Tag: nevin manimala

Environ Monit Assess. 2023 May 16;195(6):678. doi: 10.1007/s10661-023-11366-8.

ABSTRACT

Tree diameter measurement is one of the most important stages of forest inventories to assess growing stock, aboveground biomass, and landscape restoration options, among others. This study investigates the accuracy of measuring tree diameters using a Light Detection and Ranging (LiDAR)-equipped smartphone vs. a normal caliper (reference data) and the opportunity to use low-cost smartphone-based applications in forest inventories. To estimate the diameter at breast height (DBH) of single trees, we used a smartphone with a third-party app that automatically analyzed three-dimensional (3D) point clouds. For two different measurement techniques, we compared the two measurement techniques based on DBH data from 55 Calabrian pine (Pinus brutia Ten.) and 50 oriental plane (Platanus orientalis L.) trees using the paired-sample t-test and Wilcoxon signed-rank test. Mean absolute error (MAE), mean squared error (MSE), root mean square error (RMSE), percent bias (PBIAS), and coefficient of determination (R²) were used as precision and error statistics. Statistical differences were observed between the reference and smartphone-based DBH according to the paired-sample t-test and Wilcoxon signed-rank test. The R² values obtained were determined as 0.91, 0.88, and 0.88 for Calabrian pine, oriental plane, and all tree species (105 trees), respectively. In addition to the overall accuracy performance of the comparison between reference and estimations, MAE, MSE, RMSE, and PBIAS values for the DBH of 105 tree stems were calculated as 1.56 cm, 5.42 cm, 2.33 cm, and – 5.10%, respectively. The estimation accuracies increased in regular stem forms compared with forked stems particularly observed on plane trees. Further experiments are needed to investigate the uncertainties associated with trees of different stem forms, species (coniferous or deciduous), different work environments, and different types of LiDAR and LiDAR-based app scanners.

PMID:37191833 | DOI:10.1007/s10661-023-11366-8

Eur J Epidemiol. 2023 May 16. doi: 10.1007/s10654-023-01010-7. Online ahead of print.

ABSTRACT

Pediatric patients with congenital heart disease (CHD) often undergo low dose ionizing radiation (LDIR) from cardiac catheterization (CC) for the diagnosis and/or treatment of their disease. Although radiation doses from a single CC are usually low, less is known about the long-term radiation associated cancer risks. We aimed to assess the risk of lympho-hematopoietic malignancies in pediatric CHD patients diagnosed or treated with CC. A French cohort of 17,104 children free of cancer who had undergone a first CC from 01/01/2000 to 31/12/2013, before the age of 16 was set up. The follow-up started at the date of the first recorded CC until the exit date, i.e., the date of death, the date of first cancer diagnosis, the date of the 18th birthday, or the 31/12/2015, whichever occurred first. Poisson regression was used to estimate the LDIR associated cancer risk. The median follow-up was 5.9 years, with 110,335 person-years. There were 22,227 CC procedures, yielding an individual active bone marrow (ABM) mean cumulative dose of 3.0 milligray (mGy). Thirty-eight incident lympho-hematopoietic malignancies were observed. When adjusting for attained age, gender and predisposing factors to cancer status, no increased risk was observed for lympho-hematopoietic malignancies RR_/mGy = 1.00 (95% CI: 0.88; 1.10). In summary, the risk of lympho-hematopoietic malignancies and lymphoma was not associated to LDIR in pediatric patients with CHD who undergo CC. Further epidemiological studies with greater statistical power are needed to improve the assessment of the dose-risk relationship.

PMID:37191831 | DOI:10.1007/s10654-023-01010-7

J Robot Surg. 2023 May 16. doi: 10.1007/s11701-023-01606-x. Online ahead of print.

ABSTRACT

Operating room (OR) turnover time (TOT) is the time it takes to prepare an OR for the next surgery after the previous one has been completed. Reducing OR TOT can improve the efficiency of the OR, reduce costs, and improve surgeons’ and patients’ satisfaction. The objective of this study is to evaluate the effectiveness of an operating room (OR) turnover time (TOT) reduction initiative using the Lean Six Sigma methodology (DMAIC) in the bariatric and thoracic service lines. Performance improvement strategies consist of simplifying steps (surgical tray optimization) and concurrent steps (parallel task execution). We compared 2-month pre-implementation vs. post-implementation. A paired t-test was used to assess whether the difference in the measurements was statistically significant. The study found that TOT was reduced by 15.6% from an average of 35.6 ± 8.1 to minutes 30.09 ± 9.7 min (p < 0.05). Specifically, in the bariatric service line, TOT was reduced by 17.15% and in the thoracic service line, TOT was reduced by 9.6%. No adverse events related to the initiative were reported. The results of this study indicate that the TOT reduction initiative was effective in reducing TOT. The efficient use of operating rooms is crucial in hospital management, as it not only impacts finances but also affects the satisfaction of surgical teams and patients. This study shows the effectiveness of Lean Six Sigma methodology in reducing TOT and improving the efficiency in the OR.

