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1.
LGBT Health ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722250

RESUMO

Purpose: This scoping review summarizes the literature on suicide-specific psychological interventions among lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people to synthesize existing findings and support future intervention research and dissemination. Methods: Electronic databases PsycInfo and PubMed were searched for reports of psychological intervention studies with suicide-related outcome data among LGBTQ+ people. A total of 1269 articles were screened, and 19 studies met inclusion criteria (k = 3 examined suicide-specific interventions tailored to LGBTQ+ people, k = 4 examined nontailored suicide-specific interventions, k = 11 examined minority stress- or LGBTQ+ interventions that were not suicide-specific, and k = 1 examined other types of interventions). Results: Synthesis of this literature was made challenging by varied study designs, and features limit confidence in the degree of internal and external validity of the interventions evaluated. The only established suicide-specific intervention examined was Dialectical Behavior Therapy, and minority stress- and LGBTQ-specific interventions rarely targeted suicidal thoughts and behaviors (STBs). Nevertheless, most interventions reviewed demonstrated support for feasibility and/or acceptability. Only five studies tested suicide-related outcome differences between an LGBTQ+ group and a cisgender/heterosexual group. These studies did not find significant differences in STBs, but certain subgroups such as bisexual individuals may exhibit specific treatment disparities. Conclusion: Given the dearth of research, more research examining interventions that may reduce STBs among LGBTQ+ people is critically needed to address this public health issue.

2.
3.
Psychol Rep ; : 332941241255323, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802302

RESUMO

The surge in firearm sales from the onset of the COVID-19 pandemic have been linked to increases in firearm violence, which is of public concern given that having firearms in one's home is associated with increased risk for domestic violence and suicide. Consistent with pre-pandemic trends, individuals tended to purchase firearms for self-protection during COVID-19. Prior work indicates that protective firearm ownership is motivated not only by perceptions that the world (and one's local environment) is dangerous, but also by one's endorsement of masculinity norms found in U.S. cultures of honor (primarily southern and western states). Honor-based masculinity norms emphasis reputation defense, toughness, and an absolute intolerance of disrespect. The present research examined the relative motivating influences of various threat perceptions and masculine honor endorsement in predicting reasons for non-COVID-19 firearm ownership, firearm purchasing during COVID-19, and purchase intentions. Three separate samples (total N = 2483) of mostly White U.S. men completed online surveys during different months of the first year of the COVID-19 pandemic. Participants completed measures of their endorsement of masculine honor norms, factors associated with firearm purchasing (e.g., dangerous world beliefs, intolerance of uncertainty), and firearm purchasing behaviors. Results indicated that masculine honor endorsement was higher among (1) protective firearm owners compared to non-owners and non-protective owners, (2) firearm owners who purchased a firearm during COVID-19 compared to non-owners and non-purchasing owners, and (3) firearm owners with intentions to purchase firearms in the next year compared to those without intentions and undecided owners. Relative to other predictors (e.g., COVID-19 concerns, dangerous world beliefs), masculine honor endorsement was consistently the strongest predictor of these outcomes. Findings add to the literature by highlighting the strength of masculine honor endorsement in motivating (protective) firearm ownership. Implications for interpersonal violence and suicide are discussed.

4.
Geroscience ; 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38512581

RESUMO

Human cytomegalovirus (hCMV) is a ubiquitous latent persistent herpesvirus infecting 60-90% of the population worldwide. hCMV carriage in immunocompetent people is asymptomatic; thus, hCMV can be considered a component of normative aging. However, hCMV powerfully modulates many features of the immune, and likely other, systems and organs. Questions remain as to how hCMV carriage affects the human host. We used anti-CMV antibody titers as a stratifying criterion to examine the impact of "intensity" of hCMV infection as a potential biomarker of aging, inflammation, and immune homeostasis in a cohort of 247 participants stratified into younger (21-40 years) and older (> 65 years of age) groups. We showed that anti-CMV antibody titers increased with age and directly correlated to increased levels of soluble tumor necrosis factor (sTNFR) I in younger but not older participants. CD8 + cell numbers were reduced in the older group due to the loss in CD8 + T naïve (Tn) cells. In CMV carriers and, in particular, in anti-CMV Ab-high participants, this loss was mitigated or reversed by an increase in the numbers of CD8 + T effector memory (Tem) and T effector memory reexpressing CD45RA (Temra) cells. Analysis of CD38, HLA-DR, and CD57 expression revealed subset (CD4 or CD8)-specific changes that correlated with anti-CMV Ab levels. In addition, anti-CMV Ab levels predicted anti-CMV CD8 T cell responsiveness to different CMV open reading frames (ORFs) selectively in older participants, which correlated to the transcriptional order of expression of specific CMV ORFs. Implications of these results for the potential predictive value of anti-CMV Ab titers during aging are discussed.

