Tag: pubmed

Medicine (Baltimore). 2022 Dec 23;101(51):e32486. doi: 10.1097/MD.0000000000032486.

ABSTRACT

Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.

PMID:36595839 | DOI:10.1097/MD.0000000000032486

Phys Med Biol. 2022 Dec 2. doi: 10.1088/1361-6560/aca872. Online ahead of print.

ABSTRACT

OBJECTIVE: Positron emission tomography (PET) detectors providing attractive coincidence time resolutions (CTRs) offer time-of-flight information, resulting in an improved signal-to-noise ratio of the PET image. In applications with photosensor arrays that employ timestampers for individual channels, timestamps typically are not time synchronized, introducing time skews due to different signal pathways. The scintillator topology and transportation of the scintillation light might provoke further skews. If not accounted for these effects, the achievable CTR deteriorates. We studied a convex timing calibration based on a matrix equation. In this work, we extended the calibration concept to arbitrary structures targeting different aspects of the time skews and focusing on optimizing the CTR performance for detector characterization. The radiation source distribution, the stability of the estimations, and the energy dependence of calibration data are subject to the analysis.

APPROACH: A coincidence setup, equipped with a semi-monolithic detector comprising 8 LYSO slabs, each 3.9mm×31.9mm×19.0mm, and a one-to-one coupled detector with 8×8 LYSO segments of 3.9mm×3.9mm×19.0mm volume is used. Both scintillators utilize a dSiPM (DPC3200-22-44, Philips Digital Photon Counting) operated in first photon trigger. The calibration was also conducted with solely one-to-one coupled detectors and extrapolated for a slab-only setup.

MAIN RESULTS: All analyzed hyperparameters show a strong influence on the calibration. Using multiple radiation positions improved the skew estimation. The statistical significance of the calibration dataset and the utilized energy window was of great importance. Compared to a one-to-one coupled detector pair achieving CTRs of 224 ps the slab detector configuration reached CTRs down to 222 ps, demonstrating that slabs can compete with a clinically used segmented detector design.

SIGNIFICANCE: This is the first work that systematically studies the influence of hyperparameters on skew estimation and proposes an extension to arbitrary calibration structures (e.g., scintillator volumes) of a known calibration technique.

PMID:36595338 | DOI:10.1088/1361-6560/aca872

Phys Med Biol. 2022 Dec 15. doi: 10.1088/1361-6560/acabf9. Online ahead of print.

ABSTRACT

OBJECTIVE: With the development of computed tomography (CT) imaging technology, it is possible to acquire multi-energy data by spectral CT. Being different from conventional CT, the X-ray energy spectrum of spectral CT is cutting into several narrow bins which leads to the result that only a part of photon can be collected in each individual energy channel, which cause the image qualities to be severely degraded by noise and artifacts. To address this problem, we propose a spectral CT reconstruction algorithm based on low-rank representation and structure preserving regularization in this paper.

APPROACH: To make full use of the prior knowledge about both the inter-channel correlation and the sparsity in gradient domain of inner-channel data, this paper combines a low-rank correlation descriptor with a structure extraction operator as priori regularization terms for spectral CT reconstruction. Furthermore, a split-Bregman based iterative algorithm is developed to solve the reconstruction model. Finally, we propose a multi-channel adaptive parameters generation strategy according to CT values of each individual energy channel.

MAIN RESULTS: Experimental results on numerical simulations and real mouse data indicate that the proposed algorithm achieves higher accuracy on both reconstruction and material decomposition than the methods based on simultaneous algebraic reconstruction technique (SART), total variation minimization (TVM), total variation with low-rank (LRTV), and spatial-spectral cube matching frame (SSCMF). Compared with SART, our algorithm improves the feature similarity (FSIM) by 40.4% on average for numerical simulation reconstruction, whereas TVM, LRTV, and SSCMF correspond to 26.1%, 28.2%, and 29.5%, respectively.

