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Nevin Manimala Statistics

Comparison of two negative pressure ureteral access sheaths combined with day-case flexible ureteroscopy for renal stones randomized trial

Sci Rep. 2024 Nov 23;14(1):29092. doi: 10.1038/s41598-024-80934-w.

ABSTRACT

To compare the safety and effectiveness of the combination of intelligent intrarenal pressure control platforms and flexible end ureteral access sheath combined with flexible ureteroscopic lithotripsy (FURL) for the treatment of renal stones less than 2 cm with day case mode. From November 2023 to July 2024, a prospective, randomized, double-blind, parallel-controlled study was conducted to recruit 60 patients with upper urinary tract calculi measuring ≤ 2 cm in longest diameter. A total of 60 eligible patients were consecutively enrolled. Based on a pre-generated random number table and allocation scheme using SPSS 27.0, patients were assigned to either the intelligent pressure control group (IFURL, n = 30) or the head bending group (BFURL, n = 30). Blinding measures were implemented for patients, data collectors, statisticians, and analysts, with the allocation results disclosed to the surgeons prior to the start of the procedure in the operating room. The operation duration for IFURL and BFURL was 52.50 (48.00, 60.00) vs. 46.00 (36.00, 56.25), respectively (p = 0.047). Stone free rate (SFR) on the first postoperative day was 73.33% vs. 93.33% for IFURL and BFURL, respectively (p = 0.038). While, SFR was no significant difference between the two groups after two months(90.00% vs. 96.67%, p = 0.301). One patient in IFURL was readmitted after discharge due to fever 2 days post-discharge, and improved after 2 days of anti-infection treatment. One patient in BFURL was readmitted due to lumbar and abdominal pain from urine extravasation, which improved after 3 days of anti-infection treatment. SFR of one-month post-surgery for renal calculi ≤ 2 cm treated with intelligent pressure control and flexible UAS combined with FURL in day surgery mode was similar, with low infection-related complications and rehospitalization rates, showing no statistical difference. However, the overall hospitalization costs for the BFURL was lower than IFURL.

PMID:39580558 | DOI:10.1038/s41598-024-80934-w

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Sequential or simultaneous bilateral cochlear implantation: attention, memory, and language skills in children

Eur Arch Otorhinolaryngol. 2024 Nov 23. doi: 10.1007/s00405-024-09061-6. Online ahead of print.

ABSTRACT

PURPOSE: The effect of the inter-implant interval time on language and communication skills has been a subject of research for years in children with bilateral cochlear implants. This study aimed to investigate language and some attention and memory skills in children with bilateral sequential and simultaneous cochlear implants.

METHOD: The study included a total of 40 children aged between 6 and 8 years old, grouping bilateral simultaneous cochlear implanted children, sequential implanted children with 0-2 years interval, sequential implanted children with 2-4 years interval, and normal hearing peers. The language skills of the children were assessed using the Test of Language Development: Primary 4th edition, their selective attention and coping skills with disruptive effect were evaluated using the Stroop test, sustained attention and visual-motor synchronization skills were assessed using the Cancellation Test, and short-term memory skills were evaluated using the Visual Auditory Digit Span Test. The findings were analyzed using nonparametric statistical methods, with a significance level set at 0.05.

RESULTS: Children with bilateral simultaneous cochlear implants demonstrated better performance in language skills and the attention-related subtests of the Stroop test (p < 0.05). On the other hand, children with simultaneous and sequential cochlear implants achieved similar scores in the Cancellation and the Visual Auditory Digit Span Test (p > 0.05).

CONCLUSIONS: Bilateral simultaneous cochlear implantation in children is beneficial for language, selective attention, and coping with the Stroop effect. However, these children may still lag behind their normal-hearing peers in terms of language, attention, and memory skills.

PMID:39580553 | DOI:10.1007/s00405-024-09061-6

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The response characteristics and stability evaluation of vegetated slope under strong wind

Sci Rep. 2024 Nov 23;14(1):29045. doi: 10.1038/s41598-024-80428-9.

