Sample Size Research Articles

Challenges and Solutions in Teaching Writing to Azerbaijani Learners of English

This study explores the challenges and potential solutions in teaching English writing to Azerbaijani learners, focusing on linguistic, cultural, and pedagogical factors that impact writing proficiency. Through a mixed-methods approach involving surveys, interviews, and classroom observations, the research identifies key difficulties such as grammatical errors, rhetorical differences, and the influence of educational practices. The study also highlights effective strategies, including process-oriented writing activities and culturally responsive teaching methods, which enhance both writing skills and learner engagement. Despite the valuable insights, limitations such as sample size and the focus on short-term outcomes suggest the need for further research, particularly in exploring long-term impacts and the role of digital tools in writing instruction.

Diagnostic and prognostic value of time to positivity in blood cultures. An opinion paper

Time to positivity (TTP) refers to the duration required for a microbiological culture test to indicate a positive result, marking the onset of detectable bacterial or fungal growth in the sample. Numerous variables, including patient characteristics, infection source, former antimicrobial therapy, blood sample volume, and sample transportation time can influence the value of TTP. Several studies have been conducted on bloodstream infections, whereas studies on the clinical significance of yeast TTP are quite limited in the literature. Furthermore, many studies are retrospective and have a small sample size. In this opinion paper, we have formulated some questions and attempted to provide answers based on the available literature and our perspective. The objective of this opinion paper is to summarise current knowledge based on the literature, aiming to offer a critical perspective, particularly on aspects with weaker evidence, which could guide future studies in this area. We believe that TTP of blood cultures appears to exhibit considerable potential and may prove to be a valuable tool in clinical practice for estimating patient mortality risk and guiding antimicrobial therapy choices. Topics discussed include the diagnostic and prognostic role of TTP in Gram-positive and Gram-negative bacteremias and in candidemias, and the significance of differential time to positivity (DTTP). In summary, our opinion is that, based on the available literature, it is not possible to determine whether TTP provides prognostic information, particularly concerning candidemia. Therefore, clinical decisions cannot be systematically based on this parameter.

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

Abstract Background As the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy. Methods For objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool. Conclusions A PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

Determinants of long‐term paramagnetic rim lesion evolution in people with multiple sclerosis

AbstractObjectiveBaseline paramagnetic rim lesion (PRL) load predicts disease progression in people with multiple sclerosis (pwMS). Understanding how PRLs relate to other known MS‐related factors, and the practical utility of PRLs in clinical trials, is crucial for informing clinical decision‐making and guiding development of novel disease‐modifying treatments (DMTs).MethodsThis study included 152 pwMS enrolled in a larger prospective, longitudinal cohort study who had 3T MRI scans and clinical assessments at baseline and 5‐ or 10‐year follow‐ups. PRLs were identified on baseline 3T quantitative susceptibility maps and classified as persisting, disappearing, or newly appearing at follow‐up. The relationships between PRL evolution and clinical, radiological, environmental, and genetic characteristics were assessed, and clinical trial sample sizes were estimated using PRL appearance or disappearance as outcome measures.ResultsDMT use was associated with lower odds of new PRL appearance (for high‐efficacy DMTs: odds ratio = 0.088, p = 0.024), but not disappearance. Current smoking status was associated with greater baseline PRL number (B = 0.527 additional PRLs, p = 0.013). A 24‐month clinical trial in people with progressive MS for a DMT that doubles the rate of PRL rim disappearance would require an estimated 118 people with progressive MS per group at 80% statistical power.InterpretationEarly MS diagnosis and subsequent DMT initiation may reduce new chronic active inflammation. However, the utility of PRL disappearance or new PRL appearance as outcome measures in clinical trials is limited by potentially large sample sizes that are needed for moderate efficacy drugs.