5.
Proc Natl Acad Sci U S A ; 121(12): e2312207121, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38466852

RESUMO

Over the last 12,000 y, human populations have expanded and transformed critical earth systems. Yet, a key unresolved question in the environmental and social sciences remains: Why did human populations grow and, sometimes, decline in the first place? Our research builds on 20 y of archaeological research studying the deep time dynamics of human populations to propose an explanation for the long-term growth and stability of human populations. Innovations in the productive capacity of populations fuels exponential-like growth over thousands of years; however, innovations saturate over time and, often, may leave populations vulnerable to large recessions in their well-being and population density. Empirically, we find a trade-off between changes in land use that increase the production and consumption of carbohydrates, driving repeated waves of population growth over thousands of years, and the susceptibility of populations to large recessions due to a lag in the impact of humans on resources. These results shed light on the long-term drivers of human population growth and decline.


Assuntos
Crescimento Demográfico , Ciências Sociais , Humanos , Densidade Demográfica , Arqueologia , Dinâmica Populacional
6.
Suicide Life Threat Behav ; 54(3): 425-436, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38345177

RESUMO

BACKGROUND: According to the integrated motivational-volitional model of suicide, feelings of entrapment are related to the emergence of suicidal ideation (SI). However, this relation can be moderated by certain protective factors. METHODS: This study examined whether aspects of psychological flexibility (i.e., experiential avoidance, experiential acceptance, harnessing) moderated the relation between aspects of entrapment and SI severity in college students experiencing SI (N = 553) both cross-sectionally and when SI severity was measured 1 week later (N = 247). RESULTS: At baseline, experiential acceptance, but not experiential avoidance or harnessing, significantly moderated the relation between external entrapment and SI severity and internal entrapment and SI severity. No aspects of psychological flexibility prospectively moderated relations between entrapment and SI severity. CONCLUSIONS: Aspects of psychological flexibility may influence immediate vulnerability to SI severity among young adults experiencing feelings of entrapment. Implications for clinical interventions influencing changes in psychological flexibility are discussed.


Assuntos
Motivação , Ideação Suicida , Humanos , Masculino , Feminino , Estudos Prospectivos , Adulto Jovem , Modelos Psicológicos , Adulto , Estudos Transversais , Adolescente , Estudantes/psicologia , Adaptação Psicológica
7.
Suicide Life Threat Behav ; 54(3): 501-514, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38380558

RESUMO

INTRODUCTION: The Virtual Hope Box (VHB) mobile application is an adapted version of the conventional hope box intervention that is used in several evidence-based treatments for suicide behaviors. The VHB is an award-winning app developed by a collaboration between the Departments of Defense and Veterans Affairs. Multiple studies have assessed the utility and effectiveness of the VHB for use in suicide prevention, but no reviews of the literature have been conducted. METHODS: Authors performed a review of the literature using PsycINFO, EBSCOhost, and PubMed. 15 articles were ultimately included. RESULTS: Results were categorized into three areas: (1) efficacy and effectiveness, (2) feasibility, awareness, and usage in high-risk populations, and (3) implementation approaches to increase use among patients and providers. Existing evidence for the VHB supports its feasibility and acceptability, especially among military and veteran populations. Only one study investigated effectiveness in a randomized control trial. Although the VHB developers have disseminated the app nationally, low adoption rates among veteran patients and VA providers remain. Studies found that educational implementation strategies can improve utilization rates. CONCLUSIONS: Future research should examine suicide behaviors as outcomes, approaches to incorporating the VHB into treatment, and a range of populations.


Assuntos
Aplicativos Móveis , Prevenção do Suicídio , Humanos , Veteranos/psicologia
8.
J Physiol Anthropol ; 43(1): 7, 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38297353

RESUMO

BACKGROUND: Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY: Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION: The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.


