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Nevin Manimala Statistics

Clinical Outcomes of SEEG-Guided Radiofrequency Thermocoagulation in Children With Focal Drug-Resistant Epilepsy: A Multicenter Real-World Study

Ann Clin Transl Neurol. 2026 Mar 26. doi: 10.1002/acn3.70373. Online ahead of print.

ABSTRACT

OBJECTIVE: Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-RFTC) has emerged as a safe and effective minimally invasive treatment for children with drug-resistant focal epilepsy. Although evidence from real-world studies remains limited, numerous pediatric cases have demonstrated promising outcomes. This retrospective study aimed to evaluate the seizure outcomes of SEEG-RFTC in pediatric patients and identify predictive factors associated with seizure freedom.

METHODS: A retrospective observational study was conducted across two epilepsy centers, including 111 children with drug-resistant epilepsy who underwent SEEG-RFTC. Postoperative outcomes were assessed primarily by the rate of seizure freedom at the last follow-up (minimum 1 year). Potential predictive factors were analyzed through comparisons of clinical, neuroimaging, electrophysiological, and etiological variables.

RESULTS: All patients were followed for at least 1 year post-procedure, with 73 (65.8%) achieving seizure freedom. Among 46 patients with focal cortical dysplasia, the seizure-free rate was 80.4%. In 10 patients with hippocampus sclerosis, 6 (60%) were seizure-free at the final follow-up. Statistical analysis identified the course of illness (p < 0.01) and positron emission tomography (PET) findings (p = 0.01) as significant predictors of seizure freedom.

CONCLUSION: SEEG-RFTC is a safe procedure that yields favorable outcomes in a substantial proportion of pediatric patients with drug-resistant focal epilepsy. The duration of epilepsy and PET characteristics are significantly associated with the likelihood of achieving seizure freedom. These findings highlight the potential of SEEG-RFTC as a valuable therapeutic option in this population.

PMID:41888055 | DOI:10.1002/acn3.70373

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Nevin Manimala Statistics

Defining rurality: evaluating the options for the development of a new regional-rural admission scheme for professional medical programs at the University of Auckland

Rural Remote Health. 2026 Mar;26(1):9712. doi: 10.22605/RRH9712. Epub 2026 Mar 26.

ABSTRACT

INTRODUCTION: Pathways aimed at increasing the medical workforce in regional and rural areas in Aotearoa New Zealand have been implemented in universities, such as the Regional and Rural Admission Scheme (RRAS) at Waipapa Taumata Rau | The University of Auckland, to address urban-rural variations in health outcomes. A recent review of the university’s scheme suggested the program was not providing equitable opportunities for students from a rural background as originally intended. Therefore, an updated RRAS was required to be developed to address these inequities, creating a more genuine scheme that may more strongly contribute to developing the regional and rural workforce in New Zealand.

METHODS: We developed a methodological framework to identify and evaluate candidate rural definitions for the purposes of developing a new RRAS for the university. Following an extensive literature review, we utilised two sets of criteria to select candidate rural definitions, which were then evaluated using visual evaluation (mapping) and exploratory analysis. Candidate definitions were modified to use a three-group (rural-regional-urban) version to be suitable for use as an updated RRAS. We used a de-identified student dataset of applicants enrolled for the MBChB medical program at the University of Auckland from 2017 to 2023 (inclusive) and population counts from the New Zealand 2018 Census to investigate differences in potential admission numbers under each candidate definition. The New Zealand Index of Multiple Deprivation 2018 was used to assess the distribution of potential admission numbers by area-level socioeconomic status. We also examined the suitability of the candidate definitions by ethnicity, specifically for students of M&#257;ori ethnicity.

RESULTS: We selected two candidate definitions for exploratory analysis: Geographic Classification for Health (GCH) developed by the University of Otago, and the urban accessibility classification 2020 (UA 2020) by Stats NZ. We found that the three-group modified version of the UA 2020 definition consistently classified a higher proportion of students as regional and rural compared to the current RRAS and the alternative candidate definition, the three-group GCH. The modified UA 2020 was found to classify a higher number of M&#257;ori students and those living in less-deprived neighbourhoods as rural when compared to the other definitions. Therefore, our final recommendation is to update the existing RRAS using a three-group modified version of the UA 2020 by Stats NZ. Our proposed version will refocus attention to address the under-representation of rural students admitted to professional health programs at the University of Auckland, while not disadvantaging regional students.