No Evidence for a Metallicity-dependent Enhancement of Distant Giant Companions to Close-in Small Planets in the California Legacy Survey

Abstract Understanding the relationship between close-in small (CS) planets and distant giants (DGs) is central to understanding the formation of planetary systems like our own. Most studies of this connection have found evidence for a positive correlation, though significant statistical and systematic uncertainties remain due to differences in sample size, target selection bias, and even the definitions of CS and DG planets. Recently, M. L. Bryan & E. J. Lee conducted a study of 184 stars hosting super-Earths ( M sin i = 1 − 20 M ⊕ or R = 1 − 4 R ⊕) to determine the effect of stellar metallicity on the prevalence of DG companions ( M sin i = 0.5 − 20 M J , a = 1−10 au). They found that such giants are twice as common in the presence of inner planets, but only in metal-rich systems: P(DG∣CS, [Fe/H] > 0) = 28.0 − 4.6 + 4.9 % versus P(DG∣[Fe/H] > 0) = 14.3 − 1.8 + 2.0 % . Further, they found that this correlation disappears for metal-poor stars: P(DG∣CS, [Fe/H] ≤ 0) = 4.5 − 1.9 + 2.6 % versus P(DG∣[Fe/H] ≤ 0) = 5.0 − 1.3 + 1.6 % . We conducted an analogous study to test whether this effect was present in the California Legacy Survey sample. Using the same planet definitions, we did not find evidence for an enhancement in metal-rich systems: P(DG∣CS, [Fe/H] > 0) = 14 − 8 + 11 % versus P(DG∣[Fe/H] > 0) = 17.9 − 2.4 + 2.5 % . We also found a 2σ tension between our conditional rate and a 2x enhancement. We brought our results into closer agreement with M. L. Bryan & E. J. Lee by repeating our analysis with different planet definitions. For example, considering only CS planets with 1 ≤ M sin i ≤ 10 M ⊕ and DG planets with 0.5 ≤ M sin i ≤ 20 M J gives P(DG∣CS, [Fe/H] > 0) = 48 − 17 + 17 % and P(DG∣[Fe/H] > 0) = 21.8 − 2.7 + 2.9 % , consistent with a 2x enhancement. However, we find that this 2x enhancement is also present when we apply the same planet definitions to the overall sample, challenging the idea that metallicity is responsible. Our sample, though only ∼1/6 the size of M. L. Bryan & E. J. Lee, was assembled and analyzed self-consistently. The discrepancy between our findings and theirs may arise from a variety of sources, underscoring the need for large exoplanet surveys to overcome both small number statistics and sample inhomogeneities.

Linkage between empowerment, commitment and organizational citizenship behavior in Indian retail sector

Purpose The purpose of this paper is to determine the relationship between employee empowerment (structural empowerment [SE] and psychological empowerment [PE]), employee commitment (EC) and organizational citizenship behavior (OCB) within the unique context of a learning organization in the Indian retail sector. Design/methodology/approach The investigation was conducted using a survey-based questionnaire approach. Data were gathered from 222 frontline employees working in different retail stores in India. The researcher used AMOS 22.0 version and SPSS 22.0 version for the data analysis. Findings This study concluded that SE and PE have a positive and significant influence on OCB and EC. In addition, EC is a mediator between employee empowerment (SE and PE) and OCB. Research limitations/implications This research is built on cross-sectional data with a limited sample size, that is, 222 sample size. This study also offers some practical insights to managers of retail stores. Originality/value To the best of authors’ knowledge, this study is the first to empirically investigate the mediating role of EC between SE and OCB. By focusing on the interplay of these variables within a learning organization, this study sheds light on the mechanisms driving employee behavior and organizational dynamics in this rapidly evolving retail sector.

