Search

Mei-Chun Cheung,1 Janelle SK Lai,1 Joanne Yip,2 Jason Pui Yin Cheung3 1Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China; 2Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong SAR, China; 3Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong SAR, ChinaCorrespondence: Mei-Chun CheungDepartment of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, ChinaTel +852-39431862Fax +852-26035018Email meichun@swk.cuhk.edu.hkPurpose: This study aimed to investigate the effects of trunk asymmetry on the health-related quality of life of early adolescents and to identify daily activities that were associated with trunk asymmetry in this cohort.Methods: This study included 200 early adolescents (52 male and 148 female) aged 10 to 14 years in Hong Kong. Among them, 100 adolescents were considered to have trunk asymmetry with angle of trunk rotation ≥ 5° and one or more physical signs on visual inspection. The 36-Item Short Form Health Survey was used to measure the eight scales under the physical and mental domains of the health-related quality of life. The adolescents reported their average daily durations spent (1) using a computer; (2) using a smartphone; (3) watching television, videos or DVDs; (4) doing homework; and (5) doing physical exercise. Independent samples t-tests, chi-square (χ2) tests or Mann–Whitney U-tests were performed to compare the health-related quality of life and the average daily duration of daily activities between early adolescents with and without trunk asymmetry. Logistic regression was performed to investigate the odds ratios of daily activities for trunk asymmetry.Results: Compared with early adolescents without trunk asymmetry, those with trunk asymmetry had a lower health-related quality of life in some of the physical domains, namely, bodily pain and general health, and all mental domains, namely, vitality (energy/fatigue), social functioning, role limitation due to emotional problems and mental health (p < 0.05). Use of computer was found to be significantly associated with trunk asymmetry in early adolescents (OR = 1.63, 95% CI [1.23, 2.14]).Conclusion: Our results indicate that increased computer use is associated with trunk asymmetry, which negatively impacts the health-related quality of life in early adolescents.Keywords: trunk asymmetry, computer, smartphone, health-related quality of life, early adolescents

ObjectiveAdministrative data are used to describe the pancreatic cancer (pcc) population. The analysis examines demographic details, incidence, site, survival, and factors influencing mortality in a cohort of individuals diagnosed with pcc.MethodsIncident cases of pcc diagnosed in Ontario between 1 January 2004 and 31 December 2011 were extracted from the Ontario Cancer Registry. They were linked by encrypted health card number to several administrative databases to obtain demographic and mortality information. Descriptive, bivariate, and survival analyses were conducted.ResultsDuring the period of interest, 9221 new cases of pcc (4548 in men, 4673 in women) were diagnosed, for an age-adjusted standardized annual incidence in the range of 8.6-9.5 per 100,000 population. Mean age at diagnosis was 70.3 ± 12.5 years (standard deviation). Five-year survival was 7.2% (12.8% for those 80 years of age). Survival varied by sex, older age, rural residence, lower income, site of involvement in the pancreas, and presence of comorbidity.ConclusionsThe mortality rate in pcc is exceptionally high. With an increasing incidence and a mortality positively associated with age, additional support will be needed for this highly fatal disease as demographics in Ontario continue to trend toward a higher proportion of older individuals.

ObjectiveThe objective of the present analysis was to determine the publicly funded health care costs associated with the care of breast cancer (bca) patients by disease stage.MethodsIncident cases of female invasive bca (2005-2009) were extracted from the Ontario Cancer Registry and linked to administrative datasets from the publicly funded system. The type and use of health care services were stratified by disease stage over the first 2 years after diagnosis. Mean costs and costs by type of clinical resource used in the care of bca patients were compared with costs for a matched control group. The attributable cost for the 2-year time horizon was determined in 2008 Canadian dollars.ResultsThis cohort study involved 39,655 patients with bca and 190,520 control subjects. The average age in those groups was 61.1 and 60.9 years respectively. Most bca patients were classified as either stage i (34.4%) or stage ii (31.8%). Of the bca cohort, 8% died within the first 2 years after diagnosis. The overall mean cost per bca case from a public payer perspective in the first 2 years after diagnosis was $41,686. Over the 2-year time horizon, the mean cost increased by stage: i, $29,938; ii, $46,893; iii, $65,369; and iv, $66,627. The attributable cost of bca was $31,732. Cost drivers were cancer clinic visits, physician billings, and hospitalizations.ConclusionsCosts of care increased by stage of bca. Cost drivers were cancer clinic visits, physician billings, and hospitalizations. These data will assist planning and decision-making for the use of limited health care resources.

