Small Sample Size Research Articles

Online Eye Tracking for Aphasia: A Feasibility Study Comparing Web and Lab Tracking and Implications for Clinical Use.

Studies using eye-tracking methodology have made important contributions to the study of language disorders such as aphasia. Nevertheless, in clinical groups especially, eye-tracking studies often include small sample sizes, limiting the generalizability of reported findings. Online, webcam-based tracking offers a potential solution to this issue, but web-based tracking has not been compared with in-lab tracking in past studies and has never been attempted in groups with language impairments. Patients with post-stroke aphasia (n=16) and age-matched controls (n=16) completed identical sentence-picture matching tasks in the lab (using an EyeLink system) and on the web (using WebGazer.js), with the order of sessions counterbalanced. We examined whether web-based eye tracking is as sensitive as in-lab eye tracking in detecting group differences in sentence processing. Patients were less accurate and slower to respond to all sentence types than controls. Proportions of gazes to the target and foil picture were computed in 100ms increments, which showed that the two modes of tracking were comparably sensitive to overall group differences across different sentence types. Web tracking showed comparable fluctuations in gaze proportions to target pictures to lab tracking in most analyses, whereas a delay of approximately 500-800ms appeared in web compared to lab data. Web-based eye tracking is feasible to study impaired language processing in aphasia and is sensitive enough to detect most group differences between controls and patients. Given that validations of webcam-based tracking are in their infancy and how transformative this method could be to several disciplines, much more testing is warranted.

Infertility treatments and risk of breast benign diseases: a case‒control study

BackgroundTheoretically, endocrine fluctuations occurring during infertility treatments, including ovulation induction (OI) and assisted reproductive techniques (ART), could be associated with an increased risk of benign breast diseases (BBDs). To date, no studies have been conducted on this association. Therefore, the present study investigated the association between different types of infertility treatments and BBDs.MethodsThis case‒control study was conducted in Arash Women’s Hospital, Tehran, Iran. The case group included infertile women diagnosed with BBDs without atypia, and the control group included infertile women without breast disease. Breast imaging studies (mammography/ultrasound) were performed for BBD screening, and the diagnosis was confirmed by histopathological examination. Study variables were collected retrospectively from medical records, hospital databases, and questionnaires.ResultsFinally, 154 infertile women, including 50 cases (BBDs) and 104 controls (no BBDs), were compared. Our data showed that 66% of cases and 61.4% of controls had undergone at least one course of infertility treatment. There was no association between BBD risk and previous infertility treatments (OR = 1.21; 95% CI = 0.59–2.46), ART (OR = 1.14; 95% CI = 0.90–1.44), or OI cycles (OR = 1.13; 95% CI = 0.98–1.32). Stratification by confounding variables did not change these results.ConclusionsIt seems that there is no association between BBDs in infertile women and the type, duration, or number of prior infertility treatments; however, considering the small sample size of the study, the clinical significance of this finding should not be neglected. Therefore, we consider it essential to carry out more extensive, detailed, and prospective studies to distinguish the association of BBDs with different infertility treatments and medications.

Multimodal Co-Attention Fusion Network With Online Data Augmentation for Cancer Subtype Classification.

It is an essential task to accurately diagnose cancer subtypes in computational pathology for personalized cancer treatment. Recent studies have indicated that the combination of multimodal data, such as whole slide images (WSIs) and multi-omics data, could achieve more accurate diagnosis. However, robust cancer diagnosis remains challenging due to the heterogeneity among multimodal data, as well as the performance degradation caused by insufficient multimodal patient data. In this work, we propose a novel multimodal co-attention fusion network (MCFN) with online data augmentation (ODA) for cancer subtype classification. Specifically, a multimodal mutual-guided co-attention (MMC) module is proposed to effectively perform dense multimodal interactions. It enables multimodal data to mutually guide and calibrate each other during the integration process to alleviate inter- and intra-modal heterogeneities. Subsequently, a self-normalizing network (SNN)-Mixer is developed to allow information communication among different omics data and alleviate the high-dimensional small-sample size problem in multi-omics data. Most importantly, to compensate for insufficient multimodal samples for model training, we propose an ODA module in MCFN. The ODA module leverages the multimodal knowledge to guide the data augmentations of WSIs and maximize the data diversity during model training. Extensive experiments are conducted on the public TCGA dataset. The experimental results demonstrate that the proposed MCFN outperforms all the compared algorithms, suggesting its effectiveness.

