Hasil untuk "Internal medicine"

Takumi Hachimine, Yuhwan Kwon, Cheng-Yu Kuo et al.

Non-destructive extraction of the target internal part, such as batteries and motors, by cutting surrounding structures is crucial at recycling and disposal sites. However, the diversity of products and the lack of information on disassembly procedures make it challenging to decide where to cut. This study explores a method for non-destructive extraction of a target internal part that iteratively estimates the internal structure from observed cutting surfaces and formulates cutting plans based on the estimation results. A key requirement is to estimate the probability of the target part's presence from partial observations. However, learning conditional generative models for this task is challenging: The high dimensionality of 3D shape representations makes learning difficult, and conventional models (e.g., conditional variational autoencoders) often fail to capture multi-modal predictive uncertainty due to mode collapse, resulting in overconfident predictions. To address these issues, we propose VoxelDiffusionCut, which iteratively estimates the internal structure represented as voxels using a diffusion model and plans cuts for non-destructive extraction of the target internal part based on the estimation results. Voxel representation allows the model to predict only attributes at fixed grid positions, i.e., types of constituent parts, making learning more tractable. The diffusion model completes the voxel representation conditioned on observed cutting surfaces, capturing uncertainty in unobserved regions to avoid erroneous cuts. Experimental results in simulation suggest that the proposed method can estimate internal structures from observed cutting surfaces and enable non-destructive extraction of the target internal part by leveraging the estimated uncertainty.

Serap Süzük Yıldız, Ayşegül Polat, Süleyman Yalçın et al.

Introduction: Most of Bacillus spp. generally avirulent species in healthy patients, but if there is a fragile in the patient, especially their immune system, Bacillus spp. can be an agent for infections. Case Report: In this case, we report that Bacillus paranthracis, diagnosed by whole genome sequencing, is responsible for bacteremia in a T-ALL patient. A 26-year-old male patient was diagnosed with T-cell acute lymphoblastic leukemia. Bacillus paranthracis was isolated from two sets of blood cultures obtained from a patient with febrile neutropenia. Results: The bacteria was identified as Bacillus cereus group in a routine microbiology laboratory by MALDI TOF MS. Then whole genome sequencing (WGS) confirmed its name as Bacillus paranthracis. The pathogenicity of the bacterium, especially in immunocompromised patients, has also been demonstrated by WGS. Conclusions: In a microbiology laboratory, the use of Whole Genome Sequencing (WGS) is important for diagnosing diseases, especially in immunocompromised patients. It will serve the management of these patients for infection control.

Yue Du, Bianli Gu, Linlin Shi et al.

ABSTRACT Background Esophageal squamous cell carcinoma (ESCC) is a predominant and highly lethal form of esophageal cancer, with a five‐year survival rate below 20%. Despite advancements, most patients are diagnosed at advanced stages, limiting effective treatment options. Multi‐omics integration, encompassing somatic genomic alterations, inherited genetic mutations, transcriptomics, proteomics, metabolomics, and single‐cell sequencing, has enabled the identification of distinct molecular subtypes of ESCC. Method This article systematically reviewed the current status of molecular subtyping of ESCC based on big data, summarized unique subtypes with differing treatment responses and prognostic outcomes. Result Key findings included subtype‐specific genetic mutations, signaling pathway alterations, and metabolomic profiles, which offer novel biomarkers and therapeutic targets. Furthermore, this review discusses the link between molecular subtypes and immunotherapy efficacy, chemotherapy response, and drug development. Conclusion These insights highlight the potential of omics‐based molecular typing to transform ESCC management and facilitate personalized treatment strategies.

Yuqiao Tan, Minzheng Wang, Shizhu He et al.

Existing reinforcement learning (RL) approaches treat large language models (LLMs) as a unified policy, overlooking their internal mechanisms. In this paper, we decompose the LLM-based policy into Internal Layer Policies and Internal Modular Policies via Transformer's residual stream. Our entropy analysis on internal policy reveals distinct patterns: (1) universally, policies evolve from high-entropy exploration in early layers to deterministic refinement in top layers; and (2) Qwen exhibits a progressive, human-like reasoning structure, contrasting with the abrupt final-layer convergence in Llama. Furthermore, we discover that optimizing internal layers induces feature refinement, forcing lower layers to capture high-level reasoning representations early. Motivated by these findings, we propose Bottom-up Policy Optimization (BuPO), a novel RL paradigm that reconstructs the LLM's reasoning foundation from the bottom up by optimizing internal layers in early stages. Extensive experiments on complex reasoning benchmarks demonstrate the effectiveness of BuPO. Our code is available at https://github.com/Trae1ounG/BuPO.

