Category: Nevin Manimala

J Geriatr Phys Ther. 2022 Aug 5. doi: 10.1519/JPT.0000000000000360. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Thoracic hyperkyphosis is a common condition that progresses with aging and has been associated with impaired functional performance, increased risk of falls, and even mortality. Previous studies to improve posture primarily used exercise for durations of 3 months or longer. The purpose of this pilot study was to examine the feasibility of a manual therapy intervention in community-dwelling older adults over a 4-week time frame that is comparable to the typical clinical setting, to test the appropriateness and procedures for the measurement of posture and function in the older population with hyperkyphosis, and to collect preliminary data to describe change in posture and function measures.

METHODS: Twenty-four participants with hyperkyphosis or forward head posture were recruited, and 22 participants completed this pilot study. Feasibility was measured based on attendance, tolerance, safety, and retention. Issues with measurement procedures were recorded. The intervention included manual therapy and exercise 3 times a week for 4 weeks to target spinal and peripheral joint stiffness, muscle lengthening, and muscle activation. Outcomes included height, kyphotic index (KI), Block Test, Acromion to Table (ATT), Timed Up and Go (TUG), 5 times sit-to-stand (5XSTS), Functional Reach (FR), 2-minute walk test (2MWT), and Patient-Specific Functional Scale (PSFS). Data collected at visits 1, 6, and 12 were analyzed using 1-way repeated-measures multivariate analysis of variance.

RESULTS AND DISCUSSION: Measurement and intervention protocols were found to be feasible. A significant effect for the aggregate dependent variables change over time was found. Univariate analysis of each dependent variable showed significance except for FR. All postural measures (height, KI, Block Test, and ATT) significantly improved statistically. The KI and ATT exceed the minimal detectable change for clinical significance. Function showed statistical improvements in the TUG, 5XSTS, 2MWT, and PSFS. Clinical significance was reached with the PSFS. Seven of 9 measures showed a statistically significant change in just 2 weeks.

CONCLUSIONS: This pilot study suggests that manual therapy and exercise applied to older adults shows promise for improvement in measures of posture and functional performance in a clinically feasible 4-week time frame.

PMID:35939663 | DOI:10.1519/JPT.0000000000000360

Proc Natl Acad Sci U S A. 2022 Aug 16;119(33):e2111366119. doi: 10.1073/pnas.2111366119. Epub 2022 Aug 8.

ABSTRACT

We present efficient algorithms for computing the N-point correlation functions (NPCFs) of random fields in arbitrary D-dimensional homogeneous and isotropic spaces. Such statistics appear throughout the physical sciences and provide a natural tool to describe stochastic processes. Typically, algorithms for computing the NPCF components have [Formula: see text] complexity (for a dataset containing n particles); their application is thus computationally infeasible unless N is small. By projecting the statistic onto a suitably defined angular basis, we show that the estimators can be written in a separable form, with complexity [Formula: see text] or [Formula: see text] if evaluated using a Fast Fourier Transform on a grid of size [Formula: see text]. Our decomposition is built upon the D-dimensional hyperspherical harmonics; these form a complete basis on the [Formula: see text] sphere and are intrinsically related to angular momentum operators. Concatenation of [Formula: see text] such harmonics gives states of definite combined angular momentum, forming a natural separable basis for the NPCF. As N and D grow, the number of basis components quickly becomes large, providing a practical limitation to this (and all other) approaches: However, the dimensionality is greatly reduced in the presence of symmetries; for example, isotropic correlation functions require only states of zero combined angular momentum. We provide a Julia package implementing our estimators and show how they can be applied to a variety of scenarios within cosmology and fluid dynamics. The efficiency of such estimators will allow higher-order correlators to become a standard tool in the analysis of random fields.

PMID:35939667 | DOI:10.1073/pnas.2111366119

J Air Waste Manag Assoc. 2022 Aug 8. doi: 10.1080/10962247.2022.2110993. Online ahead of print.

