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Nevin Manimala Statistics

Dosimetric effects of small field size, dose grid size, and variable split-arc methods on gamma pass rates in radiation therapy

Radiol Phys Technol. 2024 May 20. doi: 10.1007/s12194-024-00809-7. Online ahead of print.

ABSTRACT

This study investigates the influence of calculation accuracy in peripheral low-dose regions on the gamma pass rate (GPR), utilizing the Acuros XB (AXB) algorithm and ArcCHECK™ measurement. The effects of varying small field sizes, dose grid sizes, and split-arc techniques on GPR were analyzed. Various small field sizes were employed. Thirty-two single-arc plans with dose grid sizes of 2 mm and 1 mm and prescribed doses of 2, 5, 10, and 20 Gy were calculated using the AXB algorithm. In total, 128 GPR plans were examined. These plans were categorized into three sub-fields (3SF), four sub-fields (4SF), and six sub-fields (6SF). The GPR results deteriorated with smaller target sizes and a 2 mm dose grid size in a single arc. A similar degradation in GPR was observed with smaller target sizes and a 1 mm dose grid size. However, the 1 mm dose grid size generally resulted in better GPR compared with the 2 mm dose grid size for the same target sizes. The GPR improved with finer split angles and a 2 mm dose grid size in the split-arc method. However, no statistically significant improvement was observed with finer split angles and a 1 mm dose grid size. This study demonstrates that coarser dose grid sizes result in lower GPRs in peripheral low-dose regions as calculated by AXB with ArcCHECK™ measurement. To enhance GPR, employing split-arc methods and finer dose grid sizes could be beneficial.

PMID:38767777 | DOI:10.1007/s12194-024-00809-7

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Nevin Manimala Statistics

Impact of thyroid carcinoma invasion of recurrent laryngeal nerve on cervical lymph node metastasis

Endocrine. 2024 May 20. doi: 10.1007/s12020-024-03879-0. Online ahead of print.

ABSTRACT

PURPOSE: Papillary thyroid carcinoma (PTC) has a favorable prognosis. However, involvement of the recurrent laryngeal nerve (RLN) significantly increases the risk of recurrence. RLN invasion was an important factor in determining the extent of thyroid surgery. The purpose of this study was to compare clinicopathologic features and characterize risk factors of central and lateral lymph node metastasis (LLNM) of RLN invasion in patients with PTC.

METHODS: A retrospective review was conducted of 130 patients with PTCs who had exclusive tumor involvement of the RLN at our institution between January 2014 and February 2019. All patients underwent total thyroidectomy and high-dose radioactive iodine (RAI) therapy. The clinicopathologic factors and prognostic outcomes of the patients with solitary and multiple RLN involvements were compared. Kaplan-Meier method was performed to compare the outcomes of tumor recurrence. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with LLNM.

RESULTS: The invasion of the RLN was similar on both sides, with 58.5% on the right, 40.0% on the left, and 1.5% on both sides. Significant differences were observed in tumor size (p < 0.001), lymph node metastasis classification (p = 0.002), RLN resection (p < 0.001), and thyroglobulin (p = 0.010) in the solitary and multiple groups. During the median follow-up of 67 months, 9 (6.9%) patients developed recurrence. There were no statistical differences in recurrence for age, tumor size, gender, multifocality, lymph node metastasis (LNM), and RLN resection. According to receiver operating characteristic (ROC) curve analyses, a cut-off of tumor size > 1.7 cm was identified as the most sensitive and specific predictor of RLN with multiple involvements or LNM invasion. Univariate and multivariate analyses revealed that central lymph node metastasis (CLNM) and RLN invasion by LNM can serve as independent risk factors for LLNM (p = 0.006 and p < 0.001, respectively).

CONCLUSION: Our results indicate that recurrence was comparable in patients with solitary and multiple RLN involvements. Multiple RLN involvement was associated with pathological features such as larger tumors, RLN resection, and LLNM. The presence of LNM invading RLN and multiple nerve involvement increases the risk of intraoperative RLN resection. A higher risk of multiple invasion or LNM invasion should be considered when tumor size > 1.7 cm. The presence of CLNM and RLN invaded by LNM were independent predictors for LLNM, which could aid surgeons in deciding on lateral lymph node dissection.

