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https://www.readbyqxmd.com/read/28212111/direct-determination-of-k-q-for-farmer-type-ionization-chambers-in-a-clinical-scanned-carbon-ion-beam-using-water-calorimetry
#1
J-M Osinga-Blättermann, S Brons, S Greilich, O Jäkel, A Krauss
Until now, the dosimetry of carbon ions with ionization chambers has not reached the same level of accuracy as that of high-energy photons. This is mainly caused by the approximately threefold larger uncertainty of the k Q factor of ionization chambers, which, due to the lack of experimental data, is still derived by calculations. Measurements of absorbed dose to water, D w, by means of water calorimetry have now been performed in the entrance channel of a scanned 6 cm  ×  6 cm radiation field of 429 MeV/u carbon ions, allowing the direct calibration of ionization chambers and thus the experimental determination of k Q...
February 17, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28210100/the-cost-effectiveness-of-a-nsclc-patient-assistance-program-for-pemetrexed-maintenance-therapy-in-people-s-republic-of-china
#2
Qiang Shi, Shanlian Hu, Wesley E Furnback, Gregory F Guzauskas, Jiejing Shen, Bruce Cm Wang
BACKGROUND: Eli Lilly and the China Primary Health Care Foundation are currently implementing a patient assistance program (PAP) in China, which allows first-line nonsquamous non-small-cell lung cancer (NSCLC) patients who complete four cycles of pemetrexed induction therapy to receive free, continuous pemetrexed maintenance therapy. OBJECTIVE: To estimate the cost-effectiveness of pemetrexed maintenance therapy vs basic standard care (BSC) and the economic impacts of providing a PAP for pemetrexed maintenance therapy to NSCLC patients who have completed pemetrexed induction therapy in a Chinese health care setting...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28209558/readiness-for-delivering-digital-health-at-scale-lessons-from-a-longitudinal-qualitative-evaluation-of-a-national-digital-health-innovation-program-in-the-united-kingdom
#3
Marilyn R Lennon, Matt-Mouley Bouamrane, Alison M Devlin, Siobhan O'Connor, Catherine O'Donnell, Ula Chetty, Ruth Agbakoba, Annemieke Bikker, Eleanor Grieve, Tracy Finch, Nicholas Watson, Sally Wyke, Frances S Mair
BACKGROUND: Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow to become accepted, integrated, and routinized at scale. OBJECTIVE: The aim of our study was to examine barriers and facilitators to implementation of digital health at scale through the evaluation of a £37m national digital health program: ‟Delivering Assisted Living Lifestyles at Scale" (dallas) from 2012-2015...
February 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28207603/needs-of-stroke-survivors-as-perceived-by-their-caregivers-a-scoping-review
#4
Shilpa Krishnan, Monique R Pappadis, Susan C Weller, Marsja Stearnes, Amit Kumar, Kenneth J Ottenbacher, Timothy A Reistetter
OBJECTIVE: Caregivers usually are not involved while planning the stroke survivor's medical and rehabilitation goals and interventions. This review aimed to identify the needs of stroke survivors as perceived by their caregivers. DESIGN: A literature search from 2003 to 2014 was conducted using Medline, CINAHL, PsychINFO, and Google Scholar. Sixty-six studies were included. Most studies excluded did not encompass caregivers' perspectives. Four reviewers screened the titles, abstracts, and full texts of the articles for inclusion...
February 16, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28207411/reporting-altered-test-results-in-hemolyzed-samples-is-the-cure-worse-than-the-disease
#5
Giuseppe Lippi, Gianfranco Cervellin, Mario Plebani
The management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement...
February 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28206671/surgery-for-cataracts-in-people-with-age-related-macular-degeneration
#6
REVIEW
Heather Casparis, Kristina Lindsley, Irene C Kuo, Shameema Sikder, Neil M Bressler
BACKGROUND: Cataract and age-related macular degeneration (AMD) are common causes of decreased vision that often occur simultaneously in people over age 50. Although cataract surgery is an effective treatment for cataract-induced visual loss, some clinicians suspect that such an intervention may increase the risk of worsening of underlying AMD and thus have deleterious effects on vision. OBJECTIVES: The objective of this review was to evaluate the effectiveness and safety of cataract surgery compared with no surgery in eyes with AMD...
February 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28197998/laser-assisted-subepithelial-keratectomy-lasek-versus-laser-assisted-in-situ-keratomileusis-lasik-for-correcting-myopia
#7
REVIEW
Jocelyn Kuryan, Anjum Cheema, Roy S Chuck
BACKGROUND: Near-sightedness, or myopia, is a condition in which light rays entering the eye along the visual axis focus in front of the retina, resulting in blurred vision. Myopia can be treated with spectacles, contact lenses, or refractive surgery. Options for refractive surgery include laser-assisted subepithelial keratectomy (LASEK) and laser-assisted in-situ keratomileusis (LASIK). Both procedures utilize a laser to shape the corneal tissue (front of the eye) to correct refractive error, and both create flaps before laser treatment of corneal stromal tissue...
