Nonparametric Research Articles

Trends in Incidence of Head and Neck Cancers in Dibrugarh District, Assam, India; During the Period 2003-2016.

Head and neck cancers are considered to be the most common cancers in developing countries, especially in Southeast Asia. In India, it accounts for one-fourth of male cancers and one-tenth of female cancers. An attempt was made to study head and neck cancer trends in the Dibrugarh district of Assam, North-East India, India. All sites viz., oral cavity and mobile tongue, oropharynx, hypopharynx, larynx, nasopharynx and others were considered separately for both the sexes to carry out the present analysis. Using the data from the Population-Based Cancer Registry, Upper Assam, Dibrugarh, annual crude incidence rate and age-specific rate were calculated for the period from 2003 to 2016. Mann-Kendall and Sen's Slope non-parametric analysis were applied to examine the trend in the percentages of Head and Neck cancers. The most frequent incidence site for HN cancers was the hypopharynx (33.50%). The disease was common among the males (78.87%) compared to the female (21.13%) population in Dibrugarh district. HN cancers are more prone to the age group 50-70years (60.93%) compared to the individuals with less than 50years (26.51%). Combining all the sites of HN cancers in male showed a significant decrease in incidence, whereas in female increasing trend was noted over a period of time. A slight decline in the percentage of head and neck cancer was documented in Dibrugarh when we combined both sexes. The results obtained from the current investigation will laid the scientific framework for proper planning and organization of prevention, diagnosis and treatment of HN cancers in Dibrugarh district, Assam.

Aeromedical retrieval for suspected preterm labour or rupture of membranes in the Northern Territory, Australia: may some cases be safely not retrieved?

BackgroundSuspected preterm labour (PTL) and prelabour rupture of membranes (PPROM) are common indications for aeromedical retrieval in the Top End, Northern Territory, Australia, where many women reside remotely and preterm birth (< 37 completed weeks of gestation) is common. The primary objective of this study was to determine rate of delivery during the index admission following aeromedical transfers from remote clinics to Royal Darwin Hospital for suspected PTL/PPROM.MethodsA retrospective cohort study of aeromedical transfers for suspected PTL/PPROM from 1 January 2020 to 31 July 2022 was undertaken. Transfers were identified through CareFlight, the regional air ambulance service, and complemented with data from hospital records. Clinical and sociodemographic characteristics were compared by delivery status during the index (post-retrieval) admission using parametric and non-parametric tests and multivariable linear regression analysis.Results238 women with singleton pregnancies were retrieved for suspected PPROM (n = 77, 32.4%) or PTL (n = 161, 67.6%), together accounting for 49.2% of all obstetric transfers (n = 483). Of 77 patients transferred for suspected PPROM, 47 (61.0%) had ruptured membranes confirmed on arrival, and 45 (95.7%) of them delivered during the index admission. None of the 30 women transferred for suspected PPROM with intact membranes on arrival delivered during the index admission. Of 161 patients transferred for suspected PTL, 13 (8.1%) had ruptured membranes confirmed on arrival, and 12 (92.3%) of them delivered during the index admission. Amongst women transferred for suspected PTL with intact membranes confirmed on arrival, 14.9% (22/149) delivered during the index admission. Prior to arrival, 120 women (50.4%) had a documented speculum examination, and 15 (6.3%) and 9 (3.8%) had cervicovaginal swab tests to assess their risks of a PPROM and PTL, respectively. Half of women who did not deliver during the index admission had received antenatal corticosteroids (n = 76).ConclusionsMany aeromedical retrievals for suspected PTL/PPROM did not result in delivery during the index admission. Women retrieved for suspected PPROM with intact membranes on arrival were less likely to deliver. Upskilling remote clinic staff and better point-of-care testing may reduce retrievals and unnecessary interventions. Prospective cohort studies designed to enable accurate prediction of which cases can be safely not retrieved are required.Trial registrationNot applicable.

