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Nevin Manimala Statistics

Assessment of the clinical knowledge of ChatGPT-4 in neonatal-perinatal medicine: a comparative analysis with ChatGPT-3.5

J Perinatol. 2024 Feb 24. doi: 10.1038/s41372-024-01912-8. Online ahead of print.

NO ABSTRACT

PMID:38402349 | DOI:10.1038/s41372-024-01912-8

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Nevin Manimala Statistics

Utilizing the sublingual form of squalene in COVID-19 patients: a randomized clinical trial

Sci Rep. 2024 Feb 24;14(1):4532. doi: 10.1038/s41598-024-54843-x.

ABSTRACT

In this study, the efficacy of sublingual squalene in decreasing the mortality rate among patients with COVID-19 was investigated. Squalene was extracted from pumpkin seed oil with a novel method. Then, the microemulsion form of squalene was prepared for sublingual usage. In the clinical study, among 850 admitted patients, 602 eligible COVID-19 patients were divided in two groups of control (N = 301) and cases (N = 301) between Nov 2021 and Jan 2022. Groups were statistically the same in terms of age, sex, BMI, lymphocyte count on 1st admission day, hypertension, chronic kidney disease, chronic respiratory disease, immunosuppressive disease, and required standard treatments. The treatment group received five drops of sublingual squalene every 4 h for 5 days plus standard treatment, while the control group received only standard treatment. Patients were followed up for 30 days after discharge from the hospital. The sublingual form of squalene in the microemulsion form was associated with a significant decrease in the mortality rate (p < 0.001), in which 285 (94.7%) cases were alive after one month while 245 (81.4%) controls were alive after 1 month of discharge from the hospital. In addition, squalene appears to be effective in preventing re-hospitalization due to COVID-19 (p < 0.001), with 141 of controls (46.8%) versus 58 cases (19.3%). This study suggests sublingual squalene in the microemulsion as an effective drug for reducing mortality and re-hospitalization rates in COVID-19 patients.Trial Registration Number: IRCT20200927048848N3.

PMID:38402329 | DOI:10.1038/s41598-024-54843-x

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Nevin Manimala Statistics

Impact of treatment guidelines and pivotal clinical trial results on a surgeon’s decision regarding treatment for gastric cancer: a retrospective cohort study using the National Clinical Database

Surg Today. 2024 Feb 24. doi: 10.1007/s00595-024-02814-0. Online ahead of print.

ABSTRACT

PURPOSES: The present study evaluated the impact of clinical guidelines for gastric cancer surgery on surgeons’ choice of procedure in real-world practice. We focused on the 2014 guideline revision recommending laparoscopic surgery and the evidence concerning splenectomy for prophylactic lymphadenectomy reported in 2015 using the National Clinical Database, which is the most comprehensive database in Japan.

METHODS: We investigated the monthly percentages of laparoscopic distal gastrectomies performed for stage I gastric cancer (LDG%) and splenectomies performed during total gastrectomy for advanced cancer (TGS%) between 2014 and 2017. We evaluated the descriptive statistics of the time-series changes in the LDG%, TGS%, and annual trends of outcomes.

RESULTS: In total, 124,787 patients were enrolled. The mean LDG% and TGS% were 69.8% and 9.2%, respectively. The LDG% and TGS% were 66.4% and 16.7%, respectively, in January 2014 and 73.1% and 5.9%, respectively, in December 2017. LDG% consistently increased, and TGS% showed a consistent downward trend throughout the observation period. There was no significant change in this trend after the publication of the guideline recommendations or clinical trial results.

CONCLUSION: No significant changes in surgical procedures were observed after publication of the guidelines or results of clinical trials.

PMID:38402328 | DOI:10.1007/s00595-024-02814-0

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Nevin Manimala Statistics

A new pilot shared method for saving bandwidth cost of OFDM

Sci Rep. 2024 Feb 24;14(1):4528. doi: 10.1038/s41598-024-55153-y.

