Tag: nevin manimala

J Radiat Res. 2023 Apr 7:rrad015. doi: 10.1093/jrr/rrad015. Online ahead of print.

ABSTRACT

Particle beam therapy (PT) is a potentially promising approach to the treatment of extrahepatic biliary cancer (EBC) because of its unique dose distribution using the Bragg peak. However, the superiority of PT to photon radiotherapy (XT) remains unclear. Therefore, we conducted a systematic review and meta-analysis to compare PT and XT for the treatment of EBC. The primary endpoint was overall survival (OS), which was pooled using a random-effects model. Nine articles comprising a total of 1558 patients (seven XT articles, n = 1488 patients; two PT articles, n = 70 patients) were screened. In addition, we compared the outcomes of XT and PT with the outcomes available from a prospective data registry (proton-net). The 1-year OS probability rates were 55, 65 and 72% for the XT group, PT group and PT registry, respectively. The 2-year OS probability rates were 26, 38 and 38% for the XT group, PT group and PT registry, respectively. The 3-year OS probability rates were 12, 35 and 18% for the XT group, PT group and PT registry, respectively. Although the difference between the 1-year OS rates of the XT group and PT registry was statistically significant, no other significant superiority was observed among these groups. In conclusion, the efficacy of PT was not superior to that of XT during this meta-analysis.

PMID:37036780 | DOI:10.1093/jrr/rrad015

JAMA Intern Med. 2023 Apr 10. doi: 10.1001/jamainternmed.2023.0512. Online ahead of print.

ABSTRACT

IMPORTANCE: Medicaid supplemental insurance covers most cost sharing in Medicare. Among low-income Medicare beneficiaries, the loss of Medicaid eligibility above this program’s income eligibility threshold (100% of federal poverty level [FPL]) may exacerbate racial and ethnic disparities in Medicare beneficiaries’ ability to afford care.

OBJECTIVE: To examine whether exceeding the income threshold for Medicaid, which results in an abrupt loss of Medicaid eligibility, is associated with greater racial and ethnic disparities in access to and use of care.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used a regression discontinuity design to assess differences in access to and use of care associated with exceeding the income threshold for Medicaid eligibility. We analyzed Medicare beneficiaries with incomes 0% to 200% of FPL from the 2008 to 2018 biennial waves of the Health and Retirement Study linked to Medicare administrative data. To identify racial and ethnic disparities associated with the loss of Medicaid eligibility, we compared discontinuities in outcomes among Black and Hispanic beneficiaries (n = 2885) and White beneficiaries (n = 5259). Analyses were conducted between January 1, 2022, and October 1, 2022.

MAIN OUTCOME MEASURES: Patient-reported difficulty accessing care due to cost and outpatient service use, medication fills, and hospitalizations measured from Medicare administrative data.

RESULTS: This cross-sectional study included 8144 participants (38 805 person-years), who when weighted represented 151 282 957 person-years in the community-dwelling population of Medicare beneficiaries aged 50 years and older and incomes less than 200% FPL. In the weighted sample, the mean (SD) age was 75.4 (9.4) years, 66.1% of beneficiaries were women, 14.8% were non-Hispanic Black, 13.6% were Hispanic, and 71.6% were White. Findings suggest that exceeding the Medicaid eligibility threshold was associated with a 43.8 percentage point (pp) (95% CI, 37.8-49.8) lower probability of Medicaid enrollment among Black and Hispanic Medicare beneficiaries and a 31.0 pp (95% CI, 25.4-36.6) lower probability of Medicaid enrollment among White beneficiaries. Among Black and Hispanic beneficiaries, exceeding the threshold was associated with increased cost-related barriers to care (discontinuity: 5.7 pp; 95% CI, 2.0-9.4), lower outpatient use (-6.3 services per person-year; 95% CI, -10.4 to -2.2), and fewer medication fills (-6.9 fills per person-year; 95% CI, -11.4 to -2.5), but it was not associated with a statistically significant discontinuity in hospitalizations. Discontinuities in these outcomes were smaller or nonsignificant among White beneficiaries. Consequently, exceeding the threshold was associated with widened disparities, including greater reductions in outpatient service use (disparity: -6.2 services per person-year; 95% CI, -11.7 to -0.6; P = .03) and medication fills (disparity: -7.2 fills per person-year; 95% CI, -13.4 to -1.0; P = .02) among Black and Hispanic vs White beneficiaries.

