Am J Epidemiol. 2022 Aug 25:kwac152. doi: 10.1093/aje/kwac152. Online ahead of print.
NO ABSTRACT
PMID:36004704 | DOI:10.1093/aje/kwac152
J Appl Clin Med Phys. 2022 Aug 25:e13752. doi: 10.1002/acm2.13752. Online ahead of print.
ABSTRACT
PURPOSE: We investigated the feasibility of thoracic spine stereotactic body radiotherapy (SBRT) using the Elekta Unity magnetic resonance-guided linear accelerator (MRL) in patients who received prior radiotherapy. We hypothesized that Monaco treatment plans can improve the gross tumor volume minimum dose (GTVmin) with spinal cord preservation and maintain consistent plan quality during daily adaptation.
METHODS: Pinnacle clinical plans for 10 patients who underwent thoracic spine SBRT (after prior radiotherapy) were regenerated in the Monaco treatment planning system for the Elekta Unity MRL using 9 and 13 intensity-modulated radiotherapy (IMRT) beams. Monaco adapt-to-position (ATP) and adapt-to-shape (ATS) workflow plans were generated using magnetic resonance imaging with a simulated daily positional setup deviation, and these adaptive plans were compared with Monaco reference plans. Plan quality measures included target coverage, Paddick conformity index, gradient index, homogeneity index, spinal cord D0.01cc , esophagus D0.01cc , lung V10, and skin D0.01cc .
RESULTS: GTVmin values from the Monaco 9-beam and 13-beam plans were significantly higher than those from Pinnacle plans (p < 0.01) with similar spinal cord dose. Spinal cord D0.01cc , esophagus D0.01cc , and lung V10 did not statistically differ among the three plans. The electron-return effect did not induce remarkable dose effects around the lungs or skin. While in the ATP workflow, a large increase in GTVmin was observed at the cost of a 10%-50% increase in spinal cord D0.01cc , in the ATS workflow, the spinal cord dose increase was maintained within 3% of the reference plan.
CONCLUSION: These findings show that MRL plans for thoracic spine SBRT are safe and feasible, allowing tumor dose escalation with spinal cord preservation and consistent daily plan adaptation using the ATS workflow. Careful plan review of hot spots and lung dose is necessary for safe MRL-based treatment.
PMID:36004700 | DOI:10.1002/acm2.13752
J Anat. 2022 Aug 25. doi: 10.1111/joa.13751. Online ahead of print.
ABSTRACT
Rib fractures are a common and serious outcome of blunt thoracic trauma and their likelihood is greater in older individuals. Osteoporotic bone loss is a well-documented aging phenomenon with sex-specific characteristics, but within rib bones, neither baseline maps of regional thickness nor the rates of bone thinning with age have been quantified across whole ribs. This study presents such data from 4014 ribs of 240 adult subjects aged 20-90. A validated cortical bone mapping technique was applied to clinical computed tomography scans to obtain local rib cortical bone thickness measurements over the surfaces of ribs 2 through 11. Regression models to age and sex gave rates of cortex thinning in local zones and aggregated across whole ribs. The statistical parametric mapping provided these relationships regionally as a function of rib surface location. All models showed significant reductions in bone thickness with age (p < 0.01). Average whole-rib thinning occurred at between 0.011 to 0.032 mm/decade (males) and 0.035 to 0.043 mm/decade (females), with sex and age accounting for up to 37% of population variability (R2 ). Rates of thinning differed regionally and by rib, with the highest bone loss of up to 0.074 mm/decade occurring in mid-rib cutaneous and superior regions of ribs 2-6. Rates were consistently higher in females than males (significantly so across whole ribs but not all local regions) and were more pronounced in cutaneous, superior, and inferior rib aspects (average 0.025 mm/decade difference in ribs 4-8) compared to pleural aspects which had the thickest cortices but saw only minor differences in thinning rates by sex (0.045 mm/decade for females and 0.040 mm/decade for males). Regional analysis showed male and female bone thickness differences that were not statistically significant at 20 years of age (p > 0.05 across practically all regions) but subsequent cortex thinning meant that substantial pleural and cutaneous regions were thinner (p < 0.05) in females than males by 55 years of age. The techniques and results from this study can be applied to assess rib bone content loss in clinical settings across wide populations. Additionally, average cortex thickness results can be mapped directly to finite element models of the thorax, and regression results are used to modify such models to represent the ribs of men and women across their full adult lifespan.
PMID:36004686 | DOI:10.1111/joa.13751
Am J Epidemiol. 2022 Aug 25:kwac154. doi: 10.1093/aje/kwac154. Online ahead of print.
