Nevin Manimala

Med Phys. 2024 Nov 15. doi: 10.1002/mp.17517. Online ahead of print.

ABSTRACT

BACKGROUND: One of the main challenges of utilizing spot-scanning proton arc therapy (SPArc) in routine clinics is treatment delivery efficiency. Spot reduction, which relies on spot sparsity optimization (SSO), is crucial for achieving high delivery efficiency in SPArc.

PURPOSE: This study aims to develop a novel SSO approach based on the alternating directions method of multipliers (ADMM) for SPArc to achieve high treatment delivery efficiency and maintain optimal dosimetric plan quality.

METHODS: In this study, SSO for SPArc is based on the least-square dose fidelity term with L0-norm regularization. The novel optimization approach is based on the ADMM framework, in which the minimum monitor unit constraint was considered to improve the plan quality. A state-of-the-art SSO method, the primal-dual active set with continuation (PDASC) algorithm published previously, was utilized as a benchmark. Two SPArc plan groups with the same beam assignment and clinical constraint were generated, in which the former group was SPArc plan with SSO utilizing ADMM, denoted as ${\text{SPArc}}_{\text{ADMM}}$ , and the later group was SPArc with SSO utilizing PDASC, denoted as ${\text{SPArc}}_{\text{PDASC}}$ . Nine clinical cases included five different cancer sites (brain, lung, liver, prostate, and head&neck cancer) were used. The SSO method’s performance was evaluated in terms of spot sparsity level (the number of zero-valued elements divided by the total number of elements), beam delivery time, dosimetric plan quality, and plan robustness.

RESULTS: Compared to the ${\text{SPArc}}_{\text{PDASC}}$ plan, the ${\text{SPArc}}_{\text{ADMM}}$ plan exhibits superior sparsity and higher delivery efficiency while maintaining good plan quality.

CONCLUSIONS: This study introduces a novel spot sparsity optimization approach using the ADMM framework to improve the delivery efficiency of SPArc. Compared to the existing state-of-the-art SSO method, such an approach could further enhance delivery efficiency while maintaining good plan quality, which could promote the implementation of SPArc in the clinic’s.

PMID:39546642 | DOI:10.1002/mp.17517

NCHS Data Brief. 2024 Oct;(512).

ABSTRACT

OBJECTIVES: This report explores changes in the overall rate of triplet and higher-order births from 1998 to 2023 by detailed plurality, maternal race and Hispanic origin, and age.

METHODS: Data are from the National Vital Statistics System birth files. Triplet and higher-order birth rates (number of triplet and higher-order births per 100,000 births) from 1998 to 2023 are presented. Also presented are the number of triplet, triplet and higher-order, and quadruplet and higher-order births, and triplet and higher-order multiple birth rates by maternal race and Hispanic origin and maternal age for 1998, 2009, and 2023.

RESULTS: From 1998 to 2023, the triplet and higher-order multiple birth rate declined 62%, from 193.5 per 100,000 total births to 73.8; the largest declines were from 2009 to 2023. The number of triplet and higher-order births declined from 7,625 to 2,653. Declines in triplet and higher-order birth rates were observed for White non-Hispanic (71%) and Hispanic (25%) mothers, while the rate for Black non-Hispanic mothers increased (25%). Triplet and higher-order birth rates declined for all age groups 20 and older from 1998 to 2023, and the largest declines were for mothers age 30 and older.

PMID:39546621

Proc Natl Acad Sci U S A. 2024 Nov 19;121(47):e2411582121. doi: 10.1073/pnas.2411582121. Epub 2024 Nov 15.

ABSTRACT

Accurate estimation of the dispersal velocity or speed of evolving organisms is no mean feat. In fact, existing probabilistic models in phylogeography or spatial population genetics generally do not provide an adequate framework to define velocity in a relevant manner. For instance, the very concept of instantaneous speed simply does not exist under one of the most popular approaches that models the evolution of spatial coordinates as Brownian trajectories running along a phylogeny. Here, we introduce a family of models-the so-called Phylogenetic Integrated Velocity (PIV) models-that use Gaussian processes to explicitly model the velocity of evolving lineages instead of focusing on the fluctuation of spatial coordinates over time. We describe the properties of these models and show an increased accuracy of velocity estimates compared to previous approaches. Analyses of West Nile virus data in the United States indicate that PIV models provide sensible predictions of the dispersal of evolving pathogens at a one-year time horizon. These results demonstrate the feasibility and relevance of predictive phylogeography in monitoring epidemics in time and space.