SIGNIFICANCE: We outline a multi-channel reconstruction algorithm tailored for spectral CT. The qualitative and quantitative comparisons present a significant improvement of image quality, indicating its promising potential in spectral CT imaging.

PMID:36595335 | DOI:10.1088/1361-6560/acabf9

JAMA Netw Open. 2023 Jan 3;6(1):e2249395. doi: 10.1001/jamanetworkopen.2022.49395.

ABSTRACT

IMPORTANCE: Surplus cryopreserved embryos pose a challenge for in vitro fertilization patients and clinics; with Roe v. Wade overturned, some states may deem the discarding of surplus embryos illegal, radically changing in vitro fertilization practice. An evidence-based tool would help limit surplus embryo creation.

OBJECTIVE: To develop a prediction tool for determining how many oocytes should be exposed to sperm to create embryos to conserve the chance of live birth while minimizing surplus embryos.

DESIGN, SETTING, AND PARTICIPANTS: This diagnostic study used data from member clinics of the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System between 2014 to 2019. A total of 410 719 oocyte retrievals and 460 577 embryo transfer cycles from 311 237 patients aged 18 to 45 years old who initiated their first oocyte stimulation cycle between January 1, 2014, and December 31, 2019, were included. Data were analyzed from February to June 2022.

EXPOSURES: Female patient age, anti-mullerian hormone level, diminished ovarian reserve diagnosis, number of oocytes retrieved, and the state where the clinic is located were included in the final models.

MAIN OUTCOMES AND MEASURES: The algorithm was based on 3 models with outcomes: (1) day of transfer; (2) proportion of retrieved oocytes that become usable blastocysts; and (3) number of blastocysts needed for transfer for 1 live birth to occur.

RESULTS: The median (IQR) age at stimulation cycle start was 35 (29-32) years and the median (IQR) number of oocytes retrieved was 10 (6-17). The likelihood of recommending that all oocytes be exposed to sperm increased with age; less than 20.0% of retrievals among patients younger than 32 years and more than 99.0% of retrievals among patients older than 42 years received recommendations that all oocytes be exposed to sperm. Among cycles recommended to expose fewer than all oocytes, the median (IQR) numbers recommended for 1 live birth were 7 oocytes (7-8) for patients aged less than 32 years, 8 (7-8) for patients aged 32 to 34 years, and 9 (9-11) for patients aged 35 to 37 years.

CONCLUSIONS AND RELEVANCE: In this diagnostic study of in vitro fertilization cycles, a prediction tool was developed to aid clinicians in determining the optimal number of oocytes to expose to sperm, reducing the number of unused embryos created and immediately addressing current patient and clinician concerns.

PMID:36595292 | DOI:10.1001/jamanetworkopen.2022.49395

Invest Ophthalmol Vis Sci. 2023 Jan 3;64(1):2. doi: 10.1167/iovs.64.1.2.

ABSTRACT

PURPOSE: The purpose of this study was to investigate optical coherence tomography (OCT)-measured retinal thickness (RT) and best-corrected distance visual acuity (BCDVA) in eyes with different types of astigmatism.

METHODS: This is a case-control study of 101 participants stratified into With-The-Rule (WTR; n = 41), Against-The-Rule (ATR; n = 25), and control (n = 35) groups by noncycloplegic subjective refraction. Inclusion criteria were ages between 18 and 45 years, spherical-equivalent (SE) refraction ≥-10.00 diopters (D), negative cylindrical power (CYL) ≤-0.75 D with axes of 0 to 30 degrees/150 to 180 degrees for WTR and 60 to 120 degrees for ATR, or CYL ≥-0.25 D for controls. Participants suffering from ocular diseases related to retinal defects, having a history of ocular surgery, with BCDVA >0.10 LogMAR, or poor OCT imaging quality were excluded. Fovea-centered scans were performed using spectral-domain OCT (SD-OCT), and RT automatically measured by the inbuilt software. Only right eyes were analyzed. Groups were matched for age, gender, SE, axial length, and corneal curvature.

