Tag: nevin manimala

J Clin Oncol. 2023 Aug 28:JCO2300617. doi: 10.1200/JCO.23.00617. Online ahead of print.

ABSTRACT

PURPOSE: The surrogacy of biochemical recurrence (BCR) for overall survival (OS) in localized prostate cancer remains controversial. Herein, we evaluate the surrogacy of BCR using different surrogacy analytic methods.

MATERIALS AND METHODS: Individual patient data from 11 trials evaluating radiotherapy dose escalation, androgen deprivation therapy (ADT) use, and ADT prolongation were obtained. Surrogate candidacy was assessed using the Prentice criteria (including landmark analyses) and the two-stage meta-analytic approach (estimating Kendall’s tau and the R²). Biochemical recurrence-free survival (BCRFS, time from random assignment to BCR or any death) and time to BCR (TTBCR, time from random assignment to BCR or cancer-specific deaths censoring for noncancer-related deaths) were assessed.

RESULTS: Overall, 10,741 patients were included. Dose escalation, addition of short-term ADT, and prolongation of ADT duration significantly improved BCR (hazard ratio [HR], 0.71 [95% CI, 0.63 to 0.79]; HR, 0.53 [95% CI, 0.48 to 0.59]; and HR, 0.54 [95% CI, 0.48 to 0.61], respectively). Adding short-term ADT (HR, 0.91 [95% CI, 0.84 to 0.99]) and prolonging ADT (HR, 0.86 [95% CI, 0.78 to 0.94]) significantly improved OS, whereas dose escalation did not (HR, 0.98 [95% CI, 0.87 to 1.11]). BCR at 48 months was associated with inferior OS in all three groups (HR, 2.46 [95% CI, 2.08 to 2.92]; HR, 1.51 [95% CI, 1.35 to 1.70]; and HR, 2.31 [95% CI, 2.04 to 2.61], respectively). However, after adjusting for BCR at 48 months, there was no significant treatment effect on OS (HR, 1.10 [95% CI, 0.96 to 1.27]; HR, 0.96 [95% CI, 0.87 to 1.06] and 1.00 [95% CI, 0.90 to 1.12], respectively). The patient-level correlation (Kendall’s tau) for BCRFS and OS ranged between 0.59 and 0.69, and that for TTBCR and OS ranged between 0.23 and 0.41. The R² values for trial-level correlation of the treatment effect on BCRFS and TTBCR with that on OS were 0.563 and 0.160, respectively.

CONCLUSION: BCRFS and TTBCR are prognostic but failed to satisfy all surrogacy criteria. Strength of correlation was greater when noncancer-related deaths were considered events.

PMID:37639648 | DOI:10.1200/JCO.23.00617

J Strength Cond Res. 2023 Aug 25. doi: 10.1519/JSC.0000000000004505. Online ahead of print.

ABSTRACT

Donahue, PT, Peel, SA, Rush, M, McInnis, AK, Littlefield, T, Calci, C, and Brutofsky, T. Examining countermovement jump strategies between women’s NCAA division I sports. J Strength Cond Res XX(X): 000-000, 2023-The purpose of this study was to examine countermovement vertical jump performance among female athletes who rely heavily on vertical jump performance within their given sport. Forty-five female athletes representing 3 teams (basketball, volleyball, and beach volleyball) competing at the NCAA Division I level completed 2 maximal effort countermovement jumps (CMJ) using a portable force platform. A 1-way analysis of variance was used to compare groups across each variable. Statistically significant differences were found between the groups regarding propulsive duration and time to takeoff with basketball showing the shortest time and beach volleyball having the longest times (p < 0.05). In addition, differences were seen in countermovement depth and mean propulsive force between the groups with basketball displaying the smallest countermovement and highest force (p < 0.05). No differences were seen in jump height and reactive strength index modified. Greater force and shorter durations in basketball athletes versus the low force and long durations in the beach volleyball athletes suggest that sporting backgrounds play a large role in how the CMJ is performed. This information can aid strength and conditioning practitioners in the design of training programs that are sport specific to the strategies used by the athlete.