Sifatul Anindho, Videep Venkatesha, Mariah Bradford et al.

Collaborative problem solving (CPS) is a complex cognitive, social, and emotional process that is increasingly prevalent in educational and professional settings. This study investigates the emotional states of individuals during CPS using a mixed-methods approach. Teams of four first completed a novel CPS task. Immediately after, each individual was placed in an isolated room where they reviewed the video of their group performing the task and self-reported their internal experiences throughout the task. We performed a linguistic analysis of these internal monologues, providing insights into the range of emotions individuals experience during CPS. Our analysis showed distinct patterns in language use, including characteristic unigrams and bigrams, key words and phrases, emotion labels, and semantic similarity between emotion-related words.

Barry P Lawlor, Vatsa Gandhi, Guruswami Ravichandran

Background: Full-field, quantitative visualization techniques, such as digital image correlation (DIC), have unlocked vast opportunities for experimental mechanics. However, DIC has traditionally been a surface measurement technique, and has not been extended to perform measurements on the interior of specimens for dynamic, full-scale laboratory experiments. This restricts the use of DIC measurements, especially in the context of heterogeneous materials. Objective: The focus of this study is to develop a method for performing internal DIC measurements in dynamic experiments. The aim is to demonstrate its feasibility and accuracy across a range of stresses (up to 650MPa), strain rates ($10^3$-$10^6$ s$^{-1}$), and high-strain rate loading conditions (e.g., ramped and shock wave loading). Methods: Internal DIC is developed based on the concept of applying a speckle pattern at an inner-plane of a transparent specimen. The high-speed imaging configuration is then focused on the internal speckle pattern. During the dynamic experiment, in-plane, two-dimensional deformations are measured via correlation of the internal speckle pattern. Results: The internal DIC experimental technique is successfully demonstrated in both the SHPB and plate impact experiments. In the SHPB setting, the accuracy of the technique is excellent throughout the deformation regime, with measurement noise of approximately 0.2% strain. For plate impact experiments, the technique performs well, with error and measurement noise of 1% strain. Conclusion: The internal DIC technique has been developed and demonstrated to work well for full-scale dynamic high-strain rate and shock laboratory experiments, and the accuracy is quantified. The technique can aid in investigating the physics and mechanics of the dynamic behavior of materials, including local deformation fields around dynamically loaded material heterogeneities.

Hu CY, Cui WS, Lei Y et al.

Cheng-Yi Hu,1 Wen-Shuai Cui,1 Yi Lei,1 Yu-Wen Tang,1 Yan-Yan Zhang,1 Qi-Min Su,1 Fang Peng,2 Yun-Fei Zeng,1 Jia-Lin Song,1 Cheng-Na Luo,1 Yan Zhou,1 Xin-Yan Li,1 Zhu-Xiang Zhao1 1Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, People’s Republic of China; 2Department of Critical Care Medicine, the Third Affiliated Hospital of Guang Zhou Medical University, Guangzhou, Guangdong, People’s Republic of ChinaCorrespondence: Zhu-Xiang Zhao, Department of Infectious Diseases, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, 510515, People’s Republic of China, Email zhaozhuxiang@126.comPurpose: To compare the effectiveness of azvudine and nirmatrelvir/ritonavir for the treatment of coronavirus disease (COVID-19).Patients and Methods: We conducted a retrospective analysis of data from 576 patients with COVID-19, comprising 195 patients without antiviral therapy, 226 patients treated with azvudine, 114 patients treated with nirmatrelvir/ritonavir, and 41 patients were treated with azvudine and nirmatrelvir/ritonavir concurrently. We compared their symptoms, mortality rates, and the length and cost of hospitalization.Results: The incidence of symptoms was similar in patients treated with azvudine and in those treated with nirmatrelvir/ritonavir. However, among patients experiencing weakness, the duration of weakness was significantly shorter in the azvudine group than in the nirmatrelvir/ritonavir group (P=0.029). Mortality did not differ significantly between the azvudine group and the nirmatrelvir/ritonavir group (18.14% vs.10.53%, P=0.068). Among “severe patients”, the mortality rate was markedly lower in patients treated with nirmatrelvir/ritonavir than in patients treated with azvudine (16.92% vs.32.17%, P=0.026). In patients with hepatic insufficiency, those treated with nirmatrelvir/ritonavir had substantially lower mortality than those treated with azvudine (15.09% vs.34.25%, P=0.016). In addition, patients treated with nirmatrelvir/ritonavir had longer hospital stays (P=0.002) and higher hospital costs (P< 0.001) than those receiving azvudine. Compared with patients treated with nirmatrelvir/ritonavir or azvudine alone, patients taking nirmatrelvir/ritonavir and azvudine concurrently had no significant improvement in survival (P> 0.05), length of stay (P> 0.05), or hospital costs (P> 0.05).Conclusion: Azvudine is recommended for patients with non-severe COVID-19 with weakness. Nirmatrelvir/ritonavir is recommended for patients with severe COVID-19, to reduce mortality, and it could be the best choice for patients with hepatic insufficiency. The concurrent use of nirmatrelvir/ritonavir and azvudine in patients with COVID-19 could be not recommended.Keywords: azvudine, nirmatrelvir/ritonavir, COVID-19, SARS-CoV-2