Implementing a stabilizing intervention for traumatized refugees in temporary accommodations in South-West Germany - a randomized controlled pilot trial

The prevalence of trauma-related disorders, such as post-traumatic stress disorder (PTSD), as well as depressive or anxiety disorders, are significantly increased in refugees compared to the general population. This is due to the high risk of burdening and potentially traumatic experiences before, during and after their flight. However, the treatment options for these mental illnesses are significantly limited due to the legal uncertainties surrounding the asylum procedure as well as language and cultural barriers. In this study, a randomized controlled pilot trial was conducted to assess the effectiveness of self-applied audio-based mindfulness and guided imagery techniques for refugees with symptoms of post-traumatic stress disorder living in temporary accommodations. The symptom burden of PTSD, depression, and anxiety symptoms, as well as perceived stress and emotional state was assessed using the PC-PTSD-5, PHQ-4, Self-Assessment Manikin, and Stress Thermometer. N=32 refugees were included in the intervention study, n=24 participants completed the study. The audio-based mindfulness and guided imagery techniques were presented to n =17 refugees in the intervention group between T1 and T2 over 4 weeks; n=15 refugees from the waiting list control group received the audio-files 6 weeks after follow-up. Efficacy was evaluated using a mixed analysis of variance. There were no significant changes in the symptoms of post-traumatic stress disorder, depression and anxiety disorder. Moreover, no changes were observed in the level of perceived stress or emotional state. Only few participants used the exercises in self-administered application during the study period. This was mainly due to the stressors of the post-migratory phase, such as job search or worries about residence status. Due to the self-administered nature of the intervention, common factors, such as therapeutic alliance or expectations regarding the intervention’s effectiveness, had minimal influence and did not contribute to the sustained use of the exercises. Additionally, regarding the life circumstances of refugees in temporary shelters, the intervention intensity may not have been sufficient to have a significant impact on the examined symptom burden. Small sample size and limited use of the exercises limit the reliability of the results.Clinical trial registrationhttps://drks.de/search/de/trial/DRKS00022862 Deutsches Register Klinischer Studien identifier, DRKS00022862.

Combining Negative Pressure Wound Therapy with Shoelace Technique for Effective Closure of Soft Tissue Defect: A Case Series

This study investigates a novel approach to wound management that combines negative pressure wound therapy (NPWT) with the shoelace technique for closure of soft tissue defects. We retrospectively reviewed three cases treated between August 2022 and January 2023, where NPWT combined with the shoelace technique facilitated effective wound closure without general anesthesia. This approach shows significant potential in managing various wound etiologies, including pressure ulcers, postoperative dehiscence, and soft tissue defects resulting from hematomas. The outcomes demonstrated promising healing with minimal complications, suggesting a viable alternative for patients unable to undergo traditional surgical procedures. Despite the study’s limitations, such as a small sample size and subjective clinical judgments, the results advocate for further research and standardization of this technique.

Perceptions of Cognitive Load and Workload in Nurse Handoffs: A Comparative Study Across Differing Patient-Nurse Ratios and Acuity Levels.

