scholarly journals Efficacy of T2 Magnetic Resonance Assay in Monitoring Candidemia after Initiation of Antifungal Therapy: the Serial Therapeutic and Antifungal Monitoring Protocol (STAMP) Trial

2018 ◽  
Vol 56 (4) ◽  
Author(s):  
Eleftherios Mylonakis ◽  
Ioannis M. Zacharioudakis ◽  
Cornelius J. Clancy ◽  
M. Hong Nguyen ◽  
Peter G. Pappas
Keyword(s):  
Magnetic Resonance ◽  
Blood Culture ◽  
Antifungal Therapy ◽  
Small Sample Size ◽  
Small Sample ◽  
Blood Cultures ◽  
Source Control ◽  
Rank Test ◽  
Duration Of Treatment ◽  
Content Type

ABSTRACTThe performance of blood culture for monitoring candidemia clearance is hampered by its low sensitivity, especially during antifungal therapy. The T2 magnetic resonance (T2MR) assay combines magnetic resonance with nanotechnology to identify wholeCandidaspecies cells. A multicenter clinical trial studied the performance of T2MR in monitoring candidemia clearance compared to blood culture. Adults with a blood culture positive for yeast were enrolled and had blood cultures and T2MR testing performed on prespecified days. Thirty-one patients completed the trial. Thirteen of the 31 patients (41.9%) had at least one positive surveillance T2MR and/or blood culture result. All positive blood cultures (7/7 [100%]) had an accompanying positive T2MR result with concordance in the identifiedCandidasp., while only 7/23 (30.4%) T2MR results had an accompanying positive blood culture. There was one case of discordance in species identification between T2MR and the preenrollment blood culture with evidence to support deep-seated infection by theCandidaspp. detected by the T2MR assay. Based on the log rank test, there was a statistically significant improvement in posttreatment surveillance using the T2MR assay compared to blood culture (P= 0.004). Limitations of the study include the small sample size and lack of outcome data. In conclusion, the T2MR assay significantly outperformed blood cultures for monitoring the clearance of candidemia in patients receiving antifungal therapy and may be useful in determining adequate source control, timing for deescalation, and optimal duration of treatment. However, further studies are needed to determine the viability ofCandidaspecies cells detected by the T2MR assay and correlate the results with patient outcomes. (This study is registered at ClinicalTrials.gov under registration number NCT02163889.)

Dotlike hemosiderin spots on T2*-weighted magnetic resonance imaging as a predictor of stroke recurrence: a prospective study

2004 ◽  
Vol 101 (6) ◽  
pp. 915-920 ◽  
Author(s):  
Toshio Imaizumi ◽  
Yoshifumi Horita ◽  
Yuji Hashimoto ◽  
Jun Niwa
Keyword(s):  
Magnetic Resonance ◽  
Small Vessel Disease ◽  
Small Sample Size ◽  
Pearson Correlation ◽  
Small Sample ◽  
Stroke Recurrence ◽  
Amyloid Angiopathy ◽  
Content Type ◽  
A Prospective Study ◽  
Fine Print

Object. Microangiopathy associated with hypertension is a notable cause of cerebral small vessel disease (SVD), including deep intracerebral hemorrhage (ICH) and lacunar infarct. Dotlike low-intensity spots (dotlike hemosiderin spots: dotHSs) on T2*-weighted magnetic resonance (MR) images have been histologically diagnosed as old cerebral microbleeds associated with lipohyalinosis, amyloid angiopathy, or other microangiopathies and located in deep or subcortical regions. The aim of this study was to determine whether dotHSs indicate the severity of microangiopathy, and if so, whether large numbers of deep dotHSs are associated with SVD recurrence. Methods. The authors prospectively analyzed the number of dotHSs in 337 patients—191 men and 146 women with a mean age of 66 ± 10.4 years (range 37–94 years)—with SVD (199 ICHs and 138 lacunar infarcts) who had been consecutively admitted to Hakodate Municipal Hospital. The follow-up period was 3.5 to 42 months (22.5 ± 13.1 months). Patients were divided into two groups based on the recurrence. The hazard ratio (HR) for recurrence was estimated based on the Cox proportional hazard model by using the number of deep and subcortical dotHSs as well as other factors. Of 337 patients, 20 were readmitted with recurrence. Results of a multivariate analysis revealed an elevated rate of recurrence in patients with many subcortical dotHSs (≥ 5, HR 4.36, p = 0.0019) or a history of ICH (HR 3.82, p = 0.014). A trend toward a positive correlation (Pearson correlation coefficient 0.548, p < 0.0001) was found between the number of deep and subcortical dotHSs. Conclusions. Although a small sample size limited the power of analyses, the findings indicate that a large number of subcortical dotHSs may predict SVD recurrence.

