15-3.5 p = 0.5) or between patients undergoing induction of labor with IV Oxytocin ± AROM and EAB+ IV Oxytocin (12.5% vs. 6.9% OR, 2.1 95% CI 0.1-2.4 p = 0.52) (9.3% vs. 6.9% OR, 0.98 95% CI 0.2-4.7 p = 0.54). There were no cases of uterine rupture in our study. Induction of labor in twin gestations is associated with a two-fold increased risk of cesarean delivery, although this is not associated with adverse maternal or neonatal outcomes. Furthermore, the method of induction of labor used does not affect the chances of success nor the rate of adverse maternal or neonatal outcomes.

Efficacy of Different Methods of General Anaesthesia in Pigs and their Influence on Haematological Parameters

Abstract This study focused on how haematology parameters differ with different types of anaesthesia that is given to piglets. In this study 18 piglets were used divided into three groups. In each of these experimental groups a different combination of anaesthetics was used. The first group received the combination of azaperone, diazepam, and ketamine. In the second group, we used the combination of azaperone, xylazine, and ketamine. In the third group, the anaesthesia was induced by azaperone, diazepam, butorphanol and ketamine. Blood samples were taken from the piglets three times throughout the procedure and the relevant haematological parameters were determined. With respect to haematological values, the combination used in group 1 appeared as the best for the anaesthesia of pig-lets. The haematological values, such as MCV (mean corpuscular volume), were similar in all groups with the exception of the third group where the MCV and the MCH (mean corpuscular haemoglobin) were significantly lower 24-hour post anaesthesia compared to the other two groups. Lymphocytes in the first two groups showed a steady decrease, while in the third group their levels increased. The opposite trend was observed for the segmented neutrophils that showed a steady increase over the 24-hour period in the 1st and 2nd group while in group 3 their levels decreased. Abolishment of pedal and nasal reflexes to external stimuli applied every 15 min post ketamine administration was observed. The piglets in the 1st group showed no reflexes to external stimuli, while the worst responses were observed in the 2nd group where many of the piglets started to show reflexes very early within the experimental time.

Flexural Strengthening of Large-Scale RC Beams with Nonprestressed and Prestressed CFRP Using Different Anchorages.

Externally bonded carbon-fiber-reinforced polymer (CFRP) technology can be used by different methods based on the anchorage device, CFRP type, and prestressing/nonprestressing. However, a direct comparison between the strengthening efficacies of different methods is still lacking. Seven large-scale RC beams were tested in this study to investigate the influences of the anchorage method, CFRP type, prestress, and prestressing system on the flexural strengthening efficacy of RC beams. The test results showed that the ultimate load increased by 38.3%, whereas the cracking and yielding loads were slightly affected when the anchorage method was enhanced from CFRP U-wraps to wedge-clamp anchors. The CFRP plate and CFRP sheet could provide a rather close flexural strengthening efficacy under the same CFRP strengthening amount. Compared to the nonprestressed CFRP plate, the prestressed CFRP plate was highly superior in improving the flexural behavior of RC beams. The cracking, yielding, and ultimate loads of the prestressed CFRP-strengthened specimens were 57.1%, 22.9%, and 5.9%, respectively, higher than those of the nonprestressed CFRP-strengthened specimen with an effective anchorage. The two types of prestressing systems based on the adhesive-friction anchor and wedge-clamp anchor were proven to be effective for flexural strengthening of RC beams with prestressed CFRP plates, and they could provide almost the same strengthening effect.

Efficacy of Different Methods of Bone-Anchored Maxillary Protraction in Cleft Lip and Palate Children: A Systematic Review and Meta-Analysis.

