Journal of investigative medicine : the official publication of the American Federation for Clinical Research
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The objectives of this retrospective study were to use preoperative 18fluoro-d-glucose (18FDG) PET/CT in patients with primary cervical squamous cell carcinoma to explore the relationship between clinical, pathological and metabolic characteristics. Eighty consecutive patients with squamous cell carcinoma of cervix received 18FDG PET/CT scan before treatment. Metabolic tumor volume (MTV), total lesion glycolysis (TLG) and the peak standardized uptake value (SUVpeak) of the cervical tumors were calculated by an iterative adaptive algorithm. ⋯ TLG and SUVpeak were independently associated with maximum tumor size (p≤0.004) and depth of cervical stromal invasion (p≤0.013). Significant linear correlation was found between SUVpeak and tumor size; the Pearson correlation coefficient was 0.34 (p=0.002). Metabolic parameters such as MTV, TLG and SUVpeak are able to predict clinical and pathological status in preoperative cervical cancer.
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Randomized Controlled Trial
Effect of calorie or exercise labels on menus on calories and macronutrients ordered and calories from specific foods in Hispanic participants: a randomized study.
The effect of menu labels on food choices is unknown in Hispanics. This study evaluated the impact of menu labels on calories and macronutrients ordered in Hispanics. 372 Hispanics (18-65 years) were randomly assigned to menus with no labels (NL) (n=127), rank-ordered calorie labels plus a statement on energy needs per meal (CL) (n=123), or rank-ordered exercise labels showing minutes of brisk walking necessary to burn the food calories (EL) (n=122). The menus had identical food choices. ⋯ Logistic regression showed that selecting foods based on health value (p=0.01) was associated with higher food label use. Menu labels did not affect food choices in Hispanic participants. Future studies should determine if nutrition, exercise, and weight perception counseling prior to menu labels intervention would result in better food choices.
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Sentinel lymph node biopsy (SLNB) is the standard of care for surgical evaluation of early-stage breast cancer and is being employed as a quality metric for accreditation of breast centers. Previous studies report disparities in SLNB receipt. The goal of this study is to determine SLNB rates and explore rationale for non-receipt of SLNB. ⋯ Chart review determined that 45/47 patients did not have SLNB, because it was a clinical decision-making; advanced age (>80 years) was cited in 27/47 women. Older women had much lower odds of receiving SLNB; however, non-receipt of SLNB was often due to a clinical reasoning. Our study highlights the importance of clinical reasoning in receiving SLNB, whereas other studies solely employing administrative databases do not.
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Healthcare services and the production of healthcare knowledge are increasingly dependent on highly functioning, multidisciplinary teams, requiring greater awareness of individuals' readiness to collaborate in translational science teams. Yet, there is no comprehensive tool of individual motivations and threats to collaboration that can guide preparation of individuals for work on well-functioning teams. This prospective pilot study evaluated the preliminary psychometric properties of the Motivation Assessment for Team Readiness, Integration, and Collaboration (MATRICx). ⋯ In contrast, the more experienced respondents were concerned with issues that reflected a collective purpose, more typical of collaborative alliances. While these different types of alliances are usually described as representing varying aspects along a continuum, our findings suggest that collaboration might be better thought of as a qualitatively different state than cooperation or coordination. These results need to be replicated in larger samples, but the findings have implications for the development and design of educational interventions that aim to ready scientists and clinicians for greater interdisciplinary work.
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A threshold probability value of 'p≤0.05' is commonly used in clinical investigations to indicate statistical significance. To allow clinicians to better understand evidence generated by research studies, this review defines the p value, summarizes the historical origins of the p value approach to hypothesis testing, describes various applications of p≤0.05 in the context of clinical research and discusses the emergence of p≤5×10(-8) and other values as thresholds for genomic statistical analyses. Corresponding issues include a conceptual approach of evaluating whether data do not conform to a null hypothesis (ie, no exposure-outcome association). ⋯ Also, in contemporary genomic studies, a threshold of p≤10(-8) has been endorsed as a boundary for statistical significance when analyzing numerous genetic comparisons for each participant. A value of p≤0.05, or other thresholds, should not be employed reflexively to determine whether a clinical research investigation is trustworthy from a scientific perspective. Rather, and in parallel with conceptual issues of validity and generalizability, quantitative results should be interpreted using a combined assessment of strength of association, p values, CIs, and sample size.