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Nevin Manimala Statistics

Comparison of semi-automatic and manual segmentation methods for tumor delineation on head and neck squamous cell carcinoma (HNSCC) positron emission tomography (PET) images

Phys Med Biol. 2024 Mar 26. doi: 10.1088/1361-6560/ad37ea. Online ahead of print.

ABSTRACT

Accurate and reproducible tumor delineation on Positron Emission Tomography (PET) images is required to validate predictive and prognostic models based on PET radiomic features. Manual segmentation of tumors is time-consuming whereas semi-automatic methods are easily implementable and inexpensive. This study assessed the reliability of semi-automatic segmentation methods over manual segmentation for tumor delineation in Head and Neck Squamous Cell Carcinoma (HNSCC) PET images.

Approach: We employed manual and six semi-automatic segmentation methods (Just Enough Interaction (JEI), watershed, grow from seeds (GfS), flood filling (FF), 30% SUVmax and 40%SUVmax threshold) using 3D slicer software to extract 128 radiomic features from FDG-PET images of 100 HNSCC patients independently by three operators. We assessed the distributional properties of all features and considered 92 log-transformed features for subsequent analysis. For each paired comparison of a feature, we fitted a separate linear mixed effect model using the method (two levels; manual method versus one semi-automatic method) as a fixed effect and the subject and the operator as the random effects. We estimated different statistics ¬- the intraclass correlation coefficient agreement (aICC), limits of agreement (LoA), total deviation index (TDI), coverage probability (CP) and coefficient of individual agreement (CIA) – to evaluate the agreement between the manual and semi-automatic methods.

Main Results: Accounting for all statistics across 92 features, the JEI method consistently demonstrated acceptable agreement with the manual method, with median values of aICC = 0.86, TDI = 0.94, CP = 0.66, and CIA = 0.91.

Significance: This study demonstrated that the JEI method is a reliable semi-automatic method for tumor delineation on HNSCC PET images.&#xD.

PMID:38530298 | DOI:10.1088/1361-6560/ad37ea

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Nevin Manimala Statistics

Photobiomodulation for Blood Pressure and Heart Rate Reduction in Mastectomized Women on Hormone Blockers: A Randomized Controlled Trial

Photobiomodul Photomed Laser Surg. 2024 Mar 26. doi: 10.1089/photob.2023.0136. Online ahead of print.

ABSTRACT

Objective: To assess the impact of intravascular laser irradiation of blood (ILIB) on the primitive carotid artery (PCA) hemodynamic variables, specifically blood pressure (BP) and heart rate (HR), in mastectomized patients undergoing hormone blocker treatments. Materials and methods: This study is a controlled, experimental, and randomized clinical trial. Patients were allocated into two groups: the experimental group (G1)-patients who received ILIB therapy using a 660 nm laser targeted at the PCA, and the control group (G2)-patients who did not receive ILIB therapy. Clinical research was conducted weekly, with measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR. The Mann-Whitney U test for independent samples was used, with a significance level of α = 0.05. Results: Systemic photobiomodulation on the PCA did not demonstrate a statistically significant difference in relation to SBP and DBP. However, for HR, the p-value was <0.05, indicating a significant difference between G1 and G2. The initial mean p > decreased from 142.3 to 116.4 mmHg in G1, and from 130.4 to 119.8 mmHg in G2. The DBP varied from 78.8 to 72.8 mmHg in G1, and from 79.1 to 74.2 mmHg in G2. A statistically significant difference was observed in HR, decreasing from 81.3 to 62.06 bpm in G1, and changing minimally from 74.1 to 75.1 bpm in G2. A considerable reduction was present in the timing of application. Conclusions: ILIB therapy applied to the PCA induces a reduction in BP and, more notably, HR in mastectomized women using the tamoxifen or aromatase inhibitors.

PMID:38530295 | DOI:10.1089/photob.2023.0136

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Nevin Manimala Statistics

Shape of radiation dose response relationship for Ischaemic heart disease mortality and its interpretation: analysis of the National Registry for Radiation Workers (NRRW) cohort

J Radiol Prot. 2024 Mar 26. doi: 10.1088/1361-6498/ad37c7. Online ahead of print.