RESULTS: One-way ANOVA showed a significant difference in both BCDVA (P = 0.039) and macular RT (P = 0.028) among the three groups. Bonferroni’s post hoc test revealed statistically significant between-group differences in BCDVA (WTR vs. controls, P = 0.041), as well as in RT at inner-nasal (WTR vs. ATR, P = 0.034) and outer-temporal subfields (WTR vs. controls, P = 0.042). BCDVA was positively associated with macular RT (r = 0.206, P = 0.041) after adjusting for age, gender, and axial length.

CONCLUSIONS: Greater RT and poorer BCDVA were found in eyes with WTR astigmatism. Our findings suggest that the effect of astigmatism on retinal thickness and BCDVA may vary depending on not only magnitude, but also axis of astigmatism.

PMID:36595274 | DOI:10.1167/iovs.64.1.2

JAMA Intern Med. 2023 Jan 3. doi: 10.1001/jamainternmed.2022.6069. Online ahead of print.

ABSTRACT

IMPORTANCE: Testing for coronary heart disease (CHD) in asymptomatic kidney transplant candidates before transplant is widespread and endorsed by various professional societies, but its association with perioperative outcomes is unclear.

OBJECTIVE: To estimate the association of pretransplant CHD testing with rates of death and myocardial infarction (MI).

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included all adult, first-time kidney transplant recipients from January 2000 through December 2014 in the US Renal Data System with at least 1 year of Medicare enrollment before and after transplant. An instrumental variable (IV) analysis was used, with the program-level CHD testing rate in the year of the transplant as the IV. Analyses were stratified by study period, as the rate of CHD testing varied over time. A combination of US Renal Data System variables and Medicare claims was used to ascertain exposure, IV, covariates, and outcomes.

EXPOSURES: Receipt of nonurgent invasive or noninvasive CHD testing during the 12 months preceding kidney transplant.

MAIN OUTCOMES AND MEASURES: The primary outcome was a composite of death or acute MI within 30 days of after kidney transplant.

RESULTS: The cohort comprised 79 334 adult, first-time kidney transplant recipients (30 147 women [38%]; 25 387 [21%] Black and 48 394 [61%] White individuals; mean [SD] age of 56 [14] years during 2012 to 2014). The primary outcome occurred in 4604 patients (244 [5.3%]; 120 [2.6%] death, 134 [2.9%] acute MI). During the most recent study period (2012-2014), the CHD testing rate was 56% in patients in the most test-intensive transplant programs (fifth IV quintile) and 24% in patients at the least test-intensive transplant program (first IV quintile, P < .001); this pattern was similar across other study periods. In the main IV analysis, compared with no testing, CHD testing was not associated with a change in the rate of primary outcome (rate difference, 1.9%; 95% CI, 0%-3.5%). The results were similar across study periods, except for 2000 to 2003, during which CHD testing was associated with a higher event rate (rate difference, 6.8%; 95% CI, 1.8%-12.0%).

CONCLUSIONS AND RELEVANCE: The results of this cohort study suggest that pretransplant CHD testing was not associated with a reduction in early posttransplant death or acute MI. The study findings potentially challenge the ubiquity of CHD testing before kidney transplant and should be confirmed in interventional studies.

PMID:36595271 | DOI:10.1001/jamainternmed.2022.6069

Phys Med Biol. 2022 Dec 9. doi: 10.1088/1361-6560/acaa85. Online ahead of print.

ABSTRACT

OBJECTIVE: In the field of radiation oncology, the benefit of MRI goes beyond that of providing high soft-tissue contrast images for staging and treatment planning. With the recent clinical introduction of hybrid MRI linear accelerators (MR-Linacs) it has become feasible to map physiological parameters describing diffusion, perfusion, and relaxation during the entire course of radiotherapy, for example. However, advanced data analysis tools are required for extracting qualified prognostic and predictive imaging biomarkers from longitudinal MRI data. In this study, we propose a new prediction framework tailored to exploit temporal dynamics of tissue features from repeated measurements. We demonstrate the framework using a newly developed decomposition method for tumor characterization.

