Search Results (33)

This paper addresses the challenges in assessing heterogeneity in meta-analytic studies. The specifics include mental health research work. Three key statistical scores in meta-analytics—Higgins’ I², Birge’s H², and the newly developed S² score—are discussed and illustrated. The paper critiques the subjectivity of these scores and introduces elasticity to enhance the accuracy and objectivity in assessing heterogeneity. The integration of elasticity into the meta-informatic score measures how heterogeneity changes as new studies are added, improving the interpretation of meta-analytic results. Also, the authors compute and compare elasticity scores in the context of mental health research, offering a novel approach to visualizing and quantifying heterogeneity. The authors demonstrate how elasticity improves the assessment of heterogeneity. The paper recommends the use of the meta-informatic S² score, integrated with elasticity, for more reliable and objective conclusions in mental health as well as in other meta-analyses. The new rectified score, S², overcomes issues with the I² score when the chi-squared distribution fails due to small sample sizes or negative values. Full article

The identification of areas that are susceptible to damage due to earthquakes is of utmost importance in tectonically active regions like Northeast India. This may provide valuable inputs for seismic hazard analysis; however, it poses significant challenges. The present study emphasized the integration of Interferometric Synthetic Aperture Radar (InSAR) deformation rates with conventional geological and geophysical data to investigate earthquake damage susceptibility in the Barapani Shear Zone (BSZ) region of Northeast India. We used MintPy v1.5.1 (Miami INsar Timeseries software in PYthon) on the OpenSARLab platform to derive time series deformation using the Small Baseline Subset (SBAS) technique. We integrated geology, geomorphology, gravity, magnetic field, lineament density, slope, and historical earthquake records with InSAR deformation rates to derive earthquake damage susceptibility using the weighted overlay analysis technique. InSAR time series analysis revealed distinct patterns of ground deformation across the Barapani Shear Zone, with higher rates in the northern part and lower rates in the southern part. The deformation values ranged from 6 mm/yr to about 18 mm/yr in BSZ. Earthquake damage susceptibility mapping identified areas that are prone to damage in the event of earthquakes. The analysis indicated that about 46.4%, 51.2%, and 2.4% of the area were low, medium, and high-susceptibility zones for earthquake damage zone. The InSAR velocity rates were validated with Global Positioning System (GPS) velocity in the region, which indicated a good correlation (R² = 0.921; ANOVA p-value = 0.515). Additionally, a field survey in the region suggested evidence of intense deformation in the highly susceptible earthquake damage zone. This integrated approach enhances our scientific understanding of regional tectonic dynamics, mitigating earthquake risks and enhancing community resilience. Full article

Background: Cerebral venous sinus thrombosis (CVT) is a rare cause of stroke, constituting 0.5–3% of all strokes with an extremely varied spectrum of presentation, predisposing factors, neuroimaging findings, and eventual outcomes. A high index of suspicion is needed because timely diagnosis can significantly alter the natural course of the disease, reduce acute complications, and improve long-term outcomes. Due to its myriad causative factors, protean presentation, and association with several systemic diseases, CVT is encountered not only by neurologists but also by emergency care practitioners, internists, hematologists, obstetricians, and pediatricians. Discussion: Anticoagulation remains the mainstay of treatment for CVT. Heparin and warfarin previously had been the anticoagulation of choice. Recently there has been an increased interest in utilizing direct-acting oral anticoagulants in the treatment of CVT given comparable safety and efficacy with ease of utilization. However recent clinical guidelines given by multiple societies including the American Stroke guidelines and European guidelines do not include these agents so far in their treatment recommendations. Ongoing multicentric clinical trials are currently reviewing the role of these agents in both short-term as well as long-term. Our review of the literature supports the safety and reinforces the efficacy of DOAC in the treatment of CVT. Additionally, patient satisfaction has been shown to be better with the use of DOAC. In conclusion, DOAC continues to have a valid role in the management of CVT. Full article

This article demonstrates the necessity of assessing homogeneity in meta-analyses using the Higgins method. The researchers realize the importance of assessing homogeneity in meta-analytic work. However, a significant issue with the Higgins method has been identified. In this article, we explain the nature of this problem and propose solutions to address it. Our narrative in this article is to point out the problem, analyze it, and present it well. A prerequisite to check the consistency of findings in comparable studies in meta-analyses is that the studies should be homogeneous, not heterogeneous. The Higgins $I^2$ score, a version of the Cochran Q value, is commonly used to assess heterogeneity. The Higgins score is an improvement in the Q value. However, there is a problem with Higgins score statistically. The Higgins score is supposed to follow a Chi-squared distribution, but it does not do so because the Chi-squared distribution becomes invalid once the Q score is less than the degrees of freedom. This problem was recently rectified using an alternative method ($S^2$ score). Using this method, we examined 14 published articles representing 133 datasets and observed that many studies declared homogeneous by the Higgins method were, in fact, heterogeneous. This article urges the research community to be cautious in making inferences using the Higgins method. Full article

