Nevin Manimala

Strahlenther Onkol. 2022 Jun 22. doi: 10.1007/s00066-022-01964-9. Online ahead of print.

ABSTRACT

BACKGROUND: The gamma index and dose-volume histogram (DVH)-based patient-specific quality assurance (QA) measures commonly applied in radiotherapy planning are unable to simultaneously deliver detailed locations and magnitudes of discrepancy between isodoses of planned and delivered dose distributions. By exploiting statistical classification performance measures such as sensitivity or specificity, compliance between a planned and delivered isodose may be evaluated locally, both for organs-at-risk (OAR) and the planning target volume (PTV), at any specified isodose level. Thus, a patient-specific QA tool may be developed to supplement those presently available in clinical radiotherapy.

MATERIALS AND METHODS: A method was developed to locally establish and report dose delivery errors in three-dimensional (3D) isodoses of planned (reference) and delivered (evaluated) dose distributions simultaneously as a function the dose level and of spatial location. At any given isodose level, the total volume of delivered dose containing the reference and the evaluated isodoses is locally decomposed into four subregions: true positive-subregions within both reference and evaluated isodoses, true negative-outside of both of these isodoses, false positive-inside the evaluated isodose but not the reference isodose, and false negatives-inside the reference isodose but not the evaluated isodose. Such subregions may be established over the whole volume of delivered dose. This decomposition allows the construction of a confusion matrix and calculation of various indices to quantify the discrepancies between the selected planned and delivered isodose distributions, over the complete range of values of dose delivered. The 3D projection and visualization of the spatial distribution of these discrepancies facilitates the application of the developed method in clinical practice.

RESULTS: Several clinical photon radiotherapy plans were analyzed using the developed method. In some plans at certain isodose levels, dose delivery errors were found at anatomically significant locations. These errors were not otherwise highlighted-neither by gamma analysis nor by DVH-based QA measures. A specially developed 3D projection tool to visualize the spatial distribution of such errors against anatomical features of the patient aids in the proposed analysis of therapy plans.

CONCLUSIONS: The proposed method is able to spatially locate delivery errors at selected isodose levels and may supplement the presently applied gamma analysis and DVH-based QA measures in patient-specific radiotherapy planning.

PMID:35732919 | DOI:10.1007/s00066-022-01964-9

Environ Sci Pollut Res Int. 2022 Jun 22. doi: 10.1007/s11356-022-21522-1. Online ahead of print.

ABSTRACT

Spatial distribution and pollution assessment of selected heavy metals such as barium (Ba), chromium (Cr), nickel (Ni), lead (Pb), vanadium (V), arsenic (As), zinc (Zn), and copper (Cu) in sediments of the Brahmaputra River watershed in Bangladesh was investigated. The mean abundances (ppm) of heavy metals in sediment samples were in decreasing order Ba (375.60) > V (67.60) > Cr (54.10) > Zn (48.20) > Ni (22.28) > Pb (20.25) > Cu (7.59) > As (4.21). Concentrations of Pb and As in the sediments are enriched relative to the average upper continental crust composition, while Ba, V, Cr, Zn, Ni, and Cu decrease considerably. A higher concentration of Pb and Ni indicates that Brahmaputra River watershed samples receive a significant contribution from anthropogenic sources of heavy metals. Chromium displays marked positive correlation with V (r = 0.91, p = < 0.01), inferring a similar source materials input into the watershed. The geo-accumulation index (I_geo) values suggest that the sediments were uncontaminated to moderately contaminated by Ni, Zn, Pb, V, and Cr, whereas moderate to heavily contaminated by As and Cu. The contamination factor (CF) confirmed that sediments in the watershed were moderate to highly contaminated by As, Cu, and Cr. The pollution load index (PLI) values for most of the samples were over one (> 1), indicating an advanced decline in the watershed sediment quality. The overall results of a multivariate statistical analysis suggest that Ba, V, Cr, and Zn contents were all-natural sources, and Pb, Ni, As, and Cu were derived from both natural and anthropogenic sources.

PMID:35732893 | DOI:10.1007/s11356-022-21522-1

Doc Ophthalmol. 2022 Jun 22. doi: 10.1007/s10633-022-09879-7. Online ahead of print.

ABSTRACT

PURPOSE: Hydroxychloroquine (HCQ) is an anti-inflammatory drug in widespread use for the treatment of systemic auto-immune diseases. Vision loss caused by retinal toxicity is a significant risk associated with long term HCQ therapy. Identifying patients at risk of developing retinal toxicity can help prevent vision loss and improve the quality of life for patients. This paper presents updated reference thresholds and examines the diagnostic accuracy of a machine learning approach for identifying retinal toxicity using the multifocal Electroretinogram (mfERG).

METHODS: A retrospective study of patients referred for mfERG testing to detect HCQ retinopathy. A consecutive series of all patients referred to Kensington Vision and Research Centre between August 2017 and July 2020 were considered eligible. Eyes suspect for other ocular pathology including widespread retinal disease and advanced macular pathology unrelated to HCQ or with poor quality mfERG recordings were excluded. All patients received mfERG testing and Ocular Coherence Tomography (OCT) imaging. Presence of HCQ retinopathy was based on ring ratio analysis using clinical reference thresholds established at KVRC coupled with structural features observed on OCT, the clinical reference standard. A Support Vector Machine (SVM) using selected features of the mfERG was trained. Accuracy, sensitivity and specificity are reported.

