Survival analysis and associated factors of highgrade glioma patients / Survival analysis and associated factors of highgrade glioma patients

Introduction: High-grade gliomas are the most common primary brain tumors in adults, and they usually have a quick fatal course. Average survival is 18 months, mainly, because of tumor resistance to Stupp protocol. Objective: To determine high-grade glioma patient survival and the effect of persuasion variables on survival. Materials and methods: We conducted a longitudinal descriptive study in which 80 untreated recently diagnosed high-grade glioma patients participated. A survey was conducted regarding their exposure to some risk factors, degree of genetic instability in peripheral blood using micronucleus quantification on binuclear lymphocytes, micronuclei in reticulocytes and sister-chromatid exchanges in lymphocytes. In the statistical analysis, this study constructed life tables, used the Kaplan-Meier, and the log-rank test, and in the multivariate analysis, a Cox proportional hazards model was constructed. Results: Eighty patients' clinical, demographic and lifestyle characteristics were analyzed, as well as their survival rates and the average survival time is 784 days (interquartile range: 928). Factors like age, exposure at work to polycyclic hydrocarbons and the number of sister-chromatid exchanges in lymphocytes in the first sampling was significantly survivalrelated in the multivariate analysis. Conclusion: We determined that only three of the analyzed variables have an important effect on survival time when it comes to high-grade glioma patients.

Introducción. Los gliomas de alto grado son los tumores cerebrales primarios más comunes en adultos y, por lo general, tienen un curso mortal rápido. La supervivencia media es de 18 meses, principalmente, como consecuencia de la resistencia del tumor al protocolo Stupp. Objetivo. Determinar la supervivencia de los pacientes con glioma de alto grado y el efecto de las variables de persuasión en la supervivencia. Materiales y métodos. Se llevó a cabo un estudio descriptivo longitudinal en el que participaron 80 pacientes con diagnóstico reciente de glioma de alto grado no tratados. Se hizo una encuesta sobre su exposición a algunos factores de riesgo, grado de inestabilidad genética en sangre periférica mediante cuantificación de micronúcleos en linfocitos binucleares, micronúcleos en reticulocitos e intercambios de cromátidas hermanas en linfocitos. En el análisis estadístico, se construyeron tablas de vida, se utilizó Kaplan-Meier y la prueba de rangos logarítmicos, y en el análisis multivariado, se construyó un modelo de riesgos proporcionales de Cox. Resultados. Se analizaron las características clínicas, demográficas y de estilo de vida de 80 pacientes, así como sus tasas de supervivencia y el tiempo medio de supervivencia fue de 784 días (rango intercuartílico: 928). Factores como la edad, la exposición laboral a hidrocarburos policíclicos y el número de intercambios de cromátidas hermanas en linfocitos en el primer muestreo se relacionaron significativamente con la supervivencia en el análisis multivariante. Conclusión. Según los resultados, el estudio determinó que solo tres de las variables analizadas tienen un efecto importante en el tiempo de supervivencia cuando se trata de pacientes con glioma de alto grado.

Inference in High-Dimensional Online Changepoint Detection.

We introduce and study two new inferential challenges associated with the sequential detection of change in a high-dimensional mean vector. First, we seek a confidence interval for the changepoint, and second, we estimate the set of indices of coordinates in which the mean changes. We propose an online algorithm that produces an interval with guaranteed nominal coverage, and whose length is, with high probability, of the same order as the average detection delay, up to a logarithmic factor. The corresponding support estimate enjoys control of both false negatives and false positives. Simulations confirm the effectiveness of our methodology, and we also illustrate its applicability on the U.S. excess deaths data from 2017 to 2020. The supplementary material, which contains the proofs of our theoretical results, is available online.

The Method but Not the Protocol Affects Lactate-Threshold Determination in Competitive Swimmers.

