Histological subtype is the most important determinant of survival in metastatic papillary thyroid cancer

<p>Abstract</p> <p>Background</p> <p>Papillary thyroid cancer (PTC) comprises the commonest type of thyroid cancer and carries the highest rate of survival. However, when metastatic disease occurs, survival is significantly affected.</p> <p>Methods</p> <p>We aimed to identify prognostic histopathological and clinical factors that modify survival in metastatic PTC. All cases of metastatic PTC treated at our department in the last 20 years were reviewed and analyzed.</p> <p>Results</p> <p>Histological subtype was the most important determinant of survival, as classic PTC demonstrated clearly improved survival compared to follicular subtype of PTC and other less frequently seen histological subtypes. The instant risk of death for the other histological subtypes was 4.56 times higher than the risk for the classic papillary type. Overall, a 10-year survival of 76.6% in our patients was seen.</p> <p>Conclusions</p> <p>Patients with aggressive variants of PTC are more at risk for the development of metastatic disease. In these patients, established treatment modalities (surgery, radioiodine therapy) should be offered promptly, as well as close follow-up.</p

A systematic review and metanalysis of questionnaires used for auditory processing screening and evaluation

The recognition of Auditory Processing Disorder (APD) as a distinct clinical condition that impacts hearing capacity and mental health has gained attention. Although pure tone audiometry is the gold standard for assessing hearing, it inadequately reflects everyday hearing abilities, especially in challenging acoustic environments. Deficits in speech perception in noise, a key aspect of APD, have been linked to an increased risk of dementia. The World Health Organization emphasizes the need for evaluating central auditory function in cases of mild hearing loss and normal audiometry results. Specific questionnaires play a crucial role in documenting and quantifying the difficulties faced by individuals with APD. Validated questionnaires such as the Children's Auditory Processing Performance Scale, the Fisher's Auditory Problems Checklist, and the Auditory Processing Domains Questionnaire are available for children, while questionnaires for adults include items related to auditory functions associated with APD. This systematic review and meta-analysis identified six questionnaires used for screening and evaluating APD with a total of 783 participants across 12 studies. The questionnaires exhibited differences in domains evaluated, scoring methods, and evaluation of listening in quiet and noise. Meta-analysis results demonstrated that individuals with APD consistently exhibited worse scores compared to healthy controls across all questionnaires. Additionally, comparisons with clinical control groups showed varying results. The study highlights (i) the importance of standardized questionnaires in identifying and assessing APD, aiding in its diagnosis and management, and (ii) the need to use sub-scores as well as overall scores of questionnaires to elaborate on specific hearing and listening situations. There is a need to develop more APD specific questionnaires for the adult population as well as for more focused research on APD diagnosed individuals to further establish the validity and reliability of these questionnaires

A systematic review and metanalysis of questionnaires used for auditory processing screening and evaluation

The recognition of Auditory Processing Disorder (APD) as a distinct clinical condition that impacts hearing capacity and mental health has gained attention. Although pure tone audiometry is the gold standard for assessing hearing, it inadequately reflects everyday hearing abilities, especially in challenging acoustic environments. Deficits in speech perception in noise, a key aspect of APD, have been linked to an increased risk of dementia. The World Health Organization emphasizes the need for evaluating central auditory function in cases of mild hearing loss and normal audiometry results. Specific questionnaires play a crucial role in documenting and quantifying the difficulties faced by individuals with APD. Validated questionnaires such as the Children’s Auditory Processing Performance Scale, the Fisher’s Auditory Problems Checklist, and the Auditory Processing Domains Questionnaire are available for children, while questionnaires for adults include items related to auditory functions associated with APD. This systematic review and meta-analysis identified six questionnaires used for screening and evaluating APD with a total of 783 participants across 12 studies. The questionnaires exhibited differences in domains evaluated, scoring methods, and evaluation of listening in quiet and noise. Meta-analysis results demonstrated that individuals with APD consistently exhibited worse scores compared to healthy controls across all questionnaires. Additionally, comparisons with clinical control groups showed varying results. The study highlights (i) the importance of standardized questionnaires in identifying and assessing APD, aiding in its diagnosis and management, and (ii) the need to use sub-scores as well as overall scores of questionnaires to elaborate on specific hearing and listening situations. There is a need to develop more APD specific questionnaires for the adult population as well as for more focused research on APD diagnosed individuals to further establish the validity and reliability of these questionnaires