ABSTRACT

As one of the major geological disasters in southeastern China, typhoon-induced vegetation slope instability causes significant loss of life and property each year. Despite the criticality of this issue, the response mechanism of vegetated slopes to wind loading in terms of soil deformation and stability still remains unclear. This research conducted field investigations on 330 historical landslides in Yongjia County, Zhejiang Province, analyzing their spatiotemporal distribution and developmental characteristics to establish a conceptual model. The influence of wind and vegetation conditions on slope dynamic parameters and soil strength parameters were subsequently determined through numerical simulations using FLAC3D software, model tests, and direct shear tests. The results show that: (1) The influence of wind on the dynamic response of vegetated slopes is significantly affected by wind speed. At wind forces ≤ 12 (hurricane: 32.7-36.9 m/s), vegetation plays a positive role in enhancing slope stability. At wind forces ≥ 13 (typhoon: 37.0-41.4 m/s), vegetation exerts a negative influence under the combined action of strong wind loads. (2) Based on the experimentally determined evolution of soil strength parameters, a formula c (v, w) was fitted to express the variation of cohesion with wind speed (v) and moisture content (w). (3) The optimized evaluation model demonstrates increased sensitivity compared to the traditional model, resulting in a 17.88% increase in sliding force and a 10.62-11.64% increase in anti-sliding force. This research accounts for both the direct and indirect effects of wind loading on vegetated slopes. The findings are expected to enhance the stability assessment of vegetated slopes under strong winds and facilitate the development of more accurate machine learning and statistical models in the future.

PMID:39580534 | DOI:10.1038/s41598-024-80428-9

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Long-lasting residual efficacy of a new indoor residual spraying product, VECTRON™ T500 (broflanilide), against pyrethroid-resistant malaria vectors and its acceptance in a community trial in Burkina Faso

Parasit Vectors. 2024 Nov 23;17(1):484. doi: 10.1186/s13071-024-06577-y.

ABSTRACT

BACKGROUND: The WHO Global Malaria Programme advocates for a comprehensive, strategic approach to managing insecticide resistance, highlighting the importance of using multiple insecticides with different modes of action through rotations and combinations. To slow the spread of resistance, it is essential to develop and evaluate new formulations that feature unique modes of action and extended residual effects. Addressing this need, Mitsui Chemicals Crop & Life Solutions, Inc., developed VECTRON™ T500, a new indoor residual spraying (IRS) formulation using broflanilide, applied at a dosage of 100 mg AI/m2. This formulation was tested in a Phase III community trial, alongside Actellic® 300CS, a commonly used IRS product containing pirimiphos-methyl, applied at the recommended dosage of 1000 mg AI/m2.

METHODS: Monthly WHO wall cone bioassays were performed to assess the efficacy of the interventions using three mosquito strains: the laboratory-bred, insecticide-susceptible Anopheles gambiae s.s. Kisumu strain, the insecticide-resistant Anopheles coluzzii VKPer strain, and wild Anopheles gambiae s.l. mosquitoes from the Vallée du Kou, where the study was conducted. Vector surveillance was carried out to compare the results between sites treated with VECTRON™ T500, Actellic® 300CS, and an untreated control site. In addition, any reported adverse effects were closely monitored to evaluate the community’s acceptance of VECTRON T500.

RESULTS: VECTRON™ T500 consistently achieved 100% mortality across all wall types for both susceptible and resistant mosquito strains over the 12-month period. In comparison, Actellic® 300CS induced < 80% mortality for both strains, irrespective of the wall substrate. When assessing delayed mortality in An. gambiae s.l. mosquitoes collected from sites treated with Actellic® 300CS (VK1) and VECTRON™ T500 (VK3), a statistically significant difference was noted after a 72-h holding period compared to the control site (RR = 0.51, CI95% = [0.31-0.6], P = 0.0026). Additionally, no adverse events were reported in households sprayed with VECTRON™ T500.

CONCLUSIONS: The residual efficacy of VECTRON T500 extended for 12 months post-spraying, effectively covering the full malaria transmission season while maintaining high mortality rates in pyrethroid-resistant malaria vectors. VECTRON T500 demonstrated non-inferiority in performance compared to Actellic® 300CS, the standard reference product. This new IRS formulation has the potential to play a crucial role in managing insecticide resistance by being integrated into a rotational strategy alongside other IRS products containing insecticides with different modes of action.

PMID:39580476 | DOI:10.1186/s13071-024-06577-y

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“Ensembled transfer learning approach for error reduction in landslide susceptibility mapping of the data scare region”

Sci Rep. 2024 Nov 23;14(1):29060. doi: 10.1038/s41598-024-76541-4.

