Search Results for: Test delle urine per la diagnosi di cancro

When I give presentations about JAMA Psychiatry, people often ask me what our “strategy” is and how we decide what papers to publish. I respond that our guiding lights are scientific rigor and clinical relevance. This has never been truer than at the present time, when medical research and practice are under scrutiny like never before. We strive to publish original research that will stand the test of time, informed opinion pieces about current challenges, and insightful review articles taking stock of progress. When we succeed in that goal, our readers recognize that our journal showcases the most impactful developments in our field. In 2024, we published a key phase 3 clinical trial on the first new antipsychotic medication with a nondopaminergic mechanism of action in history (xanomeline-trospium) and a study on the positive impact of GLP-1 receptor agonists on alcohol use disorder outcomes in a national registry. We also covered ongoing debates concerning revisions of psychiatric nosology and continued to cover all aspects of the therapeutic potential and pitfalls of psychedelics and even devoted 3 of our popular podcasts to the topic.

Campagna informativa Ifo, non sottovalutare sangue nelle urine

Objectives
Occupational noise-induced hearing loss (ONIHL) represents a prevalent occupational health condition, traditionally necessitating multiple pure-tone audiometry assessments. We have developed and validated a machine learning model leveraging routine haematological and biochemical parameters, thereby offering novel insights into the risk prediction of ONIHL.

Design, setting and participants
This study analysed data from 3297 noise-exposed workers in Shenzhen, including 160 ONIHL cases, with the data set divided into D1 (2868 samples, 107 ONIHL cases) and D2 (429 samples, 53 ONIHL cases). The inclusion criteria were formulated based on the GBZ49-2014 Diagnosis of Occupational Noise-Induced Hearing Loss. Model training was performed using D1, and model validation was conducted using D2. Routine blood and biochemical indicators were extracted from the case data, and a range of machine learning algorithms including extreme gradient boosting (XGBoost) were employed to construct predictive models. The model underwent refinement to identify the most representative variables, and decision curve analysis was conducted to evaluate the net benefit of the model across various threshold levels.

Primary outcome measures
Model creation data set and validation data sets: ONIHL.

Results
The prediction model, developed using XGBoost, demonstrated exceptional performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.942, a sensitivity of 0.875 and a specificity of 0.936 on the validation data set. On the test data set, the model achieved an AUC of 0.990. After implementing feature selection, the model was refined to include only 16 features, while maintaining strong performance on a newly acquired independent data set, with an AUC of 0.872, a balanced accuracy of 0.798, a sensitivity of 0.755 and a specificity of 0.840. The analysis of feature importance revealed that serum albumin (ALB), platelet distribution width (PDW), coefficient of variation in red cell distribution width (RDW-CV), serum creatinine (Scr) and lymphocyte percentage (LYMPHP) are critical factors for risk stratification in patients with ONIHL.

Conclusion
The analysis of feature importance identified ALB, PDW, RDW-CV, Scr and LYMPHP as pivotal factors for risk stratification in patients with ONIHL. The machine learning model, using XGBoost, effectively distinguishes patients with ONIHLamong individuals exposed to noise, thereby facilitating early diagnosis and intervention.

Objectives
To explore the reporting barriers and related factors of medication errors among nurses in hospitals in China and provide a reference for safe medication management in hospitals.

Design
Cross-sectional, online survey.

Setting
Responses were collected online from September 2022 to November 2022 across a specific tertiary hospital in Chengdu, China.

Participants
Clinical registered nurse.

Primary outcome measure
Measure the Barriers to Medication Administration Error (MAE) Reporting Questionnaire, Face-Saving Scale, the Index of Hierarchy of Authority and the Working Environment Questionnaire. Independent sample t-test, correlation analysis and multiple linear regression analysis were performed to identify factors associated with the barriers to MAE reporting.