PMID:37191820 | DOI:10.1007/s11701-023-01606-x

Support Care Cancer. 2023 May 16;31(6):339. doi: 10.1007/s00520-023-07785-5.

ABSTRACT

BACKGROUND: Depres sion is reported in up to 90% of cancer patients but to this date, a standardized screening tool for depression specifically modified for patients diagnosed with brain tumors is lacking. Thus, this study aims to develop an adapted screening tool and identify a suitable time slot for screening.

METHODS: Sixty-one patients with brain lesions were interviewed prior to neurosurgical resection. For screening purposes, established depression scores were used. A study-specific questionnaire (SSQ) was developed based on patient interviews prior to the trial. Two subgroups were analyzed: patients with benign and patients with malignant tumors (including brain metastases). As a subgroup within malignant lesions, patients with glioblastoma (GBM) were also analyzed separately.

RESULTS: Of patients, 87.5% with GBM presented with results > 16 points on the Center for Epidemiologic Studies Depression Scale (CES-D) after surgery. A decline in patients with benign brain tumors (p = 0.0058) and an increase in patients with malignant tumors (p = 0.0491) could be shown over time for CES-D scores. In this study, we established a new prototype screening tool for depression. In patients diagnosed with GBM, the number of patients needed to screen for identification of symptoms of depression was 1.59. Best time for screening was 35 days after surgery.

CONCLUSIONS: Considering the high prevalence and low number needed to screen of depression in patients diagnosed with GBM, we strongly encourage their routine screening during follow-up appointments (35 days after surgery). We encourage a plan to further establish the questionnaire developed in this pilot study.

PMID:37191815 | DOI:10.1007/s00520-023-07785-5

J Magn Reson Imaging. 2023 May 16. doi: 10.1002/jmri.28778. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with polyneuropathies typically have demyelination and/or axonal degeneration in peripheral nerves. Currently, there is a lack of imaging biomarkers to track the changes in these pathologies.

PURPOSE: To develop and evaluate the reliability of a multiparametric quantitative magnetic resonance imaging (qMRI) method of peripheral nerves in the leg.

STUDY TYPE: Prospective.

SUBJECTS: Seventeen healthy volunteers (36.2 ± 13.8 years old, 9 males) with 10 of them scanned twice for test-retest.

FIELD STRENGTH/SEQUENCE: 3 T, three-dimensional gradient echo and diffusion tensor imaging.

ASSESSMENT: A qMRI protocol and processing pipeline was established for quantifying the following nerve parameters that are sensitive to myelin and axonal pathologies: magnetization transfer (MT) ratio (MTR), MT saturation index (MTsat), T₂ *, T₁ , proton density (PD), fractional anisotropy (FA), and mean/axial/radial diffusivities (MD, AD, and RD). The qMRI protocol also measures the volume of nerve fascicles (fVOL) and the fat fraction (FF) of muscles.

STATISTICAL TESTS: The intersession reproducibility and inter-rater reliability of each qMRI parameter were assessed by Bland-Altman analysis and intraclass correlation coefficient (ICC). Pairwise Pearson correlation analyses were performed to investigate the intrinsic association between qMRI parameters. Distal-to-proximal variations were evaluated by paired t-tests with Bonferroni-Holm multiple comparison corrections. P < 0.05 was considered statistically significant.

RESULTS: The MTR, MTsat, T₂ *, T₁ , PD, FA, AD, and fVOL of the sciatic and tibial nerves, and the FF of leg muscles, had an overall good-to-excellent test-retest agreement (ICC varying from 0.78 to 0.99). All the qMRI parameters had good-to-excellent inter-rater reliability (ICC > 0.80). The data demonstrated a pattern of distal-to-proximal changes of an increased nerve MTsat and FA, and a decreased nerve T₁ , PD, MD, and RD, as well as a significantly increased muscle FF.