Akash Bihari Pati, Pritinanada Mishra, Santosh K Mahalik et al.

Introduction: Proximal hypospadias repair has many postoperative complications such as urethrocutaneous fistulae, wound dehiscence, and urethral stricture. The beneficial effect of estrogen to promote wound healing has been known. We designed a study to determine whether preoperative stimulation of tissue with estrogen can reduce the postoperative complications associated with wound healing in patients undergoing hypospadias repair. Methods: Patients with proximal hypospadias requiring two-stage repairs (chordee correction followed by urethral tubularization) were randomized to estrogen and control groups before the second stage of surgery. In the former, topical estrogen cream (0.5 mg of estriol) was applied to the ventral penis for a month, whereas normal saline gel was applied to the latter; the urethroplasty was carried out thereafter. Patients were followed up for complications. Results: There were 29 patients in the estrogen group and 31 in the placebo group after the exclusion criteria were met. There was no significant difference in the overall postoperative complications between the estrogen group (44.8%) and the placebo group (51.6%). The occurrence of urethrocutaneous fistula (37.9% vs. 51.6%) and dehiscence (41.4% vs. 45.2%) was not significantly different between the estrogen and placebo groups. Neourethral stricture occurred in four patients in the estrogen group, while none of the patients in the placebo group developed stricture. Conclusions: The preoperative application of topical estrogen cream to the ventral penis failed to demonstrate any significant effect on wound healing and complications.

Peter A. Tauber, Bernhard Kratzer, Philipp Schatzlmaier et al.

BackgroundTreg cells have been shown to be an important part of immune-homeostasis and IL-2 which is produced upon T cell receptor (TCR)-dependent activation of T lymphocytes has been demonstrated to critically participate in Treg development.ObjectiveTo evaluate small molecule inhibitors (SMI) for the identification of novel IL-2/Treg enhancing compounds.Materials and methodsWe used TCR-dependent and allergen-specific cytokine secretion of human and mouse T cells, next generation messenger ribonucleic acid sequencing (RNA-Seq) and two different models of allergic airway inflammation to examine lead SMI-compounds.ResultsWe show here that the reported 3-phosphoinositide dependent kinase-1 (PDK1) SMI BX-795 increased IL-2 in culture supernatants of Jurkat E6-1 T cells, human peripheral blood mononuclear cells (hPBMC) and allergen-specific mouse T cells upon TCR-dependent and allergen-specific stimulation while concomitantly inhibiting Th2 cytokine secretion. RNA-Seq revealed that the presence of BX-795 during allergen-specific activation of T cells induces a bona fide Treg cell type highly similar to iTreg but lacking Foxp3 expression. When applied in mugwort pollen and house dust mite extract-based models of airway inflammation, BX-795 significantly inhibited Th2 inflammation including expression of Th2 signature transcription factors and cytokines and influx into the lungs of type 2-associated inflammatory cells such as eosinophils.ConclusionsBX-795 potently uncouples IL-2 production from Th2 inflammation and induces Th-IL-2 cells, which highly resemble induced (i)Tregs. Thus, BX-795 may be a useful new compound for the treatment of allergic diseases.

