Category: Nevin Manimala

J Appl Clin Med Phys. 2023 Feb 24:e13939. doi: 10.1002/acm2.13939. Online ahead of print.

ABSTRACT

PURPOSE: There has been much research interest in automated head-and-neck (HN) planning with the goal of reducing planning time and inter-planner variability while improving plan quality. However, clinical uses are still limited and institution-dependent due to the plan complexity. This work aims to investigate whether the use of a novel semi-automated two-step optimization method (TSP) can improve the quality and efficiency of planning while providing a simple framework that other institutions can follow.

METHODS AND MATERIALS: Forty patients (two and three prescription isodose levels) were retrospectively studied. Plans were generated by TSP which incorporates a knowledge-based planning solution. Comparisons were performed for plan conformity and selected dose-volume indices between clinical plan (CP) and TSP. Blind reviews were carried out by 15 clinicians to determine preference between the CP and TSP, as well as clinical suitability.

RESULTS: For majority of patients studied, TSP had similar or slightly better conformity for the high-dose PTV, and better conformity for the low-dose PTV and 45 Gy isodose lines compared to CP. The only statistically significant difference observed for the serial organs was a reduction of the spinal cord maximum dose with TSP. Except for left parotid gland (D_mean and V₃₀ for both 2R× and 3R× groups) and oral cavity (D_mean for 3R× group), TSP had significant dose reductions for all parallel organs compared to CP. Blind reviewers either showed preference/no preference for 57.2%/21.7% (2R×) and 57.5%/27.8% (3R×) of TSP compared with CP. Excluding no preference votes, 60% of TSP were preferred. TSP was selected majority of the time when looking at the vote distribution for each patient individually.

CONCLUSION: Our TSP allows plans to be created within 90-min time frame while offering improvements in plan quality and less inter-planner variability as compared to traditional planning techniques.

PMID:36826845 | DOI:10.1002/acm2.13939

J Vis. 2023 Feb 1;23(2):12. doi: 10.1167/jov.23.2.12.

ABSTRACT

The external noise paradigm and perceptual template model (PTM) have successfully been applied to characterize observer properties and mechanisms of observer state changes (e.g. attention and perceptual learning) in several research domains, focusing on individual level analysis. In this study, we developed a new hierarchical Bayesian perceptual template model (HBPTM) to model the trial-by-trial data from all individuals and conditions in a published spatial cuing study within a single structure and compared its performance to that of a Bayesian Inference Procedure (BIP), which separately infers the posterior distributions of the model parameters for each individual subject without the hierarchical structure. The HBPTM allowed us to compute the joint posterior distribution of the hyperparameters and parameters at the population, observer, and experiment levels and make statistical inferences at all these levels. In addition, we ran a large simulation study that varied the number of observers and number of trials in each condition and demonstrated the advantage of the HBPTM over the BIP across all the simulated datasets. Although it is developed in the context of spatial attention, the HBPTM and its extensions can be used to model data from the external noise paradigm in other domains and enable predictions of human performance at both the population and individual levels.

PMID:36826825 | DOI:10.1167/jov.23.2.12

Environ Sci Pollut Res Int. 2023 Feb 24. doi: 10.1007/s11356-023-25864-2. Online ahead of print.

ABSTRACT

China is experiencing a swift transformation from a rural to an urban society. This societal transition is the result of a country’s ambition toward economic development. Rapid urbanization impacts on human wellbeing, environment, and infrastructure. Unlike many cases of urban extension, China’s urbanization has led to increase in environmental issues, rather than to contain, and posed serious challenges to achieve sustainable development. To date, nevertheless, there is a little empirical enquiry on the spatiotemporal effects of multidimensional urbanization on green total factor productivity. Taking this into account, this article constructs a spatial panel data model based on 283 Chinese cities during 2006-2019. The results showed that the three types of urbanization (i.e., population, land, and economic) have positive effect on green total factor productivity (GTFP). Population urbanization has indirect positive effect on GTFP. Local land urbanization inhibits while surrounding land urbanization promotes GTFP. Economic urbanization has positive direct effect on GTFP. Considering regional heterogeneity, population and economic urbanization have positive effect on GTFP in eastern region. In central region, land urbanization significantly promotes GTFP, while economic urbanization has significant negative effect on GTFP. In the western region, the three types of urbanization are not conducive to GTFP. Considering sized heterogeneity, population and economic types of urbanization have significant negative effect on GTFP in small- and medium-sized cities. In large cities, the three types of urbanization have significant positive effects on GTFP. Considering temporal heterogeneity, the three types of urbanization significantly promote GTFP before 2014, but economic urbanization deteriorates GTFP after 2014. Our results recommend loosening Hukou system, improving land use efficiency, and developing technology and knowledge-intensive industries.

