Search

Longitudinal data from clinical trials are commonly analyzed using mixed models for repeated measures (MMRM) when the time variable is categorical or linear mixed‐effects models (ie, random effects model) when the time variable is continuous. In these models, statistical inference is typically based on the absolute difference in the adjusted mean change (for categorical time) or the rate of change (for continuous time). Previously, we proposed a novel approach: modeling the percentage reduction in disease progression associated with the treatment relative to the placebo decline using proportional models. This concept of proportionality provides an innovative and flexible method for simultaneously modeling different cohorts, multivariate endpoints, and jointly modeling continuous and survival endpoints. Through simulated data, we demonstrate the implementation of these models using SAS procedures in both frequentist and Bayesian approaches. Additionally, we introduce a novel method for implementing MMRM models (ie, analysis of response profile) using the nlmixed procedure. [ABSTRACT FROM AUTHOR]

Medications for opioid use disorder (MOUD) increase retention in care and decrease mortality during active treatment; however, information about the comparative effectiveness of different forms of MOUD is sparse. Observational comparative effectiveness studies are subject to many types of bias; a robust framework to minimize bias would improve the quality of comparative effectiveness evidence. This paper discusses the use of target trial emulation as a framework to conduct comparative effectiveness studies of MOUD with administrative data. Using examples from our planned research project comparing buprenorphine‐naloxone and extended‐release naltrexone with respect to the rates of MOUD discontinuation, we provide a primer on the challenges and approaches to employing target trial emulation in the study of MOUD. [ABSTRACT FROM AUTHOR]

Aims: To conduct a systematic review and meta‐analysis and pool the incremental net benefits (INBs) of varenicline compared with behaviour support with bupropion or nicotine replacement therapy (NRT), behaviour support alone and unaided cessation in adult smokers making a first‐time attempt to quit. Methods: A search for economic evaluation studies was conducted from inception to 30 September 2022, on PubMed, Embase, Cost‐Effectiveness Analysis (CEA) Registry by Tufts Medical Centre, EconLit and the NHS Economic Evaluation Database (NHS EED). Eligible studies were included if they were (1) conducted among adults ages 18 years old and older who were smokers attempting to quit for the first time; (2) compared varenicline to behaviour support with bupropion or NRT, behaviour support alone and unaided cessation; and (3) performed a CEA or cost‐utility analysis. The INBs were calculated and pooled across studies stratified by country income level and study perspective using the random‐effects model. Statistical heterogeneity between studies was assessed using the I2 statistic and Cochrane Q statistic. Results: Of the 1433 identified studies, 18 studies were included in our review. Our findings from healthcare system/payer perspective suggested that the use of varenicline is statistically significantly cost‐effective compared with bupropion (pooled INB, $830.75 [95% confidence interval, $208.23, $1453.28]), NRTs ($636.16 [$192.48, $1079.84]) and unaided cessation ($4212.35 [$1755.79, $6668.92]) in high‐income countries. Similarly, varenicline is also found to be cost‐effective compared to bupropion ($2706.27 [$1284.44, $4128.11]), NRTs ($3310.01 [$1781.53, $4838.50]) and behavioural support alone ($5438.22 [$4105.99, $6770.46]) in low‐ and middle‐income countries. Conclusion: Varenicline is cost‐effective as a smoking cessation aid when compared with behavioural support with bupropion or nicotine replacement therapies and behavioural support alone in both high‐income countries and low‐ and middle‐income countries, from the healthcare system/payer perspective in adult smokers who attempt to quit for the first time. [ABSTRACT FROM AUTHOR]

Aim: To determine the effectiveness of brief reminiscence‐based psychosocial interventions in alleviating psychological distress in cancer patients. Background: Cancer patients suffer tremendous psycho‐spiritual pain, which affects their quality of life. Brief reminiscence‐based psychosocial interventions have demonstrated positive effects on the mental health of cancer patients; however, the efficacy of these interventions has been inconsistent. Design: A systematic review and meta‐analysis. Methods: This review was conducted and reported in accordance with the PRISMA 2020 checklist provided by the EQUATOR network. The Cochrane Library, Web of Science, PsycINFO, PubMed, Embase, CINAHL and Scopus databases were systematically searched from inception to 27 November 2022 to identify randomised controlled trials (RCTs) published in English. Results: Twenty studies involving 1744 cancer participants were included. The meta‐analysis showed statistically significant effects of brief reminiscence‐based psychosocial interventions on hope, anxiety and depression at post‐intervention. A separate analysis revealed that brief reminiscence‐based psychosocial interventions had a sustainable effect on hope, spiritual well‐being, anxiety and depression at 1 month after the intervention. However, no statistically significant effect on quality of life was found in our study either immediately after the intervention or at 1 month. Conclusions: Brief reminiscence‐based psychosocial interventions can significantly reduce anxiety and depressive symptoms and improve hope and spiritual well‐being in cancer patients. Relevance to Clinical Practice: This study further supports that brief reminiscence‐based psychosocial interventions should be incorporated into the routine care of cancer patients to address their psychosocial distress. Patient or Public Contribution: All authors of this article contributed to the study conception and design. All authors of the included studies provided original data for this paper. [ABSTRACT FROM AUTHOR]

Aims: To explore illegitimate tasks as a potential mechanism that links permanent nurses' perceived exposure to temporary nurses to lower levels of affective organizational commitment. Design: A time‐lagged cross‐sectional survey study. Methods: Survey data from N = 239 permanent nurses in the German‐speaking part of Switzerland were analysed via Structural Equation Models. Results: The study revealed a negative relationship between permanent nurses' perceived exposure to temporary nurses and their level of organizational commitment that was mediated by perceptions of unreasonable and unnecessary tasks. Conclusion: Healthcare institutions increasingly depend on temporary nurses to fill staffing vacancies. Our data suggest that the deployment of temporary nurses may have adverse effects on permanent nurses' affective organizational commitment via perceptions of illegitimate tasks. Impact: Our quantitative survey study provides a novel, theory‐driven understanding of how perceived exposure to temporary nurses may impact work‐related attitudes of permanent nurses. Implications for the Profession and/or Patient Care: Our findings suggest that the clinical community should limit permanent nurses' exposure to temporary nursing staff to protect their commitment. If this is not possible, we encourage strategies to counteract associated feelings of illegitimacy, for example, by showing appreciation for permanent nurses' willingness to take over responsibility for temporary nurses. Reporting Method: The study adheres to the STROBE reporting guidelines for cross‐sectional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Our study aim was to assess body mass index (BMI) change in children in the immediate 6 months of the pandemic, to follow longitudinal BMI change up to 30 months after the pandemic start, and to identify sociodemographic factors associated with these changes. Our study included a retrospective chart review of 1298 children 2 to 18 years old with office visits at an Indianapolis primary care clinic. Body mass index and sociodemographic information were collected at visits during 3 time periods: Prepandemic (March 1, 2019-February 28, 2020), Early Pandemic (June 1, 2020-November 30, 2020), and Late Pandemic (December 1, 2020-September 30, 2022). Data analysis indicated statistically significant increases in BMI monthly rate of change from Prepandemic to Early Pandemic periods. Interestingly, BMI rate of change stabilized from Early Pandemic to Late Pandemic periods but remained positive, suggesting children had slower, but persistent, continued BMI increase after the pandemic initiation. [ABSTRACT FROM AUTHOR]