The classification methods of machine learning have been widely used in almost every discipline. A new classification method, called Taba regression, was introduced for analyzing binary, multinomial, and ordinal outcomes. To evaluate the performance of Taba regression, liver cirrhosis data obtained from a Mayo Clinic study were analyzed. The results were then compared with an artificial neural network (ANN), random forest (RF), logistic regression (LR), and probit analysis (PA). The results using cirrhosis data revealed that the Taba regression model could be a competitor to other classification models based on the true positive rate, F-score, accuracy, and area under the receiver operating characteristic curve (AUC). Taba regression can be used by researchers and practitioners as an alternative method of classification in machine learning. In conclusion, the Taba regression provided a reliable result with respect to accuracy, recall, F-score, and AUC when applied to the cirrhosis data. Full article

The grain supply chain is crucial for any nation’s self-sustainability due to its huge impact on food security, economic stability, and the livelihoods of several people. The path grain takes from farmers to consumers is opaque and complicated, due to which consumers cannot trust grain quality and its origin. Although blockchain is widely used for fair and secure transactions between farmers and buyers, issues related to transparency and traceability in the grain supply chain, such as counterfeiting and middlemen involvement, have not been adequately addressed. To tackle these issues, a blockchain-based solution is proposed that unites farmers, warehouses, government central and state agencies, transporters, and food corporations on a single platform to enhance transparency, traceability, and trust among all parties. This system involves minting a non-fungible token (NFT) corresponding to each lot of grain approved by government officials. The NFT comprises grain quality, type, temperature data from sensors, weight, and ownership information, which updates as the grain lot moves across the supply chain from central agencies to state agencies and so on. NFTs enable stakeholders to track the grain lot from cultivation to end-users, providing insights into grain conditions and quality. An Internet of Things-based circuit is designed using a Digital-output relative humidity & temperature (DHT22) sensor, which offers real-time temperature and humidity readings, and geolocation coordinates are gathered from the GPS module across the supply chain. Farmers can directly interact with warehouses to sell grains, eliminating the need for middlemen and fostering trust among all parties. The proposed four-tier framework is implemented and deployed on the Ethereum network, with smart contracts interacting with React-based web pages. Analysis and results of the proposed model illustrate that it is viable, secure, and superior to the existing grain supply chain system. Full article

The current study focuses on development of phospholipid complex-loaded films of etodolac for enhanced transdermal permeation and anti-inflammatory effect. An etodolac–phospholipid complex was developed using the solvent evaporation method and was characterized by DSC, XRD, FTIR, and ¹H-NMR studies. The formation of the complex led to conversion of a crystalline drug to an amorphous form. A stoichiometric ratio of 1:1 (drug–phospholipid) was selected as the optimized ratio. Further, the developed complex was incorporated into films and systematic optimization using a central composite design was carried out using a response surface methodological approach. The desirable design space based on minimum contact angle and maximum tensile strength was selected, while the water vapour transmission rate and swelling index were set within limits. The results for swelling index, contact angle, tensile strength, and water vapour transmission rate were 60.14 ± 1.01%, 31.6 ± 0.03, 2.44 ± 0.39 kg/cm², and 15.38 g/hm², respectively. These values exhibited a good correlation with the model-predicted values. The optimized formulation exhibited improved diffusion and permeation across skin. In vivo studies revealed enhanced anti-inflammatory potential of the developed films in comparison to the un-complexed drug. Hence, the study demonstrated that etodolac–phospholipid complex-loaded films improve the transdermal permeation and provided enhanced anti-inflammatory effect. Full article