Medical errors, often resulting from miscommunication and cognitive lapses during handoffs, account for numerous preventable deaths and patient harm annually. This research examined nurses' perceived workload and cognitive load during handoffs on hospital units with varying patient acuity levels and patient-nurse ratios. Conducted at a southeastern US medical facility, the study analyzed 20 handoff dyads using the National Aeronautics and Space Administration Task Load Index to measure perceived workload and cognitive load. Linear regressions revealed significant associations between patient acuity levels, patient-nurse ratios, and National Aeronautics and Space Administration Task Load Index subscales, specifically mental demand (P = .007) and performance (P = .008). Fisher exact test and Wilcoxon rank sum test showed no significant associations between these factors and nurses' roles (P > .05). The findings highlight the need for targeted interventions to manage workload and cognitive load, emphasizing standardized handoff protocols and technological aids. The study underscores the variability in perceived workload and cognitive load among nurses across different units. Medical-surgical units showed higher cognitive load, indicating the need for improved workload management strategies. Despite limitations, including the single-center design and small sample size, the study provides valuable insights for enhancing handoff communications and reducing medical errors.

The Effect of Women’s Role on Board, ESG Performance, and Tax Avoidance

This research examines the impact of board gender diversity on tax avoidance, with ESG performance as an intervening variable. Using 87 non-financial companies listed on the Indonesia Stock Exchange (IDX) with ESG scores from Thomson-Reuters ASSET4 during the 2017-2019 period, the study reveals that board gender diversity significantly influences tax avoidance, indicating that diversity does not improve tax compliance. The male-dominated boards in Indonesia limit the effectiveness of monitoring corporate activities, including tax avoidance. Additionally, gender diversity negatively affects ESG performance, suggesting that the small number of women on boards diminishes efforts to enhance sustainability. ESG performance does not mediate the relationship between gender diversity and tax avoidance, though it can reduce tax avoidance when transparency in ESG reporting is increased. Limitations include a small sample size and data restricted to the 2017-2019. Future studies could explore alternative tax avoidance measures and other corporate governance factors.

Optimization of Long Line Management in Seaweed Farming: Strategies for Increasing Farmers' Group Income in Pinrang Regency, Indonesia

This research aims to explore the role of the long-line method in increasing the income of seaweed farmers in Pinrang Regency, South Sulawesi, Indonesia, while examining the challenges they face and the strategies they employ to overcome them. The study employs a qualitative case study approach, involving 15 seaweed farmers from various coastal villages within Pinrang Regency, representing diverse demographic backgrounds and experiences. Data collection was conducted through semi-structured interviews, allowing for an in-depth understanding of the participants' farming practices and challenges. The findings indicate that seaweed farmers increase their income by optimizing resources, collaborating within farmer groups, and adapting to environmental and market changes. Strategies such as space optimization, material reuse, and knowledge sharing among farming communities significantly enhance productivity and sustainability. Furthermore, farmers employ adaptive techniques to mitigate environmental risks and market volatility, including using durable materials and processing seaweed into higher-value products. The implications of these findings are crucial for policymakers and development organizations, as they highlight the potential of sustainable farming practices in improving the livelihoods of coastal communities. Policymakers are encouraged to develop support programs that promote resource optimization, foster community-driven farming networks, and train farmers in adaptive strategies. However, the study's limitations, including the small sample size and reliance on self-reported data, may affect the generalizability of the results. Future research should incorporate larger, more diverse samples and objective measures to enhance the robustness of the findings, and explore the long-term impacts of the long-line method on income and sustainability.

Adding Metastasis-Directed Therapy to Standard-of-Care Systemic Therapy for Oligometastatic Breast Cancer (EXTEND): a Multicenter, Randomized Phase II Trial