Evaluation of patients' care pathway before the first consultation in the radiotherapy department of Centre Hospitalier Nganda (Kinshasa) for breast cancer treatment

Introduction: That study assesses the care pathway to detect the reasons why the patients reached the radiotherapy department of Centre Hospitalier Nganda with advanced breast cancer. Material and Methods: We conducted a descriptive and analytical cross-sectional study from March 2024 to June 2024. We included all new breast cancer patients in our center. A p-value ≤ 0.05 was considered statistically significant for all analyses. An average comparison between quantitative variables was performed using the non-parametric Kruskal-Wallis test. Results and discussion: We enrolled 54 patients. The mean age was 53.13 ± 11.94 years and the median age was 51 years. A breast mass dominated the clinical picture in 87.07% of cases. Regarding the first medical contact, 77.78% of patients sought care in a conventional medical center. During the treatment, 31.48% of patients had received traditional pharmacopeia and 16.67% had undergone holistic treatment. Regarding radiotherapy indications, 14.81% of patients had no relevant indication for irradiation. The average time between the first symptoms and the radiotherapy consultation was 12.9 ± 9.2 months. There was a statistically significant positive correlation between the time from first symptoms to radiotherapy consultation and the staging of the disease (P-value=0.023). Patients who sought care at home (OR: 1.1; 95% CI 0.13-6.89) or in a conventional medical center (OR: 1.49; 95% CI 0.35-7.77) were all at risk of reaching radiotherapy with an advanced disease. Conclusion: The care pathway of breast cancer patients has a global impact on the outcome and also on the prognosis.

Near-Infrared Autofluorescence or Intraoperative Parathyroid Hormone Determination as a Surgical Support Tool in Primary Hyperparathyroidism: Too Close to Call?

Background: This study investigates the use of near-infrared fluorescence imaging (NIFI) as an alternative to intraoperative parathyroid hormone (ioPTH) measurement in patients with primary hyperparathyroidism (PHP) due to parathyroid adenoma (PA) with two preoperative imaging examinations in agreement on the position of the altered parathyroid gland. Methods: Fifty patients who underwent minimally invasive parathyroidectomy (MIP) from March 2021 to April 2024 were enrolled. MIPs utilised both NIFI and ioPTH, comparing the time to adenoma excision with NIFI against the total surgical time, including ioPTH measurement wait time. Results: Results showed successful MIPs in all patients, with a mean excision time of 44.7 min (SD ± 25.2) and a total procedure time of 85.5 min (SD ± 37.1). The median of the duration of the surgical procedure until adenoma excision was 35.0 min (IQR 38.8), while the median duration of the entire procedure was 74.5 min (IQR 40.5). This difference in medians is statistically significant using the Wilcoxon non-parametric test for paired samples (p &lt; 0.001). The average wait for ioPTH results post-excision was 37 min (SD ± 12.2). Three fluorescence patterns were identified: “cap” (46%), heterogeneous (30%), and homogeneous (24%). Conclusions: If preoperative imaging confirms PA location, NIFI could replace ioPTH reducing surgical time without compromising success rates.

Correlation between Urine Albumin Creatinin Ratio (UACR) Value to Urine Osmolality Value and Estimate Glomerular Filtration Rate (EGFR) Value on Patient with Kidney Failure

BACKGROUND : Kidney failure is one of the causes of death in the world. Laboratory tests related to kidney function are very important in the management of patients with kidney failure because they are useful in identifying any decline in kidney function, monitoring treatment and progression of kidney disease. The aim of checking the urine albumin creatinine ratio (UACR): is to assess the protein filtration function in the glomerulus. The aim of checking urine osmolality is to assess pre-renal, renal and post-renal hemodynamic status. The aim of examining the estimated glomerular filtration rate (EGFR) is to assess overall glomerular function. EGFR is the gold standard. AIMS : The aim of this research is to determine 1). the relationship between UACR values and EGFR, 2). The relationship between urine osmolality and EGFR. UACR and urine osmolality are independent variables. Meanwhile, EGFR is the dependent variable. The research sample was all chronic kidney failure in one group. Acute renal failure was made into a group and a separate analysis. METHOD : This study is a quantitative study with analytical observations through a cross sectional design using 30 samples and was conducted from May to June 2024 at the Central Laboratory Installation of Dr. Saiful Anwar Hospital, East Java Province. UACR and EGFR examination used the principle of photometric test while urine osmolality examination used the principle of electrical conductivity. The data were analyzed using the Shapiro-Wilk normality test and the Spearman non-parametric correlation test through SPSS 27. RESULT : In the normality test results, it was found that UACR and EGFR values were not normally distributed (p = &lt;0.001) while urine osmolality values were normally distributed (p = 0.523). Spearman's non-parametric correlation test showed that there was no correlation between UACR value to urine osmolality value (p = 0.342) and EGFR value (p = 0.481). CONCLUSION : The results of this study showed no correlation between UACR value to urine osmolality value and EGFR value in patients with kidney failure.

