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https://www.readbyqxmd.com/read/29676463/evaluation-of-machine-log-files-mc-based-treatment-planning-and-delivery-qa-as-compared-to-arccheck-qa
#1
Carl W Stanhope, Douglas G Drake, Jian Liang, Markus Alber, Matthias Söhn, Charbel Habib, Virgil Willcut, Di Yan
PURPOSE: A treatment planning/delivery QA tool using linac log files (LF) and Monte Carlo (MC) dose calculation is investigated as a standalone alternative to phantom-based patient-specific QA (ArcCHECK (AC)). METHODS: Delivering a variety of fields onto MapCHECK2 and ArcCHECK, diode sensitivity dependence on dose rate (in-field) and energy (primarily out-of-field) was quantified. AC and LF QAs were analyzed w.r.t. delivery complexity by delivering 12x12cm static fields/arcs comprised of varying numbers of abutting sub-fields onto ArcCHECK...
April 20, 2018: Medical Physics
https://www.readbyqxmd.com/read/29676107/-expert-consensus-on-prescription-comment-of-chinese-traditional-patent-medicine-for-promoting-the-rational-use-of-drugs-in-beijing
#2
Rui Jin, Kui-Jun Zhao, Gui-Ming Guo, Bing Zhang, Yu-Guang Wang, Chun-Miao Xue, Yi-Heng Yang, Li-Xia Wang, Guo-Hui Li, Jin-Fa Tang, Li-Xing Nie, Xiang-Lin Zhang, Ting-Ting Zhao, Yi Zhang, Can Yan, Suo-Zhong Yuan, Lu-Lu Sun, Xing-Zhong Feng, Dan Yan
With the growth of number of Chinese patent medicines and clinical use, the rational use of Chinese medicine is becoming more and more serious. Due to the complexity of Chinese medicine theory and the uncertainty of clinical application, the prescription review of Chinese patent medicine always relied on experience in their respective, leading to the uncontrolled of clinical rational use. According to the traditional Chinese medicine (TCM) theory and characteristics of the unique clinical therapeutics, based on the practice experience and expertise comments, our paper formed the expert consensus on the prescription review of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing...
March 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29672267/point-of-care-creatinine-testing-for-kidney-function-measurement-prior-to-contrast-enhanced-diagnostic-imaging-evaluation-of-the-performance-of-three-systems-for-clinical-utility
#3
Beverly Snaith, Martine A Harris, Bethany Shinkins, Marieke Jordaan, Michael Messenger, Andrew Lewington
BACKGROUND: Acute kidney injury (AKI) can occur rarely in patients exposed to iodinated contrast and result in contrast-induced AKI (CI-AKI). A key risk factor is the presence of preexisting chronic kidney disease (CKD); therefore, it is important to assess patient risk and obtain kidney function measurement prior to administration. Point-of-care (PoC) testing provides an alternative strategy but there remains uncertainty, with respect to diagnostic accuracy and clinical utility. METHODS: A device study compared three PoC analysers (Nova StatSensor, Abbott i-STAT and Radiometer ABL800 FLEX) with a reference laboratory standard (Roche Cobas 8000 series, enzymatic creatinine)...
April 19, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29667145/ethical-challenges-faced-by-healthcare-professionals-who-care-for-suicidal-patients-a-scoping-review
#4
Victoria Saigle, Eric Racine
For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps...
April 17, 2018: Monash Bioethics Review
https://www.readbyqxmd.com/read/29666813/ground-glass-opacities-management-in-the-lung-cancer-screening-era
#5
REVIEW
Marcello Migliore, Mariaconcetta Fornito, Manuela Palazzolo, Alessandra Criscione, Mariapia Gangemi, Francesco Borrata, Paolo Vigneri, Marco Nardini, Joel Dunning
Pulmonary ground glass opacity (GGO) is becoming an important clinical dilemma in oncology as its diagnosis in clinical practice is increasing due to the introduction of low dose computed tomography (CT) scan and screening. The incidence of cancer in GGO has been reported as high as 63%. The purpose of this manuscript is to review best available evidence papers on management of GGO in lung cancer to address the following questions: (I) how to correlate CT findings with malignancy; (II) when and who operate? (III) how to perform intraoperative detection of intrapulmonary GGO? (IV) wedge, segmentectomy or lobectomy? Taking a cue from a clinical scenario, a review on PubMed was conducted...