PMID:36826763 | DOI:10.1007/s11356-023-25864-2

Environ Sci Pollut Res Int. 2023 Feb 24. doi: 10.1007/s11356-023-25963-0. Online ahead of print.

ABSTRACT

This study explores the spatial and temporal evolution characteristics of transportation carbon emissions from multiple scales. Based on the integrated DMSP/OLS-NPP/VIIRS nighttime light data, a transportation carbon emission estimation model was constructed, and the spatial and temporal evolution characteristics of transportation carbon emissions in 30 provinces and some counties in China from 2000 to 2019 were analyzed. The main findings are as follows: (1) The goodness-of-fit of the estimation model improved from 51.2 to 87.15% by introducing the GDP variables. (2) At the provincial scale, the provinces with high carbon emissions from transportation were mainly distributed in the eastern region, with the highest value increasing from 19,171.6 million tons in 2000 to 71,545.98 million tons in 2019. The spatial distribution has a significant and positive spatial spillover effect, and the H-H aggregation was mainly distributed in the east-central region, showing a trend of expansion from the coast to the inland. Trend analysis showed that Shandong, Guangdong, Shanghai, and Jiangsu were areas with a rapid growth of high carbon emissions. (3) The county scale displayed a northeast-southwest evolutionary pattern, with the center of gravity in Henan. The spatial distribution showed a significant spatial agglomeration phenomenon. Trend analysis indicated that the transportation carbon emissions in 184 counties need to be controlled urgently, which was the focus of carbon emission reduction. This paper theoretically enriches the measurement method of transportation carbon emissions and overcomes the problem of insufficient spatial information of statistical data. In practice, it provides a scientific basis for accurate emission reduction and low-carbon development of transportation.

PMID:36826762 | DOI:10.1007/s11356-023-25963-0

Environ Sci Pollut Res Int. 2023 Feb 24. doi: 10.1007/s11356-023-25966-x. Online ahead of print.

ABSTRACT

Implementation of industrial wastes such as bottom ash in ground improvement can be cost-effective and environment-friendly. Ground improvement is an effective method of mitigation to improve problematic soils including soft kaolin clay soils as the problematic soils always expose to the severe settlements, low shear strength, immoderate plasticity, greater compressibility, dispersivity, bulging, erodibility, and susceptibility to climatic variables. Several studies conducted on the granular column using the bottom ash column. However, only a few studies have reported findings coherent with the statistical analysis. In this study, the lateral load capacity of bottom ash column-kaolin clay has been conducted. Coherently, the reinforced kaolin clay samples were tested via particle size distribution, Atterberg limit test, relative density, compaction test, permeability test, unconfined compression test, and unconsolidated undrained triaxial test with the single and group of encapsulated bottom ash columns with the geotextile encasement and a prediction model was developed. The effect of a number of columns, column diameter, column height, area replacement ratio, height penetration ratio, height-diameter column ratio, volume replacement ratio, and confining pressures on the shear strength of the single and group of encapsulated bottom ash columns have been investigated. The findings showed the effectiveness of using the bottom ash columns at various number of column, column diameter, column height, area replacement ratio, height penetration ratio, height-diameter column ratio, volume replacement ratio, and confining pressures can enhance the shear strength of the soil up to 77.00% at the optimal utilization of single encapsulated bottom ash column of 10-mm diameter and 80-mm height. Therefore, the study proved that the utilization of bottom ash waste as a granular column can significantly enhance the lateral load capacity of soft kaolin clay soil.