V. S. Beskin, F. A. Kniazev, K. Chatterjee

The present work is devoted to the analysis of the internal structure of relativistic jets under the condition that the velocity of the plasma flow at the jet axis vanishes. It is shown that in spite of the seemingly fundamental difference in the formulation of the problem at the axis, the key properties of the internal structure of such relativistic jets remain the same as for nonzero velocity along the axis. In both cases, at a sufficiently low ambient pressure, a dense core appears near the axis, the radius of which is close to the size of the light cylinder.

Nicolas Lanchon, Daniel Odens Mora, Eduardo Monsalve et al.

We present laboratory experiments on turbulence in a linearly stratified fluid driven by an ensemble of internal gravity waves which approaches statistical homogeneity and axi-symmetry. In a way similar to several recent experimental works, non-linearities develop through the establishment of a set of internal wave modes at discrete frequencies, when the forcing amplitude is increased. We show that the most energetic of these modes are resonant eigenmodes of the fluid domain. The discretization of the energy in frequency and wavenumber associated to the emergence of these modes prevents the flow from approaching a regime described by the Weak/Wave Turbulence Theory, in which a forward cascade carried by a statistical ensemble of weakly non-linear waves in an infinite domain forms an energy continuum in the frequency and wavenumber spaces. We then show that the introduction of slightly tilted panels at the top and at the bottom of the fluid domain allows to inhibit the emergence of the discrete wave modes. In this new configuration, the non-linear regime results in a continuum of energy over one decade of frequencies which is mainly carried by internal gravity waves verifying the dispersion relation. We therefore achieved a turbulent flow approaching a three-dimensional internal wave turbulence regime with no discretization of the energy in the frequency and wavenumber domains. These results constitute a significant step forward in the search of the laboratory observation of a fully-developed weakly-non-linear internal-gravity-wave turbulence.

Pankaj N. Maheshwari, Amandeep Arora, Mahesh S. Sane et al.

Objective: To report our experience with supracostal percutaneous nephrolithotomy (SC-PNL) and evaluate factors which could predict the risk of hydrothorax following SC-PNL. Methods: We reviewed 347 patients who underwent SC-PNL from January 2011 to December 2019. Patients were assessed for demographic characteristics, indication for the supracostal access, level of supracostal access, anatomy of the kidney (normal or malrotated), site of the puncture in relation to the mid-scapular line (medial or lateral), and whether another subcostal tract for stone clearance was required or not. Patients were assessed for the incidence of hydrothorax and requirement of intercostal drain depending on the level of percutaneous access. In addition, a multivariable logistic regression analysis model was developed to identify factors which could predict the occurrence of hydrothorax following SC-PNL. Results: Of the 347 patients with SC-PNL, 248 (71.5%) underwent a supra-12th rib approach, while the rest needed a supra-11th (n=85; 24.5%) or a supra-10th (n=14; 4.0%) rib tract. Overall, 17 (4.9%) patients developed a hydrothorax, while an intercostal-drain was required in seven of these 17 patients for 48 h. None of the patients with a supra-12th rib puncture required an intercostal-drain. More than a third of the patients with a supra-10th puncture developed a hydrothorax (35.7%) and all of them required an intercostal drain. Factors such as anteriorly malrotated kidney (odds ratio [OR]=2.722; 95% confidence interval [CI]=1.042–5.617, p=0.03), puncture medial to the mid-scapular line (OR=1.669; CI=0.542–1.578, p=0.03), and an access higher than the supra-12th level (OR=5.265; CI=1.292–9.342, p<0.001) proved to be independent predictors of hydrothorax following a SC-PCNL on multivariable analysis. Conclusion: Incidence of clinically significant hydrothorax requiring an intercostal-drain after SC-PNL is very low. Knowledge of the predicting factors will help to anticipate the risk of hydrothorax in a particular patient and take necessary peri-operative measures.

Veronica Ghini, Gaia Meoni, Lorenzo Pelagatti et al.

