Search

Background Purpose Methods Results Conclusions The findings of the 2023 AAPM Grand Challenge on Deep Generative Modeling for Learning Medical Image Statistics are reported in this Special Report.The goal of this challenge was to promote the development of deep generative models for medical imaging and to emphasize the need for their domain‐relevant assessments via the analysis of relevant image statistics.As part of this Grand Challenge, a common training dataset and an evaluation procedure was developed for benchmarking deep generative models for medical image synthesis. To create the training dataset, an established 3D virtual breast phantom was adapted. The resulting dataset comprised about 108 000 images of size 512 ×$\times$ 512. For the evaluation of submissions to the Challenge, an ensemble of 10 000 DGM‐generated images from each submission was employed. The evaluation procedure consisted of two stages. In the first stage, a preliminary check for memorization and image quality (via the Fréchet Inception Distance [FID]) was performed. Submissions that passed the first stage were then evaluated for the reproducibility of image statistics corresponding to several feature families including texture, morphology, image moments, fractal statistics, and skeleton statistics. A summary measure in this feature space was employed to rank the submissions. Additional analyses of submissions was performed to assess DGM performance specific to individual feature families, the four classes in the training data, and also to identify various artifacts.Fifty‐eight submissions from 12 unique users were received for this Challenge. Out of these 12 submissions, 9 submissions passed the first stage of evaluation and were eligible for ranking. The top‐ranked submission employed a conditional latent diffusion model, whereas the joint runners‐up employed a generative adversarial network, followed by another network for image superresolution. In general, we observed that the overall ranking of the top 9 submissions according to our evaluation method (i) did not match the FID‐based ranking, and (ii) differed with respect to individual feature families. Another important finding from our additional analyses was that different DGMs demonstrated similar kinds of artifacts.This Grand Challenge highlighted the need for domain‐specific evaluation to further DGM design as well as deployment. It also demonstrated that the specification of a DGM may differ depending on its intended use. [ABSTRACT FROM AUTHOR]

Background: Systematic review with meta-analysis integrates findings from multiple studies, offering robust conclusions on treatment effects and guiding evidence-based medicine. However, the process is often hampered by challenges such as inconsistent data reporting, complex calculations, and time constraints. Researchers must convert various statistical measures into a common format, which can be error-prone and labor-intensive without the right tools. Implementation: Meta-Analysis Accelerator was developed to address these challenges. The tool offers 21 different statistical conversions, including median & interquartile range (IQR) to mean & standard deviation (SD), standard error of the mean (SEM) to SD, and confidence interval (CI) to SD for one and two groups, among others. It is designed with an intuitive interface, ensuring that users can navigate the tool easily and perform conversions accurately and efficiently. The website structure includes a home page, conversion page, request a conversion feature, about page, articles page, and privacy policy page. This comprehensive design supports the tool's primary goal of simplifying the meta-analysis process. Results: Since its initial release in October 2023 as Meta Converter and subsequent renaming to Meta-Analysis Accelerator, the tool has gained widespread use globally. From March 2024 to May 2024, it received 12,236 visits from countries such as Egypt, France, Indonesia, and the USA, indicating its international appeal and utility. Approximately 46% of the visits were direct, reflecting its popularity and trust among users. Conclusions: Meta-Analysis Accelerator significantly enhances the efficiency and accuracy of meta-analysis of systematic reviews by providing a reliable platform for statistical data conversion. Its comprehensive variety of conversions, user-friendly interface, and continuous improvements make it an indispensable resource for researchers. The tool's ability to streamline data transformation ensures that researchers can focus more on data interpretation and less on manual calculations, thus advancing the quality and ease of conducting systematic reviews and meta-analyses. [ABSTRACT FROM AUTHOR]

Background: Radical prostatectomies can be performed using open retropubic, laparoscopic, or robot-assisted laparoscopic surgery. The literature shows that short-term outcomes (in particular, inpatient complications) differ depending on the type of procedure. To date, these differences have only been examined and confirmed in isolated cases based on national routine data. Methods: The data was based on the Swiss Medical Statistics from 2016 to 2018 from a national survey of administrative data from all Swiss hospitals. Cases with the coded main diseases neoplasm of the prostate (ICD C61) and the main treatments of laparoscopic (CHOP 60.5X.20) or retropubic (CHOP 60.5X.30) radical prostatectomies were included, resulting in a total sample size of 8,593 cases. Results: A procedure-related complication occurred in 998 cases (11.6%). By surgical procedure, complication rates were 10.1% for robotic-assisted laparoscopic radical prostatectomy 9.0% for conventional laparoscopic radical prostatectomy and 17.1% for open retropubic radical prostatectomy (p < 0.001). Conventional and robotic-assisted laparoscopic radical prostatectomies had a significantly lower risk of complications than retropubic procedures. Moreover, the risk of a procedure-related complication was almost twice as high in cases operated on retropubically; however, no significant difference was found between conventional and robotic-assisted laparoscopic cases. Discussion: The use of a surgical robot showed no advantages in radical prostatectomies regarding procedure-related during the hospital stay. However, both conventional and robotic-assisted laparoscopically operated radical prostatectomies show better results than open retropubic procedures. Further studies on the long-term course of patients based on claims data are needed to confirm the inherent benefits of surgical robots in tandem with them being increasingly employed in hospitals. [ABSTRACT FROM AUTHOR]

To better understand complex human phenotypes, large-scale studies have increasingly collected multiple data modalities across domains such as imaging, mobile health, and physical activity. The properties of each data type often differ substantially and require either separate analyses or extensive processing to obtain comparable features for a combined analysis. Multimodal data fusion enables certain analyses on matrix-valued and vector-valued data, but it generally cannot integrate modalities of different dimensions and data structures. For a single data modality, multivariate distance matrix regression provides a distance-based framework for regression accommodating a wide range of data types. However, no distance-based method exists to handle multiple complementary types of data. We propose a novel distance-based regression model, which we refer to as Similarity-based Multimodal Regression (SiMMR), that enables simultaneous regression of multiple modalities through their distance profiles. We demonstrate through simulation, imaging studies, and longitudinal mobile health analyses that our proposed method can detect associations between clinical variables and multimodal data of differing properties and dimensionalities, even with modest sample sizes. We perform experiments to evaluate several different test statistics and provide recommendations for applying our method across a broad range of scenarios. [ABSTRACT FROM AUTHOR]