March 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29666310/role-of-patient-and-public-involvement-in-implementation-research-a-consensus-study
#6
Kara Gray-Burrows, Thomas Willis, Robbie Foy, Martin Rathfelder, Pauline Bland, Allison Chin, Susan Hodgson, Gus Ibegbuna, Graham Prestwich, Kirsty Samuel, Laurence Wood, Farhat Yaqoob, Rosemary R C McEachan
BACKGROUND: Patient and public involvement (PPI) is often an essential requirement for research funding. Distinctions can be drawn between clinical research, which generally focuses on patients, and implementation research, which generally focuses on health professional behaviour. There is uncertainty about the role of PPI in this latter field. We explored and defined the roles of PPI in implementation research to inform relevant good practice guidance. METHODS: We used a structured consensus process using a convenience sample panel of nine experienced PPI and two researcher members...
April 17, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29666126/domains-of-health-related-quality-of-life-in-age-related-macular-degeneration-a-qualitative-study-in-the-chinese-cultural-context
#7
Wei Bian, Junli Wan, Graeme Smith, Shiying Li, Mingqiong Tan, Fengjiao Zhou
OBJECTIVE: To explore which areas of health-related quality of life were affected in Chinese patients, and to identify whether the areas are well covered by validated questionnaires. DESIGN: A qualitative study based on semistructured interviews was conducted. A qualitative thematic analysis following the approach of Colaizzi was used to analyse the interview data for significant statements and phrases. The themes and subthemes organised from the analysis were then compared by using the following current instruments: National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), Macular Disease Quality of life Questionnaire (MacDQoL) and Low-Luminance Questionnaire (LLD)...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29665745/heterogeneity-in-ppv-of-ras-mutations-in-cytologically-indeterminate-thyroid-nodules
#8
Fadi Nabhan, Kyle Porter, Mark Lupo, Gregory W Randolph, Kepal Narendra Patel, Richard T Kloos
BACKGROUND: RAS mutations are common in the available mutational analysis of cytologically indeterminate (Cyto-I) thyroid nodules. However, their reported positive predictive value (PPV) for cancer is widely variable. The reason for this variability is unknown and it causes clinical management uncertainty. We performed a systematic review evaluating the PPV for cancer in RAS mutation positive Cyto-I nodules and considered variables that might affect residual heterogeneity across the different studies...
April 18, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29665724/the-promise-of-complementarity-using-the-methods-of-foresight-for-health-workforce-planning
#9
Gareth H Rees, Peter Crampton, Robin Gauld, Stephen MacDonell
Health workforce planning aims to meet a health system's needs with a sustainable and fit-for-purpose workforce, although its efficacy is reduced in conditions of uncertainty. This PhD breakthrough article offers foresight as a means of addressing this uncertainty and models its complementarity in the context of the health workforce planning problem. The article summarises the findings of a two-case multi-phase mixed method study that incorporates actor analysis, scenario development and policy Delphi. This reveals a few dominant actors of considerable influence who are in conflict over a few critical workforce issues...
January 1, 2018: Health Services Management Research
https://www.readbyqxmd.com/read/29664913/cost-benefit-analysis-of-introducing-next-generation-sequencing-metagenomic-pathogen-testing-in-the-setting-of-pyrexia-of-unknown-origin
#10
Jia Hui Chai, Chun Kiat Lee, Hong Kai Lee, Nicholas Wong, Kahwee Teo, Chuen Seng Tan, Praveen Thokala, Julian Wei-Tze Tang, Paul Anantharajah Tambyah, Vernon Min Sen Oh, Tze Ping Loh, Joanne Yoong
Pyrexia of unknown origin (PUO) is defined as a temperature of >38.3°C that lasts for >3 weeks, where no cause can be found despite appropriate investigation. Existing protocols for the work-up of PUO can be extensive and costly, motivating the application of recent advances in molecular diagnostics to pathogen testing. There have been many reports describing various analytical methods and performance of metagenomic pathogen testing in clinical samples but the economics of it has been less well studied...