ABSTRACT

Statistically significant increases in ischemic heart disease (IHD) mortality with cumulative occupational external radiation dose were observed in the National Registry for Radiation Workers (NRRW) cohort. There were 174541 subjects in the NRRW cohort. The start of follow up was 1955, and the end of the follow-up for each worker was chosen as the earliest date of death or emigration, their 85th birthday or December 31, 2011. The dose-response relationship showed a downward curvature at a higher dose level > 0.4 Sv with the overall shape of the dose-response relationship best described by a linear-quadratic model. The smaller risk at dose > 0.4 Sv appears to be primarily associated with workers who started employment at a younger age (< 30 years old) and those who were employed for more than 30 years. We modelled the dose response by age-at-first exposure. For the age-at-first exposure of 30+ years old, a linear dose-response was the best fit. For age-at-first exposure <30 years old, there was no evidence of excess risk of ischemic heart disease mortality for radiation doses below 0.1 Sv or above 0.4 Sv, excess risk was only observed for doses between 0.1-0.4 Sv. For this age-at-first exposure group, it was also found that the doses they received when they were less than 35 years old or greater than 50 years old did not contribute to any increased IHD risk.

PMID:38530293 | DOI:10.1088/1361-6498/ad37c7

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Nevin Manimala Statistics

Group-based exercise training programs for military members presenting musculoskeletal disorders – A pragmatic randomized controlled trial

J Orthop Sports Phys Ther. 2024 Mar 26:1-28. doi: 10.2519/jospt.2024.12342. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effects of personalized supervised group-based programs (group physical therapy programs) to usual one-on-one physical therapy care (usual physical therapy care) on disability for military personnel suffering from low back pain, rotator cuff-related shoulder pain, patellofemoral pain syndrome or lateral ankle sprain. Secondary outcomes were pain severity, pain-related fear, health-related quality of life and patients’ satisfaction with their condition and care. DESIGN: Non-inferiority pragmatic randomized clinical trial. METHODS: One hundred and twenty military personnel from the Canadian Armed Forces, experiencing one of four targeted musculoskeletal disorders, were consecutively recruited, and randomly assigned to group physical therapy programs or usual physical therapy care. Disability, pain severity, pain-related fear, and health-related quality of life outcomes were measured at 6, 12, and 26 weeks after baseline. Satisfaction with treatment was evaluated at the end of the intervention. Intention-to-treat analyses using linear mixed models with random effects were used to compare the effects of interventions. Chi-squared tests were used to compare satisfaction. RESULTS: There were no significant Time x Group interactions for any of the primary and secondary outcomes (Time × Group p>.67). Satisfaction with treatment also did not differ between groups (p>.05). Statistically significant and clinically important improvements were observed in both groups for all outcomes after 12 weeks (Time effect: p<.01), except for health-related quality of life (p=.13). CONCLUSION: Group physical therapy programs were not inferior to usual physical therapy care for managing pain, functional capacity, and patients’ satisfaction with care of military personnel presenting with various musculoskeletal disorders. Both interventions led to clinical and statistical improvement in pain and function in the mid and long term. Group physical therapy could be an effective strategy to enhance access to care..

PMID:38530230 | DOI:10.2519/jospt.2024.12342

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Nevin Manimala Statistics

Safety and efficacy of myofascial release therapy in the treatment of patients with hemophilic ankle arthropathy. Single-blind randomized clinical trial

Physiother Theory Pract. 2024 Mar 26:1-10. doi: 10.1080/09593985.2024.2334752. Online ahead of print.

ABSTRACT

BACKGROUND: Hemophilia is characterized by degenerative joint damage. Patients with hemophilic arthropathy present joint damage, reduced range of motion, and decreased strength and functional capacity. Myofascial release therapy aims to decrease pain and improve tissue mobility and functionality.

OBJECTIVES: To evaluate the safety and efficacy of myofascial release therapy in patients with hemophilic ankle arthropathy.

METHOD: Single-blind randomized controlled trial. Fifty-eight adult patients with hemophilia were randomly allocated to the experimental group (myofascial release therapy with foam roller) or the control group (no intervention whatsoever). The daily home protocol of myofascial release therapy for the lower limbs using a foam roller lasted eight consecutive weeks. The primary variable was the safety of myofascial release therapy (weekly telephone follow-up). The secondary variables were pain intensity (visual analog scale), range of motion (goniometer), functional capacity (2-Minute Walk Test) and muscle strength (dynamometer), at baseline and at 8 and 10 weeks.