PurposePrior evidence suggests a progression-free survival (PFS) benefit from adding metastasis-directed therapy (MDT) to standard-of-care (SOC) systemic therapy for patients with some oligometastatic solid tumors. Randomized trials testing this hypothesis in breast cancer have yet to be published. We sought to determine whether adding MDT to SOC systemic therapy improves PFS in oligometastatic breast cancer. MethodsEXTEND is a multicenter phase II randomized basket trial testing the addition of MDT to SOC systemic therapy in patients with ≤5 metastases (NCT03599765). Patients were randomized 1:1 to MDT (definitive local treatment to all sites of disease, plus SOC systemic therapy) or to SOC systemic therapy only. Primary endpoint was PFS, and secondary endpoints included overall survival (OS), time to subsequent line of systemic therapy, and time to the appearance of new metastases. Exploratory analyses included quality of life (QOL) and systemic immune response measures. ResultsFrom September 2018 through July 2022, 22 and 21 patients were randomized to the MDT and no-MDT arms, respectively. At a median follow-up of 24.8 months, PFS was not improved with the addition of MDT to SOC systemic therapy (median PFS 15.6 months MDT vs 24.9 months no-MDT [hazard ratio {HR} 0.91; 95% CI 0.34–2.48, p=0.86]). Similarly, MDT did not improve OS, time to subsequent line of systemic therapy, or time to the appearance of new metastases (all p>0.05). No significant differences were found in QOL measures, systemic T-cell activation, or T-cell stimulatory cytokine concentration. ConclusionAmong patients with oligometastatic breast cancer, the addition of MDT to SOC systemic therapy did not improve PFS. These findings suggest that MDT may have no systemic benefit in otherwise unselected oligometastatic breast cancer patients, although this trial was limited by a heterogenous and small sample size and overperformance of both treatment arms.

Small-sample cucumber disease identification based on multimodal self-supervised learning

It is difficult and costly to obtain large-scale, labeled crop disease data in the field of agriculture. How to use small samples of unlabeled data for feature learning has become an urgent problem that needs to be solved. The emergence of self-supervised contrastive learning methods and self-supervised mask learning methods can solve the problem of missing labels on the training data. However, each of these paradigms comes with its own advantages and drawbacks. At the same time, the features learned by dataset in a single modality are limited, ignoring the correlation with other modal information. Hence, this paper introduced an effective framework for multimodal self-supervised learning, denoted as MMSSL, to address the task of identifying cucumber diseases with small sample sizes. Integrating image self-supervised mask learning, image self-supervised contrastive learning, and multimodal image-text contrastive learning, the model can not only learn disease feature information from different modalities, but also capture global and local disease feature information. Simultaneously, the mask learning branch was enhanced by introducing a prompt learning module based on a cross-attention network. This module aided in approximately locating the masked regions in the image data in advance, facilitating the decoder in making accurate decoding predictions. Experimental results demonstrate that the proposed method achieves a 95% accuracy in cucumber disease identification in the absence of labels. The approach effectively uncovers high-level semantic features within multimodal small-sample cucumber disease data. GradCAM is also employed for visual analysis to further understand the decision-making process of the model in disease identification. In conclusion, the proposed method in this paper is advantageous for enhancing the classification accuracy of small-sample cucumber data in a multimodal, unlabeled context, demonstrating good generalization performance.

Chemical neurolysis of genicular nerves for chronic non-cancer knee pain: A scoping review.

Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse effects and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. Scoping review. All clinical and research settings. Adult participants with chronic non-cancer knee pain undergoing chemical neurolysis of genicular nerves. A literature search in MEDLINE, EMBASE and Cochrane Library was conducted up to 4 September 2023. Articles were searched via terms and keywords relating to "knee", "pain", "knee osteoarthritis", "ablation", "alcohol", "phenol" and "chemical neurolysis". Included articles were full text primary studies and in English. Data was extracted using an electronic database by 2 independent reviewers. There were 8 studies included in this review (including 1 randomized controlled trial), comprising 192 patients. There were 4 studies that used phenol, 3 studies that used alcohol, and 1 study that used either alcohol or phenol for chemical neurolysis. Both fluoroscopy and/or ultrasound guidance were utilized for nerve target identification. All studies demonstrated that chemical neurolysis resulted in improved pain and/or functional outcomes, with no serious adverse events reported. Chemical neurolysis of the genicular nerves is a promising treatment strategy for chronic knee pain. Interpretation of the available studies are limited by study heterogeneity and small sample sizes. High-quality randomized controlled trials are required to clarify the selection of appropriate nerve targets, choice of image guidance, and to compare with other ablative modalities.