PURPOSE: The study validated variables corresponding to lactate threshold (LT) in swimming. Speed (sLT), blood lactate concentration (BLLT), oxygen uptake (VO2LT), and heart rate (HRLT) corresponding to LT were calculated by 2 different incremental protocols and validated in comparison with maximal lactate steady state (MLSS). METHODS: Ten competitive swimmers performed a 7 × 200-m front-crawl incremental "step test" with 2 protocols: (1) with 30-second rests between repetitions (short-rest incremental protocols) and (2) on a 5-minute cycle (swim + rest time, long-rest incremental protocols). Five methods were used for the assessment of sLT and corresponding BLLT, VO2LT, and HRLT: intersection of 2 lines, Dmax, modified Dmax, visual inspection, and intersection of combined linear and exponential regression lines. Subsequently, swimmers performed two to three 30-minute continuous efforts to identify speed (sMLSS) and physiological parameters corresponding to MLSS. RESULTS: Both protocols resulted in similar sLT and corresponding physiological variables (P > .05). Bland-Altman plots showed agreement between protocols (sLT, bias: -0.017 [0.002] m·s-1; BLLT, bias: 0.0 [0.5] mmol·L-1; VO2LT, bias: -0.1 [2.2] mL·kg-1·min-1; HRLT. bias: -2 [8] beats·min-1). However, sLT calculated by modified Dmax using short rest was higher compared with speed at MLSS (1.346 [0.076] vs 1.300 [0.101] m·s-1; P < .05). CONCLUSIONS: Calculated sLT, BLLT, VO2LT, and HRLT using all other methods in short-rest and long-rest incremental protocols were no different compared with MLSS (P > .05). Both 7 × 200-m protocols are valid for determination of sLT and corresponding physiological parameters, but the modified Dmax method may overestimate sLT.

Antenatal reproductive screening for pregnant people including preconception: Provides the best reproductive opportunity for informed consent, quality, and safety.

INTRODUCTION: This antenatal screening review will include reproductive screening evidence and approaches for pre-conception and post-conception, using first to third trimester screening opportunities. METHODS: Focused antenatal screening peer-reviewed publications were evaluated and summarized. RESULTS: Evidenced-based reproductive antenatal screening elements should be offered and discussed, with the pregnancy planning or pregnant person, during Preconception (genetic carrier screening for reproductive partners, personal and family (including reproductive partner) history review for increased genetic and pregnancy morbidity risks); First Trimester (fetal dating with ultrasound; fetal aneuploidy screening plus consideration for expanded fetal morbidity criteria, if appropriate; pregnant person preeclampsia screening; early fetal anatomy screening; early fetal cardiac screening); Second Trimester for standard fetal anatomy screening (18-22 weeks) including cardiac; pregnant person placental and cord pathology screening; pregnant person preterm birth screening with cervical length measurement); Third Trimester (fetal growth surveillance; continued preterm birth risk surveillance). CONCLUSION: Antenatal reproductive screening has multiple elements, is complex, is time-consuming, and requires the use of pre- and post-testing counselling for most screening elements. The use of preconception and trimesters 'one to three' requires clear patient understanding and buy-in. Informed consent and knowledge transfer is a main goal for antenatal reproductive screening approaches.

Is immediate dental implant in fibula free flap beneficial for implant survival and osteoradionecrosis in jaw reconstruction?

OBJECTIVES: This study aimed to compare the risk of osteoradionecrosis and implant survival in oral cancer patients undergoing immediate dental implants during jaw reconstruction, termed "Jaw in a Day" (JIAD), with those receiving no implants or delayed implants (non-JIAD). PATIENTS & METHODS: Clinicopathologic data were collected from prospectively enrolled JIAD patients (n = 10, 29 implants) and retrospectively from non-JIAD patients (n = 117, 86 implants). Survival analyses were performed to assess implant survival and osteoradionecrosis-free survival. RESULTS: Osteoradionecrosis occurred in 0 % of JIAD cases compared to 19.3 % in non-JIAD cases without implants and 71.4 % in non-JIAD cases with delayed implants (p = 0.008). Osteoradionecrosis-free survival was significantly better in the JIAD group than the non-JIAD group (p = 0.0059). Implants in the JIAD group all survived regardless of radiation therapy (29/29, 100 %) and 95.1 % (58/61) of implants survived in delayed implants in non-irradiated fibula without radiotherapy. Meanwhile, only 11 of 25 implants placed in irradiated fibula flaps survived, even when the implants were placed after a median time interval of 624 days after radiotherapy, and none of them were earlier than 360 days. The survival analysis revealed a significant difference (p < 0.0001). CONCLUSION: JIAD appears to offer superior outcomes in terms of implant survival and osteoradionecrosis prevention compared to delayed implant placement. Placing implants in irradiated fibula, even after years, significantly poses high risk of implant failure and osteoradionecrosis. JIAD represents a promising approach for optimal rehabilitation, particularly in oral cancer patients requiring postoperative radiotherapy. Proper positioning and orientation of implants and flaps are crucial for implant survival.