Sociodemographic variables and psychological distress of Moroccan college students

Because college students are an important category of the population highly vulnerable to mental health problems, this study aims to investigate the sociodemographic variables associated with the increase in psychological distress levels among Moroccan college students. Participants (N = 1147; mean age 20.00, SD = 2.6; 703 females and 444 males) completed a survey, which included a sociodemographic questionnaire and the Arabic version of the Brief Symptoms Inventory (BSI). Non-parametric tests were conducted to explore the data. Non-parametric tests revealed that being female, having a physical illness, experiencing depression and anxiety, having sleep problems, and living with only their mother or with a family member other than their parents are associated with a significant increase in the level of psychological distress. In summary, specific sociodemographic factors exert a notable influence on the psychological distress levels experienced by college students. Consequently, it is imperative to intensify research endeavors aimed at delving into the intricacies of college students’ mental health and its correlated ramifications.

Nonparametric Testing for Information Asymmetry in the Mortgage Servicing Market

Abstract: Our objective is to test for evidence of information asymmetry in the mortgage servicing market. Does the sale of mortgage servicing rights (MSR) by the initial lender to a second servicing institution unveil any residual asymmetric information? We are the first to analyze the originator’s selling choice of MSR. We use a large sample of U.S. mortgages that were securitized through the private-label channel during the period of January 2000 to December 2013 (more than 5 million observations). We propose a new nonparametric instrumental variable testing procedure to account for potential endogeneity. For robustness, we present parametric analyses to corroborate our results using instrumental variables. Our empirical results provide strong support for the presence of second-stage asymmetric information in the mortgage servicing market during the period of analysis and before the risk retention reform of 2014.

Assessment of predictive factors in endoscopic internal urethrotomy for bulbar urethral strictures

IntroductionDirect vision internal urethrotomy (DVIU) is usually the first treatment offered to patients with bulbar urethral strictures (US). Advances in devices and surgical techniques have contributed to reducing associated complications. Despite the favorable success rate of DVIU, various factors predicting better outcomes have been studied, including patient characteristics, stricture features, and procedural aspects. The main aim of our study is to assess predictive factors for success. MethodsWe conducted a retrospective descriptive study of patients who underwent endoscopic internal urethrotomy at our hospital over a 30 year period. Out of 788 DVIU performed, we selected 491 (62.3%) conducted for bulbar US with a minimum follow-up of 12 months. We examined clinical outcomes obtained, and assessed the relationship between different patient characteristics, stricture-related factors and procedural aspects related with clinical success -considered as the avoidance of further interventions for stricture recurrence-. Descriptive statistics were calculated and parametrical and non-parametrical comparative tests were applied. Kaplan-Meier survival analysis was used for evaluating time until recurrence. ResultsMean stricture length was 1.2 cm (SD 0.5), with only 12 patients presenting with more than 1 US in the bulbar area during DVIU. After a median follow-up of 170 months, 67.4% of patients did not experience clinical recurrence. Severe postoperative complications appear in 0.4% of cases, and need for overnight admission was 4.5%. A positive association was observed between clinical recurrence and a history of prior pelvic radiotherapy (OR 2.8, 95%IC 1.3-22.2), active smoking (OR 2.1, 95%IC 1.6-2.4), infectious etiology of stricture (OR 2.3, 95%IC 1.6-8), history of previous urethroplasty (OR 2.5, 95%IC 1.7-3.2), and higher postoperative urinary catheter sizes (OR 1.8 95%IC 1.1-2.9). Median time until recurrence after the first DVIU was 65 months, after the second was 60 months, after the third was 32 months, and after the fourth was 6 months. ConclusionsBulbar US could be safely managed with DVIU. The best clinical success is achieved in non-irradiated, non-smoker patients, without prior urethroplasties. The repetition of the procedure is significantly associated with a shorter time to clinical recurrence.

