Communicating a cancer diagnosis using a human centered design approach.

Background Labor induction, a common practice to prevent maternal and fetal complications from prolonged labor, involves stimulating contractions before they begin naturally. This can be achieved through medications, mechanical methods, or surgical interventions. Cervical ripening is crucial for successful delivery. When the cervix is not sufficiently ripe, drugs are often used to augment this process chemically. Objective To evaluate the safety and efficacy of mifepristone for cervical ripening and induction of labor. Method A sample size of 200 was used in this single-blind randomized control trial. Primarily, pregnant women with term pregnancies, Bishop scores <6, and cephalic fetal presentation were included in the study. The study population was randomly divided into test and control groups. The test group (n=100) was administered 200 mg of mifepristone orally, while the control group (n=100) received a placebo. The Bishop score was reassessed 24 hours after mifepristone administration. Patients were taken for labor induction if their Bishop score was >6. For individuals with a Bishop score of <6, 1 mg of dinoprostone gel was administered intracervically once every six hours. Safety and efficacy were assessed by analyzing several parameters associated with labor progression, maternal outcomes, and fetal outcomes. Results The mean age of patients in the test group was 26±4.5 years, while in the control group, it was 26±5 years. The induction-to-delivery interval was notably shorter in the test group (18.8±2.3 hours) than in the control group (19.24±1.8 hours, p<0.0001). After the administration of 200 mg mifepristone, the mean Bishop score in the test group was 5.74±0.8, compared to 5.13±0.76 in the control group. The increase in the Bishop score after mifepristone treatment was significantly higher in the test group than in the control group (p-value=0.013). In the study, 73 (73%) patients in the test group had a normal vaginal delivery (NVD), whereas NVD accounted for 64 (64%) patients in the control group. Instrumental deliveries were less frequent in the test group, accounting for 14 (14%) patients, compared to 16 (16%) patients in the control group. The frequency of lower segment cesarean section (LSCS) was also lower in the mifepristone-treated group at 13 (13%) compared to the control group at 20 (20%). Fetal distress in five (38%) patients and non-progression of labor in 11 (55%) patients were the most frequent indications for LSCS in the test and control groups, respectively. There was no significant difference in neonatal outcomes between the test and control groups. Meconium-stained liquor was the most frequent complication in both the test group(10, 10%) and the control group (5, or 5%). Conclusion Administration of mifepristone effectively increased the Bishopscores and reduced the induction-to-delivery interval compared to controls, highlighting its potential as a cervical ripening agent.

PurposeThe aim of this study was to evaluate the impact of polydeoxyribonucleotide (PDRN) on histologic outcomes when implant placement and lateral sinus floor elevation are performed simultaneously.MethodsThree bimaxillary premolars (P2, P3, and P4) were extracted from 4 beagle dogs 2 months before lateral sinus floor elevation. After lateral elevation of the sinus membrane, each sinus was allocated to either the test or control group. Sinuses underwent either 1) collagenated synthetic bone graft with PDRN following lateral sinus floor elevation (test group) or 2) collagenated synthetic bone graft without PDRN after lateral sinus floor elevation (control group). Eight weeks after the surgical procedure, all animals were euthanised for a histologic and histomorphometric assessment. Augmented height (AH), protruding height (PH), and bone-to-implant contact in pristine (BICp) and augmented (BICa) bone were measured. The composition of the augmented area, which was divided into 3 areas of interest located in coronal, middle and apical areas (AOI_C, AOI_M, and AOI_A), was calculated with 3 parameters: the area percentage of new bone (pNB), residual bone graft particle (pRBP), and fibrovascular connective tissue (pFVT).ResultsAH, PH, BICp, BICa total, BICa coronal, and BICa middle values were not significantly different between sinuses in the control and test groups (all P>0.05). The BICa apical of sinuses in the test group (76.7%±9.3%) showed statistically higher values than those of sinuses in the control group (55.6%±22.1%) (P=0.038). pNB, pRBP, and pFVT showed statistically significant differences between the 2 groups in AOI_A (P=0.038, P=0.028, and P=0.007, respectively). pNB, pRBP, and pFVT in AOI_C and AOI_M were not significantly different between samples in the control and test groups (all P>0.05).ConclusionsThe histologic findings revealed that lateral sinus floor elevation with PDRN might improve early new bone formation and enable higher bone-to-implant contact.