Researchers and practitioners have unanimously acknowledged the impact of legacy media coverage of past pandemics as well as COVID-19 and its importance for health-related risk communication. Therefore, this study provides scholars and health communication practitioners with a deeper understanding of the patterns, main themes, and limitations of media reporting and peer-reviewed research in the early stages of the COVID-19 pandemic in different national media environments. Because the objective is to evaluate patterns, this paper focuses on early quantitative and automated content analyses for theoretical contribution, geographic diversity, methodological rigor, and inclusion of risk and crisis communication theory. It also assesses whether authors deduced implications, for both theory and practice of health-related risk and crisis communication. We conducted a content analysis of 66 studies in peer-reviewed journals from the beginning of the pandemic until April 2022. The findings demonstrate that early quantitative analyses of the news coverage of COVID-19 are often not theory-driven, apply heterogeneous forms of framing analysis, and lack references to risk and crisis communication theory. Consequently, only few implications for health communication practice during pandemics were drawn. However, there is evidence of improvement in geographic scope compared to previous research. The discussion addresses the importance of developing a consistent approach to framing analyses of risk and crisis media coverage and the importance of well-designed cross-cultural research in a global pandemic. [ABSTRACT FROM AUTHOR]

We consider network autoregressive models for count data with a non‐random neighborhood structure. The main methodological contribution is the development of conditions that guarantee stability and valid statistical inference for such models. We consider both cases of fixed and increasing network dimension and we show that quasi‐likelihood inference provides consistent and asymptotically normally distributed estimators. The article is complemented by simulation results and a data example. [ABSTRACT FROM AUTHOR]

This article introduces a novel approach that unifies two types of models: one is the continuous‐time jump‐diffusion used to model high‐frequency market financial data, and the other is discrete‐time GQARCH for modeling low‐frequency financial data by embedding the discrete GQARCH structure with jumps in the instantaneous volatility process. This model is named GQARCH‐Itô‐Jumps model. Quasi‐likelihood functions for the low‐frequency GQARCH structure are developed for the parametric estimations. In the quasi‐likelihood functions, for high‐frequency financial data, the realized range‐based estimations are adopted as the 'observations', rather than the realized return‐based volatility estimators which entail the loss of intra‐day information of the price movements. Meanwhile, the asymptotic properties are mainly established for the proposed estimators in the case of finite activity jumps. Moreover, simulation studies and some financial data are implemented to check the finite sample performance of the proposed methodology. [ABSTRACT FROM AUTHOR]

Satisfaction with life is a core aspect of successful aging, which is influenced by a broad range of factors, including health, socioeconomic status, and social relationships. Black lesbians experience various social challenges, including racism, sexism, ageism, and heterosexualism, that may present as deterrents to aging successfully. To develop better policies and programs in support of successful aging among all adults, an understanding of the unique components associated with their intersecting identities must be explored. This study was carried out to gain a better understanding of how Black lesbians and other Black sexual minority women (BSMW) view successful aging within the context of life satisfaction. Inferential statistics were used to determine relationships between satisfaction with life (SWLS-3) and selected independent variables. Backward stepwise regression was conducted to ascertain significant relationships of the study outcome variable. The respondents were 118 Black lesbians and other BSMW aged 50 and above. Independent t-tests showed that those living with a partner had a significantly higher SWLS-3. Backwards stepwise regression indicated the predictor variables for higher rates of SWLS-3 to be harmony in life, annual household income, and provider sensitivity/cultural competence to their patient being Black. This study provides insight on factors increasing and diminishing satisfaction with life for aging Black lesbians and other BSMW. Future research should replicate this study with a more diverse and nationally representative sample, especially given the study limitations of having recruited a highly educated sample during a global pandemic. [ABSTRACT FROM AUTHOR]

Child malnutrition remains a significant concern in the Asia‐Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia‐Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia‐Pacific region between September 2000 and May 2023. Fixed‐effects or random‐effects meta‐analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta‐analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97–1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88–6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national‐level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia‐Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality. Key messages: Short interval pregnancies pose a persistent public health threat in the South Asian region.While a potential link with child malnutrition exists, reported associations often conflict.Our findings suggest that short interval births slightly increase the risk of child malnutrition.Addressing short interval pregnancies is crucial to mitigate the ongoing nutritional burden in South Asian countries. [ABSTRACT FROM AUTHOR]

Background: Nursing students are given opportunities to develop critical thinking disposition, caring behaviors, and professional commitment through clinical training. Therefore, nurse educators should move away from traditional methods toward new ones, such as internship programs in clinical training. This study assessed the effect of nursing internship programs on senior undergraduate nursing students' critical thinking disposition, caring behaviors, and professional commitment. Methods: This quasi-experimental study was conducted using a pretest-posttest design but with no control group. The study sample included 46 senior students enrolled in nursing internship programs. A demographic questionnaire, the Critical Thinking Disposition Inventory (CTDI), the Caring Assessment Report Evaluation (Care-Q), and the Nursing Professional Commitment Scale (NPCS) were used to collect data before and five months after the nursing internship programs were implemented. Results: The study findings revealed that the senior nursing students' caring behaviors improved, but the total scores of critical thinking disposition and professional commitment did not change significantly after the nursing internship programs (p > 0.05). Conclusion: According to the results, nurse educators are recommended to adopt strategies to improve the effectiveness of internship programs on critical thinking disposition and professional commitment among senior undergraduate nursing students. [ABSTRACT FROM AUTHOR]

Introduction: The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students' willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. Methods: In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. Results: The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients' personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. Conclusion: The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students' participation in disaster response. [ABSTRACT FROM AUTHOR]

