Nevin Manimala

Eur J Surg Oncol. 2024 Feb 8;50(4):108001. doi: 10.1016/j.ejso.2024.108001. Online ahead of print.

ABSTRACT

BACKGROUND: Near-pathological complete response (Near-pCR) patients constitute a distinct subgroup with limited research attention. The clinical relevance of adjuvant chemotherapy (ACT) in this patient cohort remains uncertain.

METHODS: We conducted a retrospective analysis of 245 patients with locally advanced rectal cancer (LARC) who achieved near-pCR following neoadjuvant chemoradiotherapy (NCRT) between 2011 and 2018. Based on their receipt of ACT or not (non-ACT), patients were divided into two groups. We examined their characteristics, treatment modalities, and survival outcomes, particularly focusing on 5-year disease-free survival (DFS) and 5-year overall survival (OS).

RESULTS: Among the 245 near-pCR patients, 191 (77.96%) received ACT, and 42 (17.14%) experienced disease recurrence. All 54 (22.04%) Patients in the non-ACT group exhibited a lower 5-year DFS rate (72.2% vs. 85.9%, P = 0.014) and a similar 5-year OS rate (87.0% vs. 91.1%, P = 0.351). Interestingly, those with ypT3-T4 stage tumors demonstrated a worse DFS (76.8% vs. 89.9%, P = 0.010) and OS (87.5% vs. 97.0%, P = 0.004) compared to their counterparts with ypT1-T2 stage tumors. Patients with Non-Downstage tumors showed inferior DFS (76.9% vs. 88.3%, P = 0.025) and OS (87.2% vs. 93.0%, P = 0.166) in comparison to patients with Downstage tumors. The ACT subgroup in patients with Downstage demonstrated statistically better 5-year DFS (93.0% vs. 71.4%, P = 0.001) but analogous survival rates for 5-year OS (OS: 94.0% vs. 89.3%, P = 0.402). Pathological T stage 3-4, perineural invasion (PNI) (positive) and ACT were independent factors influencing 5-year DFS in multivariate analysis. Both univariate and multivariate analysis demonstrated a link between serum carcinoembryonic antigen (CEA) before treatment ≥5 ng/ml and shorter 5-year OS. Notably, near-pCR patients with positive lymph nodes experienced notably diminished 5-year DFS in the absence of ACT post-surgery (61.1% vs. 93.2%, P < 0.001).

CONCLUSIONS: ACT demonstrated a significant positive impact on the prognosis of select near-pCR patients, particularly those with ypT1-T2 stage tumors and positive lymph nodes. ypT staging may emerge as a valuable criterion for precise post-surgical ACT guidance in near-pCR patients.

PMID:38364330 | DOI:10.1016/j.ejso.2024.108001

Biomed Phys Eng Express. 2024 Feb 16. doi: 10.1088/2057-1976/ad2a1b. Online ahead of print.

ABSTRACT

&#xD;Automated Stereotactic Radiosurgery (SRS) planning solutions improve clinical efficiency and reduce treatment plan variability. Available commercial solutions employ a template-based strategy that may not be optimal for all SRS patients. This study compares a novel beam angle optimized Volumetric Modulated Arc Therapy (VMAT) planning solution for multi-metastatic SRS to the commercial solution HyperArc.&#xD;Approach:&#xD;Stereotactic Optimized Automated Radiotherapy (SOAR) performs automated plan creation by combining collision prediction, beam angle optimization, and dose optimization to produce individualized high-quality SRS plans using Eclipse Scripting. In this retrospective study 50 patients were planned using SOAR and HyperArc. Assessed dose metrics included the Conformity Index (CI), Gradient Index (GI), and doses to organs-at-risk. Complexity metrics evaluated the modulation, gantry speed, and dose rate complexity. Plan dosimetric quality, and complexity were compared using double-sided Wilcoxon signed rank tests (α = 0.05) adjusted for multiple comparisons.&#xD;Main Results:&#xD;The median target CI was 0.82 with SOAR and 0.79 with HyperArc (p < .001). Median GI was 1.85 for SOAR and 1.68 for HyperArc (p < .001). The median V12Gy normal brain volume for SOAR and HyperArc were 7.76 cm³and 7.47 cm³respectively. Median doses to the eyes, lens, optic nerves, and optic chiasm were statistically significant favoring SOAR. The SOAR algorithm scored lower for all complexity metrics assessed.&#xD;Significance:&#xD;In-house developed automated planning solutions are a viable alternative to commercial solutions. SOAR designs high-quality patient-specific SRS plans with a greater degree of versatility than template-based methods.&#xD.

