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This study aimed to evaluate the effect of target positioning error (TPE) on radiobiological parameters, such as tumor control probability (TCP) and normal tissue complication probability (NTCP), in stereotactic radiosurgery (SRS) for metastatic brain tumors of different sizes using CyberKnife. The reference SRS plans were created using the circular cone of the CyberKnife for each spherical gross tumor volume (GTV) with diameters (φ) of 5, 7.5, 10, 15, and 20 mm, contoured on computed tomography images of the head phantom. Subsequently, plans involving TPE were created by shifting the beam center by 0.1-2.0 mm in three dimensions relative to the reference plans using the same beam arrangements. Conformity index (CI), generalized equivalent uniform dose (gEUD)-based TCP, and NTCP of estimated brain necrosis were evaluated for each plan. When the gEUD parameter "a" was set to - 10, the CI and TCP for the reference plan at the φ5-mm GTV were 0.90 and 80.8%, respectively. The corresponding values for plans involving TPE of 0.5-mm, 1.0-mm, and 2.0-mm were 0.62 and 77.4%, 0.40 and 62.9%, and 0.12 and 7.2%, respectively. In contrast, the NTCP for all GTVs were the same. The TCP for the plans involving a TPE of 2-mm was 7.2% and 68.8% at the φ5-mm and φ20-mm GTV, respectively. The TPEs corresponding to a TCP reduction rate of 3% at the φ5-mm and φ20-mm GTV were 0.41 and 0.99 mm, respectively. TPE had a significant effect on TCP in SRS for metastatic brain tumors using CyberKnife, particularly for small GTVs.
It is controversial whether hospital care mitigated or exacerbated population level racial and ethnic disparities in COVID-19 mortality. To begin answering that question, this study analyzed variations in COVID-19 hospital mortality in Illinois by patient race and ethnicity and by hospital characteristics, while providing an estimate of hospital-level variation in COVID-19 mortality.
This is a retrospective cohort study based on hospital administrative data for adult patients with COVID-19 discharged from acute care, non-federal Illinois hospitals from April 1, 2020 through June 30, 2021. The association of patient and hospital characteristics with the likelihood of death was analyzed using multilevel logistic regression.
There were 158,569 COVID-19-coded admissions to 181 general hospitals in Illinois; 14.5% resulted in death or discharge to hospice. Hospital deaths accounted for nearly 90% of all COVID-19-associated deaths over 15months in Illinois. After adjusting for patient- and hospital-level characteristics, Hispanic patients had higher mortality risk (aOR 1.26, 95% CI 1.20-1.33) as compared with non-Hispanic White patients, while non-Hispanic Black patients had lower mortality risk (aOR 0.75, 95% CI 0.71-0.79). Safety net hospitals receiving disproportionate share hospital (DSH) funds had higher mortality risk (aOR 1.81, 95% CI 1.43-2.30) compared with other hospitals.
Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.
Risk-adjusted COVID-19 hospital mortality was highest among patients of Hispanic ethnicity, while non-Hispanic Black patients had lower risk than non-Hispanic White patients. There was significant variation in hospital mortality rates, with particularly high safety net hospital mortality.The novel coronavirus disease 2019 (COVID-19) has infected over 414 million people worldwide with 5.8 million deaths, as of February 2022. Telemedicine-based interventions to expand healthcare systems' capacity and reduce infection risk have rapidly increased during the pandemic, despite concerns regarding equitable access. Atrium Health Hospital at Home (AH-HaH) is a home-based program that provides advanced, hospital-level medical care and monitoring for patients who would otherwise be hospitalized in a traditional setting. Our retrospective cohort study of positive COVID-19 patients who were admitted to AH-HaH aims to investigate whether the rate of care escalation from AH-HaH to traditional hospitalization differed based on patients' racial/ethnic backgrounds. Logistic regression was used to examine the association between care escalation within 14 days from index AH-HaH admission and race/ethnicity. We found approximately one in five patients receiving care for COVID-19 in AH-HaH required care escalation within 14 days. Odds of care escalation were not significantly different for Hispanic or non-Hispanic Blacks compared to non-Hispanic Whites. Selleckchem Ruxolitinib However, secondary analyses showed that both Hispanic and non-Hispanic Black patients were younger and with fewer comorbidities than non-Hispanic Whites. The study highlights the need for new care models to vigilantly monitor for disparities, so that timely and tailored adaptations can be implemented for vulnerable populations.
Latina immigrant women are at increased risk for poor mental health. Little is known about factors associated with somatic symptoms, the physical manifestation of distress, in this population. This study examined associations between social stressors, trauma, and somatic symptoms.
This study used survey data from a community-based sample of Latina immigrant women (n = 154). We determined the frequency of somatic symptoms and used linear regressions to estimate associations of stressors and trauma with physical symptoms.
Most participants reported mild or moderate levels of somatic symptom severity. In univariate models, all social stressors and trauma types were significantly associated with higher levels of somatic symptoms. A multivariate model suggested perceived stress was associated with increased somatic symptoms after accounting for other stressors and trauma.