PMID:39546571 | DOI:10.1073/pnas.2411582121

PLoS One. 2024 Nov 15;19(11):e0313280. doi: 10.1371/journal.pone.0313280. eCollection 2024.

ABSTRACT

PURPOSE: Comparing the outcomes of video-laryngoscopy and flexible fiberoptic bronchoscopy for endotracheal intubation in patients with cervical spine immobilization.

METHODS: All of the comparative studies published in the PubMed, Cochrane Library, Medline, Web of Science, and EMBASE databases as of 8 Jan 2024 were included. All outcomes were analyzed using Review Manager 5.4. The primary outcomes were the successful first-attempt intubation rate, intubation time, heart rate after intubation, mean arterial pressure after intubation, overall intubation success rate, risk of tissue damage and sore throat.

RESULTS: The meta-analysis included six randomized controlled studies with a total of 694 patients. The outcomes of the meta-analysis revealed that the use of video laryngoscopy was better than flexible fiberoptic bronchoscopy in terms of the successful first-attempt intubation rate (P<0.05) and intubation time (P<0.05) in patients with cervical spine immobilization. However, there were no statistically significant differences in heart rate after intubation, mean arterial pressure after intubation, overall intubation success rate, risk of tissue damage, or sore throat (all P>0.05) between the video laryngoscopy and flexible fiberoptic bronchoscopy groups.

CONCLUSIONS: Compared with flexible fiberoptic bronchoscopy, video laryngoscopy has superior tracheal intubation performance in terms of the first-attempt success rate and intubation speed. This finding was observed in patients with cervical spine immobilization who utilized a cervical collar to simulate a difficult airway. Additionally, both types of scopes demonstrated similar complication rates. Current evidence suggests that video laryngoscopy is better suited than flexible fiberoptic bronchoscopy for endotracheal intubation in patients immobilized with a cervical collar.

TRIAL REGISTRATION: Systematic review protocol: CRD42024499868.

PMID:39546549 | DOI:10.1371/journal.pone.0313280

PLoS One. 2024 Nov 15;19(11):e0300826. doi: 10.1371/journal.pone.0300826. eCollection 2024.

ABSTRACT

BACKGROUND: Although moderate and severe Covid-19 patients have shown obstructive and restrictive disorders in pulmonary function after recovery from the disease, studies evaluating the effectiveness of rehabilitation programs that seek to improve lung function are scarce.

AIM: Herein, we evaluate changes in lung function and perceived dyspnea in Covid-19 patients after undergoing 12 weeks of a pulmonary rehabilitation (PR) program.

DESIGN: Retrospective observational study.

SETTING: Cesar, Colombia Neumocesar Pneumological Center.

POPULATION: 100 outpatients with a history of Covid-19.

METHODS: Respiratory function using spirometry parameters, as well as perceived dyspnea, measured by the modified Medical Research Council (mMRC) dyspnea scale, was evaluated in 100 patients with a history of Covid-19. We used univariate and multivariate statistical approaches to assess changes in lung function and perceived dyspnea before and after a PR program to determine whether gender, age, height, weight, comorbidities, and oxygen delivery system affects the recovery of lung function and perceived dyspnea.

RESULTS: It was found that PR treatment has positive effects on respiratory pathologies caused by SARS-CoV-2 infection regardless of patient gender (S = 0,029), indicating that rehabilitation provided benefits regardless of the physical characteristics of the patients. Both univariate and multivariate statistical analyses indicated that FVC (P = 0,0001), FEV1(P = 0,0001), and mMRC (P = 0,0001) are robust diagnostic indicators of lung function recovery and perceived dyspnea. Both invasive and non-invasive positive pressure ventilatory support had deleterious effects on lung function prolongating patient recovery (P = 0,0001).

CONCLUSIONS: Rehabilitation programs can benefit patients facing respiratory pathologies caused by SARS-CoV-2 infection. Additional research on the long-term effects of the sequelae of Covid-19 is needed.