scholarly journals 250. Comparison of T2Candida Assay with Blood Culture, Candida Sepsis Score and Serum β-d-glucan in Diagnosis of Candidemia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S140-S141
Author(s):  
Sobia Nizami ◽  
Ioannis Zacharioudakis ◽  
Maria E Aguero-Rosenfeld ◽  
Henry J Neumann
Keyword(s):  
Blood Culture ◽  
Antifungal Therapy ◽  
Central Line ◽  
Blood Cultures ◽  
Source Control ◽  
Candida Spp ◽  
Icu Patients ◽  
Diagnosis And Management ◽  
Sepsis Score ◽  
Candida Sepsis

Abstract Background Although blood cultures are the clinical diagnostic standard for candidemia, their delay in results and low sensitivity has lead to increasing the use of alternate tests and diagnostic algorithms. The T2Candida magnetic resonance assay (T2C) results in a few hours, but concomitant cultures are also needed. We compared results from the T2C with β-d-glucan (BDG), blood cultures (BCx) and the Candida Sepsis Score (CSc) in diagnosis and management of candidemia. Methods This retrospective observational study included patients from July 2017 to December 2018 who had a T2C as well as BCx. Positive (+) and negative (–) results of BCx and BDG within 24 hours (24 h) of T2C were recorded, with clinical data to determine CSc at the time of T2C (recent surgery, severe sepsis, parenteral nutrition, multifocal candida colonization). Results There were 648 T2Cs done over the study period. Only the first +T2C for patients with multiple T2Cs on admission was included. There were 41 patients with +T2, in which 31 had a 24hBCx. Two patients were of pediatric age. There were 7 neutropenic, 1 post-transplant, and 27 intensive care (ICU) patients. Reasons for ordering T2C included sepsis and persistent fevers. In 18 (44%) patients, antifungals were given prior to the T2C. Eight among 31 24hBCx were positive for concordant Candida spp. (26%). Six of these 8 patients were on antifungal therapy when T2C was sent. Seventeen patients had a 24hBDG, with 7 positive (41%). Overall mean CSc in 27 ICU patients with +T2C was 2.2 ± 0.8, and 40% of adult non-neutropenic ICU patients had a CSc of 3 or above. A central line was present in 26 patients, and was removed in 16 after +T2. In 213 patients with −T2C who had 24hBCx, only 1 BCx was positive, from a PICC line in a 2-year-old patient. Seven of the 41 patients with +T2C were treated for deep-seated candidiasis with 6 weeks antifungal therapy or longer; others received 1 to 4 weeks. Thirteen patients died while on antifungal therapy. Conclusion T2Candida was used for diagnosis and management of candidemia in patients who had concomitant blood culture positive in 26%, β-d-glucan positive in 41%, and ICU Candida sepsis score 3 or above in 40% patients. It did not miss candidemia in adults, compared with blood culture within 24 hours. Positive T2Candida helped expedite source control e.g line removal. Disclosures All authors: No reported disclosures.

Psychological and physiological stress variations through casual and serious leisure

2018 ◽  
Vol 73 (3) ◽  
pp. 297-313
Author(s):  
Byung-Gook Kim ◽  
Sang-Kyung Lee
Keyword(s):  
Physiological Stress ◽  
Small Sample Size ◽  
Negative Relationship ◽  
Nonparametric Test ◽  
Small Sample ◽  
Rank Test ◽  
Future Research ◽  
Complex Nature ◽  
Serious Leisure ◽  
Content Type

Purpose The purpose of this study was to identify the role of two kinds of leisure activities (i.e. casual and serious leisure) in reducing psychological and physiological stresses and, specifically, to investigate the differences between pre- and post-psychological and physiological stresses. Design/methodology/approach The data analyses were conducted using the Statistical Package for the Social Sciences 20.0 program. Descriptive analyses were calculated to identify the characteristics of the sample, including gender, education and age. Because of the small sample size (n < 30), this study uses a nonparametric test. The Wilcoxon signed-rank test was used to examine the differences between pre- and post-stresses of psychological and physiological approaches. The Mann-Whitney U test was used to examine the differences of stresses between the casual and serious leisure groups. In addition, the Kendall rank correlation coefficient was used to measure the association between leisure experiences and stresses. Findings The findings from this study indicated that pre-overall affective stress was significantly higher than post-overall affective stress. There were significant differences between pre- and post-physiological stresses during serious leisure. Research findings also suggested that serious leisure experiences have a significant and negative relationship with cognitive stress and physiological stress. Research limitations/implications The data were obtained from two different types of leisure setting, and hence, the generalizability of the study findings to other regions needs to be explored in future studies. Research across other leisure settings also might permit the validation of more stable relationships between leisure and stresses. Future research is needed to investigate other important antecedents of individuals’ psychological and physiological stresses in the leisure setting and may identify the complex nature of leisure participants’ perceptions and their relationships with experiences. Originality/value Despite the growth of stress and leisure research, physiological-based analyses in this area are limited. Numerous studies have focused on leisure coping with negative life events based on social psychological perspectives. The finding of this study would be helpful to leisure practitioners to manifest the strengths and opportunities of experiences and performances associated with the leisure activity.