Italian validation of the pelvic floor Impact questionnaire − 7 (PFIQ-7)

Introduction and hypothesisThis study aims to translate and validate the Pelvic Floor Impact Questionnaire − short form 7 (PFIQ-7) in Italian, assessing its validity, internal consistency, and test–retest reliability. MethodsThe final version of the questionnaire was submitted to women referred to urogynecological outpatient care for genital prolapse or urinary incontinence and who either reported sexual disorders (controls) or not (cases). The questionnaire was translated into Italian using established procedural stages. Two weeks later, cases got the questionnaire for the test–retest evaluation. The non-parametric Wilcoxon test was employed to evaluate the variations between the case and control groups. Convergent validity was tested using the Italian version of the PFDI-20. The internal consistency was measured using Cronbach’s Alpha. Using Cohen’s kappa, the degree of concordance/agreement was determined. The test–retest results for different individuals were evaluated for absolute agreement using the intraclass correlation coefficient (ICC). ResultsThe study then included 45 women with a mean age of 38.0 ± 11.7 years who answered the questionnaire with no dropouts or missing items. Participants were categorized into cases and controls based on their self-reported symptoms. The questionnaire demonstrated significant construct validity by effectively distinguishing between symptomatic and asymptomatic individuals. Convergent validity testing with the PFDI-20 showed a strong linear correlation (F < 0.001) between scores. Internal consistency was excellent, with Cronbach’s Alpha values ranging from 0.90 to 0.93. Test-retest reliability was confirmed, with Cohen’s Kappa values ranging from 0.62 to 0.92 and intraclass correlation coefficients from 0.88 to 0.94, indicating high reliability. ConclusionThe Italian version of the PFIQ-7 is reliable, valid, and consistent.

Bystander dermal exposure to drift during pesticide application in vineyards: an experimental factorial study.

Although public concerns about their exposure to agricultural pesticides and the potential impacts on their health began to gain momentum around the early 2000s, there is limited data on the direct exposure of bystanders to spray drift through the deposition of drift droplets on the skin. To address these knowledge gaps in vineyards, trials were conducted on a test bench using artificial vegetation and wind. Different spraying technologies and drift mitigation measures, such as air-induction nozzles or hedgerows along the vineyard margin, were compared. Sulforhodamine B was used as a fluorescent tracer to mimic pesticide contamination under real-use conditions. In total 72 t-shirts on manikins were used, resulting in 144 cotton collectors (arms and torsos) for extracting the tracer. The dermal exposure levels were expressed in μL spray and compared using nonparametric ANOVA analyses in a factorial experimental framework. All the factor and interaction terms had a highly significant effect (p<10-6) on the exposure level. There was an exponential-like decay in the average exposure with distance (3.3, 5, 10 and 20 m, respectively). In terms of sprayers, a noticeable trend was observed with drift reduction technology. The presence of a hedgerow had a substantial effect, flattening the exposure curves with distance, regardless of the sprayer. This study produced realistic bystander exposure levels for different combinations involving the presence of a hedgerow, distances and drift reduction devices. Before entering these data into refined risk assessment models for grapevine production, hedgerows should be characterized more thoroughly, while accounting for potential secondary drift.

Molecular Insights Into Actinic Cheilitis and Lower Lip Squamous Cell Carcinoma: AURKA and AURKB Amplifications and Their Association With Tumor Microenvironment.

Lip exposure to carcinogens lead to several disorders, such as actinic cheilitis (AC) and lower lip squamous cell carcinoma (LLSCC). Although several studies have described important pathways in lip carcinogenesis, the comprehension of association of target genes in this process and their association with tumor microenvironment still need to be better understood. Tissue samples of 30 AC and 17 LLSCC cases were included for histopathological analysis, immunohistochemical expression of CD4, CD8, and PD-L1, and fluorescence insitu hybridization for AURKA, AURKB, TP53, PTEN, CCND1, and MYC. Non-parametrical tests were done and p < 0.05 was considered significant. LLSCC patients presented higher amplifications of AURKA and AURKB, deletion of TP53, and PTEN and rearrangements of MYC than AC. AURKA, AURKB, TP53, PTEN, and CCND1 changes were correlated with PD-L1 expression. AURKA and AURKB amplifications and other gene changes are pointed by their association of lip disorders.