Assuntos
Miopia , Pré-Escolar , Criança , Humanos , Estudos Prospectivos , Miopia/epidemiologia , Miopia/genética , Miopia/prevenção & controle , Refração Ocular , Acomodação Ocular , Ritmo Circadiano
9.
J Pineal Res ; 76(1): e12930, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38241677

RESUMO

Age-related sleep and circadian rhythm disturbances may be due to altered nonvisual photoreception. Here, we investigated the temporal dynamics of light-induced melatonin suppression in young and older individuals. In a within-subject design study, young and older participants were exposed for 60 min (0030-0130 at night) to nine narrow-band lights (range: 420-620 nm). Plasma melatonin suppression was calculated at 15, 30, 45, and 60 min time intervals. Individual spectral sensitivity of melatonin suppression and photoreceptor contribution were predicted for each interval and age group. In young participants, melanopsin solely drove melatonin suppression at all time intervals, with a peak sensitivity at 485.3 nm established only after 15 min of light exposure. Conversely, in older participants, spectral light-driven melatonin suppression was best explained by a more complex model combining melanopsin, S-cone, and M-cone functions, with a stable peak (~500 nm) at 30, 45, and 60 min of light exposure. Aging is associated with a distinct photoreceptor contribution to melatonin suppression by light. While in young adults melanopsin-only photoreception is a reliable predictor of melatonin suppression, in older individuals this process is jointly driven by melanopsin, S-cone, and M-cone functions. These findings offer new prospects for customizing light therapy for older individuals.


Assuntos
Melatonina , Adulto Jovem , Humanos , Idoso , Células Fotorreceptoras de Vertebrados , Células Fotorreceptoras Retinianas Cones , Opsinas de Bastonetes , Ritmo Circadiano/fisiologia , Envelhecimento
10.
J AAPOS ; 28(1): 103803, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38216117

RESUMO

BACKGROUND: Pediatric papilledema often reflects an underlying severe neurologic disorder and may be difficult to appreciate, especially in young children. Ocular fundus photographs are easy to obtain even in young children and in nonophthalmology settings. The aim of our study was to ascertain whether an improved deep-learning system (DLS), previously validated in adults, can accurately identify papilledema and other optic disk abnormalities in children. METHODS: The DLS was tested on mydriatic fundus photographs obtained in a multiethnic pediatric population (<17 years) from three centers (Atlanta-USA; Bucharest-Romania; Singapore). The DLS's multiclass classification accuracy (ie, normal optic disk, papilledema, disks with other abnormality) was calculated, and the DLS's performance to specifically detect papilledema and normal disks was evaluated in a one-vs-rest strategy using the AUC, sensitivity and specificity, with reference to expert neuro-ophthalmologists. RESULTS: External testing was performed on 898 fundus photographs: 447 patients; mean age, 10.33 (231 patients ≤10 years of age; 216, 11-16 years); 558 normal disks, 254 papilledema, 86 other disk abnormalities. Overall multiclass accuracy of the DLS was 89.6% (range, 87.8%-91.6%). The DLS successfully distinguished "normal" from "abnormal" optic disks (AUC 0.99 [0.98-0.99]; sensitivity, 87.3% [84.9%-89.8%]; specificity, 98.5% [97.6%-99.6%]), and "papilledema" from "normal and other" (AUC 0.99 [0.98-1.0]; sensitivity, 98.0% [96.8%-99.4%]; specificity, 94.1% (92.4%-95.9%)]. CONCLUSIONS: Our DLS reliably distinguished papilledema from normal optic disks and other disk abnormalities in children, suggesting it could be utilized as a diagnostic aid for the assessment of optic nerve head appearance in the pediatric age group.


Assuntos
Aprendizado Profundo , Papiledema , Adulto , Humanos , Criança , Pré-Escolar , Papiledema/diagnóstico , Fundo de Olho , Inteligência Artificial , Nervo Óptico , Encéfalo
11.
Arch Suicide Res ; 28(1): 358-371, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-36786540