February 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#8
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28194191/prediction-of-clinical-peanut-allergy-status-among-children-in-hamilton-ontario-using-chart-review-data-collected-during-2012-2015
#9
Elizabeth Simms, Gary Foster, Katherine Arias, Mark Larché, Tosha Freitag, Tina Walker, Susanna Goncharova, Andrea Marrin, Andreas Freitag, Manel Jordana, Susan Waserman
BACKGROUND: Peanut sensitization does not necessarily indicate clinical peanut allergy, and uncertainty as to whether or not there is true peanut allergy can lead to increased anxiety and decreased quality of life for patients and their families. The gold standard for diagnosing clinical peanut allergy is the oral food challenge, but this method is time-consuming and can cause severe allergic reactions. It would therefore be beneficial to develop a tool for predicting clinical peanut allergy in peanut-sensitized individuals whose peanut allergy status is unknown so as to better determine who requires an oral food challenge for diagnosis...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28192624/mr-based-synthetic-ct-generation-using-a-deep-convolutional-neural-network-method
#10
Xiao Han
PURPOSE: Interests have been rapidly growing in the field of radiotherapy to replace CT with magnetic resonance imaging (MRI), due to superior soft tissue contrast offered by MRI and the desire to reduce unnecessary radiation dose. MR-only radiotherapy also simplifies clinical workflow and avoids uncertainties in aligning MR with CT. Methods, however, are needed to derive CT-equivalent representations, often known as synthetic CT (sCT), from patient MR images for the purpose of dose calculation and DRR-based patient positioning...
February 13, 2017: Medical Physics
https://www.readbyqxmd.com/read/28191877/a-virtual-clinical-trial-comparing-static-versus-dynamic-pet-imaging-in-measuring-response-to-breast-cancer-therapy
#11
Kristen A Wangerin, Mark Muzi, Lanell Peterson, Hannah Linden, Alena Novakova, David Mankoff, Paul Kinahan
OBJECTIVE: We developed a method to evaluate variations in the PET imaging process in order to characterize the relative ability of static and dynamic metrics to measure breast cancer response to therapy in a clinical trial setting. METHODS: We performed a virtual clinical trial by generating 540 i.i.d. PET imaging study realizations for each of 22 original dynamic fluorodeoxyglucose (18F-FDG) breast cancer patient studies pre- and post-therapy. Each noise realization accounted for known sources of uncertainty in the imaging process, such as biological variability and SUV uptake time...
February 13, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28191626/intermittent-auscultation-ia-of-fetal-heart-rate-in-labour-for-fetal-well-being
#12
REVIEW
Ruth Martis, Ova Emilia, Detty S Nurdiati, Julie Brown
BACKGROUND: The goal of fetal monitoring in labour is the early detection of a hypoxic baby. There are a variety of tools and methods available for intermittent auscultation (IA) of the fetal heart rate (FHR). Low- and middle-income countries usually have only access to a Pinard/Laënnec or the use of a hand-held Doppler device. Currently, there is no robust evidence to guide clinical practice on the most effective IA tool to use, timing intervals and length of listening to the fetal heart for women during established labour...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28188672/should-we-intervene-at-stage-0-a-qualitative-study-of-attitudes-of-asymptomatic-youth-at-increased-risk-of-developing-bipolar-disorders-and-parents-with-established-disease
#13
Jo Davison, Jan Scott
BACKGROUND: Studies of potential interventions for asymptomatic individuals at risk of severe mental disorders (ie, clinical stage 0) have focused on genetic counselling or the views of adults with established disease. No study has interviewed youth at risk of bipolar disorders (BD). METHODS: Qualitative analysis of interviews with asymptomatic adolescent offspring of adults with BD (OSBD = 7) and unrelated parents with bipolar disorders (PBD = 6) to examine manifest and latent themes in the dialogue...
February 11, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28188233/multicenter-evaluation-of-cystatin-c-measurement-after-assay-standardization
#14
Anne-Sophie Bargnoux, Laurence Piéroni, Jean-Paul Cristol, Nils Kuster, Pierre Delanaye, Marie-Christine Carlier, Soraya Fellahi, Anne Boutten, Christine Lombard, Ana González-Antuña, Vincent Delatour, Etienne Cavalier
BACKGROUND: Since 2010, a certified reference material ERM-DA471/IFCC has been available for cystatin C (CysC). This study aimed to assess the sources of uncertainty in results for clinical samples measured using standardized assays. METHODS: This evaluation was performed in 2015 and involved 7 clinical laboratories located in France and Belgium. CysC was measured in a panel of 4 serum pools using 8 automated assays and a candidate isotope dilution mass spectrometry reference measurement procedure...
February 10, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28187492/are-evidence-standards-different-for-genomic-vs-clinical-based-precision-medicine-a-quantitative-analysis-of-individualized-warfarin-therapy
#15
Devender S Dhanda, Gregory F Guzauskas, Josh J Carlson, Anirban Basu, David L Veenstra
Evidence requirements for implementation of precision medicine (PM), whether informed by genomic or clinical data, are not well defined. Evidence requirements are driven by uncertainty and its attendant consequences; these aspects can be quantified by a novel technique in health economics, value of information analysis (VOI). We utilized VOI analysis to compare the evidence levels over time for warfarin dosing based on pharmacogenomic- vs. amiodarone-warfarin drug-drug interaction information. The primary outcome was the expected value of perfect information (EVPI), which is an estimate of the upper limit of the societal value of conducting future research...