Background: Emergency ward nurses face a variety of occupational hazards due to the nature of their occupational and professional duties, which can negatively affect their health. Therefore, this study aimed to evaluate the effects of an educational intervention based on the protection motivation theory on the protective behaviors of emergency ward nurses against occupational hazards in Tehran, Iran, in 2023. Methods: The present quasi-experimental study was conducted with two intervention and control groups, using a pretest-posttest design. A total of 124 nurses working in the emergency wards of four hospitals (two hospitals for the intervention group and two hospitals for the control group by random assignment) were selected by multistage sampling method. The educational intervention based on the protection motivation theory was implemented for the intervention group for three weeks. The nurses of both groups completed a demographic questionnaire and the scale of emergency ward nurses' protective behaviors against occupational hazards before, immediately, and one month after the intervention. Data analysis was performed using descriptive and inferential methods. Results: The two groups were similar in terms of demographic characteristics at the baseline (p > 0.05). Protective behaviors of emergency nurses against occupational hazards and their sub-scales (physical, chemical, biological, ergonomics, and psychosocial hazards) were higher in the intervention group than in the control group immediately and one month after the educational intervention. In addition, the measurement over time also showed the positive effect of time and educational intervention on the protective behaviors of emergency nurses against occupational hazards and their sub-scales in the intervention group. Conclusion: These findings showed that the educational intervention based on the protection motivation theory can be effective and helpful in improving the protective behaviors of emergency ward nurses against occupational hazards and their sub-scales. Future studies can focus on a more specific design of this kind of intervention based on the type of occupational hazards and needs of nurses in different wards. [ABSTRACT FROM AUTHOR]

High-resolution digital elevation models are commonly utilized for detecting and classifying landslides. In this study, we aim to refine landslide detection and classification by analyzing the geometry of landslides using slope and aspect, coupled with descriptive statistics up to the fourth central moment (kurtosis). Employing the Monte Carlo method for creating terrain topography probability distributions and ANOVA tests for statistical validation, we analyzed 364 landslides in Gorce National Park, Poland, revealing significant kurtosis differences across landslide types and lithologies. This methodology offers a novel approach to landslide classification based on surface geometry, with implications for enhancing scientific research and improving landslide risk management strategies. [ABSTRACT FROM AUTHOR]

Comparative lifetime experiments are remarkable when the study is to ascertain the relative merits of two competing products regarding the duration of their service life. This paper considers the comparative lifetime experiments of two Gompertz populations under a balanced joint progressive Type-II censoring scheme. The lifetime distributions of the units are assumed to follow the Gompertz distribution with a common shape but different scale parameters. The maximum likelihood estimates of the unknown parameters are derived. The existence of the maximum likelihood estimates is proved. Expectation-maximization and stochastic expectation-maximization algorithms are provided to calculate the estimates. The bootstrap-p, bootstrap-t, and approximate confidence intervals are established. To obtain the Bayesian estimates, it is assumed that the prior of scale parameters is a Beta-Gamma distribution and the prior of the common shape parameter is an independent Gamma distribution. Under squared error loss and LINEX loss functions, the Metropolis-Hastings algorithm is provided to compute the Bayes estimates and the credible intervals. Further, the statistical inferences with order restriction are studied when it is known a priori that the expectation of the lifespan of one population is shorter than that of the other population. A wide range of simulation experiments is conducted to evaluate the performance of the proposed methods. Finally, the lifetimes of white organic light-emitting diodes and the breaking strengths of jute fiber of gauge lengths are analyzed to illustrate the practical application of the proposed model and methods. [ABSTRACT FROM AUTHOR]

Datasets that are big with regard to their volume, variety and velocity are becoming increasingly common. However, limitations in computer processing can often restrict analysis performed on them. Nonuniform subsampling methods are effective in reducing computational loads for massive data. However, the variance of the estimator of nonuniform subsampling methods becomes large when the subsampling probabilities are highly heterogenous. To this end, we develop two new algorithms to improve the estimation method for massive data logistic regression based on a chosen hard threshold value and combining subsamples, respectively. The basic idea of the hard threshold method is to carefully select a threshold value and then replace subsampling probabilities lower than the threshold value with the chosen value itself. The main idea behind the combining subsamples method is to better exploit information in the data without hitting the computation bottleneck by generating many subsamples and then combining estimates constructed from the subsamples. The combining subsamples method obtains the standard error of the parameter estimator without estimating the sandwich matrix, which provides convenience for statistical inference in massive data, and can significantly improve the estimation efficiency. Asymptotic properties of the resultant estimators are established. Simulations and analysis of real data are conducted to assess and showcase the practical performance of the proposed methods. [ABSTRACT FROM AUTHOR]

Background: Randomized clinical trials (RCTs) shape our clinical practice. Several studies report a mediocre replicability rate of the studied RCTs. Many researchers believe that the relatively low replication rate of RCTs is attributed to the high p value significance threshold. To solve this problem, some researchers proposed using a lower threshold, which is inevitably associated with a decrease in the study power. Methods: The results of 22 500 RCTs retrieved from the Cochrane Database of Systematic Reviews (CDSR) were reinterpreted using 2 fixed p significance threshold (0.05 and 0.005), and a recently proposed flexible threshold that minimizes the weighted sum of errors in statistical inference. Results: With p < 0.05 criterion, 28.5% of RCTs were significant; p < 0.005, 14.2%; and p < flexible threshold, 9.9% (2/3 of significant RCTs based on p < 0.05 criterion, were found not significant). Lowering the p cut-off, although decreases the false-positive rate, is not generally associated with a lower weighted sum of errors; the false-negative rate increases (the study power decreases); important treatments may be left undiscovered. Accurate calculation of the optimal p value thresholds needs knowledge of the variance in each study arm, a posteriori. Conclusions: Lowering the p value threshold, as it is proposed by some researchers, is not reasonable as it might be associated with an increase in false-negative rate. Using a flexible p significance threshold approach, although results in a minimum error in statistical inference, might not be good enough too because only a rough estimation may be calculated a priori; the data necessary for the precise computation of the most appropriate p significance threshold are only available a posteriori. Frequentist statistical framework has an inherent conflict. Alternative methods, say Bayesian methods, although not perfect, would be more appropriate for the data analysis of RCTs. [ABSTRACT FROM AUTHOR]

