Tag: nevin manimala

Eur Heart J Qual Care Clin Outcomes. 2023 Sep 2:qcad050. doi: 10.1093/ehjqcco/qcad050. Online ahead of print.

ABSTRACT

AIMS: To conduct a contemporary cost-effectiveness analysis examining the use of implantable cardioverter defibrillators (ICD) for primary prevention in patients with hypertrophic cardiomyopathy (HCM).

METHODS: A discrete-time Markov model was used to determine the cost-effectiveness of different ICD decision-making rules for implantation. Several scenarios were investigated including the reference scenario of implantation rates according to observed real world practice. A 12-year time horizon with an annual cycle length was used. Transition probabilities used in the model were obtained using Bayesian analysis. The study has been reported according to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist.

RESULTS: Using a 5-year SCD risk threshold of 6% was cheaper than current practice and has marginally better total quality adjusted life years (QALYs). This is the most cost-effective of the options considered, with an incremental cost effectiveness ratio of £834 per QALY. Sensitivity analyses highlighted that this decision is largely driven by what health related quality of life (HRQL) is attributed to ICD patients and time horizon.

CONCLUSION: We present a timely new perspective on HCM ICD cost-effectiveness, using methods reflecting real-world practice. While we have shown that a 6% 5-year SCD risk cut-off provides the best cohort stratification to aid ICD decision-making, this will also be influenced by the particular values of costs and HRQL for subgroups or at a local level. The process of explicitly demonstrating the main factors which drive conclusions from such an analysis will help to inform shared decision-making in this complex area for all stakeholders concerned.

PMID:37660245 | DOI:10.1093/ehjqcco/qcad050

Prostate Cancer Prostatic Dis. 2023 Sep 2. doi: 10.1038/s41391-023-00714-x. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the histopathological concordance rates between prostate biopsies and radical prostatectomy specimens according to the applied biopsy approach (transrectal or transperineal).

METHODS: We studied patients who had been newly diagnosed with clinically significant prostate cancer and who underwent a radical prostatectomy between 2018 and 2022. Patients were included if they underwent a prebiopsy magnetic resonance imaging and if they had not been previously treated for prostate cancer. Histopathological grading on prostate biopsies was compared with that on radical prostatectomy specimens. Univariable and multivariable logistic regression analyses were performed to assess the effect of the applied biopsy approach on histopathological concordance. Additional analyses were performed to assess the effect of the applied biopsy approach on American Urological Association risk group migration, defined as any change in risk group after radical prostatectomy.

RESULTS: In total, 1058 men were studied, of whom 49.3% (522/1058) and 50.7% (536/1058) underwent transrectal and transperineal prostate biopsies, respectively. Histopathological disconcordance was observed in 37.8% (400/1058) of men while American Urological Association risk group migration was observed in 30.2% (320/1058) of men. A transperineal biopsy approach was found to be independently associated with higher histopathological concordance rates (OR 1.33 [95% CI 1.01-1.75], p = 0.04) and less American Urological Association risk group migration (OR 0.70 [95% CI 0.52-0.93], p = 0.01).

CONCLUSIONS: The use of a transperineal biopsy approach improved histopathological concordance rates compared to the use of a transrectal biopsy approach. A transperineal biopsy approach may provide more accurate risk stratification for clinical decision-making. Despite recent improvements, histopathologic concordance remains suboptimal and should be considered before initiating management.

PMID:37660218 | DOI:10.1038/s41391-023-00714-x

Int J Impot Res. 2023 Sep 2. doi: 10.1038/s41443-023-00758-6. Online ahead of print.