RESUMO

OBJECTIVE: Differences in how impulsivity is conceptualized, along with a myopic focus on impulsivity's relationship with historical suicidal behaviors, have resulted in limited implications made from prior research regarding impulsivity and suicidal thoughts and behaviors. The current study investigated the indirect effect facets of impulsivity may have on suicidal ideation, specifically, through thwarted interpersonal needs. METHODS: Participants were N = 424 undergraduate students who completed a cross-sectional survey. Participants completed the Urgency, Premeditation, Perseverance, Sensation Seeking, Impulsive Behavior Scale (UPPS), the Adult Suicide Ideation Questionnaire (ASIQ), and the Interpersonal Needs Questionnaire (INQ). Parallel mediation models were run to examine the relation between facets of impulsivity, perceived burdensomeness, thwarted belongingness, and suicidal ideation. RESULTS: Thwarted belonginess and perceived burdensomeness significantly accounted for the variance in the relation between negative urgency and suicidal ideation. Neither thwarted belongingness nor perceived burdensomeness significantly explained variance in the relation between (lack of) premeditation and suicidal ideation. Conversely, perceived burdensomeness and thwarted belonginess significantly explained the inverse relation between sensation seeking and suicidal ideation (i.e., greater sensation seeking was related to lower perceived burdensomeness and thwarted belongingness and in turn lower suicidal ideation). CONCLUSION: Negative urgency, in particular, is related to suicidal ideation through thwarted interpersonal needs. Future research should continue to differentiate between various types of impulsivity and its relationship with both suicidal ideation and behaviors utilizing both cross-sectional and ambulatory assessments of these constructs.HIGHLIGHTSNegative urgency is related to suicidal ideation.Negative urgency is related to thwarted interpersonal needs.Thwarted interpersonal needs partially explain the relation between negative urgency and suicidal ideation.


Assuntos
Relações Interpessoais , Ideação Suicida , Adulto , Humanos , Estudos Transversais , Comportamento Impulsivo , Teoria Psicológica , Fatores de Risco , Sensação
12.
Int J Radiat Oncol Biol Phys ; 118(2): 554-564, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37619789

RESUMO

PURPOSE: Our purpose was to analyze the effect on gastrointestinal (GI) toxicity models when their dose-volume metrics predictors are derived from segmentations of the peritoneal cavity after different contouring approaches. METHODS AND MATERIALS: A random forest machine learning approach was used to predict acute grade ≥3 GI toxicity from dose-volume metrics and clinicopathologic factors for 246 patients (toxicity incidence = 9.5%) treated with definitive chemoradiation for squamous cell carcinoma of the anus. Three types of random forest models were constructed based on different bowel bag segmentation approaches: (1) physician-delineated after Radiation Therapy Oncology Group (RTOG) guidelines, (2) autosegmented by a deep learning model (nnU-Net) following RTOG guidelines, and (3) autosegmented but spanning the entire bowel space. Each model type was evaluated using repeated cross-validation (100 iterations; 50%/50% training/test split). The performance of the models was assessed using area under the precision-recall curve (AUPRC) and the receiver operating characteristic curve (AUROCC), as well as optimal F1 score. RESULTS: When following RTOG guidelines, the models based on the nnU-Net auto segmentations (mean values: AUROCC, 0.71 ± 0.07; AUPRC, 0.42 ± 0.09; F1 score, 0.46 ± 0.08) significantly outperformed (P < .001) those based on the physician-delineated contours (mean values: AUROCC, 0.67 ± 0.07; AUPRC, 0.34 ± 0.08; F1 score, 0.36 ± 0.07). When spanning the entire bowel space, the performance of the autosegmentation models improved considerably (mean values: AUROCC, 0.87 ± 0.05; AUPRC, 0.70 ± 0.09; F1 score, 0.68 ± 0.09). CONCLUSIONS: Random forest models were superior at predicting acute grade ≥3 GI toxicity when based on RTOG-defined bowel bag autosegmentations rather than physician-delineated contours. Models based on autosegmentations spanning the entire bowel space show further considerable improvement in model performance. The results of this study should be further validated using an external data set.


Assuntos
Neoplasias do Ânus , Gastroenteropatias , Humanos , Algoritmo Florestas Aleatórias , Cavidade Peritoneal , Neoplasias do Ânus/radioterapia , Quimiorradioterapia/efeitos adversos , Gastroenteropatias/etiologia
13.
Assessment ; 31(3): 574-587, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37138520

RESUMO

The Suicide Status Form-IV (SSF-IV) is the measure used in the Collaborative Assessment and Management of Suicidality (CAMS). The SSF-IV Core Assessment measures various domains of suicide risk. Previous studies established a two-factor solution in small, homogeneous samples; no investigations have assessed measurement invariance. The current investigation sought to replicate previous factor analyses and used measurement invariance to identify differences in the Core Assessment by race and gender. Adults (N = 731) were referred for a CAMS consultation after exhibiting risk for suicide. Confirmatory factor analyses indicated good fit for both one- and two-factor solutions while the two-factor solution is potentially redundant. Configural, metric, and scalar invariance held across race and gender. Ordinal logistic regression models indicated that neither race nor gender significantly moderated the relationship between the Core Assessment total score and clinical outcomes. Findings support a measurement invariant, one-factor solution for the SSF-IV Core Assessment.