ABSTRACT

The orthogonal frequency division multiplexing (OFDM) system applies coherent demodulation to achieve high spectral efficiency at a bandwidth cost by the pilot tones. Considering the statistical property of the down-link channels to the users, it can be found that there is an opportunity to reduce the pilot number in the conventional designs while maintaining the same signal demodulation performances. The design philosophy involves utilizing the difference of the channel coherent bandwidths (CCBs) by allocating data to appropriate positions upon the fact that different CCBs can tolerate different minimized pilot spacing. The proposed design allows each user’s equipment’s data not to exceed its CCB with the sparser pilots. The theoretical analysis is carried out based on the concept of channel frequency response using linear interpolation with channel estimation employing the least squares (LS) method. The gain of the proposed method is demonstrated in terms of the ergodic capacities and confirmed by the simulations.

PMID:38402301 | DOI:10.1038/s41598-024-55153-y

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Nevin Manimala Statistics

The spectrum of psychological disorders in family members of patients suffering from delirium associated with critical illness: a prospective, observational study

Sci Rep. 2024 Feb 24;14(1):4562. doi: 10.1038/s41598-024-53968-3.

ABSTRACT

During intensive care unit admission, relatives of critically ill patients can experience emotional distress. The authors hypothesized that families of patients who are diagnosed with intensive care unit (ICU) delirium experience more profound depression and anxiety disorders related to stress than do families of patients without delirium. We performed a prospective observational single-center study including families of adult patients (age above 18 years) hospitalized in a 17-bed ICU of a university hospital for at least 48 h who completed research questionnaires at day 2 after admission and day 30 after initial evaluation using dedicated questionnaires (HADS, CECS, IES, PTSD-C). A total of 98 family members of patients hospitalized in the ICU were included in the final analysis (50 family members whose relatives were CAM-ICU positive (DEL+), and 48 family members of patients without delirium (DEL-)). No statistically significant differences in demographics and psychosocial data were found between the groups. In the follow-up 30 days after the first conversation with a family member, the mean PTSD score for the relatives of patients with delirium was 11.02 (Me = 13.0; SD = 5.74), and the mean score for nondelirious patients’ family members was 6.42 (Me = 5.5; SD = 5.50; p < 0.001). A statistically significant increase in IES scores for family members of patients with delirium was observed for total PTSD (p = 0.001), IES-intrusion (p < 0.001), and IES-hyperarousal (p = 0.002). The prevalence of anxiety symptoms, depression, and posttraumatic stress disorder (PTSD) was higher in families of patients diagnosed with ICU delirium within 48 h of admission to the ICU. No factors increasing the depth of these disorders in family members of patients with ICU delirium were identified. Taking appropriate actions and thus providing families with appropriate support will contribute to the understanding of unfavorable emotional states, including anxiety, stress, depression, anger, agitation, or avoidance.

PMID:38402273 | DOI:10.1038/s41598-024-53968-3

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Nevin Manimala Statistics

Designing and psychometric assessment of the moral intelligence scale for healthcare professionals

Sci Rep. 2024 Feb 24;14(1):4515. doi: 10.1038/s41598-024-55052-2.

ABSTRACT

The moral intelligence of healthcare professionals in the cardiac operating room is one of the most important aspects of professional competence. However, moral intelligence is an abstract and multidimensional concept that needs to be clarified and described based on organizational culture and environment. Therefore, there is a need to design a specific scale for measuring the moral intelligence of healthcare professionals in the cardiac operating room. This study aims to design and assess the psychometric properties of a moral intelligence scale for healthcare professionals in the cardiac operating room. The present study was a mixed method study with a sequential exploratory approach. The research was conducted in 2023-2024 in Iran. The first phase data were collected from 20 healthcare professionals and were analyzed by conventional content analysis method. In the second phase, the validity and reliability of the instrument were evaluated by involving 300 healthcare professionals in the cardiac operating room. The moral intelligence of health care professionals in the cardiac operating room was defined as moral sensitivity combined with moral commitment and moral courage for the provision of quality care that respects the principles of medical ethics. After deducing the conceptual framework, the moral intelligence scale for healthcare professionals in the cardiac operating room was developed with three dimensions: “moral sensitivity,” “moral commitment,” and “moral courage.” 11 items were removed during testing to ensure content validity. Face validity was confirmed with impact scores > 1.5 for all items. A scale was developed through factor analysis with three factors that accounted for 73.04% of the observed variance. The instrument’s reliability using Cronbach’s alpha coefficient calculation was reported as 0.94 for the entire instrument. The testretest showed no statistically significant difference between the pre and post-test scores of moral intelligence (p = 0.51). The moral intelligence scale demonstrated acceptable psychometric properties. The moral intelligence scale for health care professionals in the cardiac operating room demonstrated acceptable psychometric properties. This instrument may serve to assess the moral intelligence of healthcare professionals and determine the need for educational interventions to reduce the ethical challenges and improve the moral intelligence of this healthcare.

