Nuclear medicine is experiencing a renaissance, with U.S. Food and Drug Administration approval recently being obtained for theranostic agents and a wide variety of such agents soon to impact patient ...care significantly in the era of precision medicine. The NETTER-1 trial demonstrated the therapeutic effect of a theranostic agent in markedly improving progression-free survival in patients with metastatic gastroenteropancreatic neuroendocrine tumors. Predominantly retrospective studies have demonstrated a significant response to
Lu-labeled agents targeting prostate-specific membrane antigen (PSMA) in patients with prostate cancer. At least 2 prospective clinical trials involving
Lu-PSMA agents are under way that will likely pave the way for Food and Drug Administration approval in the United States. A significant upside to theranostics is that patients tend to tolerate these agents better than chemotherapy. Theranostic compounds are likely to impact many cancers in the near future, not only through improvements in quality of life but also in terms of survival. This article provides an overview of already approved agents as well as those on the horizon. It is important that as these agents are clinically onboarded, nuclear medicine physicians have the expertise to deploy theranostics safely and efficiently, ensuring that these agents attain and maintain their position as leading lines of therapy in managing patients with cancer as well as becoming an important aspect of nuclear medicine practice in the future.
Several studies have evaluated whether the distribution of natural environments differs between marginalized and privileged neighborhoods. However, most studies restricted their analyses to a single ...or handful of cities and used different natural environment measures.
We evaluated whether natural environments are inequitably distributed based on socioeconomic status (SES) and race/ethnicity in the contiguous United States.
We obtained SES and race/ethnicity data (2015-2019) for all U.S. Census tracts. For each tract, we calculated the Normalized Different Vegetation Index (NDVI) for 2020, NatureScore (a proprietary measure of the quantity and quality of natural elements) for 2019, park cover for 2020, and blue space for 1984-2018. We used generalized additive models with adjustment for potential confounders and spatial autocorrelation to evaluate associations of SES and race/ethnicity with NDVI, NatureScore, park cover, and odds of containing blue space in all tracts (
) and in urban tracts (
). To compare effect estimates, we standardized NDVI, NatureScore, and park cover so that beta coefficients presented a percentage increase or decrease of the standard deviation (SD).
Tracts with higher SES had higher NDVI, NatureScore, park cover, and odds of containing blue space. For example, urban tracts in the highest median household income quintile had higher NDVI 44.8% of the SD (95% CI: 42.8, 46.8) and park cover 16.2% of the SD (95% CI: 13.5, 19.0) compared with urban tracts in the lowest median household income quintile. Across all tracts, a lower percentage of non-Hispanic White individuals and a higher percentage of Hispanic individuals were associated with lower NDVI and NatureScore. In urban tracts, we observed weak positive associations between percentage non-Hispanic Black and NDVI, NatureScore, and park cover; we did not find any clear associations for percentage Hispanics.
Multiple facets of the natural environment are inequitably distributed in the contiguous United States. https://doi.org/10.1289/EHP11164.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Cognitive theories implicate information‐processing biases in the etiology of anxiety disorders. Results of attention‐bias studies in posttraumatic stress disorder (PTSD) have been inconsistent, ...suggesting biases towards and away from threat. Within‐subject variability of attention biases in posttraumatic patients may be a useful marker for attentional control impairment and the development of posttrauma symptoms. This study reports 2 experiments investigating threat‐related attention biases, mood and anxiety symptoms, and attention‐bias variability following trauma. Experiment 1 included 3 groups in a cross‐sectional design: (a) PTSD, (b) trauma‐exposed without PTSD, and (c) healthy controls with no trauma or Axis I diagnoses. Greater attention‐bias variability was found in the PTSD group compared to the other 2 groups (ηp2=.23); attention‐bias variability was significantly and positively correlated (r = .37) with PTSD symptoms. Experiment 2 evaluated combat‐exposed and nonexposed soldiers before and during deployment. Attention‐bias variability did not differentiate groups before deployment, but did differentiate groups during deployment (ηp2=.16); increased variability was observed in groups with acute posttraumatic stress symptoms and acute depression symptoms only. Attention‐bias variability could be a useful marker for attentional impairment related to threat cues associated with mood and anxiety symptoms after trauma exposure.
