Tag: nevin manimala

Med Phys. 2023 Mar 24. doi: 10.1002/mp.16383. Online ahead of print.

ABSTRACT

BACKGROUND: Stereotactic radiotherapy (SRT) has been widely used for the treatment of brain metastases and early stage non-small-cell lung cancer (NSCLC). Excellent SRT plans are characterized by steep dose fall-off, making it critical to accurately and comprehensively predict and evaluate dose fall-off.

PURPOSE: A novel dose fall-off index was proposed to ensure high-quality SRT planning.

METHODS: The novel gradient index (NGI) had two different modes: NGIx V for three-dimensions and NGIx r for one-dimension. NGIx V and NGIx r were defined as the ratios of the decreased percentage dose (x%) to the corresponding isodose volume and equivalent sphere radii, respectively. A total of 243 SRT plans at our institution between April 2020 and March 2022 were enrolled, including 126 brain and 117 lung SRT plans. Measurement-based verifications were performed using SRS MapCHECK. Ten plan complexity indexes were calculated. Dosimetric parameters related to radiation injuries were also extracted, including the normal brain volume exposed to 12 Gy (V₁₂ ) and 18 Gy (V₁₈ ) during single-fraction SRT (SF-SRT) and multi-fraction SRT (MF-SRT), respectively and the normal lung volume exposed to 12 Gy (V₁₂ ). The performance of NGI and other common dose fall-off indexes, gradient index (GI), R_50% and D_2cm were evaluated using Spearman correlation analysis to explore their correlations with the PTV size, gamma passing rate (GPR), plan complexity indexes and dosimetric parameters.

RESULTS: There were statistically significant correlations between NGI and PTV size (r = -0.98, p < 0.01 for NGI50 V and r = -0.93, p < 0.01 for NGI50 r), which were the strongest correlations compared with GI (r = 0.11, p = 0.13), R_50% (r = -0.08, p = 0.19) and D_2cm (r = 0.84, p < 0.01). The fitted formulas of NGI50 V = 23.86V^-1.00 and NGI50 r = 113.5r^-1.05 were established. The GPRs of enrolled SRT plans were 98.6 ± 1.7%, 94.2 ± 4.7% and 97.1 ± 3.1% using the criteria of 3%/2 mm, 3%/1 mm and 2%/2 mm, respectively. NGI50 V achieved the strongest correlations with various plan complexity indexes (|r| ranged from 0.67 to 0.91, p < 0.01). NGI50 V also showed the highest r values with V₁₂ (r = -0.93, p < 0.01) and V₁₈ (r = -0.96, p < 0.01) of the normal brain during SF-SRT and MF-SRT, respectively and V₁₂ (r = -0.86, p < 0.01) of the normal lung during lung SRT.

CONCLUSIONS: Compared with GI, R_50% and D_2cm , the proposed dose fall-off index, NGI, had the strongest correlations with the PTV size, plan complexity and V₁₂ /V₁₈ of the normal tissues. These correlations established on NGI are more helpful and reliable for SRT planning, quality control and reducing the risk of radiation injuries. This article is protected by copyright. All rights reserved.

PMID:36960718 | DOI:10.1002/mp.16383

J Endourol. 2023 Mar 24. doi: 10.1089/end.2022.0654. Online ahead of print.

ABSTRACT

Introduction Chronic urinary retention (CUR) is a major problem in elderly patients and leads to high levels of morbidity. CUR can be treated surgically with trans-urethral resection of the prostate (TURP), but surgery is frequently avoided in elderly patients due to increased peri-operative risks and the presence of detrusor activity (DU), which can lead to surgical failure. We report on contemporary outcomes for catheterised elderly patients undergoing TURP from a high-volume university teaching hospital. Patients and Methods Catheterised patients aged 80 years and older undergoing TURP for CUR at a university teaching hospital between 2012 and 2020 (9 years) were eligible. Those with neurogenic bladder, urethral stricture or prior TURP were excluded. Surgical success was defined as being catheter free at 3 month and 12-month follow up. Statistical analysis was performed using the Chi-squared test for grouped data and logistic regression modelling for continuous data. Results 147 patients were included and underwent TURP. Of these, 118 (80.3%) were completely catheter free or using intermittent self-catheterisation (ISC) at initial 3-month follow-up. 117 (79.6%) remained catheter-free at one year follow-up. PVR>1500ml prior to TURP (p=0.017); age ≥90 (p=0.0067); and WHO performance status ≥3 (p< 0.00001) were all identified as independent risk factors for surgical failure. A selected sub-set of patients excluding these risk factors showed overall catheter free rates of 88.8% at 3-month follow-up. Early and late complications were noted in 6.8% and 2.7% of patients. Conclusion Our contemporary series demonstrates high rates of successful post-operative voiding for selected elderly patients after TURP, with catheter free rates at 12 months of 88.8%. Overall complication rate was 9.5%, which may be justified given the alternative morbidity of long-term catheterisation. TURP remains an efficacious and cost-effective treatment for selected elderly patients who are catheterised for CUR.