DATA CONCLUSION: The proposed multiparametric qMRI method of the peripheral nerves is highly reproducible and provided healthy control data which will be used in developing monitoring biomarkers in patients with polyneuropathies.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

PMID:37191075 | DOI:10.1002/jmri.28778

J Magn Reson Imaging. 2023 May 16. doi: 10.1002/jmri.28783. Online ahead of print.

ABSTRACT

BACKGROUND: Indicators for assessing myocardial viability and risk stratification in patients with coronary chronic total occlusion (CTO) are still in the research stage.

PURPOSE: To use stress-MRI to assess myocardial function, blood perfusion, and viability and to explore their relationship with collateral circulation.

STUDY TYPE: Prospective.

SUBJECTS: Fifty-one patients with CTO in at least one major artery confirmed by X-ray coronary angiography (male: 46; age 55.2 ± 10.8 years).

FIELD STRENGTH/SEQUENCE: 3.0T; TurboFlash, balanced steady-state free precession cine, and phase-sensitive inversion recovery sequences.

ASSESSMENT: Stress-MRI was used to obtain qualitative and quantitative parameters of segmental myocardium. Myocardial segments supplied by CTO target vessels were grouped according to the degree of collateral circulation assessed by radiographic coronary angiography (no/mild, moderate, or good). Depending on qualitative stress perfusion assessment and late gadolinium enhancement (LGE) extent, segments were also categorized as negative, viable, or trans-infarcted.

STATISTICAL TESTS: Independent sample Student’s t-test, one-way analysis of variance (ANOVA) test, Mann-Whitney U test, Kruskal-Wallis test, Spearman correlation coefficient (r). P < 0.05 was considered statistically significant.

RESULTS: A total of 334 segments were supplied by CTO target vessels. The radial strain (RS), circumferential strain (CS), longitudinal strain (LS) of the negative, viable, and trans-infarcted regions showed a significant and stepwise impairment. Myocardial blood flow at rest was positively correlated with RS, CS, and LS (r = 0.42, 0.43, 0.38, respectively). Among the different collateral circulation, there were no significant differences in RS, CS, LS, and LGE volume (P = 0.788, 0.562, 0.122, 0.170, respectively), and there were also no statistically significant differences in the proportions of negative, viable, and trans-infarcted regions (P = 0.372).

DATA CONCLUSION: Myocardial perfusion obtained by stress-MRI combined with strain and LGE may comprehensively evaluate myocardial function and viability, and has potential to facilitate risk stratification of CTO.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1.

PMID:37191039 | DOI:10.1002/jmri.28783

Br J Radiol. 2023 May 16:20221116. doi: 10.1259/bjr.20221116. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether a more conservative Denver criterion set could reduce unnecessary CT angiography (CTA) studies when screening for blunt cerebrovascular injury (BCVI) following blunt trauma.

METHODS: Following ethics approval, a retrospective chart review of 447 consecutive patients undergoing emergency CTA at two large teaching hospitals was conducted to determine presence of risk factors for each Denver criterion set. Imaging studies of adults conducted between January 2016 and June 2020 containing sufficient clinical information for accurate classification were included in the study. Specificity, sensitivity, and predictive values were calculated. A two-sided Fisher exact test was used to evaluate the association between each iteration of the Denver criteria and presence of BCVI.

RESULTS: The specificities of the Original, Modified, and Expanded Denver criteria were 43.58%, 34.32%, and 24.85% respectively. Positive predictive values (PPV) followed a different trend, with respective values of 2.77%, 3.06%, and 2.78%. Sensitivity and negative predictive values (NPV) were found to be 100% for each criterion set. Being positive for a criterion set, and the presence of BCVI, was statistically significant for the original Denver criteria (p = 0.021, n = 443), but not the modified (p = 0.100, n = 345) or expanded Denver criteria (p = 0.202, n = 333).

CONCLUSION: Use of the modified and expanded Denver criteria leads to the overuse of cerebrovascular imaging on patients suffering blunt force trauma.

ADVANCES IN KNOWLEDGE: The original Denver criteria may more appropriately identify subjects for further evaluation with CTA than the current standard, while retaining diagnostic efficacy for BCVI.

PMID:37191023 | DOI:10.1259/bjr.20221116

Public Health Nutr. 2023 May 16:1-32. doi: 10.1017/S1368980023000976. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to synthesize available evidence on the effects of community-based interventions in improving various dietary outcome measures.

DESIGN: Systematic review and meta-analysis.

SETTING: We searched databases including Medline, EMBASE, PSYCINFO, CINAHL, and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis.

PARTICIPANTS: A total of 51 studies, 33 randomized and 18 non-randomized, involving 100 746 participants were included.