CLINICAL REHABILITATION IMPACT: PR programs have positive effects on patients facing respiratory pathologies caused by SARS-CoV-2 infection.

PMID:39546545 | DOI:10.1371/journal.pone.0300826

PLoS One. 2024 Nov 15;19(11):e0310970. doi: 10.1371/journal.pone.0310970. eCollection 2024.

ABSTRACT

BACKGROUND: Occupational or work-related injuries are mostly common among hospitals’ sanitary workers (SWs) in developing countries like Ethiopia. This is due to improper practiced of devices, unhygienic workplace, neglected and undermined risk factors, as well as due to lack of policy initiatives; but not studied well.

OBJECTIVE: The aim of the study was to assess the occupational injuries and its associated factors among SWs in public hospitals, eastern Ethiopia: A Modified Poisson regression Model Analysis.

METHODS: An institution-based cross-sectional study was conducted in eight public hospitals in eastern Ethiopia from May 2023 to August 30th, 2023. Out of fourteen hospitals, eight of them were selected randomly. Eight data collectors and 4 supervisors were assigned. Face-to-face interview was conducted. Eight hundred hospital SWs were recruited for the study. Occupational injury was measured using Boolean logic questionnaire either YES [1] or NO [0] for the last 12 months and the 7 days. Descriptive statistical was used for means, medians, standard deviations, and frequencies, proportions, and percentages. Modified Poisson regression was used to explore the relationship of outcome and independent variables. Accordingly, bi-variable analysis was performed to estimate unadjusted prevalence ratio (UPR). While, multi-variable model was used adjusted PR(APR) for those variables have significant values of p ≤0.20 at bi-variate analysis with confidence interval of 95% (CI:95%).

RESULT: Out of eight hundred nine SWs, 729(90.1%) were participated on the study. Self-reported occupational injuries among SWs in the last 12 months were 44.0% (95% CI: 40.4, 47.7). Of these, 92.2% (95%CI: 88.7,94.90%) and 7.8% (95%CI: 5.1, 11.3%) occupational injuries was reported from the cleaners and waste collectors, respectively. The model found that SWs those acquired diseases after recruited in the hospitals (APR:1.3;95%CI:1.1,1.6), those had sleeping disorder (APR:1.2;95%CI:1.0,1.), those had workload (APR:1.3; 95%CI:1.0, 1.8), those exposed with occupational hazards (APR:1.4; 95%CI:1.3, 1.7) were at the risk of occupational injuries as compared to their counter parts. Meanwhile, SWs those didn’t get supervision (APR: 1.0;95%CI: 1.0, 1.2) and those non-adherence to personal protective equipment (PPE) (APR:1.3;95%CI:1.0,1.5) were more likely to at the risk of occupational injuries.

CONCLUSION: The current study concluded that there was a high prevalence of occupational injuries among SWs in the current selected public hospitals. The study also found that non-compliant with PPE, work load, sleeping disorders, attitude towards workplace safety and unsupervised activities and working in high-risk environment tends to increase the risk for occupational injuries. In addition to occupational injuries the study found that SWs those acquired occupational diseases such as asthma, respiratory tract problems, allergy, infections, kidney problems and dermatology problems after recruited in hospitals.

PMID:39546541 | DOI:10.1371/journal.pone.0310970

PLoS One. 2024 Nov 15;19(11):e0305384. doi: 10.1371/journal.pone.0305384. eCollection 2024.

ABSTRACT

BACKGROUND: The occurrence of failed induction led to higher rates of health problems and death among mothers, mainly as a result of complications related to cesarean delivery, such as postpartum bleeding, morbidly adherent placenta and surgical site infection. Even though a systematic review and meta-analysis were done before July 2020 with limited studies, there were varies inconsistent studies after that and no updated summarize evidence about the issue as a nation. Therefore, this systematic review and meta-analysis aimed to assess the current pooled prevalence of failed induction and its associated factors in Ethiopia by including multiple inconsistent studies.