Results
432 (97.30%) nurses responded. Nurses’ standardised scores of barriers to MAE reporting were 3.01 (SD=1.01); the fear dimension items have the highest standardised score of 3.42 (SD=1.11). Working environment is negatively correlated with barriers to MAE reporting (r=–0.201, p

Cognetti, ‘I due Dpcm colmano un ritardo di 8 anni’

Nuovo centro di Teragnostica. Schillaci, ‘branca tra le più promettenti, per terapie sempre più personalizzate e diagnosi sempre più precoci’

A Padova 700 esperti a confronto nel congresso Emsos

Circulation, Ahead of Print. BACKGROUND:Immune cells are closely associated with all processes of cardiac repair after myocardial infarction (MI), including the initiation, development, and resolution of inflammation. Spleen extramedullary hematopoiesis (EMH) serves as a crucial source of emergency mature blood cells that are generated through the self-renewal and differentiation of hematopoietic stem/progenitor cells (HSPCs). However, how EMH responds to MI and the role of EMH in cardiac repair after MI remains unclear.METHODS:To assess the role of spleen EMH in MI, aTcf21CreERScfflox/floxMI mouse model with inhibited EMH was constructed. GFP+(green fluorescent protein) hematopoietic stem cells were sorted from eGFP (enhanced green fluorescent protein) mouse spleen by flow cytometry and injected intoTcf21CreERScfflox/floxmice to test the sources of local inflammatory cells during MI. Using highly specific liquid chromatography–tandem mass spectrometry and single-cell RNA sequencing, we analyzed the lipidomic profile of arachidonic acid metabolites and the transcriptomes of HSPCs in the spleen after MI.RESULTS:We found that MI enhanced EMH, as reflected by the increase in spleen weight and volume and the number of HSPCs in the spleen. The lack of EMH inScf-deficient mice exacerbated tissue injury after MI. Analysis of the transcriptome of spleen HSPCs after MI revealed that the type 1 interferon pathway was substantially inhibited in hematopoietic stem cell/multipotent progenitor subclusters, and the absence of type 1 interferon signaling enhanced the MI-induced spleen EMH. Lipidomics analysis revealed that prostaglandin I2 (PGI2) was markedly reduced in the spleen. PGI2 suppressed MI-induced EMH through a PGI2 receptor (IP)–cyclic adenosine monophosphate–453p-SP1 cascade in spleen HSPCs. Hematopoietic cell–specific IP-deficient mice exhibited enhanced EMH and improved cardiac recovery after MI.CONCLUSIONS:Together, our findings revealed that a PGI2–IFN axis was involved in spleen EMH after MI, providing new mechanistic insights into spleen EMH after MI and offering a new therapeutic target for treating ischemic cardiac injury.

Stroke, Ahead of Print. BACKGROUND:ANNEXA-I (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXA Inhibitors) was a randomized trial that demonstrated that andexanet compared with usual care in patients with intracranial hemorrhage associated with FXa (factor Xa) inhibitor treatment reduces the risk of hematoma expansion and increases the risk of arterial thromboembolic events.METHODS:In a secondary analysis of the ANNEXA-I trial, we compared the effects of andexanet with usual care on change in anti-FXa activity and endogenous thrombin potential (ETP) using Wilcoxon rank-sum test. We examined the associations between 1-hour reduction in anti-FXa and 1-hour increase in ETP and hematoma expansion at 12 hours (≥12.5 mL or percentage volume change ≥35%) using logistic regression, both unadjusted and adjusted for time from symptom onset to baseline scan, baseline diastolic blood pressure, hematoma volume, baseline biomarker level and time from baseline scan to treatment, and association with arterial thromboembolic events (ischemic stroke, myocardial infarction, and systemic embolism) during 30 days of follow-up using Cox regression, both unadjusted and adjusted for age, baseline biomarker level, prior MI, and eligibility for treatment with high-dose andexanet.RESULTS:ANNEXA-I enrolled 530 patients. Among 438 patients with baseline anti-FXa results, andexanet compared with usual care reduced anti-FXa activity at 1 hour (median, 8.6 versus 97.5 ng/mL; median reduction from baseline, 98.3 versus 10.9 ng/mL;P