PMID:36826761 | DOI:10.1007/s11356-023-25966-x

J Thromb Thrombolysis. 2023 Feb 24. doi: 10.1007/s11239-023-02785-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Postpartum hemorrhage (PPH) was the second leading cause of maternal death, accounting for approximately 14% of all pregnancy-related deaths between 2017 and 2019 in the United States. Several large multi-center studies have demonstrated decreased PPH rates with the use of tranexamic acid (TXA). Little data exists regarding the prevalence of TXA use in obstetric patients.

METHODS: We identified over 1.2 million US pregnancies between January 1, 2015 and June 30, 2021, with and without PPH by International Statistical Classification of Disease and Related Health Problems, Tenth Revision codes using Cerner Real-World Database™. TXA use and patient characteristics were abstracted from the electronic medical record.

RESULTS: During delivery, TXA was used approximately 1% of the time (12,394 / 1,262,574). Pregnant patients who did and did not receive TXA during delivery had similar demographic characteristics. Pregnant patients who underwent cesarean delivery (4,356 / 12,394), had a term delivery (10,199 / 12,394), and had comorbid conditions were more likely to receive TXA during hospitalization for delivery. The majority of TXA was use was concentrated in Arizona, Colorado, Idaho, New Mexico, Nevada, Utah, and Wyoming. During the study period the use of TXA increased in both patients with PPH and those without.

CONCLUSION: The data illustrate a rapid increase in the use of TXA after 2017 while the total number of pregnancies remained relatively constant. The observed increase in TXA use may reflect changing practicing patterns as the support for use of TXA in the setting of PPH prophylaxis increases.

PMID:36826757 | DOI:10.1007/s11239-023-02785-y

Insights Imaging. 2023 Feb 24;14(1):37. doi: 10.1186/s13244-023-01388-8.

ABSTRACT

BACKGROUND: Education in radiology should be an integral aspect of undergraduate medical training given the essential role of imaging in patient management. Since the introduction of the European Society of Radiology undergraduate curriculum a decade ago, radiology education has evolved.

OBJECTIVES: This survey aimed to assess the current status of undergraduate radiology education in Europe.

METHODS: An electronic survey on undergraduate teaching was distributed by the European Society of Radiology to delegates of the European Society of Radiology education committee and presidents of national radiological societies from April 1 to May 31, 2022. Data from the twenty questions were summarized using descriptive statistics.

RESULTS: There were 72 respondents from 36 countries. Radiology was taught to undergraduates in 95% (68/72), with a national or local curriculum informing radiology education in 93% (67/72). Radiology teaching was delivered by radiologists in 98% (58/59), across all years of medical school but most commonly in the fourth year of medical training (63%, 44/70), through various means including lectures, workshops, radiology department placements, online resources and simulation. Teaching hours were variable, with a minimum of 10 h reported.

CONCLUSION: This survey’s findings suggest an improvement over the last decade in the engagement of radiologists in the delivery of undergraduate radiology education in European countries affiliated with the European Society of Radiology.

PMID:36826721 | DOI:10.1186/s13244-023-01388-8

Breast Cancer Res Treat. 2023 Feb 24. doi: 10.1007/s10549-023-06875-6. Online ahead of print.

ABSTRACT

PURPOSE: Among women with non-metastatic breast cancer, marked disparities in stage at presentation, receipt of guideline-concordant treatment and stage-specific survival have been shown in national cohorts based on race, ethnicity, insurance and language. Little is published on the performance of safety-net hospitals to achieve equitable care. We evaluate differences in treatment and survival by race, ethnicity, language and insurance status among women with non-metastatic invasive breast cancer at a single, urban academic safety-net hospital.

METHODS: We conducted a retrospective study of patients with invasive ductal or lobular breast cancer, diagnosed and treated between 2009 and 2014 at an urban, academic safety-net hospital. Demographic, tumor and treatment characteristics were obtained. Stage at presentation, stage-specific overall survival, and receipt of guideline-concordant surgical and adjuvant therapies were analyzed. Chi-square analysis and ANOVA were used for statistical analysis. Unadjusted survival analysis was conducted by Kaplan-Meier method using log-rank test; adjusted 5 year survival analysis was completed stratified by early and late stage, using flexible parametric survival models incorporating age, race, primary language and insurance status.