Introduction: Clinical education is a fundamental part of nursing professional education. One method of education is the implementation of the preceptorship program, in which clinical nurses are responsible for educating nursing students. The present study aimed to determine the effectiveness of the preceptorship training program for the participation of clinical nurses in the education of nursing students. Methods: This quasi-experimental study was conducted in 2023 at the teaching hospital in Tehran, Iran. The sample consisted of 66 nurses from a teaching hospital selected using the accessible method and randomly were put into two groups. The workshop addressed the educational needs of preceptors and students, their readiness for their role, and strategies to effectively support students. Prior to the study, the nurses' level of participation was assessed utilizing a valid IMSOC questionnaire that gauged their involvement in guiding nursing students. The participation rate was reassessed after one month using the same questionnaire. The data were analyzed using SPSS version 19. Findings: The two groups were homogeneous in terms of demographic characteristics. The average score for nurses' participation in the education of students before the intervention was 101.84 ± 15.42 in the test group and 107.24 ± 10.53 in the control group; these two groups were not significantly different (P = 0.10). After the intervention, the scores reached 118.90 ± 15.11 in the test group and 106.21 ± 11.96 in the control group, indicating a significant difference (P < 0.001). A comparison of the nurses' participation scores in the test group indicated a significant difference from the pretest to the posttest, with the improvement in all nurses's participation scores (P < 0.001). However, in the control group, this difference was not significant (P = 0.41). Conclusion: The preceptorship training program is effective in light of increasing the participation of clinical nurses in the education of nursing students. This program can improve various aspects, such as motivation, satisfaction, commitment, implementation, and obstacle removal. Considering the importance of clinical training for nursing students and the essential role of preceptors, it is recommended that managers and health trustees in all university hospitals implement a preceptorship training program to increase the participation of clinical nurses in the education of nursing students. [ABSTRACT FROM AUTHOR]

Background: Risky sexual behaviour (RSB), particularly multiple sexual partnerships (MSP) continues to be a major public health concern and has been linked to the increasing STIs, including HIV/AIDS in many parts of sub-Saharan Africa (SSA), suggesting that there is an association between contextual factors and multiple sexual partnering. However, in South Africa, this association is not well established in recent literature. Hence, this study examined the contextual factors contributing to multiple sexual partnerships among young people in South Africa. Materials and methods: Data was extracted from the 2016 South Africa Demographics and Health Survey (2016 SADHS). A cross-sectional study of 3889 never-married young people. Descriptive and inferential statistics as well as multilevel logistic regression were used to analyse the data on never-married young people aged 15 to 24 years. Results: The results indicated that at the individual level, young males (61.7%) were significantly more likely than their female counterparts (56.1%) to engage in multiple sexual partners, although, the difference was not as significant as expected. At the community level clustering, the likelihood of exposure to multiple sexual partnerships significantly increased among females (OR = 1.47; 95% CI: 1.25–1.73) but decreased among their male counterparts (OR = 0.73; 95% CI: 0.58–0.92), in particular, family disruption, residential instability, and ethnic diversity led young people to engage in multiple sexual partnerships. Conclusions: There is a need to intensify programmes aimed at considering appropriate policy options to reduce the prevalence of multiple sexual partnerships. Adopting the implications of these findings is essential for a developmental strategy towards achieving the sustainable development goal of ending STIs among young people in South Africa. [ABSTRACT FROM AUTHOR]

New experimental findings continue to challenge our understanding of protein allostery. Recent deep mutational scanning study showed that allosteric hotspots in the tetracycline repressor (TetR) and its homologous transcriptional factors are broadly distributed rather than spanning well-defined structural pathways as often assumed. Moreover, hotspot mutation-induced allostery loss was rescued by distributed additional mutations in a degenerate fashion. Here, we develop a two-domain thermodynamic model for TetR, which readily rationalizes these intriguing observations. The model accurately captures the in vivo activities of various mutants with changes in physically transparent parameters, allowing the data-based quantification of mutational effects using statistical inference. Our analysis reveals the intrinsic connection of intra- and inter-domain properties for allosteric regulation and illustrate epistatic interactions that are consistent with structural features of the protein. The insights gained from this study into the nature of two-domain allostery are expected to have broader implications for other multi-domain allosteric proteins. [ABSTRACT FROM AUTHOR]

Background: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. Methods: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. Results: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). Conclusions: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices. [ABSTRACT FROM AUTHOR]

In recent years, there has been a remarkable development of simulation-based inference (SBI) algorithms, and they have now been applied across a wide range of astrophysical and cosmological analyses. There are a number of key advantages to these methods, centred around the ability to perform scalable statistical inference without an explicit likelihood. In this work, we propose two technical building blocks to a specific sequential SBI algorithm, truncated marginal neural ratio estimation (TMNRE). In particular, first, we develop autoregressive ratio estimation with the aim to robustly estimate correlated high-dimensional posteriors. Secondly, we propose a slice-based nested sampling algorithm to efficiently draw both posterior samples and constrained prior samples from ratio estimators, the latter being instrumental for sequential inference. To validate our implementation, we carry out inference tasks on three concrete examples: a toy model of a multidimensional Gaussian, the analysis of a stellar stream mock observation, and finally, a proof-of-concept application to substructure searches in strong gravitational lensing. In addition, we publicly release the code for both the autoregressive ratio estimator and the slice sampler. [ABSTRACT FROM AUTHOR]

Rapid developments in satellite remote-sensing technology have enabled the collection of geospatial data on a global scale, hence increasing the need for covariance functions that can capture spatial dependence on spherical domains. We propose a general method of constructing nonstationary, locally anisotropic covariance functions on the sphere based on covariance functions in R 3 . We also provide theorems that specify the conditions under which the resulting correlation function is isotropic or axially symmetric. For large datasets on the sphere commonly seen in modern applications, the Vecchia approximation is used to achieve higher scalability on statistical inference. The importance of flexible covariance structures is demonstrated numerically using simulated data and a precipitation dataset. Supplementary materials accompanying this paper appear online. [ABSTRACT FROM AUTHOR]

Background: Mind-body interventions focused on intentional breathing and movement have been found to mitigate the negative effects of caregiving such as such as stress, psychosocial distress, and emotional distress associated for persons living with Alzheimer's disease and related dementias. Objective: The objective was to assess the feasibility and acceptability and preliminary impacts of our 12-week mind body intervention "Gentle Yoga and Yogic Breathing" for caregivers of persons living with dementia on health outcomes including mutuality, depression and anxiety, loneliness and social support, quality of life, and physical function. Methods: We conducted a single-group cohort study in which 20 caregivers were enrolled. Data were collected at baseline and at the 12-week post-intervention endpoint. Results: The intervention was acceptable; 75% (n = 15/20) completed the study; 16 completed post-study questionnaires. Very few experienced technical issues; 31% (n = 3) most commonly reported as poor internet connectivity, 75% (n = 12/16) perceived a health benefit, 88% (n = 14/16) perceived improved day-to-day mood, and 100% (n = 16/16) would recommend the intervention to other caregivers. Although there was minimal change from baseline to 12 weeks, for health outcomes, there were very small improvements noted in anxiety and overall health. There were no reported adverse events. Conclusion: The intervention was well received and is feasible and acceptable for future studies of stress and health management interventions for caregivers of persons living with dementia. Registered with https://www.ClinicalTrials.gov (NCT03853148). [ABSTRACT FROM AUTHOR]