Background: COVID-19 will not be the last pandemic of the twenty-first century. To better prepare for the next one, it is essential that we make honest appraisals of the utility of different responses to COVID. In this paper, we focus specifically on epidemiologic forecasting. Characterizing forecast efficacy over the history of the pandemic is challenging, especially given its significant spatial, temporal, and contextual variability. In this light, we introduce the Weighted Contextual Interval Score (WCIS), a new method for retrospective interval forecast evaluation. Methods: The central tenet of the WCIS is a direct incorporation of contextual utility into the evaluation. This necessitates a specific characterization of forecast efficacy depending on the use case for predictions, accomplished via defining a utility threshold parameter. This idea is generalized to probabilistic interval-form forecasts, which are the preferred prediction format for epidemiological modeling, as an extension of the existing Weighted Interval Score (WIS). Results: We apply the WCIS to two forecasting scenarios: facility-level hospitalizations for a single state, and state-level hospitalizations for the whole of the United States. We observe that an appropriately parameterized application of the WCIS captures both the relative quality and the overall frequency of useful forecasts. Since the WCIS represents the utility of predictions using contextual normalization, it is easily comparable across highly variable pandemic scenarios while remaining intuitively representative of the in-situ quality of individual forecasts. Conclusions: The WCIS provides a pragmatic utility-based characterization of probabilistic predictions. This method is expressly intended to enable practitioners and policymakers who may not have expertise in forecasting but are nevertheless essential partners in epidemic response to use and provide insightful analysis of predictions. We note that the WCIS is intended specifically for retrospective forecast evaluation and should not be used as a minimized penalty in a competitive context as it lacks statistical propriety. Code and data used for our analysis are available at https://github.com/maximilian-marshall/wcis. [ABSTRACT FROM AUTHOR]

The text of a presentation, given in 2003, regarding my recollections of the Medical Research Council's Statistical Research Unit is provided. [ABSTRACT FROM AUTHOR]

Reference intervals for the general clinical practice are expected to cover non-pathological values, but also reflect the underlying biological variation present in age- and gender-specific patient populations. Reference intervals can be inferred from routine patient data measured in high capacity using parametric approaches. Stratified reference distributions are obtained which may be transformed to normality via e.g. a Yeo-Johnson transformation. The estimation of the optimal transformation parameter for Yeo-Johnson through maximum likelihood can be highly influenced by the presence of outlying observations, resulting in biased reference interval estimates. To reduce the influence of outlying observations on parametric reference interval estimation, a reweighted M-estimator approach for the Yeo-Johnson (YJ) transformation was utilised to achieve central normality in stratified reference populations for a variety of laboratory test results. The reweighted M-estimator for the YJ transformation offers a robust parametric approach to infer relevant reference intervals. The proposed method showcases robustness up to 15 % of outliers present in routine patient data, highlighting the applicability of the reweighted M-estimator in laboratory medicine. Furthermore, reference intervals are personalised based on the patients' age and gender for a variety of analytes from routine patient data collected in a tertiary hospital, robustly reducing the dimensionality of the data for more data-driven approaches. The method shows the advantages for estimating reference intervals directly and parametrically from routine patient data in order to provide expected reference ranges. This approach to locally inferred reference intervals allows a more nuanced comparison of patients' test results. [ABSTRACT FROM AUTHOR]

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Members of the ASA's Section on Statistical Consulting established the Pathways to Promotion Committee in 2021 to provide guidance and support for navigating a career as a collaborative statistician. In three years of existence, the Committee has produced seven webinars on relevant topics, each attended by more than one hundred participants. Committee members have given four oral presentations, organized three roundtables, led multiple discussions at ASA meetings and published four articles. These efforts have inspired, created and facilitated new connections for collaborative statisticians who feel isolated in their career path. This paper describes the formation and development of the Committee, reports its impact on the community of collaborative statisticians and discusses potential future directions. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, a group of health program implementors and research analysts across seven low- and middle-income countries (LMICs) alongside Boston-based collaborators convened to implement data-driven approaches for public health response. An intensive statistics and data science training short course was developed to ensure that in-country researchers could implement the necessary statistical methods for COVID-19 surveillance. The main goal of the course was to enable interpretation of findings from time series analyses and flag potential data issues. This manuscript summarizes our experience teaching this course, including a detailed course overview, participant feedback, and thoughts on how targeted, online courses can be used to support statistical capacity building in LMICs. [ABSTRACT FROM AUTHOR]

Background: Craniosynostosis and positional plagiocephaly (PP) both lead to deformities of the infant skull. In some cases, patients may present with concurrent craniosynostosis and PP. The forces exerted on the skull by both conditions can complicate and delay correct diagnosis and require adjustments to surgical planning. Objective: The purpose of this scoping review was to identify and analyze the existing peer-reviewed literature covering the diagnosis and treatment of concurrent craniosynostosis and PP. Design: In accordance with PRISMA guidelines, PubMed, MEDLINE, and EMBASE were searched for articles discussing concurrent diagnoses of craniosynostosis and PP. Results: Out of 633 articles discovered, 7 met inclusion criteria and discussed a cumulative total of 10 patients. The average age of referral to a craniofacial team was 17 ± 22.2 months. The most common reason for referral was craniofacial asymmetry (90%, n = 9). 40% presented with unilateral coronal synostosis (n = 4), 40% with lambdoid synostosis (n = 4), 10% with sagittal synostosis (n = 1), and 10% with metopic synostosis (n = 1). The most commonly reported clinical features were occipital flattening (90%, n = 9), ear displacement (80%, n = 8), and frontal bossing (30%, n = 3). Delayed or incorrect initial diagnosis was noted in 70% (n = 7) of patients. CT scan was the most commonly employed diagnostic tool, utilized in 100% of patients. 70% of patients (n = 7) underwent surgery at an average age of 6.75 ± 3 months. Two studies, accounting for 2 patients reported, noted altering their surgical technique to account for PP in addition to the synostotic suture. Conclusions: Coincident craniosynostosis and PP can pose a complicated diagnostic and therapeutic challenge. An in-depth understanding of the most reliable physical exam findings associated with each type of craniosynostosis combined with PP will facilitate accurate diagnosis. Consideration of the concurrent forces on the skull created by craniosynostosis and PP aid in the design of a tailored surgical plan. [ABSTRACT FROM AUTHOR]

