Entire Course Research Articles

THE PSYCHOPEDAGOGIST’S WORK IN SCHOOLS

The present work refers to the appreciation of Psychopedagogy within the school environment. It narrates the importance of the role of Psychopedagogy in identifying learning problems, which not always is observed by teachers or pedagogical coordination. In this work it is possible to detect the difficulties that the professional of the area faces inside the school for presenting a more sensitive and clinical look. This essay reports the historical path of Psychopedagogy in Brazil; it highlights an entire theoretical study about the psychopedagogical view within the school. The goal of the work is to understand the role of the Psychopedagogue within educational institutions; it aims knowing the path used by the precursors of Psychopedagogy within Brazil. This essay shows the value of Psychopedagogy within the school environment, in addition to reporting its entire course in Brazil, from the beginning to the present day. This aforementioned work will analyze the path taken by Psychopedagogy.

Geopolitical dimensions of Armenian ethno-national expansionism in the South Caucasus

Referring to the genesis of Armenian historical claims, we proceed from the widely acknowledged paradigm that the "Armenian idea" is a multi-layered phenomenon, which includes many political, socio-economic and ideological-psychological contexts.  All of these components are invisibly present in the genesis of the conflicts of the Armenian people with neighbouring nations and states. The ethno-political space of the Armenian people has always been characterised by a very complex and intricate set of problems and contradictions, which have often led to wars, deportations and violent disputes between different ethnic groups and states. The historical mission of the Armenian nation, prompted by the entire course of its development, has the aim of appropriating the territories of neighbouring nations and countries. Through the fault of the Armenian patriarch,[1] the effort to create a Georgian-Armenian federal state failed in the second half of the 18th century. Therefore, the new Armenian national leaders gave special importance to Russia, which emerged in the geopolitical struggle for the Caucasus. By the end of the 18th century, the formation of a secret Russian-Armenian geopolitical alliance began, which had as its goal the creation of an Armenian state in the Caucasus on the territories of Georgia, Azerbaijan and Turkey.

Abstract P3-03-09: Assessment of Breast Cancer Chemotherapy Dose Reduction in an Integrated Healthcare Delivery System

Abstract Background: Most cytotoxic drugs are dosed according to body surface area (BSA), yet not all patients receive the full BSA-determined dose. Prior work suggests that dose reduction may occur more frequently in obese patients, likely due to concern about inducing toxicity at high doses. Other factors, such as race/ethnicity, have been suggested to be associated with dosing, yet the factors associated with dose reduction remain poorly understood, with little known about dosing patterns in integrated healthcare delivery systems and how such patterns have changed over time. Methods: We examined chemotherapy dosing in 452 women diagnosed with stage I-IIIA primary breast cancer at Kaiser Permanente Northern California. All study participants were a part of the Pathways Study, diagnosed between 2006-2013, and treated with the common breast cancer regimen, ACT (cyclophosphamide and doxorubicin, followed by paclitaxel). We explored the association between obesity and dose reduction, and further explored other factors in relation to dose reduction, including various sociodemographic characteristics, tumor characteristics, and comorbidities. We assessed dosing using first cycle dose proportion (< 90% expected dose) and average relative dose intensity (ARDI, a metric of dose intensity over the entire course of chemotherapy). Results: Overall, 8% of women received a dose reduction >10% in the first cycle of chemotherapy and 21.2% of patients had an ARDI < 90%. Obesity was a strong predictor of dose reduction, both in the first cycle and across all cycles. In the first cycle, 21.9% of severely obese patients (body mass index, BMI: 35+ kg/m2) were dose reduced, whereas no normal weight patients (BMI: 18.5-< 25 kg/m2) experienced a first cycle dose reduction. Across all cycles, 38.4% of severely obese women had an ARDI < 90%, as compared 12.8% of normal weight women. In logistic regression models adjusted for age, race/ethnicity, and white blood cell count, obese women had 4.1-fold higher odds of receiving a dose reduction of 10% or more over the course of chemotherapy than their normal weight counterparts (95% CI: 1.9, 8.9; p-trend: 0.006). Increasing age was positively associated with dose reduction across the course of chemotherapy, as was the presence of comorbidity. Importantly, dose reduction was less common in later calendar years. Sensitivity analyses revealed that the positive association between obesity and dosing was robust to further adjustment for these other significantly associated factors. Impact: These results offer insight on factors associated with variation in chemotherapy dosing for a common breast cancer treatment regimen. Larger studies are required to evaluate relevance of these findings to other treatment regimens. Further work will be needed to determine whether dose reductions impact breast cancer outcomes. Citation Format: Elizabeth D. Kantor, Kelli O’Connell, Isaac J. Ergas, Emily Valice, Janise M. Roh, Jenna Bhimani, Narre Heon, Jennifer J. Griggs, Jean Lee, Erin J. Bowles, Donna R. Rivera, Tatjana Kolevska, Elisa Bandera, Lawrence H. Kushi. Assessment of Breast Cancer Chemotherapy Dose Reduction in an Integrated Healthcare Delivery System [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-09.

