Ultrasound-based techniques as alternative treatments for chronic wounds: A comprehensive review of clinical applications

Ultrasound (US) waves have been recently developed for the treatment of different chronic wounds with promising therapeutic outcomes. However, the clinical efficacy of these techniques is still not fully understood and standard guidelines on dose ranges and possible side effects should be determined. This paper aims to comprehensively review the recent advances in US techniques for chronic wound treatment, their therapeutic efficacies, and clinical considerations and challenges. The databases of PubMed (1985-2017), EMBASE (1985-2017), Web of Sciences (1985-2017), Cochrane central library (1990-2017), and Google Scholar (1980-2017) were searched using the set terms. The obtained results were screened for the title and abstract by two authors and the relevant papers were reviewed for further details. Preclinical and clinical studies have shown strong evidence on the therapeutic efficiency of US in chronic wounds. The main limitation on developing clinical standard protocols of US for treatment of wounds is the lack of definite dose-response for each wound. However, spatial average temporal average is the main parameter for defining US dosage in wound treatment. The range of 0.5 to 3 W/cm2 is a range of dose exerting significant therapeutic outcomes and minimum adverse effects. Low-frequency US waves can accelerate the healing speed of open wounds as well as deep-tissue injuries. In addition, US waves show promising therapeutic efficacy for chronic wounds. To develop clinical US protocol for each wound type, further in vitro and in vivo preclinical and clinical trials are needed to reach an exact dose-response for each wound type

Dataset of acute repeated sessions of bifrontal transcranial direct current stimulation for treatment of intractable tinnitus: A randomized controlled trial

Transcranial direct current stimulation (tDCS) has reportedly shown promising therapeutic effects for tinnitus (Forogh et al., 2016; Joos et al., 2014) 1,2. Studies are ongoing to determine optimum treatment protocol and the site of stimulation. Findings of the early studies are heterogeneous and most studies have focused on single session tDCS and short follow-up periods. There is no study on repeated sessions of tDCS with long term follow-up. This study presents the results of a randomized clinical trial investigating the therapeutic effects of acute multi-session tDCS over dorsolateral prefrontal cortex (DLPFC) on tinnitus symptoms and comorbid depression and anxiety in patients with chronic intractable tinnitus. The dataset includes the demographic information, audiometric assessments, tinnitus specific characteristics, and the response variables of the study. The response variables included the scores of tinnitus handicap inventory (THI), tinnitus loudness and tinnitus related distress based on 0�10 numerical visual analogue scale (VAS) scores, beck depression inventory (BDI-II) and beck anxiety inventory (BAI) scores. The dataset included the scores of THI pre and immediately post intervention, and at one month follow-up; the tinnitus loudness and distress scores prior to intervention, and immediately, one hour, one week, and at one month after the last stimulation session. In addition, the BDI-II, and BAI scores pre and post intervention are included. The data of the real (n=25) and sham tDCS (n=17) groups are reported. The main manuscript of this dataset is �Acute repeated sessions of bifrontal transcranial direct current stimulation for treatment of intractable tinnitus: a randomized controlled trial� (Bayat et al., submitted for publication) 3]. © 2017 The Author

Dataset of acute repeated sessions of bifrontal transcranial direct current stimulation for treatment of intractable tinnitus: A randomized controlled trial

Transcranial direct current stimulation (tDCS) has reportedly shown promising therapeutic effects for tinnitus (Forogh et al., 2016; Joos et al., 2014) 1,2. Studies are ongoing to determine optimum treatment protocol and the site of stimulation. Findings of the early studies are heterogeneous and most studies have focused on single session tDCS and short follow-up periods. There is no study on repeated sessions of tDCS with long term follow-up. This study presents the results of a randomized clinical trial investigating the therapeutic effects of acute multi-session tDCS over dorsolateral prefrontal cortex (DLPFC) on tinnitus symptoms and comorbid depression and anxiety in patients with chronic intractable tinnitus. The dataset includes the demographic information, audiometric assessments, tinnitus specific characteristics, and the response variables of the study. The response variables included the scores of tinnitus handicap inventory (THI), tinnitus loudness and tinnitus related distress based on 0�10 numerical visual analogue scale (VAS) scores, beck depression inventory (BDI-II) and beck anxiety inventory (BAI) scores. The dataset included the scores of THI pre and immediately post intervention, and at one month follow-up; the tinnitus loudness and distress scores prior to intervention, and immediately, one hour, one week, and at one month after the last stimulation session. In addition, the BDI-II, and BAI scores pre and post intervention are included. The data of the real (n=25) and sham tDCS (n=17) groups are reported. The main manuscript of this dataset is �Acute repeated sessions of bifrontal transcranial direct current stimulation for treatment of intractable tinnitus: a randomized controlled trial� (Bayat et al., submitted for publication) 3]. © 2017 The Author