Background: This study investigated endodontic clinical preferences, adoption of newer technologies and information sources among dentists and endodontists. Methods: Dental and endodontic society members in Australia and New Zealand were surveyed online regarding their endodontic treatment preferences, armamentarium, information sources and continuing professional education (CPE) attendance. Results: Complete responses were received from 71 endodontic specialists or postgraduates (Group E) and 139 general dentists (Group D). Most of Group E used dental operating microscopes (95.8%), endodontic cone‐beam computed tomography (CBCT; 98.6%) and calcium silicate‐based materials (CSBMs; 97.2%), significantly more (P < 0.001) than Group D (86.3% used loupes, <32% used CBCT for endodontics or CSBMs). Most respondents used dental dam always for endodontics (94.3%), electronic apex locators (EAL; 81.0%) and engine‐driven nickel‐titanium (NiTi) instruments (91.4%); Group E had more experience with engine‐driven NiTi (P < 0.001). Endodontic CPE attendance was highest at dental association programs (P < 0.001) while hands‐on NiTi training attendance was highest via commercial companies (P < 0.05). Online information sources were commonly used (38.8% of Group D, 59.2% of Group E). Conclusion: Dental dam, EAL and engine‐driven NiTi were almost universally used. The endodontic group reported high adoption of newer endodontic technologies. Endodontic CPE and information sources should be further surveyed as online engagement evolves. © 2023 Australian Dental Association. [ABSTRACT FROM AUTHOR]

This is a randomized controlled trial that aimed to evaluate the effect of the Seven-star Needle Stimulation treatment on children with Autistic Spectrum Disorders (ASD). Thirty-two children with ASD were assigned randomly into the treatment and control groups. Children in the treatment group underwent 30 sessions of stimulation over 6 weeks, while children in the control group were on a waiting list and did not receive treatment during this period of time. Intervention consisted of a treatment regime comprising of 30 sessions of Seven-star Needle Stimulation, delivered over 6 weeks. Each session lasted 5 to 10 min, children in the treatment group were stimulated at the front and back sides of their body and the head by using Seven-star Needles. The change in the children's behavior was evaluated using parents' report and neurophysiological changes were measured by quantitative EEG (qEEG). Results showed that the treatment group demonstrated significant improvement in language and social interaction, but not in stereotyped behavior or motor function, compared to the control group. qEEG spectral amplitudes in the treatment, but not in the control group, were also reduced significantly. The results suggested that Seven-star Needle Stimulation might be an effective intervention to improve language and social functioning of children with ASD. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Although much is known about the efficacy, toxicity, and direct costs of treatment for follicular lymphoma (FL), there is no data assessing the impact of this diagnosis on the work productivity of affected individuals. METHODS: We conducted a cross-sectional survey study of consecutive patients attending a malignant haematology clinic at a large multi-disciplinary cancer centre. Patients with a diagnosis of FL or other indolent non-Hodgkin's lymphoma completed questionnaires assessing health status, work productivity, and activity impairment. RESULTS: Eighty-four patients completed the survey study (95% response). Patients who continued to work reported a minimal impact on their work productivity (10%+/-standard deviation SD 20; 0%=no effect and 100%=complete impairment of activity) and on their daily activities (13%+/-SD 25) attributable to their cancer. Prior to lymphoma diagnosis, over 71% of patients were working while 14% were retired. At the time of survey administration, only 41% of patients were still able to work with a significant proportion of patients having transitioned to retirement (36%), sick leave (10%), or unemployment (4%). On multivariate analysis, significant activity impairment (daily activity impairment>50%) was predicted by poor self-rated health status (OR 32.1; 95% CI: 5.9-174.2; p<0.0001) and active chemotherapy treatment (OR 14.5; 95% CI: 0.91-230.9; p=0.059). CONCLUSIONS: Although few patients with indolent lymphoma identified significant impairment in productivity, many were unable to continue employment following diagnosis, needed to miss days from work, or imposed a significant burden on caregivers. The greatest impact on activity is apparent in patients who rate their health status as poor and in those who are currently receiving systemic therapy. [ABSTRACT FROM AUTHOR]