RESULTS: During the experimental phase, none of the patients in the experimental group developed ankle hemarthrosis. There were statistically significant changes in time*group interaction in ankle dorsal flexion (F[1.75] = 10.72; p < .001), functional capacity (F[1.16] = 5.24; p = .009) and gastrocnemius strength (F[2] = 26.01; p < .001). The effect size of the changes after the intervention was medium-large in pain intensity (d = -1.77), functional capacity (d = 1.34) and gastrocnemius strength (d = 0.76).

CONCLUSION: Myofascial release therapy is a safe form of physical therapy for patients with hemophilia. Myofascial release therapy can effectively complement prophylactic pharmacological treatment in patients with hemophilic arthropathy, improving range of motion in dorsal flexion, functional capacity and gastrocnemius strength.

PMID:38530214 | DOI:10.1080/09593985.2024.2334752

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Nevin Manimala Statistics

The effect of nurse-led remote telephone triage on symptom management of patients with cancer: A systematic review and meta-analysis

Worldviews Evid Based Nurs. 2024 Mar 26. doi: 10.1111/wvn.12721. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer patients experience many symptoms. Nurse-led remote telephone triage can improve their quality of life by contributing to the management of these symptoms.

AIMS: This study aimed to investigate the effects of nurse-led remote telephone triage on symptom management of patients with cancer.

METHODS: The searches were conducted in 10 databases and gray literature from May 2023 to July 2023 without any year limitations. A fixed-effects model was used in the meta-analysis. Cochran’s Q chi-squared test and I2 statistics were used for heterogeneity. The PRISMA checklist was used. Data obtained from the included studies were analyzed using CMA 3 software.

RESULTS: Six relevant studies (1671 patients) were included. Nurse-led remote telephone triage was found to have a positive and moderate effect on parameters such as pain (Hedge’s g = 0.21, p < .001), fatigue (Hedge’s g = 0.28, p < .001), and depression (Hedge’s g = 0.24, p < .001) in patients with cancer. Also, the remote telephone triage had a positive and low effect on outcomes such as anxiety (Hedge’s g = 0.17, p = .001), nausea (Hedge’s g = 0.17, p = .004), and vomiting (Hedge’s g = 0.16, p = .007) but did not affect diarrhea results.

LINKING EVIDENCE TO ACTION: This study showed that nurse-led remote telephone triage considerably improved the symptoms of patients with cancer. This study will increase oncology nurses’ awareness that nurse-led remote telephone triage of patients with cancer can improve their symptoms. Remote symptom triage developed using evidence-based guidelines and protocols can significantly contribute to the regular follow-up of patients’ symptoms, providing quality care, and establishing appropriate symptom management programs and systems with high levels of evidence.

PMID:38530162 | DOI:10.1111/wvn.12721

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Nevin Manimala Statistics

Patterns of primary and secondary defects associated with non-syndromic cleft lip and palate: An epidemiological analysis in a Kenyan population

Congenit Anom (Kyoto). 2024 Mar 26. doi: 10.1111/cga.12564. Online ahead of print.

ABSTRACT

Cleft lip and palate deformities substantially burden individuals and families, particularly in low-income communities. However, a comprehensive understanding of the patterns and distribution of these deformities in Kenya remains limited. This retrospective cross-sectional study analyzed 647 clinical records from the BelaRisu Foundation registry in Kenya, spanning 2018-2022. After meticulous record verification and data extraction, cleft pattern modeling was used to analyze each case. Data were imported to SPSS version 29.0 and descriptive statistics were calculated, which included means, ranges, frequencies, percentages, and standard deviations. Additionally, a comparative analysis between genders was conducted. The findings revealed a higher average age of presentation compared with previous studies in Kenya, along with a greater susceptibility of males to cleft lip and palate defects overall. Noteworthy disparities in case distribution across provinces were observed. Cleft lip emerged as the most observed primary defect, while palatal fistulae constituted the most frequent secondary defect. Interestingly, while some results aligned with global trends, others diverged significantly from the existing literature, warranting further exploration and investigation. These findings shed light on the unique patterns and distribution of cleft lip and palate deformities in Kenya, highlighting the need for targeted interventions and support systems.

PMID:38530146 | DOI:10.1111/cga.12564

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Nevin Manimala Statistics

Effects of short birth interval on child malnutrition in the Asia-Pacific region: Evidence from a systematic review and meta-analysis

Matern Child Nutr. 2024 Mar 26:e13643. doi: 10.1111/mcn.13643. Online ahead of print.