Randomized controlled trials (RCTs) are considered the gold standard for causal inference. With a sufficient sample size, randomization removes confounding up to the time of randomization and allows the treatment effect to be isolated. However, RCTs may have limited generalizability and transportability and are often not feasible in addiction research due to ethical or logistical constraints. The importance of observational studies from real‐world settings has been increasingly recognized in research on health. This paper provides an overview of modern approaches to designing observational studies that enable causal inference. It illustrates three key techniques, Directed Acyclic Graphs (DAGs), modified Disjunctive Cause Criterion and Target Trial Emulation, and discusses the strengths and limitations of their applications. [ABSTRACT FROM AUTHOR]

The physical and societal characteristics of home have been established as important in influencing the health and wellbeing of older adults, yet these have rarely been explored together. There is also limited research into variation across age groups, with older adults often examined as a homogenous group of those 65 years and over. This study advances the knowledge base by using the concept of person–environment (P-E) fit to analyse differences in personal and home environment (physical and societal) characteristics between young-old (65–74 years) and old-old (75 and above) age groups, and to assess how these characteristics influence their self-perceived health. This cross-sectional study draws upon survey data from 1,999 older adult participants from the Australian Housing Conditions Dataset. Descriptive statistics and inferential analysis were used to assess for significant differences between age groups and a binomial logistic regression was utilised to examine influences on health. The analysis found that the factors which influence health varies appreciably between age groups. For the young-old financial strain, being on the fixed-income pension and hypertension were important contributing factors, in contrast for the old-old gender (being male), having depression and the home being modified for disability were key influences. For both age groups heart disease was a contributing factor to perceived health. The results indicate the important contribution to knowledge of incorporating a wide range of person and environment characteristics when exploring P-E fit for older adults. The inclusion of societal aspects, such as financial strain, fixed-income pension, tenure and access to community aged care services when exploring influences on health, arises as a key conclusion of the study. In terms of impact, this research is significant given rising inequalities globally and specifically in the Australian context, the need for policy measures to address income inequality, and its health and social implications for older households. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate a person‐centred model of clinical supervision to enhance person‐centredness. Design: Experimental, quantitative. Methods: One hundred and three New Graduates were supported to reflect through a person‐centred lens (July–December 2020). Evaluation was undertaken at 6 months using: the Manchester Clinical Supervision Scale‐26 (effectiveness of supervision) and the Person‐centred Practice Inventory (measures attributes of the nurse/midwife, the care environment and person‐centred processes). Due to participation difficulties, scores were calculated by attendance rates using descriptive and inferential statistics. Results: Regular attendees scored higher on the supervision's effectiveness; however, this did not reach efficacy. 'Finding time' to attend contributed to low scores. Supervision scored well on its supportive function when attended. Many New Graduates perceived a decline in their care environment. Attendance aside, New Graduates averaged an increased in their person‐centred attributes and processes. Greater participation was found in those who scored higher at baseline on their person‐centred attributes and processes, and this higher scoring continued at 6 months than those who attended less. Conclusion: New Graduates who perceive themselves as person‐centred and reflective at baseline are more likely to attend a person‐centred clinical supervision and score higher at 6 months than those who attended less often. New Graduates found support within supervision during challenging times. Implications for Practice for Professional and/or Patient Care: For successful implementation of Person‐centred Clinical Supervision, New Graduates need support to attend, as attendance supports them to begin seeing value in the process. Impact: This intervention kept person‐centred practice at the forefront of New Graduates reflection, in a time of extreme change. The research has implications for nursing and midwifery management with the imperative to deliver person‐centred care and create the person‐centred cultures for staff to feel supported and empowered. Reporting Method: Transparent Evaluation of Non‐randomized Designs (TREND). Patient of Public Contribution: No patient or public contribution. Contribution to Wider Community: New Graduates grow their person‐centredness over their transitioning year; however, this can be enhanced with regular clinical supervision underpinned by person‐centred theory.Clinical supervisors can provide support to New Graduates when the environment is challenged. [ABSTRACT FROM AUTHOR]

This scholarly project implemented the 3 Wishes Project (3WP), which aims to fulfill the final wishes of dying critically ill patients, in a 16-bed tertiary intensive care unit (ICU). The project assessed outcomes through surveys, mortality, and intervention records. The initial implementation involved 11 patients and 49 fulfilled wishes. A comparison of pre- and postintervention data showed statistically significant increases in perceptions of end-of-life care, services, and interprofessional communication. All found the 3WP valuable for patients and families, and 61% reported boosted morale. [ABSTRACT FROM AUTHOR]

Background: Based on previous evidence person‐centred care (PCC) as a quality indicator is important in long‐term care (LTC) settings for older people. Effective ways to increase nurses' person‐centred care competence are missing. Aim: To evaluate the effectiveness of a continuing education (CE) intervention named 'Person First—Please' (PFP) for improving nurses' PPC competence and its connection to PPC climate. Methods: Quasi‐experimental cluster design with intervention and control groups was carried out in LTC settings for older people. The intervention group (n = 77) received a 10‐week CE intervention, with control group (n = 123) working as usual. The primary outcome was professional nurses' PCC competence. Secondary outcome was the PCC climate as perceived by nurses and, residents with their next of kin. Measurements were conducted pre−/post‐intervention and after 6 weeks using the validated, Person‐centred Care Competence scale and the Person‐centred Care Climate questionnaire, staff and patient versions. Data was analysed with descriptive and inferential statistics. Results: PCC competence was significantly increased in the intervention group and remained after 6 weeks of follow‐up. PCC climate increased in the intervention group in total score and also in all sub‐scales, across residents with their next of kin. The control group did not show any significant change. Comparisons of PCC competence and PCC climate in time between intervention and control groups confirmed that changes seen between groups were statistically significant in intervention group. Limitations: Measurements were self‐assessments, which may have been affected by bias, especially in context of competence assessment. Conclusion: The intervention was effective in increasing professional nurses' PCC competence and on person‐centred care climate in long‐term care settings for older people. [ABSTRACT FROM AUTHOR]