抽象
Traditional and Simplified Chinese s by AsianSTSS
標題：注意力偏差的變動和創傷後壓力症症狀
撮要：認知理論指出焦慮症的起源會是資訊處理偏差。創傷後壓力症(PTSD)的注意力偏差研究未有一致的結果，或許是偏差可以是接近或遠離威脅。受創病人注意力偏差的個體內變化可能是注意力控制障礙和創傷後症狀的標記。本研究報告兩個試驗，檢測創傷後威脅相關的注意力偏差，情緒和焦慮症狀，和注意力偏差的變動。試驗1包括橫斷面設計內三個組別：(a)PTSD，(b)經歷創傷但未有PTSD，和(c)沒有創傷或軸1診斷的健康對照組。對比其他兩組(n2p=.23)PTSD有更高注意力偏差的變動；而注意力偏差的變動與PTSD症狀呈顯着的正相連(r=.37)。試驗2評估經歷戰鬥及非經歷士兵在派駐前及期間的狀況。注意力偏差變動未能辨別派駐前組別，但可分辨派駐期間的組別(n2p=.16)；添加的變動只見於急性創傷後壓力症狀和急性抑鬱症狀組別。注意力偏差的變動可以是經歷創傷後情緒和焦慮症狀相連威脅暗示的注意力障礙的有效標記。
标题：注意力偏差的变动和创伤后压力症症状
撮要：认知理论指出焦虑症的起源会是信息处理偏差。创伤后压力症(PTSD)的注意力偏差研究未有一致的结果，或许是偏差可以是接近或远离威胁。受创病人注意力偏差的个体内变化可能是注意力控制障碍和创伤后症状的标记。本研究报告两个试验，检测创伤后威胁相关的注意力偏差，情绪和焦虑症状，和注意力偏差的变动。试验1包括横断面设计内三个组别：(a)PTSD，(b)经历创伤但未有PTSD，和(c)没有创伤或轴1诊断的健康对照组。对比其他两组(n2p=.23)PTSD有更高注意力偏差的变动；而注意力偏差的变动与PTSD症状呈显着的正相连(r=.37)。试验2评估经历战斗及非经历士兵在派驻前及期间的状况。注意力偏差变动未能辨别派驻前组别，但可分辨派驻期间的组别(n2p=.16)；添加的变动只见于急性创伤后压力症状和急性忧郁症状组别。注意力偏差的变动可以是经历创伤后情绪和焦虑症状相连威胁暗示的注意力障碍的有效标记。
Early microbial colonization of the gut reduces the incidence of infectious, inflammatory and autoimmune diseases. Recent population studies reveal that childhood hygiene is a significant risk factor ...for development of inflammatory bowel disease, thereby reinforcing the hygiene hypothesis and the potential importance of microbial colonization during early life. The extent to which early-life environment impacts on microbial diversity of the adult gut and subsequent immune processes has not been comprehensively investigated thus far. We addressed this important question using the pig as a model to evaluate the impact of early-life environment on microbe/host gut interactions during development.
Genetically-related piglets were housed in either indoor or outdoor environments or in experimental isolators. Analysis of over 3,000 16S rRNA sequences revealed major differences in mucosa-adherent microbial diversity in the ileum of adult pigs attributable to differences in early-life environment. Pigs housed in a natural outdoor environment showed a dominance of Firmicutes, in particular Lactobacillus, whereas animals housed in a hygienic indoor environment had reduced Lactobacillus and higher numbers of potentially pathogenic phylotypes. Our analysis revealed a strong negative correlation between the abundance of Firmicutes and pathogenic bacterial populations in the gut. These differences were exaggerated in animals housed in experimental isolators. Affymetrix microarray technology and Real-time Polymerase Chain Reaction revealed significant gut-specific gene responses also related to early-life environment. Significantly, indoor-housed pigs displayed increased expression of Type 1 interferon genes, Major Histocompatibility Complex class I and several chemokines. Gene Ontology and pathway analysis further confirmed these results.