CONCLUSION: The updated RRAS will assist in supplementing the future professional rural medical workforce, and subsequently help to reduce health outcome variations between rural and urban areas in New Zealand. The modified UA 2020 is likely to be updated regularly by Stats NZ, and therefore the RRAS can be kept up to date in the future.

PMID:41888043 | DOI:10.22605/RRH9712

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Nevin Manimala Statistics

Impact of hearing aid processing delay on temporal and spectral auditory processing

Int J Audiol. 2026 Mar 26:1-10. doi: 10.1080/14992027.2026.2642750. Online ahead of print.

ABSTRACT

OBJECTIVE: Digital hearing aid processing introduces delay. While traditional literature suggests a 10-ms threshold, evidence indicates that even shorter delays may degrade sound quality. This study examined the impact of Ultra-Low Delay (ULD; 0.5 ms) versus Standard Delay (SD; 2.7 ms) on temporal and spectral auditory processing abilities in hearing aid users.

DESIGN AND STUDY SAMPLE: Twenty experienced hearing aid users (aged 41-75 years) with bilateral, symmetrical, mild-to-moderate sensorineural hearing loss participated. Auditory performance was assessed under the ULD and SD conditions using the Frequency Pattern Test, Duration Pattern Test, Random Gap Detection Test, and Spectral-Temporally Modulated Ripple Test.

RESULTS: Statistical analyses revealed significant differences between the two processing delay conditions across all evaluated tests (p < .01). Participants demonstrated statistically superior temporal and spectral processing performance under the ULD condition compared to the SD condition.

CONCLUSIONS: The findings demonstrate that the ULD condition significantly improves central auditory temporal and spectral processing abilities compared to the SD condition. These results challenge the traditional view that delays under 10 ms are negligible and highlight the clinical importance of ultra-low delay technology for preserving auditory resolution in individuals with hearing loss.

PMID:41888031 | DOI:10.1080/14992027.2026.2642750

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RETRACTION: Enhanced Control of Bacterial Wilt Disease in Tomato Plant via Transport and Penetration Tracking by Aid of 99mTc-Labeled Ralstonia solanacearum-Specific Bacteriophage

J Labelled Comp Radiopharm. 2026 Apr;69(4-6):e70027. doi: 10.1002/jlcr.70027.

ABSTRACT

M. H. Abdel-Aal, Y. A. Hasanien, N. A. Younis, G. El Didamony, A. Askora, and G. Abdelaziz, “Enhanced Control of Bacterial Wilt Disease in Tomato Plant via Transport and Penetration Tracking by Aid of 99mTc-Labeled Ralstonia solanacearum-Specific Bacteriophage,” Journal of Labelled Compounds and Radiopharmaceuticals 68, no. 13 (2025): e4169, https://doi.org/10.1002/jlcr.4169. The above article, published online on 11 November 2025 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, V Derdau; and John Wiley & Sons Ltd. The retraction has been agreed upon following concerns raised by a third party. A subsequent investigation confirmed several deficiencies in the study, including the absence of essential controls, replicates, and appropriate statistical analysis. In addition, in Figure 3, the Ral 10, Ral 9, Ral 8 and Ral 7 bands appear to be duplicated, and there is evidence that Ral 10 has been spliced into the image. Furthermore, the images shown in Figures 12A and 12C are identical, despite representing untreated and treated plants. The authors cooperated with the investigation and explained that Figure 3 combines two images from separate experimental runs, as the gel tank could not hold all samples simultaneously. However, they were unable to provide the original images and did not comment on the duplicated bands. The authors also explained that the duplication in Figure 12 was an error due to figure mismanagement; they provided an alternative image for Figure 12C. However, this was not satisfactory to address all the concerns. As a result, the editors determined that the results cannot be validated and therefore the conclusions of the study are unreliable. The authors disagree with the retraction.

