Room model based Monte Carlo simulation study of the relationship between the airborne dose rate and the surface-deposited radon progeny

The quantitative relationships between radon gas concentration, the surface-deposited activities of various radon progeny, the airborne radon progeny dose rate, and various residential environmental factors were investigated through a Monte Carlo simulation study based on the extended Jacobi room model. Airborne dose rates were calculated from the unattached and attached potential alpha-energy concentrations (PAECs) using two dosimetric models. Surface-deposited 218Po and 214Po were significantly correlated with radon concentration, PAECs, and airborne dose rate (p-values 218Po and 214Po as predictors. In non-smoking environments, after adjusting for the effect of radon, deposited 214Po was a significant positive predictor for one dose model (RR 1.46, 95% CI 1.27–1.67), while deposited 218Po was a negative predictor for the other dose model (RR 0.90, 95% CI 0.83–0.98). In smoking environments, after adjusting for radon and room size, deposited 218Po was a significant positive predictor for one dose model (RR 1.10, 95% CI 1.02–1.19), while a significant negative predictor for the other model (RR 0.90, 95% CI 0.85–0.95). After adjusting for radon and deposited 218Po, significant increases of 1.14 (95% CI 1.03–1.27) and 1.13 (95% CI 1.05–1.22) in the mean dose rates were found for large room sizes relative to small room sizes in the different dose models

Field investigation of the surface-deposited radon progeny as a possible predictor of the airborne radon progeny dose rate

The quantitative relationships between radon gas concentration, the surface-deposited activities of various radon progeny, the airborne radon progeny dose rate, and various residential environmental factors were investigated through actual field measurements in 38 selected Iowa houses occupied by either smokers or nonsmokers. Airborne dose rate was calculated from unattached and attached potential alpha energy concentrations (PAECs) using two dosimetric models with different activity-size weighting factors. These models are labeled Pdose and Jdose, respectively. Surface-deposited 218Po and 214Po were found significantly correlated to radon, unattached PAEC, and both airborne dose rates (p \u3c 0.0001) in nonsmoking environments. However, deposited 218Po was not significantly correlated to the above parameters in smoking environments. In multiple linear regression analysis, natural logarithm transformation was performed for airborne dose rate as the dependent variable, as well as for radon and deposited 218Po and 214Po as predictors. An interaction effect was found between deposited 214Po and an obstacle in front of the Retrospective Reconstruction Detector (RRD) in predicting dose rate (p = 0.049 and 0.058 for Pdose and Jdose, respectively) for nonsmoking environments. After adjusting for radon and deposited radon progeny effects, the presence of either cooking, usage of a fireplace, or usage of a ceiling fan significantly, or marginally significantly, reduced the Pdose to 0.65 (90% CI 0.42–0.996), 0.54 (90% CI 0.28–1.02), and 0.66 (90% CI 0.45–0.96), respectively. For Jdose, only the usage of a ceiling fan significantly reduced the dose rate to 0.57 (90% CI 0.39–0.85). In smoking environments, deposited 218Po was a significant negative predictor for Pdose (RR 0.68, 90% CI 0.55–0.84) after adjusting for long-term 222Rn and environmental factors. A significant decrease of 0.72 (90% CI 0.64–0.83) in the mean Pdose was noted, after adjusting for the radon and radon progeny effects and other environmental factors, for every 10 additional cigarettes smoked in the room. A significant increase of 1.71 in the mean Pdose was found for large room size relative to small room size (90% CI 1.08–2.79) after adjusting for the radon and radon progeny effects as well as other environmental factors. Fireplace usage was found to significantly increase the mean Pdose to 1.71 (90% CI 1.20–2.45) after adjusting for other factors

Clinical and cost outcomes from different hyaluronic acid treatments in patients with knee osteoarthritis: evidence from a US health plan claims database