Repeated bilateral transcranial direct current stimulation over auditory cortex for tinnitus treatment: a double-blinded randomized controlled clinical trial

Transcranial direct current stimulation (tDCS) is a non-invasive and painless technique of brain neuromodulation that applies a low-intensity galvanic current to the scalp with the aim of stimulating specific areas of the brain. Preliminary investigations have indicated the potential therapeutic efficacy of multisession tDCS applied to the auditory cortex (AC) in the treatment of chronic tinnitus. The aim of this study was to explore the therapeutic effects of repeated sessions of bilateral tDCS targeting the AC on chronic tinnitus. A double-blinded randomized placebo-controlled trial was conducted on patients (n = 48) with chronic intractable tinnitus (>2 years duration). Participants were randomly allocated to two groups: one receiving tDCS (n = 26), with the anode/cathode placed over the left/right AC, and the other receiving a placebo treatment (n = 22). A 20 min daily session of 2 mA current was administered for five consecutive days per week over two consecutive weeks, employing 35 cm2 electrodes. Tinnitus handicap inventory (THI) scores, tinnitus loudness, and tinnitus distress were measured using a visual analogue scale (VAS), and were assessed before intervention, immediately after, and at one-month follow-up. Anodal tDCS significantly reduced THI from 72.93 ± 10.11 score to 46.40 ± 15.36 after the last session and 49.68 ± 14.49 at one-month follow-up in 18 out of 25 participants (p < 0.001). The risk ratio (RR) of presenting an improvement of ≥20 points in the THI after the last session was 10.8 in patients treated with tDCS. Statistically significant reductions were observed in distress VAS and loudness VAS (p < 0.001). No statistically significant differences in the control group were observed. Variables such as age, gender, duration of tinnitus, laterality of tinnitus, baseline THI scores, and baseline distress and loudness VAS scores did not demonstrate significant correlations with treatment response. Repeated sessions of bilateral AC tDCS may potentially serve as a therapeutic modality for chronic tinnitus

The Role of Doctor-Patient Communication Skills in Predicting Treatment Adherence

Background and Objective: The level of patient adherence to treatment and medication orders is one of the important factors influencing the effectiveness of medical treatments. The aim of this study is to investigate the relationship between doctor-patient communication skills and the level of adherence to medication orders after discharge from the hospital. Methods: This cross-sectional study was conducted on 284 patients admitted to the surgery and urology departments of Shahid Beheshti Hospital in Babol, where at least 48 hours had passed since their admission. Patients completed two questionnaires of doctor-patient communication skills (range 21-70) and Burton communication skills (range 18-90) in the hospital. Then, two weeks after discharge, the patients answered the two questionnaires of general adherence and the Morisky Medication Adherence Scale online or by telephone contact, and the results were analyzed. Findings: The mean age of the participating patients was 50.65±18.20 years and the score of general adherence to treatment orders was 24.26±5.77 (range 7-30) and medication adherence was 8.54±2.91 (range 1-11). 222 patients (78.2%) had high adherence to treatment orders. Stepwise regression analysis showed that doctors’ communication skills were a positive factor in medication adherence (p<0.001, ß=0.336) and adherence to treatment orders (p<0.001, ß=0.331). Moreover, patients’ communication skills had a positive effect on medication adherence (p=0.01, ß=0.137) and general adherence to treatment orders (p<0.001, ß=0.205). Conclusion: The results of the study showed that the communication skills of doctors and patients is a positive predictor of adherence to treatment and medication orders after discharge from the hospital