RESULTS: 1463 eyes of 748 patients were included in the study. SVM model performance was assessed on 293 eyes from 265 patients. 55 eyes from 54 patients were identified as demonstrating HCQ retinopathy based on the clinical reference standard, 50 eyes from 49 patients were identified by the SVM. Our SVM achieves an accuracy of 85.3% with a sensitivity of 90.9% and specificity of 84.0%.

CONCLUSIONS: Machine learning approaches can be applied to mfERG analysis to identify patients at risk of retinopathy caused by HCQ therapy.

PMID:35732856 | DOI:10.1007/s10633-022-09879-7

Drug Test Anal. 2022 Jun 22. doi: 10.1002/dta.3329. Online ahead of print.

ABSTRACT

The determinants of success in Olympic Games competition are specific to the athletic demands of the sporting event. A global evaluation to quantify the athletic demands across the spectrum of the Olympic Games sport events has not previously been conducted. Thus far, the interpretation and the comparison of sport physiological characteristics within anti-doping organisations (ADOs) risk assessments remains subjective without a standardised framework. Despite its subjective assessment, this information is a key component of any anti-doping programme. Sport characteristics inevitably influence the type of substances and/or methods used for doping purpose and should be captured through a comprehensive analysis. Seven applied sport scientists independently conducted an assessment to quantify the athletic demands across six preselected athletic variables. A Principal Component Analysis was performed on the results of the panel’s quantitative assessment for 160 Olympic Sport events. Sport events were clustered using the Hierarchical Density Based Spatial Clustering of Applications with Noise (HDBSCAN) algorithm. The HDBSCAN identified 19 independent cluster groups, 36 sport events remained statistically unassigned to a cluster group representing unique and eventspecific athletic demands. This investigation provides guidance to the anti-doping community to assist in the development of the sport specific physiology component of the risk assessment for Olympic Games disciplines. The dominant athletic characteristics to excel in each of these individual events will highlight areas of how athletes may strive to gain a competitive advantage through doping strategies, and inform the development of an effective and proportionate allocation of testing resources.

PMID:35732071 | DOI:10.1002/dta.3329

Adv Mind Body Med. 2022 Spring;36(2):8-13.

ABSTRACT

CONTEXT: Higher Brain Living (HBL) is a light-touch therapy, which practitioners claim can increase well-being. Although studies have suggested that its component elements-light touch, focused breathing, and positive self-talk-can increase well-being for specific populations in specific contexts, no empirical research has occurred on HBL’s efficacy.

OBJECTIVE: The study intended to measure the effects of HBL therapy on the well-being of individuals who have received it.

DESIGN: The research team designed a quasi-experimental controlled trial that used a survey to gather self-reported data related to well-being.

SETTING: The study took place in individual HBL practitioners’ locations throughout the USA.

PARTICIPANTS: Participants were adults who had attended an introductory presentation about HBL.

INTERVENTION: Participants were assigned to one of three groups: (1) the intervention group, who had responded to the baseline and postintervention surveys and had participated in HBL sessions (n = 14); (2) the control group, who had responded to the baseline and postintervention surveys and had not participated in HBL sessions (n = 9); and (3) the noncompleter group who had responded to the baseline surveys and had not completed the postintervention survey (n = 54).

OUTCOME MEASURES: Well-being was assessed using five measures that evaluated constructs associated with well-being: (1) happiness using the Subjective Happiness Scale (SHS), (2) anxiety using the Anxiety Index (AI), (3) depression using Depression Index (DI) (4) mastery using the Pearlin Mastery Scale (PM), and (5) flourishing using the Flourishing Scale (FS).

RESULTS: The study included baseline data from 77 respondents; 23 participants completed the surveys at baseline and postintervention, 14 in the intervention group and 9 in the control group. A statistically significant, greater improvement occurred for the intervention group in the measures for flourishing, mastery, and happiness compared to the control group.

CONCLUSIONS: The current study provides a foundation of empirical evidence suggesting the effectiveness of HBL as a potential treatment for improving well-being, upon which further investigation can be based.

PMID:35732064

J Occup Environ Med. 2022 Jun 16. doi: 10.1097/JOM.0000000000002550. Online ahead of print.

ABSTRACT

Investigate the associations between drug abuse and the preva- lence of the engagement and burnout dichotomy in law professionals. Methods: Eligible participants completed a questionnaire where odds ratios of drug abuse and other confounding variables and their association to engagement or burnout were calculated using multiple logistic regression. Results: When looking at all law professionals, burnout is a statistically significant predictor for drug abuse (P ¼ 0.04, not shown). Law professionals whose burnout scores fell in the highest bin have 4.71 (95% CI [1.38 – 16.08]) times higher odds of having a problem with drug abuse than those whose burnout scores fell in the second bin. Conclusion: Study findings showed a possible way to affect the prevalence of drug abuse in law professionals by affecting the engagement and burnout dichotomy.