Ballou's Ancestral Inbreeding Coefficient: Formulation and New Estimate with Higher Reliability.

Inbreeding is unavoidable in small populations. However, the deleterious effects of inbreeding on fitness-related traits (inbreeding depression) may not be an inevitable phenomenon, since deleterious recessive alleles causing inbreeding depression might be purged from populations through inbreeding and selection. Inbreeding purging has been of great interest in conservation biology and animal breeding, because populations manifesting lower inbreeding depression could be created even with a small number of breeding animals, if inbreeding purging exists. To date, many studies intending to detect inbreeding purging in captive and domesticated animal populations have been carried out using pedigree analysis. Ballou's ancestral inbreeding coefficient (FBAL-ANC) is one of the most widely used measurements to detect inbreeding purging, but the theoretical basis for FBAL-ANC has not been fully established. In most of the published works, estimates from stochastic simulation (gene-dropping simulation) have been used. In this report, the author provides a mathematical basis for FBAL-ANC and proposes a new estimate by hybridizing stochastic and deterministic computation processes. A stochastic simulation suggests that the proposed method could considerably reduce the variance of estimates, compared to ordinary gene-dropping simulation, in which whole gene transmissions in a pedigree are stochastically determined. The favorable property of the proposed method results from the bypass of a part of the stochastic process in the ordinary gene-dropping simulation. Using the proposed method, the reliability of the estimates of FBAL-ANC could be remarkably enhanced. The relationship between FBAL-ANC and other pedigree-based parameters is also discussed.

Monocular Depth Estimation via Self-Supervised Self-Distillation.

Self-supervised monocular depth estimation can exhibit excellent performance in static environments due to the multi-view consistency assumption during the training process. However, it is hard to maintain depth consistency in dynamic scenes when considering the occlusion problem caused by moving objects. For this reason, we propose a method of self-supervised self-distillation for monocular depth estimation (SS-MDE) in dynamic scenes, where a deep network with a multi-scale decoder and a lightweight pose network are designed to predict depth in a self-supervised manner via the disparity, motion information, and the association between two adjacent frames in the image sequence. Meanwhile, in order to improve the depth estimation accuracy of static areas, the pseudo-depth images generated by the LeReS network are used to provide the pseudo-supervision information, enhancing the effect of depth refinement in static areas. Furthermore, a forgetting factor is leveraged to alleviate the dependency on the pseudo-supervision. In addition, a teacher model is introduced to generate depth prior information, and a multi-view mask filter module is designed to implement feature extraction and noise filtering. This can enable the student model to better learn the deep structure of dynamic scenes, enhancing the generalization and robustness of the entire model in a self-distillation manner. Finally, on four public data datasets, the performance of the proposed SS-MDE method outperformed several state-of-the-art monocular depth estimation techniques, achieving an accuracy (δ1) of 89% while minimizing the error (AbsRel) by 0.102 in NYU-Depth V2 and achieving an accuracy (δ1) of 87% while minimizing the error (AbsRel) by 0.111 in KITTI.

Estimating cardiorespiratory fitness in older adults using the international physical activity questionnaire.

Introduction: Non-exercise estimates of cardiorespiratory fitness hold great utility for epidemiological research and clinical practice. Older adults may yield the greatest benefit from fitness estimates due to limited capacity to undergo strenuous maximal exercise testing, however, few of the previously developed non-exercise equations are suitable for use in older adults. Thus, the current study developed a non-exercise equation for estimating cardiorespiratory fitness in older adults derived from the widely used International Physical Activity Questionnaire (IPAQ). Methods: This study was a secondary analysis of baseline data from a randomized controlled trial. Participants were community-dwelling, cognitively unimpaired older adults aged 60-80 years (n = 92). They completed the IPAQ and underwent maximal exercise testing on a cycle ergometer. Stepwise linear regression was used to determine the equation in a randomly selected, sex-balanced, derivation subset of participants (n = 60), and subsequently validated using a second subset of participants (n = 32). Results: The final equation included age, sex, body mass index and leisure time activity from the IPAQ and explained 61% and 55% of the variance in the derivation and validation groups, respectively (standard error of estimates = 3.9, 4.0). Seventy-seven and 81% of the sample fell within ±1SD (5.96 and 6.28 ml·kg-1·min-1) of measured VO2peak for the derivation and validation subgroups. The current equation showed better performance compared to equations from Wier et al. (2006), Jackson et al. (1990), and Schembre & Riebe (2011), although it is acknowledged previous equations were developed for different populations. Conclusions: Using non-exercise, easily accessible measures can yield acceptable estimates of cardiorespiratory fitness in older adults, which should be further validated in other samples and examined in relation to public health outcomes.