Background: Intra-articular injection of hyaluronic acid (HA) for knee osteoarthritis (OA) effectively reduces pain and delays total knee replacement (TKR) surgery; however, little is known about relative differences in clinical and cost outcomes among different HA products. Objective: To compare disease-specific costs and risk of TKR among patients receiving different HA treatments in a commercially insured cohort of patients with knee OA in the USA. Method: Retrospective analyses using IMS Health’s PharMetrics Plus Health Plan Claims Database were conducted by identifying knee OA patients with claims indicating initiation of HA treatment at an ‘index date’ during the selection period (2007–2010). Patients were required to be continuously enrolled in the database for 12 months preindex to 36 months postindex. A generalized linear model (GLM) with a gamma distribution and log-link function was used to model aggregate patient-based changes in disease-specific costs. A Cox proportional hazards model (PHM) was used to model the risk of TKR. Both multivariate models included covariates such as age, gender, comorbidities, and preindex healthcare costs. Results: 50,389 patients with HA treatment for knee OA were identified. 18,217 (36.2%) patients were treated with HA products indicated for five injections per treatment course (Supartz and Hyalgan). The remainder were treated with HA products indicated for fewer than five injections per treatment course, with 20,518 patients (40.7%) receiving Synvisc; 6,263 (12.4%), Euflexxa; and 5,391 (10.7%), Orthovisc. Synvisc- and Orthovisc-injected patients had greater disease-specific costs compared to Supartz/Hyalgan (9.0%, p<0.0001 and 6.8%, p=0.0050, respectively). Hazard ratios (HRs) showed a significantly higher risk of TKR for patients receiving Synvisc compared to Supartz/Hyalgan (HR=1.069, p=0.0009). Patients treated with Supartz/Hyalgan, Euflexxa, and Orthovisc had longer delays to TKR than those treated with Synvisc. Conclusion: Analysis of administrative claims data provides real-world evidence that meaningful differences exist among some HA products in disease-specific cost and time to knee replacement surgery

Edge-Guided Cell Segmentation on Small Datasets Using an Attention-Enhanced U-Net Architecture

Over the past several decades, deep neural networks have been extensively applied to medical image segmentation tasks, achieving significant success. However, the effectiveness of traditional deep segmentation networks is substantially limited by the small scale of medical datasets, a limitation directly stemming from current medical data acquisition capabilities. To this end, we introduce AttEUnet, a medical cell segmentation network enhanced by edge attention, based on the Attention U-Net architecture. It incorporates a detection branch enhanced with edge attention and a learnable fusion gate unit to improve segmentation accuracy and convergence speed on small medical datasets. The AttEUnet allows for the integration of various types of prior information into the backbone network according to different tasks, offering notable flexibility and generalization ability. This method was trained and validated on two public datasets, MoNuSeg and PanNuke. The results show that AttEUnet significantly improves segmentation performance on small medical datasets, especially in capturing edge details, with F1 scores of 0.859 and 0.888 and Intersection over Union (IoU) scores of 0.758 and 0.794 on the respective datasets, outperforming both convolutional neural networks (CNNs) and transformer-based baseline networks. Furthermore, the proposed method demonstrated a convergence speed over 10.6 times faster than that of the baseline networks. The edge attention branch proposed in this study can also be added as an independent module to other classic network structures and can integrate more attention priors based on the task at hand, offering considerable scalability

Monolithically integrated wide field-of-view metalens by angular dispersionless metasurface

Meta-lenses, which are made by sub-wavelength metallic or dielectric elements, have attracted widespread attentions due to its unprecedented electromagnetic wave manipulation abilities and novel applications. Dissimilar to previous metalens doublet by all-dielectric metasurfaces in the optical band, an innovative and more robust approach by angular dispersionless meta-atom to directly eliminate aberrations in low spectrum is proposed. As a proof of concept, an elaborately selected singlet metallic resonator for simultaneously high transmission, full phase coverage and the ignored angular dispersion is presented in the microwave. The designed metalens with only one single phase gradient profile can focus wide field-of-view (FOV) incident waves of ± 40° with both a large numerical aperture of 0.56 (NA = 0.56) and high focusing efficiency of 53 % on average at microwave regime. The metalens is also fabricated by a single-step printed circuit board technique and the measured high-performance focusing are also achieved for the entire FOV. The presented on-chip and integrated wide FOV metalens provides a simple yet cost-effective method to develop wide-angle metalenses especially in low frequency band where plasmonic metasurfaces are commonly adopted. Besides, its excellent wide-angle focusing performances can satisfy diverse applications in modern radar engineering such as imaging, sensing, communications and detection, etc

Early examination of real-world uptake and second-dose completion of recombinant zoster vaccine in the United States from October 2017 to September 2019