Introduction
The management of immunoglobulin A (IgA) nephropathy remains a topic of debate. Hydroxychloroquine and mycophenolate mofetil (MMF) are two immunosuppressive agents that have recently garnered increased attention among patients with IgA nephropathy in China. Several studies have shown the comparable efficacy between MMF and enteric-coated mycophenolate sodium (EC-MPS), with lower adverse event rates for EC-MPS. The present study aims to evaluate the efficacy and safety of EC-MPS combined with hydroxychloroquine as an immunosuppressive regimen for patients with high-risk progressive IgA nephropathy, despite receiving routine supportive treatment.

Methods and analysis
This study is a multicentre, prospective, randomised controlled, open-label, blinded endpoint trial. 96 patients diagnosed with IgA nephropathy and persistent proteinuria from 12 general hospitals in Shanxi Province of China will be recruited and randomly assigned to receive either EC-MPS plus hydroxychloroquine or hydroxychloroquine alone in a 1:1 ratio. We will compare the efficacy and safety of hydroxychloroquine combined with or without oral EC-MPS (720–1080 mg/day for 6 months, and tapered to 360–540 mg/day for another 6 months) on a background of supportive care. All enrolled patients will receive standard basic treatment to achieve optimum blood pressure and the maximum tolerated dose of ACE inhibitors or angiotensin receptor blockers. The primary outcome is the change in 24-hour urine protein at 6 months relative to baseline. Participants will be subject to regular follow-up for a duration of 12 months.

Ethics and dissemination
This study has received ethical approval from the Ethics Committee of Shanxi Medical University Second Hospital (No. 2024YX-481). A duly signed and dated informed consent form must be obtained from each participant or his/her legal guardian prior to any operational procedures related to the trial. The result of this study will be presented and published at international conferences and in scientific journals.

Trial registration number
ChiCTR2400093530.

Introduction
Anxiety is a common non-motor symptom of Parkinson’s that is associated with reduced life quality, independence and health outcomes. Current anxiolytic medications and the most promising behavioural interventions have inconclusive and mixed results. Occupational therapy is effective at promoting participation in activities of daily living and is recommended in national guidelines. This cluster randomised controlled trial aims to test the feasibility and fidelity of a new occupation-based complex intervention for living well with anxiety in Parkinson’s disease (OBtAIN-PD). No such evidence-based intervention currently exists.

Methods and analysis
50 people with Parkinson’s will be recruited from Devon, UK, to undertake the OBtAIN-PD or usual care delivered by community-based occupational therapists across two National Health Service sites. Recruitment, attrition rates and feasibility of proposed outcome measures (Canadian Occupational Performance Measure, Generalised Anxiety Disorder-7, The Parkinson’s Disease Questionnaire-39, Activity Card Sort, Barthel Index and fall logs) will be tested. Resource data will be collected to aid in the feasibility assessment. Fidelity to content will be assessed using process evaluation. Subjective experiences will be explored qualitatively (10 participants, occupational therapists and decliners).

Ethics and dissemination
This trial has been registered with the ISRCTN registry. Ethical approval has been obtained from the North East – York Research Ethics Committee (reference 23/NE/0027) before data collection. Participants will receive a summary of the results at the end of the data analysis. We will publish the results in a peer-reviewed journal and on institution websites.

Trial registration number
ISRCTN62762494.

Libro del neurologo Gennaro Barbato. ‘Decisivo è il territorio’

Background
Social networks are an important, although overlooked, component of community-based health promotion. Advances in social network research have highlighted different social network intervention (SNI) strategies to improve community-based health promotion. The aim of this project is to collaborate with community and policy stakeholders to explore how to best apply these SNI strategies to improve the resilience, health and well-being of adults in Amsterdam, and more broadly in the Netherlands.