Background:The efficacy of fluoridated dentifrices in caries prevention has been well documented and research into various formulations continues for a more effective dentifrice. This study evaluated the anti-caries and anti-plaque efficacy of a dentifrice containing sodium monofluorophosphate (1000 ppm) and calcium glycerophosphate, and compared it with a non-fluoridated dentifrice.Materials and Methods:A total of 595 school children (12–15 years) were divided into test (302 children) and control (293 children) groups. The test group used the dentifrice containing sodium monofluorophosphate (1000 ppm) and calcium glycerophosphate, whereas the control group was given a placebo dentifrice. Oral examination for dental caries and plaque assessment was carried out at the start of the study and the children were followed up semiannually up to 18 months. Data were analyzed using repeated-measure analysis of variance (ANOVA) followed by one-way ANOVA.Results:The values for decayed missing filled teeth (DMFT) increased from baseline to 18 month examination from 4.43±2.03 and 4.67±2.25 (P=0.175) to 5.84±2.29 and 5.13±2.30 (P=0.001) for control and test groups, respectively. Similarly, the increase in decayed missing filled surface (DMFS) values were from 6.42±4.10 and 7.06±4.77 (P=0.082) to 8.64±4.51 and 7.92±5.07 (P=0.095) for test and control groups, respectively. The mean DMFT and DMFS values increased for both the groups; however, the increase was less in test group as compared to control group. The baseline plaque score reduced from 2.94±0.72 and 2.91±0.72 (P=0.679), respectively, for control and test groups to 1.33±0.46 and 0.91±0.38 (P<0.001), respectively, at 18 month examination.Conclusion:Results revealed that the test dentifrice was effective in inhibiting the progression of plaque and control of dental caries as compared to the placebo dentifrice.

6069 Background: To investigate the efficacy and safety of the two modes of concurrent chemoradiotherapy combined with induction or adjuvant chronotherapy for the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: A total of 266 patients with locoregionally advanced NPC were enrolled from May 2018 to July 2021 and randomly divided into a test (n = 133) and a control (n = 133) group. In the test group, the docetaxel and cisplatin plus fluorouracil (TPF) regimen was used to induce chronological chemotherapy for 3 cycles (docetaxel 75mg / m2, D1, cisplatin 75mg / m2, d1-d5, fluorouracil 750mg / m2 / D, d1-d5) + 3 cycles of concurrent chemoradiotherapy (cisplatin 100mg / m2; The control group was treated with three cycles of concurrent chemoradiotherapy (cisplatin 100mg / m2) + cisplatin plus fluorouracil (PF) regimen with adjuvant schedule chemotherapy for three cycles (cisplatin 80mg / m2 on days d1-d5, fluorouracil 800mg / m2 / d on days d1-d5). In both groups, intensity-modulated radiation therapy was used with a total dose of 69.96 Gy to the primary tumor at T1 and T2, 72.6 Gy to the primary tumor at T3 and T4, and 69.96 Gy to the positive lymph nodes. Acute adverse effects and survival were compared between the two groups. Results: A median follow-up of 19 months, 129 patients in the test group and 124 in the control group were evaluable for efficacy and adverse effects.Compliance was 96.99% and 90.22%, respectively. The 2-year overall survival rates were 91.7% and 90.5%, and the 2-year progression free survival rates were 92.4% and 90.4% in the test and control groups, respectively, with no significant difference ( P &gt; 0.05). The test group had a lower incidence of radiation mucositis, dry mouth, and dysphagia than the control group ( P &lt; 0.05), whereas the test group had a higher incidence of leukopenia, neutropenia, hemoglobin loss, vomiting ( P &lt; 0.05), decreased radiation dermatitis, platelets There were no significant differences in the categories of creatinine elevation and transaminase elevation (P &gt; 0.05). Conclusions: The patients' compliance was good and the toxic effects such as radiation mucositis, dry mouth and dysphagia were reduced under the treatment mode in which the TPF induced chemotherapy combined with concurrent chemoradiotherapy.Although the toxic effects such as leukopenia, neutropenia, hemoglobin reduction and vomiting were increased, the efficacy was comparable with that of the PF in which the adjuvant schedule chemotherapy combined with concurrent chemoradiotherapy. Clinical trial information: NCT-03574324.