Bleeding within the pleural space may result in persistent clot formation called retained hemothorax (RH). RH is prone to organization, which compromises effective drainage, leading to lung restriction and dyspnea. Intrapleural fibrinolytic therapy is used to clear the persistent organizing clot in lieu of surgery, but fibrinolysin selection, delivery strategies, and dosing have yet to be identified. We used a recently established rabbit model of RH to test whether intrapleural delivery of single-chain urokinase (scuPA) can most effectively clear RH. scuPA, or single-chain tissue plasminogen activator (sctPA), was delivered via thoracostomy tube on day 7 as either one or two doses 8 h apart. Pleural clot dissolution was assessed using transthoracic ultrasonography, chest computed tomography, two-dimensional and clot displacement measurements, and gross analysis. Two doses of scuPA (1 mg/kg) were more effective than a bolus dose of 2 mg/kg in resolving RH and facilitating drainage of pleural fluids (PF). Red blood cell counts in the PF of scuPA, or sctPA-treated rabbits were comparable, and no gross intrapleural hemorrhage was observed. Both fibrinolysins were equally effective in clearing clots and promoting pleural drainage. Biomarkers of inflammation and organization were likewise comparable in PF from both groups. The findings suggest that single-agent therapy may be effective in clearing RH; however, the clinical advantage of intrapleural scuPA remains to be established by future clinical trials. Full article

Huntington’s Disease (HD) is a neurodegenerative disorder caused by an autosomal-dominant mutation in the huntingtin gene, which manifests with a triad of motor, cognitive and psychiatric declines. Individuals with HD often present with disturbed sleep/wake cycles, but it is still debated whether altered circadian rhythms are intrinsic to its aetiopathology or a consequence. Conversely, it is well established that sleep/wake disturbances, perhaps acting in concert with other pathophysiological mechanisms, worsen the impact of the disease on cognitive and motor functions and are a burden to the patients and their caretakers. Currently, there is no cure to stop the progression of HD, however, preclinical research is providing cementing evidence that restoring the fluctuation of the circadian rhythms can assist in delaying the onset and slowing progression of HD. Here we highlight the application of circadian-based interventions in preclinical models and provide insights into their potential translation in clinical practice. Interventions aimed at improving sleep/wake cycles’ synchronization have shown to improve motor and cognitive deficits in HD models. Therefore, a strong support for their suitability to ameliorate HD symptoms in humans emerges from the literature, albeit with gaps in our knowledge on the underlying mechanisms and possible risks associated with their implementation. Full article

Background and Objectives: Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient’s spinal anatomy. In this case series, we explore the use of AR-HMD alongside more traditional robotic assistance in surgical spine trauma cases to determine their effect on operative costs and perioperative outcomes. Materials and Methods: We retrospectively reviewed trauma patients who underwent pedicle screw placement surgery guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between 1 January 2021 and 31 December 2022. Outcome distributions were compared using the Mann–Whitney U test. Results: The AR cohort (n = 9) had a mean age of 66 years, BMI of 29.4 kg/m², Charlson Comorbidity Index (CCI) of 4.1, and Surgical Invasiveness Index (SII) of 8.8. In total, 77 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 378 mL, 0.78 units transfused, 398 min spent in the operating room, and a 20-day LOS. The robotic cohort (n = 13) had a mean age of 56 years, BMI of 27.1 kg/m², CCI of 3.8, and SII of 14.2. In total, 128 pedicle screws were placed in this cohort. Intra-operatively, there was a mean blood loss of 432 mL, 0.46 units transfused units used, 331 min spent in the operating room, and a 10.4-day LOS. No significant difference was found between the two cohorts in any outcome metrics. Conclusions: Although the need to address urgent spinal conditions poses a significant challenge to the implementation of innovative technologies in spine surgery, this study represents an initial effort to show that AR-HMD can yield comparable outcomes to traditional robotic surgical techniques. Moreover, it highlights the potential for AR-HMD to be readily integrated into Level 1 trauma centers without requiring extensive modifications or adjustments. Full article

Retained hemothorax (RH) is a commonly encountered and potentially severe complication of intrapleural bleeding that can organize with lung restriction. Early surgical intervention and intrapleural fibrinolytic therapy have been advocated. However, the lack of a reliable, cost-effective model amenable to interventional testing has hampered our understanding of the role of pharmacological interventions in RH management. Here, we report the development of a new RH model in rabbits. RH was induced by sequential administration of up to three doses of recalcified citrated homologous rabbit donor blood plus thrombin via a chest tube. RH at 4, 7, and 10 days post-induction (RH4, RH7, and RH10, respectively) was characterized by clot retention, intrapleural organization, and increased pleural rind, similar to that of clinical RH. Clinical imaging techniques such as ultrasonography and computed tomography (CT) revealed the dynamic formation and resorption of intrapleural clots over time and the resulting lung restriction. RH7 and RH10 were evaluated in young (3 mo) animals of both sexes. The RH7 recapitulated the most clinically relevant RH attributes; therefore, we used this model further to evaluate the effect of age on RH development. Sanguineous pleural fluids (PFs) in the model were generally small and variably detected among different models. The rabbit model PFs exhibited a proinflammatory response reminiscent of human hemothorax PFs. Overall, RH7 results in the consistent formation of durable intrapleural clots, pleural adhesions, pleural thickening, and lung restriction. Protracted chest tube placement over 7 d was achieved, enabling direct intrapleural access for sampling and treatment. The model, particularly RH7, is amenable to testing new intrapleural pharmacologic interventions, including iterations of currently used empirically dosed agents or new candidates designed to safely and more effectively clear RH. Full article