Death awareness and psychological resilience in adults aged 50 plus

This study examines the relationship between death awareness and psychological resilience in adults aged 50 and above, focusing on the roles of religious activity, recent death experiences, and educational background. A total of 52 participants completed surveys measuring death awareness (TBS-5) and resilience (RS-10). Results indicated that religiously active individuals reported significantly lower death anxiety and higher resilience compared to non-religious participants. Additionally, individuals who had experienced the death of a loved one in the past 12 months showed a tendency toward greater openness in discussing death. No significant effects were found for educational background. While the small sample size limits the generalizability of the findings, the study highlights the importance of religious and experiential factors in shaping attitudes toward mortality and offers practical implications for end-of-life care and counseling. The results also suggest that fostering open dialogue about death and enhancing spiritual support may increase psychological resilience among older adults.

The Cytological Diagnosis of a Malignant Effusion Is Independent of the Volume of Fluid Processed.

The relationship between pleural fluid volume and cytological diagnosis of malignancy has been often investigated with conflicting conclusions on whether or not a minimum fluid volume should be defined. The primary objective of this retrospective investigation is to evaluate the relationship between fluid volume and cytological diagnosis of malignancy. A total of 511 body fluid specimen reports received between January 2018 and December 2019 were examined to investigate the relationship between diagnosis of malignancy to volume and biochemical properties. Pleural fluid (n = 252) and peritoneal fluid (n = 250) specimens were binned into two volume groups (< 75 mL, ≥ 75 mL). Pericardial fluid specimens (n = 9) were excluded due to small sample size. Prevalence of malignancy for pleural and peritoneal fluids was 20.2% and 20.08%, respectively, with no significant difference between the two volume groups. Malignant pleural effusions were associated with a serum to fluid protein ratio > 0.5 and malignant peritoneal effusions were associated with a serum ascites albumin gradient (SAAG) < 1.1 g/dL. Our study did not find a significant difference in the diagnosis of malignancy between volumes ≥ 75 mL and < 75 mL in either pleural or peritoneal fluid. Fluid volume is, therefore, not an adequacy criterion for detecting malignancy in either pleural or peritoneal fluid. Our analysis on the biochemical properties of each malignant fluid type was supportive of current use of Light's criteria and SAAG for effusion fluid evaluation.

A goodness-of-fit measure for logistic regression under separation

Logistic regression models have a severe problem called separation. The maximum likelihood estimator does not exist in logistic regression models for data structures under separation. Under separation, the forcibly estimated maximum likelihood estimate may have an extremely large value. Separation often occurs when the size of dataset is small. Consequently, goodness-of-fit measures based on the likelihood ratio and those based on covariance functions using the maximum likelihood estimate indicate that the model is excessively good regardless of the cause of the separation. The Firth and exact logistic regression methods are valid estimation methods for separation problems. Therefore, we propose methods to reasonably evaluate the goodness-of-fit measures of statistical models under separation with dataset of a small sample size with the abovementioned methods. The goodness-of-fit measures based on covariance functions which are a generalization of the multiple correlation coefficient, referred to as the regression correlation coefficient and the entropy coefficient of determination are then used combined with the abovementioned methods for the separation data. In addition, we conducted a data analysis using the definition of the non separation ratio based on the regression depth.

The contribution of public libraries in strengthening digital citizenship in Egyptian society – an exploratory study

Purpose This study aims to assess the involvement of Egyptian public libraries in supporting digital citizenship and propose a vision to leverage their role in promoting digital citizenship culture, aligning with Egypt Vision 2030 for sustainable development. Design/methodology/approach A questionnaire was used to sample 21 public library managers in Egypt. The study adopted a descriptive-analytic approach, measuring library readiness infrastructure, strategic planning for digital citizenship support and participation ratings on nine dimensions of digital citizenship as defined by the Ribble model. Findings Results indicated a moderate level of participation overall (average score of 1.72), with high levels in dimensions like digital access and digital literacy but much lower levels in others, particularly digital law and digital health and safety. Library readiness was found to have a positive effect on the level of digital citizenship promotion. Research limitations/implications The small sample size may limit generalizability. Future research should explore best practices for digital citizenship programming in libraries and strategies for overcoming implementation barriers. Practical implications The study underscores the need for Egyptian public libraries to enhance their readiness and participation in promoting digital citizenship. This requires investment in digital resources, staff training, community outreach and collaboration with educational institutions and community partners. Originality/value This study provides insights into the role of public libraries in promoting digital citizenship in the context of a developing country’s national vision. It offers a framework for libraries worldwide to assess and enhance their digital citizenship initiatives.