ABSTRACT

Landslide susceptibility map (LSM) plays an important role in providing the knowledge of slopes prone to future landslides. However, the applicability of LSM is often hindered due to high cost of data collection especially in mountainous region such as Himalayas. Therefore, this study proposes transfer learning approach (TL) to improve the performance of LSM by transferring the information from the data rich region (source) to data scare region (target). Two machine learning based model are trained in source area which is then transferred for prediction in target area and a source trained model combined with the knowledge of target is used for the prediction in the target area. The applicability of the proposed approach is tested considering Mandi district as source area and Kullu and Rudraprayag districts as target areas. Independent variables which included 11 landslide conducive factors from the source and target area, the independence was critically analysed using multi-collinearity test, while the geomorphic similarity was assessed using KL divergence method. Efficient machine learning method such as random forest (RF) and multi-layer perceptron (MLP) was used to train the models in both areas, statistical measure such as AUC-ROC, precision, recall, F-score, and accuracy were used to evaluate the performance of the LSMs. The results demonstrated the proposed approach for target area 1, the AUC value increased from 0.908 (Target trained on itself), to 0.942 (Target-Transfer Learned (TL)) and 0.959 (Target Combined) for RF and 0.896, 0.907 and 0.946 for MLP. Additionally, an increase in the precision was observed in RF while all other statistical measures increased to 0.023 for precision, 0.022 for recall, 0.023 for F-score and 0.066 for accuracy in the case of MLP. While on the other hand, in the case of target area 2, the AUC value for RF, ranged from 0.95 (Target area trained on itself), 0.80 (target TL) and 0.98 (target combined) and for MLP the AUC ranged from 0.82 for the source trained model while 0.84 for LSM obtained when both target and source data was used. Thus, the results revealed that proposed TL approach can be effective in improving the performance of LSM in data scare region in Himalayan region, thereby providing a promising approach in overcoming the issue of data limitation.

PMID:39580472 | DOI:10.1038/s41598-024-76541-4

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Post hoc analysis of ADAMANT, a phase 2 clinical trial of active tau immunotherapy with AADvac1 in patients with Alzheimer’s disease, positive for plasma p-tau217

Alzheimers Res Ther. 2024 Nov 23;16(1):254. doi: 10.1186/s13195-024-01620-7.

ABSTRACT

BACKGROUND: The spread of tau pathology closely correlates with the disease course and cognitive decline in Alzheimer’s disease (AD). Tau-targeting immunotherapies are being developed to stop the spread of tau pathology and thus halt disease progression. In this post hoc analysis of the ADAMANT clinical trial, we examined the performance of AADvac1, an active immunotherapy targeting the microtubule-binding region (MTBR) of tau, in a subgroup of participants with elevated plasma p-tau217, indicating AD-related neuropathological changes.

METHODS: ADAMANT was a 24-month, randomized, placebo-controlled, parallel-group, double-blinded, multicenter, phase 2 clinical trial in subjects with mild AD. The trial participants were randomized 3:2 to receive six doses of AADvac1 or placebo at 4-week intervals, followed by five booster doses at 14-week intervals. The primary outcome was safety. The secondary outcomes were the Clinical Dementia Rating-Sum of Boxes (CDR-SB), the Alzheimer’s Disease Cooperative Study – Activities of Daily Living score for Mild Cognitive Impairment 18-item version (ADCS-ADL-MCI-18), and immunogenicity. Volumetric MRI, plasma neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) were exploratory outcomes. The inclusion criterion for this post-hoc analysis was a baseline plasma p-tau217 level above the cutoff for AD.

RESULTS: Among 196 ADAMANT participants, 137 were positive for plasma p-tau217 (mean age 71.4 years, 59% women). AADvac1 was safe and well tolerated in this subgroup. AADvac1 reduced the rate of accumulation of log-plasma NfL by 56% and that of GFAP by 73%. The treatment differences in the CDR-SB and ADCS-ADL-MCI-18 scores favored AADvac1 but were not statistically significant. AADvac1 had no effect on whole-brain volume but nonsignificantly reduced the loss of brain cortical tissue in several regions. Importantly, the impact on the study outcomes was more pronounced in participants with higher anti-tau antibody levels.