PMID:38767775 | DOI:10.1007/s12020-024-03879-0

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Nevin Manimala Statistics

Systematic review of the economic evaluation model of assisted reproductive technology

Health Econ Rev. 2024 May 20;14(1):34. doi: 10.1186/s13561-024-00509-3.

ABSTRACT

BACKGROUND: With the increasing demand for fertility services, it is urgent to select the most cost-effective assisted reproductive technology (ART) treatment plan and include it in medical insurance. Economic evaluation reports are an important reference for medical insurance negotiation. The aim of this study is to systematically evaluate the economic evaluation research of ART, analyze the existing shortcomings, and provide a reference for the economic evaluation of ART.

METHODS: PubMed, EMbase, Web of Science, Cochrane Library and ScienceDirect databases were searched for relevant articles on the economic evaluation of ART. These articles were screened, and their quality was evaluated based on the Comprehensive Health Economics Evaluation Report Standard (CHEERS 2022), and the data on the basic characteristics, model characteristics and other aspects of the included studies were summarized.

RESULTS: One hundred and two related articles were obtained in the preliminary search, but based on the inclusion criteria, 12 studies were used for the analysis, of which nine used the decision tree model. The model parameters were mainly derived from published literature and included retrospective clinical data of patients. Only two studies included direct non-medical and indirect costs in the cost measurement. Live birth rate was used as an outcome indicator in half of the studies.

CONCLUSION: Suggesting the setting of the threshold range in the field of fertility should be actively discussed, and the monetary value of each live birth is assumed to be in a certain range when the WTP threshold for fertility is uncertain. The range of the parameter sources should be expanded. Direct non-medical and indirect costs should be included in the calculation of costs, and the analysis should be carried out from the perspective of the whole society. In the evaluation of clinical effect, the effectiveness and safety indexes should be selected for a comprehensive evaluation, thereby making the evaluation more comprehensive and reliable. At least subgroup analysis based on age stratification should be considered in the relevant economic evaluation.

PMID:38767759 | DOI:10.1186/s13561-024-00509-3

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Nevin Manimala Statistics

Diversity of Sarcocystis parasites in southeastern Baltic Sea catchment ecosystems

Parasitol Res. 2024 May 20;123(5):214. doi: 10.1007/s00436-024-08234-w.

ABSTRACT

Currently, research on apicomplexan Sarcocystis parasites is mainly carried out by analyzing animal carcasses. However, environmental studies would not only allow faster detection of possible sources of infection but also avoid the use of animals for investigations. Therefore, in the current study, we aimed to identify tested Sarcocystis species in sediment collected from water bodies located in the southeastern Baltic countries. A total of 99 sediment samples were collected during the summer from different types of water bodies in Estonia, Latvia, Lithuania, and Poland. Species-specific nested PCR targeting cox1 gene was used for the detection of selected Sarcocystis species (S. cruzi, S. bovifelis, S. hirsuta, S. arieticanis, S. tenella, S. capracanis, S. miescheriana, and S. bertrami) infecting livestock. The results showed a statistically lower (p < 0.05) occurrence of Sarcocystis parasites in Estonia (50%) compared to three countries, where the detection rate of Sarcocystis spp. DNA was remarkably higher, ranging from 88 to 100%. Among Sarcocystis species tested, S. cruzi (83.8%) and S. arieticanis (55.6%) using cattle and sheep as their intermediate hosts were most commonly identified. The detection rates of some of the analyzed Sarcocystis species were significantly different in southeastern Baltic countries. It is discussed that the detection rates of certain Sarcocystis species depend not only on the number of animals per 1 km2 but also on various ecological factors and farming practices that differ in the amount of contact domestic animals have with predators and the potential for animals to become infected through natural water or food sources.

PMID:38767751 | DOI:10.1007/s00436-024-08234-w

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Nevin Manimala Statistics

Predicting the risk of mortality and rehospitalization in heart failure patients: A retrospective cohort study by machine learning approach

Clin Cardiol. 2024 May;47(5):e24280. doi: 10.1002/clc.24280.

NO ABSTRACT

PMID:38767029 | DOI:10.1002/clc.24280

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Nevin Manimala Statistics

Psychosocial Training Program for Lifeguards: A Pilot Study

Wilderness Environ Med. 2024 May 20:10806032241252106. doi: 10.1177/10806032241252106. Online ahead of print.