scholarly journals CDK4/6 Inhibitors and Arthralgia: A Single Institution Experience

2021 ◽  
Vol 9 (2) ◽  
pp. 42
Author(s):  
Angeliki Andrikopoulou ◽  
Oraianthi Fiste ◽  
Kleoniki Apostolidou ◽  
Efthymia Skafida ◽  
Christos Markellos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Small Sample Size ◽  
Small Sample ◽  
Musculoskeletal Symptoms ◽  
Hematological Toxicity ◽  
Breast Cancer Patients ◽  
Single Institution ◽  
Duration Of Treatment ◽  
Positive Breast Cancer

Background: Aromatase inhibitors (AIs) are associated with musculoskeletal pain in one third (20–47%) of breast cancer patients. Recently, CDK4/6 inhibitors have emerged as a new therapeutic approach in hormone receptor (HR)-positive breast cancer. While hematological and gastrointestinal toxicities are frequently reported during treatment with CDK4/6 inhibitors, musculoskeletal symptoms are less commonly encountered. Methods: Herein, we present a retrospective study of 47 breast cancer patients who received CDK4/6 inhibitors along with endocrine therapy in our department between 01/01/2018 and 01/09/2020. Results: Median age at diagnosis was 58 years (29–81). Median duration of treatment was 8.76 months (SD: 7.68; 0.47–30.13 months). Median PFS was 24.33 months (95% CI; 1.71–46.96). Overall, toxicity was reported in 61.7% of the cases (29/47). Arthralgia was reported in 6.4% (3/47) of the patients. Hematological toxicity was reported in 51.1% (24/47) of the patients. Neutropenia was the main hematological toxicity observed (86.8%; 22/47) along with anemia (4.3%; 2/47), thrombocytopenia (2.1%; 1/47), and leukopenia (4.2%; 1/24). Conclusions: Though our data reflect a small sample size, we report a reduced arthralgia rate (6.4%) during treatment with CDK4/6 inhibitors compared with that reported in studies of AIs (20–47%).

Improving new product development performance by risk management

2016 ◽  
Vol 31 (3) ◽  
pp. 418-425 ◽  
Author(s):  
Mehran Salavati ◽  
Milad Tuyserkani ◽  
Seyyede Anahita Mousavi ◽  
Nafiseh Falahi ◽  
Farshid Abdi
Keyword(s):  
Risk Management ◽  
Product Development ◽  
New Product Development ◽  
Small Sample Size ◽  
New Product ◽  
Small Sample ◽  
Content Type ◽  
Total Performance ◽  
The Relationship ◽  
Npd Performance

Purpose The principal aim of this study is to investigate the relationship between technological, marketing, organizational and commercialization risk management on new product development (NPD) performance. Design/methodology/approach Based on questionnaire, the data were collected from a sample of general automotive industry in Iran. Based on theoretical considerations, a model was proposed and descriptive statistic and hierarchical regression were used to measure the relationship between risk management factors and NPD performance. Findings Data analysis revealed that if organization can amplify their knowledge and information about risk and main factors that affect NPD process, not only can they do their work better but can also increase their ability to predict future happenings that affect performance. Research limitations/implications First, due to the relatively small sample size, caution should be exercised when interpreting the results. Second, the data were collected from automotive producer in Iran, which may restrict to some extent generalizability of the findings. Practical implications The results suggest that managers should consider more attention to risk management. If managers spread the risk management in all aspects of the NPD project, total performance will be increased and it can develop the probability of NPD success. Also organizations should perform great market research due to best commercialization. Originality/value Past researches have presented complete information about NPD process. But identifying and considering the effect of the risk management parameters that are connected to the NPD process were the main thrusts to perform the study. In this paper, based on past research about risk management of NPD, the extra aspect of process that can improve total performance of NPD has been examined.