The most discussed infectious disease is coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Many research endeavors have focused on the effects of the virus on reproductive organs, as these have also been shown to carry the receptors to which the virus attaches. The results of assisted reproductive technology (ART) have been significantly affected by the pandemic, with some in vitro fertilization (IVF) centers being closed due to the risk of further spread of the disease. According to World Health Organization statistics, 17.5% of adults worldwide suffered from fertility problems in 2023; in other words, one in six people in the world have reproductive health problems. As infertility is a growing problem in the modern world and new developments in assisted reproduction are always a topic of profound interest, it is important to understand the impact of SARS-CoV-2 on reproductive health. This systematic review aimed to examine studies describing patients undergoing ART procedures with a COVID-19-positive history and to shed light on the recent evidence on the safety of COVID-19 vaccination in the ART context. A meta-analysis was conducted to confirm the results of the systematic review. The results showed a significant difference in clinical pregnancy rates between the vaccinated and unvaccinated groups and an increased miscarriage rate in those with a COVID-19-positive history. However, no significant difference in clinical pregnancy and birth rates was found in participants with a previous COVID-19 infection. The results show that further studies and research are needed, even though the spread and impact of the virus have decreased. Evidence-based information for individuals and couples undergoing infertility treatment is vital to enable informed decision-making. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Methods Results Conclusions identifier Pruritus is a common, bothersome symptom for patients with mild‐to‐moderate plaque psoriasis (PsO), yet no validated scale assesses it in this patient population. We aimed to validate the Peak Pruritus‐Numerical Rating Scale (PP‐NRS) using data from a Phase 2b study investigating the efficacy of brepocitinib in patients with mild‐to‐moderate chronic PsO.Patients completed the PP‐NRS daily from baseline for the first 2 weeks after the dose administration and subsequently only on visit days. Test–retest reliability (intraclass correlation coefficient [ICC]), construct validity (known group validity and convergent validity), ability to detect change, and meaningful within‐patient change (MWPC) were evaluated using correlation and regression analyses.The PP‐NRS demonstrated acceptable test–retest reliability (ICC: 0.86–0.89). Known‐group evidence demonstrated that PP‐NRS scores could discriminate between different degrees of disease severity. Convergent validity was supported by significant correlation coefficients between the PP‐NRS and Patient Global Assessment (PtGA), Dermatology Life Quality Index, and Psoriasis Symptom Inventory, which generally exceeded 0.50. The ability to detect change was evidenced by an approximately linear relationship between changes in PP‐NRS and Physician Global Assessment or PtGA of psoriasis scores. The value of 2.8 was determined as the MWPC for the PP‐NRS.PP‐NRS is a reliable, practical test for assessing pruritus in mild‐to‐moderate PsO clinical trials.NCT03850483. [ABSTRACT FROM AUTHOR]

The coronavirus pandemic has raised concerns about the emergence of other viral infections, such as monkeypox, which has become a significant hazard to public health. Thus, this work proposes a novel time series ensemble technique for analyzing and forecasting the spread of monkeypox in the four highly infected countries with the monkeypox virus. This approach involved processing the first cumulative confirmed case time series to address variance stabilization, normalization, stationarity, and a nonlinear secular trend component. After that, five single time series models and three proposed ensemble models are used to estimate the filtered confirmed case time series. The accuracy of the models is evaluated using typical accuracy mean errors, graphical evaluation, and an equal forecasting accuracy statistical test. Based on the results, it is found that the proposed time series ensemble forecasting approach is an efficient and accurate way to forecast the cumulative confirmed cases for the top four countries in the world and the entire world. Using the best ensemble model, a forecast is made for the next 28 days (four weeks), which will help understand the spread of the disease and the associated risks. This information can prevent further spread and enable timely and effective treatment. Furthermore, the developed novel time series ensemble approach can be used to forecast other diseases in the future. [ABSTRACT FROM AUTHOR]

• Monitoring of trends in reproductive factors is crucial to gain insight into society from a cultural and sociological point of view and to analyze the impact of these changes on reproductive health and related conditions. • Reproductive factors have relevant impact on diseases and conditions related to the endocrine system, as well as on the risk of hormone-related cancers, such as breast, endometrial, and ovarian cancer. • Mean maternal and paternal age at birth show increasing trends in high-income countries from Europe and North America. • Delaying childbirth involves a decrease in the number of children. • Sweden and the USA had the highest fertility rates, around two children in some years, while Italy and Spain had the lowest ones, with less than 1.5 children over the whole period. To provide a comprehensive picture of trends in parents' age and total fertility rate in selected most populous high-income countries from Europe and North America. Data were retrieved from official statistics published by the United Nations, the World Bank, the European Union (EU), and by national health statistics offices. Mean maternal age at birth showed increasing trends in all considered countries; in 2020, the highest mean age was observed in Italy (32.2) and Spain (32.3), and the lowest one in the USA (28.8). Mean maternal age at first birth also showed upward trends. In the 1990s, mean age at first birth ranged from 25.5 to 26.9 years, except for the USA where it was below 25 years. The countries with the highest average maternal age at first birth were Italy and Spain, reaching 31 years over the most recent years. Data on mean paternal age at birth were scant. In Germany (2019) it was 34.6 and in the USA (2014) 27.9 years. In Italy, mean paternal age increased from 34.2 in 2000 to 35.5 in 2018, in the UK from 30.7 in 1990 to 33.4 in 2017, and in Canada, a decrease was observed from 29.1 in 2006 to 28.3 in 2011. Finally, Sweden and the USA had the highest fertility rates, around two children in some years, while Italy and Spain had the lowest ones, with less than 1.5 children over the whole period. Monitoring of trends in reproductive factors is crucial to gain insight into society from a cultural and sociological point of view and to analyze the impact of these changes on reproductive health and related conditions. [ABSTRACT FROM AUTHOR]

In populations in China, colorectal cancer (CRC) screening can be mainly accessed through organized screening, opportunistic screening, and physical examination. This screening intervention is found to be effective but the exact coverage rate is difficult to measure. Based on data from published articles, official websites, and available program reports, the screening coverage rate and related indicators were quantified. A rapid review was then conducted to estimate the overall and the breakdown coverage rates of the sub‐type screening services, by leveraging the numbers of articles and the by‐type median sample sizes. Up to 2020, two central government‐funded and four provincial/municipal‐level organized CRC screening programs have been initiated and included in this analysis. For populations aged 40–74, the estimated coverage rate of organized programs in China was 2.7% in 2020, and the 2‐year cumulative coverage rate in 2019–2020 was 5.3% and the 3‐year cumulative coverage rate in 2018–2020 was 7.7%. The corresponding coverage rates of 50–74‐year‐olds were estimated to be 3.4%, 7.1%, and 10.3%, respectively. Based on the rapid review approach, the overall screening coverage rate for 40–74 years, considering organized screening programs, opportunistic screening, and physical examinations, was then estimated to be 3.0% in China in 2020. However, comparing the findings of this study with the number of health check‐ups reported in the local national health statistics yearbooks suggests that the number of CRC physical examinations may be underestimated in this study. The findings suggest that further efforts are needed to improve population access to CRC screening in China. Furthermore, evidence for access to opportunistic CRC screening and physical examination is limited, and more quantitative investigation is needed. [ABSTRACT FROM AUTHOR]