PMID:36960708 | DOI:10.1089/end.2022.0654

Phys Chem Chem Phys. 2023 Mar 24. doi: 10.1039/d2cp05874j. Online ahead of print.

ABSTRACT

Formic acid (HCOOH) is one of the highly abundant acids in the troposphere. It is important in the formation of atmospheric aerosols and impacts the acidity of rainwater. In the present scenario, the model chemistry of HCOOH(FA) sources and sinks is poorly understood. In this work, we apply quantum chemical methods coupled with advanced statistical rate theories to understand the production of FA and its catalytic behavior under tropospheric conditions. The potential energy surfaces (PES) for O₂ + OH˙CHOH and O₂ + OH˙CHOH(+FA) reactions were constructed using the CCSD(T)/6-311++G(3df,3pd)//M06-2X/6-311++G(3df,3pd) level and rate constants for the production of FA were predicted using Rice-Ramsperger-Kassel-Marcus (RRKM)/master equation (ME) simulation with Eckart tunnelling and canonical variational transition state theory (CVT) with small curvature tunnelling (SCT) between the temperature range of 200-320 K and pressure range of 0.001 to 10 bar. The reaction follows the formation of cis and trans intermediates followed by spontaneous decomposition via concerted HO₂ elimination to form stable post intermediates, which then leads to the straight formation of cis and trans formic acid. The current study also helps understand the role of cis and trans contribution to the total rate constants. The results show that O₂ + OH˙CHOH is dominated by both cis and trans isomers; however, the trans isomer plays a more important role in the catalytic reaction. This result is due to the formation of a strong hydrogen-bonded complex in the trans isomer, which is dominated by the enthalpy factor rather than the entropy factor. The results predict that the catalytic effect of FA on the O₂ + OH˙CHOH reaction is important when the concentration of FA is not included in the calculations; however, it has no effect under tropospheric conditions, when the FA concentration is included in the calculation. As a result, the total effective reaction rate constants are smaller. This work provides experimental/theoretical confirmation of Franco et al. who predicted that methanediol is the precursor for the FA formation, resolving an open problem in the kinetics of the gas phase reaction. O₂ + OH˙CHOH and O₂ + OH˙CHOH(+FA) probably explain other diol systems, which can help explain the formation of other atmospheric acids that affect aerosol formation and cloud evolution.

PMID:36960665 | DOI:10.1039/d2cp05874j

Diagn Interv Radiol. 2023 Jan 31;29(1):190-194. doi: 10.5152/dir.2022.21999. Epub 2022 Nov 29.

ABSTRACT

PURPOSE: This study aimed to evaluate the jaw pathologies of patients with bone metastases using a computer program to assess the bone scan index (BSI) for Tc-99m hydroxymethylene diphosphonate (HMDP) with single-photon emission computed tomography/computed tomography (SPECT/CT).

METHODS: Ninety-seven patients with jaw pathologies (24 with bone metastases and 73 without) were evaluated. High-risk hot spots and BSI in the patients were evaluated using the VSBONE BSI (ver.1.1) analysis software for Tc-99m HMDP that scanned SPECT/CT and automatically defined the data. The two groups were compared using the Pearson chi-square test and Mann-Whitney U test for high-risk hot spots and BSI, respectively. A P value of <0.05 was considered statistically significant.

RESULTS: High-risk hot spot occurrence was significantly correlated to bone metastases [sensitivity, 21/24 (87.5%); specificity, 40/73 (54.8%); accuracy, 61/97 (62.9%); P < 0.001]. The number of high-risk hot spots was higher in patients with bone metastases (5.96 ± 10.30) than in those without (0.90 ± 1.50; P < 0.001). Furthermore, the BSI for patients with bone metastases (1.44 ± 2.18%) was significantly higher than for those without (0.22 ± 0.44%; P < 0.001).

CONCLUSION: A computer program that assessed BSI for Tc-99m HMDP may be useful in the evaluation of patients with bone metastases using SPECT/CT.