ABSTRACT

This study proposed a decision support system (DSS) for optimizing transportation routing and disposal hub location for Thailand’s local administrative organizations’ hazardous waste management. The first step is to choose the origin and destination, as well as to collect data for each route. Each route’s decision criteria were based on traffic quality and risk measures from the perspective of users. An analytic hierarchy process (AHP) was used to compute effective weights for decision criteria. To achieve optimal routing, AHP weights were combined with a zero-one goal programming technique. The DSS operates systematically and successfully, taking into account both transportation risk and socioeconomic factors, and provides appropriate routes. Overall, this waste management system may provide useful information to decision-makers for prioritizing disposal site alternatives and implementing feasible waste management actions. The zero-one location design was then used to determine the best hub location. Based on two scenarios of six and fifteen CoG hubs, the results revealed that the best model for managing a case company’s hazardous waste was to establish 15 hubs scattered throughout the country for collecting points and then transporting them to the waste disposal plant in Phitsanulok province. Locating the hub near sink points would reduce transportation costs and backhaul issues, reducing the environmental impact of GHG emissions and increasing system efficiency. Implication StatementThe problem of waste pollution has become increasingly serious all over the world, particularly in developing countries that face significant pollution control challenges. End-of-life wastes cause economic, health, and environmental problems if they are not properly managed. As the world’s population and living standards rise, so does the amount of waste produced. The environmental impact is significant, with massive amounts of waste generated each year with only basic or minimal treatment to mitigate its impact. As a result, there is an urgent need for a method that can precisely optimize transportation routing and disposal hub location for Thailand’s local administrative organizations’ hazardous waste management (LAOs). The proposed decision support system (DSS) may provide useful information to decision-makers in prioritizing disposal site alternatives and implementing feasible waste management actions.

PMID:35939657 | DOI:10.1080/10962247.2022.2110993

Plast Reconstr Surg. 2022 Aug 8. doi: 10.1097/PRS.0000000000009521. Online ahead of print.

ABSTRACT

BACKGROUND: The 2020-2021 residency application cycle marked the first year of fully virtual integrated plastic surgery interviews. The virtual format was a double-edged sword for applicants with several advantages such as reduced costs and time lost from travel and disadvantages as the novel format introduced new stressors on top of an already demanding process. Concerns included unfair interview invitation (II) distribution, interview “hoarding,” and assessing “fit” virtually. In this study, we aimed to understand applicants’ experiences of the 2020-2021 virtual plastic surgery interview cycle.

METHODS: A survey was sent to 330 applicants in the 2020-2021 integrated plastic surgery application cycle. The survey included questions about participant demographics, pre-interview preparation, virtual interview experiences, and post-interview process. Statistical comparisons were performed on responses using SPSS.

RESULTS: Eighty-nine participants responded to the survey, representing a 27.0% response rate. Applicants received an average of 13.3 IIs (range 0-45) and attended an average of 11.4 interviews (range 0-30). Almost half (48.2%) did not feel IIs were distributed equitably and more than half (68.2%) reported that there should be a limit on the number of IIs an applicant can accept. The majority of respondents (88.1%) reported spending $500 or less on virtual interviews. Half (50.6%) participated in virtual sub-internships, of which 30.4% became significantly less interested in a program afterwards.

CONCLUSIONS: The inaugural virtual interview cycle had several advantages and disadvantages. Lessons learned from this year could be utilized towards building a more equitable, fair, and effective potential virtual cycle in years to come.

PMID:35939639 | DOI:10.1097/PRS.0000000000009521

Phytopathology. 2022 Aug 8. doi: 10.1094/PHYTO-04-22-0132-R. Online ahead of print.

ABSTRACT

Quantifying the effect of landscape composition on disease dynamics remains challenging because it depends on many factors. In this study, we used a hybrid process-based/statistical modelling approach to separate the effect of the landscape composition on the epidemiology of banana leaf streak disease (BLSD) from weather and fungicide effects. We parameterized our model with a 5-years dataset, including weekly measures of BLSD on 83 plots in Martinique. After estimating the intrinsic growth parameters of the Stage Evolution of the Disease (SED), we evaluated the dynamic effect of five fungicides. Then, we added the intra&inter-annual effect on disease dynamics using a generalized linear model. Finally, the whole model was used to assess the annual effect of the landscape on the SED for 11 plots. We evaluated the significance of the landscape composition (proportions of landscape elements in 200, 500, 800, 1000 m radius buffer zones) on the landscape effect evaluated with the model. The percentage of hedgerows in a 200 m radius buffer zone was negatively correlated to the landscape effect, i.e. it acted as a constraint against BLSD spreading and development. The proportion of managed-banana-plants in a 1000 m radius buffer zone was negatively correlated to the landscape effect, probably due to a mass effect of fungicide treatments. Inversely, the proportions of forest and the proportion unmanaged-banana-plants, both in 1000 m radius buffer zones, were positively correlated with the landscape effect. Our study provides a holistic approach of the role biotic and abiotic factors on the dynamics of BLSD.