Bone-anchored maxillary protraction (BAMP) is an effective option for adolescent cleft patients with maxillary hypoplasia. Hence, this study was conducted to access the effectiveness of the many techniques of BAMP in cleft lip and palate patients. Data was compiled through a global search of random and nonrandom studies that investigated the efficacy of various techniques of BAMP in cleft lip and palate patients. The searches were conducted in ISI Web of Science, EMBASE, Scopus, Medline, and Cochrane Central Register of Controlled Trials from the beginning until October 12, 2021. The pertinent data of the comprised studies were extracted using predetermined extraction forms. Meta-analysis results were obtained by using inverse-variance to calculate the pooled results of the outcome measures. Five studies were submitted for meta-analysis. The BAMP therapeutic methods investigated in the studies were facemask attached to miniplates (FM-MP) and class III elastics attached to maxillary and mandibular miniplates (C3-IE: class III intermaxillary elastic). The mean differences of A-VRP, A-N Prep., ANB, wits, overjet, and SNA landmarks indicated posttreatment was encouraging, showing maxillary protrusion, and correction of class III malocclusion. SNB landmark showed no statistically significant alterations posttreatment. Subgroup analysis of the C3-IE and FM-MP subgroups indicated that the changes in ANB, SNA, and overjet parameters in the FM-MP subgroup were more pronounced than in the C3-IE subgroup. No statistically significant differences were found when the results of these 2-treatment method were compared, except for in the overjet subgroup. After undergoing BAMP treatment, the maxilla showed a more horizontal growth, but no changes in the vertical dimension were observed and the mandible did not rotate clockwise. In addition, using facemask-miniplates was more effective in increasing overjet compared with using class III elastics with bone anchors. In conclusion, BAMP treatment is a suitable alternative for adolescents with cleft lip and palate malformation.

Comparing Efficacy of Different Methods for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty: Several Issues Need Special Attention.

Comparing Efficacy of Different Methods for Postoperative Analgesia in Patients Undergoing Total Knee Arthroplasty: Several Issues Need Special Attention.

Efficacy of different methods for preventing gastroesophageal bleeding in patients with liver cirrhosis: comparative analysis

Aim. To assess the clinical efficacy of preventing gastroesophageal bleeding in patients with liver cirrhosis.Materials and methods. From 2008 to 2019, the surgical treatment of 710 patients with cirrhosis was considered. The long-term results of preventing gastroesophageal variceal rebleeding were studied in three groups of patients: portosystemic shunt placement (367 patients), total esophagogastric disconnection (62 patients), and endoscopic procedures (281 patients). Observation periods varied from 1 to 115 months.Results. The lowest rebleeding rate of 15.5% was observed following shunt placement (χ2 = 9.728; df = 2; р = 0.008), while the highest rate of 40.9% was observed following endoscopic treatment. By the 5th year of follow-up, only 37.5% of patients showed no signs of bleeding following endoscopic procedures. The percentage of patients who did not experience true gastroesophageal variceal rebleeding amounted to 44%, 76%, and 85% following shunt placement, total esophagogastric disconnection, and endoscopic procedures, respectively (p &lt; 0.05).Conclusion. Irrespective of the selected procedure, all patients with cirrhosis suffer from portal rebleeding in the longterm period. However, the lowest rebleeding rate is observed following portosystemic shunt placement.

Altered cancer care delivery during COVID-19: Evaluating the impact of virtual clinics and treatment changes on oncology patient outcomes, quality of life, and satisfaction.