Objective. Assessing the level of statistical literacy of medical students in the context of the transition from clinical medicine to evidence-based medicine and the increased need for doctors who can correctly interpret data presented in various scientific sources and conduct their own research.Materials and methods. The research methods included an online survey and statistical processing of the results. Additionally, a business analysis service was used to validate the data and search for insights quickly. When statistically processing the results, descriptive statistics were used, and to compare indicators, non-parametric methods were used: Mann-Whitney and the Kruskal-Wallis test, which allow working with small samples, as well as one-way analysis of variance and correlation analysis. Confidence level of 0.05.Results. Two hundred fifty-two respondents participated in the study. The study revealed that medical students, on average, had high grades in both the computer science course (4.5±0.6 points) and the statistics course (4.4±0.6 points). The level of statistical literacy is high immediately after completing the course but decreases over several years of study. There was a significant average positive correlation between teaching GPA and ICT scores (r=0.35, p< 0.05) and a significant weak positive correlation between teaching GPA and statistics (r=0.23, p< 0.05), and an average correlation between statistics scores and ICT (r=0.59, p< 0.05). More than half (54 %) of medical students wanted to undergo more in-depth training in the field of ICT, while 35 % of medical students wanted to study programing languages in depth, business analytics tools were in second place, and 49 % of students showed an interest in the in-depth study of statistics medical specialties.Conclusion. There is a gap between students’ knowledge of statistics, computer science, and digitalization and the level of proficiency required of a specialist when entering the workforce. Its reduction is possible through students’ access to real clinical practice data throughout the entire learning process, the development of additional training programs dedicated to data analysis in medicine, and the development of a culture of working with data from the first year, including using business analytics tools and special attention focusing on competent data visualization.

Abstract Background In the realm of biomedical research, the growing volume, diversity and quantity of data has escalated the demand for statistical analysis as it is indispensable for synthesizing, interpreting, and publishing data. Hence the need for accessible analysis tools drastically increased. StatiCAL emerges as a user-friendly solution, enabling researchers to conduct basic analyses without necessitating extensive programming expertise. Results StatiCAL includes divers functionalities: data management, visualization on variables and statistical analysis. Data management functionalities allow the user to freely add or remove variables, to select sub-population and to visualise selected data to better perform the analysis. With this tool, users can freely perform statistical analysis such as descriptive, graphical, univariate, and multivariate analysis. All of this can be performed without the need to learn R coding as the software is a graphical user interface where all the action can be performed by clicking a button. Conclusions StatiCAL represents a valuable contribution to the field of biomedical research. By being open-access and by providing an intuitive interface with robust features, StatiCAL allow researchers to gain autonomy in conducting their projects.

AbstractIn practice, we may want to discover if there is a relationship between a response variable as a function of the predictor variables. Multiple linear regression (MLR) is a popular tool for such purpose. When the relationship is nonlinear, nonparametric regression methods such as local linear regression, smoothing splines, and support vector regression (SVR) provide flexible alternatives to MLR. How do we compare the performance of these methods and choose an appropriate one for use? In this research, we propose a general procedure to evaluate the performance of different regression methods for use in large data. We also propose an ensemble SVR for regression analysis. The proposed methods are applied to address research questions using the Research and Development Survey, conducted by the National Center for Health Statistics. [ABSTRACT FROM AUTHOR]

Tobacco dependence is a chronic condition driven by nicotine addiction. Successful quitting can be increased by health care provider intervention and evidence-based treatment. CDC assessed national estimates of cigarette smoking cessation indicators among U.S. adults using 2022 National Health Interview Survey data. In 2022, approximately two thirds (67.7%) of the 28.8 million U.S. adults who smoked wanted to quit, and approximately one half (53.3%) made a quit attempt, but only 8.8% quit smoking. One half of adults who smoked and saw a health professional during the past year received health professional advice (50.5%) or assistance (49.2%) to quit smoking. Among those who tried to quit, 38.3% used treatment (i.e., counseling or medication). Adults who usually smoked menthol (versus nonmenthol) cigarettes had higher prevalences of quitting interest (72.2% versus 65.4%; p<0.05) and past-year quit attempts (57.3% versus 50.4%; p<0.05), lower prevalences of receiving quit advice (48.2% versus 53.8%; p<0.05) and using cessation treatment (35.2% versus 41.5%; p<0.05), but similar prevalence of quit success (9.5% versus 7.9%; p = 0.19). Opportunities exist for both public health and health care sectors to increase smoking cessation, including expanding access to and utilization of cessation services and supports. Incorporating equitable cessation strategies into all commercial tobacco prevention and control efforts can help advance and support smoking cessation for all population groups. [ABSTRACT FROM AUTHOR]

Background: As part of the Covid-19-restrictions in Switzerland, a federal ban on non-urgent examinations and treatments was applied to all hospitals during six weeks in spring 2020 ("spring lockdown"). The aim of this study was to comprehensively investigate the consequences of the Covid-19 pandemic on Swiss inpatient admissions based on data of all hospitals, focusing on selected procedures of different medical urgency. Methods: The study includes all acute care inpatient cases (including Covid-19 cases, excluding cases in psychiatry and rehabilitation) according to the Swiss Medical Statistics of Hospitals. Besides the total number of admissions, subdivided by regions, hospital types and age groups, we focused on selected procedures representing different medical urgency: elective surgeries, cancer surgeries, and emergencies. Procedures were selected based on expert interviews. We compared the number of admissions during spring lockdown and for the whole years 2020 and 2021 in absolute numbers and in percentage changes to the corresponding periods in 2019 (baseline year). Results: During spring lockdown, the number of admissions decreased by 47,156 (32.2%) without catch-up effect by the end of 2020 (-72,817 admissions/-5.8%). With procedure-specific decreases of up to 86%, the decline in admissions was largest for elective surgery, a decline that was only fully reversed in the case of a few procedures, such as joint arthroplasty. Strikingly, admissions due to emergencies also substantially decreased during spring lockdown (stroke -14%; acute myocardial infarction STEMI: -9%, NSTEMI: -26%). Results for the selected procedures in cancer surgery showed no consistent pattern. In 2021, admission numbers for most procedures reached or even exceeded those in 2019. Conclusions: The substantial reduction in admissions, particularly in elective procedures, may reflect the impact of the triage in favor of anticipated Covid-19-cases during spring lockdown. By the end of 2020, admissions were still at lower levels relative to the previous, pre-pandemic year. The numbers in 2021 reached the same levels as those in 2019, which suggests that the Covid-19 pandemic only temporarily impacted inpatient health care in Switzerland. Long-term consequences of the observed reduction in admissions for emergencies and cancer surgery need to be investigated at the individual level. [ABSTRACT FROM AUTHOR]