Scale and Zoning Effects on Landscape Metrics for Assessing Ecological Stress from Urban Expansion

ContextLandscape metrics can effectively quantify urban landscape dynamics and their ecological stress, but incorrect metric, scale and zoning choices may lead to inaccurate result and biased land use planning.ObjectivesThis study aims to explore how the scale and zoning affected the magnitude and spatial pattern of ecological stress delineated by two related landscape metrics- Eco-erosion index(EEI) and percent of built-up area (PB).MethodsWe quantified ecological stress from urban expansion using EEI and PB across different scales and zoning patterns, based on 30 m land use and land cover (LULC) data of Shanghai, China. Descriptive and non-parametric statistics were used to analyze the sensitivity and spatial heterogeneity of EEI and PB in response to variations in grain size, extent, and zoning.ResultsOur findings indicate that EEI and PB are more sensitive to changes in extent than in grain size. EEI is better at capturing spatial heterogeneity of ecological stress in detail compared to PB at the same zoning pattern. Statistically, zoning patterns don't affect the ranking of ecological stress levels among study units. However, EEI using fine-scale zoning is more appropriate for highlighting discrepancies within the city than using broad-scale zoning at the same grain size. It is also recommended that the minimum study unit for EEI estimated with 30 m LULC grain size should be no smaller than a 5 km by 5 km grid cell.ConclusionsThis study emphasizes scale and zoning effects on EEI and PB, providing guidance for using these metrics to represent ecological stress and contributing to sustainable urban planning.

The relationship between indoor airborne culturable bacteria with passenger flow in 132 traffic stations during 2019–2020, China

This study aims to provide technical support for the development of a rational administration strategy for indoor environment and passenger flow of stations. The analysis was conducted monitor data of long distance bus stations and train/high speed railway stations from the National project. The monitor and surveyed data included indoor airborne culturable bacteria (IAB), passenger flow, area and height of stations. Data analysis involved the use of paired non-parametric tests, correlation analysis, and mixed linear regression methods. A total of 132 pairs of stations were examined in this study. Additionally, significant variations were observed in the monitoring results for the IAB and passenger flow between 2019 and 2020 (p < 0.05). Specifically, the median values of these two factors in 2020 decreased by 50.52% and 48.33%, respectively, compared to 2019. (p < 0.05). A positive relationship between the daily average passenger flow and the IAB in long distance bus stations and train stations, particularly pronounced with medium sized waiting rooms, which located in subtropical cities with a general level of economic development. The mixed effect regression analysis revealed a significant association between passenger flow (OR = 1.564, 1.288–1.898), per capita volume (OR = 0.856, 0.733–0.998), and per capita area (OR = 0.806, 0.678–0.956) with the IAB (p < 0.05) just in long distance bus stations. It is crucial to regulate passenger flow and per capita area in the waiting room of long distance bus stations to mitigate the spread of airborne culturable bacteria during infectious disease epidemics.

Adding imprecision to hypotheses: A Bayesian framework for testing practical significance in nonparametric settings

Instead of testing solely a precise hypothesis, it is often useful to enlarge it with alternatives deemed to differ negligibly from it. For instance, in a bioequivalence study one might test if the concentration of an ingredient is exactly the same in two drugs. In such a context, it might be more relevant to test the enlarged hypothesis that the difference in concentration between them is of no practical significance. While this concept is not alien to Bayesian statistics, applications remain mostly confined to parametric settings and strategies that effectively harness experts' intuitions are often scarce or nonexistent. To resolve both issues, we introduce the Pragmatic Region Oriented Test (PROTEST), an accessible nonparametric testing framework based on distortion models that can seamlessly integrate with Markov Chain Monte Carlo (MCMC) methods and is available as an R package. We develop expanded versions of model adherence, goodness-of-fit, quantile and two-sample tests. To demonstrate how PROTEST operates, we use examples, simulated studies that critically evaluate features of the test and an application on neuron spikes. Furthermore, we address the crucial issue of selecting the threshold—which controls how much a hypothesis is to be expanded—even when intuitions are limited or challenging to quantify.