ABSTRACT
The decades-long overdose epidemic in the US is driven by opioid misuse. Overdoses commonly, though not exclusively, occur in individuals with opioid use disorder (OUD). To allocate adequate resources and develop appropriately scaled public health responses, accurate estimation of the prevalence of OUD is needed. Indirect methods (e.g., multiplier method) of estimating prevalence of problematic substance use behavior circumvent some limitations of household surveys and use of administrative data. We used a multiplier method to estimate OUD prevalence among the adult Medicaid population (ages 18-64) in 19 Ohio counties that are highly affected by overdose. We used Medicaid claims data and National Vital Statistics System overdose death data, which were linked at the person level. A statistical model leveraged opioid-related death rate information from a group with known OUD to estimate prevalence among a group with unknown OUD status given recorded opioid-related deaths in that group. We estimated that 13.6% of the total study population had OUD in 2019. Males (16.7%) had a higher prevalence of OUD than females (11.4%) and persons aged 35-54 had the highest prevalence (16.7%). Our approach to prevalence estimation has important implications for OUD surveillance and treatment in the United States.
PMID:36004683 | DOI:10.1093/aje/kwac154
Biometrics. 2022 Aug 25. doi: 10.1111/biom.13742. Online ahead of print.
ABSTRACT
Modern neuroimaging technologies have substantially advanced the measurement of brain activity. Electroencephalogram (EEG) as a non-invasive neuroimaging technique measures changes in electrical voltage on the scalp induced by brain cortical activity. With its high temporal resolution, EEG has emerged as an increasingly useful tool to study brain connectivity. Challenges with modeling EEG signals of complex brain activity include interactions among unknown sources, low signal-to-noise ratio and substantial between-subject heterogeneity. In this work, we propose a state space model that jointly analyzes multi-channel EEG signals and learns dynamics of different sources corresponding to brain cortical activity. Our model borrows strength from spatially correlated measurements and uses low-dimensional latent states to explain all observed channels. The model can account for patient heterogeneity and quantify the effect of a subject’s covariates on the latent space. The EM algorithm, Kalman filtering, and bootstrap resampling are used to fit the state space model and provide comparisons between patient diagnostic groups. We apply the developed approach to a case-control study of alcoholism and reveal significant attenuation of brain activity in response to visual stimuli in alcoholic subjects compared to healthy controls. This article is protected by copyright. All rights reserved.
PMID:36004670 | DOI:10.1111/biom.13742
Br J Psychiatry. 2022 Aug 25:1-7. doi: 10.1192/bjp.2022.116. Online ahead of print.
ABSTRACT
BACKGROUND: Understanding how and under what circumstances a highly effective psychological intervention, improved symptoms of depression is important to maximise its clinical effectiveness.
AIMS: To address this complexity, we estimate the indirect effects of potentially important mediators to improve symptoms of depression (measured with the Patient Health Questionnaire (PHQ-9)) in the Healthy Activity Program trial.
METHOD: Interventional in(direct) effects were used to decompose the total effect of the intervention on PHQ-9 scores into the direct and indirect effects. The following indirect effects were considered: characteristics of sessions, represented by the number of sessions and homework completed; behavioural activation, according to an adapted version of the Behavioural Activation for Depression Scale – Short Form; and extra sessions offered to participants who did not respond to the intervention.
RESULTS: Of the total effect of the intervention measured through the difference in PHQ-9 scores between treatment arms (mean difference: -2.1, bias-corrected 95% CI -3.2 to -1.5), 34% was mediated through improved levels of behavioural activation (mean difference: -0.7, bias-corrected 95% CI -1.2 to -0.4). There was no evidence to support the mediating role of characteristics of the sessions nor the extra sessions offered to participants who did not respond to the treatment.
CONCLUSIONS: Findings from our robust mediation analyses confirmed the importance of targeting behavioural activation. Contrary to published literature, our findings suggest that neither the number of sessions nor proportion of homework completed improved outcomes. Moreover, in this context, alternative treatments other than extra sessions should be considered for patients who do not respond to the intervention.
PMID:36004665 | DOI:10.1192/bjp.2022.116
Phys Chem Chem Phys. 2022 Aug 25. doi: 10.1039/d2cp01998a. Online ahead of print.
ABSTRACT
We investigate the use of orbital-optimized references in conjunction with single-reference coupled-cluster theory with single and double substitutions (CCSD) for the study of core excitations and ionizations of 18 small organic molecules, without the use of response theory or equation-of-motion (EOM) formalisms. Three schemes are employed to successfully address the convergence difficulties associated with the coupled-cluster equations, and the spin contamination resulting from the use of a spin symmetry-broken reference, in the case of excitations. In order to gauge the inherent potential of the methods studied, an effort is made to provide reasonable basis set limit estimates for the transition energies. Overall, we find that the two best-performing schemes studied here for ΔCCSD are capable of predicting excitation and ionization energies with errors comparable to experimental accuracies. The proposed ΔCCSD schemes reduces statistical errors against experimental excitation energies by more than a factor of two when compared to the frozen-core core-valence separated (FC-CVS) EOM-CCSD approach – a successful variant of EOM-CCSD tailored towards core excitations.