DIAGNOSIS PENGERTIAN ETIKA DAN PERADABAN: SUATU SOROTAN

Appreciation of Ethics and Civilization (PEP) has been introduced as one of the General Subjects (MPU) by the Higher Education Department of Malaysia instead of the Ethnic Relations course. The PEP course has a comprehensive curriculum content that includes nine topics, and it is tied to the elements of ethics and civilization. Thus, the main objective of this paper is focused on topic 1, Appreciation of Ethics and Civilization in the Malaysian Pattern by focusing on the understanding and concept of ethics and civilization. Understandings and concepts need to be clarified as they are the most important part of understanding the entire course. The concepts of ethics and civilization need to be seen not only in terms of understanding, but need to be explained from various perspectives that are in line with the goals to be achieved from the PEP course. Since this writing is a concept paper, the writing method is qualitative based on library research. This study uses secondary sources such as research results in journals, scientific writing and historical sources. The results of the study found that the concept of ethics and civilization for the PEP course needs to be seen in the context of the civilization of the Malay World and the malay as a native people. Knowledge of the country's history is also necessary to understand the concept, and it can help students to better understand the curriculum content of the PEP course.

An exploratory study of imaging diagnostic clues for overhanging facial nerve in ultra-high-resolution CT

PurposeOverhanging facial nerve (FN) may be challenging in imaging diagnosis. The purpose of the study is to investigate the imaging clues for overhanging FN near the oval window on ultra-high-resolution computed tomography (U-HRCT) images.MethodsBetween October 2020 and August 2021, images of 325 ears (276 patients) were included in the analysis obtained by an experimental U-HRCT scanner. On standard reformatted images, the morphology of FN was evaluated and its position was quantitatively measured using the following indices: protrusion ratio (PR), protruding angle (A), position of FN (P-FN), distance between FN and stapes (D-S), and distance between FN and anterior and posterior crura of stapes (D-AC and D-PC). According to the FN morphology in imaging, images were divided into overhanging FN group and non-overhanging FN group. Binary univariate logistic regression analysis was used to identify the imaging indices independently associated with overhanging FN.ResultsOverhanging FN was found in 66 ears (20.3%), which manifested as downwards protrusion of either local segment (61 ears, 61/66) or the entire course near the oval window (5 ears, 5/66). D-AC [odds ratio: 0.063, 95% CI 0.012–0.334, P = 0.001) and D-PC (odds ratio: 0.008, 95% CI 0.001–0.050, P = 0.000) were identified as independent predictors of FN overhang (area under the curve: 0.828 and 0.865, respectively).ConclusionAbnormal morphology of the lower margin of FN, D-AC and D-PC on U-HRCTimages provide valuable diagnostic clues for FN overhang.

The role of parity in the relationship between endometriosis and pregnancy outcomes: a systematic review and meta-analysis.

Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis. A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library was performed from inception to May 2022. We searched for experimental and observational studies. Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence with the risk of bias in non-randomised studies of interventions tool incorporated. Eleven studies were included in the meta-analysis. Primiparous women with endometriosis had almost double the risk of hypertensive disorders of pregnancy (OR: 1.99, 95% CI: 1.50-2.63, P < 0.001) compared to multiparous women with endometriosis. Primiparous women with endometriosis were at significantly increased risk of preterm delivery, caesarean delivery, and placenta praevia compared to primiparous women without endometriosis. There were no significant differences in outcomes when multiparous women with endometriosis were compared to multiparous women without endometriosis. There is limited evidence to suggest that primiparous women with endometriosis may be at higher risk of adverse pregnancy outcomes compared to multiparous women. The modulatory role of parity in the pathophysiology of endometriosis and its impact on pregnancy outcomes should be investigated. Endometriosis can adversely affect pregnancy and cause complications that can affect both mother and baby. The severity and symptoms of endometriosis are lessened in pregnancy and with increasing births. Women who have previously given birth could experience fewer pregnancy complications than women giving birth for the first time. We reviewed the literature to compare pregnancy outcomes in women with endometriosis by whether they had given birth before or not. Our review included 11 studies. More women with endometriosis giving birth for the first time had blood pressure disorders in pregnancy than women with endometriosis who had given birth before. First-time mothers with endometriosis tended to have a baby born early, caesarean delivery, and an abnormally located placenta compared to those without endometriosis. This study supports the theory that women with endometriosis in their first pregnancy are at higher risk of complications and may benefit from additional monitoring.

Nerve entrapment syndromes: detection by ultrasound.

Nerve entrapment syndromes are commonly encountered in clinical practice. Accurate diagnosis and management require a knowledge of peripheral neuroanatomy and the recognition of key clinical symptoms and findings. Nerve entrapment syndromes are frequently associated with structural abnormalities of the affected nerve. Therefore, imaging allows the evaluation of the cause, severity, and etiology of the entrapment. High-resolution ultrasonography can depict early and chronic morphological changes within the entire nerve course and is therefore an ideal modality for diagnosing various nerve entrapment syndromes in different regions. This review article presents some of the most common types of nerve entrapment, with special focus on ultrasound imaging and key findings.

Modified (m)-FOLFOXIRI plus cetuximab versus m-FOLFOXIRI plus bevacizumab as initial treatment of patients with unresectable RAS and BRAF wild-type metastatic colorectal cancer: Survival analysis of the phase II randomized DEEPER trial by JACCRO.

120 Background: Triplet regimen, FOLFOXIRI, plus bevacizumab is considered as one of standard first-line treatments in metastatic colorectal cancer (mCRC). On the contrary, FOLFOXIRI plus anti-EGFR antibody has been shown to be a promising regimen with greater depth of response (DpR) in patients with RAS wild-type mCRC from the VOLFI and MACBETH trials (J Clin Oncol 2019, JAMA Oncol 2018). We therefore performed a randomized phase II study, DEEPER trial (JACCRO CC-13) [NCT02515734], to investigate the efficacy and safety of cetuximab (cet) vs. bevacizumab (bev) in combination with modified (m)-FOLFOXIRI in previously untreated mCRC patients with RAS wild-type tumors. We have reported a significantly better DpR of m-FOLFOXIRI plus cet compared to bev as the primary endpoint (Tsuji A, et al. ASCO 2021). Methods: This trial was a randomized phase II trial to evaluate modified (m)-FOLFOXIRI (irinotecan 150 mg/m2, oxaliplatin 85 mg/m2, 5-FU 2400 mg/m2) plus cet vs. bev as initial treatment in terms of DpR during the entire course as the primary endpoint in 360 patients with RAS wild-type mCRC. The aim of the trial was to show that median DpR of cet arm was more than 12.5% higher than bev arm, with a power of 85% at a significance level of 0.05, in per protocol set (PPS) consisted of patients evaluable for the DpR. Secondary endpoints included progression-free survival, overall survival, overall response rate, early tumor shrinkage rate, secondary resection rate, and toxicity. A total of 359 patients were enrolled between July 2015 and June 2019. For the PPS (median age 65y, 64% male, PS0/1: 91%/9%, left/right primary: 84%/16%), 159 and 162 patients were randomly assigned to the cet and bev arms, respectively. Clinical outcomes will be analyzed according to primary tumor sidedness which is included in the stratification factor. Additionally, we will collect data of BRAF status, and analyze the clinical outcomes in mCRC patients with RAS/ BRAF wild-type tumors and/or left-sided tumors. Pre-planned survival analysis will be performed to compare the two treatment arms at the time of 3 years after last patients’ enrollment using a log-rank test. All statistical tests are two-sided, and P values ≤ 0.05 are deemed significant. Statistical analyses will be performed using SAS version 9.4. Clinical trial information: NCT02515734 .