Open Reduction and Internal Fixation Is a Feasible Alternative to Femoral Revision Arthroplasty in Geriatric Patients with Vancouver B2/3 Type Periprosthetic Fractures: A Study Analyzing In-Hospital Outcomes

Purpose: The surgical management of periprosthetic femoral fractures is particularly challenging in geriatric patients due to physiological limitations. The choice between open reduction and internal fixation (ORIF) and hip revision arthroplasty for treating Vancouver B2 and B3 fractures remains controversial. This study aims to contribute further evidence by analyzing the in-hospital outcomes in geriatric patients with Vancouver B2/3 fractures. Methods: This retrospective study analyzed 133 patients treated for Vancouver B2/3 fractures at a level I trauma center from 2017 to 2023. Data were collected on preclinical characteristics, comorbidities, Vancouver classification, surgery-related parameters, and postoperative outcomes for an age- and gender-matched analysis. A subgroup analysis was also conducted on patients classified as American Society of Anesthesiologists (ASA) class 3 and 4. Results: Among the 133 patients, 85 suffered Vancouver B2 fractures and 48 Vancouver B3 fractures. Age-and-gender-matched analysis revealed that ORIF was more commonly performed in patients with higher ASA grades. A subgroup analysis of ASA 3 and 4 patients and an age-and-gender-matched analysis showed that ORIF resulted in shorter operation times and less blood loss. No significant differences were found in mortality or complication rates. Conclusions: ORIF is associated with shorter operation times, less bleeding, and comparable in-hospital outcomes in treating Vancouver B2/3 fractures in higher-risk geriatric patients compared to revision arthroplasty. The retrospective design and small sample size in the ORIF group are limitations of the study. Further studies with functional evaluation are still required.

Cauchy-Schwarz bounded trade-off weighting for causal inference with small sample sizes

The difficulty of causal inference for small-sample-size data lies in the issue of inefficiency that the variance of the estimators may be large. Some existing weighting methods adopt the idea of bias-variance trade-off, but they require manual specification of the trade-off parameters. To overcome this drawback, in this article, we propose a Cauchy-Schwarz Bounded Trade-off Weighting (CBTW) method, in which the trade-off parameter is theoretically derived to guarantee a small Mean Square Error (MSE) in estimation. We theoretically prove that optimizing the objective function of CBTW, which is the Cauchy-Schwarz upper-bound of the MSE for causal effect estimators, contributes to minimizing the MSE. Moreover, since the upper-bound consists of the variance and the squared ℓ2-norm of covariate differences, CBTW can not only estimate the causal effects efficiently, but also keep the covariates balanced. Experimental results on both simulation data and real-world data show that the CBTW outperforms most existing methods especially under small sample size scenarios.

MIMC-β：microdosimetric assessment method for Internal exposure of β-emitters based on mesh-type cell cluster model