PMID:37639644 | DOI:10.1519/JSC.0000000000004505

J Craniofac Surg. 2023 Aug 28. doi: 10.1097/SCS.0000000000009597. Online ahead of print.

ABSTRACT

Reconstructing facial deformities is often challenging due to the complex 3-dimensional (3D) anatomy of the craniomaxillofacial skeleton and overlying soft tissue structures. Bilateral injuries cannot benefit from mirroring techniques and as such preinjury information (eg, 2D pictures or 3D imaging) may be utilized to determine or estimate the desired 3D face shape. When patient-specific information is not available, other options such as statistical shape models may be employed; however, these models require registration to a consistent orientation which may be challenging. Artificial intelligence (AI) has been used to identify facial features and generate highly realistic simulated faces. As such, it was hypothesized that AI can be used to predict 3D face shape by learning its relationship with the underlying bone surface anatomy in a subject-specific manner. An automated image processing and AI modeling workflow using a modified 3D UNet was generated to estimate 3D face shape using the underlying bone geometry and additional metadata (eg, body mass index and age) obtained from 5 publicly available computed tomography imaging datasets. Visually, the trained models provided a reasonable prediction of the contour and geometry of the facial tissues. The pipeline achieved a validation dice=0.89 when trained on the combined 5 datasets, with the highest dice=0.925 achieved with the single HNSCC dataset. Estimated predefect facial geometry may ultimately be used to aid preoperative craniomaxillofacial surgical planning, providing geometries for intraoperative templates, guides, navigation, molds, and forming tools. Automated face shape prediction may additionally be useful in forensic studies to aid in the identification of unknown skull remains.

PMID:37639641 | DOI:10.1097/SCS.0000000000009597

J Am Med Inform Assoc. 2023 Aug 28:ocad170. doi: 10.1093/jamia/ocad170. Online ahead of print.

ABSTRACT

OBJECTIVES: Federated learning (FL) has gained popularity in clinical research in recent years to facilitate privacy-preserving collaboration. Structured data, one of the most prevalent forms of clinical data, has experienced significant growth in volume concurrently, notably with the widespread adoption of electronic health records in clinical practice. This review examines FL applications on structured medical data, identifies contemporary limitations, and discusses potential innovations.

MATERIALS AND METHODS: We searched 5 databases, SCOPUS, MEDLINE, Web of Science, Embase, and CINAHL, to identify articles that applied FL to structured medical data and reported results following the PRISMA guidelines. Each selected publication was evaluated from 3 primary perspectives, including data quality, modeling strategies, and FL frameworks.

RESULTS: Out of the 1193 papers screened, 34 met the inclusion criteria, with each article consisting of one or more studies that used FL to handle structured clinical/medical data. Of these, 24 utilized data acquired from electronic health records, with clinical predictions and association studies being the most common clinical research tasks that FL was applied to. Only one article exclusively explored the vertical FL setting, while the remaining 33 explored the horizontal FL setting, with only 14 discussing comparisons between single-site (local) and FL (global) analysis.

CONCLUSIONS: The existing FL applications on structured medical data lack sufficient evaluations of clinically meaningful benefits, particularly when compared to single-site analyses. Therefore, it is crucial for future FL applications to prioritize clinical motivations and develop designs and methodologies that can effectively support and aid clinical practice and research.

PMID:37639629 | DOI:10.1093/jamia/ocad170

Proc Natl Acad Sci U S A. 2023 Sep 5;120(36):e2221704120. doi: 10.1073/pnas.2221704120. Epub 2023 Aug 28.

ABSTRACT

While deep learning has enabled significant advances in many areas of science, its black-box nature hinders architecture design for future artificial intelligence applications and interpretation for high-stakes decision-makings. We addressed this issue by studying the fundamental question of how deep neural networks process data in the intermediate layers. Our finding is a simple and quantitative law that governs how deep neural networks separate data according to class membership throughout all layers for classification. This law shows that each layer improves data separation at a constant geometric rate, and its emergence is observed in a collection of network architectures and datasets during training. This law offers practical guidelines for designing architectures, improving model robustness and out-of-sample performance, as well as interpreting the predictions.