Investigation of various tumor-specific markers has a critical role in early diagnosis and treatment of breast cancer. The aim of the this study is to investigate the Human Leukocyte Antigen (HLA) alleles, the molecules that play an important role in immunity and tumor response of the body, and its relationship with breast cancer. In this prospective clinical study, after obtaining approval from the ethics committee of Istanbul University Experimental Medical Research Institute, 22 female patients who have been hospitalized in Istanbul University Cerrahpasa Faculty of Medicine the Department of General Surgery with a diagnosis of breast cancer were selected. In the control group, there were 22 healthy women who had no relationship and were donor candidates for renal transplantation. After collecting blood in 5 ml tubes with EDTA, HLA A, B and DR groups were measured with SSP method using the GenoVision Olerup SSP (Olerup SSP, Stockholm, Sweden) kit in Istanbul University Cerrahpasa Faculty of Medicine Blood Center Tissue Type Determination Laboratory. In patient and control group, totally 53 alleles; 17 alleles of HLA-A gene, 22 alleles of B gene, 14 alleles of DR gene were detected. A statistically significant relationship was determined between HLA-B55:01 and HLA-DRb1*18:01 alleles and the development of breast cancer (p<0.05). HLA-B13:01 antigen is determined only in the control group. It was concluded that HLA-B13:01 antigen, determined only in the control group, may be protective for breast cancer and HLA-B55:01 and HLA-DRb1*18:01 antigens, determined only in the patient group, may be a risk factor for breast cancer (Tab. 5, Ref. 22).

Effect of reapplication on pull-out bond strength of fibre post to root dentin: An in vitro study

The study is dedicated to the investigation of EEG spectral characteristics during resting states and a creative task performance (Alternative Uses Task, AUT) before and after a single session of neurofeedback (NFB) and sham-NFB training. The study involved 24 adolescents (aged 15–17 years) who were randomly divided into two independent groups both with 12 subjects. The test group (TEST) participated in one session of NFB training based on their own EEG data (power of individual alpha frequency), while the control group (SHAM) participated in one session of sham-NFB training. Spectral power in the Δ (1.5–4 Hz)-, θ (4–8 Hz)-, α1 (8–10 Hz)-, α2 (10–13 Hz)-, β1 (13–18 Hz)-, β2 (18–30 Hz)-bands of the EEG during eyes open and closed resting states, and event-related synchronisation/desynchronisation of the EEG during performance of the alternative use task before and after the NFB/SHAM session were analysed. Prior to the NFB/SHAM sessions, no differences were observed between the groups in the resting state EEG. After the NFB/SHAM session, lower EEG power values in the β2-band were observed in the test group compared to the control group in the eyes-closed condition. There was a decrease in Δ-band EEG power in frontal temporal regions in the eyes-closed condition and an increase in α2-band power in the eyes-open condition after the NFB session compared to a condition before the NFB session. In the control group, no differences in EEG spectral power were observed in the states AFTER vs. BEFORE the SHAM session. Analysis of event-related EEG synchronisation/desynchronisation during the AUT before and after the NFB session revealed no differences between the test and control groups. Intragroup comparisons of AFTER vs. BEFORE NFB/SHAM sessions revealed the following different effects: in the test group, first, EEG desynchronisation in the frequency range 17.5–30 Hz was observed in the frontal regions of the left hemisphere in the interval 220–300 ms after the presentation of the stimulus, and subsequently, there was synchronisation in the θ and low-frequency α electroencephalogram (EEG) ranges (4–9.8 Hz) (in the interval 540–1400 ms) with maximum differences in the frontal regions. The control group was characterised by synchronisation of electroencephalogram (EEG) activity in the higher frequency ranges of 9.5–26 Hz and in the narrower time interval of 520–760 ms in central and frontal electrodes. Consequently, a single NFB session in the test group resulted in changes in EEG spectral power during resting states that were not observed in the control (SHAM) group following sham training, and exhibited precise modulation of the state during creative activity.

