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Randomized Comparative Effectiveness Study of 1-Session vs. 8-Session Online Behavioral Treatment for Chronic Pain: Protocol for the national PROGRESS study.
No full textINTRODUCTION: Evidence-based behavioral pain treatments are often inaccessible or infeasible for patients. A 1-session pain relief skills class (Empowered Relief; ER) has shown efficacy for multidimensional symptom reduction in various homogenous pain populations. Comparative effectiveness evidence in heterogeneous chronic pain is needed to inform decision making and patient matching to treatment.
OBJECTIVES: Conduct a non-inferiority comparative effectiveness trial of two evidence-based online (telehealth) behavioral group treatments for chronic pain (1-session ER vs. 8 session CBT) in a nationally representative sample derived from six study sites.
METHODS: 1,200 adults ≥18 years of age with any type of pain ≥3 months with past-month intensity ≥3/10 will be recruited from six study sites. Participants are randomized 1:1 to either the online 1-session or the 8-session behavioral intervention. Patient reported data are collected to 6 months post-treatment. Medical history, diagnoses and healthcare utilization are obtained via medical records.
MAIN OUTCOME MEASURES: Multi-primary outcomes are changes in pain intensity and pain interference from baseline to 3 months post-treatment with hypothesized non-inferiority between the two study treatments. Statistical analyses include mixed models for repeated measures (MMRM). Priority secondary outcomes include sleep disturbance, pain catastrophizing, anxiety and pain bothersomeness. Exploratory heterogeneity of treatment effects will be examined.
ETHICS AND DISSEMINATION: The study protocol was approved by all six site Institutional Review Boards including Stanford University School of Medicine (IRB 65439) as the coordinating site. Results will be published in peer-reviewed journals. PCORI (funder), participants, and advisors will receive summaries of the findings.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05612750
The Relationship Between Socioeconomic Factors and the Rates of Bystander Cardiopulmonary Resuscitation.
No full textBACKGROUND: High-quality bystander cardiopulmonary resuscitation (CPR) is a key element in successful resuscitation from out-of-hospital cardiac arrests (OHCA). However, less than 40% of adults receive bystander-initiated CPR.
OBJECTIVES: To investigate the relationship between socioeconomic variables and initiation of bystander CPR in OHCA.
METHODS: A total of 504 adults were treated at one of three Emergency Departments between January 1, 2020, and December 31, 2022, for nontraumatic OHCA. Bystander CPR administration was the grouping variable, while socioeconomic variables included Area Deprivation Index (ADI), population density, income, primary language, and poverty level. Chi-squared and group t-tests were performed.
RESULTS: Overall, 4.9% of all OHCA survived to hospital discharge. Survival for bystander CPR patients was 8.4% compared to 2.7% with no bystander CPR (p \u3c 0.004). OHCA without bystander CPR occurred in places with higher state and national decile ADI (mean 6.63 vs. 4.87, p \u3c 0.001 and 70.25 vs. 55.39, p \u3c 0.001, respectively), a higher percentage of families below the poverty level (mean 14.17 vs. 9.58, p \u3c 0.001), and a lower median household income (mean 75,539, p \u3c 0.001) than cases with bystander CPR. Cases without bystander CPR happened in locales with higher population density (mean 4428 vs. 3017 persons/square mile, p \u3c 0.001), and a higher percentage of the population speaking a language other than English (mean 27.42% vs. 19.64%, p \u3c 0.001).
CONCLUSION: Bystander CPR improves OHCA survivability. Lower socioeconomic status, higher population density, and higher percentage of non-English-speaking population have lower rates of bystander CPR use. Community engagement should target these areas to improve CPR training, bystander CPR initiation, and OHCA survivability
Reduced immunogenicity of MYC amplified, metastatic prostate cancer.
No full textOBJECTIVES: Through a genomics-based approach analyzing gene expression levels and adaptive immune receptor recombinations, we sought to determine whether MYC amplification was associated with a worse outcome and reduced immunogenicity.
METHODS: MYC copy numbers and the presence of adaptive immune receptor (IR) recombination sequencing reads were quantified in genomics files representing prostate cancer samples.
RESULTS: Our results showed that increased MYC amplification was found in metastatic stages of prostate cancer. Furthermore, increased MYC amplification was not only associated with worse progression-free survival but also with reduced immunogenicity in metastatic tumors, as determined by the recovery of a reduced numbers of adaptive IR recombination sequencing reads from tumor RNAseq and tumor whole genome sequence files.