Factors Influencing Outcome After Shoulder Arthroplasty (FINOSA Study): Protocol of a Prospective Longitudinal Study With Randomized Group Allocation

Background There is an increasing need for evidence-based postoperative rehabilitation strategies to optimize patient outcome. Knowledge of potential prognostic factors could steer the development of rehabilitation protocols and could result in better treatment outcomes and higher patient satisfaction. Objective This study aimed to investigate which potential prognostic factors predict baseline shoulder pain and function and its evolution in the first 2 years following surgery, in patients with total shoulder arthroplasty. The secondary objective is to investigate which potential prognostic factors predict baseline quality of life and its evolution in the first two years following surgery. Methods To reach the aims of this project, a prospective longitudinal study, running from January 2020 to March 2025, will be carried out with a follow-up of 48 months. Patients will be randomized based on sling wear. We will study factors such as shoulder function, patient expectations, psychosocial factors, lifestyle factors, sling wear, soft tissue integrity, and physiotherapy treatment. Test moments will take place preoperatively, at 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Descriptive statistics will be used to describe the patient population characteristics. Based on literature review, expert opinion, and univariate analyses, potential prognostic factors will be chosen as covariates. A mixed regression model for repeated measures will be used to assess both the evolution of the Shoulder Pain and Disability Index within persons from baseline over time and the differences in evolution between participants. Correlation analyses will be used to investigate associations between the other outcome measures such as the Constant and Murley Score, shoulder range of motion, shoulder muscle strength, and proprioception, and the primary outcome measure, the Shoulder Pain and Disability Index score. Potential prognostic factors not included in the model will be presented in a descriptive manner. Results Data collection started in January 2020. In April 2023 the sample size was reached. Data collection will end in April 2025. Analyses will follow when data collection is completed. Conclusions Knowledge of potential prognostic factors will have implications toward better rehabilitation strategies of patients after total shoulder arthroplasty. Trial Registration ClinicalTrials.gov NCT04258267; https://clinicaltrials.gov/study/NCT04258267 International Registered Report Identifier (IRRID) DERR1-10.2196/56522

A Novel Nutraceutical Gummy for Hair Regrowth in Women: A Case Series

Introduction:Hair loss is a common concern among women, with female pattern hair loss (FPHL) and telogen effluvium (TE) being the most prevalent types. At least 50% of women experience hair loss by age 50 [1]. Many patients turn to nutritional supplements, with one hair loss clinic reporting that up to 81% of their patients use supplements [2]. While various nutraceuticals have demonstrated clinical efficacy in hair regrowth [2], none have been evaluated in gummy form. This case series aims to assess the efficacy of a novel nutraceutical gummy containing a proprietary blend of NAD, pumpkin seed extract, taurine, pea protein, ashwagandha, saw palmetto, and other anti-inflammatory ingredients in promoting hair regrowth in women with FPHL and TE. Procedure:Three women, aged 43, 52,64, with diagnoses of FPHL and TE, were included in this series. Each participant consumed two nutraceutical gummies daily for 2 or 3 months. One participant experiencing TE, also took oral minoxidil 1.25 mg daily. Baseline assessments included patient-reported outcomes related to hair shedding and photographic comparisons. Follow-up assessments were performed at 2 or 3 months. Results:All three women demonstrated noticeable improvements in hair density and a reduction in hair shedding by the 3-month mark. Participants also reported subjective improvements in hair quality, volume, and overall satisfaction with the product. No adverse effects were observed during the study period. Conclusion:This case series suggests that the novel nutraceutical gummy may be an effective, well-tolerated option for promoting hair regrowth in women with FPHL and TE. This nutraceutical can be efficacious as a sole treatment and in conjunction with traditional hair loss medical therapy. These findings highlight the potential for a gummy formulation to provide an accessible, evidence-based treatment for hair loss. Further studies with larger sample sizes are ongoing to validate these results.