The degradation of land and increasing water scarcity are existing challenges for agricultural sustainability, necessitating the implementation of improved soil-conservation practices at the watershed scale. The identification and selection of critical/prone areas based on erosion-governing criteria is essential and helps in the execution of the management process for determining priority. This study prioritizes erosion-prone sub-watersheds (alternatives) based on morphometric parameters (multiple criteria) via five Multi-Criteria Decision Analysis (MCDA) approaches, i.e., AHP: Analytical Hierarchy Process; TOPSIS: Technique for Order of Preference by Similarity to Ideal Solution; VIKOR: VIseKriterijumska Optimizacija I Kompromisno Resenje; SAW: Simple Additive Weighting; and CF: Compound Factor. Based on their priority score, 19 sub-watersheds were classified into four priority classes: low priority (0–0.25), moderate priority (0.25–0.50), high priority (0.50–0.75), and very high priority (0.75–1). The results revealed that about 8.34–30.15% area of the Burhanpur watershed is critically prone to erosion, followed by 23.38–52.05% area classed as high priority, 7.47–49.99% area classed as moderate priority, and 10.33–18.28% area classed as low priority. Additionally, four indices—percentage of changes (∆P), intensity of changes (∆I), the Spearman rank correlation coefficient test (SCCT), and the Kendall tau correlation coefficient test (KTCCT)—were employed to compare the models. This study confirms the efficacy of morphometric parameters for prioritizing sub-watersheds to preserve soil and the environment, particularly in areas for which limited information is available. Full article

Bispecific antibodies have emerged as a promising class of therapeutics in the field of oncology, offering an innovative approach to target cancer cells while sparing healthy tissues. These antibodies are designed to bind two different antigens, enabling them to bridge immune cells with cancer cells, resulting in enhanced tumor cell killing and improved treatment responses. This review article summarizes the current landscape of bispecific antibodies in lung cancer, including their mechanisms of action, clinical development, and potential applications in other solid tumor malignancies. Additionally, the challenges and opportunities associated with their use in the clinic are discussed, along with future directions for research and development in this exciting area of cancer immunotherapy. Full article

Extreme weather events such as droughts are catastrophic and can have serious consequences for people and the environment. Drought may be managed if measures are taken in advance. The success of this endeavor depends on a number of factors, not the least of which is accurate descriptions and measurements of drought conditions. Reducing the negative consequences of droughts requires an early forecast of drought conditions. The primary objective of this research is, hence, to establish a process for the assessment and prediction of drought. The drought evaluation was carried out using the standards established by the SPI and the Indian Meteorological Department. Maps of drought severity were generated using severe drought data. Thirty years’ worth of SPI readings was analyzed. Fuzzy-based drought forecasting model parameters were determined during a 25-year period, and the model was validated throughout the remaining years. The findings of this study can be used by the community to help combat the drought. Before the drought worsens, the local government can implement lifesaving mitigating measures. Full article

Inflammatory bowel disease (IBD), once thought to impact younger individuals, now manifests in approximately 10% of patients over 65, characterized by a heightened vulnerability to complications and greater diagnostic intricacies than conventional cases. However, comprehensive global epidemiological data regarding elderly-onset IBD are currently insufficient. Our study addresses this critical gap by analyzing trends in elderly-onset IBD over a decade, encompassing the estimation of annual frequencies and age-standardized rates of elderly-onset IBD burden for both genders, stratifying the data by geographical and sociodemographic factors. Our research highlights a notable increase in the proportion of elderly-onset IBD, constituting around 13% of all IBD cases. We observed a rising incidence in males, contrasted by a decreasing trend in females. The highest surge in incidence rates was seen in the Western Pacific region in both genders, but the highest burden was observed in America. Countries with high sociodemographic index (SDI) carried the greatest burden of elderly-onset IBD, while countries with low SDI had the least. The mortality and disability-adjusted life years (DALYs) rates trend downward in most regions. This study underscores an increasing incidence and proportion of IBD, particularly in elderly-onset IBD, particularly in males. While mortality and DALYs are decreasing in most regions, the overall burden remains highest in America and high-SDI countries. Effective public health interventions and comprehensive studies are required to tackle this mounting burden. Full article