CONCLUSIONS AND RELEVANCE: This cross-sectional study found that loss of eligibility for Medicaid supplemental insurance above the federal poverty level, which increases cost sharing in Medicare, was associated with increased racial and ethnic health care disparities among low-income Medicare beneficiaries. Expanding eligibility for Medicaid supplemental insurance may narrow these disparities.

PMID:37036727 | DOI:10.1001/jamainternmed.2023.0512

J Exp Psychol Hum Percept Perform. 2023 Mar;49(3):306-326. doi: 10.1037/xhp0001097.

ABSTRACT

Although group members may be diverse and have their own reasons for actions, people tend to generalize the actions of known members to unknown cases from the observer’s perspective. Nevertheless, it is unclear whether action generalization is entirely determined by statistical evidence or is additionally constrained by prior knowledge or beliefs toward group members’ actions. Given that people specifically believe that group members pursue common action goals, we hypothesized that action generalization is constrained by this belief. Accordingly, the extent of generalizing a goal underlying action does not always increase as the prevalence of the goal increases; instead, a strict monotonicity effect is observed for the action’s movement. We found that the common goal is generalized to a new group member only when all sampled group members have this target property, revealing that the relation between the prevalence of goals and the strength of their generalization violates strict monotonicity (Studies 1a and 1b). In contrast, the more group members perform the same movement, the more likely this movement is to be generalized to an unknown group member, showing monotonic generalization of movements (Studies 3a, 3b, and 3c). Importantly, these dissociative generalizations are specific to entitative social groups (Studies 2, 4, and 6) and not due to differences in experimental tasks between studies. In shared experimental paradigms, when the goal status is available, the monotonic generalization of actions is not found; however, when the goal status is unavailable and the movement is still accessed, the monotonic generalization of actions is observed (Study 5). Thus, our findings highlight that the belief that group members pursue a common goal constrains action generalization to a greater extent than statistical evidence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37036672 | DOI:10.1037/xhp0001097

Anal Chem. 2023 Apr 10. doi: 10.1021/acs.analchem.2c05292. Online ahead of print.

ABSTRACT

Plasmonic nanoparticles are finding applications within the single molecule sensing field in a “dimer” format, where interaction of the target with hairpin DNA causes a decrease in the interparticle distance, leading to a localized surface plasmon resonance shift. While this shift may be detected using spectroscopy, achieving statistical relevance requires the measurement of thousands of nanoparticle dimers and the timescales required for spectroscopic analysis are incompatible with point-of-care devices. However, using dark-field imaging of the dimer structures, simultaneous digital analysis of the plasmonic resonance shift after target interaction of thousands of dimer structures may be achieved in minutes. The main challenge of this digital analysis on the single-molecule scale was the occurrence of false signals caused by non-specifically bound clusters of nanoparticles. This effect may be reduced by digitally separating dimers from other nanoconjugate types. Variation in image intensity was observed to have a discernible impact on the color analysis of the nanoconjugate constructs and thus the accuracy of the digital separation. Color spaces wherein intensity may be uncoupled from the color information (hue, saturation, and value (HSV) and luminance, a* vector, and b* vector (LAB) were contrasted to a color space which cannot uncouple intensity (RGB) to train a classifier algorithm. Each classifier algorithm was validated to determine which color space produced the most accurate digital separation of the nanoconjugate types. The LAB-based learning classifier demonstrated the highest accuracy for digitally separating nanoparticles. Using this classifier, nanoparticle conjugates were monitored for their plasmonic color shift after interaction with a synthetic RNA target, resulting in a platform with a highly accurate yes/no response with a true positive rate of 88% and a true negative rate of 100%. The sensor response of tested single stranded RNA (ssRNA) samples was well above control responses for target concentrations in the range of 10 aM-1 pM.

PMID:37036670 | DOI:10.1021/acs.analchem.2c05292

Biochem Genet. 2023 Apr 10. doi: 10.1007/s10528-023-10372-2. Online ahead of print.