Pretreatment plasma vitamin D and response to neoadjuvant chemotherapy in breast cancer: evidence from pooled analysis of cohort studies

Background: Biological evidence has revealed anti-tumor effect of vitamin D, but whether it could predict the response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients remains inconclusive. The aim was to investigate the association between pretreatment vitamin D level and response to NAC and subsequent survival outcomes in BC patients. Materials and Methods: We systematically searched the Medline, Embase, Cochrane Library and Web of Science databases and clinical trial registries to identify relevant articles from inception to October 8, 2024. Eligible studies investigating the associations between pretreatment plasma vitamin D and response to NAC in BC patients were selected according to the predefined criteria, with the study characteristics extracted by two reviewers. The primary outcome was pathological complete response (pCR), while overall pathological response and event-free survival (EFS) were adopted as secondary outcomes. Summary effect estimates of odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Subgroup and sensitivity analyses were performed based on study characteristics and methodological quality. Results: Six retrospective cohort studies involving 1,291 BC patients were included. We observed a significant association between pretreatment vitamin D deficiency and 50% increased odds of non-pCR after NAC (OR=1.50, 95%CI 1.11-2.03, P=0.008) with no heterogeneity (I2=0%). We also identified a significant association of vitamin D with overall pathological response (OR=1.33, 95%CI 1.01-1.75, P=0.046). A similar association with EFS (HR=1.27, 95%CI 0.92-1.75, P=0.139) was also noted although the effect estimate was not statistically significant. Sensitivity analyses based on methodological quality showed consistent findings. Conclusion: Pretreatment vitamin D deficiency is associated with an inferior response to NAC in BC patients. Our meta-analysis advocates further prospective studies with large sample sizes before vitamin D supplementation could be administered to improve NAC response and subsequent prognosis of BC patients.

Determination of sample size and design of final product control plan based on product types

Determination of sample size and design of final product control plan based on product types

Exploring sexual dimorphism through palatal rugae analysis in the Javanese population of Surabaya, Indonesia

This study investigates the potential of palatal rugae patterns as a tool for sex estimation in the Javanese population of Surabaya, Indonesia. Palatal rugae on the anterior part of the maxillary mucosa exhibit unique characteristics that make them valuable for forensic identification. Through a cross-sectional study involving 60 Javanese individuals, the research examines the prevalence of various palatal rugae patterns and their correlation with sex. Results indicate significant distinctions in rugae patterns between males and females, particularly in diverging, converging, and circular patterns. A discriminant function analysis is employed to establish an equation for sex estimation using palatal rugae patterns specific to the Javanese population. Overall, the study suggests that palatal rugae patterns hold promise as a supplementary method for sex estimation in forensic science, though further research with larger sample sizes is recommended for conclusive results.

Diagnostic ability of salivary TNF-α and RANKL to differentiate periodontitis from periodontal health (case-control study)

Background Periodontitis is a chronic inflammation affecting the tooth-supporting periodontal tissues. It is diagnosed by measuring periodontal parameters. However, documenting this data takes effort and may not discover early periodontitis. Biomarkers may help diagnose and assess periodontitis. This study aimed to evaluate the potential diagnostic of the salivary tumor necrosis factor-α (TNF-α) and receptor-activator of nuclear factor ĸ-B-ligand (RANKL) in distinguishing between periodontitis and healthy periodontium. Methods The selected sample size consisted of 88 subjects; it was divided into two groups: 44 subjects in the periodontitis group and 44 subjects in the healthy group. Unstimulated salivary samples were collected from participants. Demographic data and clinical periodontal parameters were recorded. ELISA was used for the quantification of levels of TNF-α and RANKL. Results Both TNF-α and RANKL concentrations showed statistically significant differences when comparing healthy to periodontitis (p < 0.01). The sensitivity of RANKL was found to be perfect (1.00), while its specificity was high (0.92) and the area under curve (AUC) was 0.985. On the other hand, TNF-α displayed high sensitivity (0.976) and good specificity (0.893), with an AUC of 0.973. Conclusion Salivary RANKL and TNF-α showed high diagnostic precision and hold potential as helpful instruments for the timely identification and distinction of periodontal diseases (PDs), presenting opportunities for enhanced management of PD and patient welfare.