PMID:41888030 | DOI:10.1002/jlcr.70027

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Nevin Manimala Statistics

Fracture-related infection following open forefoot fractures caused by dropped objects

Foot Ankle Surg. 2026 Mar 19:S1268-7731(26)00074-3. doi: 10.1016/j.fas.2026.03.006. Online ahead of print.

ABSTRACT

INTRODUCTION: This study evaluated the rate of fracture-related infection (FRI) of open forefoot fractures caused by dropped objects, and examined associations of treatment characteristics, including intravenous and oral antibiotics and operative debridement, with FRI.

METHODS: Patients aged 18-80 years who sustained an open metatarsal or phalanx fracture caused by a dropped object between January 2021 and June 2024 were retrospectively identified from two Level 1 trauma centers. The primary outcome was FRI, determined based on the FRI consensus criteria. FRI rates were compared between those who underwent irrigation and debridement (I&D) at bedside versus in the operating room, and between those who received oral versus intravenous (IV) antibiotics. Patient characteristics were also analyzed to determine host factors associated with FRI.

RESULTS: A total of 86 patients (median age 41 years [IQR: 29-56], 58% male) were included. Eighty-five patients (99%) received antibiotics, 31 (36%) of whom received intravenous antibiotics. Sixty-six patients (77%) received an I&D at presentation, 57 (66%) at bedside and 9 (10%) in the operating room. Thirteen patients (15%, 95% CI: 8.3%-24%) developed FRI. No significant difference in FRI rate was found between patients who underwent I&D at bedside versus in the operating room (12% versus 11%, p > 0.99). Among patients who did not undergo I&D in the operating room, no significant difference in FRI rate was found between patients who received oral versus IV antibiotics (17% versus 13%, p = 0.74). Insulin-dependent diabetes was associated with an increased risk of FRI (60% versus 12%, p = 0.02).

CONCLUSIONS: In this cohort, one in seven patients developed FRI. No statistically significant differences in FRI rates were observed by I&D setting (bedside versus operative) or antibiotic route (oral versus IV), including in a subgroup analysis excluding patients treated with operating room I&D. These findings are limited by sample size and potential treatment selection bias and should not be interpreted as evidence of equivalence. Management should be individualized based on clinical judgement, resource availability, and patient factors. These findings can help guide the management protocols for “dropped objects” open forefoot fractures presenting to urgent care and the emergency department.

LEVEL OF EVIDENCE: Therapeutic Level III.

PMID:41887998 | DOI:10.1016/j.fas.2026.03.006

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Stress management reduces severe depression and anxiety symptoms in adults with cystic fibrosis: Results from the coping and learning to manage stress (CALM) intervention

J Cyst Fibros. 2026 Mar 25:S1569-1993(26)00082-2. doi: 10.1016/j.jcf.2026.03.015. Online ahead of print.

ABSTRACT

BACKGROUND: Coping and Learning to Manage Stress with CF (CALM) is a manualized intervention for adults with cystic fibrosis (AWCF). A unique feature of the CALM multisite randomized controlled trial (RCT) was the inclusion of individuals with severe symptoms of depression and/or anxiety, including those endorsing suicidal ideation. Post-hoc analyses examined the extent to which those with severe symptoms benefited from CALM.

METHODS: Analyses included 121 AWCF who participated in CALM and provided evaluable depression (Patient Health Questionnaire; PHQ-9) and/or anxiety (Generalized Anxiety Disorder-7; GAD-7) data. Established cut-points classified participants into four symptom severity groups (normal, mild, moderate, severe) for both depression and anxiety before participating in CALM. Linear mixed models examined mean depression and anxiety scores across severity groups at 4 time points: pre-CALM, post-CALM, 1-month follow-up, and 3-month follow-up.

RESULTS: Pre-CALM depression severity ranged from normal (n = 24) to severe (n = 11), with most participants reporting mild (n = 57) or moderate (n = 29) symptoms. Anxiety severity followed a similar distribution (normal=18; mild=59; moderate=27; severe=16), and 9% of participants reported suicidal ideation. AWCF reporting severe depression and/or anxiety symptoms before starting CALM showed statistically significant reductions in both depression and anxiety at the post, 1-month follow-up, and 3-month follow-up (p<.0001 for each comparison with the pre-CALM time point).