Objective: SHAPE (Simple Hysterectomy And PElvic node assessment) was an international phase III trial demonstrating that simple hysterectomy was non-inferior to radical hysterectomy for pelvic recurrence risk, but superior for quality of life and sexual health. The objective was to conduct a cost-effectiveness analysis comparing simple vs. radical hysterectomy for low-risk early-stage cervical cancer., Methods: Markov model compared the costs and benefits of simple vs. radical hysterectomy for early cervical cancer over a 5-year time horizon. Quality-adjusted life years (QALYs) were estimated from health utilities derived from EQ-5D-3L surveys. Sensitivity analyses accounted for uncertainty around key parameters. Monte Carlo simulation estimated complication numbers according to surgical procedure., Results: Simple hysterectomy was more effective and less costly than radical hysterectomy. Average overall costs were $11,022 and $12,533, and average gains were 3.56 and 3.54 QALYs for simple and radical hysterectomy, respectively. Baseline health utility scores were 0.81 and 0.83 for simple and radical hysterectomy, respectively. By year 3, these scores improved for simple hysterectomy (0.82) but not for radical hysterectomy (0.82). Assuming 800 early cervical cancer patients annually in Canada, the model estimated 3 vs. 82 patients with urinary retention, and 49 vs. 86 patients with urinary incontinence persisting 4 weeks after simple vs. radical hysterectomy, respectively. Results were most sensitive to variability in health utilities after surgery, but stable through wide ranges of costs and recurrence estimates., Conclusion: Simple hysterectomy is less costly and more effective in terms of quality-adjusted life expectancy compared to radical hysterectomy for early cervical cancer., Trial Registration: ClinicalTrials.gov Identifier: NCT01658930., Competing Interests: JSK discloses research funding from Michael Smith Health Research BC (formerly Michael Smith Foundation for Health Research), ownership of shares from Hexamer Therapeutics, and speaker fee from Astra Zeneca. MP discloses research funding from Astra Zeneca, royalties from UpToDate, and serving as an Advisory Board member for Serono-Merck., (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)

Objectives: Guided by Andersen's behavioral model, the objectives of this study were to (a) examine the associations between individual factors and the intended utilization of home-based long-term care (LTC) services among older adults in China and (b) explore the influence of community support, if any, on these associations., Methods: Using a multistage random sampling approach, we recruited 1,064 older adults in Chengdu, China. Hierarchical regression was employed to investigate the direct effects of individual predictors and community support on the intended use of home-based LTC services. The moderating effect of community support was examined using the Hayes Process., Results: Two predisposing (i.e., being old and unmarried), 4 enabling (i.e., living alone, having fewer children, and receiving less family and peer support), and 6 need factors (i.e., having more chronic illnesses; decreased performance in instrumental activities of daily living; higher levels of depression, anxiety, loneliness; and a lower self-image of aging), and low community support were significantly associated with increased intended utilization of home-based LTC. In addition, community support moderated the effects of family support (B = -0.20, p < .001), peer support (B = -0.20, p < .001), self-image of aging (B = -0.39, p < .001), depression (B = -0.34, p < .001), and loneliness (B = -0.48, p < .001) on the intended utilization of home-based LTC services., Discussion: Policy-makers and practitioners should consider delivering tailored services for older adults and involve the community in the context of enhancing home-based LTC services., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: To systematically review published evidence on cancer drug wastage and the effectiveness of mitigation methods., Methods: Search keywords for Scopus, PubMed, and EMBASE were developed using the Pearl Growing technique. Relevant articles were identified in a two-step process: first based on titles/abstracts, then on full article reviews. Among the identified English peer-reviewed articles, those considering adults ≥18 years and relevant cancer drug wastage outcomes were included. Key concepts and measures for drug wastage and its mitigation were tabulated. Trends in publication numbers were analyzed using Mann-Kendall tests. Costs were converted first to 2024 local currencies using country-wise consumer price indexes, and then to 2024 USD using exchange rates., Results: Among 6,298 unique articles, 94 met the inclusion criteria. Seventy-four (79%) of these were published since 2015, highlighting increasing attention to cancer drug wastage. Twenty-three articles (24%) explicitly reported drug wastage amounts, whereas fifty-two articles (55%) considered the mitigation methods. Most articles focused on high-income countries (n=67), single hospital settings (n=45), and retrospective study designs (n=55). Wastage mitigation techniques included vial-sharing (n=21), dose-rounding (n=17), closed-system transfer device (n=9), centralized drug preparation (n=7), and vial size optimization (n=7). A trend towards higher median wastage cost was evident in US settings ($135.35/patient-month) compared to other countries ($37.71/patient-month)), while mitigation methods across countries were not statistically significant., Conclusions: High cancer drug costs highlight the importance of minimizing drug wastage to reduce healthcare expenditure. Our review demonstrates that wastage varies by healthcare setting and mitigation technique. Future studies would benefit from reporting standards for cancer drug wastage that include reporting wastage (both in mg and cost, preferably in terms of Purchase Power Parity), as well as cohort size, considered vial sizes, considered dosages, and employed mitigation methods separately for each drug. This approach would account for variability in cancer drug wastage and help identify optimal mitigation practices tailored to the health system context., (Copyright © 2024. Published by Elsevier Inc.)