Long COVID has been recognized since early 2020, but its definition is not unanimous, which complicates epidemiological assessments. This study estimated the prevalence of long COVID based on several definitions and severity thresholds in the adult population of mainland France and examined variations according to sociodemographic and infection characteristics. A cross-sectional survey using random sampling was conducted in August–November 2022. Participants declaring SARS-CoV-2 infection were assessed for infection dates and context, post-COVID symptoms (from a list of 31, with onset time, daily functioning impact, and alternative diagnosis), and perceived long COVID. Long COVID prevalence was estimated according to the WHO, National Institute for Health and Care Excellence, United States National Centre for Health Statistics, and United Kingdom Office for National Statistics definitions. Of 10 615 participants, 5781 (54.5%) reported SARS-CoV-2 infection, with 123–759 (1.2–13.4%) having long COVID, depending on the definition. The prevalence of WHO post-COVID condition (PCC) was 4.0% (95% CI: 3.6–4.5) in the overall population and 8.0% (95% CI: 7.0–8.9) among infected individuals. Among the latter, the prevalence varied from 5.3% (men) to 14.9% (unemployed) and 18.6% (history of hospitalization for COVID-19). WHO-PCC overlapped poorly with other definitions (kappa ranging from 0.18 to 0.59) and perceived long COVID (reported in only 43% of WHO-PCC). Regardless of its definition, long COVID remains a significant burden in the French adult population that deserves surveillance, notably for forms that strongly impact daily activities. More standardized definitions will improve integrated surveillance of, and better research on, long COVID. [ABSTRACT FROM AUTHOR]

Background: In the realm of biomedical research, the growing volume, diversity and quantity of data has escalated the demand for statistical analysis as it is indispensable for synthesizing, interpreting, and publishing data. Hence the need for accessible analysis tools drastically increased. StatiCAL emerges as a user-friendly solution, enabling researchers to conduct basic analyses without necessitating extensive programming expertise. Results: StatiCAL includes divers functionalities: data management, visualization on variables and statistical analysis. Data management functionalities allow the user to freely add or remove variables, to select sub-population and to visualise selected data to better perform the analysis. With this tool, users can freely perform statistical analysis such as descriptive, graphical, univariate, and multivariate analysis. All of this can be performed without the need to learn R coding as the software is a graphical user interface where all the action can be performed by clicking a button. Conclusions: StatiCAL represents a valuable contribution to the field of biomedical research. By being open-access and by providing an intuitive interface with robust features, StatiCAL allow researchers to gain autonomy in conducting their projects. [ABSTRACT FROM AUTHOR]

Objective: Distraction osteogenesis (DO) is a well-known technique. The traditional method utilized the lengthening frequency of four times a day (QID). Many mechanical factors may affect the DO outcome. However, the effect of distraction frequency has not been proven clinically. Therefore, we aim to investigate whether the two times a day (BID) and QID lengthening frequency affect the healing index and complications of the DO. Materials and Methods: We retrospectively reviewed patients who had undergone DO from 2010 - 2021. The patient was divided into BID and QID groups. Demographics, lengthening outcomes, and complications between the two groups were compared. We used the inverse probability of treatment weighting (IPTW) to determine the effect of treatment. Results: The median healing index (HI) of the patients whose lengthening was done QID is 41.36 (IQR 32.72 - 67.68) days/cm, and BID is 49.12 (IQR 35.28 - 62.54) days/cm, which did not differ significantly. The Odds ratio of achieving HI < 45 days/cm for patients receiving QID lengthening compare to BID is 1.12 (95% CI 0.31-3.99, p = 0.862). The IPTW did not show a difference in average treatment effects between QID and BID lengthening. The rates of minor and major complications were not significantly different between the two groups (26.1% in QID group and 32.1% in BID group). Conclusion: The frequency of QID and BID lengthening results in comparable HI and complications for patients who undergo DO. However, prospective research is needed to evaluate the effect of frequency differences in a clinical setting. [ABSTRACT FROM AUTHOR]

Background: Among Chinese medical students, medical statistics is often perceived as a formidable subject. While existing research has explored the attitudes of Chinese postgraduate medical students towards statistics and its impact on academic performance, there is a scarcity of studies examining the attitudes of Chinese medical undergraduates on this subject. This study endeavors to scrutinize the attitudes of Chinese medical undergraduates towards statistics, assessing their ramifications on learning achievements, and delving into the influence of demographic factors. Methods: 1266 medical undergraduates participated in this study, completing a questionnaire that included SATS-36 and additional queries. Furthermore, an examination was administered at the end of the medical statistics course. The analysis encompassed the SATS score and exam scores, examining both the overall participant population and specific demographic subgroups. Results: Undergraduate medical students generally exhibit a favorable disposition towards statistics concerning Affect, Cognitive Competence, and Value components, yet harbor less favorable sentiments regarding the Difficulty component of SATS-36, aligning with previous research findings. In comparison to their postgraduate counterparts, undergraduates display heightened enthusiasm for medical statistics. However, they demonstrate a lower cognitive capacity in statistics and tend to underestimate both the value and difficulty of learning statistics. Despite these disparities, undergraduate medical students express a genuine interest in statistics and exhibit a strong dedication to mastering the subject. It is noteworthy that students' attitudes toward statistics may be influenced by their major and gender. Additionally, there exists a statistically significant positive correlation between learning achievement and the Affect, Cognitive Competence, Value, Interest, and Effort components of the SATS-36, while a negative correlation is observed with the Difficulty component. Conclusion: Educators should carefully consider the influence of attitudes toward statistics, especially the variations observed among majors and genders when formulating strategies and curricula to enhance medical statistics education. [ABSTRACT FROM AUTHOR]

Multiple imputation (MI) is a widely used approach to address missing data issues in surveys. Variables included in MI can have various distributional forms with different degrees of missingness. However, when variables with missing data contain skip patterns (i.e. questions not applicable to some survey participants are thus skipped), implementation of MI may not be straightforward. In this research, we compare two approaches for MI when skip-pattern covariates with missing values exist. One approach imputes missing values in the skip-pattern variables only among applicable subjects (denoted as imputation among applicable cases (IAAC)). The second approach imputes skip-pattern covariates among all subjects while using different recoding methods on the skip-pattern variables (denoted as imputation with recoded non-applicable cases (IWRNC)). A simulation study is conducted to compare these methods. Both approaches are applied to the 2015 and 2016 Research and Development Survey data from the National Center for Health Statistics. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic surgery is a minimally invasive surgical practice which is of diagnostic and therapeutic value. Aim: To determine the indications, operative findings and interventions at laparoscopy in our resource challenged settings. Methods: This was a two-year prospective study in the university of medical science teaching hospital Ondo and a private laparoscopy George and Martin laparoscopy center, Ore, Ondo State, Nigeria, between January 2020 and January 2022 which included 51 patients. Both diagnostic and therapeutic procedures were followed up during this period. Data on patients' age, gender, indications for surgery, duration of hospital stay, outcome of surgery were analyzed. Data analysis was by the SPSS version 23 (IBM incorporated, Chicago, USA). Results: Fifty one patients were put under study. The median age was 42 years (mean = 41.73; age range of 8-75years). There were more females 29 (56.9%) than males 22 (43.1%). Laparoscopy was purely diagnostic (n = 6, 11.8%), therapeutic (n = 45, 88.2%), cholecystectomy (n = 11, 21.6%) and intraperitoneal onlay mesh (IPOM) (n = 11, 21.6%) were the two most common procedures done. The mean duration of surgery was 96.96 [minutes (diagnostic)], 150 [minutes (therapeutic)]; average duration of hospital stay was 2.3 (±1.7 days). Conclusion: Laparoscopic services are expanding in our center with improved facilities, females appear to benefit more in our study and the services involved the young and elderly. [ABSTRACT FROM AUTHOR]