Who cares? Elucidating parental care evolution in extant birds.

Extant birds stand out among vertebrates in the diversity of parental care types they present, spanning absence of care to uniparental care by either sex, biparental or even cooperative care. Despite years of research, key questions remain regarding parental care evolution in birds. Firstly, the parental care type in the most recent ancestor of extant birds is a matter of controversy, with proposed ancestral states including no care, uniparental male or female care, and biparental care. Another unsolved question is the direction, order, and frequency of transitions between parental care types. We address these key questions using a database of 5,438 bird species (~50% of extant diversity) and modern phylogenetic comparative methods controlling simultaneously for model and phylogenetic uncertainty as well as potential confounding effects of state-dependent diversification. Our results indicate that the most likely ancestral state for extant birds is male-only care, with a posterior probability of 0.8. Transition rates across parental care types were generally low and heterogenous; loss of parental care virtually never occurs and transitions away from female only or cooperative care most often lead to biparental care. Given the low transition rates, future research should analyze the factors favoring the maintenance of care types.

Body physical parameters instead of water equivalent diameter to calculate size-specific dose estimate in adult chest CT.

This study aimed to investigate body physical parameters as substitutes for water equivalent diameter (Dw) while calculating size-specific dose estimates (SSDEs) during adult chest computed tomography (CT). A retrospective analysis was conducted on 776 patients. Patients were divided into training set (542 patients) and validation set (234 patients) according to a ratio of 7:3. The correlations between physical parameters and Dw were analyzed. The differences between SSDEsubstitutes and the reference SSDE (SSDEreference) were compared. Strong positive correlations were observed between body mass index (BMI) and Dw as well as between weight and Dw in overall, male, and female patients (all p < 0.001). The correlations between BMI and Dw were stronger than those between weight and Dw in overall, male, and female subjects (all p < 0.001). SSDEweight and SSDEBMI were not significantly different from SSDEreference (p > 0.05). The RMSEs of overall patients between SSDEweight and SSDEreference as well as between SSDEBMI and SSDEreference were 0.237 and 0.2, respectively. The use of sex-specific regression equations for BMI caused a slightly reduction in RMSE. Weight and BMI can be used as surrogate parameters for Dw when calculating SSDE in adult chest CT exams, with BMI being the preferred substitute parameter.

Multiclass Classification of Visual Electroencephalogram Based on Channel Selection, Minimum Norm Estimation Algorithm, and Deep Network Architectures.

This work addresses the challenge of classifying multiclass visual EEG signals into 40 classes for brain-computer interface applications using deep learning architectures. The visual multiclass classification approach offers BCI applications a significant advantage since it allows the supervision of more than one BCI interaction, considering that each class label supervises a BCI task. However, because of the nonlinearity and nonstationarity of EEG signals, using multiclass classification based on EEG features remains a significant challenge for BCI systems. In the present work, mutual information-based discriminant channel selection and minimum-norm estimate algorithms were implemented to select discriminant channels and enhance the EEG data. Hence, deep EEGNet and convolutional recurrent neural networks were separately implemented to classify the EEG data for image visualization into 40 labels. Using the k-fold cross-validation approach, average classification accuracies of 94.8% and 89.8% were obtained by implementing the aforementioned network architectures. The satisfactory results obtained with this method offer a new implementation opportunity for multitask embedded BCI applications utilizing a reduced number of both channels (<50%) and network parameters (<110 K).

A Semiparametric Bayesian Approach to Heterogeneous Spatial Autoregressive Models.