APPROACH: Two previously published MRI datasets with multiple measurements during and after radiotherapy, were used for development and testing: T$_2$-weighted multi-echo images obtained for two mouse models of pancreatic cancer, and diffusion-weighted images for patients with brain metastases. Initially, the data was decomposed using the novel monotonous slope non-negative matrix factorization (msNMF) tailored for MR data. The following processing consisted of a tumor heterogeneity assessment using descriptive statistical measures, robust linear modelling to capture temporal changes of these, and finally logistic regression analysis for stratification of tumors and volumetric outcome.

MAIN RESULTS: The framework was able to classify the two pancreatic tumor types with an textit{area under curve} AUC of 0.999, $P<0.001$ and predict the tumor volume change with a correlation coefficient of 0.513, $P=0.034$. A classification of the human brain metastases into responders and non-responders resulted in an AUC of 0.74, $P=0.065$.

SIGNIFICANCE: A general data processing framework for analyses of longitudinal MRI data has been developed and applications were demonstrated by classification of tumor type and prediction of radiotherapy response. Further, as part of the assessment, the merits of msNMF for tumor tissue decomposition were demonstrated.

PMID:36595245 | DOI:10.1088/1361-6560/acaa85

Phys Med Biol. 2022 Dec 2. doi: 10.1088/1361-6560/aca875. Online ahead of print.

ABSTRACT

Regulators require that wireless power transfer (WPT) systems and other strong magnetic field sources are compliant with the basic restrictions (BR) defined as the limits of the fields induced in the human body, i.e., the induced electric field/current density/specific absorption rate limits. This can be achieved by demonstrating compliance with the reference levels (RL) defined in air without the human body, i.e., the incident electric/magnetic field limits. Local sources, such as WPT transmitters, generate non-uniform fields that can locally exceed the RL while the induced fields are still well below the BR. In these cases, robust compliance with BR can be demonstrated, generally requiring a large number of simulations. In this study, we proposed an efficient evaluation using a homogeneous phantom and applying a coverage factor to account for the local field enhancements caused by the dielectric contrasts of the highly inhomogeneous human tissues. The generally applicable coverage factors were derived from a statistical analysis of the field enhancements observed on four magnetic near-field sources placed at different separation distances (2-80 mm) and locations on the back of 12 anatomical models. The field enhancements were characterized by the ratios between the peak induced fields in the anatomical models and those in the homogeneous half-space phantom (ε_r= 55, σ = 0.75 S/m, ρ = 1,000 kg/m³) at the same distance. The resulting 99th percentile coverage factors range from 1 and 9 depending on the dosimetric quantity. The use of these coverage factors reduces the compliance testing effort from hundreds of simulations to only one, and makes experimental testing feasible without the support of simulations. The study also demonstrates that running only a few use-case simulations with anatomical models may underestimate the exposure by more than 10 dB.

PMID:36595233 | DOI:10.1088/1361-6560/aca875

J Pediatr Orthop B. 2022 Dec 16. doi: 10.1097/BPB.0000000000001045. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with a diagnosis of arthrogryposis often present with various orthopedic conditions, one of which is congenital vertical talus (CVT). This is the first study of this specific subset of syndromic patients to evaluate the medium-term outcomes of CVT correction using the minimally invasive Dobbs method.

METHODS: All patients with vertical talus and distal arthrogryposis who received treatment at our institution between January 2006 and June 2021 were identified. Radiographs, clinical notes and Patient-Reported Outcome Measurement Information System (PROMIS) scores (when available) were retrospectively reviewed. An alpha of 0.05 was used for all statistical analyses.

RESULTS: In total 12 patients (19 feet) met all inclusion criteria and were included in the final analysis. By the time of the most recent visit, the average lateral Talar-Axis First Metatarsal Base Angle of the entire cohort increased from 13.73 ± 9.75 degrees 2 weeks postoperatively to 28.75 ± 23.73 degrees (P = 0.0076). Radiographic recurrence of the talonavicular deformity was seen in nine feet (47.4%), 4 (21.1%) of which required additional unplanned surgery, The average PROMIS scores of the entire cohort in the pain interference, mobility and peer relationship domains were 48.97 ± 9.56, 47.9 ± 11.60 and 52.87 ± 8.31, respectively.