2018: PloS One
https://www.readbyqxmd.com/read/29664529/-clinical-guidelines-using-the-grade-system-grading-of-recommendations-assessment-development-and-evaluation
#11
Carolina Mendoza, Patricia Kraemer, Paloma Herrera, Pamela Burdiles, Dino Sepúlveda, Eliozka Núñez, Cecilia Muñoz, Ignacio Neumann
The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient's values and preferences and use of resources...
November 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29664184/review-article-a-scoping-review-of-physiotherapists-in-the-adult-emergency-department
#12
REVIEW
Giovanni E Ferreira, Adrian C Traeger, Chris G Maher
To provide an overview of the literature that considers physiotherapists working in the ED in relation to their roles, training levels, patient profile, safety, effectiveness, efficiency, cost-effectiveness and the provision of low-value care. We performed a scoping review of the literature. Four databases (PubMed, EMBASE, CINAHL and Cochrane CENTRAL) were searched from their inception to December 2016 and we updated searches on PubMed in September 2017. Two reviewers independently screened studies for eligibility...
April 17, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29661589/challenges-and-research-progress-of-the-use-of-mesenchymal-stem-cells-in-the-treatment-of-ischemic-stroke
#13
REVIEW
Jipeng Jiang, Yuting Wang, Baohu Liu, Xuyi Chen, Sai Zhang
Cerebral Ischemic Stroke (CIS) has become a hot issue in medical research because of the diversity of risk factors and the uncertainty of prognosis. In the field of regenerative medicine, mesenchymal stem cells (MSCs) have an increasingly prominent position due to their advantages of multiple differentiation, low immunogenicity and wide application. In the basic and clinical research of CIS, there are still some problems to be solved in the treatment of CIS. This paper will discuss the progresses and some obstacles of current MSCs for the treatment of CIS...
April 13, 2018: Brain & Development
https://www.readbyqxmd.com/read/29661524/expressed-emotion-as-a-predictor-of-the-first-psychotic-episode-results-of-the-european-prediction-of-psychosis-study
#14
Theresa Haidl, Marlene Rosen, Frauke Schultze-Lutter, Dorien Nieman, Susanne Eggers, Markus Heinimaa, Georg Juckel, Andreas Heinz, Anthony Morrison, Don Linszen, Raimo Salokangas, Joachim Klosterkötter, Max Birchwood, Paul Patterson, Stephan Ruhrmann
OBJECTIVE: To investigate the impact of expressed emotion (EE) on the risk of developing the first psychotic episode (FEP). METHOD: The European Prediction of Psychosis Study (EPOS) investigated 245 patients who were at clinical high risk (CHR) of psychosis. The predictive value of EE alone and as a part of the multivariate EPOS model was evaluated. RESULTS: "Perceived irritability", a domain of the Level of Expressed Emotion Scale (LEE), was found to be predictive for the First Psychotic Episode (FEP), even as an individual variable...
April 13, 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/29661471/do-the-diagnostic-criteria-for-subclinical-hypercortisolism-exist
#15
Antoine Tabarin
"Subclinical hypercortisolism" (SH) refers to a condition associated with a mild chronic increase in cortisol secretion. By definition, patients with SH do not exhibit specific symptoms of overt Cushing's syndrome (such as purple striae, easy bruising, proximal muscle weakness), SH has been preferred to "subclinical Cushing's syndrome", a semantic ambiguity since Cushing's syndrome is, by definition, a set of symptoms; and to the term "preclinical Cushing syndrome" because the progression toward overt clinical hypercortisolism is very rare...