Many semiparametric spatial autoregressive (SSAR) models have been used to analyze spatial data in a variety of applications; however, it is a common phenomenon that heteroscedasticity often occurs in spatial data analysis. Therefore, when considering SSAR models in this paper, it is allowed that the variance parameters of the models can depend on the explanatory variable, and these are called heterogeneous semiparametric spatial autoregressive models. In order to estimate the model parameters, a Bayesian estimation method is proposed for heterogeneous SSAR models based on B-spline approximations of the nonparametric function. Then, we develop an efficient Markov chain Monte Carlo sampling algorithm on the basis of the Gibbs sampler and Metropolis-Hastings algorithm that can be used to generate posterior samples from posterior distributions and perform posterior inference. Finally, some simulation studies and real data analysis of Boston housing data have demonstrated the excellent performance of the proposed Bayesian method.

Exploring the Influence of Initial Estimates on Iterative Maximum Likelihood Expectation-maximization in Tomographic Reconstruction.

Purpose: To explore the influence of initial guess or estimate (uniform as "ones" and "zeros" vs. filtered back projection [FBP] image) as an input image for maximum likelihood expectation-maximization (MLEM) tomographic reconstruction algorithm and provide the curves of error or convergence for each of these three initial estimates. Methods: Two phantoms, created as digital images, were utilized: one was a simple noiseless object and the other was a more complicated, noise-degraded object of the section of lower thorax in a matrix of 256 × 256 pixels. Both underwent radon transform or forward projection process and the corresponding sinograms were generated. For filtering during tomographic image reconstruction, ramp and Butterworth filters, as high-pass and low-pass ones, were applied to images. The second phantom (lower thorax) was radon-transformed and the resulting sinogram was degraded by noise. As initial guess or estimate images, in addition to FBP tomographic image, two uniform images, one with all pixels having a value of 1 ("ones") and the other with all having zero ("zeros"), were created. The three initial estimates (FBP, ones, and zeros) were reconstructed with iterative MLEM tomographic reconstruction (with 1, 2, 4, 8, 16, 32, and 64 iterations). The difference between the object and the updated slice was calculated at the end of each iteration (as error matrix), and the mean squared error (MSE) was computed and plotted separately or in conjunction with the MSE curves of other initial estimates. All computations were implemented in MATLAB software. Results: The results of ones and zeros seemed strikingly similar. The curves of uniform ones and uniform zeros were so close to each other that overlap near-perfectly. However, in the FBP slice as an initial estimate, the resulting tomographic slice was similar with a much higher extent to the object even after 1 or 2 iterations. The pattern of convergence for all three curves was roughly similar. The normalized MSE decreased sharply up to 5 iterations and then, after 10 iterations, the curves reached a plateau until 32 iterations. For the phantom of the lower thorax section with its noise-degraded sinogram, similar to the pattern observed for simple disk-shaped phantom, the curves (normalized MSE) fell sharply up to 10 iterations and then rapidly converged thereafter until 64 iterations. Conclusion: Similar results are observed when choosing different initial guesses or estimates (uniform vs. FBP) as the starting point, based on the error calculation using MSE. The algorithm converges almost similarly for all initial estimates. Therefore, selecting a uniform initial guess image can be an appropriate choice and may be preferred over an FBP image. Reducing the processing time can be a valid reason for this choice.

A comparison of Bayesian and score methods for interval estimates of positive/negative likelihood ratios in support of diagnostic device performance evaluation.

BACKGROUND: Positive and negative likelihood ratios (PLR and NLR) are important metrics of accuracy for diagnostic devices with a binary output. However, the properties of Bayesian and frequentist interval estimators of PLR/NLR have not been extensively studied and compared. In this study, we explore the potential use of the Bayesian method for interval estimation of PLR/NLR, and, more broadly, for interval estimation of the ratio of two independent proportions. METHODS: We develop a Bayesian-based approach for interval estimation of PLR/NLR for use as a part of a diagnostic device performance evaluation. Our approach is applicable to a broader setting for interval estimation of any ratio of two independent proportions. We compare score and Bayesian interval estimators for the ratio of two proportions in terms of the coverage probability (CP) and expected interval width (EW) via extensive experiments and applications to two case studies. A supplementary experiment was also conducted to assess the performance of the proposed exact Bayesian method under different priors. RESULTS: Our experimental results show that the overall mean CP for Bayesian interval estimation is consistent with that for the score method (0.950 vs. 0.952), and the overall mean EW for Bayesian is shorter than that for score method (15.929 vs. 19.724). Application to two case studies showed that the intervals estimated using the Bayesian and frequentist approaches are very similar. DISCUSSION: Our numerical results indicate that the proposed Bayesian approach has a comparable CP performance with the score method while yielding higher precision (i.e. a shorter EW).