Metabolomics and lipidomics have been used in several studies to define the biochemical alterations induced by COVID-19 in comparison with healthy controls. Those studies highlighted the presence of a strong signature, attributable to both metabolites and lipoproteins/lipids. Here, 1H NMR spectra were acquired on EDTA-plasma from three groups of subjects: i) hospitalized COVID-19 positive patients (≤21 days from the first positive nasopharyngeal swab); ii) hospitalized COVID-19 positive patients (>21 days from the first positive nasopharyngeal swab); iii) subjects after 2-6 months from SARS-CoV-2 eradication. A Random Forest model built using the EDTA-plasma spectra of COVID-19 patients ≤21 days and Post COVID-19 subjects, provided a high discrimination accuracy (93.6%), indicating both the presence of a strong fingerprint of the acute infection and the substantial metabolic healing of Post COVID-19 subjects. The differences originate from significant alterations in the concentrations of 16 metabolites and 74 lipoprotein components. The model was then used to predict the spectra of COVID-19>21 days subjects. In this group, the metabolite levels are closer to those of the Post COVID-19 subjects than to those of the COVID-19≤21 days; the opposite occurs for the lipoproteins. Within the acute phase patients, characteristic trends in metabolite levels are observed as a function of the disease severity. The metabolites found altered in COVID-19≤21 days patients with respect to Post COVID-19 individuals overlap with acute infection biomarkers identified previously in comparison with healthy subjects. Along the trajectory towards healing, the metabolome reverts back to the "healthy" state faster than the lipoproteome.

Mehreen Sirshar, Taimur Hassan, Muhammad Usman Akram et al.

Pulmonary diseases can cause severe respiratory problems, leading to sudden death if not treated timely. Many researchers have utilized deep learning systems to diagnose pulmonary disorders using chest X-rays (CXRs). However, such systems require exhaustive training efforts on large-scale data to effectively diagnose chest abnormalities. Furthermore, procuring such large-scale data is often infeasible and impractical, especially for rare diseases. With the recent advances in incremental learning, researchers have periodically tuned deep neural networks to learn different classification tasks with few training examples. Although, such systems can resist catastrophic forgetting, they treat the knowledge representations independently of each other, and this limits their classification performance. Also, to the best of our knowledge, there is no incremental learning-driven image diagnostic framework that is specifically designed to screen pulmonary disorders from the CXRs. To address this, we present a novel framework that can learn to screen different chest abnormalities incrementally. In addition to this, the proposed framework is penalized through an incremental learning loss function that infers Bayesian theory to recognize structural and semantic inter-dependencies between incrementally learned knowledge representations to diagnose the pulmonary diseases effectively, regardless of the scanner specifications. We tested the proposed framework on five public CXR datasets containing different chest abnormalities, where it outperformed various state-of-the-art system through various metrics.

Janneke Witteveen, Saskia Boonzajer Flaes, Pé Mullenders et al.

Zeleke S, Kefale D

Shegaw Zeleke,1 Demewoz Kefale2 1Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Pediatric and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Shegaw Zeleke Email shegawzn@gmail.comBackground: Oxygen therapy is a medical treatment and prescribed to prevent or treat hypoxemia. Based on a WHO report every year at least 1.4 million deaths occur due to the lack of supplemental oxygen therapy and inappropriate administration of oxygen.Objective: To assess the knowledge and practice of nurses on supplemental oxygen therapy in Debre Tabor General Hospital, 2019.Methods: Data was collected using structured questionnaires that measure nurses&rsquo; knowledge and practice regarding supplemental oxygen therapy. Data were entered using Epi Data version 3.1 and analyzed using SPSS version 23. Bivariate and multivariate analyses were conducted to examine the association between independent and outcome variables.Results: Only one-third of nurses had a good practice on supplemental oxygen administration. Nurses who had good knowledge of supplemental oxygen administration were 12-times (AOR=12.25, 95% CI=6.48&ndash; 32.93) more likely to have a good practice of supplemental oxygen administration than those who had poor knowledge of supplemental oxygen administration.Conclusion: There is a clear knowledge and practice gap among nurses working in Debre Tabor General Hospital. The knowledge and practice level of nurses in the study area is low compared with others. The possible factors were identified; such as lack of supplemental oxygen therapy training, absence of supplemental oxygen administration standard guidelines, workload, and inadequate supply of oxygen and delivery devices.Keywords: knowledge, practice, supplemental oxygen therapy, nurse

Felicia Scaggs Huang, David I. Bernstein, Karen S. Slobod et al.