e18618 Background: The coronavirus disease (COVID-19) pandemic has created unprecedented strain on healthcare systems across the world. COVID-19 has thought to have significant impacts on the oncology patient population and has affected their care. Additional research is needed to ascertain the impact of the COVID-19 pandemic at the patient level. We sought to evaluate whether the delivery of cancer care, quality of life (QoL) and treatment outcomes of oncology patients at Mount Sinai Hospital (MSH), Toronto, Canada was impacted by the COVID-19 pandemic. Methods: A 3-part longitudinal questionnaire study including 138 oncology patients receiving active treatment or in active follow-up at MSH was conducted between June 15, 2020 and August 25, 2021. The questionnaire consisted of the EORTC QLQ-C30 (European Organisation for Research and Treatment of Cancer QoL Questionnaire Version 3) and satisfaction with virtual healthcare questionnaire. The questionnaire was completed at baseline (Jun 15-Sep 8, 2020), 1 month follow-up (Jul 15-Oct 8, 2020), and 12 months follow-up (Aug 4-Aug 25, 2021). Repeated measures analysis of variance tests were performed to evaluate EORTC QLQ-C30 subscale score changes and satisfaction with virtual care question scores over time. Results: Overall, the mean EORTC QLQ-C30 QoL scores were seen to improve in oncology patients from 65.1 (SD±22.3) at baseline to 69.1 (SD±16.9) at 12 months follow-up (p = 0.2). Within the EORTC QLQ-C30 functional scales, mean role functioning and mean social functioning scores were observed to increase over 12 months of follow-up, 66.4 to 79.2 (p &lt; 0.05) and 67.7 to 76.4 (p = 0.17), respectively. Little change was observed within other EORTC QLQ-C30 functional scales and individual symptom scales during follow-up. Over 12 months of follow-up, mean agreement (0 = strongly disagree to 6 = strongly agree) to the questionnaire statement regarding avoiding going to the hospital during COVID-19 pandemic had declined, from 4.6 (SD±2.0) at baseline to 3.9 (SD±2.2) at 12 months follow-up (p = 0.09). Although not significant, virtual care satisfaction generally decreased over the follow-up time period. 97% of 48 patients who completed the survey at 12 months of follow-up reported feeling more safe coming into the hospital when considering the current increased vaccination rates in Ontario. Conclusions: As the COVID-19 pandemic has evolved, there has been increased knowledge of disease transmission, along with the introduction of health care measures such as vaccination and treatment. During this time, cancer outpatients at MSH became more comfortable as demonstrated by improvements in both QoL and virtual care scores. Prospective studies should still be considered to assess the efficacy of different methods of improving oncology patient care and QoL during the COVID-19 pandemic.

Indexing Left Atrial Volumes: Alternative Indexing Methods Better Predict Outcomes in Overweight and Obese Populations

BackgroundLeft atrial volume (LAV) is often adjusted for body surface area (BSA). In overweight individuals this may result in underestimation of left atrial (LA) dilation. The authors investigated whether alternative indexing techniques better predict mortality and cardiovascular (CV) events. ObjectivesThe purpose of this study was to evaluate the efficacy of different methods of indexing LAV in predicting mortality and CV events across a range of body sizes. MethodsLAV was adjusted for BSA, idealized BSA (iBSA), height, and height-squared (H2) in patients aged over 50 years who underwent outpatient echocardiography and longitudinal follow-up at our institution. LA dilation was categorized using published criteria. Mortality and CV events were assessed via medical records. ResultsLAVs were calculated in 17,454 individuals. In this study, 71.2% were overweight or obese. Indexing using iBSA, height, and H2 resulted in reclassification of LA size in up to 28.4% (P < 0.001) compared with indexing using BSA. In severely obese individuals (body mass index [BMI] ≥40 kg/m2), LA dilation indexed for BSA no longer predicted mortality (P = 0.70). Other indexing methods remained predictive of mortality. Height, H2, and iBSA all had greater performance, compared with BSA, for prediction of mortality and CV events in all overweight patients with H2 showing the best overall performance (P < 0.001). Net reclassification index for mortality was significant for all alternative indexing techniques (P < 0.001) and patients whose LA was reclassified from normal to dilated had increased risk of mortality (P < 0.001) and CV events (P < 0.001) across all BMI categories. ConclusionsLA dilation based on standard indexing using BSA is nondiscriminatory for prediction of mortality in the severely obese. Indexing using height, H2, or iBSA to diagnose LA dilation better predicts mortality in this population and has better overall predictive performance across all overweight and obese populations. Using BSA indexing may lead to underappreciation of LA dilation and underestimation of patients at increased risk.