Methods and analysis
To this end, we will collaboratively develop an intervention planning tool called the ‘Health in All Networks Simulator (HANS)’. This tool will be capable of virtually testing different SNI strategies and forecasting their possible impact on resilience, health and well-being. Taking a mixed-methods approach consisting of a combination of interviews, group model building workshops and agent-based modelling with members of two communities in Amsterdam and policy stakeholders, we will foster a shared learning process while ensuring ownership and relevance of HANS to ongoing community-based health promotion practice.

Ethics and dissemination
The research project has been approved by the research ethics committee of Wageningen University (approval numbers: 2024-039; 2024-226). HANS will be shared directly with stakeholders. The results will be made available to the public via open-access publications and conferences.

Introduction
Halitosis is a term that defines any unpleasant odour smell originating from the oral cavity and may have a local or systemic origin. This project aims to determine the effectiveness of treatment involving antimicrobial photodynamic therapy (aPDT) combined with treatment using probiotics at reducing halitosis.

Methods and analysis
92 individuals from 18 to 60 years of age with a diagnosis of halitosis (sulfide≥112 ppb, gas chromatography) will be selected. The participants will be randomly allocated to four groups (n=23). Group 1 (control): brushing, dental floss and tongue scraper; group 2: brushing, dental floss, tongue scraper and aPDT with blue Light Emitting Diode (LED) +annatto; group 3: brushing, dental floss, tongue scraper and aPDT with blue Light Emitting Diode (LED) +annatto and probiotic lozenges containing Streptococcus salivarius K12 (BLIS K12); and group 4: brushing, dental floss, tongue scraper and probiotic lozenges containing S. salivarius K12 (BLIS K12). Comparisons will be made of the respiratory analysis results before and immediately after the first treatment session, at the end of the 30-day treatment period and again 60 days after the treatment initiation. Microbiological analysis (counts of colony-forming units of viable bacteria from coated tongue) will be performed at the same time. The microbiome analysis will be conducted before treatment, 30 days after treatment completion and 60 days after treatment initiation, following DNA extraction. All groups will receive oral hygiene instructions as well as brushes, toothpaste and dental floss. Data normality will be checked using Shapiro-Wilk test. In the case of normality, analysis of variance is used for the comparisons. In the case of non-parametric data, Kruskal-Wallis test will be used. Wilcoxon test will be used to analyse the results of each treatment between two assessment times.

Ethics and dissemination
This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 82830524.6.0000.5511; approval date: 2 October 2024). Participants will agree to take part in the study by signing an informed consent form. The findings will be published in a peer-reviewed journal. The collected data will be available in the OSF data repository.

Trial registration number
NCT06583720.

Introduction
Although most cochlear implant (CI) users achieve good speech understanding in quiet without visual cues, they may have limited speech understanding in noise and often have poor music perception. The present study was designed to investigate the degree to which the use of Meludia training can improve music perception, music enjoyment and speech understanding in paediatric and postlingually deafened adult CI users. The study also aims to assess the participants’ changes in cognitive skills (attention and memory) and quality of life.

Methods and analysis
This randomised controlled trial will randomise new CI users and experienced CI users older than 6 years who meet the inclusion criteria in a 1:1 ratio to either a musical training (MT) group or a non-MT (NMT) group. The NMT group will receive standard care that does not include MT. Participants in the MT group will practise with Meludia software for 4 weeks and later for 12 additional weeks. Outcomes will include scores in: ‘Listening Up’ exercises, the -Music-Related Quality of Life questionnaire, the Music Questionnaire for Paediatric Population, Disyllables in silence, Matrix test, Mini Mental State Examination, Performance IQ and the Wechsler intelligence scale for children and the Assessment of Quality of Life—8 Dimensions questionnaire. The NMT group will receive standard care that does not include MT.

Ethics and dissemination
On 16 October 2023, the study protocol was approved by the La Paz Hospital in Madrid (Spain). The findings of this study will be published in peer-reviewed publications and presented at appropriate conferences.

Trial registration number
NCT06540677.