Categorical data analysis of 2 × 2 contingency tables is extremely common, not least because they provide risk difference, risk ratio, odds ratio, and log odds statistics in medical research. A χ 2 test analysis is most often used, although some researchers use likelihood ratio test (LRT) analysis. Does it matter which test is used? A review of the literature, examination of the theoretical foundations, and analyses of simulations and empirical data are used by this paper to argue that only the LRT should be used when we are interested in testing whether the binomial proportions are equal. This so-called test of independence is by far the most popular, meaning the χ 2 test is widely misused. By contrast, the χ 2 test should be reserved for where the data appear to match too closely a particular hypothesis (e.g., the null hypothesis), where the variance is of interest, and is less than expected. Low variance can be of interest in various scenarios, particularly in investigations of data integrity. Finally, it is argued that the evidential approach provides a consistent and coherent method that avoids the difficulties posed by significance testing. The approach facilitates the calculation of appropriate log likelihood ratios to suit our research aims, whether this is to test the proportions or to test the variance. The conclusions from this paper apply to larger contingency tables, including multi-way tables. [ABSTRACT FROM AUTHOR]

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the avian influenza A (H7N5) outbreak and emphasizes the importance of not underestimating less famous subtypes of avian influenza. Avian influenza viruses are classified as highly pathogenic or low pathogenic based on the severity of the disease in poultry. While H7N5 is not commonly reported and has not been the center of significant outbreaks or public health concerns, continuous monitoring and research are essential to track potential mutations and the pathogenicity of these viruses. The article also highlights the need for robust surveillance, research, and preparedness strategies to mitigate the impact of highly genetically versatile viruses. [Extracted from the article]

The recent WHO declaration of mpox (formerly known as monkeypox) as a Public Health Emergency of International Significance highlights the need for a coordinated response and addressing global inequalities in access to health resources. The study analyzes the genetic makeup of the newly emerged mpox lineage, Clade Ib, which has been found outside of Africa. The genetic analysis shows that Clade Ib is evolving more rapidly and has a lower mortality rate compared to the original Clade I lineage. Continued genome-based monitoring is crucial for tracking the evolution of mpox and developing predictive models for containment and management. [Extracted from the article]

Peter Armitage, a renowned statistician, was born in 1924 and passed away in 2024. He studied at Trinity College, Cambridge, and worked with the statistical research unit of the Ministry of Supply during World War II. Armitage's career focused on medical statistics, and he published numerous papers in medical and statistical journals. He made significant contributions to sequential analysis, clinical trials, and statistical methods for biological assays. Armitage held positions at the London School of Hygiene and Tropical Medicine and the University of Oxford, where he established the Department of Statistics. He also authored the widely acclaimed book "Statistical Methods in Medical Research" and co-edited the "Encyclopedia of Biostatistics." Armitage's contributions were recognized through various honors and awards, and he remained active in the field even after retirement. He is survived by his children, grandchildren, and great-grandchildren. [Extracted from the article]

In the study of age estimation in living individuals, a lot of data needs to be analyzed by mathematical statistics, and reasonable medical statistical methods play an important role in data design and analysis. The selection of accurate and appropriate statistical methods is one of the key factors affecting the quality of research results. This paper reviews the principles and applicable principles of the commonly used medical statistical methods such as descriptive statistics, difference analysis, consistency test and multivariate statistical analysis, as well as machine learning methods such as shallow learning and deep learning in the age estimation research of living individuals, and summarizes the relevance and application prospects between medical statistical methods and machine learning methods. This paper aims to provide technical guidance for the age estimation research of living individuals to obtain more scientific and accurate results.

This study describes the impact of a multidisciplinary tumor board (MTB) for renal cell carcinoma (RCC) patients in a locoregional renal cancer network by evaluating shared decision making and adherence to MTB recommendations. Adherence to MTB recommendation was high (96%) and in 30% multiple treatment options were recommended, allowing for shared decision making with the patient. Objective: To describe the impact of a multidisciplinary tumor board (MTB) for renal cell carcinoma (RCC) patients in a locoregional renal cancer network by evaluating shared decision making (SDM) and adherence to MTB recommendations. Design, Setting and Participants: This prospective cohort study included all cases from a Dutch renal cancer network with suspicion of or histologically confirmed RCC discussed in MTBs between 2017-2022. Main endpoints were distribution of cases presented, proportion of recommendations with multiple treatment options enabling shared decision making (SDM), definite treatment after SDM and adherence to MTB recommendations. Further endpoints were definite treatment per tumor stage stratified by age and inclusion in clinical trials. Outcomes were displayed as means and proportions (%). Pearson's Chi-Squared test was used to analyze the effect of age on definite treatment advice. Results: Overall, 2651 cases were discussed, of which 1900 (72%) were new referrals and 751 (28%) rediscussions. Majority of cases were cT1a-b tumors (46%) and 22% were local recurrences or metachronous metastatic. Adherence to MTB recommendation was 96% and in 30% multiple treatment options were recommended, allowing for SDM. In 45% of cases with cT1a tumors multiple treatment options were recommended by the MTB, resulting in (cryo)ablation (32%) and AS (30%) as most frequent definite treatments after SDM. Among patients with cT3-4 tumors the inclusion rate in clinical trials was 47%. Conclusions: A network MTB creates opportunity to discuss multiple treatment options and clinical trials in SDM with patients at a high rate of adherence to MTB recommendation. [ABSTRACT FROM AUTHOR]

Surveillance is the standard management in low-risk cN0 penile squamous cell carcinoma (peSCC) patients. We report on main oncological outcomes of a series of low-risk cN0 peSCC patients. Patients underwent primary tumor surgery and either observation or dynamic sentinel node biopsy. Observation is a safe and effective management for low-risk peSCC patients. Younger patients may be offered a mini-invasive staging. Introduction: Surveillance is the standard management in low-risk cN0 penile squamous cell carcinoma (peSCC) patients. However, no previous analysis focused on early and long-term outcomes of these patients. We report on main oncological outcomes of a large series of low-risk cN0 peSCC patients. Patients and Methods: Between 1980 and 2017 included, 93 evaluable consecutive low-risk (ie, pT1a G1 cN0M0) peSCC patients underwent primary tumor surgery and either observation (74) or dynamic sentinel node biopsy (DSNB) (19) following a clinical diagnosis of T1 in 66 (71%), T2 in 15 (16.1%) and Tx in 12 (12.9%) patients, respectively. The statistical significance of differences in medians and proportions was tested with the Kruskal-Wallis and chi-square tests. Kaplan-Meier plots illustrated 5-year inguinal relapse (IR)-free survival rates. Results: Median age was 60 years (IQR: 50-69 years). Median follow-up was 92 months (IQR 54-133 months). Surveillance was more frequently adopted in clinical (c)T1 than in cT2 tumors (79.7% vs. 36.8%). None of 19 patients who had DSNB had nodal metastasis. Overall, 7 (7.5%) out of 93 pT1aG1cN0 peSCC patients had IR after a median interval of 9 months. Of note, 1 patient only relapsed after 12 months of surveillance. After stratification according to IR, relapses occurred more frequently in younger patients (59 vs. 64 years, P < .001). The 5-year IR-free survival rates for the entire cohort was 92% (95% Confidence interval [CI] 87-98%). Conclusions: Observation is a safe and effective management for low-risk peSCC patients. Younger patients may be offered a miniinvasive staging as an alternative. [ABSTRACT FROM AUTHOR]