Background:Study comparing the improvement of implant maintenance is limited. Clinicians must be aware of implant maintenance to improve long-term success of implant.Aims:The aim of this retrospective study was to evaluate whether the Medical Treatment Model (MTM), which is a comprehensive treatment, includes initial risk assessment, lifestyle instructions, such as diet and habits, and a customized maintenance program to improve implant prognosis.Materials and Methods:Patients who were comprehensively treated were included and divided into two groups, test and control groups. The test group included patients who started treatment with MTM, whereas control group included patients who started treatment without MTM introduction. Moreover, subsequently, compliance with maintenance, occurrence of biological complications, and implant failure were evaluated.Results:About 199 patients with 515 implants were analyzed in the control group and 38 patients with 59 implants in the test group. In the control and test groups, the percentages of patients in the four compliance categories were, respectively, 73.9% and 89.5% for excellent compliance, 7.0% and 7.9% for good compliance, 14.6% and 0% for fair compliance, and 4.5% and 2.6% for poor compliance. There was a statistically significant difference in the compliance with periodontal and implant maintenance between the test and control groups (P = 0.029).Conclusions:Within the limitation of this study, MTM significantly enhanced the compliance of patients treated with implants.

Background and ObjectivesZZAfter the bone anchored hearing aid (BAHA) surgery, soft tissue problems have frequently been reported.To solve this problem, a surgical procedure that routinely involves so-called skin thinning using BAHA dermatome has been utilized.But, this procedure includes many peri-implant complications and cosmetic trouble.Recently, a single vertical incision technique that does not involve skin thinning has been reported with favorable results.In this study, we evaluated the benefits of performing this procedure without skin thinning compared with the dermatome technique.Subjects and MethodZZWe evaluated 10 patients who were operated on without skin thinning using longer (8.5 mm) abutments (the test group) and 5 patients with the routine skin thinning and 5.5-mm abutments (the control group).A mean follow-up time was 11.3 months, the mean age was 34.2 years in the test group, the mean follow-up time was 54.5 months and a mean age is 24.5 years in the control group.ResultsZZThe mean time required for surgery was 25 minutes and 55 minutes for the test and control groups, respectively.The wound healing time was 28 days and 56 days for the test and control groups, respectively.Fixture extrusion, skin infection and skin overgrowth were not observed in the test group but fixture extrusion case, two skin infection cases and two skin overgrowth cases were observed in the control group.Two cases of abutment loosening were observed in the test group.ConclusionZZThe single vertical incision technique without skin thinning has many benefits when compared with the BAHA dermatome.With this technique, infection and skin overgrowth could be reduced, and a more rapid procedure and a more short healing time could also be possible.Moreover, the aesthetic outcome was far better when no skin thinning was involved.

BackgroundAn incentive spirometer (IS) is a medical device used to help patients improve the functioning of their lungs. It is provided to patients who have had any surgery that might jeopardize respiratory function. An incentive spirometer plays a key role in the prevention of postoperative complications, and the appropriate use of an IS is especially well known for the prevention of respiratory complications. However, IS utilization depends on the patient’s engagement, and information and communication technology (ICT) can help in this area.ObjectiveThis study aimed to determine the effect of mobile ICT on the usage of an IS (Go-breath) app by postoperative patients after general anesthesia.MethodsFor this study, we recruited patients from April to May 2018, who used the Go-breath app at a single tertiary hospital in South Korea. The patients were randomly classified into either a test or control group. The main function of the Go-breath app was to allow for self-reporting and frequency monitoring of IS use, deep breathing, and active coughing in real time. The Go-breath app was identical for both the test and control groups, except for the presence of the alarm function. The test group heard an alarm every 60 min from 9 am to 9 pm for 2 days. For the test group alone, a dashboard was established in the nurse’s station through which a nurse could rapidly assess the performance of multiple patients. To evaluate the number of performances per group, we constructed an incentive spirometer index (ISI).ResultsA total of 44 patients were recruited, and 42 of them completed the study protocol. ISI in the test group was 20.2 points higher than that in the control group (113.5 points in the test group and 93.2 points in the control group, P=.22). The system usability scale generally showed almost the same score in the 2 groups (79.3 points in the test group and 79.4 points in the control group, P=.94). We observed that the performance rates of IS count, active coughing, and deep breathing were also higher in the test group but with no statistically significant difference between the groups. For the usefulness “yes or no” question, over 90% (38/42) of patients answered “yes” and wanted more functional options and information.ConclusionsThe use of the Go-breath app resulted in considerable differences between the test group and control group but with no statistically significant differences.Trial RegistrationClinicalTrials.gov NCT03569332; https://clinicaltrials.gov/ct2/show/NCT03569332 (Archived by WebCite at http://www.webcitation.org/74ihKmQIX).