PMID:36960615 | DOI:10.5152/dir.2022.21999

Palliat Support Care. 2023 Mar 24:1-9. doi: 10.1017/S1478951523000251. Online ahead of print.

ABSTRACT

OBJECTIVES: Our research aims to compare the perception that children in the pediatric palliative care setting have of their emotional well-being, or that expressed by the parents, with the perception held by the professionals involved in their care.

METHODS: In this cross-sectional study, the emotional well-being of 30 children with a mean age of 10.8 years (standard deviation [SD] = 6.1) is evaluated. Children, or parents where necessary, evaluate their situation with a question about emotional well-being on a 0-10 visual analog scale. For each child, a health professional also rates the child’s emotional status using the same scale.

RESULTS: The average child’s emotional well-being score provided by children or parents was 7.1 (SD = 1.6), while the average score given by health professionals was 5.6 (SD = 1.2). Children or parents graded the children’s emotional well-being significantly higher than professionals (t-test = 4.6, p-value < .001). Health professionals rated the children’s emotional well-being significantly lower when the disease status was progressive than when the disease was not (t-test = 2.2, p-value = .037).

SIGNIFICANCE OF RESULTS: Children themselves, or their parents, report more positive evaluations of emotional well-being than health professionals. Sociodemographic and disease variables do not seem to have a direct influence on this perception, rather it is more likely that children, parents, and professionals focus on different aspects and that children or parents need to hold on to a more optimistic vision. We must emphasize that when this difference is more pronounced, it can be a warning sign that further analysis is required of the situation.

PMID:36960600 | DOI:10.1017/S1478951523000251

Fundam Clin Pharmacol. 2023 Mar 24. doi: 10.1111/fcp.12896. Online ahead of print.

ABSTRACT

Bladder cancer (BC) is known as a prevalent genitourinary malignancy and has a significant mortality rate worldwide. Despite recent therapeutic approaches, the recurrence rate is high, highlighting the need for a new strategy to reduce the BC cell progression. Quercetin, a flavonoid compound, demonstrated promising anti-cancer properties and could be used in the management of various malignancies such as BC. This comprehensive review summarized quercetin’s cellular and molecular mechanisms underlying anti-cancer activities. The study’s findings indicated that quercetin prevents the proliferation of the human BC cell line, promotes apoptosis of BIU-87 cells, reduces the expression of p-P70S6K, and induces apoptosis by p-AMPK. Moreover, quercetin restricts tumor growth through the AMPK/mTOR cascade and prevents colony formation of human BC cells by triggering DNA damage. Studying this review article will help researchers better understand quercetin’s functional role in the prevention and treatment of BC.

PMID:36960597 | DOI:10.1111/fcp.12896

Syst Biol. 2023 Mar 24:syad014. doi: 10.1093/sysbio/syad014. Online ahead of print.

ABSTRACT

A fundamental aspect of symbiotic relationships is host specificity, ranging from extreme specialists associated with only a single host species to generalists associated with many different species. Although symbionts with limited dispersal capabilities are expected to be host specialists, some are able to associate with multiple hosts. Understanding the micro- and macroevolutionary causes of variations in host specificity is often hindered by sampling biases and the limited power of traditional evolutionary markers. Here, we studied feather mites to address the barriers associated with estimates of host specificity for dispersal-limited symbionts. We sampled feather mites (Proctophyllodidae) from a nearly comprehensive set of North American breeding warblers (Parulidae) to study mite phylogenetic relationships and host-symbiont codiversification. We used pooled-sequencing (Pool-Seq) and short-read Illumina technology to interpret results derived from a traditional barcoding gene (cytochrome c oxidase subunit 1) versus 11 protein-coding mitochondrial genes using concatenated and multispecies coalescent approaches. Despite the statistically significant congruence between mite and host phylogenies, mite-host specificity varies widely, and host switching is common regardless of the genetic marker resolution (i.e., barcode versus multilocus). However, the multilocus approach was more effective than the single barcode in detecting the presence of a heterogeneous Pool-Seq sample. These results suggest that presumed symbiont dispersal capabilities are not always strong indicators of host specificity or of historical host-symbiont coevolutionary events. Comprehensive sampling at fine phylogenetic scales may help to better elucidate the microevolutionary filters that impact macroevolutionary processes regulating symbioses, particularly for dispersal-limited symbionts.

PMID:36960591 | DOI:10.1093/sysbio/syad014

Personal Ment Health. 2023 Mar 24. doi: 10.1002/pmh.1579. Online ahead of print.