PMID:35732047 | DOI:10.1097/JOM.0000000000002550

J Occup Environ Med. 2022 Jun 16. doi: 10.1097/JOM.0000000000002567. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the relationship between daily activities (paid work, childcare, caregiving, voluntary work, sports and social contact), occupational balance, and depressive symptoms during the COVID-19 pandemic.

METHODS: We analyzed data from the Austrian Corona Panel Project (four timepoints, 6-month period) using regression models with logarithmically transformed data and non-parametric repeated-measures tests (N = 871).

RESULTS: Results showed higher depressive symptoms among women. Family caregivers (either parents or those caring for other relatives) were at highest risk for occupational imbalance and depressive symptoms. Sports and social contact were initially associated with better outcomes, but the effects waned. There was a main effect for time point driven by the last wave (amidst the second lockdown) but no significant interaction effects between predictors and time point were found.

CONCLUSION: The results provide a nuanced depiction of the relationship between different daily activities and health-related outcomes during the pandemic, highlighting groups at risk.

PMID:35732038 | DOI:10.1097/JOM.0000000000002567

Acta Otolaryngol. 2022 Jun 22:1-4. doi: 10.1080/00016489.2022.2087235. Online ahead of print.

ABSTRACT

BACKGROUND: Presbycusis is bilateral sensorineural hearing loss associated with the progressive degeneration of cochlear and central auditory pathways with aging.

AIMS/OBJECTIVES: We aimed to reveal age-related changes in middle ear function by using wideband tympanometry (WBT).

MATERIALS AND METHODS: Fifty-eight patients diagnosed with presbycusis were compared to 52 audiologically healthy participants. WBT measurement was performed on both ears via wideband click stimulus with a tympanometer device using probe tone frequencies of 226-8000 Hz.

RESULTS: There were no statistically significant differences detected among the resonance frequencies or maximum absorbance ratios measured in both ears between groups (p > .05). The mean absorbance of the right and left ears at 4000 and 8000 Hz was statistically higher in the patient group than in the healthy controls (r = 0.038, 0.030; l = 0.015, 0.012). Moreover, mean compliance values were found to be significantly lower in the patient group than in the control group (r = 0.030 and l = 0.040).

CONCLUSION: The significant differences detected in compliance and absorbance values for high frequencies in presbycusis patients were remarkable. Thus, it has been shown that WBT yields an advantage compared to traditional tympanometry in the diagnosis and treatment of middle ear diseases.

PMID:35732016 | DOI:10.1080/00016489.2022.2087235

Biometrics. 2022 Jun 22. doi: 10.1111/biom.13709. Online ahead of print.

ABSTRACT

Measuring the treatment effect on recurrent events like hospitalization in the presence of death has long challenged statisticians and clinicians alike. Traditional inference on the cumulative frequency unjustly penalizes survivorship as longer survivors also tend to experience more adverse events. Expanding a recently suggested idea of “while-alive” event rate, we consider a general class of such estimands that adjust for the length of survival without losing causal interpretation. Given a user-specified loss function that allows for arbitrary weighting, we define as estimand the average loss experienced per unit time alive within a target period and use the ratio of this loss rate to measure the effect size. Scaling the loss rate by the width of the corresponding time window gives us an alternative, and sometimes more photogenic, way of showing the data. To make inference, we construct a nonparametric estimator for the loss rate through the cumulative loss and the restricted mean survival time, and derive its influence function in closed form for variance estimation and testing. As simulations and analysis of real data from a heart failure trial both show, the while-alive approach corrects for the false attenuation of treatment effect due to patients living longer under treatment, with increased statistical power as a result. The proposed methods are implemented in the R-package WA, publicly available from the Comprehensive R Archive Network (CRAN).

PMID:35731993 | DOI:10.1111/biom.13709

Eval Health Prof. 2022 Jun 22:1632787221109968. doi: 10.1177/01632787221109968. Online ahead of print.

ABSTRACT

Nurses’ professional values are closely associated with their ethical sensitivity and the quality of nursing care. The aim of this study was to determine surgical nurses’ perceptions of their professional values, ethical sensitivities and quality of care, the relationship between these variables, and the factors influencing these. The sample of this cross-sectional, descriptive and relational study consisted of 231 nurses working in the surgical units of two university hospitals and a training and research hospital. The study revealed a statistically significant negative relationship between the nurses’ professional values scale median score and the Moral Sensitivity Questionnaire median score, and a positive significant relationship between the Nurses’ Professional Values Scale median score and the Care Behaviors Scale median score. Having ethical problems in their professional lives increased the ethical sensitivity of nurses, while having a medical-vocational high school and vocational school of health services degree and participation in training/meetings about professional values and ethics increased the perception of the quality of nursing care. Awareness of professional values is crucial in providing quality nursing care that is in line with ethical principles; therefore, it is recommended that the continuity of surgical nurses’ participation in training/meetings on professional values and ethics be ensured, that they be supported to become members of professional associations, and that supportive working environments be provided to improve the quality of nursing care.

PMID:35731992 | DOI:10.1177/01632787221109968