The Role of Doctor-Patient Communication Skills in Predicting Treatment Adherence

Background and Objective: The level of patient adherence to treatment and medication orders is one of the important factors influencing the effectiveness of medical treatments. The aim of this study is to investigate the relationship between doctor-patient communication skills and the level of adherence to medication orders after discharge from the hospital. Methods: This cross-sectional study was conducted on 284 patients admitted to the surgery and urology departments of Shahid Beheshti Hospital in Babol, where at least 48 hours had passed since their admission. Patients completed two questionnaires of doctor-patient communication skills (range 21-70) and Burton communication skills (range 18-90) in the hospital. Then, two weeks after discharge, the patients answered the two questionnaires of general adherence and the Morisky Medication Adherence Scale online or by telephone contact, and the results were analyzed. Findings: The mean age of the participating patients was 50.65±18.20 years and the score of general adherence to treatment orders was 24.26±5.77 (range 7-30) and medication adherence was 8.54±2.91 (range 1-11). 222 patients (78.2%) had high adherence to treatment orders. Stepwise regression analysis showed that doctors’ communication skills were a positive factor in medication adherence (p<0.001, ß=0.336) and adherence to treatment orders (p<0.001, ß=0.331). Moreover, patients’ communication skills had a positive effect on medication adherence (p=0.01, ß=0.137) and general adherence to treatment orders (p<0.001, ß=0.205). Conclusion: The results of the study showed that the communication skills of doctors and patients is a positive predictor of adherence to treatment and medication orders after discharge from the hospital

Single session neurofeedback treatment alters theta/beta-1 and theta/alpha ratios but not sufficient to induce clinical enhancement in attention

Background and Aims: Neurofeedback treatment (NFT) may enhance attention performance in healthy individuals. This study investigated the effects of single session NFT on attention in healthy individuals performing a visual attention task. Methods: This was an open-label single-blinded trial conducted on 14 healthy university students (n=14; mean=23.35±0.58 years) of a major medical university in Iran. The subjects underwent a single session NFT while performing attentional network task (ANT). The NFT protocol was theta suppression/beta-1enhancement applied at Cz for 20 min. Before and immediately after NFT, EEG signals were recorded in subjects while performing ANT. EEGs were recorded using a 19 channel device and 10-20 placement protocol. Results: The single session NFT increased the theta/beta-1 ratio in most of the electrode sites and the increase was statistically significant compared to the pre-intervention in the T6 site (p=0.011). The ratio decreased in just three sites of C3, Fz, and Cz, of them Fz showed a significant reduction (p=0.026). Contrary, the theta/alpha ratio decreased in most of the electrodes where the reductions were statistically significant in P3, P4, Cz, Pz (p<0.05), and C3 (p<0.01). The F7, F8, T3, and T4 showed no significant increased theta/alpha ratio. The central, temporal and occipital regions were involved in the NFT induced changes. Single NFT did not significantly change alerting, executive, or orienting networks of ANT. Conclusions: Theta/beta-1 and theta/alpha ratios can be reliably used to assess NFT induced attention enhancement. However, single NFT did not induce clinical outcomes and repeated sessions seem necessary to modulate alerting, executive, or orienting networks of ANT

Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study.

BACKGROUND: Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. METHODS: Using cognitive testing data and data on functional limitations from Wave A (2001-2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. RESULTS: Our algorithm had a cross-validated predictive accuracy of 88% (86-90), and an area under the curve of 0.97 (0.97-0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3-4) in individuals 70-79, 11% (9-12) in individuals 80-89 years old, and 28% (22-35) in those 90 and older. CONCLUSIONS: Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations

Global mortality from dementia : Application of a new method and results from the Global Burden of Disease Study 2019

Introduction Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods We meta-analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end-stage disease to calculate the total number of deaths that could be attributed to dementia. Results We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41-4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27-2.71]) than men (0.56 million [0.14-1.51]), largely but not entirely due to the higher life expectancy in women (age-standardized female-to-male ratio 1.19 [1.10-1.26]). Due to population aging, there was a large increase in all-age mortality rates from dementia between 1990 and 2019 (100.1% [89.1-117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally.Peer reviewe