Abstract: Half of older patients with diffuse large B-cell lymphoma (DLBCL) receiving curative-intent treatment are frail. Understanding the differences in health care utilization including costs between frail and nonfrail patients can inform appropriate models of care. A retrospective cohort study was conducted using population-based data in Ontario, Canada. Patients aged ≥66 years with DLBCL who received frontline curative-intent chemoimmunotherapy between 2006 and 2017 were included. Frailty was defined using a cumulative deficit-based frailty index. Health care utilization and costs were grouped into 5 phases: (1) 90 days preceding first treatment; (2) early treatment (0 to +90 days after starting treatment); (3) late treatment (+91 to +180 days); (4) follow-up (+181 to -181 days before death); and (5) end of life (last 180 days before death). Costs were standardized to 30-day intervals (2019 Canadian dollars). A total of 5527 patients were included (median age, 75 years; 48% female). A total of 2699 patients (49%) were classified as frail. The median costs for frail vs nonfrail patients per 30 days based on phase of care were (1) $5683 vs $2586 ; (2) $13 090 vs $11 256; (3) $5734 vs $4883; (4) $1138 vs $686; and (5) $11 413 vs $9089; statistically significant in all phases. In multivariable modeling, frail patients had higher rates of emergency department visits and hospitalizations and increased costs than nonfrail patients through all phases except end-of-life phase. During end-of-life phase, a substantial portion of patients (n = 2569 [84%]) required admission to hospital; 684 (27%) required intensive care unit admission. Future work could assess whether certain hospitalizations are preventable, particularly for patients identified as frail., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

Objective: The present study aimed to examine the profile patterns of co-occurring posttraumatic stress disorder (PTSD), cognitive emotion regulation (CER), and disorganized attachment in traumatized adolescents. It also aimed to examine whether these adolescents with different profiles would differ in posttraumatic growth (PTG) and comorbid psychiatric symptoms after controlling for academic stress and egocentrism., Method: Nine hundred and forty-nine ( N = 949) adolescents were recruited from two secondary schools in China. They completed measures on PTSD, comorbid psychiatric symptoms, PTG, CER, disorganized attachment, and covariates of egocentrism and academic stress., Results: Latent profile analysis identified a four-class model as the optimal solution: low trauma group (Class 1), adaptive copers (Class 2), moderate trauma group (Class 3), and high trauma group (Class 4). After controlling for demographics and levels of egocentrism and academic stress, Class 4 had more severe comorbid psychiatric symptoms than the other three classes. Class 3 had higher levels of comorbid psychiatric symptoms than Class 2 and Class 1, while these latter two were comparable in comorbid psychiatric symptoms. Conversely, Class 4 students had lower levels of PTG than individuals in the other three classes. Class 3 had similar levels of PTG to Class 1, and these two classes reported lower levels of PTG than Class 2., Conclusions: Chinese adolescents may experience both negative and positive changes after stressful events. The extent of these psychological outcomes could vary depending on the adolescents' previous trauma experiences, emotion regulation, and attachment qualities. Implications for clinical practice were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Older-adult migrants constitute a proportion of the global population, and loneliness hinders their adaptation to host areas. However, review studies on risk factors for loneliness target general older-adults without focusing on older-adult migrants. Therefore, this study systematically reviews and synthesizes the factors influencing the loneliness of older-adult migrants., Method: Five databases were searched and screened for quantitative studies investigating the relationship between risk factors and loneliness among older-adult migrants (over age 50). Finally, 35 articles were included., Results: Factors related to loneliness in older-adult migrants were synthesized into sociodemographic, physical health, psychological, interpersonal, and acculturation-related factors. Consistent significant relationships with loneliness were found for a few risk factors, including not having spouses, low subjective financial status, poor self-rated health, poor psychological status, few non-kin ties, low quality of kin and non-kin ties, and a weak sense of belonging to either one's ethnic group or that of the host areas., Conclusion: This review discusses the unique findings on the risk factors for loneliness in older-adult migrants. Additionally, the current literature on loneliness in older-adult migrants has some research gaps, calling for longitudinal studies with a rigorous design.