Enhancing Children's Gross Motor Skills Through the Single Leg Balance Sandbag Game

Development motor rough child considered important, because If development motor rough child develop optimally then in a way No direct will influence behavior child daily. If growth physical and motoric child develop optimally, then activity motion child will become more ripe and more good . This research aims to to find out whether there is any influence game single leg balance sand bag on the gross motor skills of early childhood children . The research approach used is a quantitative approach with a Quasi Experimental research type which includes an experimental group and a control group. Data collection techniques include tests, observations, and documentation. Data analysis techniques used in study This is a descriptive data analysis and non-parametric statistical analysis with a population of 20. From the results of the non-parametric data analysis, it can be proven that the game single leg balance sand bag can has a significant influence on gross motor skills in children. Single leg balance sand bag game can affect gross motor skills in early childhood. This game can have a positive influence on children's gross motor skills. It is expected that with the Single leg balance sand bag game, children will be more enthusiastic in learning activities, can socialize well and develop more in children's gross motor skills

An Analysis of the Health Literacy Levels of Students in A Public University's Faculty of Health Sciences

Aim: This study aimed to assess the health literacy levels of students in the Faculty of Health Sciences at a public university and to investigate the relationships and differences between participants' sociodemographic characteristics and their health literacy levels. Methods: The study employed a quantitative, descriptive, cross-sectional, and correlational research design. Data were gathered through face-to-face surveys, utilizing a socio-demographic data form and the THLS-32 scale. Data analysis was conducted using IBM SPSS 22.00. Descriptive statistics, including frequency distributions, percentages, standard deviations, and arithmetic means, were calculated. The Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, which revealed a non-normal distribution. As a result, non-parametric tests (Mann-Whitney U Test and Kruskal-Wallis H Test) were applied. Correlation analyses were performed using Spearman’s Rho coefficient, and statistical significance was evaluated at a 95% confidence interval with a 5% margin of error. Results: The findings indicated that 66.3% of participants exhibited sufficient or excellent health literacy levels. Female students had significantly higher TS-AI perceptions than male students. Health Management (HM) students demonstrated higher health literacy levels compared to Emergency Aid and Disaster Management (EADM) students. The highest literacy levels were observed among final-year students, and students with social security had higher TS perceptions than those without. Conclusion: The study concluded that the health literacy levels of students in the Faculty of Health Sciences were generally high, with significant differences based on gender, department, academic year, and social security status. These findings suggest a need for targeted strategies to improve health literacy, particularly among students in certain departments and those without social security

Unlocking Global Innovation

In the dynamic landscape of global innovation, researchers increasingly adopt an integrated approach using nonparametric and regression techniques. This study highlights the significance of this method in enabling countries to understand external factors shaping innovation outcomes. Data Envelopment Analysis (DEA) serves as a robust framework for evaluating innovation efficiency, helping countries optimize their innovation processes by scrutinizing resource utilization and identifying areas for improvement. Complementing DEA, Tobit regression analysis offers insights into the nuanced influence of external drivers on innovation. The findings reveal a mixed landscape: while high-income countries dominate innovation efficiency, some lower-middle and low-income countries show notable proficiency. China, classified as an upper-middle-income country, emerges as the most referenced benchmark. Based on benchmarking, inefficient countries can enhance their innovation policies and strategies, helping to bridge the global innovation gap. Despite all input capabilities showing a negative correlation with innovation efficiency, all output variables exhibit a positive correlation. Notably, there was no association between R&amp;D and innovation efficiency in 2020, highlighting the need for judicious use of innovation inputs to avoid wastage. Additionally, the Tobit regression model exhibits a remarkable R-squared value of 0.8523, indicating that the 16 independent factors account for 85.23% of the variation in the innovation efficiency. Amidst technology-driven transformations, leveraging nonparametric analysis methodologies is essential for organizations aiming to thrive in the global innovation arena. This study highlights the crucial role of DEA in assessing innovation efficiency and emphasizes the importance of incorporating nonparametric analysis and regression techniques into strategic decision-making processes to formulate effective innovation policies.