While combined chemoradiotherapy is superior to radiotherapy alone bladder-preserving therapy in patients with bladder cancer, standard chemoradiotherapy regimens are prohibitively toxic for certain patients. We present results from our institutional experience treating patients with oral capecitabine concurrent with radiotherapy following transurethral resection of bladder tumor. Importantly, no patients required salvage cystectomy and overall toxicity was low. Introduction: Many patients with muscle-invasive bladder cancer are poor candidates for radical cystectomy or trimodality therapy with maximal transurethral resection of bladder tumor (TURBT) and chemoradiotherapy with cisplatin or mitomycin C. Given the benefit of chemotherapy in bladder-preserving therapy, less-intense concurrent chemotherapy regimens are needed. This study reports on efficacy and toxicity for patients treated with trimodality therapy using single-agent concurrent capecitabine. Materials and Methods: Patients deemed ineligible for radical cystectomy or standard chemoradiotherapy by a multidisciplinary tumor board and patients who refused cystectomy were included. Following TURBT, patients received twice-daily capecitabine (goal dose 825 mg/m2) concurrent with radiotherapy to the bladder + / ? pelvis depending on nodal staging and patient risk factors. Toxicity was evaluated prospectively in weekly on-treatment visits and follow-up visits by the treating physicians. Descriptive statistics are provided. Overall, progression-free, cancer-specific, distant metastasis-free, and bladder recurrence-free survival were estimated using the Kaplan-Meier method. Results: Twenty-seven consecutive patients met cr iter ia for inclusion from 2013 to 2023. The median age was 79 with 9 patients staged cT3-4a and 7 staged cN1-3. The rate of complete response in the bladder and pelvis was 93%. Overall, progression-free, cancer-specific, distant metastasis-free, and bladder recurrence-free survival at 2 years were estimated as 81%, 65%, 91%, 75%, and 92%, respectively. There were 2 bladder recurrences, both noninvasive. There were 7 grade 3 acute hematologic or metabolic events but no other grade 3 + toxicities. Conclusion: Maximal TURBT followed by radiotherapy with concurrent capecitabine offers a high rate of bladder control and low rates of acute and late toxicity. [ABSTRACT FROM AUTHOR]

We tested for the prognostic significante of radiographic N-stage in metastatic renal cell carcinoma (mRCC) patients with low metastatic burden (single metastatic site). After multivariable adjustment, radiographic N1 status was an independent predictor of higher cancer-specific mortality (CSM). In consequence, consideration of radiographic lymph node invasion might be of great value in this specific population of mRCC patients. Purpose: To test the prognostic significance of radiographic cN-stage in metastatic renal cell carcinoma (mRCC) patients with low metastatic burden (1 site of metastasis), relying on the Surveillance, Epidemiology, and End Results database (SEER 2010-2020). Methods: Included were mRCC patients with 1 site of metastasis, treated with systemic therapy without cytoreductive nephrectomy (CN). Kaplan-Meier plots and multivariable Cox-regression models addressed cancer-specific mortality (CSM) according to radiographic cN-stage (ccN1 vs. ccN0). Separate subgroup analyses were performed, addressing radiographic N-stage in patients with distinct histology (clear-cell vs. RCC not otherwise specified [RCC NOS]). Results: Of 1756 mRCC patients, 545 (31%) were radiographic cN1. Overall, the median CSM-free survival of the cohort was 11 months. Median CSM-free survival was 8 vs. 14 months in radiographic cN1 vs. cN0 mRCC patients (HR 1.49, P < .0001). In multivariable Cox regression analyses, radiographic cN1 status was an independent predictor of higher CSM (HR 1.39; P = .01). In subgroup analyses, addressing patients with clear-cell histology and patients with RCC NOS separately, radiographic cN1 status remained independently associated with a higher CSM in both groups (clear-cell: HR 1.36; P = .03; RCC NOS: HR 2.06; P = .009). Conclusion: In mRCC patients with low metastatic burden, presence or absence of radiographic lymph node invasion results in a clinically meaningful discrimination between those with poor prognosis and others. In consequence, consideration of radiographic lymph node invasion might be of great value in this specific population of mRCC patients. [ABSTRACT FROM AUTHOR]

A growing number of studies have reported mental health problems in men with prostate cancer. Relationships of median household income and ethnicity to suicide in prostate cancer are poorly characterized. A retrospective study from database data answered this question. Median household income and ethnicity are important factors strongly related to suicide risk in prostate cancer patients, and the lower median household income individuals and non-Spanish-Hispanic-Latino individuals were associated with higher suicide risk. Purpose: To determine whether socioeconomic disparities have an impact on the likelihood of suicide among prostate cancer patients. Methods: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with malignant prostate cancer between 2005 and 2020. The socioeconomic disparities of the patients were evaluated by median household income (MHI) and ethnicit y. Ethnicit y included Spanish-Hispanic-Latino and non-Spanish-Hispanic-Latino. A Cox proportional risk model was utilized. Using the Kaplan-Meier approach, the cumulative incidence of suicide mortality was measured. Results: A total of 857,418 US population with prostate cancer were included. In the multivariate analysis, individuals with MHI over $75,000 had a lower risk of suicide mortality than those with MHI between $54,999 and $74,999 in all patients (aHRs: 0.693, 95 CI%: 0.603-0.797). Spanish-Hispanic-Latino displayed lower overall suicide mortality in all patients (aHRs: 0.426, 95% CI: 0.323-0.561). In the subgroup analysis of different ages, individuals with MHI over $75,000 had a lower risk of suicide than those with MHI between $54,999 and $74,999 in patients 60 to 79 years (aHRs: 0.668, 95% CI: 0.562-0.794) and individuals with MHI below $54,999 had higher suicide risk than those with MHI between $54,999 and $74,999 in patients 80 + years (aHRs: 1.786, 95% CI: 1.100-2.902). Hispanic-Latino individuals had lower overall suicide mortality in 00 to 59 years (aHRs: 0.420, 95% CI: 0.240-0.734), 60 to 79 years (aHRs: 0.445, 95% CI: 0.319-0.621), 80 + years (aHRs: 0.363, 95% CI: 0.133-0.988). Conclusion: Socioeconomic disparities, including MHI and ethnicity, are important factors strongly related to suicide risk in prostate cancer patients. The lower MHI individuals and non-Spanish-Hispanic-Latino individuals were associated with higher suicide risk. [ABSTRACT FROM AUTHOR]