Editorial Introduction: Contributing to the policy process literatures

Editorial Introduction: Contributing to the policy process literatures

The Art and Science of Acoustic Recording: Re-enacting Arthur Nikisch and the Berlin Philharmonic Orchestra&amp;rsquo;s landmark 1913 recording of Beethoven&amp;rsquo;s Fifth Symphony

The Art and Science of Acoustic Recording was a collaborative project between the Royal College of Music and the Science Museum that saw an historic orchestral recording from 1913 re-enacted by musicians, researchers and sound engineers at the Royal College of Music (RCM) in 2014. The original recording was an early attempt to capture the sound of a large orchestra without re-scoring or substituting instruments and represents a step towards phonographic realism. Using replicated recording technology, media and techniques of the period, the re-enactment recorded two movements of Beethoven’s Fifth Symphony on to wax discs – the first orchestral acoustic recordings made since 1925. The aims were primarily to investigate the processes and practices of acoustic sound recording, developed largely through tacit knowledge, and to derive insights into the musicians’ experience of recording acoustically. Furthermore, the project sought to discover what the acoustic recordings of the past do – and don't – communicate to listeners today. Archival sources, historic apparatus and early photographic evidence served as groundwork for the re-enactment and guided its methodology, while the construction of replicas, wax manufacture and sound engineering were carried out by an expert in the field of acoustic recording. The wax recordings were digitised and some processed to produce disc copies playable on gramophone, thus replicating the entire course of recording, processing, duplication and reproduction. It is suggested that the project has contributed to a deeper understanding of early recordings and has provided a basis for further reconstructions of historical recording sessions.

An RNA-seq time series of the medaka pituitary gland during sexual maturation

Directing both organismal homeostasis and physiological adaptation, the pituitary is a key endocrine gland in all vertebrates. One of its major tasks is to coordinate sexual maturation through the production and release of hormones stimulating gonad development. In order to study its developmental dynamics in the model fish medaka (Oryzias latipes), we sampled both the pituitary and the ovaries of 68 female fish. Of these, 55 spanned the entire course of sexual maturation from prepubertal juveniles to spawning adults. An additional 13 showed either considerably faster or slower growth and development than the majority of fish. We used histological examination of the ovaries to determine a histological maturation stage, and analyzed the pituitary glands using RNA-seq optimized for low input. Taken together, these data reveal the timing of hormone production priorities, and form a comprehensive resource for the study of their regulation.

Optimal strategies of the age-specific vaccination and antiviral treatment against influenza

Influenza, caused by any of several human influenza viruses, is a highly contagious respiratory disease and it produces millions of cases worldwide. Vaccination and antiviral treatment are two main biomedical interventions for curtailing influenza spread. In this paper, an age-structured SVIR influenza model is used to take account for the efficacy of vaccination and antiviral treatment. Next, the stability of the disease-free equilibrium is captured by analyzing the root distributions of the characteristic equation and the existence of the endemic equilibrium is established by employing a generalized fixed point theorem. Moreover, the consideration of the availability of medical resources is settled as an optimal control problem to investigate the cost-effective interventions for the guidelines of optimal policy selection. Numerical simulations show that the outcomes of optimal control are characterized by the cost of control strategies, age structured of hosts and the different measures of influenza intervention. As a result of consequences, we recommend projecting vaccination at the early period and the implement of therapy at the entire infectious course, to slow down or eradicate influenza transmission.

Case of the Month from the Peter MacCallum Cancer Centre, Melbourne, Australia: combination of stereotactic ablative body radiotherapy and radical nephrectomy for synchronous bilateral primary renal cell carcinoma.

Case of the Month from the Peter MacCallum Cancer Centre, Melbourne, Australia: combination of stereotactic ablative body radiotherapy and radical nephrectomy for synchronous bilateral primary renal cell carcinoma.

Cardiac Vagal Regulation Is Impeded in Children With Cyclic Vomiting Syndrome.