RESULTS: 520 women with stage 1-3 invasive breast cancer were identified. Median age was 58.5 years, 56.1% were non-white, 31.7% were non-English-speaking, 16.4% were Hispanic, and 50.1% were Medicaid/uninsured patients. There were no statistically significant differences in stage at presentation between age group, race, ethnicity, language or insurance. The rate of breast conserving surgery (BCS) among stage 1-2 patients did not vary by race, insurance or language. Among patients indicated for adjuvant therapies, the rates of recommendation and completion of therapy did not vary by race, ethnicity, insurance or language. Unadjusted survival at 5 years was 93.7% for stage 1-2 and 73.5% for stage 3. Adjusting for age, race, insurance status and primary language, overall survival at 5 years was 93.8% (95% CI 86.3-97.2%) for stage 1-2 and 83.4% (95% CI 35.5-96.9%) for stage 3 disease. Independently, for patients with early- and late-stage disease, age, race, language and insurance were not associated with survival at 5-years.

CONCLUSION: Among patients diagnosed and treated at an academic safety-net hospital, there were no differences in the stage at presentation or receipt of guideline-concordant treatment by race, ethnicity, insurance or language. Overall survival did not vary by race, insurance or language. Additional research is needed to assess how hospitals and healthcare systems mitigate breast cancer disparities.

PMID:36826701 | DOI:10.1007/s10549-023-06875-6

Health Econ Rev. 2023 Feb 24;13(1):15. doi: 10.1186/s13561-022-00416-5.

ABSTRACT

The Capitation Payment Unit (CPU) financing mechanism constitutes more than 70% of health spending in Colombia, with a budget allocation of close to 60 trillion Colombian pesos for the year 2022 (approximately 15.7 billion US dollars). This article estimates actuarially, using modern techniques, the CPU for the contributory regime of the General System of Social Security in Health in Colombia, and compares it with what is estimated by the Ministry of Health and Social Protection. Using freely available information systems, by means of statistical copulas functions and artificial neural networks, pure risk premiums are calculated between 2015 and 2021. The study concludes that the weights by risk category are systematically different, showing historical pure premiums surpluses in the group of 0-1 years and deficits (for the regions normal and cities) in the groups over 54 years of age.

PMID:36826699 | DOI:10.1186/s13561-022-00416-5

Int J Comput Dent. 2023 Feb 24;26(1):37-47. doi: 10.3290/j.ijcd.b3818305.

ABSTRACT

AIM: The present study aimed to evaluate the marginal and internal fit of lithium disilicate crowns at various locations.

MATERIALS AND METHODS: A typodont maxillary left first molar was prepared for a lithium disilicate crown, scanned, and a master die fabricated. Three groups were created according to fabrication method (n = 10): conventional impression and press method (group C); scanning of definitive cast and milling method (group D); and intraoral scanning and milling method (group I). Assessment was performed using the triple-scan protocol. At the buccopalatal and mesiodistal sections, the absolute marginal discrepancy (AMD), marginal gap (MG), axial internal gap (AI), and line angle internal gap (LI) were measured. One-way analysis of variance (ANOVA) and post hoc Tukey HSD tests were used for statistical analysis (α = 0.05).

RESULTS: AMD values were significantly lower in group C than in groups D and I (P < 0.05). MG values in group C were significantly lower than those in the buccal and distal areas in group D and all areas in group I (P < 0.05). AI values in the buccal and palatal areas in group D were significantly lower than those in the mesial and distal areas in group D and all areas in groups C and I (P < 0.05). LI values were significantly lower in group C than in groups D and I (P < 0.05).

CONCLUSION: All three methods were clinically acceptable except for the marginal fit of the intraoral scanning and milling method, which was on the borderline of a clinically acceptable fit. (Int J Comput Dent 2023;26(1): 37-0; doi: 10.3290/j.ijcd.b3818305).

PMID:36825566 | DOI:10.3290/j.ijcd.b3818305