RESULTS: Overall, 37 studies found a statistically significant difference in at least one dietary outcome measure favoring the intervention group, whereas 14 studies found no statistically significant difference. Our meta-analyses indicated that, compared to controls, interventions were effective in decreasing daily energy intake (MJ/day) (MD: -0.25; 95% CI: -0.37, -0.14), fat % of energy (MD: -1.01; 95% CI: -1.76, -0.25), and saturated fat % of energy (MD: -1.54; 95% CI: -2.01, -1.07). Furthermore, the interventions were effective in improving fiber intake (g/day) (MD: 1.08; 95% CI: 0.39, 1.77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes.

CONCLUSION: This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimize dietary risk factors, which in turn decrease morbidity and mortality due to CVDs and other non-communicable diseases.

PMID:37191001 | DOI:10.1017/S1368980023000976

Am J Otolaryngol. 2023 Mar-Apr;44(2):103799. doi: 10.1016/j.amjoto.2023.103799. Epub 2023 Feb 24.

ABSTRACT

OBJECTIVE: To evaluate the usefulness of thyroidectomy videos posted on YouTube for surgical training.

METHODS: The following keywords were searched on YouTube: “thyroidectomy”, “conventional thyroidectomy”, “hemithyroidectomy”, and “thyroid lobectomy”. The first 30 videos from each search were selected for a total of 120 videos. Included videos were those displaying a conventional approach to thyroidectomy and real, non-animated patient surgery. Two independent reviewers assessed each video using the LAParoscopic surgery Video Educational Guidelines (LAP-VEGaS) and a thyroidectomy-specific grading score (TSS).

RESULTS: The search yielded 22 videos that met the selection criteria. The inter-rater agreement was excellent for the grading systems (ICC = 0.910). The average LAP-VEGaS score was of medium quality (8.82 ± 3.56 standard deviation (SD)). The highest average score (11.00 ± 1.68 SD) was assigned to videos published from academic institutions. There was no statistically significant difference in LAP-VEGaS scores when comparing the type of publisher between videos (p = 0.132). The majority of the videos (12/22, 55 %) did not include all hallmarks of thyroidectomy according to the novel TSS score. There was a significant positive correlation between TSS markers and the overall LAP-VEGaS score (r = 0.577, p = 0.005).

CONCLUSION: YouTube videos as an educational resource for thyroidectomy instructions vary in quality. Most of the thyroidectomy videos were medium quality according to the LAP-VEGaS score. YouTube sourced thyroidectomy videos should be used to supplement traditional educational methods.

PMID:37190995 | DOI:10.1016/j.amjoto.2023.103799

BJU Int. 2023 May 16. doi: 10.1111/bju.16037. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the role of multiparametric magnetic resonance imaging (mpMRI) and Gallium-68 (⁶⁸ Ga)-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) in guiding salvage therapy for patients with biochemical recurrence (BCR) post-radical prostatectomy.

PATIENTS AND METHODS: Patients were evaluated with paired mpMRI and ⁶⁸ Ga-PSMA PET/CT scans for BCR (prostate-specific antigen [PSA] >0.2 ng/mL). Patient, tumour, PSA and imaging characteristics were analysed with descriptive statistics.

RESULTS: A total of 117 patients underwent paired scans to investigate BCR, of whom 53.0% (62/117) had detectable lesions on initial scans and 47.0% (55/117) did not. Of those without detectable lesions, 8/55 patients proceeded to immediate salvage radiotherapy (sRT) and 47/55 were observed. Of patients with negative imaging who were initially observed, 46.8% (22/47) did not reach threshold for repeat imaging, while 53.2% were rescanned due to rising PSA levels. Of these rescanned patients, 31.9% (15/47) were spared sRT due to proven distant disease, or due to absence of disease on repeat imaging. Of the original 117 patients, 53 (45.3%) were spared early sRT due to absence of disease on imaging or presence of distant disease, while those undergoing delayed sRT still maintained good PSA responses. Of note, patients with high-risk features who underwent sRT despite negative imaging demonstrated satisfactory PSA responses to sRT. Study limitations include the observational design and absence of cause-specific or overall survival data.

CONCLUSION: Our findings support the use of mpMRI and ⁶⁸ Ga-PSMA PET/CT in guiding timing and necessity of salvage therapy tailored to detected lesions, with potential to reduce unnecessary sRT-related morbidity. Larger or randomized trials are warranted to validate this.

PMID:37190993 | DOI:10.1111/bju.16037