Patients are suffering from stroke experience balance dysfunction leading to poor weight shifts and reduced weight bearing on the affected lower limb. The Tetrax biofeedback system is a Centre of Pressure-controlled, video game-based exercise system designed for patients with balance dysfunction. Objective: This study aimed to investigate the effects of using Tetrax balance games and conventional rehabilitation on the balance and mobility of subjects with impaired standing balance due to stroke. Design: Pretest-posttest Randomized Clinical Trial Method: A total of thirty patients (including male and female) who have suffered a stroke at least six months back, diagnosed with hemiplegia within the age group of 35-65 years with MMSE Score = 24 were recruited. Six subjects did not give their consent. Subjects were assigned to Group 1 (test group) and Group 2 (control group), using Convenience sampling. Group 1 (test group) consisted of 12 subjects (both male and female) and received conventional therapy and tetrax sessions. Group 2 (control group) consisted of 12 subjects (both male and female) and received only conventional therapy. All participants received conventional outpatient rehabilitation therapy (which accounted for an average of 60 minutes of physiotherapy for the control group and 40 minutes for the test group per day) three days a week in an outpatient setting. The test group received additional Tetrax biofeedback balance training three days per week (20 minutes per day) for four weeks in the same outpatient setting. The Tetrax system was equipped with four independent force plates under the toes and heels. The outcome measures of the study were BBs and FIMS. All outcome measures were evaluated pretest and posttest. Result: The means standard deviations of Improvement in BBS in test and control groups are 3.83 4.64 and 1.25 1.28, respectively. On applying the t-Test, we found the mean difference of 0.077 of Improvement in BBS in the test and control group is not significant. The means standard deviations of Improvement in FIMS in test and control groups are 2.83 2.24 and 1.75 1.21, respectively. On applying the t-Test, we found the mean difference of 0.156 of Improvement in FIMS in the test and control group is not significant. Conclusion: The current study found that both groups—those receiving only conventional therapy and those receiving a combination of tetrax and conventional therapy—improved their balance significantly, although there was no significant difference between them. Keywords: Stroke, Tetrax, Balance, Weight shift in lower limbs, Postural Balance.

lunnela j, kääriäinen m & kyngäs h (2011) Journal of Nursing and Healthcare of Chronic Illness3, 119–129Web-based intervention for improving adherence of people with glaucoma Aim. To assess the effects of web-based patient-centred education and support on the adherence of people with glaucoma. Background. Glaucoma is a worldwide chronic ophthalmic illness with the symptoms of increased intraocular pressure which causes blindness. One problem is the poor adherence of people with glaucoma. Patient-centred approach should be the aim of patient education. Patient education of people with glaucoma focuses on symptoms, treatments, prognosis and medication. Design. A non-randomised experimental design with intervention of test (n = 34) and control (n = 51) groups. Method. The test group received web-based patient education and support intervention, which consist of several informational links concerning treatments, medication and self-care of glaucoma. The control group received the traditional patient education and support. The data were collected from adult people with glaucoma by self-reported ACDI instrument at baseline and follow ups (two and six months) between December 2008–May 2009. Results. Participants in both the test and the control groups showed improvement in their adherence. No statistical significant differences were found between the test and control group. Adherence to care (SUM9), support from nurses and physicians (SUM1) and care planning (SUM8) improved more in the test group than in the control group. Conclusion. The adherence of people with glaucoma in the test group improved on receiving this web-based patient education and support. However, the results of the control group also improved during the intervention. It is possible to improve chronically ill people’s adherence and self-care by developing new, time-saving and patient-centred methods using technical equipment. Relevance to clinical practice. These results are useful in developing new patient education and support methods for people with glaucoma as well as other people with chronic illness.