ABSTRACT

Previous studies found that the circadian clock gene participated in the genesis and development of breast cancer. However, research findings on the relationship between polymorphisms in the CLOCK gene and breast cancer risk were inconsistent. This study performed a meta-analysis of the association between CLOCK gene polymorphisms and breast cancer risk. PubMed, Cochrane Library, and Embase databases were electronically searched to collect studies on the association between CLOCK gene polymorphisms and breast cancer risk from inception to February 14, 2022. The quality of the included literature was assessed using the Newcastle-Ottawa Scale. For statistical analysis, odds ratio (OR) and 95% confidence intervals (CIs) were calculated using STATA 14.0. In addition, publication bias was performed by the funnel diagram and the Harbord’s regression test. And sensitivity analysis was assessed by the trim and fill method. A total of 6 eligible studies, including 10,164 subjects (5488 breast cancer cases and 4676 controls), were screened in this meta-analysis. Though we did not find a significant association between the polymorphisms in the overall CLOCK gene with breast cancer risk [OR (95%CI) = 0.98 (0.96, 1.01), P = 0.148], we found that compared with T/T types of rs3749474 in CLOCK, T/C and C/C types of rs3749474 were associated with lower risk of breast cancer [OR (95%CI) = 0.93 (0.88, 0.98), P = 0.003]. The sensitivity analysis confirmed the robustness of the results. The funnel plot showed no significant publication bias. Polymorphisms in the CLOCK gene might be associated with breast cancer risk. More studies are needed to confirm the conclusion.

PMID:37036639 | DOI:10.1007/s10528-023-10372-2

Environ Monit Assess. 2023 Apr 10;195(5):551. doi: 10.1007/s10661-023-11030-1.

ABSTRACT

This study compiles commonly available groundwater chemistry data from the Pearl Harbor Sole Source Aquifer (SSA), Hawai’i-O’ahu’s primary drinking water source-and applies hierarchical clustering analysis (HCA), principal component analyses (PCA), piper diagrams, and box plots with geospatial analysis to better define groundwater regions and correlate groundwater chemistry in those regions with land use. Groundwater in this aquifer recharges and flows through chemically similar soil and rocks, such that anthropogenic activities are a primary influence on the chemical variability of the aquifer’s differing regions. Our analyses link specific chemical species in groundwater to land use/cover categories: urban, agriculture, and natural and anthropogenically-induced saline water intrusion. To create distinct statistical groupings with different groundwater chemistry compositions, it was important that the suite of parameters used in the statistical analysis do not covary. In our case, Cl^– covaried with several major ions; however, by including F^–, alkalinity, and SiO_x that do not covary with Cl^– in the covariance matrix, we produced improved spatial grouping of HCA clusters and stronger affinities to land use designations. Results show that dominant groundwater chemistry changes with land use along flow paths. These results pertain to areas where groundwater flows from conservation land in high recharge areas of O’ahu’s mountain ranges to urban and agricultural land use regions: groundwater retains its source characteristics until about 3-6 km into agricultural and urban zoned lands. Ultimately, this study outlines a simple method for water quality regulators to use groundwater chemistry to identify risks of target contaminants based on land use.

PMID:37036575 | DOI:10.1007/s10661-023-11030-1

Anim Cogn. 2023 Apr 10. doi: 10.1007/s10071-023-01769-y. Online ahead of print.

ABSTRACT

Few studies have considered how signal detection parameters evolve during acquisition periods. We addressed this gap by training mice with differential prior experience in a conditional discrimination, auditory signal detection task. Naïve mice, mice given separate experience with each of the later correct choice options (Correct Choice Response Transfer, CCRT), and mice experienced in conditional discriminations (Conditional Discrimination Transfer, CDT) were trained to detect the presence or absence of a tone in white noise. We analyzed data assuming a two-period model of acquisition: a pre-solution and solution period (Heinemann EG (1983) in The Presolution period and the detection of statistical associations. In: Quantitative analyses of behavior: discrimination processes, vol. 4, pp. 21-36). Ballinger. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.536.1978andrep=rep1andtype=pdf ). The pre-solution period was characterized by a selective sampling of biased response strategies until adoption of a conditional responding strategy in the solution period. Correspondingly, discriminability remained low until the solution period; criterion took excursions reflecting response-strategy sampling. Prior experience affected the length and composition of the pre-solution period. Whereas CCRT and CDT mice had shorter pre-solution periods than naïve mice, CDT and Naïve mice developed substantial criterion biases and acquired asymptotic discriminability faster than CCRT mice. To explain these data, we propose a learning model in which mice selectively sample and test different response-strategies and corresponding task structures until they exit the pre-solution period. Upon exit, mice adopt the conditional responding strategy and task structure, with action values updated via inference and generalization from the other task structures. Simulations of representative mouse data illustrate the viability of this model.

PMID:37036556 | DOI:10.1007/s10071-023-01769-y

Neuroinformatics. 2023 Apr 10. doi: 10.1007/s12021-023-09630-w. Online ahead of print.