Pilot study utilizing short contact protocols for treatment of actinic keratoses (AK) with ALA gel-red light photodynamic therapy (PDT)

Background: Red light photodynamic therapy (PDT) is an effective option for actinic keratosis (AK) lesions. However, stinging pain during illumination limits utility. Objective: To compare three modified red-light PDT regimens (short incubation, whole-face application, no occlusion) and to determine whether these can reduce pain yet still provide significant AK lesion clearance. Methods: Patients in this randomized clinical trial (n = 30) were randomized into one of three groups [incubation with 10% ALA gel, illumination with red-light]: Group A: 10 min, 20 min (75 J/cm2); Group B: 20 min, 10 min (37 J/cm2); Group C: 1 hour, 10 min (37 J/cm2). Two PDT treatments were administered 8 weeks apart. Lesions were counted at each visit, and pain was recorded on a scale from 0 – 10. Results: Patients Groups A and B (shorter incubations) experienced significantly less pain during illumination than Group C. After one treatment, the AK lesion reduction in Group A (59%) was statistically non-inferior to Group C (43%), with a noninferiority margin of ±15%. Final lesion counts after two PDT treatments showed a reduction from baseline by 82% in Group C, 76% in Group A, and 74% in Group B. Groups A and B did not meet the statistical non-inferiority endpoint relative to Group C after two treatments. Limitations: Small sample size, which limited the ability to reach statistical significance after 2 PDT treatments. Conclusion: Two short/modified red light PDT regimens were essentially painless, and all three provided AK lesion clearances comparable to conventional regimens.

Role of Cooperative Leadership in Driving Technological Innovation for Sustainable Solutions

This paper examines the critical role of leadership in fostering technological innovation within cooperatives, drawing from multiple recent studies across diverse sectors. The researcher set to determine the role of cooperative leadership in driving technological innovation and to evaluate how such leadership can facilitate the development and implementation of sustainable solutions within cooperative organizations. Descriptive survey research design was adopted for the study. To guide this study, research questions and hypothesis were formulated in line with the objectives of the study. The study was anchored on Diffusion of Innovations (DOI) Theory because of its relatedness. The instrument for data collection was a structured questionnaire. The sample size of the study was 150 selected cooperative leaders, cooperative members and external stakeholders in Awka South Local Government. Data collected were analyzed using both quantitative and qualitative methods. Inferential statistics such as chi-square tests was used to test the hypotheses. The findings revealed that there is a 5 % significant effect between strategic Cooperative leadership and technological innovation that can foster sustainable solutions within the Cooperative organization with a critical value of 5.991. The study therefore, recommends that cooperatives can strengthen their leadership capabilities, adopt innovative technologies, and achieve sustainable growth while remaining aligned with their core values.

Interactive math comics: An analysis of Indonesian and Spanish students’ responses

This study investigates the responses of Indonesian and Spanish students to the use of interactive mathematics comics in their education. The research aims to see the practicality of these comics on student engagement, comprehension, and retention of mathematical concepts across different cultural contexts. Using a quantitative approach, the study analyzes data through normality and homogeneity tests to ensure the reliability and consistency of responses. Results show that Indonesian and Spanish students respond positively to interactive mathematics comics, demonstrating increased motivation and interest. However, cultural differences significantly influence the perception of specific indicators such as content quality, technical quality, and language usage. Indonesian students, who are generally accustomed to traditional teaching methods, found the comics engaging and helpful in understanding complex concepts. On the other hand, Spanish students, who are more familiar with interactive and student-centered learning, showed mixed responses depending on their educational experiences and expectations. Despite these differences, both groups recognized the value of interactive comics as a supplementary educational tool. Future research could explore a larger and more diverse sample size, including longitudinal studies to assess the sustained impact of such tools and further investigate the integration of other multimedia elements like augmented reality to enhance interactivity. From these results, the Mathematics Comic on Cartesian coordinates material developed is practical and can be used in mathematics learning. This is because the Mathematics Comic on Cartesian coordinates material received a good response, and students hope that learning mathematics will be more fun and effective.