ABSTRACT

The prevalence of penile calcification in the population remains uncertain. This retrospective multicenter study aimed to determine the prevalence and characteristics of penile calcification in a large cohort of male patients undergoing non-contrast pelvic tomography. A total of 14 545 scans obtained from 19 participating centers between 2016 and 2022 were retrospectively analyzed within a 3-months period. Eligible scans (n = 12 709) were included in the analysis. Patient age, penile imaging status, presence of calcified plaque, and plaque measurements were recorded. Statistical analysis was performed to assess the relationships between calcified plaque, patient age, plaque characteristics, and plaque location. Among the analyzed scans, 767 (6.04%) patients were found to have at least one calcified plaque. Patients with calcified plaque had a significantly higher median age (64 years (IQR 56-72)) compared to those with normal penile evaluation (49 years (IQR 36-60) (p < 0.001). Of the patients with calcified plaque, 46.4% had only one plaque, while 53.6% had multiple plaques. There was a positive correlation between age and the number of plaques (r = 0.31, p < 0.001). The average dimensions of the calcified plaques were as follows: width: 3.9 ± 5 mm, length: 5.3 ± 5.2 mm, height: 3.5 ± 3.2 mm, with an average plaque area of 29 ± 165 mm² and mean plaque volume of 269 ± 3187 mm³. Plaques were predominantly located in the proximal and mid-penile regions (44.1% and 40.5%, respectively), with 77.7% located on the dorsal side of the penis. The hardness level of plaques, assessed by Hounsfield units, median of 362 (IQR 250-487) (range: 100-1400). Patients with multiple plaques had significantly higher Hounsfield unit values compared to those with a single plaque (p = 0.003). Our study revealed that patients with calcified plaques are older and have multiple plaques predominantly located on the dorsal and proximal side of the penis.

PMID:37660216 | DOI:10.1038/s41443-023-00758-6

Sci Rep. 2023 Sep 2;13(1):14441. doi: 10.1038/s41598-023-41093-6.

ABSTRACT

Customer churn remains a critical challenge in telecommunications, necessitating effective churn prediction (CP) methodologies. This paper introduces the Enhanced Gradient Boosting Model (EGBM), which uses a Support Vector Machine with a Radial Basis Function kernel (SVM_RBF) as a base learner and exponential loss function to enhance the learning process of the GBM. The novel base learner significantly improves the initial classification performance of the traditional GBM and achieves enhanced performance in CP-EGBM after multiple boosting stages by utilizing state-of-the-art decision tree learners. Further, a modified version of Particle Swarm Optimization (PSO) using the consumption operator of the Artificial Ecosystem Optimization (AEO) method to prevent premature convergence of the PSO in the local optima is developed to tune the hyper-parameters of the CP-EGBM effectively. Seven open-source CP datasets are used to evaluate the performance of the developed CP-EGBM model using several quantitative evaluation metrics. The results showed that the CP-EGBM is significantly better than GBM and SVM models. Results are statistically validated using the Friedman ranking test. The proposed CP-EGBM is also compared with recently reported models in the literature. Comparative analysis with state-of-the-art models showcases CP-EGBM’s promising improvements, making it a robust and effective solution for churn prediction in the telecommunications industry.

PMID:37660198 | DOI:10.1038/s41598-023-41093-6

Sci Rep. 2023 Sep 2;13(1):14409. doi: 10.1038/s41598-023-41751-9.

ABSTRACT

The flame of converter mouth can well reflect the change of temperature and composition of molten steel in the furnace. The flame characteristics of converter mouth collected by device can well predict the smelting process of converter. Based on the flame spectrum data set of converter mouth, this paper uses the BEADS algorithm and rough set attribute reduction algorithm optimized by genetic algorithm to extract the features of 2048-dimensional wavelength data. Through the model, eight indexes that contribute greatly to temperature and carbon content are selected, which are f-507, f-520, f-839, f-1073, f-1371, f-1528, f-1727 and f-1826. The MIC coefficients of the eight indicators with temperature and carbon content are calculated, and the MIC coefficients of the variables is small, and the selected indicators are representative. There was a significant correlation between temperature and C content. In BP neural network of temperature prediction model, it is found that the prediction accuracy of the training set is 0.99, the prediction accuracy of the test set is 0.99, the prediction accuracy of the verification set is 0.99, and the prediction accuracy of the whole set is 0.99. Through statistics, it is found that the hit rate of the temperature model in the range of ± 5 K is 88.7%, and the hit rate in the range of ± 10 K is 98.4%. and the RMSE parameter analysis shows that the average prediction error is 3.85 K. In BP neural network of carbon content prediction model, it is found that the prediction accuracy of the training set is 0.99, the prediction accuracy of the test set is 0.99, the prediction accuracy of the verification set is 0.98, and the prediction accuracy of the whole set is 0.99. Through statistics, it is found that the hit rate of the carbon contents model in the range of ± 0.05% is 94.0%, and the hit rate in the range of ± 0.10% is 98.3%, and the RMSE parameter analysis shows that the average prediction error is 0.021%. Finally, the universality of the model is verified by MIV algorithm.