The categorization of expatriates and the support offered by host country nationals

2016 ◽  
Vol 4 (1) ◽  
pp. 18-43 ◽  
Author(s):  
Shirley C. Sonesh ◽  
Angelo S. DeNisi
Keyword(s):  
Host Country ◽  
Small Sample Size ◽  
Small Sample ◽  
Content Type ◽  
Host Country Nationals ◽  
Group Members ◽  
Expatriate Assignments ◽  
The Right ◽  
National Stereotypes

Purpose – Although several authors have suggested that host country nationals (HCNs) play an important role in the management of expatriates (e.g. Toh and DeNisi, 2003; Farh et al., 2010), research has also suggested that this relationship is not always good, and the flow of critical information to expatriates can be limited. This is especially true when HCNs categorize the expatriates as “out-group” members. The purpose of this paper is to examine potential determinants of categorization decisions as well as potential outcomes related to expatriate socialization. Design/methodology/approach – The paper employs a dyadic survey approach to determine the antecedents to expatriate categorization and HCN socialization behaviors from the perspective of both the expatriate and HCN. Findings – The results of survey data from 65 expatriate-HCN dyads indicated that expatriate ethnocentrism and the salience of the expatriates’ nationality were important predictors of categorization, but that categorization was related to only one dimension of socialization. However, affect was found to play a role in predicting socialization behaviors. Research limitations/implications – There is potential selection bias since expatriates chose HCNs as respondents, but results suggested this was not a serious problem. Other limitations include a relatively small sample size and the fact that a number of contextual issues such as national stereotypes and MNC strategy, are not controlled for. Practical implications – Implications of these findings for the successful management of expatriate assignments include sending over expatriates with the right relational skills, and those low in ethnocentrism, rather than just the right technical skills. Originality/value – The present study was one of the first to empirically test the potential role of categorization in the process of socialization.

Individuals' waste separation practice in a relationship with social bonds: a case study of Hanoi, Vietnam

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Thi Kim Nhung Nguyen
Keyword(s):  
Social Bonds ◽  
Small Sample Size ◽  
Influential Factors ◽  
Small Sample ◽  
Household Waste ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Content Type ◽  
Sociological Approach ◽  
Waste Separation

PurposeThe paper aims to ascertain whether residents in Nguyen Du ward still sort their waste at source following the end of the 3R project that ended in 2009. Additionally, this paper aims to explore the relationship between waste separation practices and social bonds.Design/methodology/approachThe Travis Hirschi theory of social control was applied, together with the mixed method research design which included a structured questionnaire survey. Twelve semi-structured interviews were also conducted with residents and the data processed by SPSS software, using Chi-Square test, Independent-Samples t-test and Pearson's correlation analysis.FindingsA proportion of respondents has continued practicing waste separation since the 3R project ended. The study also indicated that the greater the involvement in family and neighborhood activities the more the participants were likely to practice waste separation.Research limitations/implicationsThe small sample size limits the extent to which the most influential factors can be determined and therefore the degree to which the findings can be generalized.Practical implicationsThe study includes implications for rerunning the waste separation programs for households as together with community campaigns to improve individuals' attachment and commitment and thus their participation in pro-environmental behaviors.Originality/valueTo the author’s knowledge, this is the first study to take a sociological approach to investigate factors affecting household waste separation, which has attracted little attention in previous studies. Useful information is also provided to local authorities for a policy-making process to implement effective domestic waste policies.

What women want: the effect of health agency advertising on patient-doctor communication

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cynthia Morton ◽  
Sabrina Habib ◽  
Jon Morris
Keyword(s):  
Sexual Health ◽  
Small Sample Size ◽  
Health Agency ◽  
Small Sample ◽  
Communication Strategy ◽  
Future Research ◽  
Health Communications ◽  
Content Type ◽  
Women’S Sexual Health ◽  
Doctor Communication

Purpose The purpose of this study is to investigate the relationship between women’s sexual health agency and their intent to initiate communications with their doctors. The research questions examined the effect sexual health agency has on patient-doctor communication, women’s emotional responses to health advertisements encouraging patient communication with their doctors, attitude toward the message and behavioral intentions after exposure to the advertising message. Design/methodology/approach An experimental design was implemented via an online questionnaire instrument to test the differences between younger-aged women (25 to 45 years) and mature-aged women (46 to 70 years). It was observed that 188 women who reported their status as single and sexually active in the past 12 months were exposed to a health advertisement that encouraged patient-doctor communication. Analyses were conducted to compare between-group measures on sexual health agency, emotional response and attitude toward the ad and behavioral intention. Findings No statistical difference existed between younger and older women. In general, women expect their doctor to lead conversations about sexual health but are positively reinforced by health messages that encourage their assertiveness as patients. Research limitations/implications The small sample size also may have limited the study’s potential to evaluate differences between age segments. Future research should explore this further. Practical implications The study provides evidence that sexual health advertising can reinforce women’s intent to initiate conversations with doctors regardless of age. Social implications Health communications can bolster women’s sexual health agency and improve patient-initiated conversations with doctors. Originality/value The study is the first to explore advertising messaging’s potential for applying health agency as a communication strategy for encouraging sexual health communications between women and their doctors.