ABSTRACT

Research has highlighted the need for training lifeguards in psychosocial skills. Therefore, this study aims to analyze the effectiveness of a short 10-h training program encompassing dimensions associated with emotional management, focus of attention, interpersonal relationships, and lifeguard behavior, and its effects on their psychosocial skills. A total of 64 lifeguards with experience ranging from 1 to 25 years (M = 5.93, SD = 6.07), randomly divided into experimental and control groups, participated in this study. The d2 Test of Attention, the Social Intelligence Test of O’Sullivan and Guilford, and the MSCEIT Emotional Intelligence Test were used to assess psychosocial skills. A multivariate analysis of variance for repeated measures (2 × 3 (Group × Time) MANOVA) was performed to analyze the effects of the training program on psychosocial skills. The results revealed that the experimental group showed statistically significant improvements in focus of attention and emotional intelligence compared to the control group. However, it is worth noting that no statistically significant group interactions were observed for measures of social intelligence. Taken together, these results seem to highlight the importance of including psychosocial content in the general training of lifeguards.

PMID:38767021 | DOI:10.1177/10806032241252106

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Nevin Manimala Statistics

Alemtuzumab induction is associated with decreased hospitalization rates in pediatric kidney transplant: A UNOS data review for safety and outcomes with common induction regimens

Pediatr Transplant. 2024 Jun;28(4):e14783. doi: 10.1111/petr.14783.

ABSTRACT

BACKGROUND: We hypothesized that alemtuzumab use is safe in pediatric kidney transplant recipients (KTRs) with equivalent long-term outcomes compared to other induction agents.

METHODS: Using pediatric kidney transplant recipient data in the UNOS database between January 1, 2000, and June 30, 2022, multivariate logistic regression, multivariable Cox regression, and survival analyses were utilized to estimate the likelihoods of 1st-year and all-time hospitalizations, acute rejection, CMV infection, delayed graft function (DGF), graft loss, and patient mortality among recipients of three common induction regimens (ATG, alemtuzumab, and basiliximab).

RESULTS: There were no differences in acute rejection or graft failure among induction or maintenance regimens. Basiliximab was associated with lower odds of DGF in deceased donor recipients (OR 0.77 [0.60-0.99], p = .04). Mortality was increased in patients treated with steroid-containing maintenance (HR 1.3 [1.005-1.7] p = .045). Alemtuzumab induction correlated with less risk of CMV infection than ATG (OR 0.76 [0.59-0.99], p = .039). Steroid-containing maintenance conferred lower rate of PTLD compared to steroid-free maintenance (HR 0.59 [0.4-0.8] p = .001). Alemtuzumab was associated with less risk of hospitalization within 1 year (OR 0.79 [0.67-0.95] p = .012) and 5 years (HR 0.54 [0.46-0.65] p < .001) of transplantation. Steroid maintenance also decreased 5 years hospitalization risk (HR 0.78 [0.69-0.89] p < .001).

CONCLUSIONS: Pediatric KTRs may be safely treated with alemtuzumab induction without increased risk of acute rejection, DGF, graft loss, or patient mortality. The decreased risk of CMV infections and lower hospitalization rates compared to other agents make alemtuzumab an attractive choice for induction in pediatric KTRs, especially in those who cannot tolerate ATG.

PMID:38767019 | DOI:10.1111/petr.14783

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Nevin Manimala Statistics

Validity and reliability of an Arabic-language version of the postpartum specific anxiety scale research short-form in Jordan

Birth. 2024 May 20. doi: 10.1111/birt.12840. Online ahead of print.

ABSTRACT

OBJECTIVE: The English-language Postpartum Specific Anxiety Scale (PSAS) is a valid, reliable measure for postpartum anxiety (PPA), but its 51-item length is a limitation. Consequently, the PSAS Working Group developed the PSAS Research Short-Form (PSAS-RSF), a statistically robust 16-item tool that effectively assesses PPA. This study aimed to assess and validate the reliability of an Arabic-language version of the PSAS-RSF in Jordan (PSAS-JO-RSF).