PMID:38364285 | DOI:10.1088/2057-1976/ad2a1b

Biomed Phys Eng Express. 2024 Feb 16. doi: 10.1088/2057-1976/ad2a1a. Online ahead of print.

ABSTRACT

Idiopathic Normal Pressure Hydrocephalus (iNPH) is a progressive neurologic disorder (fluid build-up in the brain) that affects 0.2-5% of the UK population aged over 65. Mobility problems, dementia and urinary incontinence are symptoms of iNPH but often these are not properly evaluated, and patients receive the wrong diagnosis. Here, we describe the development and testing of a wearable device that records and analyses a patient’s gait. The movement patterns, expressed as quantitative data, allow clinicians to improve the non-invasive diagnosis of iNPH as well as monitor the management of patients undergoing treatment. The wearable sensor system comprises a miniature electronic unit that attaches to one ankle of the patient via a simple Velcro strap. The unit monitors acceleration along three axes with a sample rate of 60 Hz and transmits the data via a Bluetooth communication link to a tablet or smart phone running the Android and the iOS operating systems. The software package extracts statistics based on stride length, stride height, distance walked and speed. Analysis confirmed that the system achieved an average accuracy of at least 98% for gait tests conducted over distances 9 m. Using this device will improve the diagnostic process and management of iNPH and the treatment and management of this condition.

PMID:38364278 | DOI:10.1088/2057-1976/ad2a1a

Aging (Albany NY). 2024 Feb 15;16. doi: 10.18632/aging.205547. Online ahead of print.

ABSTRACT

BACKGROUND: The causative implications remain ambiguous. Consequently, this study aims to evaluate the putative causal relationship between gut microbiota and Esophageal cancer (EC).

METHODS: The genome-wide association study (GWAS) pertaining to the microbiome, derived from the MiBioGen consortium-which consolidates 18,340 samples across 24 population-based cohorts-was utilized as the exposure dataset. Employing the GWAS summary statistics specific to EC patients sourced from the GWAS Catalog and leveraging the two-sample Mendelian randomization (MR) methodology, the principal analytical method applied was the inverse variance weighted (IVW) technique. Cochran’s Q statistic was utilized to discern heterogeneity inherent in the data set. Subsequently, a reverse MR analysis was executed.

RESULTS: Findings derived from the IVW technique elucidated that the Family Porphyromonadaceae (P = 0.048) and Genus Candidatus Soleaferrea (P = 0.048) function as deterrents against EC development. In contrast, the Genus Catenibacterium (P = 0.044), Genus Eubacterium coprostanoligenes group (P = 0.038), Genus Marvinbryantia (P = 0.049), Genus Ruminococcaceae UCG010 (P = 0.034), Genus Ruminococcus1 (P = 0.047), and Genus Sutterella (P = 0.012) emerged as prospective risk contributors for EC. To assess reverse causal effect, we used EC as the exposure and the gut microbiota as the outcome, and this analysis revealed associations between EC and seven different types of gut microbiota. The robustness of the MR findings was substantiated through comprehensive heterogeneity and pleiotropy evaluations.

CONCLUSIONS: This research identified certain microbial taxa as either protective or detrimental elements for EC, potentially offering valuable biomarkers for asymptomatic diagnosis and prospective therapeutic interventions for EC.

PMID:38364235 | DOI:10.18632/aging.205547

J Neurosurg Spine. 2024 Feb 16:1-9. doi: 10.3171/2023.12.SPINE221330. Online ahead of print.

ABSTRACT

OBJECTIVE: Depression has been implicated with worse immediate postoperative outcomes in adult spinal deformity (ASD) correction, yet the specific impact of depression on those patients undergoing minimally invasive surgery (MIS) requires further clarity. This study aimed to evaluate the role of depression in the recovery of patients with ASD after undergoing MIS.