A systematic review of techniques and clinical evidence to adopt virtual reality in post-stroke upper limb rehabilitation

AbstractRecognizing the limitations of traditional therapy can be tedious and demotivating, we explore VR’s dynamic and immersive environment to potentially improve patient engagement and motivation. This approach promises accelerated recovery by integrating real-time feedback and progress monitoring. This study aims to compare various VR training techniques employed for upper limb rehabilitation in stroke survivors. We have followed the PRISMA guidelines for systematic reviews. Articles were filtered with title words such as “virtual reality rehabilitation”, “rehabilitation”, “upper limb”, “lower limb”, “interactive gaming system”, and “VR based games” were searched in databases (LILACS, PUBMED, IEEE, WoS, and Scopus). Articles published between 2005 and 2021 were analyzed. There were 820 articles found, but only the most relevant 96 papers were analyzed. Most of the studies were randomised controlled trials (RCTs) that were submitted in 2014 or beyond. The sample size ranged from 5 to 96 persons with chronic stroke, or adults and seniors. There were no samples analyzed for those under the age of 18. Nintendo Wii® and Microsoft’s Kinect were the most popular video gaming systems. In most of the publications, the intervention took place 2–3 sessions per week, for about 2–12 weeks, with each session lasting 30 to 60 min. The most assessed outcomes were body steadiness, upper extremity motor capabilities, daily tasks, and quality of life. The Fugl–Meyer Assessment was one the commonly used tool for measuring outcomes. After VR therapy, the research found that quality of life, dynamic steadiness, and upper extremity movement function improved. To achieve dynamic equilibrium, VR proved more beneficial than traditional treatments. The most important outcomes, the researchers focused, were day-to-day activity and physical movements of the patients. Some studies investigated the early consequences of VR on daily activities and social involvement.

Real-World Switch Rates of Risankizumab and Other Biologics in Psoriasis Patients With Psoriatic Arthritis

Background: Psoriatic patients often experience issues with lack of therapeutic efficacy and intolerance, which may result in high levels of treatment switching. This study examined real-world, 12-month switch rates and patient characteristics associated with treatment switching in patients with both PsO and PsA treated with risankizumab and other biologics. Methods: This analysis used the Merative MarketScan® Databases (2016–2024) to identify adults from the US who had ≥2 medical claims for PsO, 1 claim for PsA and did not have any other autoimmune condition in the 6 months pre- and post-index period. Patients must have initiated a PsO-approved biologic and have continuous insurance benefits for ≥6 months before and ≥12 months after the biologic initiation date. Switch rates were defined as the proportion of patients who switched to a new biologic or advanced oral in the 12-month follow-up after treatment initiation. Discontinuation and non-adherence were not included in the switch definition. Switch rates were compared between biologics with sufficient sample size (n 100). Univariate logistic regression analyses were conducted to compare switch rates for risankizumab versus other biologics. Multivariate logistic regression analyses were performed to examine the impact of baseline demographic and treatment characteristics on switch rates and determine predictors of switching. Results: Among 3032 patients, mean age at baseline was 47.4 (SD 10.78) years and 55.4% were female. Overall treatment switch rate at 12-month follow-up was 24.9% (756/3032). Of those treatments with sufficient sample size, patients receiving risankizumab had the lowest switch rate (7.3%; 15/206) compared to all other biologics, including other IL-23 inhibitors (guselkumab 16.7%, P=0.0029), IL-17 inhibitors (ixekizumab 22.4%, P<0.0001; secukinumab 23.7%, P<0.0001), TNF inhibitors (adalimumab 28.3%, P<0.0001; etanercept 35.8%, P<0.0001), and IL-12/23 inhibitors (ustekinumab 22.4%, P<0.0001). Results were similar in multivariate logistic regression analyses after adjusting for variations in baseline characteristics. Predictors of switching at 12 months included female sex (adjusted odds ratio [aOR] [95% CI]: 1.63 [1.36, 1.94]; P<0.0001), baseline anxiety or depression (aOR [95% CI]: 1.47 [1.21, 1.80]; P=0.0001), baseline major adverse cardiovascular event (aOR [95% CI]: 1.47 [1.15, 1.88]; P=0.0023), and prior targeted immunomodulator (TIM) use (aOR [95% CI]: 1.45 [1.20, 1.74]; P=0.0001). Conclusion: In a real-world setting, switching was common among psoriasis patients with PsA. Risankizumab showed the lowest rate of treatment switching at 12 months, compared with all other biologics. Sex, comorbidities, and prior TIM use were predictors of higher switch rates.