SeVRSV is a replication-competent Sendai virus (SeV)-based vaccine carrying the respiratory syncytial virus (RSV) fusion protein (F) gene. Unmanipulated, non-recombinant SeV is a murine parainfluenza virus type 1 (PIV-1) and serves as a Jennerian vaccine for human PIV-1 (hPIV-1). SeV protects African green monkeys (AGM) from infection after hPIV-1 challenge. The recombinant SeVRSV additionally targets RSV and protects AGM from lower respiratory infections after RSV challenge. The present study is the first to report on the safety, viral genome detection, and immunogenicity following SeVRSV vaccination of healthy adults. Seventeen and four healthy adults received intranasal SeVRSV and PBS, respectively, followed by six months of safety monitoring. Virus genome (in nasal wash) and vaccine-specific antibodies (in sera) were monitored for two and four weeks, respectively, post-vaccination. The vaccine was well-tolerated with only mild to moderate reactions that were also present in the placebo group. No severe reactions occurred. As expected, due to preexisting immunity toward hPIV-1 and RSV in adults, vaccine genome detection was transient. There were minimal antibody responses to SeV and negligible responses to RSV F. Results encourage further studies of SeVRSV with progression toward a clinical trial in seronegative children. Abbreviations: AE-adverse event; SAE-serious adverse event; SeV-Sendai virus; RSV-respiratory syncytial virus; PIV-1-parainfluenza virus-type 1; hPIV-1-human parainfluenza virus-type 1; F-RSV fusion protein; SeVRSV-recombinant SeV carrying the RSV F gene; Ab-antibody; MSW-medically significant wheezing; NOCMC-new onset chronic medical condition, mITT-modified Intent to Treat; ALRI-acute lower respiratory tract infection.

Hanny Al-Samkari, Rachel P. Rosovsky, Rebecca S. Karp Leaf et al.

Abstract: Platelet autoantibody (PA) testing has previously shown poor sensitivity for immune thrombocytopenia (ITP) diagnosis, but no previous study used both 2011 American Society of Hematology (ASH) guidelines for ITP diagnosis and 2012 International Society on Thrombosis and Haemostasis (ISTH) PA testing recommendations. We therefore performed a comprehensive retrospective study of PA testing in adult patients with ITP strictly applying these criteria. Of 986 PA assays performed, 485 assays in 368 patients met criteria and were included. Sensitivity and specificity of a positive test result for diagnosis of active ITP (n = 228 patients) were 90% and 78%, respectively. Sensitivity and specificity of a negative test result for clinical remission (n = 61 assays) were 87% and 91%. Antibodies against both glycoprotein IIb (GPIIb)/IIIa and GPIb/IX were required for the presence of antibodies against GPIa/IIa in patients with ITP. Logistic regression analysis revealed that more positive autoantibodies predicted more severe disease (relative to nonsevere ITP, relative risk ratio for severe ITP and refractory ITP was 2.27 [P < .001] and 3.09 [P < .001], respectively, per additional autoantibody); however, serologic testing did not meaningfully predict treatment response to glucocorticoids, intravenous immunoglobulin, or thrombopoietin receptor agonists. Sixty-four patients with ITP had multiple PA assays performed longitudinally: all 10 patients achieving remission converted from positive to negative serologic results, and evidence for epitope spreading was observed in 35% of patients with ongoing active disease. In conclusion, glycoprotein-specific direct PA testing performed using ISTH recommendations in patients meeting ASH diagnostic criteria is sensitive and specific for ITP diagnosis and reliably confirms clinical remission. More glycoproteins targeted by autoantibodies predicts for more severe disease.

Kali S. Barawi, Catrin Lewis, Natalie Simon et al.

Objective Psychological interventions for post-traumatic stress disorder (PTSD) are not always effective and can leave some individuals with enduring symptoms. Little is known about factors that are associated with better or worse treatment outcome. Our objective was to address this gap. Method We undertook a systematic review following Cochrane Collaboration Guidelines. We included 126 randomized controlled trials (RCTs) of psychological interventions for PTSD and examined factors that were associated with treatment outcome, in terms of severity of PTSD symptoms post-treatment, and recovery or remission. Results Associations were neither consistent nor strong. Two factors were associated with smaller reductions in severity of PTSD symptoms post-treatment: comorbid diagnosis of depression, and higher PTSD symptom severity at baseline assessment. Higher education, adherence to homework and experience of a more recent trauma were associated with better treatment outcome. Conclusion Identifying and understanding why certain factors are associated with treatment outcome is vital to determine which individuals are most likely to benefit from particular treatments and to develop more effective treatments in the future. There is an urgent need for consistent and standardized reporting of factors associated with treatment outcome in all clinical trials.

Sunil Amin, MD, MPH, Russell Dorer, MD, PhD, Shayan Irani, MD