February 10, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28184315/mental-capacity-and-borderline-personality-disorder
#16
Karyn Ayre, Gareth S Owen, Paul Moran
The use of the Mental Capacity Act 2005 in assessing decision-making capacity in patients with borderline personality disorder (BPD) is inconsistent. We believe this may stem from persisting confusion regarding the nosological status of personality disorder and also a failure to recognise the fact that emotional dysregulation and characteristic psychodynamic abnormalities may cause substantial difficulties in using and weighing information. Clearer consensus on these issues is required in order to provide consistent patient care and reduce uncertainty for clinicians in what are often emergency and high-stakes clinical scenarios...
February 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28183511/proposed-standardized-neurological-endpoints-for-cardiovascular-clinical-trials-an-academic-research-consortium-initiative
#17
REVIEW
Alexandra J Lansky, Steven R Messé, Adam M Brickman, Michael Dwyer, H Bart van der Worp, Ronald M Lazar, Cody G Pietras, Kevin J Abrams, Eugene McFadden, Nils H Petersen, Jeffrey Browndyke, Bernard Prendergast, Vivian G Ng, Donald E Cutlip, Samir Kapadia, Mitchell W Krucoff, Axel Linke, Claudia Scala Moy, Joachim Schofer, Gerrit-Anne van Es, Renu Virmani, Jeffrey Popma, Michael K Parides, Susheel Kodali, Michel Bilello, Robert Zivadinov, Joseph Akar, Karen L Furie, Daryl Gress, Szilard Voros, Jeffrey Moses, David Greer, John K Forrest, David Holmes, Arie P Kappetein, Michael Mack, Andreas Baumbach
Surgical and catheter-based cardiovascular procedures and adjunctive pharmacology have an inherent risk of neurological complications. The current diversity of neurological endpoint definitions and ascertainment methods in clinical trials has led to uncertainties in the neurological risk attributable to cardiovascular procedures and inconsistent evaluation of therapies intended to prevent or mitigate neurological injury. Benefit-risk assessment of such procedures should be on the basis of an evaluation of well-defined neurological outcomes that are ascertained with consistent methods and capture the full spectrum of neurovascular injury and its clinical effect...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28182451/therapeutic-alliance-subsequent-change-and-moderators-of-the-alliance-outcome-association-in-interpersonal-psychotherapy-for-depression
#18
Michael J Constantino, Alice E Coyne, Emily K Luukko, Katie Newkirk, Samantha L Bernecker, Paula Ravitz, Carolina McBride
The therapeutic alliance has historically emerged as a pantheoretical correlate of favorable psychotherapy outcomes. However, uncertainty remains about the direction of the alliance-outcome link, and whether it is affected by other contextual variables. The present study explored (a) if early alliance quality predicted subsequent symptom change while controlling for the effect of prior symptom change in interpersonal psychotherapy (IPT) for depression, and (b) whether baseline patient characteristics moderated the alliance-outcome relation (to help specify conditions under which alliance predicts change)...
February 9, 2017: Psychotherapy
https://www.readbyqxmd.com/read/28182110/a-preliminary-study-of-patient-dignity-inventory-validation-among-patients-hospitalized-in-an-acute-psychiatric-ward
#19
Rosaria Di Lorenzo, Giulio Cabri, Eleonora Carretti, Giacomo Galli, Nina Giambalvo, Giulia Rioli, Serena Saraceni, Giulia Spiga, Cinzia Del Giovane, Paola Ferri
PURPOSE: To investigate the perception of dignity among patients hospitalized in a psychiatric setting using the Patient Dignity Inventory (PDI), which had been first validated in oncologic field among terminally ill patients. PATIENTS AND METHODS: After having modified two items, we administered the Italian version of PDI to all patients hospitalized in a public psychiatric ward (Service of Psychiatric Diagnosis and Treatment of a northern Italian town), who provided their consent and completed it at discharge, from October 21, 2015 to May 31, 2016...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28181950/clinicopathologic-and-molecular-pathology-of-collecting-duct-carcinoma-and-related-renal-cell-carcinomas
#20
An Na Seo, Ghilsuk Yoon, Jae Y Ro
Collecting duct carcinoma (CDC) and related tumors [ie, renal medullary carcinoma (RMC)] are rare types of highly aggressive renal cell carcinomas (RCC) with poor prognosis. Because of the rarity and diagnostic uncertainty of them, their molecular pathology and significance have not yet been fully elucidated. CDC, RMC, fumarate hydratase-deficient RCC (including hereditary leiomyomatosis and RCC-associated RCC HLRCC-RCC), and recently reported anaplastic lymphoma kinase (ALK)-rearrangement RCC have significant morphologic overlaps, but they are separately distinct entities having different molecular pathway and clinical settings...
March 2017: Advances in Anatomic Pathology
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