A systematic review and metanalysis of questionnaires used for auditory processing screening and evaluation

The recognition of Auditory Processing Disorder (APD) as a distinct clinical condition that impacts hearing capacity and mental health has gained attention. Although pure tone audiometry is the gold standard for assessing hearing, it inadequately reflects everyday hearing abilities, especially in challenging acoustic environments. Deficits in speech perception in noise, a key aspect of APD, have been linked to an increased risk of dementia. The World Health Organization emphasizes the need for evaluating central auditory function in cases of mild hearing loss and normal audiometry results. Specific questionnaires play a crucial role in documenting and quantifying the difficulties faced by individuals with APD. Validated questionnaires such as the Children’s Auditory Processing Performance Scale, the Fisher’s Auditory Problems Checklist, and the Auditory Processing Domains Questionnaire are available for children, while questionnaires for adults include items related to auditory functions associated with APD. This systematic review and meta-analysis identified six questionnaires used for screening and evaluating APD with a total of 783 participants across 12 studies. The questionnaires exhibited differences in domains evaluated, scoring methods, and evaluation of listening in quiet and noise. Meta-analysis results demonstrated that individuals with APD consistently exhibited worse scores compared to healthy controls across all questionnaires. Additionally, comparisons with clinical control groups showed varying results. The study highlights (i) the importance of standardized questionnaires in identifying and assessing APD, aiding in its diagnosis and management, and (ii) the need to use sub-scores as well as overall scores of questionnaires to elaborate on specific hearing and listening situations. There is a need to develop more APD specific questionnaires for the adult population as well as for more focused research on APD diagnosed individuals to further establish the validity and reliability of these questionnaires

Rates, distribution and implications of postzygotic mosaic mutations in autism spectrum disorder

We systematically analyzed postzygotic mutations (PZMs) in whole-exome sequences from the largest collection of trios (5,947) with autism spectrum disorder (ASD) available, including 282 unpublished trios, and performed resequencing using multiple independent technologies. We identified 7.5% of de novo mutations as PZMs, 83.3% of which were not described in previous studies. Damaging, nonsynonymous PZMs within critical exons of prenatally expressed genes were more common in ASD probands than controls (P < 1 Ã 10-6), and genes carrying these PZMs were enriched for expression in the amygdala (P = 5.4 Ã 10-3). Two genes (KLF16 and MSANTD2) were significantly enriched for PZMs genome-wide, and other PZMs involved genes (SCN2A, HNRNPU and SMARCA4) whose mutation is known to cause ASD or other neurodevelopmental disorders. PZMs constitute a significant proportion of de novo mutations and contribute importantly to ASD risk

Development of women's breastfeeding self-efficacy and improvement of breastfeeding outcomes through antenatal classes