PMID:38402272 | DOI:10.1038/s41598-024-55052-2

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Nevin Manimala Statistics

Early Versus Late Drainage Removal in Patients Who Underwent Pancreaticoduodenectomy: A Comprehensive Systematic Review and Meta-analysis of Randomized Controlled Trials Using Trial Sequential Analysis

Ann Surg Oncol. 2024 Feb 24. doi: 10.1245/s10434-024-14959-w. Online ahead of print.

ABSTRACT

BACKGROUND: The superiority of early drain removal (EDR) versus late (LDR) after pancreaticoduodenectomy (PD) has been demonstrated only in RCTs.

METHODS: A meta-analysis was conducted using a random-effects model and trial sequential analysis. The critical endpoints were morbidity, redrainage, relaparotomy, and postoperative pancreatic fistula (CR-POPF). Hemorrhage (PPH), delayed gastric emptying (DGE), length of stay (LOS), and readmission rates were also evaluated. Risk ratios (RRs) and mean differences (MDs) with a 95% confidence interval (CI) were calculated. Type I and type II errors were excluded, comparing the accrued sample size (ASS) with the required sample size (RIS). When RIS is superior to ASS, type I or II errors can be hypothesized.

RESULTS: ASS was 632 for all endpoints except DGE and PPH (557 patients). The major morbidity (RR 0.55; 95% CI 0.32-0.97) was lower in the EDR group. The CR-POPF rate was lower in the EDR than in the LDR group (RR 0.50), but this difference is not statistically significant (95% CI 0.24-1.03). The RIS to confirm or exclude these results can be reached by randomizing 5959 patients. The need for percutaneous drainage, relaparotomy, PPH, DGE, and readmission rates was similar. The related RISs were higher than ASS, and type II errors cannot be excluded. LOS was shorter in the EDR than the LDR group (MD – 2.25; 95% CI – 3.23 to – 1.28). The RIS was 567, and type I errors can be excluded.

CONCLUSIONS: EDR, compared with LDR, is associated with lower major morbidity and shorter LOS.

PMID:38402268 | DOI:10.1245/s10434-024-14959-w

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Nevin Manimala Statistics

Mesenchymal stem cells-derived extracellular vesicles for therapeutics of renal tuberculosis

Sci Rep. 2024 Feb 24;14(1):4495. doi: 10.1038/s41598-024-54992-z.

ABSTRACT

Extrapulmonary tuberculosis with a renal involvement can be a manifestation of a disseminated infection that requires therapeutic intervention, particularly with a decrease in efficacy of conventional regimens. In the present study, we investigated the therapeutic potency of mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) in the complex anti-tuberculosis treatment (ATT). A rabbit model of renal tuberculosis (rTB) was constructed by injecting of the standard strain Mycobacterium tuberculosis H37Rv into the cortical layer of the kidney parenchyma. Isolated rabbit MSC-EVs were intravenously administered once as an addition to standard ATT (isoniazid, pyrazinamide, and ethambutol). The therapeutic efficacy was assessed by analyzing changes of blood biochemical biomarkers and levels of anti- and pro-inflammatory cytokines as well as by renal computed tomography with subsequent histological and morphometric examination. The therapeutic effect of therapy with MSC-EVs was shown by ELISA method that confirmed a statistically significant increase of the anti-inflammatory and decrease of pro-inflammatory cytokines as compared to conventional treatment. In addition, there is a positive trend in increase of ALP level, animal weigh, and normalization of ADA activity that can indicate an improvement of kidney state. A significant reduction of the area of specific and interstitial inflammation indicated positive affect of MSC-EVs that suggests a shorter duration of ATT. The number of MSC-EVs proteins (as identified by mass-spectometry analysis) with anti-microbial, anti-inflammatory and immunoregulatory functions reduced the level of the inflammatory response and the severity of kidney damage (further proved by morphometric analysis). In conclusion, MSC-EVs can be a promising tool for the complex treatment of various infectious diseases, in particularly rTB.