The risk of CRPC-M1 did not significantly vary according to the type of ADT used at progression. The risk of a CRPC-M0 progression increased 3.48 times using continuous ADT when compared to IAD. Introduction: To analyze whether the use of an intermittent (IAD) versus continuous (CAD) androgen deprivation therapy for the treatment of biochemical progression after primary treatments in prostate cancer can influence the development of nonmetastatic castration resistant prostate cancer (CRPC-M0). Patients: 170 male patients with an histologically confirmed diagnosis of PC, presenting a biochemical progression after primary treatments (82 after radical prostatectomy and 88 after external radiation therapy), nonmetastatic at imaging were considered for continuous (85 cases) or intermittent (85 cases) administration of androgen deprivation therapy. Methods: we retrospectively collect all data regarding histological diagnosis, primary treatment, imaging for M0-M1 staging, PSA at progression, time to biochemical progression from primary therapy, ADT used, IAD cycles, so to compare in 2 groups (IAD vs. CAD) time for progression from the beginning of ADT treatment and type of progression in terms of CRPC-M0 versus CRPC-M1 cases. Results: no significant (P = .4955) difference in the whole CRPC progression was found between IAD (25.8%) and CAD (30.5%) treatment at a mean of 32.7 ± 7.02 months and 35.6 ± 13.1 months respectively (P = .0738). Mean PSA at CRPC development was significantly higher in the IAD group (5.16 ± 0.68 ng/mL) than in the CAD group (3.1 ± 0.7 ng/mL) (P < .001). In all cases, imaging to detect M status at CRPC development was PET TC scan. At univariate analysis CAD administration significantly increases the RR for CRPC-M0 progression (RR 3.48; 95%CI 1.66-7.29; P = .01) when compared to the IAD administration, and this effect at multivariate analysis remained significant and independent to the other variables (RR 2.34, 95%CI 1.52-5.33; P = .03). Conclusions: in our population with biochemical progression after primary treatment for PC, the intermittent administration of ADT significantly reduces the risk to develop CRPC-M0 disease when compared to a continuous administration of ADT, whereas no difference between the 2 strategies in terms of CRPC-M1 progression exists. [ABSTRACT FROM AUTHOR]

Objective: Breast cancer related lymphedema (BCRL) may be assessed through objective measurement of limb swelling with common techniques including volumetric measurement using a tape measure or perometry, and measurement of extracellular water using bioimpedance spectroscopy (BIS). This study aimed to evaluate the performance of a stand-on BIS device for detection of BCRL, introduce a novel graphical method to compare volumetric and BIS methods alongside traditional specificity and sensitivity analysis, and determine and compare BIS thresholds with those published previously. Materials and Methods: Female participants with indocyanine green lymphography confirmed unilateral arm lymphedema (n = 197) and healthy controls (n = 267) were assessed using a cross-sectional study design. BIS and volumetric measures were obtained in a single session. Results: The BIS lymphedema index (L-Dex) method had a significantly higher sensitivity than the excess volume approach (area under the curve = 0.832 vs. 0.649, p = 0.0001). A threshold of L-Dex 6.5 had a higher true positive rate (70.6%) than L-Dex 10 (68.5%) although false positive rate increased from 0.4% to 2.6%. A threshold of 5% excess volume improved the true positive rate (68.5%) compared with 10% excess volume (49.7%) however the false positive rate increased to an unacceptable 47%. The L-Dex ranges in this study were not significantly different from previously published ranges. Conclusion: BIS was superior for identifying BCRL compared with volume measurements, reaffirming the value of this technique. However, it is recommended that BIS be used in conjunction with comprehensive evaluation of symptoms and clinical presentation. The proposed graphical method provides a simple and easily interpretable approach to compare and define concordance between the two commonly used methods for BCRL assessment namely limb volume and BIS L-Dex indices. The existing BIS (L-Dex) thresholds for presence of BCRL were also validated. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos del Centro de Estudios de Diseño y Comunicación is the property of Cuadernos del Centro de Estudios de Diseno y Comunicacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Duodenal obstruction is a common congenital abnormality in neonates, frequently resulting in mortality due to delayed treatment and postoperative complications. The delay in treatment often stems from suboptimal patient conditions for surgery, underscoring the critical role of laboratory examinations in guiding perioperative decisions. Objective: This study aims to investigate the relationship between preoperative laboratory parameters and mortality in neonates with duodenal obstruction. Methods: This descriptive-analytic study with a retrospective cohort design was conducted on neonates with duodenal obstruction treated at Dr. Soetomo Regional Public Hospital (RSUD Dr. Soetomo) in Surabaya from 2016 to 2023. Results: This study comprised 56 subjects, including 33 females (58.9%) and 23 males (41.1%). The p-values of the factors, in order of their influence on mortality, were as follows: platelet count (p = 0.002), hemoglobin level (p = 0.086), and age at surgery (p = 0.086). Correspondingly, the odds ratios (OR) for each factor were determined as follows: 4.048 for age at surgery, 4.259 for hemoglobin level, and 6.206 for platelet count. Platelet count demonstrated the highest accuracy value at 71.4%, with a sensitivity of 70.8% and specificity of 76.7%. Hemoglobin level exhibited an accuracy value of 67.8%, a sensitivity of 62.5%, and a specificity of 71.9%, while age at surgery showed an accuracy value of 66%, a sensitivity of 70.8%, and a specificity of 62.5%. Conclusion: In neonates with duodenal obstruction, a significant association exists between age at surgery, hemoglobin level, and platelet count with mortality. Among these factors, platelet count emerges as the most influential. [ABSTRACT FROM AUTHOR]

This work utilizes generalized order statistics (GOSs) to study the q-Weibull distribution from several statistical perspectives. First, we explain how to obtain the maximum likelihood estimates (MLEs) and utilize Bayesian techniques to estimate the parameters of the model. The Fisher information matrix (FIM) required for asymptotic confidence intervals (CIs) is generated by obtaining explicit expressions. A Monte Carlo simulation study is conducted to compare the performances of these estimates based on type II censored samples. Two well-established measures of information are presented, namely extropy and weighted extropy. In this context, the order statistics (OSs) and sequential OSs (SOSs) for these two measures are studied based on this distribution. A bivariate q-Weibull distribution based on the Farlie-Gumbel-Morgenstern (FGM) family and its relevant concomitants are studied. Finally, two concrete instances of medical real data are ultimately provided. [ABSTRACT FROM AUTHOR]