METHODS: Using a cross-sectional methodological design, a sample of Arabic-speaking mothers (N = 391) with infants aged up to 6 months were recruited via convenience sampling from a prominent tertiary hospital in northern Jordan. Factor analysis, composite reliability (CR), average variance extracted (AVE), McDonald’s ω, and inter-item correlation measures were all examined.

RESULTS: Explanatory factor analysis revealed a four-factor model consistent with the English-language version of the PSAS-RSF, explaining a cumulative variance of 61.5%. Confirmatory factor analysis confirmed the good fit of the PSAS-JO-RSF (χ2/df = 1.48, CFI = 0.974, TLI = 0.968, RMSEA = 0.039, SRMR = 0.019, p < 0.001). The four factors demonstrated acceptable to good reliability, with McDonald’s ω ranging from 0.778 to 0.805, with 0.702 for the overall scale. The CR and AVE results supported the validity and reliability of the PSAS-JO-RSF.

CONCLUSION: This study establishes an Arabic-language version of the PSAS-JO-RSF as a valid and reliable scale for screening postpartum anxieties in Jordan.

PMID:38767003 | DOI:10.1111/birt.12840

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Nevin Manimala Statistics

Transient IR spectroscopy of optically centrifuged CO2 (R186-R282) and collision dynamics for the J = 244-282 states

Faraday Discuss. 2024 May 20. doi: 10.1039/d3fd00179b. Online ahead of print.

ABSTRACT

Collisions of optically centrifuged CO2 molecules with J = 244-282 (Erot = 22 800-30 300 cm-1) are investigated with high-resolution transient IR absorption spectroscopy to reveal collisional and orientational phenomena of molecules with hyper-thermal rotational energies. The optical centrifuge is a non-resonant optical excitation technique that uses ultrafast, 800 nm chirped pulses to drive molecules to extreme rotational states through sequential Raman transitions. The extent of rotational excitation is controlled by tuning the optical bandwidth of the excitation pulses. Frequencies of 30 R-branch ν3 fundamental IR probe transitions are measured for the J = 186-282 states of CO2, expanding beyond previously reported IR transitions up to J = 128. The optically centrifuged molecules have oriented angular momentum and unidirectional rotation. Polarization-sensitive transient IR absorption of individual rotational states of optically centrifuged molecules and their collision products reveals information about collisional energy transfer, relaxation kinetics, and dynamics of rotation-to-translation energy transfer. The transient IR probe also measures the extent of polarization anisotropy. Rotational energy transfer for lower energy molecules is discussed in terms of statistical models and a comparison highlights the role of increasing energy gap with J and angular momentum of the optically centrifuged molecules.

PMID:38766993 | DOI:10.1039/d3fd00179b

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Nevin Manimala Statistics

Changes in Resources and Volunteering: A Longitudinal Study of Active Engagement Among Older Europeans

Gerontologist. 2024 May 20:gnae049. doi: 10.1093/geront/gnae049. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Volunteering is an important dimension of successful aging. Although prior studies have found that personal resources such as health and financial situations are associated with volunteering, there is a lack of research exploring the relationship between resource changes and volunteering. Here, we investigated whether changes in individuals’ resources were associated with volunteer engagement among older Europeans.

RESEARCH DESIGN AND METHODS: Using data from the Survey of Health, Aging, and Retirement in Europe, collected in five waves between 2011 and 2020 across 19 countries (57,410 observations from 17,498 individuals aged 50 and above), we employed asymmetric fixed-effect ordinal regression models to investigate whether positive or negative resource changes were associated with the frequency of volunteering over time. We used three resource indicators: health, financial condition, and time availability (measured by engagement in paid work, grandparenting, and family care).

RESULTS: Health deterioration and worsening financial condition were associated with a decreased frequency of volunteering. A transition out of weekly paid work and beginning to provide weekly grandchild care were both associated with an increased frequency of volunteering. We did not detect any further significant effects of resource changes on volunteering.

DISCUSSION AND IMPLICATIONS: Our study revealed asymmetrical associations between changes in resources and volunteering, providing new insights into their interplay. The results deepen our understanding of successful aging by emphasizing the need to consider the dynamics of all resources that either facilitate or hinder active engagements among older adults.

PMID:38766985 | DOI:10.1093/geront/gnae049