Home and community-based services (HCBS) for older adults have been promoted worldwide to address the growing problems of aging. This systematic review included 59 studies published from 2013 to 2023 to explore factors influencing the utilization of HCBS among older adults. The review identified 15 common factors grouped into four levels of influence: individual, inter-relationship, community, and social contextual levels. The findings suggest that HCBS utilization is a dynamic process influenced by multiple factors at different levels. Gerontological social work should incorporate ecological thinking to improve practice and strengthen caregiver-recipient relationships.

Background and Objectives: Community support has a profound positive impact on older people's health and plays a crucial role in facilitating aging in place. This impact is particularly significant in the Chinese context, where community support can alleviate the pressure on traditional family caregiving. This study translated, adapted, and validated the perceived community support questionnaire (PCSQ) for use with older Chinese., Research Design and Methods: Data for this validation study were collected from a cross-sectional survey of 1,064 Chinese aged 65 years and above. Following the cultural adaptation of the PCSQ-14, confirmatory factor analysis (CFA) was conducted to examine its factor structure. Criterion validity, convergent and discriminant validity, internal consistency reliability, and test-retest reliability of the scale were also assessed., Results: Based on the CFA results, the adapted PCSQ-14 was found to have a 3-factor solution for community integration, community participation, and community organizations. The criterion-related validity was supported by its significant correlation with depression. Convergent and discriminant validity were established, with the internal consistency of the scale being 0.90. The test-retest reliability intraclass correlation coefficient for the scale was 0.78., Discussion and Implications: The adapted version of the PCSQ-14 demonstrated promising psychometric properties in assessing perceived community support in older Chinese. The adapted PCSQ-14 could assist researchers in determining older Chinese adults' perceptions of community support, and could also assist practitioners and policymakers in developing targeted services for older people and allocating resources more effectively., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Abstract: The American Society of Hematology (ASH) develops a variety of resources that provide guidance to clinicians on the diagnosis and management of blood diseases. These resources include clinical practice guidelines (CPGs) and other forms of clinical advice. Although both ASH CPGs and other forms of clinical advice provide recommendations, they differ with respect to the methods underpinning their development, the principal type of recommendations they offer, their transparency and concordance with published evidence, and the time and resources required for their development. It is crucial that end users be aware of the differences between CPGs and other forms of clinical advice and that producers and publishers of these resources use clear and unambiguous terminology to facilitate their distinction. The objective of this article is to highlight the similarities and differences between ASH CPGs and other forms of ASH clinical advice and discuss the implications of these differences for end users., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

Developing prognostic tools specifically for patients themselves represents an important step in empowering patients to engage in shared decision-making. Incorporating patient-reported outcomes may improve the accuracy of these prognostic tools. We conducted a retrospective population-based study of transplant-ineligible (TIE) patients with multiple myeloma (MM) diagnosed between January 2007 and December 2018. A multivariable Cox regression model was developed to predict the risk of death within 1-year period from the index date. We identified 2356 patients with TIE MM. The following factors were associated with an increased risk of death within 1 year: age > 80 (HR 1.11), history of heart failure (HR 1.52), "CRAB" at diagnosis (HR 1.61), distance to cancer center (HR 1.25), prior radiation (HR 1.48), no proteosome inhibitor/immunomodulatory therapy usage (HR 1.36), recent emergency department (HR 1.55) or hospitalization (HR 2.13), poor performance status (ECOG 3-4 HR 1.76), and increasing number of severe symptoms (HR 1.56). Model discrimination was high with C-statistic of 0.74, and calibration was very good. To our knowledge, this represents one of the first prognostic models developed in MM incorporating patient-reported outcomes. This survival prognostic tool may improve communication regarding prognosis and shared decision-making among older adults with MM and their health care providers., (© The Author(s) 2024. Published by Oxford University Press.)