Assuntos
Suicídio , Adulto , Humanos , Psicometria , Ideação Suicida , Análise Fatorial
14.
15.
Suicide Life Threat Behav ; 54(1): 61-69, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37960986

RESUMO

INTRODUCTION: The Virtual Hope Box (VHB) is a smartphone application designed to support emotion regulation when one is distressed, in a crisis, or experiencing suicidal ideation (SI). Initial proof of concept studies indicate that individuals are more likely to use the VHB than traditional hope boxes, and find it both easy to setup and helpful. To our knowledge, no studies have harnessed ambulatory assessment methodology to assess VHB use as it relates to incidence of suicidal thinking. METHODS: As such, we recruited N = 50 undergraduates who endorsed SI either the past year or past 2 weeks to complete a 10-day investigation. At baseline, participants were oriented to the VHB and instructed on how to use the application. Over the next 10 days, participants responded to prompts five times per day on their personal smartphones regarding their current experiences of SI and stress as well as VHB usage. RESULTS: Results found that most participants used the VHB at least once, rated its usefulness as high, and rated their perceived likelihood of future use as high. In addition, increases in state SI severity were related to subsequent VHB use. CONCLUSION: The VHB may be a useful tool for managing crises in undergraduates experiencing suicidal thoughts.


Assuntos
Aplicativos Móveis , Ideação Suicida , Humanos , Avaliação Momentânea Ecológica , Emoções , Smartphone
17.
Am J Ophthalmol ; 261: 199-207, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37926337

RESUMO

PURPOSE: The Fundus photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) studies showed that ED providers poorly recognized funduscopic findings in patients in the ED. We tested a modified version of the Brain and Optic Nerve Study Artificial Intelligence (BONSAI) deep learning system on nonmydriatic fundus photographs from the FOTO-ED studies to determine if the deep learning system could have improved the detection of papilledema had it been available to ED providers as a real-time diagnostic aid. DESIGN: Retrospective secondary analysis of a cohort of patients included in the FOTO-ED studies. METHODS: The testing data set included 1608 photographs obtained from 828 patients in the FOTO-ED studies. Photographs were reclassified according to the optic disc classification system used by the deep learning system ("normal optic discs," "papilledema," and "other optic disc abnormalities"). The system's performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity using a 1-vs-rest strategy, with reference to expert neuro-ophthalmologists. RESULTS: The BONSAI deep learning system successfully distinguished normal from abnormal optic discs (AUC 0.92 [95% confidence interval {CI} 0.90-0.93]; sensitivity 75.6% [73.7%-77.5%] and specificity 89.6% [86.3%-92.8%]), and papilledema from normal and others (AUC 0.97 [0.95-0.99]; sensitivity 84.0% [75.0%-92.6%] and specificity 98.9% [98.5%-99.4%]). Six patients with missed papilledema in 1 eye were correctly identified by the deep learning system as having papilledema in the other eye. CONCLUSIONS: The BONSAI deep learning system was able to reliably identify papilledema and normal optic discs on nonmydriatic photographs obtained in the FOTO-ED studies. Our deep learning system has excellent potential as a diagnostic aid in EDs and non-ophthalmology clinics equipped with nonmydriatic fundus cameras. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

18.
Radiother Oncol ; 191: 110061, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38122850

RESUMO

PURPOSE: Accurate and comprehensive segmentation of cardiac substructures is crucial for minimizing the risk of radiation-induced heart disease in lung cancer radiotherapy. We sought to develop and validate deep learning-based auto-segmentation models for cardiac substructures. MATERIALS AND METHODS: Nineteen cardiac substructures (whole heart, 4 heart chambers, 6 great vessels, 4 valves, and 4 coronary arteries) in 100 patients treated for non-small cell lung cancer were manually delineated by two radiation oncologists. The valves and coronary arteries were delineated as planning risk volumes. An nnU-Net auto-segmentation model was trained, validated, and tested on this dataset with a split ratio of 75:5:20. The auto-segmented contours were evaluated by comparing them with manually drawn contours in terms of Dice similarity coefficient (DSC) and dose metrics extracted from clinical plans. An independent dataset of 42 patients was used for subjective evaluation of the auto-segmentation model by 4 physicians. RESULTS: The average DSCs were 0.95 (+/- 0.01) for the whole heart, 0.91 (+/- 0.02) for 4 chambers, 0.86 (+/- 0.09) for 6 great vessels, 0.81 (+/- 0.09) for 4 valves, and 0.60 (+/- 0.14) for 4 coronary arteries. The average absolute errors in mean/max doses to all substructures were 1.04 (+/- 1.99) Gy and 2.20 (+/- 4.37) Gy. The subjective evaluation revealed that 94% of the auto-segmented contours were clinically acceptable. CONCLUSION: We demonstrated the effectiveness of our nnU-Net model for delineating cardiac substructures, including coronary arteries. Our results indicate that this model has promise for studies regarding radiation dose to cardiac substructures.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Aprendizado Profundo , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/radioterapia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Planejamento da Radioterapia Assistida por Computador/métodos , Coração/diagnóstico por imagem , Órgãos em Risco
19.
ANZ J Surg ; 94(4): 684-690, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38149760