CONCLUSION: Despite a higher radiographic recurrence rate of talonavicular deformity in this specific subset of syndromic patients, these patients still report PROMIS scores near the population average in the pain interference, mobility and peer relationships domains. We believe that the minimally invasive Dobbs method should be recommended as the first-line treatment method for these patients. Level of evidence: Level III.

PMID:36595217 | DOI:10.1097/BPB.0000000000001045

Pain Ther. 2023 Jan 3. doi: 10.1007/s40122-022-00464-z. Online ahead of print.

ABSTRACT

INTRODUCTION: Globally, chronic pain affects more than 30% of people worldwide and is the leading cause of disability and health care utilisation. Access to timely, person-centred, cost-effective programs is unattainable for most. People living in regional, rural and remote areas are disproportionately affected due to scarcity of services and qualified, multidisciplinary health and medical professionals. Caring and supporting people with chronic pain involves a range of interventions that incorporate a multifaceted bio-psychosocial approach. Tertiary and primary chronic pain services are optimally placed to deliver integrated models of care. This pilot study explored the effectiveness of an integrated Guided Self-Help (GSH) program within a multidisciplinary tertiary pain unit in a public hospital in Australia.

METHODS: A service delivery evaluation was undertaken and a pilot study implemented to determine feasibility and useability of an integrated GSH program for people with chronic pain. A single-group pre-post evaluation was provided to a convenience sample of 42 people referred to the Flinders Medical Centre Pain Management Unit (FMC PMU). Delivered via telehealth or in person by postgraduate students, a manualised GSH workbook was utilised to support adherence and fidelity. Content included goal setting, pain conceptualisation, psychoeducation, activity scheduling, pacing and cognitive strategies. The purpose of the integrated GSH pilot program was to support participants in gaining increased pain literacy, knowledge of effective physical and psychological strategies and enhance self-management of their chronic pain. Levels of psychological distress (PHQ-9 and GAD-7), pain catastrophising (PCS), and pain severity/interference (BPI) were assessed at the beginning and end of support. Integrating the program within a multidisciplinary pain unit intended to facilitate and provide participants with an understanding of their pain through a psychosocial lens, build self-efficacy, and recognise the benefits of other non-medical supports to manage their chronic pain in the future. Outcome data were routinely collected as part of FMC PMU usual practice for clinical and quality assurance purposes, then analysed retrospectively. Thus, under the National Health and Medical Research Council (NHMRC) Ethical Considerations in Quality Assurance and Evaluation Activities guidelines (NHMRC, 2014), and verified by the Southern Adelaide Local Health Network (SALHN) Research Committee (our institutional review board) via email (dated 10/09/2020), ethical review and approval were not required for this project as it constituted a quality improvement activity – specifically, a service delivery evaluation. This project is registered with the SALHN Quality Library (for quality assurance activities that are exempt from ethical approval) (Quality Register ID 3390).

RESULTS: Participants showed statistically significant improvements on the PHQ-9 [i.e., mean drop of 2.85 (t = 3.16)], GAD [mean drop of 2.52 (t = 2.71)], and PCS [mean drop of 7.77 (t = 3.47)] with small-to-moderate effect sizes. BPI scores did not change. Results were similar when stratifying analyses by those who completed 2-5 versus 6-12 sessions.

CONCLUSION: Integrating a GSH program for people with chronic pain into a multidisciplinary tertiary pain clinic is an efficacious and scalable way to increase access to effective strategies that can increase self-efficacy and self-management. Novel, scalable, and effective solutions are needed to improve quality of life and address disparities for people with chronic pain. The psychological shifts and benefits observed support efficacy towards self-management strategies that can increase autonomy and quality of life.

PMID:36595182 | DOI:10.1007/s40122-022-00464-z