CONCLUSIONS: AWCF with severe depression and/or anxiety symptoms showed significant symptom improvement following participation in CALM. This RCT is first to provide evidence of the efficacy of a stress management intervention to effectively treat severe depression and anxiety symptoms in AWCF.

PMID:41887978 | DOI:10.1016/j.jcf.2026.03.015

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Nevin Manimala Statistics

The profile of vulnerable groups in the context of the growth of gambling in Kazakhstan: social and demographic risk factors

J Gen Psychol. 2026 Mar 26:1-24. doi: 10.1080/00221309.2026.2647742. Online ahead of print.

ABSTRACT

The primary objective of the present article is to identify the socio-demographic factors that increase the risk of developing gambling addiction in Kazakhstan and to analyze the effectiveness of rehabilitation interventions through the application of both quantitative and qualitative approaches. The research included two samples of individuals aged 18 to 65: 782 participants for the assessment of the severity of gambling addiction across different social groups, and 148 participants for the empirical evaluation of a rehabilitation program. The South Oaks Gambling Screen (SOGS) was used as the assessment tool. Research methods included quantitative analysis (descriptive statistics, t-test, ANOVA, multiple regression) and qualitative analysis (thematic analysis of semi-structured interviews in NVivo). The results highlighted the importance of considering social and demographic factors when studying gambling addiction. Men and middle-aged individuals (45-59 years) were found to be most vulnerable to gambling addiction, while women and elderly participants showed lower levels of addiction. Low income and below-average education were associated with higher levels of dependency. The rehabilitation program demonstrated high effectiveness.

PMID:41887939 | DOI:10.1080/00221309.2026.2647742

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Quality Improvement Intervention to Improve Head and Neck Cancer Care in Safety Net Hospital Settings: Outcomes From a Single-Visit Multidisciplinary Clinic Model

Head Neck. 2026 Mar 26. doi: 10.1002/hed.70244. Online ahead of print.

ABSTRACT

BACKGROUND: Safety net hospitals (SNHs)-institutions committed to providing care regardless of a patient’s ability to pay-are the primary access point for nearly one-third of the US population. Patients at SNHs consistently present with more advanced-stage head and neck cancer (HNC) and experience significant challenges related to social determinants of health (SDOH), often resulting in delays in diagnosis and treatment initiation. This delay can be associated with decreased overall survival, locoregional control, and an increased risk of recurrence. Thus, we propose utilizing a single-visit multidisciplinary clinic (MDC) to consolidate appointments and create comprehensive treatment plans to help combat systemic issues, reduce time to treatment initiation (TTI), and improve pretreatment speech language pathology (SLP), nutrition, and dental oncology consult completion.

METHODS: This retrospective cohort and quality improvement study was conducted at an urban, publicly funded tertiary care center that functions as the city’s sole SNH. Patients with newly diagnosed squamous cell carcinoma of the head and neck were identified between May 2019 and May 2022. Baseline demographics, ancillary service consultations, and treatment information from our single-institution database were collected. Patients were divided into the pre-MDC cohort and the post-MDC cohort. Primary outcome was TTI while the secondary objective was to improve completion of pretreatment evaluation by SLPs, nutrition oncology, and dental oncology. The MDC was developed using the Plan Do Study Act (PDSA) method for quality improvement and established in June 2021. HNC surgeons, radiation oncologists, medical oncologists, and ancillary services designed a clinic to host a single-day visit to include a needs assessment for treatment optimization, a comprehensive discussion of therapeutic options, and consideration of the SDOH that may present barriers to care.

RESULTS: Sixty-nine patients met the inclusion criteria. Mean age was 59.1 years (range: 34-83), and over 71% of patients were uninsured or Medicaid-insured. The post-MDC cohort was associated with a significant decrease in TTI compared to the pre-MDC cohort (44.1 ± 16.1 vs. 57.4 ± 30.5 days, p = 0.038) and trended toward improvement in those patients undergoing primary chemoradiation therapy (44.9 ± 11.1 vs. 54.9 ± 19.9 days, p = 0.097) and for patients undergoing primary surgical resection (40.0 ± 35.2 vs. 61.0 ± 41.8 days, p = 0.287). In a multivariable analysis, participation in the MDC was the only independent variable associated with a statistically significant shorter TTI in the overall patient population (p = 0.05). We also observed an improvement in pretreatment consult completion including SLP (96.0% vs. 54.5%, p ≤ 0.001), nutrition (96.0% vs. 59.1%, p ≤ 0.001), and pre-radiation therapy dental oncology evaluation (96.0% vs. 59.1%, p ≤ 0.001).