CONCLUSIONS: These results suggest that AADvac1 tau immunotherapy can reduce plasma biomarkers of neurodegeneration and neuroinflammation. These findings and possible observations on brain atrophy and cognition are hypothesis-generating and warrant further evaluation in a larger clinical trial.

TRIAL REGISTRATION: EudraCT 2015-000630-30 (primary) and NCT02579252.

PMID:39580468 | DOI:10.1186/s13195-024-01620-7

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The predictive role of PD-L1 expression and CD8 + TIL levels in determining the neoadjuvant chemotherapy response in advanced ovarian cancer

J Ovarian Res. 2024 Nov 23;17(1):234. doi: 10.1186/s13048-024-01533-x.

ABSTRACT

OBJECTIVE: To analyze how the PD-L1 expression and CD8 + tumor infiltrating lymphocyte (TIL) levels in biopsy samples before neoadjuvant chemotherapy (NACT) can predict chemotherapy response score and survival for advanced high-grade serous ovarian cancer (HGSC).

METHODS: We retrospectively analyzed 45 patients with advanced epithelial ovarian cancer between 2010 and 2018, who had received at least three cycles of NACT. PD-L1 expression and CD8 + TIL levels were evaluated by immunohistochemical staining in the pre-NAC tumor samples from which the patients had been diagnosed. The post-NACT tissue samples taken during interval debulking surgery (IDS) were used to evaluate the chemotherapy response score (CRS).

RESULTS: Among all the patients, CRS 1 (no response) was found in 8 patients, CRS 2 (partial response) in 28 patients, and CRS 3 (complete response) in 9 patients. A total of 20 (44.4%) patients had high intratumoral CD8 + TILs (iCD8 + TILs) levels, and 35 (77.8%) patients had high expression stromal CD8 + TILs (sCD8 + TILs). No statistically significant relationship was found between high and low expression of i/s CD8 + TILs levels with PFS and CRS. The study found that 33 (73.3%) patients had high levels of stromal PD-L1 (sPD-L1) expression and 28 (62.2%) patients had high levels of intratumoral PD-L1 (iPD-L1) expression. In the iPD-L1 group, patients with low expression had a PFS of 28 months, whereas those with high expression had a PFS of 17 months (p = 0.028). Among the patients with high iPD-L1 expression, 23 (82.1%) patients showed CRS2, 4 (14.3%) showed CRS3, and only 1 (3.6%) showed CRS1 (p < 0.001). However, high or low expression sPD-L1 did not significantly affect PFS and CRS (p = 0.928 and p = 0.305; respectively).

CONCLUSIONS: We found that iPD-L1 expression levels in diagnostic biopsy in ovarian cancer can predict the chemotherapy response score in interval debulking surgery.

PMID:39580458 | DOI:10.1186/s13048-024-01533-x

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Page: investigating the predictors of general psychological help seeking intention among people who attempted suicide by using structural equation modeling

BMC Psychol. 2024 Nov 23;12(1):690. doi: 10.1186/s40359-024-02200-y.

ABSTRACT

BACKGROUND: The aim of this study was to determine the role of suicide literacy, suicide stigma, perceived social support, and attitudes toward seeking professional psychological help (ATSPPH) in predicting general help-seeking intention among individuals who have attempted suicide by structural equation modeling.

METHODS: This cross-sectional study was conducted among 462 people who were referred to the hospital due to suicide attempt in one of the cities of eastern Iran in 2023. The sampling method in this study was consecutive sampling. The Pearson correlation, One-way ANOVA, and Independent-samples t-test were used to analyze data by SPSS software. Also, AMOS software was used for conducting structural equation modeling and checking the standardized direct effects and standardized indirect effects between variables.

RESULTS: Only 0.9% (n = 4) of participants answered correctly more than 17 questions regarding suicide literacy. The structural equation modeling (SEM) results showed that suicide literacy, suicide stigma, perceived social support, and ATSPPH predicted 51% variance in the general help-seeking intention (R2 = 0.51, PGFI = 0.607, PCFI = 0.568, RMSEA = 0.064). The variables of suicide literacy (estimate total effect = 0.615), ATSPPH (estimate total effect = 0.368), perceived social support (estimate total effect = 0.123), and suicide stigma (estimate total effect = 0.033) had the greatest impact in predicting the general help-seeking intention.