CONCLUSIONS: MYC amplification is associated with reduced tumor immunogenicity as assessed by the recovery of IR recombination reads from prostate cancer genomics files
The area under the waveform as an alternative measure of the photopic negative response.
No full textPURPOSE: To explore how the photopic negative response (PhNR), measured as an area defined by the ERG waveform can be used as complementary or an alternative measure to the traditionally measured PhNR amplitude.
METHODS: A retrospective chart review and data analysis of light-adapted 3.0 ERG records in patients and normal subjects patients aged 18 and older undergoing routine ERG testing was conducted. A new measure was analyzed: area defined by the PhNR curve. It was obtained in two ways: as an area under the ERG waveform (AUW) and an area above the ERG waveform (AAW) with starting points defined by the b-wave peak and time windows ranging from 5 to 45 ms in duration. A linear regression was conducted between PhNR1 amplitude (trough before i-wave), PhNR2 amplitude (trough after i-wave), PhNR AUW, and PhNR AAW. Furthermore, a prediction analysis based on AUW/AAW was conducted where the strongest correlated measures were used to predict the PhNR2 amplitude.
RESULTS: The ERG recordings of 70 patients/135 eyes (52F/18 M, average age: 49.2 ± 15.3 years) and six healthy subjects (1F/5 M, age between 22 and 58) were included in this study. 26 patients had well-defined PhNR2 troughs and were used for prediction analysis. There was good correlation between PhNR1 and PhNR2 amplitudes (r
CONCLUSIONS: Determining and using AAW/AUW for PhNR2 prediction could be a valuable method in cases where the PhNR2 peak is not well defined
Diabetes equity in Lehigh Valley: Recruitment for a national diabetes prevention program train the trainer model
No full text
Effectiveness of Corticosteroid-Sparing Topical Treatments for Vernal Keratoconjunctivitis in Children: A Report by the American Academy of Ophthalmology.
No full textPURPOSE: To review the published literature assessing the efficacy of corticosteroid-sparing topical treatments for vernal keratoconjunctivitis (VKC) in children 18 years of age and younger.
METHODS: A literature search of the PubMed database was last conducted in August 2025 and limited to articles published in English without date restrictions. The search yielded 56 articles, which were reviewed by the primary author in abstract form; 24 were selected for full-text review. Fifteen articles met the inclusion criteria and were assigned a level of evidence rating by the panel methodologist.
RESULTS: Six studies were rated level I, and 9 studies were rated level III. Level I evidence evaluated the efficacy of cyclosporine (4/6), tacrolimus (4/6), interferon alpha-2b (1/6), and sodium cromoglycate (1/6) ophthalmic preparations. Most level III evidence studies (5/9) reported outcomes using tacrolimus drops or ointment. Regardless of the medication, concentration, dosing frequency, or treatment duration, level I and level III evidence included in the assessment demonstrated that signs and symptoms of VKC in children can be improved with intervention. Apart from application site discomfort, the studies reported no significant adverse events.
CONCLUSIONS: Level I and III evidence demonstrate that treatment with corticosteroid-sparing topical interventions such as cyclosporine, tacrolimus, sodium cromoglycate, and interferon alpha-2b can improve clinical signs and symptoms of VKC in children. Most of the level I evidence supports the use of the calcineurin inhibitors-cyclosporine and tacrolimus.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references
Afterhours diagnostic radiology in the USA: radiologists\u27 views on imaging volumes, compensation, work-from-home, and compensatory time-off.
No full textPURPOSE: To understand the afterhours radiology workforce and views towards imaging volumes, compensation, overnight challenges, and work-from-home. METHODS: Survey questions focusing on the afterhours radiology workforce were created. The survey was administered by the American College of Radiology (ACR) and the data analysis performed by the ACR in partnership with an independent market research agency. The confidence level was set at 95%, with an error rate of +/- 2.2%. RESULTS: A total of 1109 out of 1844 (60.1%) survey participants responded to the afterhours survey. A majority of respondents (56%) had worked an afterhours shift while a minority had worked a late-evening (18%) or overnight shift (13%). Irrespective of practice type, the majority of radiologists thought afterhours volumes were not manageable, and afterhours compensation was not equitable. Less than half of those who worked overnight shifts believed they were given adequate compensatory time-off for recovery. The majority of respondents supported work-from-home for afterhours shifts.
CONCLUSIONS: As the largest survey to date on after-hours radiology, these findings should be carefully considered by practices aiming to successfully recruit and retain radiologists in this critical niche