Intensity of perceived stress and control of anger, anxiety and depression of people staying in Polish penitentiary institutions

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kinga Kołodziej ◽  
Anna Kurowska ◽  
Anna Majda
Keyword(s):  
Perceived Stress ◽  
Small Sample Size ◽  
Prison Population ◽  
Research Area ◽  
Cross Sectional Study ◽  
Small Sample ◽  
Emotional Control ◽  
Coping With Stress ◽  
Cross Sectional ◽  
Content Type

Purpose The purpose of this study is to assess the intensity of perceived stress and measure the subjective control of anxiety, anger and depression in a group of women and men staying in Polish penitentiary institutions. Design/methodology/approach The research was carried out in two penitentiary institutions located in the Lesser Poland Voivodeship at the turn of 2019/2020. The study group consisted of 152 prisoners. In the cross-sectional study, two standardised research tools – the Perceived Stress Scale and the Emotional Control Scale – were used. Findings Over half of the prisoners (57.24%) presented a high level of stress. The intensity of the perceived stress did not depend on the gender and age of the convicted persons. The general indicator of emotional control among the respondents averaged 51.82 points (standard deviation = 14.52) and ranged from 22 to 83 points, which means that people detained in penitentiary institutions suppressed their negative emotions at an average level. The prisoners had the best control over fear (M = 18.68), less over anger (M = 16.86) and the least over depression (M = 16.27). Statistical analysis showed a correlation between the level of emotional control and the intensity of perceived stress. Research limitations/implications The small sample size of the group participating in the study and narrowing of the research area means that results can not be generalised across all isolated prison population. Practical implications The results obtained from the study can be used by a multidisciplinary team to develop therapeutic programmes for convicted persons, the aim of which is to evaluate strategies for coping with stress and controlling emotions. Social implications Popularising reliable information related to the issue of experiencing stress and varied emotions in those staying in penitentiary institutions may lead to the elimination of harmful stereotypes functioning in society, as well as reduce the phenomenon of marginalisation of prisoners, and thus contribute to the success of the social rehabilitation process. Originality/value Research on the level of stress intensity in prisoners is important because the rates of mental health disorders among prisoners consistently exceed the rates of such disorders in the general population.

The influence of homeschooling on entrepreneurial activities: a collective case study

2017 ◽  
Vol 59 (7/8) ◽  
pp. 706-719 ◽  
Author(s):  
Sarah Jeanne Pannone
Keyword(s):  
Locus Of Control ◽  
Small Sample Size ◽  
Research Literature ◽  
Small Sample ◽  
Content Type ◽  
Collective Case Study ◽  
Internal Locus Of Control ◽  
Entrepreneurial Characteristics ◽  
Entrepreneurial Activities

Purpose The purpose of this paper is to investigate how a homeschool education influences entrepreneurial characteristics and activity. Design/methodology/approach A collective case study design was used to investigate how a homeschool education influences entrepreneurial characteristics and activity. Findings From the participant interviews, surveys, and document analysis, three salient themes emerged. First, participants noted that their home education, at least in later years, was largely self-directed and that this independent, self-motivated type of learning impacted their subsequent entrepreneurial activities. Next, participants also related that they believed the alternative nature of their homeschooling education and its emphasis on being comfortable with being different influenced their entrepreneurial pathway. Finally, the third theme to surface was the idea that homeschooling helped develop an internal locus of control, a belief that is helpful in entrepreneurial undertakings. Research limitations/implications Research limitations included a lack of generalizability due to a small sample size and possible selection bias. Practical implications Despite these shortcomings, however, several implications exist. For example, the findings from this study show that homeschooling may be a viable alternative education method for parents looking to encourage entrepreneurial traits and activities in their children. Social implications Future areas of research were also identified, including a call to research the role locus of control plays in homeschooled students. Originality/value This study addresses an area that, to the knowledge of this researcher, is completely lacking from the research literature.

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