PMID:37660162 | DOI:10.1038/s41598-023-41751-9

Commun Biol. 2023 Sep 2;6(1):901. doi: 10.1038/s42003-023-05283-2.

ABSTRACT

Early embryonic development is a dynamic process that relies on proper cell-cell communication to form a correctly patterned embryo. Early embryo development-related ligand-receptor pairs (eLRs) have been shown to guide cell fate decisions and morphogenesis. However, the scope of eLRs and their influence on early embryo development remain elusive. Here, we developed a computational framework named TimeTalk from integrated public time-course mouse scRNA-seq datasets to decipher the secret of eLRs. Extensive validations and analyses were performed to ensure the involvement of identified eLRs in early embryo development. Process analysis identified that eLRs could be divided into six temporal windows corresponding to sequential events in the early embryo development process. With the interpolation strategy, TimeTalk is powerful in revealing paracrine settings and studying cell-cell communication during early embryo development. Furthermore, by using TimeTalk in the blastocyst and blastoid models, we found that the blastoid models share the core communication pathways with the epiblast and primitive endoderm lineages in the blastocysts. This result suggests that TimeTalk has transferability to other bio-dynamic processes. We also curated eLRs recognized by TimeTalk, which may provide valuable clues for understanding early embryo development and relevant disorders.

PMID:37660148 | DOI:10.1038/s42003-023-05283-2

Nat Commun. 2023 Sep 2;14(1):5344. doi: 10.1038/s41467-023-40914-6.

ABSTRACT

Entanglement and correlation of quantum light can enhance LiDAR sensitivity in the presence of strong background noise. However, the power of such quantum sources is fundamentally limited to a stream of single photons and cannot compete with the detection range of high-power classical LiDAR transmitters. To circumvent this, we develop and demonstrate a quantum-inspired LiDAR prototype based on coherent measurement of classical time-frequency correlation. This system uses a high-power classical source and maintains the high noise rejection advantage of quantum LiDARs. In particular, we show that it can achieve over 100dB rejection (with 100ms integration time) of indistinguishable (with statistically identical properties in every degree of freedom) in-band noise while still being sensitive to single photon signals. In addition to the LiDAR demonstration, we also discuss the potential of the proposed LiDAR receiver for quantum information applications. In particular, we propose the chaotic quantum frequency conversion technique for coherent manipulation of high dimensional quantum states of light. It is shown that this technique can provide improved performance in terms of selectivity and efficiency as compared to pulse-based quantum frequency conversion.

PMID:37660136 | DOI:10.1038/s41467-023-40914-6

Ann Gen Psychiatry. 2023 Sep 2;22(1):33. doi: 10.1186/s12991-023-00464-z.

ABSTRACT

BACKGROUND: Risperidone ISM^® is a newly developed long-acting injectable (LAI) treatment for schizophrenia in adults. In the absence of head-to-head comparisons with other similar antipsychotics, the objective of this study was to generate indirect evidence of some aspects of the safety and tolerability of Risperidone ISM compared to other LAI antipsychotics for treatment of patients with schizophrenia in the maintenance treatment setting.

METHODS: A literature review was conducted systematically to identify maintenance treatment studies reporting safety and tolerability outcomes for LAI antipsychotic therapies. Following an assessment of between-trial heterogeneity, a matching-adjusted indirect comparison (MAIC) was performed to account for between-trial imbalances in patient characteristics and to generate comparative evidence for safety and tolerability endpoints.

RESULTS: The analysis showed that incidence of extrapyramidal symptoms (EPS) was found to be numerically, but not statistically significantly, lower in patients receiving Risperidone ISM than in those receiving Paliperidone palmitate (PP) (OR [95% CI] 0.63 [0.29, 1.38], p = 0.253) and statistically significantly lower than with Aripiprazole monohydrate once-monthly (AOM) (OR [95% CI] 0.25 [0.12, 0.53], p < 0.001). Use of anticholinergic agents for the alleviation of EPS was also shown to be significantly lower in Risperidone ISM patients than in those receiving PP (OR [95% CI] 0.29 [0.10, 0.83], p = 0.021) or AOM (OR [95% CI] 0.01 [0.003, 0.06], p < 0.001), suggesting a superior tolerability profile for clinically relevant EPS. Results from the sensitivity analyses comparing stabilized and stable patients receiving Risperidone ISM to those receiving AOM yielded similarly favorable conclusions in line with the base case analyses.