Rank regression method has been widely pursued for robust inference in statistical models. Unfortunately, there does not exist related literature for the function-on-scalar model, which is the focus of this paper. We study the robust estimation based on rank regression and B-spline approximations for the function-on-scalar model and further establish the theoretical properties of the proposed method under regularity conditions. Extensive simulation studies and two real data applications are given to illustrate the merits of the proposed approach. Numerical results show that the proposed method is competitive with existing robust estimation procedures. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to assess the sensitivity of cell-free DNA (cf-DNA) to different resistance training volume loads. The secondary purpose was to examine the relationship between change in cf-DNA and relative strength. Researchers hypothesized that (a) cf-DNA concentrations would increase with increasing volume load and (b) increases in relative strength would result in predicted decreases to %Δ of cf-DNA. Thirty subjects were recruited for this study, 15 men and 15 women. Blood was collected through venous draws into 4-ml vacutainers at 3 time points: immediately before (T1), after 3 sets (T2), and after 6 sets (T3) of the back squat exercise. A critical alpha of 0.05 was set for inferential statistics. A repeated-measures ANOVA showed that cf-DNA increased significantly from T1 (407.72 ± 320.83) to T2 (1,244.6 ± 875.83) (p < 0.01) and T1 (407.72 ± 320.83) to T3 (1,331.15 ± 1,141.66) (p < 0.01), whereas no difference was found from T2 to T3 (p = 1.00). The linear regression model used to examine the predictive capabilities relative strength had on cf-DNA %Δ from T1 to T3 was found to be significant (p = 0.04; R² = 0.15). The results of this study demonstrate the short response of cf-DNA in relation to variations in resistance training volume load. Results also demonstrated the positive relationship between relative strength and cf-DNA %Δ. The current study builds on the body of research that cf-DNA provides insight regarding the level of immune response after exercise training. [ABSTRACT FROM AUTHOR]

Pocock and Simon's minimization method is a popular approach for covariate‐adaptive randomization in clinical trials. Valid statistical inference with data collected under the minimization method requires the knowledge of the limiting covariance matrix of within‐stratum imbalances, whose existence is only recently established. In this work, we propose a bootstrap‐based estimator for this limit and establish its consistency, in particular, by Le Cam's third lemma. As an application, we consider in simulation studies adjustments to existing robust tests for treatment effects with survival data by the proposed estimator. It shows that the adjusted tests achieve a size close to the nominal level, and unlike other designs, the robust tests without adjustment may have an asymptotic size inflation issue under the minimization method. [ABSTRACT FROM AUTHOR]

This study intends to introduce kernel mean embedding of probability measures over infinite‐dimensional separable Hilbert spaces induced by functional response statistical models. The embedded function represents the concentration of probability measures in small open neighborhoods, which identifies a pseudo‐likelihood and fosters a rich framework for statistical inference. Utilizing Maximum Mean Discrepancy, we devise new tests in functional response models. The performance of new derived tests is evaluated against competitors in three major problems in functional data analysis including Function‐on‐Scalar regression, functional one‐way ANOVA, and equality of covariance operators. [ABSTRACT FROM AUTHOR]

Children with chronic illness are found to be at greater risk for psychiatric problems, including depression, anxiety and feelings of isolation. Particularly, HIV positive children in underdeveloped nations are more likely experiencing psychological disorders and live with socially alienated social support systems. In present study, institution-based cross-sectional research design was employed to assess the prevalence of mental health distress among HIV positive children 115(F = 69) in Ethiopia. Systematic random sampling technique was used to select participants. Quantitative data were collected with standardized instruments. Nurse Counsellors and case managers from the children's ART department participated in sample selection and data collection under the close supervision of a researcher. Descriptive and inferential statistical methods were used to analyze the quantitative data. The key findings of this study revealed that 57.4% HIV positive children reported high level in measures of anxiety and 52.2% had high depression level, while 47.8% had low self-esteem. Children's ages, parental conditions, and perceived social support shown significant association with participants' mental health condition. Perceived social support was a powerful set of predictors of children level of anxiety F = 1, 113 24.526, p <.001 and self-esteem F = 1, 113 6.494, p <.0.05. Furthermore, children's age was a strong predictor of mental health status. The present study finding asserted that HIV positive children require a lifetime of continuous treatment, care and support to ensure their physical and mental development. This study reminds families, caregivers and healthcare institutions of the development of appropriate prevention and intervention program to alleviate stressful life events and improve the psychological well-being of HIV positive children. [ABSTRACT FROM AUTHOR]

Summary: We propose a new class of priors for Bayesian hypothesis testing, which we name 'cake priors'. These priors circumvent the Jeffreys–Lindley paradox (also called Bartlett's paradox) a problem associated with the use of diffuse priors leading to nonsensical statistical inferences. Cake priors allow the use of diffuse priors (having one's cake) while achieving theoretically justified inferences (eating it too). We demonstrate this methodology for Bayesian hypotheses tests for various common scenarios. The resulting Bayesian test statistic takes the form of a penalised likelihood ratio test statistic. Under typical regularity conditions, we show that Bayesian hypothesis tests based on cake priors are Chernoff consistent, that is, achieve zero type I and II error probabilities asymptotically. We also discuss Lindley's paradox and argue that the paradox occurs with small and vanishing probability as sample size increases. [ABSTRACT FROM AUTHOR]

Background: High-quality patient care requires nurses with strong clinical competency. Thus, it is essential to examine the factors associated with clinical competency. Purpose: This studywas designed to (a) investigate head nurse leadership, staff nurse demographics, and clinical competency; (b) examine the impact of demographics on the clinical competency of staff nurses; (c) analyze the correlation between head nurse leadership and staff nurse clinical competency; and (d) examine the effects of demographics on clinical competency after controlling for the head nurse leadership. Methods: A cluster sampling method was used to collect data from 200 staff nurses at a national medical center in Taiwan. Questionnaires were used to gather information on head nurse leadership style and staff nurse clinical competency. Descriptive and inferential statistical analyses were conducted, including Mann--Whitney U test, Kruskal--Wallis test, Spearman's rank correlation coefficient, and multivariate analysis of covariance. Results: The average score for transformational leadership style among the head nurses was 2.89, whereas transactional leadership style scored an average of 2.49. The average scores for the components of clinical competency, listed from highest to lowest, were as follows: patient care (3.35), professionalism (3.28), communication skills (3.18), management (2.84), and knowledge (2.73). In addition, statistically significant differences were found in clinical competency based on demographic factors, including age, marital status, educational level, job title, and length of employment. Also, a statistically significant, positive correlation between the head nurse transformational leadership style and nurse clinical competency was found. The main effect of length of employment on the five competency components was statistically significant after controlling for transformational leadership. Furthermore, post hoc analysis of covariance revealed a significant effect of length of employment on patient care, knowledge, communication skills, and management. Conclusions: The findings of this study indicate transformational leadership and employment length impact the clinical competency of staff nurses, particularly in terms of patient care, communication skills, management, and knowledge. Providing education and training in leadership and management to current and prospective head nurses may be expected to enhance clinical competency in staff nurses and create a more nurturing work environment. Moreover, targeted training may help current head nurses gain insight into their leadership styles and acquire skills to promote transformational leadership. In addition, leadership development may help equip prospective head nurses with critical competencies before assuming leadership responsibilities. [ABSTRACT FROM AUTHOR]