Early-life environment significantly affects both microbial composition of the adult gut and mucosal innate immune function. We observed that a microbiota dominated by lactobacilli may function to maintain mucosal immune homeostasis and limit pathogen colonization.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Loss of the nipple-areola complex can be psychologically and sexually devastating. Nipple-sparing mastectomy provides robust cosmetic results, but few studies have investigated the quality-of-life ...outcomes associated with it.
The authors performed an institutional review board-approved retrospective study of 32 patients who underwent nipple-sparing mastectomy with implant-based or autologous reconstruction and 32 control patients who underwent non-nipple-sparing mastectomy with reconstruction matched by reconstruction type and operative period. They then compared premastectomy and postreconstruction responses to the BREAST-Q, a validated and breast reconstruction-specific quality-of-life questionnaire, within and between their study and control populations.
The nipple-sparing and non-nipple-sparing mastectomy groups were statistically similar in terms of mean age 49.9 ± 8.5 years (range, 36 to 69 years) and 47.7 ± 10.3 years (range, 26 to 68 years) (p = 0.29), respectively and mean body mass index 24.3 ± 3.5 kg/m (range, 17.9 to 33.7 kg/m) and 25.5 ± 5.4 kg/m (range, 19.2 to 39.2 kg/m) (p = 0.29), respectively. There were no significant between-group differences in occurrence of postreconstruction complications. The authors found significantly higher mean postreconstruction scores in the nipple-sparing mastectomy group within the Satisfaction with Breasts (p = 0.039) and the Satisfaction with Outcome (p = 0.017) domains. Finally, they noted higher median postreconstruction scores in the nipple-sparing mastectomy group within the Psychosocial Well-being (p = 0.043) and Satisfaction with Breasts (p = 0.004) domains.
Psychological concerns regarding malignancy may negatively impact premastectomy patient quality of life. Reconstructive surgery improves patients' postmastectomy quality of life. Nipple-sparing mastectomy appears to provide significantly better improvement in postreconstruction quality of life, specifically in the Satisfaction with Breasts and Satisfaction with Outcome domains of the BREAST-Q, compared with non-nipple-sparing mastectomies.
Therapeutic, III.
Endovascular embolization of pulmonary arteriovenous malformations (PAVMs) was historically performed with embolic coils. The Amplatzer Vascular Plug device (AVP) was introduced for this purpose in ...2007 and the Micro Vascular Plug device (MVP) in 2013.
The purpose of this study was to compare coils, AVPs, and MVPs in terms of risk of persistence after PAVM embolization by use of propensity score weighting to account for biases in device selection.
This retrospective study included 112 patients (78 women and girls, 34 men and boys; mean age, 45 years) who underwent embolization of 393 PAVMs with a single device type (coil, MVP, or AVP) from January 2003 to January 2020. Persistence was defined as less than 70% reduction in PAVM sac size or contrast enhancement of the sac on follow-up pulmonary CTA. A Cox proportional hazards regression model was used to assess associations between embolic device selection and PAVM persistence. Inverse propensity score weighting was used to account for differences in embolic device selection based on patient and PAVM characteristics.
The median postembolization follow-up period was 1.5 years (IQR, 0.3-5.6 years). Persistence was found in 10% (41/393) of PAVMs, including 16% (34/207) of those treated with coils, 8% (7/88) of those treated with AVPs, and 0% (0/98) of those treated with MVPs. Variables associated with embolization device (
< .25) were age, sex, pediatric versus adult status, smoking status, PAVM complexity, PAVM laterality, number of feeding arteries, and feeding artery diameter. The Cox regression model incorporated inverse propensity score weighting to account for the differences between treatment groups in these variables and incorporated feeding artery diameter because of imbalance remaining after weighting. With coils as the referent, MVPs had a hazard ratio for persistence of less than 0.01 (95% CI, < 0.01 to < 0.01;
< .001), and AVPs had a hazard ratio of 0.37 (95% CI, 0.16-0.90;
= .03).
The risk of persistence after PAVM embolization was significantly lower for MVPs alone than for coils or AVPs alone. In addition, the risk of persistence was lower for AVPs than for coils.
The findings support the clinical use of MVPs as the preferred device for PAVM embolization over coils and polytetrafluoroethylene-covered plugs.
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