Abstract The method combining Monte Carlo (MC) simulation and mesh-type cell models provides a way to accurately assess the cellular dose induced by β-emitters. Although this approach allows for a specific evaluation of various nuclides and cell type combinations, the associated time cost for obtaining results is relatively high. In this work, we propose a Microdosimetric assessment method for Internal exposure of β-emitters based on Mesh-type Cell cluster models (abbreviated as MIMC-β). This approach is applied to evaluate the dose in various types of cells (human bronchial epithelial cells, BEAS-2B; normal human liver cells, L-O2; and normal human small intestine epithelial cells, FHs74Int) exposed to β-emitters. Furthermore, microdosimetric quantity based on the cell cluster model are employed to estimate the RBE of β-emitters. The results indicate that this method can accurately and rapidly predict cellular doses caused by different types of β-emitters, significantly mitigating the efficiency challenges associated with directly employing MC to estimate the overall dose of the mesh-type cell cluster model. In comparison with results obtained from direct simulations of uniform administration of β- sources using PHITS for validation, the cellular cluster overall S-values obtained through MIMC-β show discrepancies mostly below 5%, with the minimum deviation reaching 1.35%. Small sampling sizes within the cell nucleus led to larger average lineal energies. In comparison to C-14, the differences in cellular cluster average lineal energy for Cs-134, Cs-137, and I-131 are negligible, resulting in close numerical estimations of RBE based on lineal energy. The MIMC-β can be extended to diverse cell types and β-emitters. Additionally, the RBE assessment based on the cell cluster model offers valuable insights for predicting radiobiological damage resulting from internal exposure by β-emitters. This method is expected to find applicability in various realistic scenarios, including radiation protection and radioligand therapy.

Impact of drought and development on the effectiveness of beehive fences as elephant deterrents over 9 years in Kenya

AbstractHuman–elephant conflict is growing in Africa as human populations and development increases, creating disturbance to elephant habitats. Beehive fences have been trialed as a coexistence tool with some success but all studies have looked at small sample sizes over a short time period. Our study analyses the behavior of African elephants (Loxodonta africana) that approached a network of beehive fence protected farms in two conflict villages over 9 years next to Tsavo East National Park. We compare differences in elephant raids and beehive occupation rates annually, during a drought, and during peak crop production seasons. Out of 3999 elephants approaching our study farms 1007 elephants broke the beehive fence and entered the protected farm areas (25.18%). This was significantly less than the 2649 encounters where elephants remained either outside the farm boundary or broke into the control farms (66.24%). A further 343 elephants entered the farm by walking through a gap at the end of a fence (8.56%). The annual beehive fence break‐through rates averaged 23.96% (±SE 3.15) resulting in a mean of 76.04% elephants deterred from beehive fences protected farm plots. Over six peak crop growing seasons the beehive fences kept between 78.3% and 86.3% of elephants out of the farms and crops. The beehive fences produced one ton of honey sold for $2250; however, a drought caused a 75% reduction in hive occupation rates and honey production for 3 years after negatively impacting honey profits and the effectiveness of the fences. Beehive fences are very effective at reducing up to 86.3% of elephant crop‐raids during peak crop seasons after good rainfall, but any increase in elephant habitat disturbance or the frequency and duration of droughts could reduce their effectiveness as a successful coexistence tool.

Application of Electrical Stimulation in BCI in Patients with Alzheimer’s Disease

This paper systematically discusses the application prospect of neuromodulation technology in the treatment of Alzheimer’s disease (AD). It focuses on the potential role of various techniques, including transcutaneous electrical nerve stimulation (TENS), deep brain stimulation (DBS), repeated transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), in improving the cognitive function of AD patients. With the aggravation of the global aging problem, the incidence of AD is increasing year by year, and the existing treatment methods are difficult to effectively prevent the progress of the disease. Studies have shown that technologies such as TENS and DBS can improve patients’ memory and cognitive function to some extent. For example, a study by Smith et al. (2020) found that DBS applied to the fornix resulted in a 20% improvement in memory scores over a 6-month period. However, due to the small sample size and inconsistent experimental design, the universality and reliability of the existing research results are still limited. Future studies should aim for larger, more diverse sample sizes and standardized experimental protocols to enhance the robustness of findings. This article reviews the latest research results of these neuromodulation techniques, emphasizing the importance of optimizing treatment parameters and expanding the scale of clinical trials. The paper is structured as follows: first, this paper discusses each neuromodulation technique in detail; then, this paper analyzes their potential benefits and limitations; finally, this paper provides recommendations for future research directions.