Exclusive breastfeeding is the optimal mode of feeding for the first six months of a child’s life. Modifiable factors associated with increased breastfeeding may be addressed through antenatal breastfeeding education. Breastfeeding self- efficacy has emerged as an important psychometric factor for improving breastfeeding outcomes. In Greece, the rates of exclusive breastfeeding remain rather low.Aim: The aim of the current study is to investigate whether an antenatal breastfeeding educational session on breastfeeding, in terms of antenatal preparation classes, improves the level of self-efficacy in breastfeeding, and to what extent this affects its outcome (initiation, duration, and exclusivity).Material and Methods: This was a Pre test-Post test-Control designed, quasi-experimental study, with two study groups. The intervention group consisted of 103 pregnant women that followed a four-hour antenatal breastfeeding programme, in terms of antenatal preparation classes, at a public hospital in Athens. The control group consisted of 100 pregnant women, that did not attend this programme and received only routine care, in the same setting. The study lasted for a total of 15 months (April 2016 - June 2017). The data collection was performed at 4 time points by using the following tools: Socio-demographic data and medical history questionnaire, the Breastfeeding Self-Efficacy Scale-Short Form-(BSES-SF), the Iowa Infant Feeding Attitude Scale-(IIFAS), the Edinburgh Postnatal Depression Scale-(EPDS), the Breast Feeding Knowledge Questionnaire, the Perceived Breastfeeding Barriers Questionnaire, the Satisfaction with the Educational Programme Scale and the Breastfeeding outcomes Questionnaire. Data analysis was conducted using SPSS 19.0 Statistical Software. Statistical significant level was set at 0.05.Results: The reliability of Breastfeeding Self-Efficacy Scale-Short Form and The Iowa Infant Feeding Attitude Scale was acceptable (Cronbach's a 0.93 and 0.71, respectively). Pre-intervention there were no significant differences between control and intervention group in any of the scales. Post-intervention, women in the intervention group had a more positive attitude towards breastfeeding (73.59% versus 66.14%, p<0.001), greater knowledge (14.65% versus 13.11%, p<0.001) and more breastfeeding self-efficacy (51.40% versus 45.65%, p<0.001) compared to the control group. Furthermore, they had significantly less perceived barriers regarding breastfeeding (27.40% versus 31.00%, p<0.001). Moreover, the 3rd day after their delivery, 63.10% of women in the intervention group, breastfed exclusively compared to 56.00% of women in the control group. 6 months after delivery, the percentages of complementary breastfeeding were 54.40% and 32.00%, respectively.Conclusion: Antenatal breastfeeding educational programme, in terms of antenatal parenthood education classes, was effective in increasing breastfeeding self-efficacy and improving the breastfeeding outcomes. It is recommended to integrate antenatal parenthood education in the context of routine midwifery care at the primary and secondary healthcare level of care in Greece.Εισαγωγή: Ο αποκλειστικός θηλασμός αποτελεί το βέλτιστο τρόπο διατροφής για τους πρώτους έξι μήνες της ζωής ενός παιδιού. Οι τροποποιήσιμοι παράγοντες που σχετίζονται με αυξημένη συχνότητα θηλασμού δύνανται να διαμορφωθούν μέσω της προγεννητικής εκπαίδευσης. Η μητρική αυτοαποτελεσματικότητα έχει αναδειχθεί ως ένας σημαντικός ψυχομετρικός παράγοντας για τη βελτίωση της έκβασης του ΜΘ. Στην Ελλάδα, τα ποσοστά του αποκλειστικού θηλασμού παραμένουν ιδιαίτερα χαμηλά.