Spontaneous regeneration of bone following mandibular ramus bone harvesting: a CBCT analysis.

The aim of this study was to evaluate healing at the donor site following autogenous block graft harvesting from the mandibular ramus. In this retrospective study, cone beam computed tomography images taken at different time-points were examined, and the volumes of preoperative and postoperative regions of interest were calculated in the software. Images were classified into four groups: 0-3 months, 4-6 months, 7-12 months, and >12 months post-surgery. To characterize the healing process over time, statistical analyses were conducted for both the 70% and 80% healing thresholds. Nearly half (n = 15, 47%) of the 32 patients included in this study achieved 70% bone healing within 4-12 months post-surgery. At the end of the 28-month period covered by this study, 21 patients (66%) had achieved 70% bone healing. The median time to achieve 70% healing was 9 months, while the median time to achieve 80% healing was 28 months. The findings of this study validate the feasibility of reutilizing the mandibular ramus area for additional bone augmentation when other intraoral sites are unavailable.

Neuroprotective Effect and Mechanism of Tanreqing Injection on Ischemic Stroke: Insights from Network Pharmacology and in vivo Experiments.

OBJECTIVE: To explore the neuroprotective effects and mechanism of Tanreqing Injection (TRQ) on treating ischemic stroke based on network pharmacology and in vivo experimental validation. METHODS: The chemical compounds of TRQ were retrieved based on published data, with targets retrieved from PubChem, Therapeutic Target Database and DrugBank. Network visualization and analysis were performed using Cytoscape, with protein-protein interaction networks derived from the STRING database. Enrichment analysis was performed using Kyoto Encyclopedia of Genes Genomes pathway and Gene Ontology analysis. In in vivo experiments, the middle cerebral artery occlusion (MCAO) model was used. Infarct volume was determined by 2,3,5-triphenyltetrazolium hydrochloride staining and protein expressions were analyzed by Western blot. Molecular docking was performed to predict ligand-receptor interactions. RESULTS: We screened 81 chemical compounds in TRQ and retrieved their therapeutic targets. Of the targets, 116 were therapeutic targets for stroke. The enrichment analysis showed that the apelin signaling pathway was a key pathway for ischemic stroke. Furthermore, in in vivo experiment we found that administering with intraperitoneal injection of 2.5 mL/kg TRQ every 6 h could significantly reduce the infarct volume of MCAO rats (P<0.05). In addition, protein levels of the apelin receptor (APJ)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway were increased by TRQ (P<0.05). In addition, 41 chemical compounds in TRQ could bind to APJ. CONCLUSIONS: The neuroprotective effect of TRQ may be related to the APJ/PI3K/AKT signaling pathway. However, further studies are needed to confirm the findings.

Low signs of territorial behavior in the Eurasian otter during low-water conditions in a Mediterranean river.

The Eurasian otter Lutra lutra is a territorial semi-aquatic carnivore usually found at low densities in rivers, coastal areas, and wetlands. Its diet is based on prey associated with aquatic environments. Mediterranean rivers are highly seasonal, and suffer reduced flow during the summer, resulting in isolated river sections (pools) that sometimes can be left with a minimal amount of water, leading to concentrations of food for otters. To our knowledge, this process, which was known to field naturalists, has not been accurately described, nor have otter densities been estimated under these conditions. In this study, we describe the population size and movements of an aggregation of otters in an isolated pool in the Guadiana River in the Tablas de Daimiel National Park (central Spain), which progressively dried out during the spring-summer of 2022, in a context of low connectivity due to the absence of circulating water in the Guadiana and Gigüela rivers. Using non-invasive genetic sampling of 120 spraints collected along 79.4 km of sampling transects and spatial capture-recapture methods, we estimated the otter density at 1.71 individuals/km of river channel length (4.21 individuals/km2) in a progressively drying river pool, up to five times higher than previously described in the Iberian Peninsula. The movement patterns obtained with the spatial capture-recapture model are not quite different from those described in low density, which seems to indicate a wide home range overlap, with low signs of territoriality.