PMID:35939624 | DOI:10.1094/PHYTO-04-22-0132-R

Biostatistics. 2022 Aug 8:kxac030. doi: 10.1093/biostatistics/kxac030. Online ahead of print.

ABSTRACT

Though platform trials have been touted for their flexibility and streamlined use of trial resources, their statistical efficiency is not well understood. We fill this gap by establishing their greater efficiency for comparing the relative efficacy of multiple interventions over using several separate, 2-arm trials, where the relative efficacy of an arbitrary pair of interventions is evaluated by contrasting their relative risks as compared to control. In theoretical and numerical studies, we demonstrate that the inference of such a contrast using data from a platform trial enjoys identical or better precision than using data from separate trials, even when the former enrolls substantially fewer participants. This benefit is attributed to the sharing of controls among interventions under contemporaneous randomization. We further provide a novel procedure for establishing the noninferiority of a given intervention relative to the most efficacious of the other interventions under evaluation, where this procedure is adaptive in the sense that it need not be a priori known which of these other interventions is most efficacious. Our numerical studies show that this testing procedure can attain substantially better power when the data arise from a platform trial rather than multiple separate trials. Our results are illustrated using data from two monoclonal antibody trials for the prevention of HIV.

PMID:35939566 | DOI:10.1093/biostatistics/kxac030

Biostatistics. 2022 Aug 8:kxac032. doi: 10.1093/biostatistics/kxac032. Online ahead of print.

ABSTRACT

Many scientific questions can be formulated as hypotheses about conditional correlations. For instance, in tests of cognitive and physical performance, the trade-off between speed and accuracy motivates study of the two variables together. A natural question is whether speed-accuracy coupling depends on other variables, such as sustained attention. Classical regression techniques, which posit models in terms of covariates and outcomes, are insufficient to investigate the effect of a third variable on the symmetric relationship between speed and accuracy. In response, we propose a conditional correlation model with association size, a likelihood-based statistical framework to estimate the conditional correlation between speed and accuracy as a function of additional variables. We propose novel measures of the association size, which are analogous to effect sizes on the correlation scale while adjusting for confound variables. In simulation studies, we compare likelihood-based estimators of conditional correlation to semiparametric estimators adapted from genomic studies and find that the former achieves lower bias and variance under both ideal settings and model assumption misspecification. Using neurocognitive data from the Philadelphia Neurodevelopmental Cohort, we demonstrate that greater sustained attention is associated with stronger speed-accuracy coupling in a complex reasoning task while controlling for age. By highlighting conditional correlations as the outcome of interest, our model provides complementary insights to traditional regression modeling and partitioned correlation analyses.

PMID:35939558 | DOI:10.1093/biostatistics/kxac032

Acta Oncol. 2022 Aug 8:1-11. doi: 10.1080/0284186X.2022.2106795. Online ahead of print.

ABSTRACT

OBJECTIVE: Triple-negative breast cancer (TNBC) is a subtype of breast cancer with a poor prognosis that seriously threatens women’s health. There is still a lack of effective therapeutic targets for TNBC treatment. We conducted a meta-analysis to evaluate the efficacy and safety of programmed cell death protein 1 (PD-1)/programmed death protein ligand 1 (PD-L1) inhibitors in combination with chemotherapy for TNBC patients.

METHODS: We searched PubMed, EMBASE, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) related to PD-1/PD-L1 inhibitors combined with chemotherapy. Literature conforming to the research content was identified according to the inclusion and exclusion criteria. The endpoints of efficacy were pathological complete response (pCR), event-free survival (EFS), progression-free survival (PFS), and overall survival (OS). Safety outcomes included adverse events (AEs) of any grade, AEs of grade ≥3, serious AEs, and the incidence of various AEs. We obtained odds ratios (OR), hazard ratio (HR), and 95% confidence interval (CI) for the included studies. Data analysis was performed using Review Manager software (version 5.3).