RESUMO

BACKGROUND: The causes of death following colorectal resection remain poorly explored. Few studies have addressed whether early post-operative mortality is predominantly caused by a patient's medical co-morbidities, or from factors pertaining to the presenting surgical disease process itself. This study analyses data from the Queensland audit of surgical mortality (QASM) to report the causes of in-hospital death following colorectal resection, identifies whether these were due to either medical or surgical factors, and determines the patient characteristics associated with a medical cause of death. METHODS: Through analysis of QASM Surgical Case Forms, the causes of in-hospital death were determined in 750 patients who died in Queensland following colorectal resection between January 2010 and December 2020. Deaths were attributed to a specific medical or surgical cause, with multivariate analysis used to identify independent risk factors associated with a medical cause of death. RESULTS: In total, 395 patients (52.7%) died due to surgical causes and 355 (47.3%) died due to medical causes. Respiratory co-morbidities (OR 1.832, 95% CI: 1.267-2.650), advanced malignancy (OR 1.814, 95% CI: 1.262-2.607), neurological co-morbidities (OR 1.794, 95% CI: 1.168-2.757) and advanced age (OR 1.430, 95% CI: 1.013-2.017) were independent risk factors associated with increased risk of a medical cause of death. CONCLUSION: Even in the absence of complicating surgical factors, a significant number of patients died in hospital following colorectal resection due to their underlying co-morbidities. Multi-disciplinary models of care which allow for the early recognition and treatment of medical complications may reduce post-operative mortality in these patients.


Assuntos
Neoplasias Colorretais , Humanos , Causas de Morte , Mortalidade Hospitalar , Queensland/epidemiologia , Estudos Retrospectivos , Neoplasias Colorretais/patologia , Auditoria Médica
20.
EBioMedicine ; 98: 104889, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38043137

RESUMO

BACKGROUND: There is no consensus on reporting light characteristics in studies investigating non-visual responses to light. This project aimed to develop a reporting checklist for laboratory-based investigations on the impact of light on non-visual physiology. METHODS: A four-step modified Delphi process (three questionnaire-based feedback rounds and one face-to-face group discussion) involving international experts was conducted to reach consensus on the items to be included in the checklist. Following the consensus process, the resulting checklist was tested in a pilot phase with independent experts. FINDINGS: An initial list of 61 items related to reporting light-based interventions was condensed to a final checklist containing 25 items, based upon consensus among experts (final n = 60). Nine items were deemed necessary to report regardless of research question or context. A description of each item is provided in the accompanying Explanation and Elaboration (E&E) document. The independent pilot testing phase led to minor textual clarifications in the checklist and E&E document. INTERPRETATION: The ENLIGHT Checklist is the first consensus-based checklist for documenting and reporting ocular light-based interventions for human studies. The implementation of the checklist will enhance the impact of light-based research by ensuring comprehensive documentation, enhancing reproducibility, and enabling data aggregation across studies. FUNDING: Network of European Institutes for Advanced Study (NETIAS) Constructive Advanced Thinking (CAT) programme; Sir Henry Wellcome Postdoctoral Fellowship (Wellcome Trust, 204686/Z/16/Z); Netherlands Organisation for Health Research and Development VENI fellowship (2020-09150161910128); U.S. Department of Defense Grant (W81XWH-16-1-0223); National University of Singapore (NUHSRO/2022/038/Startup/08); and National Research Foundation Singapore (NRF2022-THE004-0002).


Assuntos
Lista de Checagem , Projetos de Pesquisa , Estados Unidos , Humanos , Reprodutibilidade dos Testes , Consenso
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