Σκοπός: Σκοπός της παρούσας μελέτης είναι να διερευνήσει εάν η προγεννητική εκπαίδευση των εγκύων για τον θηλασμό, στα πλαίσια των συνεδριών προετοιμασίας γονεικότητας κατά την περίοδο της εγκυμοσύνης, βελτιώνει το βαθμό της αυτοαποτελεσματικότητάς τους στο θηλασμό και επιπλέον σε ποιό βαθμό αυτό επιδρά στην έκβασή του (έναρξη, διάρκεια και τύπο θηλασμού).Μεθοδολογία: Πρόκειται για ημι-πειραματική μελέτη παρέμβασης με σχεδιασμό Pre test-Post test-Control, με δύο ομάδες μελέτης. Η ομάδα παρέμβασης αποτελείται από 103 έγκυες, οι οποίες παρακολούθησαν 4ωρο μάθημα για το μητρικό θηλασμό, στο πλαίσιο συνεδριών προετοιμασίας γονεϊκότητας, σε δημόσιο νοσοκομείο της Αθήνας. Η ομάδα ελέγχου αποτελείται από 100 έγκυες, οι οποίες δεν συμμετείχαν στο εν λόγω πρόγραμμα και έλαβαν μόνο τη συνήθη μαιευτική φροντίδα, στην ίδια δομή. Η μελέτη διήρκεσε συνολικά 15 μήνες (Απρίλιος 2016- Ιούνιος 2017). Η συλλογή των δεδομένων έγινε σε 4 χρονικές στιγμές και πραγματοποιήθηκε με τη χρήση των εξής εργαλείων: Ερωτηματολόγιο κοινωνικο-δημογραφικών δεδομένων και μαιευτικού ιστορικού, Κλίμακα Αυτοαποτελεσματικότητας για το μητρικό θηλασμό (Breastfeeding Self-Efficacy Scale-Short Form, BSES-SF), Κλίμακα Στάσης της Αιόβα για τη Νεογνική Διατροφή (The Iowa Infant Feeding Attitude Scale, IIFAS), Ερωτηματολόγιο για την Επιλόχεια Κατάθλιψη (Edinburgh Postnatal Depression Scale, EPDS), Ερωτηματολόγιο Γνώσεων σχετικά με τον μητρικό θηλασμό (Breast Feeding Knowledge Questionnaire), Ερωτηματολόγιο Για Τα Αντιληπτά Εμπόδια του μητρικού θηλασμού (Perceived Breastfeeding Barriers Questionnaire), Κλίμακα μέτρησης ικανοποίησης για το εκπαιδευτικό πρόγραμμα (Satisfaction with the Educational Programme Scale), Ερωτηματολόγιο Δεικτών μητρικού θηλασμού. Για την ανάλυση χρησιμοποιήθηκε το στατιστικό πρόγραμμα SPSS 19.0. Η στατιστική σημαντικότητα τέθηκε στο 0,05.Αποτελέσματα: Η αξιοπιστία των ερωτηματολογίων Breastfeeding Self-Efficacy Scale-Short Form και Iowa Infant Feeding Attitude Scale ήταν αποδεκτή (συντελεστής Cronbach's a 0,93 και 0,71, αντίστοιχα). Πριν την παρέμβαση δεν υπήρχαν σημαντικές διαφορές μεταξύ των ομάδων ελέγχου και παρέμβασης σε όλες τις κλίμακες. Μετά την παρέμβαση οι γυναίκες στην ομάδα παρέμβασης είχαν καλύτερη στάση (73,59% έναντι 66,14%, p <0,001), περισσότερη γνώση (14,65% έναντι 13,11%, p <0,001), μεγαλύτερη αυτοαυτοαποτελεσματικότητα σχετικά με το θηλασμό (51,40% έναντι 45,65%, p <0,001) και λιγότερα αντιλαμβανόμενα εμπόδια για το θηλασμό (27.40% έναντι 31.00%, p<0.001), σε σύγκριση με τις γυναίκες της ομάδας ελέγχου. Επίσης, την 3η ημέρα μετά τον τοκετό τους, οι γυναίκες στην ομάδα παρέμβασης θήλαζαν αποκλειστικά σε ποσοστό 63,10% σε σύγκριση με τις γυναίκες της ομάδας ελέγχου που θήλαζαν αποκλειστικά σε ποσοστό 56,00%. Στους 6 μήνες μετά τον τοκετό τους, τα ποσοστά του συμπληρωματικού θηλασμού ήταν 54,40% και 32,00%, αντίστοιχα.Συμπέρασμα: Η προγεννητική εκπαίδευση των εγκύων για το θηλασμό, στα πλαίσια των συνεδριών προετοιμασίας γονεϊκότητας κατά την περίοδο της εγκυμοσύνης, βελτιώνει το βαθμό της αυτοαποτελεσματικότητάς τους στο θηλασμό και επιπλέον επιδρά θετικά στην έκβασή του. Συστήνεται η ενσωμάτωση της προετοιμασίας γονεϊκότητας στο πλαίσιο της συνήθους μαιευτικής φροντίδας σε επιπέδο πρωτοβάθμιας και δευτεροβάθμιας παροχής υπηρεσιών υγείας στην Ελλάδα