The aim of this study was to describe the impact of marginalization on DLBCL overall survival (OS) within the Canadian setting. We conducted a population-based retrospective cohort study of adult patients with newly diagnosed DLBCL in Ontario between 1 January 2005 and 31 December 2017 receiving a rituximab-containing chemotherapy regimen with curative intent followed until 1 March 2020. Our primary exposure of interest was the Ontario Marginalization Index (ON-Marg). The primary outcome was 2-year OS, accounting for patient age, sex, cancer characteristics, comorbidity burden, and rural dwelling status. While two-year overall survival was inferior for individuals in the most deprived marginalization quintile (70.4% Q5 vs. 76.0% Q1), after adjustment for relevant covariates neither the composite ON-Marg nor any of its dimensions had a significant effect. Within the Canadian context, among patients who receive chemotherapy, marginalization may not have a significant association with overall survival when accounting for key patient covariates, lending support for preserved outcomes.

Multi-criteria decision analysis (MCDA) is a value assessment tool designed to help support complex decision-making by incorporating multiple factors and perspectives in a transparent, structured approach. We developed an MCDA rating tool, consisting of seven criteria evaluating the importance and feasibility of conducting potential real-world evidence (RWE) studies aimed at addressing uncertainties stemming from initial cancer drug funding recommendations. In collaboration with the Canadian Agency for Drugs and Technologies in Health's Provincial Advisory Group, a validation exercise was conducted to further evaluate the application of the rating tool using RWE proposals varying in complexity. Through this exercise, we aimed to gain insight into consensus building and deliberation processes and to identify efficiencies in the application of the rating tool. An experienced facilitator led a multidisciplinary committee, consisting of 11 Canadian experts, through consensus building, deliberation, and prioritization. A total of nine RWE proposals were evaluated and prioritized as low (n = 4), medium (n = 3), or high (n = 2) priority. Through an iterative process, efficiencies and recommendations to improve the rating tool and associated procedures were identified. The refined MCDA rating tool can help decision-makers prioritize important and feasible RWE studies for research and can enable the use of RWE for the life-cycle evaluation of cancer drugs.

The treatment pattern and outcomes in patients with indolent B-cell lymphoma treated during the coronavirus disease 2019 (COVID-19) pandemic period compared to the prepandemic period are unclear. This was a retrospective population-based study using administrative databases in Ontario, Canada (follow-up to 31 March 2022). The primary outcome was treatment pattern; secondary outcomes were death, toxicities, healthcare utilization (emergency department [ED] visit, hospitalization) and SARS-CoV-2 outcomes. Adjusted hazard ratios (aHR) from Cox proportional hazards models were used to estimate associations. We identified 4143 patients (1079 pandemic, 3064 prepandemic), with a median age of 69 years. In both time periods, bendamustine (B) + rituximab (BR) was the most frequently prescribed regimen. During the pandemic, fewer patients received R maintenance or completed the full 2-year course (aHR 0.81, 95% CI 0.71-0.92, p = 0.001). Patients treated during the pandemic had less healthcare utilization (ED visit aHR 0.77, 95% CI 0.68, 0.88, p < 0.0001; hospitalization aHR 0.81, 95% CI 0.70-0.94, p = 0.0067) and complications (infection aHR 0.69, 95% CI 0.57-0.82, p < 0.0001; febrile neutropenia aHR 0.66, 95% CI 0.47-0.94, p = 0.020), with no difference in death. Independent of vaccination, active rituximab use was associated with a higher risk of COVID-19 complications. Despite similar front-line regimen use, healthcare utilization and admissions for infection were less in the pandemic cohort., (© 2023 British Society for Haematology and John Wiley & Sons Ltd.)