METHODS: Comprehensive literature was searched in PubMed, Google Scholar, and HINARI from January 1, 2013, to September 23, 2023. A random effect model was used to estimate pooled prevalence and adjusted odds ratio. Stata (version17.0) was used to analyze the data. Cochrane Q-test and I squared statistics were computed to assess heterogeneity among studies. A sub group analysis was done based on study region to minimize underling heterogeneity. Funnel plot and Eggers test were done to assess publication bias and corrected by trim and fill analysis.

RESULT: Overall, one thousand fifty-two articles were retrieved and finally twenty-eight studies were included in this systematic review, including 9757 participants. The pooled prevalence of failed induction of labor was 22.39% (95% CI: 21.57-23.21). Subgroup analysis showed that failed induction of labor was highest in Addis Ababa and lowest in Tigray region. Rural residence (AOR = 3.31, 95% CI: 2.39-4.57), nullipara women (AOR = 2.63, 95% CI: 2.14-3.24), unfavorable bishop score (AOR = 3.98, 95% CI: 2.19-7.08), hypertensive disorder during pregnancy (AOR = 3.63, 95% CI: 2.69-5.01) and premature rupture of membranes before the onset of labor (AOR = 2.51, 95% CI: 1.5-4.26) were significantly associated with failed induction of labor.

CONCLUSION: The pooled prevalence of failed induction of labor in Ethiopia was high. Unfavorable bishop score, nulliparous, rural residence, women who had premature rupture of membrane and hypertensive disorder during pregnancy were significantly associated with failed induction of labor. Therefore, Healthcare providers or obstetricians should consider proper cervical assessment for bishop score before the initiation of induction. The Ministry of Health ought to create a distinct set of guidelines specifically addressing the cervical ripening and/or induction protocol for women who experienced premature rupture of membranes (PROM) and had a hypertensive disorder during pregnancy, especially those who were administered magnesium sulfate (MgSO4).

PMID:39546537 | DOI:10.1371/journal.pone.0305384

Phys Chem Chem Phys. 2024 Nov 15. doi: 10.1039/d4cp02764g. Online ahead of print.

ABSTRACT

Some of our recent developments and applications of algorithmic graph theory for extracting the physical and chemical properties of materials from molecular dynamics simulations are presented. From the chemical viewpoint, the power of graph theory is illustrated in the search for a catalyst’s active sites at a silica solid surface. From the physical viewpoint, we present graph algorithms that recognize the structural motifs that exist at the silica/liquid water interface. Statistical analyses of the instances of these surface-water motifs provide a detailed understanding of the structures and dynamics at the aqueous interface.

PMID:39545384 | DOI:10.1039/d4cp02764g

Allergy. 2024 Nov 15. doi: 10.1111/all.16399. Online ahead of print.

NO ABSTRACT

PMID:39545381 | DOI:10.1111/all.16399

Cancer Control. 2024 Jan-Dec;31:10732748241298539. doi: 10.1177/10732748241298539.

ABSTRACT

Dynamic contrast enhancement (DCE) imaging is a valuable sequence of multiparametric magnetic resonance imaging (mpMRI). A DCE sequence enhances the vasculature and complements T2-weighted (T2W) and Diffusion-weighted imaging (DWI), allowing early detection of prostate cancer. However, DCE assessment has remained primarily qualitative. The study proposes quantifying DCE characteristics (T1W sequences) using six time-dependent metrics computed on feature transformations (306 radiomic features) of abnormal image regions observed over time. We applied our methodology to prostate cancer patients with the DCE MRI images (n = 25) who underwent prostatectomy with confirmed pathological assessment of the disease using Gleason Score. Regions of abnormality were assessed on the T2W MRI, guided using the whole mount pathology. Preliminary analysis finds over six temporal DCE imaging features obtained on different transformations on the imaging regions showed significant differences compared to the indolent counterpart (P ≤ 0.05, q ≤ 0.01). We find classifier models using logistic regression formed on DCE features after feature-based transformation (Centre of Mass) had an AUC of 0.89-0.94. While using mean feature-based transformation, the AUC was in the range of 0.71-0.76, estimated using the 0.632 bootstrap cross-validation method and after applying sample balancing using the synthetic minority oversampling technique (SMOTE). Our study finds, radiomic transformation of DCE images (T1 sequences) provides better signal standardization. Their temporal characteristics allow improved discrimination of aggressive disease.

PMID:39545376 | DOI:10.1177/10732748241298539