PMID:37639604 | DOI:10.1073/pnas.2221704120

Proc Natl Acad Sci U S A. 2023 Sep 5;120(36):e2303758120. doi: 10.1073/pnas.2303758120. Epub 2023 Aug 28.

ABSTRACT

In Arabidopsis thaliana, brassinosteroid (BR) signaling and stomatal development are connected through the SHAGGY/GSK3-like kinase BR INSENSITIVE2 (BIN2). BIN2 is a key negative regulator of BR signaling but it plays a dual role in stomatal development. BIN2 promotes or restricts stomatal asymmetric cell division (ACD) depending on its subcellular localization, which is regulated by the stomatal lineage-specific scaffold protein POLAR. BRs inactivate BIN2, but how they govern stomatal development remains unclear. Mapping the single-cell transcriptome of stomatal lineages after triggering BR signaling with either exogenous BRs or the specific BIN2 inhibitor, bikinin, revealed that the two modes of BR signaling activation generate spatiotemporally distinct transcriptional responses. We established that BIN2 is always sensitive to the inhibitor but, when in a complex with POLAR and its closest homolog POLAR-LIKE1, it becomes protected from BR-mediated inactivation. Subsequently, BR signaling in ACD precursors is attenuated, while it remains active in epidermal cells devoid of scaffolds and undergoing differentiation. Our study demonstrates how scaffold proteins contribute to cellular signal specificity of hormonal responses in plants.

PMID:37639582 | DOI:10.1073/pnas.2303758120

Ann Work Expo Health. 2023 Aug 28:wxad047. doi: 10.1093/annweh/wxad047. Online ahead of print.

ABSTRACT

OBJECTIVES: To estimate the composition and exposure to clinker and other specific components in personal thoracic dust samples of cement production workers.

METHODS: A procedure for the classification of airborne particles in cement production plants was developed based on classification trees. For this purpose, the chemical compositions of 27,217 particles in 29 material samples (clinker, limestone, gypsum, clay, quartz, bauxite, iron source, coal fly ash, and coal) were determined automatically by scanning electron microscopy (SEM) and energy-dispersive X-ray microanalysis (EDX). The concentrations of the major elements in cement (calcium, aluminium, silicon, iron, and sulphur) were used for the classifications. The split criteria of the classification trees obtained in the material samples were used to classify 44,176 particles in 34 personal thoracic aerosol samples. The contents of clinker and other materials were estimated, and the clinker contents were analysed statistically for differences between job types and job tasks.

RESULTS: Between 64% and 88% of the particles from material samples were classified as actual materials. The material types with variable composition (clay, coal fly ash, and coal) were classified with the lowest consistency (64% to 67%), while materials with a more limited compositional variation (clinker, gypsum, and quartz) were classified more consistently (76% to 85%). The arithmetic mean (AM) of the clinker content in personal samples was 62.1%, the median was 55.3%, and 95% confidence interval (CI) was 42.6% to 68.1%. No significant differences were observed between job types. However, the clinker content in samples when workers handled materials with high clinker content was significantly higher than when materials with lower clinker content were handled, 85% versus 65% (P = 0.02). The limestone content was AM 14.8%, median 13.2% (95% CI 5.5 to 20.9), whereas the other materials were present with relative abundances of median ≤ 6.4%.

DISCUSSION: Automated particle analysis by SEM-EDX followed by classification tree analysis quantified clinker with fairly high consistency when evaluated together with raw materials that are expected to be airborne in cement production plants. The clinker proportions for job types were similar. Tasks a priori ranked by assumed clinker content were significantly different and according to expectations, which supports the validity of the chosen methodology.

CONCLUSIONS: The composition of personal samples of mineral aerosols in the cement production industry could be estimated by automated single particle analysis with SEM-EDX and classification by a classification tree procedure. Clinker was the major component in the thoracic aerosol that cement production workers were exposed to. Differences between job types were relatively small and not significant. The clinker content from tasks was in agreement with assumptions.

PMID:37639571 | DOI:10.1093/annweh/wxad047

J Physician Assist Educ. 2023 Aug 28. doi: 10.1097/JPA.0000000000000522. Online ahead of print.