ABSTRACT

This study assessed the effect of a mentalisation-based therapy (MBT) treatment programme on the utilisation of Western Australian public hospitals for mental health presentations over an 18-month period. Hospital data included the number of visits to the emergency department (ED), the number of inpatient admissions to hospital and length of stay of the admissions. Participants included 76 adolescents aged 13-17 years old, who presented with borderline personality disorder (BPD) traits. The Touchstone treatment programme is a time-limited intensive programme that utilises MBT in the context of a therapeutic community. Hospital data for the participants were collected and analysed from three time points; 6 months prior to attending the programme, during the 6-month programme (active treatment) and 6 months after the programme. Results found a statistically significant decrease in hospital utilisation from pre to post programme, with a decline in ED visits, inpatient admissions and admission length of stay. This study presents promising preliminary evidence for the effectiveness of an intensive MBT programme as an intervention for adolescents with BPD features and has significant implications for the public health system in terms of providing effective community-based treatment for this difficult to treat population as well as reducing pressure on tertiary care.

PMID:36960575 | DOI:10.1002/pmh.1579

Diagn Interv Radiol. 2023 Jan 31;29(1):155-160. doi: 10.5152/dir.2022.21712. Epub 2022 Dec 28.

ABSTRACT

PURPOSE: To retrospectively analyze the effectiveness and safety of computed tomography (CT)-guided microcoil localization for scapula-blocked pulmonary nodules using penetrating lung puncture prior to video-assisted thoracic surgery (VATS).

METHODS: One hundred thirty-eight patients with 138 pulmonary nodules were included in this single-center retrospective study. Among them, 110 patients who underwent CT-guided microcoil localization using the routine puncture technique formed the routine group; the other 28 patients who underwent the CT-guided microcoil localization using the penetrating lung puncture technique formed the penetrating lung group. The main outcomes were the success rate and complication rate of the two groups.

RESULTS: The localization success rate was 95.5% (105/110) in the routine group and 89.3% (25/28) in the penetrating lung group (P = 0.205). There was no statistical difference in any of the complications (pneumothorax, intrapulmonary hemorrhage, or moderate and severe chest pain) in both groups (P = 0.178, P = 0.204, P = 0.709, respectively). Localization procedure time was significantly increased in the penetrating lung group compared with the routine group (31.0 ± 3.0 min vs. 21.2 ± 2.8 min, P < 0.001).

CONCLUSION: CT-guided microcoil localization for scapula-blocked pulmonary nodules using penetrating lung puncture prior to VATS resection is effective and safe. However, the deployment of the microcoil using penetrating lung puncture required more time than the routine puncture method.

PMID:36960572 | DOI:10.5152/dir.2022.21712

J Prim Care Community Health. 2023 Jan-Dec;14:21501319231164307. doi: 10.1177/21501319231164307.

ABSTRACT

BACKGROUND: Survey studies have found an increased prevalence of migraine in patients with inflammatory bowel disease (IBD). However, the clinical characteristics of migraines in this population are unknown. We conducted a retrospective medical record review study to characterize migraines in the IBD population.

METHODS: Six hundred seventy-five migraine patients (280 with IBD, 395 without IBD) who were evaluated at Mayo Clinic Rochester, Mayo Clinic Arizona, or Mayo Clinic Florida between July 2009 and March 2021 were included. Patients with ICD codes for migraine and either Crohn’s disease (CD) or ulcerative colitis (UC) were selected. Electronic health care records were reviewed. Patients confirmed to have IBD and migraine were included. Demographic, IBD, and migraine characteristics were collected. Statistical analysis was completed using SAS.

RESULTS: Patients with IBD were less often male (8.6% vs 21.3%, P < .001) and had a higher Charlson Comorbidity Index (>2: 24.6% vs 15.7%, P = .003); 54.6% had CD and 39.3% had UC. Patients with IBD had migraine with aura and without aura more frequently ( OR 2.20, P < .001 and OR 2.79, P < .001, respectively) than non-IBD patients. Additionally, those with IBD less commonly had chronic migraine (OR 0.23, P < .001) and less commonly had chronic migraine or treatment for migraine (ORs 0.23-0.55, P ≤ .002).

CONCLUSIONS: Migraine with and without aura have increased prevalence in IBD patients. Further study of this topic will be helpful to clarify the prevalence of migraine, establish this population’s response to treatment, and better understand the reason(s) for a low rate of treatment.

PMID:36960555 | DOI:10.1177/21501319231164307