The primary objective is to assess factors associated with treatment related high grade (CTCAE grade ≥ 3) adverse event (AE) reporting among participants in gynecologic oncology clinical trials. All AEs recorded in the Princess Margaret Clinical Trial adverse event database between 01/2016 and 12/2018 were evaluated. Gynecologic oncology clinical trials assessing systemic therapy were included. Inferential statistics on risk factors of related grade ≥ 3 adverse event reporting and GEE logistic models with Odds Ratios (OR) were performed. Multivariable analysis adjusting for age, clinical trial phase, sponsor, and therapy type. The gynecology cancer clinical trials accrued 317 unique patients (359 nested on trials) in 42 systemic therapy trials. In the period, 17,175 related AEs were reported in the gynecological cancer trials, 7.4% were grade ≥ 3. On multivariable analysis, no odds differences of grade ≥ 3 related AEs were detected according to study phase. Patients in immunotherapy clinical trials had lower odds of related grade ≥ 3 AEs than patients on targeted or other therapy (adjusted OR [aOR] 0.43; 95% CI 0.24–0.75). There was greater odds of related grade ≥ 3 AEs in clinical trials assessing combination vs single therapeutics (aOR 2.26, 95% CI 1.34–3.80). Patients aged ≥65 (aOR 1.77; 95% CI 1.08–2.89) had greater odds of related grade ≥ 3 AEs than patients aged 50 to 65 years. When compared to other disease sites, the odds of having a grade ≥ 3 related AE reported in gynecology clinical trials was no different. In this cohort, factors influencing the odds of related grade ≥ 3 AE reporting in gynecologic trials included type of therapy and age. The study phase did not correlate with odds of high-grade AE reporting. • The study assesses related high grade adverse event (AE) reporting in gynecology oncology trials at a referral cancer centre. • Study factors associated with higher odds of related grade ≥ 3 AEs were non-immunotherapy trials or drug combinations. • Patient factors associated with higher odds of related grade ≥ 3 AEs reported included age ≥ 65. • No odds differences were detected in related grade ≥ 3 AEs reported according to the clinical trial phase. [ABSTRACT FROM AUTHOR]

The quality performance of many vital systems depends on how long the units are performing; hence, research works started focusing on increasing the reliability of systems while taking into consideration that many factors may cause the failures of operating systems. In this study, the combination of a parametric generalized linear failure rate distribution model and an adaptive progressive Type-II censoring scheme for practical purposes is explored. A comprehensive investigation is performed on the risk factors that cause failure and determines which of the factors has a more harmful effect on the units. A lifetime experiment is performed under the condition of an adaptive progressive Type-II censoring scheme to obtain observations as a result of the competing factors of failures. The obtained observations are assumed to follow a three-parameter generalized linear failure rate distribution and are assumed to be competing to cause failure. Two statistical inference methods are employed for estimating this model's parameters: the frequentist maximum likelihood method and the Bayesian approach. Our model's validity is demonstrated through extensive simulations and real data applications in the medical and electrical engineering fields. [ABSTRACT FROM AUTHOR]

Sparse structure learning in high‐dimensional Gaussian graphical models is an important problem in multivariate statistical inference, since the sparsity pattern naturally encodes the conditional independence relationship among variables. However, maximum a posteriori (MAP) estimation is challenging under hierarchical prior models, and traditional numerical optimization routines or expectation–maximization algorithms are difficult to implement. To this end, our contribution is a novel local linear approximation scheme that circumvents this issue using a very simple computational algorithm. Most importantly, the condition under which our algorithm is guaranteed to converge to the MAP estimate is explicitly stated and is shown to cover a broad class of completely monotone priors, including the graphical horseshoe. Further, the resulting MAP estimate is shown to be sparse and consistent in the ℓ2$$ {\ell}_2 $$‐norm. Numerical results validate the speed, scalability and statistical performance of the proposed method. [ABSTRACT FROM AUTHOR]

The 2×2$$ 2\times 2 $$ table with a structural zero represents a common scenario in clinical trials and epidemiology, characterized by a specific empty cell. In such cases, the risk ratio serves as a vital parameter for statistical inference. However, existing confidence intervals, such as those constructed through the score test and Bayesian methods, fail to achieve the prescribed nominal level. Our focus is on numerically constructing exact confidence intervals for the risk ratio. We achieve this by optimally combining the modified inferential model method and the h$$ h $$‐function method. The resulting interval is then compared with intervals generated by four existing methods: the score method, the exact score method, the Bayesian tailed‐based method and the inferential model method. This comparison is conducted based on the infimum coverage probability, average interval length and non‐coverage probability criteria. Remarkably, our proposed interval outperforms other exact intervals, being notably shorter. To illustrate the effectiveness of our approach, we discuss two examples in detail. [ABSTRACT FROM AUTHOR]

Background: Studies have evaluated the efficacy of endoscopic incisional therapy (EIT) for benign anastomotic strictures. We performed a systematic review and meta-analysis to evaluate stricture recurrence after EIT following esophagectomy or gastrectomy. Methods: A systematic search of databases was performed up to April 2nd, 2023, after selection of key search terms with the research team. Inclusion criteria included human participants undergoing EIT for a benign anastomotic stricture after esophagectomy or gastrectomy, age ≥ 18, and n ≥ 5. Our primary outcome was the incidence of stricture recurrence among patients treated with EIT compared to dilation. Our secondary outcome was the stricture-free duration after EIT and rate of adverse events. Meta-analysis was performed with RevMan 5.4.1 using a Mantel–Haenszel random-effects model. Publication bias was evaluated with funnel plots and the Egger test. Results: A total of 2550 unique preliminary studies underwent screening of abstracts and titles. This led to 33 studies which underwent full-text review and five studies met the inclusion criteria. Meta-analysis revealed reduced odds of overall stricture recurrence (OR 0.35, 95% CI 0.13–0.92, p = 0.03; I2 = 71%) and reduced odds of stricture recurrence among naïve strictures (OR 0.32, 95% CI 0.17–0.59, p = 0.0003; I2 = 0%) for patients undergoing EIT compared to dilation. There was no significant difference in the odds of stricture recurrence among recurrent strictures (OR 0.63, 95% CI 0.12–3.28, p = 0.58; I2 = 81%). Meta-analysis revealed a significant increase in the recurrence-free duration (MD 42.76, 95% CI 12.41–73.11, p = 0.006) among patients undergoing EIT compared to dilation. Conclusion: Current data suggest EIT is associated with reduced odds of stricture recurrence among naïve anastomotic strictures. Large, prospective studies are needed to characterize the safety profile of EIT, address publication bias, and to explore multimodal therapies for refractory strictures. [ABSTRACT FROM AUTHOR]