The pathophysiology underlying cyclic vomiting syndrome (CVS) remains undefined. Scant data and distinct clinical features point to altered autonomic nervous system function. Autonomic signaling can be noninvasively assessed through cardiac indices of parasympathetic vagal regulation, which is reduced in children with disorders of gut-brain interaction. We aimed to examine dynamic cardiac vagal regulation in children with CVS compared with that in healthy controls (HC). A total of 31 children with CVS evaluated in a tertiary care CVS center and 66 HC (ages 8-18 years) underwent cardiac autonomic function assessment. Electrocardiogram recordings were conducted during 3-minute sit/stand/sit posture challenges. The electrocardiogram-derived variables heart period, respiratory sinus arrhythmia (RSA), and vagal efficiency (VE) were analyzed using linear regression and mixed-effects modeling. After exclusion of medication confounders, 23 patients with CVS were included in analyses. Both groups were comparable in age, gender, and body mass index. Compared with HC, children with CVS had shorter heart period (standardized mean difference range: 1.15-1.22, all P values < 0.05) and lower RSA (SMD range: 0.66-0.88, all P values < 0.05). Patients with CVS had significantly lower VE during the entire course of posture shifts, compared with HC ( B = -19.87, SE = 6.95, t = -2.86, P = 0.005, SMD = 0.76). Children with CVS have suboptimal parasympathetic autonomic regulation compared with HC, indexed by reduced RSA and VE, even during their interepisodic well phase. Abnormal vagal modulation may underlie CVS pathophysiology, comorbidities, and triggers. Assessing VE during posture stressors could inform therapeutic interventions.

Bladder Neck Contractures Stabilize After Placement of the Artificial Urinary Sphincter.

For male cancer survivors, the combination of stress urinary incontinence and recurrent bladder neck contracture presents a management dilemma with poor consensus. Our objective was to assess the impact of artificial urinary sphincter placement on bladder neck contracture recurrence among prostate cancer survivors with stress urinary incontinence and bladder neck contracture. Men electing artificial urinary sphincter placement at our institution undergo synchronous bladder neck contracture treatment if indicated. An institutional database was queried for men with stress urinary incontinence and ≥1 intervention for bladder neck contracture. Records were divided according to whether an artificial urinary sphincter was ever placed. The impact of artificial urinary sphincter placement on bladder neck contracture recurrence was assessed using a multivariable conditional survival analysis, with survival defined as the recurrence-free interval following bladder neck contracture intervention. The proportional hazards assumption was assessed on the basis of Schoenfeld residuals. The analytic cohort consisted of 118 in the artificial urinary sphincter group and 88 in the non-artificial urinary sphincter group. Patients in both groups underwent a median of 2 (range 1-8) bladder neck contracture interventions over the entire course of their care, encompassing 445 total bladder neck contracture interventions. The artificial urinary sphincter group was on average 2.6 years younger (P = .02) and had a higher pack-year smoking history (P < .01). The presence of an artificial urinary sphincter was associated with a 61% lower bladder neck contracture re-intervention rate (HR 0.39, P < .01, CI 0.30-0.50) at any time when accounting for number of prior bladder neck contracture interventions and bladder neck contracture risk factors. Artificial urinary sphincter placement is associated with a lower rate of bladder neck contracture re-intervention. Artificial urinary sphincter placement should not be delayed or avoided due to the presence of bladder neck contracture.

Measurable Residual Disease and Clonal Evolution in Acute Myeloid Leukemia from Diagnosis to Post-Transplant Follow-Up: The Role of Next-Generation Sequencing

It has now been ascertained that acute myeloid leukemias-as in most type of cancers-are mixtures of various subclones, evolving by acquiring additional somatic mutations over the course of the disease. The complexity of leukemia clone architecture and the phenotypic and/or genotypic drifts that can occur during treatment explain why more than 50% of patients-in hematological remission-could relapse. Moreover, the complexity and heterogeneity of clone architecture represent a hindrance for monitoring measurable residual disease, as not all minimal residual disease monitoring methods are able to detect genetic mutations arising during treatment. Unlike with chemotherapy, which imparts a relatively short duration of selective pressure on acute myeloid leukemia clonal architecture, the immunological effect related to allogeneic hematopoietic stem cell transplant is prolonged over time and must be overcome for relapse to occur. This means that not all molecular abnormalities detected after transplant always imply inevitable relapse. Therefore, transplant represents a critical setting where a measurable residual disease-based strategy, performed during post-transplant follow-up by highly sensitive methods such as next-generation sequencing, could optimize and improve treatment outcome. The purpose of our review is to provide an overview of the role of next-generation sequencing in monitoring both measurable residual disease and clonal evolution in acute myeloid leukemia patients during the entire course of the disease, with special focus on the transplant phase.