April 13, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29661232/cmpd1-inhibited-human-gastric-cancer-cell-proliferation-by-inducing-apoptosis-and-g2-m-cell-cycle-arrest
#16
Yu Li, Depeng Zhang, Kaikai Yu, Yudong Hu, Qiong Wu, Feng Qian, Zishu Wang
BACKGROUND: Gastric cancer occupies the fourth highest morbidity rate of cancers worldwide. Clinical therapies of gastric cancer remain limited because of uncertainty of mechanisms and shortness of effective medicine. Thus, new drug candidates for gastric cancer treatment is urgently needed. RESULTS: In this study, CMPD1 as a wildly used MK2 phosphorylation inhibitor was employed to find its impact on gastric cancer cell proliferation, apoptosis and cell cycle using colony formation assay and flow cytometry analysis...
April 16, 2018: Biological Research
https://www.readbyqxmd.com/read/29660004/renal-transplant-outcomes-and-de-novo-donor-specific-anti-human-leukocyte-antigen-antibodies-a-systematic-review
#17
Ankit Sharma, Joshua R Lewis, Wai H Lim, Suetonia Palmer, Giovanni Strippoli, Jeremy R Chapman, Stephen I Alexander, Jonathan C Craig, Germaine Wong
Background: Pre-transplant donor-specific anti-human leukocyte antigen antibodies (DSAs) are known risk factors for acute rejection and reduced graft survival after kidney transplantation. DSAs may also develop de novo DSAs (dnDSAs) after transplantation but the clinical implications of these antibodies remain uncertain. Methods: We undertook a systematic review of observational studies that examined the association between dnDSAs and graft and patient outcomes (through August 2017) with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system of reporting used to assess the quality of evidence available...
April 11, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29659795/managing-uncertainty-a-qualitative-study-of-gps-views-on-the-diagnosis-and-immediate-management-of-transient-ischaemic-attack-and-the-potential-of-a-diagnostic-tool
#18
Priyanka Bose, Carolyn Tarrant, Amit K Mistri, Andrew Wilson
Background: Most patients with transient ischaemic attack (TIA) present to their GP. Early identification and treatment reduces the risk of subsequent stroke and consequent disability and mortality. Objective: To explore GPs' views on the diagnosis and immediate management of suspected TIA, and the potential utility of a diagnostic tool. Methods: This is a qualitative interview study based in Leicestershire, UK. A purposive sample of 10 GPs participated in 30-minute semi-structured telephone interviews...
April 12, 2018: Family Practice
https://www.readbyqxmd.com/read/29659534/clinical-management-of-low-vitamin-d-a-scoping-review-of-physicians-practices
#19
REVIEW
Michelle Rockwell, Vivica Kraak, Matthew Hulver, John Epling
The role of vitamin D in the prevention and treatment of non-skeletal health issues has received significant media and research attention in recent years. Costs associated with clinical management of low vitamin D (LVD) have increased exponentially. However, no clear evidence supports vitamin D screening to improve health outcomes. Authoritative bodies and professional societies do not recommend population-wide vitamin D screening in community-dwelling adults who are asymptomatic or at low risk of LVD. To assess patterns of physicians’ management of LVD in this conflicting environment, we conducted a scoping review of three electronic databases and the gray literature...
April 16, 2018: Nutrients
https://www.readbyqxmd.com/read/29658834/alterations-in-thyroid-hormone-levels-following-growth-hormone-replacement-exert-complex-biological-effects
#20
Nigel Glynn, Helena Kenny, Tarik Salim, David J Halsall, Diarmuid Smith, Tommy Kyaw Tun, John H McDermott, William Tormey, Christopher J Thompson, Brendan McAdam, Donal O' Gorman, Amar Agha
OBJECTIVE: Alterations in the thyroid axis are frequently observed following growth hormone (GH) replacement, but uncertainty exists regarding their clinical significance. We aimed to compare fluctuations in circulating thyroid hormone levels, induced by GH, to changes in sensitive biological markers of thyroid hormone action. METHODS: This was a prospective observational clinical study. Twenty hypopituitary men were studied before and after GH replacement. Serum thyroid-stimulating hormone (TSH), thyroid hormones, and insulin-like growth factor 1 were measured...
April 2018: Endocrine Practice
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