comparative trial
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2021 ◽  
Author(s):  
Ian Moffat ◽  
Dave Ross ◽  
Michael Morrison ◽  
Kleanthis Simyrdanis ◽  
Amy Roberts ◽  
...  

Earth mounds are common archaeological features in some regions of Australia, particularly within the Murray-Darling Basin. These features are generally considered to have formed via the repeated use of earth oven cookery methods employed by Aboriginal people during the mid- to late-Holocene. This study assesses the relative effectiveness of key geophysical methods including magnetometry, groundpenetrating radar (GPR) and electrical resistivity tomography (ERT) in mapping, and determining the stratigraphy of earth mound sites. Three earth mounds adjacent to Hunchee Creek, on Calperum Station in South Australia's Riverland region, were chosen to conduct a comparative trial of these methods. This research demonstrated that geophysics can be used to both locate mounds and provide information as to deposit thickness and size. Individual ovens within mounds can also be located. This suggests a greater potential role for geophysics in understanding the Holocene archaeological record in Australia.


2021 ◽  
Vol 11 (12) ◽  
pp. 1297
Author(s):  
Maartje J. C. Vader ◽  
Yasmin I. Habani ◽  
Reinier O. Schlingemann ◽  
Ingeborg Klaassen

Background: The aim of this study was to investigate whether miRNA levels in the circulation could serve as a predictive biomarker for responsiveness to anti-vascular endothelial growth factor (VEGF) therapy in patients with diabetic macular edema. Methods: Whole blood samples were collected at baseline from 135 patients who were included in the BRDME study, a randomized controlled comparative trial of monthly bevacizumab or ranibizumab treatment for 6 months in patients with diabetic macular edema (Trialregister.nl, NTR3247). Best corrected visual acuity letter score (BCVA) and retinal central area thickness (CAT) were measured monthly during the 6-month follow-up. Levels of selected miRNAs were quantified. Results: Following linear regression analysis, the levels of four miRNAs were negatively associated with baseline CAT. Multivariable regression analysis confirmed this association for miR-181a. No associations with changes in CAT after 3 or 6 months of anti-VEGF treatment were found. In addition, no associations with miRNA levels with baseline BCVA or change in BCVA after 3 or 6 months of anti-VEGF treatment were found. Conclusions: Circulating miR-181a levels were negatively associated with CAT at baseline. However, no associations between miRNA levels and the response to anti-VEGF therapy were found.


Author(s):  
Yassine Beltaifa ◽  
Hussein Hamdi ◽  
Giorgio Spatola ◽  
Anne Balossier ◽  
Louise Merly ◽  
...  

<b><i>Background:</i></b> Radiosurgery has demonstrated good safety and efficacy in the treatment of multiple brain metastases (BMs). However, multi-target dose planning can be challenging and time-consuming. A recently developed real-time inverse treatment planning (IP) by convex optimization has been demonstrated to produce high-quality treatment plans with good conformity and selectivity in single-target plans. We intended to test the capacity of this IP to rapidly generate efficient plans while optimizing the preservation of normal tissue in multiple BM. <b><i>Methods:</i></b> Seventy-nine patients (mean age 62.4, age range 22–85) with a total of 272 BMs were treated by Gamma Knife Radiosurgery. All subjects were treated using a forward planning (FP) technique by an expert neurosurgeon. The new Intuitive Plan was applied and able to automatically generate an alternative plan for each patient. All planning variables were collected from the IP to be compared with the corresponding measurements obtained from the FP. A paired sample <i>t</i> test was applied to compare the 2 plans for the following variables: brain volumes receiving 10 Gy (V10) (primary endpoint), and 12 Gy (V12), planning indices (selectivity, coverage, gradient, and Paddick Conformity Index [PCI]), beam-on time (BOT), and integral doses. Additionally, the noninferiority margin for each item was calculated, and the 2 plans were compared for noninferiority using a paired <i>t</i> test. <b><i>Results:</i></b> The mean age of patients was 62.4 years old (age range 22–85), with a sex ratio of 1.02. The average number of lesions per patient was 3.4 (range 1–12). The mean prescription dose was 21.46 Gy (range 14–24 Gy). Noninferiority of the IP was concluded for V10, V12, prescription isodose volume, BOT, PCI, and selectivity. The V10 (and V12) was significantly lower with the IP (<i>p</i> &#x3c; 0.001). These volumes were 8.69 cm<sup>3</sup> ± 11.39 and 5.47 cm<sup>3</sup> ± 7.03, respectively, for the FP and 7.57 cm<sup>3</sup> ± 9.44 and 4.78 cm<sup>3</sup> ± 5.86 for the IP. Only the coverage was significantly lower with the IP (−2.3%, <i>p</i> &#x3c; 0.001), but both selectivity (+17%) and PCI (+15%) were significantly higher with the IP than FP (<i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> This IP demonstrated its capacity to generate multi-target plans rapidly, with a dose to the brain (V10) and BOT noninferior to the one of a human expert planner. These results would benefit from confirmation in a larger prospective series.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jonatan Olafsson ◽  
Xiaoran Lai ◽  
Erlend Christoffer Sommer Landsend ◽  
Snorri Olafsson ◽  
Eric Parissi ◽  
...  