PMID:38402260 | DOI:10.1038/s41598-024-54992-z

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Nevin Manimala Statistics

Remote Sensing-Based Extension of GRDC Discharge Time Series – A Monthly Product with Uncertainty Estimates

Sci Data. 2024 Feb 24;11(1):240. doi: 10.1038/s41597-024-03078-6.

ABSTRACT

The Global Runoff Data Center (GRDC) data set has faced a decline in the number of active gauges since the 1980s, leaving only 14% of gauges active as of 2020. We develop the Remote Sensing-based Extension for the GRDC (RSEG) data set that can ingest legacy gauge discharge and remote sensing observations. We employ a stochastic nonparametric mapping algorithm to extend the monthly discharge time series for inactive GRDC stations, benefiting from satellite imagery- and altimetry-derived river width and water height observations. After a rigorous quality assessment of our estimated discharge, involving statistical validation, tests and visual inspection, results in the extension of discharge records for 3377 out of 6015 GRDC stations. The quality of discharge estimates for the rivers with a large or medium mean discharge is quite satisfactory (average KGE value > 0.5) however for river reaches with a low mean discharge the average KGE value drops to 0.33.The RSEG data set regains monitoring capability for 83% of total river discharge measured by GRDC stations, equivalent to 7895 km3/month.

PMID:38402251 | DOI:10.1038/s41597-024-03078-6

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Nevin Manimala Statistics

Incidence of immunotherapy-related hyperprogressive disease (HPD) across HPD definitions and cancer types in observational studies: A systematic review and meta-analysis

Cancer Med. 2024 Feb;13(3):e6970. doi: 10.1002/cam4.6970.

ABSTRACT

BACKGROUND: While evidence of hyperprogressive disease (HPD) continues to grow, the lack of a consensual definition obscures a proper characterization of HPD incidence. We examined how HPD incidence varies by the tumor type or the type of definition used.

METHODS: We searched PubMed, Embase, the Cochrane Library of Systematic Reviews, and Web of Science from database inception to June 21, 2022. Observational studies reporting HPD incidence, in patients diagnosed with solid malignant tumors and treated with immune checkpoint inhibitors (ICI), were included. Random-effects meta-analyses were performed, and all statistical tests were 2-sided.

RESULTS: HPD incidence was 12.4% (95% CI 10.2%-15.0%) with evidence of heterogeneity (Q = 119.32, p < 0.001). Meta-regression showed that the risk of developing HPD was higher in patients with advanced gastric cancer (adjusted odds ratio [OR], 10.83; 95% CI, 2.14-54.65; p < 0.001), hepatocellular carcinoma (adjusted OR, 7.99; 95% CI, 1.68-38.13; p = 0.006), non-small cell lung cancer (adjusted OR, 7.14; 95% CI, 1.58-32.29; p = 0.005), and mixed or other types (adjusted OR, 5.09; 95% CI, 1.12-23.14, p = 0.018) than in patients with renal cell carcinoma. Across definitions, HPD defined as a tumor growth kinetics ratio ≥ 2 (adjusted OR, 1.82; 95% CI, 1.08-3.07; p = 0.025) based on the Response Evaluation Criteria in Solid Tumors (RECIST) reported higher incidence than when HPD was defined as RECIST-defined progressive disease and a change in the tumor growth rate (TGR) exceeding 50% (∆TGR > 50).

CONCLUSIONS: The incidence of immunotherapy-related HPD may vary across tumor types and definitions used, supporting the argument for a uniform and improved method of HPD evaluation for informed clinical decision-making.

PMID:38400685 | DOI:10.1002/cam4.6970