Ki67, PCNA, and MCM proteins: Markers of proliferation in the diagnosis of breast cancer

Background Catheter-directed thrombolysis (CDT) for deep venous thrombosis (DVT) of the lower extremity has good effect, but whether iliac vein stent placement after thrombolytic therapy is still controversial. The goal of this study was to evaluate the efficacy of stent placement in the iliac vein following CDT in lower extremity DVT. Methods This was a single-center, prospective, randomized controlled clinical trial. After receiving CDT, the major branch of the distal iliac vein was completely patent in 155 patients with lower extremity DVT, and 74 of these patients with iliac vein residual stenosis of &gt;50% were randomly divided into a control group (n=29) and a test group (n=45). In the test group, stents were implanted in the iliac vein, whereas no stents were implanted in the control group. We evaluated the clinical indicators, including patency of the deep vein, C in CEAP classification, Venous Clinical Severity Score (VCSS), and Chronic Venous Insufficiency Questionnaire (CIVIQ) Score. Results All patients had postoperative follow-up visits for a period of 6–24 months. Venography or color ultrasound was conducted in subjects. There was a significant difference between the patency rate at the last follow-up visit (87.5% vs. 29.6%) and the 1-year patency rate (86.0% vs. 54.8%) between the test and control groups. The change in the C in CEAP classification pre- and post-procedure was significantly different between the test and control groups (1.61±0.21 vs. 0.69±0.23). In addition, at the last follow-up visit, VCSS and CIVIQ Score were both significantly different between the test and control groups (7.57±0.27 vs. 0.69±0.23; 22.67±3.01 vs. 39.34±6.66, respectively). Conclusion The stenting of iliac vein obstruction following CDT in lower extremity DVT may increase the patency of the deep vein, and thus provides better efficacy and quality of life.

Unhealthy maternal diet leads to heavy metal exposures from the consumption of ultra-processed foods that may impact gene behavior across generations, creating conditions for the neurodevelopmental disorders known as autism and attention deficit/hyperactivity disorder (ADHD). Children with these disorders have difficulty metabolizing and excreting heavy metals from their bloodstream, and the severity of their symptoms correlates with the heavy metal levels measured in their blood. Psychiatrists may play a key role in helping parents reduce their ultra-processed food and dietary heavy metal intake by providing access to effective nutritional epigenetics education. To test the efficacy of nutritional epigenetics instruction in reducing parental ultra-processed food intake. The study utilized a semi-randomized test and control group pretest-posttest pilot study design with participants recruited from parents having a learning-disabled child with autism or ADHD. Twenty-two parents who met the inclusion criteria were randomly selected to serve in the test (n = 11) or control (n = 11) group. The test group participated in the six-week online nutritional epigenetics tutorial, while the control group did not. The efficacy of the nutritional epigenetics instruction was determined by measuring changes in parent diet and attitude using data derived from an online diet survey administered to the participants during the pre and post intervention periods. Diet intake scores were derived for both ultra-processed and whole/organic foods. Paired sample t-tests were conducted to determine any differences in mean diet scores within each group. There was a significant difference in the diet scores of the test group between the pre- and post-intervention periods. The parents in the test group significantly reduced their intake of ultra-processed foods with a pre-intervention diet score of 70 (mean = 5.385, SD = 2.534) and a post-intervention diet score of 113 (mean = 8.692, SD = 1.750) and the paired t-test analysis showing a significance of P < 0.001. The test group also significantly increased their consumption of whole and/or organic foods with a pre-intervention diet score of 100 (mean = 5.882, SD = 2.472) and post-intervention diet score of 121 (mean = 7.118, SD = 2.390) and the paired t-test analysis showing a significance of P < 0.05. Here we show nutritional epigenetics education can be used to reduce ultra-processed food intake and improve attitude among parents having learning-disabled children with autism or ADHD.