Safety and Efficacy of Dotinurad on Uric Acid in Patients With Chronic Kidney Disease With Estimated Glomerular Filtration Rate Below 25 mL/Min/1.73 m².

Introduction Dotinurad is being developed as a selective uric acid reabsorption inhibitor. However, its effect on lowering serum uric acid (UA) levels in chronic kidney disease (CKD) patients with severe renal dysfunction is unknown. Therefore, the purpose of this study was to determine the effect of dotinurad on renal function in CKD patients with an estimated glomerular filtration rate (eGFR) below 25 mL/min/1.73 m2. Methods Seven patients with CKD who received dotinurad 0.5 mg to 4 mg per day were studied retrospectively. Changes in UA, eGFR, and urine protein-to-creatinine ratio (UPCR) were analyzed. The observation period was 10.9±2.1 months. Results Serum UA levels were decreased and maintained with dotinurad administration. Nevertheless, there were no improvements noted in renal function. Additionally, no serious adverse effects were identified in any of the patients throughout the observation period. Conclusion Although the sample size in this study was small, our findings demonstrate the efficacy of dotinurad in individuals with advanced CKD who have an eGFR lower than 25 mL/min/1.73 m2.

Effectiveness of nurse-led fever, sugar-hyperglycemia, and swallowing bundle care on clinical outcome of patients with stroke at a tertiary care center: A randomized controlled trial.

Objectives: Stroke is a medical emergency, the leading cause of death, and a significant cause of disability in developing countries. The primary goals of stroke management focus on reducing disability, which needs prompt treatment in time. Fever, sugar-hyperglycemia, and swallowing (FeSS) bundle are a promising nurse-led composite for reducing disability and death. The present study aims to assess the effect of FeSS bundle care on disability, functional dependency, and death among acute stroke patients. Materials and Methods: A randomized controlled trial was conducted among 104 acute stroke patients, who were admitted within the first 48 h of stroke symptoms and had no previous neurological deficits. Randomization was stratified based on gender and type of stroke. The intervention group received FeSS bundle care, which included nurse-led fever and sugar management for the first 72 h, and a swallowing assessment done within the first 24 h or before the first oral meal. A follow-up assessment was done after 90 days to assess the disability, functional dependency, and mortality status using a modified Rankin scale and Barthel index. Results: No significant difference was noted in the 90-day disability and functional dependency between the groups. A reduction in mortality was noted in the intervention group. The risk ratio for mortality between groups was 2.143 (95% confidence interval: 0.953-4.820). Conclusion: Although no significant reduction in disability, there was a reduction in mortality in the intervention group. Hence, the study suggested the promotion of nurse-led intervention using the FeSS bundle in stroke units.

The LEADING Guideline: Reporting Standards for Expert Panel, Best-Estimate Diagnosis, and Longitudinal Expert All Data (LEAD) Studies.

Accurate assessments of symptoms and diagnoses are essential for health research and clinical practice but face many challenges. The absence of a single error-free measure is currently addressed by assessment methods involving experts reviewing several sources of information to achieve a more accurate or best-estimate assessment. Three bodies of work spanning medicine, psychiatry, and psychology propose similar assessment methods: The Expert Panel, the Best-Estimate Diagnosis, and the Longitudinal Expert All Data (LEAD). However, the quality of such best-estimate assessments is typically very difficult to evaluate due to poor reporting of the assessment methods and when it is reported, the reporting quality varies substantially. Here we tackle this gap by developing reporting guidelines for such studies, using a four-stage approach: 1) drafting reporting standards accompanied by rationales and empirical evidence, which were further developed with a patient organization for depression, 2) incorporating expert feedback through a two-round Delphi procedure, 3) refining the guideline based on an expert consensus meeting, and 4) testing the guideline by i) having two researchers test it and ii) using it to examine the extent previously published articles report the standards. The last step also demonstrates the need for the guideline: 18 to 58% (Mean = 33%) of the standards were not reported across fifteen randomly selected studies. The LEADING guideline comprises 20 reporting standards related to four groups: The Longitudinal design; the Appropriate data; the Evaluation - experts, materials, and procedures; and the Validity group. We hope that the LEADING guideline will be useful in assisting researchers in planning, reporting, and evaluating research aiming to achieve best-estimate assessments.