Extern design och marknadsföringssamarbete - ur ett konsumentperspektiv

The lack of synergy between design and marketing departments can result in less innovative products which can lead to less customer satisfaction. This problem has affected the perfume and cosmetic industry as well, which is considered to be an industry with high competitiveness but also a high innovation rate. The purpose with this study is to understand how consumers' purchase intention can be affected by the characteristics that appear in each collaboration pattern, marketing lead, design lead and co-branding, in order to contribute to a more effective cooperation between external design and marketing in the perfume and cosmetic industry. The study has been based on two theories and one previous research. The theories are Kellers (1993) Consumer Based Brand Equity and Arnoulds and Thompsons (2005) Consumer Identity Project based on the Consumer Culture Theory. The previous research on which this study is based is Hemonnet-Goujots Abecassis-Moedas' &amp; Manceaus (2020) “When external design and marketing collaborate to develop new products: A typology of patterns”. The study has been based on a qualitative research method with a deductive and a hermeneutic approach. The results showed that consumers' purchase intention is affected by brand recognition in products with a high brand consistency. In addition, consumers can be affected by the brand image and the non-product-related attributes together with the symbolic benefits of products with a high rate of innovation and thus of products where a star-based designer is involved. The Consumer's Identity Project is something that always affects the purchase intention, regardless of the characteristics of the product. The information that the study contributes with can be used by companies with external design and marketing in a strategic way to choose which collaboration pattern they want to work with.Bristen på synergi mellan design och marknadsföring kan resultera i mindre innovativa produkter, som i sin tur leder till mindre kundnöjdhet. Denna problematik har inte minst påverkat parfym- och kosmetikabranschen som anses vara en bransch med hög konkurrenskraft och med hög innovationstakt. Syftet med studien är att förstå hur konsumenternas köpintention kan påverkas av kännetecken som förekommer i respektive samarbetsmönster, marketing lead, design lead och co-branding. Detta för att bidra till ett mer effektivt samarbete mellan extern design och marknadsföring. Studien har utgått från två teorier och en tidigare forskning. Teorierna är Kellers (1993) kundbaserat varumärkeskapital (Costumer Based Brand Equity) och Arnould &amp; Thompsons (2005) konsuments identitetsprojekt (Consumer Identity Project) utifrån konsumentkulturteorin (Consumer Culture Theory). Den tidigare forskningen som denna studie har grundat sig på är Hemonnet-Goujots, Abecassis-Moedas &amp; Manceaus (2020) “When external design and marketing collaborate to develop new products: A typology of patterns”. Studien har utgått från en kvalitativ forskningsmetod med en deduktiv ansats samt ett hermeneutiskt synsätt. Resultatet visade att konsumenternas köpintention påverkas av varumärkesigenkänning vid produkter med en hög varumärkeskonsistens. Därtill kan konsumenter påverkas av varumärkesbild och de icke-produktrelaterade attributen i samband med de symboliska fördelarna vid produkter med en hög innovationstakt och därmed vid produkter där en stjärndesigner är inblandad. Konsumentens identitetsprojekt är något som alltid påverkar köpintentionen oberoende på vilka kännetecken produkten förekommer med. Informationen som studien bidrar med kan utnyttjas av företag med extern design och marknadsföring för att på ett strategiskt sätt välja vilket samarbetsmönster de vill arbeta med