METHODS: Patients who underwent MIS for ASD with a minimum postoperative follow-up of 1 year were included from a prospectively collected, multicenter registry. Two cohorts of patients were identified that consisted of either those affirming or denying depression on preoperative assessment. The patient-reported outcome measures (PROMs) compared included scores on the Oswestry Disability Index (ODI), numeric rating scale (NRS) for back and leg pain, Scoliosis Research Society Outcomes Questionnaire (SRS-22), SF-36 physical component summary, SF-36 mental component summary (MCS), EQ-5D, and EQ-5D visual analog scale.

RESULTS: Twenty-seven of 147 (18.4%) patients screened positive for preoperative depression. The nondepressed cohort had an average of 4.83 levels fused, and the depressed cohort had 5.56 levels fused per patient (p = 0.267). At 1-year follow-up, 10 patients still reported depression, representing a 63% decrease. Postoperatively, both cohorts demonstrated improvement in their PROMs; however, at 1-year follow-up, those without depression had statistically better outcomes based on the EQ-5D, MCS, and SRS-22 scores (p < 0.05). Patients with depression continued to experience higher NRS leg scores at 1-year follow-up (3.63 vs 2.22, p = 0.018). After controlling for covariates, the authors found that depression significantly impacted only 1-year follow-up MCS scores (β = 8.490, p < 0.05).

CONCLUSIONS: Depressed and nondepressed patients reported similar improvements after MIS surgery, except MCS scores were more likely to improve in nondepressed patients.

PMID:38364229 | DOI:10.3171/2023.12.SPINE221330

Eur J Prev Cardiol. 2024 Feb 13:zwae021. doi: 10.1093/eurjpc/zwae021. Online ahead of print.

ABSTRACT

AIMS: We assessed the association of temperature and temperature variability with cause-specific emergency hospitalizations and mortality from cardiovascular and respiratory diseases in Spain, as well as the effect modification of this association by individual and contextual factors.

METHODS AND RESULTS: We collected data on health (hospital admissions and mortality), weather (temperature and relative humidity), and relevant contextual indicators for 48 Spanish provinces during 2004-2019. The statistical analysis was separately performed for the summer (June-September) and winter (December-March) seasons. We first applied a generalized linear regression model with quasi-Poisson distribution to estimate daily province-specific temperature-health associations, and then we fitted multilevel multivariate meta-regression models to the evaluate effect modification of the contextual characteristics on heat- and cold-related risks. High temperature increased the risk of mortality across all cardiovascular and respiratory diseases, with the strongest effect for hypertension (relative risk (RR) at 99th temperature percentile vs. optimum temperature: 1.510 [95% empirical confidence interval {eCI} 1.251 to 1.821]), heart failure (1.528 [1.353 to 1.725]), and pneumonia (2.224 [1.685 to 2.936]). Heat also had an impact on all respiratory hospitalization causes (except asthma), with similar risks between pneumonia (1.288 [1.240 to 1.339]), acute bronchitis and bronchiolitis (1.307 [1.219 to 1.402]), and chronic obstructive pulmonary disease (1.260 [1.158 to 1.372]). We generally found significant risks related to low temperature for all cardiovascular and respiratory causes, with heart failure (RR at 1st temperature percentile vs. optimum temperature: 1.537 [1.329 to 1.779]) and chronic obstructive pulmonary disease (1.885 [1.646 to 2.159]) exhibiting the greatest risk for hospitalization, and acute myocardial infarction (1.860 [1.546 to 2.238]) and pneumonia (1.734 [1.219 to 2.468]) for mortality. Women and the elderly were more vulnerable to heat, while people with secondary education were less susceptible to cold compared to those not achieving this educational stage. Results from meta-regression showed that increasing heating access to the highest current provincial value (i.e. 95.6%) could reduce deaths due to cold by 59.5% (57.2 to 63.5).

CONCLUSION: Exposure to low and high temperatures was associated with a greater risk of morbidity and mortality from multiple cardiovascular and respiratory conditions, and heating was the most effective societal adaptive measure to reduce cold-related mortality.

PMID:38364198 | DOI:10.1093/eurjpc/zwae021

Phys Rev Lett. 2024 Feb 2;132(5):056102. doi: 10.1103/PhysRevLett.132.056102.