Aim: This study investigated the adoption of cone-beam computed tomography (CBCT) by dentists and endodontists around the world, including their preferences in endodontic CBCT usage., Methodology: An online questionnaire surveyed dental association members in Australia and New Zealand, and endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA, about their CBCT training history, considerations in acquisition/interpretation, access to and usage of CBCT, preferred scan interpreter, and preferred endodontic scan settings. Data were analysed with Chi-squared, independent sample t-tests, Cochran's Q and McNemar's tests., Results: Responses from 578 endodontic specialists or postgraduates (Group E) and 185 non-endodontic dentists (Group NE) were included. Continuing professional education (CPE) was the most common source of CBCT training (69.2%). Factors considered in CBCT acquisition/interpretation included beam hardening (75.4%), radiation exposure (61.1%) and patient movement (58.3%). Group E reported higher CBCT usage (90.8%) than Group NE (45.4%, p < .001) and greater workplace access to CBCT (81.1% vs. 25.9%, p < .001). Scans were interpreted by the respondent in most workplace scans (83.3%) and externally taken scans (60.5%); Group E were significantly more likely to interpret themselves than Group NE. Small field of view (83.6%) and high resolution (86.6%) were most preferred as settings for endodontic CBCTs; Group NE were less likely to choose these settings. There were some geographic variations within Group E., Conclusions: CBCT training was most commonly acquired via CPE. Endodontic respondents reported very high CBCT usage and access in the workplace. There are educational implications regarding CBCT limitations, appropriate applications and interpretation., (© 2023 British Endodontic Society. Published by John Wiley & Sons Ltd.)

The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Abstract: The persistence of inflammatory and neuropathic pain is poorly understood. We investigated a novel therapeutic paradigm by targeting gene networks that sustain or reverse persistent pain states. Our prior observations found that Sp1-like transcription factors drive the expression of TRPV1, a pain receptor, that is blocked in vitro by mithramycin A (MTM), an inhibitor of Sp1-like factors. Here, we investigate the ability of MTM to reverse in vivo models of inflammatory and chemotherapy-induced peripheral neuropathy (CIPN) pain and explore MTM's underlying mechanisms. Mithramycin reversed inflammatory heat hyperalgesia induced by complete Freund adjuvant and cisplatin-induced heat and mechanical hypersensitivity. In addition, MTM reversed both short-term and long-term (1 month) oxaliplatin-induced mechanical and cold hypersensitivity, without the rescue of intraepidermal nerve fiber loss. Mithramycin reversed oxaliplatin-induced cold hypersensitivity and oxaliplatin-induced TRPM8 overexpression in dorsal root ganglion (DRG). Evidence across multiple transcriptomic profiling approaches suggest that MTM reverses inflammatory and neuropathic pain through broad transcriptional and alternative splicing regulatory actions. Mithramycin-dependent changes in gene expression following oxaliplatin treatment were largely opposite to and rarely overlapped with changes in gene expression induced by oxaliplatin alone. Notably, RNAseq analysis revealed MTM rescue of oxaliplatin-induced dysregulation of mitochondrial electron transport chain genes that correlated with in vivo reversal of excess reactive oxygen species in DRG neurons. This finding suggests that the mechanism(s) driving persistent pain states such as CIPN are not fixed but are sustained by ongoing modifiable transcription-dependent processes., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)

Aim: To investigate current endodontic practices, adoption of technologies and continuing education attendance within specialist endodontic practice globally and to identify geographic trends., Methodology: A web-based survey of endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA on routine treatment preferences, armamentarium and education attendance was conducted. Chi-squared, independent sample t-tests, Cochran's Q test and McNemar's test were performed., Results: The survey was completed by 543 endodontists or endodontic post-graduate students. Almost all respondents used the dental operating microscope (DOM, 91.3%), engine-driven nickel-titanium instruments (NiTi, 97.6%), electronic apex locators (EAL, 93.0%), cone-beam computed tomography (CBCT, 91.2%) and calcium silicate-based materials (CSBMs, 93.7%). Dental dam was always used by 99.1%. Over half used irrigation adjuncts (81.8%), warm vertical compaction (74.6%) and heat-treated NiTi (60.2%). Geographic comparison between AP (Asia-Pacific, n = 78), AM (Americas, n = 402) and EM (Europe and Middle East, n = 63) was performed. AM and EM preferred single-visit treatment more (p < .001) and used higher sodium hypochlorite concentrations than AP. AM had more access to CBCT in the workplace (86.6%) than AP (65.4%, p < .001) and used CBCT for routine preoperative assessment (39.6%) more than EM (7.3%, p < .001). Almost all of EM used irrigation adjuncts (95.2%), more than AM (78.1%, p = .001). AP used steroid/antibiotic medicaments most (p < .001) and had the highest attendance at continuing education programmes., Conclusion: Several endodontic-specific armamentaria have reached almost complete adoption within global specialist endodontic practice, whilst the continued uptake of newer technologies should be followed over time. Some practising philosophies varied significantly across different geographic regions., (© 2023 British Endodontic Society. Published by John Wiley & Sons Ltd.)