RESULTS: A total of 4468 patients from eight RCTs were analyzed. PD-1/PD-L1 inhibitors in combination with chemotherapy significantly improved pCR (OR, 1.59; 95% CI, 1.28 – 1.98, p < 0.0001), EFS (HR, 0.66; 95% CI, 0.48 – 0.91, p = 0.01), and OS (HR, 0.72; 95% CI, 0.52 – 0.99, p = 0.05) in patients with TNBC compared to chemotherapy alone or placebo in combination with chemotherapy. Furthermore, we found that the pCR rate was almost identical in the PD-L1 positive group (OR, 1.65; 95% CI, 1.26 – 2.16, p = 0.0002) and the PD-L1 negative group (OR, 1.56; 95% CI, 1.04 – 2.33, p = 0.03). Among patients with advanced-stage TNBC, PFS (HR, 0.82; 95% CI, 0.74 – 0.90, p < 0.0001) was longer in the combination therapy group than in the chemotherapy group. There were no statistically significant differences between the experimental and control groups in OS (HR, 1.03; 95% CI, 0.74 – 1.42, p = 0.87). In terms of safety, we found that the combination therapy group had a significantly higher incidence of hyperthyroidism in patients with early and advanced TNBC (OR, 5.76; 95% CI, 2.38 – 13.95, p = 0.0001) (OR, 7.86; 95% CI, 2.65 – 23.29, p = 0.0002).

CONCLUSIONS: The combination of PD-1/PD-L1 inhibitors and chemotherapy could improve the survival and prognosis of patients with early and advanced TNBC. Combination treatment may be harmful to the thyroid; therefore, active surveillance and regular follow-up are necessary during treatment.

PMID:35939538 | DOI:10.1080/0284186X.2022.2106795

J Phys Chem Lett. 2022 Aug 8:7469-7475. doi: 10.1021/acs.jpclett.2c02045. Online ahead of print.

ABSTRACT

Quantum supremacy has been recently reported for random circuit sampling on the Sycamore processor with 53 qubits. Here, we analyze the statistical properties of bit strings sampled from random quantum circuits. In contrast to classical random bit strings, bit strings sampled from Sycamore random circuits give rise to heat maps with stripe patterns at specific qubits, have more bit 1 than 0, and do not pass the NIST random number tests. The difference between the Sycamore bit strings and classical random bit strings is also demonstrated by the Marchenko-Pastur distribution and the Girko circular law of random matrices. The calculation of Wasserstein distances shows that the Sycamore bit strings are farther from bit strings sampled from Haar-measure random quantum circuits than classical random bit strings. Our results show that random matrices and Wasserstein distances could be used to analyze the performance of quantum computers.

PMID:35939529 | DOI:10.1021/acs.jpclett.2c02045

Ear Nose Throat J. 2022 Aug 8:1455613221112761. doi: 10.1177/01455613221112761. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite the presence of a growing body of literature suggesting cost-ineffectiveness of routine pathologic analysis of tonsillectomy specimens, little is known about common institutional policies and practice patterns of pediatric otolaryngologists. The objectives of this study were to determine the prevalence of routine pathological evaluation of tonsillectomy specimens for uncomplicated pediatric adenotonsillectomy procedures and to evaluate opinions regarding this controversy among board-certified pediatric otolaryngologists.

METHODS: This was a cross-sectional survey study sent to board-certified pediatric otolaryngologists currently practicing and registered with the American Society of Pediatric Otolaryngology (ASPO) assessing their institutions’ or practices’ current policies on sending routine tonsillectomy specimens for pathology, their experience with this practice, and their opinions on whether routine pathologic analysis should be employed. Basic statistical analysis was then conducted.

RESULTS: Respondents mostly practiced in an academic setting (68.4%), with the next most common being academically affiliated private practice (21.8%), and private practice was the least common (9.8%). Most respondents (85.1%) did not agree with routine pathologic analysis of otherwise uncomplicated pediatric tonsillectomy specimens.

CONCLUSION: Most pediatric otolaryngologists who responded to this survey do not support routine pathological analysis of otherwise uncomplicated pediatric tonsillectomy specimens. However, the results are likely biased and should be interpreted carefully, since only a small percentage of pediatric otolaryngologists responded to the survey. Potential cost savings could be seen by patients, payers, and hospital systems with judicious use of surgical pathology, specifically in cases with concurrent signs or symptoms suspicious for malignancy.

PMID:35939505 | DOI:10.1177/01455613221112761