332 Improvement in symptoms of atopic dermatitis (AD) and AD-related quality of life with dupilumab treatment in adults: 24-week results of the DUPISTAD study

Abstract Atopic dermatitis (AD) is a chronic disease characterized by sleep disturbance, associated with night-time itching and scratching, along with skin pain, resulting in daytime drowsiness, diminished daytime productivity and overall reduced quality of life (QoL) in patients with AD. To report the effect of up to 24 weeks of dupilumab treatment on the QoL of adult patients with moderate-to-severe AD, using data from the DUPISTAD (NCT04033367) study. Phase 4, a randomized DUPISTAD study, comprised two 12-week periods: an initial placebo-controlled double-blind period, and a subsequent 12-week open-label extension (OLE) period. Adult patients with moderate-to-severe AD (Eczema Area and Severity Index score ≥12, Peak Pruritus Numeric Rating Scale [NRS] score ≥3, Sleep Disturbance NRS average score ≥5), showing an inadequate response to topical treatments, were randomized 2 : 1 to dupilumab 300 mg every 2 weeks (q2w) for both the double-blind and OLE periods or placebo for the initial double-blind period, followed by dupilumab 300 mg q2w for the OLE period. The use of concomitant topical corticosteroids was permitted during the entire course of the study. Endpoints, including Patient-Oriented Eczema Measure (POEM; scored 0–28, with higher values indicating a worse outcome), Dermatology Life Quality Index (DLQI; scored 0–30, with higher values indicating a poorer QoL), Skin Pain and Sensitivity NRS (scored 0–10, where 0 = no pain/normal sensitivity and 10 = worst possible pain/extremely sensitive) were assessed from baseline to week 24. The enrolled patients also completed a Work Productivity and Activity Impairment Questionnaire (WPAI-AD), including an NRS rating of the AD-Affected Ability to do Regular Daily Activities other than a Job (scored 0–10, where 0=‘no effect’ and 10=‘prevented me from doing my daily activities’). Formal statistical comparisons were not performed on the data resulting from the OLE period. The DUPISTAD study enrolled a total of 188 patients: 127 patients received dupilumab throughout (dupilumab–dupilumab group), and 61 patients received a placebo and then switched to dupilumab (placebo–dupilumab group). Baseline demographics and disease characteristics were well balanced. Improvement from baseline in AD-related patient-reported QoL indicators and AD symptoms was observed at week 24 in both groups, as illustrated by the mean change from baseline in POEM total scores (−14.6 in the dupilumab–dupilumab group and −15.9 in the placebo–dupilumab group), DLQI scores (−12.6 in the dupilumab–dupilumab group and −13.4 in the placebo–dupilumab group), Skin Pain NRS scores (−4.7 in the dupilumab–dupilumab group and −5.0 in the placebo–dupilumab group), Skin Sensitivity NRS scores (−4.6 in the dupilumab–dupilumab group and −5.0 in the placebo–dupilumab group), and the WPAI-AD NRS of Ability to do Regular Daily Activities scores (−4.2 in the dupilumab–dupilumab group and −3.8 in the placebo–dupilumab group). The placebo–dupilumab group experienced most of this improvement during the OLE period, as illustrated by the mean change from week 12 to week 24 in POEM total score (−11.5), DLQI score (−5.5), Skin Pain NRS score (−3.0), Skin Sensitivity NRS score (−3.0) and the WPAI-AD NRS of Ability to do Regular Daily Activities score (−2.0). The safety profile of dupilumab was consistent with the known safety profile. Dupilumab provided sustained improvements through 24 weeks in AD-related patient-reported measures of QoL and AD symptoms in adults with moderate-to-severe AD. Patients who were switched from placebo to dupilumab at week 12 showed rapid improvement in these parameters after the switch, eventually matching the improvement achieved by patients who received dupilumab from baseline through week 24.

Evaluation of Undergraduate Learning Experiences in Pediatric Dentistry during the COVID-19 Pandemic.