CONCLUSIONS: This MAIC is consistent with the safety and tolerability results obtained during the PRISMA-3 clinical trial in the long-term treatment of schizophrenia and suggests a favorable safety and tolerability profile in terms of EPS incidence and anticholinergic agent use, relative to other antipsychotic therapies used for treatment of patients with schizophrenia in the maintenance setting.

PMID:37660132 | DOI:10.1186/s12991-023-00464-z

J Ovarian Res. 2023 Sep 2;16(1):184. doi: 10.1186/s13048-023-01259-2.

ABSTRACT

BACKGROUND: We aimed to determine whether adding metformin to carboplatin treatment would reduce the damage to ovarian reserve associated with carboplatin use.

METHODS: We included 35 adult female non-pregnant albino Wistar rats approximately three months old, weighing 220-310 g. The rats were divided into five groups of seven rats according to the treatment they received. Carboplatin and salin was given to Group 2, and carboplatin plus metformin was given to Group 3. Group 4 was administered only metformin. Group 5 was administered only salin. Carboplatin was given to Groups 2 and 3 as a single dose on the 15th day, while metformin was given to Groups 3 and 4 during the 28-day experiment. After oophorectomy, histopathologic analyses of primordial, primary, secondary, and tertiary Graff follicles according to the epithelial cells surrounding the oocyte and total follicular number were conducted per section. Serum Anti-Mullerian Hormone (AMH), tissue catalase, and malonyl dialdehyde levels were measured and compared within each group.

RESULTS: The baseline and 15th-day serum AMH values of the menstrual cycle were compared among the groups, and no statistically significant differences were observed (p > 0.05). Group 3, which was given both carboplatin and metformin, had statistically significantly higher 28th-day AMH levels than Group 2, which was given only carboplatin and saline (p < 0.001). The number of primordial follicles in Group 3 was found to be statistically significantly higher than in Group 2 (p < 0.001). Tissue catalase enzyme levels in Group 3 were statistically significantly higher than in Group 2 (p < 0.001). Tissue malondialdehyde levels in Group 2 were statistically significantly higher than tissue malondialdehyde levels in Groups 3 and 4 (p < 0.001).

CONCLUSIONS: Metformin may attenuate carboplatin-induced ovarian damage, possibly through its antioxidative effects.

PMID:37660125 | DOI:10.1186/s13048-023-01259-2

Sci Rep. 2023 Sep 2;13(1):14462. doi: 10.1038/s41598-023-41797-9.

ABSTRACT

Diabetic retinopathy (DR) is one of the main causes of blindness in people around the world. Early diagnosis and treatment of DR can be accomplished by organizing large regular screening programs. Still, it is difficult to spot diabetic retinopathy timely because the situation might not indicate signs in the primary stages of the disease. Due to a drastic increase in diabetic patients, there is an urgent need for efficient diabetic retinopathy detecting systems. Auto-encoders, sparse coding, and limited Boltzmann machines were used as a few past deep learning (DL) techniques and features for the classification of DR. Convolutional Neural Networks (CNN) have been identified as a promising solution for detecting and classifying DR. We employ the deep learning capabilities of efficient net batch normalization (BNs) pre-trained models to automatically acquire discriminative features from fundus images. However, we successfully achieved F1 scores above 80% on all efficient net BNs in the EYE-PACS dataset (calculated F1 score for DeepDRiD another dataset) and the results are better than previous studies. In this paper, we improved the accuracy and F1 score of the efficient net BNs pre-trained models on the EYE-PACS dataset by applying a Gaussian Smooth filter and data augmentation transforms. Using our proposed technique, we have achieved F1 scores of 84% and 87% for EYE-PACS and DeepDRiD.

PMID:37660096 | DOI:10.1038/s41598-023-41797-9