Clinical Implications of Eosinopenia in Adult Brucellosis Patients

Objective: To analyze the differences between eosinopenia and non-eosinopenia brucellosis patients in depth. Methods: Medical records of brucellosis patients admitted to the Affiliated Infectious Diseases Hospital of Soochow University between January 1, 2013, and December 31, 2023, were reviewed retrospectively. Patients were categorized into an eosinopenia group and a non-eosinopenia group based on pre-treatment eosinophil levels. A nonparametric test was performed to estimate the differences between the two groups. Results: Among the 125 patients, 66 (52.80%) experienced eosinopenia. Patients with eosinopenia were older (52.09 ± 15.63 years vs. 46.08 ± 16.39 years, P = 0.024), had a higher proportion of hypertension (21.21% vs. 6.78%, P = 0.024), and exhibited a greater likelihood of complications (75.76% vs. 35.59%, P = 0.000), particularly hematological (68.18% vs. 23.73%, P = 0.000) and relapse (19.70% vs. 6.78%, P = 0.040). The eosinopenia group also showed higher levels of ALT (29.00 vs. 20.00, P = 0.003), AST (29.00 vs. 22.00, P = 0.037), and LOS (17.50 vs. 12.00, P = 0.000). Among certain inflammatory indicators related to brucellosis, the eosinopenia group demonstrated lower levels, such as MPV (9.75 vs. 10.70, P = 0.000), MLR (0.28 vs. 0.36, P = 0.002), and SIRI (0.67 vs. 1.03, P = 0.004). Conclusion: Brucellosis patients with eosinopenia differed in clinical manifestations and prognosis. Monitoring eosinophils may provide better prognostic assessment and suggest potential new treatment options.

Effect of Hemoglobin and Blood Glucose Levels on CT Perfusion Ischemic Core Estimation: A Post Hoc Analysis of the ESCAPE-NA1 Trial.

CT perfusion (CTP) maps can estimate the ischemic core in acute ischemic stroke based on distinctive cerebral blood flow thresholds. However, metabolic factors beyond perfusion influence the tissue tolerance to ischemia and the infarct growth rate. Underestimating the ischemic core volume (ICV) might result in overestimating the salvageable cerebral tissue and, consequently, overestimating the potential clinical benefits of reperfusion therapies. We aim to evaluate whether baseline hemoglobin and blood glucose levels influence the accuracy of baseline CTP ICV estimations. Large vessel occlusion stroke patients investigated with baseline CTP undergoing thrombectomy with near-complete reperfusion and without parenchymal hemorrhage from the ESCAPE-NA1 trial were included. Patients were subdivided into anemic (hemoglobin <130 g/L for men and <120 g/L for women) and nonanemic groups, and hyperglycemic (blood glucose level >7 mmol/L) and normoglycemic groups. Ischemic core underestimated volume (ICuV) was calculated: final infarct volume minus CTP-based ICV. The primary outcome was the presence of "perfusion scotoma" defined as ICuV ≥10 mL. Presence of "perfusion scotoma" and median ICuV were compared between anemic vs nonanemic and hyperglycemic vs normoglycemic patients using nonparametric tests and multivariable binary logistic regression with adjustment for baseline variables. One hundred sixty-two of 1,105 (15%) patients were included (median age 70.5 [interquartile range (IQR) 61-80.4], 50.6% women). The median ICuV was 7.26 mL (IQR 0-25.63). Seventy-eight (48%) patients demonstrated perfusion scotoma. Forty-two (25.7%) patients were anemic, and 65 (40.1%) were hyperglycemic. In univariable analysis, the hyperglycemic group had a higher prevalence of perfusion scotoma (65% [n = 40] vs 39% [n = 38], p = 0.006) and larger ICuV (17.79 mL [IQR 1.57-42.75] vs 6 mL [-0.31 to 12.51], p = 0.003) compared to normoglycemic patients. No significant ICuV differences between patients with and without anemia were seen. Multivariable regression analysis revealed an association between perfusion scotoma and hyperglycemia, adjusted odds ratio (OR) 2.48 (95% CI 1.25-4.92), and between perfusion scotoma and blood glucose levels, adjusted OR 1.19 (95% CI 1.03-1.39) per 1 mmol/L increase. In our study, CTP-based ischemic core underestimation was common and associated with higher baseline blood glucose levels. Individual metabolic factors beyond perfusion that critically influence the infarct growth rate should be considered when interpreting baseline CTP estimations of ischemic core.

Distribution-free tests for lossless feature selection in classification and regression

Distribution-free tests for lossless feature selection in classification and regression