PMID:36004629 | DOI:10.1039/d2cp01998a
Soc Work Public Health. 2022 Aug 25:1-9. doi: 10.1080/19371918.2022.2111389. Online ahead of print.
ABSTRACT
Holding educational campaigns with the purpose of conveying message about one particular behavior in the target group, is one of the society-based educational strategies. This study aimed to investigate the efficiency of the Campaign of COVID-19 Prevention on Health Volunteers in Urmia. The present study was a semi-experimental research, in which the sampling was done in a census way with 200 people participated. In this study, which was done as pre- and posttest, the amount of knowledge, attitude and behavior of health volunteers were evaluated by the designed questionnaires. The campaign was held for 2 months, which has benefited from the five methods of pamphlet, banners, films, social networking sites, and educational classes. After the campaign, the knowledge level, attitude and behavior of Health Volunteers increased to 35.1%, 30.09%, and 29.2%, respectively, which was meaningful statistically. Holding the campaign can trigger positive changes in improving the knowledge, attitude, and behavior of health volunteers, leading to the prevention of a plethora of health problems in society.
PMID:36004628 | DOI:10.1080/19371918.2022.2111389
Int J Qual Health Care. 2022 Aug 25:mzac067. doi: 10.1093/intqhc/mzac067. Online ahead of print.
ABSTRACT
BACKGROUND: The number of older adults with cancer is increasing. Radiotherapy is an important treatment modality in cancer, and may cause side effects and distress. Patient-reported experience measures aim to measure patients’ experience with health care. This can help health care services to improve in line with patients’ needs. To assess how Norwegian patients receiving radiotherapy experience their care, a valid and reliable tool is required. We selected the Person-centred coordinated care experience questionnaire as a tool. The aim of the study is to validate the Norwegian version of this questionnaire in a radiotherapy setting.
METHODS: A feasibility study of the Person-centred coordinated care experience questionnaire and a cross-sectional study – testing psychometric properties of the questionnaire in a Norwegian radiotherapy setting – were conducted. Participants were recruited from two different hospitals in Norway. Patient characteristics and item scores are described using descriptive statistics. We performed an exploratory factor analysis, and applied principal component analysis with a varimax rotation. Cronbach’s α was used to assess internal consistency.
RESULTS: 24 patients participated in the feasibility test, and 176 were included in the cross-sectional study where we explored the psychometric properties of the Person-centred coordinated care experience questionnaire. Three factors were identified. Internal consistency was established for the ten-item scale, with Cronbach’s α = 0.698.
CONCLUSION: Conclusions must consider the Norwegian setting and health care context. We found that the Norwegian version of the Person-centred coordinated care experience questionnaire is a relevant, valid, and reliable tool to provide insight into different areas of patients’ experiences upon receiving radiotherapy. However, further testing on a larger sample is necessitated.
PMID:36004618 | DOI:10.1093/intqhc/mzac067
Int Endod J. 2022 Aug 25. doi: 10.1111/iej.13819. Online ahead of print.
ABSTRACT
AIM: To evaluate the effect of systemic curcumin administration on the severity of apical periodontitis (AP).
METHODOLOGY: Forty male Wistar rats weighing 250-280g each, age 2.5 months, were distributed into four groups (n=10): control untreated rats (C), control rats treated with curcumin (CUR), rats with pulp exposure-induced apical periodontitis (AP), and rats with pulp exposure-induced apical periodontitis treated with curcumin (AP-CUR). Curcumin treatment was administered orally once daily for 15 days before pulp exposure and continued for 30 days after pulp exposure. The rats were sacrificed at 30 days, and the jaws were collected and reconstructed in a program specific for micro-CT. The jaws were processed for analysis of the inflammatory process using Haemotoxylin and Eosin staining and immunohistochemical assays for interleukin tumour necrosis factor alpha (TNF-α), interleukin (Il)-6, and Il-1β. Tartrate-resistant acid phosphatase (TRAP) and osteocalcin (OCN) staining were used to analyze the resorptive process on the bone surface of periapical area. Kruskal-Wallis with Dunn’s test was performed for nonparametric data, and ANOVA with Tukey’s test for parametric data, p < .05.
RESULTS: Micro-CT revealed no statistically significant differences in bone resorption between the AP and AP-CUR groups (p > .05). The levels of inflammatory cell infiltration and immunoreactivity for the proinflammatory cytokines TNF-α, Il-6, and Il-1β were significantly higher in the periapical lesions of the AP group than in the AP-CUR group (p < .05). The number of TRAP-positive multinucleated cells was higher in the AP group than in the AP-CUR group (p < .05). In OCN-positive cells, no differences were observed between the AP and AP-CUR groups (p > .05).
CONCLUSIONS: Oral supplementation with curcumin had a significant effect on the AP severity in rats, suggesting an anti-inflammatory effect of curcumin on AP development.
PMID:36004614 | DOI:10.1111/iej.13819