CONCLUSION: Implementation of a single-visit HNC MDC is associated with an improvement in TTI and pretreatment consult referral and completion for patients with HNC in a SNH setting. Our findings underscore the potential of structural care redesign to help facilitate timely care at SNHs. As SNHs continue to absorb a growing share of the HNC care burden, targeted investments in care coordination and infrastructure are critical to help deliver timely, high-quality cancer care.

PMID:41887938 | DOI:10.1002/hed.70244

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Impacts of sea-land breeze on the coastal ozone in the Pearl River Delta, China

J Environ Sci (China). 2026 May;163:811-822. doi: 10.1016/j.jes.2025.08.037. Epub 2025 Aug 23.

ABSTRACT

Ground-level ozone (O3) pollution has become increasingly prominent in coastal cities, where sea-land breeze (SLB) plays a crucial role. However, the impact mechanisms of SLB circulation on O3 pollution in coastal region remain not well understand, since the SLB influence always coupled with the synoptic-scale wind fields. Here, by using 28-year observational data and the ERA5 reanalysis dataset, we reveal significant spatial heterogeneity in the impacts of SLB across the Pearl River Delta regions. On the western bank, O3 concentrations are higher during SLB events compared to non-SLB periods under all synoptic weather patterns, since the SLB on the western bank predominantly occurs under low synoptic wind conditions, which also facilitates the O3 formation. Therefore, O3 pollution and the SLB event showed an adjoint relationship on the western bank, rather than the causation. On the eastern bank, O3 concentration had varied responses on SLB events under different synoptic weather patterns: The sea breeze from the south combined with the synoptic wind in the same direction led to enhanced atmospheric diffusion capacity, thereby reducing the O3 concentration; Once the synoptic wind is northeasterly, the counteraction between sea breezes and synoptic winds weakens dispersion conditions, resulting in O3 accumulation. Quantitative analysis using random forest modeling demonstrates that SLB changes O3 concentrations by -2.68 ppb (-8 %) under southerly weather patterns but increase by 11.51 ppb (20 %) under Northeasterly patterns on the eastern bank. We highlight the crucial regulatory role of mesoscale-synoptic scale coupling processes in regional O3 distribution.

PMID:41887899 | DOI:10.1016/j.jes.2025.08.037

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Analysis of energy consumption and emissions characteristics of plug-in hybrid electric vehicle (PHEV) under various real-world driving conditions

J Environ Sci (China). 2026 May;163:566-574. doi: 10.1016/j.jes.2025.11.033. Epub 2025 Nov 18.

ABSTRACT

The transportation sector’s reliance on internal combustion engine (ICE) vehicles contributes significantly to energy consumption and environmental degradation. Plug-in hybrid electric vehicles (PHEVs) present a viable alternative by combining electric propulsion with ICE capabilities to enhance fuel efficiency and reduce emissions. This study evaluates the energy consumption and emission characteristics of PHEVs under diverse real-world driving conditions, focusing on charge-depleting (CD) and charge-sustaining (CS) modes. Using chassis dynamometer (5-cycle, WLTC under varying temperatures) and real driving emissions (RDE) tests, the study reveals that CD mode offers superior efficiency in urban driving due to regenerative braking, while CS mode performs better under high-speed or low-temperature conditions. Notably, energy consumption in CS mode was approximately 2.98 times higher than in CD mode during urban RDE tests. Cold start conditions significantly increased emissions and delayed catalyst activation by 100-150 s. Furthermore, maintaining battery state of charge (SOC) at 60 % in CS mode achieved the highest efficiency across urban and motorway scenarios. These findings suggest that adaptive integration of CD and CS modes, optimal SOC management, and mitigation of cold start effects are essential for improving PHEV efficiency and sustainability.

PMID:41887875 | DOI:10.1016/j.jes.2025.11.033