ABSTRACT

In this paper we demonstrate a generalized and simplified pipeline called axonal spectrum imaging (AxSI) for in-vivo estimation of axonal characteristics in the human brain. Whole-brain estimation of the axon diameter, in-vivo and non-invasively, across all fiber systems will allow exploring uncharted aspects of brain structure and function relations with emphasis on connectivity and connectome analysis. While axon diameter mapping is important in and of itself, its correlation with conduction velocity will allow, for the first time, the explorations of information transfer mechanisms within the brain. We demonstrate various well-known aspects of axonal morphometry (e.g., the corpus callosum axon diameter variation) as well as other aspects that are less explored (e.g., axon diameter-based separation of the superior longitudinal fasciculus into segments). Moreover, we have created an MNI based mean axon diameter map over the entire brain for a large cohort of subjects providing the reference basis for future studies exploring relation between axon properties, its connectome representation, and other functional and behavioral aspects of the brain.

PMID:37036548 | DOI:10.1007/s12021-023-09630-w

Support Care Cancer. 2023 Apr 10;31(5):251. doi: 10.1007/s00520-023-07724-4.

ABSTRACT

OBJECTIVE: This study is to explore the effect of the Plan-Do-Check-Act (PDCA) cycle on the nutritional management of patients with nasopharyngeal carcinoma (NPC).

METHODS: A total of 100 NPC patients were randomly divided into a control group and a PDCA group, with 50 patients in each group. The control group adopted a routine nutritional management strategy, and the PDCA group adopted a PDCA cycle management strategy. The body weight, body mass index (BMI), hemoglobin, serum prealbumin, serum albumin, the Patient-Generated Subjective Global Assessment (PG-SGA) score, the Nutrition Risk Screening 2002 (NRS-2002) score, the incidence rate of nutritional risk, the grade of malnutrition, and the grade of oral mucositis were compared between the two groups.

RESULTS: The body weight, BMI, and serum prealbumin in the PDCA group were higher than those in the control group, and the difference was statistically significant (p < 0.05). The NRS2002 score and PG-SGA score in the PDCA group were lower than those in the control group, and the differences were statistically significant (p < 0.05). The incidence of nutritional risk, the grade of malnutrition, and the grade of oral mucositis were less in the PDCA group than those in the control group (p < 0.05). There was no significant difference in hemoglobin and serum albumin between the two groups (p > 0.05).

CONCLUSION: The PDCA cycle can improve body weight, BMI, and serum prealbumin in NPC patients. It can reduce the NRS2002 score, the PG-SGA score, the incidence of nutritional risk, the severity of malnutrition, and the severity of oral mucositis in NPC patients.

PMID:37036536 | DOI:10.1007/s00520-023-07724-4

J Bone Miner Metab. 2023 Apr 10. doi: 10.1007/s00774-023-01418-x. Online ahead of print.

ABSTRACT

INTRODUCTION: To analyze the association between α-tocopherol intake and cadmium (Cd) exposure and osteoporosis in population ≥ 50 years.

MATERIALS AND METHODS: Sociodemographic data, physical examination, and laboratory indicators including serum Cd level and dietary α-tocopherol intake of 8459 participants were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. The associations between α-tocopherol intake, serum Cd levels and osteoporosis were evaluated using univariate and multivariate logistic regression analyses, with the estimated value (β), odds ratios (ORs) and 95% confidence intervals (CIs). We further explored the impact of α-tocopherol intake on Cd exposure and the bone mineral density (BMD) in total femur and femur neck.

RESULTS: A total of 543 old adults suffered from osteoporosis. The serum Cd level (0.52 μg/L vs. 0.37 μg/L) and α-tocopherol intake (5.28 mg vs. 6.50 mg) were statistical different in osteoporosis group and non-osteoporosis group, respectively. High level of Cd exposure was related to the increased risk of osteoporosis [OR = 1.60, 95% CI (1.15-2.21)]. In the total femur, α-tocopherol intake may improve the loss of BMD that associated with Cd exposure [β = – 0.047, P = 0.037]. Moreover, high α-tocopherol intake combined with low Cd exposure [OR = 0.54, 95% CI (0.36-0.81)] was linked to the decreased risk of osteoporosis comparing with low α-tocopherol intake combined with high Cd exposure.

CONCLUSION: High α-tocopherol intake may improve the Cd-related osteoporosis and loss of BMD that could provide some dietary reference for prevention of osteoporosis in population ≥ 50 years old.

PMID:37036532 | DOI:10.1007/s00774-023-01418-x