A pandemic-enabled comparison of discovery platforms demonstrates a nai\u0308ve antibody library can match the best immune-sourced antibodies

As a result of the SARS-CoV-2 pandemic numerous scientific groups have generated antibodies against a single target: the CoV-2 spike antigen. This has provided an unprecedented opportunity to compare the efficacy of different methods and the specificities and qualities of the antibodies generated by those methods. Generally, the most potent neutralizing antibodies have been generated from convalescent patients and immunized animals, with non-immune phage libraries usually yielding significantly less potent antibodies. Here, we show that it is possible to generate ultra-potent (IC50 < 2 ng/ml) human neutralizing antibodies directly from a unique semisynthetic naïve antibody library format with affinities, developability properties and neutralization activities comparable to the best from hyperimmune sources. This demonstrates that appropriately designed and constructed naïve antibody libraries can effectively compete with immunization to directly provide therapeutic antibodies against a viral pathogen, without the need for immune sources or downstream optimization.

The Efficacy of Selected Sodium Hypochlorite Heating Methods for Increasing and Maintaining Its Intracanal Temperature—An Ex Vivo Study

Background: Enhancement of the temperature of sodium hypochlorite (NaOCl) solution would increase its cleaning potential and decontamination of the root canal system. Therefore, the aim of the present in vitro investigation was to compare the efficacy of different methods of NaOCl heating by evaluating the temperature profiles developed at different levels of the root canal system. Methods: Five thermocouples were applied at different levels of the root canal system of extracted human premolars. NaOCl solution was heated according to two methods: extraoral heating (50 °C, 60 °C, and 70 °C) using a magnetic hotplate heater and intracanal heating by F-06, XF-30/04, and ML-12 pluggers at 100 °C, 150 °C, and 180 °C. Results: The extraoral heating method was ineffective to produce a significant temperature increase at the root apex. Comparable results were obtained using the intracanal heating method through the ML-12 plugger that showed slightly better results only when set at 180 °C. On the other hand, negligible differences were observed in terms of temperature maintenance at several levels of the root between the F-06 and XF-30/04 pluggers, even though the time intervals were higher in case of XF-30/04. Conclusions: The intracanal heating method provided a better temperature persistence in the middle third of the root canal system. Conversely, extraoral heating was ineffective to produce a significant temperature increase at the apex of the root. Comparable results were obtained even using the ML-12 plugger.

Uncomplicated type A intramural hematoma with extension to the descending thoracic aorta is best treated by thoracic endovascular aneurysm repair in most patients.

Uncomplicated type A intramural hematoma with extension to the descending thoracic aorta is best treated by thoracic endovascular aneurysm repair in most patients.

The assessment of prophylactic and therapeutic methods for nail infections in patients with diabetes.

Diabetes mellitus is a metabolic disease widespread around the world. It may lead to organ dysfunction, immunodeficiency, vascular complications, and peripheral neuropathy. These factors contribute to susceptibility to fungal and bacterial infections of the nails, which could have serious consequences. To evaluate the knowledge about infection prophylaxis, prevalence of pathogens and a change in quality of life among different groups of diabetic patients. The study was performed using the DLQI questionnaire, interview, physical examination, mycological tests, and a survey containing multiple choice questions. The sample consisted of 120 patients. We revealed the presence of the infection in almost all of the patients, both with type 1 and type 2 diabetes. A great number of the participants lacked a credible source of information on their disease and consequently had little understanding of possible complications and prophylaxis of the nail infections. An overwhelming majority of the patients experienced pronounced discomfort of the skin and nails and felt extremely embarrassed with their nail appearance. Further research needs to be conducted to determine the efficacy of different methods of preventing nail infections in diabetic patients. Physicians, aside from implementing appropriate treatment, need to ensure that high-risk patients receive sufficient education on the prophylaxis of nail infections and on proper foot care.