ABSTRACT

The phonon dispersion of ice VII and that of its proton-ordered analog ice VIII are investigated through a combination of inelastic x-ray scattering (IXS) measurements and first-principles calculations of the oxygen sublattice dynamic structure factor. Particular attention is devoted to hydrogen-disorder in ice VII, addressed theoretically through a statistical ensemble of fictitious ordered supercell configurations. Similar phonon densities of states are found in both phases but are significantly less structured in the case of ice VII. Our data further show that, despite a full proton disorder, the acoustic phonon branches in this phase clearly inherit the periodicity of its body-centered cubic oxygen lattice. The calculations predict, however, the presence of gap openings in the one-atom phonon dispersion. These predictions are supported by revisiting the analysis of previous single-crystal IXS measurements along the longitudinal [111] branch of ice VII.

PMID:38364173 | DOI:10.1103/PhysRevLett.132.056102

Phys Rev Lett. 2024 Feb 2;132(5):050202. doi: 10.1103/PhysRevLett.132.050202.

ABSTRACT

A well-motivated method for demonstrating that an experiment resists any classical explanation is to show that its statistics violate generalized noncontextuality. We here formulate this problem as a linear program and provide an open-source implementation of it which tests whether or not any given prepare-measure experiment is classically explainable in this sense. The input to the program is simply an arbitrary set of quantum states and an arbitrary set of quantum effects; the program then determines if the Born rule statistics generated by all pairs of these can be explained by a classical (noncontextual) model. If a classical model exists, it provides an explicit model. If it does not, then it computes the minimal amount of noise that must be added such that a model does exist, and then provides this model. We generalize all these results to arbitrary generalized probabilistic theories (and accessible fragments thereof) as well; indeed, our linear program is a test of simplex embeddability as introduced in Schmid et al. [PRX Quantum 2, 010331 (2021).2691-339910.1103/PRXQuantum.2.010331] and generalized in Selby et al. [Phys. Rev. A 107, 062203 (2023).PLRAAN2469-992610.1103/PhysRevA.107.062203].

PMID:38364156 | DOI:10.1103/PhysRevLett.132.050202

Phys Rev Lett. 2024 Feb 2;132(5):057102. doi: 10.1103/PhysRevLett.132.057102.

ABSTRACT

The force autocorrelation function (FACF), a concept of fundamental interest in statistical mechanics, encodes the effect of interactions on the dynamics of a tagged particle. In equilibrium, the FACF is believed to decay monotonically in time, which is a signature of slowing down of the dynamics of the tagged particle due to interactions. Here, we analytically show that in odd-diffusive systems, which are characterized by a diffusion tensor with antisymmetric elements, the FACF can become negative and even exhibit temporal oscillations. We also demonstrate that, despite the isotropy, the knowledge of FACF alone is not sufficient to describe the dynamics: the full autocorrelation tensor is required and contains an antisymmetric part. These unusual properties translate into enhanced dynamics of the tagged particle quantified via the self-diffusion coefficient that, remarkably, increases due to particle interactions.

PMID:38364150 | DOI:10.1103/PhysRevLett.132.057102

Phys Rev Lett. 2024 Feb 2;132(5):050203. doi: 10.1103/PhysRevLett.132.050203.

ABSTRACT

Distillation, or purification, is central to the practical use of quantum resources in noisy settings often encountered in quantum communication and computation. Conventionally, distillation requires using some restricted “free” operations to convert a noisy state into one that approximates a desired pure state. Here, we propose to relax this setting by only requiring the approximation of the measurement statistics of a target pure state, which allows for additional classical postprocessing of the measurement outcomes. We show that this extended scenario, which we call “virtual resource distillation,” provides considerable advantages over standard notions of distillation, allowing for the purification of noisy states from which no resources can be distilled conventionally. We show that general states can be virtually distilled with a cost (measurement overhead) that is inversely proportional to the amount of existing resource, and we develop methods to efficiently estimate such cost via convex and semidefinite programming, giving several computable bounds. We consider applications to coherence, entanglement, and magic distillation, and an explicit example in quantum teleportation (distributed quantum computing). This work opens a new avenue for investigating generalized ways to manipulate quantum resources.

PMID:38364147 | DOI:10.1103/PhysRevLett.132.050203