Extern design och marknadsföringssamarbete - ur ett konsumentperspektiv

The lack of synergy between design and marketing departments can result in less innovative products which can lead to less customer satisfaction. This problem has affected the perfume and cosmetic industry as well, which is considered to be an industry with high competitiveness but also a high innovation rate. The purpose with this study is to understand how consumers' purchase intention can be affected by the characteristics that appear in each collaboration pattern, marketing lead, design lead and co-branding, in order to contribute to a more effective cooperation between external design and marketing in the perfume and cosmetic industry. The study has been based on two theories and one previous research. The theories are Kellers (1993) Consumer Based Brand Equity and Arnoulds and Thompsons (2005) Consumer Identity Project based on the Consumer Culture Theory. The previous research on which this study is based is Hemonnet-Goujots Abecassis-Moedas' &amp; Manceaus (2020) “When external design and marketing collaborate to develop new products: A typology of patterns”. The study has been based on a qualitative research method with a deductive and a hermeneutic approach. The results showed that consumers' purchase intention is affected by brand recognition in products with a high brand consistency. In addition, consumers can be affected by the brand image and the non-product-related attributes together with the symbolic benefits of products with a high rate of innovation and thus of products where a star-based designer is involved. The Consumer's Identity Project is something that always affects the purchase intention, regardless of the characteristics of the product. The information that the study contributes with can be used by companies with external design and marketing in a strategic way to choose which collaboration pattern they want to work with.Bristen på synergi mellan design och marknadsföring kan resultera i mindre innovativa produkter, som i sin tur leder till mindre kundnöjdhet. Denna problematik har inte minst påverkat parfym- och kosmetikabranschen som anses vara en bransch med hög konkurrenskraft och med hög innovationstakt. Syftet med studien är att förstå hur konsumenternas köpintention kan påverkas av kännetecken som förekommer i respektive samarbetsmönster, marketing lead, design lead och co-branding. Detta för att bidra till ett mer effektivt samarbete mellan extern design och marknadsföring. Studien har utgått från två teorier och en tidigare forskning. Teorierna är Kellers (1993) kundbaserat varumärkeskapital (Costumer Based Brand Equity) och Arnould &amp; Thompsons (2005) konsuments identitetsprojekt (Consumer Identity Project) utifrån konsumentkulturteorin (Consumer Culture Theory). Den tidigare forskningen som denna studie har grundat sig på är Hemonnet-Goujots, Abecassis-Moedas &amp; Manceaus (2020) “When external design and marketing collaborate to develop new products: A typology of patterns”. Studien har utgått från en kvalitativ forskningsmetod med en deduktiv ansats samt ett hermeneutiskt synsätt. Resultatet visade att konsumenternas köpintention påverkas av varumärkesigenkänning vid produkter med en hög varumärkeskonsistens. Därtill kan konsumenter påverkas av varumärkesbild och de icke-produktrelaterade attributen i samband med de symboliska fördelarna vid produkter med en hög innovationstakt och därmed vid produkter där en stjärndesigner är inblandad. Konsumentens identitetsprojekt är något som alltid påverkar köpintentionen oberoende på vilka kännetecken produkten förekommer med. Informationen som studien bidrar med kan utnyttjas av företag med extern design och marknadsföring för att på ett strategiskt sätt välja vilket samarbetsmönster de vill arbeta med

Fathers’ Educational Needs Assessment in Relation to Their Participation in Perinatal Care: A Systematic Review

Even though they are crucial for a positive pregnancy experience, many fathers may not be aware of the significance of their role in perinatal care. As it is important to identify the needs of the target population in the initial phases of a health plan in order to ensure success, the current systematic review is the first one to address the reported needs for men’s antenatal education. Methods: All studies written in English and published between 1997 and 2021 relevant to the theme were included in the review. The electronic databases of various mainstream journals were used to evaluate 87 studies. Results: In total, the validity of 17 studies was determined based on their compliance with the inclusion criteria. According to the review, men’s participation in antenatal education can significantly influence pregnancy, childbirth, parenting, couple’s relationship, and overall family functioning. Conclusion: Providing face-to-face antenatal education to men by doctors or midwives is emphasized as an important component of perinatal care preparation because it leads to positive outcomes