Nonparametric estimation of the cumulative incidence function for doubly-truncated and interval-censored competing risks data.

Interval sampling is widely used for collection of disease registry data, which typically report incident cases during a certain time period. Such sampling scheme induces doubly truncated data if the failure time can be observed exactly and doubly truncated and interval censored (DTIC) data if the failure time is known only to lie within an interval. In this article, we consider nonparametric estimation of the cumulative incidence functions (CIF) using doubly-truncated and interval-censored competing risks (DTIC-C) data obtained from interval sampling scheme. Using the approach of Shen (Stat Methods Med Res 31:1157-1170, 2022b), we first obtain the nonparametric maximum likelihood estimator (NPMLE) of the distribution function of failure time ignoring failure types. Using the NPMLE, we proposed nonparametric estimators of the CIF with DTIC-C data and establish consistency of the proposed estimators. Simulation studies show that the proposed estimator performs well for finite sample size.

The effect of ischemic preconditioning on the cardiac autonomic nervous system after exercise: A systematic review and meta-analysis

Aims: The objective of this study is to comprehensively evaluate the influence of ischemic preconditioning intervention on the autonomic control nerves of athletes during the post-exercise period. Methods: Randomized controlled trials (RCTs) were sourced from PubMed, Web of Science, Embase, Wipo, CNKI, and Cochrane databases, covering the period from inception to December 2023. The quality of the included RCTs was evaluated using the Cochrane Risk Assessment Tool, and a systematic assessment was conducted using RevMan 5.3. Results: Seven randomized controlled trials (RCTs) involving 88 subjects were included in the analysis. The meta-analysis indicated that ischemic preconditioning significantly improved heart rate during both short-term recoveries (mean difference [MD] = -3.99, 95% confidence interval [CI]: -5.93 to -2.05, p < 0.00001) and long-term recovery post-exercise (MD = -9.73, 95% CI: -12.74 to -6.73, p < 0.00001). However, there was no significant effect observed on resting state heart rate variability (HRV) or peak heart rate (HR peak) at the end of exercise (MD = -0.16, 95% CI: -2.46 to 2.14, p = 0.89). Conclusion: Ischemic preconditioning facilitates the prompt reactivation of cardiac parasympathetic nerves following exercise and enhances both short-term and long-term heart rate recovery. The extent of this recovery effect may be influenced by factors such as the dosage of the intervention, the individual’s training level, and the intensity of the exercise performed. Limitation: Given the limited number of included studies, the small sample size, and the unclear definition of some experimental procedures, it is essential to design more rigorous and comprehensive high-quality randomized controlled trials (RCTs) in the future to investigate the effects of ischemic preconditioning on cardiac autonomic control nerves following exercise. Registration: INPLASY202440069

Aromatic Serenity: How Lavender Eases Stress and Anxiety - A Literature Review

In today's fast-paced society, rising stress levels necessitate effective management strategies. While pharmacological treatments are common, their side effects have spurred interest in alternative therapies, particularly those rooted in natural remedies. Lavender (Lavandula angustifolia), long esteemed for its calming properties, has emerged as a promising non-pharmacological option. Historical use in herbal medicine for anxiety and stress-related disorders has inspired modern scientific research to explore its potential. This review synthesizes recent studies on lavender essential oil, examining its mechanisms—such as neurotransmitter modulation—and its effectiveness in diverse settings, from reducing stress among healthcare professionals to improving sleep quality. Despite promising results, limitations like small sample sizes and variability in application methods highlight the need for more rigorous research to establish lavender's efficacy and optimize its therapeutic use in stress management and mental health care.