The research was conducted among fifth-year dentistry students at Poznan University of Medical Sciences. Students who completed the entire course and passed the diploma exam in pediatric dentistry were asked to complete the anonymous questionnaire providing their opinion. The research results showed that, in the students' opinion, clinical classes-regardless of their form-allowed them to achieve the knowledge necessary to perform pediatric dental procedures. However, the students appreciated onsite classes significantly more compared to information and communication technologies (ICT) classes in gaining practical skills and social competence. (1) The significant limitations introduced because of the SARS-CoV-2 pandemic impacted the development and implementation of modern online teaching techniques, which may very well be applied to convey theoretical knowledge after the pandemic has ended. (2) Skills and social competence, indispensable in the future dental practice of dental students, can only be obtained during onsite classes. (3) Medical universities should design standards of teaching to enable them to address a possible epidemiological threat in the future, which will enable rapid response and safe continuation of practical dental education during a pandemic.

Personality traits favourable for non-adherence to treatment in patients with chronic myeloid leukaemia: role of type A and D personality

BackgroundThe introduction of BCR-ABL tyrosine kinase inhibitors (TKIs) to chronic myeloid leukemia (CML) therapy has revolutionized the treatment of this disease. Although regular TKI intake is a prerequisite for successful therapy, it has been shown that a significant proportion of patients are non-compliant. Recently there is growing evidence that personality traits may influenced the tendency for non-adherence to treatment in patients with chronic diseases. As far as we know, such a relationship in patients with CML has not been examined, yet. The aim of our study was to determine if personality traits favor non-adherence to treatment recommendations. We investigated the relationship between five-factor model personality factors (conscientiousness, neuroticism, agreeableness, extraversion, and openness) and medication non-adherence. We also checked if the patients with type A and type D personality, were at higher risk of poor medication adherence.MethodsThe following tools were used: self-constructed survey, the NEO-Five Factor Inventory, the Framingham Type A Scale, the D-Scale 14. The study included 140 CML patients treated with imatinib, dasatinib, or nilotinib.Results39% of patients reported skipping at least one dose of medication in the month prior to follow-up visit. 51% admitted to skipping such doses from the start of their treatment to the time at which our assessment was performed. We did not find any relationship between the mean values of the analyzed factors of the Big Five (neuroticism, extraversion, openness, agreeableness, conscientiousness) and adherence. However, our analysis revealed that CML patients who admitted to missing doses of drugs during the entire course of treatment demonstrated greater intensity of type A personality traits (p = 0.020). Regarding both factors of type D personality, it was revealed that higher level of negative affectivity significantly decreased the adherence (p = 0.020).ConclusionThe results of our study indicate that screening for type D and A personalities may help to identify patients who are at higher risk of poor medication adherence.

Cost-effectiveness of ceftazidime/avibactam plus metronidazole versus meropenem as first-line empiric therapy for the treatment of complicated intra-abdominal infections: A study based on the in-vitro surveillance data in China

BackgroundWith the increase in drug resistance rates of pathogens isolated from complicated intra-abdominal infections (cIAIs), ceftazidime/avibactam (CAZ-AVI) is increasingly used clinically. However, given the high drug cost and the fact that not yet covered by the health insurance payment, this study evaluated the cost-effectiveness of CAZ-AVI plus metronidazole versus meropenem as a first-line empiric treatment for cIAIs from the perspective of the Chinese healthcare system. MethodsA decision analytic model with a one-year time horizon was constructed to assess the cost-effectiveness based on the entire disease course. Model inputs were mainly obtained from clinical studies, published literature, and publicly available databases. Primary outcomes were cost, quality-adjusted life years (QALYs), life years (Lys), and incremental cost-effectiveness ratio (ICER). One-way sensitivity analysis and probabilistic sensitivity analysis were also performed. ResultsIn the base cases, compared to meropenem, CAZ-AVI plus metronidazole had a shorter mean hospital length of stay (–0.77 days per patient) and longer life expectancy (+0.05 LYs and +0.06 QALYs). CAZ-AVI plus metronidazole had an ICER of $25517/QALY, which is well below the threshold of $31509 per QALY in China. The one-way sensitivity analysis showed that the change of the treatment duration of CAZ-AVI plus metronidazole was the parameter that most influenced the results of the ICER. In probabilistic sensitivity analysis, CAZ-AVI plus metronidazole was the optimal strategy in 75% of simulations at $31510/QALY threshold. ConclusionsCAZ-AVI plus metronidazole could be considered as a cost-effective option for the empiric treatment of patients with cIAIs in China, and this benefit will be more evident when the price of CAZ-AVI decreases by 23.8%.