AbstractMeibomian gland dysfunction (MGD) is the most common cause of dry eye disease (DED). In this study, we aimed to compare the effects of eyelid warming treatment using either TheraPearl Eye Mask (Bausch & Lomb Inc., New York, USA) or Blephasteam (Spectrum Thea Pharmaceuticals LTD, Macclesfield, UK) in a Norwegian population with mild to moderate MGD-related DED. An open label, randomized comparative trial with seventy patients (49 females, 21 males; mean age 53.6 years). Patients were randomly assigned to treatment with Blephasteam (n = 37) or TheraPearl (n = 33). All received a hyaluronic acid based artificial tear substitute (Hylo-Comod, Ursapharm, Saarbrücken, Germany). Patients were examined at baseline, and at three and six months initiation of treatment. Treatment efficacy was primarily evaluated by fluorescein breakup time (FBUT) and Ocular Surface Disease Index (OSDI) scores. Other outcome measures included ocular surface staining (OSS), Schirmer’s test, and meibomian quality and expressibility. Baseline parameter values did not differ between the groups. After six months of treatment, Blephasteam improved FBUT by 3.9 s (p < 0.01) and OSDI by 13.7 (p < 0.01), TheraPearl improved FBUT by 2.6 s (p < 0.01) and OSDI by 12.6 (p < 0.01). No difference between treatments was detected at 6 months (p = 0.11 for FBUT and p = 0.71 for OSDI), nor were there differences in the other tested parameters between the treatment groups. Blephasteam and TheraPearl are equally effective in treating mild to moderate MGD in a Norwegian population after 6-months of treatment.Clinicaltrials.gov ID: NCT03318874; Protocol ID: 2014/1983; First registration: 24/10/2017.


2021 ◽  
Vol 9 ◽  
Author(s):  
Cai Liangming ◽  
Cai Xiaoqiong ◽  
Du Min ◽  
Miao Binxin ◽  
Lin Minfen ◽  
...  

This paper presents an OSA patient interactive monitoring system based on the Beidou system. This system allows OSA patients to get timely rescue when they become sleepy outside. Because the Beidou position marker has an interactive function, it can reduce the anxiety of the patient while waiting for the rescue. At the same time, if a friend helps the OSA patients to call the doctor, the friend can also report the patient's condition in time. This system uses the popular IoT framework. At the bottom is the data acquisition layer, which uses wearable sensors to collect vital signs from patients, with a focus on ECG and SpO2 signals. The middle layer is the network layer that transmits the collected physiological signals to the Beidou indicator using the Bluetooth Low Energy (BLE) protocol. The top layer is the application layer, and the application layer uses the mature rescue interactive platform of Beidou. The Beidou system was developed by China itself, the main coverage of the satellite is in Asia, and is equipped with a high-density ground-based augmentation system. Therefore, the Beidou model improves the positioning accuracy and is equipped with a special communication satellite, which increases the short message interaction function. Therefore, patients can report disease progression in time while waiting for a rescue. After our simulation test, the effectiveness of the OSA patient rescue monitoring system based on the Beidou system and the positioning accuracy of OSA patients have been greatly improved. Especially when OSA patients work outdoors, the cell phone base station signal coverage is relatively weak. The satellite signal is well-covered, plus the SMS function of the Beidou indicator. Therefore, the system can be used to provide timely patient progress and provide data support for the medical rescue team to provide a more accurate rescue plan. After a comparative trial, the rescue rate of OSA patients using the detection device of this system was increased by 15 percentage points compared with the rescue rate using only GPS satellite phones.


BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salah E. Shebl

Abstract Background Previously, we presented the short-term outcomes of surgeon-tailored mesh in patients with SUI undergoing TOT. In this report, we aim to highlight the two-year outcomes of surgeon tailored mesh in terms of subjective and objective cure rates, as well as late complications. Methods We performed a randomized, open-label comparative trial that recruited women with SUI who were scheduled to undergo TOT. Eligible patients were randomly allocated in a 1:1 ratio to receive traditional TOT mesh or surgeon-tailored polyethylene mesh. All patients were followed up for two years. Results At the end of the follow-up, there were 13 women in the traditional TOT mesh group and 14 patients in the surgeon-tailored polyethylene mesh group. Concerning the primary outcome of the present study, the cure rate was 100% in the surgeon-tailored polyethylene mesh (n = 14) and 92.9% in the traditional TOT mesh group (p = 0.39). One woman reported improved symptoms in the traditional TOT mesh group. There were no reported failures in both groups. Concerning safety, the incidence of de novo urgency was 0% in the surgeon-tailored polyethylene mesh group, compared to 7.1% in the traditional TOT mesh group (p = 0.34). None of the women in both groups reported mesh erosions, dyspareunia, or need for reoperation. Conclusion Surgeon-tailored mesh for patients undergoing TOT is a cost-effective technique, which has comparable long-term outcomes, in terms of cure rate and complications, to the traditional costly meshes. Larger multicentre studies should confirm our results.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Filippo Randelli ◽  
Alberto Fioruzzi ◽  
Mauro Magnani ◽  
Manuel Mazzoleni ◽  
Mohammad Elhiny ◽  
...  

Abstract Purpose The aim of this retrospective study was to investigate the clinical follow-up of patients with external snapping hip syndrome (ESHS) treated with endoscopic gluteus maximus tendon release and to compare the residual muscular strength and thigh circumference as an indirect outcome measure. Methods Patients of all ages with external snapping hip syndrome were treated with endoscopic gluteus maximus tendon release. Outcome measures evaluated included: visual analog scale (VAS), modified Harris Hip Score (mHHS), and Non-Arthritic Hip Score (NAHS). The gluteus maximus strength and the circumference of the thigh were also evaluated. Results Among 25 patients, 23 fulfilled the inclusion criteria and one patient was lost to follow-up. The series included 22 patients, 6 males and 16 females with a mean age of 27.9 ± 13.4 years (range 16–76 years). All patients had resolution of the snapping symptoms after the procedure. The mean follow-up was 18 ± 9.3 months. All outcomes improved in a statistically significant manner: VAS value decreased from 6.8 (range 6–8) to 0.6 (range 0–4) (p  < 0.001), mHHS increased from 48.6 (range 17.6–67) to 88.2 (range 67–94.6) (p  <  0.001), NAHS increased from 49.0 (range 21.5–66) to 90.8 (range 66–98.75) (p  <  0.001). A statistically significant reduction of operated limb thigh circumference compared to the contralateral side (3.7%) was also found, while there were no statistical differences regarding the strength of gluteus maximus muscles. Conclusions Endoscopic gluteus maximus tendon release is an excellent surgical option to treat snapping hip syndrome. The evaluated muscle strength revealed no functional impairment. The significance of the limb circumference reduction has yet to be determined. Level of evidence IV: retrospective comparative trial.


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