ABSTRACT

Child malnutrition remains a significant concern in the Asia-Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia-Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia-Pacific region between September 2000 and May 2023. Fixed-effects or random-effects meta-analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta-analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97-1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88-6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national-level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia-Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality.

PMID:38530129 | DOI:10.1111/mcn.13643

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Nevin Manimala Statistics

Interoceptive awareness mediated the effects of a 15-minute diaphragmatic breathing on empathy for pain: A randomized controlled trial

Psychophysiology. 2024 Mar 26:e14573. doi: 10.1111/psyp.14573. Online ahead of print.

ABSTRACT

Although empathy for pain plays an important role in positive interpersonal relationships and encourages engagement in prosocial behavior, it remains largely unknown whether empathy for pain could be effectively altered by psychophysiological techniques. This study aimed to investigate the impact of a single session of diaphragmatic breathing practice on empathy for pain and examine the potential mechanism involving interoceptive awareness. A total of 66 healthy participants were randomly assigned to the intervention group or the control group. The intervention group received a 15-minute diaphragmatic breathing (DB) practice with real-time biofeedback, while the control group was to gaze at a black screen at rest and not engaged in any other activities. Before and after the invention, all participants were instructed to evaluate the intensity and unpleasantness of empathy for pain while watching different pictures with pain or non-pain conditions. The Multidimensional Assessment of Interoceptive Awareness (MAIA) was then administered to measure interoceptive awareness. The results indicated a significant interaction between group and time with regard to empathy for pain and MAIA. The DB group showed a statistically significant decrease in both pain intensity and unpleasantness during the pain picture condition, as well as a noteworthy increase in MAIA scores. The control group did not demonstrate any substantial changes. More importantly, the regulation of attention, a dimension of MAIA, had a significant mediating effect on the impact of diaphragmatic breathing on reported unpleasantness. Diaphragmatic breathing could serve as a simple, convenient, and practical strategy to optimize human empathy for pain that warrants further investigation, which has important implications not only for individuals with impaired empathy for pain but also for the improvement of interoceptive awareness.

PMID:38530127 | DOI:10.1111/psyp.14573

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Nevin Manimala Statistics

Minimum acceptable diet and its predictors among children aged 6-23 months in Ethiopia. A multilevel cloglog regression analysis

Matern Child Nutr. 2024 Mar 26:e13647. doi: 10.1111/mcn.13647. Online ahead of print.

ABSTRACT

Despite significant progress made previously and the recognized health benefits of optimal feeding practices, ensuring a minimum acceptable diet in developing countries like Ethiopia remains a formidable challenge. Additionally, there is a scarcity of data in this area. Therefore, our study aims to identify predictors of a minimum acceptable diet using a powerful tool called complementary log-log regression analysis. Thus, it contributes to accelerating the pathway of ending child undernutrition thereby promoting optimal child health. A multilevel analysis was conducted among a weighted sample of 1427 children aged 6-23 months using the 2019 Ethiopian Demographic Health Survey (EDHS). The EDHS sample was stratified and selected in two stages. A minimum acceptable diet is defined as a composite of children fed with both minimum dietary diversity and minimum meal frequency. Data extraction took place between August 1 and 30, 2023. We used STATA software version 17 for data analysis. A complementary log-log regression model was fitted to identify significant predictors of the minimum acceptable diet. A p-value of ≤0.05 was used to declare statistically significant predictors. Only 10.44% (95CI: 8.90-12.15) of the children meet the minimum acceptable diet. Child aged (18-23 month) (AOR = 1.78, 95CI:1.14-2.78)], mother’s educational level (secondary and above education) (AOR = 279,95CI: 1.51-5.15), number of children three and above [(AOR = 0.78,95CI: 0.53-0.94], institutional delivery [AOR = 1.77,95CI: 1.11-3.11], having postnatal-check-up [AOR = 2.33,95CI: 1.59-3.41] and high community poverty level (AOR = 0.49,95CI: 0.29-0.85) were found to be predictors of minimum acceptable diet. In Ethiopia, only one in ten children achieve a minimum acceptable diet. Which is lower than the global report findings (16%). Enhancing maternal education programs and promoting family planning strategies to reduce household size are essential. Besides, encouraging institutional deliveries and postnatal check-ups are also recommended. It is necessary to implement targeted interventions for poverty reduction in communities to ensure that families can afford nutritious diets for their children.

PMID:38530126 | DOI:10.1111/mcn.13647