Shingrix (Recombinant zoster vaccine, RZV) was approved in October 2017 in the United States (US) for the prevention of herpes zoster in adults aged 50 years and older. The vaccine is administered in two doses, with the second dose administration recommended between two and six months after the first dose. Examination of uptake and series completion is important to ensure appropriate use, especially at the time of vaccine introduction. This report provides demographic characteristics of patients receiving RZV between October 2017 and September 2019, first- and second-dose uptake, and a cumulative estimation of second-dose completion by month for US adults aged 50 years and older. Monthly uptake increased rapidly since October 2017; overall, 7,097,441 first doses of RZV were administered along with 4,277,636 second doses during the observed timeframe. Among people with an observed first-dose administration, 70% and 80% completed the two-dose series within six and 12 months post initial dose, respectively. This evidence suggests that RZV has rapidly been adopted by a large population in the US and most are following manufacturer or policy recommendations regarding series completion. Further analyses are needed to explore potential patient, provider, and policy-relevant characteristics associated with second-dose completion that could serve as targets for further improvement

Upregulated TUBG1 expression is correlated with poor prognosis in hepatocellular carcinoma

Background Hepatocellular carcinoma (HCC) development is a complex pathological process. Tubulin gamma 1 (TUBG1) plays an oncogenic role in several human cancers; however, its functional role in HCC tumorigenesis remains unknown. Methods Herein we first evaluated the gene expression levels of TUBG1 in HCC using data from The Cancer Genome Atlas and Gene Expression Profiling Interactive Analysis databases. We then elucidated the association between TUBG1 gene expression levels and survival rates of patients with HCC. Cell cycle, proliferation, transwell migration, and matrigel invasion assays were used to study the effects of TUBG1 on the malignant phenotypes of HCC cells. Results Based on the data obtained from the aforementioned databases and our in vitro experiments, TUBG1 was found to be overexpressed in HCC and patients with high TUBG1 expression levels showed a remarkably poor overall survival rate. In addition, the expression of TUBG1 significantly promoted the malignant phenotypes of HCC cells in vitro. Gene ontology term enrichment analysis revealed that co-regulated genes were enriched in biological processes mainly involved in chromosome segregation, chromosomal region, and chromatin binding; moreover, Kyoto Encyclopedia of Genes and Genome pathway analysis showed that they were mainly involved in cell cycle, oocyte meiosis, platinum drug resistance, and the p53 signaling pathway. Conclusions We report that TUBG1 is an important oncogene in HCC. It promotes HCC progression and may serve as a potential prognostic biomarker for HCC. Future studies are warranted to unveil molecular biological mechanisms underlying TUBG1 carcinogenesis

Geographic variations in lipid-lowering therapy utilization, LDL-C levels, and proportion retrospectively meeting the ACC/AHA very high-risk criteria in a real-world population of patients with major atherosclerotic cardiovascular disease events in the United States

Objective: We assessed national- and state-level geographic variations among patients with a history of ≥1 major atherosclerotic cardiovascular disease (ASCVD) event in: (1) the proportion of patients with retrospectively identified 2018 American College of Cardiology/American Heart Association guideline very high-risk (VHR) ASCVD criteria; (2) utilization of guideline-directed lipid-lowering therapy (LLT); and (3) the proportion of patients with persistent low-density lipoprotein cholesterol (LDL-C) elevations despite statin and/or ezetimibe use. Methods: A retrospective cohort study using the Prognos LDL-C database linked to IQVIA longitudinal medical and prescription claims databases. The study period was from January 01, 2011, to November 30, 2019 and the index period was from January 01, 2016, to November 30, 2019; the index date was defined as the most recent LDL-C test during the index period. The study included patients aged ≥18 years at index who had a measured LDL-C level during the index period and had ≥1 inpatient/outpatient claim for ASCVD during the 5-year pre-index period. Results: Of patients with any ASCVD (N=4652,468), 1537,514 (33.1%) patients had ≥1 major ASCVD event. Among patients with ≥1 major ASCVD event, the VHR ASCVD criteria were retrospectively identified in 1139,018 (74.1%) patients; Hawaii had the highest (81.7%) and Colorado the lowest (65.0%) proportion of these patients. Nationally, 48.8% and 50.2% of patients with ≥1 major ASCVD event and retrospectively identified VHR ASCVD criteria, respectively, had current LLT use; Massachusetts and Colorado had the highest and lowest proportions, respectively. After standardizing for age and sex, 57.3% and 58.8% of patients with ≥1 major ASCVD event and retrospectively identified VHR ASCVD criteria, respectively, had LDL-C ≥70 mg/dL (≥1.8 mmol/L) despite statin and/or ezetimibe use, with substantial state-level variations observed. Conclusions: The study highlights high rates of elevated LDL-C and pervasive underuse of LLT in health-insured patients with a history of major ASCVD events treated in the United States, with state-level geographic variations observed