ABSTRACT

INTRODUCTION: This research highlights the prevalence of anxiety and/or depression among physician assistant (PA) students compared with the general population. It is believed that the results of this study will encourage graduate programs to place a stronger emphasis on the mental health of students and create a more positive learning environment.

METHODS: An original survey was created using questions from Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and several original questions. The survey was distributed using a SurveyMonkey link to directors of all accredited US PA programs. Program directors were asked to distribute the survey to their students. The survey remained open for 6 weeks, after which a cross-sectional statistical analysis was performed to compare the results with national anxiety and depression data in the United States.

RESULTS: There is a statistically significant increase in the rate of occurrence of anxiety and/or depression among PA students compared with the general population. According to survey results, 84.4% of respondents experienced feelings of anxiety and 80.9% experienced feelings of depression while enrolled in PA school. Physician assistant students found the greatest need for anxiety and depression treatment during the didactic portion of their program.

DISCUSSION: When compared with the national population, the level of anxiety in PA students was found to be 65.3% higher and the levels of depression in PA students to be 72.5% higher. These results should encourage PA programs and health care providers to take action regarding the mental health of future providers.

PMID:37639570 | DOI:10.1097/JPA.0000000000000522

Prosthet Orthot Int. 2023 Aug 25. doi: 10.1097/PXR.0000000000000268. Online ahead of print.

ABSTRACT

Research is essential to reflect patients’ satisfaction with their devices in the field of Prosthetics and Orthotics, record their performance and health-related quality of life. This requires culturally adapted questionnaires for each country. Periodic assessment of validity and test fit are essential elements for the long-term utility and effectiveness of psychometric tests. This article reviews the psychometric properties of the Orthotics and Prosthetics Users Survey (OPUS). The purpose, in addition to its adaptation to the Spanish-speaking population, involves a review/update of content, statistical analyses, and validity studies, until a larger number of studies are conducted. Study design: a Systematic review. A systematic literature search was carried out in specialized search engines: Alcorze (University of Zaragoza), MEDLINE (PubMed), and EMBASE of original articles published since 2000. Eleven items belonging to the OPUS were obtained, according to the language of the country where they were validated, and promising psychometric properties were confirmed (reflecting reliability values between 0.62 and 0.95; Cronbach’s α scores between 0.73 and 0.98) with sample sizes between 10 and 321. The study concluded by stating that the OPUS was validated in different languages, reporting good psychometric robustness so far. Further deployment, refinement, and validation of this survey by country is warranted in view of its promising use.

PMID:37639569 | DOI:10.1097/PXR.0000000000000268

Am J Clin Pathol. 2023 Aug 28:aqad105. doi: 10.1093/ajcp/aqad105. Online ahead of print.

ABSTRACT

OBJECTIVES: Intrapathology consultation is recommended for complex cases during frozen section (FS) as routine practice. In our institution, solicited second opinions were traditionally provided by in-person consultation (IPC). Whole-slide imaging (WSI) was implemented in 2018 as an alternative but replaced by videoconferencing in 2020. Here, we assess the accuracy of remote FS consultation using these digital modalities vs IPC.

METHODS: Gynecologic FS cases over a 4-year period overseen by 2 intraoperative consultants were grouped by consultation method: (1) IPC, (2) WSI, and (3) videoconferencing. Accuracy was determined by concordance between the FS and final report diagnoses. Turnaround time between the 3 groups was analyzed using SPSS statistical software (IBM).

RESULTS: Using WSI and videoconferencing, 100% concordance was observed, while the IPC group had a 98.5% concordance rate. Videoconferencing, however, showed longer turnaround times (mean, 45.59 minutes) than IPC (mean, 33.36 minutes). Although turnaround time positively correlated with the number of FS specimens, blocks, and H&E slides per case, no statistically significant differences in the number of specimens, blocks, and H&E slides generated were found among the consultation methods.

CONCLUSIONS: Even though turnaround time using videoconferencing is longer, the accuracy of WSI and videoconferencing for remote FS consultation is equivalent to IPC. It is therefore a safe method for conducting intrapathology FS consultation in challenging surgical cases.

PMID:37639561 | DOI:10.1093/ajcp/aqad105