CONCLUSION: The SEM results highlight the importance of paying more attention to suicide literacy, reducing suicide stigma, promoting social support, improving the positive attitude toward mental health services, encouraging people who have attempted suicide to seek psychological help, and finally preventing suicide attempt.

PMID:39580457 | DOI:10.1186/s40359-024-02200-y

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The joint distribution of years lived in good and poor health

Popul Health Metr. 2024 Nov 23;22(1):33. doi: 10.1186/s12963-024-00354-w.

ABSTRACT

BACKGROUND: Incidence-based multistate models of population health are commonly applied to calculate state expectancies, such as a healthy life expectancy (HLE), or unhealthy life expectancy (UHE). These models also allow the computation of other summary indices, such as the distributions of healthy or unhealthy lifespans.

OBJECTIVE: We aim to show how a multistate health model implies a multistate death distribution, giving joint information on years lived in good and poor health. We also propose three aggregate indices of joint health and mortality inequality.

METHODS: We propose a double-accounting approach to increment-decrement life table methods to intuitively derive a multistate health distribution over age and cumulative duration spent in each state. We then define a variety of summary lifespan inequality indices based on different distance metrics, namely Euclidean, Chebyshev, and Manhattan distances.

RESULTS: We apply the method to multistate transition probabilities between health states based on the activities of daily living index for Italian women from the Survey of Health, Ageing and Retirement in Europe in 2015-2017. We demonstrate the added value of accounting for joint years lived in health states in multistate models for our understanding of the period health and mortality conditions from the perspective of health-specific lifespans of individuals.

CONCLUSIONS: Multivariate state distributions and summary indices derived from them give a holistic representation of population health inequality. We offer selected summary indices of the multivariate distribution with different demographic interpretations from the measures derived from univariate distributions. Although more theoretical and methodological work is required to motivate a single comprehensive population health inequality index, this direction is a promising path for a better understanding of population health dynamics and relationships between univariate statistics.

PMID:39580455 | DOI:10.1186/s12963-024-00354-w

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Frontotemporal structure preservation underlies the protective effect of lifetime intellectual cognitive reserve on cognition in the elderly

Alzheimers Res Ther. 2024 Nov 23;16(1):255. doi: 10.1186/s13195-024-01613-6.

ABSTRACT

BACKGROUND: Cognitive decline with age has heterogeneous, which might be related to the accumulation of protective factors called cognitive reserve, especially intellectual engagement factors over the life course. However, how lifetime intellectual cognitive reserve (LICR) protects cognitive function in the elderly remains unclear. We aimed to examine the relationship between LICR and cognition and the mild cognitive impairment (MCI) risk, as well as the neural mechanism of LICR on cognition.

METHODS: A total of 5126 participants completed extensive neuropsychological tests, with LICR indicator encompassing early education, midlife occupational complexity, and mental leisure activities after retirement. Confirmatory factor analysis was performed to derive LICR score and cognitive function scores, then the hierarchical regression analysis was used to explore the relationship between LICR and cognitive functions and the risk of MCI. We further explored the macro- and micro-structural preservation underly LICR in 1117 participants. Multiple regressions and tract-based spatial statistics were used to explore the relationship between LICR and gray matter volume and white matter microstructure (FA value). Finally, using the mediation model to explore the relationship of “LICR-brain-cognition”.

RESULT: The new LICR index, which was more protective than its single indexes, could protect widespread cognitive functions and was associated with a reduction in MCI risk (Odds Ratio, 0.52; 95% CI, 0.47-0.57). For the structure basis of LICR, the higher LICR score was associated with the greater gray matter volume in right fusiform gyrus (t = 4.62, FDR corrected, p < 0.05) and left orbital superior frontal gyrus (t = 4.56, FDR corrected, p < 0.05), and the higher FA values in the frontotemporal related white matter fiber tracts. Furthermore, the right fusiform gyrus partially mediated the relationship between LICR and executive processing ability (β = 0.01, p = 0.02) and general cognitive ability (β = 0.01, p = 0.03).

CONCLUSIONS: The new comprehensive cognitive reserve index could promote the temporal macro-structural preservation and thus contribute to maintain better cognitive function. These findings highlight the importance of intellectual CR accumulation over the life course in successful cognitive aging and MCI prevention, thereby contributing to improve the quality of life in the elderly.

PMID:39580450 | DOI:10.1186/s13195-024-01613-6