Background: This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses. Methods: This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom underwent initial non-operative treatment comprising either antibiotics alone or in combination with percutaneous drainage. The cohort was stratified based on the outcome of non-operative treatment, specifically identifying those who required emergency surgical intervention as cases of treatment failure. Multivariable logistic regression analysis to identify independent risk factors associated with the failure of non-operative treatment was employed. Results: Failure of conservative treatment occurred for 116 patients (27.04%). CT scan Hinchey classification IIb (aOR 2.54, 95%CI 1.61;4.01, P < 0.01), tobacco smoking (aOR 2.01, 95%CI 1.24;3.25, P < 0.01), and presence of air bubbles inside the abscess (aOR 1.59, 95%CI 1.00;2.52, P = 0.04) were independent predictors of failure. In the subgroup of patients with abscesses > 5 cm, percutaneous drainage was not associated with the risk of failure or success of the non-operative treatment (aOR 2.78, 95%CI − 0.66;3.70, P = 0.23). Conclusions: Non-operative treatment is generally effective for diverticular abscesses. Tobacco smoking's role as an independent risk factor for treatment failure underscores the need for targeted behavioural interventions in diverticular disease management. IIb Hinchey diverticulitis patients, particularly young smokers, require vigilant monitoring due to increased risks of treatment failure and septic progression. Further research into the efficacy of image-guided percutaneous drainage should involve randomized, multicentre studies focussing on homogeneous patient groups. [ABSTRACT FROM AUTHOR]

To improve nonparametric estimates of lifetime distributions, we propose using the increasing odds rate (IOR) model as an alternative to other popular, but more restrictive, 'adverse ageing' models, such as the increasing hazard rate one. This extends the scope of applicability of some methods for statistical inference under order restrictions, since the IOR model is compatible with heavy-tailed and bathtub distributions. We study a strongly uniformly consistent estimator of the cumulative distribution function of interest under the IOR constraint. Numerical evidence shows that this estimator often outperforms the classic empirical distribution function when the underlying model does belong to the IOR family. We also study two different tests to detect deviations from the IOR property and establish their consistency. The performance of these tests is also evaluated through simulations. [ABSTRACT FROM AUTHOR]

Hazard function plays a crucial role in survival analysis. Its estimation has garnered a lot of attention when the survival time variable suffers from right-censoring. Most of the existing works focus on the cases that failure information is complete or missing at random (MAR). When the censoring information is missing not at random (MNAR), statistical inferences on hazard function are very challenging. In this study, estimation of hazard function is addressed under the MNAR mechanism of the failure information. Three estimators are proposed by employing the techniques of correcting biases and adjusting weighting probabilities. These estimators are validated to be consistent and asymptotically normal. Simulation studies and two real-data analyses are performed to assess the proposed methods. [ABSTRACT FROM AUTHOR]

Simple Summary: Despite guidelines recommending surgery as part of treatment for stage I small cell lung cancer (SCLC), its application remains inconsistent, and its role in stages II and III is under debate. In absence of current randomized control trials this meta-analysis compared surgery to non-surgical treatment for stages I to III SCLC. After a systematic review, ten studies with a total of 95,323 patients were analyzed. The analysis found no significant differences in patient characteristics between the surgery and non-surgery groups. The 5-year survival rate for resected patients was significantly higher compared to non-surgically treated patients. This finding was valid also for patients in stages II and III. Surgery might significantly improve survival in SCLC patients and should be considered in treatment planning even in higher stages. Introduction: Despite clear guideline recommendations, surgery is not consistently carried out as part of multimodal therapy in stage I small cell lung cancer (SCLC) patients. The role of surgery in stages II and III is even more controversial. In the absence of current randomized control trials (RCT), we performed a meta-analysis comparing surgery versus non-surgical treatment in stage I to III SCLC patients. Methods: A systematic review of the literature was conducted on 1 July 2023, focusing on studies pertaining to the impact of surgery on small cell lung cancer (SCLC). These studies were evaluated using the ROBINS-I tool. Statistical analyses, including I² tests, Q-statistics, DerSimonian-Laird tests, and Egger regression, were performed to assess the data. In addition, 5-year survival rates were analyzed. The meta-analysis was conducted according to PRISMA standards. Results: Among the 6826 records identified, 10 original studies encompassing a collective cohort of 95,323 patients were incorporated into this meta-analysis. Heterogeneity was observed across the included studies, with no discernible indication of publication bias. Analysis of patient characteristics revealed no significant differences between the two groups (p-value > 0.05). The 5-year survival rates in a combined analysis of patients in stages I–III were 39.6 ± 15.3% for the 'surgery group' and 16.7 ± 12.7% for the 'non-surgery group' (p-value < 0.0001). SCLC patients in stages II and III treated outside the guideline with surgery had a significantly better 5-year survival compared to non-surgery controls (36.3 ± 20.2% vs. 20.2 ± 17.0%; p-value = 0.043). Conclusions: In the absence of current RCTs, this meta-analysis provides robust suggestions that surgery might significantly improve survival in all SCLC stages. Non-surgical therapy could lead to a shortening of life. The feasibility of surgery in non-metastatic SCLC should always be evaluated as part of a multimodal treatment. [ABSTRACT FROM AUTHOR]

The present study aims to explore the global landscape of neurotechnology research and investigate the factors that influence its citation impact. The data for the study were extracted from the Web of Science Core Collection database, resulting in a total of 1,473 articles related to neurotechnology. The study identified a notable increase in neurotechnology research over time, peaking at 37.20% from 2020 to 2023, with Scientific Reports as the leading journal. Collaborative efforts with two to four authors constituted 42.90% of the total articles. The United States led country-level contributions (29.26%). The University of California secured the top rank with 4.48% of the total publications. The United States Department of Health and Human Services remains at the top by contributing funding to 7.46% of research papers in the field of Neurotechnology research. Statistical tests confirmed significant correlations between research funding, collaboration, and research availability mode with citation impact. Positive correlations were identified between research funding and collaboration, while open access availability showed a negative correlation with citation impact. These findings deepen our understanding of neurotechnology research dynamics, providing insights for researchers, institutions, and policymakers. [ABSTRACT FROM AUTHOR]