Future research should examine whether stress and trauma lead to higher levels of somatic symptoms among Latina immigrants.
Future research should examine whether stress and trauma lead to higher levels of somatic symptoms among Latina immigrants.Thyroid cancer (TC) is most often found in the endocrine system, the incidence of which has been on a continuous increase in recent years. For a better treatment of it, it becomes a pressing matter to further delve into the mechanism of TC onset and progression. FOXP2 is lowly expressed in diverse cancer, which has a deep connection with malignant progression of tumors. However, in TC, studies about this gene are exceedingly limited. In this study, FOXP2 was discovered to be lowly expressed in TC tissues based on the analysis of TCGA database. This finding was further confirmed by the qRT-PCR that FOXP2 was lowly expressed in TC cell lines. The results of a series of cell function assays demonstrated that overexpressed FOXP2 could hamper TC cell proliferation and stemness, facilitate apoptosis, and arrest the cell cycle. For a deep exploration of its mechanism, we mined its upstream factor miR-221-3p with the aid of starBase and mirDIP databases. The dual-luciferase reporter assay was employed to verify the binding relationship between miR-221-3p and FOXP2. Besides, we also discovered the HEDGEHOG pathway existing downstream of FOXP2 by gene set enrichment analysis. Based on these findings, we also performed a rescue experiment, the result of which indicated that the overexpression of FOXP2 was able to reverse the effects of overexpressed miR-221-3p in several cell activities including proliferation, sphere-formation, apoptosis, and cell cycle. Besides, it could also have an impact on the expression of HEDGEHOG pathway-related proteins influenced by overexpressed miR-221-3p. Our study provided the new insights into the mechanism by which miR-221-3p functions in the development of TC.
This study aimed to investigate the gender-specific association between weight misperception and estimated cardiovascular disease (CVD) risk and gender-specific moderation of weight misperception in the associations between obesity indices and CVD risk.
In 7836 men and 10,299 women aged 40-79years without CVD history from the 2014-2018 Korea National Health and Nutrition Examination Survey, the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using Pooled Cohort Equations. Weight misperception was defined as accurate estimation, overestimation, or underestimation by comparing perceived weight to actual weight category. Obesity indices were BMI and waist circumference (WC).
In fully adjusted models, odds of 10-year ASCVD risk of ≥ 7.5% were lower in men with overestimating weight (odd ratio [95% confidence interval], 0.85 [0.73, 0.99] after adjusting for BMI;0.79 [0.68, 0.92] after adjusting for WC), but higher in women with underestimating weight (1.44 [1.27, 1.63] after adjusting for BMI;1.42 [1.26, 1.61] after adjusting for WC) compared to those with accurate weight estimates. Compared to women with accurate weight estimates, the ASCVD risk associated with obesity indices was higher in those who underestimated weight (ß [95% CI], 0.33 [0.23, 0.43] for BMI;0.16 [0.13, 0.20] for WC), whereas it was lower in those who overestimated weight (-0.15 [-0.28, -0.02] for BMI; -0.07 [-0.11, -0.03] for WC). In men, weight misperception did not moderate the association between obesity indices and the ASCVD risk.
These findings suggest that weight misperception was associated with estimated CVD risk independently across gender and moderates the association between obesity indices and estimated CVD risk in women.
These findings suggest that weight misperception was associated with estimated CVD risk independently across gender and moderates the association between obesity indices and estimated CVD risk in women.
We examined the degree to which adults with inflammatory bowel disease (IBD) integrated their illness into their identity and linked illness identity to important patient-reported outcomes.
A total of 109 adults with IBD, aged 18 to 60 (M
= 35.93; 77% women) completed questionnaires on the four illness identity dimensions (rejection, acceptance, engulfment, and enrichment), medication adherence, depressive symptoms, life satisfaction, health status, and health-related quality of life (HRQoL). The illness identity scores of adults with IBD were compared to existing data from adults with congenital heart disease (CHD), refractory epilepsy (RE), and multisystemic connective tissue disorders (MSDs) using multivariate analyses of covariance. In adults with IBD, associations between illness identity and patient-reported outcomes were examined through hierarchical regression analyses, controlling for sex, age, illness duration, diagnosis, self-reported flares, and co-existing illnesses.
Adults with IBD scored higher on rejection and engulfment and lower on acceptance than adults with CHD, lower on rejection but higher on engulfment than adults with RE, and higher on engulfment and enrichment but lower on rejection than adults with MSDs. Higher engulfment scores were related to more depressive symptoms, lower life satisfaction, and a poorer health status and HRQoL. In contrast, higher enrichment scores were related to more life satisfaction and a better HRQoL. Rejection and acceptance were not uniquely related to any of the outcomes.
Adults with IBD showed relatively high levels of engulfment. Substantial associations were observed between illness identity and patient-reported outcomes, with engulfment being the strongest, most consistent predictor.
Adults with IBD showed relatively high levels of engulfment. Substantial associations were observed between illness identity and patient-reported outcomes, with engulfment being the strongest, most consistent predictor.
Homepage: https://www.selleckchem.com/products/INCB18424.html
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